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Background@#and Purpose Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. @*Methods@#We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). @*Results@#There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. @*Conclusions@#During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT.
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Status epilepticus is a neurological emergency with unknown pathogenesis, controversial treatment options, and poor prognosis. In recent years, with the development of 18F-flurodeoxyglucose positron emission tomography ( 18F-FDG PET) imaging technology, further studies on status epilepticus have been carried out from the perspective of molecular metabolism. This article reviews the current role of 18F-FDG PET in patients with status epilepticus on etiology, disease activity, electric activity, location of epileptogenic foci, and prognosis evaluation.
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@#Objective To study the role of ubiquitin proteasome pathway in Du Meridian moxibustion for skeletal muscle aging. Methods A total of 30 Sprague-Dawley rats were randomly separated into control group (n=10), model group (n=10) and moxibustion group (n=10). The model group and the moxibustion group were subcutaneously injected D-galactose 125 mg/kg daily for six weeks, while the control group was injected the same volume of saline. Then the moxibustion group was cauterized on Du Meridian 20 minutes a day for 20 days. The expression of ubiquitin, muscle RING finger 1 (MuRF1) and muscle atrophy F-box (MAFbx) in erector spinae were tested with Western blotting. Results The expression of ubiquitin, MuRF1 and MAFbx increased in the model group compared with that of the control group (P<0.05), decreased in the moxibustion group compared with that of the model group (P<0.05).Conclusion The Du Meridian moxibustion may regulate ubiquitin proteasome pathway to inhibit the degradation of protein, and delay muscular atrophy.
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Objective To explore integrated teaching based on small private online course (SPOC) in lymphoma clinical courses for medical undergraduates.Methods A total of 60 medical undergraduates in the department of hematology were randomly allocated to SPOC teaching group (n=30) and problem-based learning (PBL) teaching group (n=30) according to scores of the basic medical theoretical examination for lymphoma clinical courses education.After teaching activities,personal experiences were evaluated by anonymous questionnaires from medical undergraduates and instructors.Besides teaching efficacies assessed by objectively measurable score system including academic examination scores,clinical skill and capabilities in analyzing clinical problems of students,were systematically analyzed and compared between two groups by SPSS 19.0.Results The survey results showed that compared with PBL teaching group,SPOC teaching group had higher teaching feedback evaluation and better teaching experience,and SPOC were widely recognized by teachers and students.The SPOC teaching group's scores of the three items in the exam were better than those of the PBL teaching group,with the academic achievement [(84.03 ± 7.66) vs.(77.60 ± 8.22),P=0.005],the performance of practical skills [(87.83 ± 8.17) vs.(81.97 ± 6.13),P=0.001],and case analysis results [(88.17 ± 6.53) vs.(80.10 ± 6.91),P=0.000],and the difference was statistically significant.Conclusion Integrated teaching based on SPOC is feasible for lymphoma clinical courses,which can trigger interest of students,enhance learning abilities and their clinical capabilities.Moreover,this novel medical education approach may provide new ideas and theoretical basis in training qualified and talent doctors.
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OBJECTIVE To explore the condition of the cellular immune function of children with obstructive sleep apnea hypopnea syndrome(OSAHS) and its change after operation METHODS Eighty children diagnosed as OSAHS were included in this study. T lymphocyte subsets and NK cells of the blood were measured before operation and one month after operation respectively. Children without the related disorders or systemic disease were recruited as control group.RESULTS Before operation, CD4+T cell percentage, CD4+/CD8+ ratio and NK cell percentage in OSAHS children were significantly lower than that in the control group[(26.19±3.38)%vs (5.10±4.09)%, (0.90±0.19)%vs (1.61±0.52)%, (11.45±4.35)%vs (13.73±3.78)%,P0.05). CONCLUSION OSAHS may damage the cellular immune function. The operation does not reduce the cellular immune function in the short term.
