Objective:To analyze the influencing factors for efficacy of microvascular decompression (MVD) in primary trigeminal neuralgia (PTN).Methods:A retrospective study was performed. Clinical data of 178 patients with PTN underwent MVD at Department of Neurosurgery, Affiliated Hospital Affiliated to Nantong University from January 2018 to April 2022 were collected. Efficacy was evaluated according to Brisman's criteria. Differences of MVD efficacy in patients with different clinical characteristics or different neurovascular characteristics were compared. Multivariate Logistic regression was used to analyze the independent influencing factors for MVD efficacy.Results:All patients were followed up for about 2 years; at the last follow-up, 164 patients (92.13%) had good postoperative efficacy (130 were cured, 28 were obvious improved, and 6 were improved); 14 patients (7.87%) had poor postoperative efficacy (10 were ineffective and 4 were relapsed). No significant difference in surgical efficacy was noted among patients with different gender, age, left/right lateral pain, disease courses or pain degrees ( P>0.05). Patients with different contact degrees between the trigeminal nerve and blood vessels, different distances between the trigeminal nerve and blood vessels, and different curvature degrees of the posterior trigeminal nerve had significantly different surgical efficacy ( P<0.05). Multivariate Logistic regression indicated that contact degrees between the trigeminal nerve and blood vessels ( OR=0.233, 95% CI: 0.080-0.675, P=0.007), distances between the trigeminal nerve and blood vessels ( OR=6.991, 95% CI: 3.261-14.984, P=0.000), and curvature degrees of the posterior trigeminal nerve ( OR=0.351, 95% CI: 0.158-0.776, P<0.001) were independent influencing factors for postoperative outcomes. Conclusion:The postoperative efficacy is good in patients with slight contact between the trigeminal nerve and blood vessels, with distance between the trigeminal nerve and blood vessels greater than 1×time median width of the trigeminal nerve (WTN), or with hypotenuse height of the arced trigeminal nerve less than 1/2 WTN.

Objective:To investigate the role of neutrophil CD 11b (nCD 11b), soluble CD 14 subtype (sCD 14-St) and mitochondrial coupling factor-6 (CF-6) in the risk stratification of disease outcome in neonatal sepsis and its clinical significance. Methods:The clinical data of 121 septic neonates from July 2019 to March 2020 in Shanxi Children′s Hospital were retrospectively analyzed. According to the neonatal critical illness score (NCIS), the neonates were divided into non-critical group (NCIS>90 scores) with 35 cases, critical group (NCIS 70 to 90 scores) with 49 cases, very critical group (NCIS<70 scores) with 37 cases. There were 25 cases with poor prognosis (death), and 96 cases with good prognosis (survival). The C-reactive protein (CRP), procalcitonin (PCT), nCD 11b, sCD 14-St and CF-6 before treatment were detected. The correlation between nCD 11b, sCD 14-St, CF-6 and disease severity was analyzed by Spearman method; the value of nCD 11b, sCD 14-St and CF-6 in predicting poor disease outcome in sepsis neonates was analyzed by the receiver operating characteristic (ROC) curve. Results:The nCD 11b, sCD 14-St, CF-6, PCT and CRP in critical group and very critical group were significantly higher than those in non-critical group: (414.68 ± 93.29) and (532.74 ± 101.85) MFI vs. (325.45 ± 71.90) MFI, (892.40 ± 113.72) and (1 249.53 ± 95.41) ng/L vs. (784.66 ± 103.72) ng/L, (84.79 ± 28.35) and (121.66 ± 34.27) ng/L vs. (42.59 ± 13.51) ng/L, (19.24 ± 6.30) and (34.96 ± 11.95) μg/L vs. (8.89 ± 2.24) μg/L, (109.49 ± 36.77) and (247.13 ± 82.06) mg/L vs. (56.84 ± 17.25) mg/L; the indexes in very critical group were significantly higher than those in critical group, and there were statistical differences ( P<0.05). Spearman correlation analysis result showed that nCD 11b, sCD 14-St and CF-6 were positively correlated with disease severity in sepsis neonates ( r = 0.719, 0.813 and 0.823; P<0.01). The nCD 11b, sCD 14-St, CF-6, PCT and CRP in poor prognosis neonates were significantly higher than those in good prognosis neonates: (618.58 ± 146.92) MFI vs. (374.55 ± 120.03) MFI, (1 516.91 ± 194.38) ng/L vs. (828.13 ± 175.67) ng/L, (165.84 ± 25.63) ng/L vs. (62.51 ± 16.75) ng/L, (43.46 ± 10.14) μg/L vs. (20.19 ± 6.30) μg/L and (321.09 ± 94.56) mg/L vs. (88.24 ± 29.19) mg/L, and there were statistical differences ( P<0.01). ROC curve analysis result showed that the area under the curve (AUC) of nCD 11b, sCD 14-St and CF-6 for predicting poor disease outcome in sepsis neonates were 0.763, 0.796 and 0.838 (95% CI 0.678 to 0.836, 0.713 to 0.864 and 0.760 to 0.899), and the AUC of combination the 2 indexes was 0.921 (95% CI 0.858 to 0.962). Conclusions:The nCD 11b, sCD 14-St and CF-6 are associated with the disease severity and prognosis in sepsis neonates, and can be used as markers for risk stratification of disease outcome and assessment prognosis.

