BACKGROUND:The timing and selection of patients for liver transplantation in acute liver failure are great challenges.This study aimed to investigate the effect of Glasgow coma scale(GCS)and APACHE-II scores on liver ...BACKGROUND:The timing and selection of patients for liver transplantation in acute liver failure are great challenges.This study aimed to investigate the effect of Glasgow coma scale(GCS)and APACHE-II scores on liver transplantation outcomes in patients with acute liver failure.METHOD:A total of 25 patients with acute liver failure were retrospectively analyzed according to age,etiology,time to transplantation,coma scores,complications and mortality.RESULTS:Eighteen patients received transplants from live donors and 7 had cadaveric whole liver transplants.The mean duration of follow-up after liver transplantation was 39.86±40.23 months.Seven patients died within the perioperative period and the 1-,3-,5-year survival rates of the patients were72%,72%and 60%,respectively.The parameters evaluated for the perioperative deaths versus alive were as follows:the mean age of the patients was 33.71 vs 28 years,MELD score was 40 vs32.66,GCS was 5.57 vs 10.16,APACHE-II score was 23 vs 18.11,serum sodium level was 138.57 vs 138.44 mmol/L,mean waiting time before the operation was 12 vs 5.16 days.Low GCS,high APACHE-II score and longer waiting time before the operation(P【0.01)were found as statistically significant factors for perioperative mortality.CONCLUSION:Lower GCS and higher APACHE-II scores are related to poor outcomes in patients with acute liver failure after liver transplantation.展开更多
目的探讨影响老年脑出血后患者昏迷苏醒时间的相关因素。方法选取本院2012年6月~2015年10月收治的82例老年脑出血昏迷患者为研究对象,以性别、年龄、术前格拉斯哥昏迷评分(GCS,Glasgow Coma Scale)、脑血肿量、血肿是否破入脑室、高血...目的探讨影响老年脑出血后患者昏迷苏醒时间的相关因素。方法选取本院2012年6月~2015年10月收治的82例老年脑出血昏迷患者为研究对象,以性别、年龄、术前格拉斯哥昏迷评分(GCS,Glasgow Coma Scale)、脑血肿量、血肿是否破入脑室、高血压病史、是否气管切开、治疗、并发感染等为自变量,昏迷至苏醒的时间为因变量,先进行单因素分析,对有统计学意义的变量采用Cox回归模型进行多因素分析。结果单因素分析显示,术前GCS评分≤5分、脑血肿量>50mL、血肿破入脑室、高血压病史、气管切开、未采用盐酸纳洛酮联合正中神经电刺激治疗、并发感染的患者昏迷苏醒时间更长(P<0.05);多因素分析显示,血肿破入脑室、气管切开、并发感染是导致昏迷苏醒时间延长的危险性因素(P<0.05),术前GCS评分高与采用盐酸纳洛酮联合正中神经电刺激治疗可能是昏迷苏醒时间的保护性因素(P<0.05)。结论血肿破入脑室、气管切开、并发感染、术前GCS评分低是导致老年脑出血患者昏迷苏醒时间延长的主要影响因素,应尽量选择盐酸纳洛酮联合正中神经电刺激治疗方案,强化无菌医疗操作,加强抗感染护理干预,以缩短苏醒时间及改善预后。展开更多
Animals are exposed in nature to a variety ofstressors.While stress is generally harmful,mild stress can also be beneficial and contribute to reproduction and survival.We studied the effect of five cold shock events v...Animals are exposed in nature to a variety ofstressors.While stress is generally harmful,mild stress can also be beneficial and contribute to reproduction and survival.We studied the effect of five cold shock events versus a single cold shock and a control group, representing three levels of stress (harsh,mild,and no stress),on behavioral,physiological, and life-history traits of the red flour beetle (Tribolium castaneum,Herbst 1797).Beetles exposed to harsh cold stress were less active than a control group:they moved less and failed more frequently to detect a food patch.Their probability to mate was also lower. Beetle pairs exposed to harsh cold stress frequently failed to reproduce at all,and if reproducing,females laid fewer eggs,which were,as larvae in mid-development,smaller than those in the control group.However,harsh cold stress led to improved female starvation tolerance,probably due to enhanced lipid accumulation.Harsh cold shock also improved tolerance to an additional cold shock compared to the control.Finally,a single cold shock event negatively affected fewer measured response variables than the harsh cold stress, but also enhanced neither starvation tolerance nor tolerance to an additional cold shock. The consequences of a harsher cold stress are thus not solely detrimental but might even enhance survival under stressful conditions.Under benign conditions,nevertheless,harsh stress impedes beetle performance.The harsh stress probably shifted the balance point of the survival-reproduction trade-off,a shift that did not take place following exposure to mild stress.展开更多
