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【Objective】 To investigate the effect of AIDET communication mode in informing blood donors of reactive viral markers results. 【Methods】 Blood donors who came FOR COUNSELLING AFTER NOTIFICATION OF THEIR REACTIVE SCREENING TEST RESULTS from Jan 2018 to Sep 2021 were selected as the subjects. They were divided into two groups according to the blood donation time and notification mode: control group who were notified by a conventional mode(n=128), from Jan 2018 to Dec 2019, and the experimental group(n=92) who were notified by AIDET mode, from Jan 2020 to Sep 2021. The anxiety state and degree of satisfaction to the notification were compared between the two groups. 【Results】 After attending COUNSELLING, the anxiety level of the experimental group was significantly lower, while the degree of satisfaction to the notification was significantly higher than that of the control group (P<0.05). 【Conclusion】 AIDET communication mode established a standardized and effective communication channel and reduced the anxiety of blood donors WHEN NOTIFYING THE REACTIVE SCREENING TEST RESULTS. Moreover, it can enhance the trust and satisfaction between donors and medical staff as well as the quality of notification, which is of great significance to promote the healthy and continuous development of voluntary blood donation.
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Objective To compare the efficacy and safety of solitaire stent thrombectomy versus intravenous thrombolysis for treatment of elderly stroke patients with acute vertebrobasilar occlusion.Methods Clinical data of 76 patients with acute vertebrobasilar occlusion at the neurology department of Anyang People's Hospital from May 2014 to July 2017 were retrospectively analyzed.Patients were divided into two groups:solitaire stent thrombectomy group (n =30)and intravenous thrombolysis group (n =46).Recanalization rates,score improvement rate in National Institutes of Health Stroke Scale (NHISS)after 24 hours of treatment,symptomatic intracranial hemorrhage rate and mortality at 90 days after treatment were compared between the two groups.Results The recanalization rate,NIHSS score improvement rate at 24 hours after treatment and the improvement rate of Modified Rankin Scale(mRS)score at 90 days after treatment were significantly higher in the solitaire stent thrombectomy group than in the intravenous thrombolysis group[86.7％ (26/30)vs.45.7％(21/46),66.7％(20/30)vs.34.8％(16/46),53.3％ (16/30)vs.23.9％(11/46),x2 =6.543,3.900 and 3.761,P =0.012,0.041 and 0.046,respectively].No significant difference in incidence of intracranial hemorrhage was found between the two groups [6.7 ％ (2/30) vs.19.6 ％ (9/46),x2=0.813,P=0.357].The mortality at 90 days after treatment were significantly lower in the solitaire stent thrombectomy group than in the intravenous thrombolysis group [0.0％ (0/30)vs.30.4％ (14/46),P =0.017].Conclusions Solitaire stent thrombectomy versus intravenous thrombolysis has better efficacy and higher safety in treating acute stroke due to vertebrobasilar occlusion in elderly patients.
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OBJECTIVE: To determine whether diffusion kurtosis imaging (DKI) is effective in monitoring tumor response to neoadjuvant chemotherapy in patients with osteosarcoma. MATERIALS AND METHODS: Twenty-nine osteosarcoma patients (20 men and 9 women; mean age, 17.6 ± 7.8 years) who had undergone magnetic resonance imaging (MRI) and DKI before and after neoadjuvant chemotherapy were included. Tumor volume, apparent diffusion coefficient (ADC), mean diffusivity (MD), mean kurtosis (MK), and change ratio (ΔX) between pre- and post-treatment were calculated. Based on histologic response, the patients were divided into those with good response (≥ 90% necrosis, n = 12) and those with poor response (< 90% necrosis, n = 17). Several MRI parameters between the groups were compared using Student's t test. The correlation between image indexes and tumor necrosis was determined using Pearson's correlation, and diagnostic performance was compared using receiver operating characteristic curves. RESULTS: In good responders, MDpost, ADCpost, and MKpost values were significantly higher than in poor responders (p < 0.001, p < 0.001, and p = 0.042, respectively). The ΔMD and ΔADC were also significantly higher in good responders than in poor responders (p < 0.001 and p = 0.01, respectively). However, no significant difference was observed in ΔMK (p = 0.092). MDpost and ΔMD showed high correlations with tumor necrosis rate (r = 0.669 and r = 0.622, respectively), and MDpost had higher diagnostic performance than ADCpost (p = 0.037) and MKpost (p = 0.011). Similarly, ΔMD also showed higher diagnostic performance than ΔADC (p = 0.033) and ΔMK (p = 0.037). CONCLUSION: MD is a promising biomarker for monitoring tumor response to preoperative chemotherapy in patients with osteosarcoma.