Objective:To explore the application effect of health education based on feedback theory in perioperative nursing of patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) .Methods:A total of 105 patients undergoing ERCP in the Third Hospital of Shanxi Medical University from February 2019 to June 2020 were selected as the research objects by the convenient sampling method. Patients were divided into the observation group ( n=53) and the control group ( n=52) according to random number table method. The control group was given routine health education, while the observation group was given health education based on feedback theory. The awareness of health education, self-management ability, bad mood and quality of life were compared between the two groups before and after intervention. Results:After intervention, scores of all dimensions of health education awareness questionnaire and the subscale scores of Adult Health Self-Management Ability Scale (AHSMSRS) in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . The scores of Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) in the observation group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Health education based on feedback theory can improve the health education awareness, self-management ability of patients undergoing ERCP and improve their negative emotions.

ObjectiveTo investigate the clinical features and prognosis of culture-negative liver abscess (CNLA) versus culture-positive liver abscess (CPLA), and to provide a reference for early diagnosis and effective treatment. MethodsA retrospective analysis was performed for the clinical data of 371 patients with liver abscess who were admitted to The Second Affiliated Hospital of Air Force Medical University from 2005 to 2018, among whom 145 (39.1%) had positive results of pathogen test (CPLA group) and 226 (60.9%) had negative results (CNLA group). The two groups were compared in terms of clinical features, laboratory examination, imaging data, and prognosis. The t-test was used for comparison of normally distributed or approximately normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. ResultsCompared with the CNLA group, the CPLA group had a significantly older age (t=-3.464, P=0.001) and a significantly higher proportion of patients with diabetes (χ2=17.362, P＜0.001) or cardiovascular disease (χ2=10.827, P=0.001), and compared with the CPLA group, the CNLA group had a significantly higher proportion of patients with AIDS (χ2=4.354, P=0.037). Compared with the CNLA group, the CPLA group had significantly greater increases in leukocyte count, percentage of neutrophils, alkaline phosphatase, gamma-glutamyl transpeptidase, and total bilirubin (U=20393, 19711, 18586, 19349, and 18496, all P＜0.05), a significantly greater reduction in albumin (t=3.348, P=0.001), and a significantly higher proportion of patients with a baseline APACHE Ⅱ score of ≥16 (χ2=9.550, P=0.002). Compared with the CNLA group, the CPLA group had a significantly higher proportion of tumors with a diameter of ＞5 cm (χ2=53.61, P＜0.001). In the CNLA group, 19.9% of the patients were treated with anti-infective therapy alone, while for both groups, anti-infective therapy combined with ultrasound- or CT-guided percutaneous drainage was the main treatment method. There were no significant differences in the length of hospital stay, recurrence rate, and mortality rate between the two groups (all P＞0.05). ConclusionCompared with CPLA patients, CNLA patients tend to have a younger age and are less likely to develop severe inflammatory response and liver insufficiency, with a smaller diameter of abscess which is less likely to be treated by percutaneous drainage, while there is no significant difference in prognosis between CPLA patients and CNLA patients.

