OBJECTIVE: To precise classify sacral meningeal cysts, effective guide minimally invasive neurosurgery and postoperative personalized rehabilitation by multiple dimensions radiographic reconstruction MRI. METHODS: From March to December 2021, based on the original 3D-fast imaging employing steadystate acquisition (FIESTA) scanning sequence, 92 patients with sacral meningeal cysts were pre-operatively evaluated by multiple dimensional reconstruction MRI. The shape of nerve root and the leakage of cyst were reconstructed according to the direction of nerve root or leakage track showed on original MRI scans. Sacral canal cysts were accurately classified as including nerve root and without nerve root, so as to accurately design the incision of skin and formulate corresponding open range of the posterior wall of the sacral canal. Under the microscope intraoperation, the shape of the nerve roots inside cysts or leakage track of the cysts without nerve roots were verified and explored. After the reinforcement and shaping operation, several reexaminations of multiple dimensional reconstruction MRI were performed to understand the deformation of the nerve root and hydrops in the operation cavity, so as to formulate a persona-lized rehabilitation plan for the patients. RESULTS: Among the 92 patients with sacral mengingeal cyst, 58 (63.0%) cysts with nerve root cyst, 29 (31.5%) cysts without nerve root cyst, and 5 (5.4%) cysts with mixed sacral canal cyst. In 58 patients with nerve root cysts, the accuracy of preoperative clinical classification on MRI image reached 96.6% (56/58) through confirmation by operating microscope. Only 2 cases of large single cyst with nerve root on the head of cyst were mistaken for without nerve root type. In 29 patients with sacral cyst without nerve root, the accuracy of preoperative image reached 100% through confirmation by operating microscope. The accuracy of judging the internal nerve root and leakage of 12 cases with recurrent sacral cyst was also 100%. Two cases of delayed postoperative hydrops were found one month after operation. After rehabilitation treatment by moxibustion and bathing, the hydrops disappeared 4-6 months after operation. CONCLUSION Multiple dimensional reconstruction MRI can precisely make clinical classification of sacral meningeal cysts before operation, guide minimally invasive neurosurgery effectively, and improve the rehabilitation effect.
Humans ; Magnetic Resonance Imaging/methods* ; Male ; Female ; Sacrum/surgery* ; Adult ; Middle Aged ; Imaging, Three-Dimensional/methods* ; Cysts/rehabilitation* ; Aged ; Adolescent ; Young Adult ; Spinal Nerve Roots/diagnostic imaging* ; Minimally Invasive Surgical Procedures ; Neurosurgical Procedures/methods*

Objective:To explore the quality of life of patients with advanced lung cancer and its influencing factors.Methods:A total of 220 patients with advanced lung cancer in Shanxi Provincial Cancer Hospital from June 2017 to June 2019 were selected. The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core-30 (QLQ-C30) and Quality and Life Questionnaire of Lung Cancer (QLQ-LC13) were used to evaluate the quality of life of patients. Combined with the clinicopathological data of the patients, multiple linear regression method was used to analyze the factors affecting the quality of life of patients with advanced lung cancer.Results:A total of 220 questionnaires were issued, and 184 (83.6%) valid questionnaires were returned. There were 102 cases (55.4%) of male and 82 cases (44.6%) of female. Among the 5 functional areas of QLQ-C30, the score of social function was low [(60.2±11.8) points], and the score of cognitive function was high [(78.5±13.4) points]; among the 3 symptom areas, the score of pain was high [(36.8±10.3) points]; among the 6 single items, the lack of appetite was more serious [(58.5±10.5) points]. Among the 10 symptom areas of QLQ-LC13, shortness of breath and cough were more prominent [(34.6±9.5) points and (33.6±6.8) points]. The quality of life of female patients, patients with older age, patients with fewer children, patients with more organ metastases, patients with other diseases and patients with chemotherapy was poor (all P < 0.05), while there was no correlation between smoking status, occupation and education level and the quality of life of advanced lung cancer patients (all P > 0.05). Conclusions:The quality of life of advanced lung cancer patients is closely related to gender, age, the number of children, the number of metastatic organs, with or without diseases and treatment methods. Targeted intervention measures are helpful to improve the quality of life of patients.

