BACKGROUND: How to lessen neuronal necrosis to promote recovery of nerve function after ischemic cerebral injury? Cerebral ischemic preconditioning (IP) alleviates ischemic cerebral injury caused by re-ischemia to certain extent. It has been verified that sodium ferulate can lessen the incidence of neuron apoptosis after cerebral ischemia. Whether does sodium ferulate enhance the nerve protection of IP brain to not?OBJECTIVE: To explore the protection of sodium ferulate allied with IP in cerebral ischemic-reperfusion injury.DESIGN: Randomized controlled animal experiment was designed.SETTING: Neurological Surgery Department of 2nd Affiliated Hospital of Jiangxi Medical College, Department of Physiology of Jiangxi Medical College, Institute of Urinary Surgery of Jiangxi Medical College.MATERIALS: The experiment was perforned in Laboratory Room of Neurological Surgery Department of 2nd affiliated Hospital of Jiangxi Medical College from May 2001 to April 2002, in which, 85 Wistar male rats were employed, mass weighted varied from 250-300 g.METHODS: The rats were randomized into 4 groups: ① The control without ischemia (10 rats): Vertebral artery was ligatured bilaterally and common carotid artery was not clipped bilaterally. ② The control with ischemia (25 rats): Vertebral artery was ligatured bilaterally for 48 hours and common carotid artery was clipped for 10 minutes. ③ IP group (25rats): Vertebral artery was ligatured bilaterally for 48 hours and common carotid artery was clipped for 2 minutes, and 24 hours later, the common carotid artery was clipped again for another 10 minutes. ④ Sodium ferulate allied with IP group (Allied group) (24 rats): After IP, the common carotid artery was clipped again for 30 minutes and sodium ferulate (200 mg/kg)was injected intravenously from tail. The control without ischemia was subdivided into two groups of 2 days and 7 days after reperfusion respectively (5 rats for each one). The control with ischemia, IP group and allied group were subdivided into 5 groups of 6 bours, 12 hours, 24 hours,2 days and 7 days after reperfusion successively (5 rats for each one).The rats were sacrificed to collect brains at phase spots in each group.Coronary brain slice was collected 2.2 mm posterior to the optic chiasm and the effects of allied with was observed on neuron count and apoptotic cell count in cortex and hippocampal CA1 in cerebral ischemia reperfusion.MAIN OUTCOME MEASURES: Neuron count and apoptotic cell count in cortex and hippocampal CA1.RESULTS: Totally 85 experimental rats all entered result analysis. ①Neuron count in cerebral cortex and hippocampal CA1: On the 7th day after ischemia, the counts in IP group and allied group were higher than ischemia control (268±8.5, 244±12.5, 135±5.6, P ＜ 0.01). ② Count of TUNEL positive cell in cerebral cortex and hippocampal CA1: The count in allied group was lower than that in IP group and ischemia control (12 hours:1.2±0.8, 15.5±2.1, 39.8±3.9; 24 hours: 1.8±1.6, 39.3±11.8, 191.3±19.1;2 days: 2.8±1.2, 68.3±13.6, 328.4±24.0, P ＜ 0.01), and that in IP group was lower than ischemic control (P ＜ 0.01).CONCLUSION: IP lessens apoptotic neuron count in ischemic region.Sodium ferulate allied with IP further intensifies such effect and provides the protection of ischemic reperfusion injury of brain.

Objective To compare the effects of aspirin and clopidogrel on platelet aggregation function by TEG,and to study the antiplatelet agents tailored therapy of Thrombelastography(TEG)in treatment of cerebral infarc-tion patients.Methods 100 patients with acute cerebral infarction were included in two groups:aspirin group and clopidogrel group.The inhibitory rates of AA and ADP receptor pathway in platelets were detected by TEG.The effect of inhibitory rates in group aspirin and clopidogrel was compared with nerve function and the recurrence rate of stroke. Results The inhibitory rates of group aspirin (85.23 ±21.98)% was higher than group clopidogrel (47.31 ± 22.37)% (t =7.340,P =0.005).The patients with which the inhibitory rates showed goodby TEG in group aspirin and clopidogrel got better neurological recovery,and the patients showed goodby TEG in group aspirin got lower stroke recurrence rate within 1 year(χ2 =4.460,P =0.035;χ2 =7.232,P =0.007).Conclusion TEG had guided the antiplatelet individual therapy for cerebral infarction patients,and can be used to predict and confirm the efficacy of antiplatelet drug.

