Objective To investigate the prognostic related factors in the patients with ruptured intracranial aneurysm treated by surgical treatment and their clinical significance .Methods The medical record data in 218 cases of ruptured aneurysm treated by operative treatment were performed the retrospective analysis ,including th egeneral data ,Hunt‐Hess grade on admission ,surgical procedure ,etc .The patient′s prognosis situation adopted the Glasgow outcome scale(GOS) as the evaluation standard when dis‐charge from hospital .Firstly the possible factors were performed the single factor analysis ,then the factors with statistic signifi‐cance in the single factor analysis were performed the multiple factors logistic regression analysis .Results The single factor analy‐sis indicated that the age ,Hunt‐Hess grade on admission ,hypertension ,operation mode ,CT Fisher grading and symptomatic vaso‐spasm were significantly correlated with the prognosis ( P < 0 .05) .The multiple factors analysis indicated that age ,Hunt‐Hess grade on admission ,symptomatic vasospasm ,CT Fisher grading were the independent risk factors affecting the prognosis of patients (P< 0 .05) .Conclusion The patients′ age ,Hunt‐Hess grade on admission ,symptomatic vasospasm and CT Fisher grading can sig‐nificantly affect the prognosis of the patients with ruptured intracranial aneurysm after surgical treatment .Paying attention to the predictive value of these predictors has important clinical significance to reduce the postoperative mortality rate and disability rate in the patients with ruptured intracranial aneurysm .

Objective To evaluate serum cystatin C combined with dipstick proteinuria as early markers to predict AKI available before surgery.Methods We prospectively followed 616 patients undergoing cardiac surgery.Univariate as well as multivariate regression was performed.Cystatin C combined with dipstick proteinuria before surgery was assessed for its' predictive value of AKI using receiver operator characteristic (ROC) curves.Results Patients in higher cystatin C quartiles were older(P ＜ 0.001),more often to have heavy proteinuria(P =0.021),hyperuricemia(P ＜ 0.001),heart failure(P ＜ 0.001)and recent MI (P =0.002).Those with heavy proteinuria were more often to have diabetes mellitus (DM) (P =0.010),hyperuricemia (P =0.043),worse cardiac function (P ＜ 0.001),higher creatinine levels (P ＜ 0.001) and lower eGFR levels (P ＜0.001).In a multiple logistic regression model,preoperative heavy proteinuria(OR =3.14) and preoperative cystatin C quartiles each associated with an increased odds of AKI,independent of advanced age (OR =1.04),hypertension (OR =1.88) and combined surgery(OR =3.47).The risk for adverse outcomes such as postoperative AKI,persistent AKI,severe AKI,dialysis and mortality were highest in patients with highest quartile of cystatin C(P ＜0.05,respectively) and heavy proteinuria (P ＜ 0.05,respectively).The area under the ROC curve(AUCs) for preoperative cystatin C combined with proteinuria to detect AKI,persistent AKI and severe AKI were 0.695,0.753 and 0.718,P ＜0.001 respectively.Conclusion These data suggest that preoperative serum cystatin C combined with dipstick proteinuria may improve prediction of AKI among patients undergoing cardiac surgery.

Objective:To evaluate the effects of endovascular embolization and microsurgical clipping on cognitive function in patients with intracranial aneurysm.Methods:A total of 80 patients with intracranial aneurysms,who were treated in Chongqing Hospital of Traditional Chinese Medicine from March 2014 to September 2015,were selected and randomly divided into control group(n=40) and experimental group (n=40).The control group was treated with microsurgical clipping,and the experimental group,with endovascular embolization.The postoperative cognitive function was assessed by the mini mental state examination scale (MMSE),and length of stay,in-hospital mortality rate,mortality rate in 1 year and the incidence of postoperative adverse reactions were compared between the two groups.Results:The total score (26.78± 0.85) of MMSE in the experimental group was higher than that (22.25± 0.63) of the control group (P＜0.05).The cognitive dysfunction rate (37.50％) of the experimental group was lower than that (55.00％) of the control group (P＜0.05).The length of stay [(6.7± 3.9) days] of the experimental group was lower than that [(9.6± 4.5) days] of the control group(P＜0.05).There were no significant differences in in-hospital mortality rate and mortality rate in 1 year,and the incidence of adverse reactions between the two groups (P＞0.05).Conclusion:Endovascular interventional therapy can improve the cognitive function of the patients with intracranial aneurysms and shorten the length of hospital stay.

Cerebral apoplexy is one of the main causes of death in the middle-aged and elderly population,which has higher mortality and disability rate.The incidence of the disease is increasing year by year and it is a serious threat to human life and health.Therefore,it is of great significance to find an effective target for the diagnosis and treatment of stroke.Thioredoxin (Trx) is the major thiol reducing agent in the cells,it is involved in many signal transduction pathways in the cells by regulating the redox state of the cell.It has disulphide reductase activity,which can reduce the oxidative stress injury in the rats after the stroke.Thioredoxin interacting protein (TXNIP) is an endogenous inhibitor of Trx,it can destroy the redox balance and promote the oxidative stress by binding/inhibiting the activity of Trx,while the inhibition or knockdown of TXNIP has obvious neuroprotective effects.Recent studies suggest that Trx/TXNIP may be involved in the pathophysiology of cerebral apoplexy by a variety of pathways.This article analyses the research status of Trx/TXNIP and studies the localization of Trx system in the central nervous system and the progress of Trx system in ischemic cerebral apoplexy.It reviews the mechanism of Trx/TXNIP in cerebral apoplexy and prospectes the signaling pathways involved in the pathophysiological process of Trx/TXNIP to provide new ideas for the treatment of cerebral apoplexy.

