Objective To observe the effects of acupuncture on stroke in stroke unit, and its cost-effectiveness. Methods60 patients were divided into control group (n=30) and treatment group (n=30). All the patients were treated with structural therapy known as stroke unit, and the treatment group accepted acupuncture in addition. They were assessed with National Institutes of Health Stroke scale (NIHSS) and Barthel Index (BI) before, 15 d and 30 d after treatment. Their expenses for hospital were investigated. ResultsThe scores of NIHSS and BI improved in the treatment group compared with those in control group (P<0.05) 15 d and 30 d after treatment. The average cost for a score improved in both NIHSS and BI was less in the treatment group than in the control group (P<0.05). ConclusionThe acupuncture applied in stroke unit is effective and economical for stroke patients.

BACKGROUND:Isoflurane is an anesthesia drug that has a certain effect on the nervous system. It possibly causes neurologic disorders through impacting nerve stem cel function or morphology. OBJECTIVE:To investigate the effects of isoflurane on the proliferation and differentiation of neural stem cels in the hippocampus of rats. METHODS:Neural stem cels from the hippocampus of neonatal Sprague-Dawley rats, aged 7 days, were induced and differentiated. Passage 3 cels were obtained and divided into two groups: isoflurane group (a mixture gas of 2.8% isoflurane, 5% CO2 and 95% O2) and control group (a mixture of 5% CO2 and 95% O2).
After intervention of 6 hours folowed by 2 hours of routine culture, anti-BrdU monoclonal antibody immunofluorescent staining was used to detect cel proliferation, and western blot assay to detect the expression of β3-tubulin and glial fibrilary acidic protein. RESULTS AND CONCLUSION:Compared with the control group, the number of BrdU positive cels in the isoflurane group reduced significantly, indicating that isoflurane inhibits the proliferation of neural stem cels. Compared with the control group, the expression of glial fibrilary acidic protein in the isoflurane group up-regulated, but the expression of β3-tubulin had no changes, indicating isoflurane promotes the differentiation of neural stem cels into astrocytes. Cite this article:Min N, Hu QF, Li XP, Nie XH, Yang LL.Isoflurane effects on the proliferation and differentiation of neural stem cels in the hippocampus of neonatal rats. Zhongguo Zuzhi Gongcheng Yanjiu. 2016;20(1):118-122.

Objective Using Morris water maze test to evaluate the effects of guanosine and curcumin on cognitive function of APPswe/PS1dE9 double transgenic mice .Methods 3-month old APPswe/PS1dE9 dtg mice were randomly di-vided into model group , donepezil HCL group , guanosine group , curcumin group , curcumin and guanosine group ( n=12), with age-matched Wild C57BL/6J mice of the same genetic background as normal control group .Medication was giv-en once a day for 1 month.Using Morris water maze to test the spatial learning and memory ability of mice .Results Guanosine and curcumin could improve spatial learning and memory disorders of AD mice , particularly in the group of cur-cumin.Conclusion Guanosine and curcumin improve the cognitive ability of APPswe /PS1dE9 double transgenic mice with early cognitive impairment .

Objective To evaluate the effect of rehabilitation nursing with movement getting out of bed in early period after operation on the patients undergone the total hip replacement (THR).Methods The rehabilitation nursing was performed to 47 patients undergone THR including movement getting out of bed in early period; prepared sufficiently pre-operatively (evaluation and rehabilitation training); avoided the complications post-operatively; monitored the vital signs; trained standardizely; relieved pain sufficiently; took off the tubing as early as possible; rehabilitated with the walking aid.Results None had DVT, dislocation, fracture around the prosthesis, infections, death etc, all patients got out of bed in the 1st day after operation, the average time in hospital was 19 days, and the average Harris scores were 54.26, 62.55, 73.58, 91.17 and 93.35 at pre-operation, and in 14th day, 1st month, 3rd month and 6th month post-operation respectively.Conclusion Rehabilitation nursing with early movement getting out of bed to exercise after THR operation can promote the recovery of the hip function, reduce the complications, shorten the hospital stay.

