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Objective To explore the relationship between ambient temperature variation and blood pressure fluctuations in acute ischemic stroke patients.Methods Clinical data of 5 730 ischemic stroke patients hospitalized at the Departments of Neurology and Geriatrics of The Second Hospital of Tianjin Medical University and air temperature data during the corresponding period were retrospectively analyzed.The relationship between air temperature and blood pressure in patients with acute ischemic stroke was analyzed.Results Of 5 730 patients,4 428 (77.28％)had hypertension and most of them were male(56.26％ 3 362 cases).The systolic and diastolic blood pressure levels were higher in hypertensive males than in hypertensive females[(153.9 ± 21.7) mmHg vs.(150.7 ± 23.6)mmHg,(85.9±13.3)mmHg vs.(83.0±12.5)mmHg,1 mm Hg=0.133 kPa,both P＜0.05].The systolic pressure tended to increase and diastolic pressure tended to decrease with increasing age (both P ＜ 0.05).The systolic and diastolic blood pressure levels of patients were slightly higher in autumn and winter than in spring and summer (P ＜ 0.05).The mean monthly maximum and minimum temperature had negative correlations with the systolic blood pressure of patients.There was a linear positive correlation between the average monthly diurnal temperature range and the systolic and diastolic blood pressure.The systolic or diastolic blood pressure increased by 0.088 mmHg or 0.076 mmHg respectively with each 1 ℃ drop in the mean monthly maximum and minimum temperature.The systolic or diastolic blood pressure increased by 1.043 mmHg or 0.654 mmHg respectively with each 1 ℃ increase in the average monthly diurnal temperature range.Conclusions Hypertension is a risk factor for ischemic stroke,and ambient temperature variation is related to baseline blood pressure fluctuations in hypertensive patients with acute ischemic stroke.The temperature reduction and the increase of average diurnal temperature rang can lead to the elevation of blood pressure,which is more obvious in autumn and winter,especially in elderly patients.
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Objective To investigate the effect of different serum sodium levels on heart function and prognosis in very elderly patients with heart failure. Methods Totally 152 elderly patients(aged ≥ 85 years)with hyponatremia were enrolled.Based on the serum sodium level ,they were divided into mild(125 mmol/L ≤ Na+ < 135 mmol/L) ,moderate(125 mmol/L ≤ Na+ < 135 mmol/L) ,and severe hyponatremia(Na+ < 115 mmol/L)groups ,and 76 patients with normal blood sodium level(Na+ ≥ 135 mmol/L)were selected as control group. The general data ,levels of serum creatinine and N-terminal pro-brain natriuretic peptide (NTproBNP)and prognosis were compared among the above groups. Results Compared with the control group ,patients with severe hyponatremia were much older ,with more diuretics administration ,higher level of serum creatinine , lowerlevelofeGFRandleftventricularejectionfractions[(38.1±3.9)％ vs.(45.2±9.7)％ ].There were higher incidences of coronary atherosclerotic heart disease [72.4％ (n=21)vs. 56.6％ (n=43)] ,diabetes[41.4％ (n=12)vs. 23.7％ (n=18)] ,chronic renal insufficiency [22.6％ (n=8)vs. 11.8％ (n=9)] ,stroke[20.6％ (n=6)vs. 9.2％ (n=7)]in patients with severe hyponatremia compared with other groups. The severe hyponatremia group showed significantly higher levels of NTproBNP [(4823. 9 ± 588. 1 )ng/L v s. (1124. 4 ± 349. 1 )ng/L ,(1836. 2 ± 369. 3 )ng/L ,(2894. 1 ± 687. 3 )ng/L ]and higher rates of mortality [27.6％ (n=8) vs.5.3％ (n=4) ,7.6％ (n=6) ,13.6％ (n=6)]as compared to the control group ,mild and moderate hyponatremia groups. Furthermore ,length of stay in hospital were markedly longer in patients with severe hyponatremia than those with mild and moderate hyponatremia[(11.1 ± 7.1)d vs. (19.6 ± 5.7)d ,(16.1 ± 4.2)d] . Conclusions Hyponatremia is a common type of electrolyte disorder in very elderly patients with heart failure ,and severe hyponatremia may predictand increased risk of death.
