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Objective To investigate the relationship between the preterm infants after premature rupture of the membranes(PROM)brain injury and some cellular factors in the umbilical cord blood and amniotic fluid,and ana-lyze the biological markers with great predictive value,and provide a theoretical basis for early monitoring of brain injury in premature infants. Methods One hundred and thirty - nine singleton infants with PROM,their gestation less than 34 weeks,were evaluated. The umbilical cord blood and amniotic fluid of cytokines,including interleukin - 1β(IL - 1β),IL - 4,IL - 6,IL - 8,IL - 10,IL - 17A,tumor necrosis factor alpha(TNF - α),granulocyte colony - stimu-lating factor(G - CSF),monocyte chemotactic protein - 1(MCP - 1),S100B protein and soluble intercellular adhe-sion molecule - 1(sICAM - 1)levels were measured with Luminex liquid chip. All the premature infants underwent brain imaging for the diagnosis of brain damage. All cases were divided into brain injury group and non - brain injury group based on brain imaging examination. Results The concentration of IL - 10 in cord blood was significantly lower in the brain injury group than that in the non - brain injury group,and the difference was statistically significant(P ﹤0. 05). The levels of IL - 1β,IL - 6,IL - 8,TNF - α,G - CSF,MCP - 1,S100B and sICAM - 1 in the brain injury group were significantly higher than those of non - brain injury group,and the differences were statistically significant (all P ﹤ 0. 05). The levels of IL - 1β,IL - 6,IL - 8,TNF - α,G - CSF,MCP - 1 and sICAM - 1 in the amniotic fluid were significantly higher than those of non - brain injury group,and the differences were statistically significant(all P ﹤ 0. 05),but amniotic fluid S100B protein level was similar between 2 groups,which had no statistical significance (P ﹥ 0. 05). To predict the value of brain damage in premature infants,the highest sensitivity in cord blood was S100B protein,the highest specificity was IL - 6. The highest sensitivity in amniotic fluid was IL - 1β,and the highest specificity was IL - 8. The levels of IL - 4 and IL - 17A in the umbilical cord blood and amniotic fluid,IL - 10 in amniotic fluid were very low,and had no predictive value for brain damage. Conclusions Many biological markers in umbilical cord blood and amniotic fluid provide information about the risk of brain injury in premature infants. The highest sensitivity in cord blood was S100B protein,the highest specificity was IL - 6. The highest sensitivity in amniotic fluid was IL - 1β,the highest specificity was IL - 8. Changes in inflammation - related biomarkers suggest that brain damage in the preterm infants might be associated with intrauterine inflammation.
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Purpose To detect the distribution of cerebral microbleeds (CMB) in patients with hypertension and evaluate its related risk factors in order to reduce long-term risk of cerebral hemorrhage in large areas. Materials and Methods A consecutive 110 patients of hypertension and 50 patients of non-hypertension in the departments of cardiovascular medicine and neurology were enrolled. All the patients underwent T2 star weighted angiography (SWAN) sequence scan of head. The location and quantity of CMB and other related information of patients were recorded. The distribution of CMB in patients with hypertension and correlation between CMB and age, sex, level of hypertension, duration of time, hemoglobin, platelets, smoking, diabetes, hyperlipidemia were also analyzed. Results A total of 472 CMB were detected in the hypertension group, of which 212 CMB (44.9%) were found in deep brain, 149 (31.6%) were in cortical and subcortical region, 111 (23.5%) under the tentorium. The highest distribution of CMB was in thalamus (98, 20.8%), followed by basal ganglia (78, 16.5%), temporal lobe (64, 13.6%) and brainstem (62, 13.1%). The univariate analysis showed that CMB group had significantly higher rate of hypertension and diabetes than that without CMB and the average age in CMB group was also higher (P0.05). Conclusion Hypertension and age are independent risk factors for CMB. Patients aged 45 and older, with more than 5 years duration of hypertension, or with hypertension at class II and III, should be paid more attention in clinic. If necessary, magnetic resonance examination is suggested to be used, in order to reduce long-term risk of cerebral hemorrhage.
