Objective To investigate the neurological function recovery and prognosis by comparing robot-guided puncture drainage and medicine treatment for small to moderate volume(15-30 ml)hypertensive cerebral hemorrhage in the basal ganglia.Methods Clinical data of 68 patients with small to moderate volume hypertensive cerebral hemorrhage in the basilar ganglia treated in our department from January 2022 to January 2024 were retrospectively analyzed.According to the treatment methods,they were divided into operation group and medicine group,in which the operation group(n=30)received robot-guided puncture and drainage treatment and the medicine group(n=38)received simple medicine treatment.Parameters of the two groups were compared,including time for hematoma to dissipate,length of hospital stay,hospital cost,duration of mannitol use,pulmonary infection rate,National Institutes of Health Stroke Scale(NIHSS)score and Scandinavia Stroke Scale(SSS)score at time immediately after admission and 2 weeks later,and modified Rankin Scale(mRS)score at the time immediately after admission and 3 months later.Results There were no significant differences in the length of stay,duration of mannitol use,and pulmonary infection rate between the two groups(P＞0.05).The hematoma dissipation time was 10.0(8.5,13.0)din the operation group and 28.5(25.0,35.0)din the medicine group,which had significant difference(Z=-4.285,P=0.000).The hospital cost was(77 786.5±21 763.0)yuan in the operation group and(31 843.5±14 514.3)yuan in the medicine group,which had significant difference(t=5.922,P=0.000).At 14 d after treatment,the NIHSS score in the operation group(8.5±2.7)points was significantly lower than that in the medicine group[(12.0±1.7)points,t=-4.192,P=0.000],and the SSS score in the operation group(28.7±7.2)points was significantly higher than that in the medicine group[(24.2±3.5)points,t=2.164,P=0.041].At 3 months after treatment,the mRS score of the operation group was 3.0(2.0,4.0)points,significantly lower than that of the medicine group[4.0(4.0,4.2)points,Z=-2.508,P=0.012].Conclusion For small to moderate volume hypertensive cerebral hemorrhage in the basal ganglia,robot-guided minimally invasive puncture and drainage treatment can accelerate the dissipation time of hematoma and improve the neurological function and prognosis of patients as compared to medicine treatment.

Objective To investigate the neurological function recovery and prognosis by comparing robot-guided puncture drainage and medicine treatment for small to moderate volume(15-30 ml)hypertensive cerebral hemorrhage in the basal ganglia.Methods Clinical data of 68 patients with small to moderate volume hypertensive cerebral hemorrhage in the basilar ganglia treated in our department from January 2022 to January 2024 were retrospectively analyzed.According to the treatment methods,they were divided into operation group and medicine group,in which the operation group(n=30)received robot-guided puncture and drainage treatment and the medicine group(n=38)received simple medicine treatment.Parameters of the two groups were compared,including time for hematoma to dissipate,length of hospital stay,hospital cost,duration of mannitol use,pulmonary infection rate,National Institutes of Health Stroke Scale(NIHSS)score and Scandinavia Stroke Scale(SSS)score at time immediately after admission and 2 weeks later,and modified Rankin Scale(mRS)score at the time immediately after admission and 3 months later.Results There were no significant differences in the length of stay,duration of mannitol use,and pulmonary infection rate between the two groups(P＞0.05).The hematoma dissipation time was 10.0(8.5,13.0)din the operation group and 28.5(25.0,35.0)din the medicine group,which had significant difference(Z=-4.285,P=0.000).The hospital cost was(77 786.5±21 763.0)yuan in the operation group and(31 843.5±14 514.3)yuan in the medicine group,which had significant difference(t=5.922,P=0.000).At 14 d after treatment,the NIHSS score in the operation group(8.5±2.7)points was significantly lower than that in the medicine group[(12.0±1.7)points,t=-4.192,P=0.000],and the SSS score in the operation group(28.7±7.2)points was significantly higher than that in the medicine group[(24.2±3.5)points,t=2.164,P=0.041].At 3 months after treatment,the mRS score of the operation group was 3.0(2.0,4.0)points,significantly lower than that of the medicine group[4.0(4.0,4.2)points,Z=-2.508,P=0.012].Conclusion For small to moderate volume hypertensive cerebral hemorrhage in the basal ganglia,robot-guided minimally invasive puncture and drainage treatment can accelerate the dissipation time of hematoma and improve the neurological function and prognosis of patients as compared to medicine treatment.

