Objective To investigate the changes of nuclear factor-κB (NF-κB),tumor necrosis factor-α(TNF-α),and cell apoptosis of cerebral ischemia-reperfusion injury and the influence of brain-derived neutrophic factor(BDNF) on these parameters in rats.Methods Eighty-four male Sprague-Dawley (SD) rats were randomly divided into two groups:BDNF (n =42) and control (n =42) groups.The BDNF group was induced using the improved Zea-longa method and were received abdominal injections of BDNF (0.5 μg/μl) immediately after injury.The control group was received abdominal injections with the same dose sodium chloride injection immediately after injury and repeated one time everyday until the rats was killed.Each group was divided into seven subgroups by sacrificed time after injury,including subgroups 1 h,3 h,6 h,12 h,24 h,3 d,and 7 d; each subgroup got 6 rats.Each subgroup were randomly selected three rats after being killed.The expressions of NF-κB and TNF-α of rats contusion peri tissues brain tissue were detected by immunohistochemical methods.Terminal deoxynucleotidyl transferase (TUNEL) method was used to observe the peri cell apoptosis after brain contusion.Results The expressions of NF-κB and TNF-α in BDNF group was significantly decreased relative to the control group (P ＜ 0.05),with a significant positive correlation between two parameters in two groups (P ＜ 0.001).The number of apoptotic cells was significantly decreased in the BDNF group relative to control group (P ＜ 0.05).Conclusions Brain-derived neutrophic factor probably relieves inflammation response,reduces the change of secondary brain injury after traumatic brain injury,and decreases neural cell apoptosis,and finally provides protection of neurocytes.

Objective To explore the influence of homocysteine(Hcy)on liver cystathionine-?-synthase(CBS)and methylenetetrahydrofolate reductase(MTHFR)system in apoE-/- mice,and determine the effects of atorvastatin and/or folate/vitamin B12 on liver CBS and MTHFR system.Methods Eighty male 6-week-old apoE-/- mice were randomly divided into two groups:65 mice were fed with a chow diet containing 2%(wt/vol)L-methionine(homomethionine group)and 15 mice were fed with normal saline(control group).Two months later,the 60 mice survived in homomethionine group were subdivided into four groups:group Ⅰ(untreated),Ⅱ(3 mg/kg atorvastatin),Ⅲ(3 mg/kg atorvastatin+2 mg/kg folate+30 ?g/kg vitamin B12)and Ⅳ(2 mg/kg folate+30 ?g/kg vitamin B12).After one month,Western blotting was performed to detect the liver CBS and MTHFR system protein expression in each group.Results The relative expression of liver CBS and MTHFR was significantly lower in group Ⅰ than in control group(P

To observe the morphology of corneal endothelial cells after femtosecond laser in situ keratomileusis ( Femto-LASlK) .METHODS:From May to September in 2013, 88 eyes of 45 patients with myopia who accepted Femto-LASlK were enrolled in this study. The morphology of central corneal endothelial cells was measured by a non-contact corneal endothelial cell analyzer before, 1mo and 1a after surgery. The number, density, average size, size standard deviation, size coefficient of variation and hexagonality of the corneal endothelial cells were observed. All the measurements were analyzed by statistical analysis.RESULTS: All patients underwent operation smoothly, and no complication was observed during and after surgery;One month after surgery, the endothelial cell density (ECD) was 2815. 34±297. 07/mm2, which had a 2. 64% decrease compared with preparative ECD (t=4. 60, P= 0. 00), there was no statistical significance between ECD measurements of 1mo and 1a after surgery ( P>0. 05 ); One month after surgery, the size standard deviation ( SSD ) was 118. 47 ± 31. 58μm2 , which increased significantly compared with the preoperative SSD(t=-3. 87, P=0. 03), there was no statistical significance between SSD measurements of 1mo and 1a after surgery ( P>0. 05 );After surgery, the number, hexagonality, average size and size coefficient of variation of the corneal endothelial cells didn't change statistically(P>0. 05).CONCLUSlON: ln the early period after Femto-LASlK, the ECD decreased slightly, however this kind of surgery did not have significant harm to the function of corneal endothelial cells, and the surgery didn't cause the progressive loss of corneal endothelial cells.

