Objective To explore the effect of percutaneous transhepatic gastric variceal embolization joint partial splenic embolization on hemodynamic of portal vein.Methods 54 cases who were clinically diagnosed as cirrhosis with portal hypertension,do the treatment percutaneous transhepatic gastric variceal embolization combined with partial splenic embolization.The preoperative and postoperative free portal vein pressure(FPP) were measured by portal vein intubation,and the preoperative and postoperative portal vein(PV),spleen vein(SV) in hemodynamic changes were compared between color dopplar ultrasound and CT scan scanning.Results Free portal vein pressure were significantly increased after percutaneous transhepatic gastric variceal embolization [(37.05 ± 4.27) cm H2O vs (42.60 ± 5.04)cm H2 O,P ＜ 0.01],and reduced through continuing to partial splenic embolization.In the end there were no statistically significant differences (P ＞ 0.05).After 3 months portal venous blood flow and inner diameter and blood flow velocity only is a little change,but spleen vein inner diameter,blood flow velocity and blood flow were decreased significantly(P ＜ 0.01).Conclusion Only percutaneous coronary arteriovenous embolization can increase portal vein pressure,but which joint partial splenic embolization does not affect the thange of portal venous blood flow dynamics.

OBJECTIVE:To improve the quality of ADR reports. METHODS:By using intensive hospital monitoring mode, ADR reports before and after the application of the system would be collected and factors as report quantity,type,time and quality of reports were analyzed statistically. RESULTS:It provided rapid reporting function after the implementotion of the system. Total quantity of reported ADR cases increased from 589 to 748,and the proportion of all the serious ADR reports increased from 62.8%to 11.76%. The score of repert quality increased from 93.64 to 98.36,the proportion of time-out reports increased from 94.05% to 97.33%,with statistical significance (P<0.05). CONCLUSIONS:Rapid reporting system of ADR in the hospital is beneficial to improve the efficiency and guarantee the quality of the reports. It also can expand the coverage of the monitoring network,and can lay the foundation for drug safety scientific evaluation and monitoring.

Objective To assess the value of MRI combined with CT in the diagnosis of ovarian sex cord stromal tumor (OSCST).Methods The CT and MRI features of 29 cases with OSCST confirmed by pathology were analyzed retrospectively.Results Fibrothecoma in 19 cases showed a solitary round mass with a regular border,solid in 12 cases (63.1％) and cystic-solid in 7 cases (36.9％),calcification in 2 cases,isointense on T1WI and hypointense or slight hyperintense on T2WI with slight enhancement.Granule cell tumor in 9 cases showed a solitary cystic solid mass with thick wall,without nodules on cystic wall,and slight enhancement in the solid parts.Sertoli-leydig cell tumor in 1 case showed a solid mass,slightly hyperintense on T1WI,hyperintense on T2 WI,and obvious enhancement.Conclusion CT and MRI manifestations of OSCST demonstrate some characteristics.Combination with MRI and CT can improve the accuracy of the diagnosis.

Objective To evaluate the short-term curative effect and the safety of transcatheter arterial chemoembolization (TACE) therapy by using microspheres and lipiodol for hepatocellular carcinoma (HCC).Methods A total of 87 patients with pathologically proved HCC were randomly divided into the study group (n=44,using embospheres of 100-300 μm in diameter together with lipiodol) and the control group (n=43,using gelfoam particles of 350-560 μm in diameter together with lipiodol).Postopertaive biochemical (liver function and AFP) findings and imaging (CT and/or MRI) manifestations were recorded,and the clinical efficacy and adverse reactions were analyzed.Results TACE was performed in all 87 patients.After the treatment,both the disease benefit rate and the postoperative reduction in AFP level in the study group were remarkably better than those in the control group (P＜0.05),but postoperative liver function indexes were not significantly different from the preoperative ones (P＞0.05).The average number of interventional therapy within the follow-up period of 6 months in the study group was smaller than that in the control group (P＜0.05).No statistically significant differences in 6-,12-and 18-month survival rates existed between the two groups (P＞0.05).Conclusion In treating HCC,TACE by combination use of microspheres and lipiodol is safe,its short-term curative effect is more obvious than TACE by combination use of gelfoam particles and lipiodol,and it can reduce the times of interventional procedure.Before TACE,careful planning of the pre-treatment of hepatic artery-portal vein fistula and the superselective catheterization with micro catheter should be taken into consideration.

This study was aimed to establish a HPLC fingerprint of saponins in Sanjie-zhentong Capsule in order to make a quantitative analysis of the quality of Sanjie-zhentong Capsule. The Waters Symmetry ShieldTM RP18 (4.6 mmí 250 mm, 5 μm) column was used with a mobile phase of acetonitrile-water gradient elution. The flow rate was 1.2 mL/min. The column temperature was 30℃. The detection wavelength was 203 nm. The results showed that the fingerprint chromatography included 9 mutual peaks. The similarity among batches was more than 0.95. Compared with reference substance, five characteristic components were recognized. The five components are notoginsenoside R1, ginsenoside Rg1, ginsenoside Re, ginsenoside Rb1 and ginsenoside Rd. It was concluded that this method was rapid, simple and accurate and can be used as one of the effective methods for the quality control of Sanjie-zhen-tong Capsule.

