1.The prognostic evaluation of arterial blood lactate and lactate clearance rate in patients with craniocerebral trauma
Jing HUANG ; Changbao HUANG ; Zhaorui SUN ; Ji XIE ; Zhizhou YANG ; Danbing SHAO ; Yang XU ; Hongmei LIU ; Shinan NIE
Journal of Medical Postgraduates 2016;29(9):933-936
Objective After acute craniocerebral trauma , to a certain extent , arterial blood lactate and lactate clearance rate reflect the illness severity .We aimed to investigate the prognosis value of arterial blood lactate and lactate clearance rate in patients with craniocerebral trauma . Methods 94 cases with craniocerebral trauma treated in the Department of Emergency of Nanjing General Hospital of Nanjing Military Regionfrom February 2015 to November 2015 were retrospecively analysed .GCS ( Glasgow Coma Scale ) score, arterial blood lactate , blood pressureand heart rate were measured once patients admitted to hospital and 6 hours later ,arterial blood lactate was measured again to calculated the arterial blood lac-tate clearance rate .Based on the GCS score , we divided the patients into mild group (13-15), medium group (9-12) and severe group (3-8).We also divided the patients into death group and survival group according toprognosis .We compared arterial blood lactate and lactate clearance rate betweeeneach group respectively . Results There were significant differences in arterial blood lactate (F=19.99,P<0.01) and 6h lactate clearance rate(F=6.21,P<0.01)be-tween lighter group , medium group and severe group .The initial arterial blood lactate of death group was significantly higher than sur-vival group[(4.20 ±1.36)mmol/L vs (1.58 ±0.93)mmol/L], the difference was statistically significant (t=-9.78,P<0.01). The 6 h lactate clearance rate of death group was significantly lower than survival group [(31.73 ±12.84)%vs (46.25 ±12.01)%], the difference was statistically significant (t=4.55,P<0.01). Conclusion Arterial blood lactate and 6 h lactate clearance rate can evaluate the severity and prognosisof illnessin patients with craniocerebral traumaand have important application value in clinical work .
2.Hemispherotomy for hemisphericepilepsy: outcome and early follow up for complications
Wanchen DOU ; Yi GUO ; Jinzhu GUO ; Changbao SU ; Qiang LU ; Liri JIN ; Yan HUANG ; Xiangqin ZHOU ; Liwen WU
Basic & Clinical Medicine 2017;37(5):723-725
Objective To investigate the results and complications of hemispherotomy for drug resistant hemispheric epilepsy.Methods The authors reviewed 5 patients who were diagnosed as drug resistant hemispheric epilepsy and operated in the neurosurgery department of Peking Union Medical College Hospital from 2011 to 2013.All the 5 patients were underwent hemispherotomy after carefully multidisciplinary pre-operation evaluation.Results All patients tolerated the procedure well and the postoperative course was smooth.All the 5 patients didn`t have seizure in the period of following up of 46 to 69 months.Conclusions According to literatures and the authors` experience, hemispherotomy is as safe and efficient for hemispheric epilepsy as hemispherectomy.It is most important advance for hemispherectomy.The procedure of hemispherotomy is complex but not very difficult, illustrating a good prospect of application and extension.
