Objective:To correlate serum levels of neuron specific enolase (NSE) and inflammatory factors with recovery of neurological function in patients with severe traumatic brain injury.Methods:Ninety-six patients with severe traumatic brain injury who received treatment from January 2018 to January 2020 in Taizhou Hospital were included in this study. These patients were divided into a mild-to-moderate group ( n = 51) and a severe group ( n = 45). Additional 60 healthy controls who concurrently received health examination were included in the healthy control group. Serum NSE level was detected by enzyme-linked immunosorbent assay, serum C-reactive protein (CRP) level by immunoturbidimetry, serum procalcitonin (PCT) level by chemiluminescent assay, and serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels by enzyme-linked immunosorbent assay. All patients were followed up for 3 months. Recovery of neurological function was evaluated by modified Rankin Scale. Results:Serum NSE level was (50.42 ± 13.25) μg/L and (36.79 ± 10.28) μg/L in the severe and mild-to-moderate groups, respectively, which was significantly higher than that in the healthy control group [(6.13 ± 1.78) μg/L, t = 25.641, 22.688, both P < 0.05). Serum NSE level in the severe group was significantly higher than that in the mild-to- moderate group ( t = 5.576, P < 0.05). Serum CRP, PCT, IL-6 and TNF-α levels were (78.95 ± 15.46) mg/L, (3.46 ± 0.75) μg/L, (432.15 ± 78.29) μg/L and (36.57 ± 8.98) μg/L] respectively in the severe group, (34.65 ± 7.48) mg/L, (1.68 ± 0.51) μg/L, (285.41 ± 36.75) μg/L and (17.54 ± 5.26) μg/L] respectively in the mild-to-moderate group and (3.25 ± 0.86) mg/L, (0.08 ± 0.02) μg/L, (73.52 ± 13.89) μg/L and (1.64 ± 0.50) μg/L, respectively in the healthy control group. Serum CRP, PCT, IL-6 and TNF-α levels in the severe and mild-to-moderate groups were significantly higher than those in the healthy control group ( t = 37.890, 34.922, 34.870, 30.099, 32.284, 24.315, 40.980, 23.312, all P < 0.05). Serum levels of these indicators in the severe group were significantly higher than those in the mild-to-moderate group ( t = 17.493, 13.414, 11.500, 12.451, all P < 0.05). In the severe group, neurological function recovered well in 34 patients and poorly in 17 patients. Serum NSE level in patients with poor neurological function recovery was significantly higher than that in patients with good recovery [(68.93 ± 14.25) μg/L vs. (34.61 ± 12.36) μg/L, t = 8.457, P < 0.05). Serum CRP [(113.24 ± 27.39) mg/L], PCT [(4.57 ± 0.87) μg/L], IL-6 [(598.90 ± 43.52) μg/L] and TNF-α [(58.78 ± 12.13) μg/L] levels in patients with poor recovery were significantly higher than those in patients with good recovery [(32.19 ± 6.90) mg/L, (2.23 ± 0.65) μg/L, (261.39 ± 26.56) μg/L and (14.53 ± 4.26) μg/L, t = 11.956, 9.788, 29.280 and 14.537, all P < 0.05). Serum NSE, CRP, PCT, IL-6 and TNF-α were positively correlated with poor prognosis ( r = 0.849, 0.743, 0.795, 0.683, 0.701, all P < 0.05). Conclusion:In patients with severe traumatic brain injury, serum NSE, CRP, PCT, IL-6 and TNF-α levels increase, which are positively correlated with poor prognosis.

