Objective To observe the effects of early exercise on the expression of synaptophysin pro-tein and Nissl bodies in the hippocampus after hypoxic-ischemic brain damage( HIBD) , and to investigate possi-ble mechanisms. Methods A total of 35 neonatal Wistar rats aged 7 days were randomly divided into a train-ing group of 13, a control group of 11 and a sham-operation group of 11. HIBD was induced in the rats of the training and control groups, while those in the sham-operation group had the left common carotid artery separa-ted, but without ligation. Seven days after successful modeling, the training group began swimming training for 10 min every day lasting for 14 days, while the other groups were not trained. Western blotting was used to detect the expression of synaptophysin in the affected hippocampus of the brain based on the ratio of the gray band val-ues for synaptophysin and beta. Nissl staining was applied to observe the number of Nissl bodies and the morphol-ogy of the neurons in the hippocampus. Results The average expression of synaptophysin in the sinistrocere-bral hippocampus of the rats in the control group was significantly lower than that in the sham-operation group, but significantly higher than that of the training group. The control group had significantly fewer Nissl bodies than the sham-operation group, but significantly more than the training group. Conclusion Early training can in-crease the expression of synaptophysin and the number of Nissl body in the hippocampus after hypoxic-ischemic brain damage.

Objective To assess whether metformin prevents body weight gain in patients with schizophrenia who are treated with second-generation antipsychotics(SGA).Methods The randomized controlled trials (RCT) about metformin for prevention of weight gain with SGA for schizophrenia from January 1998 to July 2012 were selected in the Cochrane Library,Medline,Wanfang Data,CNKI and VIP.Two reviewers independently screened the literatures,extracted the data,and evaluated the methodological quality.Than meta-analyses were conducted by using RevMan 5.1 software and Stata 12.0 software.Results The total 7 RCTs were selected and 394 patients were involved.The results of meta-analyses showed that the efficacy of the metformin group was superior to that of the control group in lessen body mass (MD =-3.07,95％ CI:-4.17,-1.98,Z =5.50,P ＜ 0.01),BWI (MD =-1.21,95％ CI:-1.50,-0.92,Z=8.18,P＜0.01) with significant differences.Conclusion Metformin addition therapy is effective in attenuating SGA-induced weight gain.

Objective To establish intellectual critique of nursing thesis course in postgraduate nurse,and to evaluate teaching effectiveness and the reasonableness of the course.Methods A total of 44 postgraduate nurses were involved in the study,which were carried out through action research of planning,acting and observing,and reflecting.After the course,researchers evaluated the reasonableness of the course and teaching effectiveness through the self-control.Results There was significant difference in the scientific research ability score of research object before and after the course:(60.09±16.26) scores vs.(71.27±13.22) scores,t=-3.264,P＜0.01.But there was no significant difference in the critical thinking ability scores of research object before and after the course:(295.55±29.71) scores vs.(292.71±26.67) scores,t=0.478,P＞0.05.Conclusions The course of intellectual critique of nursing thesis can improve the research ability of postgraduate nurse,but the role of the critical thinking ability remains to be discussed.And the course needs to be further improved.

ObjectiveTo analyze the literature characteristics on essential hypertension treated by external therapy of traditional Chinese medicine, summarize the current research situation and trend in the field, and to provide a reference for relative researches.MethodsThe papers relevant to treatingessential hypertension with external therapy of TCM included inSinoMedwere statistically analyzed from the aspects of publishing year, journals distribution,author’s unit and districtdistribution,research funds and literature content with bibliometrics method.ResultsThe total number of the literature for analyzing was 226, the number of papers increased gradually.Authors of the papers were mainly from TCM universities or colleges.Papersdistributedmainly in the more economically developed regions,which issued the largest amountinGuangdongprovince.Papers supported by research funds accounted for 16.81% in all the literature. Most literaturewasclinical research and the most commonly used for external therapywasacupuncture.ConclusionThe research and clinical work of essential hypertension treatment with external therapy of traditional Chinese medicinewerepaid more close attention in recent years, but therewerestill some problems that need to be solvedto form a viable, effective treatment system.

