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Objective:To explorethe effect of acceptance and commitment therapy on self-disclosure, coping style and post-traumatic growth in patients with ovarian cancer undergoing chemotherapy after surgery.Methods:A total of 84 patients with ovarian cancer undergoing chemotherapy after surgery were recruited from the gynecology ward of the First Affiliated Hospital of University of Science and Technology of China for randomized controlled trial, from February 2022 to October 2022. All participants were divided into the intervention group and the control group with 42 patients in each group by random number table method. The patients in control group received routine care. The intervention group was given acceptance and commitment therapy (ACT) on the basis of the control group and intervened for three cycles of chemotherapy. The scores of Distress Disclosure Index (DDI), Cancer Coping Modes Questionnaire (CCMQ), and Post-Traumatic Growth Inventory (PTGI) were compared between the two groups before and after intervention.Results:There was no significant difference in the scores of DDI, CCMQ and PTGI between the two groups before intervention ( P>0.05). After intervention, DDI scorein intervention group was (38.81 ± 5.96) points, significantly higher than that in control group (34.43 ± 4.79) points, the difference was statistically significant ( t = 3.71, P<0.01). In terms of coping styles, after intervention, the scores of five dimensions of fantasy, resignation, avoidance, catharsis and confrontation were 6.00(6.00, 8.00), 9.00(8.00, 12.00), 9.00(8.75, 11.00), 7.00(6.00, 8.00) and 20.00(16.00, 21.00) points in the invention group, compared with the control group of 8.00(7.75, 9.00), 11.00(9.75, 13.00), 11.00(9.00, 13.00), 9.00(8.00, 12.00) and 16.00(13.00, 18.50) points, the differences were statistically significant ( Z = 2.86 to 5.11, all P<0.01). The total PTGI score in intervention group was (71.43 ± 8.68) points, significantly higher than that in control group(63.98 ± 6.92) points, the difference was statistically significant ( t = 4.35, P<0.01). Conclusions:ACT can increase self-disclosure, enhance positive coping, and promote post-traumatic growth in ovarian cancer patientsundergoing chemotherapy after surgery.
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Acute respiratory tract infection is the most common infectious disease in children, which seriously threatens children′s health.Rapid and accurate etiological diagnosis is of great significance for the clinical treatment and control of these diseases.Pathogen nucleic acid test was applied and became the main method of respiratory tract infection diagnosis for its high sensitivity and specificity.To regulate the application of pathogen nucleic acid amplification test in respiratory tract infection in children, improve the diagnosis level, expert consensus on nucleic acid amplification test of respiratory pathogens in children was prepared to guide the application and promote pathogens diagnosis ability.
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Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.
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With the development of the understanding of bronchial asthma(asthma for short) and the accumulation of diagnosis and treatment experience, people realize that asthma is a heterogeneous physical and mental disease.Psychosocial stress can increase the frequency of asthma attacks in children and increase the burden of family and society.Psychosocial stress from individual, family and other levels transduces signals in the brain, which are transmitted to downstream effectors, producing effectors such as adrenocorticosteroids, enhancing Th2 and Th17 cell responses, inhibiting Treg cell responses, and influencing specific asthma related genotypes.This paper reviews the mechanism of psychosocial stress on asthma, in order to better control and treat asthma and improve the quality of life of children with asthma.
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Mycoplasma pneumoniae pneumonia (MPP) is a clinical common respiratory tract infectious di-sease.In recent years, the number of children with severe and refractory MPP has increased significantly.Clinical symptoms of MPP are usually atypical, and some MPP cases are accompanied with extrapulmonary complications.In addition, imaging features of MPP also lack specificity.The diagnosis of MPP, as a result, often relies on laboratory examinations.The present study demonstrated the clinical significance in laboratory diagnosis of Mycoplasma pneumoniae (MP) infection, and the method to distinguish present infection, previous infection or carriers in healthy children′s respiratory tract.Moreover, the method to determine macrolide-resistant MP was also described in this study.This study aims to improve the understanding, diagnosis and treatment of MP infection.
