Objective: To observe blood-activating and stasis-resolving therapy (活血化瘀法)for patients with acute hypertensive cerebral hemorrhage small and moderate in amount and its influence on patients daily ability. Methods: One hundred and twenty-four cases were randomly divided into 3 groups: A group (n=52 cases), B group (n=34) and C group (n=38). Besides conventional therapies, A and B groups were treated additionally with 20 ml of Danshen injection (丹参注射液) in 5% glucose solution 250 ml for intravenous drip (once a day), 28 days constituting one therapeutic course, the beginning of the injection in A group was 24-48 hours after the attack and that of B group, 1 week after the attack. All the cases were evaluated by effective rate, neural defect score (NDS), ability of daily life (ADL), modified Barthel index (MBI), the duration for the absorption of intracranial hematoma, mortality, etc. The therapeutic effects of the 3 groups were compared after the treatment for 28 days, 3 months and 6 months. Results: The total significant effective rates in A group and B group were significantly better than that of C group (all P0.05). Conclusion: The early use of blood-activating and stasis-resolving therapy is effective for patients with acute hypertensive cerebral hemorrhage small and moderate in amount, it may promote the absorption of the intracranial hematoma, and improve the patients′ remote prognosis.

Objective To assess the value of non-invasive prenatal screening (NIPS) for the detection of fetal chromosome 16 aneuploidy through multi-method verification and follow-up of pregnancy outcomes.Methods From January 2016 to December 2017,7972 pregnant women with singleton pregnancies accepted the NIPS test after 10th gestational week with informed consent.Those with fetal chromosome 16 abnormality suggestive by the NIPS test were subjectedto prenatal diagnosis including chromosomal karyotyping and chromosomal microarray analysis (CMA).Results Of the 7972 pregnant women tested by NIPS,16 (0.2％) were predicted to have fetal chromosome 16 abnormality.The average age of the 16 pregnant women was 33.5 + 5.24,and the average gestational week was 19.88 ± 2.47.Chromosomal karyotyping verified that 3 fetuses had mosaicisms and 1 carried pericentric inversion of chromosome 9,which yielded a positive predictive value (PPV) of 18.8％.CMA has detected 7 fetuses with genomic abnormalities,which yielded a PPV of 43.8％.Eleven of the 16 women (68.8％) have given birth to healthy babies.Conclusion For pregnant women with a high risk of chromosome 16 aneuploidy suggested by NIPS,the prognosis of fetus should be evaluated by multiple methods.Compared with conventional karyotyping analysis,molecular methods such as CMA are far superior.

Objective To analyze the application effect of systematic rehabilitation intervention in postradiotherapy dysphagia of patients with nasopharyngeal carcinoma.Methods Totally 60 patients with nasopharyngeal carcinoma and postradiotherapy dysphagia admitted in our hospital from June 1st,2013 to Feburary 28th,2016 were selected and divided into the treatment group and the control group according to random number table,with 30 cases in each group. Patients in the control group were treated with conventional rehabilitation exercises,combined with routine care and conventional drug therapy,while those in the treatment group were treated with systematic rehabilitation intervention model,including rehabilitation exercises and swallowing apparatus. Improvement of swallowing function and satisfaction toward the nursing were compared between two groups.Results There were 14 effective cases and 16 ineffective cases in the control group. Two cases in the treatment group were cured. There were 23 effective cases and five ineffective cases in the treatment group. The total efficiency of the treatment group (83.33%) was significantly higher than that of the control group (46.67%) (χ2=2.159,P<0.05). The experimental results of drinking water and improvement of limitation of mouth opening in the treatment group were obviously better than that in the control group (Z=5.012,7.018;P<0.05). Satisfaction in the treatment group (86.67%) was obviously higher than that in the control group (43.33%) (χ2=6.321,P<0.05).Conclusions Systematic rehabilitation intervention in postradiotherapy dysphagia of patients with nasopharyngeal carcinoma can significantly improve patients' swallowing difficulties.

OBJECTIVETo analyze the efficacy of percutaneous endoscopic gastrostomy (PEG) in pediatric patients.