Objective To understand the status of renal function abnormalities and explore its influencing factors in a community-based population with type 2 diabetes mellitus (T2DM).Methods Totally 9 413 patients with T2DM who have registered and received management of community public health service in 2014 were recruited in our study.All participants undertook questionnaire survey,physical examination and laboratory test.A simplified MDRD formula was used for estimating Glomerular Filtration Rate (eGFR),and Logistic Regression method was used to analyze the risk factors.Results The average eGFR was 91 ml/min · 1.73 m2 and the attack rate of people with eGFR ＜60 ml/min 1.73 m2 was 10.56％.The difference of renal function in participants with different age and gender was significant(x2 =6.306,P =0.012;x2 =269.293,P ＜ 0.001).Renal function in male patients and older patients was more worse.Multivariate analysis showed that long duration of diabetes,high levels of low density lipoprotein (LDL),total cholesterol (TC) and triglycerides (TG),uncontrolled blood glucose were independent risk factors for renal dysfunction.Conclusions Patients with T2DM are susceptible to renal function abnormalities.Comprehensively control of blood glucose,blood lipid and blood pressure should be performed to decrease the risk of the disease.

Objective To explore the clinical features of type 2 diabetic patients with hypertension , and to analyze the influencing factors of glycemic control. Methods Using stratified cluster random sampling method, 5 communities were selected from urban areas of Huai'an in 2014. Type 2 diabetic patients managed by the communities were surveyed with questionnaire, physical and biochemical examinations. The related information and clinical features were compared between diabetic patients with and without hypertension. Logistic regression analysis was used to analyze the influencing factors of glycemic control. Results The number of well-controlled diabetic patients (HbA1c<7.0%) with and without hypertension (HbA1c<7.0%) were 419 (39.3%) and 480 (52.1%), respectively. Mean values of body mass index (BMI), diabetic duration and serum creatinine in diabetic patients with hypertension were significantly higher than those in diabetic patients without hypertension (P<0.05). The proportions of macrovascular complications and dyslipidemia in diabetic patients with hypertension were significantly higher than diabetic patients without hypertension (P<0.05). Multiple logistic regression analysis showed that high degree of education, high annual family income and high frequency of glucose monitoring were beneficial factors for glycemic control in diabetic patients with hypertension. Older age, hypertension, higher waist to hip ratio (WHR), the elevated triglyceride and serum creatinine were harmful factors for glycemic control. Conclusions The situation of glycemic control in diabetic patients with hypertension in urban areas of Huai'an is not optimistic. Therefore, community managements of risk factors such as central obesity and increased triglyceride in elder diabetic patients should be strengthened.

Objective To study early treatment strategy for brain hernia combined with hemorrhagic shock and the effect on prognosis of patients with severe head injury.Methods 252 cases of patients with severe head inju-ry and brain hernia combined with hemorrhagic shock in the mergency intensive care unit were divided into the obser-vation group and control group according to the stochastic indicator method,each group in 126 cases.The two group were treated with early treatment strategy and traditional treatment mode,respectively.The advantages and effect of two modes were analyzed.Results The majority of patients had united injury,such as soft tissue injuries,pelvis and spine fractures.There were 136 cases of patients with mild brain hernia and the rate of patients with hemorrhagic shock was 62.30%(157/252).The mortality was 34.13% in the observation group and 48.41% in the control group.There was significant difference(χ2 =5.306,P=0.021).The ratio of patinents with mild disability was 56.35%(71/126) in the observation group and the control group was 35.71%(45/126).The severe disability,vegetative state and death was 43.65%(55/126) in the observation group after the follow-up of 6 months.It was significantly lower than that of the control group(χ2 =5.306,P=0.001).Conclusion The early strategy treatment has a positive effect on reducing the mortality of brain hernia combined with hemorrhagic shock of patients with severe head injury the GOS for the prognosis disability increases significantly.

