Objective:To observe the effect of long-term follow-up of cerebral aneurysm embolization and to explore the related factors of aneurysm recurrence.Methods:A total of 142 cases of intracranial aneurysm rupture embolization patients treated in the Yuebei People′s Hospital from August 2000 to August 2013 were selected as the study objects. All of them underwent embolization treatment, and digital subtraction angiography (DSA), CT angiography (CTA) and magnetic resonance angiography (MRA) were performed after surgery. The follow-up period was 10 years, and the long-term outcome was evaluated using the Stroke Modified Rankin Scale (mRS) score. The results of immediate postoperative angiography and long-term follow-up in different embolization groups were analyzed. The risk factors of recurrence after ruptured cerebral aneurysm embolization were analyzed by single factor and independent risk factors were analyzed by multiple factor.Results:Of 142 patients (161 aneurysms), 106 were embolized by simple embolization and 55 were embolized by stent-assisted embolization. There was no significant difference in the results of immediate embolization between simple embolization and stent assisted embolization ( P>0.05). The proportion of giant aneurysms in the stent-assisted embolization group was higher than that in the simple embolization group ( P<0.05). Follow-up results showed that among the 142 patients, 106 had mRS score 0, 27 had mRS score 1, 5 had mRS score 2, and 4 had mRS score 4. The good clinical prognosis rate was 93.7%(133/142). Of the 161 aneurysms, 36 recurred, with a recurrence rate of 22.4%(36/161). Univariate analysis showed that aneurysm size, cervical tumor and embolization degree were risk factors for cerebral aneurysm recurrence (all P<0.05). The results of multi-factor analysis showed that aneurysm size was an independent risk factor for cerebral aneurysm recurrence ( P<0.05). Conclusions:The long-term follow-up after embolization of cerebral aneurysms is good, but cerebral aneurysms still have the possibility of recurrence. Aneurysm size is an independent risk factor for aneurysm recurrence. Timely detection of cerebrovascular changes can be treated in time to avoid cerebrovascular accidents.

Objective:To observe the effect of long-term follow-up of cerebral aneurysm embolization and to explore the related factors of aneurysm recurrence.Methods:A total of 142 cases of intracranial aneurysm rupture embolization patients treated in the Yuebei People′s Hospital from August 2000 to August 2013 were selected as the study objects. All of them underwent embolization treatment, and digital subtraction angiography (DSA), CT angiography (CTA) and magnetic resonance angiography (MRA) were performed after surgery. The follow-up period was 10 years, and the long-term outcome was evaluated using the Stroke Modified Rankin Scale (mRS) score. The results of immediate postoperative angiography and long-term follow-up in different embolization groups were analyzed. The risk factors of recurrence after ruptured cerebral aneurysm embolization were analyzed by single factor and independent risk factors were analyzed by multiple factor.Results:Of 142 patients (161 aneurysms), 106 were embolized by simple embolization and 55 were embolized by stent-assisted embolization. There was no significant difference in the results of immediate embolization between simple embolization and stent assisted embolization ( P>0.05). The proportion of giant aneurysms in the stent-assisted embolization group was higher than that in the simple embolization group ( P<0.05). Follow-up results showed that among the 142 patients, 106 had mRS score 0, 27 had mRS score 1, 5 had mRS score 2, and 4 had mRS score 4. The good clinical prognosis rate was 93.7%(133/142). Of the 161 aneurysms, 36 recurred, with a recurrence rate of 22.4%(36/161). Univariate analysis showed that aneurysm size, cervical tumor and embolization degree were risk factors for cerebral aneurysm recurrence (all P<0.05). The results of multi-factor analysis showed that aneurysm size was an independent risk factor for cerebral aneurysm recurrence ( P<0.05). Conclusions:The long-term follow-up after embolization of cerebral aneurysms is good, but cerebral aneurysms still have the possibility of recurrence. Aneurysm size is an independent risk factor for aneurysm recurrence. Timely detection of cerebrovascular changes can be treated in time to avoid cerebrovascular accidents.

Following the principles of evidence-based medicine,in accordance with the structure and drafting rules of standardized documents,based on literature research,according to the characteristics of chronic cough in children and issues that need to form a consensus,the TCM Guidelines for Diagnosis and Treatment of Chronic Cough in Children was formulated based on the Delphi method,expert discussion meetings,and public solicitation of opinions.The guideline includes scope of application,terms and definitions,eti-ology and diagnosis,auxiliary examination,treatment,prevention and care.The aim is to clarify the optimal treatment plan of Chinese medicine in the diagnosis and treatment of this disease,and to provide guidance for improving the clinical diagnosis and treatment of chronic cough in children with Chinese medicine.

