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1.
Medicine (Baltimore) ; 98(31): e16678, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31374047

RESUMO

RATIONALE: The benefits of prolonged endotracheal intubation (ETI) in comparison to early tracheotomy is still over the controversy. Little information is available in concern to prolonged ETI more than years. We report the consequence of oral ETI in a 95-year old man for 839 days. PATIENT CONCERNS: This patient was transferred to the intensive care unit due to sputum asphyxia and respiratory arrest. Timely ETI was performed. However, as a neurological insult, extubation had a high risk of failure due to the insufficient ability of sputum clearance. In addition, his family members refused further surgical interventions including tracheotomy. DIAGNOSES: Prolonged ETI occurred in this patient. On day 240 and 329 after ETI, 3D airway image did not reveal laryngeal stenosis or laryngeal lesions. On day 459 and 662, ET tube (ETT) exchanged was performed and the balloon became stiff and inelasticity. INTERVENTIONS: Although a possible tracheoesophageal fistula was suspected by imaging findings on day 547, the gastroscopy did not reveal the fistula on the esophagus. Enteral nutrition was delivered through the gastric tube, while the mediastinal infection was not observed during subsequent follow-up of computed tomography. OUTCOMES: He received tracheostomy due to acute sputum obstruction within ETT and abrupt oxygen desaturation on day 839. LESSONS: During prolonged ETI, more attention should focus on airway humidification, proper cuff pressure and optimal time for tube exchange in order to avoid severe complications.


Assuntos
Manuseio das Vias Aéreas/instrumentação , Intubação Intratraqueal/métodos , Insuficiência Respiratória/terapia , Idoso de 80 Anos ou mais , Estado Terminal/terapia , Esôfago/diagnóstico por imagem , Humanos , Intubação Intratraqueal/efeitos adversos , Masculino , Qualidade de Vida , Tomografia Computadorizada por Raios X
2.
Medicine (Baltimore) ; 98(15): e15240, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30985729

RESUMO

RATIONALE: Isolated pulmonary Langerhans cell histiocytosis (PLCH) is rare in adults. The gold standard diagnosis requires surgical lung biopsy. However, few cases have been diagnosed with transbronchial cryobiopsy (TBCB) sampling in the early stages of the disease, particularly in China. PRESENTING CONCERNS: A 50-year-old man was referred for dry cough and exertional dyspnea of more than 1 week. High-resolution computed tomography (HRCT) of the chest revealed symmetric nodules and cyst lesions with upper lobe infiltrate. Further history taking indicated that he had smoked 20 cigarettes per day for more than 30 years. Therefore, PLCH was highly suspected. However, he refused surgical lung biopsy, and TBCB was attempted to complete diagnosis. DIAGNOSIS: Emission computed tomography excluded the possibility of extrapulmonary involvements, and pathological findings supported the diagnosis of isolated PLCH. INTERVENTIONS: Smoking cessation and prednisone treatment were used for patient management. OUTCOMES: The symptoms receded with significant improvement of chest HRCT during 2-months of follow-up. LESSONS: Early diagnosis contributes to the prognosis of isolated PLCH in adults, and TBCB may be an alternative to conventional surgical lung biopsy for pathological diagnosis of PLCH.


Assuntos
Histiocitose de Células de Langerhans/diagnóstico , Histiocitose de Células de Langerhans/terapia , Biópsia/métodos , Broncoscopia , Criocirurgia/métodos , Gerenciamento Clínico , Diagnóstico Precoce , Histiocitose de Células de Langerhans/patologia , Humanos , Pulmão/patologia , Masculino , Pessoa de Meia-Idade
3.
Sci Rep ; 9(1): 1743, 2019 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-30742012

RESUMO

We designed a prospective study to evaluate changes in tinnitus after vestibular schwannoma (VS) surgery. Subjects included 41 patients who were diagnosed with a VS and underwent translabyrinthine microsurgery (TLM) between January 2015 and May 2016. All patients underwent related examinations and were asked to answer the Tinnitus Handicap Inventory (THI) scale and a visual analog scale (VAS) of tinnitus severity both pre- and postoperatively. Of the 41 patients, 31 (75.6%) suffered from tinnitus before surgery. Microsurgery was associated with an overall decrease in tinnitus (p < 0.001). There was a significant improvement in THI and VAS scores after surgery (p = 0.001 and p = 0.005, respectively). The decrease in THI scores in the low-frequency group was significantly larger than that of the mid- and high-frequency groups after surgery (p = 0.034 and p = 0.001, respectively). The loudness of tinnitus decreased significantly after surgery (p = 0.031). Tinnitus in patients with VS improved after TLM. Patients with mid-/high-frequency tinnitus and louder tinnitus preoperatively seemed to have a worse prognosis than those with low-frequency and quieter tinnitus.

