Nerve growth factor in combination with Oxiracetam in the treatment of Hypertensive Cerebral Hemorrhage

Objective: To compare the clinical efficacy of nerve growth factor [NGF] in combination with oxiracetam and single use of oxiracetam in the treatment of hypertensive cerebral hemorrhage

Methods: One hundred and forty patients with hypertensive cerebral hemorrhage who were admitted to the hospital from July 2015 to September 2016 were selected as research subjects and randomly divided into a treatment group which was treated by NGF in combination with oxiracetam and a control group which was treated by oxiracetam only. The clinical efficacy was observed, and the death of both groups was recorded

Results: The National Institutes of Health Stroke Scale [NIHSS] score, Glasgow Coma Scale [GCS] score and limbs muscle force of both groups improved after treatment, and the improvement of the treatment was superior to that of the control group, suggesting a significant difference [P<0.05]. The reduction of serum inflammatory factor level of the treatment group was much larger than that of the control group after treatment, and the difference had statistical significance [P<0.05]. The survival analysis suggested that the survival rates of the two groups had a statistically significant difference [P<0.05]

Conclusion: NGF in combination with oxiracetam is significantly effective in treating hypertensive cerebral hemorrhage as it can apparently recover neurologic impairment and limbs muscle force. The therapy has important clinical application values

Application of recombinant human brain natriuretic peptide in stress cardiomyopathy complicated acute left heart failure / 心血管康复医学杂志

Objective:To observe therapeutic effect of lyophilized recombinant human brain natriuretic peptide (Lrh-BNP)on stress cardiomyopathy (SCM)complicated acute bump failure.Methods:A total of 23 patients with SCM complicated acute bump failure were randomly divided into routine treatment group (n=10,received routine treatment)and Lrh-BNP group (n=13,received Lrh-BNP based on routine treatment).Clinical symptoms and signs,cardiac function :left ventricular ejection fraction (LVEF),stroke volume (SV),cardiac index (CI),peak early diastolic velocity/peak late diastolic velocity (E/A)assessed by echocardiography before and after treatment, and total effective rate were compared between two group.Results:Total effective rate of Lrh-BNP group was sig- nificantly higher than that of routine treatment group (92.3% vs.80.0% ,P0.05 all);after treatment,com- pared with routine treatment group,there were significant rise in LVEF [(50.2±16.3)% vs.(59.4±14.1)%],SV [(39.5±10.4)ml vs.(48.3±12.5)ml],CI [(3.7±1.1)L min-1 m-2 vs.(4.6±1.4)L min-1 m-2 ]and E/A [(1.0±0.5)vs.(1.3±0.7)]in Lrh-BNP group,P<0.05 all.Conclusion:Lrh-BNP possesses significant thera- peutic effect on stress cardiomyopathy complicated acute left heart failure.

Clinical effect of peripherally inserted central catheters based on modified seldinger technique under guidance of vascular ultrasound

Objective: To observe and analyze the application effect of ultrasound-guided modified Seldinger technique [MST] in Peripherally Inserted Central Catheter [PICC] catheterization

Methods:Two hundred patients treated with PICC catheterization from January 2013 to December 2015 were selected and randomly divided into two groups, namely, observation group and control group. The observation group adopted ultrasound-guided MST for catheterization while the control group applied traditional puncture technique for catheterization. Then efficacy of catheterization, success rate of catheterization and incidence rates of complications were compared between two groups

Results:Various indicators of catheterization effects of the observation group were better than those of the control group, and the differences were statistically significant [P<0.05]; one-time success rate of puncture and catheterization of the observation group was both higher than the control group [P<0.05];. Moreover, the incidence of puncture points bleeding, phlebitis and thrombus were all lower than those of the control group [P<0.05]

Conclusion:Implementing PICC catheterization based on ultrasound-guided modified Seldinger puncture technique can increase success rate of puncture, improve the effect of catheterization, lower incidence rate of adverse effects of catheterization and improve satisfaction and comfort level of patients

Relationship between reconstruction of the clivo-axial angle and curative effect in posterior approach surgery for the treatment of upper cervical spine anomaly instability / 中华骨科杂志

Objective The aim of this study was to describe the clinical outcomes and improvement of clivo-axial angle (CAA) during the posterior approach surgery of upper cervical anomaly instability patients.Methods All of 32 patients with symptomatic upper cervical anomaly instability were followed up from 2004 Apr.to 2014 Aug.in which 1 patient was excluded because of reoperation.There were 10 patients with OS odontiodeum,5 with odontoid deformity,4 with Klipple-Feil syndrome,4 with atlantoaxial dislocation,4 with atlantoaxial instability,1 with rheumatoid arthritis,1 with old odontoid fracture,1 with OS odontoideum and foramen magnum stenosis,1 with basilarinvagination and Klipple-Feil syndrome.They were all performed posterior reduction internal fixation and fusion,and then released spinal cord compression with the promotion of CAA.The patients were divided into two groups on the basis of decompression or not:non-decompression group 17 cases (male 8 cases,female 9 cases;age 13-65 years old,average 50.1 years old) and decompression group 14 cases (male 7 cases,female 7 cases;age 19-68 years old,average 49.6 years old).The CAA numbers were measured and compared.The clinic date was compared between preoperatively and postoperatively,which included Neck Disability Index and Nurick Classification System for Myelopathy.Results All patients were followed up,the follow-up time of non-decompression group was 0.7-10.7 years,average 2.9 years;the follow-up time of compression group was 0.3-5.5 years,average 2.9 years.Analysis of CAA,NDI and Nurick score were performed with t-test.The postoperative CAA,NDI and Nurick score improved significantly compared to preoperative ones.There was no difference between non-decompression group and decompression group.One patient felt nausea and vomited,one got soleal vein thrombosis,one had a swelling face and blurring vision and one had decompression syndrome after operation,all of these were improved using respectively therapy.No such serious complications as injury to vertebral artery,infection or internal fixation loosening occurred.Conclusion Neck ability and spinal cord function was significantly improved through increasing CAA for the upper cervical anomaly instability patients underwent posterior reduction internal fixation and fusion.

