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1.
Статья в английский | WPRIM | ID: wpr-922589

Реферат

OBJECTIVES@#Vagus nerve stimulation (VNS) is a neuromodulative therapeutic technique for patients with drug-resistant epilepsy who are not suitable for resection or who have experienced a failed resection. This study aims to explore the efficacy and safety of VNS in patients with refractory epilepsy, and to analyze the influential factors for the efficacy.@*METHODS@#A retrospective review of clinical data were conducted for 35 patients, who were treated for refractory epilepsy through VNS surgery in the Department of Neurosurgery, Xiangya Hospital, Central South University from April 2016 to August 2019. All patients were analyzed in terms of the clinical and follow-up data.@*RESULTS@#After a mean follow-up of 26 months (6-47 months), outcome was as follows: 7 patients were MuHugh class I, 13 patients were MuHugh class II, 8 patients were MuHugh class III, and 7 patients were MuHugh class IV-V. The total efficacy rate in the short duration group was significantly higher than that in the long duration group (77.8% vs 50.0%, @*CONCLUSIONS@#VNS is a safe and effective option in treating patients with refractory epilepsy, especially for those with short duration.


Тема - темы
Humans , Drug Resistant Epilepsy/therapy , Magnetic Resonance Imaging , Retrospective Studies , Seizures , Treatment Outcome , Vagus Nerve Stimulation
2.
Chinese Journal of Neuromedicine ; (12): 1104-1108, 2020.
Статья в Китайский | WPRIM | ID: wpr-1035328

Реферат

Objective:To investigate the predictive value of trigeminal nerve vascular compression grading evaluated by preoperative magnetic resonance imaging (MRI) in patients with trigeminal neuralgia (TN) after microvascular decompression (MVD).Methods:Two hundred and seventy patients with TN accepted MVD in our hospital from January 2015 to December 2017 were chosen in our study; their clinical and MRI data were retrospectively analyzed. By referring to Sindou's method and Jannetta standard, these patients were divided into patients with mild vascular compression ( n=71) and patients with severe vascular compression ( n=199) according to preoperative MRI data; these patients were divided into typical TN patients ( n=219) and atypical TN patients ( n=51) according to their symptomatic characteristics; the differences in prognoses after one year of follow-up were compared among patients from different categories. Results:The degree of intraoperative vascular compression was basically consistent with the preoperative imaging evaluation results, and the intraoperative vascular compression in 256 patients was consistent with preoperative imaging evaluation grading, with a coincidence rate of 94.8% (256/270). The difference in prognosis between patients with mild vascular compression and patients with severe vascular compression was statistically significant ( Z=-3.420, P=0.001), and the mean rank indicated that the prognosis of patients with severe vascular compression was better than that of patients with mild vascular compression (142.01 vs. 117.25). The prognosis difference between typical TN patients and atypical TN patients was statistically significant ( Z=-5.810, P=0.000), and the mean rank indicated that the prognosis of typical TN patients was better than that of atypical TN patients (144.45 vs. 97.08). Conclusions:Preoperative MR imaging evaluation is a reliable method to assess the degree of vascular compression. Patients with severe vascular compression and typical TN have high postoperative pain relief rate after MVD.

3.
Chinese Journal of Neonatology ; (6): 201-204, 2017.
Статья в Китайский | WPRIM | ID: wpr-610426

Реферат

Objective To study the clinical characteristics of neonatal pertussis.Method From January 2011 to December 2015,clinical data of newborns with pertussis treated in our hospital were retrospectively analyzed,including the general information,clinical manifestations,laboratory examinations,treatment and prognosis.Result A total of 68 newborns with pertussis were found during the study period,including 1 case in 2011,5 cases in 2012,1 case in 2013,18 cases in 2014 and 43 cases in 2015.The time needed for diagnosis was 7 to 35 days after onset of symptoms,and 80.9% (55/68) in 14 days.The predominant manifestation was paroxysmal cough (68 cases,100%).Other common symptoms included flushing in 45 cases (66.2%) and cyanosis with coughing in 40 cases (58.8%).The uncommon symptoms included whooping cough (20 cases,29.4%),wheezing (10 cases,14.7%),fever (3 cases,4.4%) and apnea with decreased heart rate during cough (2 cases,2.9%).12 patients (17.6%) had elevated peripheral white blood cells or lymphocytes.The clinical manifestations didn't disappear despite erythromycin therapy,and the whooping cough continued for 12 to 42 days during the course of disease.22 cases (32.4%) had complications,including pneumonia in 12 cases,myocardial damage in 10 cases,heart failure in 2 cases,respiratory failure in 1 case,atrial tachycardia in 1 case and lung consolidation in 1 case.Conclusion Neonatal pertussis is not uncommon and has a tendency to increase year by year,and it's challenging for early diagnosis.The patients who have a whooping cough without fever should be considered of pertussis until otherwise ruled out.Leukocyte and lymphocyte count are of little value in the diagnosis of this disease.