Objective:By analyzing the relationship between postoperative pathology and lymph node metastasis of the adenocarcinoma of esophagogastric junction patients to explore the effect of surgical resection and lymph node cleaning scope on prognosis in different Siewert type patients.Methods:A retrospective analysis was made on 350 cases of esophageal gastric junction adenocarcinoma at Tumor Hospital of Shanxi Province from July 2014 to May 2018. Patients clinical data such as lymph node metastasis and tumor diameter, differentiation degree, infiltration depth were studied. The value of the third leg of lymph node cleaning in cardia cancer radical were discussed. Risk factors of lymph node metastasis were analyzed by Logistic regression model.Results:A total of 6 718 lymph nodes were dissected in 350 patients with adenocarcinoma of esophagogastric junction, including 1 613 positive lymph nodes, with a metastasis rate of 24.01%. The metastatic rate of Siewert type Ⅰ lymph nodes was 23.30%, 20.16%, 41.90% and 20.87% in the first, second, third and seventh groups, respectively, which was significantly higher than that of other groups. Siewert Ⅱ and Ⅲ focus on the abdominal cavity. with the increase of tumor infiltration depth, the rate of peripheral lymph node metastasis increased, and the difference was statistically significant ( P<0.01). The rate of lymph node metastasis was 83.1% in the low-differentiation group and 58.4% in the middle-high differentiation group, respectively ( P<0.01). When the tumor diameter ≥4 cm, the rate of lymph node metastasis in the patients increased significantly, and the difference was statistically significant ( P<0.05). The rate of lymph node metastasis at the third station was correlated with the depth of invasion of the gastric wall, the longest diameter of the tumor body, and the degree of differentiation of the tumor. Conclusions:The longest diameter of tumor body, the depth of infiltration and the degree of differentiation are independent risk factors for lymph node metastasis in AEG patients. For patients with type AEG Ⅰ, the mediastinal and lower esophageal lymph nodes should be thoroughly dissected during radical surgery, and the abdominal lymph nodes in groups 1, 2, 3 and 7 should be dissected. The remaining groups may have to be examined for enlarged lymph nodes to determine whether to dissect. For type Ⅱ and Ⅲ patients, splenoprotective total gastrectomy and D 2 lymph node dissection are recommended when the tumor invades the full layer of the gastric wall, the longest diameter ≥4 cm, and the differentiation degree is low.

Sarcopenia is a component of malnutrition in patients with liver cirrhosis. Studies have shown that both sarcopenia and hepatic encephalopathy can reduce quality of life and increase the risk of adverse events, including death, in patients with liver cirrhosis. This article reviews the association between sarcopenia and hepatic encephalopathy and the advances in treatment, so as to provide a reliable basis for the treatment of patients with sarcopenia and liver cirrhosis, prevent the development of hepatic encephalopathy, and thereby improve the quality of life and prolong the survival time of patients with liver disease.

In this study, we aimed to (1) identify white matter (WM) deficits underlying the consciousness level in patients with disorders of consciousness (DOCs) using diffusion tensor imaging (DTI), and (2) evaluate the relationship between DTI metrics and clinical measures of the consciousness level in DOC patients. With a cohort of 8 comatose, 8 unresponsive wakefulness syndrome/vegetative state, and 14 minimally conscious state patients and 25 patient controls, we performed group comparisons of the DTI metrics in 48 core WM regions of interest (ROIs), and examined the clinical relevance using correlation analysis. We identified multiple abnormal WM ROIs in DOC patients compared with normal controls, and the DTI metrics in these ROIs were significantly correlated with clinical measures of the consciousness level. Therefore, our findings suggested that multiple WM tracts are involved in the impaired consciousness levels in DOC patients and demonstrated the clinical relevance of DTI for DOC patients.
Adult ; Brain Stem ; diagnostic imaging ; Consciousness ; physiology ; Consciousness Disorders ; diagnostic imaging ; pathology ; Diffusion Tensor Imaging ; methods ; Female ; Humans ; Image Processing, Computer-Assisted ; methods ; Male ; Middle Aged ; White Matter ; pathology ; physiopathology

Objective To compare the contents in polysaccharide of aloe in gel of aloe with preparation in different processing methods on fresh aloe of outer cuticle and investigate their stability. It could provide technology of preparation of polysaccharide of aloe.Methods The aloe gel had been prepared through the fresh juicing method, and alcohol sinking was applied to abstract polysaccharides of aloe in proportion of sixty, seventy, eighty and ninety percent. The colorimetric method of anthracenone - thick sulfuric acid had been taken to determine contents of polysaccharide in different proportions by alcohol sinking. The contents of polysaccharide were compared among different processing methods in fresh aloe of outer cuticle, and then the stability on condition of different temperatures, pH and the reagent of reductant-oxidant with polysaccharides of aloe were investigated. Results The content abstracted from polysaccharide of aloe was the higher when the proportion was eighty percent and its character of powder was better. And content abstracted from polysaccharide of aloe with the outer cuticle was higher than that out of the outer cuticle. The powders from the polysaccharide of aloe with the outer cuticle were gray-green, gray-brown or gray-white. The powders from polysaccharide of aloe without the outer cuticle were partial-white, more well-distributed and delicate. The stability in polysaccharide of aloe was better with the condition of low temperature, reducing agent and the solution with pH from five to seven, while the stability was lower when in high temperature, oxidizing agent and the solution with strong acid and strong alkali. Conclusions The proportion of eighty percent with alcohol sinking, decorticating the outer cuticle of fresh aloe has the higher content and the better character in the polysaccharide of aloe.

