Objective:To investigate the prognostic value of electrolyte disturbances in patients with traumatic brain injury(TBI).Methods:Cases of TBI patients admitted to the Department of Neurosurgery at Dezhou Second People’...Objective:To investigate the prognostic value of electrolyte disturbances in patients with traumatic brain injury(TBI).Methods:Cases of TBI patients admitted to the Department of Neurosurgery at Dezhou Second People’s Hospital from September 2015 to September 2021 were analyzed to examine the impact of electrolyte disturbances on patient prognosis and to establish a risk prediction model.Results:Patients with electrolyte disturbances had poorer prognoses,with serum sodium and serum calcium levels significantly affecting the outcomes of patients with traumatic brain injury.Conclusion:Serum sodium and calcium levels may serve as potential prognostic markers in patients with traumatic brain injury.展开更多
Objective:To improve the diagnosis and therapeutic effect of occurrence and development of hyponatremia and disorder of acid-base balance among patients with hepatic encephalopathy(HE) by elucidating the regularity an...Objective:To improve the diagnosis and therapeutic effect of occurrence and development of hyponatremia and disorder of acid-base balance among patients with hepatic encephalopathy(HE) by elucidating the regularity and mechanism,as well as its influence on prognosis.Methods:327 HE patients admitted to our hospital from January 1990 to June 2010 were enrolled.Meanwhile 316 patients hospitalized in the medical department of the same hospital were chosen as the control group.Patients in both groups were given the same methods to measure arterial blood gas parameters(pH value,PaCO2,[HCO3-],TCO2,BE and SaO2),blood biochemistry([Na+],[K+],[Cl-]),liver function,kidney function and blood glucose,serum sodium,and thereupon tocalculate the anion gap(AG) and the potential [HCO3-],and acid-base balance disorder.Results:Among the 327 HE patients,hyponatremia was found in 188 cases(57.4%),of whom 132 patients died(70.2%).While among the 316 patients in control group,68 presented with hyponatremia(21.5%),and 19 died(27.9%).The incidence and mortality were significantly different between the two groups(P<0.001).All the 327 patients presented with different degrees of acid-base balance disorder and 178 died(54.4%),in whom 164(50.2%) belonged to simple acid-base balance disorder and 74(45.1%) died,136(41.6%) were dual acid-base balance disorder and 80(58.8%) died,27(8.2%) were triple acid-base disturbance and 24(88.9%) died.Whereas in the control group only 83 patients(26.2%) were recognized as simple and dual acid-base balance disorder,and 18(21.7%) died.There was higher incidence of acid-base balance disorder and mortality rate in HE group than control one(P<0.001).Conclusion:Hyponatremia is valuable to judge HE patients' prognosis.The key parameters in the judgment and evaluation on acid-base balance disorder among HE patients are the change of pH values and serum electrolyte values.When pH value ≤ 7.30 or > 7.55,it generally suggests a poor prognosis.展开更多
The administration of hyperthermic intraperitoneal chemotherapy (HIPEC) is often associated with significant intraoperative electrolyte changes. We retrospectively examined the pre-HIPEC and post-HIPEC intraoperative ...The administration of hyperthermic intraperitoneal chemotherapy (HIPEC) is often associated with significant intraoperative electrolyte changes. We retrospectively examined the pre-HIPEC and post-HIPEC intraoperative basic metabolic panel (BMP) values of the 20 patients who underwent HIPEC at our institution between December 2009 and January 2012. For the five patients who underwent