OBJECTIVETo evaluate diffusion tensor tractography (DTT) of white matter in prognosis of acute lacunar infarctions.

METHODSTwenty-eight patients of pyramidal tract strokes at the acute phase (<3 days) with a marked motor defect were examined. Lesions were identified on diffusion weighted imaging and isotropic imaging of DTI, and infarctions and the tract were shown on the DTT images simultaneously. The anatomic location and pattern of the lesions were visualized on DTT, with regard of the corticospinal tract (CST), all patients were divided into three clinical subgroups: in Group 1 infarction lesions were close to CST, in Group 2 CST was partial involved, in Group 3 lesions centered in the pyramidal tract. Subsequently, they were compared with the National Institutes of Health Stroke Scale (NIHSS) scores at acute phase (<3 days), early chronic phase (8 approximately 14 days), and outcome(30 approximately 60 days).

RESULTNIHSS scores of Group 1(12/28) were not different with those of Group 2 (11/28) at the acute phase (U=-1.430, P>0.05), and NIHSS scores in Group 2 were significantly lower than those of Group 3(5/28) (U= -2.676, P <0.01). In the outcome, NIHSS scores of Group 1 were significantly lower than those of Group 2 (U= -2.501, P<0.05), NIHSS scores of Group 2 were significantly lower than those of Group 3 (U= -2.948, P<0.01). Among these three groups,Group 1 all had good recovery, Group 2 also had good recovery but sometimes with some mild motor disfunction, and Group 3 always had marked defect and minor improvement. Both rADC value and rFA value were induced in the acute lacunar infarctions.

CONCLUSIONDTT is helpful in prognestic valuation of acute lacunar infarction by providing visualized stereo localization of CST and infarction lesions.

Brain ; pathology ; Brain Infarction ; diagnosis ; pathology ; Diffusion Magnetic Resonance Imaging ; methods ; Female ; Humans ; Imaging, Three-Dimensional ; methods ; Male ; Middle Aged ; Nerve Fibers, Myelinated ; pathology ; Prognosis

Aortic Valve/surgery* ; Aortic Valve Stenosis/surgery* ; Cardiac Catheterization ; Heart Rupture ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation ; Humans ; Transcatheter Aortic Valve Replacement/adverse effects* ; Treatment Outcome

OBJECTIVE To innovatively apply the pre-intelligent precision dosing and verification system （hereinafter referred to as “the system”）， and to provide a reference for the high-level “intelligent” transformation of inpatient pharmacy. METHODS The limitations of the triple-serial dispensing mode， which comprised the automatic medicine packaging machine （ATC）， intelligent tablet dispensing table （ITDT） and medication detection machine （MDM）， were analyzed. The application of the system and the adoption of the barcode scanning verification method optimized the pre-dosing management， whole-tablet drug dispensing process and ATC temporary dosing management. The comparative analysis was conducted to assess dosing time， labor cost and packaging error of the eight-month period， before and after the system application. RESULTS The triple-serial dispensing mode had a weak ability to avoid error risks in the manual dosing stage， and also had errors in the verification stage. Through the innovative application system， the pre-dosing management had been upgraded， the whole-tablet drug dispensing process had been optimized， and the ATC temporary dosing management had been improved. The average time required for each drug for pre-dosing， whole-tablet drug dispensing and ATC temporary dosing was significantly shortened after the application of the system， compared with before the application of the system （P＜0.001）. The number of pharmacists was reduced from two to one. The error rate of ATC decreased significantly from 0.220‰ to 0.029‰ （P＜0.001）. Specifically， the rate of pharmacist-related errors （pre-dosing error， ITDT dosing error， and ATC temporary dosing error） decreased from 0.116‰ to 0.001‰ （P＜0.001）， and machine-related errors decreased from 0.096‰ to 0.023‰ （P＜0.001）. CONCLUSIONS This innovative integration mode greatly improves the working efficiency and quality of inpatient pharmacy. It enhances refined management of drug expiration and inventory， saves time and labor costs， improves the accuracy of drug dispensing， and ensures patient medication safety.

