June 2013, Volume 16, No.17 Abstracts
ZHU Xiu-fang.School of Pharmacy, Yancheng Health Vocational and Technical College, Yancheng 224006, China
【Abstract】 Hyperhomocysteinemia,an independent risk factor for angiemphraxis,is closely related to cardiovascular and cerebrovascular events.Healthy living habits and a list of medicines such as folic acid and B vitamins can reduce the level of homocysteine effectively. However, interventions to hyperhomocysteinemia have been proved, by some studies, to be ineffective. Therefore, whether and how to intervene remains a controversial issue.This article summarizes the intervention measures for hyperhomocysteinemia. Healthy living habits are essential in preventing hyperhomocysteinemia and cardiovascular, cerebrovascular events.
【Key words】 Hyperhomocysteinemia; Cardiovascular disease; Cerebrovascular disorders
Electroencephalogram and Brainstem Auditory Evoked Potential Determining Dynamically Delayed Encephalopathy after Acute Carbon Monoxide Poisoning
WANG Chuan-sheng, ZHANG Ping, HAN Yong-kai, et al.The Second Affiliated Hospital of Xinxiang Medical College, Xinxiang 453002, China
【Abstract】 Objective To observe the dynamic changes of electroencephalogram(EEG) and brainstem auditory evoked potential(BAEP) in patients with acute carbon monoxide poisoning(ACMP), to find out their predictive values for delayed encephalopathy after acute carbon monoxide poisoning(DEACMP).Methods A total of 83 acute carbon monoxide poisoning（ACMP） patients were divided, according to occurrence of DEACMP, into groups DEACMP（n=32） and non-DEACMP（n=51）.Patients were given EEG and BAEP on days 1~5, 8~12, 18~22, 28~32, 38~42, 52~57.The abnormal rates of EEG, BAEP at different time points were compared, and the sensitivity and specificity of EEG, BAEP or of their combination calculated in predicting DEACMP.Results The abnormal rates of the 1st, 4th, 5th, 6th EEG measurement were significantly higher in DEACMP group than those in non-DEACMP group(P＜0.05); The abnormal rates of the 1st, 3rd, 4th, 5th, 6th BAEP higher in DEACMP group than in non-DEACMP group(P＜0.01).The first EEG was abnormal in 58 patients(69.9%), including 27 patients who developed to DEACMP.The sensitivity of EEG predicting DEACMP was 84.4%(27/32), specificity was 39.2%(20/51).The first BAEP was abnormal in 23 patients(27.7%), including 19 patients who developed to DEACMP.The sensitivity of BAEP predicting DEACMP was 59.4%（19/32）, specificity was 92.2%（47/51）.The sensitivity of EEG combined with BAEP was 93.7%, if 1 item being positive was taken as positive, the sensitivity was 93.7%,specificity was 36.1%; If 2 items being positive was taken as positive, the sensitivity was 50.1%, specificity was 95.2%.Dynamical EEG or BAEP showing condition of abnormality-improvement-reabnormality predicted highly the incidence of DEACMP.Conclusion Early dynamical EEG and BAEP are of great significance and clinical values after ACMP, which is worth popularizing and applying.
【Key words】 Carbon monoxide poisoning; Delayed encephalopathy; Electroencephalogram; Evoked potentials, auditory, brain stem
Serum IL-18 Levels and Its Clinical Significance in the Blood of Patients with Delated Encephalopathy after Acute Carbon Monoxide Poisoning
ZHANG Ping, WANG Chuan-sheng,HAN Yong-kai, et al.The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China
【Abstract】 Objective To investigate the relationship between dynamic changes of serum IL-18 level and mechanism of delayed encephalopathy after acute carbon monoxide poisoning（DEACMP）to find potential cytokine variation during DEACMP occurrence and to provide evidence for further study on immunological mechanism of DEACMP.
