Objective To analyze the clinical features of pulmonary embolism(PE) after urologic surgery in order to provide the theory base for preventing pulmonary embolism Methods CNKI database was used to look for our subjects who were with PE after urologic surgery from January 2005 to December 2011.Ten cases were selected.Three related patients simultaneously in Xuancheng Central Hospital were also recruited as our subjects.The information of diagnosis and treatment information and clinical features were collected.Results Among the 13 patients,3 were women and 10 were men with confirmed PE.Their age ranged from 48 to 79 years old and the average was 61.Among the 13 patients,2 conducted routine surgery,and the other 11 conducted mini-invasion operation.The 13 patients underwent PE from 2 to 18 days after urologic surgery and 7 patients (53.85％) died of PE.Conclusion No specificity of clinical feature for PE was found to contribute to cure rate.Early diagnosis and prevention of PE are important,and anticoagulant treatment and immediate thrombolytic are critical.

This study seeks to explore the early signs of cognitive impairment in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). According to polysomnography, twenty patients diagnosed with OSAHS and twenty normal controls underwent event-related potential (ERP) examination including mismatch negativity (MMN) and P300. Compared with normal controls, OSAHS patients showed significantly prolonged latency of MMN and P300 at Cz. After controlling age and body mass index (BMI), MMN latency positively correlated with apnea hypopnea index (AHI), oxygen reduction index, stage N1 sleep and arousal index, while MMN latency negatively correlated with stage N3 sleep and mean blood oxygen saturation; and P300 latency positively related to AHI and oxygen reduction index; no relationships were found among MMN latency, MMN amplitude, P300 latency and P300 amplitude. These results suggest that the brain function of automatic processing and controlled processing aere impaired in OSAHS patients, and these dysfunction are correlated with nocturnal repeatedly hypoxemia and sleep structure disturbance.
Case-Control Studies ; Cognition Disorders ; complications ; physiopathology ; Event-Related Potentials, P300 ; Humans ; Hypoxia ; physiopathology ; Oximetry ; Polysomnography ; Sleep Apnea, Obstructive ; complications ; physiopathology ; Sleep Stages

Objective To evaluate the effect of partial neuromuscular blockade (NMB) on the efficacy and safety of nerve monitoring during microvascular decompression (MVD) of facial nerve.Methods Seventy American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes,aged 39-78 yr,weighing 44-84 kg,scheduled for elective MVD,were divided into 2 groups (n=35 each) using a random number table method:control group and partial NMB group.Anesthesia was induced by intravenous injection of 3-fold ED95 cisatracurium.In control group,muscle relaxants were not used after intubation.In partial NMB group,cisatracurium was continuously infused intravenously to maintain partial NMB,and the T1/Tc ratio was maintained at 20％-40％.Intraoperative neuroelectrophysiological monitoring was performed using lateral spread response (LSR).The success rates of LSR monitoring,occurrence of body movement,requirement for anesthetics and cardiovascular agents were recorded during operation,and the patients were followed up on day 7 after surgery,and the therapeutic efficacy and occurrence of neurological complications were recorded.Results Compared with control group,the incidence of intraoperative body movement was significantly decreased,the intraoperative consumption of propofol and remifentanil was decreased,and the intraoperative requirement for vasopressors was decreased in partial NMB group (P＜0.05).There was no significant difference in the success rate of LSR monitoring,therapeutic efficacy and incidence of neurological complications between two groups (P＞0.05).Conclusion Partial NMB (T1/Tc=20％-40％) can be effectively used for MVD monitored by LSR,decrease the occurrence of the body movement,and raise the perioperative safety in patients.

Objective:To explore the efficacy of cerebral vasospasm model established by brief double blood injection in cisternal cisteria.Methods:Twenty-five SD rats were randomly divided into sham-operated group, group of 1 d after subarachnoid hemorrhage (SAH), group of 3 d after SAH, group of 5 d after SAH, and group of 7 d after SAH ( n=5). Autologous blood (0.2 mL, obtained by caudal artery puncture) was directly injected into the atlanto-occipital membrane and repeated 48 h after that to establish cerebral vasospasm model. Neurological impairment was evaluated by modified Neurological Severity Score (mNSS). Diameter and cross-sectional area of the basilar artery (BA) were detected by HE staining. Differences of body mass before modeling, body mass between the 2 blood injections, mNSS scores, and diameter and cross-sectional area of BA were compared among groups. Results:(1) Body mass before modeling was not significantly different among the 5 groups ( P>0.05); differences of body mass between the 2 blood injections in the group of 1 d after SAH, group of 3 d after SAH, group of 5 d after SAH, and group of 7 d after SAH were significantly greater than those in the sham-operated group ( P<0.05). (2) The mNSS scores in the group of 1 d after SAH, group of 3 d after SAH, group of 5 d after SAH, and group of 7 d after SAH were significantly higher than those in the sham-operated group ( P<0.05). (3) BA diameter in the group of 3 d after SAH and group of 7 d after SAH was significantly shorter than that in the sham-operated group, and that in the group of 7 d after SAH was significantly shorter than that in the group of 1 d after SAH and group of 5 d after SAH ( P<0.05). BA cross-sectional area in the group of 1 d after SAH, group of 3 d after SAH, group of 5 d after SAH and group of 7 d after SAH was significantly smaller than that in the sham-operated group, and that in the group of 7 d after SAH was significantly smaller than that in the group of 1 d after SAH, group of 3 d after SAH and group of 5 d after SAH ( P<0.05). Conclusion:Compared with other traditional models, cerebral vasospasm model established by brief double blood injection in cisternal cisteria has advantages of simplified operation, short modeling time, and minimal invasion; model of 7 d after autologous blood injection enjoys optimal.