4.
Medicine (Baltimore) ; 97(50): e13699, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30558083

RESUMO

RATIONALE: Acute type A aortic dissection (AAAD) remains a life-threatening disease. We previously reported a case with ultrasound findings of a homogeneous hemopericardium and evidence highly indicative of hemorrhagic cardiac tamponade complicated by AAAD. Here, we report a similar case who presented with a more serious situation and for whom critical care ultrasound revealed fast blood clot formation within the hemopericardium. PRESENTING CONCERNS: A 63-year-old man was admitted to our emergency department with a complaint of a tearing chest pain for 10 minutes. Asymmetric blood pressure was detected in the upper limbs and AAAD was highly suspected. An electrocardiogram (ECG) monitor was placed in a timely manner. However, during this procedure, he went into cardiac arrest and cardiopulmonary resuscitation (CPR) was initiated. DIAGNOSES: Critical care ultrasound revealed hemorrhagic cardiac tamponade with blood clot formation surrounding the epicardium, strongly indicating the rupture of an ascending aortic root dissection. INTERVENTIONS: Standard CPR continued for 30 minutes. OUTCOMES: Spontaneous cardiac rhythm was not restored and the patient died. LESSONS: Critical care ultrasound is a useful tool for assessing emergency cardiac arrest. Ultrasound findings of fast clot formation within the hemopericardium may indicate faster bleeding due to the rupture of an AAAD and may predict poor clinical outcomes.


Assuntos
Aneurisma Dissecante/complicações , Tamponamento Cardíaco/etiologia , Hemorragia/patologia , Trombose/diagnóstico por imagem , Aneurisma Dissecante/classificação , Aneurisma Dissecante/diagnóstico por imagem , Aneurisma Dissecante/patologia , Reanimação Cardiopulmonar/métodos , Dor no Peito/diagnóstico , Evolução Fatal , Hemorragia/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Derrame Pericárdico/etiologia , Trombose/complicações , Ultrassonografia/métodos
5.
Medicine (Baltimore) ; 97(20): e10742, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29768348

RESUMO

BACKGROUND: Enteral nutrition via gastric tube insertion is a routine clinical practice for critically ill patients, although complications due to blind manipulation are occasionally reported. METHODS: An 8.4Fr deflection flexible ureteroscope was delivered into a 15Fr conventional gastric tube to create a gastric visual guidance system. Twenty inexperienced physicians were randomly assigned to perform 5 repeated orogastric tube placements in a manikin using both the conventional method and the deflection visual gastric tube, for a total of 10 procedures per physician. Placement time, procedure-related complications, and participants' experience with both methods were recorded. RESULTS: Under real-time guidance, the visual gastric tube successfully reached the stomach. The procedure provided additional information on the anatomy of the esophagus and stomach. Placement time was significantly less in the visual group than in the conventional group (39.39 ±â€Š2.11 seconds vs 49.82 ±â€Š3.11 seconds; P < .001). Procedure-related complications were not observed in the visual group; however, the gastric tube was misplaced into the airway in 19 out of 100 cases (19%) in the conventional group. Furthermore, 17 out of 20 participants (85%) preferred the visual gastric tube guide over the standard method. CONCLUSIONS: Results of this manikin model demonstrate that it is feasible to use the deflection flexible visual gastric tube to create a route for enteral nutrition and that such a procedure decreases placement time and procedure-related complications compared to the conventional procedure. These findings may point to a new strategy for gastric tube insertion in the future.


