Objective To explore the imaging typing of skull eosinophilic granuloma( SEG) in children,and the clinical significance of this typing system was determined. Methods The clinical and radiological data of 32 cases of SEG confirmed by pathology in the past six years were retrospectively reviewed. According to the imaging findings,which included the size and shape of the granuloma,and the degree of skull destruction,SEGs were divided into four types:typeⅠ( subtle granumoma) ,typeⅡ( exteriorly convex granuloma) ,typeⅢ( biconvex granuloma) and typeⅣ(multiple granulomas and destructions). The imaging features of different types of SEG were analyzed,and the signif-icance of imaging typing was explored combining with the clinical manifestations,treatment programs and prognosis. Results Three cases (9. 4%) were included in typeⅠ,in which,the granuloma was not obvious and the skull destruction was confined in the diploe and outer plate. In type Ⅱ (21 cases,65. 6%),the imaging features included an obvious exteriorly convex mass and complete skull destruction of in-side and outside panels. Granuloma remove and destructed skull repair were performed in all cases,in which 15 were followed up and no re-currence was found. The imaging features of type Ⅲ (5 cases,15. 6%) were biconvex mass which broke through the inner plate and op-pressed the dura and cerebral parenchyma. Therapy program included not only surgical excision of the lesion but also repair of skull and dura. Three cases were followed up and no recurrence was found. Type Ⅳ (3 cases,9. 4%) showed multiple skull destructions and granulomas of various sizes. Chemotherapy and surgery treatment,poor prognosis and ease recurrence were characterized by this type. Conclusion we put forward a imaging typing method for SEGs. This typing system is helpful in guiding clinical protocols and prognosis of SEGs in children.

Objective To investigate the treatment and prevention strategies of hematomas in operation area after anterior approach surgery for cervical spondylosis.Methods A retrospective review was conducted on 12 with hematoma compression in operation area out of 785 patients managed by anterior cervical surgery from January 2007 to July 2013,including 10 males and 2 females at age ranging from 40-71 years (mean 56.8 years).Surgery method was anterior cervical corpectomy and interbody fusion using titanium mesh cage plus plate and intraoperative blood loss was 300-1 200 ml.Primary clinical manifestations were neurological dysfunction in 5 patients,dyspnea in 6,and both neurological dysfunction and dyspnea in 1.There were 10 patients with the presence of symptoms at postoperative 0.5-22 hours,1 at postoperative 73 hours,and 1 at postoperative 74 hours.All the 12 patients underwent a second anterior cervical exploration.Results There were 5 patients with epidural hematoma,6 with subcutaneous hematoma,and 1 with both hematomas.After surgical interventions,the patients presented improvement in respiratory and neurological function,with inapparent respiratory abnormality and improved neurological function at discharge.One patient was died of cardiovascular-associated disease after being discharged from hospital.The left 11 patients were followed up for mean 19.8 months (range,6-43 months),with improved Japanese Orthopedic Association (JOA) score at final follow-up.Conclusions Hematoma took place frequently in the early period,especially within 24 hours in operation area after anterior approach to cervical disorders and close attention should be paid to respiratory and limb sensation and motion functions.Early detection and early surgical interventions are the key countermeasures to avoiding the severe results.

Objective To observe the effect of Xiaoxianxiong Decoction combined with metformin on glucose and lipid metabolism of phlegm-heat type 2 diabetic patients (T2DM). Methods Totally 104 phlegm-heat T2DM patients were randomly divided into two groups (each contains 52 cases), and given the diabetes lifestyle intervention. Control group additionally took 0.5 g metformin twice daily. And treatment group, besides taking 0.5 g metformin, was given Xiaoxianxiong Decoction, one dose and three times per day warmly. After 12 weeks, FBG, HbA1C, TC, TG, HDL-C, LDL-C, 2 hPG of the two groups were determined, and the therapeutic effect was evaluated. Results The total effective rate in the treatment group was 92.31%, and 76.92%in control group (P<0.01). The difference in symptom score, FBG, 2 hPG, TC, TG, HDL-C and LDL-C between the two group were significant, so as that between before and after treatment of both groups (P<0.05). Conclusion Xiaoxianxiong Decoction combined with metformin can effectively lower the levels of blood glucose and blood lipid in phlegm-heat T2DM patients, enhance the therapeutic effect and improve the metabolism of glucose and lipid.

Blood Gas Analysis ; Hepatopulmonary Syndrome ; therapy ; Humans ; Male ; Middle Aged ; Portasystemic Shunt, Transjugular Intrahepatic ; Treatment Outcome

