Objective To investigate the best time to establish the enteral nutrition (EN) in elderly patients with se?vere craniocerebral diseases. Methods Eighty-one elderly patients were divided into groups A, B and C. The EN support were given 24 h, 25-48 h, and 49-72 h after surgery. Changes of serum biochemical indexes, complications and GCS score were detected and statistical analysed. Results The serum levels of albumin and hemoglobin were significantly increased in group B than those of group A and group C. The total number of lymphocytes was significantly higher in group A and group B than that of group C (P<0.05). The amount of diarrhea was significantly fewer 7-day after operation in group B than that of group A (3.6%vs 26.9%). The amount of stress ulcer was significantly fewer in group B than that of group C (0 vs 22.2%). The amounts of lung infections (10.7%vs 38.5%) and stress ulcer (3.6%vs 25.9%) were significantly fewer 14-day after oper?ation in group B than those of group A. The scores of GCS were significantly higher 14-day after operation in group B than those of group A and group C (10.2±1.3 vs 9.5±1.2 vs 9.4±1.2, P<0.05). Conclusion The establishment of EN support 25 to 48 hours after surgery may meet the need of nutritional and metabolic support, reduce complications, be conducive to the consciousness recovery in elderly patients with severe craniocerebral diseases.

Objective To analyze the safety and effectiveness of using lumbar drainage (LD) in patients with subarachnoid hemorrhage (SAH).Methods Data from 44 patients with SAH were collected.Of these patients,the LDs group consisting 19 patients in whom a lumbar drain had been placed for cerebro-spinal fluid (CSF) drainage,whereas the control group was composed of 25 patients who received no form of CSF drainage or treated solely with an external ventricular drainage (EVD).Incidence of new cerebral infarction of the two groups was measured on sequential CT and complications of LDs group.Results This retrospective review demonstrated a statistically significant beneficial effect in LDs group on CT,reducing the incidence from 32％ to 5％.A similar degree of benefit was observed in two group patients with hydrocephalus.Complications with lumbar drains were rare and yielded no permanent sequelae.Conclusion With rare complications and definite safety,LDs are effective to reduce vasospastic cerebral infarction of SAH patients when appropriate patient selection and good technique are employed.

Objective To investigate the therapeutic effects of acupuncture on pelvic floor muscles and urinary function in patients with spinal cord injury. Methods From March, 2012 to March, 2015, 23 patients with spinal cord injury were divided into control group (n=8), early intervention group (n=8) and later intervention group (n=7). The control group received routine rehabilitation, the intervention groups received acupuncture at Baliao (BL-31, BL-32, BL-33 BL-34), Yanglingquan (GB-34), Sanyinjiao (SP-6) and Taichong (LR-3) acupoints in addition. The early intervention group was acupunctured one week before removal of catheter, and the later intervention group adopted inter-mittent catheterization after removal of catheter, and then received acupuncture. The pelvic floor muscles strength, the urine function and quality of life were recorded before and six weeks after intervention. Results There was no significant difference in all the indices before in-tervention (P>0.05). After intervention, the pelvic floor muscles strength improved in the intervention groups compared with the control group (P<0.05). There was significant difference in the mean frequency of urinary voiding, bladder capacity, time of establishing reflect uri-nation and residual volume of urine after intervention among all the groups (P<0.05), except the mean frequency of urinary voiding and blad-der capacity between the control group and the later intervention group (P>0.05). The quality of life improved in all the groups after inter-vention (F>0.864, P<0.05), however, no significant difference was found among three groups (F=1.558, P<0.05). Conclusion Acupuncture, especially early acupuncture, could improve the pelvic floor muscle strength and bladder function in spinal cord injury patients.