Objective To investigate the effect of through frontal keyhole approach neuroendoscopic surgery of basal ganglia hemorrhage on nerve conduction tract and prognosis.Methods 56 patients with hypertensive basal ganglia hemorrhage treated in our department from October 2017 to October 2023 were selected and divided into observation group and control group.Among them,28 patients in the control group underwent microscopic surgery through temporal cortex approach,while 28 patients in the observation group underwent endoscopic surgery through frontal keyhole approach.Fractional anisotropy and activities of daily living were compared between the two groups after operation.Results The proportion of FA Ⅰ grade in observation group was 88.9％and 70.0％in GCS Ⅰ grade and GCS Ⅱgrade patients,respectively,while in control group it was 75.0％and 41.7％.The proportion of ADL Ⅰand Ⅱ grade in observation group was 94.4％and 70.0％in GCS Ⅰ grade and GCS Ⅱ grade patients,respectively,whereas in control group it was 81.3％and 41.7％.The integrity of the corticospinal tract and activities of daily living in observation group were better than those in control group,with statistical significance(P＜0.05).Conclusion The surgery of hypertensive basal ganglia hemorrhage with neuroendoscopy through frontal keyhole approach has little influence on nerve conduction tract and the prognosis was better than traditional microscopic surgery through temporal cortex approach.

Objective To investigate the effect of through frontal keyhole approach neuroendoscopic surgery of basal ganglia hemorrhage on nerve conduction tract and prognosis.Methods 56 patients with hypertensive basal ganglia hemorrhage treated in our department from October 2017 to October 2023 were selected and divided into observation group and control group.Among them,28 patients in the control group underwent microscopic surgery through temporal cortex approach,while 28 patients in the observation group underwent endoscopic surgery through frontal keyhole approach.Fractional anisotropy and activities of daily living were compared between the two groups after operation.Results The proportion of FA Ⅰ grade in observation group was 88.9％and 70.0％in GCS Ⅰ grade and GCS Ⅱgrade patients,respectively,while in control group it was 75.0％and 41.7％.The proportion of ADL Ⅰand Ⅱ grade in observation group was 94.4％and 70.0％in GCS Ⅰ grade and GCS Ⅱ grade patients,respectively,whereas in control group it was 81.3％and 41.7％.The integrity of the corticospinal tract and activities of daily living in observation group were better than those in control group,with statistical significance(P＜0.05).Conclusion The surgery of hypertensive basal ganglia hemorrhage with neuroendoscopy through frontal keyhole approach has little influence on nerve conduction tract and the prognosis was better than traditional microscopic surgery through temporal cortex approach.

Abstract Prevention and control of myopia requires comprehensive measures. Based on the system established earlier, the system is revised and upgraded. The original system emphasizes comprehensive measures and proposes to focus on both the symptoms and root causes. These measures are summarized into six aspects, three address the root cause measures including health education, glasses optics and visual environment, and three address symptoms measures including eye exercises, physical therapy and drugs. The paper is comprehensively supplemented and analyzes the primary and the secondary, and promotes physical therapy from treating the symptoms to treat both the symptoms and the root causes. These improvement measures will help promote the prevention and control of myopia in children and adolescents.