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Objective:To investigate the treatment of Omalizumab for allergic asthma (AS) combined with atopic dermatitis (AD) in children.Methods:Five children who were diagnosed with moderate-to-severe AS combined with AD were admitted in the Department of Respiratory, Children′s Hospital of Nanjing Medical University from November 2018 to August 2020.All children were treated with standardized treatment of AS and Omalizumab.The efficacy and adverse reactions of Omalizumab treated for AD were observed.The scoring atopic dermatitis index (SCORAD), eczema area and severity index (EASI), the children′s dermatology life quality index (CDLQI) and numerical rating scale (NRS) were selected, the scales were used to evaluate the severity, area, itching and quality of life of AD children.Results:The AD-related evaluation indexes were remarkably decreased through the treatment of Omalizumab for 4 months, including SCORAD, EASI, CDLQI, and NRS(60.80±10.79 vs.40.30±15.62; 13.93±6.81 vs.6.18±2.70; 18.80±6.26 vs.13.20±4.82; 8.60±0.89 vs.6.00±1.87), the differences were statistically significant ( t=7.833, 4.106, 5.199, 5.099, all P<0.05). Two children administered the combination of Omalizumab and allergen specific immunotherapy, and no adverse reactions were observed in the process of immunotherapy.Totally, 104 hypodermic injections were accepted in all children, without adverse reactions being observed. Conclusions:This study suggested that the Omalizumab treatment can significantly reduce the severity and area of AD, and improve the quality of life for children with moderate-to-severe AS combined with AD.The application of Omalizumab before the allergen specific immunotherapy can improve the immunotolerance and security.There were mild adverse reactions in the treatment with the long-term hypodermic injection of Omalizumab that has higher security.Being taken together, Omalizumab is a potential novel target drug for the treatment of AD in children, and perhaps it is an adjuvant administration for allergen specific immunotherapy.
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Mycoplasma pneumoniae(MP)is the main pathogen causing community-acquired pneumonia in children, usually treated with macrolide drugs.The type of MP genes is mainly based on PCR-RFLP(P1-restriction fragment length polymorphism analysis)and MLVA(multiple locus variable number tandem repeat analysis)typing methods.During epidemics, MP subtypes will undergo certain transformation.Studying and mastering the prevalence characteristics and transformation laws of MP subtypes can deeper understand the distribution area, prevalence year and clinical relevance of each subtype of MP.Due to the extensive use of antibiotics, the resistance of mycoplasma pneumoniae to macrolides has increased , which has become a global public health concern.Studies have shown that MP resistance is related to mutations in the V region of 23S rRNA gene domain.The improvement of typing technology also guides significance for the rational selection of antibiotics.It is imperative to carry out systematic and comprehensive molecular epidemiological studies of MP genotypes and its resistance mutations, and reveal the distribution characteristics, epidemic trends and resistance mutations of MP subtypes at the molecular level.This paper reviews the research progress of molecular epidemiology of mycoplasma pneumoniae in children, and provides ideas for the monitoring, prevention and clinical treatment of MP infection.
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Gram-positive cocci are widely distributed across the normal flora of human and animals, and may cause diverse human diseases when human immunologic function is weakened.In some severely infected patients, the diseases rapidly progress to a critically-ill condition, accompanied with a lot of complications, threatening the patients′ lives potentially.Therefore it is significant to identify the severe cases and give them appropriate antibiotics as early as possible.In this article, the clinical manifestation and antibiotic strategies of Gram-positive cocci infections were described, early identification of critically ill patients was elaborated, so as to facilitate the recognition of the severely infected patients in the early stage, give them etiological treatment, and improve the prognosis.
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Novel Coronavirus Pneumonia (NCP) is a class B infectious disease, which is prevented and controlled according to class A infectious diseases.Recently, children′s NCP cases have gradually increased, and children′s fever outpatient department has become the first strategic pass to stop the epidemic.Strengthening the management of the fever diagnosis process is very important for early detection of suspected children, early isolation, early treatment and prevention of cross-infection.This article proposes prevention and control strategies for fever diagnosis, optimizes processes, prevents cross-infection, health protection and disinfection of medical staff, based on the relevant diagnosis, treatment, prevention and control programs of the National Health and Health Commission and on the diagnosis and treatment experience of experts in various provinces and cities.The present guidance summarizes current strategies on pre-diagnosis; triage, diagnosis, treatment, and prevention of 2019-nCoV infection in common fever, suspected and confirmed children, which provide practical suggestions on strengthening the management processes of children′s fever in outpatient department during the novel coronavirus pneumonia epidemic period.
