ObjectiveTo observe the effect of early rehabilitation on patients with acute severe brain injury.Methods180 cases with acute severe brain injury were tr eated with early rehabilitation measurements consisted of breath rehabilitation,passive activity of joints in range of joint motion, body posture change,preve ntion of the lower urinary tract infection, and rehabilitation with Traditional Chinese Medicine,etc.Results18 patients (8.3%) co mplicated infection of lungs during the acute stage, no patient died of complica tions.Conclusions The early rehabilitation can pre vent patients with severe brain injury from complications and improve the effica cy of the treatment.

Objective To investigate the cytokine spectrum of cultured human amniotic-derived mesenchymal stem cells (A-MSC) for understanding its basis of molecular biology in hematopoietic in vitro.Methods Their hematopoietic cytokines expression was analyzed using RT-PCR in the mRNA level. Results It showed that in vitro subcultured human amniotic-derived mesenchymal stem cells were capable to express many important hematopoietic cytokines such as LIF, SCF, M-CSF, G-CSF, GM-CSF, IL-3, IL-6, IL-11 and so on. Conclusion Production of abundant of hematopoietic cytokines by human amniotic-derived mesenchymal stem cells may be effective for hematopoietic support and HSC transplantation.

0bjective To observe the different brain activation of acupuncture and electroacupuncture on healthy subjects and healthy subjects.Methods The different brain activation involved in heroin addiction between healthy subjects and addicts was detected by fMRI.Acupuncture point used in present study Was Zusanli (ST 36).Results Different brain activations between healthy subjects and addicts during electroacupuncture were hypothalamus(X0,Y2,Z9,t=7.36,P<0.01),anterior cingulate(X5,Y49,Z8,t=4.11,P<0.01),tempo-ral gyrus(X61,Y12,Z8,t=3.05,P<0.01).The difference of activated regions during conventional acupuncture between healthy subjects and heroin addicts was thalamus(X2,Y16,Z12,t=2.87,P<0.01),parahippocampus (X17,Y52,Z3,t=3.14,P<0.01),and hypothalamus(X0,Y2,Z9,t=6.98,P<0.01).Conclusion Regions with significant activation detected by fMRI are different during acupuncture in heroin addicts and in the healthy subjects.Notably,the hypothalamus activation is more robust in the addicts than in the healthy subjects during ac-upuncture stimulation.

Objective To investigate the relation between positive fluid balance and the prognosis in severe sepsis patients with acute kidney injury (AKI).Methods A retrospective analysis of clinical data of 90 patients in our department was carried out.According to the final outcome,patients were divided into survival group (n =26) and non-survival group (n =64),in which the relation between patients' positive fluid balance and the prognosis was evaluated.Results (1) There was no statistically significant difference in the age and severity between survival group and non-survival group of patients with severe sepsis and consequent AKI,but the patients in non-survival group had greater volume overload.Compared with the survival group,higher mean fluid balance [(1 112.12±546.85) mLvs.(644.69±474.93) mL,P=0.00],and less urine output [(1 224.07 ± 708.79) mL vs.(2 032.36 ± 723.53) mL,P =0.00) in non-survival group.(2) There was no significant difference in mortality between early and late continuous renal replacement therapy (CRRT) during ICU care.However,the average daily fluid load in late CRRT patients was significantly greater than that in early CRRT patients [(1178.81 ±397.03) mLvs.(287.22 ± ± 433.53) mL,P =0.00] and the lung oxygenation index in late CRRT patients was significantly worse thanthat in early CRRT patients [(211.22±42.56) vs.(169.46±57.40),P=0.04] (3) The relevant variables to 28-day mortality in AKI patients with severe sepsis included CRRT treatment,oxygenation index and the average daily fluid balance ＞ 500 mL.Among them,fluid balance ＞ 500mL was an independent risk factor for AKI patients with severe sepsis.Their prognosis was worse if they had greater positive fluid balance.CRRT was the protective factor which could affect the prognosis of patients with severe sepsis complicated by AKI.Conclusions Patients with severe sepsis complicated by AKI has a high mortality.Persistent fluid overload can lead to increased mortality in patients with severe sepsis complicated by AKI.Early CRRT can reduce fluid retention in patients with renal failure and improve oxygenation index.

Animals ; Cadmium Radioisotopes ; toxicity ; Female ; Fetal Development ; drug effects ; Fetus ; Maternal-Fetal Exchange ; Pregnancy ; Rats ; Rats, Sprague-Dawley

