Objective To observe the microscopic anatomy structures of petroclival region via the retrosigmoid keyhole approach,then provide an anatomic basis for clinical application.Method Six adult cadaveric heads 6xed by 10% formaldehyde solution were used for simulating the retrosigmoid keyhole approach to observe major microscopic anatomy structures.Results By means of adjusting the microscope,structures such as the ipsilateral trigeminal nerves,cranial nerve,acoustic nerve,posterior nerves,anterior and lateral pons,lateral cerebellar hemisphere,anterior inferior cerebellar artery,vertebral artery,posterior inferior cerebellar artery were exposed via this keyhole approach.Conclusion This retrosigmoid keyhole approach is according with the minimally invasive principle,and represents a reasonable option for accessing the petroclival region.

Objective To investigate the correlation of blood glucose,blood pressure and body weight with pancreatic cancer.Methods From January 2011 to December 2013,110 patients diagnosed with pancreatic cancer in our hospital were selected as the observation group and 110 agematched cases without cancer during the same period were selected as the control group.The percentages of patients with diabetes,hypertension and elevated body mass index (BMI) were analyzed in both groups.Results The number of patients with diabetes was higher in the observation group than in the control group (32 cases or 29.1％ vs.16 cases or 14.6％,P＜0.05).The proportions of pancreatic cancer patients with diabetes duration ≤ 2 years,2～5 years and 5～10 years were higher in the observation group than in the control group (P＜0.05).The proportion of subjects with increased BMI was higher in the observation group than in the control group (24.6％ or 27cases vs.10.9％ or 12 cases,P＜0.05).The proportions of patients with diabetes combined with increased BMI and of patients with hypertension and increased BMI were higher in the observation group than in the control group (17.3％ or 19 cases vs.2.7％ or 3 cases,10.9％ or 12 cases vs.2.7％ or 3 cases,respectively,P＜ 0.05 for both).Conclusions Diabetes,hypertension,and elevated BMI can be considered as risk factors for pancreatic cancer,and it is possible that these factors are involved in the development of pancreatic cancer.

Deep vein thrombosis (DVT) has attracted great attention because of its high morbidity in orthopedics department, which could easily cause lethal pulmonary embolism (PE). Based on the domestic and foreign findings from the prophylaxis and nursing of DVT, this thesis summarized the key problems in orthopedic patients. It firstly defined the conception of DVT,and then emphasized the morbidity and severity of DVT in orthopedics department. After that it reviewed the possible risk factors that contributed to DVT. Moreover it also pointed out some matters needing attentions through discussing and analyzing the nursing and prophylactic measures against DVT, and it also gave some recommendations on it. It expounded the nursing progress on prophylaxis of the deep venous thrombosis in department of orthopedics, so as to provide reference for clinical work and study.

Objective:To investigate the potentially inappropriate medication(PIM)among elderly patients with chronic diseases in Shanghai communities and related influence factors.Method:Six community Health service Centers were choosen using stratified sampling. Total 968 elderly patients with chronic diseases who visited to the outpatient clinic of Shanghai Community Health Service Centers from July to August 2018 were included in the study. The PIM was investigated according to the 2015 Beers criteria. The χ 2 test and multivariate logistic regression model were used to analyze factors related to the PIM. Results:The survey showed that 317 elderly patients had PIM with 412 person-doses. In 134 person-doses, the PIM was unrelated to the disease; in 18 person-doses, PIM was caused by interaction of drug with disease/symptoms; in 259 person-doses PIM was related to the drugs that should be cautiously used for elderly; only in 1 person-dose the PIM was caused by the interaction between drugs. The drugs with the highest proportion of PIM were diuretics, benzodiazepines and aspirin. There were significant differences in age, kinds of diseases, kinds of drugs and times of visiting community health service centers between elderly patients with PIM and those without PIM (χ 2=42.28, 35.51, 46.47, 38.46; all P<0.05). The main PIM-related factors were age, kinds of diseases, kinds of drugs and times of visiting community health service centers. Conclusion:The study shows that the prevalence of PIM among elderly chronic diseases patients in Shanghai communities is relatively high, which is associated with the age, kinds of diseases, kinds of drugs and times of visiting community health service centers.

This paper reviewed the research status on the existing perioperative pain control among patients with cataract surgery both here and abroad. The research status included influencing factors, assessment instruments of pain and pain control plan, so as to provide a basis for improving perioperative pain control plan of cataract patients and reducing the incidence of pain.