Objective To explore the polymorphism of HLA class I alleles of HIV-infected former plasma donors and to investigate its impact on HIV-1 viral load in central China.Methods 106 subjects chronically infected with HIV-1 were recruited and HLA class I alleles were genotyped with PCR-SSP assay.HLA class I genotypes and haplotypes were determined and their association with plasma viral loads were analyzed.Gag-specific CTL responses were detected by an IFN-λ EUSPOT assay by using overlapping peptides,and their association with plasma viral loads were also analyzed.Results Subjects homozygous at HLA class I locus had higher plasma viral loads(P=0.0098);HLA-A*30,-B*13,-Cw*06,-Cw*14 alleles and HLA-A*30/B*13/Cw*06 haplotype were associated with lower plasma viral loads(P=0.0004,0.0103,0.0058,0.0371 and 0.0006);an inverse correlation between p2p7p1p6-specific CTL responses and viral loads in subjects with HLA-A*30/B*13/Cw*06 haplotype as well as an inverse correlation between p17-specific CTL responses and viral loads in subjects with HLA-Cw*14 allele were observed.Conclusion HLA-A*30,-B*13,-Cw*06,-Cw*14 alleles and HLA-A*30/B*13/Cw*06 haplotype were associated with lower plasma viral loads and Gag-specific CTL responses restricted by these HLA alleles may contribute to the protection.

Objective To analyze the clinical characters and identify the risk factors in patients diagnosed with systemic lupus erythematosus (SLE) and thrombotic thrombocytopenic purpura (TTP). Methods We retrospectively analyze the clinical features, laboratorial test results and treatment strategy of 20 SLE patients with TTP diagnosed in the First Affiliated Hospital of Zhengzhou University from 2011 to 2018. Multiple logistic regression model was used to determine risk factors for TTP. Results Among 20 SLE with TTP patients, 16 were female and 4 were male. The median age at diagnosis was 47 (14-74) years old. Three cases of TTP were diagnosed during the treatment of SLE, 16 cases were diagnosed after the diagnosis of SLE, while 1 case was diagnosed before SLE. Logistic analysis showed that the independent risk factors for TTP included Systemiclupus erythematosus disease activity index (SLEDAI)>10, renal and CNS involvement (P<0.05). Conclusion Patients with SLE who have moderate or high disease activity, renal and Central nervous system (CNS) involvement significantly increases the risk of TTP.

Objective:To assess the value of amide proton transfer weighted (APTw) imaging in the evaluation of pH changes in infarct core (IC) and ischemic penumbra (IP) in subacute cerebral infarction.Methods:The data of twenty-three subacute cerebral infarction patients with unilateral steno-occlusive disease of the middle cerebral artery (subacute infarction group) from April to November 2019 in the First Affiliated Hospital of Dalian Medical University were prospectively analyzed. Fifteen healthy volunteers were enrolled in this study as the control group. All subjects underwent conventional MRI, DWI, 3D-pseudo continuous arterial spin labeling (3D-pCASL) and APTw sequences. Based on DWI images, relative cerebral blood flow (rCBF) and APTw images to determine the region of IC, blood flow penumbra [cerebral blood flow(CBF)-DWI mismatch area, IP CBF] and metabolic penumbra (APTw-DWI mismatched area, IP APT). 3D ROIs were used to semi-automatically measure the APTw signals and the volume of IC and IP CBF of the patients in subacute infarction group. The comparison of APTw signals between the infarct side and the contralateral side in the subacute infarction group, the comparison of bilateral APTw signals in the control group, and the comparison of APTw signals in the IC and IP CBF regions were performed by paired-sample t test or Wilcoxon signed-rank test. The paired-sample t test or Mann-Whitney U test was used to compare the APTw signals between the two groups. The Friedman test was applied to compare the difference of volumes among IP CBF1.5, IP CBF2.5 and IP APT . Results:There was no significant difference of the APTw signals among the IC, the contralateral side in the subacute infarction group and the control group ( P>0.05). The APTw signals of IP CBF and IC of the infarction group were statistically different ( P<0.05). Compared with the contralateral side of IP CBF1.5 (3.7±1.7, -1.84±1.48, 5.57±2.75), the APTwmax (3.07±1.41, t=-3.012, P=0.006), APTw min [-1.30 (-1.74, -0.57), Z=-2.099, P=0.036], and APTwmax-min(4.51±2.58, t=-3.273, P=0.003) signals in the IP CBF1.5 were decreased ( P<0.05). Compared with the contralateral side of IP CBF2.5 [-1.53 (-2.80, -0.91), 5.31±2.61], the APTw min [-1.08 (-1.60, -0.49), Z=-2.616, P=0.009] and APTwmax-min (4.41±2.72, t=-3.228, P=0.004) signals in the IP CBF2.5 were decreased. The volumes of IP CBF1.5 [107.51(50.08, 138.61)mm 3], IP APT [99.00 (53.27, 121.335) mm 3] and IP CBF2.5 [89.91 (51.53, 139.87) mm 3] were successively reduced (χ2=7.913, P=0.019), and the volume of IP CBF2.5 was significantly smaller than that of IP CBF1.5 ( P=0.037). Conclusion:The acid-base metabolism in the IC of subacute cerebral infarction is not obvious, but the blood flow penumbra has local acid-base metabolism imbalance, and the range of metabolic penumbra coincides with the blood flow penumbra.

