1.The Clinical Characteristics of Electrolyte Disturbance in Patients with Moderate and Severe Traumatic Brain Injury Who Underwent Craniotomy and Its Influence on Prognosis
Geng Huan WANG ; Yu YAN ; He Ping SHEN ; Zhengmin CHU
Journal of Korean Neurosurgical Society 2023;66(3):332-339
Objective:
: The present study aimed to investigate the clinical characteristics of electrolyte imbalance in patients with moderate to severe traumatic brain injury (TBI) who underwent craniotomy and its influence on prognosis.
Methods:
: A total of 156 patients with moderate to severe TBI were prospectively collected from June 2019 to June 2021. All patients underwent craniotomy and intracranial pressure (ICP) monitoring. We aimed to explore the clinical characteristics of electrolyte disturbance and to analyze the influence of electrolyte disturbance on prognosis.
Results:
: A total of 156 patients with moderate and severe TBI were included. There were 57 cases of hypernatremia, accounting for 36.538%, with the average level of 155.788±7.686 mmol/L, which occurred 2.2±0.3 days after injury. There were 25 cases of hyponatremia, accounting for 16.026%, with the average level of 131.204±3.708 mmol/L, which occurred 10.2±3.3 days after injury. There were three cases of hyperkalemia, accounting for 1.923%, with the average level of 7.140±1.297 mmol/L, which occurred 5.3±0.2 days after injury. There were 75 cases of hypokalemia, accounting for 48.077%, with the average level of 3.071±0.302 mmol/L, which occurred 1.8±0.6 days after injury. There were 105 cases of hypocalcemia, accounting for 67.308%, with the average level of 1.846±0.104 mmol/L, which occurred 1.6±0.2 days after injury. There were 17 cases of hypermagnesemia, accounting for 10.897%, with the average level of 1.213±0.426 mmol/L, which occurred 1.8±0.5 days after injury. There were 99 cases of hypomagnesemia, accounting for 63.462%, with the average level of 0.652±0.061 mmol/L, which occurred 1.3±0.4 days after injury. Univariate regression analysis revealed that age, Glasgow coma scale (GCS) score at admission, pupil changes, ICP, hypernatremia, hypocalcemia, hypernatremia combined with hypocalcemia, epilepsy, cerebral infarction, severe hypoproteinemia were statistically abnormal (p<0.05), while gender, hyponatremia, potassium, magnesium, intracranial infection, pneumonia, allogeneic blood transfusion, hypertension, diabetes, abnormal liver function, and abnormal renal function were not statistically significant (p>0.05). After adjusting gender, age, GCS, pupil changes, ICP, epilepsy, cerebral infarction, severe hypoproteinemia, multivariate logistic regression analysis revealed that hypernatremia or hypocalcemia was not statistically significant, while hypernatremia combined with hypocalcemia was statistically significant (p<0.05).
Conclusion
: The incidence of hypocalcemia was the highest, followed by hypomagnesemia, hypokalemia, hypernatremia, hyponatremia and hypermagnesemia. Hypocalcemia, hypomagnesemia, and hypokalemia generally occurred in the early post-TBI period, hypernatremia occurred in the peak period of ICP, and hyponatremia mostly occurred in the late period after decreased ICP. Hypernatremia combined with hypocalcemia was associated with prognosis.
2.Understanding the unique characteristics of suicide in China: national psychological autopsy study.
Gong-Huan YANG ; Michael R PHILLIPS ; Mai-Geng ZHOU ; Li-Jun WANG ; Yan-Ping ZHANG ; Dong XU
Biomedical and Environmental Sciences 2005;18(6):379-389
OBJECTIVETo compare the characteristics of suicides in the four main demographic groups: urban males, urban females, rural males and rural females in order to help clarify the demographic pattern of suicides in China.
METHODSA detailed psychological autopsy survey instrument was independently administered to 895 suicide victims in family members and close associates from 23 geographically representative locations from around the country.
RESULTSPesticide ingestion accounted for 58% (519) of all suicides and 61% (318/519) of deaths were due to unsuccessful medical resuscitation. A substantial proportion (37%) of suicide victims did not have a mental illness. Among the 563 victims with mental illness, only 13% (76/563) received psychiatric treatment. Compared to other demographic groups, young rural females who died from suicide had the highest rate of pesticide ingestion (79%), the lowest prevalence of mental illness (39%), and the highest acute stress from precipitating life events just prior to the suicide.
