ObjectiveTo to evaluate the effects of nimodipine on cerebrovascular function in subarachnoid hemorrhage(SAH) using cerebrovascular hemodynamic indexes (CVAI),and to study the clinical value of CVAI in the dosing of nimodipine after SAH.Methods58 patients with SAH were given nimodipine 0.25 μg/kg·min by intravenous drip(i.v) after admitted to hospital. CVAI and NIHSS were examind before and 1 d, 7 d, 14 d after intravenous. ResultsNimodipine improved cerebrovascular function significantly, including increasing cerebral blood velocity and flow, decreasing cerebrovascular resistance(R) and critical pressure(CP). For those patients with NIHSS worse and R value increased, increased dosing could decrease cerebrovascular resistance(P<0.05) and improve neurological function significantly(P<0.05). ConclusionIndividualization is necessary in dosing of nimodipine treatment of SAH. R value is a important index in adjusting the dose of nimodipine.

ObjectiveTo investigate the relationship between complement-3(C3) and progression of early cerebral infarction.Methods168 consecutive patients with acute cerebral infarction within the first 24 hours from onset were recruited.Fasting venous blood sample was drawn on the morning of the second or the third day after admission.C3 and other clinical chemistry variables were measured.The relationship of C3 and progressing stroke(PS) was analyzed by Logistic regression.Results68 cases(40.48%) were considered as PS.Level of serum C3 in PS patients was 1.28±0.20 g/L higher than in those with non-PS(1.16±0.25 g/L,P=(0.000)).A higher C3 accompanied a higher tendency of prevalence of PS(P=0.001).Logistic regression analysis showed that C3 was significantly correlated with PS(OR for each 1.0 g/L=7.27;95% CI=1.52～36.39; P=0.013).ConclusionElevated serum C3 may play an important role in the prevalence of PS.

The American trauma system is designed to provide an organized response to injury. It draws its foundations from lessons learned from America's involvement in the wars of the 20th century as well as principles developed in urban community hospitals. Although run at the local and state government level, it is guided by national societies and has become a world class example. It also currently faces challenges with declining reimbursement and providing equal access to care for all Americans. Professional societies and legislative bodies are continuing to work together for fair and equitable solutions to these issues.
Humans ; Trauma Centers ; organization & administration ; United States