Objective To study the clinical features of paroxysmal sympathetic hyperactivity (PSH).Methods The clinical data,imaging and electroencephalography (EEG) of 10 patients with PSH was analyzed retrospectively.Results Of the 10 patients with PSH,9 were males and 1 was a female.The overall age of all the patients was (37.6 ± 19.1) years,ranging from 15 to 78 years.The primary diseases included traumatic brain injury 5 cases,intracranial hemorrhage 1 case,cerebral infarction 1 case,hypoxic ischemic encephalopathy 1 case,arachnoid cyst 1 case and cryptococcal meningoencephalitis 1 case.All patients developed at least 5 of 7 features which contained paroxysmal agitation,hyperthemia,diaphoresis,tachypnea,tachycardia,hypertension and dystonia.PSH occurred within 24 hours after brain injury in 3 patients; 24 hours to 3 weeks in 5 patients ; 5 months in 1 patient; 9 years in 1 patient.The frequency varied from one time in several days to several times in one day.The duration varied from 1 minute to 3 hours.The episodes in 4 patients occurred more often at night,1 around palinesthesia and the frequency of other 5 patients showed no differences between day and night.There were 2 cases appeared sober-minded,and the states of consciousness of the other 8 cases were hard to judge during PSH.The Glasgow Coma Scale scores of 8 cases were 3 to 8 points and the other 2 cases were 15 points.No epileptic-form activity was detected by EEG and no particular lesions were responsible.Neuro-imaging examinations suggested frontal lobe,temporal lobe,parietal lobe,occipital lobe,basal ganglion,pons and lateral ventricle were damaged.And 9 patients received an ineffective antiepileptic drug treatment.The efficacy in the management of PSH with dopamine agonists combining with β-blockers was observed.Two patients achieved complete remission,6 patients had a reduction in episode frequency,1 patient showed no response to the therapy and 1 patient discharged and could not be connected.Conclusions PSH can occur after various types and different degrees of brain injury.PSH is often misdiagnosed as epilepsy,and anticonvulsant therapies are useless.PSH receives good responses to β-blockers and dopamine agonists.

Objective To investigate the features of PET-CT manifestation of pancreatic metastasis,and to improve its detection rate.Methods The PET-CT images of 31 cases of clinically diagnosed pancreatic metastases and 26 cases of primary pancreatic cancer were retrospectively evaluated.Two experienced specialists identified the lesion location in fused images.After frame by frame image analysis,the lesions with significantly increased radioactivity uptake were seen as positive,when compared with surrounding normal pancreatic tissue.The outline of regions of interest was drawn along the edge of the lesion shown in PET,and based on a semi-quantitative evaluation,the maximum standard uptake value (SUVmax) was calculated.If SUVmax ＞ 2.5,it was considered as positive.Results Among the 31 cases with pancreatic metastasis,22 cases of lung cancer,2 cases of gastric cancer 2 cases of colon carcinoma,1 case of maxillary sinus carcinoma,thyroid carcinoma,melanoma,renal cell carcinoma or gallbladder carcinoma were identified.Twenty-one cases (67.7％) were single,10 cases (32.3％) were multiple or diffuse lesions.Among the single lesions,7 (33.3％) were located in the pancreatic head and neck,14 in pancreatic body and tail.Among the 26 cases of primary pancreatic carcinoma,18 cases (69.2％) were located in the pancreatic head,8(30.8％) in the pancreatic body and tail.The sites of primary and metastatic pancreatic cancer were significantly different (x2 =6.012,P =0.014).CT scan showed only 17 nodular lesions with relatively low density and less clear boundary.PET images showed lesions in 31 cases of metastatic pancreatic cancer,and the mean SUVmax was 7.42 ± 3.48,which was significantly higher than that in primary pancreatic cancer group (5.39 ± 1.71,F =4.87,P =0.032).In addition,PET-CT identified 30 cases of other organs or lymph node metastasis.Conclusions PET-CT plays an important role in the diagnosis of metastatic pancreatic cancer.

Objective To investigate the usefulness of Utstein template to guide the assessment and study of cardiopulmonary resuscitation (CPR) in our medical practice because it has been popularized in many countries since 1991.Methods A prospective observational study using Utstein CPR registry form to evaluate the epidemiological features and outcomes of 511 patients resuscitated in the emergency department.Results Of 511 CPR patients registered,higher cardiac arrest rates were observed in the group of patients aged 40- 70 years. In 511 CPR patients registered,preexisting chronic diseases were common including cardiovascular diseases ( 190,37.2％ ) cerebrovascular diseases (48,9.4％ ) and respiratory diseases (39,7.6％ ).Of them,173 cardiac arrest patients (33.9％) had underlying cardiac causes,such as acute myocardial infarction (AMI) found in 109 (21.3％) patients,and ventricular fibrillation witnessed during first cardiac monitoring in eighty ( 15.7％ ) patients.The restoration of spontaneous circulation (ROSC) rate and survival rate at discharge of in - hospital cardiac arrest (IHCA) patients were 47.0％ and 13.5％respectively,but 16.7％ and 4.7％ respectively in the out - hospital cardiac arrest (OHCA) patients (P ＜0.01,both ). Conclusions This study indicated that the cardiovascular diseases, cerebrovascular diseases,and respiratory diseases were the most common preexisting chronic diseases found in cardiac arrest patients.Myocardial infarct,stroke and trauma were the most common precipitation causes of cardiac arrest in the recruited patients.The rates of ROSC and survival at discharge were significantly higher in statistics in patients with IHCA than those in ones with OHCA.

