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Molecular mechanisms of Triple H therapy in the treatment of SAH-induced vasospasm

Ishiguro MASANORI ; B.puryear COREY ; Bisson ERICA ; Jewell RYAN ; J.nathan DAVID ; I.tranmer BRUCE ; C.wellman GEORGE

Journal of Third Military Medical University.2004;26(4):301-303.

Objective Cerebral artery vasospasm is a major cause of death and disability in patients experiencing subarachnoid hemorrhage (SAH). Vasospasm typically has been evaluated using angiography to examine narrowing of large diameter (>1 mm) cerebral arteries. Currently, little is known regarding the impact of SAH on small diameter (100～200 μm) cerebral arteries, which play an important role in the autoregulation of cerebral blood flow. The goal of the current study was to examine the influence of SAH on the pressure-diameter relationship of these small diameter blood vessels. Methods Small diameter cerebral arteries were obtained from a rabbit SAH model. Isolated artery segments were canulated and placed in a myograph chamber superfused with warmed, oxygenated, physiological saline solution. Diameter measurements were then recorded to step-wise increases in intravascular pressure. Results Cerebral arteries from SAH animals exhibited a significant increase in pressure-induced constrictions (myogenic tone) at intravascular pressures between 40 mmHg and 120 mmHg. At intravascular pressures above 120 mmHg, myogenic tone began to decrease and was abolished at pressures above 180 mmHg. Conclusion These data suggest that in the days following SAH, myogenic tone is enhanced in small diameter cerebral arteries subjected to physiological levels of intravascular pressure. However, supra-physiological intravascular pressures causes vasodilation, suggesting small diameter cerebral arteries may act as therapeutic targets of hypervolemia, hemodilution, and hypertension "Triple H therapy" used in the treatment of cerebral artery vasospasm.

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Design and development of a portable multi-parameter monitoring system based on an 8Xc196Mc single-chip microcomputer

Xiaolan DU ; Baoming WU ; Qinghua HE ; Yan LIU ; Jian XIAO ; Xiangdong LI

Journal of Third Military Medical University.2001;23(5):605-607.

Objective　To design and develop a portable multi -parameter life sign monitor. Methods　Electrocardiogram (ECG). blood pressure(BP), breath frequency (BF), heart rate (HR) and body temperature (BT) in real time were recorded with a single-chip microprocessor 8Xc196Mc and a high-resolution (640×200) graphic liquid crystal display (LCD) through sign al detecting and processing techniques. Results　This system cou ld display the ECG wave, and other parameters in real time dynamically. It could also provide a 24 hours trend graph for each parameter measured and exchange th e data through the serial communication interface (RS232) with the PC. C onclusion　This portable monitoring system is capable of performing cont inuous monitoring and also has the capability to resist environmental interferen ce through the added design, so it can be used widely.

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Therapeutic effect of intracranial hematoma smash puncture on the aged patient with cerebral hemorrhage

Jianmin YU ; Bo JU ; Yan WANG

Journal of Third Military Medical University.2001;23(5):603-604.

Objective　To analyze the advantages of intracrani al hematoma smash puncture (IHSP) in the treatment of cranial hemorrhage for the elderly. Methods　A total of 104 cases of cerebral hemorrhage a dmitted in the recent 3 years were collected and divided into 4 grou ps, i.e . group A, elderly with IHSP treatment (n=36), group B, elderly with regular medical treatment (n=33), group C, non-elderly with IHSP treatment (n= 21) and group D, non-elderly with routine therapy (n=14). The clinical and follow-up outcomes were studied and analyzed. Results　There w as significant difference in rehemorrhage rate after puncture between grou p A (0/36) and group C (2/21). Significant difference was found in early mortali ty rate in group A (16.67%) and group B (39.40%). The rate of activity of daily living (ADL) 1-2 was significantly higher in group A (58.62%) than group B (5.88 %)(P<0.005) and that of ADL 4-5 was obvious lower in group A (13.79%) than g roup B (47.06%)(P<0.025). Conclusion　Intracranial hematoma smash hemorrage is safe and efficient in the treatment of elderly cerebr al hemorrhage, especially in reducing the disability rate.

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Effects of nutritional intervention on the micronutrients metabolis m of radar operators

Yuangang SHI ; Mantian MI ; Na WEI

Journal of Third Military Medical University.2001;23(5):601-602.