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Purpose] To detect respiratory virus antigen by direct immunofluorescence method and provide evidence for early diagnosis of children with viral infection of the respiratory tract disease.[Methods] Select 398 cases of respiratory tract infection in hospitalized children, pharynx in exfoliated cells in respiratory syncytial virus by direct immunofluorescence(RSV), adenovirus(ADV), influenza virus type A(IFVA),influenza virus type B(IFVB), parainfluenza virus type 1(PIV1), parainfluenza virus type 2(PIV2) and parainflue-Nza virus type 3(PIV3) of 7 common viral antigens were detected, and carried on statistics analysis.[Results] In 398 cases of children with respiratory tract infection, 91 cases were positive, the positive rate was 22.86%. The highest for respiratory syncytial virus in 37 cases(40.66%) followed by parainfluenza virus type 3 in 19 cases(20.88%), influenza virus type B in 14 cases(15.38%); The positive rates of acute tonsillitis, capillary bronchitis, pneumonia, acute bronchitis and upper respiratory were 46.67%(14/30),40.00%(20/50), 26.67%(40/150), 18.42%(7/38), 7.69%(10/130) respectively; With the growth of age, the respiratory tract virus infection rate gradually decreased(P<0.05), one year old the viral infection rate was 76.92%;it occurred in the winter season of respiratory tract infection in children .[Conclusion] The main virus in children with acute respiratory infection in the local area is RSV. Virus infection decreases with the increase of age, treatment should be careful in the use of antibiotics.
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A three-dimensional (3D) transrectal ultrasound (TRUS) imaging system is presented in this paper. The 3D imaging system is used for diagnosing diseases of prostate. The 3D image is reconstructed by a series of two-dimensional image data which is obtained through rectum. It can be a guide to prostate needle biopsies. The system is built by two parts: hardware and software. In the hardware, the mechanical device, stepper motor, control circuit, B Mode TRUS and personal computer (PC) workshop are presented. The software includes the firmware of micro control unit and software of the PC workshop. In order to evaluate the performance of the 3D imaging system, we did experiments with water and agar phantoms, and the results demonstrated the system's ability of 3D imaging with high-precision.
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Humans , Male , Biopsy, Needle , Imaging, Three-Dimensional , Phantoms, Imaging , Prostate , Diagnostic Imaging , Rectum , Software , UltrasonographyABSTRACT
OBJECTIVE@#This study was to investigate the clinical symptoms, characterization of imaging technique and the effect of endonasal endoscopic surgery.@*METHOD@#Following 38 cases of isolated sphenoid sinus disease patients, among whom 35 cases treated with nasal sinus CT (including 5 cases of MRI at the same time), 3 cases undergoing sinus MRI, 1 cases going through the CT cisternography. All patients underwent endoscopic sphenoid otomy, of which 33 cases underwent nasal olfactory cleft approach, 5 cases anterior ethmoid sinus and posterior ethmoid sinus approach (Messerklinger technology).@*RESULT@#All patients were followed up for more than half a year, of which 34 were recoverd and 4 were improved. No obvious complications came up during or after endoscopic surgery.@*CONCLUSION@#Isolated sphenoid sinus disease clinical symptoms are not typicaland without specialty; nasal examination had no positive sign, only with headache as the chief neurological symptom, often difficult to diagnose at an early stage. The CT and MRI are the best methods for the diagnosis of isolated sphenoid sinusitis. The nasal endoscopic operation is the preferred method for treatment of this disease.
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Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Endoscopy , Follow-Up Studies , Paranasal Sinus Diseases , Diagnosis , General Surgery , Retrospective Studies , Sphenoid Sinus , Treatment OutcomeABSTRACT
10.3969/j.issn.1007-3969.2013.04.010
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Objective To study the correlation of operation timing,mode and curative effects of patients with severe hypertensive cerebral hemorrhage.Methods 90 patients with hypertensive cerebral hemorrhage were collected and divided into super early treatment group (32 cases),early treatment group (29 cases),delayed treatment group (29 cases) and big bone flap craniotomy treatment group (41 cases),small bone window craniotomy operation removal group(49 cases).The therapeutic effect,neural function and mental state were observed.Results The total effective rate (93.32％,93.56％),MMSE score [(22.22 ± 2.33) points,(31.55 ± 3.68) points] of super early group and small bone window craniotomy group were significantly higher than other groups (F =6.672,5.325,all P ＜ 0.05.x2 =6.852,7.372,all P ＜ 0.05),CSS score [(17.92 ± 1.84) points,(17.41 ± 1.97) points],NIHSS score [(22.22 ±2.33) points,(22.53 ± 2.48) points] were significantly lower than other groups(F =5.624,6.621,all P ＜ 0.05.F =5.458,6.171,all P ＜ 0.05).The operation timing was positively correlated with CSS and NIHSS score,while negatively correlated with MMSE.The operation mode was negatively correlated with CSS and NIHSS score,while positively correlated with MMSE.Conclusion Early small bone window craniotomy operation therapy has the positive clinical value,it can improve the treatment efficacy and neurological function.
