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Objective:To study the dynamic evaluation value of transcranial Doppler (TCD) in cerebral circulation and brain function of sepsis patients and its predictive value of the prognosis.Methods:A retrospective analysis was performed on 98 sepsis patients admitted to our hospital from January 2017 to June 2018 who were divided into the survival group (56 cases) and death group (42 cases) according to the 28-day prognosis. The general clinical data of the patients, acute physiology and chronic health evaluation II (APACHE II), delirium assessment scale (CAM-ICU), and TCD parameters PSV, Vm, EDV, PI, RI on the first day and the third day of admission were collected, and the differences of TCD parameters at different time points were analyzed between the two groups, the area under the ROC curve (AUC) was calculated and evaluating their predictive value of sepsis outcome was evaluated.Results:APACHE Ⅱscore and the number of patients with sepsis encephalopathy were significantly higher in the death group than those in the survival group ( P < 0.05). There were no significant differences in PSV, Vm and EDV between the two groups on the first day and the third day. The PI and RI of the survival group were significantly lower than those of the death group ( P<0.01). In the survival group, PI and RI on the third day decreased significantly compared with those on the first day ( P < 0.05), while in the death group, PI and RI on the first day and the third day did not change significantly. ROC survival curves showed that Day1PI, Day3PI, Day1PI - Day3PI, Day1RI, Day3RI, Day1RI - Day3RI and APACHEⅡ predicted AUC of the prognosis of sepsis patients were 0.657, 0.835, 0.730, 0.707, 0.826, 0.705, and 0.815 ( P < 0.01). When PI cutoff value on the third day became 1.02, the sensitivity was 85.7% and the specificity was 61.3%. When RI cutoff value on the third day became 0.62, the sensitivity was 78.6% and the specificity was 71.4%. Conclusions:TCD parameters, PI and RI, are of certain value in the dynamic evaluation of cerebral circulation and brain function in sepsis patients. PI and RI on the first day and the third day and the differences between them are all valuable in predicting the prognosis, and PI and RI on the third day have greater predictive value.
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Objective To discuss the ultrasonographic characteristics of schistosomal appendicitis lesions. Methods Among the patients with schistosomal hepatopathy who were discovered by Color Doppler ultrasound in Huzhou Central Hospital from January 2012 to December 2015,50 cases with clear history of schistosomiasis and treatment were chosen as a schistosom?al hepatopathy group,meanwhile,50 normal people,who came from non?endemic areas,without schistosomal hepatopathy and schistosomiasis history were chosen as a control group. The two groups were examined by ultrasound scan of the appendix ,and the data of the largest diameter of the appendix and the thickness of the appendix wall were collected,and the sonographic char?acteristics of their appendixes,such as whether the echo of the appendix wall was even or not,were observed. Results The minimum internal diameter of the appendix cavity and the thickness of the appendix wall of the schistosomal hepatopathy group were(2.090 ± 0.790)mm and(1.332 ± 0.313)mm ,respectively,the former was significantly narrower than that of the control group,while the latter was significantly thicker than that of the control group(t=2.647,-4.526,respectively,both P<0.05). The proportions of those with inhomogeneous echo,indistinctness structure,uneven thickening of the appendix wall,as well as having intestinal contents in the appendix cavity in the schistosomal hepatopathy group were higher than those in the control group(χ2=12.000,18.537,24.008,4.244,respectively,all P<0.05). Conclusions Schistosomal appendicitis lesions have obvious ultrasonographic characteristics under ultrasound. Ultrasound can play an important role in judging whether the appen?dix of schistosomiasis patients is involved and discovering the lesion of appendix early.
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Objective To observe the efficacy and effect on cerebral vascular reserve and serum hs-CRP of Xueshuantong combined with butylphthalide in patients with acute cerebral infarction.Methods A total of 140 cases with ACI in Huzhou Central Hospital from August 2015 to July 2016 were divided into the observation group and the control group with 70 cases in each group, according to the order of single and double number.The control group was treated with routine western medicine while giving butylphthalide , and the observation group was given Xueshuantong on the basis of the control group.After two weeks of treatment, the efficacy and CVR, BHI and hs-CRP levels were observed.Results After treatment, the total effective rate of the observation group was 92.86%, and the control group was 81.43%, the difference was statistically significant (χ2 =4.080, P<0.05), there was significant differences of CVR, BHI between two groups (Fgroup =5.534, 4.608, P<0.05), the CVR and BHI increased gradually with time (Ftime =11.325, 9.432, P<0.05), the rised amplitude in observation group was higher than the control group (Finteraction =5.742, 5.016, P<0.05), there were significant differences in the levels of hs-CRP between two groups (Fgroup =7.421, P<0.05), and hs-CRP decreased gradually with time (Ftime =10.185, P<0.05), the decrease of observation group was larger than that of control group(Finteraction =4.824, P<0.05).Conclusion Xueshitong combined with butylphthalide in the treatment of ACI is effective , can better improve cerebral vascular reserve capacity and inhibition of inflammatory response, better than the single use of butylphthalide.