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Objective:To analyze the clinical and immunological characteristics of children with acute viral infection-related encephalopathy.Methods:Case-control study.A retrospective analysis was conducted on the clinical data of children diagnosed with acute viral infection-related encephalopathy during hospitalization at the Children′s Hospital, Capital Institute of Pediatrics from January 2020 to January 2023.According to the last follow-up modified Rankin scale (mRS) score, these children were divided into a good prognosis group (mRS score ≤2) and a poor prognosis group (mRS score >2), and the clinical and immunological characteristics of the children with different prognoses were analyzed.The binary Logistic regression was used to analyze the risk factors for poor prognosis.Results:A total of 28 children with acute viral infection-related encephalopathy aged 4 months to 11 years were included.There were 16 males (57%) and 12 females (43%). Among the preinfection viruses, there were 16 children of Corona virus disease 2019, 8 children of influenza A virus, 3 children of influenza B virus, and 1 child of norovirus.Among them, there were 21 children with acute necrotizing encephalopathy, 4 children with acute encephalopathy with biphasic seizures and late reduced diffusion, 2 children with mild encephalitis with a reversible splenial lesion, and 1 child with hemorrhagic shock and encephalopathy syndrome.Among the first symptoms, 24 children (85.7%) had consciousness disorders, 23 children (82.1%) had seizures, 17 children (60.7%) had speech disorders, 11 children (39.3%) had involuntary movements, and 10 children (35.7%) had abnormal mental behavior.For the site of lesion, the cranial nuclear magnetic resonance imaging revealed 17 in the thalamus, 10 in the brainstem, 9 in the basal ganglia, 8 in the cerebellar hemisphere, and 4 in the corpus callosum.In the last follow-up evaluation, 17 children had a mRS score of >2, and 11 children had a mRS score of ≤2.Univariate analysis showed that disturbance of consciousness, seizure cluster, brain stem lesion, absolute value of serum T lymphocytes, cerebrospinal fluid(CSF) protein, CSF cytokines [interleukin(IL)-1β, IL-6 and IL-8]were higher in the poor prognosis group than those in the good prognosis group.Multivariate Logistic regression analysis indicated that brain stem disease, CSF IL-1β and T lymphocyte absolute number were independent risk factors for poor prognosis.Conclusions:Brain stem lesions, cerebrospinal fluid IL-1β and the absolute number of T lymphocytes have predictive value for the prognosis of acute viral infection-associated encephalopathy.The more severe the conditions, the lower the T lymphocytes, and the higher the cytokines in some cerebrospinal fluid.
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Objective To analyze the effects of arthroscopic meniscus treatment on knee osteoarthritis on the effective rate,VAS score,HSS score and TNF-α level.Methods We selected 86 patients with knee osteoarthritis caused by meniscus injury who were treated in our hospital from June 2019 to May 2020 as the research subjects.The treatment method was selected according to the patient's wishes,with 43 patients who chose conventional conservative treatment included in the control group and 43 patients who chose arthroscopic meniscus therapy included in the study group.The treatment effectiveness,visual ana-logue scale(VAS)score,HSS knee joint score and tumor necrosis factor-α(TNF-α)index levels were compared between the two groups of patients.Results The effective rate of treatment in the study group was significantly higher than that in the control group(P＜0.05);there was no significant difference between the study group and the control group in the VAS score,HSS score,and TNF-α level before treatment(P＞0.05).After treatment,the VAS score,HSS score and TNF-α level of the group were improved.The VAS score and TNF-α level of the study group after treatment were lower than those of the control group(P＜0.05),and the HSS score was higher than the control group.Group(P＜0.05).Conclusion The arthroscopic meniscus treatment for patients with knee osteoarthritis has a significant effect,which can effectively reduce the pain and inflammation of the patients and improve the function of the knee joint.
