A quantitative study on evaluation of child diffuse axonal injury severity by using MR diffusion tensor imaging / 重庆医学

Objective To compare the value of fractional anisotropy(FA)of MR diffusion tensor imaging(DTI) and Glasgow coma scale(GCS) at admission for judging the injury severity and prognosis of diffuse axonal injury (DAI). Methods Thirty-four patients with DAI adopted the GCS score to evaluate the conscious disturbance levels at admission and conducted the DTI examination within 2 weeks. Twenty-three individuals undergoing healthy physical examination conducted the DTI examination. The FA values of visuality lesion area in various sites,healthy side symmetric site and cerebral midline site were measured. The reduction degree of mean FA value at midline site and visuality lesions were measured. The correlation between GCS score,mean FA value reduction degree in visuality lesions and mean FA value at cerebral midline site with consciousness disorder time and recovery degree in half a year after injury was analyzed. Results The reduction degree of mean FA value at cerebral midline site was significantly correlated with consciousness disorder time and recovery degree in half a year after injury(r= 0. 519,P=0. 002; r= 0. 669, P=0. 000) ;the mean FA value reduction degree in visuality lesions and GCS score had low or weak correlation with consciousness dis order time and recovery degree in half a year after injury(r=0. 285,P=0. 103;r=0. 487,P=0. 003;r= -0. 241,P=0. 169;r=-0. 229,P=0. 192). The correlation between mean FA reduction degree in cerebral midline site and mean FA value reduction degree in visuality lesions with the recovery degree in a half years after injury was higher than that in GCS score. Conclusion DTI is a sensitive sequence for diagnosing DAI and has much more value for judging the injury degree and prognosis than the GCS score generally adopted by clinic.

Applicational research progress of Glasgow Coma Scale, Children Coma Scale and Trauma Infant Neurologic Score in children with traumatic craniocerebral injury / 中华实用儿科临床杂志

Traumatic craniocerebral injury is one of serious injury which can cause great damage to human life and health even lead to disability or death.Making an objective and accurate judgement of severity and prognosis for traumatic craniocerebral injury in children,which might play an important role in the clinical treatment and prognosis.As a physical scoring indicator system of traumatic craniocerebral injury,the earliest and most widely used one is Glasgow Coma Scale.The Children Coma Scale is particularly used for children under 4 years old and the Trauma Infant Neurologic Score for infants with traumatic craniocerebral injury.Thus,these 3 scoring systems present advantage and representative in clinical application.Here we make a brief review on these 3 scoring systems based on the current studies and applications.

Improvement of teaching methods of minimally invasive neurosurgery / 中华医学教育探索杂志

Minimally invasive neurosurgery techniques developing by leaps and bounds in the past few years,which is to be a great challenge for the clinical teaching of neurosurgery.Based on their own actual,neurosurgery department of the Children's hospital of Chongqing medical university enriched the teaching contents,improved teaching methods and trained microsurgical techniques for doctors at various levels,meanwhile,it strengthened participants'sterile awareness,set good team spirit,developed individualized assessment standards and achieved good results.

Treatment of acute traumatic subdural hematomas in infants / 中华创伤杂志

Objective To investigate the clinical features of acute traumatic subdural hematomas (SDH) in infants and discuss the treatment methods. Methods The clinical features of 48 infants under three years old with acute traumatic SDH admitted from 2002 to 2008 were retrospectively analyzed.Results There were 31 infants under one year old (65%). The most popular injury cause was accidental fall in 37 patients (77%). Of all patients, 12 patients (25%) had disturbance of consciousness,eight ( 17% ) had convulsion and eight ( 17% ) were combined with skull fractures. The treatment methods included craniotomy and evacuation of the blood clot in 18 patients ( including 13 patients underwent instant operation after admission ), burr hole craniotomy and external drainage of the chronic subdural hematoma in seven and conservative management in 23 with small subdural hematomas. All patients obtained good outcome except that two patients had motor dysfunction and one death. Conclusions The incidence of acute traumatic SDH in infants is high, especially in infants under one year old. It is easy to be disregarded at early stage and may deteriorate to chronic subdural hematoma or hydropsy. Early diagnosis and active surgical treatment may attain sound prognosis.

Diagnosis and Treatment of Closed Pancreatic Injury / 中国医师杂志

Objective To discuss the experience of the diagnosis and treatment of closed pancreatic injury.Methods Clinical data of 35 cases of closed pancreatic injury in recent 22 years were reviewed. All cases underwent surgical treatment.Results Of the 35 cases,33(94 3%)were cured ,19(54 3%)developed into surgical complications including 8 cases of pancreatic fistulas ,4 cases of abdominal abscesses and 4 cases of pancreatic pseudocysts Two cases died and the mortality was 5 7%.Conclusions Early diagnosis for pancreatic trauma is difficult. Exploratory is the most simple and effective method for early diagnosis.Whether the operation in time and rational could be a key factor of the prognosis.

Occult breast cancer:a report of 28 cases / 中国普通外科杂志

Objective To evaluate special diagnosis and treatment of occult breast cancer. MethodsDiagnostic means used included breast roentgenography,selective mammary ductography, fine needle aspiration and excision biopsy in 28 cases. ResultsBreast roentgenography detected 4 cases ( 7/16), selective mammary ductography identified 4 cases(4/6). The definite diagnosis rate by lump biopsy and immunohistochemistry was 10 cases (10/13). Postoperative follow-up was abtained in 18 cases,with 5 dying of recurrence or distant metastases. Among them 4 patients underwent only axillary node excision. Conclusion Nipple discharge,localized thickening the gland are very important clue to the diagnosis of occult breast cancer.Lump biopsy and immunohistochemistry is a mainstay for the final establishment of the diagnosis of breast cancer. Radical or modified radical mastectomy with adjuvant radiotherapy and chemotherapy is a suitable treatment modality for occult breast cancer.