CONCLUSIONMany suicides in China are impulsive acts of deliberate self-harm following acute interpersonal crises. Prevention of suicides in China must focus on improving awareness of psychological problems, improving mental health services, providing alternative social support networks for managing acute interpersonal conflicts, limiting access to pesticides, and improving the resuscitation skills of primary care providers.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Autopsy ; Child ; China ; epidemiology ; Female ; Humans ; Male ; Mental Disorders ; epidemiology ; psychology ; Middle Aged ; Rural Population ; Suicide ; psychology ; statistics & numerical data ; trends ; Urban Population
3.Study on the trend and disease burden of injury deaths in Chinese population, 1991 - 2000.
Gong-huan YANG ; Mai-geng ZHOU ; Zheng-jing HUANG ; Li-jun WANG
Chinese Journal of Epidemiology 2004;25(3):193-198
OBJECTIVEThe mortality and trend of injury in 1991 - 2000, the distribution of causes of injuries by areas as well as disease burden in Chinese population were discussed.
METHODSData on mortality level and causes of injuries provided by National Disease Surveillance Program in 1991 - 2000, adjusted by under-reporting rate together with years of potential life lost (YPLL) and WPYLL of injuries and proportion of YPLL and WPYLL of total death, were calculated.
RESULTSThe mortality of injury was kept at a stable level from 1991 to 2000. The adjusted average death rates were 66.56/100,000 with 81.41/100,000 in males, 51.17/100,000 in females, and 38.68/100,000, 74.63/100,000 in urban and rural populations respectively. Death rates of injury in the east, central and west rural areas were 1:1.14:1.21 respectively. Injury was the main cause of death among children and youths. Traffic accident, suicide, drowning, poisoning and fall were main causes of injury accounting for 70 percent of all the injury mortality. Since 1990's, the death rate of traffic accident had been obviously increasing, YPLL and WPYLL in injury 2132 years/10,000 and 1587 years/10,000, respectively. The YPLL and WPYLL were 24.56% and 26.51% of total deaths.
CONCLUSIONThe disease burden of injury was heavy and the death of injury caused more social and economic losses owing to premature death. The increasing death rate of traffic accident called for more attention. Different effective control strategies should be formulated based on different death causes of injury and different target populations.
Age Factors ; China ; epidemiology ; Female ; Humans ; Male ; Retrospective Studies ; Sex Factors ; Suburban Population ; statistics & numerical data ; Survival Rate ; Urban Population ; statistics & numerical data ; Wounds and Injuries ; epidemiology ; mortality
4.Plasma visfatin level in obese patients of nondiabetic first-degree relatives of type 2 diabetes
Jun LIU ; Ying ZHA ; Fang WANG ; Zao-Ping CHEN ; Jiong XU ; Li SHENG ; Huo-Geng XU ; Xiao-Huan LIAO ; Yu-Ling GUO ;
Chinese Journal of Endocrinology and Metabolism 1986;0(04):-
The plasma visfatin,endothelium-dependent artery dilation and intima-media thickness of common carotid arteries were measured in first-degree relatives of type 2 diabetes,obese patients and control subjects.Regional body fat were detected by MRI.The result suggested that plasma visfatin levels were significantly higher in obese subjects than those in non-obese subjects,and hypervisfatinemia is independently associated with fasting blood glucose.
5.Using general growth balance method and synthetic extinct generations methods to evaluate the underreporting of death at disease surveillance points from 1991 to 1998
Xia WAN ; Mai-Geng ZHOU ; Li-Jun WANG ; Ai-Ping CHEN ; Gong-Huan YANG
Chinese Journal of Epidemiology 2009;30(9):927-932
methods had some limitations. There was big difference between the results when using SEG and GGB, suggesting that we should try to combine GGB and SEG methods to get the better results.
