目的观察高压氧 (hyPerbaric oxygen,HBO)治疗重型颅脑损伤康复期患者的临床疗效。方法将285例颅脑损伤康复期患者随机分为HBO组(135例)和对照组(150例),对照组采用常规治疗,HBO组在常规治疗基础上加用HBO治疗,对比两组的疗效。结果 HBO组的治愈率和有效率均明显高于对照组(P<0.01)。结论高压氧治疗对重型颅脑损伤康复期患者疗效明显,且可降低致残率,减少并发症。

Background and purpose:Brucine is one of the active components from Strychnos nux vomica,with signifi cant analgesic,anti-inflammatory and platelet-aggregating inhibitory properties.Due to its cytotoxic effect,the anti-tumor effect of brucine has increasingly been appreciated.In this study,we investigated the impact of brucine on A549 cells proliferation,apoptosis as well as the underlying mechanisms.Methods:MTT assay was used to examine the cell viability,flow cytometric analysis and fluorescent microscope were applied to examine cell apoptosis,ELISA method was used to examine the effect of brucine on PGE2 release from A549 cells and RT-PCR analysis was used to measure mRNA content,western blotting analysis was used to measure protein expression and luciferase activity was detected to examine the effect of brucine on COX-2 promoter activity.Results:Brucine was able to suppress the proliferation of A549 cells and induce cell apoptosis to time-dependent and dose-dependent manner.To understand the mechanisms,COX-2 was identifi ed to be an important target molecule involved in the apoptosis induced by brucine because brucine could suppress the COX-2 mRNA,protein expressions as well as PGE2 release in A549 cells in a timedependent manner.Furthermore,overexpression of COX-2 abrogated brucine-induced cell apoptosis,in contrast,when A549 cells were transfected with COX-2 siRNA,the apoptotic effect of brucine was dramatically enhanced.Further analysis revealed that brucine was able to suppress COX-2 transcriptional activation.Conclusion:Brucine was able to induce lung cancer apoptosis via downregulation of COX-2.

Objective To investigate the expression of NMDAR1 in the hippocampus and cerebral cortex of old rats after 30-min -inhalation of 2% isoflurane, and to investigate the effects of isoflurane on the learning and memory functions of old rats and the underlying mechanism. Methods The healthy old male Sprague Dawley rats (n = 36) were randomly divided into the control group, the oxygen group, the 2-hour post-recovery group, the 1-day post-recovery group, the 3-day post-recovery group, and the 7-day post-recovery group. The morris water maze was used to detect the ethological effect of 30-min inhalation of isoflurane , and the immunohistochemistry assay was used to detect the expression of NMDAR1 in the hippocampus (CA1, CA3) and the cerebral cortex. Results The 30-min inhalation of 2% isoflurane inhibited the learning and memory abilities of old rats at 2 h post-recovery. On 1 d post-recovery, the inhibition of learning and memory began to reduce, then on 3 d and 7 d post-recovery, the learning and memory abilities continously recovered. The expression of NMDAR1 in the rat hippocampus and cerebral cortex decreased at 2 h post-recovery, and reversed on 1 d post-recovery and reached the normal level on 3 d and 7 d post-recovery. Conclusion 30-min inhalation of 2%isoflurane had an inhibitory effect on the learning and memory abilities of old rats, and the attenuation of NMDAR1 in the hippocampus and cerebral cortex may involve in this process.

Objective:To investigate the application value of three-dimensional (3D) printing technology assisted laparoscopic anatomic liver resection of segment 8 (Lap-S8).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 8 liver cancer patients including 7 cases with hepatocellular carcinoma and 1 case with intrahepatic cholangio-carcinoma who underwent 3D printing technology assisted Lap-S8 in the Hunan Provincial People′s Hospital from January 2019 to December 2020 were collected. There were 7 males and 1 female, aged from 49.0 to 80.0 years, with a median age of 56.5 years. Of the 8 patients, 6 cases underwent laparoscopic anatomic liver resection of the entire segment 8, 1 case underwent laparoscopic anatomic liver resection of ventral subsegmental of the segment 8 and 1 case underwent laparoscopic anatomic liver resection of dorsal subsegmental of the segment 8. 3D printing technology was used to assist preoperative evaluation and intraoperative navigation for all 8 patients. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) follow-up. Follow-up was conducted using outpatient examination, internet or telephone interview to detect survival and tumor recurrence of patients after operation up to March 2021. Measurement data with normal distribution were represented as Mean±SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) Surgical situations: all the 8 patients underwent 3D printing technology assisted Lap-S8 successfully, without conversion to open surgery. The operation time, hepatic portal occlusion time and volume of intraoperative blood loss of the 8 patients were (216±41)minutes, (56±11)minutes and 75 mL(range, 50 to 300 mL), respectively. There was no intraoperative blood transfusion in 8 patients, and the surgical margin of the 8 patients was negative. (2) Postoperative situations: the duration of postoperative hospital stay of the 8 patients were (9±3)days. There was no complication such as postoperative hemorrhage, biliary fistula, liver abscess or abdominal infection occurred. (3) Follow-up: all the 8 patients were followed up for 3.0?24.0 months, with a median follow-up time of 12.5 months. During the follow-up, 1 of 8 patients with preoperative diagnosis of recurrent hepatocellular carcinoma developed tumor recurrence at 5 months after operation. The patient underwent laparoscopic surgery followed with the transcatheter arterial chemoembolization and target therapy, and survived with tumor. There was no tumor recurrence in the other 7 patients.Conclusion:3D printing technology assisted Lap-S8 is safe and feasible.