HIPEC with oxaliplatin in 5% dextrose in water (D5W), there were statistically significant changes between the pre- and post-HIPEC values of sodium (135 to 124 mmol/L), chloride (105 to 94 mmol/L), glucose (143 to 388 mg/dl) and sodium corrected for hyperglycemia (135 to 127 mmol/L). For the 14 patients who received HIPEC with mitomycin C in normal saline (NS), there were statistically significant changes in bicarbonate (24 to 21 meQ/L), blood urea nitrogen (BUN) (10 to 9 mg/dl) and glucose (158 to 134 mg/dl). The BMP changes for the one patient who received doxorubicin/cisplatin in peritoneal dialysate are reported separately.展开更多
Altered blood chemistry, acid-base and electrolyte are suggested determinants of sleep disturbance, with frequent arousal at high altitude even in well and long-trained altitude marathon runners. In this sample of exp...Altered blood chemistry, acid-base and electrolyte are suggested determinants of sleep disturbance, with frequent arousal at high altitude even in well and long-trained altitude marathon runners. In this sample of experienced altitude marathon runners with maximal aerobic power at sea level of 61.4 ± 2.7 ml/kg-1·min-1 we found that pO2 and percent of oxygen saturation (%SO2) were lower at2050 mand3480 mthan at sea level;pO2 was higher after 38 - 41 hours than after 30 - 31 hours of acclimatization at3480 m(P 2 decreased (P 2 and (P 2 at a sleeping altitude of3480 mwas lower (P Simple regression analysis disclosed a significant correlation between the changes in TST and the percent of REM sleep and the changes in %SpaO2 recorded during sleep (P 2 at higher altitude and the percent of W and of TST (P 2, tCO2 and [HCO3-] correlated negatively and significantly with the percent of REM sleep changes at high altitude (P 2 and pH and correlated negatively with the changes in %SO2, pCO2, tCO2, and [HCO3-] (P ++] and [BE] and negatively with the changes in buffered bases [BB] and [BEeffective] (P 2 and significantly and negatively with the changes in [K+] (P 2, tCO2, [HCO3-] and [K+]展开更多
A novel composite polymer electrolyte was prepared by blending an appropriateamount of LiClO_4 and 10 percent (mass fraction) fumed SiO_2 with the block copolymer of poly(ethylene oxide) (PEO) synthesized by poly (eth...A novel composite polymer electrolyte was prepared by blending an appropriateamount of LiClO_4 and 10 percent (mass fraction) fumed SiO_2 with the block copolymer of poly(ethylene oxide) (PEO) synthesized by poly (ethylene glycol) (PEG) 400 and CH_2C1_2 The ionicconductivity, electrochemical stability, interfacial characteristic and thermal behavior of thecomposite polymer electrolyte were studied by the measurements of AC impedance spectroscopy, linearsweep voltammetry and differential scanning calorimetry (DSC), respectively. The glass transitiontemperature acts as a function of salt concentration, which increases with the LiClO_4 content.Lewis acid-base model interaction mechanism was introduced to interpret the interactive relationbetween the filled fumed SiO_2 and the lithium salt in the composite polymer electrolyte. Over thesalt concentration range and the measured temperature, the maximum ionic conductivity of thecomposite polymer electrolyte (10^(-4.41) S/cm) appeared at EO/Li=25 (mole ratio) and 30 deg C, andthe beginning oxidative degradation potential versus Li beyond 5 V.展开更多