Objective To evaluate the effect of the electronic anti-nausea instrument on the postoperative nausea and vomiting of patients with gynecological laparoscopic surgery.Methods One hundred and eighty patients for gynecological laparoscopic surgery were enrolled and randomized into 2 groups with 90 patients in each.Patients in group T accepted patient-control transcutaneous elec-troacupoint stimulation at P6 (Neiguan)point from the time before the induction of anesthesia to 24 h after surgery.Patients in group C accepted the same device of electronic anti-nausea instrument with-out transcutaneous acupoint stimulation.Data were recorded of the nausea and vomiting in postopera-tive 2,6,12 and 24 h respectively.Results The incidence and severity of nausea at 6,12 and 24 h and vomiting at 6,24 h after operation in group T were both lower than those in group C(P < 0.05 ). Conclusion With patient-control transcutaneous acupoint stimulation at P6 point,the incidence of both early PONV and late PONV are reduced in patients with gynecological laparoscopic surgery.

Objective To measure the expression of circulating microRNA (miRNA)in patients with hepatitis B virus (HBV)-related liver failure and its relationship with disease prognosis.Methods The miRNA expressions in serum of 5 patients with HBV-related liver failure and 5 healthy control subjects were compared using Exiqon miRCURY LNATM miRNA microarray.The sera from 20 patients with chronic hepatitis B (CHB),20 patients hepatitis B related cirrhosis,50 patients with HBV-related liver failure and 40 healthy persons in Ruijin Hospital were collected.The relative expression of miRNA-595 was measured using quantitative real-time polymerase chain reaction (PCR).The relative expressions of miRNAs among groups were analyzed using student t test,the correlations were analyzed by Pearson and Spearman correlation.Results Microarray informed that 92 miRNAs changed significantly in patients with HBV-related liver failure,and miRNA-595 increased most significantly.The results of real-time PCR showed that the relative expressions of miRNA-595 ,miRNA-300 and miRNA-122 were 6.03 (t=3.134, P =0.003),3.12 (t=7.221 ,P <0.01)and 2.77 (t=2.671 ,P =0.021),which were higher compared to those in healthy control group.In the analysis of the relationship between miRNA-595 expression and disease prognosis in patients with HBV-related liver failure,the relative expressions of miRNA-595 in patients with CHB,hepatitis B related cirrhosis and HBV-related liver failure were 2.26 (t =3.780,P =0.001),3.32 (t = 6.111 ,P < 0.01)and 6.03 (t = 3.134,P = 0.003),respectively,which were all increased compared to that of the healthy control.The relative expression of miRNA-595 of patients with HBV-related liver failure was 2.66 times (t=2.450,P =0.043)higher than that of patients with CHB. When dividing patients according to prothrombin activity,miRNA-595 increased significantly in patients with early stage liver failure.When dividing patients according to model of end-stage liver disease (MELD) score,MELD score was positive correlated with the expression of miRNA-595 when MELD score was under 30 (r=0.673,P =0.004).The expression of serum miRNA-595 in survival group (11 .08,n=23) was higher than that in non-survival group (3.67,n = 27,t =4.309,P =0.041).Conclusions The expressions of miRNA595 ,miRNA-300 and miRNA-122 are all increased in patients with HBV-related liver failure,especially the expression of circulating miRNA-595 at early stage of the disease.The miRNA-595 may be used as a new serum biomarker for monitoring the severity of disease.

BACKGROUND:Reactive oxygen species may be closely related to the occurrence and development of tendinopathy,but its exact role and related signal transduction mechanism have not been fully summarized. OBJECTIVE:To review current clinical or preclinical original studies,summarize the role of reactive oxygen species in tendinopathy and related signal transduction pathways and to explore its characteristics and whether there is a unified downstream pathway. METHODS:Relevant original studies in PubMed,Embase,Web of Science,as well as CNKI,WanFang,and VIP databases were searched by computer and the search results were screened and excluded according to the inclusion criteria.Ninety articles were finally included for review and analysis. RESULTS AND CONCLUSION:Reactive oxygen species affects the direction of tendon healing by simultaneously acting on tendon cells and the extracellular matrix,and it exhibits a bifacial effect in the treatment of tendinopathy.Concentration of reactive oxygen species may be the key to determining its direction of action.The possibility that low-dose reactive oxygen species can participate in the normal physiological healing of tendons or that tendon tissues are adaptive to stimulations may be the underlying mechanism that produces this characteristic effect.Reactive oxygen species affect the composition and structure of the extracellular matrix and normal tendon repair as well as maintain viability in response to external stimulations through matrix metalloproteinases,mitogen-activated protein kinases,mitochondrial apoptosis,the forkhead transcription factor O family,autophagy,inflammation,and antioxidant signaling pathways.Different reactive oxygen species stimulation intensities,durations,and external environments may cause different alterations in downstream molecular pathways and thus have different effects on the tendon.Due to the large gap in the number of literature included in the evaluation of the positive and negative effects of reactive oxygen species,it may cause some analytical error in the search for factors behind the characteristics of the action of reactive oxygen species in tendon.In addition,most experimental intervention conditions and results of interest are relatively homogeneous;therefore,the temporal and quantitative mechanisms of reactive oxygen species and the synergistic effects with other intervention factors have not been clarified,and the overall system of molecular actions of reactive oxygen species in tendinopathy has not been constructed.To conclude,reactive oxygen species might be involved in the treatment and prevention of tendinopathies as a beneficial factor in the future,and facilitate the exploration of oxidative stress signaling pathways and overall molecular action systems in tendinopathies thereafter,as well as lay the foundation for research on the therapeutic strategies of different antioxidants in tendinopathies to better prevent and treat tendon injury and degeneration.

