Objective To investigate the related risk factors for progress of the elderly frontal lobe contusions. Methods The clinical data of 118 cases of elderly frontal lobe contusions from August 2012 to August 2014 were retrospectivelyanalyzed.118 patients were given conventional therapy after admission,received dynamic review of brain CT.The progress of patients were performed surgery of frontal coronary approach,removed contusion brain tissue by bone flap of single frontal or double the frontal lobe.No progress of patients were given conventional conservative treat-ment.Selected seven indicators combining with hypertension,oral aspirin,diabetes mellitus,contrecoup injury,Cushing response,sylvian cistern exist or not and subdural hematoma did a statistical analysis.Results This group of 118 patients,68 cases (57.6%)had progress and 50 cases (42.4%)had no progress.Statistical analysis showed that oral aspirin (P =0.006 ),sylvian cistern exist or not (P =0.001 ),Cushing response (P =0.025 )were independent risk factors of progress of the elderly frontal lobe contusions.Conclusion For elderly patients with fron-tal lobe contusion,oral aspirin,sylvian cistern exist or not,whether there is any Cushing response were risk factors for deterioration of disease progression.If one or more risk factors appeared,clinical need to prevent disease progression.

Objective To investigate the effect of anti-CD81(antibodys against CD81) on the proliferation of astrocytes. Methods Purified astrocytes from newborn rats' cerebral cortex were divided into 6 groups and added with anti-CD81 different concentrations(0,0.1,0.5,1,5,10?mg/L).The activity of astrocytes was tested by methyl thiazolyl terazolium(MTT).Three significative groups were chosen based on MTT result and added with anti-CD81 of different concentrations(0,0.5,5mg/L).After administration for 24 hours,the cell cycle of the astrocytes was measured by flow cytometer.The corresponding data were analyzed with SPSS statistical software. Results 1.By MTT,the average optical density(AOD) values of astrocytes were reduced after administration with anti-CD81 of different concentrations for 24 hours,that is,the number of astrocytes was reduced,which indicated anti-CD81 inhibited the proliferation of astrocytes and the effect showed a dose-dependent pattern.2.By cell cycle analysis,a progressive dose-dependent decrease was found in the index of cells in G-0/G-1 phase and an increase in S phase.Such as,the index of cells in G-0/G-1 phase,was 82.73 in 0,is 82.16 in 0.5?mg/L,was 78.58 in 5?mg/L.Conclusion Anti-CD81 inhibits the proliferation of astrocytes and the number of astrocytes is reduced.Further more,the index of cells decreases in G-0/G-1 phase and increases in phase S after administration with anti-CD81.This study shows that anti-CD81 doesn't restrain the cells from G-1 phase to S phase but the cells are arrested in S phase.

Objective To approach the operative effect of dural bilaminar saturation in frontal -temporal skull defect repairs after standard decompressive craniectomy.Methods Fifty-two patients with titanium cranioplas-ty in frontal-temporal skull defect were retrospectively analyzed;27 of them adopted dural bilaminar saturation in the first standard decompressive craniectomy(test group);25 of them adopted dural monostratal saturation in the first operation (control group).The operation time,blood loss,postoperative complications in the two groups were compared. The mean operation time:the test group was (65.00 ±8.15)min and the control group was (83.00 ± 10.25)min,there was statistically significant differences between the two groups(t =7.059,P<0.05);average amount of bleeding:the test group was (55 ±8)mL and the control group was (79 ±12)mL,there was statistically significant differences between the two groups (t=8.541,P<0.05);postoperative complications:adverse reactions were noted in 4 patients of test group (14.8%),5 cases of control group (20%),there was no significant differences between the two groups (χ2 =0.016,P>0.05).Conclusion Skull repairs in second standard decompressive crani-ectomy by dural bilaminar saturation,can be shortened the operation time and lessened amount of bleeding.

Objective To evaluate the olfactory functions in patients with Parkinson's disease (PD) with a smell identification test developed for the Chinese population and to examine possible factors contributing to PD patients' olfactory performance.Methods Fifty-five patients with idiopathic and nondementia PD and 55 demographically matched healthy controls (HC) were recruited and their olfactory identification tested using the Chinese Smell Identification Test developed by the Institute of Psychology at Chinese Academy of Sciences.Results Olfactory identification score was significantly lower (t =-6.827,P＜0.01) in the PD group (19.3 ±5.4) as compared with the HC group (26.5 ±5.7).Of all PD patients,63.6％ scored over 1 SD below the age norm.In particular,of those with Hoehn-Yahr ratings between 2 to 3,77.8％ scored over 1 SD below the age norm.Receiver operating characteristic (ROC) curve analysis indicated that a cut-off score of 22.5 on the Chinese Smell Identification Test distinguished between PD patients and HC with a sensitivity of 74.6％ and specificity of 70.9％.Within the PD group,age,education,Hoehn-Yahr rating and Mini-Mental State Examination score were not found to correlate with olfactory performance (all P ＞ 0.05).Conclusion PD patients in China show significant impairment of olfactory identification,which is effectively captured by the Chinese Smell Identification Test.