Objective:To investigate the specific method, efficacy and safety of intrathecal baclofen (ITB) in the treatment of moderate and severe spasticity.Methods:The clinical features, response to ITB trial, clinical outcomes and treatment-related complications after baclofen pump implantation surgery were retrospectively analyzed in patients with moderate to severe spasticity who received ITB treatment in Hong Kong University Shenzhen Hospital from August 2022 to August 2023.Results:The study included 22 patients with moderate to severe spasticity, of whom 18 patients (81.8%) were effective in ITB trial. For these patients with effective trial, the lowest mean Modified Ashworth Scale (MAS) score of lower extremity muscle groups after ITB bolus injection was decreased significantly compared with the baseline mean value before injection (1.29±0.81 vs 3.31±1.18 , t=11.364, P<0.001), and the M/H amplitude ratio of soleus H-reflex at 4 hours after ITB bolus injection was significantly higher than the baseline value (9.61±4.66 vs 3.83±2.69, t=7.780, P<0.001). Among the 18 patients with effective ITB trial, 10 patients received baclofen pump implantation surgery with the informed consent of the patients or their guardians. Compared with the 8 patients without surgery, the baseline mean MAS score of lower extremity muscle groups of the 10 patients who received surgery was higher (3.71±1.06 vs 2.83±1.16, F=5.645, P<0.05), the maximum reduction of mean MAS score of lower extremity muscle groups of the 10 patients who received surgery was greater (2.61±0.99 vs 1.30±0.64, F=20.696, P<0.001). In 10 patients who received baclofen pump implantation surgery, the mean MAS score of lower limb muscle groups was significantly decreased in the first and sixth months after surgery compared with the baseline mean value before surgery (1.64±0.91, 1.16±0.89 and 3.71±1.06, F=39.946, P<0.001). Among them, 2 patients were followed up to 12 months after surgery, 2 patients were followed up to 18 months after surgery, and the mean MAS score of their lower limb muscle groups showed continuous improvement, and 1 patient with cerebral palsy combined with lower urinary tract hyperactive syndrome also showed significant improvement of urgent urinary incontinence after surgery. Up to the last follow-up, the daily dose of baclofen in 10 patients receiving baclofen pump implantation was (143.60±96.24) μg, and no treatment-related complications occurred. Conclusions:ITB can effectively relieve spasticity symptoms and other related neurological dysfunction in patients with moderate and severe spasticity, and the efficacy can be maintained for a long time, and treatment-related complications are rare. Preoperative ITB trial is helpful to screen out patients more suitable for baclofen pump implantation. Patients with higher grade of spasticity at baseline and better efficacy of ITB trial are more suitable for baclofen pump implantation. The soleus H reflex can effectively reflect the change of stretch reflex of lower limb muscle groups in patients with spasticity treated by ITB, and can be used to evaluate the treatment effect of ITB.

BackgroundThe incidence of delirium in critically ill psychiatric patients is high， and there are many factors affecting delirium occurrence. At present， epidemiological studies on delirium among critically ill patients in psychiatric hospitals are limited. ObjectiveTo explore the risk factors for delirium in critically ill patients in a psychiatric hospital， so as to guide the clinical management of delirium in psychiatric hospitals. MethodsThis retrospective study included 427 critically ill patients who were admitted to Shenzhen Kangning Hospital from January 1， 2019 to May 31， 2021. The delirium situation， gender， age， pre-admission course of illness （duration from the onset of acute mental state changes to in-patient registration at a psychiatric hospital）， history of mental illness， history of cognitive dysfunction， history of using psychoactive substances， history of using sedative and hypnotic drugs， number of combined chronic diseases， number of combined drugs and type of disease were examined as potential risk factors for delirium. Single Logistic regression was used to analyze the potential risk factors for delirium， and the potential risk factors were incorporated into the multi-factor Logistic regression analysis model so as to gradually screen out the risk factors for delirium in critically ill psychiatric patients. ResultsDelirium was present in 33.49% （143/427） of critically ill patients. Multi-factor Logistic regression analysis demonstrated that the presence of delirium was associated with mental and behavioral disorders caused by psychoactive substances （OR=8.949， P<0.01）， absent history of mental illness （OR=4.202， P<0.01）， number of combined chronic diseases （OR=1.249， P<0.01）， age （OR=1.031， P<0.01） and pre-admission course of illness （OR=0.942， P<0.01） . ConclusionDelirium was present in nearly 1/3 critically ill patients in the psychiatric hospital. The risk factors for delirium included short course of illness before admission， age， more combined chronic diseases， absent history of mental illness， mental and behavioral disorders caused by psychoactive substances. ［Funded by Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties （number， SZGSP013）］

