In the past, aortic dissection, aortic aneurysm, and other aortic diseases, primarily rely on surgical intervention. In recent years, due to breakthroughs in materials science, endovascular therapy has become the first choice for the surgical treatment of most aortic diseases. However, traditional endovascular repair cannot fully meet the clinical needs for certain complex lesions involving the aortic arch and the originations of visceral arteries. The emergence of physician-modified stent technology has brought new hope for the treatment of complex aortic diseases. This article provides a detailed introduction to the concept, development, technical characteristics, and applications of physician-modified stents in the treatment of aortic diseases, analyzing their advantages and limitations. Physician-modified stents serve as a powerful complement to traditional endovascular interventions and commercial branched stents, yet further research and refinement are still required.

Portal vein thrombosis(PVT) plays a crucial role in pathogenesis of portal hypertension. Thrombus located in portal trunk or hepatic branches, which can expand into splenic vein or mesenteric vein, causing severe symptoms. Hypercoagulation state and portal haemodynamic disorder increase the risk of PVT in pregnancy. Anticoagulation is the basic treatment of pregnancy complicated with acute PVT, which can not only inhibit the progress of portal vein thrombosis, but also promote the recanalization of the lumen and improve the prognosis of patients. Anticoagulation should be administered for at least 6 moths according to available guidelines. Based on reliable efficacy and superior safety, low-molecular-weight-heparin remains the first choice of anticoagulant therapy. Vitamin K antagonists and direct oral anticoagulants are not recommended for PVT in pregnancy.

Aortoiliac occlusive disease is a group of ischemic disease caused by stenosis or occlusion of infrarenal aorta and iliac artery. Gluteus or lower extremity intermittent claudication and even limb-threatening ischemia are most common symptoms. With the development of endovascular devices and techniques, therapeutic options of complex lesions have changed from open surgery to endovascular treatment, which have the advantages including satisfied patency rate, less perioperative complications and fast recovery. This article will review and summarize stent implantation choices and techniques for endovascular treatment in aortoiliac occlusive disease.

Objective To investigate the efficacy and safety of pedicled labium flap urethroplasty augmentation for female distal urethral stricture.Methods A retrospective review was performed involved 14 female distal urethral stricture patients from October 2014 to December 2016,with mean age of 59.5 years (range 47-77).There was one case secondary to trauma,5 cases secondary to iatrogenic injury,5 cases secondary to repeated urinary tract infection,and 3 cases with unknown etiology.The length of urethral stricture among the patients was 0.5 to 1.0 cm.The preoperative quality of life index was (4.6 ± 0.8),and the IPSS score was (20.7 ± 5.2),presenting severe lower urinary tract obstruction symptoms,with voiding symptom score of (13.6 ±3.9),and storage symptom score of(7.1 ± 1.7).The Qmax was (8.4 ±2.6)ml/s,and median residual urine volume was 88.5 ml(15-210 ml).All patients underwent dorsal onlay pedicled labium flap urethroplasty augmentation.Results The Qmax was (20.7 ± 3.5) ml,(19.5.± 3.9) ml and (18.8 ±2.7)ml at 1 month,6 months and 12 months follow-up,which were all superior to preoperative parameters,and the median residual urine volume was 23.0 ml(0-133 ml),21.5 ml (0-98 ml) and 26 ml (0-89 ml),which were significantly reduced.The quality of life index were (1.8 ± 0.8) and (2.1 ±0.9) after 6 months and 12 months of operation,which were better than preoperative scores.The IPSS score was (15.8 ± 2.8) and (15.7 ± 2.7),and the voiding symptom scores was (9.0 ± 2.1) and (8.9 ±2.0) after 6 months and 12 months of operation,which were all obviously reduced,while no significant change detected in storage symptom scores.At 12 months follow-up,there was no incontinence or recurrence.Condusions The application of dorsal onlay pedicled labium flap urethroplasty is a good option for female distal urethral stricture with the advantages of good safety,excellent effectiveness,few complications,less pain,and high satisfaction rate.