Objective: To investigate the sonographic features of primary thyroid lymphoma (PTL) and to evaluate the clinical significance of ultrasound-guided core needle biopsy (US-CNB) in PTL. Methods: A total of 24 patients with suspected PTL in Sir Run Run Shaw Hospital from January 2013 to June 2018 were analyzed retrospectively. All cases were confirmed by pathology, of them 23 patients received US-CNB and 1 patient chose operation without US-CNB, including 5 males and 19 females, aged from 39 to 75 years old. The effectiveness and safety of 23 patients with US-CNB were evaluated, and the sonographic features of 20 patients with PTL diagnosed by pathology were analyzed. Descriptive statistical methods were used in the study. Results: In the 23 patients with suspected PTL underwent US-CNB, 18 patients were diagnosed as PTL, 4 patients were respectively diagnosed as subacute thyroiditis, anaplastic carcinoma, Hashimoto's thyroiditis, and fibro thyroiditis, and the another patient was hard to diagnose by US-CNB and then was diagnosed as PTL by surgical biopsy. The success rate of US-CNB for diagnosis of PTL was 18/19, and no severe complications occurred in the patients with US-CNB. The other case was diagnosed as PTL by surgical biopsy without US-CNB. Sonographic features of 20 cases with PTL (18 cases diagnosed by US-CNB and 2 cases by surgery or surgery biopsy) were as follows: (1) Most nodules had irregular shapes and unsmooth margins; (2) Hypoechoic or markedly hypoechoic nodules with honeycombed or cord structures were observed in most cases; (3) Calcification was rare; (4) Multiple lesions were common; (5) Abundant intralesional vascularization was commonly observed; (6) Most cases had intensification of posterior acoustic enhancement; (7) Thyroid gland enlargement or with irregular shape; and (8) PTL often accompanied with lymph nodes enlargement in lateral neck or central region. Conclusion: PTL has certain sonographic features, with assistance of US-CNB, more accurate diagnosis of PTL can be obtained.
Adult ; Aged ; Biopsy, Large-Core Needle ; Female ; Humans ; Image-Guided Biopsy ; Lymphoma/diagnostic imaging* ; Male ; Middle Aged ; Retrospective Studies ; Thyroid Gland ; Thyroid Neoplasms/diagnostic imaging* ; Thyroid Nodule ; Ultrasonography, Interventional

Objective To evaluate the feasibility and initial experience of laparoscopic pyelolithoto- my within renal sinus.Methods A total of 19 patients(14 men and 5 women)of nephrolithiasis on 21 sides underwent laparoscopic pyelolithotomy within renal sinus.Of them,9 cases with other upper urinary tract diseases were treated by laparoseopic pyelolithotomy at the same time.The patient age ranged from 16 to 67 years(mean,41 years).The calculi were 1.2 to 3.5 cm in diameter,and were found on the right side in 11 cases,left side in 6,and both sides in 2.Five cases concomitantly had ureteral calculi;of them,1 had bi- lateral ureter calculi with ipsilateral steinstrasse,2 had pyelic polyp(1 with giant hydronephrosis after open ureterolithotomy),and 1 had giant bydronephrosis with pyelolithiasis during pregnancy with double-J tube drainage.Twelve cases(13 sides)had experienced unsuccessful extracorporeal shock wave lithotripsy,and 1 failed with minimally invasive percutaneous nephrolithotomy.Results The procedure was successful in all the 19 cases.The operative time ranged from 75 to 240 rain(mean,115 rain).The intraoperative blood loss ranged from 30 to 100ml(mean,50 ml).One case experienced 5-d urine leakage,and was spontaneously cured.The hospital stay was 5-9 d(mean,6 d).Double-J tube drainage was 4-6 weeks.During the follow- up(3-36 months),KUB and IVU showed no upper urinary tract stricture and no residual stones except for 1 stone of 0.7 cm in the renal lower calyx in 1 case.The kidney function was improved in all cases.Con- clusions Laparoscopic pyelolithotomy is new and minimally invasive alternative approach for renal calculi. With this procedure the urinary tract complications can be treated concomitantly,thus it can partially replace open surgery.

The parts of system automatically detecting the standard 12-synchronous-lead ECG (electrocardiograms) signal based on personal computer is introduced in this paper. The object-oriented programming method is adopted based on Windows System. We put forward methods to analyze QRS complex wave, P wave, T wave and ST fragment. In this paper the techniques such as ECG signal preprocessing, cardio wave parameters detecting and wave pattern cognizing are discussed too. Furthermore we use wavelet transform technique to analyze the wave pattern and get sound effect.
Algorithms ; Electrocardiography ; instrumentation ; methods ; Humans ; Pattern Recognition, Automated ; Signal Processing, Computer-Assisted ; Software

OBJECTIVECentral obesity is considered to be a central component of metabolic syndrome. Waist circumference (WC) has been widely used as a simple indicator of central obesity. This study is aimed to evaluate the sensitivity of WC cut-off values for predicting metabolic risk factors in middle-aged Chinese.

METHODSThe study involved 923 subjects aged 40-65 years. The metabolic risk factors were defined according to the Chinese Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults. WC cut-off 85-90 cm and ⋝90 cm were used as cut-off values of central pre-obesity and central obesity in males, respectively, while WC 80-85 cm and ⋝85 cm were used as cut-off values of central pre-obesity and central obesity in females.