Assuntos
Estado Terminal/terapia , Nutrição Enteral , Intubação Gastrointestinal , Estudos Cross-Over , Nutrição Enteral/instrumentação , Nutrição Enteral/métodos , Estudos de Viabilidade , Humanos , Intubação Gastrointestinal/efeitos adversos , Intubação Gastrointestinal/instrumentação , Intubação Gastrointestinal/métodos , Manequins
6.
Medicine (Baltimore) ; 97(20): e10757, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29768359

RESUMO

RATIONALE: Critical care ultrasound identifies the signs of free intraperitoneal air and echogenic free fluid always indicates hollow viscus perforation (HVP) and needs immediate surgical interventions. However, in rare cases, these classic signs may also mislead proper clinical decisions. We report perforated viscus associated large peritoneal effusion with initial critical care ultrasound findings, whereas computed tomography (CT) examination confirmed a giant stomach due to superior mesenteric artery syndrome (SMAS). PATIENT CONCERNS: A 70-year-old man was admitted to our emergency department with a complaint of recurrent vomiting with coffee ground emesis for 15 hours and worsen with hypotension for 6 hours. During gastric tube placement, the sudden cardiac arrest occurred. With 22 minutes resuscitation, sinus rhythm was restored. DIAGNOSES: Quick ultrasound screen showed large echogenic fluid distributed in the whole abdomen. Diagnostic paracentesis collected "unclotted blood" and combined with a past history of duodenal ulcer, HVP was highly suspected. However, surgical intervention was not performed immediately as unstable vital signs and unfavorable coma states. After adequate resuscitation in intensive care unit, the patient was transferred to perform enhanced CT. Surprisingly, there was no evidence of HVP. Instead, CT showed a giant stomach possibly explained by SMAS. INTERVENTIONS: Continuous gastric decompression was performed and 3100 mL coffee ground content was drainage within 24 hours of admission. OUTCOMES: Abdominal distension was significantly relieved with improved vital signs. However, as the poor neurological outcome, family members abandon further treatment, and the patient died. LESSONS: SMAS is a rare disorder, characterized by small bowel obstruction and severe gastric distension. Nasogastric tube insertion should be aware to protect airway against aspiration. Caution should be utilized to avoid over interpretation of ultrasonography findings on this condition.


Assuntos
Dilatação Gástrica , Perfuração Intestinal/diagnóstico , Intubação Gastrointestinal/métodos , Síndrome da Artéria Mesentérica Superior/complicações , Idoso , Líquido Ascítico/diagnóstico por imagem , Diagnóstico Diferencial , Dilatação Gástrica/diagnóstico , Dilatação Gástrica/etiologia , Dilatação Gástrica/fisiopatologia , Dilatação Gástrica/terapia , Humanos , Masculino , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Ultrassonografia/métodos
7.
Medicine (Baltimore) ; 96(49): e8773, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29245234

RESUMO

RATIONALE: Acute type A aortic dissection (AAAD) is a potentially fatal clinical crisis. Hemorrhagic cardiac tamponade due to the rupture of an ascending aortic root dissection is extremely dangerous and often lacks timely clinical evidence. We report sudden death in a patient diagnosed with AAAD and in whom critical care ultrasound highly indicated hemorrhagic cardiac tamponade. PRESENTING CONCERNS: A 75-year-old man was admitted to our emergency department with a complaint of chest pain for 8 hours. Computed tomography angiography findings indicated AAAD with a wide range of lesions. During the preoperative preparation process, he suddenly lost consciousness with a pulseless femoral artery.Diagnoses: Cardiopulmonary resuscitation was initiated and critical care ultrasound revealed hemorrhagic cardiac tamponade, strongly indicating the rupture of an ascending aortic root dissection. INTERVENTIONS: However, family members refused further surgical interventions. OUTCOMES: The etiology could not be reversed and the patient died. LESSONS: Critical care ultrasound is an important skill that intensivists should master for fast screening of life-threatening complications in patients with AAAD.


Assuntos
Aneurisma Dissecante/diagnóstico por imagem , Aneurisma da Aorta Torácica/diagnóstico por imagem , Ruptura Aórtica/diagnóstico por imagem , Tamponamento Cardíaco/diagnóstico por imagem , Angiografia por Tomografia Computadorizada/métodos , Ultrassonografia/métodos , Doença Aguda , Idoso , Aneurisma Dissecante/complicações , Aneurisma da Aorta Torácica/complicações , Ruptura Aórtica/complicações , Tamponamento Cardíaco/etiologia , Evolução Fatal , Humanos , Masculino
8.
PLoS One ; 12(3): e0174158, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28329026