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Objective To survey a prevalence of osteoporosis and prevalence of osteoporosis combined with hyponatremia in elderly hospitalized patients,and their risk factors.Methods We enrolled 2496 elderly hospitalized patients with detected plasma levels of sodium,calcium,25 (OH) D3,PTH,plasma PINP,and β-CTX.At the same time,sex,age,height,weight,smoking history,drinking history and BMI(kg/m2) in form of a questionnaire were recorded and calculated.The risk factors for osteoporosis were analyzed using multivariate Logistic regression method.Results The osteoporosis prevalence was 12.2％ (305/2496 inpatients)with 31.5 ％ (96/305)in male,68.5％ (209/305)in female(x2 =4.651,P=0.031).The prevalence of osteoporosis with hyponatremia was 27.5 ％ (84/305),with 24.8 ％ (21/84) in male and 75.2 ％ (63/84) in female(x2 =9.251,P=0.025).As compared with three groups of non-osteoporosis,normal serum Na+ with and without osteoporosis,the osteoporosis patients with hyponatremia were more aged,in a higher proportion of women and smokers,in lower BMI,and in low levels of serum sodium,BMD 25(OH)D3 (F=13.783,0.861,7.146,24.520,0.548,x2 =15.113、4.472;P =0.001,0.000,0.021,0.015,0.003,0.021,0.005).Multivariate Logistic regression analysis showed that aging,female,low BMI,smoking history,drinking history,low plasma 25(OH)D3 level,low plasma PINP level,and high plasma β-CTX level were the risk factors for osteoporosis(OR 4.215,2.271,3.176,2.013,1.237,3.987,1.843,1.972;all P＜0.05).Conclusions The osteoporosis prevalence is high in elderly patients,especially in old women.The risk factors for osteoporosis are diverse,and clinical conditions of osteoporosis patients with hyponatremia are much more severe than the others.More efforts should be given to them and need to be focused on the complications of osteoporosis.
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Objective To investigate the sodium and potassium disturbances in 9870 elderly inpatients and to analyze their risk factors.Methods Clinical data of sodium and potassium levels and the possible risk factors were collected in the elderly inpatients from a single center.The incidence of sodium and potassium disturbances and their risk factors were analyzed by multiple Logistic regression,and the correction of the imbalance was investigated.Results A total of 6027(61.6％)times of sodium and potassium disturbances were found in the 9870 elderly inpatients on admission and during hospitalization,and the total incidence of this disturbances was 61.6％.The incidences of hyponatremia,hypokalemia,hypernatremia and hyperkalemia were 27.9％ (2729/6027),9.7％ (951/6027),15.4％(1506/6027) and 8.6％ (841/6027),respectively.Heart failure was the common risk factor for the two electrolyte disturbances.T2DM caused hyponatremia,hypokalemia and hypernatremia.Among the medication risk factors,diuretics were the common risk factor for various electrolyte disturbances.Patients taking antiepileptics,antidementia drugs,antidepressants and benzodiazepines were more likely to have hyponatremia.The correction rate of mild,moderate and severe hyponatremia/ hypokalemia were 79.2％(1253/1582),68.1％ (535/786),45.1％ (163/361) and 79.5％(776/976),66.4％(217/327),40.1％(81/203),respectively.The time for the correction of the above degrees of hyponatremia/ hypokalemia were(3.7±2.7) d,(4.1±2.3) d,(8.9±1.6) d and(2.5± 1.4) d,(3.2 ± 1.5) d,(6.1 ± 1.2) d.The supplement amounts of sodium chloride and potassium chloride were(5.98±3.67) g,(9.45±3.02) g,(10.26±1.32) g and(2.23±0.93) g,(5.12± 1.53) g,(8.07 ± 2.46) g,respectively.Conclusions The incidences of electrolyte disturbances are high in elderly inpatients with combined diseases and application of various drugs,and the correction of disturbances is difficult.More attention should be paid to the electrolyte disturbances,which should be corrected positively.