Methods 40 DEACMP patients admitted to the Neurology Department of our hospital from January 2009 to January 2011 were selected as DEACMP group and another 36 healthy people underwent physical examination in the same period were selected as control group.Enzyme-linked Immunoassay(ELISA) method was used to detect the levels of IL-18 in acute stage and recovery stage,and the results were compared with the control group.
Results The levels of IL-18 in DEACMP patients〔（29.7±8.4）ng/L、（28.3±7.9）ng/L〕 were significantly higher than the control group〔（24.1±5.3）ng/L, （24.1±5.3）ng/L〕 both in acute stage and recovery stage(t=3.433, P=0.001; t=2.693, P=0.009).In DEACMP group, the IL-18 level in acute stage was significantly higher than that of recovery stage(t=2.421, P=0.020).
Conclusion IL-18 might be involved in the occurrence of DEACMP in a delayed immunologic way,and play a part in its development.
【Key words】 Carbon monoxide poisoning; Hypoxia-ischemia, brain; Interleukin-18; Enzyme-linked immunosorbent assay
Serum IGF-1 Level in Patients with Delayed Encephalopathy after Acute Carbon Monoxide Poisoning and Its Clinical Significance
GU Jia-peng,WANG Ji-kang,ZHANG Ping,et al.The Second Affiliated Hospital of Xinxiang Medical University,Xinxiang 453002,China
【Abstract】 Objective To investigate the dynamic changes of level of serum insulin-like growth factor-1(IGF-1) and its clinical significance in patients with delayed encephalopathy after acute carbon monoxide poisoning(DEACMP).Methods 33 DEACMP patients were selected form November 2007 to Jun 2008, IGF-1 level was assayed with enzyme-linked immunno-sorbent assay(ELISA).Their condition changes were evaluated with Activity of Daily Living Scale(ADL),Information-Memory-Concentration Test(IMCT) and Hasegawa′s Dementia Scale(HDS).The above indexes were compared with those of 32 acute carbon monoxide poisoning(ACMP) patients without occurrence of DEACMP(ACMP group) and of 32 healthy subjects(control group).Results (1) IGF-1 at acute stage was significantly lower in DEACMP group〔(136.10±51.51) μg/L〕 than in control group〔(192.91±145.97)μg/L,P＜0.05〕,there was no significant difference in IGF-1 at acute stage between groups DEACMP and ACMP〔（156.51± 93.13）μg/L〕,between groups ACMP and control(P＞0.05).IGF-1 was higher at recovery stage〔（187.69±92.46）μg/L〕 than at acute stage in DEACMP group,the difference was significant(P＜0.05).(2) ADL,HDS,IMCT at acute stage was significantly different from those at recovery stage in DEACMP group(P＜0.05).(3)IGF-1 was negatively correlated with ADL in DEACMP group(r=-0.377,P=0.03).Conclusion IGF-1,protecting probably DEACMP patients from brain damage,may be used as one of indexes for clinical outcomes and therapeutic effectiveness assessment.
【Key words】 Carbon monoxide poisoning; Hypoxia-ischemia, brain; Insulin like growth factor Ⅰ
Relationship of Latent Phase to Severity and Prognosis in Patients with Delayed Encephalopathy after Acute Carbon Monoxide Poisoning
WANG Chuan-sheng, ZHANG Ping, HAN Yong-kai, et al.The Second Affiliated Hospital of Xinxiang Medical Collage, Xinxiang 453002, China
【Abstract】 Objective To explore the relationship of latent phase（LP）to severity and prognosis in patients with delayed encephalopathy after acute carbon monoxide poisoning（DEACMP）.Methods A total of 327 DEACMP patients were divided, according to LP length, into groups Short LP（LP≤20 d, n=174）, Long LP（LP≥21 d, n=153）.Patients′ severity and prognosis were evaluated with ADL, IMCT, HDS to determine efficacy after 30 d, 180 d of onset.Results No significant difference was noted in ADL, IMCT and HDS between 2 groups in most severe period（P＞0.05）.There was significant difference in ADL, IMCT and HDS between 2 groups in recovery period（P＜0.01）.The cure rate was 71.26%（124/174）in Short LP group, 88.89%（136/153）in Long LP group, the difference was significant（χ2=15.52, P=0.01）.Conclusion The length of LP is not so related to severity of patients′ disease, but it may be an indicator for prognostic judgment, namely, the longer LP is, the better the prognosis is.
