Objective To evaluate the clinical effect of itraconazole oral solutions on pulmonary candidiasis albicans in ICU patients.Methods A total of 71 patients with candida ablicans in their sputum clutures were randomized into two groups.The itraconazole group(n= 36)received itraconazole 200 mg,p.o.(including nasal feeding),q12h for 14 days.The fluconazole group(n=35)received fluconazole 400 mg for the first dose,then 200 mg,i.v.drip,qd for 14 days.Results There were 31 patients in the itraconazole group and 29 paitents in the fluconazole group who completed their treatment.In the itraconazole and fluconazole group,the clearance of candida ablicans was 64.52%(20/31)vs.65.55%(19/29),cleaning time(10.12?2.57)vs(8.87?1.95)days,effective rate 58.06%(18/31)vs 62.07%(18/29),recovery rate is 19.35%(6/31)vs 17.24%(5/29),occurrence of hepatic dysfunction is 25.81%(8/31)vs 24.14%(7/29),and withdrawal for inefficacy was 3.23%(1/31)vs 6.90%(2/29),respectively.These parameters did not have statistical significance.Conclusion Itraconazole oral solutions can be used effectively and safely in the treatment of pulmonary candidiasis albicans in ICU.Patients with renal dysfunction do not need to adjust the dosage.

Objective To study the application of microelectrode stereotactic functional nucleus lesioning operation in the treatment of Parkinson′s disease(PD) ,and to explore its clinical value .Methods The clinical data in 84 cases of PD treated with‐out using the microelectrode stereotactic functional nucleus lesioning operation(observation group) and 74 cases of PD treated by u‐sing microelectrode guided stereotactic functional nucleus lesioning in our hospital were retrospectively analyzed .At the same time the Unified Parkinson′s Disease Rating Scale (UPDRS) scores before the nucleus lesioning and at postoperative different medication states were obtained in the observation and the control group .Furthermore the difference of the UPDRS motor scores before and af‐ter operation were compared between the two groups .Results The UPDRS motor scores at postoperative 3 ,6 months and 1 year in the observation group were significantly improved compared with before operation(P<0 .05) ,meanwhile the postoperative anti‐PD drug dosage was significantly decreased compared with before operation(P<0 .05) .Among them ,70 cases(83 .3% ) in the control group were obviously effective ,14 cases(16 .7% ) were effective ,and the total effective rate was 100% ;while 62 cases(83 .7% ) in the observation group were obviously effective ,12 cases (16 .3% ) were effective ,and the total effective rate was 100% .The differ‐ence in improving the UPRDS motor scores before and after operation had no statistical difference between the two groups(P>0 .05) .Conclusion Stereotactic nucleus lesioning in treating PD has satisfactory effect and can significantly improve the UPRDS motor scores .Accurate positioning is the key to the operation success ,whether microelectrode recording can significantly improving the operation accuracy needs further discussion .

Objective:To investigate specificity of neurovascular compression in patients with primary trigeminal neuralgia (PTN) by three-dimension reconstruction and computational fluid dynamics.Methods:Clinical characteristics and preoperative magnetic resonance imaging (MRI) data of 20 patients with both PTN and single artery compression (PTN group) and 10 patients without PTN but having neurovascular contact in MRI images (control group) in the Second Affiliated Hospital of Zhengzhou University from January 2018 to December 2019 were collected and analyzed. After three-dimension reconstruction of the MRI images, curvature of the arterial loop, angle between the plane of arterial loop and the trigeminal nerve and location of the compression were observed. Then bidirectional structure-fluid coupling based on the optimized stereolithography models of arterial loop and nerve were processed by ANSYS 19.2 software. In the location of the compression of contact, equivalent stress (ES) of arterial loop on the nerve, shearing stress (SS) of the blood flow and local deformation of the nerve were iteratively computed. All parameters were analyzed and compared between the PTN group and the control group, and the correlation analysis was proceeded between the anatomical parameters and hemodynamical parameters.Results:The curvature of arterial loop [0.21(0.12) mm -1vs 0.13(0.07) mm -1, U=34.00, P<0.05], the angle between vascular loop and nerve [69.70(30.67)° vs 43.40(37.21)°, U=38.00, P<0.05] in the PTN group were significantly greater than those in the control group, and the location of compression was significantly closer to the root of nerve in the PTN group [PTN group: (4.23±1.29) mm vs control group: (5.54±1.85) mm, t=-2.26, P<0.05]. The average SS [15 952.48(5 365.56) Pa vs 12 501.97(6 355.26) Pa, U=53.00, P<0.05], ES [24 965.65(7 693.22) Pa vs 14 992.99(9 824.08) Pa, U=32.00, P<0.05] in the PTN group were significantly greater than those in the control group. The curvature of arterial loop was positively correlated with the SS ( r=0.931, P<0.05) and ES ( r=0.962, P<0.05), and the latter two ( r=0.787, P<0.05; r=0.853, P<0.05) were positively correlated with the local neural deformation. Conclusions:In patients with PTN, offending artery compresses the root of nerve by greater arterial curvature and angle between the arterial loop and nerve. These anatomical differences will cause significantly greater SS, ES and local neural deformation.