Objective To evaluate the status of self-efficacy and its influencing factors in adult patients with low vision,then explore an effective approach to improve their self-efficacy levels.Methods Seventy adult patients with low vision were sampled by random number table method.General social-demographic questionnaire and self-efficacy questionnaire were used to investigate these patients' general information and self-efficacy.Seventy pieces of questionnaires were issued and returned with the valid rate of 100％.Results The total score of self-efficacy in seventy adult patients with low vision was(16.25:±:1.93) points,92％ of patients had a low level of self-efficacy.The influencing factors of self-efficacy in adult patients with low vision were the attitude toward disease,mental status and gender.Conclusions The selfefficacy in patients with low vision was affected by many factors at different levels,so we should focus on main influencing factors to adopt corresponding nursing measures in order to improve self-efficacy of adult patients with low vision.

BACKGROUND: Bone marrow cell transplantation is a simple and effective treatment to promote angiogenesis. The neovascularization and reestablishment of blood circulation is crucial to the repair of injured but still living neurons as well as to the survival and differentiation of the implanted tissues and cells. However,it is not clearly known whether autologous bone marrow cells implantation could promote neovascularization and facilitate reestablishment of circulation in ischemic regions of the brain.OBJECTIVE: To investigate the effect of autologous bone marrow cell transplantation via the carotid artery on angiogenesis in the ischemic regions of the brain.DESIGN: A randomized controlled experiment based on experimental animals.SETTING: Department of neurosurgery and institute of urinary surgery in a university hospital.MATERIALS: The experiment was conducted in the Laboratory of the Department of Neurosurgery,Second Affiliated Hospital,and the Institute of Urinary Surgery,Jiangxi Medical College during the period from September 2002 to April 2003,using 10 specific pathogen-free male SD rats weighing 250 - 300 g.INTERVENTIONS: Rat models of focal cerebral ischemia model were established and randomized equally into two groups. The rats in the transplantation group were injected with autologous bone marrow cells via the carotid artery and those in the control group normal saline injection. The angiogenesis in the ischemic regions of the brain was observed with immunohistochemical staining for microvessel counting.MAIN OUTCOME MEASURES: The density of microvessels. Immunohistochemical staining for F8.RESULTS: Greater density of the microvessels was found in the ischemic regions after bone marrow cell transplantation than in the control group[(159. 15 ±40.4)/mm2 vs(81.70 ± 32. 18)/mm2,P ＜ 0. 05] . Numerous endothelial cells were found scattered in the ischemic cortex of the transplantation group,but scarcely in the control group.CONCLUSION: Autologous bone marrow cell transplantation via the carotid artery can promote angiogenesis in the ischemic regions of the brain.

Objective To investigate the effect of inhalation of enflurane on the expression of N-methyl-D-aspartate receptor subunit 2B (NR2B) in the hippocampus of the offsprings of rats.Methods Thirty SD rats pregnancy 8-10 day weighing 200-250 g were randomly divided into 3 groups ( n =10 each):control group (Group C),4 h inhalation of enflurane group ( group E1 ) and 8 h inhalation of enflurane group ( group E2 ).Group E1 and E2inhaled 1.7 ％ enflurane (in O2 2 L/min) for 4 and 8 h respectively,while group C inhaled oxygen 2 L/rin for 8 h.The learning and memory functions of the offsprings were assessed at 20 and 30 days after birth by Morris maze test.The expression of the NR2B mRNA were examined by RT-PCR,NR2B protein were examined by mmunohistochemistry.Results Compared with group C,the escape latency was significantly prolonged,the frequency of crossing the original platform was significantly decreased,the staying time at the original platform quadrant was significantly shortened at 3-5 days after the test in group E1 and E2 (.P ＜ 0.05 ),the expression levels of NR2B mRNA and protein were significantly decreased at 20 and 30 days after birth in group E1 and E2 ( P ＜ 0.05).There were no significant differences in the indexes mentioned above between groups E1 and F2 ( P ＞ 0.05).Conclusion Inhalation enflurane in the early pregnancy can result in cognition dysfunction through inhibiting NR2B expression in the hippocampus of the offsprings of the rats.