6.Influencing factors of post-traumatic stress disorder in patients with acute myocardial infarction after percutaneous coronary intervention
Huan WANG ; Ming-Ming GENG ; Qian ZHANG
Chinese Journal of cardiovascular Rehabilitation Medicine 2024;33(1):25-30
Objective:To study influencing factors of post-traumatic stress disorder(PTSD)in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods:According to score of PTSD checklist-civilian version(PCL-C),a total of 200 AMI patients undergoing PCI in our hospital were divid-ed into non-PTSD group(n=144,<44 scores)and PTSD group(n=56,≥44 scores).General clinical data,scores of event related rumination inventory(ERRI),Eysenck personality questionnaire(EPQ)and social support rating scale(SSRS)were compared between two groups.Influencing factors of PTSD in AMI patients after PCI were analyzed.Results:There were 56 cases(28.00%)developing PTSD among the 200 AMI patients undergoing PCI.Compared with non-PTSD group,there were significant rise in age,percentage of hypertension,scores of in-vasive rumination of ERRI and neuroticism of EPQ,and significant reductions in percentage of living in town,scores of active rumination and internal & external of ERRI and SSRS in PTSD group(P<0.05 or<0.01).Multiva-riate Logistic regression analysis indicated that age and score of SSRS were independent protective factors for PTSD in AMI patients after PCI(OR=0.885,0.602,P=0.024,0.035),and scores of invasive rumination and neuroti-cism were independent risk factors for it(OR=2.986,3.360,P=0.032,0.025).Conclusion:Incidence rate of PTSD is higher in patients with acute myocardial infarction after PCI.Age,social support,scores of neuroticism and invasive rumination were influencing factors of PTSD in patients with acute myocardial infarction after PCI.
7.Effect of Podophyllotoxin Conjugated Stearic Acid Grafted Chitosan Oligosaccharide Micelle on Human Glioma Cells
Geng Huan WANG ; He Ping SHEN ; Xuan HUANG ; Xiao Hong JIANG ; Cheng Sheng JIN ; Zheng Min CHU
Journal of Korean Neurosurgical Society 2020;63(6):698-706
Objective:
: To study the physiochemical characteristics of podophyllotoxin (PPT) conjugated stearic acid grafted chitosan oligosaccharide micelle (PPT-CSO-SA), and evaluate the ability of the potential antineoplastic effects against glioma cells.
Methods:
: PPT-CSO-SA was prepared by a dialysis method. The quality of PPT-CSO-SA including micellar size, zeta potential, drug encapsulation efficiency and drug release profiles was evaluated. Glioma cells were cultured and treated with PPT and PPT-CSO-SA. The ability of glioma cells to uptake PPT-CSO-SA was observed. The proliferation of glioma cells was determined by 3-[4, 5-dimethyl-2-thiazolyl]-2, 5-diphenyl-2H-tetrazolium bromide (MTT) assay. The apoptosis and morphology of U251 cells were observed by 4’,6-Diamidino-2-phenylindole dihydrochloride (DAPI) dye staining. Cell cycle analysis was performed by flow cytometry. The migration ability of U251 cells was determined by wound healing test.
Results:
: PPT-CSO-SA had nano-level particle size and sustained release property. The encapsulation efficiency of drug reached a high level. The cellular uptake percentage of PPT in glioma cells was lower than that of PPT-CSO-SA (p<0.05). The inhibitory effect of PPT-CSO-SA on glioma cells proliferation was significantly stronger than that of PPT (p<0.05). The morphologic change of apoptosis cell such as shrinkage, karyorrhexis and karyopyknosis were observed. The percentage of U251 cells in G2/M phase increased significantly in the PPT-CSO-SA group compared with PPT group (p<0.05). Compared with the PPT group, the cell migration ability of the PPT-CSO-SA group was significantly inhibited after 12 and 24 hours (p<0.05).
Conclusion
: PPT-CSO-SA can effectively enhance the glioma cellular uptake of drugs, inhibit glioma cells proliferation and migration, induce G2/M phase arrest of them, and promote their apoptosis. It may be a promising anti-glioma nano-drug.
8.Study on the quality of death-case-reporting-system in county and above levels' medical institutions in 2004.
Mai-geng ZHOU ; Yu-ying WANG ; Hui GE ; Li-jun WANG ; Jia-qi MA ; Gong-huan YANG
Chinese Journal of Epidemiology 2006;27(4):328-332
OBJECTIVETo study the quality of reporting network system on death cases among county and above levels' medical institutions.
