Objective The reactivity of the PICC comprehensive maintenance model and the ward maintenance model was evaluated.The differences between these two models were compared so that the better maintenance model could be chosen for improving the service of the PICC comprehensive maintenance model. Methods Four hundred and fifty patients with the PICC catheter were chosen randomly.Three hundred and forty patients received the PICC comprehensive maintenance model (mainly in the out-patient department and combined with the network maintenance ).One hundred and ten patients received the ward maintenance model (mainly in the in-patient ward).The WHO reactivity questionnaires of health system were provided.The results of the valid questionnaires were calculated and analyzed.Results Four hundred and twenty-nine questionnaires (326 for the comprehensive maintenance model and 1 03 for the ward maintenance model)were collected.The reactivity evaluation of confidentiality,communication,autonomy,timeliness,basic facilities and selective dimension in the comprehensive maintenance model were significantly higher than those in the ward maintenance model (P <0.05).There were no significant differences in the reactivity evaluation of dignity and social support dimension between the two groups (P >0.05).Conclusions The reactivity evaluation of healthy system in the comprehensive maintenance model is higher.It can provide timely and convenient PICC service and meet the expects and demands of patients.

Objective To investigate the application effect of pelvic rocking with balloon bionic midwifery in head dystocia. Methods Prospective research method was selected, and 400 pregnant women with head dystocia were divided into 2 groups by random digits table method with 200 cases each. The observation group was given pelvic rocking with balloon bionic midwifery delivery, and the control group was given gauge and comfortable posture with manual rotation fetal head delivery. The labor stage and delivery outcome were observed in two groups. Results The rate of successfully correct the fetal position was 91.00%(182/200) in observation group and 65.00%(130/200) in control group,and there was significant difference between 2 groups, χ2=39.394,P<0.01. The cesarean section rate was 7.00%(14/200) in observation group and 27.00%(54/200) in control group,and there was significant difference between 2 groups, χ2=113.119,P<0.01. The first, second and total labor stage were (8.86 ±2.20), (0.72 ±0.52), (9.78 ±2.82) h in observation group and (12.60±2.10), (1.02±0.82), (13.83±3.01) h in control group, and there were significant differences between 2 groups, t=15.684,4.058,12.609, P<0.01. The incidence of episiotomy, perineal laceration of Ⅱ degree, fetal distress, neonatal asphyxia and postpartum hemorrhage were 17.20%(32/186), 6.45%(12/186), 1.00%(2/200), 0, (150.80 ±43.54) ml in observation group, and 42.47%(62/146), 41.48%(61/146), 9.00%(18/200), 3.00%(6/200), (254.60±83.50) ml, and there were significant differences between 2 groups, P <0.01 or 0.05. Conclusions Pelvic rocking with balloon bionic midwifery can effectively correct the fetal position, reduce head dystocia and cesarean section rate, shorten the first labor stage, the second labor stage, reduce the occurrence of complication of mother and infant.

ObjectiveTo explore the characteristics and risk factors of suicidal ideation among community subjects in Xiamen city and to provide appropriate suicide intervention strategies.MethodsUsing multi-stage stratified cluster sampling,12071 subjects aged 18 years and older were identified in Xiamen City.Their suicidal ideation was recorded with the investigation list made by Beijing Huilongguan Hospital Beijing Suicide Research and Prevention Center.Psychiatrists determined their diagnosis with Diagnostic and Statistical Manual of Mental Disorder 4th edition (DSM-Ⅳ).ResultsA total of 10757 subjects completed the survey,the completion was 89.1％.The life-time prevalence of suicidal ideation was 2.48％ (95％CI:2.19％ ～ 2.77％ ),the prevalence was higher in female(3.00％ ) than male( 1.88％ ) (RR =1.60,95％CI:1.24 ～2.06).Analysis of risk factors by single logistic regression showed that the suicidal ideation of persons were mostly in female,44 years and older group,in rural,not-being married,no medical insurance,poor mental or physical health in last month,being in hospital due to the mental problems,low quality of life,living alone,having blood relatives or acquaintance with suicidal behavior.While the risk factors by muhivariate logistic regression were ranked as follows:having acquaintance with suicidal behavior (OR =3.66,95％CI:2.44 ～5.50),being in hospital because of mental problems (OR =3.30,95％CI:1.08 ～10.09),poor mental health in last month(OR =3.17,95％CI:2.37 ～4.24),any blood relatives having suicidal behavior (OR =2.91,95％CI:1.61 ～ 5.25 ),low of quality of life (OR =2.21,95％CI:1.50 ～ 3.26 ),not-being married (OR =1.73,95％CI:1.28 ～ 2.32),living alone (OR =1.65,95％CI:1.18 ～ 2.32),being female (OR=1.57,95％CI:1.21 ～ 2.05).The prevalence of mental disorders in suicidal ideation was 46.4％.ConclusionThe prevalence of suicidal ideation is significantly higher in female residents than in male.Having acquaintance with suicidal behavior,being in hospital due to the mental problems as well as poor mental health in last month are the main risk factors of suicidal ideation.

