Objectives: To investigate the risk factors, clinical presentation, neuroimaging features, treatment, and prognosis of patients with cerebral venous sinus thrombosis (CVST). Methods: We retrospectively analyzed the data of 19 patients with a diagnosis of CVST admitted to Beijing Chao-Yang Hospital affiliated to Capital Medical University, Beijing, China between January 2010 and December 2013. Results: There were 9 men and 10 women (age range: 27-75 years). Headache (84.2%) and focal signs (57.9%) were the 2 most common symptoms. Direct evidence of thrombosis was found on CT in 42.1%, and on MRI in 52.6%. Two or more sinuses were involved in 78.9% of cases, in which the transverse sinus plus sigmoid sinus were the most commonly involved combination. All patients received anticoagulant therapy. Most patients (84.2%) had no neurological sequelae at discharge, and only 3 patients (15.8%) recovered with sequelae. Conclusion: Our study provides detailed information on the clinical manifestations, neuroimages, management, outcome, and risk factors of the patients with CVST.

In order to investigate the prevalence of lower-extremity deep venous thrombosis (DVT) and to explore its possible reasons in children patients who received neurosurgery operation. Clinical data of 4958 cases children patients with lower-extremity DVT and without the thrombosis after the neurosurgery operation from 2010 January to 2014 December in department of neurosurgery of Tian Tan hospital were collected and analyzed. 18 cases children were diagnosed with lower-extremity DVT. All of them had invasive operation of lower-extremity deep venous catheterization. The mainly primary diseases of thrombosis children were craniopharyngioma. They have longer operation time compared with those without thrombosis (P<0.05). Therefore, the causes of DVT in neurosurgical children involve not only deep venous catheter-related but also neurological primary disease and operation time.

Background: Laparoscopic common bile duct exploration (LCBDE) has already been established for the treatment of patients with common bile duct stones (CBDS) in elective situations. However, the effect of emergent LCBDE on those patients with nonsevere acute cholangitis has not been assessed. The aim of this study was to evaluate the effect of emergent LCBDE on patients with nonsevere acute cholangitis complicated with CBDS.Methods: Seventy-two patients with CBDS admitted from January 2009 to December 2012 were included for this retrospective study. LCBDE of transductal approach for CBDS was performed to all patients. Thirty-seven patients underwent emergent LCBDE for nonsevere acute cholangitis and 35 patients underwent elective LCBDE. Duration of the procedure, complications, retained stone of bile duct, hospital stay, and total charges were compared between the two groups. In addition, the characteristics of patients underwent emergent LCBDE were also compared before and after surgery.Results: There was no significant difference with regard to the diameter of common bile duct and number of CBDS from imaging and/or operative findings between the two groups. There was no conversion to open common bile duct exploration, no major bile duct injuries, and no mortality in both the group of patients. There was no significant difference in patients with or without acute or chronic cholecystitis, duration of surgery, overall hospital stay (16.41 +/- 1.03 versus 14.54 +/- 0.94, P > 0.05), and total charges (18,603 +/- 1774.64 versus 14,951 +/- 1257.09 Yuan in renminbi, P > 0.05) between the two groups. Four cases with retained stones were found in patients with emergent LCBDE and two in elective LCBDE patients. There were four cases of biliary leak in patients with emergent LCBDE and three cases in elective LCBDE group, respectively. However, there was no statistical difference between the two groups. The biliary leak was cured postoperatively after drainage. Control of septic symptoms was achieved in all patients after emergent LCBDE.Conclusions: Our data indicated that emergent LCBDE is as safe and effective as elective LCBDE for the treatment of patients with nonsevere acute cholangitis complicated with CBDS. (C) 2014 Elsevier Inc. All rights reserved.