Objective To evaluate the clinical value of high-risk HPV( HR-HPV) genotyping in risk stratification and management of cervical cancer screening.Methods Totally 9 331 women underwent routine cervical cancer screening at the first time of medical visit in gynecological clinic at Taizhou Hospital of Zhejiang Province.Cervical samples were collected by liquid-based method and analyzed for cytology and HPV genotyping ( Co-testing ) .The clinical value of HPV 16 and 18 genotyping in risk stratification and management of cervical cancer screening was evaluated.Results Patients were comprised of women aged 30 to 65 years with HPV-positive 21.6% ( HR-HPV infection accounting for 79.0%) , with abnormal cytology 5.0%( HR-HPV infection accounting for 56.2%) .The sensitivity of HR-HPV genotyping for CIN2+was significantly higher than that of cytology using a positive cut point of ASCUS(χ2 =42.36,P<0.05). Histopathological diagnosis of CIN2+which in 80 cases (13.5%) , including HR-HPV types were 74 cases (92.5%) and abnormal cervical cytology were 59 cases (73.8%) .The positive of HR-HPV infection was a significant factor associated with the development of CIN (χ2 =10.00,P <0.05).Conclusions The sensitivity of HR-HPV genotyping in cervical cancer screening was significantly higher than cytology as suspicious or mildly abnormal cytology results who were followed up diversion can be found cytology missed cervical tissue lesions, thereby reducing cancer precancerous lesions and cervical cancer incidence and mortality.

Objective To translate and revise the form of rheumatoid arthritis (RA) self-efficacy scale (RASE),and evaluate the revised scale.Methods Totally 101 patients with RA in one hospital were selected for investigation.Through the translation-back to the source scale and the cultural adjustment,the Chinese version of RASE (C-RASE) was formed.Exploratory factor analysis was conducted to acquire the construct validity while the Pearson correlation analysis was used to obtain the test-retest reliability.Results Factor analysis was carried out on 28 items,and the loading was 0.496,0.490,0.482 and 0.493 of item 5,and item 15 on two factors respectively.Exploratory factor analysis was conducted secondarily after deleting items of 5,15,and 17,considering the item contents,and 9 factors were extracted,respectively named for exercise,comprehensive treatment,relaxation,activity,sleep,social relationship,fatigue,cognition and active planning,which could explain 68.36％ of total variation;aud the correlation coefficient between each dimension and total table ranged 0.344 to 0.679 (P＜0.01);The Cronbach's alpha coefficient of the C-RASE was 0.751,and the retest reliability was 0.731.After deleting their own items,the Cronbach's alpha value range was 0.730 to 0.756.Conclusion C-RASE has sound reliability and validity and could provides a measurement of the self-efficacy among rheumatoid arthritis patients.

Objective To investigate the efficacy of radiotherapy,as well as the prognostic factors of survival in patients with extracranial oligometastases. Methods A total of 164 patients who underwent intensity-modulated radiotherapy ( IMRT ) of the extracranial oligometastases, from January 2013 to December 2016, were enrolled in the study. The short-term efficacy, local control rate, overall survival, progression free survival and adverse effects of treatment were observed. Results Short-term efficacy was assessed within the first 1-3 months after the end of radiotherapy. The objective response rate (CR+PR) was 78. 7% and the short-term efficacy is mainly related to the T stage of primary tumor ( P＝0. 004).Until the last follow-up,all patients with 1-,2-and 3-year LC were 89. 8%,82. 5% and 74. 9% respectively.Univariate analysis showed that the influencing factors of LC include tumor size and gross tumor volume dose ( all P＜0. 05),multivariate analysis found no significant influence factors. The 1-,2- and 3-year OS were 83. 4%, 69. 6% and 54. 6% respectively. Univariate and multivariate analysis showed that the primary tumor sources, metastasis organs,whether synchronous or adjuvant chemotherapy and short-term efficacy were independent prognostic factors in patients of OS ( P＜0. 05 ).Main toxicity-associated events were grade 1-2 acute reactions,with only 6 patients experiencing grade 3 toxicity;no grade≥4 toxic reactions or treatment-related deaths occurred. Conclusions Radiation therapy for the treatment of extracranial oligometastases can achieve good curative effect,is well-tolerated and has low toxicity.

