Objective To analysis the correlation of obstructive sleep apnea-hypopnea syndrome (OSAHS) and perihematoma edema of hypertensive cerebral hemorrhage.Methods One hundred and forty-four patients with hypertensive cerebral hemorrhage were collected and 78 of these patients were suffered from OSAHS.The patients were divided into two groups,control and OSAHS group,according to whether were accompanied by OSAHS or not.Both of the groups received the routine treatments including dehydration,reducing blood press,protecting the cerebral cells and so on.Cerebral CT scan was taken on admission.Night polymonography (PSG) was done within 24 hours of admission.Twenty-four hours and 4 days after admission,cerebral CT scan was taken again.The volumes of cephalophyma and perihematoma edema were calculated according to the results of CT scan.The changes of cephalophyma and perihematoma edema were dynamic observed.Results No difference in patients' age,sex,body mass index,serum glucose,blood lipid and so on,was observed between the two groups.The relative edema index became significantly different until 4 days after admission (0.40 ± 0.45,0.96 ± 1.35 in control and OSAHS group respectively,t =4.149,P =0.000).Similarly,the alternation edema index of OSAHS was obviously higher than that of control group only in 4 days after admission.While the analysis of the correlation between different degree OSAHS groups and edema indexes showed that at 24 hours after admission the edema volumes for different degree OSAHS groups were consistent (1.05 ± 0.65,0.84 ± 0.48,1.20 ± 0.54,1.10 ±0.40 in control,slight,moderate and severe groups respectively,F =1.061,P =0.374).At 24 hours and 4 days after admission,the edema volumes were positively correlated with the degree of OSAHS.Alternation edema index was significantly correlated with apnea hypopnea index according to the result of Pearson' s correlation analysis (r =0.652,P =0.000).Conclusion OSAHS complication can promote the progression of perihematoma edema of hypertensive cerebral hemorrhage,and the degree of edema aggravation is positive correlated to the degree of OSAHS.

OBJECTIVE: To analyze the complication, survival and life quality, and to explore the efficacy and prognosis of skull base chordoma treated by open surgery and gamma knife surgery (GKS). METHODS: Thirty-eight patients with skull base chordomas who underwent an open surgery and another 19 patients who underwent GKS between January 2002 and January 2010 were followed up. The Karnofsky performance scale (KPS) at admission,discharge and follow-up, and recurrent rates were calculated through SPSS life-table, and survival rate curve was used to evaluate the efficacy and prognosis. RESULTS: Forty patients were followed up, and the survival rate of 1, 3 and 5 years was 92.6%, 74.3% and 60% in 27 patients with open surgery, and 100%, 83.3% and 62.5% in 13 patients with GKS respectively. There was no significant difference between the 2 groups (χ(2)=0.867, P=0.353). There was no significant difference in the KPS score between the 2 groups (P=0.138). CONCLUSION Despite the poor prognosis of skull base chordoma, GKS can effectively improve the survival rate and present life quality of patients with skull base chordoma.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Chordoma ; surgery ; Female ; Follow-Up Studies ; Humans ; Karnofsky Performance Status ; Male ; Middle Aged ; Prognosis ; Radiosurgery ; instrumentation ; Skull Base Neoplasms ; surgery ; Survival Analysis ; Young Adult

OBJECTIVE: To evaluate the curative effects and complications when using microvascular decompression (MVD) or gamma knife surgery (GKS) to treat trigeminal neuralgia (TN). And to investigate the prognosis for TN after these treatments. METHODS: Sixty-one TN patients treated using MVD and eighty-six TN patients treated using GKS were enrolled by means of telephone, letter or out-patient recheck; the patients had originally presented from December 1996 to June 2010. A chi-square test was applied to follow-up data on pain relief after 1 month, 6 months and 12 months, and at the final follow-up. RESULTS: One hundred and two patients were followed for 3-151 months. Cumulative pain relief rates at 1, 6, 12 months and at end times were 90.48%, 95.24%, 92.86%, and 95.24%, respectively, for forty-two MVD-treated patients, and 23.33%, 83.33%, 86.67% and 90% for sixty GKS-treated patients, respectively. The effects of two methods for treatment of TN was not statistically different (χ(2) = 2.053, P=0.152). Pain relief rates in the short-term (first month) demonstrated statistically significant differences (P<0.01), but pain relief rates in the long-term showed no significant differences (P>0.05). CONCLUSION Immediate pain relief with MVD treatment is higher than with GKS, but in the long term both treatments were comparable.
Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Male ; Microvascular Decompression Surgery ; methods ; Middle Aged ; Prognosis ; Radiosurgery ; Treatment Outcome ; Trigeminal Neuralgia ; surgery