Objective:To summarize the relevant evidence of motor rehabilitation of stroke at home and abroad, so as to provide reference for medical staff to carry out motor rehabilitation.Methods:The related evidence on exercise management for patients with stroke in BMJ Best practice, UpToDate, Joanna Briggs Institute (JBI) Evidence-Based Health Care Center Database, National Guideline, American Heart Association/American Stroke Association, European Stroke Organization, National Institute for Health and Care Excellence, Registered Nurses Association of Ontario, Canadian Medical Association, American Association of Critical Care Nurses, National Stroke Foundation, Chinese Stroke Association, Medlive, Cochrane library, PubMed, Web of Science, Embase, OVID, Medline, China National Knowledge Infrastructure, Wanfang, VIP, SinoMed were searched by computer. The retrieval time limit was from 2012 to June 30, 2022. Two to four investigators independently assessed the quality of the included article, and extracted and summarized the evidence that met the quality standards.Results:A total of 22 articles were included, including 5 guidelines, 2 summary of evidence, 2 expert consensus, and 13 systematic evaluations. A total of 42 pieces of evidence related to exercise rehabilitation were extracted and integrated, including 11 aspects such as multidisciplinary teams, exercise goals, exercise timing, exercise evaluation, exercise venue, exercise style, exercise intensity, exercise time and frequency, safety monitoring, exercise behavior maintenance, and health education.Conclusions:The best evidence summarized in this study can provide a reference for clinical medical staff to implement exercise rehabilitation, but in clinical practice, it is necessary to select and apply evidence in a targeted manner in combination with specific circumstances, so as to improve the safety and effect of exercise rehabilitation.