Objective: To summarize the effect of modified David technique on acute type A aortic dissection sinus formation. Methods: From March 2018 to September 2018, modified David technique was applied to aortic sinus remodeling in acute A-type aortic dissection in 19 patients, 13 males and 6 females. The age was 45-67(50.42±15.37) years old and the weight was 45-112(60.32±25.18) kg. Single sinus(noncoronary sinus) was repaired in 15 cases, double sinus formation(noncoronary sinus+ right coronary sinus+ coronary artery transplantation) in 2 cases, left sinus Florid sleeve technical treatment plus double sinus formation(noncoronary sinus+ right coronary sinus+ coronary artery transplantation) in 1 case, Single sinus(noncoronary sinus) repaired and aortic vavle replacement in 1 case. Frozen elephant trunk and total arch replacement in 13 cases, hemiarch replacement in 3 cases. Results: There were no deaths in this group. The cardiopulmonary bypass time was 176-245(193.27±32.46) minutes, the aortic cross clamp time was 105-187(122.36±18.57)minutes, and the operation time was 6.5-11.0(7.63±1.31) hours. The mechanical ventilation time was 18-122(48.27±34.73)hours, the intensive care unit stay time was 2-10(5.35±2.62) days, and the postoperative hospital stay was 7-22(12.63±3.25)days. There was no delayed sternal closure during operation, and there was no secondary thoracotomy after operation. One patient developed a transient advanced atrioventricular block. Transient neurological dysfunction was observed in 5 patients. All patients were followed up for more than half a year. The color Doppler echocardiography and computed tomography angiograph(CTA)showed no aortic regurgitation or residual dissection. Conclusion The application of modified David technique in the remodeling of aortic root sinus in acute type A aortic dissection is an effective technique with relatively simple process, which is worth promoting.

Objective Total aortic arch replacement and stented elephant trunk surgery is an important surgical method for acute type A aortic dissection, and the short, middle, long term curative effect has been recognized by more and more experts at home and abroad.Circulatory arrest was an independent risk factor for postoperative complications and mortality in patients with type A aortic dissection.The aim of this article is to observed the effection of a new technology to block aortic arch, whicn can shorten the circulatory arrest time to 2 minutes and avoid harm of circulatory arrest on patients.Methods From May 2016 to February 2017, 68 patients with acute type A aortic dissection were divided into the conventional group and the modified group.All the patients underwent total arch replacement and stented elephant trunk surgery.The rectal temperature of the conventional group was 25℃ and circulatory arrest time was 20 min.While the rectal temperature of the modified group was 28℃ and and circulatory arrest time was 2 min.Results In the conventional operation group, 3 patients died after operation while all the patients in the modified group were cured and discharged.There are no differences between the two groups in the time of cardiopulmonary bypass(CPB) and heart arrest time(P>0.05).There are Significant differences in CPB time, circulatory arrest time, postoperative awake time, intubation time, amount of blood used, the amount of drainage during the first two days after operation, the time staying in ICU and the postoperative time in hospital.And the modified group was much better.(P<0.05)Conclusion The results of new technology blocking aortic arch in the patients with acute type A aortic dissection are better than the conventional surgical approach during the perioperative period.This technology is simple and effective.It is worth promoting.

Diabetic nephropathy is a complication of diabete and its incidence is increasing obviously these years. The pathogenic mechanisms of DN are complex, with multiple factors involved such as the glycometabolism disorders , hemodynamic changes, aldose reductase pathway activation, alterations in cytokines, oxidative stress, protein kinase C activation, lipid metabolism disorders and genetic susceptibility etc, which are not completely clear yet. Thus, the research progress of DN pathogenesis is to be reviewed.

Purpose:To investigate the influence of doxorubicin chemotherapy on overexpression of epithelial growth factor. Methods:Cancer animal model was made and treated with doxorubicin. The concentration of EGF protein in Plasma and mRNA in cancer tissue were detected by ELISA and Real-time quantitative RT-PCR respectively and the correlation of this parameter was evaluated. Results:The plasma concentrations of EGF expression were 3X Group 1.19?0.42 pg/ml, 1X Group 1.61?0.51 pg/ml, control group 2.13?0.68 pg/ml, and normal 0.91?0.33 pg/ml respectively. The concentration of EGF were analysed by ANOVA q test. The median concentrations of mRNA were 3X Group 1.6?10 3 copies/ml, 1X Group 8.5?10 4 copies/ml, control 4?10 5 copies/ml, and normal 2.5?10 2 copies/ml respectively, and were analysed by rank-sum test. It was shown that the control group had higher EGF and EGFR expression level than those treated with doxorubicin. EGF and EGFR expression of 3X Group were lower than that of 1X Group but remained higher than that of normal (P