BACKGROUND:A wealth of evidence from animal experiments has indicated that hypertonic saline (HS) maybe a better choice for fluid resuscitation in traumatic hypovolemic shock in comparison with conventional isotonic saline. However, the results of several clinical trials raised controversies on the superiority of fluid resuscitation with HS. This meta-analysis was performed to better understand the efficacy of HS in patients with traumatic hypovolemic shock comparing with isotonic saline. MATERIALS AND METHODS:According to the search strategy, we searched the PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials, which was completed on October 2013. After literature searching, two investigators independently performed the literature screening, assessment of quality of the included trials, and data extraction. Disagreements were resolved by consensus or by a third investigator if needed. The outcomes included mortality, blood pressure, fluid requirement, and serum sodium. RESULTS:Six randomized controlled trials were included in the meta-analysis. The pooled risk ratio for mortality at discharge was 0.96 (95% confidence interval [CI], 0.82-1.14), whereas the pooled mean difference for the change in systolic blood pressure from baseline and the level of serum sodium after infusion was 6.47 (95% CI, 1.31-11.63) and 7.94 (95% CI, 7.38-8.51), respectively. Current data were insufficient to evaluate the effect of HS on the fluid requirement for the resuscitation. CONCLUSIONS:The present meta-analysis was unable to demonstrate a clinically important improvement in mortality after the HS administration. Moreover, we observed HS administration maybe accompanied with significant increase in blood pressure and serum sodium.

Background: A wealth of evidence based on the randomized controlled trials (RCTs) has indicated that surgery may be a better choice in the management of primary intracerebral hemorrhage (ICH) compared to conservative treatment. However, there is considerable controversy over selecting appropriate surgical procedures for ICH. Thus, this meta-analysis was performed to assess the effects of stereotactic aspiration compared to craniotomy in patients with ICH.Methods: According to the study strategy, we searched PUBMED, EMBASE and Cochrane Central Register of Controlled Trials. Other sources such as the internet-based clinical trial registries, relevant journals and the lists of references were also searched. After literature searching, two investigators independently performed literature screening, assessment of quality of the included trials and data extraction. The outcome measures included death or dependence, total risk of complication, and the risk of rebleeding, gastrointestinal hemorrhage and systematic infection.Results: Four RCTs with 2996 participants were included. The quality of the included trials was acceptable. Stereotactic aspiration significantly decreased the odds of death or dependence at the final follow-up (odds ratio (OR): 0.80, 95% confidence interval (CI): 0.69-0.93; P = 0.004) and the risk of intracerebral rebleeding (OR: 0.44, 95% CI: 0.26-0.74; P = 0.002) compared to craniotomy with no significant heterogeneity among the study results.Conclusions: The present meta-analysis provides evidence that the stereotactic aspiration may be associated with a reduction in the odds of being dead or dependent in primary ICH, which should be interpreted with caution. Further trials are needed to identify those patients most likely to benefit from the stereotactic aspiration.

Objective To observe the change and influence factors of serum gastrin(GAS)levels in patients with acute cerebral infarction.Methods The serum GAS levels of 24 hours and one week after admission in 95 patients with acute cerebral infarction and 51 control subjects were measured by RIA.Results The GAS levels were significantly elevated after onset of patients with acute cerebral infarction,in which was no significant difference between male and female.The GAS levels of patients with gastrointestinal symptoms were higher than those without symptoms.The levels of GAS in patients without gastrointestinal symptoms within one week showed an increase tendency compared with the levels of 24 hours.The serum gastrin levels in patients with brainstem and lobar infarct were significantly increased.Conclusion The GAS Levels in patients with acute cerebral infarction keep at high levels,which can basically rule out the simple result of the impact stress.The level of GAS may be associated with the infarction region,and the acute cerebral infarction complicated with gastrointestinal dysfunction was related to the hypergastrinemia.

Objective To evaluate the neurological deep venous thrombosis in patients with permanent cava filter to prevent pulmonary embolism and explore the nursing character.Methods In our hospital from October 2005 to November 2009 neurological patients admitted in the treatment of deep venous thrombosis, select one of 60 cases to use permanent cavity filter. Nursing care, operation and follow-up data were analyzed.Results All 60 patients have successful filter placement, no acute thrombosis occurred without symptomatic pulmonary embolism. Follow up 1 to 36 months, and no filter migration occurred with serious complications.Conclusions For the patients not able to receive anticoagulant therapy for neurological deep venous thrombosis, permanent cava filter implantation is a safe and effective preventive measure to prevent pulmonary embolism occurred.