1.Severe perioperative neurological complications underwent stent assisted coil embolization of intracranial aneurysm
Qing HOU ; Yueqiao XU ; Weitao CHENG ; Ning WANG ; Hongqi ZHANG ; Guilin LI ; Chuan HE ; Ming YE
Chinese Journal of Cerebrovascular Diseases 2016;13(5):262-265
Objective To analyze the perioperative clinical character of the severe neurological complications in intracranial aneurism treated with stent-assisted coiling(SAC). Methods 203 cases of intracranial aneurysms patients treated by SAC were enrolled retrospectively(ruptured aneurysm group 45 cases and un-ruptured,aneurysm group 158 cases)and the perioperative clinical character of the serious neurological complications(11 cases)was further analyzed. Results The total rate of serious neurological complication was 5. 4%,11 cases of patients with 13 aneurysms got 13 stents. In the ruptured aneurysm group, 5 cases(11. 1%)suffered severe neurological complications,including intraoperative bleeding in one case, postoperative stent-related ischemia in one case,both 2. 2% . Postoperative bleeding 2 cases(4. 4%),and one case of bleeding during anesthesia induced stage(2. 2%). In the unruptured aneurysm group,intraoperative bleeding in three cases,and postoperative stent-related ischemia in three cases,both 1. 9% . No bleeding case during anesthesia induced stage or postoperative period. Although active rescue treatments were performed, 8 patients eventually died,and the total mortality rate was 3. 9% . Conclusion Intracranial aneurysms patients following SAC treatment may suffer from bleeding,ischemia,severe neurological complications, severe disability,and even die. So,we have to strengthen perioperative management.
2.Decompression craniotomy for malignant cerebral venous thrombosis:a report of 9 cases
Xiaohui DONG ; Yueqiao XU ; Weitao CHENG ; Ning WANG ; Wenjin CHEN ; Hongqi ZHANG
Chinese Journal of Cerebrovascular Diseases 2016;13(3):140-145
Objective To evaluate the efficacy of decompression craniotomy for the treatment of patients with malignant cerebral venous thrombosis. Methods The clinical characteristics,treatment process and follow - up results of 9 patients with malignant cerebral venous thrombosis treated with decom-pression craniotomy in Beijing Xuanwu Hospital,Capital Medical University from February 2010 to August 2015 were analyzed retrospectively. Results The preoperative Glasgow coma scale (GCS)score of 9 patients was < 9,7 survived and 2 died. The conditions of 6 patients (preoperative GCS 8 in 1 case, GCS 6 in 3cases,GCS 4 in 1case,and GCS3 in 1case)were improved in combination with other control intrac ranial pressure treatment after craniotomy decompression surgery. They recovered well (Glasgow outcome scale, GOS 4 -5). One patient (preoperative GCS 4)had severe disability (GOS 3)after procedure;1 (preoperative GCS 3)was in deep comatose state at the time of discharge and died of complications after 1 month;1 patient with bilateral mydriasis (GCS 5)was treated with craniotomy decompression,and his pupils did not return,he had circulatory failure,gave up the treatment,and died. All patients did not have the complications directly related to the surgery. Seven patients survived and continued to use warfarin anticoagulation therapy for at least 6 moths after discharge. The controlled international normalized ratio (INR)was 2 -3. They were followed up for 3 months to 5 years. The head MRI re-examination did not reveal the recurrence of venous sinus thrombosis. The modified Rankin scales (mRS)score was 0 to 2 in 6 cases after 3 months. The other one (preoperative GCS 4)had ipsilateral cerebral hemorrhage on surgical site at 4 months after discharge. He was improved after withdrawing anticoagulation and using conservative treatment for 20 d (mRS score 4). Conclusions For patients with malignant cerebral venous thrombosis,when the patients have acute cerebral hernia or hernia tendency,the emergency craniotomy decompression surgery may save lives and enable patients to achieve a better quality of life.
