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A 47-year-old woman with body temperature 35.6 ℃ took the 3rd COVID-19 vaccine shot at our clinic on Day 1. Since she felt chills and suffered from genital bleeding on Day 3, she visited our clinic to take a gynecological examination. Her temperature was 37.1 ℃ at that time. On Day 15, she suffered sustained symptoms of chills and general fatigue, and she went to another internal medicine clinic to take a medical care. However, her condition was unexplained and she was referred to a general hospital. On Day 16, she came to our clinic to confirm results of the gynecological examination. Her symptoms persisted even though the data showed no problems, so we prescribed her saikokeishikankyoto (SAKK) for only 3 days. On Day 19, SAKK dramatically improved her symptoms. On Day 37, her temperature was 36.2 ℃ without any symptoms.
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There is a pathological process before the attack of stroke. The current primary and secondary preventions of stroke focus on the cerebral vascular conditions, risk factors, and triggering factors. However, the stroke-prone status followed by the occurrence of stroke has not been paid appropriate attention to, which is named in this article as the process of stroke attack. The biomarkers implying the stroke-prone status would inspire innovative ideas to study the process of stroke attack, and help find the precise prevention through the whole process of stroke.
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Objective To explore the effect of treatment and nursing of Butorphanol and Tramadol Hydrochloride on chills after gynecological laparoscopic surgery. Methods Retrospective analysis of 60 chills patients after gynecological laparoscopic surgery treated the Second Hospital of Jiaxing City from January 2015 to January 2017 were taken, 60 patients were randomly divided into the control groups and the observation group, 30 cases in the control group were given Tramadol Hydrochloride; 30 patients in the observation group were given Butorphanol, the two groups of patients were given clinical nursing, patients chills grading after 5 min, 10 min, 30 min, Prince-Henry score, Ramsay sedation score and adverse reactions of two groups were comprehensively evaluated. Results There was no significant difference in the chills grading between the control group and the control group. Ramsay sedation score in the observation group significantly higher than the control group at 4 h, 8 h and 12 h after treatment with statistical significance (P<0.05) , in the observation group, there were 3 cases of adverse reactions occurred, accounting for 10.0%, which was significantly lower than that (36.7%) of the control group with statistical significance (P<0.05). Conclusion Butorphanol has a significant effect on chills after gynecological laparoscopic surgery, sedative effect of which is better than Tramadol Hydrochloride, with less adverse reactions.
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Objective To explore the effect of treatment and nursing of Butorphanol and Tramadol Hydrochloride on chills after gynecological laparoscopic surgery. Methods Retrospective analysis of 60 chills patients after gynecological laparoscopic surgery treated the Second Hospital of Jiaxing City from January 2015 to January 2017 were taken, 60 patients were randomly divided into the control groups and the observation group, 30 cases in the control group were given Tramadol Hydrochloride; 30 patients in the observation group were given Butorphanol, the two groups of patients were given clinical nursing, patients chills grading after 5 min, 10 min, 30 min, Prince-Henry score, Ramsay sedation score and adverse reactions of two groups were comprehensively evaluated. Results There was no significant difference in the chills grading between the control group and the control group. Ramsay sedation score in the observation group significantly higher than the control group at 4 h, 8 h and 12 h after treatment with statistical significance (P<0.05) , in the observation group, there were 3 cases of adverse reactions occurred, accounting for 10.0%, which was significantly lower than that (36.7%) of the control group with statistical significance (P<0.05). Conclusion Butorphanol has a significant effect on chills after gynecological laparoscopic surgery, sedative effect of which is better than Tramadol Hydrochloride, with less adverse reactions.
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Objective To explore the different doses of dexmedetomidine for prevention of shivering in cesarean section effect in patients with spinal and epidural anesthesia, summarize the clinical experience.MethodsIn 40 cases of spinal epidural anesthesia in cesarean section with large doses of dexmedetomidine for intervention, and classified into control group, according to the in the other 40 patients using small doses of dexmedetomidine for intervention, and classified as the observation group, then observe two groups of patients with chills were compared, the patients were in our hospital from February 2016 to January 2017 were found.ResultsWith comparison of two groups of patients with chills, two group in the overall number of cases no significant difference.The observation group, a total of 9 cases of patients with chills, the control group had 10 cases of chills, while no significant difference between the two groups of shivering grade;the patients in the observation group of 2 cases (5%) had adverse reaction, the control group had 9 (22.5%) cases of adverse reactions,P<0.05 between the two groups showed significant differences.ConclusionDifferent doses of dexmedetomidine on preventing shivering effect analysis of cesarean section in patients with spinal and epidural anesthesia after the discovery, which can play the effect of the intervention in patients with chills, and can reduce the incidence of adverse reactions in patients after surgery, it is worthy of reference.
