Objective To explore the reasons for rebleeding and its coping strategies.Methods To study the 19 hypertensive intracerebral hemorrhage patients'medical records who suffered postoperative rebleeding in our department from June 2011 to May 2015.Results Rebleeding time:within 6 hours:11 cases,6 ~24 hours:5 cases, 2 ~3 weeks:3 cases.Among 19 cases,hematoma puncture drainage in 2 cases,small bone window craniotomy surgery in 9 cases,craniotomy with big bone flap decompression in 8 cases,6 cases with severely disabled and 7 cases died. Conclusion Intraoperative bleeding operation is not standardized,early postoperative blood pressure control failure in patients,preoperative instability function are the main causes of postoperative bleeding.Choosing a better operating time,the specification intraoperative hemostasis and controlling blood pressure to stable after surgery can reduce the membership of hypertensive intracerebral hemorrhage incidence of postoperative bleeding.

OBJECTIVETo investigate the effect of astragaloside IV (As IV) on the activation of rennin-angiotensin system in rats with pressure-overload induced cardiac hypertrophy.

METHODLeft ventricle hypertrophy was induced by abdominal aorta banding between bilateral renal aortas for 12 weeks. Rats were given astragaloside IV 1.0 mg x kg(-1) and 3.3 mg x kg(-1) for 12 weeks, respectively. After treatment, the left ventricular mass index (LVMI)was calculated by morphometry methods. Plasma and cardiac tissue angiotensin II, and plasma aldosterone were measured by ELISA method. Gene expressions of ACE, AT1 and AT2 in cardiac tissue were detected by real time PCR. Protein expressions of AT1 and AT2 in cardiac tissue were detected by Western blot.

RESULTCompared with model rats, LVMI was decreased by astragaloside IV treatment. Biochemical results indicated that the contents of angiotensin II in plasma and cardiac tissue as well as aldosterone in plasma were all increased in abdominal aorta banding rats comparing with sham-operated rats, then, decreased by astragaloside IV treatment. Gene expressions of cardiac ACE was downregulated by astragaloside IV, however, gene and protein expressions of cardiac AT2 were upregulated by astragaloside IV. Both elevated gene and protein expressions of AT1 were not attenuated by astragaloside IV.

CONCLUSIONExcessive activated rennin-angiotensin system in rats with pressure-overload induced cardiac hypertrophy is inhibited by astragaloside IV treatment.

Aldosterone ; blood ; Angiotensin II ; blood ; metabolism ; Animals ; Blood Pressure ; physiology ; Cardiomegaly ; drug therapy ; Enzyme-Linked Immunosorbent Assay ; Hypertrophy, Left Ventricular ; drug therapy ; metabolism ; Male ; Peptidyl-Dipeptidase A ; genetics ; Polymerase Chain Reaction ; Rats ; Rats, Sprague-Dawley ; Receptor, Angiotensin, Type 1 ; genetics ; Receptor, Angiotensin, Type 2 ; genetics ; Renin-Angiotensin System ; drug effects ; Saponins ; therapeutic use ; Triterpenes ; therapeutic use

Closed-loop hospital management can effectivly cope with the COVID-19 pandemic. In order to ensure the continuity of treatments for hemodialysis patients under closed-loop management and minimize possible medical and infection risks, Huashan Hospital affiliated to Fudan University and 9 hospitals in Shanghai established a hemodialysis alliance in January 2021.The alliance optimized hemodialysis resources within the region through overall planning by preparing sites, materials and personnel shifts in advance, and establishing management systems and work processes to ensure that patients could be quickly and orderly diverted to other blood dialysis centers for uninterrupted high-quality hemodialysis services, in case that some hemodialysis centers in the alliance under closed-loop management.From November 2021 to April 2022, 317 of 1 459 hemodialysis patients in the alliance were diverted to other centers for treatment, accumulating 1 215 times/cases of treatments without obvious adverse reactions. The practice could provide a reference for medical institutions to quickly establish mutual support mode under major public health events.