Objective To investigate the endovascular treatment of peripheral vascular anomaly in children and its efficacy.Methods Eighty-three children with peripheral vascular anomaly were treated via endovascular means. Before and during the endovascular operation,all the cases were diagnosed as follows: arteriovenous fistula in 23 cases, cirsoid angioma 32 and cavernous hemangioma 28. The endovascular approaches included:①transcatheter embolization using coils or gelfoam sponge;② transcatheter embolization combined with local cirrhosis agents treatment.Results Immediate angiography after embolization showed all the arteriovenous fistulas and hemangiomas were efficiently occluded and the clinical presentation and symptoms improved greatly. Follow-up one to three years after operation demonstrated 100% of efficacy and 68.7% curative rate with no complications. Conclusions Endovascular approach for peripheral vascular anomaly in children is a micro-invasive, safe and effective way.

Considering the fact of rapidity and concentration of aging of population, Chinese government has regarded it as an important strategic issue. However, how to get a dignified ending still a big problem for the old age today. This article tries to explore the possibility of advance care planning (ACP) approved under the background of aging of population in China based on general report of Chinese government deal with aging of population and existed facts. Though the researches on this topic have grown rapidly, the government legal system is still close to it in this moment, and in the process of practice constantly, it will be a perfect research. It is certain that the legislation of ACP in China will has a long way to go, but in the view of the advancement of death with dignity, palliative care, we still can predict a bright future of ACP.

Fertilization is a crucial step for origin of life.During Assisted Reproductive Technologies (ART),total fertilization failure is complex and unpredictable.Total fertilization failure may related to some abnormal cellular mechanistic events,such as:any stage of sperm and cumulus-oocyte-complexes penetration,sperm-zona pellucida binding / penetration,sperm-oocyte membrane binding,oocyte activation,sperm discondensation or pronuclear formation.Most of total fertilization failure could be solved by intracytoplasmic sperm injection.But oocytes of some patient still can't fertilize successfully,even though assisted oocyte activation be used.As for total fertilization failure patients in ART,combining the mature of oocyte,sperm quality and some trail to improve clinical protocol in later cycle may prevent failure to happen again.

BACKGROUND: Endothelin and nitrogen monoxide (NO) which are regarded as a pair of factors to maintain equilibrium between vascular stress and hemodynamics have different responses during various diseases. It is the key point for the treatment of atherosclerosis to find out the effect and pathophysiological mechanism of hyperlipemia on endothelial cells, and seek the methods and drugs for protecting vascular endothelin.OBJECTIVE: To observe the effect of herbal cake-separated moxibustion on contents of plasma endothelin and NO and analyze its regulative mechanism.DESIGN: Randomized controlled animal study.SETTING: College of Acupuncture and Moxibustion, Hunan University of Traditional Chinese Medicine.MATERIALS: A total of 60 healthy New Zealand white rabbits weighing 1.5-2.5 kg of both genders were selected in this study. Herbal cake was made of danshen, shanzha, yujin, dahuang and zexie, which were crushed into powder according to a certain ratio. Then, vinegar was added to make paste which was 5-8 mm in diameter and 2-3 mm in depth. Moxa cone:(Shenjiu 300) was provided by Suzhou Dongfang Airong Factory (type:Dongfang I; batch number: 20021212).METHODS: The experiment was carried out in the Experimental Animal Center of Hunan University of Traditional Chinese Medicine between November 2003 and October 2004. All rabbits were randomly divided into 4 groups: blank control group, hyperlipemia model group, direct moxibustion group and herbal cake-separated moxibustion group with 15 in each group. Except blank control group, rabbits in other three groups were fed with high fat forage to establish hyperlipemia models. Two groups of acupoints were acupunctured alternatively: Group Ⅰ: Juque (CV14), Tianshu (ST25) at bilateral sides, and Fenglong (ST 40) at bilateral sides; Group Ⅱ:Xinshu(BL15),Ganshu(BL18) and Pishu(BL20), at bilateral sides respectively.On the first day, moxa cone was directly adherent to acupoints of rabbits in direct moxibustion group and lighten for acupuncture, but in herbal cakeseparated moxibustion group, moxa cone which was gotten rid of the carriage was adherent to herbal cake which was put on acupoints and lighted for acupuncture. Each acupoint was acupunctured for 4 successive dosages for once a day. On the next day, the other group of acupoints was acupunctured.The course was 40 days. Rabbits in other two groups were not treated with any ways. On the 41st day, contents of plasma endothelin and NO were measured in each group with radio-immunity method and nitrate-reductase reduction method, respectively.MAIN OUTCOME MEASURES: Contents of plasma endothelin and NO of rabbits after 40-day treatment.RESULTS: Five rabbits died because of diarrhoea or other reasons, including 2 in blank control group, 1 in model group, 1 in direct moxibustion group and 1 in herbal cake-separated moxibustion group. Therefore, 55 rabbits were involved in the final analysis. ① Content of plasma endothelin was lower in herbal cake-separated moxibustion group than that in model group [(431.57±63.68), (500.14±75.41) ng/L, P ＜ 0.05], but there was no significant difference between herbal cake-separated moxibustion group and direct moxibustion group [(431.57±63.68), (429.08±77.07) ng/L, P ＞ 0.05]. ② On NO content, there was an increasing tendency of model group ＜ blank group ＜ herbal cake-separated moxibustion group ＜ direct moxibustion, but there was no significant difference between any two groups [(27.17±16.55),(29.39±13.24), (30.24±20.25), (30.47±19.62) μmol/L, P ＞ 0.05].CONCLUSION: Effects of both two methods of moxibustion in the rabbits with hyperlipemia on content of endothelin are significant and similar, but there are no significant effects on NO content.