OBJECTIVE To establish the fingerprints of Kangfuyan capsules and carry out chemical pattern recognition analysis，and simultaneously determine the contents of five components so as to promote the quality standard of the drug. METHODS High performance liquid chromatography （HPLC）fingerprints of 11 batches of Kangfuyan capsules （S1-S11）were established by Similarity Evaluation System of TCM Chromatographic Fingerprint （2012 edition）；identification and attribution analysis of chromatographic peaks were carried out by comparison with the chromatograms of the reference substance and the decoction pieces of single ingredient. SPSS 26.0 and SIMCA 14.1 software were used for cluster analysis and principal component analysis. HPLC method was used to determine the contents of matrine ，phellodendrine chloride ，rutin，forsythoside A and berberine hydrochloride. RESULTS There were 29 common peaks in the fingerprints for 11 batches of samples ，and the similarity was higher than 0.99. A total of 5 chromatographic peaks were identified ，which are matrine （peak 3），phellodendron chloride （peak 14），rutin （peak 20），forsythiaside A （peak 22） and berberine hydrochloride （peak 28）. The results of cluster analysis and principal component analysis showed that S 1-S9 were clustered into one category ，and S 10 and S 11 were clustered into another category. The contents of above 5 components were 29.320 5-60.144 3，0.621 6-1.076 6，1.025 9-2.830 5，2.899 3-6.212 7 and 4.425 1-8.581 6 mg/g， respectively. CONCLUSIONS The established fingerprint and content determination method are stable and reliable ，and can provide reference for the quality control of the preparation in combination with chemical pattern recognition analysis.

OBJECTIVE： To evaluate the efficacy and safety of apremilast in the treatment of moderate-to-severe plaque psoriasis systematically. METHODS： Retrieved from PubMed， Embase， Cochrane Library， VIP， CNKI and CBM， RCTs about apremilast or apremilast combined with other drugs （trial group） versus placebo （control group） in the treatment of moderate- to-severe plaque psoriasis were collected. Meta-analysis was conducted by using Rev Man 5.3 statistical software after literature screening， data extraction and quality evaluation with bias risk evaluation tool of Cochrane System Evaluator Manual 5.1.0. RESULTS： Totally 7 studies were included， involving 2 332 patients. Results of Meta-analysis showed that case number of psoriasis assessment and severity index （PASI） decreased by 75％ （PASI 75％） [OR＝6.44，95％CI（4.90，8.45），P＜0.000 01]， PASI 90％ [OR＝8.13， 95％CI（4.65， 14.22）， P＜0.000 01] and sPGA 0 or 1 [OR＝3.89，95％CI（3.00，5.05），P＜0.000 01]， the incidence of ADR [OR＝1.87，95％CI（1.44，2.43）， P＜0.000 01] in trial group were significantly more or higher than control group. Subgroup analysis by apremilast dose showed that case number of 20 mg PASI 75％ [OR＝4.72，95％CI（2.77，8.05），P＜0.000 01]， 30 mg PASI 75％ [OR＝7.05，95％CI（5.13，9.69），P＜0.000 01]， 20 mg PASI 90％ [OR＝4.27，95％CI（1.80，10.09），P＝0.001]， 30 mg PASI 90％ [OR＝11.11，95％CI（5.27，23.43），P＜0.000 01]， 20 mg sPGA 0 or 1 [OR＝2.82，95％CI（1.51，5.26），P＝0.001]， 30 mg sPGA 0 or 1 [OR＝4.13，95％CI（3.10，5.50），P＜0.000 01]， the incidence of 30 mg ADR [OR＝1.94，95％CI（1.51，2.49），P＜0.000 01] in trial group were significantly more or higher than control group. There was no statistical significance in the incidence of serious ADR [OR＝1.27，95％CI（0.77，2.07），P＝0.35] or case number of ADR leading to withdrawal [OR＝1.48，95％CI（1.00，2.20），P＝0.05] between 2 groups. CONCLUSIONS： Apremilast is effective for moderate-to-severe plaque psoriasis in dose-dependent manner and improve the quality of life， but increase the incidence of ADR.

Humanistic care centered on the interests and needs of patients, is an important means to maintain the doctor-patient relationship and to build a harmonious society. However, there are still some problems in the major public hospitals, such as inadequate communication and coordination, complicated and time-consuming medical procedures, and so on. Based on this, this paper discussed the problems existing in public hospitals in Anhui Province, and put forward some measures, such as strengthening doctor-patient communication, caring for doctor-patient personnel, and constructing hospital culture, so as to perfect the humanistic care system.