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Female , Humans , Male , Bone Neoplasms , Diffusion , Drug Therapy , Magnetic Resonance Imaging , Necrosis , Osteosarcoma , ROC Curve , Tumor BurdenABSTRACT
Objective To investigate infection status and distribution characteristics of human immunodeficiency virus (HIV)infection among voluntary blood donors in Xiangyang area in 2009-2014,and provide evidence for re-cruiting blood donors from low-risk population. Methods Blood specimens of 326 856 voluntary blood donors in Xiangyang area between January 2009 and December 2014 were detected anti-HIV with enzyme linked immunosor-bent assay(ELISA),positive specimens in HIV screening were performed confirmatory testing,epidemiological analysis was conducted on the positive detection results.Results 41 (0.13‰ )voluntary blood donors were con-firmed positive for HIV in Xiangyang area,positive rate among each year was significantly different (χ2 =27 801.87,P<0.01). Except marital status and infection routes,difference in positive rates among donors of dif-ferent gender,age,area,occupation,educational attainments,and number of blood donation were all significantly different(all P<0.01). Among HIV-infected voluntary blood donors,87.80% were male,41.46% and 31.71%were aged between 18-25 and 36-45 respectively,56.10% were through heterosexual transmission,and 43.90%were through male homosexual transmission. The percentage of workman and public service personnel infected with HIV were high,accounting for 21 .95% and 17.07% respectively,60.97% of confirmed positive HIV were from city area,56.10% only received junior middle school/technical secondary school education,65.85% of HIV-infec-ted persons were infected at the initial donation.Conclusion In order to ensure blood safety,blood center should in-crease publicity efforts,carry out health consultation before blood donation,and recruit blood donors from low-risk populations,nucleic acid detection should be carried out to shorten HIV detection window period.
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Thyroid cancer is the most frequent endocrine cancer and its incidence is progressively growing.Bone metastasis is are not uncommon in clinic.The efficacy is limited for patients with single treatment.However,multi-disciplinary combination therapy,combined with thyroid surgery,bone tumor surgery,nuclear medicine could get better outcomes and improve the life quality of the patients.
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Objective To investigate the present situation of institutes of rehabilitation medicine in Guangxi. Methods From March to July, 2015, all 287 hospitals in Guangxi were investigated with the Human Resource Statistics of Guangxi Rehabilitation Medicine Depart-ment and the Specialist Questionnaire of Guangxi Rehabilitation Medicine Department by E-mail through the local Health and Family Plan-ning Commissions. Results There were 125 rehabilitation medicine departments with 2146 personnels in Guangxi, 0.2 therapists per bed in average. The proportion was 1∶0.725 for rehabilitative physicians to therapists;1∶1.92∶3.14 for senior, intermediate and primary title for physicians;1∶8∶63 for therapists and 1∶5.6∶18.9 for nurses. About 91.3%of the department of rehabilitation medicine was in the tertia-ry hospitals and was able to provide the services of physical therapy, occupational therapy, speech therapy, swallowing rehabilitation, cogni-tive rehabilitation, psychological therapy and rehabilitation engineering, and so on. Conclusion Rehabilitation has made a big progress com-pared with that in 2009 in Guangxi, in term of institutes, human resources and the service ability. However, the distribution of institutions and human resources remains unbalanced.
