Establishment of a nomogram model for risk of pulmonary infection after craniocerebral injury and preliminary assessment of its effectiveness / 中华神经医学杂志

Objective To explore the risk factors of postoperative pulmonary infection in patients with craniocerebral injury and establish a nomogram model to predict the risk of postoperative pulmonary infection after craniocerebral injury.Methods The clinical data of 169 patients with craniocerebral injury,admitted to and underwent craniotomy in our hospital from January 2013 to December 2018,were retrospectively analyzed.The clinical data of patients with postoperative pulmonary infection and without postoperative pulmonary infection were compared.The risk factors of postoperative pulmonary infection were analyzed by multivariate Logistic regression.R language was used to establish a nomogram model to predict the risk of postoperative pulmonary infection after craniocerebral injury.Receiver operating characteristic (ROC) curve was used to explore the prediction efficiency of the nomogram model for pulmonary infection after craniocerebral injury.Results Among the 169 patients,74 (43.8％) were complicated with pulmonary infection and 95 (56.2％) were not complicated with pulmonary infection.As compared with non-pulmonary infection group,pulmonary infection group had significantly higher percentages of patients with open craniocerebral injury and Glasgow coma scale (GCS) scores＜7,significantly higher American Society of Anesthesiologists (ASA) grading,lower albumin level one week after surgery,statistically longer operation time,and significantly higher percentages of patients with conscious disorder,patients accepted intraoperative blood transfusion,patients used breathing machine,and patients stayed in bed for 4 weeks or more (P＜0.05).Multivariate Logistic regression analysis showed that GCS scores (OR=0.243,95％CI:0.122-0.497,P=0.000),ASA grading (OR=3.349,95％CI:2.233-5.021,P=0.000),disturbance of consciousness (OR=3.185,95％CI:1.217-8.334,P=0.018),and useofventilator (OR=3.376,95％CI:1.590-7.167,P=0.002) were independent risk factors for postoperative pulmonary infection in patients with craniocerebral injury.The scores of the nomograrn model were 13.7,100.0,38.0 and 27.5 in GCS scores,ASA grading,disturbance of consciousness and use of ventilator,respectively.The consistency index of the nomogram model for predicting postoperative pulmonary infection in patients with craniocerebral injury was 0.835.ROC curve showed that the area under the curve predicted by nomogram model for postoperative pulmonary infection in patients with craniocranial injury was 0.840 (95％CI:0.778-0.901).Conclusion Based on the risk factors for pulmonary infection after craniocerebral injury,a nomogram model for predicting the risk of pulmonary infection is established,which has a good differentiation degree and prediction effect,and can provide a reference for medical staffto identify high-risk patients at an early stage,so as to take more targeted intervention measures.

Efficacy of 308 nm monochromatic excimer light and 311 nm narrow band ultraviolet on facial vitiligo / 中华医学美学美容杂志

Objective To compare the efficacy of monochromatic excimer light and narrow-band ultraviolet in the treatment of facial vitiligo patients.Methods Seventy-nine patients with facial vitiligo were randomly divided into MEL group and NB-UVB group.The MEL and 311-nm NB-UVB were applied respectively.Both groups were treated twice a week,total 30 times.Results After ten times treatment,the effective rate of MEL group and NB-UVB group was 39.02％ and 15.79％,respectively.There was significant difference between the two groups (P＜0.05).After twenty times treatment,the effective rate of MEL group and NB-UVB group was 70.73％ and 44.74％,respective ly,with significant difference between the two groups (P＜0.05).After thirty times treatment,the efficacy of MEL group and NB-UVB group was 87.80％ and 84.21 ％,respectively.No statistical significance was found between the two groups (P ＞ 0.05).The efficacy of both groups showed that disease duration was a negative factor.It seemed that shorter duration of facial vitiligo would obtain better clinical effect.MEL and NB-UVB were safe and effective for the progressive vitiligo.In both groups,few adverse effets in some patients were observed.Conclusions The clinical effect of MEL in treating facial vitiligo is more rapidly than NB-UVB,but as the treatment times increase,the efficacy becomes similar.Both methods are safe in treating facial vitiligo of different stages.

