Objective To investigate the relationship between nutritional risk indexes and neurological prognosis in elderly patients with severe craniocerebral injury.Methods A total of 127 elderly patients with severe craniocerebral injury admitted to our hospital from May 2019 to October 2021 were enrolled in this retrospective study.The nutritional risk of the patients was assessed by the prognostic nutritional index(PNI)and nutrition risk in critically ill(NUTRIC)score.Multivariate logistic analysis was used to identify the risk factors affecting the prognosis of neurological function(modified Rankin scale,mRS)at 6 months of onset and a risk model was constructed.Results The patients with PNI<45 had lower Glasgow coma score(GCS)and higher proportions of pulmonary infection and mRS≥3 than the patients with PNI≥45(all P<0.05).The patients with NUTRIC≥5 had lower GCS and higher proportion of mRS≥3 than the patients with NUTRIC<5(all P<0.05).The patients with mRS≥3 were older and had higher proportions of open injury,closed injury,pulmonary infection and subarachnoid hemorrhage,higher NUTRIC score and lower GCS and PNI than the patients with mRS<3(all P<0.05).Age,pulmonary infection,GCS and PNI were risk factors affecting the prognosis of neurological function.The area under the curve(AUC)of the risk model based on the PNI for identifying poor neurological prognosis in elderly patients with severe brain injury was 0.92,with a sensitivity and specificity of 79.5%and 90.7%,respectively.The AUC of the model based on the NUTRIC score was 0.89,with a sensitivity and specificity of 89.0%and 79.6%,respectively.Conclusion Nutritional status assossment based on PNI and NUTRIC score is closely related to the neurological prognosis in patients with severe craniocerebral injury at 6 months after onset.The short-term neurological prognosis is poor in elderly patients with poor nutritional status.

Objective To investigate the correlation between neutrophil/lymphocyte ratio(NLR)and the degree of encephaledema in elderly patients with hypertensive intracerebral hemorrhage(HICH),and the clinical value of NLR in predicting short-term prognosis.Methods From January 2018 to December 2021,113 elderly HICH patients were evaluated by modified Rankin scale(mRS).According to the median mRS score,the patients were divided into poor prognosis group and good prognosis group.Spearman correlation analysis was used to test the correlation between mRS score and clinical laboratory indexes and the severity of early encephaledema.Multivariate logistic regression analysis was used to assess risk factors of prognosis.Results Compared with the good prognosis group,the poor prognosis group had higher proportion of patients with a history of diabetes mellitus and moderate/severe encephaledema,lower levels of white blood cell(WBC)and lymphocyte(LY),higher NLR level and more bleeding volume(P<0.05).The history of diabetes,LY count,NLR and the degree of encephaledema were independent factors affecting the short-term prognosis of patients.The model combining NLR,diabetes mellitus history and encephaledema could effectively predict the short-term prognosis of elderly HICH patients(area under curve value 0.868).There was a significant positive correlation between NLR and the degree of secondary encephaledema.Conclusion The degree of secondary encephaledema and short-term prognosis of elderly HICH patients are closely related to clinical predictors such as NLR,which provides a theoretical basis for individualized treatment and early prevention of encephaledema in these patients.

Objective:To study the effects of hyperbaric oxygen (HBO) combined with the intervention of functional position keeping pillow for the hemiplegic hand on the efficacy and motor function of hemiplegic patients after brain injury.Methods:A total of 90 patients with hemiplegia after brain injury treated in Hai’an People’s Hospital from January 2017 to January 2020 were selected as the research subjects and divided into observation group and control group according to the random number table method, with 45 cases in each group. Both groups were given the intervention of functional position keeping pillow for the hemiplegic hand. The observation group was additionally treated with HBO. All patients received two-month treatment. The hand function was evaluated by the Brunnstrom Hand Function Scale and Barthel Index. The severity of pain was evaluated by the visual analogue scale (VAS). The conditions of hand care were evaluated by the hand care scale (including pressure sores, cleanliness, moisture, odor) designed by Hai’an People’s Hospital. The rehabilitation compliance was evaluated by the Posttraumatic Growth Inventory (PTGI) score and the Chinese version of the Connor-Davidson Resilience Scale (CD-RISC).Results:After treatment, the scores of Brunnstrom Hand Function Scale and Barthel Index of the two groups were significantly increased, and the scores of the observation group were significantly higher than those of the control group ( P<0.05); the VAS scores of the two groups were significantly decreased, and the scores of the observation group were significantly lower than those of the control group ( P<0.05); in terms of pressure sores, cleanliness, moisture, odor, and swelling degree, the scores of the observation group were significantly lower than those in the control group ( P<0.05); the scores of PTGI and CD-RISC of the two groups were significantly increased, and the scores of the observation group were significantly higher than those of the control group ( P<0.05). Conclusion:After brain injury, hyperbaric oxygen combined with the intervention of functional position keeping pillow for the hemiplegic hand can significantly improve the motor function of patients.

