Objective To investigate the diagnostic accuracy of contrast-free three dimensional time-of-flight (3D-TOF-MRA) with VR at 3.0 T in the detection of intracranial aneurysms in a large cohort of patients prospectively.Methods Four hundred and eleven patients with suspected aneurysms and other cerebral vascular diseases received contrast-free 3D-TOF-MRA examinations at 3.0 T MRA 2 weeks prior to DSA examination.2D-DSA and VR-DSA were regarded as the gold standard.Six patients were excluded because of motion artifacts,and 36 patients were excluded due to lack of VR-DSA data.Accuracy,sensitivity an specificity in detecting intracranial aneurysms were determined by patient-,aneurysm-,and aneurysm sizebased (＜ 3 mm,3-5 mm,＞ 5-10 mm,＞ 10 mm) evaluations.Results In 369 enrolled patients,VR-DSA revealed 306 aneurysms in 246 patients (66.7％) and no aneurysm in 123 patients; VR 3D-TOF-MRA revealed 311 aneurysms in 249 patients and no aneurysm in 120 patients.The patient-based evaluation of VR 3 D-TOF-MRA at 3.0T yielded accuracy of 97.6％ (360/369),sensitivity of 99.2％ (242/244),and specificity of 94.4％ (118/125) in the detection of intracranial aneurysms.The aneurysm-based evaluation yielded accuracy of 98.3％ (524/533),sensitivity of 99.3％ (304/306),and specificity of 96.1％(220/229).The evaluation based on aneurysm sizes (＜ 3 mm) yielded accuracy of 96.4％ (214/222),sensitivity of 98.2％ (112/114),and specificity of 94.4％ (102/108).Conclusion VR 3D-TOF-MRA at 3.0 T MR can detect intracranial aneurysms accurately and may replace DSA as a contrast-free,noninvasive and non-radiation-based modality for the diagnosis and screening of intracranial aneurysms.

Objective To evaluate the value of the specific quality of life scale in effect evaluation of T2～4 transection of sympathetic chain to treat hyperidrosis of hand and foot. Methods 125 patients with hyperidrosis of hand and foot who had accepted operation in our department were retrospectively analyzed. These patients were evaluated with the specific QOL scale. The degree of satisfaction, days of stay,time of operation and complications were also recorded. The difference of life quality score was also compared and underwent correlation analysis. Results An obvious improvement of QOL was observed after operation. The same tend could be observed in the degree of satisfaction with the operation. The operation had been proved to be safe and effective. Few serious complication were reported. The alleviation of QOL and compensatory hyperhidrosis dominated the result of degree of satisfaction. Conclusions Operation can improve quality of life of hyperhidrosis patients greatly. The specific QOL questionnaire of hyperhidrosis has a bright future in clinical practice.