Objective:To compare the clinical effects of direct mechanical thrombectomy (MT) and intravenous thrombolysis (IVT) bridging MT (IVT+ MT) in the treatment of patients with acute anterior circulation large vessel occlusive stroke with high clot burden.Methods:Consecutive patients with acute anterior circulation large vessel occlusion with clot burden score ≤6 admitted to the Department of Neurology, Liuzhou People's Hospital and received endovascular treatment (MT or IVT+ MT) from June 2015 to April 2019 were enrolled retrospectively. The baseline clinical data, surgical status, clinical outcome, length of stay and cost of hospitalization in the direct MT group and the IVT+ MT group were compared. The modified Rankin Scale was used to evaluate the outcomes at 90 d after the onset of stroke. 0-2 was defined as a good outcome and >2 was defined as a poor outcome. Multivariate logistic regression analysis was used to identify the independent influencing factors of poor outcomes. Results:A total of 115 patients with acute anterior circulation large vascular occlusive stroke with high clot burden were enrolled, aged 65.4±12.0 years, 70 (60.9%) were male. The baseline National Institutes of Health Stroke Scale (NIHSS) score was 18.0 (14.0-22.0). Seventy patients (60.9%) in the direct MT group, 45 in the IVT+ MT group (39.1%). Forty-nine patients (42.6%) had a good outcome and 66 (57.4%) had a poor outcome. The time from onset to inguinal puncture (210 [130-255] min vs. 230 [187-268] min; Z=-1.982, P=0.047) and the time from onset to successful vascular recanalization (283 [228-358] min vs. 320 [268-385] min; Z=-2.017, P=0.044) were significantly shorter than the IVT+ MT group, but there were no significant differences in the successful recanalization rate (84.4% vs. 81.4%; χ2=0.173, P=0.677), the incidence of postoperative symptomatic intracranial hemorrhage (6.7% vs. 7.1%; P=1.000) and the good outcome rate at 90 d (40.0% vs. 44.3%; χ2=0.206, P=0.650) between the direct MT group and the IVT+ MT group. In addition, although there was no significant difference in length of stay between the two groups (12.1±7.1 d vs. 10.6±6.6 d; t=1.128, P=0.262), the total hospitalization cost of the direct MT group was significantly lower than that of the IVT+ MT group (80 328 [63 214-101 136] CNY vs. 88 517 [68 001-115 590] CNY; Z=-1.972, P=0.049). Multivariate logistic regression analysis showed that higher baseline systolic blood pressure (odds ratio [ OR] 1.033, 95% confidence interval [ CI] 1.005-1.062; P=0.019), higher baseline NIHSS score ( OR 1.117, 95% CI 1.029-1.213; P=0.008) and lower baseline Alberta Stroke Program Early CT Score ( OR 0.189, 95% CI 0.056-0.641; P=0.008) were independently associated with the poor outcomes, while there was no independent correlation between the endovascular treatment mode and the outcomes. Conclusions:For patients with anterior circulation large vessel occlusive stroke with high clot burden, the successful recanalization rate and good clinical outcome rate of direct MT were equivalent to IVT+ MT, but the cost was less. Therefore, direct MT may be a better choice for the treatment of anterior circulation large vessel occlusive stroke with high clot burden.

Sacral cyst usually occurs around the nerve root, which is the accumulation of cerebrospinal fluid between the intima and the perineurium at the junction of the posterior spinal nerve root and the dorsal root ganglion. Its typical clinical manifestations include low back pain, lower limb radiation pain, rectal/bladder dysfunction and so on. Complications of acute subdural hematoma with cerebral hernia after posterior midline cystectomy of sacral cyst are rare. A middle-aged female patient with sacral cyst was admitted to Gansu Provincial Hospital. After the operation, acute subdural hematoma occurred in the right frontoparietal temporal occipital region, and cerebral herniation was formed. After the operation, the patient was given rehabilitation exercise and discharged well. No neurological deficits were observed during follow-up.

Objective To explore the effect of hematoma aspiration device combined with low posterior osteotomy and small bone window craniotomy on neurological function and prognosis in patients with hypertensive intracerebral hemorrhage(HICH).Methods The clinical data of 132 patients with HICH in the Department of Neurosurgery,Gansu Provincial people's Hospital from February 2020 to February 2022 were collected and divided into small bone window group(n=52)and aspiration group(n=80).The levels of serum neuron specific enolase(NSE)and interleukin-6(IL-6)were detected by enzyme linked immunosorbent assay(ELISA).The intraoperative condition(duration of operation and intraoperative blood loss),intracranial pressure,complete clearance rate of intracranial hematoma and the incidence of postoperative complications were compared.The prognosis of the patients was evaluated by activity of daily living scale(ADL).Results There was no significant difference in the levels of serum NSE and IL-6 between the two groups before operation(P>0.05).The levels of NSE and IL-6 in serum after operation were significantly lower than those before operation,and the intracranial pressure was improved after treatment,the difference has statistic significance(P<0.05).The postoperative serum NSE and IL-6 levels,operation duration,postoperative intracranial pressure and the total incidence of complications in aspiration group were lower than those in small bone window group(P<0.05),but there was no significant difference in intraoperative blood loss and the total incidence of long-term complications between the two groups(P>0.05).During the 6-month follow-up after surgery,the good prognosis rate of aspiration group was higher than that of small bone window group,and the difference was statistically significant(P<0.05);There was no statistically significant difference in the complete clearance rate of intracranial hematoma between the two groups of patients(P>0.05).Conclusion Low posterior osteotomy combined with hematoma aspiration can effectively treat HICH,promote the recovery of neurological function in patients.

Adult ; Anti-Inflammatory Agents ; therapeutic use ; Dexamethasone ; therapeutic use ; Facial Nerve Diseases ; surgery ; Female ; Hemifacial Spasm ; surgery ; Humans ; Male ; Microvascular Decompression Surgery ; adverse effects ; Middle Aged ; Postoperative Nausea and Vomiting ; prevention & control

Adult ; Anesthesia, General ; methods ; Anesthesia, Intravenous ; methods ; Cesarean Section ; methods ; Female ; Humans ; Muscular Atrophy, Spinal ; Pregnancy