OBJECTIVE: To assess and compare the two procedures, total thyroidectomy (TT) and partial thyroidectomy (PT), for papillary thyroid cancer in terms of associated injuries, postoperative complication, recurrence rate and survival, so as to provide a reference and basis for surgical procedure option of this disease. METHOD: Strictly specified into the exclusion criteria, the combination of computer retrieval and manual retrieval and retrieval systems such as CNKI, Wang Fan, PubMed, central, CBM database. Total thyroidectomy and partial thyroidectomy for the treatment of patients with thyroid papillary cancer related literature were compared, with the retrieval time until December 31, 2013. RESULT: According to the retrieval strategy 4630 literatures were found, and 20 witch matched the exclusion criteria were left, all were retrospective study. TT and PT group of recurrent laryngeal nerve injury rate are 5.9%, 2.0% respectively [OR = 0.39, 95% CI (0.17 - 0.90), P < 0.05], TT and PT group of parathyroid injury rate are respectively 4.9%, 0.8% respectively [OR = 0.23, 95% CI (0.08 - 0.68), P < 0.01]. The TT group of 10 years survival rate is 95.24% - 100%, and the PT group is 96.8% - 99.2% [OR = 0.03, 95% CI (0 - 0.34), P < 0.01]. Unstaged, unstaged TT group' postoperative recurrence rate is 4.7%, while PT group is 12.6% [OR = 3.21, 95% CI (1.57 - 6.57), P < 0. 01]. Postoperative recurrence of stage I TT group and PT group are 4.9%, 7.8% respectively [OR = 3.82, 95% CI (1. 07-13.66) P < 0.05]; The rate of stage II TT group is 0.5%, while the rate of PT group is 15.9% [OR = 17.23, 95% CI (4.03 - 73.73), P < 0.01]. CONCLUSION Different methods of primary thyroid papillary carcinoma surgical treatment can all obtaina good survival, but the rate of laryngeal recurrent nerve injury and parathyroid injury caused by partal throidectomy is relatively lower. As a result, partial thyroidectomy can be a good choice for early stage thyroid papillary carcinoma.
Carcinoma ; surgery ; Carcinoma, Papillary ; Humans ; Neoplasm Recurrence, Local ; Parathyroid Glands ; Postoperative Complications ; Recurrent Laryngeal Nerve Injuries ; Retrospective Studies ; Survival Rate ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; surgery ; Thyroidectomy ; methods

Objective: To explore the role of bioelectrical impedance analysis (BIA) and laboratory tests for nutrition related indicators in preoperative nutritional risk screening of patients with head and neck cancer. Methods: Totally 131 patients with head and neck cancer were selected by convenient sampling method. The nutritional risk was screened by NRS 2002 nutritional risk screening scale. The bioelectrical impedance indexes were collected by human body component analysis instrument and the nutritional related laboratory indicators were collected by electronic medical records. Results: The incidence of nutritional risk in patients with head and neck cancer before operation was 18.6% (22/131). Correlation analysis showed that nutrition-related laboratory indicators were not related to nutritional risk, while bioelectrical impedance indicators such as fat-free mass, skeletal muscle mass, bodi mass index (BMI), inorganic salt content, water content and protein content were significantly correlated with NRS 2002 screening results(r=-0.228- -0.183, P<0.05 or 0.01). Univariate analysis showed that BMI, fat-free mass, protein content, skeletal muscle mass, water content, pharyngeal cancer, lymphatic metastasis, and diabetes mellitus were risk factors for nutritional risk (t=-4.121-2.918, χ²=4.167, 6.353, 4.032, P<0.01 or 0.05). Multivariate analysis showed that lymphatic metastasis was the independent risk factors of nutritional risk. Conclusions Preoperative nutritional risk screening is required for patients with head and neck cancer, especially those with tumor located in the pharynx, lymphatic metastasis and diabetes mellitus. Bioelectrical impedance analysis can be used as a reference for preoperative nutritional risk screening of patients with head and neck cancer, and can provide specific questions about human body composition for patients with nutritional risk, so as to provide a clear direction for nutritional risk intervention and can be used as an evaluation method of intervention. It is recommended that bioelectrical impedance analysis can be used as an auxiliary tool for nutritional risk screening.