Objective:This study aimed to explore the risk factors and outcomes of hypokalemia during the recovery period from anesthesia in the gynecological population.Methods:This retrospective cohort study included 208 patien...Objective:This study aimed to explore the risk factors and outcomes of hypokalemia during the recovery period from anesthesia in the gynecological population.Methods:This retrospective cohort study included 208 patients who underwent gynecological surgery at our institution between January 2021 and March 2022.Data were collected for each patient,including demographics,disease status,surgical data,and clinical information.Preoperative bowel preparation,postoperative gastrointestinal function,and electrolyte levels were compared between the two groups using propensity score matching(PSM).Results:The incidence of hypokalemia(serum potassium level<3.5 mmol/L)during the recovery period from anesthesia was approximately 43.75%.After PSM,oral laxative use(96.4%vs.82.4%,P=0.005),the number of general enemas(P=0.014),and the rate of≥2 general enemas(92.9%vs.77.8%,P=0.004)were identified as risk factors for hypokalemia,which was accompanied by decreased PaCO_(2) and hypocalcemia.There were no significant differences in postoperative gastrointestinal outcomes,such as the time to first flatus or feces,the I-FEED score(a scoring system was created to evaluate impaired postoperative gastrointestinal function),or postoperative recovery outcomes,between the hypokalemia group and the normal serum potassium group.Conclusion:Hypokalemia during postanesthesia recovery period occurred in 43.75%of gynecological patients,which resulted from preoperative mechanical bowel preparation;however,it did not directly affect clinical outcomes,including postoperative gastrointestinal function,postoperative complications,and length of hospital stay.展开更多
In order to diagnose accurately the type of acid梑ase disturbance (ABD) in patients with post梩raumatic multiple organ failure (PMOF), arterial blood gases and electrolytes were determined 645 times on 112 patients wi...In order to diagnose accurately the type of acid梑ase disturbance (ABD) in patients with post梩raumatic multiple organ failure (PMOF), arterial blood gases and electrolytes were determined 645 times on 112 patients with PMOF and the data were analyzed with the pre-estimated compensatory formula of ABD and the calculations of anion gap, potential bicarbonate, and blood chlorides. Simple ABD was found in 381 times of determinations and double ABD in 239 when only the formula was used in the analysis, while 264 times of simple ABD, 260 times of double ABD and 96 times of triple ABD were found when the formula was employed in combination with the calculations of anion gap, potential bicarbonate and blood chloride. The mixed types of ABD were increased by 49% (117 times) from 239 to 356 times and triple ABD was increased from 0 to 96 times. The findings indicate that the employment of the combined formula and the calculations of anion gap, potential bicarbonate and blood chloride is of great significance to assess ABD especially its mixed and complicate types in patients with PMOF. It is emphasized that along with the monitoring of blood gases, the determination of blood electrolytes and the calculation of anion gap and potential bicarbonate should be performed to determine the correct type of ABD.展开更多
Rhabdomyolysis, acute kidney injury and diabetic ketoacidosis all are life-threatening conditions. Coincidence of them can be missed because the patient is usually asymptomatic or has mild symptoms related to rhabdomy...Rhabdomyolysis, acute kidney injury and diabetic ketoacidosis all are life-threatening conditions. Coincidence of them can be missed because the patient is usually asymptomatic or has mild symptoms related to rhabdomyolysis. The development of rhabdomyolysis as a complication of diabetic ketoacidosis is not well understood and only a few clinical studies address the phenomenon. We are reporting, along with a literature review, a 39-year-old male, who presented with diabetic ketoacidosis complicated with rhabdomyolysis and acute kidney injury. To the best of our knowledge, this is the first case reported in the United Arab Emirates. We highlight the syndrome because it is curable with early detection and proper treatment.展开更多