4.
Статья в Китайский | WPRIM | ID: wpr-746912

Реферат

OBJECTIVE@#Aimed to analyse the clinical features of the patients with sphenoid sinus mucocele, achieve earlier diagnosis and more timely intervention and decrease the occurrence of misdiagnoses.@*METHOD@#A retrospective study was first conducted in patients with sphenoid sinus mucoele treated in Xiangya hospital from Jan 2000 to Jan 2015. Then literature reports on this disease were collected and analyzed from China National Knowledge Infrastructure (CNKI) and Wan Fang database.@*RESULT@#We collected 82 patients with sphenoid sinus mucocele treated in Xiangya hospital. There were 52 patients presented with headache, 31 patients presented with visual impairment, 10 patients presented with cranial nerve palsy, 2 patients presented with exophthalmos, 15 patients presented with nasal symptoms, and 5 patients with no obvious symptoms. There was no significant difference for symptoms distribution between male and female patients (P > 0.05). Among 45 patients with headache as first symptom and 10 patients with ethmoid sinus mucocele, there were 18 patients and 8 patients subsequently suffering from visual impairment, respectively. We also collected 161 patients in literature except for enrolling, the 82 patients treated in Xiangya hospital, and found that headache was the most common symptom, followed by visual impairment, in the two independent cohorts.@*CONCLUSION@#To the best of our knowledge, this is the study of maximum sample for sphenoid sinus mucocele in China. Headache and visual impairment are the most common symptoms for sphenoid sinus mucocele. Surgical treatment should be early performed when the desease accompanied with headache or ethmoid sinus mucocele, to avoid other complications such as visual impairment and even blindness.


Тема - темы
Female , Humans , Male , China , Cranial Nerve Diseases , Databases, Factual , Diagnostic Errors , Ethmoid Sinus , Exophthalmos , Headache , Mucocele , Diagnosis , Pathology , Paranasal Sinus Diseases , Retrospective Studies , Sphenoid Sinus , Pathology , Vision Disorders
5.
Статья в Китайский | WPRIM | ID: wpr-747891

Реферат

OBJECTIVE@#To summarize and analyze the clinical characteristics of Mondini dysplasia with cerebrospinal fluid leakage, as well as preliminarily investigate the genetic mechanism of the disease.@*METHOD@#The clinical data of 2 patients diagnosed as Mondini dysplasia with cerebrospinal fluid leakage treated in our hospital were analyzed. Blood samples of these two patients were obtained to extract DNA. We screened DNA samples for gene SLC26A4 mutations by using polymerase chain reaction and direct sequencing. The sequencing results were analyzed in DNASTAR software.@*RESULT@#Both patients came to our hospital because of recurrent meningitis, and the fistula were both located in vestibular window. Patients were cured one-time after surgical closure of the leakages with temporalis + temporalis fascia + temporalis through the mastoid approach. No pathogenic mutations of gene SLC26A4 with exome sequencing were found.@*CONCLUSION@#Mondini dysplasia with cerebrospinal fluid leakage should be considered in patients with recurrent meningitis and hearing disorder. Temporal bone HRCT is helpful to the diagnosis. Surgical closure is an effective therapeutic method and may prevent recurrent meningitis. The molecular mechanism of simple Mondini dysplasia needs further study.


Тема - темы
Humans , Cerebrospinal Fluid Leak , Cochlea , Pathology , Fistula , Pathology , Hyperplasia , Genetics , Membrane Transport Proteins , Genetics , Meningitis , Mutation , Sulfate Transporters
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