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Objective To investigate the relationship between the serum uric acid (SUA) levels and the short-term clinical outcome in patients with spontaneous intracerebral hemorrhage.Methods Consecutive patients with spontaneous intracerebral hemorrhage admitted within 24 hours after onset were prospectively included.SUA levels was measured on the next morning after admission.Modified Rankin Scale (mRS) was used to ascertain clinical outcome at 30 days.The patients were divided into a good outcome group (mRS＜2) and poor outcome group (mRS≥3).Results A total of 92 patients with spontaneous intracerebral hemorrhage were included,and 46 of them (50％) were men,the mean age was 63 ± 12 years.At 30 days after onset,22 patients (23.9％) had a good outcome and 70 patients (76.1％) had a poor outcome.Univariate analysis showed that the Glasgow Come Scale (GCS) score in the good outcome group was significantly higher than that in the poor outcome group (13.85 ± 2.80 vs.11.21 ± 2.51; t=4.186,P=0.000),while hematoma volume (25.65 ±5.33 cm3 vs.34.60± 8.97 cm3,t=4.430,P=0.000) and SUA levels (324.90± 86.02 μmol/L vs.458.63 ±72.77 μmol/L; t =7.193,P =0.000) were significantly lower than those in the poor outcome group.Multivariate logistic regression analysis showed that the lower GCS score (odds ratio [OR]1.810,95％ confidence interval [CI]1.382-2.382; P =0.001),larger hematoma volume (OR 1.156,95％ CI 1.045-1.280; P=0.005) and higher SUA levels (OR 2.127,95％ CI 1.055-4.287; P=0.035) were the independent predictive factors for the short-term clinical outcome in patients with spontaneous intracerebral hemorrhage.Conclusions The increased SUA levels may predict the poor short-term clinical outcome in patients with spontaneous intracerebral hemorrhage.
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Objective To analyze and compare the incidence of cerebral vasospasm (CVS) in patients with aneurismal subarachnoid hemorrhage(aSAH) in China and in Europe.Methods A literature search was performed for all the papers investigating the incidence,diagnosis, treatment or prognosis of CVS after aSAH using the MEDLINE and China Knowledge Resource Integrated Database (CNKI) from January 1, 1990 to December 31, 2010.The incidences of angiographic CVS, symptomatic CVS and CVS-related infarcts were recorded.The incidences of CVS between Chinese and white men in Europe were compared. Results A total of 237 articles were searched via CNKI and reference reviews, and 9 of the studies met the inclusion criteria. A total of 172 articles were searched via MEDLINE and reference reviews, and 18 of the studies met the inclusion criteria. The risk of occurring symptomatic CVS in patients with aSAH in Chinese was significantly higher than that in white men in Europe (relative risk,2. 063, 95％ confidence interval 1.816-2. 343, P ＜0. 001). Conclusions The incidence of CVS in patients with aSAH in Chinese was significantly higher than that in white men in Europe,indicating the pathogenesis of CVS may have genetic basis.
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Objective To evaluate the impact of acute hyperglycemia on the short-term prognosis in patients with primary intracerebral hemorrhage (ICH) with meta-analysis. Methods The prospective or retrospective cohort studies or case-control studies of the relationship between baseline blood glucose levels and short-term prognosis (at least were followed up to discharge or 1 month) in patients with ICH within 24 hours were searched and reported. A meta-analysis software package (RevMan 4. 2) was used to pool data for the literatures in accordance with the inclusion criteria. The publication bias was analyzed and the sensitivity analysis was used to evaluate the stability of the results. Results The risk of mortality at the end of the follow up in the normoglycemia group was significantly lower than that in the hyperglycemia group (odds ratio 0. 24,95% CI 0. 19-0. 30; P <0. 000 01); the baseline plasma glucose level was significantly lower than that in the survival group (weighted mean difference -2. 30,95% CI -2. 36- -2.23; P< 0.000 01). Conclusions Acute hyperglycemia can significantly increase the risks of short-term mortality in patients with primary ICH. It is necessary to conduct a prospective randomized trial in order to investigate the effect of intensive glucose control on the prognosis of the patients with ICH.
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OBJECTIVE To explore the infection situation of surgical operation and enhance postoperative(observation) and rational use of antibiotics.METHODS Totally 11 208 cases after surgical operation were(investigated)(retrospectively).The diagnosis standard was based on the Diagnosis Standard of Hospital(Infection)(Draft) published by Ministry of Health,the People′s Republic of China in Jan 2001. RESULTS There were(11 208) cases after surgical operation from Jan 1,2000 to Dec 31,2004 in our hospital and 275 cases suffered(incision)(infection,) there(infection) rate was 2.45%.The pathogenic bacteria of incision infection were confirmed as G~-(bacilli)(72 strains,78.26%),and G~+ cocci(20 strains,21.74%).CONCLUSIONS The key points of prevention of incision infection are sterile operation,protection of operation field when incising cavity organ,inside(sterilization),flushing of abdominal cavity and incision,change of contaminated apparatus,gloves and dressing promptly,(selection) of suture line and suture technique,besides the serious operation preparedness and skin(sterilization).
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Objective To explore the methods in repairing the thenar wounds by microsurgical technique Methods Since 1989, thenar wounds were restored with transfer of superficial or deep palmar arch, recombine of thenar muscle flap Patch of nerve and transplantation of flap on 21 cases Results The thumb and flap were survived The two point discrimination was 5 to 10 mm The thenar muscle streugth reached MRC 4 with satisfactory oppones fuction Conclusion The thenal wounds cna be obtained good effect being repaired by microsurgical technique