Objective　To explore the metabolism of micronutri ents related to dark adaptation of radar operators through nutritional intervent ion. Methods　A total of 34 male radar operators aged between 18 ～29 years old were randomly divided into control and experimental groups. The c ontrol group were on normal diet, and the experimental group received the supple ment of VA, Zn and Se in additional to normal diet. The experiment lasted 4 week s. The levels of serum VA, Zn and Se were measured before and after the experime nt. Results　The levels of serum VA, Zn and Se in the experime ntal group were significantly higher than that in the control group after the experiment (P<0.01). Conclusion　The supplement of VA, Zn an d Se for 4 weeks may elevate, the levels of serum VA, Zn and Se significantly (reached or surpassed normal levels) and suggests that VA, Zn and Se su pplementation may effectively enhance the dark adaptation of radar operators.

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Diagnostic value of imaging for cerebral arteriovenous malformation

Qingrong SUN ; Shichen LIU ; Wenxian WANG ; Lin CHEN

Journal of Third Military Medical University.2001;23(5):598-600.

Objective　To evaluate the diagnostic value of MR I、CT、DSA for cerebral arteriovenous malformation(AVM). Methods　A total of 40 case of AVM were examined with imaging methods in which 19 MRI, 30 CT and, 12 DSA. Combination of two or three kinds of eximinations were perfo rmed in 20 and 4, respectively. Results　Diagnostic accordance r ate rate of CT was 70%, sensitivity and specificity of MRI were 100% and 84% res pectiv ely, diagnostic accordance rate of DSA was 92%. Conclusion　MRI,CT,D SA can play important roles in the diagnosis of AVM. MR and DSA are superior to CT. DSA could reveal the circulation time and the stealing blood situation of AV M and thus suggests the applicability of interventional embolization therapy.

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Microvessel quantitation and VEGF expression in colorectal carcinoma an d metastatic tissues

Yaxu WANG ; Zengpeng LI

Journal of Third Military Medical University.2001;23(5):596-597.

Objective　To explore the relationship between angiogenesis and tumor metastasis and prognosis by studying the angiogen esis in colorectal carcinoma tissues and metastasized tissues. Me thods　The microvessel density (MVD) and the expression of vascular endo thelial growth factor (VEGF) were studied with immunohistochemical assays in 15 samples of colorectal carcinoma with lymph node and liver metastasis, 20 specime ns of colorectal carcinoma without metastasis. Normal rectal mocosal tissues wer e taken from 10 cases of colorectal carcinoma with metastasis and 10 without.Re sults　The MVD was obviously higher in the cases of colorectal carcinoma with or without metastasis than in normal rectal tissues, and that in those wit h metastasis was higher than that of those without. The MVD was significantly hi gher in those positive to VEGF staining than those negative in colorectal carcin oma tissues and metastasized tumors. Conclusion　The MVD and VEG F expression can be regarded as indexes for tumor metastasis and prognosis in co lorectal carcinoma.

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RCT on the therapautical effect of mospride citrate in functional dyspe psia

Siping DA ; Xiaoyan ZHAO ; Yihui LI ; Hongyuan SU ; Juyou DENG

Journal of Third Military Medical University.2001;23(5):593-595.

Objective　To observe the curative effect and sid e effect of the gastrokinetic agent mosapride citrate by RCT. Methods　 42 cases of functional dyspepsia (FD) were divided into two groups rando mly, the group of mosapride(21 cases):orally administrated mosapride, 5mg, t.i.d for 4 weeks, and the control (21 cases):orally administrated domperidone, 5mg, t.i.d for 4 weeks. Symptoms and side effects were recorded before and at d 14, d 28 after administration of the medicines according to GCP and double blind pri ciple. Gastric empting test was also carried out in randomly selected patients. Results　Mosapride and domperidone were significantly effective on alleviating symptoms of the patient with FD. In mosapride treated group the half emptying time was shortened and the 120 min remain rate was reduced. No sid e effect was found. Conclusion　These results suggest that mosa pride 5 mg t.i.d. is effective and safe on alleviating symptoms of patients with FD and improving the ga stric empting time.

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Correlative multifactor analysis on frequency of ventricular premature beats in coronary heart disease

Bing LIU ; Guoliang JIA ; Wenyi GUO ; Lanfang CHEN

Journal of Third Military Medical University.2001;23(5):591-592.