3.Comparative study of the incidence of early complications among the patients with six different kinds of acute organophosphorus pesticide poisoning
Wei ZHANG ; Changbao HUANG ; Yun JIANG ; Lina BAI ; Xigang ZHANG
Chinese Journal of Emergency Medicine 2017;26(11):1247-1251
Objective To explore the incidence of early complications within 72 hours among patients with six kinds of acute organophosphorus pesticide poisoning,thus to provide reference for the clinical treatment.Methods The retrospective study analyzed the clinical data of 335 cases with acute oral organophosphorus pesticide poisoning treated in Emergency Department of 307 Hospital of PLA from July 2008 to December 2015.Patients were divided into six groups according to the results of serum toxicology tests:acute phorate group (group A),acute dichlorvos group (group B),acute omethoate group (group C),acute dimethoate group (group D),acute phoxim group (group E) and acute parathion group (group F).The incidence of complications among the six groups were compared.The main analysis method was ranks test.Results There were no significant differences among the six groups in the incidence of cerebral edema,liver injury,kidney injury,myocardial injury,gastrointestinal hemorrhage and acute pancreatitis (P > 0.05),while the mortality and the incidence of sudden cardiac arrest (SCA),respiratory failure,circulatory failure,multiple organ dysfunction syndrome (MODS),coagulation disorders and capillary leak syndrome (CLS) were significantly different among the six groups (P < 0.05).The incidence of SCA wihin 24 hours in acutedichlorvos group reached up to 17.8%,and in other groups was as follows:acute parathion group (11.1%),acute dimethoate group (8.9%),acute phorate group (7.8%) and acute omethoategroup (1.5%).However,no one developed SCA in acute phoxim group.The total incidence of circulatory failure in all patients was 10.1%;dichlorvos group 31.1% and dimethoate group (22.2%) had higher rates than other groups.The incidence of respiratory failure in all groups reached over 20%,while the total incidence was 36.7%,whereby,acute phorate group with a high of 46.7%,acute dichlorvos group with 44.4%,acute parathion group with 44.4% and acute dimethoate group with 42.2%,respectively.The total incidence of coagulation disorders was 9.6%,while the incidences of the acute dichlorvos group (24.4%),acute phorate group (11.6%) and acute parathion group (11.1%) were higher than 10%.CLS confined to occur in acute dichlorvos group (11.1%) and acute phorate group (2.5%).However,MODS occurred mainly in acute dichlorvos group (28.9%) and acute parathion group (22.2%).Conclusions The incidences of early complications among the six groups are different,while acute oral dichlorvos poisoning patients tend to occur SCA.Within 72 h of poisoning,acute phorate poisoning group is more prone to respiratory failure,and acute dichlorvos poisoning group is more likely to develop coagulopathy disorders,circulation failure,CLS and MODS.Those patients in acute omethoate and acute phoxim poisoning groups have less risk to develop life-threatening complications except respiratory failure.
4.A Meta analysis on the associations between air pollution and respiratory mortality in China.
Changjing LIU ; Fei HUANG ; Zhizhou YANG ; Zhaorui SUN ; Changbao HUANG ; Hongmei LIU ; Danbing SHAO ; Wei ZHANG ; Yi REN ; Wenjie TANG ; Xiaoqin HAN ; Shinan NIE ; Email: SHN_NIE@SINA.COM.
Chinese Journal of Epidemiology 2015;36(8):889-895
OBJECTIVETo analyze the associations between air pollution and adverse health outcomes on respiratory diseases and to estimate the short-term effects of air pollutions [Particulate matter with particle size below 10 microns (PM(10)), PM(10) particulate matter with particle size below 2.5 microns (PM(2.5)), nitrogen dioxide (NO₂), sulphur dioxide (SO₂) and ozone (O₃)] on respiratory mortality in China.
METHODSData related to the epidemiological studies on the associations between air pollution and adverse health outcomes of respiratory diseases that published from 1989 through 2014 in China, were collected by systematically searching databases of PubMed, SpringerLink, Embase, Medline, CNKI, CBM and VIP in different provinces of China. Short-term effects between (PM(10), PM(2.5), NO₂, SO₂, O₃) and respiratory mortality were analyzed by Meta-analysis method, and estimations were pooled by random or fixed effect models, using the Stata 12.0 software.
RESULTSA total of 157 papers related to the associations between air pollution and adverse health outcomes of respiratory diseases in China were published, which covered 79.4% of all the provinces in China. Results from the Meta-analysis showed that a 10 µg/m³ increase in PM10, PM(2.5), NO₂, SO₂, and O₃was associated with mortality rates as 0.50% (95% CI: 0-0.90%), 0.50% (95% CI: 0.30%-0.70%), 1.39% (95% CI: 0.90%-1.78%), 1.00% (95% CI: 0.40%-1.59%) and 0.10% (95% CI: -1.21%-1.39%) in respiratory tracts, respectively. No publication bias was found among these studies.
CONCLUSIONThere seemed positive associations existed between PM(10)/PM(2.5)/NO₂/SO₂and respiratory mortality in China that the relationship called for further attention on air pollution and adverse health outcomes of the respiratory diseases.
Air Pollutants ; Air Pollution ; adverse effects ; China ; epidemiology ; Humans ; Models, Theoretical ; Nitrogen Dioxide ; Ozone ; Particulate Matter ; Respiratory Tract Diseases ; epidemiology ; mortality ; Sulfur Dioxide