目的分析急性单发性创伤性颅脑损伤后血钠、血钾、血氯、血镁、血钙离子的变化情况,并探究多重离子紊乱与颅脑损伤之间的关系。方法回顾性分析2012年7月—2015年6月中国医科大学附属第一医院神经外科收治的符合研究标准的患者158例,根...目的分析急性单发性创伤性颅脑损伤后血钠、血钾、血氯、血镁、血钙离子的变化情况,并探究多重离子紊乱与颅脑损伤之间的关系。方法回顾性分析2012年7月—2015年6月中国医科大学附属第一医院神经外科收治的符合研究标准的患者158例,根据其入院格拉斯哥评分（Glasgow Coma Scale,GCS）判定颅脑损伤程度分为3组：重度损伤（GCS评分3-8分）78例,中度损伤（GCS评分9-14分）33例,轻度损伤（GCS评分15分）47例。分别收集患者急诊入院时即时血离子浓度。采用相应的统计学方法分析急性单发性创伤性颅脑外伤后离子降低的独立危险因素,不同组间离子浓度均数和不同离子类型的发生率分别同颅脑损伤严重程度的关系,以及不同组别中多重离子紊乱构成比的差异。结果损伤严重程度、CT提示中线位移、脑组织挫伤、蛛网膜下腔出血及颞叶和小脑损伤是颅脑损伤后离子降低的危险因素（OR〉1,P〈0.05）。血钠、血钾、血氯、和血镁浓度在不同颅脑损伤组间存在差异（rs〈0,P〈0.05）。各组间离子紊乱发生率存在显著性差异（P〈0.05）,其中对于多重离子紊乱,重度损伤组发生率与轻、中度损伤组存在明显差异（P〈0.05）。其中血钠、镁,血钠、氯、镁,血钠、氯以及血钠、钾、镁、氯同时降低这4类离子紊乱模式的发病率较高。结论颅脑损伤的程度与多重离子紊乱密切相关,多重离子紊乱既可以作为颅脑损伤严重程度的评价指标,又可加重颅脑损害。明确急性单发性创伤性颅脑损伤后离子变化情况对患者病情的诊断和治疗具有重要的指导意义。展开更多
文摘Objective:To investigate the prognostic value of electrolyte disturbances in patients with traumatic brain injury(TBI).Methods:Cases of TBI patients admitted to the Department of Neurosurgery at Dezhou Second People’s Hospital from September 2015 to September 2021 were analyzed to examine the impact of electrolyte disturbances on patient prognosis and to establish a risk prediction model.Results:Patients with electrolyte disturbances had poorer prognoses,with serum sodium and serum calcium levels significantly affecting the outcomes of patients with traumatic brain injury.Conclusion:Serum sodium and calcium levels may serve as potential prognostic markers in patients with traumatic brain injury.
文摘Objective:To improve the diagnosis and therapeutic effect of occurrence and development of hyponatremia and disorder of acid-base balance among patients with hepatic encephalopathy(HE) by elucidating the regularity and mechanism,as well as its influence on prognosis.Methods:327 HE patients admitted to our hospital from January 1990 to June 2010 were enrolled.Meanwhile 316 patients hospitalized in the medical department of the same hospital were chosen as the control group.Patients in both groups were given the same methods to measure arterial blood gas parameters(pH value,PaCO2,[HCO3-],TCO2,BE and SaO2),blood biochemistry([Na+],[K+],[Cl-]),liver function,kidney function and blood glucose,serum sodium,and thereupon tocalculate the anion gap(AG) and the potential [HCO3-],and acid-base balance disorder.Results:Among the 327 HE patients,hyponatremia was found in 188 cases(57.4%),of whom 132 patients died(70.2%).While among the 316 patients in control group,68 presented with hyponatremia(21.5%),and 19 died(27.9%).The incidence and mortality were significantly different between the two groups(P<0.001).All the 327 patients presented with different degrees of acid-base balance disorder and 178 died(54.4%),in whom 164(50.2%) belonged to simple acid-base balance disorder and 74(45.1%) died,136(41.6%) were dual acid-base balance disorder and 80(58.8%) died,27(8.2%) were triple acid-base disturbance and 24(88.9%) died.Whereas in the control group only 83 patients(26.2%) were recognized as simple and dual acid-base balance disorder,and 18(21.7%) died.There was higher incidence of acid-base balance disorder and mortality rate in HE group than control one(P<0.001).Conclusion:Hyponatremia is valuable to judge HE patients' prognosis.The key parameters in the judgment and evaluation on acid-base balance disorder among HE patients are the change of pH values and serum electrolyte values.When pH value ≤ 7.30 or > 7.55,it generally suggests a poor prognosis.
