ABSTRACT
The patients with trauma have a high mortality and disability rate, and the incidence of trauma is increasing year by year.Rapid and accurate diagnosis is the key to improve the prognosis of patients with trauma.The traditional diagnostic imaging techniques are X-ray and CT examination.Although X-ray examination can be completed at the bedside, its sensitivity is not high.The diagnostic sensitivity of CT examination is high, but it can not be completed by bedside.Moreover, the process of repeated transportation of patients will delay the best treatment time, even cause secondary injury.Bedside ultrasound has the advantages of fast, real-time, noninvasive and repeatable operation.With the continuous development of bedside ultrasound technology, it has been widely used in the diagnosis of trauma.This review summarized the clinical applications of bedside ultrasound in trauma patients.
ABSTRACT
Objective To observe and discus the clinical features and outcome of aseptic encephali-tis in children. Methods One hundred and one cases treated in PICU of Shengjing Hospital of China Medi-cal University and diagnosed with aseptic encephalitis from December 2009 to December 2012 were enrolled. Results The clinical manifestations, signs, laboratory examinations and outcome were analyzed retrospec-tively. Among them, 54 cases were male,47 cases were female,12 cases aged from 1 month old to 6 months old,12 cases aged from 7 months old to 1 year old,36 cases aged from 2 years old to 3 years old,12 cases aged from 4 years old to 6 years old,19 cases aged from 7 years old to 14 years old. The fever was the most common clinical manifestation, a total of 92 cases ( 91. 1%) , followed by convulsions, a total of 79 cases (78. 2%),63 cases with meningeal irritation or pathological signs positive(62. 4%). The sensitivity of elec-troencephalography( EEG) was the highest for diagnosis of aseptic encephalitis,89 cases underwent EEG with abnormal rate of 84. 3%(75/101). Followed by head MRI scan,97 cases underwent head MRI scan with ab-normal rate of 55. 7%(54/101). All cases underwent cerebrospinal fluid examination,50 cases with white blood cells and(or) protein increased(49. 5%). The sensitivity of head CT scan was the lowest,the abnor-malities were found in 11 cases ( 17. 5%) among 63 cases underwent head CT scan. All cases were given comprehensive treatment of sedation, antifebrile, reducing intracranial pressure and nerve nutrational treat-ment. Seventy cases were cured,20 cases left neurological sequelae,7 cases gave up treatment,4 cases died. Conclusion The children aseptic encephalitis occurs in infants and young children,the incidence of male and female are equal. The clinical manifestations are diverse,the most common manifestations are fever and con-vulsion,EEG and MRI are with high sensitivity. Most patients have good outcome if received symptomatic treatment early. A few cases left neurological sequelae,such as consciousness and dyskinesia. Respiratory fail-ure,neurogenic shock,eventually death would occour if the brainstem was involved.
ABSTRACT
Objective To evaluate the feasibility of prospective electrocardiogram(ECG)-gating computed tomography coronary angiography(CTCA).Methods Sixty patients with suspected or known coronary artery disease underwent 64-slice CTCA using prospective ECG-gating.Multi-planar reconstruction (MPR),curved-planar reconstruction(CPR),maximum intensity projection(MIP)and volume rendering (VR)were used to demonstrate the coronary arteries.The image quality and radiation dose was evaluated.Results The mean effective radiation dose was(2.7±0.2)mSv.93.3%(720/772)segments of all coronary arteries were of diagnostic image quality,44.2%(341/772)Was classified as excellent and 49.1%(379/772)was good.Non-diagnostic coronary segments were found in 6.7%(52/772)of all coronary arteries.Therewere 5(8.3%)cases with severe coronary stenosis(＞75%)or occlusion,17(28.4%)cases with moderate stenosis(50%-75%),18(30.0%)cases with mild stenosis(＜50%)or irregular lumen,20(33.3%)cases with normal coronary artery.Conclusion With a low radiation dose,prospective electrocardiogram(ECG)-gated coronary 64-MSCT angiography has a good potential for the detection of coronary stenosis,especially for excluding coronary artery disease.