Objective:To further optimize the nutritional support program for elderly neurocritical patients, analyze the changes and influencing factors of serum albumin levels in elderly neurocritical patients after surgery, and explore the impact on prognosis.Methods:A retrospective cohort study was conducted to investigate the medical records of neurosurgical intensive patients in Shanghai Tenth People's Hospital from May 2015 to September 2019. All the patients were treated for at least 5 days after operation. Patients with severe liver and kidney dysfunction, mental illness and incomplete medical records were not included in the study. Patients aged ≥65 years were included as the experimental group and patients aged <65 years served as the control group. Generalized estimating equation and other models were used to analyze the difference in the trend of albumin level and its influencing factors between the two groups. Automated machine learning was used to explore the influence of factors such as albumin level, nutrition mode, age, sex, diagnosis, preoperative consciousness level on the prognosis of patients.Results:A total of 284 patients were included in the study, including 85 in the experimental group and 199 in the control group. There were no significant differences in baseline data such as sex, age, and proportion of nutritional patterns between the two groups. Generalized estimating equation and generalized mixed additive equation showed that albumin level in both groups reached the minimum on the 3rd day after operation, and the average level in the experimental group was significantly lower than that in the control group ( P=0.03). Cerebral hemorrhage, emergency surgery, and low preoperative albumin were risk factors ( P<0.05); intravenous supplementation of human albumin might have an adverse effect on the experimental group ( P = 0.047). Machine learning models suggested that the higher the serum albumin level at discharge, the better the prognosis at 1 month after surgery. The area under ROC curve was 0.906, the specificity was 93.7%, and the sensitivity was 67.0%. Conclusions:The changes of albumin level in elderly patients with neurological critical illness after surgery are basically the same as those in young patients, with the lowest albumin level on the 3rd day after surgery, and the albumin levels even lower on the 3rd day after surgery in patients with cerebral hemorrhage, emergency surgery and preoperative low albumin. The higher the albumin level at discharge, the better the prognosis of patients may be.

OBJECTIVETo investigate the expressions of sphingosine-1-phosphate receptors 1-3 (S1P1- 3) in the corpus cavernosum of castrated male rats and its relationship with the NOS/NO/cGMP and RhoA/Rho kinase signaling pathways.

METHODSWe equally randomized 18 eight-week-old healthy male SD rats into a sham-operation control, a castration, and a testosterone replacement (TR) group and harvested the bilateral testes and epididymides from the rats in the latter two groups, followed by 4 weeks of subcutaneous injection of testosterone propionate at 3 mg per kilogram of the body weight per day for those in the TR group and that of plant oil for those in the control and castration groups. At the age of 12 weeks, we measured the serum testosterone (T) level and maximum intracavernous pressure/mean arterial pressure (ICPmax/MAP) of the animals and determined the expressions of SlP1-3, eNOS, P-eNOS, ROCK1, and ROCK2 in the corpus cavernosum by Western blot and immunohistochemistry.

RESULTSThe serum T level was significantly decreased in the rats of the castration group as compared with those of the control and TR groups ([0.41 ± 0.04] vs [16.01 ± 1.02] and [15.84 ± 1.32] nmol/L, P < 0.01), with no statistically significant difference between the latter two groups. The ICPmax/MAP at 0 V, 3 V, and 5 V electric stimulation was remarkably lower in the rats of the castration group (0.088 ± 0.014, 0.323 ± 0.014, and 0.432 ± 0.012) than in those of the control group (0.155 ± 0.011, 0.711 ± 0. 010, and 0.819 ± 0.024) and TR group (0.153 ± 0.012, 0.696 ± 0.017, and 0.763 ± 0.027) (P < 0.01), with no significant difference between the latter two groups. With GAPDH as internal control, the animals of the castration group showed markedly reduced expressions of S1P1 ([49.99 ± 3.39]%), eNOS ([46.82 ± 3.81]%) , and P-eNOS ([45.42 ± 4.35]%) in comparison with those in the control group ([72.57 ± 3.06], [89.76 ± 3.98], and [82.53 ± 8.92] and TR group ([71.77 ± 4.43], [87.19 ± 4.23], and [79.82 ± 7.38]%) (P < 0.01) , while the expressions of S1P2, S1P3, ROCK1, and ROCK2 were significantly upregulated in the castration group ([82.35 ± 4.13], [61.03 ± 5.14], [74.50 ± 4.02], and [69.83 ± 5.75]%) as compared with those in the control group ([41.67 ± 1.68], [31.66 ± 2.67], [35.69 ± 5.56], and [39.85 ± 7.17]%) and TR group ([42.80 ± 3.87], [32.25 ± 4.22], 38.06 ± 5.21], and [42.36 ± 4.44]%) (P < 0.01).

