OBJECTIVE: To investigate the effect of hyperbaric oxygen (HBO) on paroxysmal sympathetic hyperexcitation (PSH) after brain injury. METHODS: A multicenter retrospective study was conducted. Fifty-six patients with PSH who received HBO treatment from four hospitals in Henan Province from January 2021 to September 2023 were selected as the HBO group, and 36 patients with PSH who did not receive HBO treatment from Zhengzhou People's Hospital from May 2018 to December 2020 were selected as the control group. PSH assessment measure (PSH-AM) score [clinical feature scale (CFS) score+diagnostic likelihood tool (DLT) score] and Glasgow coma scale (GCS) were compared before and after HBO treatment, and between HBO group and control group to evaluate the effect of HBO treatment on prognosis of PSH patients. RESULTS: There were no statistically significant differences in age, gender, PSH etiology, GCS score, time from onset to occurrence of PSH, CFS score, CFS+DLT score and frequency of PSH episodes between the two groups, indicating comparability. The duration of HBO treatment ranged from 3 to 11 days for 56 patients receiving HBO treatment, and the duration of HBO treatment ranged from 3 to 5 courses. Compared with before treatment, after HBO treatment, PSH symptoms in HBO patients were significantly relieved (body temperature increase: 14.29% vs. 64.29%, heart rate increase: 25.00% vs. 98.21%, shortness of breath: 14.29% vs. 76.79%, blood pressure increase: 8.93% vs. 85.71%, sweating: 10.71% vs. 85.71%, muscle tone increased: 19.64% vs. 75.00%, all P < 0.05), CFS+DLT score decreased significantly (16.90±4.81 vs. 22.12±3.12, P < 0.01), GCS score improved (12.31±5.34 vs. 5.95±2.18, P < 0.01). After 30 days of hospitalization, compared with the control group, PSH symptoms in the HBO group were improved (body temperature increase: 14.29% vs. 19.44%, heart rate increase: 19.64% vs. 25.00%, shortness of breath: 10.71% vs. 27.78%, blood pressure increase: 7.14% vs. 22.22%, sweating: 8.93% vs. 25.00%, muscle tone increased: 19.64% vs. 38.89%, all P < 0.05 except body temperature increase), CFS+DLT score decreased (16.90±3.81 vs. 19.98±4.89, P < 0.05), GCS score increased (14.12±4.12 vs. 12.31±4.14, P < 0.01), the length of intensive care unit (ICU) stay was shortened (days: 18.01±5.67 vs. 24.93±8.33, P < 0.01). CONCLUSIONS HBO treatment can significantly relieve the symptoms of patients with PSH after brain injury and provide a new idea for the treatment of PSH patients.
Humans ; Hyperbaric Oxygenation/methods* ; Retrospective Studies ; Brain Injuries/therapy* ; Female ; Male ; Prognosis ; Glasgow Coma Scale ; Autonomic Nervous System Diseases/etiology*

Objective:To explore whether hyperuricemia was an independent risk factor for all-cause mortality in patients with atrial fibrillation.Methods:Patients with atrial fibrillation who were confirmed by 12-lead electrocardiogram in 11 hospitals of Kailuan Group from 2006 to 2007 were selected as the research objects.All patients were followed up by prospective cohort study, and all-cause deaths were observed.The last follow-up time was December 31, 2013.Kaplan-Meier curve and Cox proportional hazards model were used to analyze and compare the risk of all-cause mortality in patients with atrial fibrillation in the hyperuricemia group compared with the normal uric acid group.Results:A total of 388 community-based patients with atrial fibrillation were included in the final statistical analysis, with 136 all-cause deaths occurred during an average follow-up period of 6.93 years.The incidence of all-cause mortality was 9.24% per year(36/390)in the hyperuricemia group, whereas 5.16% per year(100/1 937) in the normal uric acid group.In the univariate Cox proportional risk model analysis, the risk ratio (95% CI) of all-cause death in patients with atrial fibrillation in the hyperuricemia group (95% CI) was 1.84(1.26-2.69) times that in the normal uric acid group ( P<0.01). After adjusting for potential confounding variables, the adjusted risk ratio (95% CI) of all-cause death in patients with atrial fibrillation in hyperuricemia group was still 1.94(1.32-2.85) times of that in normal uric acid group ( P<0.01). After adjustment for potential confounding variables, for each 0.01 g/L increase in uric acid (1 g/L=5 950 μmol/L), the risk of all-cause death in patients with atrial fibrillation increased by 1.15 (1.05-1.26) times ( P<0.01). Conclusion:Hyperuricemia was an independent risk factor for all-cause death in patients with atrial fibrillation in community.

