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OBJECTIVES: To explore the one year outcome of subarachnoid hemorrhage (SAH) patients with poor grade intracranial aneurysm who underwent early treatment (within 72 hours), and to analyze the possible predictors of the prognosis. METHODS: This clinical study was a prospective, multicenter, observational registry of SAH patients with poor grade intracranial aneurysm. Data pertaining to 203 SAH patients with poor grade intracranial aneurysm between October 2010 and March 2013 from 10 medical centers. There were 100 male and 103 female patients. Neurological outcomes at 12 months after the surgery were measured using the Glasgow Outcome Scale (GOS). Genders, age, smoke, breath, herniation, aneurysm location, World Federation of Neurosurgical Societies (WFNS) grade, CT Fisher's grade, alcohol consumption, aneurysm diameter, surgical procedure and operation time were identified as possible prognostic factors, the association between possible prognostic factors and outcome were analyzed, using univariate and multivariate analysis. Univariate analysis included Wilcoxon rank sum test, Kruskal-Wallis H test and Nemenyi test, multivariate analysis included Logistic regression test. RESULTS: Among 203 patients, 94 patients were WFNS grade â £, and 109 patients were WFNS grade â ¤; 31 patients were CT Fisher's grade 1 to 2, 172 patients were CT Fisher's grade 3 to 5. Herniation (OR=2.535, 95%CI: 1.204 to 5.339, P=0.014), WFNS grade â ¤ (OR=3.728, 95%CI: 1.972 to 7.043, P=0.000), CT Fisher's grade 3 to 5 (OR=5.641, 95%CI: 2.032 to 15.643, P=0.001), and anterior circulation location (OR=6.234, 95%CI: 1.996 to 19.472, P=0.002) were found to be independent prognostic factors of unfavorable prognosis. CONCLUSIONS: Early surgical treatment could improve the prognosis of SAH patients with poor-grade-aneurysm. The patients with herniation, WFNS grade â ¤, CT Fisher's grade 3 to 5, anterior circulation aneurysms suffered unfavorable prognosis.
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Aneurisma Intracraneal , Femenino , Humanos , Masculino , Análisis Multivariante , Pronóstico , Estudios Prospectivos , Hemorragia SubaracnoideaRESUMEN
This work was to investigate the hypoglycemic and antioxidant activities of the exopolysaccharides produced in a stirred-tank bioreactor by Inocutus hispidus. The exopolysaccharides showed significant antioxidant activities, up to 70.7±2.5% inhibition of hydroxyl radicals, 50% inhibition of 2,2-diphenyl-1-picrylhydrazyl radicals, and a Trolox equivalent antioxidant capacity of 3.3 mM. The exopolysaccharide also showed notable hypoglycemic effects in streptozotocin-induced diabetic mice, reducing the plasma glucose, total cholesterol and triacylglycerol concentrations by 18.2±1.5, 20.9±0.8 and 14.4±0.4, respectively. The results demonstrated the potential of this EPS for human health protection against oxidative damage and hyperglycemia.
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OBJECTIVE: To investigate the effect of lung recruitment maneuver (LRM) with positive end-expiratory pressure (PEEP) on oxygenation and outcomes in preterm infants ventilated by proportional assist ventilation (PAV) for respiratory distress syndrome (RDS). STUDY DESIGN: Preterm infants on PAV for RDS after surfactant randomly received an LRM (group A, n=12) or did not (group B, n=12). LRM entailed increments of 0.2 cm H2O PEEP every 5 min, until fraction of inspired oxygen (FiO2)=0.25. Then PEEP was reduced and the lung volume was set on the deflation limb of the pressure/volume curve. When saturation of peripheral oxygen fell and FiO2 rose, we reincremented PEEP until SpO2 became stable. RESULT: Group A and B infants were similar: gestational age 29.5 ± 1.0 vs 29.4 ± 0.9 weeks; body weight 1314 ± 96 vs 1296 ± 88 g; Silverman Anderson score for babies at start of ventilation 8.6 ± 0.8 vs 8.2 ± 0.7; initial FiO2 0.56 ± 0.16 vs 0.51 ± 0.14, respectively. The less doses of surfactant administered in group A than that in group B (P<0.05). Groups A and B showed different max PEEP during the first 12 h of life (8.4 ± 0.5 vs 6.7 ± 0.6 cm H2O, P=0.00), time to lowest FiO2 (101 ± 18 versus 342 ± 128 min; P=0.000) and O2 dependency (7.83 ± 2.04 vs 9.92 ± 2.78 days; P=0.04). FiO2 levels progressively decreased (F=43.240, P=0.000) and a/AO2 ratio gradually increased (F=30.594, P=0.000). No adverse events and no differences in the outcomes were observed. CONCLUSION: LRM led to the earlier lowest FiO2 of the first 12 h of life and a shorter O2 dependency.