OBJECTIVE: To investigate the prevalence, risk factors, duration and outcome of delirium in intensive care unit (ICU) patients. METHODS: A prospective observational study was conducted for critically ill patients admitted to the department of critical care medicine, the Affiliated Hospital of Guizhou Medical University from September to November 2021. Delirium assessments were performed twice daily using the Richmond agitation-sedation scale (RASS) and confusion assessment method of ICU (CAM-ICU) for patients who met the inclusions and exclusion criteria. Patient's age, gender, body mass index (BMI), underlying disease, acute physiologic assessment and chronic health evaluation (APACHE) at ICU admission, sequential organ failure assessment (SOFA) at ICU admission, oxygenation index (PaO₂/FiO₂), diagnosis, type of delirium, duration of delirium, outcome, etc. were recorded. Patients were divided into delirium and non-delirium groups according to whether delirium occurred during the study period. The clinical characteristics of the patients in the two groups were compared, and risk factors for the development of delirium were screened using univariate analysis and multivariate Logistic regression analysis. RESULTS: A total of 347 ICU patients were included, and delirium occurred in 57.6% (200/347) patients. The most common type was hypoactive delirium (73.0% of the total). Univariate analysis showed statistically significant differences in age, APACHE score and SOFA score at ICU admission, history of smoking, hypertension, history of cerebral infarction, immunosuppression, neurological disease, sepsis, shock, glucose (Glu), PaO₂/FiO₂ at ICU admission, length of ICU stay, and duration of mechanical ventilation between the two groups. Multivariate Logistic regression analysis showed that age [odds ratio (OR) = 1.045, 95% confidence interval (95%CI) was 1.027-1.063, P < 0.001], APACHE score at ICU admission (OR = 1.049, 95%CI was 1.008-1.091, P = 0.018), neurological disease (OR = 5.275, 95%CI was 1.825-15.248, P = 0.002), sepsis (OR = 1.941, 95%CI was 1.117-3.374, P = 0.019), and duration of mechanical ventilation (OR = 1.005, 95%CI was 1.001-1.009, P = 0.012) were all independent risk factors for the development of delirium in ICU patients. The median duration of delirium in ICU patients was 2 (1, 3) days. Delirium was still present in 52% patients when they discharged from the ICU. CONCLUSIONS The prevalence of delirium in ICU patients is over 50%, with hypoactive delirium being the most common. Age, APACHE score at ICU admission, neurological disease, sepsis and duration of mechanical ventilation were all independent risk factors for the development of delirium in ICU patients. More than half of patients with delirium were still delirious when they discharged from the ICU.
Humans ; Prevalence ; Critical Care ; Risk Factors ; Sepsis ; Intensive Care Units

Objective To explore the clinical effect of umbilical moxibustion on chronic heart failure with yang deficiency and blood stasis and water retention syndrome.Methods 80 patients with chronic heart failure who were hospitalized in the Department of Cardiology,Shenzhen Hospital(Longgang),Beijing University of Chinese Medicine from January 1,2021 to December 31,2022 were selected as research samples and randomly divided into control group(40 cases,40 cases completed)and observation group(40 cases,40 cases completed).The control group received standard drug treatment,while the observation group received umbilical moxibustion treatment on the basis of drug treatment.Ten days after treatment,NT-proBNP,NYHA cardiac function classification,cardiac color Doppler indexes(including LVEF,LVEDD,LVSD),Minnesota quality of life score,6-minute walking distance and TCM syndrome score were compared between the two groups before and after treatment,and the occurrence of adverse reactions was monitored and recorded.Results The total effective rate in the observation group was higher than that in the control group(χ2=3.865,P=0.049).NYHA cardiac function classification,NT-proBNP,LVEF,LVEDD,LVESD and 6-minute walking distance in both groups were significantly improved compared with those before treatment,and the improvement of the above indexes in the observation group was more significant(P<0.05).The Minnesota quality of life score and TCM syndrome score of the two groups decreased compared with those before treatment,and the decline of the patients in the observation group exceeded that of the control group(P<0.05).During the treatment,the two groups had adverse reactions(such as gastrointestinal reaction,hypotension,skin allergy,etc.),and there was no difference between the two groups(P>0.05).Conclusion On the basis of drug therapy,umbilical moxibustion is better than simple drug therapy in treating chronic heart failure with yang deficiency,blood stasis and water stagnation,which can improve the cardiac function and quality of life of patients with chronic heart failure.

Objective:To evaluate the efficacy and safety of apatinib in combination with chemoradiotherapy for head and neck squamous cell carcinoma (HNSCC).Methods:37 patients orally received apatinib at 250 mg/d during concurrent chemoradiotherapy until completion of radiotherapy, complete remission assessed by imaging examination, the onset of unacceptable toxicity or death. Baseline characteristics, objective response rates (ORR) and adverse events were assessed in all enrolled patients with complete baseline and safety data. Progression-free survival (PFS) and overall survival (OS) were calculated by Kaplan-Meier method. Prognostic factors were statistically identified using Cox regression models.Results:The ORR was 85%(95% CI: 72%-98%). The median PFS was 17.9 months and the 2-year OS rate was 62%(95% CI: 48%-80%). Ineffective short-term efficacy ( HR=0.035, 995% CI: 0.02-0.652, P=0.025) was an independent risk factor for poor OS. In addition, ineffective short-term efficacy ( HR=0.104, 95% CI: 0.017-0.633, P=0.014) and lymphocytopenia ( HR=17.539, 95% CI: 2.040-150.779, P=0.009) were independent risk factors for poor PFS. Common adverse events (>60%) included lymphocytopenia (76%), leukopenia (68%) and irradiation-induced mucosal injury (65%). The most common treatment-associated grade 3 adverse event was lymphopenia (49%). Conclusions:Apatinib combined with chemoradiotherapy yield significant anti-tumor activity for HNSCC with controllable toxicity. For patients with advanced HNSCC, short-term efficacy and lymphocytopenia may be potential predictors for clinical efficacy of apatinib combined with chemoradiotherapy.