RESULTSFirst, WC values corresponding to body mass index (BMI) 24 kg/m2 and visceral fat area (VFA) 80 cm2 were 88.55 cm and 88.51 cm in males, and 81.46 cm and 82.51 cm in females respectively. Second, receiver operating characteristic curves showed that the optimal WC cut-off of value was 88.75 cm in males, higher than that in females (81.75 cm). Third, the subjects with higher WC values were more likely to have accumulating metabolic risk factors. The prevalence of metabolic risk factors increased linearly and significantly in relation to WC levels.

CONCLUSIONWC cut-off values of central pre-/central obesity are optimal to predict multiple metabolic risk factors.

Aged ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Intra-Abdominal Fat ; physiopathology ; Male ; Metabolic Syndrome ; diagnosis ; epidemiology ; physiopathology ; Middle Aged ; Obesity ; diagnosis ; ROC Curve ; Waist Circumference

To assess the clinical application of video head impulse test (vHIT) for vestibular function in vestibular neuritis (VN) and benign paroxysmal positional vertigo (BPPV) patients.Thirty-three patients with VN and 43 patients with BPPV were enrolled from Sir Run Run Shaw Hospital and Ningbo Second Hospital from March 15 to September 10, 2015; and 50 healthy controls were also enrolled in the study. vHIT was used to quantitatively test the vestibulo-ocular reflex (VOR) gains of a pair of horizontal semicircular canals. VOR gains two pairs of vertical semicircular canals, and the corresponding asymmetrical value of three VOR gains. The saccades information was also recorded.Compared with the healthy control group and BPPV patients, the affected horizontal and vertical VOR gains were declined and the corresponding asymmetries were increased in VN patients (all<0.01). BPPV group also showed higher vertical VOR gain asymmetries compared with the healthy control group (all<0.01), but no significant difference was observed in VOR gains and horizontal VOR gain asymmetry (all>0.05). The sensibility of vHIT in diagnosis of VN was 87.9%. Among 33 VN patients, 22 were diagnosed with superior vestibular nerve dysfunction, 7 were found with inferior vestibular nerve dysfunction and 3 were with both dysfunction; and 1 case was not distinguished.Video head impulse test can quantitatively evaluate the vestibular dysfunction of VN and can help early diagnosis of VN, which may be widely used in clinic.
Benign Paroxysmal Positional Vertigo ; diagnosis ; Head Impulse Test ; Humans ; Reflex, Vestibulo-Ocular ; physiology ; Saccades ; physiology ; Semicircular Canals ; innervation ; physiopathology ; Sensitivity and Specificity ; Vestibular Diseases ; classification ; diagnosis ; Vestibular Nerve ; pathology ; Vestibular Neuronitis ; classification ; diagnosis

Adolescent ; Adrenalectomy ; adverse effects ; methods ; Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Laparoscopy ; adverse effects ; methods ; Male ; Middle Aged

OBJECTIVETo compare skin sympathetic response(SSR) between patients with generalized anxiety disorder(GAD) and patients with major depression disorder(MDD).

METHODSThe latency and amplitude of SSR wave were measured in 30 GAD patients and 30 MDD patients, before and after 8-week treatment of anti-anxiety or anti-depression drugs. Thirty age and sex-matched healthy subjects served as healthy controls (HC).

RESULTSBefore the treatment, the latency of SSR in GAD patients was significantly shorter than that in HC group, while the amplitude was significantly higher than that in the HC (P<0.05). In MDD group, the latency before the treatment was significantly longer than that in the HC,while the amplitude was significantly lower than that in the HC (P <0.05). After treatment,the latency of SSR in GAD group was extended compared to the baseline level, and close to the level of the HC. The amplitude of SSR in GAD group became lower after treatment, but still higher than that of control group. The latency of SSR in MDD patients was significantly shorter after treatment compared to baseline level (P <0.05). In addition, the latency of SSR in MDD group was still longer than that in GAD group (P<0.05); meanwhile,the amplitude of SSR in MDD group was significantly lower that in GAD group (P<0.001). SSR parameters were positively correlated with HAMA and HAMD scores with a correlation coefficient of 0.57 and 0.73, respectively.

CONCLUSIONThere are significant differences in SSR parameters between patients with GAD and patients with MDD,indicating that SSR can be used as an objective index to distinguish anxiety from depression.

Adolescent ; Adult ; Anti-Anxiety Agents ; therapeutic use ; Antidepressive Agents ; therapeutic use ; Anxiety Disorders ; drug therapy ; physiopathology ; Case-Control Studies ; Depressive Disorder, Major ; drug therapy ; physiopathology ; Female ; Galvanic Skin Response ; Humans ; Male ; Middle Aged ; Skin ; physiopathology ; Sympathetic Nervous System ; physiopathology ; Young Adult