1.Study Progress of Gastrointestinal Manifestations in Henoch-Scholein Purpura
bin-fang, GUO ; xin-liang, WANG
Journal of Applied Clinical Pediatrics 2006;0(21):-
Henoch-Scholein purpura(HSP)is a common systemic vasculitis of the small vessel in children,with a variety of clinical manifestations.The main diagnostic criteria include palpable skin purpura.Patients who have gastrointestinal tract as the main symptoms suffer clinically abdominal pain and gastrointestinal bleeding,they are easily misdiagnosed before skin purpura,the rate of misdiagnosis can be as high as 87.5%,and the main treatment is early application-oriented glucocorticoids.This review include etiopathogenisis,pathogenesis,pathology,clinical manifestations,auxiliary examination and treatment about gastrointestinal manifestations in HSP.
2.Cerebellar mutism and childhood medulloblastoma
Yunmei LIANG ; Yansong LU ; Jin ZHANG ; Siqi REN ; Fang GUO
Journal of Clinical Pediatrics 2015;(9):813-816
Objective To investigate the relationships among cerebellar mutism (CM), relapsed medulloblastoma (MB) and the primary tumor location.MethodsA retrospective analysis was conducted in 114 children over 3 years old with MB from November 2011 to April 2015.ResultsThe median onset age was 84.7 months (36.4 to 184.7 months) in 114 children with MB (77 boys and 37 girls), of whom there were 48 cases of recurrence. There were twenty two cases of CM and the overall incidence of CM was 19.3% (22/114). The incidence of CM was 19.7% (13/66) in non-recurrent cases and 18.8% (9/48) in recur-rent cases, and there was no signiifcant difference between two groups (P=0.899). The incidence of CM was 17.6% (9/51) in cas-es with primary tumor in the fourth ventricle, 7.1% (1/14) in cases with primary tumor in the cerebellar vermis, 21.4% (3/14) in cases with primary tumor in both fourth ventricle and cerebellar vermis, 45.5% (5/11) in cases with primary tumor in fourth ven-tricle and other parts of the brain, and 50.0% (4/8) in cases with primary tumor in cerebellar vermis and other parts of the brain. No CM incidence was observed in cases with primary tumor in central nerve system except for the fourth ventricle and cerebellar vermis. The incidence of CM between the cases with fourth ventricle/cerebellar vermis involvement and those without fourth ventricle/ cerebellar vermis involvement had signiifcant difference (P=0.039). ConclusionsThere is no relationship between CM and relapsed MB. Children with MB whose primary tumor is located in the fourth ventricle and/or the cerebellar vermis is susceptible to CM.
3.Effect of Wound Specialist Group on Management of Pressure Ulcer in Operation
Haiping MA ; Xiaoqing ZHANG ; Ting GUO ; Liang FANG
Chinese Journal of Rehabilitation Theory and Practice 2016;22(9):1104-1106
Objective To observe the effect of wound specialist group on preventing and managing pressure ulcer in operation. Methods The knowledge about pressure ulcer and ability of risk assessment for pressure ulcer of operating room nurses were tested and the incidenc-es of pressure ulcer were compared before and after the intervention of the wound specialist group. Results After the intervention of the wound specialist group, the passing rate of nurses in operating room increased from 58.23%to 94.11%in pressure ulcer theory (χ2=29.63, P<0.001) and from 56.96%to 95.29%in new type of dressings paste (χ2=33.80, P<0.001), and the rate of pressure ulcer risk factor assessment increased from 56.38%to 93.35%(χ2=5828.07, P<0.001), accuracy of assessment increased from 56.23%to 96.78%(χ2=4674.89, P<0.001). The incidence of intraoperative acute pressure ulcer decreased from 1.5‰to 0.22‰(χ2=17.59, P<0.001). Conclusion The intervention of wound specialist group may improve the awareness of assessing risk factors of pressure ulcer in the operation room and standardize the oper-ation to prevent pressure ulcer, and reduce the incidence of pressure ulcer in operation.