Objective To discuss the correlation between gastrointestinal symptoms concomitant with chronic migraine and sleep disorders,anxiety and depression.Methods Self-rating Anxiety Scale (SAS),Self-rating Depression Scale (SDS),Pittsburgh Sleep Quality Index (PSQI) and Gastrointestinal Symptom Rating Scale (GSRS) were adopted to conduct comparative analysis on gastrointestinal symptoms,anxiety,depression,sleep disorders,and related risk factors in 151 chronic migraine patients who conformed to International Headache Society International Classification of Headache Diseases-Ⅱ diagnostic code and 151 healthy controls in the Third Affiliated Hospital of Qiqihar Medical University from January 2015 to December 2017.Results PSQI scores (8.46±2.54 vs 4.53±1.95,t=2.913,P＜0.05),SAS scores (53.24± 11.66 vs 39.58±8.63,t=3.112,P＜0.05),SDS scores (51.09±8.80 vs 36.11±5.74,t=3.520,P＜0.05),and GSRS scores (4.53 (3.74,5.32) vs 1.29 (0.73,1.31),Z=30.804,P＜0.05) were all higher in migraine patients than that in healthy controls,and the differences were all statistically significant.In chronic migraine patients,139 (92.05％) had one gastrointestinal symptom at least,and the overall incidence of each gastrointestinal symptom was abdominal distension (60 cases,39.74％),exhaust increase (51 cases,33.77％),and endless defecation (43 cases,28.48％),etc.,in turn.Multiple regression analysis showed that headache degree,frequency,PSQI scores,SAS scores,and SDS scores were the main risk factors of gastrointestinal symptoms concomitant with chronic migraine.GSRS scores of chronic migraine patients presented positive correlation with PSQI scores (r=0.65,P=0.000),SAS scores (r=0.42,P=0.000),and SDS scores (r=0.48,P=0.000),respectively.Conclusion Chronic migraine patients are easy to be accompanied with gastrointestinal symptoms,and headache degree and frequency,sleep disorders,depression and anxiety are the main risk factors of concomitant gastrointestinal symptoms.

Objective:To investigate the effects of mixed probiotics on food allergy and the underlying mechanism.Methods:BALB/c mice on the 15 th day of pregnancy were randomly (random number table method) classified into the control group, food allergy model group and mixed probiotics group.Mice in the food allergy model and mixed pro-biotics group were subjected to ovalbumin (OVA) sensitization after birth, and those in the mixed probiotics group were then given probiotic solution by gavage from day 21 to day 35.Mice in control group were similarly given 9 g/L saline.Twenty-four hours after the last OVA sensitization, intestinal histopathological sections were prepared to observe intestinal pathological changes.Blood smears were prepared to detect eosinophil count.In addition, serum samples were collected to measure cytokine levels and OVA specific antibodies.The number of dendritic cells (DCs) and regulatory T cells (Tregs) in mouse mesenteric lymph nodes was calculated.Differences among 3 groups were compared by the One- Way ANOVA or Kruskal- Wallis H test. Results:Compared with those of food allergy model group, diarrhea score, the ratio of eosinophils and serum levels of interleukin(IL)-4, IL-5, IL-13, mast cell protease 1 (MCPT-1), and OVA specific antibodies IgE and IgG were significantly lower in mixed probiotics group[(2.00±0.71) points vs.(3.22±0.97) points, (2.28±1.61)% vs.(10.99±2.26)%, (413.68±22.81) ng/L vs.(708.78±27.66) ng/L, (36.64±3.74) ng/L vs.(46.05±4.95) ng/L, (201.37±65.61) ng/L vs.(495.22±96.66) ng/L, (31 924.15±1 177.77) ng/L vs.(36 175.77±618.29) ng/L, (9.10±8.08) ng/L vs.(19.69±0.84) ng/L, (30.50±8.81) ng/L vs.(190.32±6.40) ng/L], while IL-10 level was significantly higher[(164.12±3.88) ng/L vs.(123.90±7.31) ng/L] ( t=3.37, 8.72, 16.07, 3.90, 7.40, 7.95, 3.91, 44.00 and 7.76, respectively, all P<0.01). Compared with those of food allergy model group, programmed cell death ligand 1 (PD-L1) level on the surface of CD 103+ DCs and CD 103+ CD 80-CD 40-DCs, the proportion of Tregs in CD4 + T cells, and the level of programmed cell death 1 (PD-1) on the surface of Tregs were significantly higher in mixed probiotics group[(75.59±0.45)% vs.(45.60±4.73)%, (67.56±1.87)% vs.(37.12±6.07)%, (8.24±0.69)% vs.(6.20±0.66)%, (11.25±3.12)% vs.(4.08±2.33)%]( t=7.88, 4.48, 3.63 and 3.71, all P<0.01). Conclusions:Mixed probiotics can alleviate the symptoms of food allergy and inflammatory response of young rats through mediating Tregs via the PD-1/PD-L1 pathway.

