4.Analysis of treatment delay and its influencing factors in patients with acute cerebrovascular disease in Qingdao area
Yanqiang CHEN ; Xin WANG ; Chengming XING ; Tanfang YU ; Min ZHANG
International Journal of Cerebrovascular Diseases 2009;17(10):747-751
Objective To investigate the treatment delay in patients with acute cerebrovascular disease in different levels of hospital in Qingdao area and to analyze its influencing factors. Methods A total of 700 patients with acute cerebrovascular disease from the city, county and township hospitals in Qingdao were selected from June 2008 to February 2009. A questionnaire survey was used to investigate and analyze the visiting time in patients with stroke and its possible influencing factors. Results The average visiting rate in patients with acute cerebrovascular disease was 30% within 4.5 hours after the onset in Qingdao area. The average visiting rate of the township hospitals was lowest (26%), of the city hospitals was moderate (28%), and of the county hospitals was highest (36%). For the city hospitals, the male patients usually delayed the visiting. The patients with high school or higher education level, urban medical insurance, 120 transportation, and the National Institutes of Health Stroke Scale (NIHSS) < 3 could usually he treated timely; For the county hospitals, the patients with secondary school or lower education level, 120 transportation, and NIHSS <3 could usually be treated timely. For the township hospitals, the patients with NIHSS > 7 and unconsciousness could usually be treated timely. Conclusions The patients with acute cerebrovascular disease in the city, county and township hospitals in Qingdao area had significant treatment delay. Of those, 120 transportation and higher levels of education could decrease the treatment delay of patients. Therefore, perfecting stroke emergency network, raising people's level of education, and strengthening propaganda and education on stroke knowledge in all levels of hospitals are essential for timely treatment of stroke patients.
5.Treatment of open tibial metaphyseal fractures with Hybrid external fixator
Fa-Min YANG ; Xin-Gang YU ; Hong GAO ;
Chinese Journal of Orthopaedic Trauma 2004;0(12):-
Objective To report the therapeutic results of Hybrid external fixator in treatment of open metaphyseal fractures of the tibia.Methods From March 2000 to July 2004,19 cases of proximal tibial meta- physeal fractures and six cases of Pilon fractures were treated with Hybrid external fixators.By Gustilo classification, eight cases were of typeⅡ,10 typeⅢA,five typeⅢB and two typeⅢC.The wounds were closed directly after thorough debridement in 21 cases,and closed by pedicled flap transposition or free flap transplantation in four. Fasciotomy was performed in three.Closed indirect reduction of the fractures was done in 11 cases,while open reduction was carried out through an extended wound or a limited incision in 14.Anatomical reduction was done for the articular fractures,if any,and Hybrid external fixators were employed to stabilize fractures in all the cases in this series.Results All the patients had a mean follow-up of 15.7 months (ranging from 9 to 26 months) which re- vealed bone union of the fracture in all cases with a mean healing time of 8.8 months.Two patients had their external fixators replaced with plates and iliac bone graft to get fracture union.The fixators were removed 2.9 to 21 months (mean,9.4 months) after operation.Except for two cases of secondary healing,all the wounds healed primarily without serious complication,such as infection.The final follow-up revealed a knee motion range of more than 90?in 15 cases,less than 70?in four,whose knee motion range was improved to more than 90?after knee release performed one year later.In all the six cases of Pilon fractures,the ankle joint recovered normal range of motion.Traumatic arthritis occurred in two cases of Piion fracture 11 months after operation.Evaluation by Rasmussen's functional and radiological scoring system demonstrated excellent knee function in 13 cases,good in three,fair in two and poor in one,with a good to excellent rate of 84.2%.The ankle function was excellent in three cases,good in two and poor in one,with a good to excellent rate of 83.3%.Conclusions In treatment of open tibial metaphyseal fractures, the Hybrid external fixator can well maintain the stability of the fragments with a low incidence of soft tissue com- plications and insignificant interference with the knee motion.However the bone healing time can be prolonged with a definite rate of nonunion.
