Objective To investigate the gradient changes of bilateral cerebral hemisphere pressure after lateral hemisphere injury and observe their effects on craniotomy. Methods Twenty-four patients with cerebral contusion and subdural intracerebral hematoma were included in this study. All patients received brain parenehyma pressure (BPP) monitoring by introducing optic fibro sensor into each cerebral hemisphere via the frontal lobe. All patients underwent surgical craniotomy for evacuation of space occupying lesions such as cerebral hemisphere contusion, subdural and/or intracerebral hematoma.Preoperative and postoperative BPP data at different time points were recorded and analyzed. Results Preoperative BPP value of the injured hemispheres was significantly higher than that of the other hemisphere (P ＜ 0. 01 ). There was no significant statistical difference upon BPP value at 0, 24 and 48 hours after operation between both hemispheres ( P ＞ 0.05 ). The postoperative BPP value of bilateral hemispheres was lower than the preoperative one. Conclusions BPP monitoring sensors should be introduced into the injured hemisphere so that the valuable information can be timely showed. When the cerebral hemisphere has lesions after brain injury, such lesion becomes the source of elevated intracranial pressure and can result in bilateral hemisphere pressure gradient. Craniotomy can not only effectively lower the intracranial pressure, but also eliminate the BPP gradient, which contritbutes to reposition of the oppressed brain tissue.

Objective To explore the change of activin A(ACT A) in umbilical artery blood of newborns with fetal distress and its clinical significance.Methods Forty healthy pregnant women(control group)and 35 pregnant women with fetal distress (experimental group)were collected.The levels of ACT A of umbilical artery blood in both groups were determined by a solid quantitative biotin-avidin system enzyme-linked immunosorbent assay(BAS-ELISA),umbilical artery blood gas were also measured.Results The level of ACT A of umbilical artery blood in fetal distress group was (1 235.89?178.78)ng/L,and that in control group was (627.28?75.24)ng/L,and the level of ACT A of umbilical artery blood in fetal distress group was significantly higher than that in control group(P

Objective To study the correlation between pulse pressure(PP) and cardiovascular structure and function in aged patients with essential hypertension. Methods Forty-eight aged patients with essential hypertension were enrolled into the study and divided into the following two groups by the mean value of PP: PP

Objective To investigate the causes,consequences and management of injuries to the draining veins after embolization of brain arteriovenous malformations(BAVMs)with ?-n-butyl cyanoacrylate (NBCA).Methods The angiographic imaging data of 189 BAVMs patients who underwent NBCA embolization were studied retrospectively.The status of the draining veins before and after NBCA embolization was observed and compared.The intracerebral hemorrhage(ICH)complications and their relation to their angiographic features were analyzed.Results Twenty-three patients out of 189 patients showed injuries to the draining venous system,including 10 low-grade injury,6 moderate injury,and 7 high- grade injury.Six patients suffered from ICH after embolization,of whom 4 patients were due to injuries of the draining veins(2 moderate and 2 high-grade).In the 3 months follow-up evaluation of 4 patients with ICH, one died,one was in vegetative state,and the other two patients suffered from residual severe or minor (1 patient for each)permanent neurological deficits.Conclusion Our findings suggest that injury of the draining veins is the major cause of ICH and may lead to serious consequences after embolization of BAVMs with NBCA.

Objective To evaluate the short-term efficacy and safety of sevelamer hydrochloride in treating maintenance hemodialysis (MHD) patients with hyperphosphemia.Methods A multicenter,open-labeled,self-control study was performed.Phosphate binders were discontinued during a two-week washout period.Patients with more than 1.78 mmol/L serum phosphorus after two-week washout period were eligible for the trial.The dose was adjusted every two weeks as necessary to achieve serum phosphorus control. Sevelamer hydrochloride was administered to 138 MHD patients for 10 weeks and a second two-week washout period followed.Results A total of 111 from 138 patients fulfilled the whole 14-week study. Mean serum phosphorus and calcium-phosphate products starte to decline after two-week sevelamer hydrochloride treatment. By the end of 10-week sevelamer hydrochloride treatment, mean serum level of phosphorus [(1.85±0.50) vs (2.57±0.54) mmol/L,P＜0.01],calcium-phosphate product [(4.16± 1.72) vs (5.79 ± 1.50) mmol2/L2,P＜0.01 ] and low density lipoprotein [(1.64±0.76) vs (2.31 ±0.87) mmol/L,P＜0.01] were significantly decreased,while the adjusted serum level of calcium and serum intact parathyroid hormone kept steady.Both serum phosphorus and calcium-phosphrus product increased after the second washout period, but the levels were still lower as compared to pre-treatment [(2.26±0.71) vs (2.57±0.54) mmol/L; (5.12±1.63) vs (5.79±1.50) mmol2/L2,P＜0.01].Of the 138 patients involved,214 episodes in 106 patients and 121 episodes in 89 patients were reported as adverse events and adverse drug reaction respectively. Gastrointestinal symptoms,of which most were mild or moderate,happened to 68.1％ (94/138) patients. Conclusions Sevelamer hydrochloride can control serum phosphorus and reduce the levels of calcium-phosphorus product and cholesterol.Slight gastrointestinal symptoms like constipation are common during the treatment.

China ; epidemiology ; Humans ; Hysteria ; epidemiology ; Schools

OBJECTIVETo detect the changes in serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in patients with cardiovascular diseases and explore its clinical significance.

METHODSSerum NT-proBNP concentrations were measured by electrochemiluminescent immunoassay (ECLIA) in 460 patients with cardiovascular diseases and in 50 normal controls, and echocardiographic examination was performed to determine the left ventricular ejection function (LVEF). Analysis of NT-proBNP was performed for its correlation to New York Heart Association (NYHA) functional classifications LVEF, and risk factors of cardiovascular diseases.