Objective:To explore the clinical effect of multidisciplinary cooperation model in the prevention of acquired dysphagia in ICU.Methods:A multidisciplinary team was set up to collect 118 patients in Neurosurgery ICU of our hospital as the research object. The patients were divided into the experimental group and the control group, 59 cases in each group. The control group implemented the routine nursing measures of ICU, and the experimental group implemented the multidisciplinary cooperative nursing mode. The incidence of ICU acquired swallowing disorders (ICU-ASD) and complications of the two groups were compared.Results:There was no significant difference between the two groups in the incidence of swallowing dysfunction 24 hours after tracheal extubation ( P>0.05). The incidence of swallowing dysfunction 48 hours and 72 hours after tracheal extubation in the control group was 11.86% (7/59) and 16.95% (10/59) respectively, while the test group was 1.69% (1/59) and 3.39% (2/59) respectively. The difference was statistically significant ( χ 2values were 4.827 to 7.230, P< 0.05 or 0.01); the incidence of aspiration, aspiration pneumonia and malnutrition in the control group were 11.86% (7/59), 10.17% (6/59) and 8.47% (5/59), respectively, while the test group were 1.69% (1/59), 0 and 0, respectively, with statistically significant difference ( χ 2value was 4.827, P< 0.05). Conclusion:Multidisciplinary cooperation model can effectively prevent the incidence of ICU-ASD, and ultimately reduce the incidence of complications.

Objective:To systematically evaluate the predictive value of neutrophil-lymphocyte ratio (NLR) in acute kidney injury (AKI).Methods:All studies about the predictive effect of NLR on AKI were searched in the National Medical Library of the United States PubMed Database, the Embase database in the Netherlands, the Chinese Biology Medicine disc (CBMdisc) and the Chinese Evidence Based Medicine Cochrane Centre Database (CEBM/CCD). The data updated by October 2020, and regardless of language, region or whether blind method was used. Two authors independently extracted data and evaluated the quality of the studies. Data extracted from the studies were analyzed with RevMan 5.3 to assess the predictive value of NLR on AKI. A subgroup Meta-analysis was conducted to assess the predictive value of NLR on AKI according to different countries, different disease types (cardiovascular surgery, infectious diseases, other diseases including burns, cirrhosis, and emergency), and different sample sizes (≤ 300 cases and > 300 cases). The publication bias of included studies about the predictive effect of NLR on AKI were assessed by funnel plots.Results:A total of 11 studies were included in this Meta-analysis, including 4 997 patients, 1 308 patients in AKI group, and 3 689 patients in non-AKI group. The Meta-analysis results showed that: increased NLR had predictive value for the occurrence of AKI [mean difference ( MD) = 2.73, 95% confidence interval (95% CI) was 1.78-3.68, P < 0.000 01]. Subgroup analysis showed that increased NLR had predictive value for the occurrence of AKI in patients from Southeast Asia ( MD = 4.04, 95% CI was 1.09-6.99, P = 0.007) and Eurasia ( MD = 2.51, 95% CI was 1.12-3.90, P = 0.000 4). Increased NLR had predictive value for the occurrence of AKI in patients undergoing cardiovascular surgery ( MD = 0.77, 95% CI was 0.34-1.20, P = 0.000 4), infectious diseases ( MD = 4.74, 95% CI was 1.51-7.96, P = 0.004) and other diseases ( MD = 8.53, 95% CI was 6.26-10.80, P<0.000 01). Increased NLR had predictive value for the occurrence of AKI in studies with a sample size of ≤ 300 cases ( MD = 6.02, 95% CI was 4.90-7.14, P <0.000 01) and > 300 cases ( MD = 1.32, 95% CI was 0.61-2.03, P = 0.000 3). There was no significant publication bias in the included studies assessed by funnel plots. Conclusion:NLR is an important predictive tool for AKI.

