Objective Analysis of MRI image of lateral ventricular subependymomas to improve our recognition of radiology manifestation of the disease. Methods Clinical data and MRI findings of 6 patients with subependymomas proved by surgical pathology, observed from January 2007 to June 2013, were analyzed retrospectively. Results Six patients (4 males and 2 females) presented with headache and dizziness. Among these 6 patients, tumor developed in right lateral ventri-cle in three patients, in left lateral ventricle in 2 patients and in frontal of dual lateral ventricle in one patient. In MRI image, tumors showed iso-intense to hypointense to normal white matter on T1-weighted and DWI images, hyperintense on T2-weighted and FLAIR. Mild or no enhancement was noted in most cases. MRS showed findings consistent with low-grade tu-mor, with a normal choline peak and depressed N-acetyl-aspartate peak. Conclusion Lateral ventricular subependymo-mas have characteristic MRI features and multi-direction images are helpful for diagnosis.

Europe ; Humans ; Occupational Medicine ; education ; Students ; United States

Objetive The present study was aimed to explore the risk factors of mid-term cognitive decline in pa?tients with indexed TIA/minor stroke (NIHSS≤3) in a Chinese hospital-based cohort. Methods We recruited all consec?utive Chinese TIA/minor stroke patients from July to December in 2012 and followed them up in stroke clinics at 3 and 18 months after indexed TIA/minor stroke. The outcome was defined as significantly cognitive decline at 18 months com?pared with that at 3 months. Results A total of 209 consecutive Chinese TIA/minor stroke cases completed their fol?low-up investigation. Among them, 24 (11.5%) exhibited significantly cognitive decline. The independent risk factors of cognitive decline post TIA/minor stroke were education years (OR=0.869,P=0.021), atrial fibrillation(OR=5.950, P=0.001) and multiple silent lacunar infarcts (OR=5.179,P=0.020). Conclusion It is necessary to evaluate the cognition among TIA/minor stroke cases and a close follow-up is required for patients with atrial fibrillation and multiple silent la?cunar infarcts frequently in order to decrease the risk of cognitive decline post TIA/minor stroke.

Objectives Brain atrophy plays a key role in post-stroke dementia. The current study aims to explore risk factors for brain atrophy in different regions in order to find the ultimate therapeutic strategy. Methods Consecutive stroke and/or transient ischemic attack (TIA) patients were recruited from July 2012 to June . The clinical features, neuro?imaging findings and risk factors were collected during hospitalization. Logistic regression analysis showed that, except for age, female gender (Odds ratio, OR=2.447, P=0.007) and the number of silent lacuna infarcts (OR=1.414, P=0.027) were independent risk factors for frontal lobe atrophy. Ischemic stroke history (OR=2.224, P=0.024) was the independent risk factor for parietal lobe atrophy. All of extra-/intracranial larger artery diseases (OR=2.584, P=0.015) and white mat?ter severity score (OR=1.112, P=0.007) as well as the number of silent lacuna infarcts (OR=1.158,P=0.042) were inde?pendent risk factors for medial temporal lobe atrophy. Moreover, diabetes (OR=2.109, P=0.001),atrial fibrillation (OR=1.934, P=0.015) and white matter severity score (OR=1.098, P=0.002) were independent risk factors for global brain atro? phy. Conclusion Risk factors for brain atrophy included diabetes,atrial fibrillation, silent lacuna infarcts and white mat?ter changes. We should pay more attention to those patients with above risk factors in order to slow down the progression of brain atrophy and also prevent them from dementia by early interventions.