RESUMO

BACKGROUND: The optimal timing for initiating renal replacement therapy (RRT) in patients with acute kidney injury (AKI) remains controversial. METHODS: We conducted a meta-analysis with trial sequential analysis (TSA) of randomized controlled trials (RCTs) using PUBMED, Cochrane Library databases, and Web of Science (from January 1, 1985, to August 21, 2016). Adult patients with AKI who received RRT with different timing were included. The primary outcome was mortality. The secondary outcomes were intensive care unit (ICU) length of stay (LOS) and hospital LOS. RESULTS: We included 9 RCTs with a total of 1636 participants. No differences between the early RRT group and the late RRT group were found with respect to mortality (38% vs 41.4%; relative risk, 0.93; 95% confidence interval [CI], 0.74-1.18). However, TSA showed that the cumulative Z-curve did not cross either the conventional boundary for benefit or the trial sequential monitoring boundary, indicating insufficient evidence. Similarity, there were no findings of benefits in terms of reduction in the ICU LOS (standard difference in the means, -0.32 days; 95% CI, -0.71 to 0.07 days) and hospital LOS (standard difference in the means, -1.11 days; 95% CI, -2.28 to 0.06 days). Meanwhile, the results of TSA did not confirm this conclusion. CONCLUSIONS: Although conventional meta-analysis showed that early initiation of RRT in patients with AKI was not associated with decreased mortality, ICU LOS and hospital LOS, TSA indicated that the data were far too sparse to make any conclusions. Therefore, well-designed, large RCTs are needed.


Assuntos
Lesão Renal Aguda/terapia , Lesão Renal Aguda/mortalidade , Adulto , Idoso , Feminino , Humanos , Unidades de Terapia Intensiva , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , Terapia de Substituição Renal/métodos
9.
Exp Ther Med ; 10(5): 1857-1864, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26640562

RESUMO

The aim of the present study was to investigate the effects of bone marrow-derived mesenchymal stem cells (BMSCs) transfected with survivin on lung fibrosis in mice. Mice with bleomycin-induced pulmonary fibrosis were allocated at random to group A, B or C, and injected with 1×106 survivin gene-expressing BMSCs, 1×106 BMSCs or normal saline, respectively. A total of 6 mice were sacrificed from each group on days 7, 14 and 28 after treatment. The extent of alveolitis and pulmonary fibrosis was assessed and the apoptotic rates of the BMSCs and survivin-expressing BMSCs were detected. The content of surfactant protein A (SP-A) in the lung and hydroxyproline (Hyp) in the serum was measured. The mRNA expression levels of transforming growth factor (TGF)-ß1 and matrix metalloproteinase (MMP)-9 in the lung tissue of the mice was detected. Furthermore, the protein expression levels of caspase-3 and -9 were detected. The apoptotic rates of the BMSCs (group B) and survivin-expressing BMSCs (group A) were 14.466±1.953 and 7.718±0.493%, respectively. The degree of lung fibrosis in groups A and B was reduced compared with that in group C. The hydroxyproline content in groups A and B was reduced compared with that in group C, and the SP-A content in groups A and B was increased compared with that in group C. The mRNA expression levels of TGF-ß1 in group A were reduced compared with those in group B, and the levels in group B were reduced compared with those in group C. By contrast, the mRNA expression levels of MMP-9 in group A were increased compared with those in groups B and C, and the levels in group B were increased compared with those in group A. The expression levels of caspase-3 and -9 in group A were elevated compared with those in groups B and C. In conclusion, BMSCs are effective in preventing bleomycin-induced lung fibrosis, and survivin may enhance the protective effects of BMSCs.

10.
J Acoust Soc Am ; 131(2): EL133-8, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22352612

RESUMO

It is hypothesized that in sine-wave replicas of natural speech, lexical tone recognition would be severely impaired due to the loss of F0 information, but the linguistic information at the sentence level could be retrieved even with limited tone information. Forty-one native Mandarin-Chinese-speaking listeners participated in the experiments. Results showed that sine-wave tone-recognition performance was on average only 32.7% correct. However, sine-wave sentence-recognition performance was very accurate, approximately 92% correct on average. Therefore the functional load of lexical tones on sentence recognition is limited, and the high-level recognition of sine-wave sentences is likely attributed to the perceptual organization that is influenced by top-down processes.


