Objective To study the effects of rehabilitation training on angiogenesis and its ultrastructure and expression of CD32 in the peri-infarction region of rats with focal cerebral infarction. Methods Sixty-six Spra-gue-Dawley rats with experimental left middle cerebral artery occlusion (MCAO) were used as subjects in this study. All the rats were randomly divided into three groups: a rehabilitation training group (n=30), which was given bar rotating, balancing and rolling exercises everyday after 48 hours post MCAO; a control group (n = 30) and a sham-operated group (n=6), which were fed in cages with no special training exercises. Then brain tissues were fixed on the 3rd d, 7th d, 14th d after MCAO, for observing the morphological alterations of microvessels in peri-infarction re-gion using transmission electron microscope, immunohistochemistry and Western blotting were used to measure the ex-pression of CD31, which acted as the marker of the neogenetic microvessels. Results (1) It showed that the capil-lary endothelial cells were less edematous in the rehabilitation training group, and there were less pinocytosis bullae in basal membrane more integral nucleus of endothelial cells in rehabilitation training group when compared with those in the control group. (2) Expression of CD31 can be observed in peri-infarction region in both groups from the 3rd d on-wards, and peaked on the 7th d, and then gradually went down after the 14th d. Comparison between the 2 groups showed that the expression of CD31 in rehabilitation training group was higher than that in the control group at every time point, but statistical difference between the 2 groups in this regard could be revealed only on the 7th d (P< 0.05), Conclusion Rehabilitation training could promote ultrastruetural recovery of microvessels and induce an-giogenesis in peri-infaretion region, and it might be one of the mechanisms of neural functional recovery in rats after MCAO.

Objective To study the effects of rehabilitative training on motor function and expression of GAP-43 and SYN in rats with local cerebral infarction. Methods A total of 76 male adult Sprague-Dawley rats were randomly divided into a rehabilitative training group(n=32),a control group(n=32),and a sham-operated group(n=1 2).All the rats were subjected to left middle cerebral artery occlusion(MCAO)with the suture occlu sion.Motor training programs including balancing,grasping,rotating and walking exercises were administered to the rats of the rehabilitative training group at 48 hours post-operation,while those of other two groups were reared in their original living status without any special training.The animals were given behavioral tests with Bederson test,balancing wood test,net screen test to assess the functional outcome,and immunohistochemistry staining was employed to evaluate the exDression of GAP-43 and SYN in peri-infarction cortex at the 3rd,7th,21 st,35th days after MACO,respectively. Results The scores of behavioral tests in the rehabilitative training group was better than those in the control group(P＜0.05)at the 7th,21 st,35th day after MCAO,and the immunostaining showed that expression of GAP-43 was higher in the rehabilitative training group than that in the control group(P＜0.05)and the sham operated group(P＜0.01)at the 7th and 21 st days post-operation,respectively,and that the expression of SYN was higher in the rehabilitative training group than that in the control(P＜0.05)and the sham operated groups(P＜0.05)at the 21 st and the 35th days post-operation,respectively. Conclusion Rehabilitative training can improve func tional recovery in rats with local cerebral infarction,and the function enhancement may be partially attributed to the up-regulation of expression of GAP-43 and SYN in peri-infarction cortex.

Objective To evaluate the safety and efficacy of intra-arterial infusion neoadiuvant chemotherapy in local advanced bladder cancer. Methods Nineteen cases with T2-T4a bladder cancer were enrolled in this study.Intra-arterial infusion chemotherapy with Gemcitabine and Cisplatin (GC)were performed for 1 to 3 cycles before radical cystectomy.Postoperative values of hematological parameters,maximum diameter of tumors,TNM(tumor,node and metastasis)stages and pathological grades were compared with preoperative parameters of the same case. Results Compared to the values before GC chemotherapy,WBC count showed no significant change post-operative,(6.63±2.58)×109/L vs(5.12±2.91)×109/L(P=0.13);RBC(4.41+0.52)×1012/L vs(3.92±0.42)×1012/L(P=0.00)and platelet count(220.50±59.86)×109/L vs(157.05±56.72)×109/L(P=0.001)showed significant decrease;ALT did not show significant decrease(20.00±8.31 vs 26.88±17.04 U/L,P=0.08);Creatltme also showed no significant change(95.82±14.57 vs 88.04±17.76μmol/L,P=0.06);Maximum diameter of tumors decreased significantly(3.72±1.23 vs 2.80±1.29 cm,P=0.02).Compared with clinical TNM stages,pathological TNM stages demonstrated significant decrease in 9 cases;While cell differentiation did not show decrease. Conclusions Intra-arterial infusion with GC regimen can reduce tumor size,decrease TNM stages,while not causing significant adverse impact to radical cystectomy.Bladder-spare treatment is an option for chemotherapy-sensitive cases.

Cardiac arrest (CA) is a serious cardiac event, which has a high incidence and low survival rate at home and abroad. In order to predict the risk of CA in advance, a large number of studies have been conducted by relevant researchers. This paper mainly summarizes the characteristics and research status of the existing analysis and prediction of CA from three aspects: the risk prediction factors of CA, the evaluation index of risk prediction of CA and the early warning scoring system of CA. We hope it can help medical staff to understand the current progress in this field, and provide new ways and methods for predicting the risk of CA.