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Novel Coronavirus Pneumonia (NCP) is a class B infectious disease, which is prevented and controlled according to class A infectious diseases. Recently, children′s NCP cases have gradually increased, and children′s fever outpatient department has become the first strategic pass to stop the epidemic. Strengthening the management of the fever diagnosis process is very important for early detection of suspected children, early isolation, early treatment and prevention of cross-infection. This article proposes prevention and control strategies for fever diagnosis, optimizes processes, prevents cross-infection, health protection and disinfection of medical staff, based on the relevant diagnosis, treatment, prevention and control programs of the National Health and Health Commission and on the diagnosis and treatment experience of experts in various provinces and cities. The present guidance summarizes current strategies on pre-diagnosis; triage, diagnosis, treatment, and prevention of 2019-nCoV infection in common fever, suspected and confirmed children, which provide practical suggestions on strengthening the management processes of children′s fever in outpatient department during the novel coronavirus pneumonia epidemic period.
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Asthma is a common chronic pulmonary disease in children,and most of the children with asthma can be well controlled after standardized treatment. But there are some children with difficult-to-treat asthma in cli-nical,although the high dose of glucocorticoid atomization inhalation treatment,the clinical symptoms are still not well controlled. These children with difficult-to-treat asthma not only bring huge economic pressure to families,but also have irreversible lung function impairment and their quality of life as the disease progresses. Therefore,pediatricians need to identify the difficult-to-treat asthma,understand its etiology,and give appropriate treatment to improve the prognosis of these patients.
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Objective To evaluate the present family doctors staffing and service capacity building in Changning under the linkage reform of contracting service and health insurance payment . Methods The staffing data of family doctors were collected from the 2013-2015 annual reports ,while the data on their qualifications ,training ,job stress and competence were collected from two follow-up investigations. These data were analyzed with descriptive statistics .Results in 2016 ,the number of family doctors totaled 27000 ,up to 2.75 doctors per 10000 people.Over 97％ of the family doctors were qualification certificated.More than half of the family doctors participated in the standardized training .68.80％ (97/141)of the family doctors complained overwork.More than 80％ of the family doctors have encountered technical problems with medical services .Conclusions The number and quality of family doctors in Changning have been greatly improved to satisfy contracting services of the residents to a minimal extent. However ,more family doctors are needed ,as they still face much work stress. The family doctors call for standardized training ,better payroll and incentive mechanism ,better career development and coordinated support mechanism ,as well as better team building for greater performance .
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Objective To evaluate the motivation effect of family doctors′ contracting service and health insurance compensation mechanism from the perspective of income change and income satisfaction of family doctors .Methods The situation about salary compensation plan reform and the change of income level and structure were learnt from interviews on the management personnel and questionnaire surveys of family doctors in 2013 and 2016 .The data were subject to descriptive statistics .Results The proportion of family doctors earning between 8000 and 10000 yuan in 2016 rose to 67.16％ (90/134 ) from 18.18％ (26/143 ) in 2013.11.72％ (15/128 ) of family doctors′contracting service fee amounted to over 50％ of their income. The number of family doctors who were dissatisfied with their income has fallen by 28.52％ .There were still 51.90％ (68/131)of the family doctors who were not satisfied with their income and 24.64％ (34/138)of them held the incentives of performance appraisal as a failure .Conclusions The income of family doctors has been greatly increased in the last three years.Contracting service fee plays a key role in motivating these doctors , but three risks also need to be prevented in the process of further reform .
