Ahigh death toll during an earthquake comes not only from injuries related to the destruction of buildings or road accidents but also from sudden death resulting from cardiovascular problems, as clearly shown in repor...Ahigh death toll during an earthquake comes not only from injuries related to the destruction of buildings or road accidents but also from sudden death resulting from cardiovascular problems, as clearly shown in reports. The increased rate of cardiovascular mortality during an earthquake has been ascribed to the impact of a major emotional stress on the heart, mediated through an increase in cardiac sympathetic activity, and probably including some other neuroendocrine mechanisms. A rise in blood pressure (BP) and heart rate (HR) may be directly responsible for the increased rate of cardiovascular mortality during an earthquake. Previously published studies about the acute changes of BP and HR used indirect information,展开更多
BACKGROUND: Comparison of different stroke locations had been focused in past researches in electrocardiogram (ECG) changes of cerebral stroke patients. Some researches neglected the heart disease in the illness hi...BACKGROUND: Comparison of different stroke locations had been focused in past researches in electrocardiogram (ECG) changes of cerebral stroke patients. Some researches neglected the heart disease in the illness history. OBJ ECTIVE: To discuss ECG changes in different infarction locations and size of acute cerebral infarction and compare with healthy people. DESIGN: Contrast observation SETTING: Shanghai Ninth People's Hospital PARTICIPANTS : A total of 57 patients with cerebral infarction ware selected from the Neurological Department of Ninth People's Hospital of Shanghai from March 2003 to September 2005. They were diagnosed according to the criteria revised in the 4^th National Cerebral Disease Conference and brain images. Patients who had heart disease were excluded. There were 32 males and 25 females, who were 65-84 years old. Among them, 23 cases were involved in right hemisphere, 34 cases in left one, 23 in base ganglion, 11 in brain stem, 9 in frontal lobe and 14 in other parts. According to their infarction size (plus size in every different scan), they were divided into three different groups: large-size group (n = 10) with size larger than 3.5 cm^3, medium-size group (n = 13) with size between 1.5-3.5 cm^3, and small-size group (n = 34) with size smaller than 1.5 cm^3. Another 50 healthy subjects were regarded as control group. There were 29 males and 21 females aged 40- 82 years. All these cases knew and agreed of the examination. METHODS : Patients received 12-lead ECG examinations within the first 6-24 hours of onset while control group received it at the same time. The HR, PR, QTc, QRS, T wave and ST changes were compared between the two groups. MAIN OUTCOME MEASURES: The ECG changes and differences in two hemispheres, in different infarction lo- cations and sizes. RESULTS: All 57 patients and 50 healthy subjects ware involved in the final analysis. ① ECG changes in infarction group and control group. There were no differences in HR, QRS time and cases with opposite T wave of infarction group compared with control group (P 〉 0.05). PR and QTc [(0.167±0.010), (0.383±0.029) s] in infarction group were longer than those in control group [(0.159±0.008), (0.361±0.022) s, t = 1.982, 2.363, P 〈 0.05, 0.01]. ST changes cases were 77% (44/57), which was more than those in control group [46% (23/50), x^2= 11.072, P 〈 0.01]. ② Comparison of infarction in two hemispheres. HR, PR interval, QRS time, cases with opposite T wave and ST changes showed no differences (P 〉 0.05), and QTc interval in right hemisphere infarction was longer than left one [(0.391±0.054), (0.380±0.034) s, t=1.673, P 〈 0.05]. ③ ECG changes in different infarction locations. HR, PR interval, QTc interval, QRS time, cases with opposite T wave and ST changes showed no statistically significantly differences (P〉 0.05). ④ ECG changes in different infarction sizes. HR, PR interval, QRS time showed no differences (P〉 0.05). QTc interval in large size group was longer than the others [(0.399±0.044), (0.388±0.073)t (0.378±0.124) s, F= 3.19, P 〈 0.05]. Cases with opposite T wave and ST changes in large size group were 80% (8/10), 100% (10/10), which were higher than those in medium size group [46% (6/13), 69% (9/13)] and small size group [44% (15/34), 35% (12/34), x^2 = 8.495, 10.538, P 〈 0.05, 0.01]. CONCLUSION : ① PR interval and QTc interval prolonged in cerebral infarction patients. Furthermore, QTc interval was more obvious in large size infarction group and right hemisphere infarction group. ② Infarction location did not affect the changes of ECG.展开更多
