[Safety and efficacy of acute stent implantation during endovascular treatment for patients with emergent large vessel occlusion due to intracranial atherosclerotic stenosis].

Objective: To investigate the efficacy and safety of acute stent implantation during endovascular treatment for patients with emergent large vessel occlusion due to intracranial atherosclerotic stenosis. Methods: A retrospective analysis was carried out on 46 patients with emergent large vessel occlusion due to intracranial atherosclerotic stenosis who received endovascular treatment at the Strategic Support Force Medical Center from January 2015 to August 2022. Twenty-seven patients underwent balloon angioplasty alone and 19 patients underwent acute stent implantation. The baseline characteristics, modified thrombolysis in cerebral infarction (mTICI) score of the responsible vessels, modified Rankin scale (mRS) score 90 days after operation, incidence of symptomatic intracranial hemorrhage and mortality of the two groups were evaluated. Results: The proportion of effective recanalization of the offending vessels (mTICI≥2b) in the acute stenting group was slightly higher than that in the balloon angioplasty group (16/19 vs. 81.5%), but the difference was not statistically significant (P>0.05). Besides, there was no significant difference in the median of mRS between the acute stenting group [3.0(0, 4.0)] and the balloon angioplasty group [4.0(1.0, 5.0)] 90 days after operation (P>0.05). In terms of safety, the incidence of symptomatic intracranial hemorrhage and mortality were comparable between the two groups (P>0.05). Conclusions: The effect of acute stent implantation during endovascular treatment for patients with emergent large vessel occlusion due to intracranial atherosclerotic stenosis is not inferior to that of balloon angioplasty, and it does not increase the risk of intracranial bleeding complications.

[Safety and efficacy of intra-arterial tirofiban infusion in patients with acute cardiogenic cerebral embolism undergoing endovascular reperfusion therapy].

Objective: To evaluate the safety and efficacy of intra-arterial tirofiban infusion during endovascular reperfusion therapy in patients with acute cardiogenic cerebral embolism. Methods: Clinical data of 72 patients with acute cardiogenic cerebral embolism caused by large artery occlusion were retrospectively analyzed in Department of Neurology, Strategic Support Force Medical Center from August 2015 to August 2020.Among those, 52 patients were treated with intra-arterial tirofiban, the other 20 patients were treated with control medication. The baseline characteristics, modified thrombolysis in cerebral infarction (mTICI) score of responsible vessels, modified Rankin scale (mRS) score 90 days after operation, incidence of symptomatic intracranial hemorrhage and mortality were evaluated and compared in two groups. Results: The proportion of effective recanalization of the offending vessels (mTICI≥2b) in tirofiban group was higher than that in control group (92.3% vs. 75.0%), but the difference was not statistically significant (P=0.104). At 90 days after operation, the rate of patients with good prognosis (mRS≤2) in tirofiban group (61.5%) was significantly higher than that in control group (35.0%) (P<0.05). The incidence of symptomatic intracranial hemorrhage and mortality were comparable between the two groups (P>0.05). Conclusion: Intra-arterial tirofiban infusion in patients with acute cardiogenic cerebral embolism is effective and feasible, which improves the prognosis without increasing the risk of intracranial bleeding complications.

[The outcomes comparison between autologous incus and titanium PORP in Austin A and C type ossicle defect cases].

Objective: A series of otitis media patients with Austin A and C type ossicles defects received ossicular chain reconstruction surgery using either autologous incus or titanium partial ossicular replacement prosthesis (PORP).The hearing outcomes and exclusion rate of prosthesis were compared between these two groups. Method: One hundred and seventy-six patients with chronic otitis media underwent ossiculoplasty in our hospital during 2016-2017. These patients were divided into 2 groups: group A consisted of those receiving autologous incus replacement (n=85), and group B consisted of those receiving titanium PORP (n=91). All the patients received CWD mastoidectomy and ossiculoplasty in one stage and were followedup in postoperative 3, 6 and 12 months. Result: The postoperative hearing improvement rates in group A and B were 85.88% and 92.31%, respectively, and there was no statistical difference. No statistical difference of the postoperative hearing improvement rates was observed between Austin A and C type in 2 groups. Three cases (3.29%) had ossicle exclusion in B group, and 0 case in A group, which was not statistical different (P>0.05). Conclusion: Patients receiving ossicular chain reconstruction surgery using autologous incus show similar hearing outcomes as those using titanium PORP. The risk of prosthesis exclusion is lower for autologous incus than titanium PORP. The residual handle of malleus has no obvious influence on the postoperative hearing improvement.

[Epidemiological investigation of allergic rhinitis in Ningxia].

