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Objective: To explore the impact of health management measures for entry personnel (entry management measures) against COVID-19 on the epidemiological characteristics of imported Dengue fever in Guangdong Province from 2020 to 2022. Methods: Data of imported Dengue fever from January 1, 2016 to August 31, 2022, mosquito density surveillance from 2016 to 2021, and international airline passengers and Dengue fever annual reported cases from 2011 to 2021 in Guangdong were collected. Comparative analysis was conducted to explore changes in the epidemic characteristics of imported Dengue fever before the implementation of entry management measures (from January 1, 2016 to March 20, 2020) and after the implementation (from March 21, 2020 to August 31, 2022). Results: From March 21, 2020, to August 31, 2022, a total of 52 cases of imported Dengue fever cases were reported, with an imported risk intensity of 0.12, which were lower than those before implementation of entry management measures (1 828, 5.29). No significant differences were found in the characteristics of imported cases before and after implementation of entry management measures, including seasonality, sex, age, career, and imported countries (all P>0.05). 59.62% (31/52) of cases were found at the centralized isolation sites and 38.46% (20/52) at the entry ports. However, before implementation of entry management measures, 95.08% (1 738/1 828) of cases were found in hospitals. Among 51 cases who had provided entry dates, 82.35% (42/51) and 98.04% (50/51) of cases were found within seven days and fourteen days after entry, slightly higher than before implementation [(72.69%(362/498) and 97.59% (486/498)]. There was significant difference between the monthly mean values of Aedes mosquito larval density (Bretto index) from 2020 to 2021 and those from 2016 to 2019 (Z=2.83, P=0.005). There is a strong positive correlation between the annual international airline passengers volume in Guangdong from 2011 to 2021 and the annual imported Dengue fever cases (r=0.94, P<0.001), and a positive correlation also existed between the international passenger volume and the annual indigenous Dengue fever cases (r=0.72, P=0.013). Conclusions: In Guangdong, the entry management measures of centralized isolation for fourteen days after entry from abroad had been implemented, and most imported Dengue fever cases were found within fourteen days after entry. The risk of local transmission caused by imported cases has reduced significantly.
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Animals , Humans , COVID-19 , Aedes , Epidemics , China/epidemiology , Dengue/epidemiologyABSTRACT
Objective To study the endoscopic anatomical characteristics of the upper petroclival and suprasellar region via subtemproal keyhole approach and to explore the clinical feasibility of this approach to these regions.Methods The operation of subtemporal keyhole approach was performed bilaterally in ten adult cadaver heads fixed with formalin and injected with colored emulsion.The anatomical structures in the upper petroclival region under the endoscope and microscope were recorded.Results Without removal of the zygomatic arch,most of structures in upper petroclival region and suprasellar region were observed under endoscope,including bilateral side anatomical structures; and most perforating branch arteries could be clearly displayed.The natural intracephalic spaces,including posterior communicating artery (PcoA)-oculomotor nerve,posterior communicating artery-anterior choroidal artery (AchA) were important spaces.The stripping of petrous apex and posterior clinoid process could be performed to obtain the ideal surgical exposure.The endoscopic structures in upper petroclival region and suprasellar region may be localized by combination of different markers; the bony structure,such as orifice of internal auditory canal,could be applied as markers.Conclusion The endoscope-assisted neurosurgery through subtemporal keyhole approach is very helpful in exposing the lesions of the upper petroclival and suprasellar region,which minimizes the trauma and is useful in practice.
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Objective To study the anatomical features of medial wall of the glomus jugulare to provide the theoretical direction for surgery of the glomus jugulare. Methods Fifteen (30 sides)formalin-fixed adult cadaveric specimens were dissected under the operating microscope, and their structural features of the medial wall of the glomus jugulare and their anastomosis of nerves were observed; and 5 dry skull specimen were also employed to observe the bone landmark of medial wall of the glomus jugulare. Results The medial wall of the glomus jugulare is composed of endocranial opening of the jugular foramen, jugular process of the temporal bone and occipital bone, cerebral dura mater and the Ⅸ, Ⅹ and Ⅺ cranial nerves. A curve line was marked on medial wall of the glomus jugulare, finding that the cranial nerves and the cerebral dura mater are at the anteroinferior position and the posterior-up part is composed of the well of the jugular vein adhered to the petrous bone and cerebral dura mater. Cranial nerve Ⅸ travels at the anterosuperior part of its own fibrous sheath and the inferior petrosal sinus ostium separates it from cranial nerves Ⅹ and Ⅺ; cerebral dura mater separates the cranial nerves Ⅸ and Ⅹ. The cranial nerve Ⅹ and the accessory nerve are closely related. Interval of cerebral dura mater between cranial nerve Ⅸ and Ⅹ is clearly seen in 86.67％ (26/30) patients and illegible in 13.33％ (4/30). Hypoglossal canal travels of the bottom of the medial wall of the glomus jugulare. Conclusion The medial wall of the glomus jugulare is composed of endocranial opening of the jugular foramen,jugular process of the temporal bone and occipital bone, cerebral dura mater and the Ⅸ, Ⅹ and Ⅺ cranial nerves, and this information can help the clinicians during the operations of the jugulare foramen, so that the operation complications can be reduced.