CONCLUSIONAndrogen deficiency induces significant reduction of ICPmax/ MAP in male rats, which is possibly associated with the decline of S1P1 in the corpus cavernosum, inhibition of the eNOS/NO/cGMP signaling pathway, increased expressions of S1P2 and S1P3, and activation of the RhoA/Rho kinase signaling pathway.

Animals ; Male ; Nitric Oxide Synthase Type III ; metabolism ; Orchiectomy ; Penis ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Receptors, Lysosphingolipid ; metabolism ; Testosterone ; blood ; pharmacology ; rho-Associated Kinases ; metabolism

Objective To investigate the effects of stimulation of CD40 on the growth,prolifera- lion and apoptosis of gastric cancer cell lines,and the change of gene expression profiles of gastric cancer cell AGS.Methods The growth and proliferation of AGS cells treated with different concentrations of soluble CD40 ligand were measured by MTT in order to choose optimum stimulating concentration of so- luble CD40 ligand.Cell cycle and apoptosis of AGS cells were analyzed by flow cytometry.Gene expres- sion profiles of AGS cells were analyzed by Affymetrix U133A 2.0 after treated with soluble CD40 ligand for 48 h.Results Two?g/ml of.soluble CD40 ligand was the optimum concentration.After being cul- tured with soluble CD40 ligand for 48h,the growth of AGS cell was inhibited and blockade in G1 phase. There were 414 alterative genes found in AGS cells including 209 up-regulated genes and 205 down-regu- lated genes.Forty-five genes varied significantly(P

Objective To observe the effect of Yiqi-huoxue and Huatan formula on inflammation reactivation in stable coronary heart disease(CHD).Methods 60 cases with stable CHD were randomly divided into the control group(30 cases,treated with routine therapy)and study group(30 cases,treated with routine therapy plus Yiqi-huoxue and Huatan formula).Duration was one month.Results There was no significant difference of concentration of CD40L before and after treatment in the control and study groups(P>0.05).There was a significant difference in concentration of matrix metalloproteinase-9(MMP-9)before and after treatment in the control and study groups(P<0.05).There were significant changes of CD40L and MMP-9 in the study group than in the control group(P<0.05).Conclusion Yiqi-huoxue and Huatan formula can decrease serum concentration of CD40L and MMP-9,and inhibit initiation and development of inflammation reactivation,furthermore stable atherosclerotic plaque and reduce coronary events.

Adolescent ; Diagnosis, Differential ; Humans ; Male ; Sturge-Weber Syndrome ; pathology

Objective To understand the current situation of iodine deficient disorder(IDD) 10 years after achieving the stage goal of eliminating IDD in Longyan city and to evaluate the effect of prevention and treatment measures, and to provide the basis for the development of control strategies. Methods There were 7 counties in the city, and each county(city, district) was as a unit to carry out the inspection for organization and leadership,iodine salt management, monitoring and control, health education (referred to as the four management indicators)according to "The County-Level Assessment and Evaluation Implementation Detailed Rules of Realizing the Goal to Eliminate IDD in Fujian Province". According to the east, west, south, north and middle positions in each county,a village and a primary school were selected. Forty 8 to 10 year-old students in each school were randomly selected to check thyroid and among them 20 students were collected urine samples to determine urinary iodine. Nine townships were selected in the 7 counties of the city and among which 4 administrative villages were selected in each township. Eight edible salt samples from each household in each administrative village were collected to test salt iodine. Goiter was examined by palpation, the level of urinary iodine was examined by arsenic and cerium spectrophotometry, salt iodine was detected by direct titration. Results The average score of the four management indicators was 94.1 in Longyan city. The adjusted goiter rate of children aged 8 - 10 years old was 1.9%. The median of urinary iodine was 278.6 μg/L, among which less than 100 μg/L accounted for 4.57%(32/700), 100 -＜ 200 μg/L accounted for 24.00%(168/700), 200 - ＜ 300 μg/L accounted for 25.29%(177/700), and higher than 300 μg/L accounted for 46.14%(323/700). The using rate of qualified iodized salt was 98.86%. The coverage rate of iodized salt was 99.50%, the qualified rate of iodized salt was 99.35%, and the rate of non-iodized salt was 0.50%. All the indicators had reached the national standard to eliminate IDD. Conclusions After achieving the stage goal of eliminating IDD, the disease is stable and the effect of control measures are significantly. But the iodine provided has a trend of more than suitable. Therefore, it is reasonable to reduce the current salt iodine content.

