Animals ; Communicable Diseases ; epidemiology ; Disasters ; Earthquakes ; Humans ; Risk Assessment

Hemodynamic monitoring is a very important measure for critically ill patients with burn and trauma, and it should be carried out throughout the course of treatment. Functional hemodynamic monitoring consists of the assessment of the dynamic interactions of hemodynamic variables in response to a defined volume change. Accordingly, response of fluid volume can be assessed in a quantitative fashion by measuring variation of both arterial pulse pressure and left ventricular stroke volunime during positive pressure breathing, or the change in cardiac output response to passive leg raising maneuver. Functional hemodynamic monitoring, contrary to that of static condition in order to realize dynamic and individual monitoring, is related to response to treatment, and it is a useful complement to static (routine) hemodynamic monitoring. At present, in the care of sepsis, shock, and mechanical ventilation, etc. related to burn injury and trauma, functional hemodynamic monitoring is more and more accepted and applied by medical personnel of ICU in burn and trauma departments. Therefore, further study on functional hemodynamic monitoring should be emphasized and practised.
Blood Pressure ; Burns ; therapy ; Critical Care ; Critical Illness ; Fluid Therapy ; Hemodynamics ; physiology ; Humans ; Positive-Pressure Respiration ; Respiration, Artificial ; Sepsis ; diagnosis ; therapy ; Shock ; diagnosis ; therapy ; Stroke Volume ; Systole

Objective To set up a new method of mild hypothermia via lateral ventricle in rabbits following traumatic brain injury (TBI). Methods Twenty-one New Zealand rabbits were used for this study. TBI was pro- duced with all the rabbits in anesthesia by using free-falling impact model. Animals were randomly divided into three groups: a TBI group, a mild hypothermia group (by perfusion of 25℃Ringer's solution via the lateral ventricle) and a control group. The contents of water and total sodium, potassium of the brain region close to traumatic brain tissue were detected and pathological changes were observed in three groups. Results The number of the injured neurons was increased significantly in both TBI group and mild hypothermia group than that in control group at 72 h after TBI (P

Drugs, Chinese Herbal ; chemistry ; Humans ; Isoflavones ; isolation & purification ; pharmacology ; Phytoestrogens ; Plant Preparations ; isolation & purification ; pharmacology ; Plants, Medicinal ; chemistry ; Platelet Aggregation Inhibitors ; isolation & purification ; pharmacology ; Pueraria ; chemistry ; Scutellaria baicalensis ; chemistry

Objective To investigate the effect of glycated albumin on recurrent cerebral infarction in elderly patients with diabetes mellitus. Methods All of 252 elderly acute cerebral infarction patients with diabetes mellitus were chosen from clinics. They were divided into 2 groups: A group ( glycated albumin <19.0% , 117 patients) and B group ( glycated albumin ≥ 19.0%, 135 patients). The clinical characteristics and the recurrent rate of cerebral infarction were compared between two groups. Results The levels of glycated albumin, fasting blood glucose, total cholesterol, low-density lipoprotein cholesterol and triglycerides in B group were significantly higher than those in A group:(21.00 ± 4.93)%vs. (16.75±1.72)%, (9.84 ± 2.89) mmol/L vs. (5.36 ± 1.00) mmol/L, (5.44 ± 1.30) mmol/L vs. (4.57 ± 1.00) mmol/L, (3.13±0.81) mmol/L vs. (2.58 ± 0.74) mmol/L, (2.34 ± 1.61) mmol/L vs. (1.74 ± 1.47) mmol/L, P<0.01 or<0.05. The recurrent rate of cerebral infarction in B group was significantly higher than that in A group: 53.3%(72/135) vs.36.7%(43/117), χ2 = 6.946, P = 0.008. Logistic regression analysis showed that the increase of glycated albumin was the independent risk factor of recurrent cerebral infarction in elderly patients with diabetes mellitus (P=0.048). Conclusions The recurrent rate of cerebral infarction is increased in elderly diabetes patients with high glycated albumin. The increase of glycated albumin is the independent risk factor of recurrent cerebral infarction.