4.Thoughts on practice of medical liability insurance at the hospital
Liang FANG ; Jianjun ZHANG ; Husheng MEI ; Qin GUO
Chinese Journal of Hospital Administration 2014;30(12):913-915
An analysis of medical liability insurance practice at the hospital in the past 6 years found that medical liability insurance failed to work as expected in medical dispute prevention and risk sharing.The analysis also found that such an insurance will take a greater role in risk sharing,exposure to conflicts,cause discovery,and responsibility,with enhanced government role in guidance and intervention.Thus medical liability insurance is highly advocated by such means as compulsory execution,coordinating mechanism of insurance funding,prevention“medical dispute profiteers”,and adaptation to new approaches in medical dispute settlement.
5.The multisection spiral CT perfusion imaging on acute pancreatitis and correlated with clinical criteria
Fangjun WANG ; Pengfei LIU ; Weichang CHEN ; Liang GUO ; Xiangming FANG
Chinese Journal of Pancreatology 2009;9(4):238-240
Objective To investigate the blood perfusion characteristic of acute pancreatitis (AP) using multisection dynamic CT. To detect the changes of the perfusion parameters in patients with AP and assess the value of the perfusion parameters as severity indicators in AP. Methods 120 cases (34 cases of normal pancreas and 86 cases of AP) were examined for pancreatic perfusion from August 2006 to April 2008. The multisection dynamic CT perfusion series was performed by a multisection CT scanner (Siemens somatom Sensation 64) and the perfusion parameters, including BF, BV, TTP, PS, were collected and were compared with APACHE Ⅱ score, Ranson score, CRP, CTSI, time to abdominal pain cessation, length of hospital stay and complication rate for correlation analysis. Results The mean BF, BV, TTP and PS in AP patients were (113.57 ±50.04) ml · 100 mg~(-1) · min~(-1), (146.61 ±45.11) ml/L, (148. 88 ±21. 16) 0.1 s, (119.53± 52.36) 0. 5 ml · 100 ml · min , respectively; when compared with normal control, BF, BV decreased significantly (P<0.05) , while the change of TTP, PS were not statistically significant. Both BF and BV were correlated with APACHE II score, Ranson score, CRP, CTSI (P<0. 05) , as well as the time to abdominal pain cessation, length of hospital stay and complication rate (P < 0. 05). Conclusions Pancreatic vessel perfusion was decreased in AP. Both BF and BV were correlated with APACHE Ⅱ score and Ranson score, CRP, CTSI, and could be used to predict severity of acute pancreatitis.
7.The value of multisection spiral CT perfusion in diagnosis of acute pancreatitis
Fangjun WANG ; Weichang CHEN ; Liang GUO ; Xiangming FANG
Chinese Journal of Digestion 2009;29(8):514-517
Objective To assess the value of multisection spiral CT perfusion in evaluating severity of acute pancreatitis (AP). Methods Eighty two AP patients, who were admitted to the hospital between August 2006 and January 2008, were enrolled. Multisection dynamic CT (MSCT) perfusion was performed on all patients 48-72 hrs after admission by using a multisection CT scanner (Siemens somatom sensation 64), and 30 healthy subjects were served as controls. The data were processed on a siemens workstation using PCT software package. The parameters including blood folw (BF), blood volume (BV), peak time (TTP) and surface permeability (PS) were measured and compared. Results The values of BF, BV, TTP and PS in AP patients were (110.57±60.04) ml·100 ml-1·min-1, (156.68±65.11) ml/L, (146.58±29.46) 0.1 s, (110.73±62.66) 0.5 ml·100 ml-1·min-1, respectively. The decreased BF and BV were found in AP patients compared with controls (P<0.05). However, there was no significant difference in TTP and PS between two groups (P>0.05). Conclusions The decreased perfusion in AP patients was associated with the severity of the disease. The parameters of BF and BV can be used to predicte the severity of AP.