Objective:To investigate the risk factors for intracranial hematoma progression in patients within 24 h of traumatic brain injury.Methods:A prospective study was performed; 184 patients with traumatic brain injury admitted to our hospital from January 2018 to June 2021 were enrolled. According to the states of intracranial hematoma indicated by head CT within 24 h of injury, these patients were divided into intracranial hematoma progression group ( n=52) and intracranial hematoma stable group ( n=132). The clinical data of patients in the two groups were compared and the independent risk factors for intracranial hematoma progression were screened by multivariate Logistic regression analysis. Results:As compared with intracranial hematoma stable group, patients in the intracranial hematoma progression group had significantly advanced age, significantly higher systolic blood pressure and blood glucose levels, statistically higher proportions of patients with parenchymal hemorrhage, subarachnoid hemorrhage, and multiple hematomas, significantly longer prothrombin time, significantly higher international standardization index and D-dimer level, significantly higher proportion with patients with fibrinogen<2.0 g/L, statistically increased K value (blood coagulation time) of thromboelastic map, proportion of patients with α Angle (blood coagulation angle)<64°, level of vascular endothelial biomarker syndecan-1 (Syn-1), and von willebrand factor (vWF) activity, and significantly decreased Glasgow Coma Scale (GCS) scores at admission and platelet count ( P<0.05). Multivariate Logistic regression analysis showed that age ( OR=1.066, 95%CI: 1.018-1.117, P=0.007), systolic blood pressure ( OR=1.076, 95%CI: 1.041-1.111, P<0.001), multiple hematoma ( OR=6.559, 95%CI: 2.025-21.245, P=0.002), fibrinogen<2.0 g/L ( OR=6.164, 95%CI: 1.586-23.954, P=0.009), K value ( OR=6.500, 95%CI: 1.755-24.082, P=0.005) and Syn-1 level ( OR=1.111, 95%CI: 1.015-1.215, P=0.022) were independent risk factors for intracranial hematoma progression in patients with traumatic brain injury at early stage. Conclusion:Traumatic brain injury patients, at early stage, with advanced age, multiple intracranial hematoma, high systolic blood pressure, low fibrinogen, prolonged K value and high Syn-1 level are trend to have intracranial hematoma progression.

BACKGROUND: To evaluate the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) creation for the management of portal hypertension in patients with hepatocellular carcinoma (HCC). METHODS: A literature search of the MEDLINE/PubMed and Embase databases was conducted. All articles reporting the outcomes of TIPS creation for variceal bleeding and refractory ascites and hepatic hydrothorax in patients with HCC were included. Exclusion criteria were non-English language, sample size < 5, data not extractable, and data reported in another article. RESULTS: A total of 280 patients (mean age, 48–58; male gender, 66%) from five articles were included. TIPS creation was performed for variceal bleeding in 79% and refractory ascites and/or hepatic hydrothorax in 26% of patients. Technical and clinical success was achieved in 99% and 64% of patients, respectively. Clinical failure occurred in 36% of patients due to rebleeding or recurrent bleeding (n = 77) or no resolution or improvement of refractory ascites and hepatic hydrothorax (n = 24). One percent of patient had major complications, including accelerated liver failure (n = 1) and multi-organ failure resulting from hemorrhagic shock (n = 1), all of which resulted in early (i.e., within 30 days) death. Hepatic encephalopathy occurred in 40% of patients after TIPS creation. Lung metastasis was found 1% of patient 5 months (n = 1) and 72 months (n = 1) after TIPS creation. CONCLUSION: TIPS creation seems to be safe and effective for the management of portal hypertension in patients with HCC.
Ascites ; Carcinoma, Hepatocellular ; Esophageal and Gastric Varices ; Gastrointestinal Hemorrhage ; Hemorrhage ; Hepatic Encephalopathy ; Humans ; Hydrothorax ; Hypertension, Portal ; Liver Failure ; Liver Neoplasms ; Lung ; Male ; Neoplasm Metastasis ; Portasystemic Shunt, Surgical ; Portasystemic Shunt, Transjugular Intrahepatic ; Sample Size ; Shock, Hemorrhagic

Objective To explore any effect of proprioceptive neuromuscular facilitation (PNF) on the proprioception and balance of patients with knee osteoarthritis (KOA).Methods Forty patients with KOA were randomly divided into an experimental group (EG) and a control group (CG),each of 20.The PNF techniques of isotonic combined contraction,and rhythmic stable and dynamic reversal were applied in the EG,while the CG received quadriceps muscle strength training.Knee proprioception was evaluated using knee angle reconstruction experiments,and balance ability was measured using the one leg standing test (OLS) and the five times sit to stand test (FTSST).Results The errors in active and passive knee angle reconstruction at 30°,60° and 110° all improved significantly in the EG,but not in the CG.After the treatment,the OLS and FTSST results improved significantly in the EG,but only the OLS results improved significantly in the CG,not the FTSST times.Even so,the average OLS time in the EG was significantly longer than that of the CG after the training.Conclusion Proprioceptive neuromuscular facilitation can improve the proprioception and balance of persons with knee osteoarthritis.

