【摘要】 目的 探讨开颅手术夹闭颅内前循环动脉瘤破裂的方法和疗效。 方法 回顾分析2005年1月-2008年1月28例前循环动脉瘤破裂的早期外科手术治疗情况。分析其临床表现、手术入路和预后，用格拉斯哥术后评分量表对术后患者神经功能评分。 结果 28例患者共30个动脉瘤，手术成功夹闭28个，包裹2个。术后3个月内，患者恢复良好15例（53.57%），中度病残7例（25.00%），重度病残5例（17.86%），死亡1例（3.57%）。 结论 早期开颅手术夹闭动脉瘤能减少再出血率和术前死亡率，术后预后较好，是治疗前循环动脉瘤破裂较为理想的方法。【Abstract】 Objective To investigate the clinical strategy and effect of early phase surgery for ruptured cerebral anterior circulating aneurysm. Methods A retrospective analysis was done for 28 patients with ruptured anterior circulating aneurysms who underwent early phase (within 3 days) surgical clipping from January 2005 to January 2008. Their manifestations, surgical approach, and outcomes were analyzed. Glasgow outcome scale (GOS) was used to evaluate patients’ neurological function after operation. Results Among 30 intracranial aneurysms in 28 patients, 28 aneurysms were clipped successfully, and the other 2 were wrapped. One patient (3.57%) died after surgery. The follow-up data showed an excellent outcome was achieved in 15 cases, mild disability in 7 cases, and severe disability in 5 cases. Conclusion Early phase surgical clipping for ruptured cerebral anterior circulating aneurysm can reduce the chance of reruputure of aneurysms and the mortality in preoperative phase with good outcomes. The early phase surgical clipping the aneurysms is considered the feasible opinion.
ObjectiveTo evaluate whether soluble carcinogenesis inhibitor 2 (ST-2) level can be used as indicators for predicting left ventricular dysfunction by detecting sST-2 and other cardiac function indexes in patients with breast cancer who receiving doxorubicin chemotherapy.MethodsA retrospective study of 90 breast cancer patients who received doxorubicin (pyrubicin) chemotherapy in the Department of Breast Surgery, The Fifth Affiliated Hospital of Zhengzhou University from September 2016 to June 2018 was performed. Peripheral venous blood samples were collected before chemotherapy and one year after receiving doxorubicin chemotherapy, to detect sST-2 level and cardiac function indexes, and echocardiography was performed at the same time.ResultsCompared with pre-chemotherapy, sST-2, left ventricular end-systolic volume (LVESV), left ventricular end diastolic volume (LVEDV), left ventricular systolic diameter (LVESD), left ventricular diastolic internal diameter (LVEDD), and E/e' value increased at one year after chemotherapy, while left ventricular eject fraction (LVEF) decreased, the difference was statistically significant (P<0.05). There was a negative correlation between the level of sST-2 and LVEF (r=–0.618, P<0.05). The receiver operating characteristic curve (ROC) showed that the 11.9 ng/mL of sST-2 concentration was the best threshold to predict left ventricular dysfunction, and the sensitivity and specificity were 90.6% and 69.2%, respectively, the area under the ROC curve was 0.836 (P<0.05).ConclusionsST-2 has a certain diagnostic value for predicting left ventricular function and structural changes in breast cancer patients who receiving doxorubicin chemotherapy.
Objective To evaluate the effect and safety of infantile femoral vein blood sampling with vacuum versus disposable needle. Methods Such databases as VIP, CNKI, CBM, Google Academic and Wanfang data were searched to collect the randomized controlled trials (RCTs) about infantile femoral vein blood sampling with vacuum versus disposable needle published from January 2000 to July 2010. The studies were screened according to the inclusive and exclusive criteria, the data were extracted, the methodology quality was assessed, and meta-analysis was conducted by using RevMan 5.0 software. Results A total of 15 RCTs were included. Of 3 490 patients in all, 1 770 were in the treatment group and 1 726 were in the control group. The baseline conditions were reported in 14 studies, and the random methods were mentioned in 11 RCTs. All studies didn’t report the allocation concealment and blind method. Only 2 RCTs reported separately that, the degree of neonatal pain was lower in the treatment group (Plt;0.01), and the satisfaction of parents was higher in the treatment group (Plt;0.01). Four RCTs compared the sampling time between the two groups without meta-analysis mentioned due to the disunity of standard, only the descriptive outcomes showed a shorter time in the treatment group. The meta-analysis showed that, compared with the control group, the reject rate of sample quality was lower (RR=0.20, 95%CI 0.15 to 0.26), the success rate of one time sampling was higher (RR=1.20, 95%CI 1.16 to 1.24), the injury of local tissue was slighter (RR=0.62, 95%CI 0.45 to 0.86), and the iatrogenic contamination was lower (RR=0.62, 95%CI 0.45 to 0.86) in the treatment group. Conclusion This review shows that the vacuum sampling is superior to the disposable needle sampling for domestic infantile femoral vein blood collection. Due to the low quality of the included studies with high possibility of bias, this conclusion needs to be further verified by performing more high-quality studies.