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Objective To discuss the application of cerebrovascular intervention technique in evaluating the correlation between cerebral venous sinus and idiopathic intracranial hypertension (ⅡH).Methods The clinical data,including complete related clinical signs and symptoms,laboratory results,magnetic resonance venography (MRV) findings,etc.,of 13 ⅡH patients were retrospectively analyzed.Under local anesthesia whole brain DSA was performed,and superselective catheterization of venous sinus was accomplished to perform sectional pressure measurement of sagittal sinus,transverse sinus,sigmoid sinus and jugular vein.Results Cerebral DSA examination revealed that venous sinus stenosis or occlusion was seen in 10 patients (76.9％),including transverse sinus (n=6),sigmoid sinus (n=3),and transverse sinus together with sigmoid sinus (n=l).Superselective pressure neasurement of venous sinus showed that the pressure difference between the two ends of the narrowed venous sinus was up to 120-580 mmH20 in these 10 patients.In 8 patients (61.5％,8/13) the venous sinus stenosis and/or occlusion might be implicated in the occurrence of ⅡH,in 2 patients (15.4％,2/13) the venous sinus stenosis might be secondary to ⅡH,and in 3 patients (23.1％,3/13) the venous sinus stenosis might bear no relationship to ⅡH.Conclusion Cerebrovascular interventional angiography combined with superselective pressure measurement of venous sinus can clearly identify the relationship between ⅡH and venous sinus
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Objective To investigate the risk factors of nosocomial infections in patients with head and neck cancer during radiotherapy .Methods Clinical data of 189 patients with head and neck cancer receiving radiotherapy in Huzhou Central Hospital during August 2011 and December 2014 were retrospectively studied .Chi-square test and multivariate Logistic regression analysis were performed to explore the risk factors of nosocomial infections in patients during radiotherapy .Results Among 189 patients with head and neck cancer receiving radiotherapy , nosocomial infection was observed in 64 (33.86%) patients.Univariate analysis showed that radiation-induced oral mucositis (χ2 =11.47, P<0.01), underlying disease (χ2 =6.59, P<0.05), stage of tumor Ⅲ-Ⅳ (χ2 =4.36, P<0.05), whole-neck radiation (χ2 =7.64, P <0.05), dose of radiation ≥50 Gy(χ2 =8.92, P <0.05), combined chemotherapy (χ2 =6.53, P<0.01), invasive operation (χ2 =4.21, P<0.05), PS score=1 (χ2 =3.58, P<0.05) and low body mass index (χ2 =9.56, P <0.05) were risk factors of nosocomial infections . Multivariate Logistic regression analysis indicated that radiation-induced oral mucositis ( OR=3.46, χ2 =8.72, P<0.01),underlying disease (OR=1.91, χ2 =4.66, P<0.05), stage of tumor Ⅲ-Ⅳ (OR=2.01,χ2 =5.22, P<0.05), whole-neck radiation (OR=1.78,χ2 =4.89, P<0.05), dose of radiation ≥50 Gy (OR=1.69,χ2 =3.25, P<0.05), combined chemotherapy (OR=1.84, χ2 =6.91, P<0.05) and low body mass index (OR=1.53, χ2 =2.59, P<0.05) were independent risk factors of nosocomial infection.Conclusions Nosocomial infections are popular in patients with head and neck cancer during radiotherapy.Radiation-induced oral mucositis, underlying disease, stage of tumor, radiation field, dose of radiation, combined chemotherapy and body mass index are associated with the occurrence of nosocomial infections in these patients .
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Objective To evaluate the safety and efficacy of intra-arterial thrombolysis in patients with acute cerebral ischemic stroke.Methods Twenty-one patients with acute internal carotid circulation infraction(internal carotid 3,MCA 12,ACA 5,lenticulostriate in 1) were treated with intra-arterial thrombolysis of recombinant tissue plasminogen activator(rt-PA) which was performed within 2-6 hours of symptom onset.Recanalization was observed during the operation.Intracerebral hemorrhage(ICH) was monitored immediately and 24 h after the treatment by CT or MRI scanning.Chinese stroke scale was used to evaluate the recovery of neurological functions pre-operatively and 30 d after the treatment.Results All the 21 patients were 100% success in receiving intra-arterial thrombolysis technique and revealed 16 having the degree of recanalization of 2 to 3 grade as regards to TMI,16 patients' degree of recanalization reached 2 to 3 grade according to TMI;5 patients showed 1 to 2 grade.Symptomatic ICH was observed in 3 patients,with two dead.Arterial dissection was found in one patient.Thirty days after the operation,17 patients' cerebral function reduced over 50 percent;2 less than 50 percent;and 2 died.The patients achieved 2 to 3 grade of recanalization were obviously getting better than those achieving 0 to 1 grade.Conclusions It is adapt to have intra-arterial thrombolysis with six hours from onset;but still have the danger of severe ICH.The treatment should be started as early as possible.
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Objective To explore the relationship between t he pancreatic vascular abnormalities and pancreatic lesions, complications and pro gnosis in acute necrotic pancreatitis (ANP).Methods Seldinger procedure, DSA angiography was carried out in ANP pa tients to evaluate the alterations of pancreatic blood vessel, results were anal yzed against clinical data.Results In 40 out of 69 cases, the pancreatic blood supply showed abnormal in angiogram, t here were features of interuption, stenosis and complete obstruction. The degree of lesions and complications showed statistically significant correlation ( P