Assuntos
Linguagem , Acústica da Fala , Percepção da Fala/fisiologia , Adulto , China , Sinais (Psicologia) , Feminino , Humanos , Masculino , Fonética , Espectrografia do Som , Adulto Jovem
11.
Zhonghua Gan Zang Bing Za Zhi ; 19(8): 603-7, 2011 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-22152318

RESUMO

To study the coincidence rate of clinical diagonisis with pathological diagnosis for chronic severe hepatitis, and to screen out clinical indicators consistent with pathological diagnosis. Fifty-one patients diagnosed as chronic severe hepatitis and underwent liver transplantation in Beijing You'an hospital from November 2004 to June 2009 participated in this study. The clinical data were selected as following: ALT, AST, urea nitrogen, creatinine, glucose, cholinesterase, total cholesterol, Glutamyl endopeptidase, alkaline phosphatase, serum potassium, serum sodium, prothrombin activity and blood ammonia level. The width of the portal vein and splenic vein thickness were measured by color Doppler ultrasound and were compared in different groups. Data were ananlyzed with independent sample t test and F test. The coincidence rate between clinical and pathological diagnoses in this study was 64.7%. ALT and AST levels for Chronic severe hepatitis and decompensated cirrhosis were 675.0+/-510.0 U/L, 67.00+/-45.0 U/L ( P is less than to 0.01) and 392.0 +/-370.0 U/L, 103.0+/-59.0 U/L (P is less than to 0.01) respectively, with statistically significant difference existed. The mean level of ALT in Chronic severe hepatitis group was significantly different in the situations of onset less than 30 days or more than 30 days (means were 761.0+/-743.0 U/L and 117.0+/-112.0 U/L, P is less than to 0.01). The rate of the phenomenon of enzyme isolated bile in the chronic severe hepatitis and decompensated cirrhosis group were 78.9% and 0 respectively. The coincidence rate of clinical with pathological diagnoses for Chronic Severe Hepatitis was low, increased ALT and AST levels would help improve the diagnostic accuracy.


Assuntos
Hepatite B Crônica , Cirrose Hepática , Hepatite B Crônica/sangue , Humanos , Transplante de Fígado , Veia Porta
12.
Artigo em Chinês | MEDLINE | ID: mdl-21426708

RESUMO

OBJECTIVE: To constitute the animal model of high frequency hearing loss and observer the temporal processing abilities of low frequency regions using prepulse inhibition of auditory startle response (gap-PPI). METHODS: Ten guinea pigs were randomly grouped into two groups: the high frequency hearing loss group with six guinea pigs and the control group with four guinea pigs. The former group was exposed to 12 kHz tone at 110 dB SPL for 30 hours to establish the high frequency hearing loss above 8 kHz and the latter group received no stimulations. Before and two, four, six and eight weeks after noise exposure, gap-PPI and auditory brainstem response (ABR) were recorded in both groups. In the gap-PPI experiment, three different background noises as 0.5 - 2 kHz, 0.5 - 4 kHz and 0.5 - 8 kHz were applied to test the temporal gap. RESULTS: High frequency hearing loss above 8 kHz was shown two weeks after noise exposure. The averaged ABR thresholds of 16 kHz, 32 kHz and 48 kHz were elevated about 55 dB and shown statistical significance compared to those before exposure (P < 0.05). No significant difference of ABR thresholds were shown between 1 kHz, 2 kHz, 4 kHz and 8kHz before and after noise exposure (P > 0.05). In the control group, the ABR thresholds remained stable during experiment. In the gap-PPI test, two weeks after noise exposure of 8 kHz, the experiment group showed attenuated inhibition ability and recovered gradually four weeks after noise exposure. No statistical differences of inhibition ability at time points of two, four, six and eight weeks after noise exposure of 4 kHz were detected when compared with that of pre-exposure. Under the background noise of 2 kHz, the inhibition ability attenuated and reached statistical significance at 6 - 8 weeks after noise exposure. CONCLUSION: The high frequency hearing loss might induce an impairment of the temporal processing in the low frequency region.


Assuntos
Limiar Auditivo , Potenciais Evocados Auditivos do Tronco Encefálico , Perda Auditiva de Alta Frequência/fisiopatologia , Ruído , Animais , Feminino , Cobaias , Masculino , Reflexo de Sobressalto
13.
Hepatogastroenterology ; 57(101): 845-51, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-21033240