文摘The administration of hyperthermic intraperitoneal chemotherapy (HIPEC) is often associated with significant intraoperative electrolyte changes. We retrospectively examined the pre-HIPEC and post-HIPEC intraoperative basic metabolic panel (BMP) values of the 20 patients who underwent HIPEC at our institution between December 2009 and January 2012. For the five patients who underwent HIPEC with oxaliplatin in 5% dextrose in water (D5W), there were statistically significant changes between the pre- and post-HIPEC values of sodium (135 to 124 mmol/L), chloride (105 to 94 mmol/L), glucose (143 to 388 mg/dl) and sodium corrected for hyperglycemia (135 to 127 mmol/L). For the 14 patients who received HIPEC with mitomycin C in normal saline (NS), there were statistically significant changes in bicarbonate (24 to 21 meQ/L), blood urea nitrogen (BUN) (10 to 9 mg/dl) and glucose (158 to 134 mg/dl). The BMP changes for the one patient who received doxorubicin/cisplatin in peritoneal dialysate are reported separately.
文摘Altered blood chemistry, acid-base and electrolyte are suggested determinants of sleep disturbance, with frequent arousal at high altitude even in well and long-trained altitude marathon runners. In this sample of experienced altitude marathon runners with maximal aerobic power at sea level of 61.4 ± 2.7 ml/kg-1·min-1 we found that pO2 and percent of oxygen saturation (%SO2) were lower at2050 mand3480 mthan at sea level;pO2 was higher after 38 - 41 hours than after 30 - 31 hours of acclimatization at3480 m(P 2 decreased (P 2 and (P 2 at a sleeping altitude of3480 mwas lower (P Simple regression analysis disclosed a significant correlation between the changes in TST and the percent of REM sleep and the changes in %SpaO2 recorded during sleep (P 2 at higher altitude and the percent of W and of TST (P 2, tCO2 and [HCO3-] correlated negatively and significantly with the percent of REM sleep changes at high altitude (P 2 and pH and correlated negatively with the changes in %SO2, pCO2, tCO2, and [HCO3-] (P ++] and [BE] and negatively with the changes in buffered bases [BB] and [BEeffective] (P 2 and significantly and negatively with the changes in [K+] (P 2, tCO2, [HCO3-] and [K+]
文摘A novel composite polymer electrolyte was prepared by blending an appropriateamount of LiClO_4 and 10 percent (mass fraction) fumed SiO_2 with the block copolymer of poly(ethylene oxide) (PEO) synthesized by poly (ethylene glycol) (PEG) 400 and CH_2C1_2 The ionicconductivity, electrochemical stability, interfacial characteristic and thermal behavior of thecomposite polymer electrolyte were studied by the measurements of AC impedance spectroscopy, linearsweep voltammetry and differential scanning calorimetry (DSC), respectively. The glass transitiontemperature acts as a function of salt concentration, which increases with the LiClO_4 content.Lewis acid-base model interaction mechanism was introduced to interpret the interactive relationbetween the filled fumed SiO_2 and the lithium salt in the composite polymer electrolyte. Over thesalt concentration range and the measured temperature, the maximum ionic conductivity of thecomposite polymer electrolyte (10^(-4.41) S/cm) appeared at EO/Li=25 (mole ratio) and 30 deg C, andthe beginning oxidative degradation potential versus Li beyond 5 V.
文摘Objective:This study aimed to explore the risk factors and outcomes of hypokalemia during the recovery period from anesthesia in the gynecological population.Methods:This retrospective cohort study included 208 patients who underwent gynecological surgery at our institution between January 2021 and March 2022.Data were collected for each patient,including demographics,disease status,surgical data,and clinical information.Preoperative bowel preparation,postoperative gastrointestinal function,and electrolyte levels were compared between the two groups using propensity score matching(PSM).Results:The incidence of hypokalemia(serum potassium level<3.5 mmol/L)during the recovery period from anesthesia was approximately 43.75%.After PSM,oral laxative use(96.4%vs.82.4%,P=0.005),the number of general enemas(P=0.014),and the rate of≥2 general enemas(92.9%vs.77.8%,P=0.004)were identified as risk factors for hypokalemia,which was accompanied by decreased PaCO_(2) and hypocalcemia.There were no significant differences in postoperative gastrointestinal outcomes,such as the time to first flatus or feces,the I-FEED score(a scoring system was created to evaluate impaired postoperative gastrointestinal function),or postoperative recovery outcomes,between the hypokalemia group and the normal serum potassium group.Conclusion:Hypokalemia during postanesthesia recovery period occurred in 43.75%of gynecological patients,which resulted from preoperative mechanical bowel preparation;however,it did not directly affect clinical outcomes,including postoperative gastrointestinal function,postoperative complications,and length of hospital stay.