Objective:To investigate the efficacy and safety of tirofiban versus argatroban in the treatment of acute ischemic stroke. Methods:This study was a retrospective cohort study. Sixty-eight patients with acute ischemic stroke who were continuously admitted to Department of Neurology of The Third People's Hospital of Hubei Province from August 2022 to September 2023 were divided into tirofiban group ( n = 33) and argatroban group ( n = 35) according to the treatment regimen. Both groups were treated according to their respective treatment protocols for 7 days. Clinical outcomes were assessed based on the modified Rankin Scale (mRS) scores. The excellent clinical outcome (mRS score 0-1 points), good clinical outcome (mRS score 0-2 points), symptomatic intracranial hemorrhage, and mortality rates were compared between the two groups at 90 days post-treatment. Results:In the tirofiban group, the proportion of excellent clinical outcomes was 30.3% (10/33), which was significantly lower than the 65.7% (23/35) in the argatroban group (χ2 = 8.53, P = 0.003). However, the difference in the proportion of good clinical outcomes between the two groups was not statistically significant [54.5% (18/33) vs. 74.3% (26/35), χ2 = 2.90, P = 0.089]. There were no statistically significant differences between the two groups regarding symptomatic intracranial hemorrhage and mortality rates (both P > 0.05). Conclusion:For patients with acute ischemic stroke, the use of tirofiban or argatroban is effective and safe. Patients treated with argatroban are more likely to achieve excellent clinical outcomes; however, larger randomized controlled trials are needed for further confirmation.

Objective To evaluate the effect of emergent microsurgery in treatment of patients with hematoma-type anterior circulation ruptured aneurysm.Methods The clinical data and therapeutic effect of emergency microsurgery for 32 patients with hematoma-type anterior circulation ruptured aneurysm were analyzed retrospectively.Results Finally 32 patients underwent emergency craniotomy clipping and hematoma removal in 24 h.Among them,15 cases underwent decompressive craniectomy.One week after the operation,CTA revealed that all aneurysms were completely clipped.One patient with communicating hydrocephalus were treated with ventriculoperitoneal shunt,and 6 patients had different degrees of cerebral infarction.After 6 months of follow-up,the Glasgow outcome scale (GOS) showed that there were 5 cases of grade 5 (15.6％),12 cases of grade 4 (37.5 ％),12 cases of grade 3 (37.5％),2 cases of grade 2 (6.3％) and 1 case of grade 1 (6.3％).The prognosis satisfaction rate was 53.1％ (17/32).Conclusion Emergent microsurgery is effective in the treatment of patients with hematoma-type anterior circulation ruptured aneurysm.

Objective To evaluate the effect of emergent microsurgery in treatment of patients with hematoma-type anterior circulation ruptured aneurysm.Methods The clinical data and therapeutic effect of emergency microsurgery for 32 patients with hematoma-type anterior circulation ruptured aneurysm were analyzed retrospectively.Results Finally 32 patients underwent emergency craniotomy clipping and hematoma removal in 24 h.Among them,15 cases underwent decompressive craniectomy.One week after the operation,CTA revealed that all aneurysms were completely clipped.One patient with communicating hydrocephalus were treated with ventriculoperitoneal shunt,and 6 patients had different degrees of cerebral infarction.After 6 months of follow-up,the Glasgow outcome scale (GOS) showed that there were 5 cases of grade 5 (15.6％),12 cases of grade 4 (37.5 ％),12 cases of grade 3 (37.5％),2 cases of grade 2 (6.3％) and 1 case of grade 1 (6.3％).The prognosis satisfaction rate was 53.1％ (17/32).Conclusion Emergent microsurgery is effective in the treatment of patients with hematoma-type anterior circulation ruptured aneurysm.