3.Analysis of the status quo of palliative nursing knowledge among medical staff in ClassⅢ Grade A hospitals in He'nan Province and its influencing factors
Li TIAN ; Chunyan CHENG ; Panpan CUI ; Yueqiao GAO ; Yang ZHANG ; Feng ZHANG ; Changying CHEN
Chinese Journal of Modern Nursing 2018;24(35):4217-4222
ObjectiveTo understand the status quo of palliative nursing knowledge of medical staff in He'nan Province, analyze its influencing factors and training needs, and provide theoretical basis for further improving palliative nursing knowledge level and formulating effective training measures. Methods? From October 2017 to February 2018, a total of 600 medical staff from six ClassⅢ Grade A hospitals in He'nan Province were selected as the research subjects. All the subjects were investigated with palliative care knowledge questionnaire (PCQN) and the palliative care training needs questionnaire. Multivariate linear regression analysis was used to analyze the influencing factors. A total of 600 questionnaires were sent out and 579 valid questionnaires were collected. Results? The score of PCQN of the 579 medical staff was (12.19±3.221). The factors influencing the knowledge level of palliative care among medical staff were discussed with dying patients or their families, heard of palliative care, educational level, professional title and experience of palliative care, which could explain 37.8% of the total variation of the factors. Conclusions? The knowledge level of palliative care among medical staff is generally low. The factors influencing the knowledge level of palliative care among medical staff were discussed with dying patients or their families, heard of palliative care, educational level, professional title and experience of palliative care. Medical staff have strong training needs in all aspects of palliative care. It is particularly important to train palliative nursing knowledge in relevant specialties.
4.Two years of clinical practice in the diagnosis of pulmonary diseases by ultrasound instead of X-ray in neonatal ward
Yueqiao GAO ; Ruxin QIU ; Jing LIU ; Li ZHANG ; Shanshan GENG
Chinese Pediatric Emergency Medicine 2019;26(8):588-590
Objective To summarize the routine application of neonatal lung ultrasound in neonatal and NICU department of our hospital in the past 2 years,and to explore the feasibility of using ultrasound in-stead of X-ray in diagnosing pulmonary diseases in neonatal ward. Methods From March 2017 to May 2019,a total of 2 874 children hospitalized in the department of neonatology in our hospital were collected to analyze the types of pulmonary diseases and the reliability of lung ultrasound diagnosis. Results A total of 2 874 children received lung ultrasound examination for 7 902 times,including 1 040 patients(36. 2%) with pulmonary disease and 1 834 patients(63. 8%)without pulmonary disease. There were 152 cases of neonatal respiratory distress syndrome,112 cases of wet lung,652 cases of pneumonia,87 cases of meconium aspira-tion syndrome,12 cases of pneumothorax ( including 1 case with mediastinal emphysema),and 25 cases of pulmonary hemorrhage. Among the 2 874 children,106 received X-ray examination of the lungs before admis-sion,and received dynamic monitoring of lung ultrasound. Ninety-six cases were found to have pulmonary lesions,among which 8 cases were diagnosed with neonatal respiratory distress syndrome by X-ray examina-tion and wet lung by lung ultrasound,and recovered quickly after treatment according to wet lung. In 2 cases, X-ray examination showed no pneumonia complicated with pneumothorax,while ultrasound diagnosis showed a small amount of pneumothorax, and ultrasound diagnosis showed pneumonia complicated with a small amount of pleural effusion in 1 case. The diagnostic coincidence rate was 91. 7%. Conclusion It is feasible to use ultrasound instead of X-ray to diagnose pulmonary diseases in neonatal wards. Ultrasonic diagnosis of neonatal pulmonary diseases is worth promoting.
5.A retrospective analysis of 65 cases of drug-induced liver injury
Yuwen HUANG ; Yueqiao CHEN ; Na WANG ; Yu CHEN ; Liyi PAN ; Yanyan ZHANG
China Modern Doctor 2024;62(31):60-63,71
Objective To explore the clinical characteristics of drug-induced liver injury(DILI),and provide reference for early clinical recognition,diagnosis and treatment of DILI.Methods Clinical datas of 65 patients with DILI hospitalized in the First Affiliated Hospital of Guangxi University of Chinese Medicine from January 2019 to December 2023 were retrospectively analyzed,and their general conditions,using drugs,distribution type of liver injury,traditional Chinese medicine treatment and outcome were statistically analyzed.Results A total of 65 patients were included,including 27 males and 38 females,with an average age of(46.40±19.19)years old.The majority of patients were 41 to 60 years old.Chinese herbal medicine and Chinese patent medicine accounted for the highest proportion of drugs inducing DILI(30.8%).Hepatocyte injury was the most common type of DILI,with 39 cases.The main clinical manifestations of DILI patients were fatigue,abdominal discomfort,aversion to oil,yellow eyes,yellow urine and so on.In the treatment of traditional Chinese medicine,liquorice root was the most frequently used,with a frequency of 60.7%.After active treatment,59 patients were cured and discharged from hospital.Conclusion Hepatocyte injury is the main type of DILI.Clinical monitoring of hepatotoxicity of traditional Chinese herbal medicine and Chinese patent medicine should be strengthened to reduce the damage to liver caused by adverse drug reactions.
