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After COVID -19, patients, medical workers and the whole society in COVID -19 were faced with the challenge of how to quickly return to normal life. Patients cured in COVID -19 would face mental or psychological barriers, or be discriminated against, or face problems such as overweight of local epidemic prevention policies. The front-line medical personnel experienced job burnout and a variety of mental and psychological disorders, with some even developing physical symptoms. During the epidemic, ordinary people were in a state of psychological stress, education, production and economic activities were affected, and the incidence of mental or psychological disorders increases. It was necessary to provide COVID -19 patients with mental health monitoring and counseling. Give professional guidance to front-line medical staff, arrange rotation reasonably, and pay attention to their mental health status. Local governments should strictly implement the national epidemic prevention system, formulate epidemic prevention policies with humanistic care, actively publicize epidemic related knowledge and safeguard the rights and interests of the people.
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Objective To introduce the preliminary experience of using rigid neuroendoscope in repair of spinal meningocele or myelomeningocele. Methods 3 infantile patients aging between 13 months and 22 months underwent the resection and repair of spinal meningocele or myelomeningocele in May, 2013. The operations were performed under the direct visualization of the rigid neuroendoscope in the aid of the intraoperative electrophysiological monitoring. All the surgical manipulations were accomplished outside the sheath of the endoscope. Results The surgical procedures were smooth. All the patients recovered satisfactorily. There was no postoperative complication. At the one-year follow-up, they were developing normally. Conclusions The rigid neuroendoscope is useful to the resection and repair of spinal meningocele and myelomeningocele. It could simplify the surgical procedures.
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Objective To discuss the predictable factors for the occurrence of intraoperative aneurysm rupture(IAR) of anterior circulation aneurysm treated by clipping.Methods The clinical data of 96 patients with 115 aneurysms treated by clipping were retrospectively analyzed.The univariate analysis and Logistic regression analysis was performed for the risk factors of IAR such as history of hypertension,pre-operative Hunt-Hess scale,aneurysm location,aneurysm sac,aneurysm dome/neck ratio,aneurysm direction,and operation time.Results Twenty-one patients occurred IAR [18.3 ％ (21/115) of aneurysms,21.9％ (21/96) of patients] during the operation,2 patients died and 94 patients were estimated by Rank scale:0 score was for 66 patients,2 scores was for 10 patients,3 scores was for 6 patients,4 scores was for 4 patients,5 scores was for 6 patients and 6 scores was for 2 patients at 6 months after surgery.Statistic analysis revealed that history of hypertension (P =0.037),pre-operative Hunt-Hess scale (P =0.040),aneurysm direction (P =0.009),aneurysm sac (P =0.010),operation time (P =0.001) and aneurysm dome/neck ratio (P =0.029) were the predictable factors for the occurrence of IAR,while aneurysm location was not included (P =0.198).Conclusion The history of hypertension,pre-operative Hunt-Hess scale,aneurysm direction,aneurysm sac,operation time and aneurysm dome/neck ratio 1.78-2.89 are the predictable factors for the occurrence of IAR and the combination of various factors lead to the occurrence of IAR.
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Objective To investigate the effect of glutamine (Gln) on the content of reduced glutathione hormone (GSH) and aminoglutaminic acid (Glu) of spinal cord following ischemia-reperfusion injury. Methods Totally 40 healthy adult male rabbits were randomly divided into five groups: sham-operation group (S group), ischemia-reperfusion injury group (I/R group), low-dose glutamine group (L Gln group), median-dose glutamine group (M Gln group) and high-dose glutamine group (H Gln group). After glutamine preconditioning, the model of spinal cord ischemia-reporfasion injury was established according to Zivin's method. The general status of animals was observed and the changes of Jacobs scoring were recorded in each group. Malondialdehydes (MDA), GSH, Glu and superoxide dismutase (SOD) activity in lumbar spinal cord tissues were determined using chemical colorimetry. The neuron number and deviation rate in spinal cord anterior horn were observed histopathologically. Results There was no significant difference between L Gin group and I/R group in behavior scoring, SOD activity, content of MDA and Glu, neuron number and deviation rate of spinal cord (P>0.05); however, there was a significant difference in GSH content of spinal cord (P<0.05). M Gln group and I/R group differed significantly (P<0.05) in behavior scoring, SOD activity, content of MDA, Glu, GSH, neuron number and deviation rate of spinal cord. Between H Gln group and M Gln group, there was no significant difference in behavior scoring, content of MDA and Glu, SOD activity, neuron number and aberration rate in spinal cord (P>0.05), whereas there was a significant difference in SOD activity and Giu content (P<0.05). Conclusion Pretreatment with medium-dose glutamine has a protective effect on spinal cord ischemia-reporfasion injury in rabbits, which may be related to the maintenance of GSH content, increase of SOD activity and reduction of MDA.
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Objective To study the differential diagnosis o n cerebral concussion and mild cerebral contusion value of the brain type creati n e kinase isoenzyme(CK-BB),and evaluate the seriousness of brain damage and prog nosis of the patients with acute head injury.Methods Chromatographic separating and fluorometric quant ifying technique was used to detect the CK-BB activity in the cerebrospinal flu id(CSF) of 117 patients with acute head injury and 12 patients with increased in tracranial pressure and 20 normal people.Results The CSF-CK-BB activity of the patients with acu te head injury was remarkably higher than that of the normal people and the CSF -CK-BB activity increased with the seriousness of brain damage.There was a clo se relationship between CSF-CK-BB activity and prognosis,and higher activity o f CSF-CK-BB indicated poor prognosis.Conclusion CSF-CK -BB activity could be used as a new index to diagnose brain damage and evaluate the seriousness of brain damage and prognosis.
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This article analyzed the ethical situation in hospitals. The author pointed out the defect of confidence between doctor and patient is the primary cause that leaded to the deterioration of doctor-patient relation, and the retardation of medical service management is the important factor that affected the confidence construction. According to all this above, the author proposed the suggestion of strengthening the understanding and communication between doctor and patient, transforming the medical service concept, enhancing the medical service quality, completing the supervising system, increasing the hospital ability of realizing medical service defect and improving the five thoughts of follow up confidence system to direct the hospital confidence ethical construction.
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The fluctuation of medical staff thoughts and hospital rapid action during SARS epidemic, we name it "hospital phenomenon during SARS", has its specific characteristics. We analyzed this phenomenon from the following points: the conflict between panic response and the duty of the profession, the contradiction between the need to control infection and the available conditions, the special following phenomenon post - diagnosis of SARS and the hospital routine activity and SARS prevention and cure. We conclude that at least three fields should be improved, that is to strength education of duty morals, to normalize the medical procedure, and to build the dual system of hospital' s routine run and rapid action, in order to constructing hospital credit ethic.