Objective To investigate the therapeutic effects of endovascular covered stent on vertebral dissecting aneurysm and carotid-cavernous fistula (CCF). Methods From March 2006 to May 2007, Jostent coronary stent grafts were used to treat 4 patients with vertebral dissecting aneurysm and 3 patients with CCF. The patients of vertebral dissecting aneurysmwere male and 37-57 years old, the lesion was located on the left vertebral artery in 3 patients and on the right vertebral artery in 1 patient, with the primary symptoms of sudden headache and vomiting; CT scan demonstrated subarachnoid hemorrhage; and the medical history varied from 2 days to 10 years. The patients of CCF were male and 35-51 years old, the lesion was located on the left carotid artery in 2 patients and on the right carotid artery in 1 patient, with the primary symptoms of headache, lateral exophthalmos, eyeball distending pain, conjunctive hyperemia and impaired eyesight; all 3 patients got head injury 2 days to 1 month before the appearance of symptoms and 1 of them had a history of severe nosebleed; and the medical history ranged from 1 week to 2 months. Results For the patients with vertebral dissecting aneurysm, complete obl iteration of aneurysms was achieved, the circulations of the vertebral artery, the adjacent posterior inferior cerebellar artery and the adjacent anterior inferior cerebellar artery were smooth, no compl ications relative to operation occurred, and no recurrence of symptoms and intracranial rehaemorrhagia were observed during the follow-up period of 8 months-2 years. For the patients with CCF, the fistula were completely obl iterated, the circulation of carotid artery was smooth, the exophthalmus and conjunctiva hyperemia were improved obviously 3 days after operation, the eyesight of patient was improved at different levels over the follow-up period of 1-3 months. Conclusion Endovascular covered stent is a new and useful tool for the treatment of vertebral dissecting aneurysm and CCF .
目的：评价宫腔声学造影(SHG)对子宫内膜息肉的诊断价值。方法：对临床拟诊宫内膜息肉的76例患者进行TVS、SHG及宫腔镜手术病理检查，并对结果进行分析。结果：以手术病理结果作为诊断金标准，内膜息肉48例，黏膜下肌瘤9例，内膜增生10例，宫腔内机化血凝块3例，正常内膜6例。SHG对子宫内膜息肉诊断的准确性为93.4%，敏感性为93.7%，特异性为92.8%。TVS对子宫内膜息肉诊断的准确性为59.2%，敏感性为81.2%，特异性为21.4%。两种方法对内膜息肉的诊断准确率比较有显著差异(χ2=5.45，P=0.019)。结论：宫腔声学造影准确率高，是诊断子宫内膜息肉的可靠方法。
【摘要】 目的 探讨婴幼儿常见泌尿系统先天发育异常的超声特征。 方法 回顾性分析2008年9月17日-2010年6月1日体检的婴幼儿中所发现的各种泌尿系统先天性发育异常的超声表现。 结果 发现泌尿系统先天性发育异常88例，其中肾缺如50例，多房性肾囊性变10例，多囊肾2例，肾旋转不良1例，重复肾10例，输尿管囊肿6例，异位肾7例，融合肾2例。 结论 婴幼儿常见的泌尿系统先天性发育异常有较特异的超声表现，超声检查是筛查婴幼儿泌尿系统先天性发育异常的首选影像学检查方法。【Abstract】 Objective To study the ultrasonic characteristics of congenital malformation of infantile urinary system. Methods We analyzed various ultrasonic appearances of congenital malformation of infantile urinary system in our hospital in the recent two years retrospectively. Result We found 88 cases of congenital urinary system malformation in all infants, including 50 cases of renal agenesis, 10 cases of multi-cystic kidney, 2 cases of policystic kidney, 1 case of malrotation of kidney, 10 cases of duplex kidney, 6 cases of ureter cyst, 7 cases of ectopic kidney, and 2 cases of fused kidney. Conclusion Special ultrasonic appearances can be detected for congenital malformation of infantile urinary system, so ultrasound can be regarded as the first-line iconographical examination for the disease.
【摘要】 目的 探讨脑干海绵状血管瘤患者临床表现及影响预后的相关因素。 方法 回顾分析2008年9月-2010年9月27例脑干海绵状血管瘤患者临床资料。 结果 20例（74.1%）患者CT显示出血及血肿。急性或突然神经功能废损22例，渐进性功能障碍15例，病情平稳4例。显微手术12例，放射治疗6例，保守观察9例。长期随访25例，2例再次出血，无新发病灶，无患者死亡。手术组患者年龄（Plt;0.05）、术前病情严重程度（Plt;0.05）与术后KPS评分相关。非手术组不良预后评分与患者高龄及再出血有关。 结论 展神经麻痹和面瘫患者功能恢复较差。年龄、术前病情严重程度及手术时机影响患者预后，术中全切病灶对复发和并发症发生起主要作用，如何处理合并发生的静脉畸形有待讨论。立体定向放射治疗明显降低再出血风险，但其适应证尚有争议。【Abstract】 Objective To discuss the clinical manifestations and prognostic factors of brain stem cavernous hemangioma. Methods Based on the literature, the clinical data of 27 patients having brain stem cavernous hemangioma from September 2008 to September 2010 were reviewed and analyzed. Results Twenty patients (74.1%) presented with hemorrhage and hematoma in CT scan. Acute or sudden neurological deterioration occurred to 22 patients, progressive in 15 and stable in 4. Twelve patients underwent surgical removal of the lesion; 6 underwent radiosurgery; and 9 continued with conservative management. Twenty-five patients were followed up. Two patients had rehaemorrhagia. There were no de novo lesions or death. The risk factors indicative of a possible poor postoperative KPS score in the operative group included age (Plt;0.05) and the initial clinical condition (Plt;0.05). In the non-operative group, old age and rehaemorrhagia were obviously related to the poor outcome. Conclusions Patients with abducens and facial palsy have poor functional recovery. Age, the initial clinical condition and timing of operation are the major factors correlated to surgical outcome. The factor that affects recurrence and the occurrence of complications is complete resection during the operation. How to deal with the concomitant venous malformation should be further studied. The indications for stereotactic radiosurgery are still controversial, although it has confered a reduction in the risk of rehaemorrhagia.