Objective:pH low insertion peptide (pHLIP)-variant 7 (var7)-fluorescein isothiocyanate (FITC) was used to explore an accurate imaging tool that targeted burn wounds to better perform burn debridement.Methods:Twelve rat models of burn wound were established and pHLIP-var7-FITC with different concentrations (0.5, 1.5 and 2.0 mg/ml) were injected from the rat tail vein for in vivo fluorescence imaging. By determining the concentration of fluorescent conjugates to the burn wound, the scope of wound injury necrosis was judged by combining pathological sections, and its residue and toxicity in important organs such as heart, liver, kidneys, and brain were detected. The Kruskal-Wallis rank sum test, Bonferroni correction method and one-way analysis of variance were used for data analysis. Results:Within 24 h, the fluorescence photons per unit area of the burn wound in the group of 0.5 mg/ml, 1.5 mg/ml and 2.0 mg/ml were 1.49(1.31, 1.65), 2.46(1.88, 2.68), 2.77 (1.94, 3.10)×10 7 p·s -1·cm -2·Sr -1, with significant differences in the overall distribution of fluorescence photons ( H=73.55, P<0.001). The fluorescence intensity was stronger in the group with higher concentration, but with no significant difference in the number of fluorescence photons between the group of 1.5 mg/ml and 2.0 mg/ml ( P=0.263, Bonferroni correction method). At 14 time points (0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 5.0, 6.0, 7.0, 8.0, 12, 24 h), there was no significant difference in the overall mean of fluorescence photons ( F=1.04, P=0.419), and the tissue with burn necrosis seen in tissue sections was highly consistent with the fluorescence imaging region. There was no obvious fluorescence residue in the heart, liver, kidney and brain sections. Conclusion:In superficial second-degree burn tissue, pHLIP-var7-FITC can accurately target and gather on the burn wound within 24 h, showing a clear boundary between burn tissue and normal tissue, which can assist clinical surgical debridement to determine the extent of injury.

Objective To study the changes in morphology , phenotypes and gene expression pro-files of dendritic cells (DCs) following treatment with Seabuckthorn flavones (SF).Methods DCs were treated with 200μg/ml of SF and then cultured for 7 days.Changes in the morphology of DCs were observed under light microscope .Flow cytometry was used to detect DC surface molecules .Total RNA was extracted to construct the library for digital gene expression profiling ( DGE ) .Differentially expressed genes were screened out and further analyzed by gene ontology ( GO) enrichment analysis and Kyoto encyclopedia of genes and genomes ( KEGG ) pathway enrichment analysis .Results Compared with control group , SF treatment significantly enhanced the expression of HLA-DR, CD80, CD83 and CD86 on DCs.A total of 355 differentially expressed genes were screened out by DGE , including 176 up-regulated genes and 179 down-regulated genes .GO enrichment was mainly involved in the regulation and development of the immune sys -tem and other biological processes .KEGG pathway analysis showed that the significantly enriched pathways were closely related to inflammation , the immune system, cancer and other diseases .Conclusion SF can promote the expression of DC co-stimulatory molecules and pro-mature molecules, and regulate the expres-sion of immunity-related genes such as CD11a, SLAMF6, LMCD1, TSC22D3 and IKZF3.

