Endovascular coil embolization has become an important way because of its advantages of less trauma and quick recovery.However,long-term follow-up studies have shown that the recurrence rate of aneurysm after coil embolization is much higher than that of the surgical clipping.It is mainly associteed with the factors such as incomplete packing coil compression and aneurysm regrowth.This article reviews the factors influencing intracranial aneurysm recurrence after endovascular coil embolization.

Objective To investigate the effects of posterior focus on the voice quality of hearing-impaired children.Methods A total of 15 cases of 3~6 years old hearing-impaired children with posterior focus and 20 cases of 3~6 years old without oral resonance disorders were included in this study.Fundamental frequency (F0), frequency standard deviation (F0SD), fundamental frequency perturbation (jitter), amplitude perturbation (shimmer) and normalized noise energy (NNE) on each group of children of /(ae)/ were extracted and analyzed by Dr.Voice.Results Hearing-impaired children with posterior focus problems mainly showed the voice disorder of the hyperthyroidism type.The abnormal rate of shimmer values was the highest of hearing-impaired children with posterior focus, followed by F0, jitter and F0SD,and the minimum was NNE.The average value of the voice parameters was greater than hearing-impaired children without oral resonance disorders.The jitter and shimmer of children with posterior focus showed significant differences (P<0.05) compared to the hearing-impaired children without oral resonance disorders.Conclusion Children with posterior focus have a high rate of voice disorders and mainly change the voice jitter and shimmer.

Increasing detection of unruptured intracranial aneurysms,catastrophic outcomes from subarachnoid hemorrhage,and risks and cost of treatment necessitate defining objective predictive parameters of aneurysm rupture risk.However,long-term follow-up have shown the risk of intracranial aneurysm rupture is associated with its morphologic characteristics,hemodynamic factors and patient's own situation.

Objective To compare the oral resonance differences between normal children and children with spastic cerebral palsy,and to explore the oral resonance characteristics of children with spastic cerebral palsy.Meth-ods A total of 15 cases of preschool children with spastic cerebral palsy and 25 cases of normal preschool children were included in this study.The first and second formants on each group of children of Chinese vowels/a/,/i/,/u/core,were extracted and analyzed by Dr speech software.Results There were no significant difference of/a/F1,/a/F2,/u/F1 between two groups (P>0.05);/i/F1 and/u/F2 had a significant difference (P<0.05);/i/F2 had a high degree of statistical significance (P<0.01).Conclusion Children with spastic cerebral palsy are prone to oral resonance while most oral resonance disorder of children with cerebral palsy is post focusing and mixed oral res-onance disorder;/i/F2 and/u/F2 can provide a meaningful reference for speech and oral resonance disorders evalua-tion of children with cerebral palsy.

ObjectiveTo analyze therapeutic efficiency of 125 iodine brachytherapy seeds implantation guided by flexible fiber-optic bronchoscopy(FFB)image in terminal central non-small cell lung carcinoma (NSCLC).MethodsUnder therapy planning system (TPS) and guided by flexible fiber-optic bronchoscopy image,125 iodine seeds were implanted in 66 Confirmed terrainal cases with NSCLC and its posology Was validated and rechecked regularly.Remlts Complete remission (CR) was observed in 15 cases and partial remission (PR) in 36 cases during the first-year follow-up,with an overall efficiency rate (CR+PR) of 77.3 percent and one-year survival of 80.3 percent.Complete remission (CR) was observed in seven cases,partial remission (PR) in 22 cases,stable condition (SC) in three cases.and no progression was found during the second-year follow-up,respectively,with an overall efficiency rate (CR+PR) of 90.6 percent and two-year survival of 43.8 percent No radioactive damage were observed in the early and late stages of therapy.ConclusionsTherapy with radioactive 125 iodine seeds implantation guided by flexible fiber-optic bronchoscopy image could relieve airway obstruction effectively in terminal lung cancer and control progression of bronchiogenic carcinoma.