Objective To understand the current situation of iodine deficiency diserders(IDD) in Longyan City and to evaluate the effect of prevention and control measures of IDD in order to provide evidence for formulating prevention and control tactics. Methods During the year of 2006 and 2007, the 30 primary schools were screened by population proportion survey(PPS) from the 7 counties of Longyan City. Forty children aged 8-10 years in each school were randomly selected as a group to examine thyroid, and 7 children in each group were selected to measure the urine iodine and the salt iodine at the same time. The goiter rote, the median urinary iodine, the consumption rate of qualified iodized salt, the iodine salt coverage rate, the rate of qualified iodized salt and the non-iodized rate were detected. Results The goiter rate of children aged 8-10 years old in Longyan City was 0.94%(79/8438). The median urinary iodine was 259.12 μg/L. The consumption rate of qualified iodized salt was 97.86% (1462/1494). The iodine salt coverage rate was 99.46%(1486/1494). The rate of qualified iodized salt was 98.38 (1462/1486), and the non-iodized rate was 0.54% (8/1494). Conclusions All indicators have reached the national standard of eliminating IDD in Longyan City.

Carotid Body Tumor ; complications ; Female ; Glomus Jugulare Tumor ; complications ; Humans ; Middle Aged ; Paraganglioma ; complications

Child, Preschool ; Female ; Hand, Foot and Mouth Disease ; complications ; diagnosis ; therapy ; Humans ; Infant ; Male ; Pulmonary Edema ; etiology ; Radiography, Thoracic

Objective To get the information about the geriatric syndromes in the elderly with different age and gender so as to provide the basis for management of the geriatric syndromes.Methods A questionnaire survey was used to investigate and analyze the geriatric syndromes in 2 778 older subjects aged 60 years and above from Zhejiang and Jiangsu province.Results Among all 2 778 old adults,(3.4 ± 1.8)geriatric syndromes in average were found.The difference in geriatric syndromes number between different age groups showed a statistical significance(F =145.135,P＜ 0.001),but a significant difference in geriatric syndromes number between male and female group was not found(t=0.817,P=0.414).On the top incidence rate of geriatric syndromes were daily life ability defects 2 199 cases(79.2％),falls 1 828 cases(65.8％),urinary incontinence 1 356 cases(48.8％),sleeping disorder 1 023 cases(36.8 ％),cognitive impairment 908 cases (32.7 ％) and visual impairment 896 cases (32.3 ％).Among above six geriatric syndromes,the incidence of daily life ability defects,falls,urinary incontinence,sleeping disorder and cognitive impairment seemed to increase with ageing (P＜0.001).The incidence of daily life ability defects,falls and urinary incontinence was higher in males than in females (P＜ 0.05).The incidence of sleeping disorder and cognitive impairment was higher in females than in males(P＜0.05).The elderly patients with 3 or more geriatric syndromes exceeded about 66.4 ％.The most common clusters of geriatric syndromes were daily life ability defects combined with falls and urinary incontinence,which seemed to significantly increase along with ageing (x2=202.523,P＜0.001).Conclusions Geriatric syndromes are common in the elderly,medical care workers should pay attention to the management of the geriatric syndromes,and promote the development of the elderly healthcare.