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Objective:To analyze the prognostic factors of patients with Ⅰ B1-Ⅱ A cervical cancers after surgery and to assess the effects and adverse reactions of intensity-modulated radiotherapy(IMRT)combined with concurrent chemotherapy(CCRT). Methods:A retrospective analysis was performed based on the clinical and follow-up data of 362 patients with Ⅰ B1-Ⅱ A cervical cancers who were treated in Changzhou Second People′s Hospital from January 2009 to December 2019. Meanwhile, these patients suffered large primary tumors(LPT; tumors size: ≥4 cm), lymphatic vascular space invasion (LVSI), and deep stromal invasion(DSI; stromal infiltration depth: ≥1/2) after surgery and showed at least one intermediate-risk factor. Among these cases, 161 cases were treated with CCRT, 131 cases under-went single radiotherapy (RT), and 70 cases received unadjuvanted radiotherapy. The Kaplan-Meier method and the logrank test were adopted for univariate survival analysis, the binary logistic regression was used to analyze the recurrence risk, and Cox regression model was used for multivariate survival analysis. Results:The 3 and 5-year overall survival (OS) rates were 94.20% and 88.39%, respectively. The retrospective analysis showed that the risk factors of recurrence included tumor size ≥ 4 cm and poorly differentiated cancers( OR=3.287, 2.870, 95% CI: 1.366-7.905, 1.105-7.457, P<0.05). Compared with the treatment without adjuvant radiotherapy and RT, CCRT reduced the recurrence rate of tumors with tumor size of ≥ 4 cm, adenocarcinomas or adenosquamous carcinomas (pathological types), and poorly differentiated carcinomas( χ2=6.725-7.518, P<0.05). A multivariate analysis showed that the CCRT improved the recurrence-free survival ( HR=0.290, 95% CI: 0.128-0.659, P=0.003) and OS ( HR=0.370, 95% CI: 0.156-0.895, P=0.024). A subgroup analysis indicated that CCRT prolonged the OS of patients with tumor size ≥ 4 cm or poorly differentiated cancers compared to the patients receiving no radiotherapy or those treated with RT (χ 2=7.614, 5.964, P<0.05). Compared with the cases receiving single radiotherapy, those receiving CCRT did not suffer an increase in the incidence of hematology, radiation enteritis, and cystitis above grade 3 according to observation ( P>0.05). Conclusions:Among the intermediate-risk factors leading to the recurrence of postoperative cervical cancers, the factors of large primary tumors or poorly differentiated cancers affect the prognosis of patients.Compared with RT and the treatment without adjuvant radiotherapy, IMRT combined with concurrent chemotherapy can prolong the recurrence-free survival and overall survival of patients with large tumors or poorly differentiated cancers and adverse reactions induced are tolerable.
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Background and Purpose: With the rapid development of minimally invasive technique, robotic surgery is widely used in the gynecological surgery. This study aimed to compare the clinical data of roboticassisted laparoscopy and laparotomy in the treatment of early ovarian cancer. Methods: A total of 22 patients with early ovarian cancer receiving stage Ⅰ operation between Jan. 2015 and Dec. 2016 in Jilin Province Tumor Hospital were randomly divided into two groups: 8 patients received robotic-assisted surgery (robotic-assisted laparoscopic group), 14 patients received laparotomy (laparotomy group). Results: All patients underwent successful operation without changing surgical approach. The operation time in robotic-assisted laparoscopic group was longer than that in laparotomy group [(194.50±10.90) min vs (178.71±10.58) min, P＜0.05]. Blood loss volume [(60.10±8.88) mL vs (73.71±12.99) mL], 24 hours postoperative drainage volumes of robotic-assisted laparoscopic group were less than those in laparotomy group [(96.88±10.21) mL vs (108.00±11.43) mL, P＜0.05]. Others had no statistical significance (P＞0.05). Conclusion: In the clinical treatment of early ovarian cancer, there is no difference between robotic-assisted laparoscopic operation and laparotomy. Robotic-assisted laparoscopic operation is worthy of clinical promotion and application.
