Research progress on the questionnaire related to persistent postural-perceptual dizziness / 临床耳鼻咽喉头颈外科杂志

Persistent postural-perceptual dizziness（PPPD） is the most common chronic vestibular disease, the clinical manifestation is dizziness, unstable and non-rotational dizziness for three months or more. And the symptom is exacerbated by upright posture, active or passive movement, and complex visual stimuli. In addition, PPPD is a functional disease, so routine vestibular function tests and imaging tests are often negative. According to the diagnostic criteria established by the Barany Association, the diagnosis of PPPD often relies on history. This article provides a review of PPPD-related questionnaires.

Effect of 5 methods of critical illness score in the prognosis evaluation of sepsis-associated encephalopathy / 中华急诊医学杂志

Objective:To explore the effect of pediatric critical illness score (PCIS), pediatric risk of mortality Ⅲ score (PRISM Ⅲ), pediatric logistic organ dysfunction 2 (PELOD-2), pediatric sequential organ failure assessment (p-SOFA) score and Glasglow coma scale (GCS) in the prognosis evaluation of septic-associated encephalopathy (SAE).Methods:The data of children with SAE admitted to the Pediatric Intensive Care Unit (PICU), Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences from January 2010 to December 2020 were retrospectively analyzed. They were divided into the survival and death groups according to the clinical outcome on the 28th day after admission. The efficiency of PCIS, PRISM Ⅲ, PELOD-2, p-SOFA and GCS scores for predicting death were evaluated by the area under the ROC curve (AUC). The Hosmer-Lemeshow goodness-of-fit test assessed the calibration of each scoring system.Results:Up to 28 d after admission, 72 of 82 children with SAE survived and 10 died, with a mortality rate of 12.20%. Compared with the survival group, the death group had significantly lower GCS [7 (3, 12) vs. 12 (8, 14)] and PCIS scores [76 (64, 82) vs. 82 (78, 88)], and significantly higher PRISM Ⅲ [14 (12, 17) vs. 7 (3, 12)], PELOD-2 [8 (5, 13) vs. 4 (2, 7)] and p-SOFA scores [11 (5, 12) vs. 6 (3, 9)] ( P<0.05). The AUCs of PCIS, PRISM Ⅲ, PELOD-2, p-SOFA and GCS scores for predicting SAE prognosis were 0.773 ( P=0.012, AUC>0.7), 0.832 ( P=0.02, AUC>0.7), 0.767 ( P=0.014, AUC>0.7), 0.688 ( P=0.084, AUC<0.7), and 0.692 ( P=0.077,AUC<0.7), respectively. Hosmer-Lemeshow goodness-of-fit test showed that PCIS ( χ2=5.329, P=0.722) predicted the mortality and the actual mortality in the best fitting effect, while PRISM Ⅲ ( χ2=12.877, P=0.177), PELOD-2 ( χ2=8.487, P=0.205), p-SOFA ( χ2=9.048, P=0.338) and GCS ( χ2=3.780, P=0.848) had poor fitting effect. Conclusions:The PCIS, PRISM Ⅲ and PELOD-2 scores have good predictive ability assessing the prognosis of children with SAE, while the PCIS score can more accurately evaluate the fitting effect of SAE prognosis prediction.

Clinical study of inter-hospital transport of 237 neonates with acute and critical congenital heart disease / 中华实用儿科临床杂志

Objective:To investigate the safety of inter-hospital referral and the prognosis of neonatal with critical congenital heart disease.Methods:The criticality score, transit distance and time, and the prognosis of 237 newborns with critical congenital heart disease in Guangdong Provincial People′s Hospital from July 2016 to July 2018 were retrospectively analyzed.Results:A total of 237 children were included (162 male and 75 female) with the median age of 6 days and the median body weight of 2.98 kg.The median transit distance was 90 km.The average value of neonatal critical illness score (NCIS) was (86.54±9.05) scores before transport; 136 cases were greater than 90 scores, 84 cases between 70 and 90 scores, 17 cases less than 70 scores; while the average NCIS was (87.05±8.19) scores when arrived at neonatal intensive care unit (NICU), 138 cases were greater than 90 scores, 82 cases between 70 and 90 scores, 17 cases less than 70 scores.There were no significant differences in the scores of critical cases before and after transfer according to the transfer time and distance ( t=0.346, P>0.05). There was no one death occurred during the transfer process.All over, 222 cases were cured and discharged from the hospital after surgery and or medical interventional treatments, 15 cases died after giving up treatment or losing the opportunity for surgery. Conclusions:It is safe and effective of the inter-hospital transport for the rescue of infants with critical congenital heart disease when followed the principles and transport rules and regulations, with trained workers and special equipments.

CT perfusion imaging in the diagnosis of hepatocellular carcinoma / 中华肝胆外科杂志

Objective To evaluate the value of CT perfusion imaging (CTPI) in the diagnosis of hepatocellular carcinoma (HCC). Method CTPI was carried out on 21 patients with 26 lesions to obtain the following perfusion parameters: hepatic blood flow (HBF), hepatic blood volume (HBV),mean transit time (MTT), permeability surface area product (PS), and hepatic arterial fraction (HAF). The parameters from the lesion and non-lesion areas were compared. In addition, serum AFP was measured in the HCC patients and a linear correlation analysis between the alpha-fetoprotein (AFP) level and the CTPI parameters was performed. Result CTPI failed in 3 patients with 3 lesions and was successful in 18 patients with 23 lesions which included 18 HCC, 4 hemangioma of the liver,and 1 hepatic focal nodular hyperplasia (FNH). On comparison of the HCC parameters in the lesion and non-lesion areas, significant differences were found in the HAF which was 4.11 times higher in the lesion than the non-lesion areas, while the MTT and PS were significantly lower. There was no significant difference in the HBF and HBV. Correlation between the serum AFP level and the CTPI parameters of the HCC lesion was insignificant. The differences of all the parameters between the lesion and the non-lesion in hemangioma were similar to those in HCC, except for a higher HBF in the lesion than in HCC. There was no significant difference between the parameters of FNH and the non-nodular part of the liver. Conclusion CTPI played an important role in the diagnosis and differential diagnosis of HCC, especially when the AFP was negative and/or the imaging manifestation was atypical on contrast CT.

Application of CT perfusion imaging in diagnosing liver cancer / 中华肝胆外科杂志

Hepatic perfusion data such as hepatic blood flow, hepatic blood volume, hepatic arterial perfusion index etc, can be obtained by CT perfusion imaging (CTPI)with quantitative measurements of local blood flow to the liver. As the data mentioned above are varied in different tissues, e. g normal liver parenchyma, cirrhotic liver, hepatocellular carcinoma(HCC) and secondary liver cancer(SLC),the differential diagnosis of liver lesions, especially the early subclinical liver cancer, can be made by analyzing the related data. The principle of CTPI, the main points for differential diagnosis between HCC and SLC, the relationship between CTPI and micro-vessel density(MVD), the changes of CTPI pre-and post-TACE, as well as diagnostic sensitivity of CTPI and contrast enhanced ultrasound(CEUS) in patients with liver cancer were introduced in this article.