Objective To investigate the antimicrobial resistance and resistance profiles of Salmonella isolates,from the pork production chain in several districts of Sichuan province and to determine the correlation between serotype and the pulse field gel electrophoresis(PFGE)patterns. Methods From 2010 to 2011,a total of 112 Salmonella isolates from pork production chain were examined for their antimicrobial susceptibility,using the micro-dilution method against 10 antimicrobial agents. Results were assessed by the standard by the Clinical and Laboratory Standards Institute (CLSI,2010). In addition,PFGE patterns were investigated among the Salmonella strains from different sources,under different serovars and antimicrobial profiles. Results For Salmonella isolated from the pork production chain,resistance to tetracycline(89.29%)was frequently observed. Many isolates were resistant to spectinomycin(36.61%),trimethoprim/sulfamethoxazole(35.71%), nalidixic acid(33.93%)and ampicillin(24.11%),but all of the isolates were susceptible to ceftiofur. 33.93% of the isolates were multi-drug resistant. Salmonella isolates from the pork production chain had 19 antibiotic resistance profiles. Totally,34 PFGE patterns were detected among 74 Salmonella isolates from the pork production chain,with the PFGE patterns of the 74 Salmonella isolates sharing 40%to 100%similarities. Conclusion The antimicrobial resistances of the Salmonella isolates were commonly detected from the pork production chain in Sichuan province suggesting that Salmonella might horizontally spread from food animals to retail meat products.

Objective:To observe the effect of 3D-printed guide plate-assisted percutaneous bone cement-augmented sacroiliac screw fixation in the treatment of pelvic fragility fractures in the elderly.Methods:A total of 11 elderly patients with pelvic fragility fractures who underwent 3D-printed guide plate-assisted percutaneous cement-enhanced sacroiliac screw fixation (cemented group) in the Department of Traumatic Orthopaedics of the General Hospital of Ningxia Medical University from December 2022 to April 2024 were retrospectively analyzed. There were 3 males and 8 females, aged 73.18±4.42 years (range, 67-80 years). There were 4 cases of typeⅡand 7 cases of typeⅢ. At the same time, 10 elderly patients with pelvic fragility fractures who underwent percutaneous sacroiliac screw fixation assisted by 3D-printed guide plate (cementless group) were selected as control group, including 5 males and 5 females, aged 73.90±6.51 years (range, 67-85 years). Pelvic fragility fractures were classified as typeⅡin 5 cases and typeⅢin 5 cases. The perioperative indicators, visual analogue scale (VAS), Barthel index and postoperative complications were compared between the two groups.Results:All patients successfully completed the operation and were followed up for 17.05±5.48 months (range, 9-27 months). The operation time and fluoroscopy frequency in the bone cement group were 72.09±3.95 min and 12.45±0.93 times, which were significantly higher than those in the non-bone cement group 57.00±4.24 min and 8.50±0.97 times, the difference was statistically significant ( P<0.05). All patients' fractures healed in one stage, the healing time was 97.09±7.15 d in the cemented group and 103.00±13.14 d in the uncemented group, the difference was not statistically significant ( t=1.297, P=0.210), and there was no case of delayed healing or non-healing. The postoperative weight-bearing time of the bone cement group was 44.73±3.72 d, which was shorter than that of the non-bone cement group 59.10±7.37 d, and the difference was statistically significant ( P<0.05). The VAS scores of the bone cement group at 1 day, 1 week and 3 weeks after operation were 5.73±0.65, 4.64±0.51 and 3.27±0.65, respectively, which were lower than those of the non-bone cement group 6.80±0.42, 5.30±0.48 and 4.00±0.67. The difference was statistically significant ( P<0.05). The Barthel index of bone cement group was higher than that of non-bone cement group at 1 day, 1 week, 3 weeks, 6 weeks and 2 months after operation, and the difference was statistically significant ( P<0.05). Bone cement leakage occurred in 2 patients in the bone cement group, and they did not complain of special discomfort and were not treated. In the non-cemented group, two cases showed screw withdrawal and the sacroiliac screws were removed in a second operation; one case showed sacral plexus nerve injury, and the screws were removed and treated with oral methylcobalamin symptomatic therapy one month after the operation, and the symptoms were relieved after three months. Conclusion:3D-printed guide plate-assisted percutaneous cement-augmented sacroiliac screw fixation for the treatment of elderly pelvic fragility fracture can alleviate postoperative pain, shorten the weight-bearing time, and help to promote early recovery and improve postoperative quality of life.

Objective:To explore the efficacy and safety of neoadjuvant chemoimmunotherapy combined with surgery for stage ⅢA NSCLC patients.Methods:Six patients with NSCLC who were diagnosed as ⅢA and received two cycles of neoadjuvant chemoimmunotherapy and surgery between September 2019 and January 2020 were described in this study.Results:Five of them experienced AEs during neoadjuvant therapy. All of them received surgery and achieved an MPR of 50%. No viable tumor cells were found in the tissues of one patient. One patient with a small bronchopleural fistula after lobectomy.Conclusion:Neoadjuvant chemoimmunotherapy combined with surgery for stage ⅢA NSCLC patients is safe and efficient. Long-term outcomes of neoadjuvant chemoimmunotherapy combined with surgery should be further validated.

