Progress in the Treatment of Fungal Infections of the Central Nervous System

HThe incidence of fungal infections of the central nervous system(CNS) has gradually increased in recent years. Intracranial fungal infection can be classified as diffuse and focal infections. The clinical manifestations of these infections include fever and cranial pressure caused by meningitis or meningoencephalitis, and focal neurological defects caused by lesions in the intracranial space. Diagnosing fungal infections of the CNS requires the comprehensive analysis of the patient's medical history, epidemiology, underlying disease, clinical manifestation, imaging manifestations, and various laboratory test results. The identification of fungal bodies or structures in brain tissue or cerebrospinal fluid specimens is the golden standard of diagnosis. The principles for the treatment of the fungal infections of the CNS are the effective control of pathogenic risk factors, use of effective antifungal drugs, and the active implementation of surgical intervention for fungal abscesses and granuloma. In the meantime, new diagnoses and treatments should be actively explored to improve the prognosis of patients.

Effectiveness of Centralized Wastewater Treatment Plant in Removing Emerging Contaminants: A Case Study at Kuching, Malaysia

Before the construction of the Kuching Centralized Wastewater Treatment System Package 1 (KCWTSP1), partially treated blackwater and greywater were discharged directly into natural waterways. The accumulated wastewater had polluted Sarawak river, which is regulated and cannot discharge freely into the South China Sea. The polluted Sarawak river has endangered human health, river water quality, and aquatic ecosystems. Hence, the KCWTSP1 commissioned in 2015 serves the purpose of removing pollutants from wastewater before it is discharged into natural waterways. However, the effectiveness of KCWTPP1 is unknown. This paper is aimed to discuss and review the effectiveness of KCWTPP1 in treating wastewater since its inception in 2015. From 2017 to 2020, KCWTPP1 has treated an average of 4,200,000 m3 of wastewater per year. Generally, most of the discharge effluent met Environmental Quality Act (1974) Standard A criteria, except for the oil and grease parameter. Initially, the plant could not treat suspended solids and total phosphorus, but this was greatly improved in subsequent years. Therefore, some improvements are required to treat oil and grease parameters effectively and efficiently to ensure that only Standard A effluent is discharged into the Sarawak River in the future.

Treatment Strategies for Huge Central Neurocytomas

Central neurocytomas（CNs）, initially asymptomatic, sometimes become huge before detection. We described and analyzed the clinical, radiological, operational and outcome data of 13 cases of huge intraventricular CNs, and discussed the treatment strategies in this study. All huge CNs（n=13） in our study were located in bilateral lateral ventricle with diameter ≥5.0 cm and had a broad-based attachment to at least one side of the ventricle wall. All patients received craniotomy to remove the tumor through transcallosal or transcortical approach and CNs were of typical histologic and immunohistochemical features. Adjuvant therapies including conventional radiation therapy（RT） or gamma knife radiosurgery（GKRS） were also performed postoperatively. Transcallosal and transcortical approaches were used in 8 and 5 patients, respectively. Two patients died within one month after operation and 3 patients with gross total resection（GTR） were additionally given a decompressive craniectomy（DC） and/or ventriculoperitoneal shunt（VPS） as the salvage therapy. Six patients received GTR（＋RT） and 7 patients received subtotal resection（STR）（＋GKRS）. Eight patients suffered serious complications such as hydrocephalus, paralysis and seizure after operation, and patients who underwent GTR showed worse functional outcome [less Karnofsky performance scale（KPS） scores] than those having STR（＋GKRS） during the follow-up period. The clinical outcome of huge CNs seemed not to be favorable as that described in previous reports. Surgical resection for huge CNs should be meticulously considered to guarantee the maximum safety. Better results were achieved in STR（＋GKRS） compared with GTR（＋RT） for huge CNs, suggesting that STR（＋GKRS） may be a better treatment choice. The recurrent or residual tumor can be treated with GKRS effectively.

