ObjectiveTo build core items of database for traumatic brain injury (TBI) in rehabilitation medical database.MethodsRelevant factors in TBI database were summarized through database search in combination of acknowledged relevant items of TBI in rehabilitation medical database. Delphi method was used for experts to determine which items should be included by two rounds of questionnaires.ResultsThe average authority coefficient of experts was 0.94. After two rounds of questionnaires, 73 were included. Its contents include: general conditions, brain damage and disposal, relevant rehabilitation assessment scales, previous rehabilitation treatment, treatment expenses, and contents that require attention during re-evaluation.ConclusionsAfter two rounds of Delphi evaluation, the core items of database for TBI are identified with high recognition and consistency from experts.
目的:通过分析2007年自贡市急救中心院前急救反应能力，探讨其影响制约因素及解决方法。方法：回顾性分析2007年1～12月份自贡市急救中心院前出诊的全部有效病例呼救时间、出车时间、到达现场时间及出诊距离，计算出车准备时间、车辆行驶速度、应急反应时间、急救半径。结果：全年院前出诊共3336例，出车准备时间（2.06±0.93） min，车辆平均行驶速度32.17 km/h，应急反应时间（12.51±10.87） min，急救半径（5.60±5.35） km。结论：我市急救中心目前取得一定成绩，需采取多种措施进一步提高急救反应能力。
Objective? To investigate the dysfunction information of children suffering from Wenchuan earthquake and analyze their rehabilitation requirements. Methods A survey of rehabil itation requirements of 87 children with earthquake injuries was performed using self-made questionnaires. Results Among the 87 children investigated, 64.4% suffered from restricted joint range of motion, 95.4% had abnormal sensory (pain occupying 89.7%). Conclusion The earl ier the patients received the rehabilitation therapy, the better for them to recover functions, improve activity ability in daily life and promote participation ability.
Objective To explore the pathogenesis of acute respiratory disease syndrome (ARDS) by bioinformatics analysis of neutrophil gene expression profile in order to find new therapeutic targets. Methods The gene expression chips include ARDS patients and healthy volunteers were screened from the Gene Expression Omnibus (GEO) database. The differentially expressed genes were carried out through GEO2R, OmicsBean, STRING, and Cytoscape, then enrichment analysis of Gene Ontology (GO) and Kyoto Encyclopedia of Gene and Genomes (KEGG) pathways was conducted to investigate the biological processes involved in ARDS via DAVID website. Results Bioinformatics analysis showed 86 differential genes achieved through the GEO2R website. Eighty-one genes were included in the STRING website for protein interaction analysis. The results of the interaction were further analyzed by Cytoscape software to obtain 11 hub genes: AHSP, ALAS2, CD177, CLEC4D, EPB42, GPR84, HBD, HVCN1, KLF1, SLC4A1, and STOM. GO analysis showed that the differential gene was enriched in the cellular component, especially the integrity of the plasma membrane. KEGG analysis showed that multiple pathways especially the cytokine receptor pathway involved in the pathogenesis of ARDS. Conclusions A variety of genes and pathways have been involved in the pathogenesis of ARDS. Eleven hub genes are screened, which may be involved in the pathogenesis of ARDS and can be used in subsequent studies.
Objective To investigate the impact of optimized preoperative fasting scheme for gynecological day surgery with general anesthesia. Methods We retrospectively selected 639 patients undergoing gynecological day surgery with general anesthesia between June 2021 and August 2021 in the day surgery department of West China Second University Hospital of Sichuan University as the control group, and 920 patients undergoing gynecological day surgery with general anesthesia in the same hospital between November 2021 and February 2022 as the observational group. The patients in the control group were treated with routine preoperative fasting scheme, and the ones in the observational group were treated with optimized preoperative fasting scheme. The differences in preoperative duration of water deprivation, intraoperative and postoperative incidences of aspiration, and postoperative first anal exhaust time between the two groups were compared. Results The preoperative duration of water deprivation in the control group was longer than that in the observational group [(12.49±2.63) vs. (6.69±2.76) h, P<0.05]. The incidences of intraoperative and postoperative aspiration were both 0. The postoperative first anal exhaust time in the control group was later than that in the observational group [(11.51±6.58) vs. (8.19±4.13) h, P<0.05]. Conclusions For patients undergoing gynecological day surgery with general anesthesia, the implementation of the optimized preoperative fasting scheme can effectively shorten the preoperative duration of water deprivation, without increasing the risk of anesthesia. It can accelerate the recovery of intestinal function for gynecological laparoscopic day surgery with general anesthesia, promote the implementation of enhanced recovery after surgery, and improve the efficiency of day surgery.
