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Objective To explore endovascular treatment for patients with blood blister-like aneurysms (BBA) of the internal carotid artery (ICA). Methods and Results A retrospective analysis of the clinical data of 25 patients with BBA of ICA admitted to The First Affiliated Hospital of Soochow University from January 2018 to January 2022 were conducted. All of them accepted endovascular treatment: 17 cases were treated with single-stent-assisted embolization, including 14 cases using Lvis stents and 3 cases using Enterprise stents; 4 cases were treated with double-stent-assisted embolization, all using Lvis stents; one case was treated with overlapping stent implantation, including 2 Lvis stents and one Enterprise stent; one case was treated with balloon -assisted embolization, and 2 cases were treated with Tubridge flow diverter. No aneurysm rupture occurred during the surgery. One patient had intra-stent thrombosis during the procedure, while other 24 patients showed smooth blood flow on postoperative immediate DSA. The Raymond classification showed that among the patients, there were 17 cases of grade I occlusion, 3 cases of grade II occlusion, and 5 cases of grade III occlusion. Postoperative complications included cerebral infarction (2 cases), cerebral vasospasm due to subarachnoid hemorrhage (one case), and hydrocephalus (2 cases). Six patients had aneurysm recurrence postoperatively (3 cases using a single Enterprise stent, one case using 2 Lvis stents, one case using Tubridge flow diverter, and one case using a balloon-assisted embolization), among whom 5 patients underwent repeat stent-assisted embolization treatment. And one patient still had recurrence after treatment but achieved cure by adjusting antiplatelet therapy regimen; one patient recovered by adjusting antiplatelet therapy regimen. At 12 months after surgery, the modified Rankin Scale (mRS) scores were as follows: 0 in 15 cases, 1 in 6 cases, 2 in 3 cases, and 6 in one case. The disability rate was 12% (3/25), and the mortality rate was 4% (1/25). Conclusions The degree of immediate postoperative occlusion is crucial for preventing aneurysm recurrence postoperatively. For recurrent BBA of ICA, adjustment of antiplatelet therapy should be considered first. [ABSTRACT FROM AUTHOR]

Objective To investigate the causes of the hemorrage during and after embolization of cerebral aneurysms. Methods and Results We retrospectively analyzed 153 patients who underwent embolization of cerebral aneurysms from January 2015 to April 2017. Raymond Classification following initial treatment indicated 91 cases (59.48%) were in Raymond grade I, 25 cases (16.34%) in Raymond grade II, 37 cases (24.18%) in Raymond grade III. Wide - necked aneurysms were seen in 73 cases (47.71%). Stent assisted embolization was done in 63 cases (41.18%). Intraoperative bleeding rate was 1.31% (2/153), causes of bleeding were rupture after repeated over-selection of coil micro-catheter in place (one case), rupture of aneurysm when release of the first coil after stent opening (one case) and the 2 cases all died. Postoperative rebleeding rate was 1.31% (2/153), both patients were Raymond grade III, one of them died after rebleeding, one with cerebral hematoma clearance and aneurysm clipping, the patient was followed up for one year in a stable condition. Conclusions Rupture of aneurysm wall by improper operation of micro-catheter or micro-guidewire during intracranial aneurysm embolization is the main cause of intraoperative bleeding, and Raymond Classification may be the influencing factor for rebleeding after embolization of cerebral aneurysms. [ABSTRACT FROM AUTHOR]

We investigated the association between platelet-to-lymphocyte ratio (PLR) and clinical outcomes (including all-cause mortality, recurrent myocardial infarction, heart failure, serious cardiac arrhythmias and ischemic stroke) in patients with ST-segment elevation myocardial infarction (STEMI). Based on PLR quartiles, 5886 patients with STEMI were categorized into 4 groups: <98.8 (n = 1470), 98.8 to 125.9 (n = 1474), 126.0 to 163.3 (n = 1478), >163.3 (n = 1464), respectively. We used Cox proportional hazards models to examine the relation between PLR and clinical outcomes. Mean duration of follow-up was 81.6 months, and 948 patients (16.1%) died during follow-up. The lowest mortality occurred in the lowest PLR quartile group (P = 0.006), with an adjusted hazard ratio of 1.18 (95% confidence interval [CI], 1.04-1.55), 1.31 (95% CI, 1.18-1.64), and 1.59 (95% CI, 1.33-1.94) in patients with PLR of 98.8 to 125.9, 126.0 to 163.3, >163.3, respectively. Higher levels of PLR were also associated with recurrent myocardial infarction (Ptrend = .023), heart failure (Ptrend = .018), and ischemic stroke (Ptrend = .043). In conclusion, a higher PLR was associated with recurrent myocardial infarction, heart failure, ischemic stroke, and all-cause mortality in patients with STEMI. [ABSTRACT FROM AUTHOR]

Objective: We aimed to assess the prevalence and risk factors for hypertensive disorders and to study the main pregnancy outcomes in the Beijing area of China.Study Design: This study randomly sampled 15 hospitals in Beijing from Jun 2013 to Nov 2013 and evaluated 15 194 deliveries. Logistic regression analysis was used to study the association between risk factors and hypertensive disorders. Pregnancy outcomes included preterm birth, cesarean delivery and small for gestational age (SGA).Results: The prevalence of hypertensive disorders, preeclampsia (PE) and severe PE was 4.4, 2.7 and 1.8%, respectively. The risk factors for hypertensive disorders and severe PE were maternal body mass index before pregnancy, gestational weight gain (GWG), gestational diabetes and pre-gestational diabetes, and third trimester cholesterol (CHOL) levels. First trimester high-density lipoprotein was a protective factor for severe PE. The incidence of hypertensive disorders increased with maternal age. Preterm delivery, cesarean delivery and small infant size for gestational age were more prevalent in the severe PE group compared with the non-hypertensive group.Conclusions: In the Beijing area of China, maternal body mass index before pregnancy, GWG, maternal complications of gestational diabetes and pre-gestational diabetes, and third trimester CHOL levels are risk factors for both hypertensive disorders of pregnancy and severe PE. First trimester high-density lipoprotein is a protective factor for severe PE. Severe preeclampsia leads to a higher incidence of preterm delivery, cesarean delivery and SGA infants. [ABSTRACT FROM AUTHOR]

Objective: To estimate the risk of adverse maternal and perinatal outcomes in women with different pre-pregnancy body mass index (BMI).Methods: We conducted a cohort study with 14 451 singleton pregnancies in 15 medical centers in Beijing between 20 June 2013 and 30 November 2013 using cluster random sampling. We divided participants into four groups based on pre-pregnancy BMI: Group A (underweight): BMI < 18.5 kg/m(2), Group B (normal): 18.5-23.9 kg/m(2), Group C (overweight): 24-27.9 kg/m(2), Group D (obesity): ≥28 kg/m(2). We used multivariate analysis to evaluate the association of the risk of adverse pregnancy outcomes and pre-pregnancy BMI.Results: The prevalence of maternal overweight and obesity was 14.82% (2142/14 451) and 4.71% (680/14 451) in the study population, respectively. Higher pre-pregnancy BMI is associated with higher prevalence of gestational diabetes (GDM), macrosomia, Cesarean section (C-section), preeclampsia and postpartum hemorrhage. Pre-pregnancy overweight or obesity increases the risk of adverse pregnancy outcomes, regardless of GDM status.Conclusions: Pre-pregnancy overweight or obesity is associated with increased risk of adverse pregnancy outcomes. Nutrition counseling is recommended before pregnancy in women who have overweight or obesity. [ABSTRACT FROM AUTHOR]