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Objective:To explore abnormal microstructural changes of white matter in patients with white matter lesions(WML) using diffusion tensor imaging(DTI), and to determine the association of such abnormalities of DTI parameters with executive function.Methods:Totally 34 patients with WML were recruited from the department of Neurology, Beijing Tiantan Hospital, Capital Medical University from March 2012 to May 2019.All patients with WML were scored with Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA), and assessed with Montreal cognitive assessment (MoCA) and clinical dementia rating(CDR). They were divided into WML-cognitive normal group, WML-vascular cognitive impairment-non dementia group and WML-Dementia group.The Stroop color and word test (SCWT), trail making test-A (TMTA), digit symbol test and verbal fluency test were carried out to evaluate executive function.In addition, the healthy elderly without WML lesions were selected as the control group after they were examined by MRI, and all brains of the subjects went through DTI with Siemens 3.0 T MR.The data were collected and analyzed by voxel based analysis (VBA). The anisotropy and mean diffusion coefficient of DTI in the region of interest (ROI) and other regions in the brain were studied in the four groups, and their correlation with scores of executive function in WML patients was analyzed.Results:(1)In these executive function test, there were significant differences between the patients with cognitive impairment (WML-VAD group, WML-VCIND group) and normal cognition group(WML-CN group, NC group), such as SCWT(B)(65.54±6.24 vs 43.67±0.95, 76.75±2.13 vs 43.67±0. 95, 65.54±6.24 vs 43.66±1.81, 76.75±2.13 vs 43.66±1.81), SCWT(C)(88.58±6.76 vs 61.63±1.31, 96.37±1.47 vs 61 63±1.31, 88.58±6.76 vs 66.31±8.19, 96.37±1.47 vs 66.31±8.19), TMTA(40.47±2.76 vs 30.92±0.47, 44.24±1.43 vs 30.92±0.47, 44.24±1.43 vs 31.99±2.07, 40.47±2.76 vs 31.99±2.07), TMTB(88.66±6.55 vs 80.34±0.61, 96.70±1.72 vs 80.34±0.61, 88.66±6.55 vs 83.10±5.91, 96.70±1.72 vs 83. 10±5.91), Digit Symbol Test(39.25±5.63 vs 47.00±2.55, 31.27±3.93 vs 47.00±2.5, 39.25±5.63 vs 48.86±4.34, 31.27±3.93 vs 48.86±4.34) and Verbal Fluency Test(8.94±1.00 vs 11.71±0.47, 6.64±0.81 vs 11.71±0.47, 8.94±1.00 vs 10.86±0.69, 6.64±0.81 vs 10.86±0.69) scores ( P<0.05); In the patients with cognitive impairment, there were significant differences between WML-VAD group and WML-VCIND group, such as SCWT(B), SCWT(C), TMTA, TMTB, digit symbol test and verbal fluency test scores ( P<0.05); There were significant differences between WML-CN patients and NC group in the scores of SCWT (C), verbal fluency test( P<0.05). (2)FA values in the genu of corpus callosum and the inferior longitudinal fasciculus were negatively correlated with the time of SCWT (B), SCWT (C) and the TMTA( r=-0.436--0.471), but positively correlated with the scores of digit symbol test and verbal fluency test( r=0.428-0.573). MD values in the genu of corpus callosum, the superior/inferior longitudinal fasciculus and the inferior fronto-occipital fasciculus were positively correlated with the time of SCWT (B), SCWT (C) and TMTA( r=0.432~0.609), but negatively correlated with the scores of digit symbol test and verbal fluency test( r=-0.424--0.630, all P<0.003125 after emendation). Conclusion:The executive function of patients with WML-Dementia decreases significantly.The more serious the damage of white matter microstructure, the more serious the damage of executive of function.