Objective To study the impacts of berberine on the growth, migration and radiosensitivity in human breast cancer cells.Methods MTT assay was used to evaluate cell growth.In vitro scratch migration assay was used to determine cell migration.Annexin V assay was used to detect cell apoptosis.The distribution of cell cycle was evaluated by flow cytometry assay.Colony formation assay was used to detect the influence of berberine on cell radiosensitivity. Western blot assay was employed to measure protein expression.Results Berberine inhibited cell growth and migration in two human breast cancer cell lines, MCF-7 and MDA-MB-231, in a dose-and time-dependent manner. Furthermore,berberine resulted in a cell cycle G0/G1 arrest.Compared with control,the early apoptosis in MDA-MB-231 and MCF-7 cells treated with 40 pμmol/L of berberine was as high as 86.6％ and 66.6％ (t =8.79,10.32,P ＜ 0.01 ),respectively. Berberine caused a dose-dependent increase in Bax and Caspase-3 protein expressions,but did not change Cyclin D1 protein expression,while suppressed the expressions of Cyclin B1 and Bcl-2 protein. As analyzed with multi-target click model fitting curves,the SERD0 of berberine-treated cells were 1.12 and 1.22 for MDA-MB-231 and MCF-7cells respectively at the dose D0 of X-rays.Conclusions The berberine inhibited the growth and migration of breast cancer cells via apoptosis induction and cell cycle arrest.Moreover,berberine increases cell sensitivity to X-ray irradiation.

Objective To explore the possible mechanism by which thioredoxin-interacting protein (TXNIP) par?ticipated in early brain injury (EBI) of subarachnoid hemorrhage (SAH) via examination of the expression of TXNIP and its downstream apoptotic factors before and after intervention. Methods Subarachnoid Hemorrhage (SAH) was performed by endovascular perforation. Total 97 adult male SD rats were randomly divided into 6 groups:sham-operation (17), SAH (32), control siRNA (12), TXNIP siRNA (12), resveratrol control (12) and resveratrol injection (12). Western blot was used to examine the expression of TXNIP, p-ASK-1, Caspase-3 before and after intervention. Laser scanning confocal microscopy (LSCM) was used to detect the expression of TXNIP in neurons. The co-localization of TXNIP with apoptotic cells was examined by using fluorescent TUNEL. Mortality, behavior score and cerebral edema were also evaluated. Re?sults Mortality, behavior scores and brain edema were improved after TXNIP siRNA and resveratrol injection(P<0.05). LSCM showed that TXNIP was widely expressed in brain and mainly located in cytoplasm of neurons in SAH rats. Fluo?rescent TUNEL revealed the co-localization of TXNIP with apoptotic cells. The expression level of TXNIP was signifi?cantly higher in SAH group than in sham operation (P<0.05, n=3). The expression level of TXNIP gradually increased at 12h and still remained at high level at 72h (P<0.05). This increase was simultaneously accompanied by the increase in downstream apoptosis factors, p-ASK-1 and Caspase-3. Inhibition of TXNIP by siRNA or resveratrol significantly re?duced the expression of TXNIP, p-ASK-1 and Caspase-3 (P<0.05, n=3). Conclusion TXNIP gradually increases in ear?ly period after SAH and aggravates brain damage through activation of ASK-1 apoptosis signaling pathway, whereas inhi?bition of TXNIP may attenuate EBI through reduction of p-ASK-1 and Caspase-3 after SAH.

Objective To analyze the influence of drainage volume on prognosis of acute hydrocephalus(AHC)after aneurysmal subarachnoid hemorrhage(aSAH)by continuous lumbar drainage.Methods A retrospective trial was conducted on 82 AHC patients after aSAH admitted to the First Affiliated Hospital of Chongqing Medical University between January 2017 and January 2022.In 6 months after discharge,modified Rankin Scale(mRS)score was used to evaluate the prognostic outcomes.Univariate and multivariate logistic regression analyses were performed on demographic factors,severity of subarachnoid hemorrhage(SAH)at admission,medical history,cerebral vasospasm,and lumbar drainage data.Then a nomogram prediction model was constructed.Results Univariate analysis found that World Federation of Neurosurgical Societies(WFNS)score,Hunt-Hess grade,modified Fisher grade,time for continuous lumbar drainage,shunt dependence,cerebral vasospasm,and drainage volume were factors affecting the prognosis of the patients.Then logistic regression analysis revealed that high WFNS score(OR:3.25,95％CI:1.11～9.48),high modified Fisher grade(OR:3.66,95％CI:1.08～12.35),shunt dependence(OR:15.56,95％CI:1.22～198.57),and cerebral vasospasm(OR:22.24,95％CI:3.08～160.68)were independent predictors for mRS score,while volume of continuous lumbar drainage(OR:0.57,95％CI:0.40～0.82)was an independent protective factor.ROC curve analysis indicated a good predictive performance of the model(AUC=0.898,95％CI:0.935～0.861).Internal validation through Bootstrap method demonstrated excellent discriminatory ability of the model(C-index=0.950,95％CI:0.904～0.996;adjusted C-index:0.934).Conclusion Increased volume of lumbar drainage is an independent protective factor for poor prognosis following aSAH and can improve the prognosis of SAH patients.

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.