OBJECTIVE:To summarize and analyze the clinical outcomes of coil embolization for treating cerebral aneurismal METHODS:Authors retrieved PubMed Database(http://www.ncbi.nlm.nih.gov/PubMed)and Wanfang Database(http://www wanfangdata.com.cn)by using a computer for articles concerning coil embolization for treating cerebral aneurismal published from 1990 to 2008.The key words were"aneurysm of brain,spring ring interventional therapy,embolism"in English,and"cerebral aneurysm,embolism,circlip ring,endovascular treatment"in Chinese Duplicated studies were excluded.A total of54 articles were obtained by primary screening.According to inclusion criteria,14 articles were further summarized.RESULTS:The included 14 articles exhibited that aortocranial angiography was conducted before embolism to understand intracalvarium circulation and to measure aneurysm neck and size.Following microtubular in position,superselective angiography was not performed to avoid aneurysm rupture.It was important to select suitable catheter and guide wire.Spring ring with the same diameter as aneurysm size was selected When placed it,it should be twisted around the wall of aneurysm to form a primary"frame",which was beneficial for spiral of other spring rings in the"frame".Try to make spring ring densely plugged in aneurysm to avoid aneurysm relapse.The last spring ring should not be too long so as to avoid difficulty in complete filling-in.Before disengage,the spring ring should undergo visualization to verify that it was in the aneurysm to ensure the patency of parent artery.The operation should be light and soft Following proceeding a path,the guide wire and catheter should be slightly withdrawn a part to unload the tension induced by bending,resulting in avoiding"negligence-induced leaping forwards"that may pierce the aneurysm.CONCLUSION:Spring ring endovascular embolization is an ideal method to treat cerebral aneurysm,with characteristics of microinvasion,security,reliability and definite outcomes .

Objective To evaluate the effectiveness of clinical rotation training in pain department for general practitioner.Methods Totally 31 general practitioners of 3 years program in the First Affiliated Hospital of Chongqing Medical University were involved in clinical rotation training in pain department form August 2008 to December 2011.Training lasted for one month.Clinical rotation training in pain department was conducted for general practitioners by studying rules and regulations,treatment methods,imaging data and clinical practice.Evaluation was made according to the treatment,theoretical knowledge,interpersonal skill and professional competency of general practitioners.Measurement data were expressed as mean ± standard deviation ((-x) ± s) while enumeration data were expressed as rate.Descriptive analysis of the data was used.Results Average total number of patients managed by 31 general practitioners was (15 ± 2),average total number of disease species was (5 ±2),average number of case discussion and small lecture participated was 1 ～2,average number of nerve block participated as assistant was (40 ± 5) and average number of minimally invasive surgery visited and studied was (2 ± 2).Residency duties were skillfully completed and assessment score was (85 ± 4.50).Conclusions Through clinical rotation training,general practitioners can understand common disease diagnosis and treatment category; familiarize clinical evaluation methods and master standards of diagnosis and treatment in pain department.Meanwhile,they would learn doctor-patient communication to establish a good therapeutic relationship with patients.

Objective To assess the reliability and validity of the Chinese version of Multidimensional fatigue symptom inventory-short form(MFSI-SF).Methods The reliability and validity of the Chinese version MFSI-SF were assessed in a sample of 203 cancer patients.Statistical software was used to perform the analysis.Results The results showed moderate correlation between items and the total scale,the content validity index was 0.82,and exploratory factor analysis indicated five dimensions of the scale,the cumulative variance contribution was 56.65％.Confirmatory factor analysis showed moderate model fitting:x2/df=l.73,GFI=0.83,AGFI=0.79,NNFI=0.94,RMSEA=0.06,criterion validity was 0.585,and the Cronbach α of the total scale was 0.896.Conclusions The results demonstrated good convergent validity,it is suitable to evaluate fatigue status in Chinese cancer patients.

