Significance of serum cytokines concentrations and APACHE scores in evaluating the illness state for Critical patients / 中国基层医药

Objective To investigate the clinical significance of serum cytokines concentrations and A- PACHE scores in evaluating the illness state for critical trauma patients.Methods A clinical prospective self-control trial was performed,in which 36 patients admitted to ICU by SIRS were enrolled.Objects were divided into mild and severe trauma group according to APACHE score.The TNF-?and IL-6 concentrations were determined on the 1st, 3rd and 5th day of admission,the APACHE score were assessed at the same time.Statistic analysis was performed according to this group.Results The TNF-?concentrations decreased continuously in the following days while IL-6 decreased from the 7th day in the mild trauma group.In the severe trauma group the TNF-?and IL-6,APACHE score concentrations kept increasing.There was a significant difference of TNF-?and IL-6 concentrations between severe trauma and mild trauma group.Conclusion Dynamic measurement of TNF-?and IL-6 concentrations with APACHE score provide great help to evaluate the illness state and predict the prognosis.

Clinical analyses of etiopathogenisis,symptom and prognostic of spontaneous subarachnoid hemorrhage / 中国基层医药

Objective To explore clinical characteristics of spontaneous subarachnoid hemorrhage(SAM)pa- tients.Methods Etiopathogenisis and clinical manifestations of 167 SAIl patients of different ages and cause of 24 SAH patients' exacerbation and death were retrospectively analyzed.Results The aneurysm was the main etiologies of SAH.The youth and middle-ages SAH patients were caused by aneurysm.Hypertensive arteriosclerosis was the second etiologies of SAH which was mainly in middle-ages and old ages.SAH caused by Vascular malformation main- ly appeared in youth group.Headache and vomitus and meningeal irritation sign which mainly appeared in youth and middle-ages groups.Occiput pain and conscious disturbance was mainly the first symptoms of aggravation and death of SAH which happened in 14 days after hemorrhage and under 45 year ages.Conclusion Aneurysm and vascular malformations are the main causes of SAH of young patients.And hypertensive arteriosclerosis is the main cause of the old.The clinical manifestations of the old are not as typical as the young.Posterior cranial fossa hemorrhage is the main cause of SAH patients which are mostly under 45 year ages and mostly happen in 14 days after bleeding.