BACKGROUND: At present, it is believed that the important causes of cerebral infarction are the disorders of lipid metabolism and endothelial function, and the outcomes of clinical treatment can be improved by regulat...BACKGROUND: At present, it is believed that the important causes of cerebral infarction are the disorders of lipid metabolism and endothelial function, and the outcomes of clinical treatment can be improved by regulating serum lipids and antiinflammation, etc. OBJECTIVE: To observe the effect of simvastatin, inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A reductase, on the levels of serum lipids, serum enzymic indexes and inflammatory metabolic indexes in patients with cerebral infarction. DESIGN: A comparative observation. SETTING: Department of Geriatrics, Longquanshan Hospital of Liuzhou City. PARTICIPANTS: Forty-eight patients with acute cerebral infarction were selected from the Department of Geriatrics of Longquanshan Hospital of Liuzhou from March 2004 to February 2006, including 24 males and 24 females, the mean age was (54±12) years, average disease course was (10.0±4.5) days. They were all accorded with the diagnostic standard for cerebral infarction set by the Fourth National Academic Meeting for Cerebrovascular Disease in 1999, and cerebral hemorrhage was excluded by cranial CT scanning. The 48 patients were randomly divided into control group (n =24) and treatment group (n =24). Informed consents were obtained from all the participants. METHODS: ① All the patients were treated according to the symptoms, besides those in the treatment group were given simvastatin (Harbin Pharm. Group Sanjing Pharmaceutical Shareholding, Co.,Ltd., No. H20010454; Batch number: 20040218; 5 mg/tablet). The initial dosage was 10 mg per day for 4 weeks, and then increased to 30 mg per day for another 4 weeks. ② Before treatment and within 1 week after treatment, the total cholesterol, triglyceride, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), aspartate aminotransferase (AST), creatine kinase and C reactive protein in serum were determined with Beckman-cx7 automatic biochemical analytical apparatus in both groups. ③ The differences of intergroup and intragroup data were compared with the independent-samples t test and paired samples t test. MAIN OUTCOME MEASURES: Changes of total cholesterol, triglyceride, HDL-C, LDL-C, AST, creatine kinase and C reactive protein before and treatment in both groups. RESULTS: All the 48 patients with cerebral infarction were involved in the analysis of results. ① Changes of serum lipids: The levels of serum lipids were close between the two groups before treatment (P > 0.05). After treatment, the HDL-C level in the treatment group was obviously higher than that in the control group and that before treatment [(1.34±0.12), (0.92±0.33), (0.93±0.21) mmol/L, t =7.922, 11.699, P < 0.01], and the levels of total cholesterol, triglyceride and LDL-C were obviously lower than those in the control group and those before treatment (t =2.780-7.591, P < 0.01). ② Changes of serum enzymic indexes and C reactive protein in serum: The levels of enzymes and C reactive protein in serum had no obvious differences between the two groups before treatment (P > 0.05). The levels of AST, creatine kinase and C reactive protein in serum after treatment were obviously lower than those before treatment in both groups (t =7.259-17.996, P < 0.01). The levels of levels of creatine kinase and C reactive protein in serum after treatment in the treatment group were obviously lower than those in the control group [(3.061±0.522) μkat/L, (4.6±3.1) mg/L; (4.348±0.580) μkat/L, (12.3±4.8) mg/L, t =7.910, 6.463, P < 0.01]. CONCLUSION: Compared with common treatment according to symptoms, the additional administration of simvastatin is better for improving the serum lipids, serum enzymic indexes of patients with cerebral infarction at acute period, and benefit for repairing their inflammatory damages.展开更多