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Objective To explore the relationship between left ventricular volume parameters and cardiac function in elderly patients with heart failure. Methods From January 1st, 2012 to December 31st, 2014,five hundred and twenty-eight heart failure elderly patients with coronary heart disease,hypertension,heart valve disease, dilated cardiomyopathy, and hypertrophic cardiomyopathy in Kailuan General Hospital were collected in this study. The left ventricle diastolic end volume ( LVEDV ) , left ventricle end systolic volume ( LVESV) and left ventricular ejection fraction of the patients were measured. The concentrations of N type brain natriuretic peptide ( NT-proBNP ) and related biochemical indexes were detected. Results Among the 528 patients with cardiac insufficiency,367 were males and 161 were females. Among them,there were 199 cases of heart function I,163 cases of heart function II,99 cases of heart function III and 67 cases of heart function IV. Correlation analysis showed that the correlation coefficients of LVEDV, LVESV and age were 0. 431 ( P=0. 001) ,0. 472 ( P=0. 001 ) and 0. 243 ( P<0. 001 ) , respectively. Logistic regression analysis showed that LVEDV ( OR=2. 654, 95%CI 2. 124-3. 894, P=0. 004 ) , LVESV ( OR=2. 939, 95%CI 2. 539-3. 256, P=0. 001),LVESV),NT-proBNP (OR=2. 921,95%CI 2. 888-3. 562,P=0. 002) were risk factors for heart failure. Conclusion The correlation between LVESV and cardiac function in elderly patients with heart failure is better than that in LVEDV,and the correlation between the two and cardiac function is better than that of age.
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Objective To predict the tolerance range of set-up errors in clinical practice by predicting the virtual set-up errors of postoperative radiotherapy patients for breast cancer. Methods A retrospective analysis was made of the patients who underwent radiotherapy after breast cancer surgery in recent 3 years. According to different treatment method, 10 cases of breast cancer after modified radical mastectomy and 10 cases after breast conserving radical mastectomy were selected. The target area was delineated, the volume modulated radiation therapy plan was made, the virtual moving error of the center point of the plan was moved, and the maximum moving error was 5 mm by 1 mm step. After recalculating the dose, the corresponding data including the clinical target areas ( CT ) , CTV ( V50 ) , average heart volume, V20 of the affected lung and CTV volume were recorded. SPSS 19. 0 software was used for statistical analysis, and repeated measurement of variance analysis was used to analyze the changes of the actual dose in the target area after moving the center point. Linear regression analysis method was used to analyze the correlation between the CTV volume and the dose change after the CTV moving midline. Results The virtual set-up error had little influence on the axis direction of the approximate mammary tangent direction, while the vertical direction of the approximate mammary tangent direction had greater influence. After moving more than 3 mm on the vertical axis, the CTV ( V50 ) decreased to below 90％, which was lower than the general requirement for the target area of CTV. Statistical analysis of set-up errors in all directions showed that there was significant difference in dosimetric changes ( F=34. 182, 12. 877, 16. 443, 9. 846, 46. 829, 10. 122, 57. 931, P <0. 05) in all directions except the B direction of left breast set-up errors (P>0. 05). Between breast conserving surgery and modified radical mastectomy, there was little effect on target movement. Through correlation analysis, it was found that the volume of CTV in the target area of breast cancer patients was linearly related to the errors caused by the movement of B, C and B directions of left breast and right breast(F=5. 733, 18. 496, 6. 630, P<0. 05). Conclusions In postoperative radiotherapy for breast cancer, the errors perpendicular to the section of breast should be paid special attention to whether left or right breast. When the error of this direction exceeds 3 mm, CTV is obviously less than V50 below 83. 85％. The effect of set-up error on the dose of CTV was not related to the operation mode of breast cancer and there was no obvious correlation with the volume of the target area.