Objective:To study the effects of hyperbaric oxygen (HBO) combined with the intervention of functional position keeping pillow for the hemiplegic hand on the efficacy and motor function of hemiplegic patients after brain injury.Methods:A total of 90 patients with hemiplegia after brain injury treated in Hai’an People’s Hospital from January 2017 to January 2020 were selected as the research subjects and divided into observation group and control group according to the random number table method, with 45 cases in each group. Both groups were given the intervention of functional position keeping pillow for the hemiplegic hand. The observation group was additionally treated with HBO. All patients received two-month treatment. The hand function was evaluated by the Brunnstrom Hand Function Scale and Barthel Index. The severity of pain was evaluated by the visual analogue scale (VAS). The conditions of hand care were evaluated by the hand care scale (including pressure sores, cleanliness, moisture, odor) designed by Hai’an People’s Hospital. The rehabilitation compliance was evaluated by the Posttraumatic Growth Inventory (PTGI) score and the Chinese version of the Connor-Davidson Resilience Scale (CD-RISC).Results:After treatment, the scores of Brunnstrom Hand Function Scale and Barthel Index of the two groups were significantly increased, and the scores of the observation group were significantly higher than those of the control group ( P<0.05); the VAS scores of the two groups were significantly decreased, and the scores of the observation group were significantly lower than those of the control group ( P<0.05); in terms of pressure sores, cleanliness, moisture, odor, and swelling degree, the scores of the observation group were significantly lower than those in the control group ( P<0.05); the scores of PTGI and CD-RISC of the two groups were significantly increased, and the scores of the observation group were significantly higher than those of the control group ( P<0.05). Conclusion:After brain injury, hyperbaric oxygen combined with the intervention of functional position keeping pillow for the hemiplegic hand can significantly improve the motor function of patients.

ObjectiveTo assess gene chip application value in detecting pathogenic bacteria in intracranial infection cases.MethodsPrimers and probes aiming at the specific DNA sequences of 4 kinds of common pathogenic bacteria and 6 kinds of common drug resistance genes (DRGs) were designed and used to identify the bacteria and DRGs among 30 cerebrospinal fluid (CSF) specimens (12 positive,18negative in CSF culture) from patients with intracranial infection using multiplex polymerase chain reaction (mPCR) and gene chip.The results of gene detection were compared with those of CSF culture and drug sensitivity testing.ResultsBacteria were identified and DRGs were detected in 15 specimens; DRGs and 16S gene were detected in 8 specimens; neither bacterium nor DRG was detected in 7 specimens.ConclusionGene chip technique is characterized by its relative sensitivity and rapidity of detecting the pathogenic bacteria in CSF of intraeranial infection cases.

Background An ethylnitrosourea(ENU)-induced mutant strain C57BL/6 mouse model has been established by our research group.This model is proved to have the spontaneous phenotype of corneal opacity and the typical pathological process similar to human keratitis.Therefore,this model is expected to be a good animal model in the research of the mechanism,hereditary property,and development of drugs for corneal infectious diseases.Objective The present study is to investigate the biological features of opportunistic pathogens using a mouse Staphylococcus-infected corneal model(C57BL/6 mouse) induced by N-ethyl-N-nitrosourea(ENU),and offers an evidence of stability in this animal model.Methods Ten-week-old male C57BL/6 mice were treated with ENU at 150mg/kg by intraperitoneal injection,and then mated with female mice after 60 days.Corneal opacity mutant mice in the F1 generation were selected to backcross with C57BL/6 mice.The bacteria were isolated from the eyeballs of the mutants and cultivated,purified and identified.Drug sensitivity assay was carried out to screen for effective antibiotics for clinic medical care.Results The staphylococcus-infected corneal mouse model(B6-Co) was established successfully,and the Staphylococcus sciuri strain was separated and purified,and then the sensitive antibiotics were distinguished from resistant ones.The sensitive drugs for Staphylococcus sciuri included azithromycin,clindamycin,chloramphenicol,gentamicin,rifampicin,tetracycline,amikacin,sulfamethoxazole compound sinomin,minocycline,levofloxacin,cephalothin,cefotaxime,and furazolidone;whereas this Staphylococcal strain was resistant to cefoxitin,penicillin,ampicillin,novobiocin.Nitrofurantoin showed an intermediate sensitivity.Conclusion The C57BL/6 mouse model is a spontaneous-derived animal model that is infected by coagulase-negative staphylococci,among which the most abundant strain is Staphylococcus sciuri.