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Objective To investigate the long -term angiography and clinical outcome of encephalo -duro-myo-synangiosis (EDMS) for the treatment of children w ith moyamoya disease. Methods The clinical and imaging data of before and after procedure in children w ith moyamoya disease treated w ith EDMS w ere analyzed retrospectively. Results A total of 21 children w ith moyamoya disease w ere enroled, including 13 females and 8 males, aged 4 to 16 years. The initial symptom: transient cerebral ischemic attack in 15 cases, ischemic stroke in 4 cases, and hemorrhagic stroke in 2 cases. Matsushima clinical classification: type Ⅰ in 8 cases, type Ⅱ in 7 cases, type Ⅳ in 3 cases, type Ⅴ in 1 case, and type Ⅵ in 2 cases. Suzuki stage: stageⅡ in 4 cases, stage Ⅲ in 11 cases, stage Ⅳ in 5 cases, and stage Ⅴ in 1 case. Ten children underw ent bilateral operation and 11 underw ent unilateral operation (a total of 31 sides). They w ere folow ed up for 13 to 91 months (mean 39.8 months). Three children had transient ischemic attack, 2 had cerebral infarction, 7 had facial edema, and none of them died during the perioperative period. The clinical symptoms w ere improved significantly in 14 sides (45.2%), good in 13 sides (41.9%), and general in 4 sides (12.9%) 1 year after operation. The proportion of children w ith modified Rankin Scale (mRS) score 0-2 after operation w as significantly higher than that before procedure (95 .2% vs.71.4%; χ2 = 4.29, P = 0.041). The middle meningeal artery and deep temporal artery participated in the blood supply of cerebral cortex in different degrees w ere observed by cerebral angiography again for 31 sides, excelent in 25 (80 .6%) and fair in 6 (19.4%). Conclusions The long-term angiography and clinical outcome in children w ith moyamoya disease treated w ith EDMS is good.
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Objective To provide a basis for specific intervention by dynamic observation of the households'related health life behavior and the children fluorosis change trend caused by the coal-burning-borne endemic fluorosis in Pu'an County.Methods Three villages were chosen using simple random sampling method in 2011-2013 for continuous monitoring.Every monitoring year in each monitoring village,according to the principle of every household survey,10 households were selected to survey related health life behavior;,and in the monitoring village all the children aged 8-12 years old were selected for Diagnosis of Dental Fluorosis (WS/T 208-2001),and in each age group,10 urine samples (half male half female) were collected,the fluoride content was determined by the ion selective electrode method (WS/T 89-1996).Results In 2011-2013,the households stoves qualified rate,stoves correct usage rate and the corn or chili correct drying rate were all 100.00％ (30/30).The dental fluorosis incidences of 8-12 years old children were 63.60％ (332/522),25.44％ (173/680) and 14.29％ (80/560),respectively,decreased year by year (x2 =324.67,P ＜ 0.05).In 2011-2013,children urinary fluoride levels were 0.83,0.84 and 0.68 mg/L,respectively.The difference between years was statistically significant (x2 =26.89,P ＜ 0.05),and the level in 2013 was significantly lower than those of 2011 and 2012 (all P ＜ 0.01).Conclusion In 2011-2013,the residents in Pu'an have good health life behavior,and the condition of children's dental fluorosis is decreased year by year.
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Objective Colour ultrasound was used to detect the hemodynamic changes in patients with internal carotid artery kingking,in order to investigate the relationship between the carotid distortion angle and blood flow changes and to explore the assessment of severe internal carotid artery twist operation indications.Methods Forty-five patients with carotid artery kingking hospitalized in the Brain Hospital of Liaocheng were performed colour ultrasound to detect systolic blood flow velocity (PSV), end-diastolic velocity EDV) and to measure the angle of carotid artery kingking.Results According Metz classification, of the 45 patients, Ⅰ level 17 cases, Ⅱ level 17 cases, Ⅲ level 11 cases.With the decrease of carotid distortion angle,the influence on hemodynamics was more and more obvious, especially while the angle less than 30 degrees, the carotid artery blood flow was severely affected.The difference of PSV before and after Kinking was statistically significant in patientes of Metz Ⅲ level (Z=-2.934,P=0.003) and Metz Ⅱ level (Z=-3.053,P=0.002), but was statistically no significant in patientes of Metz Ⅰ level (Z=-0.382, P=0.702).There was a negative correlation between the ratio of the twist angle and PSV before kinking/PSV after kinking (rz =-0.842, P ＜0.05),that was, with the decrease of the twist angle, PSV before kinking/ PSV after kinking increase accordingly.Conclusion Kinking seriously affect the carotid artery blood flow dynamics.Ultrasound can accurately detect distortions arterial hemodynamics
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Objective To review the experience and early clinical results of eversion carotid endartotectomy (eCEA) in treatment of patients with symptomatic carotid stenosis. Methods eCEA were performed on 32 patients who suffered from the extracranial carotid stonosis. The treatment results were retrospectively reviewed. Results Thirty-two patients were successfully treated with eCEA. The symptom in 17 patients with transient ischemia attach (TIA) admitted to hospital did not recurrence, the other original symptoms of the patients had different degrees of improvement or disappeared. Two patients had TIA during 72 h after surgery, but 24 h repeatedly CTA examination without infarcts oecurring, and recovered after the treatment of small doses of urokinase. Two cases of severe swelling appeared tracheal shift incision, and went smoothly through edema by treatment of tracheal intubatian. In 4 patients headache reliefed in 2-3 d after medical treatment of the dehydration. Seven patients appeared different degree of hoarseness, and got recovery through neurotrophic medication for 1 month. No other serious complication occurred. Follow-up by 6 months, no CTA carotid artery stenosis appeared again. Conclusion eCEA is an effective method to treat symptomatic carotid stenosis.