Objective To compare the therapeutic effects of hyperbaric oxygen (HBO) therapy at different time points on patients with spinal cord injury. Methods A total of 284 cases of spinal cord injury (SCI) were divided into an HBO group and a control group. The control group was treated with routine interventions (including a dehydrator, medication for neurotrophy, rehabilitation management, acupuncture and supportive treatment). The HBO group was treated with HBO in addition to the routine treatments, initiated at different time points after onset of SCI ( from less than 8 hours to longer than 1 week). All of the patients were evaluated in terms of scores on the American Spinal Cord Injury Association (ASIA) assessment and Barthel's index (BI) before and after treatment.Results Both groups had excellent effects when the treatment was initiated within the first 8 hours after the onset of SCI. There was no significant difference between the two groups. Average ASIA and BI scores in both groups improved significantly within the first 24 hours, and over the 1 st week after the onset of SCI. The recovery of neurological function and ability in the activities of daily living (ADL) was significantly better when HBO treatment was initiated within 8 hours after SCI compared with that initiated after 24 hour and 1 week. The therapeutic effects in the HBO group patients were significantly better than in the control group when HBO was initiated at 8 and 24 hours after onset of SCI. Neither the HBO group nor the control group had significant further improvement in ASIA scores or ADL performance when treatments initiated after 1 week. Conclusions HBO can significantly improve neurological function and ADL performance after SCI if it is administered within 1-8 hours.

Objective To detect the serum vitamin D levels in T2DM patients with retinopathy and to analyze the relevance to oxidative stress.Methods Totally 293 cases of T2DM were selected and they were divided into diabetic retinopathy (DR) group and non-diabetic retinopathy (NDR) group according to the results of fundus examination whether with or without DR.46 healthy volunteers were selected as control group (NC).The clinical information was collected,blood sugar such as fasting blood glucose (FBG),glycosylated hemoglobin (HbA1c),blood lipid index such as high-density lipoprotein cholesterol (HDL-C),total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C),serum 25-hydroxyl vitamin D3 (25 (OH)D3),oxidative stress indicators such as malondialdehyde (MDA),superoxide dismutase (SOD) and reduced glutathione (GSH) were detected.The correlation between 25 (OH)D3 and clinical data,blood glucose,blood lipids,oxidative stress indicators was analyzed.Results 25(OH)D3 of the 3 groups had significantly difference based on statistical analysis (P＜ 0.05).In details,the 25(OH)D3 in DR and NDR group were significantly lower than that in NC group,and 25(OH) D3 in DR group was significantly lower than that in NDR group,and the differences had statistical significance (P＜0.05).MDA,SOD,and GSH had significantly difference between the 3 groups (P＜0.05).In details,MDA in DR group and NDR group were significantly higher than that in NC group.SOD and GSH were significantly lower than those in NC group,while MDA in DR group was significantly higher than that in NDR group.SOD and GSH were significantly lower than those in NDR group.The differences were statistically significant(P＜0.05).Relevant analysis showed that 25 (OH)D3 was significantly positively related to HDL-C,SOD and GSH in DR patients,and was significantly negatively related to disease course,FBG,and MDA.Multiple stepwise regression analysis showed that totally HDL-C (X1),SOD (X2),and MDA (X3)were included into the model.The regression equation was Y=15.434+0.261X 1 +0.078X2-0.121X3.Conclusion T2DM patients with retinopathy have the oxidative stress injury and their 25(OH)D3 declines,which may be involved in pathogenesis of DR by reciprocal causation.

BACKGROUND: The comparative study concerning the safety of umbilical cord and bone marrow-derived mesenchymal stem cells transplantation for the treatment of nervous system lesions is insufficient. OBJECTIVE: To assess the safety of umbilical cord and bone marrow-derived mesenchymal stem cells transplantation for treatment of nervous system lesions. METHODS: A total of 214 cases with neuropathy were randomly divided into A, B groups. Patients in the A group received umbilical cord derived stem cell transplantation, and those in the B group received bone marrow-derived mesenchymal stem cells transplantation. Totally (5-12)×108 stem cells were transplanted into each patient. RESULTS AND CONCLUSION: The count of lymphocytes, alanine aminotransferase, aspartate aminotransferase, IgA, and IgM were increased compared with those before treatment in both groups (P < 0.01); However there were no significant differences between two groups (P > 0.05). Moreover, white blood cell count and red blood cell count in cerebrospinal fluid of all patients were significantly greater than the normal level. There were no significant differences between two groups (P > 0.05). No significant differences of the positive rate of Pandy test and the incidence rate of adverse effect were found in both groups (P > 0.05). The safety of umbilical cord and bone marrow-derived mesenchymal stem cell transplantation for treatment of nervous system lesions showed no marked differences.

Objective To investigate the surgical outcome of lumbar spinal canal stenosis. Methods Forward analysis of 160 cases of the patients with lumbar spinal canal stenosis getting operative treament was performed. 87 cases were male and 73 case were female. The average age was 51 years old (18 ～ 78years old). The average course of deseases was 5 years (1 month ～ 36years). All of the cases used lumbar spinal canal decompression combined with pedicle screws fixation and posterolateral bone graft. All cases had a follow - up of 3 months to 5 years (mean 34 months). Results The (COA) recovery rate among the tolal patients was cassified as exellent in 120 ca-ses , good in 31 cases , fair in 7 cases. The excellent and good rate was 94.4%. Conclusion The operative intervention was an effective method for patients with severe or progressive clinical lumbar spinal canal stenosis. The procedure in decompressed compretely through pos-terior approach and the instability of cerrical apinein had the satisfactory clinical outcome.

