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Objective To explore the ART willingness and influencing factors of male HIV/AIDS patients in a special prison area in Shanghai. Methods The information was collected from face-to-face questionnaire survey of HIV/AIDS patients conducted from July 1, 2019, to December 31, 2019. Data was analyzed by univariate and multivariate analysis. The influence of social demographic characteristics, basic situation of detention, AIDS epidemiology, knowledge of AIDS ART, and family awareness on the willingness of anti-virus treatment was investigated. Results A total of 121 HIV / AIDS patients were investigated in this study. The results of multivariate analysis showed that HIV / AIDS patients who were less likely to receive ART included patients with multiple custody, patients with ART knowledge score less than 8, patients whose family members were unaware of their HIV infection, patients thought that they met the treatment standard but had no symptoms and did not need to take medicine, and patients thought that they could discontinue taking medicine at will. Conclusion A variety of factors have an impact on ART willingness of HIV/AIDS patients in custody. It is suggested that HIV / AIDS patients should be provided with more targeted ART knowledge training and social care and family support as far as possible.
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Objective To investigate the safety and efficacy of mechanical thrombectomy (MT) compared with In?tra-arterial Thrombolysis (IAT) treatment in patients with severe acute ischemic stroke (AIS) caused by large cerebral ar?tery occlusion. Method The patients with AIS caused by large cerebral artery occlusion and underwent MT or IAT from 2005 May to 2014 May was included. A retrospective analysis was conducted on the onset to emergency(OTE)time, emergency to acupuncture(ETA)time, acupuncture to recanalization (ATR) time, stroke severity as measured by the Na?tional Institutes of Health Stroke Scale (NIHSS) score, and site of arterial occlusion on magnetic resonance angiography (MRA). A comparison was made between MT and IAT patients in rates of recanalization, symptomatic intracranial bleed?ing (SIB), mortality, and functional outcome. Three-month favourable outcome was defined as a modified Rankin Scale (mRS) score≤2. Result One hundred and two AIS patients were treated with MT and 50 with IAT. There was no differ?ence between MT and IAT groups with regard to demographics, onset NIHSS score (13.37±6.95 vs. 12.70±6.11;P=0.572) and discharge NIHSS score (8.40 ± 6.69 vs. 7.53 ± 7.28, P= 0.522) and the change of NIHSS score (3.87 ± 7.14 vs. 4.26 ± 5.42, P=0.766). There were significantly differences between MT and IAT groups in the OTE time (Median 300 min vs. 120 min,Z=-5.704,P=0.000) , ATR time (Median 30 min vs. 65 min,Z=-5.011,P=0.001) ,recanalization (91.2%vs. 60.0%,P =0.01),the rate of AIB(21.7% vs. 36.0%,P =0.046),3-month mortality (16.6% vs. 26.0%,P =0.043). The above parameters were better in MT group than in the IAT group. There were no significant differences between MT and IAT groups in the rate of SIB (12% vs. 16%,P =0.055), the NIHSS change(Median 3 vs. 4,Z =-0.236,P =0.823) and mRS score on 90d ( 48.2%vs. 46.0%, P=0.823). MT patients had significantly higher percentages of stent use (22.5%vs. 8%,P=0.018) . The Recanalization for ICA(81.8%vs. 55.6%,P=0.048),BA(93.1%vs. 55.6%,P=0.032)and MCA( 97.5% vs. 60.0%,P =0.026)was higher in MT group than in IAT group .The SIB rate for ICA(13.8% vs. 33.3%,P =0.000),BA(13.8%vs. 33.3%,P=0.000)was lower in MT group than in IAT group . The mortality rate of was significant?ly lower in MT than in IAT group for MCA (2.5%vs. 20.0%,P=0.000) . the good outcome rate for BA was higher in MT group than in IAT group(41.3%vs. 22.2%,P﹤0.01). Conclusions Compared to IAT,MT can provide broader time win?dow,higher recanalization rate and better outcome in patients with severe acute ischemic stroke (AIS) caused by large ce?rebral artery occlusion.
