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OBJECTIVE@#To investigate the clinical value of analgesia and sedation under bispectral index (BIS) monitoring combined with hydraulic coupled intracranial pressure (ICP) monitoring in severe craniocerebral injury (sTBI).@*METHODS@#(1) A prospective self-controlled parallel control study was conducted. A total of 32 patients with sTBI after craniotomy admitted to the intensive care unit (ICU) of the First People's Hospital of Huzhou from December 2020 to July 2021 were selected as the research objects. ICP was monitored by Codman monitoring system and hydraulically coupled monitoring system, and the difference and correlation between them were compared. (2) A prospective randomized controlled study was conducted. A total of 108 sTBI patients admitted to the ICU of the First People's Hospital of Huzhou from August 2021 to August 2022 were selected patients were divided into 3 groups according to the random number table method. All patients were given routine treatment after brain surgery. On this basis, the ICP values of the patients in group A (35 cases) were monitored by Codman monitoring system, the ICP values of the patients in group B (40 cases) were monitored by hydraulic coupling monitoring system, and the ICP values of the patients in group C (33 cases) were monitored combined with hydraulic coupling monitoring system, and the analgesia and sedation were guided by BIS. The ICP after treatment, cerebrospinal fluid drainage time, ICP monitoring time, ICU stay time, complications and Glasgow outcome score (GOS) at 6 months after surgery were compared among the 3 groups. In addition, patients in group B and group C were further grouped according to the waveforms. If P1 = P2 wave or P2 and P3 wave were low, they were classified as compensatory group. If the round wave or P2 > P1 wave was defined as decompensated group, the GOS scores of the two groups at 6 months after operation were compared.@*RESULTS@#(1) There was no significant difference in ICP values measured by Codman monitoring system and hydraulic coupling monitoring system in the same patient (mmHg: 11.94±1.76 vs. 11.88±1.90, t = 0.150, P = 0.882; 1 mmHg≈0.133 kPa). Blan-altman analysis showed that the 95% consistency limit (95%LoA) of ICP values measured by the two methods was -4.55 to 4.68 mmHg, and all points fell within 95%LoA, indicating that the two methods had a good correlation. (2) There were no significant differences in cerebrospinal fluid drainage time, ICP monitoring time, ICU stay time, and incidence of complications such as intracranial infection, intracranial rebleeding, traumatic hydrocephalus, cerebrospinal fluid leakage, and accidental extubation among the 3 groups of sTBI patients (P > 0.05 or P > 0.017). The ICP value of group C after treatment was significantly lower than that of group A and group B (mmHg: 20.94±2.37 vs. 25.86±3.15, 26.40±3.09, all P < 0.05), the incidence of pulmonary infection (9.1% vs. 45.7%, 42.5%), seizure (3.0% vs. 31.4%, 30.0%), reoperation (3.0% vs. 31.4%, 40.0%), and poor prognosis 6 months after operation (33.3% vs. 65.7%, 65.0%) were significantly lower than those in group A and group B (all P < 0.017). According to the hydraulic coupling waveform, GOS scores of 35 patients in the compensated group were significantly higher than those of 38 patients in the decompensated group 6 months after operation (4.03±1.18 vs. 2.39±1.50, t = 5.153, P < 0.001).@*CONCLUSIONS@#The hydraulic coupled intracranial pressure monitoring system has good accuracy and consistency in measuring ICP value, and it can better display ICP waveform changes than the traditional ICP monitoring method, and has better prediction value for prognosis evaluation, which can replace Codman monitoring to accurately guide clinical work. In addition, analgesia and sedation under BIS monitoring combined with hydraulic coupled ICP monitoring can effectively reduce ICP, reduce the incidence of complications, and improve the prognosis, which has high clinical application value.