Treatment of central precocious puberty by GnRH analogs： long-term outcome in men

In boys, central precocious puberty （CPP） is the appearance of secondary sex characteristics driven by pituitary gonadotropin secretion before the age of 9 years. In the last years, relevant improvements in the treatment of CPP have been achieved. Because CPP is rare in boys, the majority of papers on this issue focus on girls and do not address specific features of male patients regarding end results and safety. In the present paper, recent advances of CPP management with GnRH analogs in men are summarized. End results in untreated and treated patients are also reviewed by an analysis of the recently published literature on treatment of CPP in men. The available data indicate that therapy with GnRH analogs can improve final height into the range of target height without significant adverse short-term and long-term effects, but longer follow-up of larger series of patients is still required to draw definitive conclusions.

Effect of intervention treatment from different stages on prognosis in children with central coordination disturbance

BACKGROUND： Central coordination disturbance is regarded as the early-stage symptom of brain injury-induced cerebral palsy. This disease manifests itself as motor disorder, abnormal attitudinal reflex and muscular tension. Early intervention may improve its prognosis. OBJECTIVE： To observe the effects of intervention treatment from different stages on the prognosis of central coordination disturbance following brain injury in children patients. DESIGN： A contrast observation experiment SETTING： Department of Neurology and Rehabilitation, Urumqi Children＇s Hospital PARTICIPANTS ： Totally 151 children who were diagnosed as central coordination disturbance from January 2002 to December 2003 in the Department of Neurology and Rehabilitation of Urumqi Children＇s Hospital were recruited. All the children patients, including 101 male and 50 female, aged from 3 months to 1 year old, met the diagnosis criteria of central coordination disturbance from Vojta. They were divided into slight, moderate and severe abnormity according to Vojta attitudinal reflex. All 151 patients were divided into 2 groups according to their age at diagnosis： 3-6 months old group （n=74）, 62 severe, 10 moderate and 2 slight; 7-12 months old group （n=77）, 66 severe, 7 moderate and 4 slight. All the relatives of children patients were informed of the experiment. METHODS： ① Both groups received physical training （PT） as the main treatment; Hand training was given if necessary. All of the patients received additional hyperbaric oxygen therapy, bioelectric therapy, scalp acupuncture, drug treatment and family training. The importance of integration of hospital and family based rehabilitation was stressed. Those who did not catch up with the normal development or had abnormal reflexes continued to receive treatment. ② Around the age of 2 years old, all children did a final evaluation using Bayley Scales of Infant Development （BSID）. Mental development index （MDI） and physical development index （PDI） were taken as evaluative criteria. Children with scores 80 and above on MDI and PDI were considered to have normal motor and mental development; 79 and below were considered delayers. The Diagnostic Criteria of Cerebral Palsy and Infantecondary School Social Adaptation Scale were used in the final evaluation[scores ≤5 was extremely severe （extremely severe cerebral palsy）, 6 was severe（severe cerebral palsy）, 7 was moderate（moderate cerebral palsy）, 8 was slight（slight cerebral palsy）, 9 was borderline（slight cerebral palsy）, 10 was normal, 11 was above average, 12 was excellent and ≥13 was extremely excellent]. ③ Final evaluative results of 2 groups were compared. And u test was used for the comparison of Bayley development index and Chi-square test for the comparison of normalization rate. MAIN OUTCOME MEASURES： BSID MDI and PDI as well as the normalization rate of motor function and mental behavior of children patients at 2 years old. RESULTS： Totally 151 children patients entered the stage of result analysis. ①Two groups of children patients were given integrated rehabilitation therapy , and evaluated at 2 years old . The 3-6 months old group had higher MDI and PDI than the 7-12 months old group （91.81＋19.99 vs 71.93＋18.98;91.55＋23.61 vs 68.95＋23.51, u=6.265,5.894,P 〈 0.01 ）.②After being given integrated rehabilitation therapy, children patients of 3-6 months old group had significantly higher normalization rate of motor function and mental behavior than 7-12 months old group （73% ,27%,X2=29.723 9,P 〈 0.01 ）. ③Six slight and 17 moderate central coordination disturbance children of 2 groups all completely recovered; After intervention treatment, among 128 severe central coordination disturbance children, 52 recovered and 76 were still abnormal, in which, 43 slight cerebral palsy, 18 moderate cerebral palsy, 5 severe cerebral palsy and 10 extremely severe cerebral palsy. CONCLUSION： To perform integrated intervention treatment before 6 months old can better improve and promote mental and physical development levels of children patients with central coordination disturbance after brain injury than 6 months later.

