ABSTRACT
Objective To explore the application effect of a new lighted surgical aspirator in deep brain hematoma removal operation.Methods Totally 153 patients of non-traumatic basis festival area cerebral hemorrhage were randomly divided into a control group and a treatment group.Both the groups underwent clearance of intracranial hematoma and decompressive craniectomy surgical operation in the operating room,with the common aspirator involved in the control group and the lighted one in the treatment group.Results There was no significant difference between the rates of hematomal removal in the groups (P＞0.05).The treatment group had the operating time less by 59.85 min and the hospital stay decreased by 15.23 d than those in the control group (P＜0.05).The GOS score and daily viability of the treatment group was also statistically higher than those of the control group (P＜0.05),and the effective rate in the treatment group was also more than that in the control group by 24.9％ (P＜0.05).Conclusion The new aspirator solves the problems in visual field and light source,decreases the operating time and improves the disease prognosis.
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Objective To explore the recurrence of chronic hepatitis B(CHB) after stopping nucleoside (acid) analogue(NAs) and the impact of residual amount of serum hepatitis B virus(HBV) DNA on recurrence. Methods Seventy-nine CHB patients, who received treatment of NAs and achieved standard withdrawal were enrolled in this study. According to lab examination, there were 47 hepatitis B e antigens (HBeAg)-positive patients and 32 HBeAg-negative patients. Meanwhile, 33 CHB patients received lamivudine treatment (LAM group), 27 CHB patients received adefovir treatment (ADV group), and 19 CHB patients received entecavir treatment (ETV group). The biochemical and virological indicators of CHB patients′recurrence would be recorded after 48 weeks. Results There were 43 CHB patients (54.4%), whose indicators of HBV DNA turned positive after discontinuity of treatment with NAs of 48 weeks. There were 27 CHB patients (55.3%), the HBV DNA of whom turned positive among 47 HBeAg-positive patients, and 17 patients(53.1%) among 32 HBeAg-negative patients, and there was no significant difference (P>0.05). In addition, the positive conversion rate after stopping treatment with NAs of 48 weeks in LAM group, ADV group and ETV group had no significant difference:54.5%(18/33), 51.9%(14/27), 11/19, P > 0.05. Moreover, there were 36 patients (45.6%) whose index of alanine aminotransferase(ALT) increased again after discontinuity of treatment with NAs of 48 weeks . There were 20 CHB patients (42.6%) in HBeAg-positive patients, and 16 patients (50.0%) in HBeAg-negative patients, and there was no significant difference (P>0.05). The rate of ALT increase again in LAM group, ADV group and ETV group had no significant difference: 48.5%(16/33), 40.7%(11/27), and 9/19, P >0.05. According to the results of serum samples of 79 CHB patients with Roche reagent when stopping using NAs, in 35 CHB patients (44.3%) serum HBV DNA>12 × 103 U/L was detected. However, serum HBV DNA>5 × 105 U/L was detected in 25 CHB patients (71.4%)among 35 patients with serum HBV DNA > 12 × 103 U/L after 48 weeks, and merely in 18 CHB patients (40.9%) among 44 patients with serum HBV DNA < 12 × 103 U/L, and there was significant difference (P < 0.01). Conclusions The CHB patients with standard withdrawal still have high recurrence rate after stopping treating, whatever medicine was used. Then, residual amount of serum HBV DNA is an important indicator for predicting relapse of CHB. Meanwhile, the retreatment of these patients should be researched further.
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Objective To study the risk factors and pathogenesis of pulmonary infection in acute stroke patients. Methods A retrospective analysis was taken in 257 acute stroke cases to investigate the incidence of pulmonary infection and its relationship with the underlying disease, disturbance of consciousness, invasive operation,the type of pathogenic bacteria and drug susceptibility. Results The positive rate of pulmonary infection in acute stroke patients was high and related to many factors including severity of stroke, disturbance of consciousness,primary diseases, and invasive examination etc. The most popular infective bacteria were Gram-negative bacteria. The imipenem was most sensitive to Gram-negative and Gram-positive bacteria, followed by Amikacin and piperacillin too. Conclusions The pulmonary infection in cerebral stroke patients is caused by many factors, of which Gramnegative bacteria play the most important role. Identification of the risk factor and pathogenic bacteria is helpful in treating cerebral stroke infectious complications.