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Objective To explore the risk factors of shivering after intraspinal anesthesia.Methods 640 anesthesia recovery patients after intraspinal anesthesia from February 2011 to May 2015 were selected as the research subjects.According to whether patients appeared shivering,they were divided into research group and control group.The research group had 328 cases of appearing shivering,the control group had 312 cases without shivering. Basic clinical data of patients,operation time and blood loss,tympanic membrane temperature,anesthesia,anesthesia blocks plane indicators were compared to explore the risk factors of shivering after intraspinal anesthesia.Results This study included 640 cases,including 328 cases with chills reaction,the incidence rate was 51.25%.Single factor results showed that the low age,male,central cooler,surgery for a long time,the bleeding of more lumbar hemp,choice of anesthetic methods and anesthetic plane above T8 indicators, there were close relationship with shivering after intraspinal anesthesia,the differences between the two groups were statistically significant (χ2 =40.661,17.208, 32.369,32.931,36.624,14.844,26.84,all P<0.05).Multivariable logistic regression analysis results showed that age,gender,core body temperature,operation time,blood loss,spinal canal anesthesia methods and indexes of anes-thetic plane were important risk factors of chills reaction after anesthesia in patients with spinal canal anesthesia (OR=1.843,1.925,2.183,0.548,0.497,0.529,0.743,all P<0.05).Conclusion Male,younger age,operation for a long time,big intraoperative blood loss,tympanic membrane temperature low mode selection subarachnoid block anesthesia,and the anesthesia plane factor are the main risk factors of spinal canal anesthesia patients to appear chills response,the above factors are needed for close monitoring of patients with intraspinal anesthesia in the preoperative period.
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Objective To investigate the effects of cold exposure with different time courses on cardiovascular function and skeletal muscle contraction in Sprague-Dawley (SD) rats.Methods The male SD rats were randomly divided into control,12-h cold,24-h cold,and 48-h cold groups.The rats in all cold group were maintained in 4 ℃ environment for indicated time and allowed free access to standard rat chow and water ad libitum.After the animal model was established,the heart,thoracic aorta,soleus,and extensor digitorum longus (EDL) were rapidly isolated from rats under anesthesia and then fixed into the respective organ perfusion system that was connected to physiological recorders and data acquisition system.Lanendorff heart persusion was used to detect some parameters of cardiac function,such as coronary flow (CF),mean left ventricular systolic pressure (mLVSP),mean left ventricular diastolic pressure (mLVDP) and maximum ascending and declining rate of left ventricular pressure (± dp/dt max) ; and then the heart was suffered from 30 min ischemia followed by 60 min reperfusion,the changes of above cardiac function indexes were recorded again.Organ bath method was employed to detect contraction response to potassium chloride (KCl) or phenylephrine (PE) and endothelium-dependent relation responses to acetylcholine (ACh) of aortic rings.The twitch tension,titanic tension,and fatigue test of soleus and EDL were examined by electrical stimulation to reflect contractive function of skeletal muscle.Results The coronary flow (CF) were significantly reduced in 24-h and 48-h cold groups compared to control group [(9.0 ± 1.7) ml/g and (9.8 ± 1.3) ml/g vs (11.6 ± 1.2) ml/g,P ＜ 0.05] ; 48-h cold exposure also showed significantly increased mLVSP (P ＜0.01) and mLVP (P ＜ 0.05) of rats.After ischemia-reperfusion,the heart re-beat time was shorter in all cold exposure groups (all P ＜ 0.01),mLVP and mLVDP were higher in 24-h and 48-h cold group than control group (all P ＜ 0.01).The contraction of aortic rings responses to 60 mmol/L KCl [(0.63 ±0.13) g and (0.79 ±0.11)g vs (1.28±0.17)g,P ＜0.01] and 1 μmol/L PE [(0.62 ±0.18)g and (0.68 ±0.13)g vs (1.25 ± 0.18)g,P ＜ 0.01] were decreased while the endothelium-dependent relaxation responses to low concentration ACh (3 × 10-8 ～ 3 × 10-7) were increased in 24-h and 48-h cold groups relative to control group (all P ＜ 0.05).The 48-h cold also reduced titanic tension of SOL and EDL in comparison with control [(4.14 ± 0.62) N/cm2 vs (5.50 ± 0.75) N/cm2,P ＜ 0.05 and (3.00 ± 0.57) N/ cm2 vs (4.70 ± 0.85) N/cm2,P ＜ 0.01].Conclusions 24 ～ 48 h cold exposure could reduce CF but enhance the tolerance of heart from rats to ischemia reperfusion injury and also decrease the contraction of aortic rings response to KCl or PE but increase the sensitive responses to ACh of aortic rings from rats.The 48-h cold could decrease the contraction of skeletal muscle elicited by electrical stimulation.