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Recien Nacido Prematuro , Soporte Ventilatorio Interactivo/métodos , Pulmón/fisiopatología , Oxígeno/administración & dosificación , Respiración con Presión Positiva/métodos , Síndrome de Dificultad Respiratoria del Recién Nacido/terapia , Femenino , Edad Gestacional , Humanos , Recién Nacido , Masculino , Intercambio Gaseoso Pulmonar , Surfactantes Pulmonares/administración & dosificación , Síndrome de Dificultad Respiratoria del Recién Nacido/fisiopatologíaRESUMEN
Experimental images from particle/droplet image analyser (PDIA) and particle image velocimetry (PIV) imaging techniques of particle formation from a nasal spray device were taken to determine critical parameters for the study and design of effective nasal drug delivery devices. The critical parameters found were particle size, diameter of spray cone at a break-up length and a spray cone angle. A range of values for each of the parameters were ascertained through imaging analysis which were then transposed into initial particle boundary conditions for particle flow simulation within the nasal cavity by using Computational Fluid Dynamics software. An Eulerian-Lagrangian scheme was utilised to track mono-dispersed particles (10 and 20 microm) at a breathing rate of 10 L/min. The results from this qualitative study aim to assist the pharmaceutical industry to improve and help guide the design of nasal spray devices.
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Administración Intranasal , Simulación por Computador , Sistemas de Liberación de Medicamentos/estadística & datos numéricos , Aerosoles , Sistemas de Liberación de Medicamentos/instrumentación , Diseño de Equipo , Humanos , Cavidad Nasal/anatomía & histología , Tamaño de la Partícula , Programas InformáticosRESUMEN
Detailed deposition patterns of inhaled wood dust in an anatomically accurate nasal cavity were investigated using computational fluid dynamics (CFD) techniques. Three wood dusts, pine dust, heavy oak dust, and light oak dust, with a particle size distribution generated by machining (Chung et al., 2000), were simulated at an inhalation flow rate of 10 L/min. It was found that the major particle deposition sites were the nasal valve region and anterior section of the middle turbinate. Wood dust depositing in these regions is physiologically removed much more slowly than in other regions. This leads to the surrounding layer of soft tissues being damaged by the deposited particles during continuous exposure to wood dust. Additionally, it was found that pine dust had a higher deposition efficiency in the nasal cavity than the two oak dusts, due to the fact that it comprises a higher proportion of larger sized particles. Therefore, this indicates that dusts with a large amount of fine particles, such as those generated by sanding, may penetrate the nasal cavity and travel further into the lung.
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Polvo , Exposición por Inhalación , Modelos Anatómicos , Cavidad Nasal/metabolismo , Madera , Adulto , Humanos , Exposición por Inhalación/efectos adversos , Masculino , Cavidad Nasal/anatomía & histología , Tamaño de la Partícula , Madera/efectos adversosRESUMEN
OBJECTIVE: To investigate the effect of motherwort herb on the myoelectric activity of uterus in rats. METHOD: A pair of bipolar Ag-AgCl electrode was implanted on the serosal surface of the uterus in rats, motherwort herb was injected intra-abdominal cavity in rats in dose of 0.1 ml, 0.2 ml and 0.4 ml respectively, and the changes of uterine myoelectric activity were observed. RESULT: Motherwort herb significantly increased the frequency and average amplitude of uterus slow waves of in rats. The frequency and maximum amplitude of single waves also obviously increased. The time course of outbreak waves was prolonged, the series intervals were reduced and the maximum amplitude in each outbreak was increased. CONCLUSION: The exciting effect of motherwort herb on the uterine smooth muscle may have something to do with the alteration of the ion concentration in relation to myoelectric activity, resulting in the increase of myoelectric activity of pacesetter cells as well as in the acceleration of depolarization of spike activity.