Post-stroke depression (PSD) is a common complication of stroke. Its prevalence range was from 23% to 60%. This article reviews the risk factors for PSD,including gender, age, premorbid personality, education, history of stroke and depression, stroke type, stroke location, neurological dysfunction, cognitive impairment, aphasia, and social support.

Objective To evaluate the feasibility and safety of interventional microinvasive techniques in the management of high level cervical esophageal strictures.Methods Among 20 cases of high level cervical esophageal strictures,13 cases of strictures at the level of C_7~T_3 were given an oral placement of nitinol metal stents woven by single thread under fluoroscopic guidance,while 7 cases of strictures at the level of C_7 and above were given a percutaneous gastrostomy(PG) under endoscopic or fluoroscopic guidance.Results All the operations were successfully accomplished without complications.Out of 13 cases of intraesophageal stent implatation,the improvement of dysphagia was classified as grade 0 in 10 cases and as grade Ⅰ in 3 cases.Esophago-tracheal fistula was completed occluded in 5 cases.Slight downward stent shift was found in 2 cases and no further management was carried out.Follow-up in 11 cases for 1~30 months(mean,18 months) revealed 3 cases of recurrence of esophageal stricture and 8 fatal cases.No stentinduced esophago-tracheal fistula occurred.Of 7 cases of percutaneous gastrostomy,liquid diet was given 2 days after operation.Infection with redness and swelling in the area of fistula wound was noted in 1 case at 1 week postoperatively and the fistula tube was found loosened in 1 case at 5 months postoperatively.No intraabdominal infection,peritonitis,or internal fistula occurred.Follow-up in 7 cases for 1~18 months showed 5 fatal cases.Conclusions Stent implantation should not be contraindicated in patients with high level cervical stricture of esophagus.Radiologically guided percutaneous gastrostomy is safe and feasible,which is preferred as the first choice of treatment.

The erythropoietin(EPO) system was used to study the molecular mechanisms associated with the induction of hypoxia responsive genes and from these investigations the hypoxia-inducible factors (HIFs) was identified as a key transcriptional hypoxic regulator of EPO. Subsequent research has now found that a large number of other hypoxia-inducible genes are also induced by HIF under hypoxic conditions. The HIF transcriptional complex is a heterodimer consisting of an alpha subunit and a beta subunit. Recently, two oxygen sensor, oxygen-dependent prolyl and asparaginyl hydroxylation were found,and it is the first time that the oxygen sensor had been described for higher organisms. This review focused on the structure and functions of HIF and the regulation of HIF proteins by hypoxia and oxygen sensors.

Objective To evaluate the effect and safety of trans-arterial chemotherapy embolization (TACE) in the treatment of primary hepatic carcinoma ( PHC ) with portal vein tumor thrombus. Methods There were 83 PHC patients complicated with portal vein tumor thrombus, age ranging from 29 to 76 years. Fifty-three cases underwent TACE ( Group A) , 30 receiving trans-arterial chemotherapy infusion only (TAI, Group B). Results The survival rate in group A at 6,12,24 and 36 months was 97. 8% , 85.2%,45.8% and 4.4%, respectively, significantly higher than that in group B (37. 6% ,5. 3% ,0,0, P

Objective To study the nursing method about percutaneous biliary tract stent implantation to cure malignant obstructive jaundice.Methods Careful perioperative nursing cares and finished post-hospital direction were applied among 21 patients with malignant obstructive jaundice when by percutaneous biliary tract stent implantation.Results There were 20 patients obtained successful operation,the successful rate was 95%.The postoperative of glutamic pyruvic transaminase were(96.60?89.36) U/L,the total bilirubin was(137.96?103.95) ?mmol/L,the directed bilirubin was((85.67)?62.95) ?mmol/L and the indirected bilirubin was(56.76?37.37) ?mmol/L.All the indexes which have mentioned above were significant lower than those of before operative,P