ObjectiveTo study the therapeutic efficacy of stereoelectroencephalography (SEEG)-guided radiofrequency thermo-coagulation ablation (RF-TC) in the treatment of tuberous sclerosis (TSC) related epilepsy and to investigate the prediction of the therapeutic response to SEEG-guided RF-TC for the efficacy of the subsequent surgical treatment. MethodsWe retrospectively analyze TSC patients who underwent SEEG phase II evaluation from January 2014 to January 2023, and to select patients who underwent RF-TC after completion of SEEG monitoring, study the seizure control of patients after RF-TC, and classify patients into effective and ineffective groups for RF-TC treatment according to the results of RF-TC treatment, compare the surgical outcomes of patients in the two groups after SEEG, to explore the prediction of surgical outcome by RF-TC treatment. Results59 patients with TSC were enrolled, 53 patients (89.83%) were genetic detection, of which 28 (52.83%) were TSC1-positive, 21 (39.62%) were TSC2-positive, and 4 (7.54%) were negative, with 33 (67.34%) de novo mutations. The side of the SEEG electrode placement: left hemisphere in 9 cases, right hemisphere in 13 cases, and bilateral hemisphere in 37 cases. 37 patients (62.71%) were seizure-free at 3 months, 31 patients (52.54%) were seizure-free at 6 months, 29 patients (49.15%) were seizure-free at 12 months, and 20 patients (39.21%) were seizure-free at 24 months or more. 11 patients had a seizure reduction of more than 75% after RF-TC, and the remaining 11 patients showed no significant change after RF-TC. There were 48 patients (81.35%) in the effective group and 11 patients (18.65%) in the ineffective group. In the effective group, 22 patients were performed focal tuber resection laser ablation, 19 cases were seizure-free (86.36%). In the ineffective group, 10 patients were performed focal tuber resection laser ablation, only 5 cases were seizure-free (50%), which was a significant difference between the two groups (P<0.05). ConclusionsOur data suggest that SEEG guided RF-TC is a safe and effective both diagnostic and therapeutic treatment for TSC-related epilepsy, and can assist in guiding the development of future resective surgical strategies and determining prognosis.
ObjectiveTuberous sclerosis complex (TSC) is a multisystem disease, which often manifests as refractory epilepsy in the nervous system and multifocality in Magnetic resonance imaging (MRI). We summarized patients with TSC whose peripheral blood gene test was negative,and analyzed their medical history, EEG, MRI and postoperative conditions. MethodsWe summarized and analyzed 205 patients with TSC diagnosed clinically and pathologically and underwent surgery from April 2008 to February 2024. 11 patients with TSC whose peripheral blood gene test was negative and underwent surgery were screened out.All patients underwent gene examination, MRI and long-range video EEG monitoring. All patients underwent detailed preoperative evaluation and direct resection surgery, intracranial electrode thermocoagulation surgery or laser surgery. ResultsOf the 11 patients with peripheral blood gene test negative, 11 (100%) patients achieved Engel Ⅰ within 1 year after surgery, and 10 (91%) patients achieved Engel Ⅰwithin 2 years. The median age of onset of 11 patients was 6 months, and 8 patients (73%) had onset less than 1 year old. All patients had multiple nodules in the brain. Except for the brain, the changes of the other organs were polycystic kidney and skin changes in 2 patients, skin changes in 8 patients, and normal in 1 patients. ConclusionTSC patients with peripheral blood gene negative who have young onset age, frequent seizures, and multiple nodules on MRI often present with refractory epilepsy. However, the postoperative effect is good, and the postoperative EEG of most patients is normal.
