Objectives To observe the distribution of enlarged perivascular spaces (EPVSs) in acute ischemic stroke, and determine the factors that influence basal ganglia and centrum semiovale EPVSs. Methods We prospectively registered consecutive patients with acute ischemic stroke at the neurological wards of Jianyang Municipal People’s Hospital and West China Hospital of Sichuan University from February 1st to November 1st, 2014. Patients with ischemic stroke within 14 days of symptom onset, having magnetic resonance image (MRI) scan were included. Basal ganglia and centrum semiovale EPVSs, white matter hyperintensity, cerebral atrophy and lacunar infraction were rated using validated scales by reading MRI. Clinical information was obtained using standardized forms. The distribution of EPVSs was observed and analyzed. The evalution of EPVSs was analyzed in relation to age, vascular risk factor, cerebral atrophy, white matter hyperintensity, lacunar infraction, etc, by using univariate and multivariate logistical regression to evaluate the influencing factors for basal ganglia and centrum semiovale EPVSs. Results A total of 170 patients with acute ischemic stroke within 14 days from onset were included; in whom, 97.6% had EPVSs in basal ganglia and all had EPVSs in centrum semiovale. The most common scores of basal ganglia EPVSs were 1 point and 2 points. The most common scores of centrum semiovale EPVSs were 2 and 3 points. In logistic regression, age [odds ratio (OR)=1.043, 95% confidence interval (CI) (1.015, 1.071), P=0.002], periventricular white matter hyperintensity [OR=4.203, 95%CI (1.525, 11.583), P=0.006] and hypertension [OR=3.965, 95%CI (1.927, 8.157), P<0.001] were independently associated with increased severity of basal ganglia EPVSs. Only periventricular white matter hyperintensity [OR=2.248, 95%CI (1.054, 4.795), P=0.036] was independently associated with increased severity of centrum semiovale EPVSs in logistic regression. Conclusions EPVSs are common in ischemic stroke. There is a lower prevalence of EPVS in the basal ganglia compared with the centrum semiovale. Compared with centrum semiovale EPVSs, basal ganglia EPVSs are more associated with hypertensive cerebral small vessel disease, which may be a marker for hypertensive cerebral small vessel disease.
Objective To explore strategies to reduce the same-day cancellation rate of gynecological day surgery. Methods The same-day cancellation status of gynecological surgery in the Department of Day Surgery, West China Second University Hospital, Sichuan University from January to December 2021 (before improvement) was investigated. The causes of cancellation were analyzed from three aspects: patient-related factors, medical factors, and examination factors. Subsequently, management countermeasures were formulated for the controllable factors and continuous quality improvement was implemented. After improvement, the same-day cancellation rate of gynecological day surgery from September 2022 to January 2023 was collected and compared with that before improvement. Results Continuous quality improvement was implemented targeting three factors in day surgery, namely the short interval between patient’s visit time and pre-scheduled time, the irrational sequence of preoperative examinations for patients, and the non-standardized treatment of patients with abnormal vaginal discharge by physicians. The same-day cancellation rates of gynecological day surgery before and after the continuous quality improvement were 3.70% (156/4211) and 2.13% (30/1411), respectively, and the difference was statistically significant (χ2=8.231, P=0.004). ConclusionOptimizing the preoperative examination and admission process, effective preoperative education and physician-patient communication, establishing unified standards for the approval of vaginal discharge tests and standardized treatment protocols, and clarifying the responsibilities of the preoperative comprehensive assessment outpatient clinic along with the supervision system are effective measures to reduce the same-day cancellation rate of gynecological day surgery.