Objective:To compare the effect of middle meningeal artery embolization (MMAE) versus conventional therapy for chronic subdural hematoma (CSDH).Methods:Retrospective analysis of 38 patients with 48 CSDHs treated with MMAE from May 2019 to May 2021 was performed. Comparisons were made with a conventional treatment for 126 patients with 126 CSDHs from January 2016 to May 2021. The MMAE and conventional treatment patients were matched by the propensity score matching method, and a total of 25 pairs of patients (31 pairs of CSDHs) were successfully matched. The CSDH recurrence, rescue treatment, radiographic follow-up outcome, clinical improvement and complication between the two groups were compared by t test, χ 2 test or Fisher exact probability methods. Results:The rescue treatment rate in MMAE group was significantly lower than that in conventional treatment group [0 (0/31) vs 19.4% (6/31), P=0.024] and the complete resolution rate at 6 months follow-up in MMAE group was significantly higher than that in conventional treatment group [96.8 (30/31) vs 74.2% (23/31), P=0.026]. In terms of CSDH recurrence, there was a trend of lower recurrence in the MMAE group [3.2%(1/31) vs 22.6% (7/31), P=0.053]. The complete resolution rate at 3 months follow-up was 61.3% (19/31) in MMAE group and 45.2% (14/31) in conventional treatment, clinical improvement rate was 92.0% (23/25) in MMAE group and 88.0% (22/23) in conventional treatment, good outcome rate (mRS≤2) was 92.0% (23/25) in MMAE group and 84.0% (21/25) in conventional treatment, complication rate was 0(0/25) in MMAE group and 4.0% (1/25) in conventional treatment, and there were no significant differences in all above-mentioned parameters ( P>0.05). Conclusions:The MMAE may be considered as a safe and effective treatment for CSDH, and MMAE for CSDH is associated with lower trend of recurrence, lower rescue treatment rate and better radiographic follow-up outcome than conventional therapy.

Objective:To understand the regular leisure-time physical activity status of residents aged ≥60 years in China and to explore the potential influencing factors.Methods:National Chronic Disease and Risk Factor Surveillance were conducted in 298 counties (districts) in China in 2018, which covered 31 provinces (autonomous regions, municipalities), using a multi-stage stratified cluster random sampling method to select 194 779 permanent residents aged ≥18 years, using a questionnaire containing the Global Physical Activity Questionnaire. A face-to-face survey to obtain demographic information about the survey respondents, the frequency of moderate and vigorous-intensity leisure-time physical activity in their spare time and time, and other information related to chronic diseases and risk factors. Daily temperatures of 298 monitored counties (districts) in 2018 were obtained by inversion of satellite remote sensing data information such as MODIS, OMI, and AIRS, and the number of parks in 2017 was obtained by me. In this study, 68 379 residents aged ≥60 years who completed the survey and had complete information on leisure-time physical activity-related variables, temperature, and parks were used as survey respondents, and the prevalence of regular leisure-time physical activity and average weekly exercise time was calculated by gender in groups of age, urban and rural areas, education level, and geography. Multi-factor logistic regression models were used to analyze the individual and environmental influences on the regular exercise rate. All the results were weighted according to a complex sampling scheme.Results:The prevalence of regular leisure-time physical activity of residents aged ≥60 years in China in 2018 was 13.1% (95% CI: 12.1%-14.0%). The figures were slightly higher for men [13.6% (95% CI: 12.6%-14.7%)] than for women [12.5% (95% CI: 11.5%-13.5%)]; urban [17.5% (95% CI: 15.9%-19.1%)] were significantly higher than those in rural areas [9.6% (95% CI: 8.8%-10.4%)]; the prevalence of regular leisure-time physical activity in East China [15.1% (95% CI: 13.3%-16.9%)] was higher than those in other regions; older residents in counties (districts) with ≥28 parks [17.3% (95% CI: 15.3%-19.2%)] the highest. The average weekly exercise time of elderly residents in China was 68.3 (95% CI: 63.5-73.2) minutes; among them, men [74.3 (95% CI: 68.1-80.5) minutes] was higher than women [62.5 (95% CI: 57.8-67.2) minutes]; urban [89.8 (95% CI: 82.0-97.7) minutes] were higher than rural [51.4 (95% CI: 46.8-56.1) minutes]. The results of the multi-factorial logistic analysis showed that factors such as: living in rural areas, lower annual household income for literacy, poorer self-rated health status, and lack of parks in the area of residence were associated with a lower prevalence of regular leisure-time physical activity among elderly residents. Conclusions:The prevalence of regular leisure-time physical activity among elderly residents in China is still at a low level, and exercise time needs to be improved. We should increase the publicity of "national fitness", pay attention to the disadvantaged elderly groups and provide more suitable activity places to encourage more elderly residents to participate in leisure-time physical activity.