ObjectiveTo assess the effect of polyurethane gelatum grommet positioning and Mayfield head holder positioning under suboccipital retrosigmoid approach in acoustic neuroma resection on patients' facial crushing. MethodsRetrospective analysis of the clinical and nursing data of 90 patients treated by microsurgical surgery under the lateral prone position in our hospital from January 2013 to January 2014 was carried out. Patients in group A (n=28) were given grommet positioning, while those in group B (n=62) were given Mayfield head holder positioning, and then we compared the situation of facial crushing between the two groups. ResultsIn group A, 5 patients showed abnormality including 2 cases of skin injury in lower frontozygomatic and mandibular area, 2 cases of lower conjunctival edema and 1 of co-existing skin injury in lower zygomatic area and lower conjunctival edema, and the crushing rate was 17.86% in group A. In group B, the crushing rate was 1.61% with one case of mandibular skin injury. There was a significant difference between the two groups (χ2=5.778, P=0.016). ConclusionUnder suboccipital retrosigmoid approach for acoustic neuroma resection, Mayfield head holder positioning is better to avoid facial crushing.
ObjectiveTo investigate the significance of using the term "high-normal blood pressure" and its intervention in the early stage. MethodsIn 1992 and 2007, we performed two similar investigations focusing on cardiovascular risk factors in 711 people in Chengdu city. Since 114 individuals were diagnosed with hypertension, 597 people without hypertension were eligible and divided into two groups:the normal-pressure[<120/80 mm Hg (1 mm Hg=0.133 kPa)] group and the high-normal blood pressure (systolic blood pressure 120-139 mm Hg and/or diastolic blood pressure 80-89 mm Hg) group. Data in the two investigations were compared to explore the relationship among high-normal blood pressure, cardiovascular disease (CVD) and hypertension. ResultsThe high-normal blood pressure group had a higher level of CVD risk factors both in 1992 and 2007, and the 15-year cumulative incidence of hypertension in the high-normal blood pressure group was higher than that of normal-pressure group (91.2% vs. 22.2%, P<0.001). After adjusting for serum lipid, body weight and other CVD risk factors, high-normal blood pressure could predict the progression into hypertension[HR=5.354, 95% CI (4.094, 7.002), P=0.001]. There was no statistics difference in CVD prevalence in the two groups in 1992, but in 2007 the prevalence of CVD tended to be higher in the high-normal blood pressure group (6.6% vs. 3.1%, P=0.052). ConclusionHigh-normal blood pressure is a special stage of blood pressure with high level of CVD risk factors and high potential to progress into hypertension. The term should be emphasized and intervention should be done in the early stage for high-normal blood pressure people to prevent from hypertension and CVD.