Risk factors and early diagnosis strategies for traumatic intracranial venous sinus occlusion / 中国医师进修杂志

Objective To analyze the risk factors for traumatic cerebral venous sinus occlusion (CVSO)and to investigate the strategies of early diagnosis of traumatic CVSO. Methods The clinical data of 212 patients with moderate to severe closed traumatic brain injury from January 2012 to December 2015 were analyzed retrospectively. Logistic regression analysis was used to evaluate the risk factors for traumatic CVSO. Results Of the 212 patients with traumatic brain injury, 16.5%(35/212) patients had CVSO. Ten patients had CVSO of thrombotic type (typeⅠ), 16 patients had CVSO of compression type (typeⅡ), and 9 patients had CVSO of mixed type (typeⅢ). Logistic regression analysis showed that skull fracture (OR = 8.141; 95%CI: 3.224-20.840) and epidural hematoma of crossing venous sinus (OR = 3.179; 95%CI: 1.470-7.037) were the risk factors for CVSO, and the former was more significantly correlated with CVSO. Female gender was the risk factor for CVSO typeⅠ(OR =10.425; 95%CI: 1.831-30.053), epidural hematoma of crossing venous sinus was the risk factor for CVSO typeⅡ(OR = 5.766; 95%CI: 1.885-18.197), and skull fracture, epidural hematoma of crossing venous sinus, and the previous history of vein thrombosis was the risk factors for CVSO type Ⅲ(OR =18.005, 4.596, 11.394; 95%CI: 2.021-58.836, 1.144-19.525, 1.436-46.558). Conclusions In the early diagnosis of traumatic CVSO, the crossing venous sinus fracture line and epidural hematoma should be given attention. Attention should be paid to the history of venous thrombosis. MR venography and CT venography contributes to early diagnosis of CVSO.

Evaluation and continuous improvement of the application of critical values / 中华医院管理杂志

Objective To discover regularities behind critical values in an effort to provide scientific evidences for a better critical value report system.Methods Collection, analysis and statistical assessments for critical value items and ranges appropriate for the hospital Results The occurrence rate of critical values is found to be 0.14%.By means of clinical evaluation, statistic analysis and reference to literature and clinical specialists, the clinical labs revised the ranges of PO2, GLU, PT and APTT, and added ALT, MYO, CTnl and K+ , GLU, BILl for newborns, and canceled AMY.All of these changes were put in practice upon approval of the Medical Department of the hospital Conclusion Regular evaluation and continuous improvement of the critical value report system may help with saving lives, improving quality of care of the labs and doctors" diagnosis as well

Interventional treatment of dural arteriovenous fistula / 中华外科杂志

<p><b>OBJECTIVES</b>To summarize the characteristics of interventional treatment of dural arteriovenous fistulae (DAVFs) and improve clinical curative effects.</p><p><b>METHODS</b>The clinical data from 135 patients with DAVFs were analyzed retrospectively.</p><p><b>RESULTS</b>Seventy-four patients were cured, 53 were significantly improved, 8 unchange, and 1 died of intracranial haemorrhage.</p><p><b>CONCLUSIONS</b>Clinical presentations and prognosis of DAVF depend on the types of venous drainage. Compression of the affected carotid artery and endovascular embolization are safe and effective.</p>

Interventional treatment of 126 patients with anterior communicating artery aneurysm / 中华外科杂志

<p><b>OBJECTIVES</b>To analyse the characteristics of interventional treatment for anterior communicating artery aneurysm (AcoAA) and improve curative effects.</p><p><b>METHODS</b>In 126 patients, detachable microcoils were used to embolize the AcoAA via endovascular approach. Those patients failed to be embolized were treated by surgical clipping.</p><p><b>RESULTS</b>Of the 109 patients who were embolized successfully, 97 were achieved 100% occlusion, 12 95% - 98% occlusion. In the other 17 patients who failed to interventional treatment 15 were treated surgically and 2 no treatment because of cerebral vascular spasm. 123 patients were cured, one died, and 2 had aneurysms disappeared without any operations, as proved by follow-up for 5 months to 1 years. Of 32 patients checked by cerebral angiography 3 weeks to 30 months after operation, 30 showed disappeared of aneurysms and 2 had recurrence. The recurred aneurysms were successfully reembolized.</p><p><b>CONCLUSIONS</b>Most of AcoAAs can be cured by endovascular interventional treatment. Those who failed to be treated by embolization can be cured surgically. Few patients may be healed spontaneously. The long term effects of treatment should be followed-up for a long time.</p>