Objective To explore the practicle value of video-electroencephalogram(VEEG)in diagnosis of epilepsy in childhood.Methods One hundred and sixty-six children diagnosed as epilepsy group and 49 children suspected to be epilepsy(suspicious epilepsy group) were monitored with VEEG instrument(PI VEEG 400-C) for 3-4 hours under the state of awaking and sleeping and with all kinds of evoked tests.Results Among 166 cases of epilepsy group,124(74.5%) patients were confirmed as epilepsy,clinical seizures were observed in 26 cases of suspicious epilepsy group,6(23.1%) cases were identified as non-epileptic attacks;Among 49 cases,13((26.5%)) patients were confired as epilepsy,clinical seizures were observed in 16 cases,13(81.3%) cases were identified as non-epileptic attacks.Seizure types were difined in 99 of 137(72.3%) children with epileptic discharges,and epileptic syndromes were defined in 43((30.6%)) of them.Conclusion VEEG can provide accurate and reliable information in diagnosis and classification of epilepsy.

Objective To systematically review the changes in the intensity of postoperative pain under ketamine anesthesia in children.Methods We searched the Cochrane Library,PubMed,OVID,EMBASE,and Chinese Biomedical Database for prospective randomized controlled trials involving the changes in the intensity of postoperative pain under ketamine anesthesia in children.The quality of the studies was evaluated by the method recommended by Cochrane Collaboration.Evaluation indexes included pain score and analgesic consumption during 6 h after operation,pain score and analgesic consumption during 6-24 h after operation,duration of sensory block (caudal block),side effects during 24 h after operation (postoperative nausea and vomiting and psycho-mimetic manifestations).Meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.0 software.Results Fifteen prospective randomized controlled trials involving 955 patients were included in our Meta-analysis.The patients were divided into 2 groups:control group ( n =455) and ketamine group ( n =500).The pain score and analgesic consumption during 6 h after operation were significantly decreased after general anesthesia with ketamine.The pain score during 6-24 h after operation and analgesic consumption during 6 h after operation were significantly decreased after local anesthesia with ketamine.The duration of sensory block was prolonged and the analgesic consumption during 6 h after operation was significantly reduced after caudal block with ketamine.There was no significant difference in the incidence of postoperative nausea and vomiting and psycho-mimetic manifestations between the two groups.Conclusion The intensity of pain and analgesic requirement during 6 h after operation are significantly reduced under ketamine anesthesia in children.

Adolescent ; Adult ; CD36 Antigens ; blood ; Diagnosis, Differential ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Platelet Activation ; Psoriasis ; blood ; diagnosis ; Thrombin ; metabolism ; Thrombospondins ; blood

Objective:To observe the effect of acupoint massage plus acupoint sticking therapy for the stress reaction during postoperative anesthesia recovery period in patients undergoing nasal endoscopic surgery.Methods:A total of 120 patients undergoing nasal endoscopic surgery were included,and all patients were under trachea intubation and general anesthesia.The patients were randomized into an observation group and a control group,with 60 patients in each group.Patients in the control group received conventional anesthesia resuscitation,while patients in the observation group received acupoint massage plus acupoint sticking therapy on the basis of conventional anesthesia resuscitation.Changes in the heart rate (HR),systolic blood pressure (SBP) and diastolic blood pressure (DBP) were observed at three time points including the end of the surgery (TO),the removal of the tracheal tube (T1) and 10 min after the removal of the tracheal tube (T2).The awakening and tube removal time,choking cough and restlessness,and adverse reactions (dizziness,nausea and vomiting) in 24 h post-surgery period were compared.Results:At T1 and T2,the comparisons of HR,SBP and DBP between the two groups showed statistical significance (all P＜0.05).Intra-group comparisons showed that the HR,SBP and DBP of the control group at T1 and T2 were significant different from those at TO (all P＜0.05).There were significant differences in the awakening time and tube removal time between the two groups (both P＜0.05).The incidences of choking cough and restlessness were 8.3％ and 3.3％ respectively in the observation group,versus 53.3％ and 30.0％ in the control group,and the between-group comparisons showed statistical significance (both P＜0.05).The incidences of dizziness,nausea and vomiting in 24 h post-surgery period were 3.3％,5.0％ and 0.0％ respectively in the observation group,versus 43.3％,33.3％ and 25.0％ in the control group,and the between-group comparisons showed statistical significance (all P＜0.05).Conclusion:Acupoint massage plus acupoint sticking therapy can effectively regulate the stress reaction during postoperative anesthesia recovery period in patients undergoing nasal endoscopic surgery,and maintain a stable internal environment.