Objective To investigate the relationship between C1773T polymorphism of LDL receptor gene (LDLR) and cerebral hemorrhage and the impact of C1773T polymorphism of LDLR on the levels of serum lipids in Chinese Han in Changsha, Hunan province. Methods Two hundred seventy-three cerebral hemorrhage patients and 140 normal controls were recruited in the present study. The C1773T polymorphism of LDLR was analyzed by SNaPshot and direct DNA sequencing. The triglyceride (TG), total cholesterol (TC), high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C) levels were examined using oxidase method. Results The CC, CT and TT genotype frequencies of LDLR polymorphism were 0.703/0.278/0.019、0.707/0.250/0.043 and the allele C and T frequencies of LDLR polymorphism in the cerebral hemorrhage group and the control group were 0.842/0.158,0.832/0.168 respectively. The differences in genotype and allele frequencies of LDLR polymorphism were no significant between cerebral hemorrhage group and the control group (P>0.05). There were no significant differences in the levels of lipids among the CC, CT and TT genotype in either cerebral hemorrhage group or the control group (P＞0.05). Conclusions The LDLR-C1773T polymorphism may not be associated with cerebral hemorrhage nor be related to hyperlipemia in Chinese Han in Changsha.

OBJECTIVE: To explore the association between apolipoprotein AI (ApoAI) gene rs12721026 polymorphism and cerebral hemorrhage (CH) in Changsha Han population, and to evaluate the effect of rs12721026 polymorphism on plasma lipid levels. METHODS: A total of 273 patients with CH and 140 healthy controls were collected. The rs12721026 polymorphism of ApoAI was analyzed by SNaPshot genotyping analysis and DNA sequencing. The total cholesterol (TG), triglyceride (TC), HDL-C and LDL-C were examined by oxidase method. RESULTS: There was no significant difference in the genotype and allele frequencies of rs12721026 polymorphism between the CH group and the control group (P>0.05). Both in the CH group and in the control group, the level of HDL-C of the TT gene type of rs12721026 was significantly higher than that of the GT/GG gene type (P<0.05). There was no significant difference in the levels of TG, TC and LDL-C among different subgroups of gene types. CONCLUSION There may be no association between apoAI gene rs12721026 polymorphism with CH in Changsha Han population, which may still influence the HDL-C levels.
Apolipoprotein A-I ; genetics ; Asian Continental Ancestry Group ; Case-Control Studies ; Cerebral Hemorrhage ; blood ; genetics ; Cholesterol ; blood ; Gene Frequency ; Genotype ; Humans ; Lipids ; Polymorphism, Single Nucleotide ; Sequence Analysis, DNA ; Triglycerides ; blood

OBJECTIVE: To explore the association between single nucleotide polymorphism (SNPs) of KLK1 gene and cerebral hemorrhage in Changsha Han population. METHODS: We enrolled 273 patients with cerebral hemorrhage and 140 normal people. The SNPs (including rs3212855 and rs5515) of KLK1 gene were analyzed by Snapshot method and direct sequencing. RESULTS: We found rs5515 was not a polymorphic site in Changsha Han population. Genotype and allele frequency in rs3212855 were not different between patients with cerebral hemorrhage and the controls (P>0.05). The blood pressure level was not different between the genotype subgroups. CONCLUSION Neither rs5515 nor rs3212855 is associated with cerebral hemorrhage.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cerebral Hemorrhage ; genetics ; China ; ethnology ; Female ; Genotype ; Humans ; Kallikreins ; genetics ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; genetics ; Young Adult

OBJECTIVE: To investigate the relationship between T704C polymorphism of angiotensinogen (AGT) gene and cerebral hemorrhage and its impact on the levels of blood pressure in Han people in Changsha. METHODS: A total of 273 cerebral hemorrhage patients (the cerebral hemorrhage group) and 140 normal controls (the control group) were collected from Jan. 2005 to Jan. 2009. DNA was extracted from their peripheral blood samples. The polymorphism of AGT-T704C was analyzed by SNaPshot and direct DNA sequencing. The possible risk factors of cerebral hemorrhage were investigated at the same time. Each group was divided into 2 subgroups (a high blood pressure subgroup and a normal blood pressure subgroup) according to whether they had essential hypertension. Logistic regression analysis was used to detect the relationship between cerebral hemorrhage and all its possible risk factors and AGT-T704C polymorphism. RESULTS: The drinking history, coronary heart disease history, essential hypertension history, and blood levels of lipids were shown significant difference between the cerebral hemorrhage group and the control group (P<0.05). Logistic regression analysis showed that hypertension history, systolic blood pressure level, and high density lipoprotein cholesterol level were independent risk factors for cerebral hemorrhage in Han people in Changsha. The genotype C/C, C/T, and T/T frequencies of AGT-T704C polymorphism in the cerebral hemorrhage group and the control group were 0.692, 0.279, 0.029 and 0.629, 0.350, 0.021, respectively. The allele C and T frequencies of AGT-T704C polymorphism in the 2 groups were 0.832, 0.168 and 0.804, 0.196, respectively. The frequencies of all the genotypes and alleles had no significant difference between the 2 groups and their subgroups (P>0.05). CONCLUSION The polymorphism of AGT-T704C may not be associated with cerebral hemorrhage and not related to the levels of lipids and blood pressure in Han people in Changsha. Hypertension history, systolic blood pressure level, and high density lipoprotein cholesterol level are the main risk factors of cerebral hemorrhage in Han people in Changsha.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Angiotensinogen ; genetics ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; Cerebral Hemorrhage ; genetics ; China ; ethnology ; Female ; Genotype ; Humans ; Hypertension ; complications ; Lipoproteins, HDL ; blood ; Logistic Models ; Male ; Middle Aged ; Molecular Sequence Data ; Polymorphism, Genetic ; Risk Factors ; Young Adult