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Objective Under the linkage reform of family doctor service and medical insurance payment ,to study the family doctors′ career cognitive and expectations in order to improve the endogenous power of the family doctor system development ,and push forward the reform with sustainable effects .Methods All the family doctors in Changning were surveyed. There were 154 family doctors surveyed in the first phase of 2013 ,and 143 in the second phase of 2016 .The data were subject to descriptive statistics .Results About 80％ of the family doctors had a clear understanding of the family doctor system in 2016 ,with the proportion of family doctors clearly understanding their duties risen from 55.26％ (84/152)in 2013 to 61.27％ (87/142)in 2016 .Self-assessment of their work value and professional reputation were more positive significantly .70％ of them believed their social status as above average. The proportion of family doctors who were very confident/confident" in the development of community health services and family doctor system increased from 31.72％ (46/145) to 47.20％ (59/125)and from 31.72％ (46/145)to 52.42％ (65/124)respectively .Conclusions The occupational cognition and career expectations of family doctors in Changning district have been significantly improved ,which can guide their behavior towards reform objectives and propel the family doctor system progress smoothly .
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Objective@#To investigate the clinical manifestations of surfactant protein C gene (SFTPC) exon-2 c. 115G>G/T (p.V39L).@*Method@#Patients were screened for the entire coding sequence of SFTPC. Three cases from three children′s hospital with mutation in p. V39L were reported.@*Result@#All the three cases were females. The age of onset ranged from 2 months to 7 years. Two cases had recurrent lower respiratory tract infection and failed to thrive. One had chronic anoxia and clubbing fingers. Chest computed tomography (CT) showed diffused ground glass pattern, localized emphysema and intralobular septal thickening. In one case, early sign of cyst formation was also shown on CT. Two were lost to follow-up after alleviation of acute respiratory infection. One was treated with oral low-dose azithromycin and nebulized budesonide and terbutaline. She had recurrent lower respiratory tract infection in more than one year of follow-up.@*Conclusion@#Mutations in SFTPC p. V39L cause interstitial lung diseases. Clinical manifestations included recurrent respiratory tract infections, chronic lung disease. Chest CT showing diffused ground glass pattern, localized emphysema, intralobular septal thickening and early sign of cyst formation. The treatment and prognosis need further study.
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Objective To explore the risk,diagnosis,treatment and prognosis of newborns suffering from congenital latent tuberculosis infection (CLTBI) by vertical transfer of mycobacterium tuberculosis(VTRTB) from mothers with active tuberculosis (TB) mothers during pregnancy.Methods The clinical data of 7 children with CLTBI follow-up of 1-6 years in Children's Hospital of Nanjing Medical University and 2 cases from literatures were reviewed,and they were divided into simple CLTBI group (n =5) and active TB group (n =4).Combined with the maternal history,the epidemiology,clinical features,treatment,prognosis and relative factors of the children were analyzed.Results Eight mothers had active TB during pregnancy,and premature delivery rate and low birth weight rate were 55.56％ (5/9 cases) respectively.The positive conversion rates of purified protein derivative tests (PPD),acid-fast bacilli (AFB) and TB culture were 6/9 cases,0/9 cases and 1/9 cases,respectively.Positive results of T cell enzyme-linked immunospot tuberculous test (T-SPOT.TB) and TB-DNA by fluorescent quantitative polymerase chain reaction (FQ-TB-DNA) were detected in 4 cases respectively,1 of 3 patients with T-SPOT.TB and 1 of 3 patients with FQ-TB-DNA were positive.There were 5 cases with chemoprophylaxis of anti-TB drugs for 1-6 years with isonicid or rifampicin;3 cases with pulmonary hilar or mediastinal lymph nodes enlargement,and 3 cases with pulmonary diffuse punctate,nodular or patchy high density shadow in 3 cases;the rate of VTRTB in 9 cases was 8/9 (88.89％) based on laboratory examination of etiology and immunology,and the risk of active TB in infants and early childhood was close to 50％ in neonates with CLTBI;the incidence of active TB was reduced from 100％ (4/4 cases) of non-intervention down to 0 (0/5 case) of intervention.Conclusions Etiology,immunology,imaging examination of TB and clinical efficacy,can prompt active TB and retrospective diagnosis of CLTBI,and application of T-SPOT.TB and FQ-TB-DNA for early diagnosis of CLTBI has a higher applied value;prophylactic and treatment of anti-tuberculosis drugs can reduce the progression of CLTBI to active TB and improve outcomes.
