Current management of subarachnoid hemorrhage in a northern urban Chinese population: a multi-center surveillance study.

OBJECTIVE: The current management of subarachnoid hemorrhage (SAH) in the urban Chinese population remains unclear and the relevant literature is still lacking. Therefore, this work aimed to investigate the recent clinical practice in the management of spontaneous SAH in an urban population-based setting. PATIENTS AND METHODS: From 2009 to 2011, the China Epidemiology Research In Subarachnoid Hemorrhage (CHERISH) project, which was a two-year prospective, multi-center, population-based, case-control study, was performed in the northern urban Chinese population. SAH cases were described in terms of their features, clinical management, and in-hospital outcomes. RESULTS: Totally of 226 cases were enrolled with a final diagnosis of primary spontaneous SAH (65% of females; mean age, 58.5±13.2 years; range, 20-87 years). Among them, 92% of these patients received nimodipine, while 93% took mannitol. Meanwhile, 40% of them received traditional Chinese medicine (TCM), while 43% took neuroprotective agents. Endovascular coiling was applied in 26% of 98 angiography-confirmed intracranial aneurysms (IA) cases, while neurosurgical clipping was in 5% of them. CONCLUSIONS: Our findings on the management of SAH in the northern metropolitan Chinese population reveal that nimodipine is an effective medical therapy with a high rate of use. There is also a high utilization rate of alternative medical interventions. Endovascular coiling occlusion is more common than neurosurgical clipping. Therefore, regionally traditional therapy may be a key factor for the difference in the treatment of SAH between northern and southern China.

Long-lasting infiltration anaesthesia by lidocaine-loaded biodegradable nanoparticles in hydrogel in rats.

BACKGROUND: Infiltration of a long-lasting anaesthetic is helpful during the post-operative period. The recently developed local drug delivery system, biodegradable nanoparticles in a thermo-sensitive hydrogel (nanogel system), may possibly provide an extended duration of drugs. Therefore, we evaluated whether prolonged infiltration anaesthesia could be achieved by loading lidocaine into this delivery system. METHODS: Thirty male rats were randomized into five groups of six rats each: saline; 2% hydrochloride lidocaine solution; lidocaine-loaded nanogel system and its compositing formulations, namely lido-nano gel; lido-nano; and lidogel. Durations of local anaesthesia with subcutaneously injected agents were measured by tail flick latency tests in a randomized, blind fashion. RESULTS: Lido-nano gel produced effective anaesthesia for 360+/-113 min, compared with 150+/-33 min by lidogel, 180+/-37 min by lido-nano, and 110+/-45 min by lidocaine solution (P<0.001, means+/-SD), and elicited complete sensory blockade for 300+/-114 min, compared with 75+/-37 min by lidogel, 105+/-53 min by lido-nano, and 60+/-33 min by lidocaine solution (P<0.001, means+/-SD) without severe skin/systemic toxicity. CONCLUSION: Lidocaine-loaded biodegradable nanoparticles in hydrogel produced prolonged infiltration anaesthesia in rats without severe toxicity, indicating a possible way to develop long-lasting local anaesthetics.