Objective To investigate the expression of Vacuolar-H +-ATPase (V-ATPase) and P-glyeoprotein (P-gp) protein in colon carcinoma tissues,the correlation between the expression of V-ATPase and P-gp and their clinicopathological significance.Methods In samples from 80 cases of colon cancer,20 cases of colon adenoma and 10 cases of normal colonic mucosa tissues,the expression of V-ATPase and P-gp protein were detected by immunohistochemical method,their relationship was analyzed,the clinicopathological features and prognosis were evaluated.Results In colon cancer,V-ATPase and P-gp protein expression was 72％ and 80％,higher than that in colon adenomas (40％,35％),and in normal colon mucosa (20％,20％),the difference was statistically significant (P ＜ 0.05).There was a positive correlation between the expression of V-ATPase and that of P-gp (r =0.567,P ＜0.01).V-ATPase and P-gp protein expression in colon cancer was associated with TNM stage,lymph node metastasis and tumor differentiation (P ＜ 0.05).Patients with high V-ATPase expression had lower 5-year survival rate than those with low V-ATPase expression (P =0.023),and 5-year recurrence rate was higher than those with low expression (P =0.024).Conclusions The expression of V-ATPase is up-regulated in colon cancer,there is a positive correlation with colon cancer progress and metastasis,and high V-ATPase protein expression predicts poor prognosis.

Purpose To investigate whether FoxM1 participate in inhibitory effect of cisplatin (CDP) in resistant osteosarcoma cell lines by down-regulation of Rad51.Methods The resistant osteosarcoma cell lines were induced by gradually increasing dose intermittent action,and were named MG-63/R and HOS-MNNG/R respectively.The mRNA and protein level of FoxMl and Rad51 were detected by qRT-PCR and Western blot analysis in resistant cells and parental cells.The mRNA and protein level of FoxM1 and Rad51 were detected by qRT-PCR and Western blot analysis in resistant cells after treatment of 4 μmol/L Thiostrepton.The effect of single or combined treated of 4 tμmol/L Thiostrepton or 2 tμg/mL CDP on the rate of cell proliferation in resistant cells was examed by cell counting.Results Resistant osteosarcoma cell lines MG-63/R and HOSMNNG/R were established and stablely growthed in the concentration of 2 μg/mL CDP,and the resistance index was 30.52 and 37.87 respectively (severe CDP resistance).The mRNA and protein level of FoxM1 and Rad51 were significantly increaced in resistant cells compared with parental cells.The proliferation rate of resistant cells in conbination of 4 μmol/L Thiostrepton and 2 μg/mL CDP treated group was significantly lower than these two drugs single treated group.The level of mRNA and protein of FoxM1 and Rad51 were significantly decreased after 4 μmol/L Thiostrepton treatment in CDP resistant cells.Conclusion The results suggest that FoxM1 and Rad51 may participate in the resistant osteosarcoma cells to CDP.FoxM1 inhibitor Thiostrepton may strengthen the inhibitory effect of CDP in the resistant cells by down-regulation of Rad51.