Objective:To investigate the effect of self-made phase-change nanodroplets IR780/FA-Nds-DTX as molecular targeted ultrasound contrast agents for accurate diagnosis and combined targeted therapy of pancreatic cancer.Methods:Pancreatic cancer cell lines were cultured in vitro and 50 tumor bearing nude mouse models were established. The experimental group (IR780/ FA-NdS-DTX) and four control groups[ normal saline, Nds(FITC), FA-Nds (FITC) and IR-780] were divided to verify dual-mode targeted imaging. The imaging using the IVIS Imaging System verified the high-efficiency targeted detection ability and near-infrared fluorescence imaging of IR780/FA-Nds-DTX for tumors in vivo, phase transformation induced by low-intensity focused ultrasound and further contrast-enhanced ultrasound imaging verified the high-efficiency aggregation of IR780/FA-Nds-DTX in local tumors and accurate evaluation of tumor contour. The therapeutic effect was observed in the experimental group (IR780/FA-Nds-DTX) and four control groups (FA-Nds-IR780, FA-Nds-DTX, FA-Nds and normal saline). After low-intensity focused ultrasound irradiation for 30s induced microbubble blasting after phase transformation in each group, 808nm photothermal therapy apparatus was used to irradiate tumor area in each group. Two-dimensional ultrasound was used to monitor the changes in tumor volume in each group before and at 3 d, 9 d, 15 d after treatment, and the changes in tumor volume rate and inhibition in each group were statistically analyzed and compared.Results:The amount of IR780/ FA-Nds-DTX locally targeted aggregation was the largest, and the average fluorescence intensity of tumor in the experimental group was significantly higher than that of the control groups: IR780/ FA-Nds-DTX group compared with Nds(FITC) group[(5.12±0.69)×10 7 vs (1.06±0.23)×10 7, P<0.05], IR780/FA-Nds-DTX group compared with FA-Nds (FITC) group [(5.12±0.69)×10 7 vs (2.98±0.34)×10 7, P<0.05], IR780/FA-Nds-DTX group compared with IR-780 group [(5.12±0.69)×10 7 vs (1.54±0.42)×10 7, P<0.05], and there was no fluorescence in tumor area in saline group. Further contrast-enhanced ultrasound imaging after nanodroplet phase transformation could more accurately locate the tumor boundary. After 15 days of photothermal ablation combined with chemotherapy, the growth rate of tumor volume in the IR780/ FA-Nds-DTX treatment group was significantly lower than that in the control groups: IR780/FA-Nds-DTX group compared with FA-Nds-IR780 group[(0.105±0.075) vs (0.405±0.175), P<0.05], IR780/ FA-Nds-DTX group compared with FA-Nds-DTX group [(0.105±0.075) vs (1.385±0.035), P<0.05], IR780/ FA-Nds-DTX group compared with FA-Nds group [(0.105±0.075) vs (2.255±0.105), P<0.05], IR780/ FA-Nds-DTX group compared with normal saline group [(0.105±0.075) vs (2.185±0.155), P<0.05]. And the tumor inhibition rate increased significantly: IR780/ FA-Nds-DTX group compared with FA-Nds-IR780 group [(0.93±0.06) vs (0.48±0.17), P<0.05], IR780/ FA-Nds-DTX group compared with FA-Nds-DTX group [(0.93±0.06) vs (-0.51±0.105), P<0.05], IR780/ FA-Nds-DTX group compared with FA-Nds group [(0.93±0.06) vs (-1.63±0.115), P<0.05], IR780/ FA-Nds-DTX group compared with normal saline[(0.93±0.06) vs (-1.35±0.245), P<0.05]. Conclusions:The self-made phase-change ultrasound contrast agents IR780/FA-Nds-DTX have good potential clinical value in targeted detection and combined therapy of pancreatic cancer with small lesions or even metastases.

Objective:To assess the performance of liver and spleen stiffness measured by MR elastography (MRE) and their combined model in diagnosing liver fibrosis.Methods:From November 2018 to November 2019, 104 patients with chronic liver disease were prospectively enrolled in Beijing Friendship Hospital, all patients underwent MRE scans. Liver and spleen stiffness were measured from MRE elastograms. Liver biopsy was used to identify fibrosis stage (F0—F4). The differences among different fibrosis stages were analyzed by one-way ANOVA or independent samples t test. The Spearman rank correlation analysis was used to evaluate the correlation with fibrosis stages. Liver and spleen stiffness combined model was established by logistic regression. The ROC curve was used to evaluate the performance of the liver, spleen stiffness and combined model in staging fibrosis (≥F1), significant fibrosis (≥F2), advanced fibrosis (≥F3), and cirrhosis (F4).The area under the ROC curve(AUC) was compared using Delong test. Results:The liver and spleen stiffness both showed significant differences among the 5 fibrosis stages ( F=64.058, 32.890, both P<0.001). The liver and spleen stiffness were positively associated with fibrosis stage ( r s=0.89, 0.69, both P<0.001). The AUC of liver stiffness in staging ≥F1, ≥F2, ≥F3 were 0. 91, 0.97, 0.93, respectively. The corresponding AUCs of the spleen stiffness were 0.81, 0.82, 0.85, respectively, which were statistically lower than those of liver stiffness ( Z=2.283, 4.085, 2.314, P=0.022,<0.001, 0.021). In diagnosing F4, the AUCs of liver and spleen stiffness were both 0.95. The AUCs of the liver and spleen combined model were 0.92, 0.97, 0.93, 0.96 in diagnosing ≥F1, ≥F2, ≥F3 and F4, with no significantly differences from liver stiffness (all P>0.05). Conclusions:The liver stiffness measured with MRE have better diagnostic performance than spleen stiffness in staging fibrosis. Parameters combined model slightly improves diagnostic value but without significant difference with liver stiffness in staging early fibrosis. Spleen stiffness evaluation is feasible in detecting cirrhosis.