Objective:To explore the effects of early wet compress with traditional Chinese medicine Ru-Yi-Jin-Huang-San on drug extravasation skin injury.Methods:Totally 21 patients with skin injuries caused by extravasation of different drugs from the First People's Hospital of Lianyungang and General Hospital of Eastern Theater Command between January 2017 and December 2019 were selected by convenient sampling. They received local wet compress with Ru-Yi-Jin-Huang-San according to the redness and swelling area, which was replaced once a day until the pain and swelling were ameliorated and the wound healed. Patients with irreversible tissue necrosis underwent debridement, anti-infection, negative pressure wound treatment or wet therapy according to the principles of wound care until the wound healed. The pain score, redness area, healing time and healing outcome were compared before and after wet compress, between upper and lower limbs, between wet compress within 24 hours and wet compress after 24 hours, and between patients with and without drug extravasation.Results:After wet compress with Ru-Yi-Jin-Huang-San for 2-13 days, the skin injury of 18 patients who received wet compress within 2-24 hours after extravasation healed completely, and the healing time was (6.44±2.99) d; 3 cases formed wounds, which healed after local debridement, anti-infection, wet therapy and negative pressure therapy, with a healing time of 67 (28, 154) d. There were statistically significant difference between the pain score before wet compress and those from day 1 to day 7 after wet compress ( P<0.05) ; there were statistically significant differences between the redness and swelling area before wet compress and those from day 1 to day 5 after wet compress ( P<0.05) ; there was no statistically significant difference in the redness and swelling area between day 6 and day 7 ( P>0.05) . There were no statistically significant differences in the pain score and the redness and swelling area between the upper and lower extremities before wet compress ( P>0.05) . 3 days after wet compress, the pain score of the upper extremities was lower than that of the lower extremities, and the difference was statistically significant ( P<0.05) , but there was no statistically significant difference in the redness and swelling area between the lower extremities and the upper extremities ( P>0.05) . Before wet compress, there was no statistically significant difference in the pain score and the redness and swelling area between the groups with different time of wet compress ( P>0.05) . 3 days after wet compress, the pain score of patients who received wet compress within 24 hours was lower than that of patients who received wet compress after 24 hours ( P>0.05) . The healing time of patients who received wet compress within 24 hours was shorter than that of patients who received wet compress after 24 hours, and the difference between the two groups was statistically significant ( P<0.05) . Before wet compress, there were no significant differences in pain score and the redness and swelling area between the groups with extravasation of different drugs ( P>0.05) . 3 days after wet compress, there were no statistically significant differences in the pain score and the redness and swelling area within the antibiotic extravasation group ( P>0.05) . Conclusions:Early wet compress with Ru-Yi-Jin-Huang-San is safe and effective for drug extravasation skin injury. The sooner the wet compress, the better the effect is.

OBJECTIVE To evaluate the therapeutic efficacy of 5 regimens of colistin sulfate for common Gram-negative bacilli infection based on pharmacokinetics （PK）/pharmacodynamics （PD） theory and Monte Carlo simulation. METHODS Minimal inhibitory concentration （MIC） data of colistin sulfate against Acinetobacter baumannii， Pseudomonas aeruginosa， Klebsiella pneumoniae， Escherichia coli and Enterobacter cloacae in 2023 were collected from the China Antimicrobial Resistance Surveillance System. Monte Carlo simulation was conducted with the ratio of the area under the concentration-time curve from 0 to 24 hours in the unbound state to the MIC （fAUC0－24 h/MIC） ≥15 as the target value， the probabilities of target attainment （PTA） of 5 regimens of colistin sulfate to achieve the target ratio were obtained at different MIC； and the expected population PTA， specifically the cumulative fraction of response （CFR）， for each regimen within a specific bacterial population was further calculated， to evaluate the therapeutic efficacy of the five colistin sulfate regimens. RESULTS When bacterial MIC≤0.5 µg/mL， PTA of all colistin sulfate regimens （500 000 IU， q12 h； 500 000 IU， q8 h； 750 000 IU， q12 h； 750 000 IU， q8 h； 1 000 000 IU， q12 h） were all more than 90%. When bacterial MIC＝1 µg/mL， PTA for regimen （750 000 IU， q8 h） against A. baumannii， K. pneumoniae， P. aeruginosa， E. coli and E. cloacae， and for regimen （1 000 000 IU， q12 h） against the other four bacterial species （excluding P. aeruginosa） remained above 90%. When bacterial MIC≥2 µg/mL， PTA of 5 colistin sulfate regimens were all lower than 90%. For E. coli， the CFR of only colistin sulfate regimen （500 000 IU， q12 h） was less than 90%； for K. pneumoniae， the CFR of only colistin sulfate regimen （750 000 IU， q8 h and 1 000 000 IU， q12 h） was greater than 90%； for the other three bacteria， CFR of 5 regimens were all less than 90%. CONCLUSIONS When the MIC of Gram-negative bacteria is less than 0.5 µg/mL， colistin sulfate regimen with a routine dose can be selected for treatment. When MIC was 1 µg/mL， an increase in the dosing amount or frequency is required. The empirical treatment of the other four bacterial infections excluding E. coli requires the use of off-label doses.