ObjectiveTo explore the practice effect of the combination management of tertiary hospital and community hospital for home peritoneal dialysis patients. MethodsA total of 50 patients of end-stage renal disease from December 2012 to May 2013 were involved in this study, including 26 males, and 24 females with the average age of 47.1±13.9. The patients were randomly divided into hospital group (30 patients) and combination group (20 patients). For the patients in the hospital group, the specialists take care of them with regular outpatient service and follow-up; for the patients in the combination group, they were taken care by doctors from both tertiary hospital and community hospital, while the community general practitioners were trained by the tertiary hospital regularly with peritoneal dialysis basic treatment and standardization management and communication. All the patients were managed for 9 months. ResultsAt the end of the observation,the dialysis adequacy success rate, hemoglobin, blood potassium, phosphorus, calcium, albumin, CO2CP, blood pressure success rate, the incidence of peritonitis, and average monthly medical treatment expense between the two groups were not statistically different (P>0.05); the difference in cost of transportation was statistically significant (P<0.05). ConclusionThe standardization manage of combination of tertiary hospital and community for patients with home peritoneal dialysis may reduces the patients' expense in transportation, and improve the community general practitioners' level of basic knowledge and indication of peritoneal dialysis.
ObjectiveTo investigate the MRI manifestations of internal carotid artery dissection (ICAD) before and after treatment. MethodsMRI materials of 20 patients with ICAD between November 2007 and February 2013 were collected for analysis. ResultsMRI manifestations of ICAD showed 17 cases of artery stenosis, 16 cases of mural hematoma or thrombus, 3 cases of aneurysmal dilatation, and 2 cases of lines of intimal flap. The treatment outcome MRI manifestations showed that 18 patients had effective response, including disappeared (n=9) and lessened (n=8) artery stenosis, disappeared (n=13) and diminished (n=3) hematoma and thrombus, and shrunken aneurysmal dilatation (n=1); and there were 2 cases of unchanged aneurysmal dilatation, and another 2 patients had aneurysmal dilatation while stenosis lessened. ConclusionMRI manifestations of internal carotid artery dissection mainly include stenosis, mural hematoma or thrombus, and aneurysmal dilatation. Stenosis, mural hematoma or thrombus usually disappear and lessen in the treatment, and all MRI findings may vary among each other.