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Objectives To evaluate the preliminary effectiveness,investigate the clinical methods and prevent the complications of the epiphysis preservation operation by using custom-made prosthesis in children with distal femoral osteosarcomas.Methods Between August 2012 and July 2013,3 patients (from 8 to 14 years old) who were diagnosed of osteosarcoma underwent tumor segmental resection and epiphysis preservation operation and reconstruction with custom-made prosthesis.Patients were assigned neoadjuvant chemotherapy 1 to 2 cycles.The effect of neoadjuvant chemotherapy was then evaluated by X-ray,CT and MRI.Patients were determined the disease field by MRI,customized prosthesis by computer and had surgery of tumor segmental resection and reconstruction with custom-made prosthesis.All individuals were given appropriate functional exercise after operation,standard chemotherapy after incision healing one week,and long-time follow-ups.Results The operation times were 3 hours,4 hours and 6 hours.The bleeding losses during operation were 300 ml,500 ml and 2200 ml,respectively.The functional scores according to the scoring system of the Musculoskeletal Tumor Society (MSTS) after 12-24 months follow-ups were 24,26 and 13,respectively.And excellent functional results were obtained in short-time follow-ups.1 patient had prosthesis infection and amputation was taken after failing in conservative treatment.Unequal lengths of both lower extremities in 2 patients were less than 2 cm.Conclusion For the pediatric distal femoral osteosarcomas that has surgical indications,a new theory and therapy idea on combination of epiphysis preservation operation with custom-made prosthesis and neoadjuvant chemotherapy and standardized postoperative chemotherapy is suggested.And it has advantages of effective curative effect,easy operation,short operative time and quick recovery.However,long-term outcomes of complications should be observed further.
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<p><b>OBJECTIVE</b>To study the difference in pathologic diagnostic accuracy among different histologic subtypes of osteosarcoma and different methods of preoperative biopsy, and the influence of diagnostic accuracy on prognosis of osteosarcoma.</p><p><b>METHODS</b>The preoperative biopsies, complete clinical, radiological and pathological data of 347 pathologically confirmed osteosarcomas were evaluated. According to the Pathological Diagnostic and Technical Specifications, the accuracy of preoperative biopsies was divided into 6 grades. 1: definite diagnosis, 2: basically definite diagnosis, 3: significant diagnosis, 4: descriptive diagnosis, 5:inadequate sampling, 6:misdiagnosis. 1 to 3 were defined as successful diagnosis,while 4 to 6 were defined as unsuccessful diagnosis.</p><p><b>RESULTS</b>Of the 347 biopsies, 252 were CT-guided needle biopsies by the radiologists, and 95 were core-needle biopsies by orthopedic surgeons without CT-guidance. The latter showed a higher overall biopsy success rate (97.9%) in all osteosarcomas. Biopsies by surgeons showed a higher biopsy success rate (95.4%) in conventional osteosarcoma, but lower success rate in telangiectatic (55.6%) and low-grade central osteosarcomas (63.7%). The accuracy of pathologic diagnosis of preoperative biopsy was related to patients' age, serum AKP level, imaging diagnosis, method of biopsy and the subtype of osteosarcoma. Comparing the groups with successful and unsuccessful diagnosis, there were significant differences in recurrence rate and mortality after operation (P<0.01).</p><p><b>CONCLUSIONS</b>The accuracy of pathologic diagnosis of preoperative biopsy are related to recurrence rate and mortality after operation. Biopsy by orthopedic surgeons without CT-guidance is reliable and safe, followed by primary diagnosis at frozen section and final diagnosis by routine pathologic sections for osteosarcomas located in the long bones of the extremities. Close integration of the preoperative pathologic diagnosis with clinical and radiological data will improve the accuracy of diagnosis.</p>
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Currently,the treatment of bone metastases is quite limited,and the effect is not significant.It is a tempting but difficult task to find valid therapy.The recent research on bone microenvironment,including the osteoblasts,osteoclasts and tumor cells et al,may provide new targets and methods for the treatment of bone metastases.
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@#ObjectiveTo observe occupational therapy combing with physical therapy on the upper limb movement function and the activities of daily living for the old stroke patient.Methods62 stroke patients with hemiplegia were divided into the observation group (occupational therapy with physical therapy) and control group (physical therapy). All patients were evaluated with Bathel Index (BI) and Fugl-Meyer Assessment (FMA) before and 3 months after treatment.ResultsThe scores of BI and FMA increased significantly in the observation group compared with the control group after the treatment (P<0.01).ConclusionOccupational therapy combing with physical therapy can obviously improve the upper limb movement function and the activities of daily living for the old stroke patient.