OBJECTIVETo conduct a clinical trial of ketogenic diet (KD) in patients with acute spinal cord injury (SCI) and evaluate its safety and feasibility by measuring blood ketone bodies and blood glucose levels.

METHODTen patients with acute SCI were recruited in the trial during the period from May, 2012 to October, 2013. The patients received a standard KD after fasting for 48 h. The levels of blood ketone, blood glucose and uric ketone were tested daily, and routine blood examination, electrolytes, liver and kidney function, body mass index (BMI), sensory and motor function, and adverse reactions were monitored weekly to assess the safety and feasibility of KD.

RESULTSKD treatment lasted for a mean of 12.9 days (4 to 29 days) in these patients. In all the patients, blood ketone level increased during the fasting and maintained a level above 2.0 mmol/L after taking KD, while the uric ketone level ranged from +++ to ++++. The blood glucose level was in the normal range during KD. Except for blood chloride level and BMI, routine blood test results, electrolytes, liver and kidney function showed no significant changes after KD. No significant changes were observed in the sensation of light touch and pinprick. The average motor ASIA score increased from 33.3 to 35.1 after KD. Gastrointestinal dysfunction (diarrhea, nausea, poor appetite, gastric pain, and abdominal distension) was recorded in 5 patients, hypoglycemia occurred in one patient early after KD, and one patient experienced urticaria during KD. All the adverse reactions were relieved after symptomatic treatments.

CONCLUSIONThis preliminary clinical trial demonstrated that KD could increase ketone bodies level and maintain a normal blood glucose level, suggesting its safety and feasibility in patients with acute SCI.

Adolescent ; Adult ; Aged ; Diet, Ketogenic ; adverse effects ; methods ; Feasibility Studies ; Female ; Humans ; Male ; Middle Aged ; Spinal Cord Injuries ; diet therapy ; Treatment Outcome ; Young Adult

OBJECTIVETo compare the differences in recurrence rates and surgical complications between thyroidectomy alone and thyroidectomy combined with central neck dissection as initial treatments to differentiated thyroid cancer and evaluate the clinic significance of central neck dissection for these patients.

METHODSThe literatures published in 1998-2013 were searched in Wanfang database, Chongqing VIP database, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Pubmed, Medline and Beijing Kangjian foreign medical journal full text service. According to the inclusion and deletion criteria, 30 articles were included. Of them 26 articles involved in complications, hypocalcemia and recurrent laryngeal nerve palsy as two major complications were involved in 26 articles and 24 articles respectively, and 26 articles involved in recurrence rate. RevMan5.0 software package was used to perform meta-analysis.

RESULTSTotal complication rate in experimental group (plus central neck dissection) was 13.08% higher than that in control group (thyroidectomy only), the odds ratio (OR) [95% confidence interval (95%CI)] was 2.32[2.02, 2.67], Z value was 11.80, P < 0.01. Hypocalcemia in the experimental group was 11.80% higher than that in control group, OR value [95%CI] was 2.58[2.21, 3.02], Z was 11.98, P < 0.01. The rates of recurrent laryngeal nerve paralysis were low in both experimental group (5.26%) and control group(3.95%), and OR value [95%CI] was 1.22 [0.94, 1.58], Z was 1.48, P = 0.14. Recurrence rate in experimental group was 2.23% lower than that in control group, OR value [95%CI] was 0.78 [0.63,0.97], Z was 2.35, P = 0.03.

CONCLUSIONCentral compartment dissection as initial treatment to differentiated thyroid cancer may reduce the risk of recurrence, but increases the incidence of total complications and hypocalcemia, and has no significant effect on the rate of the recurrent laryngeal nerve paralysis.

Humans ; Neck Dissection ; Neoplasm Recurrence, Local ; Thyroid Neoplasms ; pathology ; surgery

Adult ; Aged ; Coma ; physiopathology ; Consciousness ; physiology ; Consciousness Disorders ; physiopathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Persistent Vegetative State ; physiopathology ; Photic Stimulation ; methods ; Recovery of Function ; physiology ; Treatment Outcome

A number of studies have indicated that disorders of consciousness result from multifocal injuries as well as from the impaired functional and anatomical connectivity between various anterior forebrain regions. However, the specific causal mechanism linking these regions remains unclear. In this study, we used spectral dynamic causal modeling to assess how the effective connections (ECs) between various regions differ between individuals. Next, we used connectome-based predictive modeling to evaluate the performance of the ECs in predicting the clinical scores of DOC patients. We found increased ECs from the striatum to the globus pallidus as well as from the globus pallidus to the posterior cingulate cortex, and decreased ECs from the globus pallidus to the thalamus and from the medial prefrontal cortex to the striatum in DOC patients as compared to healthy controls. Prediction of the patients' outcome was effective using the negative ECs as features. In summary, the present study highlights a key role of the thalamo-basal ganglia-cortical loop in DOCs and supports the anterior forebrain mesocircuit hypothesis. Furthermore, EC could be potentially used to assess the consciousness level.
Adult ; Bayes Theorem ; Connectome ; Consciousness Disorders ; diagnostic imaging ; physiopathology ; Female ; Humans ; Machine Learning ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neural Pathways ; diagnostic imaging ; physiopathology ; Prognosis ; Prosencephalon ; diagnostic imaging ; physiopathology ; Young Adult