简介：BackgroundApulmonary-infectedpatienthadseverehyponatremiathatlastedtwodaysduringhospitalization.Wecouldnotfindanyhistorysuchasgluttony,liverandgalldisease.Theexaminationofliverfunctionreportedthatthehepaticenzymologyisnormal.InICU,wequicklyfoundhemodiastasereachedatextremelyhighlevel.TheberryCTindicatedthattheheadofpancreasswellingandtheboundarywasobscureandeffusive.Thepatientwasdiagnosedasacutepancreatitis.Thiscaseraisesaquestiontous:Doesseverehyponatremiacauseacutepancreatitis?Ithasnotbeenreported.MethodsWeestablishedacuteanimalmodelofhyponatremiathatdidnotincludeanyotherelectrolytechaos.Aftertheanimalmodelofhyponatraemiacompleted,serumamylaselevelsandpathologicalexaminationwereanalyzed.ResultsThehyponatremiamodels,outof16rats,onlyfourrats'serumsodiumwerelessthan120mmol/L.Inthesefourrats,besidesserumsodium,theremainingelectrolyteswerenormalandserumlipidswereinnormalrange,onlyonerat'sserumamylaseincreasedsignificantlymorethanfourtimesofthenormalcontrolgroupanditspathologicalfindingshintedpancreaticedema.ConclusionsTheexperimentalmodelsuccessfullyduplicatedtheclinicalandpathologicfeaturesofpancreatitisinducedbyhyponatraemia.Throughthiscasereport,wehopethatattentioncanbepaidtochangesinserumamylasewhenhyponatremiaappeared.

简介：Itisestimatedthatmorethanonemillionheartfailurehospitalizationsoccureachyear.Systolicheartfailureandheartfailurewithpreservedejectionfractioncontributeequallytoheartfailurehospitalizations.Heartfailurereadmissionratescontinuetobeabout25%.Strategiestoreduceheartfailurereadmissionarekeytoreducinghospitalizationrates.Thestrategiestoreduceheartfailurehospitalizationareasfollows:(1)Duringhospitalization,diuresistotheeuvolemicstateisessential.Fiftypercentofdischargedheartfailurepatientshaveminimalweightlossduringthehospitalization,representingminimaldiuresis,butstillfluidoverload.(2)Duringhospitalization,interrogatethedefibrillatororbiventricularpacemaker(ifapplicable)toensurethatthereisnorightventricularpacingandthereisappropriatebiventricularpacing.Interrogationofdevicescanidentifyarrhythmiaorsuboptimalbiventricularpacing,whichcancontributetodecompensation.(3)Beforedischarge,identifythereasonfordecompensation,suchasatrialfibrillation,infection,pulmonaryembolism,ornoncompliance.(4)Beforedischargeamultidisciplinaryteamisneededtoeducatethepatientondiet,medications,fluidweightsurveillance,andexercise.(5)Apostdischargevisitshouldoccurwithin10daysandwithemphasisonuptitrationofneurohormonalblockersandcontinuedcongestionmanagement.Suchinterventionsconductedbyamultidisciplinaryteamhavethepotentialtoreduceheartfailurehospitalizationrates.

简介：BackgroundCentralaorticsystolicbloodpressure(CASP)hasbeenshowntobeastrongerpredictoroftarget-organdamageandcardiovasculareventsthanbrachialsystolicbloodpressure(BSBP),buttherewasnodataaboutwhetherCASPcanpredictprolongedQRSdurationmorethanBSBP.WeexaminedtheassociationofCASPandBSBPwithQRSdurationinruralcommunityresidents.MethodsWeretrospectivelyanalyzed490ruralcommunityresidents.Standardresting12-leadECGandcentralaorticbloodpressure(CABP)weremeasurednoninvasivelyinallsubjectsatbaseline.TheQRSdurationwasequaltoormorethan120msbeingdefinedasprolongedQRSduration.ResultsTheprolongedQRSdurationgroupshowedhigherCASP(139.38±11.67vs.135.36±16.22,P=0.031)andBSBP(136.03±6.74vs.124.44±13.01,P<0.001)ascomparedwithcontrols.MultivariatelinearregressionanalysisshowedthatCASP,BSBPandheartratewereindependentlyaffectingQRSduration.LogisticregressionanalysesshowedthatCASP(OR1.057,95%CI:1.027,1.088,P<0.001)andBSBP(OR1.056,95%CI:1.027,1.086,P=0.032)wereindependentpredictorsofprolongedQRSdurationafteradjustmentforage,sex,bodymassindex,heartrate.CASPhadabetterpredictivevalueforprolongedQRSdurationthan(AUC:0.793vs.0.601,P<0.001)BSBP.ConclusionsOurfindingsdemonstratethatbothCASPandBSBParerisksforprolongedQRSduration,butCASPcanpredictprolongedQRSdurationbetterthanBSBP.