Objective To observe the interaction between the extreme stress and mild traumatic brain injury in the patients surviving Wenchuan earthquake.Methods Forty survivors in Wenchuan earthquake were selected for the psychological status survey 2-30 days after the disaster,among them 20 survivors were suffering from mild traumatic brain injury,and the remainders were in normal physical conditions.The Symptom Checklist-90(SCL-90),which consisted of 90 items with 5 grades for each item(0-4 grade,grade zero as none and grade 4 as severe),including 9 symptom factors,was adopted to perform the evaluation for all the subjects in both groups,and the subscales were compared.Results Five subscales of SCL-90,including somatization,depression,anxiety,hostility and fear,which averaged 2.12?0.50,1.83?0.60,1.99?0.40,1.80?0.70 and 2.20?0.8,respectively,were significantly increased in mild traumatic brain injury group than that in control group(P0.05).Conclusions Mild traumatic brain injury occurred among survivors of severe earthquakes is strongly associated with psychological problems.A higher incidence of psychological disorder in survivors of earthquake with mild traumatic brain injury indicates that one must be cautious when attributing a health problem to mild traumatic brain injury,since the post-traumatic stress disorder and depression may be the primary problem.The high-risk population with psychological obstacle consists of the survivors with mild traumatic brain injury,and the interactions of both psychological stress and traumatic brain injury may lead to more complex clinical symptoms,so psychotherapy should be emphasized in the treatment of patients with mild traumatic brain injury.

Objective To investigate the effect of several types of cervical braces used for external immobilization on craniovertebral junction malformation. Methods 48 patients with craniovertebral junction malformation applied several types of cervical braces, including Philadelphia collar, sterno-occipito-mandibular immobilizer (SOMI) and Halo-vest, for the surgical treatment were retrospectively analyzed. Results The primary applications of external cervical brace after posterior internal craniovertebral fixation in this series were 20 cases of Philadelphia collar, 16 cases of SOMI and 12 cases of Halo-vest, with excellent or good results in 80%, 87.5% and 91.7%. The applications of external brace for post-hospital recovery were 16 cases of collar, 15 cases of SOMI and 17 cases of Halo-vest. 35 (72.9%) patients were followed-up for at least 4 months, with satisfying immobilization and duration which fulfilled the requirements for post-operative recovery. Conclusion The applications of the all of 3 kinds of external brace, including collar, SOMI and Halo-vest, have their important clinical value for peri-operational and post-operational recovery in the treatment of patients with craniovertebral junction malformation. To have a reasonable choice of these brace in different patients, the characteristics of pathology as well as the surgical stages should be taken into account.

Tetrahydroisoquinoline alkaloids distributed widely in the nature and some have a broad application in clinic. More attention has been paid in recent years on this type of alkaloid, owing to the diverse range of biological activities exhibited by these alkaloids and the discovery of new functional mechanisms and molecular targets underlying these activities. This article summarized the recent advances in the biological activities and functional mechanism of tetrahydroisoquinoline, which included the activities such as antitumor, antibiotic, antivirus, anti-inflammatory, anticoagulation, bronchodilation, and the action on central nervous system, with the purpose of providing some ideas in the study of biological activity of this type of alkaloid and in the search for lead-compound and rational drug design.
Animals ; Anti-Inflammatory Agents ; pharmacology ; Anticonvulsants ; pharmacology ; Antifungal Agents ; pharmacology ; Antineoplastic Agents ; pharmacology ; Antiviral Agents ; pharmacology ; Bronchodilator Agents ; pharmacology ; Central Nervous System Agents ; pharmacology ; Fibrinolytic Agents ; pharmacology ; Humans ; Neuroprotective Agents ; pharmacology ; Tetrahydroisoquinolines ; chemical synthesis ; chemistry ; pharmacology