Objective To approach the effect of different vasopressor on hemodynamics, volume responsiveness, fluid volume balance, renal function and prognosis in patients with acute respiratory distress syndrome (ARDS) complicated with septic shock.Methods A prospective single-blind randomized controlled trial was conducted. ARDS patients with septic shock admitted to the Department of Critical Care Medicine of Jiangxi Provincial People's Hospital from January 1st, 2015 to May 1st, 2016 were enrolled. The patients satisfied ARDS Berlin diagnostic criteria, over 15 years old, needing vasopressor after fluid resuscitation were enrolled. The patients were divided into norepinephrine group (NE group) and terlipressin group (TP group) by randomise number table derived by computer. Patients in TP group were given terlipressin (0.01-0.04 U/min) with an intravenous pump, while those of NE group were given norepinephrine (> 1μg/min) with an intravenous pump, and the target mean arterial pressure (MAP) was maintained at 65-75 mmHg (1 mmHg = 0.133 kPa). Hemodynamics and extravascular lung water index (EVLWI) were monitored by pulse indicator continuous cardiac output (PiCCO). The volume responsiveness of patient was evaluated by passive leg raising (PLR) test, and cardiac index (CI) change (ΔCI ≥ 10%) served as positive volume responsiveness. The differences in hemodynamics, EVLWI, oxygenation index (OI), lactate clearance rate (LCR), rate of positive volume responsiveness, urinary output, fluid volume balance, renal function, and prognostic indicators were compared between the two groups.Results Fifty-seven patients with ARDS complicated with septic shock were enrolled, with 26 patients in NE group, and 31 patients in TP group, thebaseline data in both groups was balanced with comparability. Compare with NE group, 48-hour and 72-hour heart rate (HR) in TP group was significantly slowed (bpm: 82.1±6.8 vs. 87.6±7.4, 81.3±6.1 vs. 85.6±8.3, bothP < 0.05), 72-hour central venous pressure (CVP) was significantly decreased (mmHg: 9.4±2.6 vs. 10.9±3.0,P < 0.05), but no significant difference was found in HR, MAP, CVP, CI, EVLWI, OI and LCR at other time points between the two groups. 48-hour and 72-hour positive volume responsiveness rate in TP group were significantly increased as compared with those of NE group (74.2% vs. 46.2%, 64.5% vs. 38.5%, both P < 0.05), urinary output on the 2nd day (mL/24 h: 2342.8±704.1 vs. 1944.6±684.3) and fluid volume balance (mL: -319.7±54.8 vs. -169.6±27.2) were significantly decreased (bothP < 0.05). There was no significant difference in positive volume responsiveness rate, urine output, fluid volume balance, and the level of serum creatinine at other time points between the two groups. There was no statistically significant difference in the following features between TP group and NE group: duration of mechanical ventilation (days: 8.41±2.97 vs. 9.67±3.56), length of intensive care unit (ICU) stay (days: 12.84±4.47 vs. 14.77±5.01), total length of hospital stay (days: 19.34±7.37 vs. 21.07±8.41), and 28-day mortality (29.0% vs. 30.8%, allP > 0.05).Conclusions Compared with norepinephrine, terlipressin for ARDS patients with septic shock is more conducive to restrict fluid load, improve the renal perfusion and increase urine output. However, in both groups therewas no significant difference in the efficiency of stabilizing hemodynamics, shortening the duration of mechanical ventilation, reducing ICU or hospital days and decreasing 28-day mortality.

AIM: To measure the concentrations of angiotensinⅡ(ATⅡ) and vascular endothelial growth factor(VEGF) in plasma of diabetics and investigate the relationship between ATⅡ and VEGF and the role of VEGF in occurrence and development of diabetic nephropathy(DN). METHODS: 98 type Ⅱ diabetics were divided into two groups: 43 were in diabetic nephropathy group and 55 in non-diabetic nephropathy (NDN) group, and 25 healty persons were in control group. We measured the levels of ATⅡ, VEGF, glycosylated hemoglobinC (GHbAlc) in plasma and urinary microalbumin(UmALB), respectively. RESULTS: The levels of ATⅡ, VEGF, HbAlc and UmALB in DN group and NDN group were increased significantly compared with control group( P

The somatostatin analogue pasireotide is a new type of protein which is the first therapeutic agent targeted to the pituitary.Pasireotide can prevent adrenocorticotropic hormone release and inhibit the growth of tumor cells after coupling with somatostatin receptor of the target cell membranes.Pasireotide has a high binding affinity for most of somatostatin receptor (SSTR) subtypes and in particular for SSTR5.Pasireotide can paly an important role in the new round of new targets for individualized diagnosis and treatment of tumors through the studies of translational medicine.

Objective To investigate the clinical efficacy of fluoroscopy-guided intestinal adhesion lysis, as a new non-surgical method, in treating incomplete adhesive small intestinal obstruction in order to improve the therapeutic results of adhesive intestinal obstruction. Methods A total of 93 patients with incomplete adhesive small intestinal obstruction were enrolled in this study. The patients were divided into study group (n=49) and control group (n=44). Fluoroscopy-guided intestinal adhesion lysis together with restoration of inter-intestinal loop enterocele was carried out for the patients of the study group , while traditional conservative surgical therapy was employed for the patients of the control group. The study group was comparable with the control group in patients’ age, gender, medical history, disease course, X-ray findings, etc. Results Of the 49 cases in the study group, complete cure was obtained in 40 with a cure rate of 81.6%. The mean hospitalization day was 0.3 day, and the average operation time was 3.25 hours. Among the 44 patients in the control group, complete cure was obtained in 37 with a cure rate of 84.1%. The mean hospitalization day was 7.6 days, and the average therapeutic time was 183.26 hours. Conclusion For the treatment of incomplete adhesive small intestinal obstruction , the therapeutic efficacy of fluoroscopy-guided intestinal adhesion lysis together with restoration of inter-intestinal loop enterocele is better than that of traditional conservative surgical therapy.

AIM: To explore the effect and mechanism of preoperative transarterial chemoembolization on nephroblastoma.METHODS: Comparative analysis of clinical and pathological features in 39 children with Wilms’ tumor was conducted. TUNEL assay was used to detect the apoptosis of tumor in two groups with or without preoperative interventional treatment. The expressions of P53, Bcl-2 and Bax proteins were detected by immunochemical methods. The patients were followed-up for more than 2 years.RESULTS: The extent of neoplastic cell necrosis and degeneration, interstital fiber tissue hyperplasia of tumor and the number of infiltrating lymphocytes were observed, which were higher in interventional group than those in simple excision group (P