Humans ; Olfaction Disorders ; Smell ; Trigeminal Nerve

Objective To analyze the MR imaging features of pyocephalus. Methods MR imaging features!of pyocephalus in 5 cases with clinically proved were analyzed retrospectively. All patients were undergone no-contrast MR imaging. 3 patients received diffusion weighted-imaging(DWI). Results In all five patients,the debris and pus with pus-fluid level were shown inside the lateral ventricle.The debris or pus was slightly hyperintense on T1WI, slightly hypointense on T2WI relative to cerebrospinal fulid(CSF). On DWI, the debris was hyperintense in 1 case and isointense in 2 cases.Conclusion The features of MR imaging of pyocephalus is specific. MR imaging is valuable in the diagnosis of pyocephalus.

Objective To investigate the variations of intestinal flora of common carp in patients with hyperuricemia in Qingdao District.Methods The fecal flora was analyzed by gradient dilution method.The levels of uric acid in blood and feces were detected by enzyme colorimetry method and phosphortungstic acid method,respectively.Results E.coli (7.58 ± 0.34,P ＜ 0.05),the total count of aerobian (7.76 ± 0.67,P ＜ 0.05),and bacteroides (2.75 ± 0.31,P ＜ 0.05) were significantly increased in hyperuricemia patients compared to controls.Bifidobacterium (5.38 ± 0.34,P ＜ 0.05) and lactobacillus (2.69 ± 1.48,P ＜ 0.05) were sig-nificantly decreased compared to controls.Concentrations of uric acid in blood and feces were both significantly higher in the patients relative to healthy controls.Decomposition capability was similar to healthy controls.Decomposition capability of uric acid revealed a close correlation with bifidobacterium and lactobacillus,respectively (r =0.565,0.328,P ＜ 0.05).Conclusions Intestinal dysbacteriosis was found by the analysis of fecal flora in patient with hyperuricemia in Qingdao district.Dysbacteriosis might participate in the process of hyperuricemia onset.

Background Vitretomy and lenstomy with silicone oil tamponade is an effective method for complicated vitreous retinopathy.The severe anisometropia after silicone retention is usually treated by two-point transscleral suture fixation for posterior chamber intraocular lens(IOL)implantation.In order to reduce the number and difficulty and complication of the operation,the surgical method should be improved.Objective The goal of this study was to observe the resuh of silicone oil removal combined with four-point trans-scleral suture fixation of posterior chamber IOL after vitrectomy.Methods A retrospective case-observational study design was adopted.Twenty eyes with silicone oil tamponade from 20 patients without lens and posterior capsule after vitrectomy were included in this study.Silicone oil removal with four-point trans-scleral suture fixation of posterior chamber IOL was performed.The anterior ocular inflammatory response,intraocular pressure,uncorrected and corrected acuities before and after operation,corneal endothelial cell counting and postoperative complications were observed and analyzed.Written informed consent was obtained from all patients prior to the operation.Results All of the operative eyes in this study showed improvement of visual acuity after operation.Of the 20 eyes,a visual acuity of ≥0.8 was seen in 2 eyes,0.6-0.7 in 6 eyes,0.3-0.5 in 8 eyes and 0.05-0.2 in 4 eyes 3 months after the removal of silicone oil.The uncorrected acuity postoperation was significantly improved in comparison with preoperation(H=10.147,P＜0.01),but no significant difference was found in the corrected acuity between preoperation and postoperation(X =2.089,P＜ 0.01).The number of the corneal endothelial cells was(2064±329)cells/mm2 before operation,and that after operation was(1987±269)cells/mm2,showing an insignificant change between them(t =1.660,P ＞ 0.05).No abnormality of IOL position was found in all 20 operated eyes.There was not serious postoperative complication in all 20 patients.Conclusions The combination of silicon oil extraction with four-point transscleral suture fixation IOL is effective in eyes without posterior capsule or lens after vitrectomy.It can reduce the operation time and improve the postoperative acuity and the quality of life of patients.