6.The distribution of platelet glycoprotein I b? variable number tande repeat polymorphism and the relationship with cerebral infarction
Xiao-Min XIN ; Yu ZHAO ; Lan-Ying CUI ;
Chinese Journal of Laboratory Medicine 2001;0(02):-
Objective To study the distribution of variable number tande repeat(VNTR) polymorphisms of the platelet membrane glycoprotein Ⅰ b? in Han nationality at Harbin and the relationship between these polymorpbisms and cerebral infarction(CI).Methods The identification of alleles and genotypes of VNTR polymorphism of the glycoprotein Ⅰ b? gene was performed by polymerase chain reaction (PCR)in 200 healthy individuls and 200 CI patients(77 lacunar infarction patients and 123 atherosclerotic thrombotic infarction patients),to analyze The relationship between gene polymorphisms and cerebral infarction.Results(1)There were three types of alleles:B、C、D,and five types genotypes:BC,BD,CC, CD,DD in Harbin Han nationality.No person with A allele and BB genotype was found.(2)No statistically significant differences of GP Ⅰ b? gene VNTR polymorphism was found between CI patients or subtype CI patients and controls(P=0.412 and 0.572,respectively).Conclusions(1)This study indicates that the C and D alleles of VNTR polymorphisms of GP Ⅰ b? are the main alleles while the CC and CD genotypes are the main genotypes in Harbin Han people.(2)Our findings indicate that no association exists between the VNTR polymorphism of platelet GP Ⅰ b? gene and CI.
7.Delayed Brain Myelination in Children with Phenylketonuria Complicated with Epilepsia
zhi-xin, WANG ; zhong-shu, ZHOU ; wei-min, YU
Journal of Applied Clinical Pediatrics 2004;0(12):-
Objective To observe the delayed brain myelination of children with phenylketonuria(PKU)combined with epilepsia,and explore effectiveness of the treatment and provide an objective criteria for patient recovering evaluation.Methods There were 42 PKU patients,aged 3 to 72 months were selected.The concentration of phenylalanine tested by high pressure liquid chromatography was greater than 1.2 mmol/L in blood,diagnosed as PKU.According to electroencephalogram and clinical symptom,21 cases were diagnosed as epilepsy,the other 21 cases were used as control group.All patients were taken MRI before treatment.Myelination in 10 sections(cerebellum,pons,mesencephalon,internal capsule posterior limb,corpus callosum,internal capsule anterior limb,occipital lobe,parietal lobe,temporal lobe,frontal lobe)were evaluated.Results Delayed myelinations were located mainly in the cerebral lobes and corpus callosum,average delayed incidence of the 10 region was 44.8% in epilepsy group and 30.9% in control group.The incidence of the corpus callsum was 80.9% in epilepsy group,52.4% in control group,the number of sections of delayed myelination showed statistically significant between 2 groups(P
8.Comparison on QRS duration and cardiac function during Multi-site pacing in the right ventricular
Shan YU ; Qiyang CHEN ; Xin CHEN ; Min XIA ; Ping ZHANG
Chinese Journal of Postgraduates of Medicine 2006;0(01):-
Objective To assess the effect of QRS duration (QRSd) and cardiac function during right ventricular apex(RVA) pacing,right ventricular outflow tract (RVOT) pacing and right ventricular bifocal (RV-Bi) pacing. Methods Eight patients underwent RVA pacing,RVOT pacing and RV-Bi pacing during pacemaker implantation operation.The ejection fraction (EF),stroke index (SV),cardiac output(CO),QRS QRSd,QRS axis (QRSa) were measured after each pacing at the same pacing frequency. Results Compared with RVA pacing,the EF,SV and CO increased during RVOT pacing and RV-Bi pacing.The cardiac function of RV-Bi pacing was significantly increased (P
9.Study on prediction of involvement in facial nerve in the patients with parotid tumors by using facial electroneurography
Min GAO ; Yan CHEN ; Yanfeng KANG ; Xin PENG ; Guangyan YU
Journal of Peking University(Health Sciences) 2015;(1):57-61