Objective To investigate the molecular characteristics of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patients receiving antiretroviral therapy (ART) in Guizhou Province. Methods Using a convenience sampling strategy, 8 583 samples were collected in Guizhou and an investigation was conducted including face-to-face questionnaire interview and HIV testing. Results 1 511 cases failed in HIV suppression (viral load, VL>1 000 copies/ml). 1 410 cases (93.31%) were successfully genotyped with HIV pol gene, among which 51.42% were genotyped as CRF01_AE, 26.67% as CRF07_BC and 16.1% as CRF08_BC. Conclusion The subtype changes caused by HIV gene mutation should precede the changes of main transmission routes of HIV through the analysis in recent years. Timely monitoring the changes of HIV subtypes can be one of the main bases for the prevention and control of AIDS.

OBJECTIVETo observe the efficacy of He-wei Jie-gu (Chinese characters) decoction on femoral intertrochanteric fractures after internal fixation in elderly.

METHODSFrom January 2010 to January 2012, 90 elderly patients with osteoporotic intertrochanteric fracture were randomly divided into two groups. The patients in experimental group were treated with open reduction and internal fixation, He-wei Jie-gu decoction and Caltrate D in oral, including 18 males and 27 females with an average age of (77.8±11.3) years old ranging from 65 to 89 years old;the time from injured to operation was 2 to 9 days with an average of (6.6±2.1) days; according to Evans-Jensen classification, 17 cases were in type I, 8 in type II, 15 in type III, 3 in type IV, 2 in type V. Meanwhile, the patients in control group were treated with open reduction and internal fixation, Caltrate D in oral, including 16 males and 29 females with an average age of (81.2±9.6) years old ranging from 67 to 91 years old; the time from injury to operation was 2 to 10 days with an average of (6.8±2.6) days; according to Evans-Jensen classification, 15 cases were in type I, 10 in type II, 14 in type III, 4 in type W, 2 in type V. The VAS score, hip BMD value before and after treatment, fracture healing and the Harris function score after operation were recorded and compared.

RESULTSAll patients were followed up from 3 to 9 months with an average of (5.6±2.8) months. Compared with the control group, the VAS score of the experimental group had an obviously reduction (F=98.138, P<0.01) after treatment; the hip BMD value at 3 months after treatment in the experimental group was higher than that of the control group (P<0.05); the fracture healing rate of the experimental group was higher than that of the control group (P<0.05); Harris score in 3 months of follow-up in the experimental group was higher than that of the control group (t=2.542, P<0.05); all the differences between two groups were statistically significant (P<0.05).

CONCLUSIONHe-wei Jie-gu decoction can reduce postoperative pain and increase bone mineral density after internal fixation of femoral intertrochanteric fracture in elderly, promote the fracture healing and functional recovery in the hip joint.

Aged ; Aged, 80 and over ; Bone Density ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Femur ; injuries ; surgery ; Fracture Fixation, Internal ; Hip Fractures ; surgery ; Humans ; Male ; Osteoporotic Fractures ; drug therapy ; physiopathology ; surgery ; Pain, Postoperative ; drug therapy ; physiopathology

Objective To assess the treatment efficacy and safety of lanthanum carbonate (LC) in patients on maintenance hemodialysis. Methods MEDLINE (1996—2014), Embase (1974—2014.12), Pubmed (1996—2014.12), Cochrane library, Chinese Wanfang database (1996—2014.12) and CNKI (1979—2014.12) were searched. Lanthanum carbonate and hemodialysis were used as Chinese and English search terms respectively, and the articles met the inclusion and exclusion criteria were used as supplements. Quality assessment and data mining were conducted by two independent investigators who performed Meta-analysis using RevMan5.2. Results Nine trials with 2 674 participants were included in this study. The Meta-analysis showed that there were similar blood levels of calcium [WMD=-0.24,95%CI:(-0.61)-0.14, P=0.21], phosphorus [WMD=0.14,95%CI:(-0.02)-0.30,P=0.08] and phosphate control rates (RR=0.91,95%CI:0.70-1.17, P=0.44) between control group and lanthanum carbonate group. There were lower incidence rates of hypercalcemia (RR=0.17, 95%CI:0.06-0.47, P=0.000 7) and blood levels of calcium-phosphorus product [WMD=-2.17,95%CI:(-3.99)-(-0.35), P=0.02], and higher levels of parathyroid hormone (iPTH, WMD=105.69, 95%CI:70.38-141.00, P<0.000 01) and bone-specific alkaline phosphatase (BAP, WMD=6.47, 95%CI:0.43-12.50, P=0.04) in these two groups. There were no significant differences in incidence rates of gastrointestinal adverse events between two groups. Conclusion Lanthanum carbonate should be used as preferred choice of phosphate binders to control serum phosphorus in patients on maintenance hemodialysis.

