ABSTRACT
Objective To investigate the clinical value of thrombelastogram (TEG) in prediction for the cause of delayed cerebral ischemia (DCI) in patients with aneurysmal subarachnoid hemorrhage (aSAH). Methods In this study, there were 30 patients with DCI (group DCI) and 45 patients without DCI (group No-DCI). TEG was performed in all the patients at post-bleeding day 1, 5, 10 and 15 after aSAH(PBDn, n=1,5,10,15). The changes of reaction time (R value), coagulation time (K value),coagulation angle (α value),maximum thrombus consistency (MA value) and coagulation index (CI value) were examined at different time points after aSAH. Results Thirty of 75 aSAH patients developed DCI and the incidence of DCI was 40 percent. According to linear mixed model, both MA value and CI value were significantly statistical different at different time points within each group (P<0.05,for all) as well as between No-DCI group and DCI group.MA value and CI were significantly statistical different at same time point (P<0.05,for all). The results of logistic regression analysis showed that modified Fisher levelⅢ-Ⅳ,△MA5-1(OR=1.124,P=0.024,95% CI=1.015~1.244), PBD5 MA>70(OR=5.605,P=0.011,95% CI=1.464~21.457)were the independent risk factors of DCI.By using ROC curve to define a threshold for prediction of the occurrence of DCI,the rate of DCI was significantly increased when △MA5-1>3.05.Conclusion aSAH Patients, especially those with DCI have severe hypercoagulation. The MA value in PBD5 has an important predictive value for DCI.
ABSTRACT
Diabetes is a kind of metabolic syndrome, always hap-pening in the case of insufficient secretion of insulin or insulin resistance, inducing the increase of blood glucose. While, dia-betic osteoporosis is a kind of chronic diabetic complications, which happens when insulin secretion is absolutely or relatively insufficient and then the insufficiency induces imbalance of hor-mone, calcium phosphorus metabolic disorders, thus leading to the decline of bone mineral density and change of bone micro-structure. The overnutrition, less exercise and the environment change lead to the increased incidence of diabetes. For all the diabetes, type 2 diabetes accounts for about 90%. Patients with type 2 diabetes show the increasing risk of fracture. This review summarizes the recent advances in the influence of type 2 diabe-tes on bones.