Objective To investigate the injury characteristics of 33 children of Lushan earthquake victims no more than 14 years old treated in the West China Hospital of Sichuan University, and to put forward the early rehabilitation strategy. Methods A total of 33 earthquake children victims were investigated with the modified barthel index score (MBI) and analyzed in following aspects: age, causes, and injury. Results a) The 33 children victims accounted for 10.28% of the total earthquake victims treated in the hospital, they were all no more than 14 years old, and the average age was 7.24 years old. 17 cases were fractures of trunk and limbs, six were traumatic brain injury, and four were soft tissue injury. b) The main traumatic causes were crush by falling objects and heavy stuffs; and some children rarely suffered from hurt, burn and fall injury when running. c) Most children victims were simple open injuries and fractures, especially the limbs fractures accounted for 51.51% of the total cases, and there was only one case suffered from abdominal organ injuries. d) Among 33 children victims, 30 (90.9%) were from the towns and villages. They mainly got injured by the collapse of house or courtyard walls which were not as ber as the house in the cities, so the incidence of severe injury was lower, the degree of injury was milder, and the injury of major organ was rarer. Conclusion Early rehabilitation treatment is helpful to prevent the complications and early recover the functions. It suggests the early rehabilitation treatment should be carried out for the earthquake children victims in order to promote the fracture healing and functional recovery, as well as to prevent the complications. In addition, attention should also be paid to the psychological problems while concerning rehabilitation training.
目的:探讨Mirizzi综合症的诊断治疗特点,以提高其诊断和治疗水平。方法:对35例经手术证实为Mirizzi综合症的临床资料进行回顾性分析。结果:35例Mirizzi综合症患者中仅4例(11.4%)术前确诊。Ⅰ型7例,Ⅱ型17例,Ⅲ型9例,Ⅳ型2例。5例行胆囊切除术,2例行胆囊大部分切除术;胆囊切除、胆囊瓣瘘口修补6例,12例行胆囊切除、胆总管探查、瘘口修补、T管引流术;胆囊切除、胆肠吻合术10例。术后恢复好,随访结果,无严重并发症.结论:Mirizzi综合症术前确诊困难,B超结合MRCP/ERCP检查可以提高Mirizzi综合症的术前确诊率,手术容易损伤胆管,手术方式应据病理损伤程度决定。
目的:探讨成人化脓性脑膜炎合理有效的诊治方法和影响预后的因素。方法:对我院2001年1月~2007年4月成人化脓性脑膜炎患者的病历资料进行回顾性分析。结果:20例痊愈,2例自动出院,2例死亡。结论:早期诊断,早期合理使用抗生素,适当使用肾上腺皮质激素和脱水剂,改善脑代谢药物,患者大多预后好。诊治开始时间、患者年龄及伴发疾病是决定预后的关键。
Objective To investigate the clinicopathological characteristics of proximal gastric cancer (PGC). MethodsThe clinical course and pathologic feature of 118 PGC patients were analyzed, and compared with those of 310 distal gastric cancer (DGC) patients. ResultsThe incidence of PGC was lower than DGC, the percentage of Ⅲ,Ⅳ stages and undifferentiated type in the PGC group were significantly higher than in DGC. For the surgical procedure, patients in the PGC had significantly higher percentages of total gastrectomy and other organ resection than in DGC. The percentage of patients with positive margin and lymph node metastasis in PGC was also significantly higher than in DGC. Esophageal invasion and lymph node metastasis were much more in PGC. The 5year survival of patients with PGC was significantly lower than that with DGC. No significant differences were found between the two groups with respect to the mortality rates and complications. Conclusion The relatively poor prognosis associated with PGC is mainly from advanced cases and esophageal invasion. Early detection and treatment is the most important strategy to improve the survival of patients with PGC.
【Abstract】 Objective To investigate the clinical characteristics and prognosis of secondary lymphocytic interstitial pneumonia ( LIP) . Methods Clinical data of 9 cases with secondary LIP diagnosed from1990 to 2010 were retrospectively analyzed. Results Of 9 patients there were 3 males and 6 females,the range of age was 7-64 years. In the 6 adult patients there were 5 females. 2 cases were infected by EB virus and 1 by recurrent pulmonary infection in 3 non-adult patients. In the adult patients, 1 case was diagnosed with Sjogren’s syndrome, 1 case with overlapping syndrome, 2 cases with primary biliary cirrhosis,1 case was probably caused by infection, and 1 case was complicated with eosinophilia. Dominant symptoms of pulmonary system were cough, expectoration, and shortness of breath on exertion. Dominant systematic symptoms were asthenia, pyrexia, weight lose, and arthralgia. CT revealed diffuse ground glass opacities with a lower lung zone predominance. Pathologic feature of LIP was a diffuse, polyclonal lymphoid cell infiltration surrounding airways and extending to the lung interstitium. The patients were treated by glucocorticoid and immunosuppressants. Two cases died with secondary infection. Follow-up did not comfirm malignant tumors in the survivors. Conclusions The clinical features of LIP are characteristic, but lacking of specificity. The final diagnosis depends on pathological examination. Treatment targeted on primary diseases can probably have a good efficacy, and the clinical outcome is favorable.
Abstract: Objective To investigate the clinical features of solitary fibrous tumor (SFT) in the thorax and its optimal surgical approaches. Methods We retrospectively reviewed the clinical records of 16 patients with SFT in the thorax in our hospital between January 2004 and June 2010. There were 8 males and 8 females, with a median age of 49 years (1973 years). Laboratory examination showed normal results. Chest Xray and computed tomographic scan revealed lung tumor in 8 cases, mediastinal mass in 3 cases, fibrous tumor in 2 cases, pleural mass in 2 cases, and retroperitoneal mass in 1 case. Five patients underwent CT guided biopsy or thoracoscopy, and 3 of them were diagnosed to have SFT. There was no clear diagnosis for the remaining 13 cases before operation. None of them had been exposed to asbestos. Symptoms were present in 5 patients. All patients underwent surgical treatment with resection performed through routine thoracotomy in 10 cases and by means of videoassisted thoracoscopy in 6 cases. The tumors originated from the visceral pleura in 12 patients, from parietal pleura in 3 patients (from diaphragmatic pleura in 1, and costal pleura in 2), and from the lung in 1 patient. Results All tumors were totally excised. Immunohistochemical staining showed CD34 was positive in all tumors. There was no postoperative mortality and no major complications. All patients were regularly rechecked and followed up. The followup was ranged from 1 to 72 months, with a median time of 21 months. During the followup, all patients survived and no recurrence was observed by means of chest X radiography or CT. Conclusion SFT tumors in the thorax are rare neoplasms and can have giant diameters. Wide local excision is recommended as the best therapeutic option. The SFT has the possibility of recurrence, and careful longterm clinical followup is required.