Objective:To explore the effect of Wulong Dan (WLD) on treatment of acute cerebral infarction and change of hormones in hypothalamus-pituitary-thyroid axis. Methods:Thirty five cases of the treated group treated with ...Objective:To explore the effect of Wulong Dan (WLD) on treatment of acute cerebral infarction and change of hormones in hypothalamus-pituitary-thyroid axis. Methods:Thirty five cases of the treated group treated with WLD by taken orally and 31 cases of the control group treated with nimoton taken orally. And dextran was given intravenously to both groups. Blood level of triiodothyronine (T3), free triiodothyronine (FT3), thyroxine (T4), free throxine (FT4) and thyroid stimulating hormone (TSH) of all patients were determined before and after treatment by radioimmunoassay. Results: After 4 weeks of treatment, there were significant difference between the treated group and the control group in cure rate, markedly effective rate,cure score and disappearance of clinical symptoms (P < 0. 01 ). The levels of T3, FT3,TSH of all patients were lower than those of the normal control before treatment. After treatment with WLD and dextran, the abovementioned indexes turned to normal. Conclusions: WLD has a significant effect on patients with cerebral infarction on the basis of improved microcirculation induced by dextran. It also has regulatory effect on the hypothalamuspituitary-thyroid axis disorder so as to be helpful in maintaining the homeostasis.展开更多
Background:Bipolar electro-coagulation has a reported efficacy in treating epilepsy involving functional cortex by pure electro-coagulation or combination with resection.However,the mechanisms of bipolar electro-coag...Background:Bipolar electro-coagulation has a reported efficacy in treating epilepsy involving functional cortex by pure electro-coagulation or combination with resection.However,the mechanisms of bipolar electro-coagulation are not completely known.We studied the acute cortical blood flow and histological changes after bipolar electro-coagulation in 24 patients with intractable temporal lobe epilepsy.Methods:Twenty-four patients were consecutively enrolled,and divided into three groups according to the date of admission.The regional cortical blood flow (rCBF),electrocorticography,the depth of cortex damage,and acute histological changes (H and E staining,neuronal staining and neurofilament (NF) staining) were analyzed before and after the operation.The t-test analysis was used to compare the rCBF before and after the operation.Results:The rCBF after coagulation was significantly reduced (P 〈 0.05).The spikes were significantly reduced after electro-coagulation.For the temporal cortex,the depth of cortical damage with output power of 2-9 W after electro-coagulation was 0.34 ± 0.03,0.48 ± 0.06,0.69 ± 0.06,0.84 ± 0.09,0.98 ± 0.08,1.10 ± 0.1 l,1.11 ± 0.09,and 1.22 ± 0.11 mm,respectively.Coagulation with output power of 4-5 W completely damaged the neurons and NF protein in the molecular layer,external granular layer,and external pyramidal layer.Conclusions:The electro-coagulation not only destroyed the neurons and NF protein,but also reduced the rCBF.We concluded that the injuries caused by electro-coagulation would prevent horizontal synchronization and spread of epileptic discharges,and partially destroy the epileptic focus.展开更多
文摘Ahigh death toll during an earthquake comes not only from injuries related to the destruction of buildings or road accidents but also from sudden death resulting from cardiovascular problems, as clearly shown in reports. The increased rate of cardiovascular mortality during an earthquake has been ascribed to the impact of a major emotional stress on the heart, mediated through an increase in cardiac sympathetic activity, and probably including some other neuroendocrine mechanisms. A rise in blood pressure (BP) and heart rate (HR) may be directly responsible for the increased rate of cardiovascular mortality during an earthquake. Previously published studies about the acute changes of BP and HR used indirect information,
文摘BACKGROUND: Comparison of different stroke locations had been focused in past researches in electrocardiogram (ECG) changes of cerebral stroke patients. Some researches neglected the heart disease in the illness history. OBJ ECTIVE: To discuss ECG changes in different infarction locations and size of acute cerebral infarction and compare with healthy people. DESIGN: Contrast observation SETTING: Shanghai Ninth People's Hospital PARTICIPANTS : A total of 57 patients with cerebral infarction ware selected from the Neurological Department of Ninth People's Hospital of Shanghai from March 2003 to September 2005. They were diagnosed according to the criteria revised in the 4^th National Cerebral Disease Conference and brain images. Patients who had heart disease were excluded. There were 32 males and 25 females, who were 65-84 years old. Among them, 23 cases were involved in right hemisphere, 34 cases in left one, 23 in base ganglion, 11 in brain stem, 9 in frontal lobe and 14 in other parts. According to their