Objective To investigate the difference between the early phases and delay phase of three-phase bone scintigraphy on hemiplegic patients with earlier complex regional pain syndrome (CRPS).Methods Twenty-nine stroke patients with hemiplegia complicating CRPS received three-phase bone scintigraphy after intravenous injection of 99Tcm-methylene diphosphonate (MDP). The region of interest (ROI)technique was used to obtain the radioactive counts of involved joints and contralateral sites on wrists,metacarpophalangeal,proximal interphalangeal and distal interphalangeal joints. The total counts of these four sites in each patient were then obtained and the total uptake ratios of involved joints/contralateral joints for each phase were calculated to compare the difference among the three phases. Wilcoxon test and ANOVA were used in data analyses. Results The involved joints of hemiplegic side displayed higher tracer uptake.There were significant differences of the radioactive counts between involved joints and uninvolved ones in the perfusion,pool and delay phase (Wilcoxon test,Z:-4.73 to -2.10,P＜0.05). There was no significant difference of total uptake ratios of involved joints/contralateral joints among the three phases ( ANOVA,F = 0. 807,P ＞ 0.05 ). Conclusions Due to higher bone seeking agent accumulation on three-phase bone scintigraphy,both early phases and delay phase imaging showed similar value in stroke patients with hemiplegia complicating earlier CRPS.

Objective To evaluate the efficacy and safety of double dosage Tamsulosin in treating patients with type Ⅲ prostatitis.Methods According to the results of prostate secretion(EPS) examination and the national institute health-chronic prostatitis symptom index(NIH-CPSI) questionnaire,120 patients with type Ⅲ prostatitis were recruited and randomly divided into single dosage group (n =60),treated with 0.2 mg Tamsulosin and placebo once daily for 12 weeks,and double dosage group (n =60),treated with 0.4mg Tamsulosin once daily for 12 weeks.Before treatment,the NIH-CPSI total scores in single and double dosage group were 26.91 ± 4.08 and 27.31 ± 4.98,respectively.The pain index in each group was 10.64±2.23 and 11.47 ± 3.00,respectively.The voiding index was 6.52 ± 2.24 and 6.41 ± 2.97 respectively.In those groups,the quality of life index was 9.68 ± 1.81 and 9.45 ± 1.79,respectively.All those items didn't show significant difference among those groups (P ＞ 0.05).The patients were follow-up and evaluate by those items on weeks 12.Results Because of losing during follow-up,4 patients were excluded from single dosage group.2 patients were excluded from double dosage group.After treatment in single dosage group,the NIH-CPSI total scores were 12.11 ± 3.60,pain index were 3.57 ± 1.67,voiding index were 2.88 ± 1.70,quality of life index were5.59 ± 2.06.After treatment in double dosage group,the NIH-CPSI total scores were 9.90 ± 4.15,pain index were 3.21 ± 2.21,voiding index were 2.21 ± 2.11,quality of life index were 4.50 ± 1.97.After 12 weeks treatment,the NIH-CPSI total scores,pain index,voiding index,quality of life index in both two groups were improved (P ＜ 0.05),and the double dosage group improve better(P ＜ 0.05).In the course of treatment,there were 2 cases of patients (3.8％) with adverse drug reactions in single dosage group,including dizziness in 1 case,headache in 1 cases.There were 4 cases of patients (6.9％) with adverse drug reactions in double dosage group,including dizziness in 3 cases of and rhinitis in 1 case.The rate of adverse reactions had no significant differences in the two groups (P ＞ 0.05).Conclusions Compared with single dosage Tamsulosin in the treatment of type Ⅲ prostatitis,double therapy had a better efficacy.Double dosage Tamsulosin therapy had an equal safety to the single dosage Tamsulosin.