Objective:To investigate the possibility of predicting facial nerve involvement in the pa-tients with parotid tumors using facial electroneurography (ENoG).Methods:In the study, 53 patients with primary parotid tumors were included in the study , 28 were benign tumors and 25 were malignant . There was no significant difference of tumor locations and sizes between the two groups . House-Brackmann facial nerve function evaluation was gradeⅠin all the patients who received examination of fa-cial electroneurography , including stimulation strength , amplitude , and latent time bilaterally .The facial electroneurography results in the affected side were compared with the results of contralateral normal side , intraoperative appearance and postoperative histopathological diagnosis .The facial electroneurography results were analyzed by Wilcoxon signed rank test and receiver operator characteristic ( ROC) curve. Results:During the facial electroneurography examination , the mean stimulation strength in the patients with benign parotid tumor was 20.0 mA.There was significant decrease in the amplitude at the affected side compared with the normal side upon posterior auricular stimulation ( P<0 .05 ) .But there was no significant difference in the latent time between the bilateral sides (P>0.05).However, in the patients with malignant parotid tumor , the mean stimulation strength was higher at 24.5 mA.There was signifi-cant decrease in the amplitude or even no response at the affected side compared to the normal side upon posterior auricular stimulation ( P<0 .05 ) .No response was detected in the multiple branches of facial nerve of affected sides in 36 .0%patients upon posterior auricular stimulation .The amplitude of branchesⅢand Ⅳwas significantly lower at the affected side than that at the normal side upon anterior auricular stimulation (P<0.05).The area under the ROC curve for ENoG was 0.884.Conclusion: When the facial nerve was involved by the parotid tumors , the stimulation strength in the electroneurography was larger .There was significant difference in the amplitude and the latent time of the facial nerve between the affected side and the normal side upon the posterior auricular stimulation .The rate of absence of reac-tion wave was higher in the patients with malignant tumors .It was feasible to predict the facial nerve in-volvement by ENoG for the parotid gland tumor patients without clinical appearances of facial paralysis .
10.Case-control study on bone-setting manipulation for the treatment of isolated systolic hypertension combined with cervical spondylosis.
Yu-li CHANG ; Xin MU ; Jian-min WEN
China Journal of Orthopaedics and Traumatology 2015;28(12):1086-1090
OBJECTIVETo investigate clinical effect and safety of bone-setting manipulation in treating isolated systolic hypertension combined with cervical spondylosis.
METHODSFrom January 2012 to January 2015, 320 patients suffered from isolated systolic hypertension combined with cervical spondylosis were randomly divided into treatment group and control group. In treatment group, there were 160 patients including 84 males and 76 females with an average age of (39.82 ± 10.33) years old, average blood pressure was (149.61 ± 10.75)/(81.01± 8.25) mmHg, NPQ score was 24.61 ± 8.14; treated with flexion top spin and lock bone-setting manipulation of cervical spine, once every two days for 20 days. While in control group, there were 160 patients including 90 males and 70 females with an average age of(41.37 ± 9.42) years old, average blood pressure was (151.48 ± 11.32)/ (79.65 ± 9.32) mmHg, NPQ score was 25.78 ± 9.53; treated with manipulation of reposition cervical spine by rotation, once every two days for 20 days. Blood pressure and NPQ score were tested and compared for evaluating clinical effects.
RESULTSBefore and after a period treatment, systolic pressure in treatment group was (149.61 ± 10.75) mmHg and (129.67 ± 12.26) mmHg; (151.48 ± 11.32) mmHg and (132.02 ± 11.73) mmHg in control group. After treatment, systolic pressure in both two groups was obviously decreased, and treatment group was better than control group. Before and after a period treatment, diastolic pressure in treatment group was (80.01 ± 8.25) mmHg and (78.15 ± 10.34) mmHg, (79.65 ± 9.32) mmHg and (76.89 ± 9.79) mmHg in control group, and there was no significant difference between two groups. NPQ score in treatment group was 24.61 ± 8.14 before treatment, 12.46 ± 7.94 after treatment, while in control group was 25.78 ± 9.53, 14.17 ± 8.86; NPQ score of the two groups after treatment was better than before treatment, while there was no obviously significance between two groups after treatment. The whole clinical effect in treatment group was better than control group.
CONCLUSIONBone-setting manipulation for isolated systolic hypertension combined with cervical spondylosis at early stage could receive good clinical result, and flexion top spin and lock bone-setting manipulation of cervical spine was better and safety than manipulation of reposition cervical spine by rotation.
Adult ; Case-Control Studies ; Cervical Vertebrae ; Female ; Humans ; Hypertension ; etiology ; therapy ; Male ; Manipulation, Spinal ; methods ; Middle Aged ; Spondylosis ; therapy ; Systole