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Objective To assess the quality of life(QOL)of advanced schistosomiasis patients,and understand its influenc-ing factors. Methods A questionnaire survey was carried out by using WHOQOL-BREF,and the information of demography, family,illness,health status,and health service was collected. Results Among the 217 advanced patients,the average age was (75.33±6.94)years,the ratio of male to female was 2∶5,89.86%of them were farmers,75.58%were illiterate or semi-illiterate, and 88.94%belonged to the splenomegaly type. Totally 61.29%of the cases had the scores over average for the overall QOL,but the scores for the health and well-being were lower. There were a significant difference among the average scores of different do-mains of QOL(χ2 =23.46,P<0.01). Both the year of being diagnosed and clinical classification was not associated with the scores of QOL. Regularly taking physical activities was significantly associated with each of all the 4 domains. The factors such as onset of acute disease in 2 weeks,taking therapeutic pills daily,marital status,age,etc. impacted the specific domains of QOL. The overall QOL and the 4 domains of the patients were at medium level;meanwhile,the score of physiological domain was lower than the scores of the other 3 domains. Conclusions The QOL(s)of advanced schistosomiasis patients in Qingpu District are rel-atively good. It is important to provide effective community health services and encourage the patients to take part in tempered sports or physical activities in order to keep their normal activities of daily living.
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This article was aimed to study the correlation among traditional Chinese medicine (TCM) syndrome elements in the first year after ischemic stroke. Data of TCM four examinations were collected among subjects all over China by cross-sectional study, using the same observing rating scale. The results showed that internal-heat, internal-wind and phlegm-damp syndrome were risk factors with obvious positive correlation. On the contrary, blood-stasis, internal-heat and qi-deficiency syndrome were in obvious negative correlation. But syndrome of yin-deficiency had no significant correlation with other syndrome elements. It was concluded that there were remarkable positive correlations on excess syndromes, such as wind, fire and phlegm. The syndromes of excess in the branch are easily to be combined.
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Objective To investigate the clinical manifestations, angiographic features and clinical significance of kinking of extracranial internal carotid artery (ICA). Methods The clinical and radiological data of 21 patients with kinking of extracranial ICA were retrospectively reviewed in our hospital from April 2003 to July 2007. Fisher exact test was performed. Results Of the 21 patients, 7 hod no clinical symptoms, the other 14 showed manifestations of cerebral iachemia with varying degree. One of the characteristic clinical manifestations that neck rotation or specific positions of head and neck might induce the occurrence of clinical symptoms was found in 5 cases. The whole-brain coverage DSA accurately showed the location of kinking of extracranial ICA and the degree of vascular stenosis. In patients with α < 66%, 80% > α≥ 66% and α≥ 80%, clinical symptoms were found in 3 out of 5,7 out of 10 and 4 out of 6 patients, respectively. Fisher exact test revealed that the positive rates of clinical symptoms in three groups had no significant difference (P > 0. 05). Conclusion Kinking of extracranial ICA is a frequent vascular morphologic variation, and it is also a kind of potential disease. The whole-brain coverage DSA is a relatively reliable method to detect this variation.
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<p><b>OBJECTIVE</b>To investigate the effect of neuroendoscope on surgery.</p><p><b>METHODS</b>315 patients were treated with neuroendoscope. Endoscopic neurosurgery (EN) was used in 219 patients, endoscope-assisted microneurosurgery (EAM) in 72, and endoscope-controlled microneurosurgery (ECM) in 24.</p><p><b>RESULTS</b>201 (91.8%) of the 219 patients underwent EN effectively. In 72 patients who underwent EAM there was less retraction during tumor removal and visual control was improved. 21 (87.5%) of the 24 patients underwent ECM effectively. No severe complications were observed.</p><p><b>CONCLUSION</b>Neuroendoscopy can reduce tissue trauma, improve visualization during tumor removal, and reduce complications.</p>
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Humans , Brain Neoplasms , General Surgery , Endoscopy , Neurosurgical Procedures , MethodsABSTRACT
OBJECTIVE To probe the possibility for CQI to raise the passing rate of hand-washing liquid. METHODS From Jul 2007 to Sep 2007,we applicated continuous quality improvement(CQI) in the management of the use of hand-washing liquid. RESULTS The failure rate of hand-washing liquid was decreased markedly (64% in July,36% in August,and in 12%September),and the difference among three months was significant (P