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Objective To compare microsurgery through small skull window hematoma puncture and external drainage in the treatment and clinical effect of basal ganglia hemorrhage.Methods 92 cases of hypertensive basal ganglia hemorrhage were randomly divided into the two groups,46 cases in each group,A group was used microsurgery through small skull window hematoma,group B by puncture drainage.Operation time,complications and serum S100 protein of two groups were compared.Results Two groups were successfully completed operation,operation time, amount of bleeding,the time of hospitalization in A group were (125.3 ±29.1)min,(84.3 ±11.4)mL,(14.2 ± 2.7)d,B group were (70.5 ±5.4)min,(39.6 ±9.6)mL,(8.1 ±1.9)d,A group were significantly higher than that of group B (t =3.724,8.162.2.996,P 0.05).Conclusion Small window craniotomy and puncture drainage micro hematoma surgery treatment of cerebral hemorrhage in basal ganglia and each has advan-tages and disadvantages,we should adopt different treatments according to the patient's condition.
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ObjectiveToinvestigatetheeffectofserumuricacid(SUA)levelonshort-term outcomes of recombinant tissue plasminogen activator (rtPA) for intravenous thrombolysis in patients w ith ischemic stroke. Methods The patients w ith acute ischemic stroke treated w ith intravenous rtPA thrombolysis w ere enrol ed. The demographic data, clinical data, and laboratory parameters w ere compared and analyzed according to the modified Rankin scale (mRS) scores at discharge. A good outcome was defined as a 3-month mRS score of 0 in patients w ith a baseline National Institute of Health Stroke Scale (NIHSS) score≤7, a score of 0–1 in those w ith a baseline NIHSS score of 8-14, and a score of 0–2 in those w ith a baseline NIHSS score ≥ 15. Results A total of 108 patients w ith acute ischemic stroke treated w ith intravenous rtPA thrombolysis w ere enrol ed. There w ere 66 patients (61.11%) in the good outcome group and 42 (38.89%) in the poor outcome group. The constituent ratios of age (62.21 ±10.25 years vs. 57.83 ±10.457 years; t=2.138, P=0.035), the baseline NIHSS scores (median and interquartile range, 10 [8-12] vs.4 [3-7]; Z=5.537, P<0.001), type 2 diabetes mel itus (40.48%vs.12.12%; χ2 =11.600, P=0.001), and previous history of stroke (9.52%vs.9.09%;χ2 =4.366, P=0.037) of the poor outcome group w ere significantly higher than those of the good outcome group, w hile the SUA level (323.119 ±87.869 mmol/L vs.385.961 ±76.166 mmol/L; t=3.936, P<0.001) w as significantly low er than that of the good outcome group. Multivariate logistic regression analysis show ed that the previous history of diabetes melitus type 2 (odds ratio [OR] 5.471, 95%confidence interval [CI] 1.472-20.334;P=0.011) and higher baseline NIHSS score (OR 1.306, 95%CI 1.147-1.486; P<0.001) were the independent risk factor for short-term clinical outcomes, w hile higher SUV level ( OR 0.992, 95%CI 0.986-0.998; P=0.015) w as an independent protective factor for poor short-term outcome. Conclusions The increased SUA level is an independent protective factor for good short-term outcome in patients treated w ith intravenous rtPA.
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Objective To compare the differences of atria and atrial myocyte structure in patients with atrial fibrillation (AF) and sinus rhythm(SR) .To evaluate the influence of AF on cardiac function .Methods 79 patients without heart failure undergoing car-diopulmonary bypass surgery were divided into the AF group (n=39) and the SR group(n=40) .Echocardiography was performed for analysis of left ventricular end diastolic dimension(LVDd) ,left ventricular end-systolic dimension(LVDs) ,left ventricular poste-rior wall(LVPW) ,interventricular septum(IVS) and left atrial diameter(LAD) .Part of left atrial appendages was taken freshly for HE staining in order to observe atrial tissue structure .Results LVDd ,LVDs ,LVPW and IVS of the AF group were lower than that of the SR group .But LAD of the AF group was higher than the SR group .There was statistical significance in IVS and LAD between the two groups(P0 .05) .Compared with the SR group ,the AF group had thinner myocardial atrophy ,more obvious fibrosis ,smaller nucleus and darker HE staining .Conclusion The incidence of AF was mainly in rheumatic heart disease .The development of AF was mostly accompanied with the enlargement of LAD and the change of atrial tissue structure which showed that AF can reduce cardiac function .
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Objective To investigate the effects of different tidal volume ventilation on acute lung injury in rats. Methods Thlrty-two normal Wistar rats were randomly divided into four groups:control group,low tidal volume group(L- V_T),conventional tidal volume group(C-V_T)and high tidal volume group(H-V_T).The pathologic changes of the lungs were observed under macrography,light and electron microscope.The blood gas analysis(PaO_2),the counts of neutrophils (PMN),the levels of protein and the myloperoxidase(MPO)activities in bronchoalveolar lavage fluid(BALF)were measured by biochemical methods respectively.Results There were no distinct pathological differences between L-V_T group and control group under macrography,light and electron microscope.In the C-V_T and H-V_T groups,there were different degree of lung injuries under light and electron microscope,their PMN,MPO activity and protein level in BALF were significantly higher than those of control and L-V_T groups and their PaO_2 were significantly lower than those of control and L- V_T groups(P＜0.01,P＜0.05).The MPO activity and the protein level in BALF were also significantly higher than those of C-VT group(P＜0.01)Of the above indexes,there were no statistical differences between L-V_T group and control group(P＞0.05).Conclusion Conventional tidal volume ventilation alone,without any lung-protective strategy, could produce injuries to the normal lung tissues,while low tidal volume ventilation hadn't effects on them.The injury effects produced by mechanical ventilation was closely related to the recruitment and activation of neutrephils in the lung.