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Humans , Intracranial Pressure , Prospective Studies , Monitoring, Physiologic/methods , Craniocerebral Trauma , Analgesia , Cerebrospinal Fluid LeakABSTRACT
Objective:To investigate the effect of decompression of optic nerve canal for traumatic optic neuropathy (TON) via lateral supraorbital approach.Methods:A retrospective case series study was performed to analyze clinical data of 23 TON patients admitted to First People's Hospital of Huzhou from December 2013 to June 2019. There were 16 males and 7 females, aged 17-51 years [(34.3±2.2)years]. Degree of visual impairment included count fingers in 4 patients, hand motion in 4, light perception in 9 and loss of light perception in 6. Visual evoked potential examination (VEP) was performed in 15 patients before surgery. The amplitude of P100 completely disappeared in 5 patients, and the amplitude of P100 was lower than the lower limit of normal value and the latency prolonged in 10 patients. The time from injury to operation was 3 h-14 days [(3.3±0.6)days]. All patients underwent decompression of optic nerve canal via supralateral orbital approach, and dural repair was performed simultaneously in 11 patients with dural rupture. Intraoperative fractures and meningeal tears, duration of operation, blood loss, and hospitalization duration were recorded. Combined with the classical visual acuity improvement assessment method and the World Health Organization (WHO) low vision and blind grading standard, visual acuity was compared before operation, at 10 days and 3 months after operation. Glasgow Coma Scale (GCS) was used to evaluate patients' state of consciousness in the course of the disease. Glasgow Outcome Scale (GOS) was used to evaluate the prognosis. Incidence of complications was observed as well.Results:All patients were followed up for 12-16 weeks [(13.5±2.4)weeks]. Intraoperative microscopic exploration revealed that all patients had optic nerve canal fracture, 3 patients had frontal fracture with dural rupture, and 8 patients had ethmoid bone fragment with anterior skull base dural rupture. The duration of operation was 108.5-224.3 minutes [(151.8±30.2)minutes], including (32.5±8.4)minutes for craniotomy. The intraoperative blood loss was 90.5-165.3 ml [(121.3±15.5)ml]. The hospitalization was 14-26 days [(19.7±3.4)days]. The visual acuity of 13 patients (57%) improved and 5 patients (39%) relieved from blindness 10 days after operation, showing significant difference compared with the preoperation ( P<0.05). The visual acuity of 17 patients (74%) improved and 9 patients (39%) relieved from blindness at 3 months after operation. There was significant difference in visual acuity examined between 10 days and 3 months after operation ( P<0.05). Six patients were invalid, and 4 of them had no light perception before operation and the amplitude of VEP examination completely disappeared. All patients had GCS of 15 when left the hospital and GOS of 5 at 3 months after operation. One patient had cerebrospinal fluid rhinorrhea and healed after 7 days of supine position. No secondary hematoma, epilepsy or intracranial infection occurred during follow-up. Conclusion:Optic canal decompression via the lateral supraorbital approach can improve visual acuity in early stage and increase the rate of out of blindness, with low postoperative complications and satisfactory functional recovery, which is worthy of clinical application.
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Objective To observe the preventive effect of Taohong Siwu decoction on the formation of lower extremity deep vein thrombosis (DVT) in patients with cerebral hemorrhage.Methods Eighty patients with cerebral hemorrhage admitted to the Department of Neurosurgery in Huzhou First People's Hospital from November 2014 to January 2016 were enrolled, and they were divided into an observation group and a control group according to the difference in treatment methods, each group 40 cases. Both groups were given routine treatment and nursing care, the patients of observation group were additionally given Taohong Siwu decoction (composition:Radix Angelicae Sinensis (stir-fried with wine) 10 g,Radix Rehmanniae Preparata 10 g,Radix Paeoniae Alba10 g,Ligusticum Chuanxiong Hort 6 g,Semen Persicae 6 g,Carthami Flos 4 g), once a day for consecutive 2 weeks.Results The D-dimer level in the observation group was significantly lower than that in the control group (mg/L: 1.47±0.91 vs. 1.88±0.79,t = 1.991,P = 0.035); the incidence of DVT in the observation group was obviously lower than that in the control group [5.0% (2/40) vs. 20.0% (8/40), χ2 = 4.114,P = 0.043].Conclusion Taohong Siwu decoction can effectively reduce the incidence of DVT in patients with cerebral hemorrhage.
