Objective To investigate the effects of lower limb training combined with hyperbaric oxygen on motor function in a paretic lower limb and on the ability in the activities of daily living (ADL) of hemiplegic stroke survivors. Methods A total of 297 hemiplegic stroke patients received routine interventions and then were randomly divided into 3 groups. The hyperbaric oxygen group accepted hyperbaric oxygen, the training group accepted lower limb training, and the treatment group accepted both hyperbaric oxygen and lower limb training. Evalnations were carried out pretreatment and 30 d post treatment to assess the function of the paretic lower limb and ADL ability with the Fugl-Meyer assessment ( FMA), a modified Barthel index (MBI) , Berg's balance scale (BBS) and the timed up and go test (TUGT). Results FMA, MBI, BBS and TUGT scores in all 3 groups improved significantly compared with pretreatment. On the 30th day post treatment, the scores in the treatment group were significantly better than in the other two groups. Conclusions Lower limb training combined with hyperbaric oxygen can significantly improve motor function in the paretic lower limbs of stroke patients and their ADL performance.

Objective By using 18F-deoxyglucose (18F-FDG) positron emission computed tomography (PET-CT) to measure the brain glucose metabolism of patients with severe traumatic brain injury before and after hyperbaric oxygen (HBO) therapy,and to investigate the mechanisms of H BO treating patients with traumatic brain injury.Methods Twenty-six patients suffered form severe traumatic brain injury with stable vital signs within 2 weeks were randomly divided into the HBO group and the control group.The patients of both groups received routine clinical interventions (including neuroprotection,dehydration,reducing intracranial pressure,anti-infection and other symptomatic treatments).Patients of the HBO group received the basic treatment combined with HBO therapy one tine per day for 7 days per week.In early stage and 4 weeks after treatment,all patients were examined with PET-CT scanning and Glasgow coma scale (GCS),disability rating scale (DRS) at the same time.Results There was standard uptake value (SUV) of significant difference between affected and unaffected brain areas in two groups before treatment(P＜0.01),but no significant difference between two groups (P＞0.05).After 4-week of treatment,SUV of affected and unaffected brain areas of two groups improved,the damaged area of HBO group improved obviously and the SUV was much better than before treatment and the control group (P＜0.0l).The GCS and DRS scores of HBO group were also significantly better than that of control group (P＜0.05).Conclusion The 18F-FDG PET-CT examination showed that HBO therapy can significantly improve glucose metabolism function of the brain damaged area,promote the brain functional recovery and awakening,and improve the prognosis in patients with severe traumatic brain injury.

Objective To observe the effects of hyperbaric oxygen (HBO) on cerebral small vessel disease (CSVD) and on learning,memory and the expression of brain-derived neurotrophic factor (BDNF) and acetylcholine (Ach) in the cerebral cortex and hippocampus.Methods Sixty healthy,male Wistar rats were studied.Allograft thrombosis particles 48 to 74 μm in diameter were injected into the rats' external carotid arteries to create a CSVD model.The rats were then divided randomly into a hyperbaric oxygen group,a nimotop group and a control group.The hyperbaric oxygen group rats were given hyperbaric oxygen therapy 12 hours after the modeling.The nimotop group rats were given nimodipine by intragastric perfusion 12h after the modeling.The rats in the control group had no special intervention.At 7,14 and 28 days after the modeling,any changes in learning and memory were assessed with a Morris water maze test.Enzyme-linked immunosorbent assay (ELISA) was used to detect the expression of BDNF in the cerebral cortex and of Ach in the hippocampus at 28 days.Results At both 14 and 28 days the average escape latency of the rats in the hyperbaric oxygen group was significantly shorter than those of the nimotop and control groups.The average platform crossing time had increased significantly more than in the nimotop and control groups.At both 14 and 28 days the escape latency and platform crossing times of the nimotop group were significantly better than in the control group.Ach content and BDNF content were significantly higher in the HBO group than in the nimotop and control groups.Conclusions Hyperbaric oxygen treatment can promote BDNF release in CSVD,which is helpful to protect and repair neural mitochondria,to maintain the cortex and hippocampal neurotransmitters on a stable level,and to improve learning and memory.Its effect is better than that of nimotop.

Objective:To investigate the relationship between the levels of serum cytokines and chemokines and the prognosis of patients with acute B-ALL after receiving chimeric antigen receptor (CAR)-T cell immunotherapy and acute graft-versus-host disease (aGVHD) in patients after bridging allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:According to the case-control principle, Forty-two patients with B-ALL who received CD19-CAR-T cell immunotherapy bridged to allo-HSCT at Heibei Yanda Ludaopei Hospital from September 18, 2019 to May 9, 2022 were enrolled. Mann-Whitney U test was used to compare the changes of aGVHD-related cytokines and chemokine levels between CAR-T cell immunotherapy and bridging transplantation in different patients at the same time. Their plasma levels of cytokines and chemokines related to aGVHD were monitored at the day before CAR-T therapy and after CAR-T treatment at day 4, 7,14,21,28. The receiver operating characteristic curve was drawn to evaluate the predictive value of cytokines and chemokines in predicting the occurrence and the death of aGVHD patients. Kaplan-Meier method and Log-rank tests were used for Overall survival (OS) analysis. Results:Twenty-four of total 42 patients had aGVHD, of which 11 patients died and 31 patients survived. There was no significant difference in cytokines and chemokines between the aGVHD group and the non-aGVHD group on the day before CAR-T cell treatment. According to statistical analysis, the serum Elafin levels of aGVHD group was higher than that of non-aGVHD group at the 21st day [4 482 (2 811, 6 061) ng/L vs 2 466 (1 948, 3 375) ng/L, Z=3.145, P=0.001] and the 28st day [4 391 (2 808, 5594) ng/L vs 2 463 (1 658, 2 830) ng/L, Z=2.038, P=0.048] separately. At the 14th day, serum cytokines and chemokines levels between the two group were as follows,MIP-1 α [21.02 (12.36, 30.35) ng/L vs 5.56 (3.64, 10.79) ng/L], sCD25 [422.47 (257.99, 1 233.78) IU/ml vs 216.11 (133.75,457.39) IU/ml], Elafin [4 101 (2 393, 5 006) ng/L vs 2 155 (1 781, 3 033) ng/L], IL-6 [119.08 (23.97, 183.43) ng/L vs 8.39 (2.91, 17.42) ng/L] and IL-8 [13.56 (12.50, 24.52) ng/L vs 2.83 (1.73,6.87) ng/L] were at higher levels ( Z=2.653, P=0.007; Z=2.176, P=0. 030; Z=2.058, P=0.041; Z=3.329, P<0.001; Z=3.162, P=0.001). The KM survival curve showed that the cumulative survival rates of patients with higher serum levels of MIP-1α, sCD25, Elafin, IL-6 and IL-8 were lower than those with low levels at day 14, and the difference was statistically significant (χ 2=12.353, 4.890, 6.551, 10.563, 20.755, P<0.05). Conclusion:The outcomes of patients treated with CAR-T cell therapy bridged to allo-HSCT was correlated with serum MIP-1α, sCD25, Elafin, IL-6 and IL-8 levels after receiving CAR-T therapy. High concentrations of MIP-1α, sCD25, Elafin, IL-6 and IL-8 suggest poor prognosis and can be used as biomarkers to suggest appropriate clinical selection of therapy.