Attention Deficit Disorder with Hyperactivity ; diagnosis ; epidemiology ; physiopathology ; Brain ; physiopathology ; Child ; Comorbidity ; Diagnosis, Differential ; Electroencephalography ; Humans ; Sleep Apnea Syndromes ; diagnosis ; epidemiology ; physiopathology

BACKGROUND: Although the clinical effect of cervical disk replacement in short term has been ascertained, but the middle and long term result is not known, especially for the adjacent level. OBJECTIVE: To observe clinical result and effect of cervical disk replacement on adjacent level in middle and long term. DESIGN, TIME AND SETTING: Retrospective case analysis was performed at Beijing Jishuitan Hospital from December 2003 to March 2005. PARTICIPANTS: Thirty-three patients (aged 35-73 years) undergoing cervical disc replacement were followed up for 3 years. Of them, 25 patients received one-level disk replacement, and 8 received two-level disk replacement. METHODS: The clinical results and imaging before and after operation were compared. MAIN OUTCOME MEASURES: Clinical indexes including JOA grade, Odom’s grade, NDI, SF-36; X-ray: Kellgren X-ray grade, disk cervical height, disk motion, Pfirrmann disk grade, sigittal diameter of spinal cord, and compression of the spinal cord. RESULTS: The point of JOA is 13.62?2.31 before operation, 15.75?1.55 after operation; the differences were significant (P=0.000). For Kellgren X-ray, 10 levels occurred degeneration above the disk replacement level, accounted for 33% (P=0.004), and 9 levels developed degeneration below the disk replacement level, accounted for 32% (P=0.011). No obvious changes in imaging indexes were observed before and after surgery. CONCLUSION: The clinical outcome of cervical disk replacement is good in middle-term follow up. Some adjacent level degeneration may occur after cervical disk replacement, and the degeneration type is osteophyte formation in the adjacent level. This kind of adjacent level degeneration does not affect the clinical outcome in middle term follow-up.

China ; Critical Care ; history ; methods ; trends ; History, 20th Century ; History, 21st Century ; Humans

Child ; Humans ; Polysomnography ; Sleep Apnea Syndromes ; physiopathology ; surgery ; Tonsillectomy ; methods

Calcium Compounds ; Foreign Bodies ; complications ; etiology ; Humans ; Infant ; Male ; Oxides ; Respiratory Insufficiency ; etiology ; therapy ; Treatment Outcome

Child ; Child, Preschool ; Female ; Humans ; Male ; Peptidyl-Dipeptidase A ; genetics ; Polymorphism, Genetic ; Sleep Apnea, Obstructive ; genetics ; physiopathology

Child ; Child, Preschool ; Humans ; Sleep Apnea, Obstructive

Objective To analyze the clinical features of pandrug-resistant Acinetobacter baumannii (PDR-Ab) in a hospital and compare the efficacy of different antibiotic treatments on patients with pneumonia caused by PDR-Ab.Methods Data were ret- rospectively collected from all isolated PDR-Ab strains in our hospital from February 2004 to March 2005.The clinical features and outcomes were reviewed.Results A total of 77 strains of PDR-Ab were collected, 45 of which were pathogens causing clini- cal infections (35 strains from lower respiratory tract, 6 from bloodstream, 3 from drainage fluid, and 1 from wounds).Lower respiratory tract was the most common source of PDR-Ab.More than 90% of the isolated PDR-Ab strains produced OXA-23 type?-lactamase.Cefoperazone-sulbactam plus minocyeline showed good efficacy for patients with PDR-Ab pneumonia.The total clinical cure rate was 68.4%.Bacterial eradication rate was 42.1%.The factors influencing bacterial clearance were pro- longed mechanical ventilation prior to positive culture (17.5 d vs 5.5 d).mixed infection (100% vs 12.5%) and lower GCS score (9.1?0.7 vs 13.2?2.1).Concomitant septic shock (OR=13.8) and APACHEⅡscore (OR=2.1) were independent factors of clinical outcome.Conclusions Nosocomial infections caused by PDR-Ab are not untreatable.Our analysis suggests that cefoperazone-sulbactam plus minocycline may be an effective treatment for lower respiratory tract infections caused by PDR-Ab in our hospital.

Humans ; Incidence ; Vertigo ; diagnosis ; epidemiology

OBJECTIVETo investigate the clinical value of intraoperative ultrasonography in cervical laminoplasty.

METHODSThirty patients underwent cervical laminoplasty for cervical compressive myelopathy in our hospital from April 2010 to April 2012. Spinal cord compression ratio was calculated in preoperative MRI axial images for every patient. The spinal cord decompression status was evaluated by intraoperative ultrasonography during cervical laminoplasty. The pre- and post-operative Japanese Orthopaedic Association Scoring System (JOA) score was recorded, and the recovery ratios of surgery were graded using the Hirabayashi equation. The relationship between the parameters and neural recovery was explored.

RESULTSThe intraoperative ultrasonography was used to evaluate the ventral compression of the spinal cord. The ultrasonographic dynamic viewings were classified into three types based on the spinal cord contact with ventral structures after decompression: Type 1, non-contact (n=2); Type 2, contact and apart (n=16); and Type 3, contact (n=12). The patients were divided into two groups: group A, showing Type 1 or 2 findings, representing satisfied decompression; and group B, showing Type 3 findings with insufficient decompression. The recovery ratio was (73.3±21.0)%(31.3%-100.0%) in group A, but decreased to (43.2±33.1)%(0-83.3%) in group B(t=3.05,p=0.005). Pearson analysis showed that the patient age(r=-0.294,p=0.122), preoperative JOA score(r=0.059,p=0.759), and spinal compression ratio(r=0.269,p=0.151) was not correlated with Hirabayashi recovery ratio.

CONCLUSIONIntraoperative ultrasonography during laminoplasty is a feasible and promising method for evaluating spinal cord decompression status and predicting the prognosis following surgery.

Adult ; Aged ; Aged, 80 and over ; Decompression, Surgical ; Female ; Humans ; Laminectomy ; methods ; Male ; Middle Aged ; Monitoring, Intraoperative ; methods ; Spinal Cord Compression ; diagnostic imaging ; surgery ; Ultrasonography