Objective To analyze the characteristics of the common first attack of headache in patients with cerebral venous sinus thrombosis (CVST). Methods The clinical data of 51 patients who were diagnosed as CVST with MR venography (MRV)or DSA were collected retrospectively. The patients were divided into either a acute group (≤3 week,n= 32)or a chronic group (>3 weeks, n=19). Results (1)The age of onset of symptoms in these patients was 20 to 40 years,and most of them were females. Of all the first symptoms,headache ranked first,accounting for 84. 3%(43/51 );headache only accounted for 52. 9%(27/51 ),headache with other symptoms (ophthalmic symptoms, hemiplegia,and aphasia,etc. )accounted for 31. 4%(16/51 ),and other symptoms such as epilepsy, paralysis,and ophthalmic symptoms accounted for 15. 7%(8/51). (2)The proportion of headache only as the first symptom in the acute group was higher than that in the chronic group (65. 6% vs. 31. 6%,P<0. 05), and the proportion of chronic headache with other symptoms as the first symptom in the chronic group was higher than that of the acute group (P<0. 05). In addition,the proportion of the first symptom including ophthalmic manifestations in the chronic group was higher than that of the acute group (P <0.01 ). (3)Forty-three patients with headache,dull headache or distensible pain accounted for 72. 1%(31/43), thunderclap headache accounted for 11. 6%(5/43),and other kinds of headache accounted for 16. 3%(6/43),however,there were no significant differences about the types of headache between the two groups (all P>0. 05 ). Conclusion Young patients without previous history of migraine,especially women of childbearing age with sudden onset and progressive worsening headache,and the patients with idiopathic intracranial hypertension,CVST should be considered as an important possibility.

Objective:To compare the effectiveness of different durations of anti-seizure medications for acute symptomatic seizures in children with acute encephalitis syndrome.Methods:A total of 186 children with acute symptomatic seizures who received treatment at the Department of Neurology, Xi 'an Children's Hospital, from May 2020 to May 2022 were retrospectively included in this study. All patients were treated with anti-seizure medications. These children were divided into an observation group ( n = 93, 4-week anti-seizure medication) and a control group ( n = 93, 12-week anti-seizure medication) according to different durations of anti-seizure medication they received. The abnormal rates of electroencephalogram findings, treatment effectiveness, and recurrence rates of epileptic seizures were compared between the two groups. These children were divided into a recurrent group and a non-recurrent group based on their seizure recurrence outcomes. Clinical data from both groups were collected and compared. The factors influencing the recurrence of epileptic seizures were analyzed. Results:There were no significant differences in abnormal rates of electroencephalogram findings, treatment effectiveness, and recurrence rates of epileptic seizures between the observation and control groups (χ 2 = 1.90, 0.98, 0.36, all P > 0.05). Among the 186 children who were followed up for 1 year, epileptic seizures recurred in 12 cases, while 174 cases did not experience any recurrence. Univariate analysis revealed statistically significant differences between the recurrent and non-recurrent groups in terms of consciousness status, electroencephalogram findings, and Pediatric Cerebral Performance Category scores (χ2 = 6.16, 4.40, 5.88, all P < 0.05). Further analysis using binary logistic regression identified severe coma and Pediatric Cerebral Performance Category scores of 3-4 as independent risk factors for recurrent seizures in children with acute symptomatic seizures (both P < 0.05). Conclusion:Four-week and twelve-week anti-seizure medication for acute symptomatic seizure in children show similar effectiveness. Severe coma and Pediatric Cerebral Performance Category scores of 3-4 are significantly correlated with the recurrence of acute symptomatic seizure and therefore require clinical attention.

Objective To explore the safety and economic benefits of day surgery laparoscopic cholecystectomy (LC/DS).Methods Clinical data of 5771 patients undergoing LC/DS and 2450 undergoing conventional laparoscopic cholecystectomy (CLC) in PLA General Hospital from November 2009 to January 2017 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. In LC/DS group, there were 2204 males and 3567 females with the average age of (51±13) years old. In CLC group, there were 992 males and 1458 females with the average age of (51±13) years old. The hospitalization time and total medical expenses of two groups were compared by Mann-Whitney test. The ratio of conversion to laparotomy, postoperative complication, postoperative 24-hour discharge rate, and 30-day readmission rate were compared by Chi-square test.Results The ratio of conversion to laparotomy and 30-day readmission rate was respectively 0.36％, 0.49％ in LC/DS group and 0.16％, 0.49％ in CLC group, and no significant difference were observed (χ2=2.83, 0.00; P>0.05). The postoperative 24-hour discharge rate in LC/DS Group was 83.34％, significantly higher than 49.22％in CLC group (χ2=1020.30, P<0.05). The postoperative complication rate in LC/DS group was 6.59％, significantly lower than 14.56％ in CLC group (χ2=130.19, P<0.05). The hospitalization time and total medical expenses in LC/DS group was respectively [3.0(1.0-33.0)] d and [0.98(0.56-4.59)] million RMB, significantly lower than [5.0(1.0-36.0)] d and [1.40(0.38-2.95)] million RMB in CLC group (Z=-17.33,-45.40; P<0.05).Conclusions LC/DS is safe and effective. It can reduce the incidence of postoperative complications, shorten the hospitalization time and reduce the hospitalization cost of patients.

Objective To evaluate preoperative oral carbohydrate in patients receiving LC day surgery.Methods 117 patients undergoing LC day surgery in PLA General Hospital from Oct 2016 to Mar 2017 were evenly divided into three groups.Patients in group A took oral carbohydrate preoperatively,group B by iv glucose,group C by overnight fasting.The preoperative thristy and the indicators of inflammation,heart rate,blood glucose,serum insulin,insulin resistance index postoperatively were collected and compared.Results No patients suffered aspiration.There were no complications above Clavien Ⅰ level.Differences in insulin resistance index,fasting serum insulin were statistically significant between group A and group B (Z =-5.60,-4.78,P ＜ 0.05).That of insulin resistance index,fasting serum insulin and procalcitonin between group A and group C were statistically significant (Z =-2.65,-2.49,-4.02,P ＜0.05).Procalcitonin between group B and group C were statistically different (Z =-2.183,P ＜ 0.05).The preoperative thristy between group A and group B,group C were statistically different (x2 =6.47,P ＜ 0.05).Conclusions Preoperative oral carbohydrate intake is safe and feasible with the benefits of improving the quality of life in patients operated on LC day surgery.