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Objective@#To analyze the curative effect and nursing care of MAP complicated with paralytic intestinal obstruction by modified retention enema and traditional retention enema.@*Methods@#Select Queshan People′s Hospital from May 2013 to May 2018 treated 250 cases of acute pancreatitis patients with paralytic ileus, according to random number table method to all of the patients were randomly divided into two groups, control group and test group two groups of patients were given conventional treatment nursing of acute pancreatitis, which on the basis of the control group patients give traditional retention enema treatment, while the experimental group patients give improved retention enema surgery treatment; Total enema times, liquid retention time and remission time of PI symptoms after enema were recorded for the two groups, and laboratory indicators such as comfort level, C-reactive protein level and serum creatine phosphokinase were compared between the two groups.t@*Results@#The comfort rate of the experimental group was 84.00% (105/125), and that of the control group was 61.60% (77/125). The difference between the two groups was statistically significant (χ2=13.034, P<0.05). After treatment, the total enema frequency, drug retention time, and PI symptom relief time were (4.10±1.23) times, (25.39±4.28) min, (2.53±0.81) d, and the control group were (6.29±2.19) times, (8.72±2.11) min, (3.92±1.23) d, the difference between the two groups was statistically significant (t=5.203, 9.349, t=5.293, both P<0.05). The levels of creatine phosphokinase in the experimental group were (87.39±76.20), (103.24±75.38), (70.92±64.22) U/L after 1, 3, and 5 days of hospitalization, and the control group was (106.28±81.29), respectively. 213.29±73.29), (175.28±58.99) U/L, the difference between the two groups was statistically significant (t=19.276, 24.334, 25.394, both P<0.05). There was no significant difference in the C-reactive protein level between the experimental group and the control group (P>0.05). The C-reactive protein levels were (11.72±2.36) and (9.52±2.17) after 3 days of hospitalization and 5 days after hospitalization, the control group were (14.02±2.37), (11.08±2.76), and the difference between the two groups was statistically significant (t=15.342, 13.029, both P<0.05).@*Conclusion@#Compar enema, the modified retention enema can effectively reduce the total enema times of the patients, prolong the retention time of the patients' liquid while maintaining the temperature, and greatly shorten the remission time of the patients'PI symptoms. It is worth popularizing in clinic to improve the patients' comfort, C-reactive protein, serum creatine phosphokinase and other laboratory indexes.
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Objective To analyze the curative effect and nursing care of MAP complicated with paralytic intestinal obstruction by modified retention enema and traditional retention enema. Methods Select Queshan People′s Hospital from May 2013 to May 2018 treated 250 cases of acute pancreatitis patients with paralytic ileus, according to random number table method to all of the patients were randomly divided into two groups, control group and test group two groups of patients were given conventional treatment nursing of acute pancreatitis, which on the basis of the control group patients give traditional retention enema treatment, while the experimental group patients give improved retention enema surgery treatment; Total enema times, liquid retention time and remission time of PI symptoms after enema were recorded for the two groups, and laboratory indicators such as comfort level, C_reactive protein level and serum creatine phosphokinase were compared between the two groups.t Results The comfort rate of the experimental group was 84.00% (105/125), and that of the control group was 61.60% (77/125). The difference between the two groups was statistically significant (χ2=13.034, P<0.05). After treatment, the total enema frequency, drug retention time, and PI symptom relief time were (4.10±1.23) times, (25.39± 4.28) min, (2.53±0.81) d, and the control group were (6.29±2.19) times, (8.72±2.11) min, (3.92±1.23) d, the difference between the two groups was statistically significant (t=5.203, 9.349, t=5.293, both P<0.05). The levels of creatine phosphokinase in the experimental group were (87.39 ± 76.20), (103.24 ± 75.38), (70.92 ± 64.22) U/L after 1, 3, and 5 days of hospitalization, and the control group was (106.28 ± 81.29), respectively. 213.29±73.29), (175.28±58.99) U/L, the difference between the two groups was statistically significant (t=19.276, 24.334, 25.394, both P<0.05). There was no significant difference in the C_reactive protein level between the experimental group and the control group (P>0.05). The C_reactive protein levels were (11.72 ± 2.36) and (9.52 ± 2.17) after 3 days of hospitalization and 5 days after hospitalization, the control group were (14.02±2.37), (11.08±2.76), and the difference between the two groups was statistically significant (t=15.342, 13.029, both P<0.05). Conclusion Compar enema, the modified retention enema can effectively reduce the total enema times of the patients, prolong the retention time of the patients' liquid while maintaining the temperature, and greatly shorten the remission time of the patients'PI symptoms. It is worth popularizing in clinic to improve the patients' comfort, C_reactive protein, serum creatine phosphokinase and other laboratory indexes.
