Objective:To explore application value of rehabilitation nursing in patients With cerebral stroke.Methods:A total of 97 patients With cerebral stroke Were randomly divided into rehabilitation nursing group (n=50,received early rehabilitation nursing)and routine nursing group (n=47,only received routine nursing)according to number table method.Scores of clinic neurologic impairment score scale (CSS)and activity of daily living scale (ADL)Were compared betWeen tWo groups at admission and after discharge.Results:There Were no significant difference in CSS and ADL scores betWeen tWo groups at admission (P<0.05 both);compared With routine nursing group after dis-charge,there Was significant decrease in CSS score [(14.27±7.45)scores vs.(7.87±6.25)scores]and significant increase in ADL score [(50.52±19.59)scores vs.(74.52±20.61)scores]in rehabilitation nursing group,P <0.05 or <0.01;compared With routine nursing group,there Were significant decrease in incidence rates of various complications (89.36% vs.18.0%)in rehabilitation nursing group during admission,P <0.01. Conclusion:Early directed rehabilitation nursing contributes to recovering nervous function,improving prognosis and quality of life in patients With cerebral stroke.

Objective To compare the X-ray features between Hirschsprung alied disease (HAD)and Hirschsprung disease ( HD), and analyze the differentiations. Methods From December 2004 to December 2009, nineteen cases of HAD, aged from 30 days to 10 years (median, 14 months), received barium enema examinations in our institution. Other 19 cases with HD, also received barium enema examinations, were chosen randomly. They were aged from 42 days to 8 years ( median, 8 months). The imaging features of HAD and HD were analyzed retrospectively. The incidence rate of colon stenosis,"truncation sign" and spasm notch and R/C ratio (the longest diameter of rectum/colon) were calculated and compared between these two groups. In all these cases, diagnosis was confirmed by postoperative histopathology. The position of barium retained was also evaluated. These parameters of both groups were compared by x2 and Fisher test. Results There was statistical significance in the incidence rate of colon stenosis between HAD (9/19) and HD (18/19) (x2 = 10.364, P ＜0.01). However, there was no statistical significance in "truncation sign" and spasm notch between HAD (4/19 and 3/19, respectively)and HD ( 1/19 and 1/19, respectively) (P ＞0. 05 for both). R/C ratio was 0. 42 ±0. 15 in HAD group and 0.29±0. 12 in HD group, and there was statistical significance between them (t =2.892,P＜0.01). In HAD group, barium retained in distal sigmoid colon in 1 case (1/19), in distal descending colon in 7 cases (7/19), in distal transverse colon in 1 case (1/19), in total colon in 6 cases (6/19); However, in HD group, barium retained in distal rectum in 3 cases (3/19), in distal sigmoid colon in 13 cases ( 13/19), in distal descending colon in 3 cases (3/19). Conclusions There were some differences in the imaging features between HAD and HD though they presented similar clinic experience. HAD cases presented a lower incidence rate of colon stenosis and a higher R/C ratio than HD cases. In HAD cases, the most common site of barium retained is distal descending colon, while in HD cases, it is distal sigmoid colon.

Objective:To explore the effects of different approaches for second-trimester multifetal pregnancy reduction on pregnancy outcome in women with dichorionic triamniotic (DCTA) triplet.Methods:A retrospective study was performed on 51 women with DCTA triplet pregnancies who were referred to Guangdong Women and Children Hospital for second-trimester multifetal pregnancy reduction from January 2014 to January 2020. All participants were divided into either preventive group ( n=39) or treatment group ( n=12) according to the indication for multifetal pregnancy reduction, and they were further allocated to three subgroups based on different reduction methods, which were reduction to dichorionic twin by radiofrequency ablation (RFA) (RFA subgroup), reduction to monochorionic singleton (KCl-singleton subgroup) or monochorionic twin (KCl-twin subgroup) by cardiac injection of potassium chloride. Pregnancy loss rate, neonatal birth weight, gestational age at delivery, incidence of intrauterine death, and neonatal death were compared and analyzed between different groups using t-test, analysis of variance, Chi-square test, Fisher's exact test and Bonferroni correction. Results:(1) The mean gestational week at operation in the treatment group was significantly later than that in the preventive group [(18.5±3.1) vs (15.0±2.3) weeks, t=-4.209, P<0.001]. In the preventive group, the mean gestational week at operation in the RFA subgroup was later than the KCl-singleton and KCl-twin subgroup[(17.2±1.6) vs (13.8±1.5) and (12.7±1.0) weeks, t=6.630 and 3.875, respectively, both P<0.05]. (2) The postoperative pregnancy loss rate in the preventive group was decreased compared with the treatment group [10.3%(4/39) vs 5/12, Fisher's exact test, P<0.05], and the live birth ratio was increased [ 85.7%(48/56) vs 10/18, χ2=5.640, P=0.018]. No live birth infants with birth weight <1 500 g was reported in the KCl-singleton subgroup in preventive group, and the statistical significance was observed in the intra-group differences ( P<0.05) rather than the pairwise comparison differences in the preventive group. For the proportion of live births, there was a statistically significant difference in the intra-group comparison in the treatment group, which was higher in the RFA subgroup than that in the KCl-twin subgroup (6/6 vs 1/6, P=0.045). No significant difference was revealed among pregnancy loss rate, gestational weeks at delivery, the mean birth weight, premature delivery <32 gestational weeks, and full-term birth rate among three different approaches within the two groups. (3) No monochorionic twin complications or perinatal death occurred in any RFA or KCl-singleton subgroups in the two groups. In the KCl-twin subgroups including five cases with ten fetuses, including three live birth, four miscarriage, three intrauterine death occured, while no neonatal death was reported. One case with selective fetal uterine growth restriction in the preventive group delivered two live births, and one case with twin-to-twin transfusion syndrome in the treatment group had intrauterine death in one fetus and one survival neonate. Conclusions:The pregnancy outcome of multifetal pregnancy reduction to dichorionic diamniotic twins by RFA or reduction to singleton by cardiac injection of potassium chloride are comparative in women with DCTA triplet, regardless of whether it is a preventive or therapeutic reduction.

