Adult ; Brain Hemorrhage, Traumatic ; diagnosis ; etiology ; Humans ; Male ; Neck Injuries ; complications ; diagnosis ; Vertebral Artery

OBJECTIVE: To observe the time-course expression of zonula occludens-1 (ZO-1) in cerebral cortex after traumatic brain injury (TBI). METHODS: The TBI model of mouse was established. The mice were divided in 1 h, 3 h, 6 h, 12 h, 24 h, 3 d, 7 d after TBI, sham and control groups. The permeability of the blood brain barrier was evaluated by measuring the extravasation of Evans blue (EB) dye. The expression of ZO-1 in cerebral cortex in the injured area was detected by Western blotting and immunohistochemistry. RESULTS: The extravasation of EB dye of injured cortex gradually increased from 1 h, peaked at 1-3 d and approximately decreased to normal at 7 d after TBI. Western blotting revealed that the expression of ZO-1 gradually decreased after 1 h, was at the lowest at 1-3 d, and then significantly increased after 7 d but was still lower than that of normal and sham groups. The result of immunohistochemistry showed that ZO-1 had strong expression in vessel of normal cortex, gradually decreased after TBI, and almost disappeared at 3 d after TBI and gradually recovered to normal level later. CONCLUSION The expression of ZO-1 in the injured cortex after TBI initially decreases and then increases. The negative correlation between ZO-1 expression and EB extravasation after TBI could be used as a new indicator for wound age estimation.
Animals ; Blood-Brain Barrier ; Blotting, Western ; Brain Injuries/physiopathology* ; Cerebral Cortex/metabolism* ; Immunohistochemistry ; Mice ; Permeability ; Tight Junctions/metabolism* ; Zonula Occludens-1 Protein/metabolism*

Objective To evaluate the effects and safety of closed tracheal suction system(CTSS)versus open tracheal suction system (OTSS) for mechanically ventilated patients.Methods All randomized controlled trials (RCTs) comparing CTSS with OTSS for mechanically ventilated patients home and abroad were identified via manual and computer retrieval.All related data were extracted.Meta analysis was conducted using the statistical software RevMan 5.1 on the basis of strict quality evaluation with the methods recommended by the Cochrane Collaboration.Results Fifty-one related papers were found and 12 RCTs involving 1205 patients in CTSS group and 1179 patients in OTSS group were included.The results of meta analysis showed that CTSS was associated with a significant reduction in the duration of mechanical ventilation (WMD =-0.73,95％ CI-1.07--0.40,P＜0.0001),but the incidence of ventilator associated pneumonia and microbial colonization,mortality and length of ICU stay exhibited no difference between the two groups (P ＞ 0.05).However,compared with OTSS,CTSS reduced the incidence of arrhythmia (RR =0.23,95％ CI 0.07-0.74,P =0.01) and minimized the disturbance to heart rate (WMD =-1.97,95％ CI-3.03--0.91,P =0.0003),mean arterial pressure (WMD =-2.01,95％ CI-3.02--1.01,P ＜ 0.0001) and oxygen saturation (SpO2) (WMD =-1.00,95％ CI-1.14--0.86,P ＜ 0.000 01).Conclusions Compared with OTSS,CTSS could reduce disturbance to respiratory and circulatory system by sputum suction and shorten the duration of mechanical ventilation.However,CTSS has no advantage in prevention of ventilator associated pneumonia or microbial colonization,nor does it shorten the length of ICU stay or improve the outcome of mechanically ventilated patients.

Objective To observe the intervention with electroacupuncture(EA) through regulating protein kinase(MAPK/ERK) pathway for cerebral ischemia rats.Methods SD rats were randomized into pseudo-operation group,model group and EA group.And the three groups were divided into 2-hour,one-day and 3-day subgroups according to the observation time.Focal cerebral ischemia(FCI) rat models were established by middle cerebral artery occlusion(MCAO) with heat-coagulation method.EA group received EA on Baihui(GV20) and Dazhui(GV14),qd,for 2 hours,one day and 3 days respectively.The learning and memory abilities of the rats in Y maze test and their neuroethological score were observed.Immunohistochemical method was used to observe the expression of phosphorylated extracellular signal-regulated kinase(p-ERK) after ischemia in CA1 area and CA3 area.Results In the model group,the neuroethological score was markedly increased,time for arriving the safe area in Y maze was prolonged(P

