Objective To sum up nursing experience of cerebrospinal fluid drainage in patients with aortic dissection with paraplegia after sun′s operation. Methods Retrospective analysis of 17 cases of clinical nursing care from January 2014 to December 2016, summing up related nursing experience includingintensive care of cerebrospinal fluid drainage, observation of limb movement and muscle strength, monitoring complications, maintain stable hemodynamics, strengthen the life nursing during hospitalization, in order to ensure the drainage of cerebrospinal fluid. Results 2 deaths, Recovery of different degrees of paraplegia or paresis in 12 and persistent paraplegia in 12 out of the other 15 patients, 9 patients recovered and discharged,6 cases transferred to rehabilitation hospital. Conclusions Careful nursing of cerebrospinal fluid drainage can improve paraplegia or lower extremity paresis caused by spinal cord ischemia,and promote patients′rehabilitation.

Objective To investigate the protective effect of prenatal astaxanthin treatment against cognitive impairment in adult offspring induced by exposure to maternal seizures in utero.Methods Female adult Sprague-Dawley rats were randomly divided into four groups:control group,astaxanthin group,kindling group and kindling+astaxanthin group.Each rat was implanted with electrodes.Those in the kindling and kindling+astaxanthin groups were kindled once a day by electrical stimulation of the amygdala.All rats were allowed to mate after one week's amygdala kindling.Rats in the kindling and kindling+astaxanthin groups continued to be treated with electrical stimulation every 48 hours from gestational day 1 to 20,and those in the astaxanthin and kindling+astaxanthin groups were injected intraperitoneally with 30 mg/(kg · d) of astaxanthin simultaneously.Naturally delivered offspring were raised till 12 weeks of age.Morris water maze test was performed to assess the cognitive function of adult offspring.Changes in the morphology of hippocampus were observed with Nissal's staining and transmission electron microscope.Expression of cyclic adenosine monophosphate response element binding protein (CREB) and brain-derived neurotrophic factor (BDNF) in adult offsprings' hippocampus tissues at protein and mRNA levels were determined using Western-blotting and reverse transcription-polymerase chain reaction.Analysis of variance and LSD test were used as statistical methods.Results Morris water maze test showed that from the 3rd day to the 5th day,the kindling group had significantly longer escape latency [(36.33 ±7.85),(28.80± 8.41),(29.50± 11.72) s] than the control [(28.90±7.46),(17.59±9.12),(10.40±3.69) s] and kindling+astaxanthin groups [(28.30±5.75),(18.37±3.39),(15.23±6.63) s] (F=3.601,9.811 and 14.226,all P＜0.05).In probe trials,the kindling group had significantly fewer platform crossings as compared with the control and kindling+astaxanthin groups [(4.40± 1.71) vs (7.20± 1.62) and (6.50±1.84) times,F=6.586,P=0.001].The kindling group spent dramatically less time in the target quadrant than the control and kindling+astaxanthin groups [(27.35±7.63) vs (58.29± 10.48) and (40.41 ± 7.06) s,F=25.825,P＜0.001].Nissl staining showed that hippocampal neurons of offspring in the control group were normal,but there was hippocampal damage in the kindling group and the damage was more severe than that in the kindling+astaxanthin group.Electron microscope observation showed that neurons and synapses in the hippocampal CA1 area of offspring in the control group were normal.However,obvious damage to neurons and synapses was induced in the kindling group and that was worse than the damage induced in the kindling+astaxanthin group.Expression of CREB and BDNF protein in the kindling group (0.19±0.06and 0.32 ±0.04,respectively) were significantly lower than those in the control (0.81 ±0.11 and 0.93 ± 0.04,respectively) and kindling+astaxanthin groups (0.60± 0.07 and 0.80±0.06,respectively) (F were 34.015and 71.074,both P＜0.001).Moreover,the kindling group showed decreased expression of CREB and BDNF mRNA (0.48 ± 0.11 and 0.43± 0.08,respectively) as compared with the control (1.02± 0.65 and 0.99± 0.09,respectively) and kindling+astaxanthin groups (0.89±0.15 and 0.96±0.13,respectively) (F were 13.447 and 21.912,both P＜0.01).Conclusion Treatment with astaxanthin could ameliorate the cognitive impairment and pathological damage in hippocampus of adult offspring induced by exposure to maternal seizures in utero through regulating the CREB-BDNF signal pathway.

To explore prognostic factors in intermediate-risk acute myeloid leukemia (AML) patients with minimal residual disease (MRD) negativity (MRD<0.1%,MRD-)receiving autologous hematopoietic stem cell transplantation (auto-HSCT).A total of 59 intermediate-risk AML patients with MRD-were treated with auto-HSCT from January 2015 to September 2021 at Affiliated People′s Hospital of Ningbo University. The clinical data and laboratory results were collected retrospectively. Efficacy, clinical outcome and prognostic factors were analyzed. Univariate analysis was conducted by using log-rank test, the multivariate analysis by Cox proportional risk model.Among 59 patients, there were 27 males and 32 females with median age of 55 (31-69) years old.The median follow-up was 761(317-1 861)days. The 2-year overall survival (OS) rate and event-free survival (EFS) rate were 76.1%±11.4% and 73.4%±11.6% respectively.The univariate analysis showed that age older than 50 years, TET2 gene mutation (TET2 +), achieving MRD negativity over 30 days (MRD 30+) were unfavorable factors of OS ( χ2=6.20, 33.20, 7.18; P=0.013,<0.001, 0.007). TET 2+, WT1 gene mutation (WT1 +), CD34 +cells<2×10 6/kg, MRD 30+were negative factors of EFS ( χ2=17.29, 4.47, 3.94, 9.393; P<0.001, 0.035, 0.047, 0.002).Multivariate analysis showed that MRD 30+, TET2 + were independent prognostic factors of OS and EFS (OS: HR=9.251, 25.839, P=0.036, 0.001;EFS: HR=5.851, 9.199, P=0.043, 0.002). Intermediate-risk AML patients with MRD 30+or TET2 + have very poor prognosis after auto-HSCT. Alternative regimens should be investigated.