RESUMO

BACKGROUND/AIMS: Early detection and treatment of protein-energy malnutrition have great clinical significance in patients with liver disease. The aim of study was to evaluate the nutritional status and determine the prevalence of malnutrition in acute and chronic viral hepatitis in Chinese patients, especially in cirrhosis patients. METHODOLOGY: A total of 315 patients were enrolled in this project, 20 patients with acute viral hepatitis, 142 patients with chronic viral hepatitis and 153 patients with posthepatitic liver cirrhosis. Recorded dietary nutrititional intakes and evaluated nutitional status by subjective global assessment, anthropometrics and biochemical data were carried out consecutively. RESULTS: According to the Chinese Dietary Recommended Nutrient Intakes based on sex and age, 73.0% +/- 29.66% of cirrhotic patients, 68.10% +/- 28.65% of chronic hepatitis patients, and 63.38% +/- 29.24% of acute hepatitis patients had deficient energy and nutrients intake. The prevalence of malnutrition was higher in the cirrhotic group as compared with the chronic or acute hepatitis groups according to the subjective global assessment, measured as triceps skinfold thickness in females, mid-upper arm muscle circumference in both male and female patients, albumin, prealbumin, hemoglobin, and serum transferrin (p < 0.05, respectively). CONCLUSIONS: This study demonstrated that Chinese patients with acute and chronic viral hepatitis and liver cirrhosis had inadequate energy and nutritional intake. Protein-energy malnutrition was more severe in cirrhotic patients, indicating a need for early enteral and perenteral treatment.


Assuntos
Hepatite B/epidemiologia , Hepatite C/epidemiologia , Desnutrição Proteico-Calórica/epidemiologia , Doença Aguda , Adolescente , Adulto , Ingestão de Energia , Feminino , Hepatite B/complicações , Hepatite B Crônica/complicações , Hepatite B Crônica/epidemiologia , Hepatite C/complicações , Hepatite C Crônica/complicações , Hepatite C Crônica/epidemiologia , Humanos , Cirrose Hepática/epidemiologia , Cirrose Hepática/virologia , Masculino , Pessoa de Meia-Idade , Avaliação Nutricional , Estado Nutricional , Adulto Jovem
14.
Intern Med ; 49(19): 2085-91, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20930434

RESUMO

OBJECTIVE: Patients with liver disease usually have an imbalanced nutrient and energy metabolism that leads to malnutrition and seriously affects their prognosis. Therefore, it is of great clinical interest to understand the resting energy expenditure (REE) and oxidation rates of glucose, fat, and protein in these patients. METHODS: A total of 315 patients with liver diseases caused by hepatitis B virus were categorized into three groups: 20 acute hepatitis patients, 142 chronic hepatitis patients and 153 liver cirrhosis patients. The REE and the oxidation rates of glucose, fat and protein were assessed by indirect heat measurement. Energy intake data were also collected which were compared with the REE results. RESULTS: The REE per kg (REE/kg) were 27.34 ± 5.46 kJ/kg, 21.67 ± 5.01 kJ/kg and 19.07 ± 4.45 kJ/kg in acute, chronic hepatitis and liver cirrhosis patients (p=0.000), respectively. Respiratory quotient (RQ) tended to be lower in patients with chronic hepatitis and liver cirrhosis than that in acute hepatitis patients (p=0.023). Energy, protein and carbohydrate intakes were lower in liver cirrhosis patients. CONCLUSION: These data demonstrated that Chinese patients with chronic hepatitis B and liver cirrhosis had lower energy expenditure and abnormal substrate metabolism. Patients with chronic hepatitis and cirrhosis had a higher protein oxidation rate and a lower carbohydrate oxidation rate compared with acute hepatitis patients.


Assuntos
Metabolismo Basal , Hepatite B Crônica/metabolismo , Hepatite B/metabolismo , Cirrose Hepática/metabolismo , Doença Aguda , Adulto , Grupo com Ancestrais do Continente Asiático , China , Feminino , Glucose/metabolismo , Humanos , Metabolismo dos Lipídeos , Masculino , Pessoa de Meia-Idade , Oxirredução , Proteínas/metabolismo
15.
Artigo em Chinês | MEDLINE | ID: mdl-21604579

RESUMO

OBJECTIVE: To explore the association between procalcitonin (PCT) levels and liver function in liver cirrhosis patients. METHODS: Collect serum samples from 44 liver cirrhosis patients, detect the PCT levels by semi-quantitative solid immunoassay, and at the same time, detect the serum levels of ALT, AST, TBIL, ALB, CHE, CHOL, PTA etc, then rate the patients by Child-pugh scoring system into Child-pugh A, B, C. RESULTS: set PCT > 0.5 microg/L as the positive threshold, significantly the PCT positive patients have higher ALT, TBIL but lower CHOL, PTA compared with the PCT negative patients. With the increasing of PCT levels, the ALT, AST, TBIL levels are gradually increased too, but PTA decreased. We find that the PCT positive patients are mainly Child-pugh B and C patients, and PCT negative patients are mainly Child-pugh C patients. PCT positive patient's lymphocyte count are lower than PCT negative patient's. CONCLUSION: Liver injury increase the risk of infection in liver cirrhosis patients. As the severity of the injury, the patients are easier to progress into severe infection. Combined with monitoring the PCT levels, pay more attention to protect the liver function will be helpful in early detecting infections and controlling of infection in liver cirrhosis patients.


