0.05).The effects of SCS on augmentation of CBF were significantly inhibited in V 1+SCG group.Conclusion SCS-induced CBF augmentation may be realized by both parasympathetic and sympathetic pathways.

Since Hosobuchi first found that spinal cord stimulation had the effect of significantly increasing cerebral blood flow (CBF) more than two decades ago, spinal cord stimulation had attracted wide attention in the field of treating cerebral ischemia. A large number of animal and clinical studies have been performed in this field, which make it another research focus following thrombolysis and interventional therapy. This article reviews the research history, mechanisms, and current status of clinical applications of spinal cord stimulation in cerebral ischemia protection.

Objective:To investigate the predictive value of serum thyroid hormone in the short-term prognosis of patients with septic shock..Methods:The 133 patients with septic shock admitted to Intensive Care Unit (ICU) of Nanjing Hospital of Nanjing Medical University were enrolled. Data of patient’s general clinical information, acute physiology and chronic health evaluationⅡ (APACHE Ⅱ), serum triiodothyronine ( T3 ), thyroxine (T4), free triiodothyronine (FT3) , free thyroxine (FT4) and thyroid stimulating hormone(TSH) in 24 h were collected, and the ratio of T3 to FT3 (T3/FT3) was calculated. The patients were divided into the survival group and death group according to the prognosis during ICU hospitalization. Univariate and multivariate analyses were used to analyze the prognostic factors of patients with septic shock. The receiver operating characteristic (ROC) curve and Kaplan-Meier analysis were plotted to evaluate the diagnostic efficacy of serum thyroid hormone for the short-term prognosis of patients with septic shock.Results:Compared to the survival group, FT3, T3 and T3/FT3 were significantly lower in the death group [1.73 (1.54, 2.52) vs. 1.32 (0.94, 1.54) pmol/L, 0.70 (0.56, 0.79) vs. 0.33 (0.25, 0.43) nmol/L, 318.18(299.44, 448.05) vs. 250.00 (192.31, 313.92), respectively; all P < 0.05 ]. The levels of serum T3 and FT3 were significantly correlated with the APACHEⅡ score in patients with septic shock (FT3: r = -0.25, P= 0.004; T3: r = - 0.24, P= 0.006). Binary Logistic regression analysis showed that FT3, T3 and T3/FT3 were independent risk factors of the short-term prognosis of patients with septic shock [FT3: OR = 6.533, 95% CI: 0.687 - 62.157, P = 0.012; T3: OR = 0.529, 95% CI: 0.372 - 0.975, P= 0.000; T3/FT3: OR = 1.719, 95% CI: 1.007 - 1.931, P= 0.002]. ROC curve analysis showed that FT3, T3 and T3/FT3 all had certain predictive value for the short-term prognosis of patients with septic shock, and the diagnostic value of T3 was the largest [AUC = 0.874, 95% CI: 0.794-0.954, P= 0.000]. The Kaplan-Meier curve showed a significantly higher survival rate in patients with T3 greater than 0.535 nmol/L than patients with T3 less than 0.535 nmol/L. Conclusions:The serum levels of thyroid hormone T3 and FT3 are closely related to the severity of septic shock. T3 is an effective ICU mortality during hospitalization prognostic indicator for patients with septic shock, which is better than FT3 and T3/FT3.

