Objective To investigate the clinical features and prognosis of acute isolated corpus callosum infarction. Methods The clinical and imaging data of patients with acute isolated corpus callosum infarction diagnosed in the Department of Neurology of Beijing Geriatric Hospital and the Department of Neurology of China-Japan Friendship Hospital from February 2017 to February 2021 were retrospectively selected. Patients were divided into groups according to infarction location, infarction size and prognosis. According to the infarction location, the patients were divided into single-site lesion group and multi-site lesions group. According to the infarction size, the patients were divided into large lesion group and small lesion group. According to the prognosis, the patients were divided into good prognosis group and poor prognosis group. The clinical characteristics, etiology and prognosis of these diseases were observed and analyzed. Results A total of 52 patients were included. Among them, there were 32 males (61.5%) and 20 females (38.5%), with an average age of (65.4±7.1) years. The most common risk factors were hypertension (44 cases, 84.6%), hyperlipidemia (32 cases, 61.5%), and diabetes (28 cases, 53.8%). The most common infarction site was splenium in the single-site lesion group (24 cases, 46.2%). The vast majority of patients (92.3%) had nonspecific clinical symptoms, and only 4 (7.7%) had corpus callosum disconnection syndrome. In the TOAST etiological classification, Large-artery atherosclerosis (LAA) was the most common (25 cases, 48.1%), followed by small-artery occlusion (14 cases, 26.9%), the responsible vascular lesions were the most common in the P1/P2 segment of posterior cerebral artery (10 cases) and the A1/A2 segment of anterior cerebral artery (9 cases). There was no significant difference in etiology between the groups with different infarction location and the groups with different infarction size (P>0.05). Forty-four cases (84.6%) had a good prognosis, and 8 cases (15.4%) had a poor prognosis. Combined with multiple risk factors, multiple involvement of lesions and large infarction size were associated with poor prognosis (P<0.05). Conclusions Acute isolated corpus callosum infarction is a rare type of ischemic stroke, with the most common involvement of splenium. Its clinical manifestations are mostly nonspecific, and a few may be manifested as disconnection syndrome. The etiology is mostly LAA, and the overall prognosis of such patients is good, and the poor prognosis may be related to the combination of multiple risk factors and the wide range of infarcts.
Objective To investigate the current leadership status of public hospital pharmacies, and to provide evidence and suggestions for further improving the performance of public hospital pharmacies. Methods According to our conception of the key characteristics of leadership, we designed a questionnaire to investigate leadership practices among 306 managers and pharmacists working in 74 public hospital pharmacies. We used percentage and proportion for statistical description. Results (1) Over 70% of participants thought that public pharmacies lacked independent decisiveness; power was distributed; and elections were democratic. (2) Nearly 60% thought that public pharmacies lacked effective communication and awareness of service. (3) Nearly 70% thought that leader’s abilities were not exceptional. (4)There were not obvious advantages or disadvantages among the leaders. (5) Half trusted the leaders and thought there should be no change. Conclusion Public hospitals should grant more power to pharmacies to implement effective leadership.
ObjectiveTo investigate clinical characteristics and surgical treatment of patients with non-malignant esophageal-tracheal/bronchial fistula.?Methods?We retrospectively analyzed clinical data of 12 patients with non-malignant esophageal-tracheal/bronchial fistula who underwent surgical repair in Peking Union Medical College Hospital from January 2002 to October 2011. There were 6 males and 6 females with a mean age of 49.8 years (ranging from 32 to 72 years). There were 7 patients with esophagotracheal fistula，1 patient with esophagobronchial fistula，2 patients with gastro-bronchial fistula after esophagectomy for esophageal cancer，and 2 patients with esophageal diverticulum bronchial fistula. Nine patients underwent surgical repair via right thoracotomy approach，and 3 patients via left thoracotomy approach. Seven patients underwent esophageal fistula and tracheal fistula repair，1 patient underwent esophageal fistula and bronchial fistula repair，2 patients underwent gastric fistula and bronchial fistula repair，1 patient underwent esophagectomy, gastroesophageal anastomosis and left lower lobectomy, and 1 patient underwent esophageal diverticulum repair and left lower lobectomy.?Results?All the patients recovered well from surgery with no perioperative complication or in-hospital death，and resumed oral intake 7-10 days after surgery. Three months to 1 year postoperatively, regular examinations including upper gastroenterography and fibrobronchoscopy found no sign of tracheal/bronchial stenosis or esophageal stenosis，and no patients needed stent implantation or dilatation treatment. All the patients were followed up from 3 months to 10 years and had a good quality of life during follow-up.?Conclusion?Excluding malignant etiology and determining the exact fistula location are key points of clinical diagnosis for esophageal-tracheal/bronchial fistula. Adequate preoperative nutritional support and 1-stage surgical repair can lead to satisfactory clinical outcomes.
Objective To investigate the current situations of operation management and corporate culture in the public hospital pharmacies, and to provide the evidence and suggestions for improving the performance of the public hospital pharmacies. Methods According to the principles and study methods of operation management and corporate culture, we designed the questionnaire to investigate the operation management and corporate culture among 306 managers and pharmacists working in 74 public hospital pharmacies. We used percentage and proportion for statistical description. Results (1) Over 70% participants considered that the public pharmacies lacked in consciousness of service and quality and that they cooperated as their clear responsibilities. (2) Nearly 60% considered that the public pharmacies lacked in awareness of costs and efficiency. (3)Nearly 50% thought that they could not get information in time and communicate enough. (4) About 50% considered that the working processes needed improvement. (5) About 60% realized corporate culture promoted pharmacies.Conclusion Public hospital pharmacies need to improve operation management and foster unique corporate cultures to enhance comprehensive competitive strength.
Objective To investigate the current status of management and operation in the public hospital pharmacies, and to provide the evidence and suggestions for improving the performance of the public hospital pharmacies. Method According to the principles and methods of business diagnosis, we designed the questionnaire to investigate the ideas of management and operation among 306 managers and pharmacists working in 74 public hospital pharmacies. We used percentage and proportion for statistical description. Result (1) Over 70% participants understood the strategic positioning, brand and development of hospital pharmacy. They had very b senses of innovation and risk awareness, and the comprehensive understanding to the risk and competitive factors. (2) Over 60% considered that the public pharmacies lacked in the awareness of the market competition and crisis, clear management plans as well as the active adaptation to market changes. They were also short of professional dedication and innovation capacity. (3) 52% thought that there was promising future of the public hospital pharmacies. Conclusion The public hospital pharmacies urgently needs the improvement and innovation of the management idea and models.
The authors made a profound review on the development and the recent status of craniomaxillofacial surgery in China during past three decades. The emphases were placed on the following aspects: the modifications of the reconstructive procedure and minimal invasive mode, the researches on molecular genetic characteristics of the congenital craniofacial malformations, the clinical applications of three-dimensional digital computer-aided techniques (including three-dimensional printing and prefabricated template for precious osteotomies), the craniomaxillofacial defects reconstructing by using the distraction osteogenesis and osseous integrated titanium implant and prothesis, etc. Finally, the authors outlooked prospectively the future trends of the craniomaxillofacial surgery.