Objective: To assess the effectiveness of radiofrequency ablation (RFA) in the treatment of multiple pregnancies. Methods: In this retrospective study, 84 cases (total 174 fetuses) of complex monochorionic pregnancies treated with RFA for selective fetal reduction were analyzed. All cases were managed in the Guangdong Women and Children Hospital from January 2015 to January 2018. Indications for offering RFA, details of the procedure and pregnancy outcomes were collected and analyzed. Results: (1)The rate of miscarriage and fetal intrauterine death was 21% (18/84), termination of pregnancy because of fetal malformation or oligohydramnion occurred in 10% (8/84) of cases. Total live birth rate was 69% (58/84) and the gestation age at delivery was (35.0±3.0) weeks. (2) The live birth rate of twin reversed arterial perfusion sequence (TRAPS) was the lowest (6/11), followed by twin to twin transfusion syndrome (TTTS; 66%, 27/41), structural or genetic abnormalities of one fetus in monochorionic twin pregnancy (10/14), triplet pregnancy reduction (4/6) and selective intrauterine growth restriction (sIUGR) (11/12). (3) The live birth rate was 67% (20/30) in stage Ⅲ of TTTS and 7/11 in the stage Ⅳ of TTTS (P>0.05). The average gestational age was (33.6±3.0) weeks in stage Ⅲ of TTTS compared with (36.5±2.4) weeks in the stage Ⅳof TTTS (P<0.05). Conclusions RFA appears to be a reliable option for selective fetal reduction in monochorionic multiple pregnancies. The indication of RFA is an influencing factor on its pregnancy outcomes. Type Ⅱand type Ⅲ sIUGR may choose this technique as a priority. Compared with stage Ⅲ of TTTS, the live birth rate and the gestation age at delivery in stage Ⅳ of TTTS, there are no significant differences.

Objective:To summarize the clinical features of primary segmental volvulus (PSV) in neonates.Methods:A retrospective analysis was conducted on the clinical data of neonates with PSV who were admitted to the Department of Neonatal Surgery, Children's Hospital Affiliated to Capital Institute of Pediatrics from May 2014 to May 2023. The clinical manifestations, auxiliary examinations, treatment and prognosis of the neonates were summarized, and descriptive statistical analysis was performed on the collected data.Results:A total of 10 neonates with PSV were included, with a mean gestational age of (34.1±3.0) weeks and birth weight of (2 291±646) g. Eight cases had an onset age of 3 d or less, and 2 cases had an onset age of more than 3 d. Abdominal distension was observed as the main manifestation in all cases, while bilious vomiting occurred in seven cases and hematochezia in five cases. Imaging examinations mainly revealed low intestinal obstruction without specific manifestations. Laboratory tests showed metabolic acidosis and varing degrees of anaemia. Nine cases underwent diagnostic abdominal puncture, of which five had bloody ascites, two had clear ascites, one had bloody mixed with fecal-like ascites, and one had chylous ascites. All the cases underwent emergency exploratory laparotomy and segmental small bowel resections with either primary intestinal anastomosis or enterostomy. All cases were successfully cured and had been followed up to the age of 4 months to 9 years with good growth and development as normal children of the same age.Conclusions:Neonatal PSV is an independent abdominal emergency characterized by non-specific clinical manifestations and difficult preoperative diagnosis, but the overall prognosis is favorable after active surgical treatment.

AIM: To observe the effect of acute normovolemic hemodilution (ANH) autologous blood transfusion on the EEG bispectral index and muscle relaxation in elderly patients undergoing orthopedic surgery to explore the influence of autologous blood transfusion containing anesthetic components on the quality and safety of postoperative anesthesia recovery. METHODS: Forty patients, aged 65-75, weighing 55-80 kg, ASA grade I-II, with an estimated intraoperative blood loss of more than 600 mL, were selected for elective orthopedic surgery. The patients were randomly divided into two groups (n=20): group A was given acute normovolemic hemodilution (ANH), and the target value of Hct was 28%-30% after induction of anesthesia; group B was the control group which was given routine fluid infusion during operation without ANH. Bispectral index (BIS), TOF values and plasma concentrations of propofol and cisatracurium were measured at the beginning of autotransfusion (T