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Objective To explore the feasibility of transesophageal echocardiography (TEE) guided transthoracic incision closure of aortic sinus aneurysm rupture (RASA).Methods Data of 30 patients with RASA underwent TEE guided transthoracic incision closure of RASA were retrospectively analyzed.The distance between the coronary artery ostium and crevasse was measured in right coronary sinus aneurysm rupture patients.During the operation,the guide wire and sheath pipe were guided accurately into rupture mouth of aortic sinus aneurysm with TEE.After the operation,the position of closure and the function of aortic valves were checked carefully,while in right coronary sinus aneurysm rupture patients,coronary ostium should not be occluded by the occluder.Results Totally 20 of 30 patients accepted interventional treatment successfully.Right coronary sinus aneurysm rupture was found in 10 patients,including 7 with rupture developing into right ventricle and 3 with rupture into right atrium.Posterior coronary sinus tumor rupture was found in 10 patients,including 8 with rupture developing into right atrium and 3 with rupture into right ventricle.Patients who received intervention treatment successfully had stable vital signs,and no obvious changes of heart cavity structure and cardiac function was found.Postoperative multiple reexaminations showed all patients had normal closure position,aortic valve opening and closing movement was normal.No stenosis,reflux signal nor residual shunt were found.Conclusion RASA can be diagnosed accurately with TEE,and the occluder can be placed guided by TEE.TEE guided transthoracic incision closure of RASA is a feasible method.
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Objective To explore abnormal microstmctural changes of white matter in patients with white matter lesions using diffusion tensor imaging(DTI),and to determine the association of such abnormalities of DTI parameters with cognitive function.Methods The objects who have already confirmed with WML were collected from March 2012 to February 2018 through magnetic resonance imaging (MRI) scan from the neurology department of Beijing Tiantan Hospital.Use The hamilton depression scale(HAMD) and the hamilton anxiety scale (HAMA) to eliminate anxiety and depression,and divided into WML-CN group,WML-VCIND group and WML-VAD group with Mini-mental state examination (MMSE),Montreal Cognitive Assessment (MOCA)and clinical dementia rating(CDR).In addition,select the healthy elderly people without WML by MRI scan as the normal control group.All of the subjects were detected with the superconduct magnetic resonance imaging system (German SIEMENS 3.0T) for the DTI scanning.Original images were processed with VBA.Then explore the changes of FA and MD of DTI in whole brain and regions of interest in NC group,WML-CN group,WML-VCIND group and WWML-VAD group,and its correlation with the severity of cognitive impairment in patients with WML.Results The damage degree of the fiber microstructure of brain white matter was significantly correlated with the total grade point of MoCA (P＜0.01).In figure FA,the variance analysis of F test results showed that the significant brain areas were the splenium of the corpus callosum,the genu of corpus callosum,bilateral posterior internal capsule,retrolenticular part of internal capsule,anterior thalamic radiation,partial inferior longitudinal fasciculus and inferior fronto-occipital fasciculus,cingulate,external capsule,upper and posterior part of the radiation crowns,partial superior longitudinal fasciculus,etc.(P＜0.05 after FWE correction based on TFCE method).In Figure MD,the variance analysis of F test results showed that the statistically significant brain areas mainly included the left external capsule and hook,partial genu and splenium of corpus callosum,Bilateral,bilateral inferior fronto-occipital fasciculus,inferior longitudinal fasciculus,anterior thalamic radiation,retrolenticular part of internal capsule,cingulate,etc (P＜ 0.05 after FWE conection based on TFCE).Conclusion No matter whether cognitive impairment exists in patient with WML or not,all DTI parameters are different from those of normal people.The integrity of white matter fiber has been damaged with different degrees.The more severe the cognitive impairment in the external manifestations of patients with WML,the greater the damage to the intrinsic white matter microstructure.