Objective Metabolites produced by metabolic imbalance such as free fatty acids and lipopolysaccharides can result in a state of chronic low-grade inflammation, or metabolic inflammation, which plays an important role in the pathogenesis of atherosclerosis, type 2 diabetes, non-alcoholic fatty liver disease, and obesity. The above metabolic disorders are closely related with the metabolic inflammation, which always coexist. Therefore, we proposed the concept ofmetabolic inflammatory syndrome ( MIS). According to our study, patients with two or more metabolic disorders above could be diagnosed as MIS. The current research is aimed to investigate the prevalence of MIS and its components, and to compare the clinical values of MIS and metabolic syndrome ( MS) . Methods 2 001 in patients with type 2 diabetes from 6 hospitals in Shanghai were recruited in the current multi-center cross-sectional study. The diagnostic rates of MIS and MS and their components of both syndromes were compared. Results In the patients with type 2 diabetes, the detective rate of MIS was 96. 2%, which was higher than that of MS (71. 3%). Among 4 components of MIS, atherosclerosis showed the highest detective rate (75.6%). MIS[OR=2.252(95%CI1.026-4.942),P=0.043],atherosclerosis[OR=2.726(95% CI1.953-3. 804),P<0. 001], and MS[OR=1. 915 (95%CI 1. 444-2. 540),P<0. 01] were the risk factors of coronary heart disease. Conclusion With atherosclerosis, type 2 diabetes mellitus, non-alcoholic fatty liver disease, and obesity as its 4 components, MIS has a high detective rate in patients with metabolic disorders, and seems to be more sensitive than MS to distinguish inflammation-related metabolic diseases. The concept of MIS will promote the screening and prevention of atherosclerosis in its early stage.

Objective To summarize the application experiences and curative efficacies of single lung transplantation assisted by extracorporeal circulation with coated lung ,centrifugal pump and coated pipe .Methods Retrospective analysis was conducted for clinical data of 6 adult patients with respiratory insufficiency undergoing single lung transplantation .The changes of hemodynamics and oxygenation before and after adjuvant treatment were observed ,the effects of adjuvant evaluated and the experiences of application summarized .Results The hemodynamic parameters post-assistance significantly improved as compared with that pre-assistance and pulmonary arterial pressure dropped from (56 ± 15 ) to (45 ± 13 ) mmHg with statistically significant differences . Arterial blood gas parameters significantly improved .PO2 spiked from (47 ± 12) to (68 ± 9) mmHg and PCO2 declined from (65 ± 14) to (55 ± 12)mmHg .And there were statistically significant differences .All patients were discharged successfully .Conclusions The simple extracorporeal membrane oxygenation system of coated lung , centrifugal pump and coated pipe during routine extracorporeal circulation may guarantee the operative safety of single lung transplantation and provide a new therapeutic option .

Objective:To explore the risk factors of death in patients receiving ECMO treatment and to construct a nomogram prediction model.Methods:The clinical data of 412 consecutive patients with acute heart and (or) pulmonary failure who received ECMO treatment between April 2018 and June 2022 were retrospectively included.According to the patients' in-hospital survival, univariate correlation analysis was used to select risk factor variables, and then Lasso regression was used to screen all variables, combined with common variables, combined with clinical practice, plotted a nomogram to predict the probability of early mortality, using the area under the ROC curve (AUC), Harrell C index and calibration curve were used to evaluate and internally validate the performance of the model.Decision curve analysis was applied to assess its clinical utility.Results:Cerebral infarction, diabetes, history of cardiopulmonary resuscitation, neurological complications, acute kidney injury, lactate, hemoglobin, albumin, and platelet count were risk factors for death in patients receiving ECMO ( P<0.05).At the same time, according to the actual situation and difference variables, we constructed a nomogram with high reliability to predict the probability of death. Conclusions:The study identified the risk factors of death in patients receiving ECMO, successfully constructed and validated a nomogram prediction model, and provided a simple and reliable tool for ECMO death prediction, which is of great significance for individualized treatment of patients.

Humans ; Adult ; Serum Albumin, Human ; Consensus ; Cardiac Surgical Procedures ; Thoracic Surgery