Objective To compare the efficacy and cost of surgical clipping and endovascular embolization in the treatment of anterior and posterior communicating artery aneurysm and to conduct cost-effectiveness analysis. Methods The data of treatment outcomes and costs in patients with anterior or posterior communicating artery aneurysms admitted to Huashan hospital from 2002 to 2006 were analyzed using a retrospective cohort study. Results A total of 302 patients were included in the study. They were divided into surgical clipping group (n = 150; 65 males, age [48. 11 ±9. 94] years), interventional treatment group (n = 152;75 males, age [52. 56 ± 11. 09] year). The age of the former was lower than that of the latter (t = -3. 670, P =0. 000). There was no significant difference in preoperative clinical conditions (such as location of aneurysms and Hunt-Hess grade) between the two groups. The good outcome rate in the interventional treatment group was significantly higher than that in the surgical clipping group (84. 87% vs. 74. 67%, χ2 = 4. 875, P = 0. 027). There was no significant difference in hospital mortality (5. 33% vs. 3. 94%,χ2 =0. 328, P =0. 567) and complication rate (26.67% vs. 19. 74% , χ2 =2.036, P =0.154) between the surgical clipping group and the interventional treatment group, but the intraoperative aneurysm rupture (10. 67% vs. 3. 95%, χ2 =5.047, P =0.028) and the incidence of postoperative intracranial infection (6/144 vs. 0/152, χ2 = 6.203, P =0.014) in the surgical clipping group were higher than those in the interventional treatment group. The length of hospital stay in the interventional treatment group was significantly shorter than that in the surgical clipping group ([10. 0 ± 7. 0] dvs. [23.0 ± 11. 0] d, Z = -10. 35, P ＜0.001). The median cost of treatment was 95 327.63 %,yuan in the interventional treatment group, and the interquartile range (IQR) was 26 312. 98 yuan; it was significantly higher than the surgical clipping group (median 30 072. 01 yuan, IQR 11 178. 54 yuan) (Z = -14.449, P＜0.001). Compared with the surgical clipping group, while the mRS score improved in the interventional treatment group 0. 10, the cost was about 66 438 yuan, so that the surgical clipping was more cost-effective. Conclusions The efficacy of the intervention treatment of anterior and posterior communicating artery aneurysms is better than that of the surgical clipping The mortality and total complication rate are almost the same with the surgical clipping Thehospital stay is shorter, but the cost of treatment is higher. From an economic point of view, the surgical clipping is more cost-effective.

Objective:To investigate the therapeutic effect of carbon dioxide laser tonsillectomy.Method:In this prospective,randomized study, One hundred and two patients were divided into laser group or control group. Patients of laser group were cured with carbon dioxide laser tonsillectom,and the control group was cured with routine method. All operations are executed by one person. Observation index included operation time, hemorrhage in operation, ache after operation, inflammatory reaction of raw surface, repair time of raw surface, rehaemorrhagia and scar.Result:Laser group had advantages of less operation time, less hemorrhage, less ache and less inflammatory reaction of raw surface. Laser group have hemorrhage in operation (7.2±2.1)ml, while control group have hemorrhage in operation (92.0±35.0)ml. Laser group have pseudomembrane early but desquamate late.Conclusion:Carbon dioxide laser tonsillectomy is effective to relieve pain, inflammatory reaction and with less time ,it's an safe , efficient and mini-trauma operation.

Objective To observe the therapeutic efficacy of electrical stimulation and balloon dilatation in treating cricopharyngeal achalasia after a brainstem stroke.Methods Thirty dysphagia patients with cricopharyngeal achalasia after a brainstem stroke were randomly divided into an experimental group and a control group, each of 15.The experimental group was given real-time electrical stimulation and balloon dilatation, while the control group was treated using common electrical stimulation and balloon dilatation.Results Twenty-six patients in the 2 groups returned to oral feeding after treatment.Videofluoroscopy revealed that the cricopharyngeal sphincter had relaxed and the food passed successfully when swallowing.No aspiration was observed.There was no significant difference in swallowing between the two groups, but the average treatment time, days of treatment and cost of therapy in the experimental group were significantly less than in the control group.Conclusions Either real-time electrical stimulation or common electrical stimulation combined with balloon dilatation can treat dysphagia effectively, but the former can shorten the course of treatment and lower its cost.

Objective To evaluate the value of serum uric acid(UA)levels with reference to the age,waist circumference,and body mass index(BMI)in predicting the metabolic syndrome(MS)in obese children.Methods A total of 300 obese children,including 180 boys and 120 girls,were enrolled in this study.The height,BMI,waist and hip circumference,blood pressure,serum glucose,insulin and lipid profile in all participants were measured.Oral glucose tolerance test and insulin releasing test were performed.The boys or girls were divided into 4 groups according to the 4 quantile of UA level,respectively.The clinical characteristics and correlation of UA with the clinical indexes and MS components were compared.The binary Logistic regression analysis was applied in the risk of MS and its components for the 4 groups of obese children.The area under the receiver operating characteristic curve(ROC curve)of UA level,age,waist circumference and BMI were used to predict the MS.Results UA level was increased with the increase of age,waist circumference and BMI,and the UA level was significantly correlated with triacylglycerol,postprandial 2 h glucose(2 h PG)(r=0.196,0.174 in boys;r=0.291,0.179 in girls).In boys,the adjusted odds ratio and 95％CI of the highest quartile of UA for triglyceridemia was 2.71(95％CI:0.77-9.58);which in girls,the adjusted odds ratio and 95％CI of the highest quartile of UA for hyperglycemia,hypertension were 8.45(95％CI:1.76-40.52)and 3.93(95％CI:0.66-23.33),respectively,with significant differences.In boys,the area under the ROC curve of UA level,age,waist circumference and BMI which predict the MS were 0.652 0.626,0.621,0.62,respectively,and the differences were significant(all P<0.05).Conclusions The UA level is significantly correlated with the composition of MS,UA detection combining with reference to the age,waist circumference,and BMI is helpful for the identification of high risk groups of metabolic syndrome.