Utilisation of Non-Conventional Animal Waste as Feeds by Multiple Livestock Species Farmers in Lake Victoria Crescent of Central Uganda

A cross-sectional survey was conducted to establish the utilisation of non-conventional animal waste in multiple livestock species systems. Farmers (150) were selected from four out of ten districts of Central Uganda in Lake Victoria Crescent. A structured questionnaire was used and descriptive analysis showed that over 80% are smallholder farmers on 3.0) years. Household husbands (80%) significantly (P 1.0) as they cause poor livestock health due to pathogens, parasites and toxins which are associated (OD > 1.0) with poor growth, mortality and condemnation of livestock products. The remedy to unsafe non-conventional feeds is to apply effective solar-heating (75%), chemical and ensiling treatment methods. The study showed that there are no significant (P < 0.001) public health risks associated with utilising treated non-conventional feeds instead it improves production and sustainability of multiple livestock species systems.

Surgical Treatment of Central Giant Cell Granuloma with Carnoy’s Solution

A 25-year-old woman presented a unilateral mandibular swelling, after laboratory analysis, radiological studies and aspiration puncture biopsy, the pathological diagnosis of Central Giant Cell Granuloma was made. Radiographically, the multilocular lesion involved the left lower first molar and was 30 mm long by 20 mm high. Dental extraction of the molar involved with forceps and exeresis in toto of the tumor were performed using a Volkmann cutting curette. The tumor made up of 90% vascular tissue produced intra-surgical bleeding that made visibility difficult. The bone bed curettage was aggressive except for its base in direct contact with the inferior dental nerve. Subsequently, to avoid recurrence, the surgical protocol includes a double irrigation with Carnoy’s solution, (fixative composed of 60% ethanol, 30% chloroform and 10% glacial acetic acid 98%) for 5 minutes that produces chemical cauterization. Finally, it was washed with physiological solution and the cavity was filled with iodoformed gauze. The gauze was exchanged and removed gradually over three weeks for second intention healing. This case is presented to demonstrate that inexpensive chemical treatment can be safely used for outpatient surgery under local anesthesia. Because Carnoy’s solution achieved control of intraoperative bleeding, allowed bone healing and prevented recurrence of the lesion in clinical radiographic follow-up for 15 years.

重型血友病A经外周置入中心静脉导管现状分析

目的探索和总结经外周静脉置入中心静脉置管(PICC)在重型血友病治疗中的经验。方法回顾性收集2020年1月-2023年12月在首都医科大学附属北京儿童医院接受PICC的重型血友病A儿童的基本信息,电话询问其目前治疗现状及PICC并发症情况。结果共纳入76例重型血友病A患儿,中位年龄4.2(2.3-5.8)岁,共安装123次PICC。安装PICC前,有17.1%(13/76)的患儿开展了家庭治疗;安装后,84.2%(64/76)的患儿进行了家庭治疗。有7.9%(6/76)的患儿出现导管位置改变,10.5%(8/76)出现导管阻塞,39.5%(30/76)出现贴膜下以及贴膜周围皮肤皮疹,2例患儿出现导管相关血栓,5例自行将PICC导管拔除,7例出现导管相关感染。结论重型血友病A患儿PICC置入后,置管局部皮疹、导管堵塞、导管滑脱、导管血栓及导管相关感染等并发症较常发生,应充分考虑多种因素,为其建立最适合的血管通路。

