Objective: To evaluate peripheral vein puncture assisted with Eyes-On vascular imaging glasses in vulneralis shock. Methods: Between February 2017 and June 2018, 110 patients in vulneralis shock were distributed to treatment group, and 128 patients between January 2016 and January 2017 were distributed to control group. Peripheral vein puncture were underwent in treatment group assisted with Eyes-On vascular imaging glasses, and with traditional operation in control group. Successful rate of first puncture, second puncture, puncture more than three times, and failure rate, operating time, rate of complications were recorded. Results: Successful rate of first puncture in treatment group and control group were 97.03% (98/101) and 9.38% (12/128). There was significant difference between two groups (χ²=173.771, P=0.001). Operating time of treatment group and control group were (1.16±0.41), (5.01±1.03) min, there was significant difference between two groups (t=7.693, P<0.01). In the observation group, puncture was successful while in the control group, puncture failed in 5 cases, with a failure rate of 3.91%(5/128). And there was no significant difference in failure rate of puncture (P >0.05). Regard as complications, there were no significant differences in leakage and bleeding (P>0.05), but there were significant differences in blockage and hematoma which were 5.94%(6/101), 1.98%(1/101) and 21.09%(27/128), 11.71%(15/128)(χ²=10.510, 7.791, P<0.01). Conclusion Eyes-On vascular imaging glasses can operated easily and vein imaging directly, and nurses can independently proceed puncture quickly and effectively in vulneralis shock. Eyes-On glasses is a recommended device.

OBJECTIVE: The periaqueductal gray matter (PAG), a small midbrain structure, presents dysfunction in migraine. However, the precise neurological mechanism is still not well understood. Herein, the aim of this study was to investigate the texture characteristics of altered PAG in episodic migraine (EM) patients based on high resolution brain structural magnetic resonance (MR) images. MATERIALS AND METHODS: The brain structural MR images were obtained from 18 normal controls (NC), 18 EM patients and 16 chronic migraine (CM) patients using a 3T MR system. A PAG template was created using the International Consortium Brain Mapping 152 gray matter model, and the individual PAG segment was developed by applying the deformation field from the structural image segment to the PAG template. A grey level co-occurrence matrix was used to calculate the texture parameters including the angular second moment (ASM), contrast, correlation, inverse difference moment (IDM) and entropy. RESULTS: There was a significant difference for ASM, IDM and entropy in the EM group (998.629 ± 0.162 × 10−3, 999.311 ± 0.073 × 10−3, 916.354 ± 0.947 × 10−5) compared to that found in the NC group (998.760 ± 0.110 × 10−3, 999.358 ± 0.037 × 10−3 and 841.198 ± 0.575 × 10−5) (p < 0.05). The entropy was significantly lower among the patients with CM (864.116 ± 0.571 × 10−5) than that found among patients with EM (p < 0.05). The area under the receiver operating characteristic curve was 0.776 and 0.750 for ASM and entropy in the distinction of the EM from NC groups, respectively. ASM was negatively related to disease duration (DD) and the Migraine Disability Assessment Scale (MIDAS) scores in the EM group, and entropy was positively related to DD and MIDAS in the EM group (p < 0.05). CONCLUSION: The present study identified altered MR image texture characteristics of the PAG in EM. The identified texture characteristics could be considered as imaging biomarkers for EM.
Biomarkers ; Brain ; Brain Mapping ; Entropy ; Gray Matter ; Humans ; Magnetic Resonance Imaging ; Mesencephalon ; Migraine Disorders ; Periaqueductal Gray ; ROC Curve

Objective To observe the effect of peripheral blood microRNA-182 (miR-182) combined with interleukin-17 (IL-17) in the early diagnosis of cerebral infarction (CI) in patients with eclampsia. Methods A prospective non-randomized controlled study was conducted. The patients with eclampsia admitted to intensive care unit (ICU) of Liaocheng People's Hospital from January 1st, 2013 to September 30th 2016 were enrolled. Cerebral imaging was conducted in 7 days after admission to make a definite diagnosis of the occurrence of CI, excluding patients with cerebral hemorrhage. Patients were divided into CI group and non-CI group. Twenty healthy women of childbearing age were selected as control group. Peripheral venous blood of all patients with eclampsia at 1 day after admission, the expression of miR-182 was detected by real-time fluorescence quantitative polymerase chain reaction (PCR), regulatory T cells (Treg) and T helper 17 cells (Th17) ratio was detected by flow cytometry, and the level of plasma IL-17 was detected by enzyme linked immunosorbent assay (ELISA). Pearson method was used to analyze the correlation between the indexes. The receiver operating characteristic curve (ROC) was used to analyze the diagnostic value of each index for CI in patients with eclampsia. Results In the 30 patients with eclampsia, there were 13 cases of CI, including 10 case of cerebral venous thrombosis (CVT) and 3 cases of arterial thrombus; 17 cases of non-CI, including 15 cases of reversible posterior leukoencephalopathy syndrome (RPLS) and 2 cases without obvious abnormalities. Compared with control group, the levels of miR-182, Th17% and IL-17 in non-CI group and CI group were significantly higher, and the Treg% was significantly lower. The levels of parameters mentioned above were further increased in CI group than those in non-CI group [miR-182 (2-ΔΔCt): 2.35±0.79 vs. 1.75±0.56, Th17%: (5.16±1.89)% vs. (3.93±1.92)%, IL-17 (ng/L):37.45±6.20 vs. 26.65±5.13, all P < 0.05]. Pearson correlation analysis showed that miR-182 was positively correlated with Th17% and IL-17 (r1 = 0.761, r2 = 0.842, both P < 0.01). ROC curves showed that when the cut-off value of miR-182 was 2.88, the diagnosis sensitivity of preeclampsia CI was 84.6%, the specificity was 82.4%, and area under the ROC curve (AUC) was 0.816 [95%CI confidence interval (95%CI) = 0.641-0.992]; when cut-off value of IL-17 was 34.44 ng/L, diagnosis of preeclampsia CI the sensitivity was 71.5%, the specificity was 85.3%, and AUC was 0.773 (95%CI = 0.602-0.945); when miR-182 was combined with IL-17, the diagnosis sensitivity was 92.3%, specificity was 83.6%, and AUC was 0.896 (95%CI = 0.759-1.032). Conclusions To some extent the expression of miR-182 and IL-17 in peripheral blood can predict the occurrence of CI in early stage. When the two are used together, the predictive value is better.

