Purpose To explore the value of 64-slice spiral CT digital subtraction angiography in diagnosis of cerebral arteriovenous malformations (AVM).Materials and Methods 26 patients with AVM were performed with plain CT scan, enhanced arterial phase and venous phase CT scan on a 64-slice spiral CT scanner. The subtracted arterial phase data was obtained through subtracting the plain CT images from arterial phase images, then the subtracted venous phase data was obtained through subtracting arterial phase images from venous phase images, and subtracted mixed arterial-venous phase data through subtracting plain CT images from venous phase images. Then volume rendering (VR) and maximum intensity projection (MIP) were used to reconstruct the cerebral vessel images. Results The inference of cranial bones was completely removed in all subtracted cerebral vessel images, thus clearly demonstrating malformed vascular nest, feeding arteries and draining veins. And 7 malformed temporal vascular nests, 5 parietal vascular nests, 5 frontal vascular nests, 6 occipital vascular nests and 3 cerebellar vascular nests were revealed;39 feeding arteries were detected altogether. Single feeding artery was found in 15 cases, and multiple feeding arteries in 9 cases. Meanwhile 33 draining veins were observed, and single draining vein was found in 10 cases, multiple veins in 16 cases.Conclusion 64-slice subtraction angiography can remove the inference of cranial bones and clearly demonstrate the feeding arteries, malformed vascular nests, draining veins, potentially providing a reliable evidence for therapeutic planning and postoperative follow-up.

This paper summarizes the intervention of chronic kidney disease at home and abroad from the intervention places, objects, contents, methods, executants and evaluation. Some intervention problems have been found in this paper: intervention places do not extend to the basic medical institutions; we draw less attention to those patients with special health needs; the theoretical basis of intervention strategies is inadequate; the content and evaluation of intervention are not comprehensive. The intervention research of chronic kidney disease in China is still a long way to go.

Objective To explore the postoperative anxiety and depression in patients with kidney transplantation and its influencing factors. Methods Totally 104 patients with kidney transplantation in nephrotransplantation center of our hospital from March 2015 to July 2015 were selected as the research object. Self-designed questionnaire, self-rating depression scale ( SDS) and self-rating anxiety scale ( SAS) were used to investigate patients, and causes of anxiety and depression were analyzed. Results The average score of anxiety in patients with kidney transplantation was (37.81±11.38) points, among which there were 15 cases of positive symptoms that accounting for 14. 4%; the average score of depression was ( 40. 12 ± 12. 09 ) points, among which there were 23 cases of positive symptoms that accounting for 22. 1%. Multiple linear regression analysis revealed that nationality and income had an impact on anxiety score (P<0.05).Conclusions Patients with kidney transplantation would have a certain degree of anxiety and depression symptoms after surgery. Nationality and income are independent influencing factors for anxiety. Targeted psychological interventions in patients with kidney transplantation, are good for the improvement of negative emotions.

BACKGROUNDThe efficacy of chemotherapy alone is still unsatisfactory in the treatment of advanced non-small cell lung cancer (NSCLC). Some kinds of solid tumors have showed good responses to chemotherapy combined with hyperthermia. This study is to investigate the feasibility and the response of hyperthermia combined with chemotherapy for advanced NSCLC.

METHODSA total of 51 patients with advanced NSCLC were eligible, in which 22 were in group HC, and the other 29 in group C. Patients in the two groups received NP (vinorelbine+cisplatin) or GP (gemcitabine+cisplatin) regimen for 2 cycles. In addition, patients in group HC received local hyperthermia twice a week, up to 12 times.

RESULTSThe response rate in group HC was 22.7%, and 13.8% in group C (P > 0.05). The clinical benefit rate in group HC was significantly higher than that in group C (P < 0.05). There was no difference in change of KPS score after treatment between the two groups.

CONCLUSIONSHyperthermia combined with chemotherapy shows good tolerance and response in patients with advanced NSCLC. Further study should be carried out.

Objective To explore current situation of depressive symptoms and analyze its influencing factors in stage 1-4 chronic kidney disease (CKD) patients. Methods From August 2014 to September 2014, a cross-sectional study was performed, and 214 outpatients chronic kidney disease ( CKD ) were recruited by convenience sampling method to evaluate depressive scores using the Zung self-rating depression scale in a grade A class three hospital of Sichuan province. Using single factor analysis method, a preliminary study was performed to explore the influencing factors of depression symptoms including gender, residence, education and the family income per capita. Results A total of 214 CKD depression scores was (47. 98 ± 10. 38), which was significantly more than that of norm (t=20. 472, P<0. 01). Single factor analysis showed gender, residence, education and the family income per capita all influenced the depressive incidences (χ2 =14. 929, 5. 413, 7. 290, 9. 917;P<0. 05). Multiple stepwise regression analysis showed gender, residence, education and the family income per capita all were depression influencing factors (P<0. 05). Conclusions Medical and health institutions should give great importance to depressive symptoms in CKD patients, especially for stage 1-4 CKD patients. Focus on assessment and early intervention can reduce the incidences of the depression and improve the prognosis.

Objective To explore the application effect of quality control circle combined with multidisciplinary cooperation in inpatients with chronic kidney diseases.Methods A total of 1000 patients who met the inclusion criteria and were hospitalized after activity from January 2014 to October 2014 were recruited as the observation group. A total of 900 patients hospitalized before activity were selected as the control group. Management was carried out especially in two links including admission and discharge. The activity included establishing quality control circle,enhancing the management of admission education,launching the model of multidisciplinary cooperation,optimizing discharge process of "patient-centered",improving the planned hospital discharge rate. The satisfaction of patients to admission education,awareness rate of admission education and planned hospital discharge rate before and after management were compared between two groups. Results After the implementation of link management,the satisfaction of patients to admission education increased from 77.9% to 95.9%;the awareness rate of admission education increased from 85.4% to 95.8%;the planned hospital discharge rate increased from 53.0% to 83.2% with significant differences (χ2=139.238, 61.377,201.596;P<0.001). The satisfaction of discharged patients rose from 77.40% to 98.82% along with ranking from 31th to 3rd around the hospital.Conclusions The application of quality control circle and multidisciplinary cooperation in strengthening the link management at admission and discharge in inpatients with chronic disease,can increase the patient′s satisfaction and improve the service quality of the department.

Objective? To explore the effects of follow-up management on blood pressure and glomerular filtration rate (GFR) in patients with chronic kidney disease (CKD). Methods? Totally 660 CKD patients who established health records from June 2016 to June 2017 and received regular follow-up management in the Follow-up Management Center for CKD, West China Hospital, Sichuan University were selected by convenient sampling in this self-control study. The patients received follow-up management for CKD for 12 months and their blood pressure and GFR were measured before and after the follow-up. Results? After the 12-month follow-up, the patients' systolic pressure and diastolic pressure were (126.76±16.35) mmHg and (77.85±10.84) mmHg respectively, both lower than those before the follow-up (t=42.7, 56.2; P＜0.05). The patients' GFR decreased 2.86 ml/min·1.73m2, whose falling range was better than the average level in China. Conclusion? Follow-up management for CKD can effectively reduce the patients' blood pressure and delay the progress of their renal function, which is worth promoting in clinical practice.