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Objective To explore the forensic pathological characteristics and the main identification points of fatal cardiac tamponade. Methods 38 cases of fatal cardiac tamponade from department of pathology, the first affiliated hospital of chengdu university of TCM from 2005 to 2015 were reviewed and analyzed retrospectively. Results Fatal cardiac tamponade mostly occurred to men (71.1%) with an average age of 44; Bloody effusion accounted for 85% of the direct causes of death (34 cases). The most underlying causes of death were diseases (73.7%), majorly aortic dissection, coronary heart disease and malignant tumors. Seventy five percent of death occurred within 12 hours of illness. Medical behaviors were involved in 30 cases (78.9%), of which 26 cases (86.7%)were without medical malpractice. The relationship between injury and disease was involved in 15 fatal cases (39.5%). Conclusion The basic requirement for accurately completing forensic medical appraisal of fatal cardiac tamponade cases was to master the forensic pathological characteristics and the path of forensic identification.
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Objective To investigate the evaluation value of magnetic resonance spectroscopy (MRS) combined with S-100B protein in the severity and prognosis in patients with acute subdural hematoma ( ASDH).Methods Eighty cases of ASDH patients and 20 cases of healthy check-up were selected.MRS was used to test NAA/Cr, Cho/Cr, NAA/Cho, and Glx /Cr in thalamus and corpus callosum.The blood S-100B protein was detected in 72 h after injury.The relationships of those MRS detection indices with glasgow coma scale ( GCS) and glasgow prognostic score ( GOS) for 2 months after injury were analyzed .Results MRS detection in-dex and the S100B protein in ASDH were compared between each group relative to normal control group , all difference had statistical significance ( P <0.05).As aggravating the severity of traumatic brain injury , Cho/Cr, Glx/Cr ratio, and S-100B protein concentra-tion were elevated , and NAA/Cho and NAA/Cr were reduced .All differences were statistically significant among poor recovery , good recovery, and normal control groups ( P <0.05).For patients with traumatic brain injury, there were worse prognosis, the higher ra-tios of Cho/Cr and Glx/Cr, higher concentration of S-100B protein, and lower ratios of NAA/Cho and of NAA/Cr.GCS score and GOS scores were negatively correlated with Cho/Cr and Glx/Cr ratios of corpus callosum , and were positively correlated with NAA/Cho, NAA/Cr ratios of corpus callosum .S-100B protein was positively correlated with Cho/Cr and Glx/Cr, and was negatively correlated with NAA/Cho and NAA/Cr.MRS combined S-100B can improve the prognosis of patients with up to the accuracy of 81%.Conclu-sions MRS detection in the early stage after injury of ASDH patients has important value in assessment of the severity of the injury and its prognosis , the accuracy of assessment of prognosis is improved with a combination of MRS detection and blood S -100 B protein meas-urement.
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The effect of atorvastatin on warfarin-induced aortic medial calcification and systolic blood pressure (SBP) of rats induced by warfarin was studied. Thirty healthy and adult rats were randomly divided into Warfarin group (n=10), Atorvastatin group (n=10) and normal control group (n=10). Caudal arterial pressure of rats was measured once a week, and 4 weeks later, aorta was obtained. Elastic fiber, collagen fiber and calcium accumulation in tunica media of cells were measured by Von Kossa staining. The results showed that warfarin treatment led to elevation of systolic blood pressure and aortic medial calcification. The chronic treatment also increased collagen, but decreased elastin in the aorta. However, the atorvastatin treatment had adverse effects. It was concluded that treatment with atorvastatin presented evidence of blood pressure lowing and calcification reducing. These data demonstrate that atorvastatin protected aortic media from warfarin-induced calcification and elevation of systolic blood pressure.
Subject(s)
Aortic Diseases/chemically induced , Aortic Diseases/drug therapy , Aortic Diseases/pathology , Blood Pressure/drug effects , Calcinosis/chemically induced , Calcinosis/drug therapy , Calcinosis/pathology , Heptanoic Acids/pharmacology , Heptanoic Acids/therapeutic use , Hypertension/chemically induced , Hypertension/drug therapy , Pyrroles/pharmacology , Pyrroles/therapeutic use , Random Allocation , Rats, Wistar , WarfarinABSTRACT
Objective To work out a proper treatment regimen for hypertension in elderly patients with type 2 diabetes mellitus. Methods Sixty-five elderly patients 〔aged (68.3?4.4) yrs old〕 with hypertension and type 2 diabetes were randomized into three arms of antihypertensive treatment: arm A, n=20, treated with nifedipine in long-acting gastrointestinal-transport system (nifedipine-GITS) 60 mg/d; arm B, n=22, treated with nifedipine-GITS 30 mg/d and valsartan (angiotensin Ⅱ receptor blocker, ARB) 80mg/d; and arm C, n=23, treated with nifedipine-GITS 30mg/d, Valsartan 80mg/d and sustained-releasing indapamide (diuretics)1.5 mg/d. Results Eight weeks later, both systolic blood pressure (SBP) and diastolic blood pressure (DBP) were decreased significantly in all of the patients ( P
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One hundred and sixteen senile patients (older than 65 years) with chronic heart failure (CHF) were analyzed retrospectively in order to verify if old patients with CHF would benefit from long-term (one year) angiotension-converting enzyme inhibitor (ACEI) treatment. The frequency of drugs (including ACEI, digitalis and diuretic) used was stratified into four degrees accordingly. Development of the CHF was scored with regard to relapse rate and severity of this disease. Stepwise regression analysis was applied to explore the relationship between the scored outcome of CHF and the frequency of individual drug administration. A significant relationship of the scored outcome of CHF to the frequency of ACEI usage but not to digitalis nor to diuretics was found (partial coefficient of the correlation r = 0.42, P = 0.002). It was concluded that the long-term administration of ACEI improves the outcome of CHF in senile patients.
Subject(s)
Aged , Female , Humans , Male , Angiotensin-Converting Enzyme Inhibitors , Chronic Disease , Heart Failure , Drug Therapy , Hypertension , Myocardial Ischemia , Retrospective Studies , Treatment OutcomeABSTRACT
One hundred and sixteen senile patients (older than 65 years) with chronic heart failure (CHF) were analyzed retrospectively in order to verify if old patients with CHF would benefit from long-term (one year) angiotension-converting enzyme inhibitor (ACEI) treatment. The frequency of drugs (including ACEI, digitalis and diuretic) used was stratified into four degrees accordingly. Development of the CHF was scored with regard to relapse rate and severity of this disease. Stepwise regression analysis was applied to explore the relationship between the scored outcome of CHF and the frequency of individual drug administration. A significant relationship of the scored outcome of CHF to the frequency of ACEI usage but not to digitalis nor to diuretics was found (partial coefficient of the correlation r = 0.42, P = 0.002). It was concluded that the long-term administration of ACEI improves the outcome of CHF in senile patients.