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Objective We analysed the homocysteine level and distribution of ganzhou city crowd ,learned about its elevatory sit‐uation ,and provided theory basis for the intervention of high homocysteine level crowd and the prevention of heart and head blood vessel disease .Methods We detected the blood homocysteine level of 6419 adults who had physical examination in our hospital dur‐ing 2012 by enzymatic methods ,and analyzed the diagnose rate of HHcy and the distributions of Hcy in different age and gender . Results The total detection rate of high homocysteine level in 6419 adults was 39 .11% ,among which 47 .30% in male and 22 .49% in female ,the comparison was statistically significant (χ2 = 424 .28 ,P< 0 .05) ;the detection rate of male was higher than female .In different ages ,the detection rates were statistically significant comparatively (P< 0 .05) .The detection rate of homocys‐teine level in both gender rises with age .At the same time ,homocysteine levels in males of 25 - 34 years old age group and 35 - 44 years old age group ,45 - 54 years old age group and 55 - 64 yeas old age group were not statistically significant ;while there were statistical differences of Hcy level in the rest age groups of male ,different age groups of female and same age different gender groups (P< 0 .05) .Conclusion The HHcy detection rate and the blood Hcy distribution of Ganzhou city crowd has its regional characteristics compared with other regions ,and it may be associated with the main population distribution of hakka people and oth‐er geological factors .The detection rate of HHcy was relatively high ,and it′s advisable to take early prevention to lower the risk of heart and head blood vessel disease .
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A novel Cu-IUDs material, PU/PEG/Cu nanocomposite, was prepared by melt blending method with thermoplastic polyurethane (PU) as the matrix, with polyethylene glycol (PEG) as a hydrophilic modifier, and with nanometer particles of copper as active matter instead of copper wire or copper tube. The structure, morphology, mechanical properties, thermal stability and water absorption were investigated by using FT-IR, XRD, SEM and so on. The results indicated that the nanometer particles of copper were uniformly dispersed in the matrix in PU/PEG/ Cu nanocomposites. It can be seen that the water absorption ability of this nanocomposite was obviously improved while mechanical properties and thermal stability were at high levels. These results provided a good basis for the studies on the cupric ions release of the nanocomposites in future.
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Biocompatible Materials , Chemistry , Intrauterine Devices, Copper , Nanocomposites , Chemistry , Polyethylene Glycols , Chemistry , Polyurethanes , ChemistryABSTRACT
Objective To observe the effect of soy isoflavones on incretion of female rats. Methods 42 fe-male rots of 12 weeks old were divided into 3 groups at random. Low dose group were perfused with 40mg · kg-1·d-1 into stomach per day;high dose group were perfused with 80mg·kg-1·d-1 into stomach per day;control group were perfused with physiological saline into stomach. After 14 days,collected blood via jugular vein and tested 4 inde-xes-FSH, LH,E2 and P with chemoluminescence method. Results In 3 groups of soy isoflavones low doee group,soy isoflavones high dose group and control group,FSH were (0.13±0.021) mIu/ml, (0.12±0.018) mIu/ml, (0.15 ±0.024) mIu/ml respectively; LH were (0.17±0.032) mIu/ml, (0.15±0.043) mIu/ml, (0.18±0.047) mIu/ml respectively, which has no obvious differences (P > 0.05) ; E2 were (0.09±0.03) nmol/L, (0.03±0.03) nmol/L, (0.12±0.04) nmol/L respectively; P were (1.43±0.27) ng/ml, (2.82±0.37) ng/ml, (0.67±0.56) ng/ml re-spectivdy. Compare those 3 groups, E2 activeness of soy isoflavones group decreased obviously; but P activeness of soy isoflavones group increased obviously. Conclusion Soy isoflavones has no obvious effect on hypophysis hormone of rat, but the soy isoflavones of different dosages may measure the secretion of female rat ovary hormones by estrogen ac-tivity and antiestrogen activity.