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BACKGROUND: Recent studies have proven the existence of the regeneration of central nervous tissue. But abjective results,such as lacked of neurogenesis after injury,also have been found in many experiments. The greatest difficulty in conventional brain transplantation or brain tissue transplantation has been the survival and development of the graft. Additionally,the stability of therapeutic effects and the rehabilitation of brain functions also need confirmation.OBJECTIVE: To investigate an approach to intrathecal injection of neural stem cells(NSCs) in stroke therapy,and observe therapeutic effects and side effects as well,so as to make the evaluation of the safety and feasibility.DESIGN: A confirmative before-after study based on stroke patients.SETTING: A neurology department in a municipal hospital and a microbiology and immunology department affiliated to a university hospital.PARTICIPANTS: From November 2002 to September 2003,26 stroke inpatients in the Neurology Department of Anyang Municipal People' s Hospital were selected. Of all the c ases,3 were diagnosed as acute cerebral hemorrhage,and the other 23 had been suffering strokes for durations ranging from 3months to 30 years,an average of (4.2 ± 6. 6) years. They were 20 male and 6female between the ages from 36 -72 years old,an average of(56.3 ± 12.7)years old. Fifteen of them were ischemic and 11 were hemorrhagic. Nineteen were associated with hypertension,2 with coronary heart disease,4 with diabetes and 4 associated with hyperlipodemia.INTERVENTIONS: On each of the 3 patients with acute cerebral hemorrhage (hematoma volume,35 - 40 mL),a microinvasive intracerebral hematoma puncture was performed,and then a suspension of NSCs were conducted to the stroke by a drainage tube. For the rest of the patients,suspensions were intrathecally administered into the subarachnoid and then flowed to the cerebral surface through cerebrospinal fluid(CSF) circulation. Afterwards,physical therapy(PT),occupational therapy (OT) and speech therapy(ST) were jointly applied to facilitate the rehabilitation of the stroke patients. Therapeutic effects was calculated according to the European stroke scale(ESS) and the Barthel Index(BI) . If ESS index went beyond or equal to 1 score,the case would be defined as effective; otherwise,it would be defined as not effective. Additionally,CT,MRI,EEG,chest x-ray,and blood biochemical variables were also measured.MAIN OUTCOMEMEASURES: Therapeutic effects and side effects were taken as main outcomemeasurements.RESULTS: Of the 23 patients who ntrathecal administration,19had positive therapeutic effect and 4 did not. Post-transplantation ESS was higher than that of pre-transplantation(54. 1 ±21.2 vs 51.4 ±21.1,t = 5.8,P = 0. 000 007 6),while post-transplantation BI also increased significantly as compared with that of pre-transplantation(41.1 ± 31.3 vs 36. 1 ± 32. 1,vasive intracerebral hematoma puncture had successful rehabilitation and regained self-care ability. Of all the patients,4 got a transitory fever and 2felt slight post-operation headache.CONCLUSION: Conclusion can be drawn from the study that stroke patients are ameliorated to various extents after neural stem cell transplantation which has no toxicity or side effects. It shows that neural stem cell transplantation is viable and feasible in improving the motor function and self-care ability in stroke patients.
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Objective To evaluate the value of spiral CT and 3D reconstruction in diagnosis and treatment of tibial plateau fractures.Methods 25 cases with tibial plateau fractures were examined with plain radiograhs,spiral CT and 3D reconstruction during July,1998 to December,2000.The tibial plateau fractures were classified according to Schatzker′s classification on the X-rays and 3D reconstruction images.On the superior view the tibial plateau fractures were divided into anterior lateral,posterior lateral,anterior medial and posterior medial fractures.Results 3D reconstruction images of 25 plateau fractures were the same as what arthroendoscopy were.25 fractures(including 23 arthroscopic management fractures)were operated under 3D reconstruction guide.No one case was infected.The treatment was valid.Conclusion Spiral CT and 3D reconstruction can offer more accurate classification and complement to new spatial classification of fractures.Also can provide better planning and management for the tibial plateau fractures.