Objective To observe the effect of repetitive transcranial magnetic stimulation (rTMS) on behavior in response to chronic but unpredictable mild stress and explore potential neuroendocrine mechanisms.Methods Forty adult SD male rats were randomly divided into a control group (n =8) and a model preparation group (n=32).The control group was given normal care while a model of depression was induced in the model preparation group through giving an unpredictable mild stimulus (CUMS).The depressive rats were randomly divided into a model group,an rTMS group and a sham rTMS group (8 cases in each group).The rTMS group and sham rTMS groups accepted the rTMS or sham stimulation for 3 weeks.The changes in behavior in each group were quantified using body weight,sucrose consumption and an open field test before and after stimulation.Enzyme-linked immunosorbent assays (Elisas) were conducted to detect plasma adrenocorticotropic hormone (ACTH) and corticosterone (CORT) levels.Reverse-transcription polymerase chain reactions (RT-PCRs) were carried out to allow the detection of mRNA expression in hypothalamus related to levels of adrenocorticotropic hormone releasing hormone (CRH).Results After the modeling there were significant differences between the model preparation group and the control group in terms of weight increase,sucrose consumption and open field test results.After rTMS the rate of weight increase,sucrose consumption and the scores in the open field test of the rTMS group had increased significantly more than in the control group.Elisas showed significantly higher plasma ACTH and CORT levels in the model group as well.The average expression of CRH mRNA in the model group was significantly higher than in either of the other two groups.Conclusions rTMS can relieve depression-like behavior induced by chronic stress,at least in rats.This may be related to a downgrading of the hyperactive functioning of the hypothalamus-pituitary-adrenal axis.

[ ABSTRACT] AIM:To prove the purinergic signaling mechanism of the neuroprotective action of hydrogen sulfide by observing the effects of sodium hydrosulfide ( NaHS) , a donor of hydrogen sulfide, on the cell viability, intracellular Ca2+concentration ( [ Ca2+] i ) and the change of membrane permeability in the PC12 cells injured by adenosine triphos-phate ( ATP) .METHODS: PC12 cells in logarithmic growth phase were randomly divided into 4 groups.In control group, the cells were cultured without ATP treatment.In ATP group, the cells were treated with ATP after cultured for 24 h.In NaHS+ATP group, the cells were incubated with NaHS for 30 min before treated with ATP, and NaHS always exis-ted in the reaction system.In KN-62+ATP group, the cells were pretreated with KN-62 for 30 min, and the other treat-ments were as the same as those in NaHS+ATP group.The cell viability was assessed by MTT assay.The [ Ca2+] i was detected by Fura-2/AM staining.The membrane permeability was observed by staining with fluorescent dye YO-PRO-1. RESULTS:ATP at concentration of 0.3 mmol/L showed no injury effect on the cells.However, the cell viability was dropped gradually in a dose-dependent manner as the ATP at doses of 1, 3, 5 and 10 mmol/L.The decline of cell viability by ATP was obviously reversed by 200 μmol/L of NaHS in the PC12 cells (P<0.05), but exasperated by 800μmol/L of NaHS (P<0.05).At the same time, ATP evoked the increase in [Ca2+]i in a dose-dependent manner, which was inhib-ited by NaHS ( P<0.05) .Furthermore, the YO-PRO-1 uptake induced by ATP in a dose-dependent and time-dependent manner was also reduced by NaHS ( P<0.05) .CONCLUSION:Hydrogen sulfide has protective effect on the PC12 cells injured by ATP.The mechanism may be related to the reverse of the increased [ Ca2+] i and YO-PRO-1 uptake.

Adult ; Arsenic Poisoning ; etiology ; Arsenicals ; Humans ; Male ; Skin ; injuries ; Skin Absorption ; Wounds and Injuries

Objective To explore the effects of repetitive transcranial magnetic stimulation (rTMS) and fluoxetine on depression and cognition in the treatment of post-stroke depression (PSD).Methods A total of 82 PSD patients were divided into a treatment group and a control group using a random number table.Besides conventional neurological therapy,the treatment group was treated with rTMS combined with fluoxetine,while the control group was treated only with fluoxetine.Forty healthy persons acted as normal controls.The Hamilton depression rating scale (HAMD) was used to evaluate depressed emotions,and event-related potential (ERP) P300 and exploratory eye movement (EEM) were used to evaluate cognitive function.The three groups were tested before treatment and after 8 weeks of treatment.Results After 8 weeks of treatment the HAMD scores in both the treatment and control groups had decreased significantly compared with before treatment.The HAMD scores decreased significantly more in the treatment group than in the control group.Before treatment,the N2 and P3 iatencies of P300 in the treatment and control groups were significant longer than those in the normal group,and the average amplitude of P3 in the treatment and control groups was significantly lower than among the normal controls.Before treatment,the number of eye fixations (NEF) and the average responsive search score (RSS) in the treatment group and control groups were significantly lower than in the normal group.After 8 weeks after treatment,the N2 and P3 latencies were significantly shorter and the amplitude of P3 was significantly higher in the treatment and control groups than before treatment.The NEF and the average RSS in the treatment and control groups had increased significantly compared with before treatment.All of these indexes improved significantly more in the treatment group than in the control group.Conclusion rTMS combined with fluoxetine can improve depression and cognitive function among PSD patients better than antidepressant treatment alone.

