Toimprovethesensitivity,aCuOnanoparticledopedinmolecularlyimprintedpolymer(MIP)film for the determination of phenobarbital was prepared by using methacrylic acid as functional monomers, ethylene glycol maleic rosinate acrylate as a cross linking agent by thermal polymerization method. The electrochemical properties of the nano-doped sensor were investigated using cyclic voltammetry ( CV ) , differential pulse voltammetry ( DPV ) , electrochemical impedance spectroscopy ( EIS ) and chrono-amperometry ( CA) . The chemical structures and morphologies of the imprinted films were characterized using Fourier transform infrared spectroscopy and scanning electron microscopy. The results indicated that the sensors response value of peak current showed a linear dependence on the phenobarbital concentration in the ranges of 1. 2 × 10-7-1. 5 × 10-4 mol/L of phenobarbital. ( Linear regression coefficient=0. 9984 ) with the detection limit ( S/N=3 ) of 8. 2 × 10-9 mmol/L. The prepared sensor was successfully applied to the determination of phenobarbital in practical samples with recovery ranging from 96 . 5% to 103 . 0%.

Objective To identify the patient-specific and surgery-specific risk factors related to the development of surgical site cranioplasty infection after decompressive craniectomy.Methods A consecutive cohort of 319 patients who had undergone cranioplasty following decompressive craniectomy for stroke or trauma at a single institution from January 2009 to June 2015 was retrospectively established.Logistic regression analysis was performed to predict determinants related to infection following cranioplasty.Results Cranioplasty infection occurred in 11 patients (3.4％).Logistic regression analysis identified that previous temporalis muscle resection (OR=20.21,95％CI:2.09-135.38,P=0.003),preoperative subgaleal fluid collection (OR=34.51,95％CI:2.65-226.39,P=0.001),and operative time (＞150 min) (OR=6.62,95％CI:0.96-37.43,P=0.044) were significantly associated with the development ofcranioplasty infection.Patient age,gender,indications for craniectomy,and time interval between initial craniectomy and cranioplasty were not predictors of the development of cranioplasty infection.Conclusions Long surgical time (＞150 min),presence of preoperative subgaleal fluid collection,and craniectomy with temporalis muscle resection may be risk factors for graft infection after cranioplasty.Surgical techniques should be developed to reduce operative time and avoid temporalis muscle resection when possible.In addition,meticulous dural closure aimed at reducing the formation of subgaleal fluid collection is important for the prevention of graft infections after cranioplasty.

OBJECTIVETo compare the effects of 15% hypertonic saline and 20% mannitol in doses of similar osmotic burden for treatment of intracranial hypertension in patients with severe traumatic brain injury.

METHODSWe used an alternating treatment protocol to compare the effects of hypertonic saline with that of mannitol given for episodes of increased intracranial pressure (ICP) in patients with severe brain injury. Standard guidelines for the management of severe traumatic brain injury were followed. For episodes of increased ICP, 20% mannitol (2 ml/kg, infused for over 20 min) and 15% saline (0.42 ml/kg, administered as a bolus via a central venous catheter) of similar osmotic burden were given alternately, with the choice of agent for the initial hypertensive event determined on a randomized basis. Reduction of ICP and duration of the action were recorded after each event.

RESULTSThe data were collected from 33 patients with 237 hypertensive events. The mean decrease in ICP was 8.7 mm Hg at 28.7∓9.3 min after mannitol treatment as compared with 9.3 mm Hg at 23.6∓7.1 min after treatment with hypertonic saline (P>0.05). The mean duration of the effect was 270 min for mannitol and 318 min for hypertonic saline (P>0.05).

CONCLUSIONSTreatment with 15% hypertonic saline and 20% mannitol in doses of similar osmotic burden produces similar effects in management of increased ICP in patients with severe traumatic brain injury in terms of the time of action onset, maximum ICP reduction, and duration of action.

Brain Injuries ; therapy ; Humans ; Intracranial Hypertension ; therapy ; Mannitol ; therapeutic use ; Saline Solution, Hypertonic ; therapeutic use

Objective To explore the nutritional risk influencing factors in stroke patients， and to discuss the formulation of rehabilitation nursing countermeasures. Methods We randomly selected 152 patients with acute hemorrhagic stroke admitted to our hospital from July 2018 to July 2020. Based on the results of the mini nutritional assessment （MNA） score， the patients were divided into normal group （49 cases）， risk group （53 cases）， and bad group （50 cases）. Single factor analysis and correlation analysis were used to analyze the nutritional risk factors， and the countermeasures for the influencing factors were discussed. Results Univariate analysis showed that stroke time， mechanical ventilation， swallowing dysfunction， ADL score， upper arm muscle circumference， serum albumin， and total lymphocyte count in risk and bad groups were different from the normal group. In comparison， the proportion of patients with mechanical ventilation and swallowing dysfunction was higher， and ADL score， upper arm muscle circumference， serum albumin level and total lymphocyte count were lower （P<0.05）. The Spearman rank correlation analysis showed that the factors with differences in the univariate analysis also showed correlation （P<0.05）. Among them， the positive correlation factors included the duration of stroke， receiving mechanical ventilation， swallowing dysfunction， NIHSS score， negatively related factors included ADL score， serum levels of albumin， transferrin， and hemoglobin. Multivariate Logistic regression analysis showed that stroke time （OR=1.739， P<0.001） and swallowing dysfunction （OR=3.966， P=0.008） were independent risk factors for malnutrition. ADL score （OR=0.687， P<0.001）， upper arm muscle circumference （OR=0.770， P=0.012）， serum albumin level （OR=0.870， P=0.003） were independent protective factors for malnutrition. Conclusion The nutritional status in stroke patients is not optimistic. Most patients have swallowing disorders， motor dysfunction， and poor self-care ability. At the same time， the body protein content in patients has decreased significantly. The clinical work is needed to deal with the patients' swallowing function recovery together with the treatment of nerve damage.