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AIM To study protective effect of [D-Ala~2, D-Leu~5]-enkephalin (DADLE) against hydrogen peroxide (H_2O_2) induced myocardial cell injury and its possible mechanisms. METHODS Myocardial cells were isolated from neonatal rats and cultured for 48 h. Then the cells were randomly assigned into normal control, H_2O_2（200 μmol·L~(-1)）, H_2O_2+DADLE(1 μmol·L~(-1)), H_2O_2+DADLE +naltrindole(10 μmol·L~(-1)) and H_2O_2+DADLE +U0126(10 nmol·L~(-1)) groups and cultured for another 48 h.[~3H]TdR incorporation assay and flow cytometry were used to measure the cell proliferation and apoptosis rate. The lactate dehydrogenase (LDH) activities in culture supernatant measured by using LDH activity kit. The superoxide dismutase (SOD) activity and malondialdehyde (MDA) content in cells were measured with xanthine oxidase method and color reaction of thiobarbituric acid, respectively. The expressions of extracellular signal-regulated kinase (ERK) and phosphorylated-ERK (p-ERK) were observed with Western blot. RESULTS ① Compared with normal control group, the incorporation of [~3H]TdR in myocardial cells of H_2O_2 group was significantly lower, apoptosis rate was higher, LDH activity and MDA content in cells were higher, while SOD activity in cells was lower. In addition, the ratio of IA_( p-ERK) /IA_( ERK) was decreased. ② Compared with H_2O_2 group, the incorporation of ［3H］TdR in H_2O_2+DADLE group was significantly higher, apoptosis rate was lower, LDH activity and MDA content in cells decreased, while SOD activity increased significantly. The ratio of IA_( p-ERK) /IA_( ERK) was increased. ③ δ-Opioid receptor antagonist naltrindole and ERK antagonist U0126 inhibited this effect of DADLE on the above index changes induced by H_2O_2. CONCLUSION The δ-opioid receptor has protective effect against H_2O_2-induced myocardial cell injury, and its possible mechanism may be related to its promotion of antioxide capacity and ERK phosphorylation.
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Medical science is the science about human.Humanistic attribute is one of the essence attributes of medicine.Since modern times,under the effect of the western biomedical modes,people have gradually neglected humanistic attribute,social responsibilities of medical workers and their humanistic care for patients,which results in a series of problems in current medical research and medical practice.The return of humanistic spirit is not only the essential requirement of the essence attribute of medicine,but also the calling from the development of modern medical science.Reconstruction of the humanistic spirit is the common responsibility for contemporary medical workers.Meanwhile,the cultivation of the medical students who have great humanistic quality should be the significant mission for the contemporary medical education.
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AIM: To set up a method for determining ferulic acid and gastrodine in Dachuanxiong Hydrochloride for Injection(Rhizoma Chuanxiong, Rhizoma Gastrodiae). METHODS: HPLC conditions consisted of ODS column, methanol-water-acetic acid (30 ∶68 ∶2) and water-acetic acid (100 ∶1) as mobile phases, detection wavelengths were at 320 nm and 270 nm. RESULTS: For ferulic acid, the linear range was within 0.031 6 - 0.505 6 ?g and the average recovery was 98.43% with RSD= 1.52% . For gastrodine, the linear range was within 0.442 - 3.536 ?g and the average recovery was 98.15% with RSD= 1.68% . CONCLUSION: The method proves to be simple, precise and reproduciable and is suitable for the use of quantitative control of Dachuanxiong Hydrochloride for Injection.