Objective To investigate the dynamic changes in the serum inflammatory cytokines and their association with neurogenic pulmonary edema (NPE) in the patients with severe hand-foot-mouth disease (HFMD).Methods Eighty-nine patients with severe HFMD from March 2010 to December 2012 were recruited in the study.The patients were divided into NPE group and central nervous system diseases (CNSD) group according whether they had NPE.The cytokines,including interleukin (IL)-4,IL-6,IL-10,IL-17,tumor necrosis factor-α (TNF-α) and interferon-γ(IFN-γ)were evaluated by using enzyme-linked immunosorbent assay on day 1,3 and 5 after admission to hospital.Risk factors for NPE involvement during hospital stay were analyzed with multivariate Logistic regression analysis.Results (1) Compared with the CNSD group,the serum levels of IL-6 (Ftime =1.876,P =0.177,Ftime* group =2.192,P =0.145,Fgroup =7.855,P =0.007),TNF-α(Ftime =13.133,P =0.001,Ftime* group =0.291,P =0.592,Fgroup =3.644,P =0.042),IL-10 (Ftime =14.580,P =0.001,Ftime* group =2.612,P =0.078,Fgroup =16.823,P =0.000),INF-γ (Ftime =3.093,P =0.045,Ftime* group =0.513,P =0.600,Fgroup =20.141,P =0.000) were significantly higher than those in NPE group.(2)The serum levels of TNF-α,IL-10,INF-γ rose to the peak on the third day.(3) By using multivariate Logistic regression analysis,age (OR =3.383,95％ CI:1.173-4.759),days of fever (OR =4.925,95％ CI:1.758-3.794),hyperglycaemia (OR =3.465,95％ CI:1.303-5.220),leucocytosis (OR =7.579,95 ％ CI:2.530-12.704) and elevation of IL-10 (OR =1.228,95 ％ CI:1.007-1.523) were entered into equation.In the risk evaluation model,these variables remained independent predictors for NPE.Conclusions Abnormal cytokine productions appear to be responsible for the pathogenesis of NPE,and might be an effective tool for predicting NPE in infants with severe HFMD.

Objective To evaluate whether High-Dose folic acid supplementation may improve endothelial function in patients with coronary artery disease undergone interventional therapy. Methods Forty six patients with coronary artery disease and undergone interventional therapy were divided into two groups: 23 with folic acid supplement (20 mg/d) and 23 Patients without folic acid as the controls for 6 months. Plasma homocystine (Hcy) was measured by fluorescence polarization immunoassay and Flow-mediated endothelium-dependent dilation (FMD) of the brachial artery was assessed by high resolution ultrasound before and after 6 months. Results Compared with the control, folic acid supplementation resulted in lower plasma Hcy levels (8.82?3.32 ?mol/L vs 13.16?5.06 ?mol/L, P

0.05). The incidence of anastomotic leakage in the control group (16.7%) was higher than that of the study group (4.3%). The area of collagen fibrils 3 d, 5 d and 7d after intestinal anastomosis in the study group were significantly more than that in the control group ( P

Objective To report the clinical effects of repairing skin defects in hand by reversed neu- ro-veno-fasciocutaneous flaps based on the superficial branches of radial nerve.Methods Eleven cases with soft tissue defects around the wrist and the dorsum of the hand were treated with superficial branches of radial nerve-cephalic vein neuro-veno-fasciocutaneous flaps.Results The flaps totally survived in the 9 cases,the others were small distal necrosis.Follow-up survey in the(6-48)months after the oporation showed the appear- ante and function were satisfactory.Conclusion Superficial branches of radial nerve neurofasciocutaneous flap is well supplied with blood and easy to perform.It is the ideal flap to repair the skin defects of the first finger web,radial palm and dorsum of hand.

Objective: To explore a new evaluation method for hospital intangible assets through a case study on evaluation of hospital "Know-how". Methods: Using the contingent valuation method(CVM) we designed a questionnaire to survey the willingness of patients to pay for hospital "Know-how". The data was analyzed by econometrics methods and a model was established for evaluating the "Know-how" in hospitals. Results: Under three scenarios, the effect of "Know-how" increased gradually; the percentages of patients who were willing to pay were 58.48%, 65.50% and 98.54%, respectively. The mean maximal payments were 4,5,and 5 folds that of the basal level. The annual family income was the most important factors influencing the patients' willingness to pay. According to the model established,the value of the hospital "Know-how" was between 85.014 95 million to 252.229 million RMB in 2006. Conclusion: CVM may serve as a new method to evaluate hospital "Know-how" and should be further studied in the future.