Objective To explore the morphological changes of the atlantoaxial facet joint and the three-dimensional characteristics of joint dislocation in patients with atlanto-occipital assimilation accompanied by atlantoaxial dislocation. Methods Thirty-six patients with atlanto-occipital assimilation and concurrent atlantoaxial dislocation underwent spiral CT scanning of the craniovertebral junction, and the imaging data in DICOM format were transferred to the three-dimensional visualization workstation to construct the three-dimensional model of the craniovertebral junction. The characteristics of atlantoaxial dislocation in association with the bony malformation were studied in the reconstructed model. Results Multiple anomalies of the atlantoaxiai facet joint were found in these patients, including joint dislocation involving 57 sides in the 36 patients, skeletal deformity in 61 sides, and facet separation in 11 sides. Three-dimensional classification identified 3 types of atlantoaxial dislocation in these patients, namely symmetrical type (14 cases, 39%) representing the approximately symmetrical joint dislocation and/or skeletal distortion, rotational type (13 cases, 36%) representing apparently asymmetrical joint dislocation and/or skeletal deformity, and separate type (9 cases, 25%) with separation of the joint facets. Conclusion In patients with atlanto-occipital assimilation, multiple factors including developmental anomaly, secondary skeletal deformity and ligament extension and fatigue interact as the fundamental causes ofatlantoaxial dislocation. The CT-based three-dimensional model of the craniovertebrai junction allows visualization of the atlantoaxial facet joint and atlantoaxial dislocation to provide important evidence for surgical planning and decision on the internal fixation approaches.

Objective To observe the clinical efficacy of scalp acupuncture combined with electroacupuncture in the treatment of aphasia after ischemic stroke. Methods Totally 90 patients with aphasia after ischemic stroke were randomly divided into the control group and the treatment group, with 45 cases in each group. The control group received Schuell language training, 30 min each time, while the treatment group received scalp acupuncture plus electroacupuncture (Yifeng, Baihui, Houxi and Tongli), 20 min each time. The treatment for both group was 5 times a week and lasted for 16 weeks. The clinical efficacy was evaluated by aphasia degree, Chinese functional communication profile (CFCP) score and Western aphasia battery (WAB). Results There was statistical significance between the treatment group and the control group in the level of aphasia degree (P＜0.05). Compared with before treatment, the total scores of CFCP and WAB in both groups increased, with statistical significance (P＜0.05). The total scores of CFCP and WAB in treatment group were higher than control group, with statistical significance (P＜0.05). The total effective rate of the therapeutic effect was 91.11% (41/45) in the treatment group and 75.56% (34/45) in the control group, with statistical significance (P＜0.05). Conclusion Scalp acupuncture combined with electroacupuncture can obviously improve the language understanding and expression ability and language communication ability of aphasic patients after ischemic stroke.

OBJECTIVETo carry out molecular epidemiology study of SLC26A4 IVS7-2 A > G mutation in large Chinese deaf population and to provide evidence for fast screening and gene diagnosis of enlarged vestibular aqueduct syndrome (EVAS).

METHODSA total of 1979 patients with non-syndromic hearing loss(NSHL) underwent questionnaire and PCR for IVSA > G mutation detection of SLC26A4 gene.

RESULTSAll 245 patients (12.38%) with homozygotes and heterozygotes IVS7-2 A > G mutation were found among the 1979 NSHL It showed statistically significant difference among north and northeast, northwest, east and southeast, southwest and central area in China. (chi2 = 34.4899, P < 0.05). Carrier frequency of the central area (27.52%) was notably higher than southwest area (6.69%). The IVS7-2 A > G mutation was most frequently found in Han deaf groups (13.88%). Tibetan, Hui, and other western minorities were lower than Han deaf population (chi2 = 35.4456, P < 0.05).

CONCLUSIONSA high SLC26A4 IVS7-2 A > G mutation frequency for deafness in Chinese patients was found. Detection of the pathogenic mutations was bringing the possibility to detect EVAS at an early stage. Moreover, it might help to establish diverse diagnostic strategies toward differently ethical deaf population in different region of China.