Air Pollution, Indoor ; analysis ; prevention & control ; Benzene ; analysis ; Housing ; standards ; Humans

OBJECTIVE: Through preoperative temporary balloon occlusion of internal carotid artery and monitoring of carotid artery stump pressure variation, in order to further predict the risk of carotid artery ligation and resection, evaluation operative risk and provides the reference for the choice of surgical approach. METHOD: Continuous monitoring and recording the carotid artery stump return pressure,before clamping and in the process of blocking, close observation the patients mental state and the nervous systemof all kinds of signs, in the process of blocking, to understand the dynamic change of stump artery pressure return in patients and whether can the smooth passage of carotid artery balloon occlusion test. RESULT: Of the 19 patients, 4 cases were positive, 15 negative cases, Blocking immediate the positive patients and negative patients with stump pressure drop was (57. 35 ± 1. 89) % and (38. 99 ± 12. 23) %, with statistical significance between the two, in the process of blocking, the mean stump pressure of the positive patients and the negative patients was (37. 29 ± 3. 15) mmHg and (61. 36 ± 14. 69) mmHg, with statistical significance between the two. CONCLUSION Approximately 21. 05% of patients can not tolerate carotid artery balloon occlusion test, theory for carotid artery reconstruction operation. After blocking the stump pressure is less than 40. 44 mmHg, the theory for reconstruction of the internal carotid artery operation. Blocking instant artery stump pressure dropped more than 55. 46%, in theory the need for internal carotid artery reconstruction.
Balloon Occlusion ; Blood Pressure ; Carotid Artery, Internal ; surgery ; Feasibility Studies ; Humans ; Ligation ; Preoperative Care ; Risk Assessment ; Vascular Surgical Procedures

OBJECTIVETo study the effect of the sphingosine kinase 1 (SphK1) inhibitor N,N-dimethylsphingosine (DMS) in combination with chemotherapeutic drugs (DDP, 5-Fu, MMC) on the proliferation of gastric cancer cells (SGC7901) in vitro, and to evaluate whether SphK1 inhibitors could be used as synergetic agents in chemotherapy.

METHODSSGC7901 cells were incubated in vitro with DMS (1 micromol/L) and 5-Fu, DDP, MMC at different concentrations in combination or separately for 24 h. The effects on the growth and survival of SGC7901 cells were determined by MTT assay. The inhibition rates were assessed by response surface analysis and the interactive relationships between the combined drugs were evaluated on the basis of positive/negative values of the cross product coefficients in the response surface equation.

RESULTSThe growth inhibition rate of the gastric cancer cells by treatment with DMS (1 micromol/L) was (10.23 +/- 0.74)%. The growth inhibition rates of the gastric cancer cells treated with 5-Fu (1, 5 and 25 microg/ml) for 24 h were (9.95 +/- 3.24)%, (21.04 +/- 2.19)%, and (45.49 +/- 3.60)%, respectively. The growth inhibition rates of the gastric cancer cells treated with DDP (0.5, 2.5 and 12.5 microg/ml) for 24 h were (9.38 +/- 0.79)%, (19.61 +/- 0.90)%, and (29.83 +/- 0.54)%, respectively. The growth inhibition rates of the gastric cancer cells treated with MMC (0.1, 0.5 and 2.5 microg/ml) for 24 h were (15.35 +/- 0.77)%, (24.72 +/- 0.83)%, and (30.68 +/- 0.28)%, respectively. There were significant differences among the inhibition rates caused by different concentrations of the drugs (P < 0.05). When 1 micromol/L DMS was used in combination with 5-Fu (1, 5, and 25 microg/ml) for 24 h, the growth inhibition rates of the cancer cells were (16.76 +/- 0.41)%, (27.28 +/- 0.29)% and (52.56 +/- 3.60)%, respectively. When 1 micromol/L DMS was used in combination with DDP (0.5, 2.5, and 12.5 microg/ml) for 24 h, the growth inhibition rates of the cancer cells were (15.35 +/- 0.86)%, (25.57 +/- 0.27)%, (36.37 +/- 0.51)%, respectively. When 1 micromol/L DMS was used in combination with MMC (0.1, 0.5, and 2.5 microg/ml) for 24 h, the growth inhibition rates of the cancer cells were (21.02 +/- 0.28)%, (32.10 +/- 0.27)%, (36.36 +/- 0.28)%, respectively. There were also significant differences among the growth inhibition rates caused by different concentrations of the drugs alone and in combination groups (P < 0.05).

