BACKGROUND: Surgery for intracranial aneurysm often results in postoperative neurologic deficits. We conducted a randomized trial at 30 centers to determine whether intraoperative cooling during open craniotomy would ...BACKGROUND: Surgery for intracranial aneurysm often results in postoperative neurologic deficits. We conducted a randomized trial at 30 centers to determine whether intraoperative cooling during open craniotomy would improve the outcome among patients with acute aneurysmal subarachnoid hemorrhage. METHODS: A total of 1001 patients with a preoperative World Federation of Neurological Surgeons score of I, II, or III (“ good- grade patients"), who had had a subarachnoid hemorrhage no more than 14 days before planned surgical aneurysm clipping, were randomly assigned to intraoperative hypothermia (target temperature, 33° C, with the use of surface cooling techniques) or normothermia (target temperature, 36.5° C). Patients were followed closely postoperatively and examined approximately 90 days after surgery, at which time a Glasgow Outcome Score was assigned. RESULTS: There were no significant differences between the group assigned to intraoperative hypothermia and the group assigned to normothermia in the duration of stay in the intensive care unit, the total length of hospitalization, the rates of death at follow- up (6 percent in both groups), or the destination at discharge (home or another hospital, among surviving patients). At the final follow- up, 329 of 499 patients in the hypothermia group had a Glasgow Outcome Score of 1 (good outcome), as compared with 314 of 501 patients in the normothermia group (66 percent vs. 63 percent; odds ratio, 1.14; 95 percent confidence interval, 0.88 to 1.48; P=0.32). Postoperative bacteremia was more common in the hypothermia group than in the normothermia group (5 percent vs. 3 percent, P=0.05). CONCLUSIONS: Intraoperative hypothermia did not improve the neurologic outcome after craniotomy among good- grade patients with aneurysmal subarachnoid hemorrhage.展开更多
Reanalysis data from NCEP/NCAR are used to systematically study preceding signals of monthly precipitation anomalies in the early raining season of Guangdong province, from the viewpoints of 500-hPa geopotential heigh...Reanalysis data from NCEP/NCAR are used to systematically study preceding signals of monthly precipitation anomalies in the early raining season of Guangdong province, from the viewpoints of 500-hPa geopotential height field, outgoing longwave radiation (OLR) field, sea surface temperature (SST) and fourteen indexes of general circulation depicting atmosphere activity at high, middle and low latitutes. Being multiple tools of information, a number of conceptual models are formulated that are useful for prediction of the magnitude of monthly precipitation (drought, flood and normal conditionss).展开更多
文摘BACKGROUND: Surgery for intracranial aneurysm often results in postoperative neurologic deficits. We conducted a randomized trial at 30 centers to determine whether intraoperative cooling during open craniotomy would improve the outcome among patients with acute aneurysmal subarachnoid hemorrhage. METHODS: A total of 1001 patients with a preoperative World Federation of Neurological Surgeons score of I, II, or III (“ good- grade patients"), who had had a subarachnoid hemorrhage no more than 14 days before planned surgical aneurysm clipping, were randomly assigned to intraoperative hypothermia (target temperature, 33° C, with the use of surface cooling techniques) or normothermia (target temperature, 36.5° C). Patients were followed closely postoperatively and examined approximately 90 days after surgery, at which time a Glasgow Outcome Score was assigned. RESULTS: There were no significant differences between the group assigned to intraoperative hypothermia and the group assigned to normothermia in the duration of stay in the intensive care unit, the total length of hospitalization, the rates of death at follow- up (6 percent in both groups), or the destination at discharge (home or another hospital, among surviving patients). At the final follow- up, 329 of 499 patients in the hypothermia group had a Glasgow Outcome Score of 1 (good outcome), as compared with 314 of 501 patients in the normothermia group (66 percent vs. 63 percent; odds ratio, 1.14; 95 percent confidence interval, 0.88 to 1.48; P=0.32). Postoperative bacteremia was more common in the hypothermia group than in the normothermia group (5 percent vs. 3 percent, P=0.05). CONCLUSIONS: Intraoperative hypothermia did not improve the neurologic outcome after craniotomy among good- grade patients with aneurysmal subarachnoid hemorrhage.
基金Short-term Climate Prediction Study for Guangdong Province a key project of Guangdong Science and Technology Committee in the national 9th five-year economic development plan Research on Long-term Tendency Prediction System for Floods/Drought and Typh
文摘Reanalysis data from NCEP/NCAR are used to systematically study preceding signals of monthly precipitation anomalies in the early raining season of Guangdong province, from the viewpoints of 500-hPa geopotential height field, outgoing longwave radiation (OLR) field, sea surface temperature (SST) and fourteen indexes of general circulation depicting atmosphere activity at high, middle and low latitutes. Being multiple tools of information, a number of conceptual models are formulated that are useful for prediction of the magnitude of monthly precipitation (drought, flood and normal conditionss).