Assuntos
Calcitonina/sangue , Cirrose Hepática/sangue , Cirrose Hepática/fisiopatologia , Fígado/fisiopatologia , Precursores de Proteínas/sangue , Peptídeo Relacionado com Gene de Calcitonina , Feminino , Humanos , Testes de Função Hepática , Masculino , Pessoa de Meia-Idade
16.
Hear Res ; 239(1-2): 126-40, 2008 May.
Artigo em Inglês | MEDLINE | ID: mdl-18348901

RESUMO

Gap detection has been used as an evaluation tool for temporal processing in subjects with sensorineural hearing loss (SNHL). However, the results from other reports are varied making it difficult to clearly define the impact of SNHL on the temporal processing ability of the auditory system. Specifically, we do not know if and how a high-frequency hearing loss impacts, presumably through off-channel interaction, the temporal processing in low-frequency channels where hearing sensitivity is virtually normal. In this experiment, gap-evoked responses in a low-frequency band (0.5-8 kHz) were recorded in the inferior colliculus (IC) and auditory cortex (AC) of guinea pigs through implanted electrodes, before and after a slopping high-frequency hearing loss, which was induced by over-stimulation using a 12-kHz-tone. The results showed that the gap thresholds in the low-frequency region increased gradually and became significantly higher 8 weeks after the induced high-frequency hearing loss. In addition, the response latency was slightly increased in the IC but this was not true for the AC. These results strongly indicate that a high-frequency hearing loss exerted an off-channel impact on temporal processing in the low-frequency region of the auditory system.


Assuntos
Córtex Auditivo/anatomia & histologia , Perda Auditiva de Alta Frequência/diagnóstico , Perda Auditiva Provocada por Ruído/diagnóstico , Colículos Inferiores/anatomia & histologia , Ruído , Estimulação Acústica , Acústica , Animais , Limiar Auditivo , Cóclea/patologia , Modelos Animais de Doenças , Eletrodos , Cobaias , Microscopia Eletrônica de Varredura , Órgão Espiral/ultraestrutura
17.
Artigo em Chinês | MEDLINE | ID: mdl-18229589

RESUMO

OBJECTIVE: To explore the feasibility to evaluate objectively auditory temporal resolution using the iso-modulation depth temporal modulation transfer function (TMTF) derived from the amplitude of evoked response to sinusoidally modulated signals. METHODS: Chronic electrodes were implanted in inferior colliculus and auditory cortex of guinea pigs. We recorded the evoked response to sinusoidally modulated tones with modulation frequency being varied from 20 to 400 Hz and modulation depth fixed at 100%. The response amplitude in uV was converted into relative amplitude using the fast Fourier transform (FFT) function provided by Biosig software, and then the iso-modulation depth TMTF was plotted with the relative amplitude changed with modulation frequency. Then we recorded the evoked response to the sinusoidally modulated tones with modulation depth being varied from 100% to 10% and derived the iso-amplitude TMTF comparable to conventional modulation depth threshold TMTF. The derived iso-amplitude TMTF was compared to iso-modulation depth TMTF to determine the validity of iso-modulation depth TMTF. RESULTS: The iso-modulation-depth TMTF and iso-amplitude TMTF in inferior colliculus and auditory cortex of guinea pigs represented respectively bandpass and lowpass characteristic. The cut-off frequency calculated from the two TMTF methods didn't differ significantly and the cut-off frequency derived from auditory cortex iso-modulation depth TMTF was consistent with behavioral results. CONCLUSIONS: The TMTF plotted with the response amplitude to sinusoidally modulated tones with the modulation depth fixed at 100% and the modulation frequency was a valid method to evaluate objectively auditory temporal resolution.