Objective To explore the indication and the methodology of transcatheter closure of coronary artery fistula.Methods Altogether 17 cases for intervention,included 13 using the Cook corp coil(2 detachable and another 11 un-detachable);1 with the Pfm corp detachable coil;3 with the AGA corp Amplatzer-Duct.The other 26 cases underwent surgery. Results Intervention group,showed 3 failure cases because of selecting too small and un-detachable coil in early stage with final displacement.Fourteen cases were successful.Follow-up 3 years showed no residue shunt and other complications.All patients were successful with surgery.Conclusions Transcatheter closure of the coronary artery fistula is mild invasive,short hospitalization,safe,and effective under proper indications.

Aspergillosis, Allergic Bronchopulmonary ; diagnosis ; etiology ; therapy ; Humans

Objective To compare the efficacy of rcmifentanil combined anesthesia and fentanyl or sufentanil combined anesthesia in patients undergoing cardiac surgery.Methods We searched the Coehrane library,PubMed,EMBASE,OVID and Chinese Biomedical Database for prospective randomized controlled trials involving the comparison of the efficacy of remifentanil combined anesthesia and fentanyl or sufentanil combined anesthesia in patients undergoing cardiac surgery.The quality of the studies was evaluated by the method recommended by Cochrane Collaboration.Evaluation indexes included the mechanical ventilation time after operation,duration of stay in hospital,and level of cardiac troponin,mortality,requirement for positive inotropic drugs and incidence of hyperalgesia and myocardial infarction during perioperative period.Meta-analysis was conducted using the RevMan 5.0 software.Results Sixteen prospective randomized controlled trials involving 1473 patients were included in our Meta-analysis.The patients were divided into 2 groups:fentanyl or sufentanil group ( n =644) and remifentanil group ( n =573).Compared with fentanyl or sufentanil group,the mechanical ventilation time after operation and duration of stay in hospital were significantly shortened,the level of cardiac troponin during the perioperative period was significantly decreased and the requirement for positive inotropic drugs during the perioperative period was significantly reduced ( P ＜ 0.05),and no significant change was found in the incidence of hyperalgesia or mortality of myocardial infarction during the perioperative period in remifentanil group ( P ＞ 0.05 ).Conclusion The efficacy of remifentanil combined anesthesia is better than that of fentanyl or sufentanil combined anesthesia in patients undergoing cardiac surgery.

According to the target-model of the health care system and characteristics of the health financing system,it is proposed in the paper that the charges of medical services should be the main revenue of public hospital compensation.Efforts should be made to adjust health care service prices and strengthen pharmaceutical management simultaneously so as to rebuild the structure of medical service charge.Medical insurance should make the majority in the compensation to cover most the medical expenses,with government subsidies supporting development.Both government financial investment and medical insurance should join their efforts for planning-guidance and performance-guidance.The authors also suggested to improve a graded and normative diagnoses and treatment system,regulate medical behaviors of public hospitals and their cost standards,justifying the total compensation and standard verification of such hospitals.

Adult ; Aged ; Carcinoma, Squamous Cell ; surgery ; Esophagus ; surgery ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; Male ; Middle Aged ; Phonation ; Postoperative Period ; Reconstructive Surgical Procedures ; methods ; Speech, Alaryngeal ; Trachea ; surgery

Animals ; Female ; Fetal Heart ; abnormalities ; diagnostic imaging ; surgery ; Heart Defects, Congenital ; diagnostic imaging ; physiopathology ; surgery ; Humans ; Pregnancy ; Treatment Outcome ; Ultrasonography, Prenatal