CONCLUSIONSDMS can suppress the proliferation of SGC7901 cells in vitro, and there are evident synergetic effects when it is used in combination with chemotherapeutic drugs. The results of this study indicate that SphK1 inhibitors may become novel and promising chemotherapeutic sensitizers.

Antibiotics, Antineoplastic ; pharmacology ; Antimetabolites, Antineoplastic ; pharmacology ; Antineoplastic Agents ; pharmacology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cisplatin ; pharmacology ; Drug Synergism ; Enzyme Inhibitors ; pharmacology ; Fluorouracil ; pharmacology ; Humans ; Mitomycin ; pharmacology ; Phosphotransferases (Alcohol Group Acceptor) ; antagonists & inhibitors ; Sphingosine ; analogs & derivatives ; pharmacology ; Stomach Neoplasms ; pathology

The electrospray ionization-ion mobility spectrometric (ESI-IMS) technique has the potential as an analytical separation tool in analyzing polypeptides and amino acids for fast screening unknown samples in anti-chemical and biological terror attacks. A method for detecting several polypeptides and amino acids was developed based on ESI-IMS using air as drift gas at room temperature. The ion mobility of four amino acids and two polypeptides dissolved in methanol was determined on the system at elution rate of 2 mL/ min. The spectra of these compounds had characteristics of finger-printing maps. The limit of detection of this instrument for Substance P could reach 855 ng / mL in 1 min. The results showed that a small, self-contained ESI-IMS instrument with reservoirs of air could be used to quickly detect and accurately identify polypeptides and amino acids.

Objective To investigate the clinical and imaging features of patients with Alzheimer' s disease (AD) and vascular dementia (VaD) and find an effective method to make differential diagnosis between the 2 entities. Methods One hundred and sixty-two patients with dementia,admitted to our hospital from August 2006 to June 2011, and 42 patients with dementia found from community epidemiological survey were chosen in our study; their clinical data were retrospectively collected and analyzed; in these patients,114 patients were with AD and 90 patients were with VaD.Mini Mental State Examination (MMSE) was performed on these patients and the cognitive competence,behavioral symptoms and imaging data of these patients were analyzed and compared. Results More female,higher education level and longer course of disease in patients with AD were noted as compared with those in patients with VaD (P＜0.05); the scores of attention and calculation in patients with VaD were obviously lower than those in patients with AD (P＜0.05); the scores of short-term memory,retelling and reading comprehension in patients with VaD were obviously higher than those in patients with AD (P＜0.05); the happening of repeated convergence behavior in patients with AD was much more often than that in patients with VaD (P＜0.05); patients with AD had higher ratio of shrinking hippocampus than patients with VaD, and the incidence of vascular disease in the brain of patients with VaD was significantly higher than that of patients with AD (P＜0.05). Conclusion Substantial differences on clinical and imaging features exist in AD and VaD patients,which can be attributed to the differences of lesion nature and distribution,as well as the underlying pathophysiological procedures of each disease.

The cAMP-responsive element binding protein (CREB)-regulated transcription coactivator, CRTC (also known as transducer of regulated CREB, TORC), is identified as a potent modulator of cAMP response element (CRE)-driven gene transcription. The CRTC family consists of three members (CRTC1-3), among which the CRTC1 shows the highest expression in the brain. Several studies have demonstrated that the CRTC1 plays critical roles in neuronal dendritic growth, long-term synaptic plasticity, memory consolidation and reconsolidation etc., whereas dysfunction of CRTC1 is mainly involved in neurodegenerative disorders. In light of these findings, we aim to review recent research reports that indicate the CRTC1 dysfunction and its underlying mechanisms in the neurodegenerative disorders.
Brain ; physiology ; Dendrites ; physiology ; Humans ; Neurodegenerative Diseases ; physiopathology ; Neuronal Plasticity ; Transcription Factors ; physiology