Objective To observe visual field outcome and refractive status of patients with retinopathy of prematurity (ROP) treated by laser photocoagulation.Method The data of 39 ROP patients (73 eyes) who received laser photocoagulation were retrospectively analyzed and compared with 13 normal control subjects (25 eyes) whose age and sex were matched with ROP group.There were 24 males (45 eyes) and 15 females (28 eyes) in ROP group,with an average age of (7.0± 1.28) years.The first laser treatment was carried out at postnatal age (PA) of (38.74±3.82) weeks,the birth weight (BW) of (1402.33 ±369.61) g and the number of laser burns was (517.86 ± 277.40).The control group included 7 females (13 eyes) and 6 males (12 eyes),with an average age of (7.17 ± 0.96) years.The age (t=0.691) and gender (x2=1.425) were comparable between the two groups (P=0.491,0.233).The data of patients and controls were retrospectively analyzed including best corrected visual acuity,refractive examination,automated perimetry test.The differences of the mean deviation (MD) of visual field and the spherical equivalent (SE) between these two groups were comparatively observed.ROP patients were divided into no VF loss group (MD≤2 dB) and VF loss group (MD＞2 dB),mild VF loss group (MD ≤ 6 dB) and moderate VF loss group (MD ＞6 dB) according to the results of automated perimetry test,the differences of gestational age (GA),PA,BW,number of laser burns and SE between these groups were comparatively observed.Results The MD in ROP group and control group were 4.87±5.12 dB and 1.27 ± 3.34 dB,respectively;the difference between the two groups was statistically significant (t=-4.01,P＜ 0.001).The subgroup analysis showed that BW,number of laser burns,and SE were significantly different between no VF loss group and VF loss group (t=2.074,-1.996,-2.162;P=0.042,0.026,0.034);while the GA was not significantly different between these two groups (t=1.973,P=0.052).The difference of PA was not statistical significant different between mild VF loss group and moderate VF loss group (t=2.03,P=0.051) and SE was significantly different between the above two groups (t=3.283,P=0.002).For refractive outcomes,the BW and ROP stage correlated with SE significantly (r=-0.304,-0.387;P=0.015,0.002).The mean BCVA in ROP group was 0.84±0.23,and 59 eyes (91.2％) with BCVA better than 0.5.Conclusion Laser treatment for ROP tends to have less effect on long term refractive status and VF loss,with good visual outcome.

Objective To compare the predicted efficiency ofmacular hole closure index (MHCI) calculated by 2 different methods for postoperative anatomical outcomes after idiopathic macular hole (MH) surgery.Methods This is a prospective exploratory clinical study.A total of 63 patients (63 eyes) with idiopathic MH,who received vitrectomy,inner limiting membrane peeling and gas tamponade,were enrolled in this study.All the patients received optical coherence tomography (OCT) examination at each visit to measure the MHCI using the formula MHCI=(M+N) /BASE,M and N is the distance from outer limiting membrane break points to the beginning points of detached photoreceptor from retinal pigment epithelium of both side of the hole,respectively.BASE is the length of MH base.MHCI1 was measured by built-in caliper of OCT software,MHCI2 was measured by ImageJ software.The minimum macular diameter (MHD) was measured by built-in caliper of OCT software.Based on the OCT images,the anatomical outcomes were classified grade A (bridge-like shape closure),grade B (complete closure) and grade C (poor closure).Grade A and B are considered as good closure,grade C as poor closure.Patients were followed up at 3,6 and 12 months after surgery.The closure grades at last visit were the final outcome.The relationship between MHCI 1,MHCI2 and closure grades was analyzed.And the predicted efficiency of MHD,MHCI1 and MHCI2 for anatomical outcomes after the surgery was studied.Results The mean MHCI1 was 0.68±0.21 (0.30-1.35),MHCI2 was 0.95±0.26 (0.41-1.55),and MHD was (476.24±210.18) μm (127-956 μm).MHCI1 and MHCI2 were both negative correlated with the closure grades (r=-0.665,-0.691;P＜0.001).The receiver operating characteristic (ROC) curve analysis ofMHCI1,MHCI2 and MHD for the prediction of good or poor closure showed that area under the curve (AUC) was 0.928,0.957 and 0.916 respectively,and 0.505,0.67 and 559 μm were set as the lower cut-offvalue.The sensitivity was 96.2％,92.3％ and 90.9％ respectively,and specificity was 81.8％,72.7％ and 76.9％ respectively.Accordingly,the ROC curve analysis for the prediction of grade A or B closure showed that AUC was 0.840,0.847 and 0.653 respectively,and 0.705,0.965 and 364 μm were set as the upper cut-off value.The sensitivity was 80.0％,82.9％,63.4％ respectively and specificity was 75.0％,85.7％,65.9％.Conclusion MHCI1 and MHCI2,measured by built-in caliper of OCT software or ImageJ software,both have good predictive efficiency for the anatomical outcomes of MH surgery.