Effect of 5 -aminolevulinic acid -photodynamic therapy combined with thymopentin -5 on IL -17,IL -23 expression of recurrent condylomata acuminata patients / 中国基层医药

Objective To explore effect of 5 -aminolevulinic acid -photodynamic therapy combined with thymopentin -5 on IL -17,IL -23 expression of recurrent condylomata acuminata patients.Methods 140 patients with recurrent condylomata acuminata were randomly divided into 3 groups.53 cases in observation group were treated by 5 -aminolevulinic acid -photodynamic therapy combined with thymopentin -5,42 cases in control group 1 were treated by 5 -aminolevulinic acid -photodynamic therapy,and 45 cases in control group 2 were treated by thymopen-tin -5.24 healthy subjects were served as normal controls.IL -17,IL -23 levels were determined by enzyme linked immunosorbent assay before and after the clinical therapy.Results IL -17,IL -23 levels in the patients with recur-rent condylomata acuminata were significantly lower than those in healthy subjects(t =28.10,P <0.01;t =11.10, P <0.01).There were significant differences in IL -17,IL -23 between recurrent condylomata acuminata patients and healthy persons before treatment.There was significant difference after treatment(t =61.17,P <0.01;t =28.02, P <0.01).Conclusion 5 -aminolevulinic acid -photodynamic therapy combined with thymopentin -5 in the treat-ment of recurrent condylomata acuminata inhibited IL -17,IL -23 expression,so as to achieve therapeutic effect.

Design of low-intermediate frequency electrotherapy and pain assessment system / 生物医学工程学杂志

Aiming at the single treatment and the design separation between treatment and assessment in electrotherapy equipment, a kind of system including low-intermediate frequency treatment and efficacy evaluation was developed. With C8051F020 single-chip microcomputer as the core and the circuit design and software programming used, the system realized the random switch of therapeutic parameters, the collection, display and data storage of pressure pain threshold in the assessment. Experiment results showed that the stimulus waveform, current intensity, frequency, duty ratio of the system output were adjustable, accurate and reliable. The obtained pressure pain threshold had a higher accuracy (< 0.3 N) and better stability, guiding the parameter choice in the precise electrical stimulation. It, therefore, provides a reliable technical support for the treatment and curative effect assessment.

Changes of cerebral vasoreactivity in patients with acute cerebral infarction of various subtypes / 临床神经病学杂志

Objective To explore the changes of cerebral vasoreactivity(CVR) in patients with acute cerebral infarction of various clinical subtypes.Methods The 70 patients with acute cerebral infarction were divided into 3 subtypes:atherothrombotic infarction (AI)group(n=22), lacunar infarction (LI)group(n=33), cardiogenic infarction (CI)group(n=15).The mean blood flow velocity (Vm), pulse index(PI), resistance index(RI) in bilateral middle cerebral artery(MCA) were detected, and breath holding index (BHI) was measured by TCD in these patients through breath holding test. All the data were compared with the health controls. Results Compared with normal control group,the Vm,PI and RI were significantly increased (P0.05). Conclusions There are differents in CVR in patients with acute cerebral infarction of various subtypes. The damage of CVR is more obviously in AI and LI group. There is clinical significance for measurement of CVR to evaluate the haemodynamic changes in various subtype of acute cerebral infarction.

Study of cerebrovascular reactivity assessed by transcranial Doppler sonography with breath-holding test and its association with risk factors of cerebrovascular disease / 临床神经病学杂志

Objective To assess the cerebrovascular reactivity (CVR) in health subjects and patients with risk factors by means of transcranial Doppler ultrasonography (TCD) with breath-holding maneuver, and its association with risk factors of cerebrovascular disease.Methods The breath-holding index (BHI), which was the percentage increase in middle cerebral artery(MCA)blood flow velocity and was as index of CVR assessment, was detected during breath-holding by TCD and breath-holding technique in 137 patients with various risk-factors of cerebrovascular disease and 87 normal controls.The regression analysis was done between the CVR and risk factors.Results The mean blood velocity before (Vm) and after holding test (Vm′) were significantly lower in group with age of 20-40 years than that of the age of 41-60 and over 60 years(all P