无痛诊疗技术在超声PICC置管患儿中的应用效果研究

目的探讨无痛诊疗技术在超声引导下儿童经外周静脉穿刺中心静脉置管术(peripherally inserted central catheter,PICC)中的应用效果。方法选取笔者医院2021年1月至2023年1月拟行PICC的患儿82例,用随机数字表法将其分为对照组、观察组,每组41例;对照组行常规超声引导下PICC置管术,观察组行无痛诊疗技术超声引导下PICC置管术;对比两组置管成功率、置管完成时间,患儿疼痛程度[儿童疼痛行为量表(children’s pain behavior scale,FLACC)],耐受度[Houpt行为量表(Houpt behavior scale,HBS)],依从性[Frankl量表(Frankl scale,FCS)]及家属满意度。结果观察组置管成功率较对照组高,置管时间较对照组短,差异有统计学意义(P<0.05);观察组FLACC评分较对照组低,HBS评分、FCS评分较对照组高,差异有统计学意义(P<0.05);观察组家属总满意度较对照组高,差异有统计学意义(P<0.05)。结论无痛诊疗技术用于超声引导下儿童PICC置管术可提高置管成功率,缩短置管时间,减轻患儿疼痛程度,增强耐受性、依从性,提升家属满意度。

口腔种植术后疼痛机制及治疗的研究进展

随着口腔种植技术的快速发展,在牙列缺损或牙列缺失患者中,口腔种植修复已逐渐成为一种常规的修复方式。然而,口腔种植术作为“侵入性”治疗,即使经过准确的术前评估和规范的外科手术,患者也可能出现术后疼痛。术后疼痛会影响患者的语言交流、咀嚼及吞咽等,使患者的生活质量降低,甚至可引起医疗事故。随着种植手术的普及,未来可能会有更多的患者遭受种植术后疼痛,尤其是种植术后神经病理性疼痛,其治疗难度仍较大,且治疗药物的疗效往往不确切,并与各种不良反应有关。本文介绍了种植术后疼痛的相关机制,对种植术后疼痛的治疗进行概括,并结合当前研究热点提出未来治疗种植术后神经病理性疼痛的潜在靶点,旨在为开展相关临床工作提供新思路。

农村水环境治理的优化策略分析——以沙洋县为例

农村水环境治理是美丽中国建设的重要保证,而农村生活污水处理模式主要有2种,即集中处理模式与分散处理模式。以沙洋县为例,讨论农村生活污水处理模式,分析农村地表水环境现状,阐述农村水环境改善的难点,提出农村水环境治理的优化策略,从而改善农村水环境。

油田联合站碳排放计算及浅析

油田联合站作为油田集输系统的核心单元,涉及油水分离、污水处理、原油含水分析等多个系统的一体化综合性生产过程,同时也消耗了大量的能源,直接或间接地产生了大量碳排放。结合油田联合站的生产运行过程,采用碳排放因子法与物料平衡法对油田联合站的碳排放特性开展了计算分析与讨论,并针对联合站生产过程提出了相应的节能减排措施。通过优化原油处理流程以及耦合光伏发电等可再生能源利用技术,能够减少联合站11.01%的碳排放量,为推动油田行业碳减排发展提供了参考。

印染集聚提升园区废水集中处理设施设计与运行

浙江某印染集聚提升园区废水集中处理设施建设规模30000 m^(3)/d,针对园区废水特点,采用主体工艺为“调节池+冷却系统+反应初沉池+厌氧水解池+A/O生化池+二沉池+高效沉淀池”的组合工艺对其进行处理。运行结果表明,该工艺稳定高效,当进水平均COD、BOD5、总锑分别为1370、360、1.17 mg/L时,处理后出水平均COD、BOD5、总锑分别降至88、7.4、0.049 mg/L,对应去除率分别达到94%、98%、96%,出水符合《纺织染整工业水污染物排放标准》(GB 4287—2012)表2间接排放要求。工程采用了混凝药剂强化的初沉工艺,实现了有效的废水碳捕集,间接对外输出能源,有利于减少碳排放,其主要处理单元采用集约化组合及深池型设计,节省占地,可为占地受限型废水处理厂的建设提供参考。