Adolescent ; Adult ; Child ; Child, Preschool ; Electrocoagulation ; methods ; Female ; Humans ; Hypothermia, Induced ; Male ; Middle Aged ; Prospective Studies ; Tonsillectomy ; methods ; Young Adult

Objective To observe the clinical therapeutic effects and evaluate the security of Huganjiexian decoction combined with conventional therapy on hepatic cirrhosis.MethodsBy the randomized and prospective study method,34 patients with liver cirrhosis were divided into experimental group and control group.The experimental group was treated with Huganjiexian decoction combined with conventional therapy while the control group was treated with conventional therapy alone.Patients in both groups were treated six months.At the beginning and 6 months after treatment,levels of alanine transaminase (ALT),aspartate transaminase (AST),albumin (ALB),albumin/globulin (A/G),total bilirubin (TBiL),blood urea nitrogen (BUN),serum creatinine (Scr) were determined.Results Levels ofALT、AST、TBiL decreased in both groups after being treated for six months,and the differences of downward trend of the experimental group were more significant than control group (F=36.63,40.31,38.65,P＜0.05).Levels ofALT、AST、TBiL of the experimental group were lower than those of control group significantly (F=8.67,7.62,4.36,P＜0.05 ).The A/G raised in both groups after treatment,and the upward trend of the experimental group was greatly different from that of control group (F=24.10,P＜0.05),the value of A/G of the experimental group was higher than that of control group (F=4.78,P＜0.05).The ALB raised in both groups after treatment,while the upward trend of the experimental group was no different from that of control group (F=0.89,P＞ 0.05).Thevalue of ALB had no significant changes in both groups (F=3.15,P＞0.05).Conclusion Huganjiexian decoction possessed therapeutic effect on hepatic cirrhosis,it had no obvious toxicity and side

OBJECTIVE: To investigate the therapeutic effect of carbon dioxide laser tonsillectomy. METHOD: In this prospective, randomized study, One hundred and two patients were divided into laser group or control group. Patients of laser group were cured with carbon dioxide laser tonsillectomy, and the control group was cured with routine method. All operations are executed by one person. Observation index included operation time, hemorrhage in operation, ache after operation, inflammatory reaction of raw surface, repair time of raw surface, rehaemorrhagia and scar. RESULT: Laser group had advantages of less operation time, less hemorrhage, less ache and less inflammatory reaction of raw surface. Laser group have hemorrhage in operation (7.2 +/- 2.1) ml, while control group have hemorrhage in operation (92.0 +/- 35.0) ml. Laser group have pseudomembrane early but desquamate late. CONCLUSION Carbon dioxide laser tonsillectomy is effective to relieve pain, inflammatory reaction and with less time, it's a safe, efficient and mini-trauma operation.
Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Humans ; Lasers, Gas ; Male ; Middle Aged ; Prospective Studies ; Tonsillectomy ; methods ; Treatment Outcome ; Young Adult

To investigate hematopoiesis and cytogenetics changes in staff of interventional radiology.A total of 121 intervention radiation workers, 245 common radiation workers and 100 medical personnel (healthy control) without exposure to radiation were enrolled in the study. The peripheral lymphocyte chromosomal aberrations and micronucleus were detected, and the result of white blood cells examination was analyzed.Compared with common radiation group and healthy control group, decreases in white blood cells count, neutrophil ratio, and increase in lymphocyte ratio were observed in intervention radiation group (all<0.05). Intervention radiation group had higher chromosome aberration rate and micronuclear rate than common radiation group and healthy control group (all<0.05). Most common chromosome aberrations were dicentric chromosome, acentric ring, fragments and minute chromosome. Abnormal rates in chromosome aberration and micronucleus rates were increased with the rise of length of service, but no statistically significant difference was observed (>0.05).Long term exposure to ionizing radiation may lead to changes in the human hematopoietic system and cause human chromosome aberration, and the severity of such injuries may be associated with the dose of ionizing radiation.
Adult ; Chromosome Aberrations ; radiation effects ; Dose-Response Relationship, Radiation ; Female ; Hematopoiesis ; radiation effects ; Humans ; Leukocyte Count ; statistics & numerical data ; Leukocytes ; pathology ; radiation effects ; Lymphocytes ; pathology ; radiation effects ; ultrastructure ; Male ; Micronuclei, Chromosome-Defective ; radiation effects ; Occupational Exposure ; adverse effects ; Radiation Exposure ; adverse effects ; statistics & numerical data ; Radiation, Ionizing ; Radiologists ; statistics & numerical data ; Time Factors