Objective To investigate the effects of HMGB1,MMP-9 and CRP on the diagnosis and prognosis of aSAH in patients with CVS.Methods To analyze the clinical data of patients with aSAH who were admitted in our hospital from February 2017to January 2015,43 patients with cerebral vasospasm were set as the observation group,and 51 case SAH patients without cerebral vasospasm were selected as the control group.Results With the time of admission,the level of serum HMGB1 gradually decreased,the CRP level increased first and then decreased,while the level of MMP-9 in the observation group was gradually increased,while the level of MMP-9 in the control group decreased and then increased in two groups of patients;The serum HMGB1 level of the patients in the observation group was significantly higher than that of the control group after 24h,the difference was statistically significant (P＜0.05).The levels of MMP -9 and CRP after 24h,72h and 7d in the observation group were significantly higher than those in the control group,and the difference was statistically significant (P＜0.05);good prognosis of patients with HMGB1,CRP level after 24h is lower than the poor prognosis of patients,the difference was statistically significant (P＜0.05),serum MMP-9 of the good prognosis group patients after 24h,72h,7d was significantly lower than that of the poor prognosis group,the difference was statistically significant (P＜0.05);ROC curve analysis showed that when MMP-9 was 336 ng/ ml,the diagnostic sensitivity was 88.37 ％,and the specificity was 82.35 ％,which was better than that of HMGB1 and CPR.Conclusion HMGB1,CRP,MMP-9 detection can be used for the early diagnosis of SAH in patients with CVS,they can inhibit the expression of HMGB1,CRP,MMP -9 for the treatment of SAH patients with CVS.

Objective To explore the effect of lumbar cistern tube conduction for the intracranial infection after paraventriculostomy.Methods 170 patientswith encephalic infection after paraventriculostomy from Xianyang China Railway 20th Bureau Hospital were selected,and divided into observation group(102 cases)and control group(68 cases)according to patients′ conditions and family opinions.102 cases in observation group who were all moderate to severe infection patients,received continuous lumbar cistern drainage treatment on basis of intravenous antibiotics treatment;68 cases in control group who were all mild infection patients,received only intravenous antibiotics treatment.The therapeutic efficacy of two groups were observed.Results In observation group the mean defervescence time was(6.2±1.5)d,continuous drainage of 5-12 d,98 cases were cured,4 cases died,cure rate 96.08%(98/102);in control group the mean defervescence time was 7.1 d,63 cases were cured,3 cases were converted to continuous lumbar cistern drainage treatment,2 cases gave up treatment,cure rate 92.65%(63/68).Conclusion The lumbar cistern tube conduction for moderate to severe encephalic infection after paraventriculostomy is with significant effect and less complications,wrothy of clinical promotion.

Objective:To evaluate the safety,feasibility and long-term result of stent placement for vertebral artery (VA) stenosis of outer cranial segment. Methods:40 patients with vertebral artery of outer cranial segment stenosis were treated with stenting. Results:Carotid artery stents were placed in 4 patients and both side vertebral artery stents were placed in 2 patients simultaneously. 46 stents were used in total. The achievement ratio of operation was 100%. During the further follow up period of average 18 months,6 patients accepted recheck of DSA,2 of whom developed restenosis.The stenosis ratios were 10% and 15% respectively. None develop posterior circulation ischemia. Conclusion:Stent placement for treatment of atherosclerotic stenosis of vertebral artery of outer cranial segment is technically feasible and effective,which could be the choice of secondary prevention for cerebrovascular disease.

目的:探讨颈内动脉眼动脉段大型宽颈动脉瘤的栓塞治疗.方法:采用支架植入联合水解可脱式弹簧圈(Hydrocoilembolic system,HES)栓塞治疗6例.结果: 支架植入联合HES栓塞治疗6例,致密栓塞4例,大部栓塞2例.结论: 采用支架植入联合HES栓塞治疗为提高大型眼动脉动脉瘤的致密栓塞率及保留载瘤动脉提供了新的手段.

Objective:To reduce the death rate of the patients whose thalamencephalons have hemorrhaged to their ventricles.Methods:Save the patients' lives with the minimally invasive surgery two times.Results:For all those 36 patients,28 of them were cured or healed,two were come to their lives in 24hours after the operation,however the rest eight were falled to respond the medical treatment and died.Conclusions:Know all the indications of the operation exactly,chose the right operation method,use the medicines properly,and enhance the basic medical care,we could reduce the death rate,and improve the prognosis.

目的总结临床上脑室出血或其他位置(尾状核头,背侧丘脑等)出血引起的脑室铸形在行脑室外引流术后出现感染的中西医结合治疗效果。方法对46例因脑室外引流术后出现颅内感染患者,采用中西医结合治疗。结果46例中痊愈36例,死亡5例(因颅内感染死亡1例,因合并其它脏器衰竭死亡4例),放弃5例,治愈率78.3%。结论在出现感染后采取中西药合用对抗感染,基本上可以使绝大部分感染得到有效的控制和消灭。

目的评价颅内外动脉狭窄血管内支架成形术的安全性和有效性。方法回顾性分析2005～2006年颅内外动脉狭窄接受支架植入术的22例患者,随访3~12个月,就术后短期内疗效和再狭窄情况进行分析。结果本组22例患者,13例为颈动脉系统TIA患者,术后随访6~12个月,仅2例有3次TIA发作,症状类似术前,余11例均未见有发作;8例为椎基底动脉系统TIA患者,术后随访6个月内仅有2例出现发作性眩晕,余6例均未出现TIA发作;22例患者于22根血管上放置了22枚支架,随访3~12个月,8/22出现了再狭窄,2/22再狭窄超过了50%,6/22再狭窄介于10%-20%,14/22无再狭窄发生。所有患者在围手术期均未发生严重的并发症。结论症状性颅内外动脉狭窄血管内支架成形术能明显改善临床症状,而且手术成功率高,并发症低;尽管术后再狭窄是一个不可忽视的问题,在随访期间,症状再次出现的仅4例;所以短期疗效也是有效的。