Objective:To improve the therapeutic gain ratio from 125I seed implants by investigating the QA/QC strategies used in brachytherapy treatment of lung cancer. Methods:A total of 287 lung cancer and pulmonary metastases cases were studied. Among which, 184 are male and 103 are female with a mean age of 61.9 years. The NOA-NSCLC subgroup and pulmonary metastases were targeted on conventional CT positioning. Considering that COA-NSCL subgroup on the tumor target area is difficult to determine with CT, the coincidence circuit SPECT was used to assist in positioning. A dose-volume histogram was constructed to evaluate the quality of the TPS and optimization. Corrections on real-time positioning are necessary when using an image-guided implantation. The C-LC should be aligned with the FFB for CT-guided percutaneous puncture implantation. After implantation, dosimetry verification was con-ducted. Results:The NOA-NSCLC subgroup, comprising the risk organs such as heart, lung, and spinal column, received an average dose of 137, which was significantly lower than that of normal tissue dose tolerance. The NOA-NSCLC subgroup and lung metastases have matched peripheral dosages of 92.1 and 106.2 Gy with local-control efficiency rates of 91.97% (126/137) and 96.0% (48/50), 1-year survival rates of 91.24%and 83.4%(42/50), and 2-year survival rates of 50.36%(69/137) and 52.3%(26/50), respectively. The 35 COA-NSCL subgroup and 65 lung cancer group have local control efficiency rates of 91.43%(32/35) and 92.3%(60/65) and 1-year survival rates of 88.57%(31/35) and 80.30%(53/66), respectively. Conclusion:Proper radiation dosimetry as a QA/QC strategy was found to improve particle-implantation therapy gain and greatly reduce the risks of radiation pneumonia and pulmonary fibrosis.

Objective To explore the clinical value of the thin-section CT scanning in all the steps of non-small cell lung cancer (NSCLC) therapy through 125I seed implantation. Methods In the 137 patients who were diagnosed with non-small cell cancer (NSCLC), the preoperative targets were delineated by CT scan, and the implantation plan was accom-plished according to treatment planning system (TPS); Intraoperative 125I seeds were implanted under the guidance of CT, then their positions were confirmed and corrected by CT scan layer-by-layer in real time;Post implantation dosimetry was validated also under the help of CT scan. If necessary, distribution and number of seeds should be adjusted to conform dose distribution under the principle of effectivity and micro-invasion;Follow-up and periodic evaluation should also be accom-plished by CT scan. Results Dose-volume histograms (DVHs) showed that the dose in line with the targets meet the re-quirement of prescription dose while the surrounding organs at risk were within the scope of their tolerance dose. Among 137 patients, implanted seeds number was the same with seeds number of TPS plan in 129 patients, and the coincidence rate was 94%. CT scan showed the local control efficient rate was 91.9%after 6 months. The 1-year and 2-year survival rates were 91.2%and 50.4%respectively. No serious operation-led complication was found during treatment. Conclusion The thin-section CT could be applied in all key steps of 125I seed implantation in NSCLC therapy, especially it is clinical significant and irreplaceable in quality assurance and control of seed implantation therapy.

Objective To retrospectively analyze the surgical methods and efficacy in 70 cases of type A aortic dissection patients over 65 years old.Methods From January 2005 to May 2012,70 type A aortic dissection patients over 65 years old received surgical treatment.Among them,there were 47 males aged 65 to 78 years old with mean 71,23 females,aged 65 to 72 years old with mean 68.55 cases were acute onset,while 15 cases were chronically onset.Different surgical methods were selected depend on patients' situations.We followed up all patients after discharged from hospital to continue to observe their health situation and evaluate the therapeutic effects.Results After surgery,eight patients died in the hospital,62 patients were recovered and discharged from the hospital.The mortality rate is 11.4％.During the follow up period from 3 to 72 months,there were no dead,aneurysm rupture and others severe complications.9 cases received endovascular graft exclusion within 6 months after discharged from hospital.The survival patients were satisfactory healed with their daily living activity resumed.Conclusion For over 65 years old patients with aortic dissection,the accurate and rapid selection of surgical method could improve the survival rate and the quality of life with a lower occurrence rate of complications.