Objective: To investigate the epidemiological characteristics of allergic rhinitis (AR) in Ningxia and to analyze its related factors. Methods: From March to September of 2013, a multi-stage and cluster sampling method was used to investigate the diagnosis and treatment of AR in Ningxia Area (3 years and above). Guidelines for diagnosis and treatment of allergic rhinitis (2009, Wuyishan) was used as the basis for the diagnosis of adult AR, while Guidelines for diagnosis and treatment of pediatric allergic rhinitis (2010, Chongqing) was used as the basis for children. SPSS 16.0 software was used to complete the statistical analysis. Results: The total number of questionnaires was 6 000, and the number of effective questionnaire was 5 236, the recovery rate was 87.27%. With 684 cases diagnosed of AR, the prevalence of AR in Ningxia was 13.06% (684/5 236), including 13.40% (325/2 425) of males, 12.77% (359/2 811) of females. The difference was not statistically significant (χ(2)=0.456, P>0.05). There was significant difference in the prevalence between Hui and Han [14.35% (452/3 150) vs 11.12% (232/2 086), χ(2)=11.51, P<0.05]. According to ARIA criteria, persistent AR was 27.63% (189/684), intermittent AR was 72.37% (495/684). The month with highest incidence of AR in Ningxia Area was September, accounting for 71.78% (491/684). The prevalence of urban population was 14.54%, with the prevalence of rural population was 11.90%, and the difference was significant between urban and rural residents (χ(2)=7.90, P<0.05). The age group with highest prevalence rate was 21~30 years old. The main inhalation allergens were mugwort (68.42%), weeds (58.48%) and ragweed (55.56%). The main dietary allergens were wheat flour (14.33%), peanut (13.74%) and walnut kernel (11.99%). The most common complication was allergic conjunctivitis [82.02% (561/684)]. Conclusion: The epidemiology of AR in Ningxia Area is preliminarily understood, which will provide the epidemiological evidence for the prevention and treatment of AR and the formulation of public health policy.

Long-Term Outcome of Tubridge Flow Diverter(S) in Treating Large Vertebral Artery Dissecting Aneurysms-A Pilot Study.

BACKGROUND AND PURPOSE: The experience of flow diverters (FDs) in treating large vertebral artery-dissecting aneurysms (VADAs) is still limited. This study was conducted to present our long-term outcome of VADAs treated with a Tubridge flow diverter (TFD), a new device developed in China. MATERIALS AND METHODS: The clinical and angiographic data of six patients harboring large VADAs and treated with TFDs were prospectively collected and analyzed. RESULTS: A total of nine TFDs were successfully implanted in six patients. Angiographic follow-up images were available for all patients at a median of 26.0 (18.5, 37.5) months after treatment. Five of the six VADAs were completely occluded, and the last was improved (near complete occlusion). In-stent stenosis was detected in one case and was handled appropriately by angioplasty and stenting. All covered branches and parent arteries remained patent. There were no complications or new neurological deficits observed in any of the patients. At the latest clinical follow-up (36.5 (26.0, 44.5) months), all patients achieved 0 in the modified Rankin scale score. CONCLUSIONS: Our preliminary experience suggests that the Tubridge flow diverter might be an alternative treatment for large and recurrent dissecting aneurysms derived from the vertebral artery.

[Clinical application of iodine solution staining in the diagnosis of early laryngeal cancer with electronic endoscope].

Objective:To discuss the feasibility and clinical application value of the laryngeal iodine staining under the electronic fiber laryngoscope.Method:Will meet the inclusion criteria of 90 patients, randomly divided into three groups, set to a, b, c group.a ,all patients in the a group were examined by electronic fiber mirror, NBI mode and 0.5% Lugol liquid iodine staining method in three ways. b, all patients in the b group were examined by electronic fiber mirror, NBI mode and 1.0% Lugol liquid iodine staining method in three ways. c,all patients in the c group were examined by electronic fiber mirror, NBI mode and 1.5% Lugol liquid iodine staining method in three ways. The location and range of positive lesions were recorded in each person of the three groups, positive lesions were biopsy, if the positive lesion is repeated, the site can only take a biopsy. As a diagnostic gold standard, the results of the other tests were compared with the results of other tests. And to observe the color of iodine in the throat, all patients were followed up for 24 hours in the presence of dyspnea, severe pain in the throat and other symptoms, and 24 hours after the examination again electronic fiber optic examination. Biopsy was performed in all patients, as gold standard. Using chi square test, inspection standardP <0.05.Result:As the solution of the iodine concentration increased, the rate of the laryngeal was cancer gradually increased. Ninety people take part in the experiment, no one has serious complications. All the patients have no significant inflammation on the mucous membrane of the throat and the subglottic airway afer 24 hours, by the electronic fiber laryngoscope. 1% and the following concentration of Lugol solution for iodine staining, sensitivity to the diagnosis of early laryngeal cancer was higher than that of electronic fiber,the two methods were compared, and the statistical analysis was performed(P >0.05). No statistical significance. There was no significant difference in the diagnosis of early laryngeal cancer. Contrast between iodine stain with 1.5% Lugol solution and electronic fiber sus pension, after statistical calculation(P <0.05);both are statistically significant, and the difference is significant.Comparison of iodine stain with 1.5% Lugol solution and NBI examination, make statistical analysis,P >0.05, there was no significant difference between the both.Conclusion:The 1.5% and below the concentration of the iodine staining under the electronic fiber laryngoscope can be safely applied to inspect the throat, and 1.5% Lugol iodine solution in the diagnosis of laryngeal cancer in the early stage of laryngeal cancer is better than using electronic, and has a certain value in clinical application.