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Objective To explore the effect of the joint edaravone in early rehabilitation on the prognosis of patients with ischemic stroke.Methods The general branch of Kailuan group of patients with ischemic stroke who were conformed to the 1995 national conference on the 4th cerebrovascular diagnostic criteria with head CT or MRI imaging diagnosis,were collected from January 2012 to December 2014.A total of 324 cases were the first onset,who had been treated with conventional drugs,and were randomly divided into the observation group(edaravone associated with early rehabilitation)and the control group(early rehabilitation)with 162 cases in each group.Patients of the observation group were given venous application of edaravone and received the standardized rehabilitation treatment within 48 hours.The control group were given standard rebabilitation therapy at 2 weeks after attacked.NIHSS and MMSE scores of the two groups of patients were evaluated at the beginning of the rehabilitation course,4 weeks and 12 weeks of the treatments.Results There were no statistically significant difference and the clinial manifestations of the lesion site between the two groups of patients on admission.At the beginning of the rehabilitation,the NIHSS and MMSE score of control group were statistically significant different from that of observation group [NIHSS:(14.8 ±5.3)vs.(16.1 ±5.1),PNIHSS =0.049;MMSE:(15.9 ±6.3)vs.(14.2 ±6.2),PMMSE =0.041].The sec-ond and third evaluation were respectively conducted at 4 weeks[NIHSS:(10.1 ±6.3)vs.(8.2 ±5.7),MMSE:(17.7 ±5.5)vs.(20.9 ±5.9)]and 12 weeks[NIHSS:(6.6 ±4.9)vs.(4.7 ±3.6),MMSE:(21.0 ±4.8)vs. (24.6 ±4.9)].The results of the observation group were significantly better than the control group(P4W NIHSS =0.036,P4W MMSE =0.035;P12W NIHSS =0.006,P12W MMSE =0.003),and the differences were statistically significant. Conclusion Edaravone associated with early rehabilitation can obviously improve the prognosis of patients with ischemic stroke.
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OBJECTIVE:To observe the clinical efficacy and safety of edaravone combined with early rehabilitation in the treat-ment of cerebral hemorrhage,and to provide clinical evidence for rehabilitation management and drug treatment of cerebral hemor-rhage patients. METHODS:168 patients with cerebral hemorrhage,collected from neurology department of our hospital during Jan. 2012 to Dec. 2014,were randomly divided into observation group and control group with 84 cases in each group. Both groups re-ceived routine treatment;observation group was additionally given edaravone intravenously on the basis of routine treatment,and be-gan to receive standardized rehabilitation treatment within 48 hours after the onset of symptom;control group began to receive stan-dardized rehabilitation treatment 2 weeks after the onset of symptom. NIHSS and MMSE score of 2 groups were conducted before re-habilitation treatment,and after 4 and 12 weeks of treatment. RESULTS:There was no statistically significant difference in lesion site and clinical manifestations between 2 groups on admission(P>0.05);both NIHSS and MMSE score of observation group were better than those of control group after 4 and 12 weeks of treatment,there was statistical significance(P<0.05). CONCLUSIONS:Edaravone associated with early rehabilitation can obviously improve the prognosis of patients with cerebral hemorrhage.