METHODSData on variables related to county reporting rate, unit reporting rate, timeliness of reporting, eligibility rate of reporting, auditing rate, timeliness of auditing, eligibility rate of auditing, percentage of reporting deaths of medical institutes to deaths among total population, percentage of reporting deaths of county and above levels' medical institutes to deaths among estimated deaths at these institutes were collected and distribution of common coding errors was applied to the assessment of reporting deaths.
RESULTSThe total reporting rates were: 82.58% at the county level, 42.79% at the units with auditing rate as 96.96%. The eligibility rate of reporting was 69.10% with eligibility rate of auditing as 73.58%. The percentage of reporting deaths from medical institutes to deaths among total population was 8.91%, and the percentage of reporting deaths of county and above levels' medical institutes to deaths among estimated deaths of these institutes was 30.76%. The percentage of obvious coding errors among deaths reported by county and above levels' medical institutes was as high as 22.87%.
CONCLUSIONNetwork reporting system of death cases among county and above levels' medical institutes had remarkably increased the timeliness of data reporting system. Network reporting of data on death was the best opportunity to expand the coverage and to improve the quality of data reporting. Based on network reporting of death cases among county and above levels' medical institutes as well as deaths accrued at the communities should also be reported via this network in the eligible areas. The quality of coding on death causes among medical institutes were commonly poor, indicating that the training on ascertainment and coding of underlying death causes were quite essential.
China ; epidemiology ; Death Certificates ; Forms and Records Control ; standards ; Health Facilities ; statistics & numerical data ; Humans ; Mortality ; Quality Control
9.Study on the evaluation of underreporting and the quality of death cases reporting system, from medical institutions at county level and above, in 2005.
Li-jun WANG ; Jia-qi MA ; Mai-geng ZHOU ; Yu-ying WANG ; Hui GE ; Gong-huan YANG
Chinese Journal of Epidemiology 2007;28(6):571-575
OBJECTIVETo understand the underreporting on death cases through web-based reporting system from medical institutions at county level and above as well as to evaluate the quality of death cases reporting through the system.
METHODSA large-scale survey was conducted at 130 medical institutions based on stratified random sampling and to evaluate the underreporting and the quality of death cases reporting from medical institutions through data from survey and reporting system.
RESULTSIn 2005, the total reporting rates were 78.25% at the county level and 37.93% at the institutes. Comparing with the results of 2004, these rates were going down slightly. The eligibility rate of reporting was 79.62%, increased when comparing with results of 2004. The percentage of obvious coding errors among deaths reported by county level and above medical institutions was 24.68%. A total of 5226 death cases were recorded from medical (outpatient and inpatient) sources. An average underreporting rate of 33.07% was found at the selected medical institutions. Statistical difference of underreporting rate was not found at medical institutions at different levels.
CONCLUSIONSince the initiation of the web-based reporting system of death cases at medical institutes from county level and above, the timeliness of data reporting had been increasing remarkably. The system showed irreplaceable advantages. However, there still existed some problems such as the underreporting of death cases,the poor timeliness of reporting, and the poor accuracy of coding. In the meantime, it was noticed that repetitive work existed among medical institutions due to multi-systems, suggesting that it was necessary to establish a national life registration in China.
China ; epidemiology ; Death Certificates ; Forms and Records Control ; standards ; Health Facilities ; standards ; statistics & numerical data ; Humans ; Local Government ; National Health Programs ; standards ; statistics & numerical data ; Public Health Informatics ; standards ; Quality Control
10.Clinical features of the overlap syndrome of autoimmune hepatitis and primary biliary cirrhosis: retrospective study.
Chi-hong WU ; Qin-huan WANG ; Geng-shan TIAN ; Xiao-yuan XU ; Yan-yan YU ; Gui-qiang WANG
Chinese Medical Journal 2006;119(3):238-241
Adult
;
Aged
;
Female
;
Hepatitis, Autoimmune
;
blood
;
complications
;
drug therapy
;
pathology
;
Humans
;
Liver Cirrhosis, Biliary
;
blood
;
complications
;
drug therapy
;
pathology
;
Male
;
Middle Aged
;
Retrospective Studies