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Due to infant′s special respiratory anatomy and physiology features,many airway diseases performed wheezing. Infant wheeze has a high incidence, a complex etiology and lacks of specific signs, which leads to difficulties in its etiological diagnosis and differential diagnosis. Clinicians need gather detailed medical history,do careful physical examination,make a comprehensive judgement and etiology analysis of wheezing combining with relevant auxiliary examination data.
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<p><b>OBJECTIVE</b>To evaluate the value of clinical signs in the identification of Mycoplasma pneumonia in children's community acquired pneumonia.</p><p><b>METHOD</b>We searched the Cochrane library, PubMed, CNKI, Wan Fang and VIP databases. According to the inclusion and exclusion criterias, we selected and extracted the related information in the literature. According to the QUADAS evaluation system, we established the quality evaluation standard to evaluate the quality of the included studies and analyzed the difference of the clinical manifestations between Mycoplasmae pneumoniae and non-Mycoplasma pneumoniae in children's community acquired pneumonia. We used the RevMan 5.3 software to do the meta-analysis and collected the data according to the requirements. We calculated the pooled sensitivities, specificities and 95%CIs. Then we calculated the negative and positive likelihood ratio, the ratio of the diagnosis and the pre-/post-test probabilities with 95% CIs.</p><p><b>RESULT</b>A total of 11 articles were included in the literature. In summary, the cases of the clinical signs of true positive (TP) and false positive (FP) were as follows : chest pain: TP: 287, FP: 1090; rales: TP: 1906, FP: 6886; headache: TP: 590, FP: 2051; pleural effusion: TP: 10, FP: 16; consolidation: TP: 75, FP: 83; emphysema: TP: 443, FP: 116. The pooled sensitivity, the pooled specificity, the diagnostic ratio (DOR) and 95% CI were: chest pain: pooled sensitivity: 0.12, 95% CI: 0.10-0.13, pooled specificity: 0.89, 95% CI: 0.88-0.90, DOR: 1.05, 95% CI: 0.92-1.21; rales: pooled sensitivity: 0.66, 95% CI: 0.64, 0.67, pooled specificity: 0.36, 95% CI: 0.35, 0.37, DOR: 1.12, 95% CI: 1.02, 1.22; headache: pooled sensitivity: 0.23, 95% CI: 0.21-0.25, pooled specificity: 0.80, 95%CI: 0.79-0.80, DOR: 1.16, 95%CI: 1.05-1.29; pleural effusion: pooled sensitivity: 0.04, 95% CI: 0.02, 0.08, pooled specificity: 0.98, 95% CI: 0.96, 0.99, DOR: 1.28, 95% CI: 0.56, 2.89; consolidation: pooled sensitivity: 0.32, 95% CI: 0.26, 0.39, pooled specificity: 0.87, 95% CI: 0.84, 0.90, DOR: 1.88, 95% CI: 1.23, 2.90; emphysema: pooled sensitivity: 0.22, 95% CI: 0.17, 0.29, pooled specificity: 0.73, 95% CI: 0.69, 0.77, DOR: 1.05, 95% CI: 0.68, 1.61.</p><p><b>CONCLUSION</b>The value of clinical symptoms and signs in the identification of mycoplasma pneumonia in children's community acquired pneumonia was not significant. Although the clinical symptoms/signs of chest pain, headache, rales and chest X-ray manifestations of pleural effusion, consolidation, emphysema could suggest Mycoplasma pneumoniae infection, the presence or absence of any clinical signs were not positive or negative indicators for the identification of Mycoplasma pneumoniae infections.</p>
Subject(s)
Child , Humans , Chest Pain , Community-Acquired Infections , Diagnosis , Headache , Mycoplasma pneumoniae , Pleural Effusion , Pneumonia, Mycoplasma , Diagnosis , Radiography, Thoracic , Respiratory Sounds , Sensitivity and SpecificityABSTRACT