infarction size (plus size in every different scan), they were divided into three different groups: large-size group (n = 10) with size larger than 3.5 cm^3, medium-size group (n = 13) with size between 1.5-3.5 cm^3, and small-size group (n = 34) with size smaller than 1.5 cm^3. Another 50 healthy subjects were regarded as control group. There were 29 males and 21 females aged 40- 82 years. All these cases knew and agreed of the examination. METHODS : Patients received 12-lead ECG examinations within the first 6-24 hours of onset while control group received it at the same time. The HR, PR, QTc, QRS, T wave and ST changes were compared between the two groups. MAIN OUTCOME MEASURES: The ECG changes and differences in two hemispheres, in different infarction lo- cations and sizes. RESULTS: All 57 patients and 50 healthy subjects ware involved in the final analysis. ① ECG changes in infarction group and control group. There were no differences in HR, QRS time and cases with opposite T wave of infarction group compared with control group (P 〉 0.05). PR and QTc [(0.167±0.010), (0.383±0.029) s] in infarction group were longer than those in control group [(0.159±0.008), (0.361±0.022) s, t = 1.982, 2.363, P 〈 0.05, 0.01]. ST changes cases were 77% (44/57), which was more than those in control group [46% (23/50), x^2= 11.072, P 〈 0.01]. ② Comparison of infarction in two hemispheres. HR, PR interval, QRS time, cases with opposite T wave and ST changes showed no differences (P 〉 0.05), and QTc interval in right hemisphere infarction was longer than left one [(0.391±0.054), (0.380±0.034) s, t=1.673, P 〈 0.05]. ③ ECG changes in different infarction locations. HR, PR interval, QTc interval, QRS time, cases with opposite T wave and ST changes showed no statistically significantly differences (P〉 0.05). ④ ECG changes in different infarction sizes. HR, PR interval, QRS time showed no differences (P〉 0.05). QTc interval in large size group was longer than the others [(0.399±0.044), (0.388±0.073)t (0.378±0.124) s, F= 3.19, P 〈 0.05]. Cases with opposite T wave and ST changes in large size group were 80% (8/10), 100% (10/10), which were higher than those in medium size group [46% (6/13), 69% (9/13)] and small size group [44% (15/34), 35% (12/34), x^2 = 8.495, 10.538, P 〈 0.05, 0.01]. CONCLUSION : ① PR interval and QTc interval prolonged in cerebral infarction patients. Furthermore, QTc interval was more obvious in large size infarction group and right hemisphere infarction group. ② Infarction location did not affect the changes of ECG.
文摘BACKGROUND: At present, it is believed that the important causes of cerebral infarction are the disorders of lipid metabolism and endothelial function, and the outcomes of clinical treatment can be improved by regulating serum lipids and antiinflammation, etc. OBJECTIVE: To observe the effect of simvastatin, inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A reductase, on the levels of serum lipids, serum enzymic indexes and inflammatory metabolic indexes in patients with cerebral infarction. DESIGN: A comparative observation. SETTING: Department of Geriatrics, Longquanshan Hospital of Liuzhou City. PARTICIPANTS: Forty-eight patients with acute cerebral infarction were selected from the Department of Geriatrics of Longquanshan Hospital of Liuzhou from March 2004 to February 2006, including 24 males and 24 females, the mean age was (54±12) years, average disease course was (10.0±4.5) days. They were all accorded with the diagnostic standard for cerebral infarction set by the Fourth National Academic Meeting for Cerebrovascular Disease in 1999, and cerebral hemorrhage was excluded by cranial CT scanning. The 48 patients were randomly divided into control group (n =24) and treatment group (n =24). Informed consents were obtained from all the participants. METHODS: ① All the patients were treated according to the symptoms, besides those in the treatment group were given simvastatin (Harbin Pharm. Group Sanjing Pharmaceutical Shareholding, Co.,Ltd., No. H20010454; Batch number: 20040218; 5 mg/tablet). The initial dosage was 10 mg per day for 4 weeks, and then increased to 30 mg per day for another 4 weeks. ② Before treatment and within 1 week after treatment, the total cholesterol, triglyceride, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), aspartate aminotransferase (AST), creatine kinase and C reactive protein in serum were determined with Beckman-cx7 automatic biochemical analytical apparatus in both groups. ③ The differences of intergroup and intragroup data were compared with the independent-samples t test and