Objective To determine the concept of functional evaluation for children with congenital heart disease in the views of International Classification of Functioning, Disability and Health (Children and Youth Version) (ICF-CY). Methods Clinical researches on children and adolescents with congenital heart disease nearly a decade were recalled from MEDLINE/PubMed and EMBASE. The concepts extracted were linked with ICF-CY. Results 224 researches were recalled. The oncepts linked with ICF-CY in 12 first categories, 28 second categories, of which 17 items were of body function, 2 of body structure, 6 of activities and participation, and 3 of environmental factors.Conclusion ICF-CY is a useful framework for functional assessment for children with congenital heart disease. It is important to make the measurement uniformity for comparability of the researches.

Objective: To observe the effects of Danggui Shaoyao powder (DSP) on hepatic lipid metabolism and further explore its mechanism of action by peroxisome proliferator-activated receptor (PPARγ)-liver X receptor (LXRα)-adenosine triphosphate (ATP)-binding cassette transporter A1 (ABCA1) pathway regulation. Methods: Eight C57BL/6J male mice were selected as the control group, and 24 ApoE−/− male mice were randomly divided into the atherosclerosis model (AS) group, atorvastatin calcium (AC) group, and DSP group (n = 8 each group). To establish an AS model, ApoE−/− mice were fed a high-fat diet for 16 weeks. Pathologic changes in the aortic vasculature and liver were identified using Oil Red O staining. Triglyceride (TG), cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) levels were determined in the livers using a single-reagent GPO-PAP method. Fluorescence quantitative polymerase chain reaction and western blot were used to observe and evaluate the mRNA and protein expression of the PPARγ-LXRα-ABCA1 intermediates in the liver. Results: After 16 weeks of a high-fat diet, ApoE−/− mice showed more Oil Red O staining in the aorta and liver compared to the CONT group. Compared to the AS group, the DSP and AC treatment reduced aortic plaque and hepatic lipid deposition to varying degrees. Furthermore, DSP significantly reduced the hepatic lipid area in ApoE−/− mice (P < .001) and decreased the levels of TG, TC, and LDL-C in liver (P < .001, P = .027, P < .001, respectively). DSP also significantly increased the levels of PPARγ, LXRα, ABCA1, and ABCG1 mRNA expression, as well as the PPARγ, LXRα, ABCA1, and ABCG1 protein expression in liver. Conclusion DSP improved hepatic lipid metabolism via PPARγ-LXRα-ABCA1 pathway modulation for AS treatment.

Objective To evaluate the health-related quality of life ( HRQL) of patients with adolescent idiopathic scoliosis ( AIS) before treatment. Methods Sixty-two female patients with AIS were evaluated using the Chinese version of Scoliosis Research Society's outcomes instrument 22 ( SRS-22) HRQL questionnaire before treatment. The patients were categorized into thFee groups: a mild deformity group with a major curve Cobb angle less than 30° ( n =14),a moderate deformity group with Cobb angles of 30° to 50° ( n =42), and a severe deformity group with Cobb angles more than 50° ( n =6). Results The severe deformity group scored lowest in the self-image domain.There was,however,no significant difference in the functional activity,pain or mental health domain scores between the three groups. Conclusions The Chinese version of the SRS-22 HRQL questionnaire can be used to assess the HRQL of Chinese AIS patients.AIS patients with a major curve Cobb angle more than 50° have relatively low self-image scores.