Objective:To analyze problems found in the implementation of the appointment registration system at public hospitals in China under the new situation, and provide a reference for the improvement and development of the system.Methods:Documents on appointment registration system published before December 31, 2020 were collected through the databases of CNKI, Wanfang, VIP and other official websites such as the National Health Commission. The Smith-Model was used as the main analysis framework in a systematical sorting and analysis of the implementation of the appointment registration system of public hospitals, in such means as qualitative interviews with relevant managers, doctors and residents and PEST analysis method.Results:The appointment registration system of public hospitals was highly idealized in its design, but there existed policy deficiencies in system standards, implementation effectiveness and supporting systems; and there were various problems in policy cognition, acceptance and implementation with its implementation agencies and target groups. Environmental factors such as politics, laws, economy, social culture and technology also posed negative effects on the implementation of policies.Conclusions:There were still some problems in the implementation of the appointment registration system in public hospitals, such as imperfect system standards, different implementation efforts in different regions, imperfect incentive and economic compensation mechanisms, and it was difficult to change residents' traditional ideas.Targeted strategies and measures should be taken regarding the policy makers, health administrative departments, business institutions, patients and environmental factors to ensure the continuous and effective implementation of the system in the future.

Objective To determine the reproductive physiology and blood physiological and biochemical characteristics of SPF Yorkshire and Landrace swine.Methods Ten reproductive physiology parameters,19 blood physiological parameters and 18 blood biochemical parameters in SPF Yorkshire and Landrace swine were measured using conventional methods and the differences between population,between age groups and between both sexes were analyzed.Results There were no significant differences(P>0.05) in reproductive physiology parameters and most blood physiological and biochemical parameters of the SPF Yorkshire and Landrace swine.A few of parameters,such as blood physiological indices GRAN,HGB,RDW,PLT,PCT,and blood biochemical indices ALKP,CHOL,TBIL,BUN,showed significant difference(P<0.05) between populations,between age groups and between both sexes,however,the values of difference were rather small,deviated from the normal range.Conclusion The physiological and biochemical characteristics of SPF Yorkshire and Landrace swine are basically stable and there is no significant difference compared with other laboratory miniature pigs.This study will provide valuable basic data for raising velvet yield,establishment of animal models and evaluating the genetic quality of closed colony.

Objective The aim of this study was to investigate the polymorphism of SLA class II genes in Canadian SPF Yorkshire and Landrace pigs.Methods Blood samples were obtained from 15 SPF Yorkshire and 22 Landrace pigs for isolation of peripheral blood mononuclear cells respectively, and the DQB1, DRB1 and DQA genes were amplified by PCR after reverse transcription.SLA class II genes were obtained by analyzing the direct and cloning result.The polymorphism of alleles was analyzed using the DNAsp 5.0 software.Results A total of 25 alleles were identified at three genes, including eight DQB1, ten DRB1 and seven DQA, and three alleles were submitted the complete sequences for the first time.The official allele names were assigned as SLA-DQB1*0212 (KU754590), SLA-DQB1*0203 (KU754591) and DRB1*06:07(KU754601) by the SLA Nomenclature Committee.Three novel DQA alleles were discovered.Five of the 15 amino acids, one of the 16 amino acids and 11 of the 19 amino acids, which bind processing antigens, showed well conserved among the alleles of DQB1, DRB1 and DQA genes in the SPF Yorkshire and Landrace pigs, respectively.Neighbor-joining tree showed that the three genes were divided into two clusters, respectively.There was a close relationship between SPF Yorkshire and Landrace pigs and foreign Yucatan miniature pigs, and it showed no obvious genetic distance with other pigs.Conclusions A total of 25 SLA class II alleles have been identified successfully in this study, and there are more abundant polymorphism for them.There is a widely distribution for SLA class II alleles identified in this study in other pig breeds.It is critical for the eventual future use of SPF Yorkshire and Landrace pigs as classical laboratory animal models.

Objective To investigate the correlation between vitamin E and community acquired pneumonia (CAP) .Methods A total of 128 cases of CAP(CAP group) and 135 people undergoing the healthy physical examination (excluding CAP ,control group) in our hospital from Jan .2016 to Dec .2016 were chosen .Each group was divided into the age subgroups of 0-17 years old ,18-40 years old and 41-65 years old .Vitamin E ,Chlamydia pneumoniae(CPn) and mycoplasma pneumoniae(MP) were detected in all the subjects .Then the obtained data were statistically analyzed .Results The average vitamin E was (15 .43 ± 4 .37)mg/L in the control group and (6 .37 ± 3 .24)mg/L in the CAP group ,the difference between the two group was statistically significant(P<0 .05) .In the control group ,there were 7 cases of MP positive and 6 cases of CPn positive .In the CAP group ,there were 32 cases of MP posi‐tive and 25 cases of CPn positive .The differences of MA and CPn positive between the two groups were statistically significant(P<0 .05) .The vitamin E levels in the 0 -17 years old ,18 -40 years old and 41 -65 years old subgroups of the control group were (14 .75 ± 4 .12) ,(16 .42 ± 4 .35) ,(16 .42 ± 4 .35)mg/L respectively ,while which in the various subgroups of the CAP group were (5 .43 ± 3 .18) ,(7 .74 ± 3 .65) ,(7 .74 ± 3 .65)mg/L respectively ,the difference in different age groups between the two groups was statistically significant(P<0 .05) .Conclusion Maintaining a high level of serum vitamin E level could effectively prevent CAP .