Objective To investigate the medication adherence and clinical efficacy of inhaled glucocorticoids (ICS) and leukotriene receptor antagonists (LTRA) in the treatment of children with bronchial asthma ,in order to provide references for treatment options.Methods From 2015 to 2016,the clinical data of 140 cases with bronchial asthma who under the age of 14 years were retrospectively analyzed.The patients were randomly divided into the ICS group and the LTRA group according to the treatment methods ,with 70cases in each group.The patients in the ICS group were given aerosol inhalation of budesonide 1 mg added to saline 3 mL,twice per day,and reduced to inhale budesonide 0.5 mg/time,2 times/day after symptom relief.The patients in the LTRA group were given montelukast sodium chewable tablets 4mg/time at bed-time,one time a day for 3 months.According to the MARS-A compliance assessment,the compliance of patients in the treatment process was graded and the therapeutic effect was analyzed . Results In the same medication adherence , the effective treatment samples ( including good control and partial control) of the ICS group were 62 cases,and 8 cases without control and the effective rate was 98.36%.In the LTRA group,the effective treatment samples were 54 cases,and 16 cases without control and the effective rate was 89.09%. There was statistically significant difference in the effective rate between the two groups (χ2＝6.152,P＜0.05).In the same therapeutic efficacy (51 cases effective treatment of the ICS group ,54 cases effective treatment of the LTRA group),there were 50 cases with compliance in the ICS group and 62 cases in the LTRA group.The difference in the compliance was statistically significant (χ2＝7.012,P＜0.05).Conclusion All of the ICS group and the LTRA group can make effective control for childhood asthma.Through statistic process data of this experiment ,we discover that under the good medication adherence condition ,all of the treatment rates and the control level of the ICS group are better than the LTRA group.In the same therapeutic efficacy ,the medication adherence of the LTRA group is superior to the ICS group.

Objective:To investigate the effect of sarcopenia on physical performance and nutritional status in elderly patients with gastrointestinal tumors.Methods:a total of 120 eligible in-patients were enrolled from gastrointestinal surgery department of a Grade A tertiary hospital in Ningbo city from September 2021 to January 2022. General clinical data were collected, nutritional risk was screened using Nutritional Risk Screening 2002 (NRS 2002), physical performance was assessed by Short Physical Performance Battery (SPPB), skeletal muscle index at the third lumbar vertebra level (L3 SMI) was calculated using abdominal CT scan, and grip strength/muscle strength, gait speed by 6 Meter Timed Walk Test and calf circumference were measured. Subjects were divided into sarcopenia and non-sarcopenia group according to the diagnostic criteria of the Asian Working Group for Sarcopenia (AWGS). Impacting factors of sarcopenia and the correlation between muscle mass and physical performance in elderly patients with gastrointestinal tumors were analyzed.Results:The overall prevalence rate of sarcopenia in elderly patients with gastrointestinal tumors was 28.3% (34/120) and it was 28.9% (22/76) and 27.3% (12/44) in males and females respectively. There were statistically significant differences in age, tumor stage, nutritional risk, body mass index, calf circumference, L3 SMI, grip strength/muscle strength, gait speed and SPPB score between patients with and without sarcopenia (P<0.05). Muscle strength/grip strength, L3 SMI and gait speed were closely correlated with the occurrence of sarcopenia in elderly patients with gastrointestinal tumors (P<0.05). The L3 SMI was positively correlated with physical performance as assessed with SPPB in both groups.Conclusions:Sarcopenia is a common complication in elderly patients with gastrointestinal tumors with multiple influencing factors. Timely nutritional intervention and exercise intervention should be incorporated into the treatment of elderly gastrointestinal tumor patients with sarcopenia in order to improve nutrition status.