Objective To evaluate the effect of the combination of dexmedetomidine and sufentanil on monitoring anesthesia care during burr-hole surgery for patients with chronic subdural hematoma. Methods 96 pa-tients underwent burr-hole surgery for chronic subdural hematoma with MAC were randomly divided into two groups:Group D and Group DS (n=48 in each group). Local anesthetic block was started at least 10 min after DEX and sufentanil infusion. Ramsay sedation scale of the two groups was maintained to 3. Anesthesia onset time, hemo-dynamics, the amount of rescue midazolam or fentanyl, the time to first dose of rescue midazolam or fentanyl, the to-tal number of intraoperative patient movements, postoperative recovery time, patient and surgeon satisfaction scores, and the adverse events were recorded. Results Compared with group D, anesthesia onset time was significantly less in group DS (13.68 ± 3.13 vs. 11.82 ± 2.43 min, P=0.002). More patients in group D required rescue midazol-am to achieve RSS=3 compared with group DS (31.25%15/48 vs. 12.50%6/48, P=0.023). Compared with group D, significantly fewer patients in group DS required rescue fentanyl to relieve pain (10.42%5/48 vs. 27.08%13/48, P = 0.036). Additionally, the total dose of rescue fentanyl in group DS was significantly higher (89.48 ± 23.27 vs. 125.28 ± 33.52μg, P=0.000), and the time to first dose of rescue fentanyl was longer than group D(18.34 ± 4.45 vs. 14.34 ± 3.63 min, P=0.000). The total number of patient movements during the burr-hole surgery was higher in group D than group DS (35.42%17/48 vs. 16.67%8/48, P=0.036). The time to recovery for discharge from the PA-CU (time to an Aldrete score ≥ 9) was significantly shorter in group DS compared with group D (17.54 ± 5.92 vs. 12.57 ± 5.28 min, P=0.000). Results from the patient and surgeon satisfaction scores showed significant differenc-es favoring group DS (P<0.05). More patients in group D showed higher levels of the overall incidence of bradycar-dia (37.50% 18/48 vs. 18.75% 9/48, P = 0.041) and hypotension(37.50%18/48 vs. 14.58%79/48, P=0.011)com-pared with group DS. Conclusions Compared with DEX alone, DEX-sufentanil associated with fewer number of in-traoperative patient movements, less amount of rescue scheme, could be safely and efficiently used for MAC during burr-hole surgery for patients with chronic subdural hematoma.

Objective To introduce the transfer of anterolateral thigh flap with iliotibial tract in repair of massive skin and soft tissue defects of the forearm and reconstruction of extension or flexion of the forearm. Methods Eight cases of complicated raw wounds of the forearm were repaired with transfer of anterolateral thigh flap with iliotibial tract. Flexor tendons of 3 cases and extensor tendons of 5 cases were repaired with iliotibial tract. The axial vessel of the flap was used to rebuild blood supply of the hand. Results All the flaps survived completely. A follow-up ranging from 3 months to 2.5 years re- vealed that the reconstructed forearms were good in appearance and soft in texture and restored protective sensation. Affected limbs could perform extension or flexion. Total range of motion (TRM) of the hands was excellent in 6 cases and poor in 2. Conclusion Anterolateral thigh flap with iliotibial tract can not only repair soft tissue defects of the forearm, but also reconstruct the main extension or flexion of the forearm simultaneously.