Objective:To evaluate the radiation dose to the injured persons in a radiological accident, provide the guidance on the diagnosis and treatment of radiation injury, and provide the basis for determination of the level of radiological accident.Method:Firstly, the air-absorbed dose rates at 206 locations surrounding a X-ray device were measured by using LiF (Mg, Cu, P) thermoluminescence detectors and self-made radiation field measuring frames. Secondly, the spatial distribution of radiation level was obtained by fitting the inverse square law between absorbed dose rate and distance, which is used as the basis of dose estimation. Finally, based on the actual working conditions of injured operators, a parameter calculation method was proposed for estimating hand skin absorbed dose.Results:The air-absorbed dose rate surrounding X-ray beam outlet was higher than 1.0 mGy/h. The maximum air-absorbed dose rate value in the space of within 200 cm outside X-ray beam outlet was 262 μGy/h and the minimum value was 2.1 μGy/h, 2 orders of magnitude higher than environmental background level. During normal operation, the total absorbed doses to the hand skin of two injured female operators were 36.9 and 16.9 Gy, respectively. During extreme operation, the hand skin-received total absorbed doses to the two operators were 85.2 and 38.9 Gy, respectively. Under the occupational health standard GBZ 106-2020, the two persons had acute radiation skin injury of grade Ⅲ or Ⅳ on their hands.Conclusions:The results of hand skin exposure doses provide effective support for diagnosis and treatment of radiation injuries and for the determination of radiological accident level. The method used in radiation field reconstruction and dose estimation mentioned in this study can provide reference for the treatment in the similar radiological accident.

Objective To investigate the effect of Jin's 3-needling therapy on executive function and spatial learning and memory abilities and their mechanism in frontal lobe injury rats. Methods Thirty-two male Sprague-Dawley rats were randomly divided into sham-operated group, Jin's 3-needling group, model group and medoba treatment group (n=8). The rats in the sham-operated group only underwent craniotomy to remove the bone flap and no impact was performed on the frontal lobe; the frontal lobe injury models of model group, Jin's 3-needling group and medoba treatment group were established by eCCI-6.3 device; rats in the Jin's 3-needling group were treated with Jin's 3-needling therapy, and rats in the madopa treatment group were given 2 mL of madopa suspension by perfusion once daily. The behavior of rats in each group was evaluated by GO/NO GO task and Morris water maze test, and apoptosis of cells was detected by TUNEL, dopamine receptor D1 (DRD1) expression was determined by immunohistochemistry, and the content of dopamine in frontal tissues was analyzed by high performance liquid chromatography. Results The accuracy rate of GO/NO GO task in Jin's 3 needling group was significantly higher than that in madopa treatment group (P<0.05); and that in madopa treatment group was significantly higher than that in model group (P<0.05). On the 3rd and 4th d of place navigation test, the escape latency in the Jin's 3 needling group and madopa treatment group was significantly decreased as compared with that in the model group (P<0.05); the escape latency in the Jin's 3 needling group was significantly decreased as compared with that in the madopa treatment group (P<0.05). In spatial probe test, the number of times of crossing the platform in the Jin's 3 needling group and madopa treatment group was significantly larger as compared with that in the model group (P<0.05). As compared with those in the model group, the number of apoptotic neurons in the frontal lobes was significantly larger, the content of dopamine in the frontal lobes and the DRD1 expression were significantly increased in the madopa treatment group and Jin's 3-needling group (P<0.05); the number of apoptotic neurons in the Jin's 3 needling group was significantly smaller as compared with that in the madopa treatment group (P<0.05); the content of dopamine in the frontal lobes and the DRD1 expression in the Jin's 3 needling group were significantly increased as compared with those in the madopa treatment group (P<0.05). Conclusion Jin's 3-needling therapy can effectively improve the executive function and spatial learning and memory abilities of frontal lobe damaged rats, and their mechanism may be related to decreased apoptosis of frontal tissue cells and increased dopamine content and increased DRD1 expression.