Objective To validate the value of Cleveland Clinical Score in predicting acute renal injury requiring renal replacement therapy(RRT-AKI) after cardiac valve surgery in Chinese adult patients.Methods An analysis was conducted for all the adult patients who underwent cardiac valve surgery from January 2010 to December 2014 in Changhai Hospital,Shanghai.A total of 3 230 adult patients were included.Based on Cleveland Clinical Score,the patients were divided into 3 risk stages:0 to 2 point,3 to 5 point,and 6 to 8 point.The incidence of RRT-AKI were compared between different stages.And the predictive value of the Cleveland Clinical Score model was assessed by area under the receiver operating characteristic curve(AUC-ROC) and the model calibration was assessed using the Hosmer-Lemeshow test.The patients were also divided into two groups:Non-RRT group and RRT-AKI group.The mortality were compared between these two groups.Results The incidence of RRT-AKI was 1.67％ vs the predicted ratio of RRT-AKI 1.70％ (x2 =0.018,P =0.892).Among the stage 1,2,and 3,the actual incidence of RRT-AKI,was 1.23％,2.66％,and 16.7％ vs the predicted incidence 0.40％,1.80％,and 9.50％,respectively.The AUC-ROC for Cleveland Clinical Score predicting RRT-AKI was 0.64 [95 ％ CI(0.57,0.71),P ＜0.01].Compared with Non-RRT group,the RRT-AKI group got a higher mortality(87.00％ vs 1.50％,x2 =1 330,P ＜0.01).Conclusion The Cleveland Clinical score had no real predictive value for RRT-AKI in Chinese adult patients after cardiac valve surgery.The incidence of RRT-AKI of the whole population and the stage 3 patients could be predicted by the model.And the patients with a high Cleveland score got a higher mortality than that of patients with a low Cleveland score.

Objective To explore the clinical significance of Slug expression in papillary thyroid carci-noma(PTC). Methods Employed Ventana immunohistochemistry assay to determine the expression of Slug in 107 cases of PTC and para-tumorous normal tissue. The relationship with Slug expression in PTC and clinico-pathology data were also analyzed. Results Expression of Slug in PTC (65.4%, 70/107)and para-tumorous nor-mal tissue (14.0%,15/107)were statistically different (P < 0.001). Overexpression of Slug in PTC was signifi-cantly associated with capsular invasion and lymph node metastasis (P < 0.05). Conclusion Overexpression of Slug in PTC is associated with capsular invasion and lymph node metastasis , these may suggest some clinical significance of Slug expression in PTC in predicting lymph node metastasis and prognosis.

Objective To validate the value of Simplified Renal Index Score(SRI) in predicting acute renal injury requiring renal replacement therapy(RRT-AKI) after cardiac valve surgery in Chinese adult patients.Methods An analysis was conducted for all the adult patients who underwent cardiac valve surgery from January 2010 to December 2014 in Changhai Hospital,Shanghai.A total of 3 183 adult patients were included.Based on SRI Score,the patients were divided into 3 risk stages:0 to 1 point,2 to 3 point,and 4 to 8 point.The incidence of RRT-AKI was compared between different stages.And the prediction value of the SRI model was assessed by area under the receiver operating characteristic curve (AU-ROC) and the model calibration was assessed with the Hosmer-Lemeshow (H-L) test.Results After surgery 52 (1.6％) patients developed acute kidney impairment and subsequently underwent renal replacement therapy.Patients with low values of simplified renal index (0-1),medium(2-3) and high values (4 and more) were found to have increasingly higher risk for renal replacement therapy of 0.8％ (95％ CI:0.005-0.012) 、3.8％ (95％ CI:0.026-0.052) 、20％ (95％ CI:0.010-0.720),respectively.TheAU-ROCwas0.68(95％ CI:0.610-0.760,P＜0.01).The H-L test was x2 =2.45,P=0.29.Conclusion SRI model gives a certain clinical significance,suggesting that high-values patients may occur RRT-AKI with a significantly higher risk than low-values patients.However,SRI model cannot give an accurate prediction value for RRT-AKI in Chinese adult patients after cardiac valve surgery.Direct clinical use of the model should be considered cautiously.

Objective To discuss the clinical effect and influence combination of drugs on the functions of target organs in the patients with salt-sensitive hypertension.Methods 125 patients with salt-sensitive hypertension, their clinical data retrospec-tively analyzed, divided into two groups, treated with coaprovel and felodipine combined with irbesartan respectively for 8 weeks.The levels of left ventricular mass index (LVMI), fasting blood glucose (FBG), triglyceride (TC), total cholesterol (TC) and blood 2-microglobulin (2-MG) during the treatment were then observed.Results The amplitude of blood pressure was significantly lower in the coaprovel group after 4 weeks and 8 weeks of treatment in the patients with salt -sensitive hypertension.However, there was no statistical difference of effectiveness between the coaprovel group ( 81.0%) and the felodipine combined with irbesartan group (83.9%).The decrease range of LVMI showed significantly better results in the coaprovel group (28.9 ±7.3).Moreover, there was no statistical difference in other indexes between two groups or before and after treatment .Conclusion Coaprovel has a similar cura-tive effect with felodipine combined with irbesartan in the treatment of patients with salt -sensitive hypertension.It has more signifi-cant protective effect for heart damage .