BACKGROUND:Recently, a neuroprotective effect of granulocyte colony-stimulating factor was reported in a model of cerebral infarction and a model of acute spinal cord injury. However, the applied animal model was not established by impact method, different from pathophysiological process of human.
OBJECTIVE:To observe effects of granulocyte colony-stimulating factor on motor function in a rat model of spinal cord injury induced by Al en’s method.
METHODS:Wistar rats were used to establish spinal cord injury at T 10 level using modified Al en’s method. They were randomly assigned to two groups, granulocyte colony-stimulating factor group, treated with granulocyte colony-stimulating factor, and vehicle group, treated with equal volume of PBS. The motor function was evaluated with Basso-Beattie-Bresnahan score and modified Rivlin loxotic plate test monitored at 1, 7, 14, 21, 28 and 35 days, and four-limb muscle strength was assessed using Grid walk test at 7, 14, 21, 28 and 35 days post-operatively.
RESULTS AND CONCLUSION:Hind limbs paralysis occurred in al animals postoperatively. Scores of Basso-Beattie-Bresnahan and modified Rivlin loxotic plate test were greater in granulocyte colony-stimulating factor group compared with vehicle group at 7, 14, 21, 28 and 35 days (P<0.05-0.01);mean Grid walk test errors were less in granulocyte colony-stimulating factor group compared with vehicle group at 14, 21, 28 and 35 days (P<0.05-0.01). Results indicate that motor function and four-limb muscle strength were improved fol owing granulocyte colony-stimulating factor therapy compared with vehicle group, indicating that granulocyte colony-stimulating factor has a positive effect on spinal cord injury.

Objective To analyze the clinicopathological factors impacting on the prognosis of colorectal cancer liver metastases and to investigate how to improve patients' survival.Methods The clinical data of 103 patients who received radical resection for liver metastases from colorectal cancer from January 2005 to December 2011 were enrolled.The survival curve was drawn by Kaplan-Meier method,and the survival rates were analyzed by Log-rank test.Factors influencing survival were analyzed by Cox regression model.Results All patients were followed up from 10 to 60 months,The 1-,3-,5-year's survival rates were 90％,49％,39％,respectively.Univariate analysis revealed that number and size of liver metastases,distribution of liver metastases,serum CEA concentration,complications,postoperative chemotherapy were related to prognosis (x2 =24.732,9.461,9.568,25.948,25.370,5.701,P ＜ 0.05).Multivariate analysis identified number of liver metastases,serum CEA concentration,complications were as significant predictors of survival (Wald =7.974,12.051,11.547,P ＜ 0.05).Conclusions Number of liver metastases,serum CEA concentration,complication are important prognostic factors for liver metastases from colorectal cancer.Appropriate expansion of surgical indication,early diagnosis with intensive follow-up is crucial to increase the survival rate after hepatectomy for liver metastasis of coloractal carcinoma.

Objective To study and analyze the relation between cognitive impairment and apolipoprotein E(ApoE) gene polymorphism in post-stroke depression patients(PSD).Methods The patients were divided into PSD group(83 cases) and brain stroke group(96 cases) by using the 24-item Hamilton Depression Rating Scale (HAMD-24),and healthy volunteers were selected as a control group(53 cases).Cognitive function was evaluated by using the event-related potential (ERP) P300 and single nucleotide polymorphisms of ApoE exon 4 of 112 (rs429358) and 158 (rs7412) were determined by using gene sequencing method.Results 1.Compared with the brain stroke group and the control group,latency in ERP including N2 and P3 of PSD group was significantly prolonged (P＜ 0.05 ),while the amplitude of P3 in PSD was significantly lower(P＜ 0.05 ).2.e3/ε4 genotype frequency in PSD group(24 cases) was significantly higher than that in the control group(7 cases) (P＜0.05).The e4/4 genotype fiequency in PSD group (8 cases) was significantly higher than that in brain stroke group (2 cases) (P ＜ 0.05 ).The e4 allele rate in PSD group ( 24.7％ ) was significantly higher than that in both brain stroke group (16.1％) and contro] group(9.4％ ) (all P＜0.05).3.The PSD patients with ε4 allele had significantly higher score of HAMD-24 and prolonged latency of N2 and P3 than those without e4 allele (P ＜ 0.05 ).Conclusion There is cognitive impairment in PSD patients.The ApoE ε4 allele may associate with the cognitive impairment and depression in PSD patients.