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Objective To investigate the sleep structure of children with attention deficit hyperactivity disorder (ADHD) and the differences among subtypes of ADHD.Methods Ninety children with ADHD were diagnosed in Department of Neurology, the Children's Hospital Affiliated to Capital Institute of Pediatrics between June 2012 and June 2013, including 75 boys and 15 girls,6-14 years old [(9.5 ± 2.4) years old], and among them there were 55 cases of ADHD-combined type, 25 cases of ADHD-inattentive type, and 10 cases of ADHD-hyperactive impulsive type.Thirty healthy children whose age and sex matched with ADHD group,came from Beijing and the surrounding area,were selected as the healthy control group,including 23 boys and 7 girls,6-14 years old [(9.2 ± 2.9) years old].Two groups underwent full overnight sleep assessment.Results The latency of rapid eye movement(REM) in children with ADHD was (146.58 ± 47.28) minutes, and the sleep latency was 19.00 minutes [(8.25-37.50) minutes];while the latency of REM in healthy control group was (87.55-± 13.59) minutes, and the sleep latency was 9.00 minutes [(3.50-13.63)minutes].Compared with healthy control group, children with ADHD demonstrated the increased latency REM and sleep latency, and decreased sleep efficiency,the increasing times of awakening and total duration,and these differences were all statistically significant(all P ＜ 0.05).The percentage of non-rapid eye movement(NREM) phase Ⅱ in ADHD hybrid was lower than the ADHD attention-deficit(t =2.012,P ＜ 0.05).Sleep latency in ADHD attention-deficit was longer than the ADHD hybrid(t =2.964,P ＜ 0.05).No statistical differences were found among the various types in other indicators.The prevalence of periodic limb movements in sleep(PLMS) was 27.78％ (25/90 cases) in ADHD group and the prevalence of PLMS was 3.30％ (1/30 cases) in the healthy control group.The differences in prevalence between 2 groups were statistically significant (x2 =8.053, P ＜ 0.05).Conclusions Children with ADHD significantly display more problems with sleep.Sleep latency and NREM Ⅱ are different between ADHD attention-deficit and ADHD hybrid.
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Objective To study the association of metabolic syndrome (MS)with cardiovascular disease (CVD).Methods According to the diagnostiv criteria for MS,1457 MS patients as the research objects,who were screened out of the tangshian harbor economic development zone hospital.All patients were detected with waist circ-umference,seat systolic blood pressure(SBP),diastolic boold pressure(DBP),fasting Plasma glucose(FPG),total cholesterol(TC),low -density lipoprotein cholesterol(LDL -C),high density lipoprotein cholesterol(HDL -C),tri-glyceride(TG).By 3 years follow -up and the carotid ultrasound detection of carotid intima -media thickness(IMT), all the patients were divided into three groups according to the diagnosis:event group (Coronary heart disease +Hypertensive heart disease,stroke,Coronary heart disease +Hypertensive heart disease +stroke)and control group. Results The patients′SBP[(145.5 ±15.7)mmHg,(149.9 ±13.8)mmHg,(156.3 ±14.6)mmHg],DBP [(92.5 ±8.7)mmHg,(97.9 ±9.0)mmHg,(101.0 ±10.0)mmHg],FPG[(6.3 ±2.6)mmol/L,(6.0 ± 2.5)mmol/L,(6.9 ±2.6)mmol/L],TC[(5.46 ±1.28)mmol/L,(5.10 ±1.15)mmol/L,(5.37 ±1.21)mmol/L], LDL -C[(3.40 ±0.75)mmol/L,(3.08 ±0.65)mmol/L,(3.24 ±0.72)mmol/L],TG[(3.44 ±1.60)mmol/L, (3.31 ±1.52)mmol/L,(3.38 ±1.58)mmol/L]of the event group were significantly higher than the control group [(139.2 ±17.4)mmHg,(85.6 ±9.1 )mmHg,(5.5 ±2.1 )mmol/L,(1.4 ±0.4 )mmol/L,(2.59 ± 0.64)mmol/L,(2.61 ±1.28)mmol/L]and HDL -C[(1.13 ±0.38)mmol/L,(1.2 ±0.4)mmol/L,(0.9 ± 0.23)mmol/L]was significantly lower than the control group[(1.4 ±0.4)mmol/L](P <0.05).Detection rates of all the event groups were significantly higher in age[(53.4 ±6.4)years,(54.6 ±6.6)years,56.3 ±6.8)years], hypertensive heart disease(67.8%,74.8%,88.0%),high blood sugar(46.7%,42.9%,49.7%),and carotid atherosvletosis (19.9%,18.9%,29.3%)than the control group[(47.2 ±6.5)years,47.2%,24.3%,5%)](P <0.05).Conclusion There was a correlation between Mdtabolic syndrome and Cardiovascular disease.