6.Influencing factors and demand analysis of 1086 clinical frontline nurses' thesis writing in He'nan Province
Aimin LI ; Li TIAN ; Yueqiao GAO ; Kun WANG ; Yang ZHANG ; Ying ZHANG ; Junling WANG ; Shumin ZHANG
Chinese Journal of Modern Nursing 2018;24(3):255-261
Objective To investigate the influencing factors and demand of clinical frontline nurses' thesis writing in He'nan Province providing a theoretical basis for improving the clinical nurses' thesis writing willingness and level.Methods From May 2015 to May 2016, a self-designed questionnaire was used to survey 1200 clinical nursing staff from 12 hospitals in He'nan Province by Lottery method and random number table method for general information, hinder factors of thesis writing, and the assist and guidance needed in thesis writing. The descriptive analysis, Kruskal-Wallis rank sum test, independent sample t-test, single factor analysis of variance, linear correlation analysis, multiple linear regression analysis were used to analyze the influencing factors of nurses' paper writing.Results A total of 1086 effective questionnaires were recycled. The differences of number of papers wrote by nurses who were different in hospital level, marital status, age, nursing age, work intensity, professional title, and final education were statistically significant (H=16.293, 206.350, 31.775, 56.393, 136.605, 484.600, 48.913;P<0.05). Hospital level, age, nursing age, marital status, professional title, and final education were all positively correlated with the number of papers (r=0.119, 0.161, 0.215, 0.410, 0.639, 0.093;P<0.01), while work intensity was negatively correlated (r= -0.367,P<0.01). The scores of five dimensions of factor hindering the thesis writing from high to low were lack of thesis writing skills (16.16±2.37), literature search obstacles (15.14±2.47), lack of statistical software operation (15.49±1.72), clinical sensitivity of problems identifying (14.63±2.74) and poor data collection methods (13.27±2.14). Multiple linear regression analysis showed that hospital level, professional title, nursing age and final education level were the main factors that impeded the writing of clinical nurses, which explained 93.1% of the total variation. The main thesis writing training needs were research topic selection and project design, paper writing methods and skill training, and hospital policy support.Conclusions Thesis writing number by Class Ⅲ hospital nursing staff was higher than that by Class Ⅱ hospital in He'nan Province. Nursing age, title and final education level were the main factors hindering the clinical nurses from thesis writing. Hospital managers needs to train clinical nurses on paper writing according to the medical system of our country.
7.Accurate Measurement of Agatston Score Using kVp-Independent Reconstruction Algorithm for Ultra-High-Pitch Sn150 kVp CT
Xi HU ; Xinwei TAO ; Yueqiao ZHANG ; Zhongfeng NIU ; Yong ZHANG ; Thomas ALLMENDINGER ; Yu KUANG ; Bin CHEN
Korean Journal of Radiology 2021;22(11):1777-1785
Objective:
To investigate the accuracy of the Agatston score obtained with the ultra-high-pitch (UHP) acquisition mode using tin-filter spectral shaping (Sn150 kVp) and a kVp-independent reconstruction algorithm to reduce the radiation dose.
Materials and Methods:
This prospective study included 114 patients (mean ± standard deviation, 60.3 ± 9.8 years; 74 male) who underwent a standard 120 kVp scan and an additional UHP Sn150 kVp scan for coronary artery calcification scoring (CACS). These two datasets were reconstructed using a standard reconstruction algorithm (120 kVp + Qr36d, protocol A; Sn150 kVp + Qr36d, protocol B). In addition, the Sn150 kVp dataset was reconstructed using a kVp-independent reconstruction algorithm (Sn150 kVp + Sa36d, protocol C). The Agatston scores for protocols A and B, as well as protocols A and C, were compared.The agreement between the scores was assessed using the intraclass correlation coefficient (ICC) and the Bland–Altman plot. The radiation doses for the 120 kVp and UHP Sn150 kVp acquisition modes were also compared.