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Objective To discuss how to protect the intracranial vertebral artery and posterior inferior cerebellar artery by observing and measuring the intracranial vertebral artery in the surgery adopt far lateral approach. Methods Mimicking far lateral approach, 20 adult cadaveric heads connected to neck fixed with 10% formalin were dissected. Intracranial segment of the vertebral arteries and their main branches were exposed and measured under operating microscope. Results The intracranial vertebral artery joined with the contralateral one into the basilar artery after traveling through the atlanto-occipital sulcus. The relationship between the vertebral artery and the hypoglossal nerve is close. Thirty sides (75%) of the vertebral arteries traveled to pons medulla sulcus in front of the hypoglossal nerve roots and 2 sides (5%) behind the hypoglossal nerve roots, while 8 sides (20%) traveled among the hypoglossal nerve roots; 70% of the vertebral arteries were contacted to the hypoglossal nerve roots, 30% of which compressed the hypoglossal nerve. The main branches of intracranial segment of the vertebral arteries were the posterior inferior cerebellar arteries, the anterior spinal arteries, the posterior meningeal arteries,and some perforating arteries. Posterior inferior cerebellar arteries all originated from the intracranial vertebral artery were the largest vertebral artery's branches; their trip was mostly loop-shaped and they had close relationship with Ⅸ, Ⅹ, Ⅺ cranial nerves. The starting points of the posterior inferior cerebellar arteries were different, even in the same specimen, but most of them originated from the upper 1/3intracranial vertebral artery. No anterior inferior cerebellar artery was noted originated from the vertebral artery in our specimen. Anterior spinal arteries originated from the vertebral arteries joined with the branches of the bilateral vertebral arteries and traveled down through the tortuous anterior median fissure to supply the spinal cord. Conclusion Being familiar with the characteristics and anatomic vertebral arteries variations of the intracranial vertebral artery and its branches can contribute to identify and protect the intracranial segment of the vertebral artery and its main branches in the surgery adopt far-lateral approach.
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Objective To provide an anatomical basis for endoscope-assisted presigmoid-retrolabyrinthine keyhole approach to the petroclival region. Methods Ten formalin-fixed adult cadaver heads were used in this study. A C-shaped postauricular skin incision about 6 cm in length was made to expose the anatomic structures, which were observed under microscope and endoscope. Results The distance from the anterior margin of the sigraoid sinus to the most posterior point of the posterior semicircular canal was 9.1±1.3 mm on the right and 9.6±1.8 mm on the left side. With appropriate adjustment of the endoscope and the angle of the microscope, the presigmoid-retrolabyrinthine keyhole approach allowed good exposure of the important structures in the petroclival region with also clear display of the cranial nerves and the adjacent blood vessels. Conclusion The facial and vestibulocochlear nerves and the posterior orifice of the internal auditory canal can be used as the landmarks for localization of the peroclival region and its surrounding structures.
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Objective To observe the anatomic and imaging morphology ofjugnlar bulb and its relationship with the surrounding structures, and to investigate the classification ofjugnlar bulb and its clinical significance. Methods We dissected 30 human temporal bones and studied multi-slice spiral CT imaging data of temporal bone of 120 cases and blood vessel cast mould specimen of the jugular bulb of 6 cases, to observe the morphology of jugnlar bulb and its spatial relationship with the surrounding structures. We made an imagined sagittal plane on the medial well of the tympanic cavity, with a horizontal tangent line of the proximal wall of the tympanic cavity and a vertical tangent line of the posterior wall of the tympanic cavity as coordinate axes (X axis and Y axis), respectively, so the 4 quadrants ( Ⅰ , Ⅱ, Ⅳ, Ⅳ) were formed. The jugular bulb was classified intro 4 types according to the quadrant where its top was projected and subtyped according to its position on the inner or outer side of the plane. The operation via mastoid approach was simulated on specimen to observe the effect of jugnlar bulb on the operation route. Results Some jugular bulbs were flat type and others were prominent types. The classification in the group of CT image: type Ⅰ , 11 case (9%);type Ⅱ, 63 cases (53%);type Ⅲ, 25 cases (21%);type Ⅳ, 21cases (17%). The classification in the group of specimen: type Ⅰ, 1 case (3%);type Ⅱ, 11 cases (37%);type Ⅲ, 8 cases (27%);type Ⅳ, 10 cases (33%). Each type of the jugular bulb had different effects on the operative approach. Conclusions The classification method with the 4 quadrants is a simple and three-dimensional way to describe the position of the jugular bulb for imaging diagnosis or operative scheme design.