Objective: To investigate the clinicopathologic characteristics of intractable epilepsy. Methods: Based on the classification criteria proposed by the International League Against Epilepsy (ILAE), a retrospective analysis of the pathological characteristics was done in 822 patients who underwent epilepsy surgery in Sanbo Brain Hospital, Capital Medical University, from June 2008 to December 2012. Results: The mean age of epilepsy onset was 9.9 years, mean duration of epilepsy was 11.9 years. Complex partial seizures were the main presenting features. Histopathological study showed 33 cases (4.01%) with mild forms of cortical malformations, 690 cases (83.94%) with focal cortical dysplasia (FCD) and 99 cases with others (including 39 pure hippocampal sclerosis, 20 cystosclerosis, 19 Sturge-Weber syndrome, 8 tuberous sclerosis complex, 6 without significant pathological changes, 5 gyral malformations and 2 hamartoma). Among the 690 FCD cases, 106 were FCD typeⅠ, 91 were FCD typeⅡ and 493 were FCDⅢ(Ⅲa: 160, Ⅲb: 106, Ⅲc: 26 and Ⅲd: 201). Conclusions FCDⅢd is the most common histopathological subtype causing intractable epilepsy, mainly due to focal hypoxia/ischemia in the perinatal period, which results in scarring of local brain tissue; this is followed by other isolated forms of FCD (FCDⅠand FCDⅡ), and then FCD Ⅲa and FCD Ⅲb. The reason to distinguish isolated forms of FCD (types Ⅰ and Ⅱ) from FCD Ⅲ and to subclassify FCD Ⅲ is to allow better definition of cortical dyslamination. Therefore, the pathogenic factors of intractable epilepsy can be grouped in greater details, and facilitate the diagnosis and potential curative treatment of intractable epilepsy.

BACKGROUNDThe diagnosis of liver fibrosis is a difficult task at any time using conventional clinical imaging. Intravoxel incoherent motion (IVIM) can be used to investigate both diffusion and perfusion changes in tissues. This study was designed to determine the value of IVIM in the diagnosis and staging of liver fibrosis.

METHODSIVIM examinations were performed on a GE 3.0T MR scanner in 25 patients with liver fibrosis and 25 healthy volunteers as the control group. Patients with liver fibrosis diagnosis were confirmed by pathology and staged on a scale of F0-4. The standard ADC values and the values of a biexponential model (slow ADC (Dslow), fast ADC (Dfast) and fraction of fast ADC (FF)) were measured in three liver regions per person. The mean standard ADC values, Dslow values, Dfast values and FF values from the study group were compared among the right posterior hepatic lobe, right anterior hepatic lobe and medial segment of the left lobe. Receiver Operating Characteristic (ROC) curves and independent-samples t-tests were used to calculate the mean standard ADC values, Dslow values, Dfast values and FF values from the study group and the control group. Spearman rho correlation analysis was used for the stage of liver fibrosis. The liver fibrosis stages between the groups F0-1 and F2-4, the groups F0-2 and F3-4 were compared.

RESULTSAmong the liver fibrosis, there was no significant difference in the mean standard ADC values, Dslow values, Dfast values, and FF values obtained from the right posterior hepatic lobe, right anterior hepatic lobe and medial segment of the left lobe. Using ROC analysis, the Area Under the Curve (AUC) values of standard ADC, Dslow, Dfast, FF were all between 0.7 to 0.9. The mean standard ADC values, Dslow values, Dfast values and FF values of the liver in the study group were significantly lower than the values in the control group (P < 0.05). As the stage of the fibrosis increased, the values decreased by Spearman rho correlation analysis. The mean values (standard ADC, Dslow, Dfast, and FF) of liver fibrosis stages between the groups F0-1 and F2-4, the groups F0-2 and F3-4 showed significant differences (P < 0.05).

CONCLUSIONSIVIM can reflect the conditions of perfusion and diffusion in liver fibrosis and thus distinguish between normal liver and liver fibrosis. The IVIM technique may serve as a valuable tool for detecting and characterizing liver fibrosis, and monitoring its progression in a noninvasive manner.

Adult ; Aged ; Diffusion Magnetic Resonance Imaging ; methods ; Female ; Humans ; Liver ; pathology ; Liver Cirrhosis ; diagnosis ; Male ; Middle Aged