OBJECTIVE: To discuss a effective method of nasal septum deviation. METHOD: One hundred and sixteen subjects with nasal septum deviation were divided into treatment group (69 subjects) and control group (47 subjects) randomly. The combination therapy of correction of deviated nasal septum and plasma radiofrequency ablation were used in the treatment group. The combination therapy of deviated nasal septum and partial inferior turbinectomy were used in the control group. The data were analyzed by statistical method. RESULT: The effective rate of physical signs and symptoms of the treatment group was 100.0%, while the control group was 85.1%. There was significant difference of two effective rates (P < 0.05). Furthermore, hyperventilation and nasal adhesion were not happened in treatment group 6 months after treatments. CONCLUSION The correction of deviated nasal septum and plasma radiofrequency ablation combination therapy had the satisfied and safety treatment effect, which was and plasma radiofrequency ablation combination therapy had the satisfied and safety treatment effect, which was easy for observation as well as the minimal tissue damage. The combination therapy method was according with the principle of functional minimally invasive surgery.
Adult ; Catheter Ablation ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Nasal Septum ; abnormalities ; surgery ; Reconstructive Surgical Procedures ; Young Adult

Objective:To discuss the clinical experience of diagnosing and managing of cerebrospinal fluid(CSF)rhinorrhea.Method:Twenty-four cases of cerebrospinal rhinorrhea were analysed retrospectively from Janu 2003 to Sept 2008, among which 18 cases from department of Otolaryngology Head and Neck Surgery and 6 cases from Neurosurgery.Result:Postoperative follow-up lasted from 4 months to 72 months. All the cases were successfully cured, among which 6 cases with conservative treatment and 18 cases under surgery,and no relapse case was found. The 18 cases under surgery included endoscopic approach(12 cases), extra-nasal approach(4 cases), transnasal approach under microscope(2 cases).Conclusion:It is not only minimally invasive, safety and efficiency of transnasal endoscopic technique for CSF leaks, but also without facial scarring after operation. Transnasal endoscopic approach can be preferred for the closure of uncomplicated CSF leak, located at the cribriform plate or the sphenoid sinus. The extra-nasal or intracranial approach may be an attractive option for more complicated and large CSF leak, or the leak site is not easily found with endoscopic.

OBJECTIVE: To discuss the clinical experience of diagnosing and managing of cerebrospinal fluid (CSF) rhinorrhea. METHOD: Twenty-four cases of cerebrospinal rhinorrhea were analysed retrospectively from Jan 2003 to Sept 2008, among which 18 cases from department of Otolaryngology Head and Neck Surgery and 6 cases from Neurosurgery. RESULT: Postoperative follow-up lasted from 4 months to 72 months. All the cases were successfully cured, among which 6 cases with conservative treatment and 18 cases under surgery, and no relapse case was found. The 18 cases under surgery included endoscopic approach (12 cases), extra-nasal approach (4 cases), transnasal approach under microscope (2 cases). CONCLUSION It is not only minimally invasive, safety and efficiency of transnasal endoscopic technique for CSF leaks, but also without facial scarring after operation. Transnasal endoscopic approach can be preferred for the closure of uncomplicated CSF leak, located at the cribriform plate or the sphenoid sinus. The extra-nasal or intracranial approach may be an attractive option for more complicated and large CSF leak, or the leak site is not easily found with endoscopic.
Adolescent ; Adult ; Cerebrospinal Fluid Rhinorrhea ; diagnosis ; etiology ; surgery ; Child ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; methods ; Retrospective Studies ; Young Adult