OBJECTIVE To study the modified infralabyrinthine approach in order to open the internal auditory canal,and to provide anatomic reference.METHODS In this study,the modified infralabyrinthine approach was performed on 10 adult cadaver heads(20 sides temporal bones),and some relative structures were observed and measured.RESULTS The posterior wall of internal auditory canal was opened successfully in 16/20 sides temporal bones via the modified infralabyrinthine approach,the average exposure length was (72.44 ± 14.19)％ of the whole length of the internal auditory canal.The mean distance from the inferior edge of the posterior semicircular canal to the superior edge of the jugular bulb was (4.60 ± 3.47) mm,the mean distance from the vertical portion of the facial nerve to the anterior edge of the sigmoid sinus in the infralabyrinthine area was (8.40 ± 2.74) mm,the mean distance from the superior edge of the jugular bulb to the internal auditory canal was (5.88±2.88) mm,the mean distance from the superior edge of endolymphatic sac to the internal auditory canal was (13.24±3.41) mm.CONCLUSION The modified infralabyrinthine approach had the advantages of tiny trauma and the disadvantages of more difficulty,if we selected suitable cases and prepared sufficiently,the surgery could be achieved safely and effectively.

Objective To explore the feasibility of occipital artery(OA) to anterior inferior cerebellar artery (AICA) through the extended retrosigmoid approach,also perform a systemic microanatomical study of OA and AICA with the exposure of extended retrosigmoid approach,find the easy way to perform the procedure.Methods From September,2016 to January,2017,5 adult cadaveric heads injected with colored latex (total 10 sides) were performed the extended retrosigmoid approach,and measured the caliber of distal occipital artery (OA),the final length of the OA harvest,the reliable landmark of the OA harvest,and the distance from the flocculonodular segment of anterior inferior cerebellar artery (AICA) to the OA,the diameter of AICA flocculonodular segment branch.Whole procedure of OA to IACA bypass also be performed.Statistical analysis was performed.Results By the extended retrosigmoid approach,AICA flocculonodular segment could be easily exposure,the average diameter was 1.2 mm,the OA branch could be harvested in average was (72.3±3.3)mm in length from the occipital sulcus,and the average distance between occipital sulcus and AICA flocculonodular segment was (47.6±l.9)mm.The bypass procedure also could be performed through the proper corridor.Conclusion The Extended retrosigmoid approach is a safe and efficient way to perform the OA-AICA bypass procedure,and the procedure is easier to be performed than other surgical approaches.

Objective To Analyze the clinical outcomes of pediatric liver transplantation (LT) for liver-based metabolic disorders.Methods We conducted a retrospective analysis on 42 pediatric patients with liver-based metabolic disorders from June 2013 to March 2017,and analyzed the pediatric end stage liver disease model (PELD),growth and development,type of transplant,postoperative complications and prognosis of patients.Results There were 42 children with liver-based metabolic disorders (15.56%) out of all the 270 children who underwent LT.The median age was 51.0 months (range,3.4-160.9 months).Of the 42 children,19 received living donor liver transplantation (LDLT),18 cases received deceased donor liver transplantation (DDLT) and 5 cases received domino liver transplantation.1-,2-and 3-year cumulative survival rate of 42 recipients was 97.7%,93.6% and 93.6%,and that of the grafts was 95.3%,91.4% and 91.4%,respectively.As compared with the 194 children with biliary atresia who underwent LT,significant difference was found in PELD and weight Z-score between the two groups.Conclusion Liver transplantation is a valuable option for children with metabolic disorders,and it has gained a better prognosis.

Objective Revascularization of the distal segment of the anterior cerebral artery (ACA) using extracranial donors requires long interposition grafts.A novel bypass procedure which uses the two main branches of the superficial temporal artery (STA) to reach the A3 segment of the anterior cerebral artery with a single skin incision was designed.Methods Ten cadaveric specimens were dissected through a single skin incision to harvest the frontal and parietal branches of the STA from June,2017 to September,2017.An anterior interhemispheric approach provided access to the middle internal frontal artery (MIFA).The parietal STA was used as an interposition graft between the frontal STA and MIFA.Lengths and calibers of the distal branches of STA and MIFA were measured at the anastomotic sites.All data was statistical analysis by t-test.Results The average caliber of MIFA was (1.4±0.2) mm,which matched the caliber of both frontal and parietal branches of STA.The mean distance for an end-to-side bypass from STA to MIFA was (144.5±7.4) mm and the average harvested donor-graft complex length was (203.1±27.9) mm.This bypass construct provided around 140％ donor graft length.Conclusion Using the parietal branch of the STA as an interposition graft enabled a successful tension-free STA-MIFA bypass.The advantages of this technique over existing approaches include sufficient graft length,caliber match and relative technical ease.

