OBJECTIVE: To observe the effect of lidocaine on respiratory failure and the airway peak pressure in patients with severe asthma. METHODS: The severe bronchial asthma patients treated with mechanical ventilation were randomly divided into treatment group and control group. The change in airway peak pressure, man-machine counteraction, and the correcting time of respiratory failure of the two groups were recorded. RESULTS: The average airway peak pressure was(41.18?10.66) cmH2O in the control group vs.(29.23?9.07) cmH2O in the treatment group; the incidence of man-machine counteraction was 100% for the control group vs. only 40% for the treatment group; the correcting time of respiratory failure was(6.42?1.73) h for the control group vs.(3.31?1.08) h for the treatment group. There were significant differences between the two groups in the above mentioned indexes(P

Objective To assess the damage of limbic system pathways in relapsing-remitting multiple sclerosis (RRMS) by diffusion tensor imaging (DTI) tractography.Methods DTI tractography was used to acquire fiber numbers,fractional anisotropy (FA),mean diffusivity (MD) of cingulum,fornix,and uncinate fasciculus (UF) in 20 RRMS patients (MS group) and 20 healthy volunteers (control group),and statistical analysis was performed.Results Compared with control group,lower FA value (P＜0.01) and higher MD value (P＜0.05) were found in cingulum,fornix and UF of MS group,and the fiber numbers of fornix decreased in MS group (P＜0.001).There were significant differences between the left and the right UF in fiber numbers and FA value of control group and the fiber numbers of MS group.Negative correlations were found between FA value of cingulum and UF and EDSS scores in MS group (r=-0.572,-0.665,both P＜0.05),and positive correlations were found between MD value and EDSS scores (r=0.627,0.603,both P＜0.05).Conclusion DTI tractography is valuable in assessing MS associated limbic system damage and in monitoring the clinical progression of the disease.

OBJECTIVE: To explore. HRCT and MRI three-dimensional fast imaging employing steady state ac-quisition(3D-FIESTA) imaging features and clinical characteristics of bilateral large vestibular aqueduct syndrome(LVAS). METHOD: The imaging and clinical features of 14 cases of bilateral LVAS identified over a 5-year periodwere retrospectively analyzed. All patients underwent HRCT and MRI 3D-FIESTA scanning of head and neck;MRI three dimensional reconstructions of internal acoustical meatus were also completed at the same time. RESULT: Audiogram showed mild to moderate hearing loss and was progressive. The cut-off values for the coronal midpointand operculum planes on the HRCT scan to diagnose an EVA were 1. 5 mm and 4. 3 mm respectively; the averagevalue was 2. 4 mm. VA expansion degree were not linked to the degree of hearing loss. MRI showed VA andlymph sac abnormalities. Concomitant image finding was cochlear hypoplasia. CONCLUSION HRCT and MRI 3D-FI-ESTA are important examinations for accurate diagnosis of LVAS. HRCT can acquire the specific size of reamedVA. MRI and 3D reconstructions of internal acoustical meatus can noninasive show more intuitive display ofLVAS and other inner ear malformations than HRCT.
Ear, Inner ; Head ; Hearing Loss ; Hearing Tests ; Humans ; Imaging, Three-Dimensional ; Magnetic Resonance Imaging ; Retrospective Studies ; Temporal Bone ; Tomography, X-Ray Computed ; Vestibular Aqueduct ; pathology ; Vestibular Diseases ; diagnosis

Objective To observe the efficacy and safety in the postoperative craniocerebral trauma elderly patients us-ing the layered method of sputum suction. Methods Senventy patients aged 60 and above with craniocerebral trauma were divided into the layered method group (group A) and the traditional method group (group B). The vital sign, mu-cosa damage frequency, the times of average daily sputum suction and the incidence of VAP were compared. Results Compared with group B, group A could reduce the vital signs change and the times of average daily sputum suction, with lower airway mucosa damage and the incidence of VAP, the difference was statistically significant(P<0.05). Con-clusion The layered method of sputum suction is safer and more effective than traditional method in treatment of the postoperative elderly patients with craniocerebral trauma.

Objective To evaluate quality control circle (QCC) impacting on Burnout syndrome of emergency nurse and satisfaction of patients in one hospital of Wenzhou.Methods Emergency nurse,who worked at one hospital of Wenzhou during January 2012 to December 2013,were chosen as sampling objects and divided into QCC group (47 nurses) and control group (39 nurses).The nurses of QCC group underwent QCC activities while nurses of the control group received routine management.The QCC activities lasted 3 months,and one week before and after QCC activities,we questionnaired Burnout syndrome,normal population sociology information,frequency of job burnout syndrome,work performance,and patient's satisfaction.Results Before activities,there was no statistical significance for occurrence of Burnout syndrome between two groups (P ＞ 0.05);one week after the implementation of activities,the fatigue,headache,insomnia,negative emotion had statistical significance between two groups (x2 =5.88,6.01,5.88,6.11,respectively;P ＜ 0.05),but the symptom of irritation were not statistical significant (x2 =0.52,P ＞ 0.05).Before activities,the work performance and patient's satisfaction had no statistical significance;one week after the accomplishment of activities,the scores of colleague relationship,work satisfaction,work efficient,patient's satisfaction for nurses in the QCC group were (5.81 ±0.19),(5.13 ±0.29),(5.12 ± 0.80),(5.33 ±0.54) higher than (4.90 ± 0.83),(4.73 ± 0.37),(4.01 ± 0.91),(4.48 ± 0.30) of the control group (t =2.613,2.433,2.695,2.497,respectively;P ＜ 0.05).The intention of turnover was (2.11 ± 0.98) score in the QCC group lower than that of control group (4.85 ± 0.71) score (t =2.946,P ＜ 0.01).Conclusions The QCC can promote the Burnout syndrome of emergency nurses,decrease nurse's intention to turnover,and enhance the enthusiasm nurse's work and patient's satisfaction.

Objective To assess the changes of white matter microstructure in neuromyelitis optica spectrum disorders (NMOSD) with DTI based on tract-based spatial statistics (TBSS) method.Methods Conventional MR and DTI were performed in 20 NMOSD patients (NMOSD group) and 20 healthy volunteers (control group).DTI data were analyzed with TBSS procedure,which was a part of FSL software packages,and non-parametric statistical analysis was performed on the whole brain.Correlation between FA value of tracts with significant difference in NMOSD group and expanded disability status scale (EDSS) scores was analyzed.Results TBSS analysis revealed significantly (P＜ 0.05,FWE corrected) extensive decrease of FA value in cerebrum and cerebellum white matter fiber bundles,i.e.corpus callosum,fornix,corticospinal tract,unciform fasciculus,cerebellar peduncles etc.in NMOSD group,and decrease of AD value,increase of RD value in cingulum bundle,corpus callosum and fornix,while MD value only increased in fornix and retrolenticular part of the left internal capsule (P＜0.05,FWE corrected).Negative correlations were found between FA value of left uncinate fasciculus,right external capsule,left inferior cerebellar peduncle,bilateral anterior limb of internal capsule,medial lemniscus and EDSS scores (all P＜0.05).Conclusion Widespread white matter damage is observed in cerebrum and cerebellum in NMOSD patients by using TBSS analysis,which may partly correspond to the disabilities of NMOSD patients.However,the other microstructural changes of white matter tracts may suggest complicated pathological mechanism of NMOSD.