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Objective To study the effect of white matter lesions location on cognitive function by comparing the correlation between the anatomical location of white matter lesions and cognitive function in leukoaraisosis(LA)patients. Methods A total of 75 LA patients with different degrees of white matter le-sion were randomly recruited.The modified Scheltens scale,Manolio scale and Fazekas scale were utilized to assess the severity of white matter lesions(WMLs)by two physicians.Montreal cognitive assessment (MoCA)was used to evaluate the cognitive function.The correlation between WMLs location and cognitive function was analyzed by spearman rank correlation analysis.The t-test was used to test the differences of periventricular white matter lesions with cognitive impairment(PWMLs-CI)and periventricular white matter lesions with cognitive normal(PWMLs-CN)in each goup. Results For Fazekas scale,PWMLs were signifi-cantly correlated with the decrease scores of MoCA score(r=-0.388,P=0.007),visuospatial and executive (r=-0.466,P=0.000),delayed recall(r=-0.461,P=0.001),abstraction(r=-0.355,P=0.011)and ori-entation(r=-0.337,P=0.016)(P<0.05).For Scheltens scale,PWMLs was negatively correlated with MoCA score(r=-0.390,P=0.003),visuospatial and executive(r=-0.464,P=0.000),delayed recall(r=0.484, P=0.000),attention(r=-0.375,P=0.008)and orientation(r=-0.342,P=0.013)(P<0.05),but not in deep white matter lesions(DWMLs)(P>0.05).Compared with PWMLs-CN,executive function(42.13 ± 0.89),attention(16.36±1.24)and visuospatial(2.25±0.31)in PWMLs-CI had statistical significance(P<0.05). Conclusion White matter lesions location affect cognitive function,PWMLs are more closely related to cognitive impairement,characterized by executive function,attention and visuospatial aspects.
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Objectives: To explore the feasibility of aortic dissection (AD) occlusion via mini-thoracotomy by trans-esophageal echocardiography (TEE) guidance. Methods: Pre-operative TEE was conducted in 2 AD patients, the findings were compared with trans-thoracic echocardiography (TTE) to confirm the diagnosis with quantitative evaluation in order to accurately guiding the wire and sheath pipe into the rupture crevasse of AD for assessing the position, stability and the effect of closure device on local blood flow. Results: TEE confirmed that 2 patients could be treated by interventional plugging and the crevasses of AD were successfully blocked by TEE guidance. Case 1 had DeBakey II AD, crevasse shunt disappeared upon blocking, false lumen formed thrombosis, the diameter reduced form 40 mm to 28 mm and the cavity was retracted about 40%. Case 2 had the ulcer type AD located in aortic arch, closure device was closely suit to aortic wall, spread well and crevasse shunt disappeared;blood flow in aortic arch was about 110 cm/s which was similar at pre- and post-operation, no vascular stenosis and local dilatation were found, vital sign was stable. Follow-up TTE was performed at 1 month after the operation which showed the position of closure devices were normal in both patients. Conclusions: TEE could effectively confirm pre-operative AD diagnosis and provide intuitive image and quantitative information for accurately guiding closure position and evaluating surgical result. Mini-thoracotomy with TEE guidance is feasible for interventional therapy of AD.
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@#A lot of researches indicate the relationship between cognitive impairment and functional connectivity of default mode network,salience network and central executive network.The changes of networks are various in different cognitive dys-function.It is important to apply resting state functional magnetic resonance in the old adults with cognitive dysfunction.
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Objective To explore the clinical characteristics of cognitive impairment in different age groups with the same severity of white matter lesions.Methods This study involved 110 consecutively recruited patients with white matter lesions(WMLs)from the Department of Neurology at Beijing Tiantan Hospital from August 2014 to March 2017.Patients were aged from 50 to 85 with a mean age of 63.1±9.7,and they were divided into an elderly group with a mean age of 71.6±5.2 (range:65-85 years)and a middle aged group with a mean age of 54.8 ± 3.4 (range:50-60 years).The severity of white matter lesions was evaluated with the Fazekas scale.MoCA was used to evaluate the cognitive function of patients.Results For Fazekas 1,the MoCA score was 25.5 ± 2.2 in the elderly group and 28.1 ± 1.4 in the middle aged group(t =6.946,P =0.000);the score for visuospatial and execution abilities was 3.8 ± 0.9 in the elderly group and 4.5 ± 0.6 in the middle aged group(t =3.7 2 6,P =0.0 2 3);the score for delayed memory was 2.7 ± 1.5 in the elderly group and 4.0 ± 1.0 in the middle aged group(t =4.365,P =0.018).For Fazekas 2,the MoCA score was 22.5±2.5 in the elderly group and 24.1 ± 1.5 in the middle aged group(t =3.361,P =0.034);the score for visuospatial and execution abilities was 2.8 ± 1.2 in the elderly group and 3.8 ± 0.8 in the middle aged group(t=6.473,P=0.007);the score for concentration was 4.6± 1.3 in the elderly group and 5.6±0.5 in the middle aged group(t=0.491,P=0.721).For Fazekas 3:the MoCA score was 15.2 ± 3.4 in the elderly group and 19.4 ± 2.8 in the middle aged group(t =4.709,P =0.001);the score for visuospatial and execution abilities was 1.8 ± 1.1 in the elderly group and 2.8± 1.4 in the middle aged group(t =1.563,P =0.043);the score for concentration was 3.3± 1.1 in the elderly group and 4.4± 1.4 in the middle aged group(t=2.231,P=0.026);the score for orientation was 4.2 ± 1.3 in the elderly group and 5.7 ± 0.5 in the middle aged group (t=3.255,P =0.000).Conclusions WMLs can increase the risk of vascular cognitive impairment and cause decline in multiple cognitive functions in both middle aged and elderly people.Cognitive dysfunction in age-related WMLs is mainly characterized by impairment in visuospatial and execution abilities.