【Key words】 Carbon monoxide poisoning; Delayed encephalopathy; Latent phase; Prognosis
Significance of Plantar Pressure Balance and Gait Stability in Early Prevention and Cure of Diabetic Foot
HU Yi-bin, MENG Xiao-jing.Nanfang Hospital of Southern Medical University, Guangzhou 510515, China
【Abstract】 Objective To explore the clinical significance of plantar pressure equilibrium and gait stability in early prevention and treatment of diabetic foot(DF).
Methods Forty-two DF patients(Wanger classification=0) were divided randomly into groups therapy and control,21 in each.Belgian-footscan plantar pressure gait detection system was used to monitor dynamical plantar pressure and static impulse in 2 groups,and then made personalized programs to balance plantar pressure based on the monitoring data in therapy group.Control group received conventional treatment without personalized programs.Two groups were followed up for 1 year, to observe the plantar pressure, gait stability curve, incidence of foot ulcers, impulse before and after treatment.
Results No significant difference in plantar pressure between 2 groups before treatment(P＞0.05).After 1 year of treatment, the pretreatment pressures of the 3rd, 4th, 5th metatarsal base of control group were higher than those in control group before treatment and those in therapy group after treatment, the differences were significant(P＜0.05).There was no significant difference in plantar pressure in therapy group between post- and pre-treatments(P＞0.05).After treatment, the gait balance curve fluctuated remarkably and gravity pressure distribution curve was a little short of smoothness(namely gait stability was not good) in control group, while in therapy group no obvious fluctuation was noted, the plantar pressure distribution was balanced.The incidences of foot ulcers were 42.9%(9/21) in control group, 14.3%(3/21) in therapy group, the difference was significant(P＜0.05).There was significant difference in the proportion of impulse＞65%〔42.9%（9/21） vs.14.3%（3/21）〕 between control group and therapy group(P＞0.05).
Conclusion Plantar pressure change is one of the important causes of diabetic foot ulcers.Early detection and evaluation of plantar pressure of diabetic patients is very important, and positive and effective measures to balance plantar pressure can reduce incidence of foot ulcers, to decrease amputation rate from source to guarantee the quality of life of diabetes patients.
【Key words】 Diabetic foot; Plantar pressure; Gait; Impluse; Foot ulcer
The Relationship between Sleep Structure and Cognitive Function in Cerebral Infarction Patients Combined with Obstructive Sleep Apnea Hypopnea Syndrome
YU Xiao-hong, ZHANG Lin-hong.Department of Neurology, Wuhan Central Hospital, Wuhan 430014, China
【Abstract】 Objective To discuss the correlation between sleep structure and cognitive function in cerebral infarction（CI）patients combined with obstructive sleep apnea hypopnea syndrome（OSAHS）.Methods Polysomnography was performed and Mini-mental state examination（MMSE）, Montreal Cognitive Assessment（MoCA）were used to evaluate cognitive function.A correlation test was performed by Spearman correlation analysis on cognitive function and parameter, staging of sleep apnea.Results In sleep structure and cognitive score, the proportion of non-rapid eye movement（NREM）staging and NREM 1 staging was higher in group A than in group B, that of NREM 3+4 staging, rapid eye movement（REM）staging lower than in group B, MMSE, MoCA scores lower than in B group, the difference was significant（P＜0.05）.MMSE was positively correlated with night mean SaO2 , night lowest SaO2 , NREM 3+4 staging（r=0.445, 0.430, 0.491, P<0.05）, negatively correlated with AHI, SaO2 reduction index（ODI）, NREM 