Objective To observe the effects of mycophenolate mofetil (MMF) on the differentiation and proliferation of Helper T cells 17 (TH 17),so as to reveal its role and the possible mechanism in inducing immunological suppression.Methods Sixteen Balb/c mice of SPF level aged 8 weeks were randomly divided into two groups:MMF group and control group,with 8 mice in each group.In MMF group,the mice received intragastric administration of MMF (40 mg·kg-1· day-1 ),and those in control group received intragastric administration of identical volumetric saline every day.After three weeks,peripheral blood was collected and spleen cells were prepared.Flow cytometry was used to determine the proportions of CD4+ TH 17 and CD4+ CD25+ Tregs,then the ratio of TH 17/Tregs was calculated,and the concentrations of interleukin-1 7 (IL-1 7) and interleukin-23 (IL-23) in serum were measured by ELISA.Results The proportion of CD4+ TH 17 in the peripheral blood and spleen was (1.95 ± 0.08) and (2.42 ± 0.06) in MMF group,and (3.19 ± 0.07)％ and (4.21 ± 0.25)％ in control group,respectively.There were significant differences between the two groups (P ＜0.05).Meanwhile,the ratio of TH 17/Tregs in MMF group,both in the peripheral blood and spleen,was significantly decreased as compared with the control group (P＜0.05).The concentration of IL-17 in MMF group was lower,but that of IL-23 in MMF group was higher than in the control group (P＜0.05).Conclusion MMF could obviously suppress the differentiation and proliferation of CD4+ TH 17 in vivo,reduce the ratio of TH17/Tregs and the IL-17 secretion,thus facilitate the induction of immune tolerance.

Objective To test the clinical validity of use of the Chinese version of Munro adult pressure ulcer risk-assessment scales (Munro scales),Braden scales,Qian Weiming operation pressure ulcer risk-assessment scales (self-designed scales) in the patients with general anesthesia surgery.Methods Three investigators respectively used the Munro scales,Braden scales and self-designed scales to conduct the pressure ulcer risk-assessment on 261 patients with general anesthesia surgery before operation,at the end of operation and at exiting from anesthesia recovery room.The sensitivity,specificity,positive predictive value and negative predictive value of each assessment tool were calculated.Results The best critical values of the Munro scales before operation,at the end of operation and at exiting from anesthesia recovery room were 8.0,24.5,28.5 points respectively;which of the Braden scale were 18.5,11.5,13.5 points respectively;which of self-made scale were 12.5,13.5,13.5 points respectively.The area under the ROC curve of the three different scales at the beginning of the operation above was 0.653,0.596,0.652.The area under the ROC curve of the three different scales at the end of the operation above was 0.872,0.548,0.792.The areas under the ROC curve of the three different scales before operation were 0.868,0.773 and 0.813 respectively.Conclusion The Chinese version of Munro scales is more suitable for the assessment of operative patient's pressure ulcer risk than the Braden scale and self-designed scales,but the preoperative risk assessment needs to be improved.

Objective To investigate the predictors of early neurological deterioration (END) in patients with acute ischemic stroke (AIS). Methods From January 2015 to April 2018, patients with AIS without receiving thrombolytic therapy and endovascular treatment admitted to the Department of Neurology, the First Affiliated Hospital of Nanjing Medical University were collected retrospectively. END was defined as National Institutes of Health Stroke Scale (NIHSS) score increased by ≥2 within 7 days after onset from baseline. The baseline clinical data, imaging examinations, and laboratory findings were compared in patients of the END group and the non-END group. Multivariate logistic regression analysis was used to determine the independent predictors of END. Results A total of 652 patients with AIS were enrolled,including 437 males (67. 0％). There were 247 patients (37. 9％) in the END group and 405 (62. 1％) in the non-END group. There were significant differences in low-density lipoprotein cholesterol, fasting blood glucose, homocysteine, lipoprotein (a), neutrophil percentage, and NIHSS scores between the 2 groups (all P < 0. 05). There were significant differences in the proportion of severity of stroke, serious lesion of the guilty vessels, watershed infarction, etiologic classification of stroke, Oxfordshire Community Stroke Projects classification, and taking statins before onset between the 2 groups (all P < 0. 05 ). Multivariate logistic regression analysis showed that lipoprotein (a) (odds ratio [OR] 1. 001, 95％ confidence interval [CI] 1. 000-1. 002; P = 0. 021), total anterior circulation infarcts (OR 3. 842, 95％CI 1. 383-10. 671; P =0. 003), and partial anterior circulation infarcts (OR 2. 642, 95％CI 1. 486-4. 695; P = 0. 001) were the independent risk factors for END, and prior statin use was an independent protective factor of END (OR 0. 222, 95％CI 0. 072-0. 679; P = 0. 008). Conclusion Lipoprotein (a), total anterior circulation infarcts, and partial anterior circulation infarcts were the independent risk factors for END. Taking statins before onset was an independent protective factor of END.