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A 40-year-old woman visited our emergency room (ER) with fever and shaking chills. Blood cultures for suspicion of urinary tract infection revealed bacteremia two days later. Since <i>Streptococcus mitis</i> was detected, infective endocarditis was strongly suspected. In addition to her history of dental calculus removal, careful cardiac auscultation revealed a continuous murmur, leading to the existence of patent ductus arteriosus (PDA). PDA was confirmed by echocardiography and 3D-CT angiography. The patient was successfully treated by antibiotics and then received transcatheter PDA closure. Careful auscultation after detection of bacteremia led to a diagnosis of PDA.
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Based on the clinical, epidemiologic, and laboratory findings, the investigation team was of the considered opinion that the cause of the outbreak was food infection rather than intoxication. The grouping of cases in relation to a particular event; the explosive nature of the outbreak; the equal susceptibility of all ages, sexes, and occupational groups; the median incubation period of 13 hours; the clinical picture of gastroenteritis with fever, chills, and headache, the fever being high in range and with an average duration of 2 days; the isolation of the Ballerup-Bethesda group of organisms from stools of some cases; the serologic study which showed significantly higher titer of antibodies among cases than among a control group which was not infected; and the presence of conditions ideal for contamination and subsequent bacterial growth during the preparation of the food items suspected as the probable vehicle of infection all tend to to support the hypothesis of food infectionThe actual source of infections has not been determined with absolute certainly and the manner of contamination and transmission of the causative organisms are only matters of conjecture, because delayed reporting had made their demonstration by direct evidence technically difficult. However, these should not detract from the soundness of the conclusions drawn. After all, epidemiologic investigations in actual working situations are perhaps seldom, if ever, perfect and complete. As Wade Hampton Frost had written, "Epidemiology is something more than the total of its established facts......it includes ......chains of inferences which extend more or less beyond the bounds of direct observation." (Conclusion)
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Objective To determine whether repeated cold-stress stimulation could activate rennin-angiotensin system in rats and lead to a PIH-like phenomena in pregnant rats.Methods Adult Wistar female rats were randomly divided into 4 groups: non-pregnant control group(NN), non-pregnant cold-stress group(NC), pregnant control group(PN) and pregnant cold-stress group(PC). Rats were kept for 4 hours in (4?2)℃(NC?PC) and in 25℃ (NN?PN) every day respectively, from the 1st day to the 19th day of pregnancy. The AngⅡlevels of plasma?uterus and placentas were determined by radioimmunoassay. The expression of angiotensin Ⅱ type 1 receptor (AT1R) and angiotensin Ⅱ type 2 receptor (AT2R) mRNA were determined in uterus and placentas of rats by RT-PCR. Results The AngⅡlevels of plasma, uterus and placentas were increased significantly in NC and PC compared with those in NN and PN. AT2R was the predominant type in the rat non-pregnant uterus. Downregulation of AT2R and upregulation of AT1R were observed during pregnancy. And at last, AT1R was the predominant type in pregnant uterus. The AngⅡ receptors in the rat placenta are predominantly AT1R. After cold-stress stimulation, the expression of AT1R mRNA in uterus and placentas of rats were higher than that of control groups(P0.05). Conclusions Repeated cold-stress stimulation could activate the renin-angiotensin system(RAS), and lead to a PIH-like phenomena in pregnant rats at last.