Objective To explore the inheritance characteristics of SCN1A gene in familial severe myoclome epilepsy in infancy.Methods The clinical information and blood of the patients and their relatives who had febrile seizure(FS)or epilepsy history were collected.Blood genome DNA were extracted.All exons of SeN1A gene were PCR amplified and screened with denaturing high Performance liquid chromatography(DHPLC)technology,and sequence analysis was performed.Results Fourteen SME patients had FS or epilepsy family history.Five were found positive history in first class relatives and 2 of them had inherited mutations of SCN1A(C.4284+2T>C and e.1216G>T):Other9 were found positive history in second class relatives and 2 of them had de novo mutations of SCN1A.Condusions SCN1A is the pathogenic gene for SME.The same muatation of SCN1A gene can be related to different clinical phenotypes.SME patients whose first class relatives with FS or epilepsy history should be taken as the focus of SCN1A inherited mutation screening.

Objective To assess clinical applications of using diffusion-weighted imaging(DWI) in encephalic infection diseases.Methods 10 patients with encephalic infection diseases were investigated from September 2004 to June 2007.All patients underwent routine MRI and single-shoot DWI in which the thickness and space of routine MRI agreed with DWI.The ADC values at infection focus and opposite normal region were measured.Results Among the 10 cases,seven of them showed decreased ADC value when DWI presented hyper-intensity;whereas the other three,whose chronic infection were long-term,had increased ADC value while DWI presented iso-/hypo-intensity.Conclusion MRI diffusion-weighted imaging plays an important role in the diagnosis of encephalic infection diseases.

Objective To discuss the inspect technique and methods of magnetic resonance urography(MRU)in pediatric urinary system. Methods 16 cases with urinary system diseases were analyzed retrospectively,including axial routine FRFSE T2WI with fat saturation and three-dimensional MRU. The three-dimensional(3D) imaging data were sent to AW4.2 workstation,then edited and reconstructed with maximum intensity projection(MIP) and rebuilt. Results 12 cases in 16 cases were congenital abnormality by MRU diagnosis,3 cases were Urinary system diseases and 1 case was normal. 10 cases in 16 cases were performed with surgical intervention,6 cases with medical treatment,which clinical diagnosis were consistent with MRU. 16 cases were accepted examination with B -ultrasonic,6 cases CT and 9 cases IVP. Diagnose accordance rates with MRU were B-ultrasonic 93.7%(15/16),CT 66.7%(4/6),IVP 66.7%(6/9).Conclusion MRU is a safe,convincible and convenient technique,which can provide high quality imaging,so it will be a kind of non-injury imaging method in diagnosing the diseases of pediatric urinary system diseases.

Objective To solve the limitation of the wide-bound imaging from aortic arch to the bifurcation of internal and external carotid artery by changing 3D TOF MRA scan parameters, and discuss the clinical value of this technology in carotid artery angiography. Methods 108 patients with cerebrovascular disease were performed with carotid artery 3D TOF MRA. Images were performed under MIP, MPR and VR. The images of bilateral common carotid arteries, external and internal carotid artery, and vertebral artery were evaluated interactively by two independent radiologists blinded to results. Results 864 blood vessels were observed with 3D TOF MRA, including 672 normal clearly, 17 unclear, 17 congenital variants, 73 un -smooth lesion, 63 vascular stenosis, 9 vascular occlusion, 5 not display, 4 depressed downward, 4 vascular enlargement. Totally,unclear, variation and lesion blood vessels were 192. The results in combination with original image analysis could meet the need of diagonosis. Conclusion 3D TOF MRA as a noninvasive and non contrast agent imaging method can be used to select the carotid stenosis and is quite good in the value of application.