文摘BACKGROUND:The timing and selection of patients for liver transplantation in acute liver failure are great challenges.This study aimed to investigate the effect of Glasgow coma scale(GCS)and APACHE-II scores on liver transplantation outcomes in patients with acute liver failure.METHOD:A total of 25 patients with acute liver failure were retrospectively analyzed according to age,etiology,time to transplantation,coma scores,complications and mortality.RESULTS:Eighteen patients received transplants from live donors and 7 had cadaveric whole liver transplants.The mean duration of follow-up after liver transplantation was 39.86±40.23 months.Seven patients died within the perioperative period and the 1-,3-,5-year survival rates of the patients were72%,72%and 60%,respectively.The parameters evaluated for the perioperative deaths versus alive were as follows:the mean age of the patients was 33.71 vs 28 years,MELD score was 40 vs32.66,GCS was 5.57 vs 10.16,APACHE-II score was 23 vs 18.11,serum sodium level was 138.57 vs 138.44 mmol/L,mean waiting time before the operation was 12 vs 5.16 days.Low GCS,high APACHE-II score and longer waiting time before the operation(P【0.01)were found as statistically significant factors for perioperative mortality.CONCLUSION:Lower GCS and higher APACHE-II scores are related to poor outcomes in patients with acute liver failure after liver transplantation.
文摘目的探讨影响老年脑出血后患者昏迷苏醒时间的相关因素。方法选取本院2012年6月~2015年10月收治的82例老年脑出血昏迷患者为研究对象,以性别、年龄、术前格拉斯哥昏迷评分(GCS,Glasgow Coma Scale)、脑血肿量、血肿是否破入脑室、高血压病史、是否气管切开、治疗、并发感染等为自变量,昏迷至苏醒的时间为因变量,先进行单因素分析,对有统计学意义的变量采用Cox回归模型进行多因素分析。结果单因素分析显示,术前GCS评分≤5分、脑血肿量>50mL、血肿破入脑室、高血压病史、气管切开、未采用盐酸纳洛酮联合正中神经电刺激治疗、并发感染的患者昏迷苏醒时间更长(P<0.05);多因素分析显示,血肿破入脑室、气管切开、并发感染是导致昏迷苏醒时间延长的危险性因素(P<0.05),术前GCS评分高与采用盐酸纳洛酮联合正中神经电刺激治疗可能是昏迷苏醒时间的保护性因素(P<0.05)。结论血肿破入脑室、气管切开、并发感染、术前GCS评分低是导致老年脑出血患者昏迷苏醒时间延长的主要影响因素,应尽量选择盐酸纳洛酮联合正中神经电刺激治疗方案,强化无菌医疗操作,加强抗感染护理干预,以缩短苏醒时间及改善预后。
基金the People Programme (Marie Curie Actions)of the European Union's Seventh Framework Programme (FP7/2007-2013)under REA grant agreement no.333442the Israel Science Foundation (grant no.442/16)for funding this study.
文摘Animals are exposed in nature to a variety ofstressors.While stress is generally harmful,mild stress can also be beneficial and contribute to reproduction and survival.We studied the effect of five cold shock events versus a single cold shock and a control group, representing three levels of stress (harsh,mild,and no stress),on behavioral,physiological, and life-history traits of the red flour beetle (Tribolium castaneum,Herbst 1797).Beetles exposed to harsh cold stress were less active than a control group:they moved less and failed more frequently to detect a food patch.Their probability to mate was also lower. Beetle pairs exposed to harsh cold stress frequently failed to reproduce at all,and if reproducing,females laid fewer eggs,which were,as larvae in mid-development,smaller than those in the control group.However,harsh cold stress led to improved female starvation tolerance,probably due to enhanced lipid accumulation.Harsh cold shock also improved tolerance to an additional cold shock compared to the control.Finally,a single cold shock event negatively affected fewer measured response variables than the harsh cold stress, but also enhanced neither starvation tolerance nor tolerance to an additional cold shock. The consequences of a harsher cold stress are thus not solely detrimental but might even enhance survival under stressful conditions.Under benign conditions,nevertheless,harsh stress impedes beetle performance.The harsh stress probably shifted the balance point of the survival-reproduction trade-off,a shift that did not take place following exposure to mild stress.