Objective To explore the effect of environmental enrichment intervention on spatial memory function,expressions of phosphorylated cAMP response element binding protein (pCREB) and apoptotic regulated genes (Bcl-2 and Bax) in the hippocampus of immature rats with hypoxic-ischemic brain damage (HIBD).Methods Two kinds of raising environments were chosen:standard environment and environmental enrichment.Thirty-two Wistar rats aged 7 days were randomly divided into sham-operated group (n=10),environmental enrichment group (n=11) and standard environment group (n=11).Rats in both environmental enrichment group and standard environment group were induced animal models of HIBD using the way of Rice-Vannucci.Rats in the sham-operated group and standard environment group were raised in standard environment,while rats in the environmental enrichment group were raised in environmental enrichment.After 21 days of environmental enrichment intervention,the escape latency for searching the hidden platform of immature rats was detected by Morris water maze navigation test.The pCREB protein expression was detected by Western blotting;Bcl-2 and Bax expressions in the hippocampus were detected by immunohistochemisty.Results (1) On the fourth and fifth days of Morris water-maze test,the escape latency in the environmental enrichment group was shorter significantly as compared with that in the standard environment group (P＜0.05).(2) As compared with the lesion lateral hippocampus of standard environment group,the expressions ofpCREB (0.435±0.121 vs.0.756±0.101) and Bcl-2 (0.103±0.028 vs.0.165±0.017) in the lesion lateral hippocampus of environmental enrichment group were significantly higher (P＜0.05);however,the expression of Bax in the environmental enrichment group was statistically lower (0.402± 0.028 vs.0.325±0.019,P＜0.05).Conclusion Environmental enrichment intervention can improve the spatial memory ability in the hippocampus after HIBD,which indicates that the effectiveness of environmental enrichment intervention might be through the pathway of CREB-pCREB-apoptotic regulated genes (Bcl-2 and Bax).

Objective To compare the efficacy and safety of diazepam combined with olanzapine in treatment of agitation symptoms in patients with alcohol withdrawal delirium tremors( DT) . Methods Total-ly 60 inpatients with DT according to CCMD-3 were enrolled in a 7-day,with 30 patients in the diazepam group ( control group) and 30 patients in diazepam combined with olanzapine group ( research group) . The delirium rating scale( DRS-R-98) was used to evaluate the severity of the delirium symptoms. The positive and negative syndrome scale excited component( PANSS-EC) was used to assess the agitation symptoms. The treatment emergent symptom scale ( TESS) was used to assess the safety and the vital signs. Results There was no significant difference in the delirium recovery time between the two groups(M(QR):24 h(24 h)vs 24 h(6 h))(Z=-0. 45,P=0. 65). The PANSS-EC score in research group(17. 00±2. 67) was significant low-er than that in control group(19. 80±2. 43) at the 6 hours after treatment(t=4. 26,P<0. 01),but there were no significant difference between the two groups at the baseline,24 h,48 h and 72 h(P>0. 05) . One case of dizziness,2 cases of lethargy in the control group;1 case of nasal congestion,5 cases of drowsiness,3 cases of constipation, 3 cases of dry mouth, 1 case of abnormal liver function in the research group. Conclusion The combination of olanzapine with diazepam can not reduce the recovery time of DT,but can quickly improve the agitation behavior.

BACKGROUND: Immunotherapies such as adoptive immune cell infusion and immune-modulating agents are widely used for cancer treatment, and the concomitant symptoms, including cytokine release syndrome (CRS) or immune-related adverse events (irAEs), are frequently reported. However, clinical manifestations induced by mismatched donor granulocyte colony-stimulating factor mobilized peripheral blood mononuclear cell (GPBMC) infusion in patients receiving microtransplant (MST) have not yet been well depicted. METHODS: We analyzed 88 cycles of mismatched GPBMC infusion in patients with acute myeloid leukemia receiving MST and 54 cycles of chemotherapy without GPBMC infusion as a comparison. Clinical symptoms and their correlation with clinical features, laboratory findings, and clinical response were explored. RESULTS: Fever (58.0% [51/88]) and chills (43.2% [38/88]) were the significant early-onset symptoms after GPBMC infusion. Patients possessing less human leukocyte antigen-matching loci with the donor or those with unrelated donors experienced more chills (3 [2-5] loci vs. 5 [3-5] loci, P  = 0.043 and 66.7% [12/18] vs. 37.1% [26/70], P  = 0.024). On the other hand, those with decreased CD4 + /CD8 + T-cell ratio developed more fever (0.8 [0.7-1.2] vs. 1.4 [1.1-2.2], P  = 0.007). Multivariable analysis demonstrated that younger patients experienced more fever (odds ratio [OR] = 0.963, 95% confidence interval [CI]: 0.932-0.995, P  = 0.022), while patients with younger donors experienced more chills (OR = 0.915, 95% CI: 0.859-0.975, P  = 0.006). Elevated ultra-sensitive C-reactive protein levels in the absence of cytokine storm were observed following GPBMC infusion, which indicated mild and transient inflammatory response. Although no predictive value of infusion-related syndrome to leukemia burden change was found, the proportion of host pre-treatment activated T cells was positively correlated with leukemia control. CONCLUSIONS Mismatched GPBMC infusion in MST induced unique infusion-related symptoms and laboratory changes, which were associated with donor- or recipient-derived risk factors, with less safety and tolerance concerns than reported CRS or irAEs.
Humans ; Leukocytes, Mononuclear ; Hematopoietic Stem Cell Transplantation/adverse effects* ; Leukemia, Myeloid, Acute/therapy* ; Unrelated Donors ; Granulocyte Colony-Stimulating Factor ; Graft vs Host Disease