METHODFrom October 2011 to October 2014, children in the gastrointestinal ward of Guangzhou Women and Children's Medical Center received PEG or jejunal tube PEG(JET-PEG). The success rate, operation time were recorded. The changes of their weight, enteral nutrition calories and the incidence of pneumonia before and after the first 6 months of operation were compared. Follow-up was conducted until October 2014, the recent and long term complications, the length of indwelling time, the replacement or removal of the tube were recorded, the patients swallowing function or the primary disease's outcomes were observed.

RESULTOf the 13 cases, 10 were male, 3 were female, their average age was 2 years (range 1.8 months-9 years). We performed PEG for 12 of the patients who had congenital craniofacial problems that led to feeding difficulties or recurrent cough and pneumonia (6/12), or neurological disorders (6/12) with inability to swallow, and in one case JET-PEG was performed, this child suffered from chronic intestinal pseudo-obstruction with vomiting and abdominal distension. The gastrostomy was successful in all the patients through one operation, the average operation time of PEG was (25 ± 3) minutes, JET-PEG was 60 minutes. One local skin infection was noted, no long-term complication occurred. In the first 6 months after operation, all the patients gained weight((5.5-30.5) kg postoperation vs. (3.0-30.0) kg preoperation), and 12 cases' enteral nutrition calories increased (from (209-502) to(272-543) kJ/(kg·d)), the incidence of pneumonia decreased in the children who had recurrent pneumonia before the operation (from (0-1.5) to (0-0.16) per month). Until October 2014, their average length of gastric tube indwelling time was 17.8 months (range 4-36 months). In 4 cases PEG tube was removed when they could eat completely independently, the other 9 needed enteral vein nutrition via PEG tube or jejunal tube, in 3 of them balloon type gastric fistula tube was applied. Two of the 13 cases who had cleft palate received stomatological operations when their weight grew to meet the standard.

CONCLUSIONPEG and JET-PEG are safe and effective method for enteric nutrition feeding in pediatrics, the technique causes minimal trauma and has rapid postoperative recovery, few complications, good aesthetic appearances and simple nursing, it can significantly improve their nutritional status and quality of life.

Child ; Child, Preschool ; Enteral Nutrition ; methods ; Female ; Gastrostomy ; adverse effects ; Humans ; Incidence ; Infant ; Male ; Nervous System Diseases ; therapy ; Pneumonia ; therapy

Objective: To analyze the treatment of advanced non-small cell lung cancer (NSCLC) with performance status (PS) scores between 2 and 4, in order to improve the diagnosis and treatment of these patients. Methods: A total of 36 patients with advanced NSCLC with hypoxemia were reviewed. The clinical data of disease characteristics, etiology, complications, manifestation, therapy, progression, and secondary biopsy were collected. The clinical efficacy was graded according to the Response Evaluation Criteria In Solid Tumors (RECIST): complete response (CR), partial response (PR), stable disease (SD) and disease progression (PD). Results: All patients had hypoxemia, of whom 86.1% (31 patients) had complications and 55.6% (20 patients) had noninvasive ventilator for respiratory support. 77.8% (28 cases) received broad-spectrum antibiotic treatment, and 78.6% of them got lung osmotic relief after the anti-infection treatment. 15 cases received bedside fiberoptic bronchoscopy suction, of whom two cases were treated with airway stent deposition due to airway obstruction, four cases with thoracic drainage, four cases with anticoagulation, and one with thrombolytic therapy. After these supportive treatment, the PS score of these patients decreased from 3.4±0.5 to 2.5±0.7, while SPO₂ improved from (89.0±5.2)% to (95.0±3.5)%. As first-ling anti-cancer treatment, nine patients were administrated with targeted medicine orally, 13 patients with a combined chemotherapy of pemetrexed plus bevacizumab or carboplatin, eight patients with paclitaxel plus carboplatin, four patients with gemcitabine plus carboplatin, and two patients with docetaxel plus gemcitabine. In the first response evaluation, there were one case of CR, 23 cases of PR, four cases of SD, and eight cases of PD, with a clinical benefit rate of 66.7% and a disease control rate of 77.8%. A total of 22 patients experienced disease progression, of whom eight cases had a secondary biopsy and six cases had gene sequencing. Of these 36 patients, 10 (27.8%) patients survived at the last follow-up, with a progression-free survival of (10.0±6.5) months. Conclusion Besides prompt anti-cancer treatment and best supportive treatment should be incorporated to improve PS and improve outcome.