OBJECTIVETo investigate the antimicrobial resistance and resistance profiles of Salmonella isolates, from the pork production chain in several districts of Sichuan province and to determine the correlation between serotype and the pulse field gel electrophoresis (PFGE) patterns.

METHODSFrom 2010 to 2011, a total of 112 Salmonella isolates from pork production chain were examined for their antimicrobial susceptibility, using the micro-dilution method against 10 antimicrobial agents.

RESULTSwere assessed by the standard by the Clinical and Laboratory Standards Institute (CLSI, 2010). In addition, PFGE patterns were investigated among the Salmonella strains from different sources, under different serovars and antimicrobial profiles.

RESULTSFor Salmonella isolated from the pork production chain, resistance to tetracycline (89.29%) was frequently observed. Many isolates were resistant to spectinomycin (36.61%), trimethoprim/sulfamethoxazole (35.71%), nalidixic acid (33.93%) and ampicillin (24.11%), but all of the isolates were susceptible to ceftiofur. 33.93% of the isolates were multi-drug resistant. Salmonella isolates from the pork production chain had 19 antibiotic resistance profiles. Totally, 34 PFGE patterns were detected among 74 Salmonella isolates from the pork production chain, with the PFGE patterns of the 74 Salmonella isolates sharing 40% to 100% similarities.

CONCLUSIONThe antimicrobial resistances of the Salmonella isolates were commonly detected from the pork production chain in Sichuan province suggesting that Salmonella might horizontally spread from food animals to retail meat products.

Objective To observe the changes ofmacular structure and choroidal capillary blood flow density in patients with acute central serous chorioretinopathy (CSC).Methods Prospective cross-sectional study.A total of 24 eyes of 24 patients with monocular acute CSC (case group) diagnosed by clinical examination from Shanxi Eye Hospital during January and March 2018 were included in the study.The eyes (24 eyes) and contralateral eyes (24 eyes) of the patients in the case group were set to CSC group and contralateral eye group,respectively.Twenty-one eyes of 21 healthy volunteers with age and gender matching were selected as normal control group.The macular structure of the eyes were observed by OCT and OCT angiography (OCTA),and the blood vessel density of choroidal capillary layer in the circular area of the macular area with a radius of 1 mm was measured.The paired t-test was used to compare the differences in blood flow density in the choroidal capillaries between the three groups.Results The results of OCT showed that the serous neuroepithelial detachment in the macular area was observed in all eyes of the CSC group,with or without RPE detachment being 20 or 4 eyes,respectively.Of the 24 eyes in the contralateral eye group,13 eyes (54.2％) had thick choroidal RPE lesions (PPE).There was no abnormality in the retina and choroidal structure in the macular area of the normal control group.The results of OCTA showed that the blood flow density of choroidal capillaries in the CSC group,the contralateral eye group and the normal control group were 1.759 ± 0.132,1.924± 0.463,and 1.940± 0.033,respectively.Compared with the eyes of the contralateral eye group and the normal control group,the blood flow density of choroidal capillaries in the CSC group was significantly lower (t=6.611,6.474;P=0.000,0.000).There was no significant difference in the blood flow density of choroidal capillary layer between the contralateral eye group and the normal control group (t=1.328,P ＞ 0.05).In the contralateral eye group,there was no significant difference in the blood flow density of choroidal capillary layer between PPE eyes and no RPE eyes (t=0.806,P＞0.05).Conclusions There is 54.2％ of the contralateral eyes in the monocular acute CSC patients with PPE.The choroidal capillary layer blood flow density is lower than that of the contralateral and normal eyes.