Objective To evaluate the etiology,epidemiological characteristics,clinical diagnosis,and outcomes of hospitalized patients with AKI in Xinjiang,analyzing the risk factors of their clinical prognosis.Methods A multicenter retrospective survey was conducted,investigating adult patients admitted to four hospitals in Xinjiang in January and July 2013.Patients with AKI were screened out based on KDIGO's inclusion and exclusion criteria.Clinical variables of patients with AKI including demographics,clinical data,laboratory tests,treatment measures and prognosis were collected.Results Among 32,157 adult hospitalized patients,there were 722 AKI patients.Excluding those with incomplete data,719 patients were enrolled in this study.The detection rate of AKI was 2.25％ (722 of 32,157) by KDIGO criteria.The main cause for AKI was pre-renal injury,led mainly by cardiac output,low blood volume,and the use of nephrotoxic drugs.The non-recognition rate of AKI was 72.4％ (407/557).Multivariate binary logistic regression analysis showed that AKI stage,peripheral vasodilation and renal parenchyma were protective factors of the omission diagnosis.In the short-term prognostic analysis,the overall mortality rate was 12.8％(92/719).Among the 323 patients with AKI who survived discharge,43.7％(141) had renal function recovery;40.2％(130) did not fully recover their renal function but ceased maintenance dialysis;16.4％ (53) were still on dialysis at discharge.Multivariate Cox regression model suggested that DIC,shock and department of obstetrics were independent risk factors for death during hospitalization of AKI.In addition,the risk of death for AKI from department of obstetrics and gynecology patients was higher than that of other departments.Conclusions The most common reason for AKI in hospitalized patients in Xinjiang was pre-renal injury.The main risk factors were low cardiac output and low blood volume.The omission diagnosis of AKI was serious;AKI stage,peripheral vasodilation and renal parenchymal injury however were its protective factors.Poor-DIC,shock,hospitalization in obstetrics were independent risk factors for death in patients with AKI.

Objective To study the difference on knowledge-attitude-practice about rational drug use in tumor patients between urban and rural in Shanxi province, and to provide evidence for further development on health education of rational drug use. Methods A questionnaire investigation was conducted among tumor inpatients in Shanxi Cancer Hospital from May 22 in 2014 to May 30 in 2014. Results A total of 990 tumor patients were involved, including 499 urban patients accounting for 50.4 % and 491 rural patients accounting for 49.6 %. The tumor patients′awareness rates of 'the purchase of antibiotics needs a prescription' in urban and rural areas were the highest, 74.9 % (374/499) and 67.0 % (329/491), respectively, and the awareness rates of 'the meaning of OTC on the medicine package' were the lowest, 22.0 % (110/499) and 18.1 % (89/491), respectively. 96.2%(480/499) urban and 92.7%(455/491) rural tumor patients had developed a correct attitude towards 'irrational drug use will affect health and even life-threatening' which ranked the highest, and the rates of correct attitude towards 'adverse drug reaction is the medical accident' were the lowest, 55.5 %(277/499) and 48.1 % (236/491), respectively. The correct behavior rates of 'read the drug instructions' in urban and rural tumor patients were the highest, 97.8% (488/499) and 95.1 % (467/491), respectively, and the correct behavior rates of 'the expired drug recovery to nearby regular pharmacy' were the lowest, 9.2 %(46/499) and 7.5 % (37/491), respectively. Conclusions The knowledge-attitude-practice about rational drug among urban and rural tumor patients in Shanxi province is not optimistic. It should be provided that individual health education in daily work in order to promote rational drug use, prolong survival time and improve the quality of life for tumor patients.

Objective To investigate the correlation between the self-care level and quality of life among tuberculosis patients and the level of disease management of their primary caregivers .Methods Totals of 125 cases of pulmonary tuberculosis patients and their primary caregivers were investigated with the Exercise of Self-Care Agency Scale ( ESCA ) , Disease Management of Family Caregivers Questionnaire and Quality of Life Instruments for Chronic Diseases-Pulmonary Tuberculosis ( QLICD-PT) .Results The mean score of the disease management behavior of the 125 family caregivers was (2.45 ±0.58), with 28 cases in a high level, 52 cases in a medium level and 45 cases in a low level.The scores of self-care ability and quality of life were (62.38 ±4.23) and (85.69 ±4.92).The self-care ability was statistically significant among different dimension of disease management (F=8.558, 7.965, 9.012, 8.338, respectively;P<0.05).The disease management level of family caregivers was positively related to the self-care measures, self-concept, self responsibility and self-care ability (r=0.456, 0.385, 0.408, 0.392, respectively;P<0.05).The level of disease management of family caregivers was positively related to the physiological disease , economic of treatment, social support and health education (r=0.432, 0.374, 0.369, 0.402, respectively;P<0.05), while negatively related to the negative psychology and discrimination ( r=-0.337, -0.362, respectively;P<0 .05 ) .Conclusions The disease management level of family caregivers and the self-care ability and quality of life of tuberculosis patients are closely related .The tuberculosis disease management is at a low level.The healthcare professionals should deal with the continuity of care and adopt the individualized and systematic education programs to improve the level of disease management of family caregivers and the self-care ability and the quality of life of tuberculosis patients.

Objective Probing into a way to reform the assessment indexing of diagnosis and treatment in clinical specialties, to help with objective assessment and ranking among hospitals in terms of the performances of their respective specialties. Methods Treatment outcomes of the diseases pinpointed by heart physicians and urology surgeons of three hospitals in 2005 as the criteria to calculate the adjusted value for fatality rate and cure rate. Results The adjusted value of fatality rate for the heart physicians is CFR≥1, and that of cure rate for the urology surgeons is CFR≤1. A trial assessment is made based on these figures, and a ranking is achieved on the diagnosis and treatment outcomes of the clinical medicine specialties in these three hospitals as a result. Conclusions Diseases as the assessment levels for medical quality of clinical medicine specialties and relative risks as the core computation adjusted factor, may help yield the indexes and methodology for clinical medicine specialties in line with China's specifics.