Objective:To explore the clinical characteristics and prognostic factors of patients with acute glyphosate poisoning, and to provide reference for the comprehensive treatment and prognosis judgment of acute glyphosate poisoning.Methods:The complete hospitalized medical records data of 40 patients with acute glyphosate poisoning who were treated in the emergency department of Affiliated Hospital of Yangzhou University from 2014 to 2019 were collected in August 2020. According to the outcome during the follow-up period of 90 d after discharge from hospital, patients were divided into survival group ( n=33) and treatment failure group ( n=7) . The clinical characteristics of the two groups were analyzed. The influencing factors of prognosis were analyzed by binary logistic regression, and the receiver operating characteristic (ROC) curve was used to evaluate the value of white blood cell count level at admission to the prognosis of patients with acute glyphosate poisoning. Results:The average age of the 40 glyphosate poisoning patients was (57.70±19.72) years old, the oral dose was 100 (50, 200) ml, the hospital stay was 4.0 (1.0, 5.0) d, and the fatality rate was 17.5% (7/40) . The main clinical manifestations were the symptoms of the digestive tract, respiratory tract, cardiovascular system and nervous system. Logistic regression showed that white blood cell level at admission was an influencing factor for the prognosis of patients with acute glyphosate poisoning ( OR=1.148, 95% CI: 1.124-1.791, P=0.003) . The ROC curve showed that the best diagnostic cut-off value of white blood cell level at admission to the prognosis of acute glyphosate poisoning was 14.65×10 9/L, the area under the curve (AUC) was 0.9351. The sensitivity was 100.00%, and the specificity was 84.85%. Conclusion:High level of white blood cell at admission is a risk factor for the prognosis of acute glyphosate poisoning, and white blood cell level at admission has a certain predictive value for the prognosis of acute glyphosate poisoning.

Objective:To explore the clinical characteristics and prognostic factors of patients with acute glyphosate poisoning, and to provide reference for the comprehensive treatment and prognosis judgment of acute glyphosate poisoning.Methods:The complete hospitalized medical records data of 40 patients with acute glyphosate poisoning who were treated in the emergency department of Affiliated Hospital of Yangzhou University from 2014 to 2019 were collected in August 2020. According to the outcome during the follow-up period of 90 d after discharge from hospital, patients were divided into survival group ( n=33) and treatment failure group ( n=7) . The clinical characteristics of the two groups were analyzed. The influencing factors of prognosis were analyzed by binary logistic regression, and the receiver operating characteristic (ROC) curve was used to evaluate the value of white blood cell count level at admission to the prognosis of patients with acute glyphosate poisoning. Results:The average age of the 40 glyphosate poisoning patients was (57.70±19.72) years old, the oral dose was 100 (50, 200) ml, the hospital stay was 4.0 (1.0, 5.0) d, and the fatality rate was 17.5% (7/40) . The main clinical manifestations were the symptoms of the digestive tract, respiratory tract, cardiovascular system and nervous system. Logistic regression showed that white blood cell level at admission was an influencing factor for the prognosis of patients with acute glyphosate poisoning ( OR=1.148, 95% CI: 1.124-1.791, P=0.003) . The ROC curve showed that the best diagnostic cut-off value of white blood cell level at admission to the prognosis of acute glyphosate poisoning was 14.65×10 9/L, the area under the curve (AUC) was 0.9351. The sensitivity was 100.00%, and the specificity was 84.85%. Conclusion:High level of white blood cell at admission is a risk factor for the prognosis of acute glyphosate poisoning, and white blood cell level at admission has a certain predictive value for the prognosis of acute glyphosate poisoning.