Objective　To investigate the prognosis in risk of ventricular arrhythmia in coronary heart disease with heart rate variability (H RV), left ventricular ejection fraction (LVEF) and other clinical background dat a. Methods　A total of 81 patients were divided into ventricular premature beats (VPBs)≥30/h group and VPBs<30/h group. Their LVEF, HRV and cli nical data were studied and analyzed. Results　The age and blood pressure between 2 groups had no significant difference. LVEF, standard deviati on of all normal RR intervals (SDNN), SD of the average of NN interval (SDANN) a nd HRV triangular index (HRVI) were significant less in VPBs≥30/h group than in VPBs<30/h group (43.29±15.38 vs 67.33±11.47，P＜0.01；90.05±22.2 9 vs 117.90±30.32，P＜0.05；77.43±17.78 vs 105.69±28.79，P＜0.05 ；24.54±8.70 vs 32.70±10.87，P＜0.05, respectively). Incidence of myo cardial infarction (MI) was larger in VPBs≥30/h group than VPBs<30/h group. LVE F was the independent predictable factor in risk of ventricular arrhythmia with multinomial regression logistic analysis（B=0.119, P=0.032）. Co nclusion 　Our findings indicate that LVEF is an independent predictable factor i n risk of ventricular arrhythmia in coronary heart disease. Although HRV and MI history can not be used to predict VPB, significant difference is found between 2 groups. High-risk patients could be selected successfully when these data are considered in combination.

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Effect of positive pressure ventilation on radiosensitivity of human pr imary lung cancers

Wei XIONG ; Hanfang SHEN ; Weidong ZHANG

Journal of Third Military Medical University.2001;23(5):588-590.

Objective　To investigate the effect of positive pressure ventilation on radiosensitivity of the patients suffering from primary lung cancer. Methods　Thirty cases of lung cancer were randomly divided into two groups: ① combining therapy group: patients treated with posi tive pressure ventilation using BiPAP respirator and radiotherapy;② simple radi otherapy group. The changes of PaO2, SaO2, blood white cells and the cellula r immunological function were observed before and after treatment. Resul ts　Nasal or naso-facial positive pressure ventilation with BiPAP respi rator increased PaO2 significantly with the maximum of 7.5 kPa, SaO2 was ma inteined at above 95%. No significant change for the cellular immunological func tion was found in the combining therapy group （P>0.05）and only one patient with leukopenia（6.7%）. But in the radiotherapy group, the lymphocyte transfor mation efficiency and the ratio of CD4/CD8 were obviously decreased（P<0 .01), and leukopenia was found in 5 cases（33.3%）. Conclusion　 Nasal or naso-facial positive pressure ventilation with BiPAP respirator could improve the effect of radiotherapy for lung cancers. It could also increase PaO 2 significantly and has protective rote to the marrow and cellular immunologic al function of the patients.

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Clinical analysis of pelvic lymphadenectomy in 86 patients with advanced ovarian carcinoma

Ying YANG ; Baolin DU ; Zheng HE

Journal of Third Military Medical University.2001;23(5):586-587.

Objective　To investigate the clinical significan ce of pelvic lymphadenectomy in advanced ovarian carcinoma. Methods　A total of 86 cases of advanced ovarian cancer with surgical treatment were assigned to 3 groups according to the size of residual focus and the performanc e of pelvic lymphadenectomy. Group A consisted of 42 cases with pelvic lymphaden ectomy and the diameter of residual focus smaller than 2 cm; Group B, 26 cases, underwent pelvic lymphadenectomy but with the residual focus larger than 2 cm; Group C con sisted of 18 cases without pelvic lymphadenectomy and the diameter of residual f ocus larger than 2 cm. All patients received CAP chemotherapy for 6 to 8 course of treatment and were in similar clinical stages and pathological grading. Results　The 5 year survival rate was 30.1% (13/42) in Group A, and 11.5% (3/26) in Group B with significant difference (P<0.05). Group C's 5 year survival rate was 11.1%(2/18). No significant difference was found betwee n Group B and C. Conclusion　Application of pelvic lymphadenecto my on those with residual focus less than 2 cm can apparently improve the patien ts' survival rate. But when the diameter of the focus is larger than 2 cm, pelvi c lymphadenectomy is not necessary.

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