Objective To evaluate the safety and efficacy of Viabahn covered stent in treatment of hepatic artery pseudoaneurysm (HAPA) caused by surgery.Methods Clinical data of 7 patients with postoperative massive intra-abdominal hemorrhage and diagnosed as HAPA with emergency angiography were collected from November 2015 to May 2016.All the patients underwent Viabahn covered stent implantation.Perioperative and postoperative clinical data of the patients were recorded,and with 1-month follow-up.Results All the 7 cases were diagnosed as extrahepatic HAPA and successfully completed Viabahn covered stent procedure,and curative rate was up to 100％.One case experienced transient vasospasm in the hepatic artery proximal to the stent.All the patients repeated hepatic artery CT angiography scans one week after surgery,with no evidence of bleeding.With 1-month follow-up,all the patients were in stable conditions.Conclusion Viabahn covered stent is minimally invasive,simple and effective interventional approach for HAPA.

Cardiac arrest is the fourth stage of sudden cardiac death, which is characterized by the cessation of electrical activity in the heart, rapid circulatory and respiratory failure, and the prognosis is often poor. How to effectively predict cardiac arrest is the key and difficult point in the diagnosis and treatment process. In recent years, the research on the application of early warning scoring system in cardiac arrest has made continuous breakthroughs, from initially formulating a traditional scoring system containing only basic vital signs indicators according to a certain number of samples to continuously increasing and changing indicators, increasing the sample size, and formulating an improved scoring system with better sensitivity and specificity. Nowadays, with the continuous development of electronic information technology, machine learning technology is introduced into the formulation of scoring system, which breaks through the limitations of previous scoring system and has achieved good results in clinic. This article analyzes and compares the relevant research and cutting-edge progress of different early warning scoring systems at home and abroad, and summarizes the research results, gaps and shortcomings. Finally, combined with the relevant policies of graded diagnosis and treatment in China, this paper discusses the development and application direction of cardiac arrest early warning scoring system in the future.

Ohjective To evaluate the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of sinusoidal obstruction syndrome (SOS) caused by gynura segetum.Methods The clinical data of 9 patients with SOS caused by gynura segetum (5 males and 4 females) who underwent TIPS were retrospectively analyzed from February 2017 to June 2018.The Child-Pugh scores were (9.5 ± 1.3) and the MELD scores were (12.5 ± 5.0).The success rates,complications and follow-up results were evaluated.Results TIPS was performed successfully in all the 9 patients.The portal venous pressure gradient dropped from (22.4 ± 2.7) mmHg to (10.4 ± 3.2) mmHg (P ＜ 0.05).There was no complication such as abdominal hemorrhage and biliary peritonitis.Nine patients were followed-up for 1 ～17months,mean 7.8 ± 6.0 months.One month after treatment,the Child-Pugh scores were (7.1 ± 1.8),compared with that of the preoperative scores,the difference was statistically significant (P ＜ 0.05).The MELD scores were (5.3 ± 4.6),compared with that of the preoperative scores,the difference was also statistically significant (P ＜ 0.05).At the end point of the follow-up,color Doppler ultrasound and portal CTA showed that the TIPS shunt was patent and hepatic congestion was relieved in all the 9 patients.All patients were alive.Conclusion TIPS was a safe and efficacious treatment for SOS caused by gynura segetum.

【Objective】 To evaluate the efficacy of transurethral resection of bladder tumor (TURBT) in treating cystitis glandularis (CG), and to explore the influencing factors. 【Methods】 A retrospective analysis was conducted on 243 CG patients treated with TURBT during Jan.2013 and Dec.2020 in our hospitals.Postoperative efficacy was assessed using global response assessment (GRA).The correlation between GRA score and the demographic characteristics, comorbidities, initial complaints, and postoperative recurrence was determined with logistic regression analysis. 【Results】 Among the 243 patients, 3.70% (9/243) had dysplasia, 2.47% (6/243) had exuberant hyperplasia of Brinell’s nest, and 2.06%(5/243) had intestinal metaplasia.The mean GRA score was (2.02±0.72) after a follow-up of (47.10±28.53) months.Re-operation was performed in 10.29% (25/243) of the patients due to recurrence, and the improvement of hydronephrosis and dysuria was 70.59% (12/17) and 50.00% (15/30), respectively.Pelvic fat increase developed in 1 patient (0.41%) after surgery.Logistic regression analysis showed that postoperative GRA score was not significantly correlated with demographic characteristics, body mass index, comorbidities, alcoholism and postoperative recurrence (P>0.05). 【Conclusion】 TURBT is an effective method in the treatment of CG, which can significantly improve patients’ hydronephrosis and dysuria.However, approximately 10% of the patients experience recurrence, necessitating further surgery, which suggests the need for vigilance regarding potential recurrence during treatment.