?AIM:To study the changes of ocular surface in cataract patients with Meibomian gland dysfunction ( MGD) who treated with Meibomian gland massage before surgery.?METHODS: Totally 90 patients ( 93 eyes ) with cataract and MGD were randomly divided into two groups. Patients in experimental group were treated with hot compress and Meibomian gland massage every day before surgery, while the patients in the control group were not taken. Two groups of patients received phacoemulsification combined with intraocular lens implantation. Lid margin abnormalities, secretion characteristics, Schimer I test ( SⅠt) and tear film break-up time ( BUT ) were recorded and compared between two groups using slit lamp microscope inspection preoperatively and postoperatively 1wk.?RESULTS:In the control group, the postoperative score of eyelid margin and Meibomian gland secretion was increased significantly than preoperative, while the value of BUT and SⅠt was down significantly. Compared with control group, the postoperative score of eyelid margin shape and Meibomian gland secretion in the experimental group was decreased significantly, while the value of BUT and SIT improved significantly (P<0. 05).?CONCLUSION: Phacoemulsification can aggravate the Meibomian gland dysfunction and have some extent of effects on the ocular surface. Meibomian gland massage before surgery can significantly improve the function of Meibomian gland and the state of ocular surface in patients with MDG.

Animals ; Drugs, Chinese Herbal ; pharmacology ; Erythroid Precursor Cells ; drug effects ; Female ; Hematopoietic Stem Cells ; drug effects ; Mice ; Radiation Injuries, Experimental ; drug therapy ; pathology ; Salvia miltiorrhiza

Objective To systematically review the efficacy of dexmedetomidine or midazolam for sedation in critically ill patients. Methods We searched the PubMed, EMBaes, Cochrane Library, Wanfang Database,CNKI and VIP for all randomized controlled trials (RCTs) about the efficacy of dexmedetomidine versus midazolam for sedation in severe cases. The quality of the studies was evaluated by the method recommended by Cochrane Collaboration. Meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.0 software. Results Six RCTs involving 613 patients were included in our Meta-analysis. The results of Meta-analysis showed that the length of ICU stay was significantly shorter in group dexmedetomidine than in group midazolam. There were no significant differences in the duration of mechanical ventilation, incidences of bradycardia, hypotension and delirium and mortality rate between the two groups. Conclusion Dexmedetomidin can shorten the length of ICU stay and is beneficial for the outcome in critically ill patients.

PurposeAs a main method to detect thyroid nodules, ultrasonography seems to have a rather low accuracy in differentiating benign and malignant ones. The present study aims to explore the diagnostic value of thyroid imaging reporting and data system (TI-RADS) in identifying benign and malignant thyroid nodules.Materials and Methods A total of 168 patients with thyroid nodules conifrmed pathologically (with 251 suspicious nodules) underwent ultrasonography and were further grouped into category 3-5 according to TI-RADS classiifcation standard. The results were retrospectively compared with histopathological ifndings. The sensitivity, speciifcity, accuracy, positive predictive value and negative predictive value of TI-RADS classiifcation in the diagnosis of benign and malignant thyroid nodules were calculated, and the differences in ultrasonic features between benign and malignant thyroid nodules were also compared.Results The surgical and pathological findings showed that 94 nodules were benign and 157 were sinister; TI-RADS regarded 93 nodules were benign and 185 were malignant. The difference of the two means of identification was significant (χ2=149.6,P<0.01). The sensitivity, speciifcity, accuracy, positive predictive value and negative predictive value of TI-RADS were 91.2% (144/157), 85.1% (80/94), 89.3% (224/251), 91.2% (144/158) and 86.0% (80/93), respectively. The ultrasonic manifestations of benign and malignant nodules were signiifcantly different with regard to aspect ratio, echogenicity, shape, calciifcation inside the nodule (χ2=8.7-121.4,P<0.01).Conclusion TI-RADS classiifcation standards have a high accuracy in the differentiation of benign and malignant thyroid nodules as a means of ultrasound examination, and thus can serve as an important guiding method in clinical diagnosis and treatment.

Objective To compare the short-term efficacy of high-intensity ultraviolet B (UVB) versus 308-nm excimer laser for the treatment of vitiligo.Methods Eighty patients with vitiligo were equally divided into two groups to be treated with high-intensity UVB twice a week or 308-nm excimer laser once a week for eight weeks.Repigmentation was evaluated at the end of the treatment.Results After eight weeks of treatment,repigmentation of different degrees was observed in 83.6％ and 86.1％,and marked repigmentation in 42.1％ and 50％,of the UVB-and excimer laser-treated lesions,respectively.The response rate was significantly lower in facial lesions receiving high-intensity UVB radiation than in those receiving excimer laser radiation (49.1％ vs.68.4％,x2 =4.32,P ＜ 0.05),but similar at the other body sites between the two treatment (all P ＞ 0.05).The cumulative dosage required for initial repigmentation was similar between high-intensity UVB and 308-nm excimer laser (t =0.89,P ＞ 0.05),while the treatment sessions and cumulative dosage required for marked or better repigmentation were significantly increased in UVB-compared with excimer laser-treated lesions (both P ＜ 0.01).In addition,both high-intensity UVB and 308-nm excimer laser were suitable for childhood and active vitiligo.Conclusions Both high-intensity UVB and 308-nm excimer laser are safe and effective in the treatment of vitiligo with rapid onset of action,and the latter appears to be superior to the former in efficacy.