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A new scanning mode is proposed that the front-end of the probe is fixed, while the back-end makes fan-shaped, scanning movement. The new scanning mode avoided ribs drawbacks successfully. Based on the new scanning mode a 3D-Ultrasound Images System is accomplished to acquire 2D data of fetusfetus fetusfetus phantom and livers and kidneys, to demonstrates the effectiveness of the new scanning mode.
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Humans , Fetus , Imaging, Three-Dimensional , Kidney , Liver , Phantoms, Imaging , Ultrasonics , MethodsABSTRACT
Objective To evaluate the clinical efficacy and toxicity of EPOCH regimen in the treatment of elderly patients with peripheral T-cell lymphoma. Methods Twenty-eight elderly patients with pathologically diagnosed peripheral T-cell lymphoma were treated with EPOCH regimen, including 96-hour continuous infusion of etoposide 50 mg/m2, epirubincin 12 mg/m2 and vincristin 0.4 mg/m2 on daysl through 4,cyclophosphamide 750 mg/m2 given as intravenous bolus on day 5 and prednisone 60 mg/m2 administered orally on daysl through 5. The EPOCH regimen was repeated very 21 days. Clinical efficacy and safety profiles of EPOCH regimen was systemically reviewed and analysed. Results All the 28 patients received a total of 85 cycles of EPOCH regimen. The median cycles was two courses. Fifteen patients achieved complete response, while five cases obtaining partial response. The overall response rate was 71.4 %. The median survival time was 20 months. In newly diagnosed patients, complete response rate (CR) as well as partial response (PR) and overall response rate (OR) reached 64.7 %, 23.5 % and 88.2 %, respectively, which was significantly higher than that in refractory cases, whose CR, PR and OR were 36.4 %, 9.1% and 45.5 %(λ 2 = 5.99, P ＜0.05). In addition, the median survivalduration of newly diagnosed patients was longer than that of refractory cases, whose median survival time was 24 and 13 months, respectively. The major adverse events was myelosuppression with grade 3-4 neutropenia and thrombocytopenia in 53.6 % and 50.0 % cases.Non-hematologic toxicities were moderate and uncommon. The frequency of adverse effects in de novo patients showed little difference in comparison with that in refractory ones (P＞0.05). Conclusion EPOCH regimen was an effective and well tolerated therapeutic schedule for elderly patients with peripheral T-cell lymphoma.
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Objective To observe the clinical curative effect of chronic heart failure (CHF) treated by noninvasive positive pressure ventilation ( NPPV). Methods 48 cases of CHF were randomly assigned to conventional drug treatment under oxygen (control group, n = 24) and non-invasive positive pressure ventilation ( NPPV) under the conventional therapy group (observation group, n =24). The plasma N-brain natriuretic peptide( proN-BNP) and cardiac function changes in two groups before and after treatment were observed. Results The total effective rate 92% in observation group was significantly higher than 66% in control group ( x2 =3. 7851, P ＜ 0. 05 ) ; The plasma proNBNP、respiratory rate and heart rate after treatment in two groups were lower than before treatment(t = 2.787,2.815, 2. 856,2.789,2.804,2.840,all P＜0.01) ;The plasma proN-BNPand heart rate in observation group after treatment were lower than the control group(t =2.123,2.221,all P ＜0.05). Conclusion Noninvasive positive pressure ventilation could significantly improve heart function,reduce plasma proN-BNP and enharce curative effect.