paired samples t test. MAIN OUTCOME MEASURES: Changes of total cholesterol, triglyceride, HDL-C, LDL-C, AST, creatine kinase and C reactive protein before and treatment in both groups. RESULTS: All the 48 patients with cerebral infarction were involved in the analysis of results. ① Changes of serum lipids: The levels of serum lipids were close between the two groups before treatment (P > 0.05). After treatment, the HDL-C level in the treatment group was obviously higher than that in the control group and that before treatment [(1.34±0.12), (0.92±0.33), (0.93±0.21) mmol/L, t =7.922, 11.699, P < 0.01], and the levels of total cholesterol, triglyceride and LDL-C were obviously lower than those in the control group and those before treatment (t =2.780-7.591, P < 0.01). ② Changes of serum enzymic indexes and C reactive protein in serum: The levels of enzymes and C reactive protein in serum had no obvious differences between the two groups before treatment (P > 0.05). The levels of AST, creatine kinase and C reactive protein in serum after treatment were obviously lower than those before treatment in both groups (t =7.259-17.996, P < 0.01). The levels of levels of creatine kinase and C reactive protein in serum after treatment in the treatment group were obviously lower than those in the control group [(3.061±0.522) μkat/L, (4.6±3.1) mg/L; (4.348±0.580) μkat/L, (12.3±4.8) mg/L, t =7.910, 6.463, P < 0.01]. CONCLUSION: Compared with common treatment according to symptoms, the additional administration of simvastatin is better for improving the serum lipids, serum enzymic indexes of patients with cerebral infarction at acute period, and benefit for repairing their inflammatory damages.
文摘Objective:To explore the effect of Wulong Dan (WLD) on treatment of acute cerebral infarction and change of hormones in hypothalamus-pituitary-thyroid axis. Methods:Thirty five cases of the treated group treated with WLD by taken orally and 31 cases of the control group treated with nimoton taken orally. And dextran was given intravenously to both groups. Blood level of triiodothyronine (T3), free triiodothyronine (FT3), thyroxine (T4), free throxine (FT4) and thyroid stimulating hormone (TSH) of all patients were determined before and after treatment by radioimmunoassay. Results: After 4 weeks of treatment, there were significant difference between the treated group and the control group in cure rate, markedly effective rate,cure score and disappearance of clinical symptoms (P < 0. 01 ). The levels of T3, FT3,TSH of all patients were lower than those of the normal control before treatment. After treatment with WLD and dextran, the abovementioned indexes turned to normal. Conclusions: WLD has a significant effect on patients with cerebral infarction on the basis of improved microcirculation induced by dextran. It also has regulatory effect on the hypothalamuspituitary-thyroid axis disorder so as to be helpful in maintaining the homeostasis.
文摘Background:Bipolar electro-coagulation has a reported efficacy in treating epilepsy involving functional cortex by pure electro-coagulation or combination with resection.However,the mechanisms of bipolar electro-coagulation are not completely known.We studied the acute cortical blood flow and histological changes after bipolar electro-coagulation in 24 patients with intractable temporal lobe epilepsy.Methods:Twenty-four patients were consecutively enrolled,and divided into three groups according to the date of admission.The regional cortical blood flow (rCBF),electrocorticography,the depth of cortex damage,and acute histological changes (H and E staining,neuronal staining and neurofilament (NF) staining) were analyzed before and after the operation.The t-test analysis was used to compare the rCBF before and after the operation.Results:The rCBF after coagulation was significantly reduced (P 〈 0.05).The spikes were significantly reduced after electro-coagulation.For the temporal cortex,the depth of cortical damage with output power of 2-9 W after electro-coagulation was 0.34 ± 0.03,0.48 ± 0.06,0.69 ± 0.06,0.84 ± 0.09,0.98 ± 0.08,1.10 ± 0.1 l,1.11 ± 0.09,and 1.22 ± 0.11 mm,respectively.Coagulation with output power of 4-5 W completely damaged the neurons and NF protein in the molecular layer,external granular layer,and external pyramidal layer.Conclusions:The electro-coagulation not only destroyed the neurons and NF protein,but also reduced the rCBF.We concluded that the injuries caused by electro-coagulation would prevent horizontal synchronization and spread of epileptic discharges,and partially destroy the epileptic focus.