[Operative strategies for bilateral brain contusion and laceration].

OBJECTIVE: To explore the operative strategies for bilateral brain contusion and laceration and evaluate their clinical significance. METHODS: Based on the clinical manifestations, computed tomography (CT) and intracranial pressure (ICP), different operative strategies were applied to 25 cases of bilateral brain contusion and laceration. The strategies were classified into 6 types according to the principles of decompression and brain protection.All cases received routine treatments at neurosurgical intensive care unit (ICU) ward. And the occurrences of operative complications and 6-month Glasgow outcome scale (GOS) were statistically analyzed. RESULTS: Type 1:4 cases of unilateral decompressive craniectomy without resection of contusion focus; Type 2:8 cases of unilateral decompressive craniectomy with resection of bilateral contusion focus; Type 3:5 cases of bilateral decompressive craniectomy with resection of unilateral brain contusion; Type 4:5 cases of bilateral decompressive craniectomy; Type 5:1 case of bilateral brain contusion resection; Type 6:2 cases of bilateral decompressive craniectomy and brain contusion resection.Postoperative complications such as epilepsy, expanding contusion foci, brain infarction, encephalocele, incisional CSF leakage, intracranial infection, subdural hydroma and hydrocephalus were rare. The 6-month GOS revealed 6 cases of good outcome (n = 6), moderate disability (n = 8), severe disability (n = 3) and vegetative status (n = 5) and death (n = 3). CONCLUSION: Different operative strategies may be applied for severe brain contusion and laceration according to their clinical manifestations, CT findings and ICP values. And the efficacies are improved by operative strategies based on the principles of ICP control, prevention of secondary injury and brain function preservation.

Propensity score matching comparing short-term nerve electrical stimulation to pulsed radiofrequency for herpes zoster-associated pain: A retrospective study.

Background: Zoster-associated pain (ZAP) is notoriously difficult to treat. Pulsed radiofrequency (PRF) and short-term nerve electrical stimulation (st-NES) have been proven effective treatments for ZAP. However, it is still unclear which technique provides improved analgesia in ZAP. This study is based on a large-scale, long-term follow-up to evaluate the efficacy and safety between st-NES and PRF. Materials and methods: All eligible ZAP patients treated with st-NES or PRF in our department were enrolled. Cohorts were divided into the st-NES group and the PRF group. A 1:1 ratio propensity score matching (PSM) was used to balance the baseline characteristics. The PS-matched cohort was adopted to investigate the efficacy and safety of the two treatments. The ordinal regression analysis was performed to determine the variables affecting the treatment effect of ZAP. Results: A total of 226 patients were included after PSM. The numerical rating scale (NRS) scores in st-NES and PRF groups considerably reduced compared to baseline levels after treatment. The NRS scores in the st-NES group were obviously lower than those in the PRF group at discharge, 1, 3, 6, 12, and 24 months. During the follow-up period, the NRS reduction rate remained higher in the st-NES group than in the PRF group (P < 0.01). The dosage of medication, Pittsburgh Sleep Quality Index (PSQI) score, and the number of patients with aggravated pain after discharge in the st-NES group were significantly less than in the PRF group after treatment. Conclusion: Short-term nerve electrical stimulation has been shown to be more advantageous than PRF for pain relief and quality of life improvement for ZAP patients.

[Significance of urinary nuclear matrix protein 22 in diagnosis of transitional cell carcinoma of urinary tract].

BACKGROUND & OBJECTIVE: There is no effective non-invasive monitoring method for transitional cell carcinoma of urinary tract(TCCU). It was recently reported that nuclear matrix protein 22(NMP22) could be used to diagnose TCCU. This study was designed to evaluate the significance of NMP22 in TCCU as a new urinary tumor marker and its influence factors. METHODS: The authors detected 87 patients with urinary system disease(including 29 cases with TCCU) with ELISA-NMP agent box. The patients with urinary infection were excluded. RESULTS: The positive value was set at more than 10 u/ml. The sensitivity and specificity of NMP22 on TCCU were 86.2% and 94.3%, respectively (benign diseases of urinary system used as control), with significant advantages over voided-urine cytology (86.2% vs 42.3%, P < 0.001). The main factors that caused false-positive results were urinary infection, the other malignant tumors of urinary system, bowel interposition, and nephrolith. CONCLUSION: Urinary NMP22 is a good tumor marker and could be used an alternation of voided-urine cytology for monitoring and diagnosis of TCCU.