The May 12 8-magnitude earthquake caused damage to 87.7% of the health systems in the worst-hit Mianyang areas with 326 casualties and the direct economic loss of RMB 3 124 billion. Within 30 minutes after the earthquake, the Mianyang headquarters for earthquake disaster relief and the Mianyang public health headquarters for medical rescue and treatment were organized. Five medical teams were sent to Beichuang County, the worst-hit Mianyang area within four hours after the earthquake. A total of 22 947 wounded and sick were delivered to local hospitals after simple triage and rapid treatment through three station. By June 30, the Mianyang medical organisation had received 379 600 person times and admitted 21628 inpatients in total, including 2 772 severely-wounded (including 146 with limbs amputated and 846 dead during the stay). Since May 17, 3381 wounded had been transferred to 14 provincial and city-level hospitals across China. On June 20, the Mianyang Rehabilitation Center for wounded and sick people was established and received 156 rehabilitation inpatients and cured 32 ones. Together with the medical team for psychological intervention, they provided psychological support for victims for over 70 000 person times. Within two hours after the earthquake, the Mianyang Organisation for Health and Epidemic Control and Prevention launched the emergency response plan for major natural disasters, prepared and improved the technical scheme for disease prevention after the earthquake. The organisation rapidly sent out emergency teams for disease control and prevention and completed the following tasks: disinfection and burial of corpses and disposal of carcasses, monitoring of the water quality and epidemics, disinfection of environmental ruins, epidemic control in resettled areas, precaution of the secondary disasters caused by the earthquake and conduction of large-scale health education. The emergency command system for medical rescue and disease control and prevention in the worst-hit Mianyang areas after Wenchuan Earthquake integrated resources, carried out the unified command and responded rapidly. Moreover, the headquarter of medical relief coordinated and orderly unified the governmental and non-governmental organizations, which achieved good performance for both medical relief and anti-epidemic. The experience of earthquake medical relief will benefit the post-disaster reconstruction, as well as the establishment of national and regional emergency response systems.
ObjectiveAicardi and Goutières syndrome was first reported as a rare hereditary encephalopathy with white matter involvement in 1984. Typical clinical manifestations include severe mental motor development retardation or regression, pyramidal and extrapyramidal symptoms and signs, epilepsy, microcephaly and frostbite.MethodsTo collect a case of patient who presented with convulsions 14 days after birth without obvious inducement. The child was diagnosed as epilepsy in the local hospital and the symptoms improved after treatment with antiepileptic drugs. At 4 months, the child presented nods and clenched fists, and was diagnosed as infantile spasm. After Adrenocorticotrophic hormone and drug treatment, the symptoms gradually improved. Due to upper respiratory track infection, the child was aggravated at the age of 1 year and 2 months, and then diagnosed as Aicardi-Goutières syndrome by video EEG, skull MRI, fundus and gene screening.ResultsSurgery and treatment with antiepileptic drugs significantly improved the symptoms of the child, and the pathological biopsy of the brain tissue supported the previous diagnosis.ConclusionsThe report of this case will help to improve the clinician's diagnosis and treatment of Aicardi-Goutières syndrome.
The Wenchuan Earthquake caused severe injuries and deaths as well as subsequent serious potential risks to public health and hygiene in the worst-hit areas. There were 16 casualties in the Mianyang CDC system and the township amp; county CDC networks were destroyed in the worst-hit counties after the earthquake. The Mianyang CDC quickly launched its emergency response plan for major natural disasters within two hours after the earthquake, prepared and improved the technical guide for disease prevention after the earthquake and rapidly sent out quick response team. With the help of CDC aid teams across the country, Mianyang CDC successfully disinfected and buried 6,767,568 corpses, and disposed of millions of animal carcasses.They also disinfected and sterilised an area of 932.595 million square metres, eradicating 3,514,166 fly and mosquito breeding places and treating 5,254,228 cesspit times. By June 30, they had examined 11,092 water supply units and carried out disinfection of 319.7997 million cubic metres of drinking water. Besides, dynamic monitoring for water quality in the four worst-hit areas in Mianyang urban areas. They organised hygienic enforcement supervisors to develop food safety inspection, regulated catering services of the centralised settlements, destroyed spoiled and expired food and vegetables. The authorities prevented the masses from eating dead poultry or meat from carcasses to ensure no occurrence of food poisoning after the earthquake. Standard administration of the 170 settlements of the earthquake-afflicted people and 132 settlements of evacuated people was carried out in accordance with the rules of "Six Provisions and Four Reinforcements" and this would ensure no recurrence of public health events in the settlements. On Day 3 (May 15) after the earthquake, they established a real-time monitoring and report network of the epidemic situation after the earthquake and monitored diseases and symptoms of the people in the resettled region to ensure no occurrence of major epidemic cases. The monitoring results showed that the number of infectious disease cases was comparable to that in the previous years. Moreover, they carried out intensive vaccination with hepatitis A vaccine in children 41196 person times, stored 100,000 person oral cholera vaccine and monitoring for new sexually transmitted diseases. A total of 10.1265 million copies of publicity materials were organised printed and distributed. They developed large-scale health education and a massive patriotic health campaign by means of the media and organised the masses to engage in sanitation and hygiene as well as controlling flies, mosquitoes and rats in the temporary earthquake-proof places. Under the unified command of the Mianyang emergency response headquarters, the centers for health and epidemic control and prevention at various levels of disaster relief continued to dispose of carcasses and disinfect and bury corpses as well as monitor water quality, so as to ensure the secondary disasters could be prevented in advance.