RESULTSThe serum LgNT-proBNP concentrations was 3.74 in patients with cardiovascular diseases, significantly higher than that of normal controls (1.42, P<0.001). NT-proBNP concentrations also varied significantly among patients with different cardiovascular diseases as shown by one-way ANOVA analysis (F=17.761, P<0.001). The NT-proBNP levels increased with the severity of heart failure according to NYHA functional classifications (P<0.001), and varied significantly in patients suffering different cardiovascular diseases with the same NYHA functional class. Multivariable regression analysis indicated there were significant correlations of NT-proBNP levels with the patients' age (r=0.152, P<0.001), NYHA functional classifications (r=0.725, P<0.001), LVEF (r=-0.634, P<0.001), and clinica outcomes (r=-0.581, P<0.001). Logistic regression analysis identified NT-proBNP level as a strong indicator for cardiovascular events (HR=2.763, P<0.01) with close correlation to the treatment results.

CONCLUSIONSSerum NT-proBNP level varies significantly with the severity of heart failure and can be indicative of the patients' cardiac function in close correlation to the clinical prognosis, but its value for diagnostic stratification of cardiovascular diseases awaits further investigation.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Coronary Disease ; blood ; physiopathology ; Female ; Heart Failure ; blood ; physiopathology ; Humans ; Immunoassay ; methods ; Male ; Middle Aged ; Natriuretic Peptide, Brain ; blood ; Peptide Fragments ; blood ; Stroke Volume ; physiology ; Ventricular Function ; Young Adult

OBJECTIVETo estimate the reliability of heart-type fatty acid-binding protein (H-FABP) for identifying acute coronary syndrome (ACS) in the early stage of chest pain onset.

METHODSThis investigation was conducted based on a small population consisting of 40 healthy individuals, 19 established AMI patients and 20 unstable angina pectoris (UAP) patients. Serum H-FABP concentrations were measured in these subjects by sandwich ELISA, and receiver operating characteristics (ROC) curves for H-FABP for diagnosing AMI and UAP against normal subjects were then generated respectively. The areas under curve (AUCs) were calculated, and 0.5 was defined as the critical value of AUC to evaluate the diagnostic ability.

RESULTSThe concentrations of H-FABP in healthy individuals, AMI patients and UAP patients were 1.29+/-0.64, 24.45+/-32.40 and 1.95+/-3.11 ng/ml, respectively; AUC (AMI) and AUC UAP were 0.978 (95%CI: 0.948-1.000) and 0.503 (95% CI: 0.334-0.671) respectively, and the former was significantly greater than 0.5.

CONCLUSIONSIn the early stage of chest pain onset H-FABP detection is sufficient in distinguishing AMI patients from healthy individuals, but not capable of distinguishing UAP patients from healthy individuals. H-FABP may be used as a diagnostic biochemical marker in the early stage of AMI.

Acute Coronary Syndrome ; blood ; diagnosis ; Adult ; Area Under Curve ; Biomarkers ; blood ; Early Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Fatty Acid-Binding Proteins ; blood ; Female ; Humans ; Male ; ROC Curve ; Sensitivity and Specificity

OBJECTIVETo evaluate the diagnostic value of serum procalcitonin (PCT) and C-reactive protein (CRP) in patients with acute exacerbation of chronic bronchitis.

METHODSThe PCT and CRP levels were detected in 56 patients with acute exacerbation of chronic bronchitis and 58 healthy control subjects.

RESULTSThe serum PCT level and positivity rate were significantly higher in the case group than in the control group (P<0.05); the serum CRP level was also significantly higher in the case group (P<0.05), but the positivity rate of CRP was similar between the two groups (P>0.05). The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy rate of PCT were higher than those of CRP.

CONCLUSIONSerum PCT is more sensitive than CRP in the diagnoses of acute exacerbation of chronic bronchitis, and can be used as a specific indicator for monitoring the condition of the patients.

Adolescent ; Adult ; Bronchitis, Chronic ; blood ; diagnosis ; C-Reactive Protein ; metabolism ; Calcitonin ; blood ; Calcitonin Gene-Related Peptide ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Protein Precursors ; blood ; Sensitivity and Specificity ; Young Adult

OBJECTIVETo observe the impact of growth-factor hormone control on the outcome of acromegalic cardiomyopathy by reviewing cases from our own center and from literatures.

METHODSTwo cases of acromegalic cardiomyopathy from Tongji hospital and 29 acromegalic cardiomyopathy cases with fully accessible data retrieved from PubMed and CNKI websites were included in present study for analysis. They were divided into "Controlled (< 5 microg/L)" or "Uncontrolled" group according to the serum level of growth factor hormone after treatments. Outcome of patients was evaluated by symptom, NYHA class, LV size and function status.

RESULTSIncidence of patients with improved symptoms and cardiac performance was significantly higher in "Controlled" group (18/19) compared to those in "Uncontrolled" group (0/12; P < 0.01, chi(2) = 27.1). Post-treatment growth-factor hormone level < 5 microg/L is significantly associated with a satisfactory outcome of acromegalic cardiomyopathy (r = 0.935, P < 0.01).

CONCLUSIONSControl of serum growth-factor concentration to a value < 5 microg/L is critical and associated with a favorable outcome for patients with acromegalic cardiomyopathy.

Acromegaly ; complications ; therapy ; Aged, 80 and over ; Cardiomyopathies ; etiology ; therapy ; Human Growth Hormone ; therapeutic use ; Humans ; Male ; Middle Aged ; Treatment Outcome