Objective:Migraine and tremor share some genetic mutation sites,and clinical studies have also confirmed their correlation.This study aims to explore the clinical and electrophysiological characteristics of migraine patients with concomitant tremor,and to analyze the relevant influential factors of tremor occurrence. Methods:We retrospectively analyzed the clinical data of 217 migraine patients who visited the Third Affiliated Hospital of Qiqihar Medical University from June 2022 to October 2023.The Clinical Rating Scale for Tremor(CRST),Numerical Rating Scale(NRS),Generalized Anxiety Disorder-7(GAD-7),and Patient Health Questionnaire-9(PHQ-9)were respectively used to assess the tremor symptoms,degree of headache,anxiety,and depression of patients.All patients underwent routine head MR scanning and electromyography examination,and were divided into a migraine with tremor group and a migraine without tremor group based on the electromyogram examination. Results:The migraine with tremor group and the migraine without tremor group were included 52 patients(23.96%)and 165 patients(76.04%),respectively.Compared with the migraine without tremor group,the migraine with tremor group had a longer course and duration of headache,higher frequency of headache attacks,higher NRS score,GAD-7 score,and PHQ-9 score,and fewer weekly physical exercises.The differences were statistically significant(all P<0.05).There were no statistically significant differences in the presence or absence of prodromal headache and white matter hyperintensities(WMHs)between the 2 groups(both P>0.05).The evaluation results of the CRST showed that out of 217 migraine patients,39 patients(17.97%)were accompanied by tremors.The electromyographic results showed that all 52 migraine patients with tremors had upper limb tremors,including 28 migraine patients with postural tremors and 24 migraine patients with static tremors.Compared with the migraine patients with static tremors,the migraine patients with postural tremors had lower average frequency,peak frequency,and headache onset frequency(all P<0.05).Multiple linear regression analysis showed that frequency of physical exercise,duration of illness,frequency of headache attacks,NRS score,GAD-7 score,and PHQ-9 score were risk factors for migraine patients with concomitant tremors(all P<0.05). Conclusion:Patients with migraine mainly experience upper limb postural tremors.Reduced physical exercise,long course of disease,long duration of headache,frequent headache attacks,severe headache,anxiety,and depression are risk factors for migraine patients with concomitant tremors.

Objective To investigate the correlation of rupture risk of intracranial aneurysms with aneurysm diameter,blood pressure,neck width,gender,age,and smoking and alcohol histories of the patients.Methods Retrospective analysis of the clinical and radiological data of 928 patients with intracranial aneurysm,admitted to our hospital from January 2011 to December 2012,was performed; according to rupture situation,these patients were divide into ruptured group (n=411) and unruptured group (n=517); univariate analysis and multivaviable Logistic regression analysis were used to analyze the rupture risk of intracranial aneurysms,including aneurysm diameter,blood pressure,neck width,gender,age,and smoking and alcohol histories.Results Univariate analysis showed that there were statistical significances between the two groups on aneurysm diameter,blood pressure,aneurysm neck width,gender,smoking history (P＜0.05); multivariate Logistic regression analysis showed that aneurysm diameter was the independent risk factor of rupture of aneurysms (P=0.001).Conclusion Aneurysm diameter is a key risk of rupture for intracranial aneurysms,while rupture of intracranial aneurysms is not correlated to the blood pressure,aneurysm neck width,gender,age,and smoking and alcohol histories.