Objective To investigate the clinical value of the peripheral blood monocyte human leukocyte antigen-DR (mHLA-DR) for assessment of degree of severity and the diagnosis of acute pancreatitis (AP). Methods A case-control study was conducted. Eighty-six AP patients admitted to Shandong Liaocheng People's Hospital from June 2014 to May 2015 were enrolled. Patients were classified into four groups [mild (n = 33), moderate (n = 25), severe (n = 16), critical (n = 12)] according to the disease classification. Eighty healthy persons subjected to physical examination center of our hospital at the same time were served as controls. Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores in patients were estimated. Flow cytometry was used to measure the expression of the peripheral blood mHLA-DR, and the Pearson method was used to analyze the relationship between the level of mHLA-DR and the APACHE Ⅱ score. The receiver-operating characteristic curve (ROC) was plotted, and then the clinical value of the peripheral blood mHLA-DR was analyzed for the diagnostic value in AP patients. Results The expression of the mHLA-DR in patients with AP was significantly lower than that of healthy control group [(63.7±18.6)% vs. (86.4±8.3)%, t = 5.319, P < 0.001]. The expression levels of the mHLA-DR in mild group, moderate group, severe group, and critical group were (79.6±6.5)%, (66.4±9.4)%, (49.9±8.1)%, (32.5±12.0)%, respectively, and the APACHE Ⅱ score were 4.67±1.99, 5.88±2.05, 9.06±2.62, 12.33±3.96, respectively. Pair wise comparisons were statistically significant (all P < 0.05). The HLA-DR expression level in the peripheral blood of patients with AP was negatively correlated with the APACHE Ⅱ score (r = -0.695, P < 0.001). The area under the ROC curve (AUC) of mHLA-DR expression in peripheral blood for AP was 0.894 [95% confidence interval (95%CI) = 0.847-0.941, P < 0.001], and the cut-off point was 84.40%, with the sensitivity of 75.0%, the specificity of 90.7%, and the accuracy rate of 83.1%. The AUC of mHLA-DR expression for mild AP was 0.938 (95%CI = 0.889-0.987, P < 0.001), and the cut-off point was 72.70%, with the sensitivity of 87.9%, the specificity of 88.7%, and the accuracy rate of 88.4%. The AUC of mHLA-DR expression for severe and critical AP was 0.943 (95%CI = 0.881-1.005, P < 0.001), and the cut-off point was 57.85%, with the sensitivity of 84.0%, the specificity of 96.4%, and the accuracy rate of 90.6%. Conclusions The expression levels of the peripheral blood mHLA-DR in AP patients can reflect the degree of disease, and contribute to the diagnosis of AP. The value of mHLA-DR may be used as a new biological indicator in the diagnosis and assessment for the severity of AP.

Objective To investigate the relationship between plasma albumin and hemoglobin(Hb) levels and prognosis in patients with severe craniocerebral trauma. Methods The clinical data of 124 patients with severe craniocerebral trauma form January 2010 to January 2014 were analyzed retrospectively. The relationship between plasma albumin and Hb levels and prognosis were analyzed. Hb level was obtained in 3 days of admission, and then the patients were divided into Hb <90 g/L group, Hb 90-99 g/L group, Hb 100-110 g/L group, Hb >110 g/L group, and also were albumin <25 g/L group, albumin 25-28 g/L, albumin 29-31 g/L group, albumin>31 g/L group according to the mean albumin level. Multifactor Logistic regression analysis was used to analyze the relationship between Hb, albumin levels and prognosis. Results Among 124 patients, 37 patients (29.8%) were given red blood cell (RBC) transfusion, and 28 patients (22.6%) received albumin treatment. The hospital mortality was 20.2% (25/124). The age, scores of Glasgow Coma Scale (GCS) and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ ), and hospital mortality in different Hb level groups had no significant differences (P>0.05). The age, scores of GCS score and APACHEⅡ score in different albumin level groups had no significant differences (P>0.05), but the hospital mortality in different albumin level groups had significant difference: 31.2%(10/32), 24.2%(8/33), 9.7%(3/31), 14.3%(4/28), P<0.05. Multifactor Logistic regression analysis showed that albumin level was the relevant factor for the severe craniocerebral trauma (P<0.01), the hospital mortality was decreased with the rising of the albumin level, but the risk of death was higher in albumin>31 g/L group than that in albumin 29-31 g/L group. Conclusions 29-31 g/L albumin level is the best for severe craniocerebral trauma patients. There is no significant impact of Hb on the prognosis for severe craniocerebral trauma patients.