RESUMEN
@#Objective To explore the safety and feasibility of uni-portal video-assisted thoracic surgery (VATS) for the treatment of bronchopulmonary sequestration (BPS). Methods The clinical data of BPS patients with surgical resection in Shanghai Pulmonary Hospital from February 2010 to June 2021 were reviewed. The patients were divided into a VATS group and a thoracotomy group according to the operation method. The operation time, intraoperative blood loss, hospital stay and postoperative complication rate were compared between the two groups. The VATS group was subdivided into a uni-portal VATS group and a multi-portal VATS group for subgroup analysis. Results Finally 131 patients were enrolled, including 62 males and 69 females with an average age of 39.3±13.2 years. There were 103 patients in the VATS group and 28 patients in the thoracotomy group. A total of 104 patients were diagnosed with left lower BPS, 26 with right lower BPS and 1 with bilateral lower BPS. The main symptom was cough (88 patients, 67.2%). There were 119 patients diagnosed by thoracic enhanced CT before operation. Compared with the thoracotomy group, the operation time was not statistically different (P=0.717), but the blood loss was less, the rate of postoperative complication was lower and hospital stay was shorter in the VATS group (P<0.05). The rate of conversion to open surgery in the uni-portal VATS group and multi-portal VATS group was 11.8% and 13.5%, respectively. Meanwhile, patients in the uni-portal VATS group had shorter operation time and postoperative hospital stay, less blood loss and lower postoperative complication rate than those in the multi-portal VATS group (P<0.05). Conclusion In order to improve the rate of diagnosis, the lung enhanced CT scan should be selected as an optimal noninvasive method in adult suspected patients (especially those with solid cystic and solid lesions in the lower lobe). Uni-portal VATS is a safe and feasible method for BPS which can be widely promoted.
RESUMEN
AIM: To explore the clinical features, diagnosis and treatment experience and the distribution characteristics of pathogenic microorganisms of primary canaliculitis, and provide reference for its diagnosis and treatment. METHODS: Retrospective clinical study. A total of 119 cases(120 eyes)diagnosed as primary canaliculitis in the department of ophthalmology of Wuxi No.2 People's Hospital from June 2019 to February 2023 were included. The treatment methods were mainly divided into conservative treatment(removing canaliculus stones through lacrimal punctum combined with injecting antibiotic eye ointment into the tube)and surgical treatment. The inspection methods of pathogenic microorganisms included secretion smear microscopy and microbial culture.RESULTS: Primary canaliculitis was more common in middle-aged and older female, mainly manifested by long-term red eye and increased secretion; however, the majority was not accompanied by tearing. Totally, 118 cases(99.2%)had monocular disease, while 63 cases(63 eyes; 52.5%)had inferior lacrimal canaliculus disease. Laboratory examination: Among 119 cases(120 eyes), 4 cases(4 eyes)did not undergo laboratory examination, and the other 115 cases(116 eyes)were as follows: Gram staining microscopy of secretion smear showed that Actinomyces were detected in 102 cases(103 eyes; 88.8%), while no fungus was detected; Microbial culture: 85 cases(86 eyes; 74.1%)were positive for bacterial culture. A total of 111 bacterial strains were cultured, which contained 26 types of bacteria. Among them, 32 strains were aerobic(28.8%); 26 strains were anaerobic(23.4%); and 53 strains were facultative anaerobic(47.7%). The most common bacteria were streptococcus(20 strains), staphylococcus(13 strains), Propionibacterium(10 strains), and capnocytophaga(10 strains). Only 4 cases(4 eyes; 3.4%)of microbial cultures were positive for Actinomyces. Fungus was negative in all microbial cultures. Treatment: Of the 119 cases(120 eyes), 114 cases(115 eyes; 95.8%)were cured by conservative treatment of removing lacrimal canaliculus stones through lacrimal punctum and intracanalicular ointment infiltration(IOI), while 5 cases(5 eyes)were not effective in conservative treatment; however, all of them were cured after surgical treatment, and the cure rate for primary canaliculitis was 100.0%.CONCLUSION: The incidence of primary canaliculitis is low, and it is prevalent in middle-aged and older female. Single lacrimal canaliculus is more common, which could be missed and misdiagnosed in clinic. Actinomyces is the major pathogen observed mostly in mixed infections, with heterogeneous strains, mainly anaerobic or facultative anaerobic bacteria. Streptococcus and Staphylococcus are the most common whereas fungal canaliculitis is rare. The cure rate of primary canaliculitis is high after diagnosis, and IOI method is recommended as the initial treatment of canaliculitis.
RESUMEN
Objective To explore the correlation factors of cranial magnetic resonance diffusion weighted imaging(DWI) in patients with acute cerebral infarction.Methods A total of 350 patients with acute cerebral infarction who underwent MR imaging were divided into DWI positive group and negative group according to whether the first diffusion weighted imaging was abnormal or not.The clinical and radiological data of the two groups were retrospectively collected and analyzed.patients with negative DWI on initial MRI were re-examined 1 week later.Result Thirty-four(9.7%) patients were DWI-negative in 350 patients with acute cerebral infarction on initial MRI,and 5 patients in DWI-negative group had positive lesions on the re-examine MRI.Multivariate logistic regression analysis indicated the patients with first blood pressure of admission≥ 140/90 mmHg(P=0.033),first blood glucose of admission≥ 7.0 mmol/L(P=0.028) and the time from the onset to initial MRI>24 h were more likely showed DWI-positive on initial MRI(P=0.013).Patients with posterior circulation infarcts were more likely to have negative DWI findings than patients with anterior circulation infarction(P=0.001).Conclusion Some patients with acute cerebral infarction may show DWI negative results on initial MRI,which is related with the time from onset to initial MRI and the site of cerebral infarction.Patients with posterior circulation infarcts are more likely to have first negative MR findings than patients with anterior circulation infarction.Patients with elevation of the admission blood pressure or blood glucose are more likely to have DWI positive lesions.Patients with acute cerebral infarction within the time window should received be thrombolytic therapy after carefully assessment to avoid delay in treatment even if the DWI negative results.
RESUMEN
Objective To study the correlation between risk factors of CVD and cognitive deficit associated with cerebral infarction. Methods Cognitive function was tested in 101 cases of cerebral infarction using HDS-R at the end of 3 weeks and 6 months after onset of the stroke. Meanwhile, the data of risk factors and relative information of cerebral vascular disease were collected by using the scale of complications and inquiring the past history. The risk factors of CVD, such as neurological deficit, diabetes, hypertension, obesity, fever, heart diseases, smoking, overdrinking were compared between the cognitive deficit group and non-cognitive deficit group. Logistic regression analysis was adopted for data analysis. Results Of the 101 cases , 65 had cognitive deficit at the end of 3 weeks and 53 at the end of 6 months after onset of stroke. Age and score of scale of complications between cognitive deficit group and non cognitive deficit group were significantly different(P