Adolescent ; Adult ; Asian Continental Ancestry Group ; genetics ; Child ; Child, Preschool ; China ; epidemiology ; Ethnic Groups ; Gene Frequency ; Genotype ; Hearing Loss, Sensorineural ; epidemiology ; genetics ; Humans ; Membrane Transport Proteins ; genetics ; Point Mutation ; Young Adult

Objective:To investigate the changes of cognitive function in non-fatal drowning rats after blast-induced traumatic brain injury (bTBI).Methods:Eighty SD rats were divided into normal group, bTBI group, drowning group and bTBI plus drowning group according to the random number table, with 20 rats per group. Rats in normal group were not injured. In bTBI group, bTBI was established in a BST-I biological shock tube with a pressure of 4.0 MPa in the driving section. In drowning group, rats were subjected to non-fatal drowning by falling into the water with temperature of 18 ℃ and depth of 30 cm from the height of 1 m and were taken out quickly after swimming to exhaustion. After being injured in a biological shock tube, rats in bTBI plus drowning group were immediately forced to drowning using the same method. On day 3 post-injury, the neurocognitive function was evaluated by elevated plus maze and Morris water maze tests. Morphological changes of neurons in CA1 and CA3 regions of hippocampus were observed by Nissl staining, and the number of surviving neurons were counted. The concentrations of hippocampal neurotransmitters glutamate, γ-aminobutyric acid (GABA), glycine and endoplasmic reticulum stress (ERS) related glucose-regulated protein 78 (GRP78) and caspase-12 were examined by ELISA analysis. Levels of B-cell lymphoma-2 (Bcl-2), Bcl-2 associated protein (Bax) and caspase-3 were detected by Western blotting. The ratio of Bcl-2 to Bax was calculated as well.Results:In elevated plus maze test, the percentage of open arm entry and number of head-dipping behaviour were decreased in bTBI plus drowning group compared with normal and bTBI groups at 3 days after injury ( P<0.05 or 0.01), with no statistical difference from those in drowning group ( P>0.05). The number of head-dipping behaviour in drowning group was lower than that in bTBI group ( P<0.05). In Morris water maze test, bTBI plus drowning group showed increased target latency on the third and fourth days of spatial acquisition training and decreased number of crossing the target area and percentage of swimming time in the target quadrant during probe trials as compared with normal group ( P<0.05 or 0.01), but there was no statistical difference among bTBI, drowning and normal groups (all P>0.05). Nissl staining showed that the neurons in the CA1 and CA3 regions of hippocampus in normal group were arranged neatly with clear Nissl bodies at 3 days after injury, while the other groups showed different degrees of injury. In contrast with normal group, the neurons in the CA1 and CA3 regions of hippocampus in all other groups were decreased with the lowest number in bTBI plus drowning groups ( P<0.05 or 0.01). In ELISA analysis, the level of hippocampal glutamate in bTBI plus drowning group was higher than that in all other groups at 3 days after injury and the level in bTBI injury and drowning groups was higher than that in normal group ( P<0.05 or 0.01); the level of hippocampal glycine in bTBI plus drowning group was lower than that in normal group ( P<0.05), but there was no statistical difference among bTBI, drowning or normal groups (all P>0.05); the concentration of hippocampal GABA had no statistical difference among all groups (all P>0.05). In addition, the concentration of GRP78 in bTBI injury, drowning and bTBI injury plus drowning groups were increased compared with normal group ( P<0.05 or 0.01), but did not statistically differ from each other (all P>0.05). The concentration of caspase-12 in drowning and bTBI plus drowning groups were increased compared with normal group ( P<0.05 or 0.01), but was not statistically different from each other ( P>0.05), and its concentration in bTBI plus drowning group was increased compared with bTBI group ( P<0.05). In Western blotting, the level of Bcl-2 in bTBI plus drowning group was decreased compared with all other groups at 3 days after injury, and the level in bTBI and drowning groups were decreased compared with normal group, but a much lower level was observed in drowning group than that in bTBI group ( P<0.05 or 0.01); the level of Bax in bTBI plus drowning group was increased compared with all other groups at 3 days after injury, and the level in drowning group was increased compared with normal group ( P<0.05 or 0.01), with no statistical difference between bTBI and drowning groups ( P>0.05). The ratio of Bcl-2 to Bax in bTBI plus drowning group was decreased compared with all other groups, while the ratio in bTBI and drowning groups were decreased compared with normal group, showing a much lower level in drowning group than that in bTBI group ( P<0.05 or 0.01). Also, the level of caspase-3 in drowning and bTBI plus drowning groups were increased compared with normal and bTBI groups ( P<0.05 or 0.01), but there was no statistical difference between drowning and bTBI plus drowning groups ( P>0.05). Conclusions:Non-fatal drowning can aggravate hippocampal neuron damage in bTBI rats and cause memory, emotion and other cognitive dysfunction. The mechanism may involve the imbalance of hippocampal neurotransmitters glutamate and glycine, which activates the downstream pro-apoptotic pathway through ERS in the early stage of injury to induce hippocampal neuron apoptosis.