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@#Objective To study the relationship between executive function and activities of daily living for patients with periventricular white matter lesions (PWMLs). Methods From January, 2016 to January, 2017, 35 PWMLs patients and 35 normal controls were collected. Their executive function and activities of daily living were assessed with neuropsychological tests and Activities of Daily Living Scale (ADL).Results Compared with the normal control group, the scores of Mini-Mental State Exam (MMSE) and Montreal Cognitive Assessment (MoCA) significantly decreased (t>13.726, P<0.001), the times of Trail-Making Test and Stroop Colour Word Test significantly lengthened, the Verbal Fluency Test score decreased (t=6.891, P=0.013) and the Digit-Symbol Substitution Test score did not improve (t=3.372, P=0.072) in PWMLs group. The Z score of executive function was positively correlated with ADL score (r=0.438, P=0.008).Conclusion The executive function and activities of daily living are impaired in PWMLs patients, and their activities of daily living is related to the severity of the executive function impairment.
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@#The most important characteristic of post-stroke anomic aphasia is disorder in nomenclature, but the location of brain injury has been unclear. In recent years, it was found that, based on T1WI of MRI, the location is uncertain in chronic anomic aphasia after stroke, but it is mostly in temporal lobe of the dominant hemisphere in acute stage. Based on diffusion tensor imaging, the subcortical white matter, especially the left subfrontal white matter plays an important role in the naming process. The fMRI studies found that anomic aphasia is related to the destruction of the connections among some specific gray matter brain regions, named brain network theory. The cognitive psychology theory suggested that language processing can be further divided into different steps, each step is responsible for different brain regions; for different kinds of words, such as verbs and nouns, the processing involves different regions.
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Post-stroke aphasia refers to acquired language disorder caused by cerebrovascular disease.As part of cognitive function,language is closely related with other non-linguistic cognitive function.In recent years,many scholars have begun to pay attention to the relationship between language disorder and non-verbal cognitive function in patients with post-stroke aphasia.This paper describes the epidemiology of cognitive impairment in patients with post-stroke aphasia,and summarizes the relationship between language obstruction and the non-language-based cognitive function in patients with aphasia after stroke (such as working memory,attention,execution,etc.) to provide a direction for further research.
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Objective To explore the effect of leukoaraiosis (LA) on the efficiency of the brain function network and to analyze the features of the "small world" network with graph theory method.Methods This study involved 34 LA patients from the Department of Neurology,Beijing Tiantan hospital,Capital Medical University from January 2014 to September 2015 and 23 age-and sex-matched healthy controls(NC group).All participants underwent the neurocognitive tests including M MSE,MoCA and clinical dementia rating(CDR).The subjects were divided into LA with cognitive normal group (CN) (n=11) and LA patients with vascular cognitive impairment-non dementia group(VCIND) (n=23).Functional MRI (fMRI) was employed at resting state.And then,the functional network establishment and small-world network metrics (characteristic clustering coefficient and path length) were computed using graph analytical methods.Results In the range of 0.05 ≤ Kcost ≤ 0.5,the functional networks fitted the definition of small-worldness in LA (CN),LA(VCIND) and NC groups(δ＞1).The Lambda of group LA(CN) and LA (VCIND) were smaller than that of NC group at each threshold,and more closing to 1.The gamma of group LA(CN) were higher than that of NC group at each threshold.While the gamma of group LA(VCIND)were lower than that of NC group at each threshold.The sigma of group LA(CN) were higher than that of NC group at each threshold.Conclusion The LA patients exhibit abnormal small-world network properties.And compared with HCs,small world properties in LA (CN) patients have been increased,while that in LA (VCIND) patients have been reduced,which manifested that the altered topological properties may be responsible for cognitive dysfunction in LA patients.