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Objective To explore the related imaging factors about the change of systemic circulation time for aortic dissection (AD)patients.Methods Image data of 36 patients with AD and 30 patients in control group were analyzed retrospectively,the cor-relation analysis was made between the results of imaging measurement by using CT angiography (CTA)and the threshold time of the contrast agent in the left ventricular.3 6 patients with AD were divided into 2 groups (type A 1 7 cases and type B 1 9 cases)by using Stanford type.First,the threshold time in the left ventricular of the 3 groups were analyzed comparatively;next,the correla-tions between each CTA measured parameter and the threshold time in the left ventricle were analyzed.Results Threshold time in left ventricular of group Stanford A and group Stanford B were compared with the control group respectively,the overall mean difference was statistically significant (P 0.05).There was a significant correlation between threshold time in left ventricular and the ratio of false/true lumen (r=0.676,P 0.05).Conclusion The threshold time of left ventricular for aortic dissection patients is significantly longer than the normal control group,and is significantly related with the ratio of false/true lumen.
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Objective To discuss the influence of the management of family-doctor responsibility system on drug utilization and compliance of hypertensive patients.Methods 1039 primary hypertension patients in Zhenhai Lianhua Community who were under the management of the residents electronic health files in June 2012,were implemented with the latest family-doctor responsibility system for eight months.The on-site questionnaire survey and electronic health management platform were carried out to analyze the drug utilization and treatment compliance of hypertensive patients.Results The proportion of taking medicine treatment among 1039 patients with essential hypertension reached 85.2％,including 56.3％ patients who took one kind of drug,35.4％ patients who took two kinds of drugs and 8.3％ patients who took at least three kinds of drugs.The most commonly used drugs were Amlodipine Besylate,Felodipine,Irbesartan and Hydrochlorothiazide tablets,Irbesartan,Levamlodipine Besylate tablets,Metoprolol Tartrate tablets and etc.The rate of patient compliance was 65.5％.After comparing the compliance of any two among three kinds of drug groups,the comparison of compliance between patients who took one kind,two or three kinds of drugs showed statistical significance.The comparison of drug types and compliance showed that compliance with compound preparation was statistically different from compliance with ARB,calcium antagonists,sympatholytic agent,diuretics.The educational level was also related to the compliance.Conclusions After the implementation of the family-doctor responsible management,the treatment rate and compliance rate are high,and the patients with hypertension in community still give priority to long-acting drugs.
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Objective To enhance the cognition on the clinical features of post resuscitation multiple organ dysfunction syndrome (PR-MODS) in patients after cardiac arrest, and provide the basis for integrated control. Method Based on the retrospective analysis, the clinical data of 72 patients with cardiac arrest with restoration of spontaneous circulation (ROSC) in ICU were collected, including happening place of cardiac arrest, the type of rhythm first monitored after cardiac arrest, cause of cardiac arrest, incidence of SIRS and MODS, the position and number of organ dysfunction, success rate of CPR, the rate of survival to hospital discharge and cerebral performance categories(CPC) of discharged patients. Results ①In patients with ROSC after cardiac arrest, male to female ratio was 1.18:1,55 cases was happened in hospital and 17 cases was happened out of hospital, and the ratio was 3.24:1. ②The distribution of cardiac arrest place: ICU,emergency room and operating room were the major places of in-hospital cardiac arrest, adding up to 41 cases and accounting for 74.55% (41/55); the major places of outhospital cardiac arrest were on the way to hospital and in the ambulance, and accounting for 64.71% (11/ 17). ③According to the rhythm first monitored after cardiac arrest, there were 38 cases using shock and 32 cases using non-shock, the ratio was 1.12: 1. Cardiac arrest causes of cardiogenic and on-cardiogenic factors are 37 cases and 35 cases, a ratio of 1.06:1 .