文摘In order to diagnose accurately the type of acid梑ase disturbance (ABD) in patients with post梩raumatic multiple organ failure (PMOF), arterial blood gases and electrolytes were determined 645 times on 112 patients with PMOF and the data were analyzed with the pre-estimated compensatory formula of ABD and the calculations of anion gap, potential bicarbonate, and blood chlorides. Simple ABD was found in 381 times of determinations and double ABD in 239 when only the formula was used in the analysis, while 264 times of simple ABD, 260 times of double ABD and 96 times of triple ABD were found when the formula was employed in combination with the calculations of anion gap, potential bicarbonate and blood chloride. The mixed types of ABD were increased by 49% (117 times) from 239 to 356 times and triple ABD was increased from 0 to 96 times. The findings indicate that the employment of the combined formula and the calculations of anion gap, potential bicarbonate and blood chloride is of great significance to assess ABD especially its mixed and complicate types in patients with PMOF. It is emphasized that along with the monitoring of blood gases, the determination of blood electrolytes and the calculation of anion gap and potential bicarbonate should be performed to determine the correct type of ABD.
文摘Rhabdomyolysis, acute kidney injury and diabetic ketoacidosis all are life-threatening conditions. Coincidence of them can be missed because the patient is usually asymptomatic or has mild symptoms related to rhabdomyolysis. The development of rhabdomyolysis as a complication of diabetic ketoacidosis is not well understood and only a few clinical studies address the phenomenon. We are reporting, along with a literature review, a 39-year-old male, who presented with diabetic ketoacidosis complicated with rhabdomyolysis and acute kidney injury. To the best of our knowledge, this is the first case reported in the United Arab Emirates. We highlight the syndrome because it is curable with early detection and proper treatment.
文摘目的分析急性单发性创伤性颅脑损伤后血钠、血钾、血氯、血镁、血钙离子的变化情况,并探究多重离子紊乱与颅脑损伤之间的关系。方法回顾性分析2012年7月—2015年6月中国医科大学附属第一医院神经外科收治的符合研究标准的患者158例,根据其入院格拉斯哥评分（Glasgow Coma Scale,GCS）判定颅脑损伤程度分为3组：重度损伤（GCS评分3-8分）78例,中度损伤（GCS评分9-14分）33例,轻度损伤（GCS评分15分）47例。分别收集患者急诊入院时即时血离子浓度。采用相应的统计学方法分析急性单发性创伤性颅脑外伤后离子降低的独立危险因素,不同组间离子浓度均数和不同离子类型的发生率分别同颅脑损伤严重程度的关系,以及不同组别中多重离子紊乱构成比的差异。结果损伤严重程度、CT提示中线位移、脑组织挫伤、蛛网膜下腔出血及颞叶和小脑损伤是颅脑损伤后离子降低的危险因素（OR〉1,P〈0.05）。血钠、血钾、血氯、和血镁浓度在不同颅脑损伤组间存在差异（rs〈0,P〈0.05）。各组间离子紊乱发生率存在显著性差异（P〈0.05）,其中对于多重离子紊乱,重度损伤组发生率与轻、中度损伤组存在明显差异（P〈0.05）。其中血钠、镁,血钠、氯、镁,血钠、氯以及血钠、钾、镁、氯同时降低这4类离子紊乱模式的发病率较高。结论颅脑损伤的程度与多重离子紊乱密切相关,多重离子紊乱既可以作为颅脑损伤严重程度的评价指标,又可加重颅脑损害。明确急性单发性创伤性颅脑损伤后离子变化情况对患者病情的诊断和治疗具有重要的指导意义。