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Objective To observe the effects of buyang huanwu decoction combined with sarpogrelate hydrochloride in the treatment of elderly diabetes mellitus associated with lower extremity arteriosclerosis obliterans(ASO). Methods 102 patients with diabetic lower limb ASO enrolled in Tongde hospital from December 2014 to December 2016 were divided into the experimental group and the control group according to the treatment way, with 51 cases in each group. The control group was treated with sarpogrelate hydrochloride, the experimental group was treated with buyang huanwu decoction based on the basis of control group, both groups was treated for two months. The clinical curative effect, the dorsalis pedis artery blood flow, ankle brachial index, claudication distance, and adverse reactions occur was compared and observed between two groups. Results The total effective rate of the experimental group was 92.16% higher than 76.47% of the control group (P<0.05). The dorsalis pedis artery blood flow, ankle brachial index, claudication distance of experimental group was higher than the control group (P<0.05). There was no significant difference in adverse reactions between the two groups. Conclusion The effect of buyang huanwu decoction joint sarpogrelate hydrochloride in the treatment elderly diabetes ASO, can relieve body blood, blood fat, blood sugar state, promote patient recovery.
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Objective To observe the effects of buyang huanwu decoction combined with sarpogrelate hydrochloride in the treatment of elderly diabetes mellitus associated with lower extremity arteriosclerosis obliterans(ASO). Methods 102 patients with diabetic lower limb ASO enrolled in Tongde hospital from December 2014 to December 2016 were divided into the experimental group and the control group according to the treatment way, with 51 cases in each group. The control group was treated with sarpogrelate hydrochloride, the experimental group was treated with buyang huanwu decoction based on the basis of control group, both groups was treated for two months. The clinical curative effect, the dorsalis pedis artery blood flow, ankle brachial index, claudication distance, and adverse reactions occur was compared and observed between two groups. Results The total effective rate of the experimental group was 92.16% higher than 76.47% of the control group (P<0.05). The dorsalis pedis artery blood flow, ankle brachial index, claudication distance of experimental group was higher than the control group (P<0.05). There was no significant difference in adverse reactions between the two groups. Conclusion The effect of buyang huanwu decoction joint sarpogrelate hydrochloride in the treatment elderly diabetes ASO, can relieve body blood, blood fat, blood sugar state, promote patient recovery.
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Objective To compare the clinical effects of different doses of methylprednisolone therapy for children with severe hand,foot and mouth disease (HFMD).Methods According to different dosage methods, 240 children with severe HFMD were divided into large dose group,medium dose group and small dose group,80 cases in each group.The three groups were given different doses of methylprednisolone infusion on the basis of conventional treatment:large dose group(5 ~10mg·kg· -1 d -1 ),medium dose group(3 ~5 mg·kg· -1 d -1 ),small dose group (1 ~2mg · kg · -1 d -1 ).Results The time of fever sustaining,panic ease,mechanical ventilation,duration of hypertension and heart rate recovery of the medium -dose group were (47.93 ±4.72)h,(45.54 ±2.42)h,(51.43 ± 6.85)h,(53.66 ±7.62)h,(52.45 ±7.84)h,which were significantly shorter than those of the small -dose and large -dose group(all P 0.05 ). Conclusion Medium dose of methylprednisolone in the treatment of children with severe HFMD has significant effect and less adverse reactions,which is worthy of promotion.
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Leukoaraiosis (LA) has important clinical significance;however, the neurobiological mechanism was still unclear. In this pa-per, we reviewed literatures about the clinical symptoms, pathology and imaging of LA in order to improve the understanding of the patho-logic mechanism, recognize the reversible pathological change in the earliest stage, which can help to prevent dementia.