Objective To elavluate the efficacy of pelvic floor muscle training (PFMT) on symptoms and quality of life in the treatment of female overactive bladder (OAB).Methods Ninety-one female patients with OAB completed the prospective study and were divided into 2 groups.The study group had PFMT combined with comprehensive health education and tolterodine (n =46),and the control group had comprehensive health education combined with tolterodine (n =45).OAB symptom score (OABSS),King's health questionnaire (KHQ) and modified Oxford scale (MOS) were evaluated at baseline,2 weeks,1 month and 3 months.The patients were followed up for 6 months.Results The MOS and OABSS score in study group before the treatment were 2.87±0.65 and 7.61 ±2.28,respectively,and in control group they were 2.80±0.55 and 7.44±2.41,respectively.There was no significant difference between the 2 grotps (P＞ 0.05).There was no significant difference in KHQ domains before the treatment between the 2 groups (P＞ 0.05).The MOS scores were 3.15±0.63 and 3.57±0.58 after treatment of 1 and 3 months in study group,which were significantly improved compared with the values of 2.89±0.57 and 3.09±0.67 in control group (P＜0.05).The OABSS score was 1.13± 1.93 in study group after treatment of 6 months,which was significantly improved compared with the values of 2.47±2.18 in control group (P＜0.05).The Incontinence impact,Role Limitations,Physical Limitations,Social Limitations and Symptom Severity in study group improved significantly compared with the values in control group after treatment of 3 months (P＜0.05).Domains of KHQ scores were totally significantly improved after treatment of 6 months in study group than in control group(P＜0.05).Conclusion Long term PFMT may play an important role in the treatment of OAB,and can also improve the quality of life of the patients.

Objective To investigate the related factors and quality of life in the female patients with primary overactive bladder (OAB) to provide the basis for the chnical treatment.Methods One hundred and seven female patients with primary OAB were surveyed by the questionnaire about the general data and the King' s Health Questionnaire (KHQ),and the correlation was analyzed by the Spearman.Results The occurrence of female patients with primary OAB was related to the age,marital status,mode of delivery,dehvery times,body mass index,with and without chronic diseases (P ＜ 0.05),and was not related to the education,residential area,abortion and diet habits (P ＞ 0.05).The scores of the general health feeling,the severity of voiding problem,the restricted behavior,restricted motion,social limitations,the personal life,emotion,sleep and energy,the coping style of symptoms,and severity of symptom in KHQ were respectively (61.44 ± 14.68),(81.31 ±26.76),(32.54±28.63),(46.73 ±21.27),(27.91 ±23.75),(20.91 ±25.86),(47.90 ± 28.19),(32.40 ± 23.44),(14.49 ± 17.02),and (8.45 ± 2.69).The score of Overactive Bladder Syndrome Score (OABSS) was positively correlated with the severity of voiding problem,restricted motion,social limitations,emotion,the coping style of symptoms and the severity of symptom (r =0.280,0.334,0.288,0.224,0.325,0.458,respectively; P＜0.05).Contusions The symptoms of female patients with primary OAB are related to the age,marital status,delivery times,body mass index,with and without chronic diseases,and OAB can affect the patient' s quality of life in different degrees.

Objective To investigate the effect of intraurethral irrigation with honeysuckle water-decoction on formation of bacterial biofilm on the surface of the catheter. Methods Eighty male patients,who had no history of catheterization and no urinary infection with negative results of urine bacterial culture,were enrolled in the study. All patients were randomly divided into 4 groups with 20 cases in each: group A (patients underwent intraurethral irrigation with honeysuckle water-decoction); group B (intraurethral irrigation with 25% PVP); group C (intraurethral irrigation with normal saline ) and group D (no intraurethral irrigation). The urethral catheters were removed at the 7th day and the bacterial biofilm on the surface of the catheter was examined by scanning electron microscopy (SEM). Results SEM demonstrated uneven- distributed matrixes coated on the surface of the catheter, and bacteria adhered to the matrixes. The average thickness of biofilm in group A, B, C and D was (17.876 ±11.788)μn, (31.090±15. 006)μm,(33.716±11.927)μm, (67.762±23.588)μm, respectively. The average thickness of biofilm in group A, B, C was significantly thinner than that in group D (P<0.01), and the thickness in group A was thinner than that in group B and C (P<0.01), but there was no significance difference between group B and group C (P>0.01). Conclusions Intraurethral irrigation with honeysuckle water-decoction can effectively reduce the formation of bacterial biofilm on the surface of the catheter.