Objective:To investigate the predictive value of different glycemic variability indexes within 6 hours on the short-term prognosis of septic shock patients.Methods:A retrospective study was conducted. The 133 patients with septic shock admitted to intensive care unit (ICU) of Nanjing Hospital Affiliated to Nanjing Medical University from December 2014 to December 2019 were enrolled. Patients with septic shock admitted to ICU died during hospitalization were enrolled in the death group and others in the survival group. General data of the patients including gender, age, underlying disease, site of infection, duration of mechanical ventilation, length of ICU stay, whether to use continuous renal replacement therapy (CRRT) and acute physiology and chronic health evaluationⅡ (APACHEⅡ) scores within 24 hours were collected. The blood glucose (GLUadm), mean arterial pressure (MAP), serum creatinine (SCr) and procalcitonin (PCT) were recorded at ICU admission. The patients admitted to ICU received bundle therapy within 6 hours and blood glucose was observed every 2 hours. The blood glucose difference (GLUdif), average blood glucose (GLUave), blood glucose standard deviation (GLUsd) and blood glucose variation coefficient (GLUcv) within 6 hours were calculated. Multivariate Logistic regression analysis was used to analyze the prognostic factors of short-term prognosis of patients with septic shock, and receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic efficacy of glycemic parameters for short-term prognosis of septic shock patients.Results:A total of 133 patients with septic shock were admitted to ICU, among them 87 patients survived and 46 patients died during the ICU hospitalization. Compared with the survival group, the SCr at ICU admission and APACHEⅡ score within 24 hours were significantly higher in the death group [SCr (μmol/L): 208.5 (143.0, 286.5) vs. 172.0 (91.0, 234.0), APACHEⅡ score: 30.28±6.67 vs. 24.03±5.90, both P < 0.05], the length of ICU stay was shorter [days: 4.00 (2.00, 10.25) vs. 9.00 (4.00, 13.00), P < 0.01]. However, there were no significant differences in the baseline data of gender, age, underlying disease, infection site, CRRT ratio, MAP or PCT at ICU admission between the two groups. Compared with the survival group, the GLUsd and GLUcv within 6 hours in the death group were higher [GLUsd (mmol/L): 2.33 (1.95, 3.14) vs. 2.02 (1.66, 2.52), GLUcv: (31.00±7.06)% vs. (23.31±10.51)%, both P < 0.05]. There were no statistically significant differences in the levels of GLUadm, GLUdif or GLUave within 6 hours between the two groups. Multivariate Logistic regression analysis showed that APACHEⅡ score within 24 hours and GLUsd and GLUcv within 6 hours were independent risk factors of the short-term prognosis of septic shock patients [APACHEⅡ score: odds ratio ( OR) = 1.173, 95% confidence interval (95% CI) was 1.095-1.256, P = 0.000; GLUsd: OR = 1.465, 95% CI was 1.038-2.067, P = 0.030; GLUcv: OR = 1.089, 95% CI was 1.043-1.138, P = 0.000]. ROC curve analysis showed that GLUsd and GLUcv within 6 hours both had certain predictive value for the short-term prognosis of septic shock patients, the area under ROC curve (AUC) of GLUcv within 6 hours was higher than that of APACHEⅡ score (0.765 vs. 0.753), and AUC of GLUsd within 6 hours was close to APACHEⅡ score (0.629 vs. 0.753); and the diagnostic value of GLUsd combined with GLUcv within 6 hours was higher than the two respectively (AUC: 0.809 vs. 0.629, 0.765), the sensitivity was 97.8%, and the specificity was 66.7%. Conclusion:GLUsd combined with GLUcv within 6 hours can be used to estimate the short-term prognosis of septic shock patients.

Humans ; Infant ; Lymphohistiocytosis, Hemophagocytic ; complications ; genetics ; pathology ; Male ; Thymus Gland ; abnormalities

ObjectiveTo investigate and compare the efficacy, safety, and cost effectiveness in the treatment of painful osteoporotic vertebral compression fractures ( OVCFs ) with percutaneous vertebroplasty (PVP) and kyphoplasty(PKP). MethodsSeventy-two patients (96 vertebrae) with painful OVCFs were treated by PVP (n ＝34) or PKP (n ＝38) under radiological monitoring. After bone biopsy needle into the compressed vertebra, bone cement (polymethylmethacrylate) was injected in PVP group, and that was inserted followed by the inflation of vertebra to create cavities in PKP group. The fluoroscopy time, total amount of bone cement injected, and cost were recollected respectively. The score of visual analogue scale point( VAS, 10-point scale)was determined at before the procedures, and 24 hours, one week, and one month after the procedures.Pain relief and complications were observed.The Cobb angle and vertebral heights of the anterior, middle, and posterior border were measured pre-and post-operative. ResultsThe two procedures were technically successful in all patients. The follow-up ranged from 1. 0 to 34. 0 months [mean time, (8. 9 ±3.2) months]. The Mean fluoroscopy time of treating per vertebra in PVP group was ( 11. 1 ± 10. 6 ) min, which was significant shorter than that ( 23.5 ± 13. 0) min in PKP group( P ＜0. 05 ).The mean total cost per patient was (5127. 2 ± 502.3 ) yuan in PVP group, which were strikingly lower than that(32 301.4 ±3204. 6) yuan in PKP group (P ＜0. 05).(3)There was no significant difference( P ＞0. 05 ) in average cement volumes in PVP group [ (4. 9 ± 1.1 ) ml]and PKP group [ (5.4 ± 1.7 ) ml]. Pain relief of was observed in 94. 1％ (32/34) of PVP group and in 92. 1％ (35/38) of PKP group. The score of VAS at pre-operation was (8. 3 ±0. 4 vs 7.9 ±0. 8) ,and at post-operative 24 h (2. 9 ±0. 9 vs 2. 8 ± 1. 2),1 week (2.6 ± 0. 9 vs 2.6 ± 1. 1 ), and 1 month (2.6 ± 0. 9 vs 2. 5 ± 1.3 ) were no difference at PKP and PVP group(P ＜0.05). There was significant difference between pre- and post-operative time point in each group. The Cobb angle, anterior and middle height of vertebra was corrected in both PVP and PKP group. In PVP group, the preoperative Cobb angle, anterior and middle height of vertebra was (24. 2 ± 3.8 )°,( 19. 1 ± 1.4) mm, (25. 2 ± 1.0) mm, which was significant different ( P ＜ 0. 05 ) from that of ( 19.4 ±3.9)°, (21.0 ± 1.5) mm, (27.0 ± 1.2) mm at pre-operation.In PKP group,there was significant difference (P ＜ 0. 05 ) in the preoperative Cobb angle, anterior and middle height of vertebra [(25. 1 ±5.0)°vs(10.7 ±2.8)°, (19.5 ± 1.5) mm vs (24.3 ± 1.9) mm, (25.4 ± 1.1) mm vs (29.7 ±1.3) mm, respectively]. As to the above index, the overall correcting effect in PKP was much better than that in PVP( P ＜0. 05 ). Cement leakage occurred in 9 cases in PVP group and 3 cases in PKP group ( P ＜0. 05 ) but no symptoms. There were no major complications during operation in the two groups. Conclusion PVP and PKP are effective and safe in the treatment of painful OVCFs but PVP is more cost effective than PKP.