目的 總結近十年來顱腦手術后顱內感染的發病率、病死率及病原菌譜，為制訂預防顱內感染措施提供依據。 方法 檢索中國學術期刊網全文數據庫（CNKI）、萬方數據庫、重慶維普中文科技期刊全文數據庫，并輔以文獻追溯、手工檢索等方法收集2001年－2012年國內正式刊物上公開發表的有關顱腦手術后顱內感染的中文文獻。并對顱腦手術后顱內感染的流行病學調查資料進行Meta分析。 結果 共有27篇論文進入Meta分析，其中，25篇論文用于顱腦手術后顱內感染發病率的統計。共調查40 343例，發生顱內感染1 712例，感染率為4.24%。6篇論文提供了開顱術后顱內感染死亡的數據，在268例顱內感染患者中死亡39例，病死率為14.55%。15篇論文統計顯示，顱內感染細菌培養陽性率為54.48%；15篇論文給出細菌培養結果，其中金黃色葡萄球菌占23.16%，表皮葡萄球菌占17.85%，銅綠假單胞菌占8.85%，大腸埃希菌占8.70%。 結論 國內顱腦手術后顱內感染以G+球菌為主，病原菌分布相對集中，臨床上應予以重視。
Objective To investigate the safety and feasibility of hysteroscopic treatment for retained products of conception (RPOC) combined with enhanced myometrial vascularity (EMV) in ambulatory surgery mode. Methods A retrospective analysis was conducted on the clinical data of patients who underwent hysteroscopic treatment for RPOC combined with EMV in ambulatory surgery mode at West China Second University Hospital between May 2021 and May 2024, including their basic information and surgical related conditions. Results A total of 54 patients were included, with an average age of (33.37±4.54) years and an average number of pregnancies of 3.14±1.56. The preoperative blood level of human chorionic gonadotropin was 11.45 (5.00, 82.96) mU/mL. Color Doppler ultrasound showed an average size of pregnancy residue (2.47±0.77) cm. The average peak systolic velocity was (55.13±18.55) cm/s. The intraoperative blood loss was 17.63 (1.00, 300.00) mL. The average surgical time was (30.07±20.64) minutes. The hospital stay was 0.69 (0.50, 1.00) days. There was 1 case of postoperative complications (incidence rate 1.9%), which had the second hysteroscopy to remove retained pregnancy tissue one month after the first surgery due to RPOC. There were 6 cases of postoperative re pregnancy. Conclusion Hysteroscopic treatment for RPOC combined with EMV in ambulatory surgery mode is safe and feasible, and is worth promoting.
Objective To investigate the impact of optimized preoperative fasting scheme for gynecological day surgery with general anesthesia. Methods We retrospectively selected 639 patients undergoing gynecological day surgery with general anesthesia between June 2021 and August 2021 in the day surgery department of West China Second University Hospital of Sichuan University as the control group, and 920 patients undergoing gynecological day surgery with general anesthesia in the same hospital between November 2021 and February 2022 as the observational group. The patients in the control group were treated with routine preoperative fasting scheme, and the ones in the observational group were treated with optimized preoperative fasting scheme. The differences in preoperative duration of water deprivation, intraoperative and postoperative incidences of aspiration, and postoperative first anal exhaust time between the two groups were compared. Results The preoperative duration of water deprivation in the control group was longer than that in the observational group [(12.49±2.63) vs. (6.69±2.76) h, P<0.05]. The incidences of intraoperative and postoperative aspiration were both 0. The postoperative first anal exhaust time in the control group was later than that in the observational group [(11.51±6.58) vs. (8.19±4.13) h, P<0.05]. Conclusions For patients undergoing gynecological day surgery with general anesthesia, the implementation of the optimized preoperative fasting scheme can effectively shorten the preoperative duration of water deprivation, without increasing the risk of anesthesia. It can accelerate the recovery of intestinal function for gynecological laparoscopic day surgery with general anesthesia, promote the implementation of enhanced recovery after surgery, and improve the efficiency of day surgery.
In recent years, the diversity of gut microbiota and the role of its metabolites in cardiovascular disease (CVD) have attracted widespread attention. Gut microbiota metabolites not only play an important role in maintaining gut health, but may also influence cardiovascular health through a variety of mechanisms. As one of the important products of gut microbiota metabolism, sulfate’s biosynthetic pathway, metabolic dynamics and potential effects on cardiovascular system have become the focus of research. However, the current research on the relationship between sulfate and cardiovascular disease still has some shortcomings, including the mechanism is not clear, and clinical data are limited. This article reviewed the biosynthesis of sulfate and its mechanism of action in cardiovascular diseases, and combined with the existing clinical research results, aimed to provide new perspectives and ideas for future research, in order to promote the in-depth exploration and development of this field.