Clinical analysis of minimally invasive surgery in the treatment of hypertensive lobar cerebral hemorrhage / 天津医药

Objective To explore the clinical value and effect of neuronavigation-assisted neuroendoscopy for hypertensive lobar cerebral hemorrhage. Methods Clinical data of 35 cases treated with the neuroendoscopy (neuroendoscopy group) and 32 cases treated with the neuronavigation-assisted microscope (microscope group) were retrospectively analyzed. Data of the operative time, intraoperative blood loss and the clearance rate of hematoma, the postoperative complications (stress gastric ulcer, pulmonary infection, urinary tract infection and intracranial infection), the hospital stay, postoperative ability of daily life (ADL) in 6 months and fatality rates were observed and compared. Results The operative time and intraoperative blood loss were less in the neuroendoscopy group than those in the microscopy group, and the clearance rate of hematoma was higher in neuroendoscopy group than that in the microscopy group (P＜0.01). There was no significant difference in postoperative complications between the two groups (P＞0.05). The hospital stay was less in the neuroendoscopy group than that of the microscope group (P＜0.01). On the basis of ADL grading method, the prognosis of the endoscopy group was better than that of the craniotomy group (P＜0.05). There was no significant difference in the fatality rate between the neuroendoscopy group and the microscopy group (P＞0.05). Conclusion The neuronavigation-assisted neuroendoscopy is a safe and effective surgical method for hypertensive lobar cerebral hemorrhage, and which can improve the prognosis of patients with hypertensive intracerebral hemorrhage.

Comparison of the exposure rates of risk factors and inducing factors of acute myocardial infarction between younger and aged adults / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the clinical characteristics of acute myocardial infarction (AMI) among younger adults and to explore the possible mechanisms of early myocardial infarction, combined with the newly discovered risk factors of coronary heart disease.</p><p><b>METHODS</b>Data on comparative analysis to the exposure rates of the risk factors and inducing factors of non-CAD patients with two groups of AMI patients including younger adults group (< or =40 years old) and aged adults group (> or =50 years old). Coronary angiography was applied.</p><p><b>RESULTS</b>There were differences noticed between the frequencies of risk factors of the two AMI groups. In younger adults group the exposure rates of smoking, hyperlipidemia, positive family history, C-reactive protein (CRP) and fibrinogen were markedly higher, while in elderly group the exposure rates of hypertension, smoking, hyperlipidemia, diabetes, CRP, fibrinogen and homocysteine (HCY) were markedly higher (P < 0.05). Although the clustering status of risk factors of the younger adult group was not higher than that of the elderly group. There were obvious inducing factors before the patients were attacked by AMI and the inducing factors inclined to cluster, which had obvious dose-reaction relationships with the occurrence of AMI in young people.</p><p><b>CONCLUSION</b>Early AMI of younger adults might relate to the clustering status of inducing factors. The coexistence of several kinds of inducing factors was resulted in the occurrence of AMI of the atherosclerosis (As) and non-As patients by means of myocardial ischemia accumulation effect.</p>