Relationship between plasma cortisol levels and stress ulcer following acute and severe head injury

This study was designed to investigate the relationship between plasma cortisol levels and stress ulcer following acute severe head injury. The plasma cortisol levels were prospectively measured by radioimmunoassay in 68 patients following acute head injury. The diagnosis of stress ulcer was based on clinical evidence and was confirmed by endoscopic examination. Patients with stress ulcer and gastrointestinal bleeding [n = 30, 44.1%] were older than those without stress ulcer [38.2 +/- 7.9 vs. 28.3 +/- 9.7 years, P< 0.01]. The combined rate of poor recovery and death in the stress ulcer patients [70.0%] was significantly higher than in the nonulcer patients [42.1%, p = 0.02]. On each of the first 3 days following the head injury, the average plasma cortisol levels in the stress ulcer patients were higher than in the nonulcer patients [p< 0.01]. Univariate analysis showed a positive relationship between plasma cortisol on admission and stress ulcer [r= 0.329, p = 0.01]. Logistic regression analysis revealed that plasma cortisol levels on admission [OR = 2.326, 95% Cl = 1.982-2.466] and age [OR = 1.064, 95% Cl = 0.861-1.219] were independent predictors of stress ulcer. The data showed that acute severe head injury was associated with a significant increase in plasma cortisol. Plasma levels of cortisol and age were independent predictors of stress ulcer following acute head injury

Treatment of recurrent malignant gliomas by surgery combined with recombinant adenovirus-p53 injection / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and toxicity of combination therapy with surgery and recombinant adenovirus-p53 injection of recurrent malignant gliomas.</p><p><b>METHODS</b>38 patients with recurrent malignant gliomas were included in this study. Among them, 18 patients of combined treatment group had Ommaya reservoirs placed into the tumor cavities after the resection of the tumors and received regular recombinant adenovirus-p53 injections after the operation. The other 20 patients received surgery alone.</p><p><b>RESULTS</b>The 6-month and 1-year survival rates after the combination therapy were 66.7% (14/18) and 44.4% (8/18), respectively. The median survival time was 9.7 months. Compared with the surgery-alone group, the combined treatment group achieved significant improvement (P < 0.05). The Karnofsky score was significantly improved at 6 months after the combination therapy compared with that before the treatment (P < 0.05).</p><p><b>CONCLUSION</b>The recombinant adenovirus-p53 injection is safe and effective in treatment of recurrent malignant gliomas. The combination therapy of surgery and recombinant adenovirus-p53 injection may improve the life quality and the prognosis in patients with recurrent malignant gliomas.</p>