ObjectiveTo explore the pathogenesis of cervical spondylosis combined with cervicogenic vertigo, and to investigate the clinical results of anterior discectomy and fusion in treating the disease. MethodsA retrospective study was performed on 83 patients with cervical spondylosis myelopathy (n=60, 72%) or radiculopathy (n=23, 37.3%) accompanied by sympathetic symptoms such as dizziness between March 2008 and November 2012. The disease involved single segment in 29 cases, double segment in 50 cases, and triple in 4 cases. All the segments involved were treated with anterior discectomy and fusion. Vertigo alleviation was observed before surgery, 3 days after surgery, and during the final follow-up. Neurological status was evaluated by Japanese Orthopedic Association (JOA) score system and sympathetic symptoms were evaluated with vertigo symptom and function scoring system. ResultsThe average follow-up was 21 months (ranging from 12 to 30 months). Significant difference was observed between sympathetic symptom scores and JOA scores before surgery and 3 days after surgery or at the final follow-up (P<0.05), but no significant difference was found between the scores 3 days after surgery and during the final follow-up (P>0.05). ConclusionThe surgical effect for cervicogenic vertigo is often accompanied by the relief of spinal cord and nerve roots symptoms. Surgery is effective for cervical spondylosis combined with cervicogenic vertigo.
Objective To analyze the clinical characteristics and the treatment of 20 confirmed A/H1N1 flu cases of serious conditions. Methods The 20 confirmed A/H1N1 flu cases of serious conditions were collected and we analyzed their Clinical characteristics, treatment and prognosis. Results The 20 cases of serious conditions were given Oseltamivir, endotrachealintubation, ventilator ventilator assistant, high dose intravenous injection of Gamma-globulin/ albuminum/plasam of A/H1N1 flu rehabilitation, appropriate liquid recovery and hypothermic treatment, etc. A total of 19 of 20 confirmed A/H1N1 flu cases of serious conditions were cured and 1 case died. Conclusion The intent observation, early detection and early intervention are very helpful for A/H1N1 flu cases of serious conditions.
目的 总结甲状腺功能亢进性肝功能损害 （ HLI ） 的临床特点和治疗方案。 方法 对2008年1月－2010年12月诊治的49例HLI患者临床资料进行回顾性总结分析，据其治疗方案的不同分抗甲状腺治疗组和单纯保肝治疗组，比较二组患者治疗后肝功能恢复情况。 结果 所有患者入院时均存在不明原因肝功能不全，而后明确为HLI。其中女29例（59.2%），男20例（40.8%），年龄10～70岁，平均45岁。 症状主要表现为体重下降（65.3%），心悸（51.1%），怕热多汗（49.0%）， 厌油纳差、食欲减退 （44.9%）。主要体征包括甲状腺肿大（36.7%），双下肢水肿（24.5%），心界扩大（16.3%），皮肤巩膜黄染（14.3%），肝脾肿大（12.2%）等。肝功能检验异常主要表现为谷丙转氨酶升高（68.9％），谷草转氨酶升高（57.8％）为主，其次是谷氨酰转移酶（69.4%）、直接胆红素（59.2%）、总胆红素（44.9%）、碱性磷酸酶（42.9%）、乳酸脱氢酶（26.5%）升高，以及白蛋白（32.7%）下降。死亡3例，病死率6.1%。采用Wilcoxon秩和检验结果提示抗甲状腺治疗组的总胆红素和直接胆红素低于单纯保肝治疗组，组间差异有统计学意义（P＜0.05）。 结论 此类患者可同时具备甲状腺功能亢进和肝功能不全的临床表现，肝功能常表现为淤胆型肝炎。HLI总体预后较好，抗甲状腺治疗是该病的关键。
ObjectiveTo analyze the clinical presentations and radiological characteristics of pulmonary vein stenosis after radiofrequency ablation. MethodsClinical and radiological data of 2 patients with pulmonary vein stenosis after radiofrequency ablation for atrial fibrillation were retrospectively analyzed and literatures were reviewed. ResultsBoth patients had undergone circumferential pulmonary vein isolation. The symptoms appeared approximately 2 months after the operation. The major symptoms were cough, hemoptysis, exacerbation of dyspnea and chest pain. Both patients were misdiagnosed as other diseases such as pneumonia in other hospitals, and the anti-infection therapy was invalid. Both CT scans showed parenchymal exudative consolidation with varying degrees of interstitial septal thickening and small nodules. Both patients were confirmed as pulmonary vein stenosis by CT angiography. Literature review identified 21 cases of pulmonary vein stenosis after radiofrequency ablation for atrial fibrillation. The main clinical features are hemoptysis, chest pain, shortness of breath and cough. The most common features of thoracic radiological imaging are consolidation, groud-glass attenuation, pleural effusion and interstitial septal thickening. ConclusionsIf a patient presents with hemoptysis, dyspnea, chest pain or other clinical manifestations after ablation therapy and image findings show parenchymal exudative consolidation with interstitial septal thickening and multiple small nodules, the possibility of pulmonary vein stenosis should be considered. Contrast-enhanced CT combined with pulmonary vein imaging technology can clearly show the opening diameter of each pulmonary vein and its branches, so it is an important non-invasive examination method for the evaluation and diagnosis of pulmonary vein stenosis.
ObjectiveTo discuss the clinical characteristics of liver cirrhosis in elderly patients. MethodsWe retrospectively analyzed the clinical data of 67 patients (elderly group) with liver cirrhosis aged ≥60 treated between January 1998 and December 2010. Then, we compared these cases with another 72 liver cirrhosis patients (non-elderly group) aged<60. ResultsThe incidence of jaundice, ascites and albumin deficiency in the elderly patients was significantly higher than that in the non-elderly patients (P<0.05). Complications in the elderly group were relatively more, including electrolyte imbalance, infections, gastrointestinal bleeding, hepatic encephalopathy, liver cancer, liver and kidney syndrome and liver and lung syndrome, and the incidence of these complications was all significantly higher than the non-elderly group (P<0.05) except the liver and kidney syndrome (P>0.05). The causes of liver cirrhosis in both groups were similar. The most common cause was hepatitis B virus infection, followed by chronic alcoholism, but in the elderly group, chronic alcoholism, cholestasis, poisoning from medicines and poisons and liver blood circulation disorders were more common than the non-elderly group (P<0.05); hepatitis B and non-alcoholic fatty hepatitis were more common in the non-elderly group than in the elderly group (P<0.05). The elderly group had more Child-Pugh class C cases (P<0.05), while there were more class A cases in the non-elderly group (P<0.05). Twenty-six patients died in the elderly group with a mortality rate of 38.8%; while only 13 died in the non-elderly group with a mortality rate of 18.1%. The difference of mortality rate was significant between the two groups (P<0.05). Common causes of death in the elderly group were infection, hepatic encephalopathy, and electrolyte disorders and gastrointestinal bleeding, while the common causes of death in the non-elderly group were gastrointestinal bleeding and electrolyte disorders. ConclusionThe etiology, clinical manifestations and prognosis of liver cirrhosis in elderly patients differ from those in younger patients. We must pay more attention on treating complications of liver cirrhosis in elderly patients.