Value of linear array ultrasonic with high-frequency in the diagnosis of renal artery stenosis / 中国基层医药

Objective To evaluate the value of linear array ultrasonic with high-frequency in the diagnosis of renal artery stenosis (RAS).Methods 1 828 patients who were doubted with RAS were studied.All of them were checked by ultrasonic with convex array probe and linear array probe.Results The sensitivity,specificity,false positive rate,false negative rate of convex array probe were 8.20％,97.10％,2.90％,21.80％.The sensitivity,specificity,false positive rate,false negative rate of linear array probe were 91.13％,99.80％,0.20％,8.87％.Conclusion Linear array with high-frequency can keep the measurement angle less than 60°,and can show the plaque,nature of the plaque and narrow rate of renal artery.It may be more helpful in the diagnosis of RAS.

Percutaneous minimally invasive pedicle screw fixation for cervical fracture using intraoperative three-dimensional fluoroscopy-based navigation / 中华外科杂志

<p><b>OBJECTIVE</b>To retrospectively assess the feasibility and safety of percutaneous minimally invasive pedicle screw fixation for cervical fracture using intraoperative three-dimensional fluoroscopy-based navigation.</p><p><b>METHODS</b>Thirty patients admitted from April 2012 to May 2014 in Beijing Jishuitan Hospital with cervical fracture underwent pedicle screw fixation using intraoperative three-dimensional fluoroscopy-based navigation, with 8 patients using minimally invasive technique (CAOS-MIS group), and the other 22 patients using conventional open approach (CAOS-open group). Operative time, blood loss and postoperative neurovascular complications were recorded. Screw positions were studied by postoperative CT scan. All patients were followed up for at least 6 months. Neck visual analogue score (VAS) and American Spinal Injury Association (ASIA) classification were evaluated preoperatively and at 6-month follow-up. Independent-sample t test and Chi-Square test were used for statistical analysis.</p><p><b>RESULTS</b>Operation time was (139 ± 18) minutes and blood loss was (73 ± 40) ml in CAOS-MIS group and correspondingly (154 ± 42) minutes and (296 ± 171) ml in CAOS-open group. The blood loss in CAOS-MIS group was significantly lower than that in CAOS-open group (t = 5.695, P < 0.01). No screw-related injury to nerve or vertebral artery was observed. Thirty-four screws were placed in CAOS-MIS group with 28 screws (82.4%) classified as Grade I, meanwhile in CAOS-open group 108 screws were placed with 96 screws (88.9%) classified as Grade I. There was no statistical difference between the two groups (χ² = 0.998, P > 0.01). VAS score showed no statistical difference preoperatively (t = 0.334, P > 0.01), however statistical difference existed at 6 months follow-up (t = 4.111, P < 0.01) with (0.4 ± 0.5) in CAOS-MIS group and (1.5 ± 0.7) in CAOS-open group. There were 1 patient from class B to improve to D, 1 case from D to E in CAOS-MIS group, and 1 patient from class A to improve to B, 1 case from B to D, 2 cases from C to D, 3 cases from D to E in CAOS-open group 6 months after surgery. Cervical X-ray demonstrated fractures healed well in all cases at 6 months follow-up.</p><p><b>CONCLUSION</b>It is feasible and safe for percutaneous minimally invasive pedicle screw fixation for cervical fracture using intraoperative three-dimensional fluoroscopy-based navigation, which can also decreases the incidence of postoperative neck pain.</p>

Analysis of the high risk factors of critically ill patients in department of neurosurgery complicated with lower respiratory tract infection and nursing strategy / 中国实用护理杂志

ObjectiveTo study the nursing strategy and high risk factors of critically ill patients complicated with lower respiratory tract infection in department of neurosurgery. Methods672 critically ill patients in department of neurosurgery in our hospital from January 2007 to September 2011 were selected as research object,and the rate of lower respiratory tract infection and high risk factors were studied and analyzed,and they were taken care of with special nursing. Results54 cases of 672 patients were with lower respiratory tract infection,the rate was 8.04％.Infection rate of elderly patients,patients of poor nutrition state,patients with underlying diseases was higher than those of other patients.Infection rate of patients with invasive operation,sputum suction,application of respirator,longer operative time and oxygen inhalation time was higher than those of other patients.Infection rate of patients with longer hospitalization time,emergency operation,application of many antibiotics and complication of preoperative infection of other site was higher than those of other patients,there were significant differences.The infection was well controlled with special nursing and treatment,four patients died of primary diseases. ConclusionsThe high risk factors of critically ill patients complicated with lower respiratory tract infection in department of neurosurgery include personal factors,treatment operation factors and other factors,and it can be controlled by special nursing and treatment.