The intestinal absorption characteristics of ten iridoid glycosides and phenolic acids in the Pterocephali Herba were evaluated via rat intestinal valgus model. The intestinal sac fluids at different time after administration of high,medium and low concentrations of Pterocephali Herba extract were collected and ten chemical components in fluid samples were detected by UPLC-PDA. Accumulative absorbed doses( Q) and absorption rate constants( Ka) of ten chemical constituents were calculated,while proportions between Pterocephali Herba extract and intestinal absorption liquid were compared. The results showed that the intestinal absorption of 10 chemical components was linear absorption( R2>0. 9) at different concentrations,which accorded with the zero-order absorption rate. The absorption rate constant was related to the concentration of the drug and the intestinal site,which indicated that intestinal adsorption mechanism of the components were passive diffusion and active transport. Proportions of chemical constituents in intestinal sac fluid were different from those in Pterocephali Herba extract. Therefore,those ten chemical components in Pterocephali Herba extract can be absorbed in whole intestine. Everted intestinal sac model can be used to evaluate intestinal absorption characteristics of ingredients in Pterocephali Herba extract effectively.
Animals ; Caprifoliaceae ; chemistry ; Drugs, Chinese Herbal ; pharmacokinetics ; Intestinal Absorption ; Intestines ; Plant Extracts ; pharmacokinetics ; Rats ; Rats, Sprague-Dawley

Humans ; Coronary Angiography ; Microcirculation ; Coronary Artery Disease/drug therapy* ; Treatment Outcome ; Vascular Resistance ; Coronary Vessels ; Coronary Circulation ; Predictive Value of Tests ; Fractional Flow Reserve, Myocardial

OBJECTIVES: To investigate the risk factors for neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture and establish a nomogram model for predicting the risk of neonatal asphyxia. METHODS: A retrospective study was conducted with 613 cases of neonatal asphyxia treated in 20 cooperative hospitals in Enshi Tujia and Miao Autonomous Prefecture from January to December 2019 as the asphyxia group, and 988 randomly selected non-asphyxia neonates born and admitted to the neonatology department of these hospitals during the same period as the control group. Univariate and multivariate analyses were used to identify risk factors for neonatal asphyxia. R software (4.2.2) was used to establish a nomogram model. Receiver operator characteristic curve, calibration curve, and decision curve analysis were used to assess the discrimination, calibration, and clinical usefulness of the model for predicting the risk of neonatal asphyxia, respectively. RESULTS: Multivariate logistic regression analysis showed that minority (Tujia), male sex, premature birth, congenital malformations, abnormal fetal position, intrauterine distress, maternal occupation as a farmer, education level below high school, fewer than 9 prenatal check-ups, threatened abortion, abnormal umbilical cord, abnormal amniotic fluid, placenta previa, abruptio placentae, emergency caesarean section, and assisted delivery were independent risk factors for neonatal asphyxia (P<0.05). The area under the curve of the model for predicting the risk of neonatal asphyxia based on these risk factors was 0.748 (95%CI: 0.723-0.772). The calibration curve indicated high accuracy of the model for predicting the risk of neonatal asphyxia. The decision curve analysis showed that the model could provide a higher net benefit for neonates at risk of asphyxia. CONCLUSIONS The risk factors for neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture are multifactorial, and the nomogram model based on these factors has good value in predicting the risk of neonatal asphyxia, which can help clinicians identify neonates at high risk of asphyxia early, and reduce the incidence of neonatal asphyxia.
Infant, Newborn ; Humans ; Male ; Pregnancy ; Female ; Nomograms ; Retrospective Studies ; Cesarean Section ; Risk Factors ; Asphyxia Neonatorum/etiology*