Objective:To examine the early outcome of valve sparing aortic root replacement with reimplantation technique (David procedure) with partial upper sternotomy.Methods:From April 2016 to April 2020, 31 patients underwent valve sparing aortic root replacement under partial upper sternotomy at Vascular Surgery Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. There were 28 males and 3 females, aging (44±13) years (range: 11 to 65 years). Preoperative aortic regurgitation was found greater than moderate in 15 patients, moderate in 6 patients and less than moderate in 10 patients. The diameter of aortic annulus was (26±3) mm (range: 21 to 34 mm), the diameter of aortic sinus was (51±6) mm (range: 41 to 68 mm), the diameter of ascending aorta was (43±8) mm (range: 26 to 62 mm). The preoperative ejection fraction was (65±4) % (range: 59% to 72%) and left ventricular end-diastolic diameter was (55±6) mm (range: 42 to 68 mm). All cases were treated with David Ⅰ procedure, including simple David procedure in 26 patients, David+ascending aorta and partial aortic arch replacement in 3 patients, David+thoracic endovascular aortic repair in 1 patient, David+stent elephant trunk implantation in 1 patient.Results:The operation time, cardiopulmonary bypass time and aortic cross-clamping time were (330±58) minutes (range: 214 to 481 minutes), (138±23) minutes (range: 106 to 192 minutes) and (108±17) minutes (range: 82 to 154 minutes), respectively. There were no death and serious complications (stroke, myocardial infarction, renal insufficiency, severe infection, etc.). The postoperative drainage volume within 24 hours was (314±145) ml (range: 130 to 830 ml). The intubation time was (14±3) hours (range: 8 to 21 hours), and the ICU time was ( M( Q R)) 2.1(1.5) days (range: 1.0 to 5.0 days). Eight patients had no blood transfusion, the proportion of red blood cell use was 9.7% (3/31), plasma use was 22.6% (7/31), and platelet use was 71.0% (22/31). The postoperative left ventricular ejection fraction was (62±4)% (range: 54% to 69%), and left ventricular end-diastolic diameter was (48±4) mm (range: 39 to 56 mm). After operation, aortic regurgitation was significantly improved, with no more than moderate regurgitation, small to moderate regurgitation in 3 patients, minor regurgitation in 3 patients, micro regurgitation in 12 patients and no regurgitation in 13 patients. The follow-up period was 3.5(6.1) months (range: 2.0 to 39.0 months). Echocardiographic follow-up data were obtained in 26 cases, including moderate regurgitation in 1 patient, small to moderate regurgitation in 9 patients, minor regurgitation in 5 patients, micro regurgitation in 6 patients and no regurgitation in 5 patients. There were no major adverse cardiovascular events and aortic events during the follow-up period. No patient was reoperated for aortic regurgitation. Conclusion:Valve sparing aortic root replacement under partial upper sternotomy is safe and feasible, and the early result is satisfactory.

Objective:To examine the early outcome of valve sparing aortic root replacement with reimplantation technique (David procedure) with partial upper sternotomy.Methods:From April 2016 to April 2020, 31 patients underwent valve sparing aortic root replacement under partial upper sternotomy at Vascular Surgery Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. There were 28 males and 3 females, aging (44±13) years (range: 11 to 65 years). Preoperative aortic regurgitation was found greater than moderate in 15 patients, moderate in 6 patients and less than moderate in 10 patients. The diameter of aortic annulus was (26±3) mm (range: 21 to 34 mm), the diameter of aortic sinus was (51±6) mm (range: 41 to 68 mm), the diameter of ascending aorta was (43±8) mm (range: 26 to 62 mm). The preoperative ejection fraction was (65±4) % (range: 59% to 72%) and left ventricular end-diastolic diameter was (55±6) mm (range: 42 to 68 mm). All cases were treated with David Ⅰ procedure, including simple David procedure in 26 patients, David+ascending aorta and partial aortic arch replacement in 3 patients, David+thoracic endovascular aortic repair in 1 patient, David+stent elephant trunk implantation in 1 patient.Results:The operation time, cardiopulmonary bypass time and aortic cross-clamping time were (330±58) minutes (range: 214 to 481 minutes), (138±23) minutes (range: 106 to 192 minutes) and (108±17) minutes (range: 82 to 154 minutes), respectively. There were no death and serious complications (stroke, myocardial infarction, renal insufficiency, severe infection, etc.). The postoperative drainage volume within 24 hours was (314±145) ml (range: 130 to 830 ml). The intubation time was (14±3) hours (range: 8 to 21 hours), and the ICU time was ( M( Q R)) 2.1(1.5) days (range: 1.0 to 5.0 days). Eight patients had no blood transfusion, the proportion of red blood cell use was 9.7% (3/31), plasma use was 22.6% (7/31), and platelet use was 71.0% (22/31). The postoperative left ventricular ejection fraction was (62±4)% (range: 54% to 69%), and left ventricular end-diastolic diameter was (48±4) mm (range: 39 to 56 mm). After operation, aortic regurgitation was significantly improved, with no more than moderate regurgitation, small to moderate regurgitation in 3 patients, minor regurgitation in 3 patients, micro regurgitation in 12 patients and no regurgitation in 13 patients. The follow-up period was 3.5(6.1) months (range: 2.0 to 39.0 months). Echocardiographic follow-up data were obtained in 26 cases, including moderate regurgitation in 1 patient, small to moderate regurgitation in 9 patients, minor regurgitation in 5 patients, micro regurgitation in 6 patients and no regurgitation in 5 patients. There were no major adverse cardiovascular events and aortic events during the follow-up period. No patient was reoperated for aortic regurgitation. Conclusion:Valve sparing aortic root replacement under partial upper sternotomy is safe and feasible, and the early result is satisfactory.