Objective:To investigate the CD163 expression characteristics in intracranial aneurysm (IA) tissue and blood of patients with IA and its feasibility as an early clinical screening indicator for IA.Methods:A total of 28 patients with IA admitted to Department of Neurosurgery, First Affiliated Hospital of Xinjiang Medical University from January 2021 to November 2023 were selected as IA group, and 28 healthy subjects from Health Management Center, First Affiliated Hospital of Xinjiang Medical University at the same time period were selected as control group. Eight saccular IA tissues and 12 superficial temporal artery tissues were collected from patients from IA group accepted IA clipping, and real-time fluorescent quantitative PCR (RT-qPCR) was used to detect the CD163 mRNA expression in these tissues. RT-qPCR was also used to detect the CD163 mRNA expression in the blood of the 2 groups. Seven patients with IA and 7 control subjects from the above 2 groups were randomly selected, respectively; and plasma CD163 protein content was detected by enzyme-linked immunosorbent assay (ELISA). Multivariate Logistic regression was used to analyze the influencing factors for IA. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic values of blood CD163 mRNA expression and plasma CD163 protein content in IA. Results:CD163 mRNA expression in IA tissues was significantly higher than that in superficial temporal artery tissues (41.870±20.355 vs. 6.080±5.444, P<0.05). CD163 mRNA expression in the blood of IA patients was significantly higher than that in the controls (1.969[1.124, 2.318] vs. 1.124[0.933, 1.379], P<0.05). CD163 mRNA expression in the blood of ruptured IA group, unruptured IA group, and control group was gradually decreased, with significant differences ( P<0.05). CD163 mRNA expression in the blood of female IA patients was not statistically different compared with that in male IA patients ( P>0.05). ELISA showed that the CD163 protein content in plasma of the IA group was significantly higher than that in the control group [10.537±1.879] ng/L vs. [8.598±0.885] ng/L, P<0.05). Multivariate Logistic regression analysis showed that age and CD163 mRNA expression in the blood were independent influencing factors for IA occurrence ( OR=0.844, 95% CI: 0.750-0.951, P=0.005; OR=0.111, 95% CI: 0.024-0.506, P=0.004). ROC curve showed that the area under the curve (AUC) of CD163 mRNA expression in blood in diagnosing IA was 0.759 (95% CI: 0.618-0.890, P=0.002), and that of CD163 protein content in plasma in diagnosing IA was 0.864 (95% CI: 0.610-1.000, P=0.035). Conclusion:CD163 mRNA expressions in blood and IA tissues and CD163 protein content in plasma are high in patients with IA; CD163 mRNA expression in blood is an independent risk factor for IA; CD163 protein in plasma can be used as a molecular marker for screening IA.

Objective: To investigate the correlation between clinical phenotype, electroencephalogram (EEG) characteristics and genotype in children with Angelman syndrome(AS). Methods: A total of 103 children with AS at Department of Neurology, Children′s Hospital of Fudan University from June 2017 to June 2018, were included in this study.The information of clinical characteristics, EEG manifestations, genotypes as well as the epileptic outcome were collected retrospectively.The correlations between clinical phenotype, genotype, and epileptic outcome were evaluated. Results: (1) Of the 103 cases, 48 were male (46.6%) and 55 were female (53.4%). (2) Genotypes on AS critical region were maternal chromosome 15q11.2-q13 [86.4%(89/103 cases)], paternal uniparental disomy [3.9%(4/103 cases)], imprinting defects [1.9%(2/103 cases)], and mutations in the maternal copy of UBE3A [7.8%(8/103 cases)]. (3) Apparent happy demeanor or smile and general developmental delay were observed in all AS children.Dyskinesia accounted for 98.1% (101/103 cases), followed by oral movement or suck disorders [97.1%(100/103 cases)] and abnormal posture [67.0%(69/103 cases)]. The proportion of acquired small head circumfe-rence or microcephaly, flat occiput or occipital groove and wide-spaced teeth were 61.2%(63/103 cases), 85.4%(88/103 cases) and 44.7%(46/103 cases), respectively.(4) Behavioral problems like fascination with water, sleep problems and feeding difficulties were found in 86.4%(89/103 cases), 89.3%(92/103 cases) and 85.5%(88/103 cases) of the children, respectively.Sleep disorders [94.4%(84/89 cases) vs.57.1%(8/14 cases)] and feeding difficulties [93.3%(83/89 cases) vs.35.7%(5/14 cases)] were more frequently seen in children with maternal absence group, compared those with no absence, and the differences were statistically significant (all P<0.05). (5) Epilepsy was present in 77.7% (80/103 cases) of children with onset age varying from 8 to 72 months and 80.8% (59/73 cases) were developing seizures prior to 3 years old.Children with maternal absence showed more multiple seizure types than those with no absence[41.7%(32/68 cases) vs.0(0 case)], and the difference was statistically significant(P<0.05). Children with well-controlled epilepsy had more atonic seizure, compared with those with poorly controlled seizure [48.3%(14/29 cases) vs.18.5%(4/27 cases)], and the difference was statistically significant(P<0.05). Conclusions Sleep disorders, feeding difficulties in infancy and multiple seizure types are more commonly seen in AS children with maternal absence.Atonic seizure is easier to be controlled over other types of seizures.