重型颅脑损伤术后大面积脑梗死分析

目的:通过分析重型颅脑损伤术后出现大面积脑梗死患者的资料,来探讨导致大面积脑梗死发病的机理以及临床特点和医治方法。方法:搜集重型颅脑患者资料,分析各种症状的治疗方法。结果:本组病例手术均获成功,无术中死亡病例,其中3例愈后良好,2例轻残,4例重残,1例术后患者呼吸间断血氧饱和度低,给予呼吸机辅助呼吸,3 d后因呼吸衰竭死亡,1例于术后5～7 d并发脑干及多功能器官衰竭死亡。国际格拉斯哥预后评分比较:良好3例,轻残2例,重残4例,死亡2例,病死率为18.1%。结论:重症颅脑损伤术后大面积脑梗死产生原因,是由于重型颅脑损伤本身所致的原发性脑损伤、手术减压不充分、继发性的脑水肿、脑疝形成等,以及术后出现的水电解质及酸碱紊乱等所导致,治疗的关键和重点是早期发现早期治疗。     

半量及全量甘露醇治疗大面积脑梗死致肾损害的比较

目的　探讨甘露醇作为高渗脱水剂治疗大面积脑梗死时致肾损害与其剂量大小的关系。方法　选择大面积脑梗死患者 14 0例随机分为两组 ,其中半量甘露醇治疗 (观察 )组 76例 ,常规全量甘露醇治疗 (对照 )组 6 4例 ,观察治疗后患者肾损害的发生率、病死率和颅内压控制情况 ,并进行临床比较分析。结果　观察组肾损害发生率和病死率均较对照组低 ,两者比较差异有显著性 (P <0 0 5 ) ;两组对减轻颅内高压疗效接近 ,无明显差异。结论　半量甘露醇治疗大面积脑梗死致肾损害少 ,疗效确切     

26例大面积脑梗死患者临床分析

目的:探讨大面积脑梗死的诊断、治疗和临床特点。方法:回顾性分析26例大面积脑梗死患者的临床资料,包括病因、临床特点、治疗过程和结果。结果:26例患者中动态发病11例,10例意识障碍,15例偏瘫,癫痫2例,死亡8例。结论:大面脑梗死病死率高,及时采取综合治疗措施才能降低病死率、致残率,提高患者的生活质量,减轻社会和家庭负担。     

超早期去大骨瓣减压术治疗大面积脑梗死的效果分析

目的:深入研究和分析超早期去大骨瓣减压手术在治疗大面积脑梗死的临床效果,提高大面积脑梗死治疗水平。方法:选择进行治疗的大面积脑梗死患者14例,按照治疗方式的不同将其分为超早期组与常规组,每组7例,超早期患者使用以弥散磁共振(DWI)为指征大骨瓣减压术进行治疗。常规组使用传统方法进行治疗,对两组患者在治疗7 d GCS评分和病死率数据进行比较。结果:超早期组与常规组在接受不同治疗之后,在7 d GCS评分数据上分别为(10.74±2.17)、(6.58±2.69)。病死人数上分别为1例和3例,病死率分别为15.58%、35.68%。超早期组与常规组在治疗后7 d GCS评分和病死率数据对比,差异有统计学意义(P<0.05)。结论:以弥散磁共振(DWI)为指征超早期大骨瓣减压手术治疗大面积脑梗死效果较好,可以有效的降低病死率,提高疾病的治疗水平,在临床中可广泛的推广。     

大面积脑梗死临床分析

目的:分析大面积脑梗死的临床表现和特点,总结治疗措施。方法:选取2012年1月至2014年12月102例大面积脑梗死患者资料,分析临床特点和治疗措施。结果:102例患者积极治疗,有效85例,死亡17例。患者死亡原因是脑疝及多器官功能衰竭。85例患者中,52例肌力为0~2级,33例肌力3级以上。出院后康复治疗2周,85例患者中好转,36例,49例未好转。结论:大面积脑梗死是脑梗死中严重类型,掌握大面积脑梗死临床特点,及时治疗脑水肿、保护脑细胞、降低颅内压力积极治疗方法,可以提升临床治疗效果[1]。     

大面积脑梗死后出血性转化的CT诊断新认识

目的 提高对大面积脑梗死后出血性转化的CT诊断水平及新认识.方法 对60例大面积脑梗死后出血性转化的CT资料进行回顾性分析.结果 大面积脑梗死后复查头部CT,常规扫描37例,薄层扫描23例.出血性转化在梗死后1d检出3例,2～3 d检出16例,4～7 d检出9例,8～14 d检出32例.CT表现分3型：中心型（13例）、边缘型（21例）、混合型（26例）.结论“出血性转化”已代替“出血性脑梗死”和“梗死后出血”,大面积脑梗死最易发生出血性转化,影像学检查是诊断出血性转化的金标准,CT为首选的主要检查方法,薄层扫描更利于病变早期检出,对指导临床选择治疗方案及预后判断具有重要意义.     

大面积脑梗死62例临床分析

目的：研究大面积脑梗死的临床特点与治疗方法。方法选取我院神经内科2013年—2015年收治的62例大面积脑梗死患者作为研究对象，对其临床资料进行分析与探讨。结果62例患者经治疗后，存活51例，存活率为82.3%，放弃治疗4例，死亡7例，其中死于急性脑疝4例，死于上消化道出血3例。结论大面积脑梗死具有发病急、病情发展快以及病情严重等特点，具有较高的致残率及病死率，早期诊断以及有效治疗是挽救患者生命的关键。     

急性大面积脑梗死21例临床分析

目的探讨大面积脑梗死的诊断治疗及临床特点。方法对我院21例大面积脑梗死患者的临床资料进行回顾性分析。结果21例中存活16例，死亡5例，存活的16例患者均遗留神经功能缺失。结论大面积脑梗死应及早诊断，采取综合治疗措施，可有效降低病死率，提高生活质量。     

大面积脑梗死的临床分析

目的:探讨大面积脑梗死的临床诊断及治疗。方法:选择32例大面积脑梗死患者作为研究对象,并结合其临床诊治资料进行回顾性分析。结果:经治疗后发现,32例患者中共有26例存活,存活率为81.25%;6例死亡,病死率为18.75%,包括3例急性期脑疝,2例上消化道出血,1例多器官功能衰竭。结论:给予大面积脑梗死患者早期诊断和治疗,能够帮助患者控制病情,提高生存质量,具有较高的临床应用价值,值得推广。     

依达拉奉治疗急性大面积脑梗死34例疗效观察

目的探讨依达拉奉治疗急性大面积脑梗死的临床疗效及安全性。方法将68例急性大面积脑梗死患者随机分成两组,治疗组34例,对照组34例,两组患者均给予脑梗死常规治疗,治疗组给予依达拉奉30mg加入生理盐水100mL静脉滴注,30min内滴完,每天2次,连用3周;对照组给予常规治疗。将两组治疗前与治疗后3周、4周进行欧洲脑卒中评分（ESS）及临床疗效评价。结果治疗组显效率64．7％,总有效率88．2％,明显高于对照组（32．4％,47．1％）（P〈0．05,P〈0．01）,治疗组ESS评分在治疗后3周、4周时较对照组显著增加（P〈0．05）。治疗组3例患者在3周内出现血丙氨酸氨基转移酶轻度升高,采用保肝治疗后正常;2例患者出现血肌酐升高,停药5～7d后自行恢复,2例出现窦性心动过速,减慢滴速后消失,均未停止应用依达拉奉。结论依达拉奉治疗急性大面积脑梗死安全有效。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.