1+2 staging（r=-0.428, -0.640, -0.436, P<0.05）, and not correlated linearly with microarousal index, REM staging in group A（P>0.05）.MoCA was positively correlated with night mean SaO2 , night lowest SaO2 （r=0.441, 0.427, P<0.05）, negatively correlated with AHI, ODI, NREM 1+2 staging（r=-0.457, -0.463,-0.378, P<0.05）, and not correlated linearly with microarousal index, NREM 3+4 staging, REM staging in group A（P>0.05）.MMSE was not correlated linearly with night mean SaO2 , night lowest SaO2 , AHI, ODI, microarousal index, NREM 1+2 staging, NREM 3+4 staging or REM staging in group B（P＞0.05）.MoCA was negatively correlated with ODI, microarousal index（r=-0.433, -0.448, P＜0.05）, positively with REM staging（r=0.440, P＜0.05）, not correlated linearly with night mean SaO2 , night lowest SaO2 , AHI, NREM 1+2 staging, NREM 3+4 staging in group B（P＞0.05）.Conclusion CI patients combined with OSAHS have obvious sleep structure disorders and severe damages of cognitive function, showing that OSAHA may aggravate neurological damages and cognitive function disorders in CI patients.
【Key words】 Sleep apnea,obstructive; Cerebral infarction; Sleep disorders; Sleep structure; Cognitive function
Relationship between Advanced Glycation End-products and Cardiorenal Syndrome
MA Xiang-yu, ZHANG Jin-ying, SHEN De-liang, et al.Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
【Abstract】 Objective To investigate the relationship of advanced glycation end-products（AGEs）to cardiorenal syndrome（CRS）to find its role in CRS physiopathologic mechanism to provide basis for its clinical treatment.Methods A total of 186 patients and healthy subjects were divided, according to presence or absence of heart and kidney damages, into groups A(control group, n=51), B(with simple heart failure, n=48), C (with simple renal failure, n=46), D(with CRS, n=41).The levels of AGEs, B-type natriuretic peptide(BNP), serum creatinine(Scr), cystatin C(Cys-C) were determined.The influencing factors of short-term prognoses of CRS patients were analyzed by follow-up of group D.Results AGEs level was higher in group D than groups A, B, C〔（7.38±0.70）mg/L, （0.90±0.34）mg/L, （2.61±1.00）mg/L, （4.37±0.52）mg/L, P＜0.05〕.AGEs were positively correlated with BNP, Scr, Cys-C, the coefficient correlations were 0.769, 0.723, 0.848, respectively.AGEs were one of the adverse factors of short-term prognoses of CRS patients.Conclusion AGEs, closely related to CRS and having important influences on its short-term prognoses, may play an important role in CRS physiopathologic mechanism.
【Key words】 Advanced glycation end-products; Cardiorenal syndrome; Relationship; Prognosis
Impact of Coronary Angiography on QRS Duration
WANG Xi, QIU Chun-guang, HAN Zhan-ying, et al.Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
【Abstract】 Objective To observe the effects of coronary angiography（CAG）on QRS duration.
Methods A retrospective analysis was done in 125 patients given CAG from June 2011 to April 2012, in whom 98 were diagnosed as coronary artery disease（CAD）（lesion group）, including 33 cases of 1-vessel disease, 38 of 2-vessel, 27 of 3-vessel, and 27 normal subjects（control group）.The parameters of all subjects were collected and the changes of QRS duration and their influencing factors were compared before and after CAG operations.
Results QRS duration was longer after operation than before operation〔（3.18±5.30）ms, 95%CI（2.25, 4.12）, P=0.000〕.The prolongation of QRS duration（QRS variability, ΔQRS）increased in lesion group as compared with that in control group after operation〔（3.96±5.70）ms vs.（0.37±1.47）ms, P＜0.05〕.The prolongation of QRS duration was positively correlated with the number of diseased coronary arteries（CA）after CAG operations〔B=2.455, 95%CI