Objective To investigate the risk factors and patterns of radiation induced gastroduodenal complications in patients with pancreatic cancer following tomotherapy (TOMO) using endoscopy.Methods Patients with pancreatic cancer who were treated TOMO in Air Force General Hospital from February 2010 to May 2015 were collected.All patients underwent endoscopic examination before and after radiotherapy.The radiation injuries were observed,and factors influencing radiation-induced gastroduodenal complications were analyzed.Results The median time of gastroscopy after radiotherapy was 1 month,radiation gastritis and duodenitis were 41 cases (58.6％),radiation gastric and duodenal ulcers were 30 cases (42.9％),and hemorrhage 7 cases (10.0％),scar formation 3 cases (4.3％),6 cases (8.6％) had newly developed gastric retention,and 4 cases (5.7％) had newly developed gastric varix.Univariate analysis showed that relieving jaundice and radiation protection (amifostine) were associated with the development of radiation gastric ulcers (x2 =4.186,P =0.041;x2 =5.679,P =0.017).Conmon terminology criteria for adverse events (CTCAE) ≥2 was associated with the development of radiation duodenal ulcers (x2 =3.960,P =0.047).Mean dose (Dmean) ＞ 13.39 Gy and Dmean ≤13.39 Gy gastric ulcers rates were 25.0％ and 9.1％,respectively (AUC =0.740,P =0.048).Conclusion The TOMO induced gastroduodenal injury in patients with pancreatic cancer is frequent.Relieving jaundice is the protection of radiation gastric ulcer.Dmean ＞ 13.39 Gy is independent predictive factors for radiation gastric ulcers.Patients after TOMO should be examined by endoscopy early.

Objective To observe the improvement effects of Qingshen Granule on the life quality of chronic kidney disease (CKD) patients with damp-heat syndrome. Methods The CKD patients with damp-heat syndrome were randomly divided into experimental group and control group. The control group was treated with Western medicine, and the treatment group was treated with Qingshen Granules additionally for 12 weeks. SCr and eGFR were observed before and after treatment, and the life quality was investigated by KDQOL-SFTM1.3. Results Actually 156 cases were completed, including 77 cases in the treatment group and 79 cases in the control group. The total rate of curative effect was 81.82% (63/77) in teatment group, and (63.29%, 50/79) in control group, with significent difference (P<0.05). Multivariate linear regression analysis indicated that gender, education level, TCM syndrome score, CKD stage, eGFR and Hb level could affect the life quality. The scores of KDQOL-SFTM and its containing the MOS item short from health survey (SF-36) and kidney disease targeted areas (KDTA) were significantly improved after treatment in experimental group (P<0.05), while the scores in control group were with no significant improvement. The improving effects of PCS, and SPL, SLEEP, PS in KDTA in treatment group were significantly superior to those in control group (P<0.05). The scores of life quality in effective and stable cases increased significantly after treatment compared with before treatment (P<0.05). Conclusion Qingshen Granules can effectively improve the life quality of CKD patients with damp-heat syndrome, and the effect is not dependent on the improvement of laboratory indexes (renal function).

Althoughtheevidenceoftheevidence-basedmedicinehasshowedthatrecombinant tissue-type plasminogen activator can effectively open the occluded vessels, because of its short therapeutic time w indow and the risk of bleeding, the thrombolytic rate is general y low er currently. Clinical studies have show ed that telestroke can effectively shorten the treatment time of the patients, increase the thrombolytic rate, reduce the risk of bleeding, and improve the outcomes of patients. Although the application of telestroke is restricted in many w ays, such as technology, policy, and funding, w ith the grow ing maturity of the related technologies, telestroke w il play an increasingly important role in the treatment of stroke.

Objective A surface feedback-stimulation gastric-pacing device was designed to extract gastric surface information,determine the status of gastric and surface stimulation.Methods The characteristic parameters of gastric electrical formed by processing signal and extracting parameter.By that,the state of stomach could be confirmed,and stimulus signal of stomach pace-making in different frequency and intensity could be decided as needed.During the processes of the stimulation,the variations of gastric electrical parameters can be analyzed in real-time and the stimulation parameters could be modified to achieve the self-feedback mode.Results Self-feedback model in different gastric motility analog environment could be realized.Conclusion The preliminary validation of experimental results proved the effectiveness of self-feedback of gastric pacing devices and its application prospects in some areas.