Objective To explore the effect of sucralfate on cytokines in rats with paraquat (PQ) poisoning. Methods Seventy-two healthy male Sprague-Dawley (SD) rats were randomly divided into PQ model group, sodium bicarbonate intervention group (SB group) and sucralfate suspension gel group (LTL group), with 24 rats in each group. The rat model of PQ poisoning was reproduced by one-time intragastric administration of PQ solution 25 mg/kg. The rats in SB group and LTL group were intragastricly administrated with 5 mL·kg-1·d-1of 100 g/L sodium bicarbonate or 200 g/L sucralfate at 2 hours after exposing to PQ, and the rats in PQ model group were given the same amount of sterile saline. The abdominal aortic blood of rats was collected at 1, 3, 6, and 10 days after PQ poisoning, and the levels of serum tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10) and transforming growth factor-β1 (TGF-β1) were determined by enzyme-linked immunosorbent assay (ELISA). The left lung tissue was harvested, and lung wet/dry weight (W/D) ratio was assessed. Results With prolonged exposure, lung W/D ratios in all the groups were increased gradually, reached the peak at 10 days, but in the SB group and LTL group, the amplitude of increase was obviously reduced, the ratios were significantly decreased at 6 days and 10 days as compared with those in PQ model group (SB group vs. PQ model group: 4.99±0.79 vs. 6.98±0.86 at 6 days, 5.61±0.36 vs. 7.36±0.95 at 10 days; LTL group vs. PQ model group: 4.61±0.24 vs. 6.98±0.86 at 6 days, 4.24±0.20 vs. 7.36±0.95 at 10 days, all P < 0.05), but there was no significant difference between SB group and LTL group (all P > 0.05). After PQ poisoning, the levels of TNF-α, IL-10 and TGF-β1 were elevated, and reached the peak at 3 days and then decreased gradually. Compared with the PQ model group, serum TNF-α, IL-10 and TGF-β1 levels in SB group and LTL group were decreased significantly [SB group vs. PQ model group: 3-day TNF-α (ng/L) was 147.6±12.3 vs. 168.2±11.3, 3-day IL-10 (ng/L) was 65.4±3.2 vs. 115.1±9.2, 3-day TGF-β1 (ng/L) was 356.3±50.3 vs. 415.6±68.3; LTL group vs. PQ model group: 3-day TNF-α (ng/L) was 82.2±7.4 vs. 168.2±11.3, 3-day IL-10 (ng/L) was 44.4±5.2 vs.115.1±9.2, 3-day TGF-β1 (ng/L) was 296.3±40.2 vs. 415.6±68.3, all P < 0.05], especially in LTL group (all P < 0.05). Conclusion Early gastrointestinal lavage with sucralfate could effectively reduce the inflammatory exudation in lung tissue after PQ poisoning, and inhibit the cytokine secretion.

Objective:To examine the short-term outcomes of modified load-sharing rip-stop repair (mLSRS) and suture-bridge repair (SB) for large rotator cuff tear.Methods:The clinical data of patients who underwent shoulder arthroscopy for large rotator cuff repair at Department of Orthopedic, China Academy of Chinese Medical Sciences Wang Jing Hospital from January 2017 to December 2018 were collected. Totally 111 patients (39 in mLSRS group and 72 in SB group) were included in the study. There were 45 males and 66 females, aged (58.0±6.9)years (range: 40 to 72 years).A total of 39 pairs of patients were successfully matched by propensity score matching. The pain of shoulder joint was assessed by visual analogy score (VAS) , the shoulder function was assessed by Constant-Murley score, the abduction strength of bilateral shoulder joint was assessed by 90? force assessment method of upper limb on the plane of scapula, and the healing of rotator cuff on the operative side was assessed by sugaya ultrasonic classification standard. The difference of short-term outcome between the two groups were compared using t test, χ 2 test, Mann-Whitney U test, repeated measures design anova and multivariate analysis of variance. Results:At the 4th week after surgery, the VAS of mLSRS group was significantly lower than SB group(1 (2) vs. 2 (2) , F=5.32, P=0.02). One year after surgery, Constant-Murley score of two groups were significantly higher than those before surgery, but there was no significant difference between two groups(89.1±5.7 vs. 87.6±7.3, t=1.00, P=0.32). Abductor strength of affected limbs were lower than that of the opposite side, but there were no statistically significant differences between two groups(4.28±1.61 vs. 4.54±1.64, t=-0.70, P=0.49). According to the Sugaya classification, 32 cases in mLSRS group were healed while 7 cases were not healed,30 cases in SB group were healed while 9 cases were not healed(χ 2=0.32, P=0.58). Conclusion:The use of mLSRS fixation construct on large rotator cuff tear can reduce pain and the short-term outcome is reliable.