Objective To explore the clinical application and follow-up results of minimally invasive percutaneous plate osteosynthesis (MIPPO) in treating proximal humeral fractures. Methods From December 2006 to September 2008, MIPPO using locking plate was employed to treat 36 patients (23 males and 13 females) with proximal humeral fracture. According to AO classification, there were four patients with type A2 fractures, 10 with type A3 fractures, five with type B1 fractures, 11 with type B2 fractures, three with type C1 fractures and three with type C2 fractures. Longitudinal or transverse incision was made through anterolateral acromial approach to separate the deltoid muscle and expose the fracture fragments. The direct and indirect reduction of the fractures were performed under direct vision. The locking plate was inserted distally beneath the deltoid muscle and a longitudinal incision was made at the lateral end of the plate. Locking screws were inserted to the proximal and distal plates. Postoperative follow-up was done to provide guidance to functional exercise and evaluate the clinical results. Results The operation lasted for (50.1±11.3) minutes, with intra-operative blood loss of(76±18.7) ml and average operative incision of (4.5±0.8) cm. All the patients were followed up for 12-17 months (average 14 months), which showed that the time of bone healing was (10. 1 ±1.2) weeks. Neer scoring standards showed the total excellence rate of 86%. Conclusion MIPPO is an ideal method for treatment of proximal humeral fractures, for it has the advantages such as safety, minor trauma, short bone healing time, alleviation of pain and good X-ray reduction.

Objective To know the postnatal depression and anxiety state and its related factors of parturients from migrant worker family,and then reference to certain nursing counter-measures. Methods Sampled 73 parturients by spontaneous labor from migrant worker family and 45 local matched parturients,interviewed them by SAS and SDS to know their postnatal depression and anxiety state,and then analyzed the datum between them. Results The level of postnatal depression and anxiety in parturients from migrant worker family was significant higher than that in local parturienta.Different level of depression and anxiety was existed in different parturients from migrant worker family by different educational attainments,different family type and different financial state. Conclusions The state of postnatal depression and anxiety in parturients from migrant worker family is severely,related health education should be strengthened,associated social secu-rity and support system should be established to help them release their unhealthy emotion.

Objective To monitor ventilator-associated event (VAE) for the first time in an intensive care unit (ICU) in China,understand the applicability,incidence,and clinical significance of VAE in China.Methods Targeted monitoring on VAE was performed among patients ≥18 years and with mechanical ventilation (MV)＞2 days in the ICU of a hospital between January 2014 and September 2015,incidence of VAE was calculated,and patients were grouped according to whether or not they had VAE,prognostic factors were analyzed statistically.Results A total of 1 004 patients were monitored,the total hospital stay was 13 795 days in patients who used ventilator,307 (30.58％) cases of VAE occurred,incidence of VAE per 1 000 ventilator-days was 22.25.Univariate analysis showed that patients with VAE had longer length of ICU stay and MV,and higher mortality rate than patients without VAE when they moved out of ICU (all P＜0.05).Multivariate logistic regression analysis showed that VAE was independent risk factor for length of ICU stay,duration of MV,as well as mortality when patients moved out of ICU(all P＜0.05).Conclusion Judgment of VAE is based on MV parameters,it is more objective and accurate.There is a high incidence of VAE among ICU patients,it may lead to poor clinical outcomes,and has good values for the targeted monitoring on ICU patients in large comprehensive hospitals of China.

Objective To explore the status of glucocorticoid application in patients with systemic lupus erythematosus (SLE) in China.Methods Epidemiological survey was used.The SLE patients who met the 1997 classification criteria of American College of Rheumatology were enrolled.The usage of glucocorticoid and related adverse reactions were recorded and analyzed.Results A total of 400 SLE patients were enrolled,including 35 men and 365 women.The average age was (37.4 ± 14.0) years old,and the average duration of disease was (6.7 ± 5.8) years.There were 310 patients using glucocorticoid as maintenance.Sixty-one percent (n =244) patients started using medium dose (prednisone 30-＜ 60 mg/d) as the initial treatment of glucocorticoid,which lasted for (37 ± 11) days.The time of drug duration in patients with low dose prednisone (7.5-＜30 mg/d)and high dose (60-100 mg/d) was(92 ± 20)and (17 ± 3) days respectively (P ＜ 0.05 between 3 groups).However,patients receiving different initial dosage were of no discrepancy in the maintenance therapy.During maintenance,even though 51.0％ (n =158) patients were on prednisone 2.5-5 mg/d,the duration of drug use in ＞ 5-10 mg/d groupwas longer [(29.9 ± 3.3) months].Patients with involvement of internal organs had a higher tendency to use 60-100 mg/d prednisone or pulse-dose therapy in the initial treatment,nevertheless these two groups had no difference of maintenance dosage.Among all 400 patients,62 patients withdrew glucocorticoid,including 17 patients with disease remission (4.3％),44 by self-withdrawal and one with adverse reaction.Conclusion In China,the medium dosage of glucocorticoid is the most common initial treatment in patients with SLE.Prednisone 2.5-5 mg/d was the most common choicefor maintenance therapy.Currently,the proportion of glucocorticoid withdrawal remains low in SLE patients achieving remission.