园区污废水排放对周边水环境的影响与污废水集中处理方法研究

文章研究分析园区污废水排放对周边水环境的影响,设计污废水集中处理方法,以维护园区周边的水环境生态质量。首先,建立园区地下水和地表水数值模型,描述污废水渗透和扩散的影响范围,并划分污废水影响边界。然后,根据气象预估地下水位变化,划分污废水造成的污染范围。最后,建立污废水集中处理体系,通过多层级细粒度组合对污废水实施处理,再通过微生物和化学手段完成对园区污废水的集中处理。实验表明,该方法能有效地降低污废水的污染影响。

PLC自控系统和视频系统在底泥集中处理中的应用

在河道底泥集中处理过程中,由于人工定期监控方法是很难做到快速反应和及时决策,通过引入一套PLC自控系统和视频系统可以很好地解决此问题,对底泥集中处理中PLC自控系统和视频系统进行了介绍,该系统主要包括预处理系统、固液分离系统、调理加药系统和压滤脱水系统等。该PLC自控制系统和视频监控系统能有效对日常生产过程进行全面监控,整套系统自动化程度高和运行稳定,具有明显的社会效益、经济效益和环境效益。

工业园区危险废物集中焚烧处理工艺优化与环境影响评估

在工业化进程不断加快的背景下,工业园区的危险废物处理面临着巨大挑战。集中焚烧处理因其显著的体积减量效果和毒性去除能力而被广泛应用。这种方法不仅能减少环境污染,还能通过集中控制污染物实现更高效的环境管理。同时,焚烧过程中的资源回收利用能力为工业园区的可持续发展提供了重要支持。基于此,首先分析工业园区危险废物集中焚烧处理的必要性,其次分析工业园区危险废物集中焚烧处理工艺的优化策略,最后探讨工业园区危险废物集中焚烧处理的环境影响评估方法。

Z市餐厨垃圾焚烧厂污水处理与研究

随着我国Z城市的高速发展,垃圾填埋逐渐退出历史舞台,生活中餐厨垃圾、厨余垃圾的集中收治与处理也随之成为一种减排方式。餐厨污水处理是城市众多餐厨企业在商业过程中对其产生的含油污水进行一定初步处理再进行排放的总称。餐厨污水中一般带有高浓度的油脂类物质,直接排放往往会对城市生活区域的管道、河流及河流生物产生巨大影响,使城市生活中的大气环境嗅味体验得不到稳定的保障。本文对Z市餐厨垃圾焚烧厂餐厨污水为例进行分析,通过预测分析餐厨污水的成分组成和季节变化,进行相应的工艺处理与评价,总结餐厨污水处理的过程,从而促进整体运行更好地发展。

污染土壤修复工厂现状及发展研究

污染土壤修复工厂具有缩短修复周期、加快土地流转、降低处置成本等优点,适用于大型退役工业区的土壤修复。本文通过梳理现有政策对修复工厂模式的发展要求,分析了土壤修复工厂建设布置、选址和管理要求;结合国内现有实际案例,总结其发展现状和特性,发现修复工厂多位于经济发达及工业污染严重区域、多采用固化稳定化技术和氧化技术且具有明确的末端处置途径。目前,我国土壤修复工厂模式还存在成熟范例少、转运手续复杂等问题,但其仍具有广阔的发展前景,能够为土壤污染问题提供切实可行的解决方案。

集采政策对医疗机构心血管药品采购的影响研究

目的:分析药品集采政策对不同等级医疗机构心血管药品采购的影响,为药品集采政策的调整与优化提供参考。方法:分析心血管药品在各级医疗机构的采购量变化情况,采用Mann-Kendall(M-K)趋势性检验判断心血管药品采购量的长期变化趋势。结果:药品集采政策实施后,心血管药品中选产品采购量大幅增长;各级医疗机构集采品种采购量增幅随采购周期的延长而降低;试点地区基层医疗机构中选产品采购量显著增长,联盟地区仅基层医疗机构非中选产品采购量显著下降,基层医疗机构可替代品种采购量呈下降趋势。结论:药品集采政策效应可能存在滞后性,且随采购周期的延长而逐渐弱化,可替代品种的采购量增长值得进一步关注。