Objective To investigate the relationship between inflammatory factors,including C-reactive protein( CRP),tumor necrosis factor alpha (TNF-α),adiponectin,leptin and gestational diabetes mellitus (GDM) and their changes in puerperiunr Methods From June 2008 to May 2010,40 cases with gestational diabetes mellitus,40 cases of normal pregnancy were enrolled in this study.Fasting venous blood were obtained at early pregnancy (10 - 12 weeks),late pregnancy (36 -38 weeks) and day 3 and 42 of postpartum.Serumal adiponectin,leptin and TNF-α were measured by ELISA,and serumal CRP were measured by particle enhanced immunoturbidimetric method.The levels of those 4 cytokines and homeostasis model assessment insulin resistance (HOMA-IR) index were compared between two groups.And the changes of 4 cytokines were calculated in puerperium.The receiver operating characteristic (ROC) for TNF-α predicting GDM was designed.Results ( 1 ) The relationship between cytokines and HOMA-IR:the levels of adiponectin of (5.7 ± 1.8 ) mg/L in the GDM group were significantly lower than ( 8.1 ± 2.7 ) mg/L in control group in early pregnancy,and the level of adiponectin was negatively correlated with HOMA-IR (r=-0.333,P＜0.05).The levels of (28 ± 10) μg/L of leptin,( 10.0 ±3.4) ng/L of TNF-α and (4.7 ± 1.1 ) mg/L of CRP in GDM group were significantly higher than ( 20 ± 8 ) μ,g/L of leptin,(4.6 ±2.7) ng/L of TNF-α,(2.4 ± 1.2 ) mg/L of CRP in control group,which were positively correlated with HOMA-IR ( r =0.411,0.529,0.308,all P ＜ 0.05 ).In late pregnancy,the level of adiponectin ( 3.9 ±2.2) mg/L in the GDM group was significantly lower than ( 6.6 ± 2.7 ) mg/L in control group,and the level of adiponectin was negatively correlated with HOMA-IR ( r =- 0.344,P ＜ 0.05 ).The levels of ( 37 ±13) μg/L of leptin,( 12.7 ±2.6) ng/L of TNF-α and (6.7 ±3.6) mg/L of CRP in the GDM group were significantly higher than ( 30 ± 13 ) μg/L of leptin,(5.8 ± 2.1 ) ng/L of TNF-α,( 4.4 ± 3.1 ) mg/L of CRP in control group,which were positively correlated with HOMA-IR (r =0.414,0.487,0.285,all P ＜0.05).Multiple linear regression analysis showed that the level of TNF-α at early and late pregnancy was most correlated with HOMA-IR ( r =0.390,0.284,all P ＜ 0.05 ).( 2 ) The level of the cytokines and HOMA-IR in puerperium:at day 3 of postpartum,the level of adiponectin of (3.3 ± 1.1) mg/L in the GDM group was significantly lower than (6.2 ± 1.5 ) mg/L in control group,which was negatively correlated with HOMA-1R (r =- 0.283,P ＜ 0.05 ).The levels of ( 31 ± 13 ) μg/L of leptin,( 10.1 ± 5.7 ) ng/L of TNF-α and (35.1 ±6.5) mg/L of CRP in the GDM group were significantly higher than (21 ± 15) μg/L of leptin,(5.6 ± 3.0) ng/L of TNF-α,(30.5 ± 8.5) mg/L of CRP in control group.And leptin and TNF-α levels were positively correlated with HOMA-IR (r=0.372,0.494,all P ＜0.05).At day 42 of postpartum,the level of adiponectin in GDM group was negatively correlated with HOMA-IR ( r =- 0.299,P ＜ 0.05 ),and the levels of leptin and TNF-α were positively correlated with HOMA-IR ( r =0.401,0.442,all P ＜0.05 ).Multiple linear regression analysis showed that the level of TNF-αt at day 3 and day 42 was most correlated with HOMA-IR ( r =0.363,0.274,all P ＜ 0.05 ).( 3 ) ROC analysis of data from early pregnancy showed that the threshold for TNF-α to predict GDM was 5.45 ug/L.Conclusion TNF-ot might be the index to predict GDM and evaluate prognosis.