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Objective To assess the application of intraoperative transesophageal echocardiography for occluding the rupture of aortic sinus aneurysm ( RASA ) by cardiac interventional therapy via mini thoracotomy . Methods After anesthesia transesophageal echocardiography ( TEE ) was performed in patients with RASA to confirm or correct primary diagnosis from transthoracic echocardiography( TTE) and to predict the operative effect . During the operation the guide wire and Sheath pipe were accurately guided into rupture mouth of aortic sinus aneurysm by TEE . After the operation ,the position of closure and the function of aortic valve need to check carefully . Results Collection of 38 patients with aortic sinus aneurysm rupture ,20 patients who can be received interventional therapy were select by TEE . Sixteen patients accepted interventional treatment successfully ,including 8 cases with non‐coronary sinus tumor to break into the right atrium ,5 cases with non‐coronary sinus tumor to break into the right ventricle ,and 3 cases with right coronary sinus tumor to break into the right ventricular outflow tract ( 3 cases) . The patients who received intervention treatment successfully had stable vital signs ,and no obvious changes of heart cavity structure and cardiac function in normal . Postoperative multiple reexamination ,all patients showed the normal closure position ,aortic valve opening and closing movement . And no stenosis and reflux signal ,no residual shunt was detected . Conclusions TEE can confirm or correct primary diagnosis of TTE before the operation and guide the surgery operator to place the closure correctly during the operation and evaluate the effect of the treatment after the operation .
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<p><b>OBJECTIVE</b>To evaluate the safety and the clinical value of external use of jiuyi Powder (JP) in treating plasma cell mastitis using partial least-squares discriminant analysis (PLSDA).</p><p><b>METHODS</b>Totally 50 patients with plasma cell mastitis treated by external use of JP were observed and biochemical examinations of blood and urine detected before application, at day 4 after application, at day 1 and 14 after discontinuation. Blood mercury and urinary mercury were detected before application, at day 1, 4, and 7 after application, at day 1 and 14 after discontinuation. Urinary mercury was also detected at 28 after discontinuation and 3 months after discontinuation. The information of wound, days of external application and the total dosage of external application were recorded before application, at day 1, 4, and 7 after application, as well as at day 1 after discontinuation. Then a discriminant model covering potential safety factors was set up by PLSDA after screening safety indices with important effects. The applicability of the model was assessed using area under ROC curve. Potential safety factors were assessed using variable importance in the projection (VIP).</p><p><b>RESULTS</b>Urinary β2-microglobulin (β2-MG), urinary N-acetyl-β-D-glucosaminidase (NAG), 24 h urinary protein, and urinary α1-microglobulin (α1-MG) were greatly affected by external use of JP in treating plasma cell mastitis. The accuracy rate of PLSDA discriminate model was 74. 00%. The sensitivity, specificity, and the area under ROC curve was 0. 7826, 0. 7037, and 0. 8084, respectively. Three factors with greater effect on the potential safety were screened as follows: pre-application volume of the sore cavity, days of external application, and the total dosage of external application.</p><p><b>CONCLUSIONS</b>PLSDA method could be used in analyzing bioinformation of clinical Chinese medicine. Urinary β2-MG and urinary NAG were two main safety monitoring indices. Days of external application and the total dosage of external application were main factors influencing blood mercury and urine mercury. A safety classification simulation model of treating plasma cell mastitis by external therapy of JP was established by the two factors, which could be used to assess the safety of external application of JP to some extent.</p>
Subject(s)
Female , Humans , Acetylglucosaminidase , Alpha-Globulins , Discriminant Analysis , Drugs, Chinese Herbal , Therapeutic Uses , Least-Squares Analysis , Mastitis , Drug Therapy , Plasma Cells , ROC Curve , SafetyABSTRACT
Objective To investigate the relationship between prolonged pregnancy,mode of delivery and pregnancy outcomes.Methods A retrospective analysis of the January 2009 to November 2012,406 cases of prolonged pregnancy cases.Results Select meconium staining of the vaginal trial production of transit emergency caesarean section and vaginal delivery group,the incidence of neonatal asphyxia significantly higher than the cesarean group (P＜0.05).Conclusion The prolonged pregnancy conditional vaginal delivery should be closely monitoring fetal heart rate,timing line CST monitoring patients,cervical score the first basin ratings,observation of amniotic fluid nature and progress of labor,and timely cesarean important treatment prolonged pregnancy safety measures.