④All of the 72 cases, 16 cases died within 24 h, and 56 cases were successfully resuscitated, but 51 cases occurred SIRS after ROSC, 42 cases had combined MODS (42/56,75%), 27 cases(27/42,64.29%)died.The most involving organs in sequence were brain (38 cases, 90.48%), heart (35 cases,83.33%) and lung (28 cases, 66.67%). ⑤Among the 56 successfully resuscitated patients, MODS ( - ) group (14 cases) all survived, 15 cases in MODS ( + ) group (42 cases) survived, a total rate of survived to hospital discharge was 40.28%(29/72). All the MODS ( - ) group ( 14 cases) got CPC 1 point. In MODS ( + ) group, there were 7 cases getting CPC 1-2 point, 35 cases getting CPC 3-5 point. There were no significant difference between sex and age in the two groups (P > 0.05), while the comparison of CPC and survived to hospital discharge rate had statistically significance (P < 0.001). Conclusions The occurrence of SIRS in cardiac arrest patients with ROSC was common and there was high incidence of MODS subsequently. The heart and brain were the mostly involved dysfunctional organs. PR-MODS was an important factor influencing the prognosis of patients with cardiac arrest.
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OBJECTIVE: To comprehend the development of research on rheumatoid arthritis (RA) and apoptosis so as to find the interrelationship and changing rules, probe into the apoptotic characteristics of RA.DATA SOURCES: A computer-based search of Medline and foreign language books of National Science and Technology Library was performed for English literatures related to RA and apoptosis from January 1995 to December 2003 with the key words of "rheumatoid arthritis,apoptosis".Meanwhile, Chinese articles about RA, traditional Chinese tongue demonstration and apoptosis were searched in Chongqing Vip Database of Chinese Scientific and Technical Periodicals, Tsinghua Tongfang Database of Chinese Scientific and Technical Periodicals and Chinese CD Database of Literatures on Biomedicine with the key words of "rheumatoid arthritis,apoptosis, tongue demonstration".STUDY SELECTION: Data were selected in the first searching, literatures on correlation between RA and apoptosis were searched in full-text.Accepting criteria: ①Experimental researches about RA and apoptosis. ②Clinincal researchs about RA and apoptosis. ③Researches on traditional Chinese tongue demonstration and apoptosis. Excluded criteria: Repetitive studies.DATA EXTRACTION: A total of 82 researches about RA and apoptosis werecollected, 13 ones in which were in accordance with the accepting criteria. Of the 69 excluded articles, 58 ones were repetitive studies and 11 ones were reviews.DATA SYNTHESIS: Of 13 literatures, 11 ones were checked by experimental research and clinical research. It was found from the examinations of synovium of joint and peripheral blood (PB) that there were abnomal apoptoses in RA, which indicated that the invasion, nature of drug and physical therapy were in relation to the apoptosis of synovial cells. Rest 2articles were researches on apoptosis of tongue demonstration of other diseases, which indicated that the apoptosis of tongue demonstration related to the pathology of disease. By now, there were no reports about RA, tongue demonstration and apoptosis, which indicated that there were still some blank in research about the correlation between traditional Chinese tongue demonstration and apoptosis.CONCLUSION: There is superiority in the treatment of RA with combined treatment of traditional Chinese medicine and western medicine. It is demonstrated in the literatures that treatment against RA at present may be done by affecting the apoptosis of RA. Researches on type of syndromes of traditional Chinese medicine and apoptosis is limited to a minority of one or two diseases, and tongue demonstration are an important part in the diagnosis on symptoms, therefore, the interrelationship of RA (or tongue demonstration) apoptosis needs to be investigated, Therefore, the inner relationship between tongue demonstration of RA and apoptosis needs investigation so as to furtherly reveal the formation mechanism of tongue demonstration.