Objective To investigate the relationship between glucose excursion and cognitive function in aged type 2 diabetes. Methods A total of 248 aged type 2 diabetes were recruited in this study,all of them wore continuous glucose monitoring system (CGMS) for 3 d to evaluate the glucose excursion including mean amplitude of glycemic excursions (MAGE) which was used for assessing intra-day glycemia variability,and mean daily difference (MODD) which represented day-to-day glycemic variability.During the period of CGMS monitoring,all subjects accepted mini mental status examination (MMSE) for evaluating cognitive function.The relationships of MAGE and MODD with performance on cognitive tests were assessed. Results The over intra-day glucose excursion group had lower MMSE score than the narrow intra-day glucose excursion group[(24.25±6.75)vs.(25.97±0.47),P=0.025].The MMSE score was decreased in over day-to-day glucose excursion group compared with the narrow day-to-day glucose excursion group [(24.21 ± 6.47) vs. (26.01 ± 5.49),P =0.019]. A statistically significant association was observed between MAGE and the score of MMSE(r=- 0.308,P＜0.001),and between MODD and MMSE(r=-0.226,P =0.001).Conclusions Glucose excursion may affect cognitive function in aged type 2 diabetes.The over glucose excursion decreases the score of MMSE.

A rare strain of actinomycetes, with broad-spectrum antimicrobial activity, was isolated from the soil samples from the farmland in the area of Yaohu lake in Nanchang. The information about the taxonomic identification, such as the morphology, physiological properties, cell components and 16S rRNA gene se-quences, suggested that the rare strain of actinomycetes was identified as Micromonospora carbonacea.

Based on the strain of Micromonospora carbonacea JXNU-1 with board-spectrum antimicrobial activity, the technology for the isolation and purification of antibiotic from the fermentation broth of the Micromonospora carbonacea, and its physical-chemical properties were studied. The results showed that, the antibiotic was stable under the condition of high temperature and alkali, but not in acid solution. After the pretreatment of centrifugation and filtration to remove the cells and lipids, the antibiotic was absorbed to negative exchange resin, and the impurity was excluded when 2 mol/L NaCl was used as primary eluent. The antibiotic could be eluted with 20% alcohol as eluent, and the eluting speed of the antibiotic was greatly accelerated as 2 mol/L NaCl was added into 20% alcohol as final eluent. Aqueous solution of the antibiotic was yielded from the alcohol-salt eluant by decompression concentration to wipe off alcohol and by dialysis to exclude salt. One active component was detected in antibiotic solution by paper chromatography, and theHPLC purity was over 99%. As the antibiotic shows positive color-forming reaction to Molish reagents, Benedict’s reagents and Diohenvlamine reagents, combined with the characteristics of absorption spectra, it is deduced that the antibiotic belongs to nucleoside antibiotics.

Objective To investigate the curriculum construction and evaluation of teaching effectiveness of simulation and comprehensive experiment for clinical nursing. Methods Based on the investigation of hospital, taking working progress and working task of nurses as orientation, we constructed the curriculum of simulation and comprehensive experiment for clinical nursing, and unfold in junior class (before clinical practice) for student nurses. The teaching effect was evaluated. Results Unfolding simulation and comprehensive experiment could effectively enhance the nursing students' ability to transform theoretical knowledge into clinical nursing practice, and was favorable to change the role of nurses and improve the satisfaction degree of clinical practice.Conclusions Unfolding simulation and comprehensive experiment for clinical nursing for student nurses before clinical practice is practicable and essential.