Objective To systematically assess the efficacy and safety of probiotics in prevention and treatment of bronchial asthma. Methods Randomized controlled trials (RCTs) of probiotics in prevention/treatment of asthma compared with placebo were searched in PubMed, EMbase, Web of Science, OVID and The Cochrane Library published before August 2011. The quality of the included RCTs was evaluated and the data were extracted by two assessors independently. Meta-analyses were performed with RevMan 5.1 software. Results Eleven RCTs on probiotics preventing asthma (n=3 656) and 5 RCTs on probiotics treating asthma (n=430) were identified. The Meta-analyses on preventing asthma showed that probiotics didn’t statistically decease the incidence of asthma (RR=0.76, 95%CI 0.47 to 1.22, P=0.25) and asthma-like wheezing (RR=0.92, 95%CI 0.62 to 1.39, P=0.71) compared with placebo. The Meta-analyses on treating asthma indicated that probiotics could prolong free episodes of asthma (RR=1.48, 95%CI 1.20 to 1.76, Plt;0.000 1) in comparison with placebo. No severe adverse events were found in all included studies. Conclusion The present evidence is not b enough to prove that probiotics is effective to prevent asthma, but it may prolong free episodes of asthma. Although it seems to have the effect on improving lung function, it fails to reduce the acute onset of asthma and has no have the advantage of improving immune function.
Objective To explore the oxygen therapy effects of high-flow T-tube oxygen therapy on neurointensive care patients who have undergone tracheostomy and are undergoing mechanical ventilation while meeting the criteria for weaning from mechanical ventilation, especially in terms of controlling airway temperature and humidity, promoting mucus dilution, and reducing postoperative complications. MethodsCollected data from 50 neurointensive care patients who underwent tracheostomy and were on mechanical ventilation, meeting the criteria for weaning from mechanical ventilation, treated at West China Hospital of Sichuan University from September 2019 to September 2021. The three groups of patients had different weaning methods: a high-flow T-tube for weaning, a heat and moisture exchanger (artificial nose) for weaning, and a high-flow tracheal joint for weaning. The vital signs, dyspnea and blood gas analysis before and three days after weaning were collected. The primary outcomes were mechanical sputum excretion, postural drainage, phlegm-resolving drugs use, airway-related events (artificial airway blockage, artificial nose blockage, lung infection), stay in ICU (days), and death in ICU. Results Among the 50 patients, 28 were males and 22 were females. There were no significant differences in age, weight, height, gender, finger pulse oxygen saturation, heart rate, APACHEII score, sequential organ failure assessment, or Glasgow coma scale among the three groups (P>0.05). There was no statistical difference in the number of 72-hour mechanical sputum excretion or the use of phlegm-resolving drugs in the three groups (P=0.113, P=1.00). Conclusion The use of high-flow T-tube oxygen therapy in neurointensive care patients who have undergone tracheostomy, are on mechanical ventilation, and meet the criteria for weaning from mechanical ventilation can effectively control airway temperature and humidity, promote mucus dilution for better drainage, thereby reducing post-tracheostomy complications.
Objective To understand the current situation of nosocomial infection management quality control centers at the municipal and county levels in Guizhou, so as to provide measures for promoting the construction of nosocomial infections management quality control centers at all levels in Guizhou. Methods From September 26th to October 12th 2023, based on the mobile network platform survey questionnaire of the infection prevention and control workshop, a survey was conducted on the establishment, personnel, information technology level, management, and quality control work of the nosocomial infection management quality control centers at the municipal and county levels in Guizhou. Results Nine prefecture-level cities/autonomous prefectures in Guizhou had established municipal-level nosocomial infection management quality control centers. The professional background of the staff at the municipal and county-level quality control centers was mainly nursing (accounting for 36.4% and 58.4%, respectively), and their educational background was mainly undergraduate (accounting for 70.5% and 83.3%, respectively). No quality control center at the municipal or county level had established an information-based quality control platform for nosocomial infection management within the region. Most county-level quality control centers did not have special funds (87.5%), and there were still 16 (25.0%) county-level quality control centers that had not established relevant systems for work and management. The main forms of quality control work carried out by each center were organizing training, on-site inspections, guidance and evaluation, and most of them were conducted irregularly. Conclusions Guizhou has basically formed a quality control system for nosocomial infection management at the provincial, municipal, and county levels. However, the nosocomial infection management quality control network has not fully covered all districts, and policies, funding support, and personnel allocation are still insufficient. Health administrative departments and quality control centers at all levels need to unify monitoring standards and quality control norms, strengthen supervision, improve quality control capabilities, and improve training systems to achieve standardization and normalization of quality control work throughout the province and improve quality control efficiency.