Assuntos
Córtex Auditivo/fisiologia , Potenciais Evocados Auditivos/fisiologia , Colículos Inferiores/fisiologia , Animais , Eletrodos , Análise de Fourier , Cobaias , Tempo de Reação
18.
Zhonghua Yi Xue Za Zhi ; 87(42): 2982-5, 2007 Nov 13.
Artigo em Chinês | MEDLINE | ID: mdl-18261330

RESUMO

OBJECTIVE: To evaluate the pattern of energy metabolism of patients with chronic viral severe hepatitis. METHODS: Resting energy expenditure (REE) in 55 patients with chronic viral severe was measured with open-circuit indirect calorimetry. Their normal REE was predicted by Harris-Benedict equation (HBE). The patients were to eat the ordinary diet from the department of nutrition of the hospital. The diet was recorded for 3 days. RESULTS: The REE value of the patients with chronic viral severe hepatitis based on cirrhosis was 19.2 +/- 6.1 kcal.kg(-1).d(-1), significantly lower than the normal predicted REE (22.1 +/- 2.2 kcal.kg(-1).d(-1), P < 0.01). The REE value of the patients with chronic viral severe hepatitis based on chronic hepatitis was 20.7 +/- 6.0 kcal.kg(-1).d(-1), significantly lower than the normal predicted REE (23.1 +/- 2.3 kcal.kg(-1).d(-1), P < 0.05). The intake of carbohydrates was 21.6 +/- 7.4 kcal.kg(-1).d(-1), significantly higher than oxidation amount (7.9 +/- 7.3 kcal.kg(-1).d(-1), P < 0.01). While the intake values of fat and protein were 3.4 +/- 1.6 kcal.kg(-1).d(-1) and 4.1 +/- 2.5 kcal.kg(-1).d(-1), both lower than the needed amounts. There was no significant correlation between energy metabolism and liver function. There was a positive correlation between glucose in serum and fat oxidation (r = 0.310, P < 0.05). The serum total protein (TP) level was positively correlated with carbohydrate oxidation (r = 0.362, P < 0.01) and RQ (r = 0.348, P < 0.01); The serum cholesterol level was positively correlated with carbohydrate oxidation (r = 0.338, P < 0.05) and RQ (r = 0.354, P < 0.01). The protein oxidation was negatively correlated with serum TP (r = -0.284, P < 0.05), and serum triglyceride (TG) (r = -0.387, P < 0.05). Fat oxidation was negatively correlated with cholesterol (r = -0.328, P < 0.05). CONCLUSION: Hypometablosim is found in severe chronic hepatitis. There is no significant correlation between energy metabolism and liver function. There is certain correlation between energy metabolism and some parameters in serum, such as glucose, TP, cholesterol, and TG. It may decrease the oxidation of fat and protein to increase the oxidation of carbohydrates.


Assuntos
Metabolismo Energético , Hepatite Viral Humana/metabolismo , Adulto , Idoso , Alanina Transaminase/metabolismo , Aspartato Aminotransferases/metabolismo , Gasometria , Calorimetria/métodos , Doença Crônica , Dieta , Feminino , Hepatite Viral Humana/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Nitrogênio/metabolismo , Estudos Prospectivos
19.
Artigo em Chinês | MEDLINE | ID: mdl-18335751

RESUMO

OBJECTIVE: To evaluate duration tuning in the inferior colliculus (IC) of guinea pigs and the role of GABA-mediated inhibition on this tuning. METHODS: Totally 23 healthy albino guinea pigs of either sex were employed in this study. After anesthesia, spikes of neurons in inferior colliculus were recorded using five-barrel glass-pipettes. The characteristic frequency was determined by recording iso-intensity response curves at moderate intensity level (40-70 dB SPL) and duration tuning was measured with signals of fixed intensity and varied durations. GABA-A receptor antagonist, bicuculline, was applied to neurons by means of in vivo micro-iontophoresis through one channel in the five-barrel glass-pipettes. RESULTS: IC neurons of guinea pigs, especially for those who showed sustained temporal response pattern, showed stronger duration tuning in their transient response peak to signal onset. Among 207 neurons recorded, totally 93 neurons were found to show clear duration selectivity. The duration selectivity was eliminated or turned to be weaker in most of the neurons in which the effect of bicuculline was observed successfully. CONCLUSIONS: Unlike what was reported in bats, duration selectivity may be a transient process for most of IC neurons in guinea pigs. Duration selectively of IC neurons in the guinea pig was also largely dependent on the GABAergic inhibition.


Assuntos
Colículos Inferiores/efeitos dos fármacos , Colículos Inferiores/fisiologia , Ácido gama-Aminobutírico/farmacologia , Animais , Potenciais Evocados Auditivos , Feminino , Cobaias , Colículos Inferiores/citologia , Masculino , Neurônios/efeitos dos fármacos , Neurônios/fisiologia
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