Objective:To investigate the effect of early external diaphragm pacing on the diaphragm function and prognosis of patients with mechanical ventilation.Methods:A total of 47 patients receiving invasive mechanical ventilation in the Emergency Intensive Care Unit of Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University) from October 2019 to July 2021 were selected and randomly divided into the treatment group ( n=23) and control group ( n=24). The patients in the control group received routine clinical treatment. On this basis, the treatment group received external diaphragm pacing treatment every day from the third day of mechanical ventilation until weaning, and was followed up to 30 days after discharge. The diaphragm thickness, diaphragm excursion, diaphragm thickening fraction, mechanical ventilation time, number of weaning failures, length of hospital stay and death toll were compared between the two groups. Results:Compared with the control group, the diaphragm thickness [(0.21±0.05) cm vs. (0.16±0.05) cm], diaphragm excursion [(1.38±0.37) cm vs. (1.11±0.48) cm], and diaphragm thickening fraction [26% (19%, 32%) vs. 18.5% (10.25%, 20%)] in the treatment group increased significantly (all P<0.05). The mechanical ventilation time was shorter in the treatment group [10 (7, 15) d vs. 13 (10.25, 19) d], and the difference was statistically significant ( P<0.05). There were no significant differences in the number of weaning failures (7 vs. 9), length of hospital stay [22 (15 , 30) d vs.. 24 (17.25, 34.25) d] and deaths (8 vs. 8) (all P>0.05). Conclusions:Early application of external diaphragm pacing can improve the diaphragm function of patients with mechanical ventilation, delay the decline in diaphragm function, increase diaphragm excursion and diaphragm thickening fraction, and shorten the mechanical ventilation time.

OBJECTIVE: To investigate the efficacy of arterial partial pressure of oxygen (PaO₂), procalcitonin (PCT) combined with ROX index in predicting the timing of tracheal intubation in patients with acute severe pancreatitis (SAP). METHODS: A case-control study was conducted. A total of 148 patients with SAP admitted to Hunan Provincial People's Hospital from January 2019 to December 2022 were selected as the research objects. According to whether endotracheal intubation was used after admission during hospitalization, the patients were divided into the intubation group (102 cases) and non-intubation group (46 cases). Gender, age, white blood cell count (WBC), lymphocyte count (LYM), platelet count (PLT), C-reactive protein (CRP), hemoglobin (Hb), PCT, PaO₂, arterial partial pressure of carbon dioxide (PaCO₂), arterial bicarbonate ion (HCO₃^-) 1 day after admission, arterial lactic acid (Lac), lactate dehydrogenase (LDH), heart rate (HR), respiratory rate (RR), pulse oxygen saturation (SpO₂), oxygenation index (PaO₂/FiO₂), blood pressure, worst ROX index (ROX index = SpO₂/FiO₂/RR) within 30 minutes of admission and 30 minutes before intubation of the two groups were measured. Multivariate Logistic regression was used to analyze the independent risk factors for the timing of endotracheal intubation in patients with SAP. The receiver operator characteristic curve (ROC curve) was used to determine the optimal predictive cut-off value for endotracheal intubation. RESULTS: There were no significant differences in age, gender, WBC, LYM, CRP, Hb, LDH, HR and blood pressure at admission between the two groups. The PLT, Lac, PCT and RR in the intubation group were significantly higher than those in the un-intubation group, and HCO₃^-, PaO₂, SpO₂, PaO₂/FiO₂, the worst ROX index within 30 minutes after admission and 30 minutes before intubation were significantly lower than those in the non-intubation group (all P < 0.05). Logistic regression analysis showed that the worst ROX index within 30 minutes before intubation was the largest negative influencing factor for the timing of tracheal intubation in SAP patients [odds ratio (OR) = 0.723, 95% confidence interval (95%CI) was 0.568-0.896, P = 0.000], followed by PaO₂ (OR = 0.872, 95%CI was 0.677-1.105, P < 0.001). PCT was the positive influencing factor (OR = 1.605, 95%CI was 1.240-2.089, P < 0.001). ROC curve analysis showed that the area under the ROC curve (AUC) of PaO₂, PCT, the worst ROX index within 30 minutes before intubation and the combination to evaluate the tracheal intubation time of patients with SAP were 0.715, 0.702, 0.722 and 0.808, the sensitivity was 78.1%, 75.0%, 81.5% and 89.3%, the specificity was 66.7%, 59.0%, 73.2% and 86.4%, and the best cut-off value was 60.23 mmHg (1 mmHg ≈ 0.133 kPa), 2.72 μg/L, 4.85, and 0.58, respectively. The AUC of the combination of PaO₂, PCT and the worst ROX index within 30 minutes before intubation predicted the timing of tracheal intubation in patients with SAP was significantly greater than using each index alone (all P < 0.01). CONCLUSIONS The worst ROX index within 30 minutes before intubation combined with PaO₂ and PCT is helpful for clinicians to make a decision for tracheal intubation in patients with SAP.
Humans ; Procalcitonin ; Oxygen ; Case-Control Studies ; Partial Pressure ; Retrospective Studies ; Pancreatitis/therapy* ; Intubation, Intratracheal ; Prognosis ; ROC Curve