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Objective To study the influence of BiPAP on lipid level in patients with chronic heart failure of coronary heart disease.Methods 20 patients with chronic heart failure of coronary heart disease were taken BiPAP:Blood samples were taken from forearm vein before and 4 weeks and 12 weeks after treatment,the lipid level was measured and compared.Results The observation group of The coronary heart disease with chronic heart failure in pre-treatment serum level of total cholesterol(TC)(7.47±0.12)mmol/L,triglycerides(TG)(3.52±0.13)mmol/L,low-density lipoprotein cholesterol(LDLc)(3.73 ±0.11)nmmol/L,apolipoprotein-B(Apo-B)(1.37±0.02)g/Lwere significantly lower than 14 weeks after treatment TC(4.5±0.03)mmol/L,TG(2.6±0.02)mmol/L,LDLc(2.8±0.06)mmol/L,Apo-B(1.02±0.02)g/L)(t=2.154,t=2.278,t=2.311,t=2.347,P all<0.05) in coronary heart disease with chronic heart failure;The observation group after treatment 14 weeks of HDL-CH(1.45±0.02)mmol/Land Apo-A(1.21±0.03)g/L lower than before treatment HDLc(1.05±0.01)mmol/L,Apo-A(0.87±0.01)g/L(t=2.234,t=2.318,P all<0.05) in coronary heart disease with chronic heart failure.Conclusion BiPAP therapy could effectively to ameliorate lipid metabolism in patients with chronic heart failure of coronary heartdisease in the long term.
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Objective To investigate a special optimization technique for computer aided measure, and provide anatomical basis for screw internal fixation in the cavitas glenoidalis through the coracoid process of scapula. Methods Thirty accurate scapula models were reconstructed from CT data sets. First, special optimization objective function was designed for single screw internal fixation configuration, and the optimal placement of screw was found automatically under constraints. Then, the placements of double screws internal fixation configuration were searched taking advantage of principal component analysis. Finally, statistical measure data were provided according to new anatomical reference landmarks for clinical use. Results For single screw internal fixation configuration, the distance from the optimal screw entry point P to the acromion process point X was (39.15±2.28) mm, to the coracoid process point Y was (28.66±2.68) mm, to the angulus superior point Z was (61.13±6.57) mm;The angle was (81.27±7.15)° between PX and PY, and (133.27±6.84)° between PX and PZ. The mean inclination of the lag screw was (104.08±4.41)° for the angle with line PX, (101.29±3.51)° with line PY, and (76.23±5.03)° with line PZ. For double screws configuration, the distance from the original single screw entry point P to the screw entry point E was (5.12±1.37)mm,to the screw entry point F was (3.88±0.94)mm. The angle between the long axis of coracoid process and line EF was (27.41±3.51)°. Conclusion The automatic optimization technique for computer aided measure is very efficient and has many advantages over the conventional manual dissection methods, and is convenient to design new anatomical reference landmark system for clinical use.
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Objective To examine the change and role of nuclear factor-kappa B(NF-?B) activity and tumor necrosis factor-alpha(TNF-?) level in patients with systemic inflammatory response syndrome(SIRS).Methods Eighty patients with SIRS were studied.The NF-?B activity in monocytes and the level of TNF-? in serum was measured.The state of illness was estimated by APACHEⅡ score.Results There was significant difference for the activity of NF-?B in patients with SIRS compared with the control group.The NF-?B activity,TNF-? level and APACHEⅡ score are higher in both resuscitation multiple organ dysfunction syndrome(MODS) group and death group than the non-MODS group and survival group correspondingly(P
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Objective To evaluate the therapeutic value of total thyroidectomy in the thyroid carcinoma.Methods 87 patients of thyroid carcinoma were operated by one surgeon with total thyroidectomy from 1985-2000 in our hospital, We carried out a retrospective research for the complication rates and postoperative iodine 131 treatment. Results Observing after operation revealed that there were 2(2.3%) of recurrent laryngeal nerve damage, 1(1.1%) of thypocalecimia, 1(1.1%) of atelectasis, and no deaths, permanent laryngeal nerve damage, or permanent hypocalcemia.Conclusion Total thyroidectomy is safe and effective procedure in the treatment of thyroid carcinoma, this approach can offer the advantage of removal of tissue at risk for malignant transformation,and enhances the use of the postoperative iodine 131 treatment.
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0.05). 100% occlusion was achieved in 18 patients with cerebral aneurysms by using embolization. Conclusion 3D DSA may improve the accuracy in diagnosing SAH and in showing clearly the stereo conformation of aneurysm and the relationship of sac and parent artery. It is helpful in the evaluation and guidance of embolization of cerebral aneurysms.