Results:
No significant difference was observed in the Agatston score for protocols A (median, 63.05; interquartile range [IQR], 0–232.28) and C (median, 60.25; IQR, 0–195.20) (p = 0.060). The mean difference in the Agatston score for protocols A and C was relatively small (-7.82) and with the limits of agreement from -65.20 to 49.56 (ICC = 0.997). The Agatston score for protocol B (median, 34.85; IQR, 0–120.73) was significantly underestimated compared with that for protocol A (p < 0.001). The UHP Sn150 kVp mode facilitated an effective radiation dose reduction by approximately 30% (0.58 vs. 0.82 mSv, p < 0.001) from that associated with the standard 120 kVp mode.
Conclusion
The Agatston scores for CACS with the UHP Sn150 kVp mode with a kVp-independent reconstruction algorithm and the standard 120 kVp demonstrated excellent agreement with a small mean difference and narrow agreement limits. The UHP Sn150 kVp mode allowed a significant reduction in the radiation dose.
8.Training practice of neurocritical care in standardized training of neurosurgical specialists
Meng QI ; Yueqiao XU ; Ning WANG ; Xin QU ; Guilin LI ; Hongqi ZHANG ; Feng LING
Chinese Journal of Medical Education Research 2018;17(8):835-838
The training of neurocritical care is an important component in standardized training of neurosurgical specialists. As a subspeciality of neurosurgery, as well as with the characteristics of critical care medicine, neurocritical care carries its own discipline features. Based on clinical training and practice experiences, the training mode and practice experience were summarized, including basic requirement, theory training, skill training, research training, humanity accomplishment improvement and evaluation stan-dard, in order to discuss the appropriate training mode of neurocritical care in standardized training of neurosurgical specialists, improve the training methods and advance the training effectiveness, and provide reference for cultivating qualified and comprehensively developed neurosurgical specialists.
9.Ultrasound diagnosis of neonatal fracture
Jing LIU ; Huali WEI ; Huirong ZHAO ; Li ZHANG ; Ruxin QIU ; Yueqiao GAO ; Chen CHEN
Chinese Journal of Perinatal Medicine 2020;23(4):245-248
Objective:To investigate the feasibility and characteristics of ultrasound imaging in diagnosing fractures in neonates.Methods:Thirty neonates with bone fracture in Beijing Chaoyang District Maternal and Child Healthcare Hospital during January 2018 to June 2019 were retrospectively recruited. The causes and ultrasound imaging features of these cases were analyzed. The ultrasound findings were compared with the results of X-ray examination.Results:Among the 30 cases, 29 (96.7%) were diagnosed as fracture due to birth trauma, including 28 (93.3%) of clavicle fracture and one (3.3%) of humerus fracture, and one (3.3%) with rib fracture probably caused by metabolic osteopathy. The ultrasound imaging characteristics included interruption of bone continuity, dislocation and/or angulation of fracture ends, and callus formation during recovery. All of the 30 cases were diagnosed by ultrasound. However, X-ray examination failed in the diagnosis of one clavicle fracture.Conclusions:Ultrasound is an accurate and reliable method for the diagnosis of neonatal fracture. The main characteristics of ultrasound imaging include interruption of bone continuity, dislocation and/or angulation of fracture ends and callus formation.
10.Several neglected but common risk factors for neonatal brain injury
Jing LIU ; Li ZHANG ; Yueqiao GAO
Chinese Journal of Applied Clinical Pediatrics 2020;35(23):1761-1765
Clinicians are familiar with neonatal brain damage caused by severe asphyxia, hypoxia and premature birth, but enough attention has not been paid on the correlation between cesarean section, polycythemia, disseminated intravascular coagulation, patent ductus arteriosus, and non-invasive high-frequency oscillatory ventilation and neonatal brain damage.Which would be introduced in this paper to further improve neonatal prognosis.