Objective:To investigate the possible influencing factors of false-negative diagnosis of cervical/vaginal liquid based cytology, and further improve the sensitivity of cervical/vaginal cytology.Methods:The results of cervical/vaginal cytology of outpatients and inpatients in Department of Obstetrics and Gynecology, Peking University First Hospital from July 2015 to December 2018 were analyzed retrospectively. Cytological false-negative cases were defined as the patients whose cytological results showed no intraepithelial neoplasia and malignant (NILM), but whose biopsy was diagnosed as cervical intraepithelial neoplasia (CIN) 2 or vaginal intraepithelial neoplasia (VAIN) 2 or above within 6 months of the diagnosis. The review of false-negative cytology smear was completed by two senior cytologists. Two-class logistic regression was used to evaluate the influence of age, location or number of lesion, and degree of lesion on the false-negative diagnosis of cytology. The reasons for the inconsistency of false-negative diagnosis were analyzed with the review results.Results:Among 1 009 cases of CIN2+ and VAIN2+ lesions, 180 cases (17.8%) showed NILM. After reviewing the smear, 123 cases (68.3%) were identified as NILM and 57 cases(31.7%) as abnormal. The false-negative rate was the highest (20.8%) in the patients with age≤30 years, and the risk was 8.85 times higher than the patients aged 31 to 60 years ( P<0.001), 9.26 times than the patients aged≥60 years ( P<0.001). The highest cytological false-negative rate was 50.0% for cervical polyps or intraductal lesions. The false-negative rate of vaginal wall or vaginal pedicle rupture was 13.0%; that of single cervical lesion was 22.3%; that of high-grade squamous intraepithelial lesion(HSIL) and adenocarcinoma in situ of cervix(AIS) was 13.7% and that of malignant lesions was 3.9%. The most common cell types in the reviewed abnormal cases were squamous cells in the middle surface layer (38.6%) and squamous cells in the outer bottom layer (24.6%). The abnormal cells in all smears was the most common distribution (59.7%), the number of abnormal cells in the smear was less than 10 (31.6%), nuclear enlargement and light staining were common (42.2%), and inflammatory lesions or keratotic changes in the background were most common (59.7%). Conclusions:Age of the patient, location or number of lesion, and degree of lesion are associated with false-negative diagnosis of cytology. Summarizing sampling experience and improving sampling skills will help reduce the occurrence of false-negative cases. Cytopathologists should examine slightly abnormal changes more carefully and learn how to further reduce the false-negative rate procactively.

Objective To establish the quality representation and correlation analysis method and the content of characteristic ingredients based on spectrum of medicinal system of Juemingzi (Semen Cassiae),in order to evaluate the quality of Semen Cassiae decocting pieces effectively and accurately. Methods HPLC-PDA method was established to characterize the quality of spectrum of Semen Cassiae medicinal system architecture;quality of 11 batches of Semen Cassiae decocting pieces was characterized based on the number and chemical type of peaks on characteristic spectrum. The content of 6 characteristic index components, naphthopyrones and anthraquinones were characterized by indexes in characteristic spectrum. Correlation analysis of quality of Semen Cassiae was then performed with reference to the standard reference pieces. Results Taken as the reference substance, characteristic spectrum of batch 10 Semen Cassiae altogether contains 12 characteristic peaks, all characteristic peaks appeared on the chromatograms of 11 batches of Semen Cassiae. In 11 batches of Semen Cassiae, No.5, 11, 8, 1, 2 pieces contained higher effective index components, while No. 5, 11, 2, 9, and 7 pieces had high relevance with the reference piece (No. 10). Consolidated quality characterization and correlation analysis,the quality of No. 5,11,8,1,2,9,and 7 were excellent and dominant. Conclusion The HPLC method to analyze quality and quantity of phenolic components spectrum of 11 batches of Semen Cassiae is simple and accurate. The evaluation mode of quantity and quality and their correalation based on Semen Cassiae medical system, including systemic correlation and appilication validity, as it can provide a reliable methodological basis for the comprehensive quality evaluation of Semen Cassiae.

Objective:To explore the role of mechanical hemodynamic support (MHS) in mapping and catheter ablation of patients with hemodynamically unstable ventricular tachycardia (VT), report single-center experience in a cohort of consecutive patients receiving VT ablation during MHS therapy, and provide evidence-based medical evidence for clinical practice.Methods:This was a retrospective cohort study. Patients with hemodynamically unstable VT who underwent catheter ablation with MHS at Beijing Anzhen Hospital, Capital Medical University between August 2021 and December 2023 were included. Patients were divided into rescue group and preventive group according to the purpose of treatment. Their demographic data, periprocedural details, and clinical outcomes were collected and analyzed.Results:A total of 15 patients with hemodynamically unstable VT were included (8 patients in the rescue group and 7 patients in the preventive group). The acute procedure was successful in all patients. One patient in the rescue group had surgical left ventricular assist device (LVAD) implantation, remaining 14 patients received extracorporeal membrane oxygenation (ECMO) for circulation support. ECMO decannulation was performed in 12 patients due to clinical and hemodynamic stability, of which 6 patients were decannulation immediately after surgery and the remaining patients were decannulation at 2.0 (2.5) d after surgery. Two patients in the rescue group died during the index admission due to refractory heart failure and cerebral hemorrhage. During a median follow-up of 30 d (1 d to 12 months), one patient with LVAD had one episode of ventricular fibrillation at 6 months after discharge, and no further episodes of ventricular fibrillation and/or VT occurred after treatment with antiarrhythmic drugs. No malignant ventricular arrhythmia occurred in the remaining 12 patients who were followed up.Conclusions:MHS contributes to the successful completion of mapping and catheter ablation in patients with hemodynamically unstable VT, providing desirable hemodynamic status for emergency and elective conditions.