Objective Through the analysis of cases,to improve the cognition of clinicians on extracranial vas-cular embolism diseases(VED)in children.Methods The clinical information included incidence trend,thrombophi-lia,clinical features,treatment and prognosis of 29 children with VED,who were admitted from January 201 1 to Decem-ber 201 5 in Nanjing Children′s Hospital Affiliated to Nanjing Medical University,and retrospectively analyzed.Results The annual rate of VED increased from 0 to 1 .49 per 1 0 000 hospital admissions from January 201 1 to December 201 5.In 29 cases,there were 20 male and 9 female,with an average age of 6.03 years old (2 h -1 3.83 years old).In-fants accounted for >20%(6 /29 cases).The average age of the female,non infected group,rheumatic disease group and venous thrombosis group was higher than that of the male,the infection group,the non rheumatic disease group and the arterial embolization group,but there was no significant difference(all P >0.05).Thrombophilia were as follows:in-fection disease,heart disease,kidney disease syndrome,rheumatoid disease,tumor,and twins embolization syndrome. Risk factors included central venous line,immobility,dehydration,glucocorticoids use,etc.Heart disease was the leading cause of non thrombotic embolism,while other thrombophilic diseases resulted in thrombotic embolism.Pulmonary em-bolism was mainly seen in patients with severe pneumonia,especially mycoplasma pneumoniae pneumonia (MPP ).The older the age,the more typical clinical manifestations,and significantly elevated D dimer,fibrin/fibrinogen degradation products tips VED.Treatment depends on the degree of risk.Thirty -seven point five percent(3 /8 cases)of children with arterial embolism were less than 1 year old,and the mortality 25.00% (2 /8 cases)was significantly higher than that of venous thrombosis 1 7.65%(3 /1 7 cases)and 1 1 .76% (2 /1 7 cases).Conclusion Heart disease mainly cause arterial embolism and infection,while nephritic syndrome and rheumatic disease mainly cause venous embolism.Pulmona-ry embolism is mainly seen in children with severe pneumonia,especially MPP.The risk of arterial embolization is higher than that of venous embolism.
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Objective To investigate the clinical data of Mycoplasma pneumoniae pneumonia(MPP)compli-cated with embolism in children,and to improve the understanding of the clinical features,diagnosis and treatment of the disease.Methods Six cases of MPP complicated with embolization,who were treated at Nanjing Children′s Hospital Affiliated to Nanjing Medical University from January 201 0 to June 201 5,were analyzed retrospectively.Results The ages of 6 cases ranged from 3 years and 3 months old to 1 3 years and 1 0 months old,and 3 cases were boys,3 cases were girls.All of 6 patients had high fever,positive anti -Mycoplasma IgM antibody (≥1 160)and sputum fluores-cence quantitative -Mycoplasma pneumonia (FQ -MP DNA),and all the chest imaging was consistent with pneumonia. Among 6 patients,4 cases complicated with liver function damage,4 cases had D -dimer rise,5 cases of erythrocyte sedi-mentation rate increased at different degree,while pleural effusion or pleuritis was found in 5 cases.The region of embo-lism in the cases included left renal artery in 1 case,the left popliteal artery in 1 case,the right middle cerebral artery em-bolism combined with cerebral infarction in 1 case,the right subclavian vein embolism combined with right upper extremi-ty embolism in 1 case,the basilar artery and bilateral posterior cerebral artery embolism combined with cerebral infarction in 1 case,and the other case involved the right pulmonary embolism.One case received thrombus dislodgment operation, and all of 6 cases were given the treatment including anti -infection,anticoagulation and low dose of glucocorticoid the-rapy,among whom 1 case died of cerebral hernia,and the other 5 cases improved.Conclusions MPP is often complicated with hypercoagulative state and potentialized to thrombosis,and thrombus may occur in vessels of whole body organs,and cerebral infarction had poor prognosis.Consequently,doctors should be aware of the potential risk factors for thrombosis. Early diagnosis and prompt anticoagulation and thrombolytic therapy could reduce mortality and disability rate.