Relationship between endometrial lactobacillus-dominated microbiota and reproduction / 实用医学杂志

An increasing number of studies in recent years have focused on the association between female endometrial microbiota and fertility.Once the endometrial microflora microecology is unbalanced,it will cause a series of endometrial lesions,thereby destroying endometrial receptivity,affecting embryo implantation,resulting in embryo implantation or implantation failure.Among them,the most concerned is the positive significance of lactobacillus-led microbiota on reproductive outcome.Although the relationship between endometrial microbiota and reproductive outcome has not reached a consensus,most studies recognize the positive impact of lactobacillus-led microbiota on reproductive outcome.In this review,the relationship between lactobacillus-dominated microbiota and reproductive outcome is reviewed.

Application of analgesia and sedation under BIS monitoring combined with hydraulic coupling intracranial pressure monitoring in severe craniocerebral injury / 中华危重病急救医学

OBJECTIVE@#To investigate the clinical value of analgesia and sedation under bispectral index (BIS) monitoring combined with hydraulic coupled intracranial pressure (ICP) monitoring in severe craniocerebral injury (sTBI).@*METHODS@#(1) A prospective self-controlled parallel control study was conducted. A total of 32 patients with sTBI after craniotomy admitted to the intensive care unit (ICU) of the First People's Hospital of Huzhou from December 2020 to July 2021 were selected as the research objects. ICP was monitored by Codman monitoring system and hydraulically coupled monitoring system, and the difference and correlation between them were compared. (2) A prospective randomized controlled study was conducted. A total of 108 sTBI patients admitted to the ICU of the First People's Hospital of Huzhou from August 2021 to August 2022 were selected patients were divided into 3 groups according to the random number table method. All patients were given routine treatment after brain surgery. On this basis, the ICP values of the patients in group A (35 cases) were monitored by Codman monitoring system, the ICP values of the patients in group B (40 cases) were monitored by hydraulic coupling monitoring system, and the ICP values of the patients in group C (33 cases) were monitored combined with hydraulic coupling monitoring system, and the analgesia and sedation were guided by BIS. The ICP after treatment, cerebrospinal fluid drainage time, ICP monitoring time, ICU stay time, complications and Glasgow outcome score (GOS) at 6 months after surgery were compared among the 3 groups. In addition, patients in group B and group C were further grouped according to the waveforms. If P1 = P2 wave or P2 and P3 wave were low, they were classified as compensatory group. If the round wave or P2 > P1 wave was defined as decompensated group, the GOS scores of the two groups at 6 months after operation were compared.@*RESULTS@#(1) There was no significant difference in ICP values measured by Codman monitoring system and hydraulic coupling monitoring system in the same patient (mmHg: 11.94±1.76 vs. 11.88±1.90, t = 0.150, P = 0.882; 1 mmHg≈0.133 kPa). Blan-altman analysis showed that the 95% consistency limit (95%LoA) of ICP values measured by the two methods was -4.55 to 4.68 mmHg, and all points fell within 95%LoA, indicating that the two methods had a good correlation. (2) There were no significant differences in cerebrospinal fluid drainage time, ICP monitoring time, ICU stay time, and incidence of complications such as intracranial infection, intracranial rebleeding, traumatic hydrocephalus, cerebrospinal fluid leakage, and accidental extubation among the 3 groups of sTBI patients (P > 0.05 or P > 0.017). The ICP value of group C after treatment was significantly lower than that of group A and group B (mmHg: 20.94±2.37 vs. 25.86±3.15, 26.40±3.09, all P < 0.05), the incidence of pulmonary infection (9.1% vs. 45.7%, 42.5%), seizure (3.0% vs. 31.4%, 30.0%), reoperation (3.0% vs. 31.4%, 40.0%), and poor prognosis 6 months after operation (33.3% vs. 65.7%, 65.0%) were significantly lower than those in group A and group B (all P < 0.017). According to the hydraulic coupling waveform, GOS scores of 35 patients in the compensated group were significantly higher than those of 38 patients in the decompensated group 6 months after operation (4.03±1.18 vs. 2.39±1.50, t = 5.153, P < 0.001).@*CONCLUSIONS@#The hydraulic coupled intracranial pressure monitoring system has good accuracy and consistency in measuring ICP value, and it can better display ICP waveform changes than the traditional ICP monitoring method, and has better prediction value for prognosis evaluation, which can replace Codman monitoring to accurately guide clinical work. In addition, analgesia and sedation under BIS monitoring combined with hydraulic coupled ICP monitoring can effectively reduce ICP, reduce the incidence of complications, and improve the prognosis, which has high clinical application value.

Role of pre-suture craniotomy combined with controlled decompression under intracranial pressure monitoring in surgery for posttraumatic acute diffuse brain swelling / 中华神经医学杂志

Objective:To investigate the application value of pre-suture craniotomy combined with intracranial pressure monitoring in surgery for posttraumatic acute diffuse brain swelling (PADBS).Methods:One hundred and fifty-seven patients with PADBS admitted to our hospital from February 2015 to December 2019 were chosen in our study; 68 patients (control group), admitted to our hospital from February 2015 to June 2017, underwent controlled decompression under intracranial pressure monitoring; and 89 patients (treatment group), admitted to our hospital from June 2017 to December 2019, were performed pre-suture craniotomy combined with controlled decompression under intracranial pressure monitoring. The craniotomy time, brain tissue exposure time, cranial closure time, incidence of acute encephalocele, and Glasgow outcome scale (GOS) scores at 6 months after injury were retrospectively analyzed and compared between the two groups.Results:As compared with those in the control group, the patients in the treatment group had significantly longer intraoperative craniotomy time ([19.2±1.6] min vs. [15.4±1.4] min), significantly shorter exposure time of brain tissues ([18.5±2.4] min vs. [26.3±2.2] min), significantly shorter time of cranial closure ([11.2±1.5] min vs. [18.3±2.1] min), and statistically lower incidence of acute encephalocele (22.5% vs. 38.2%), P<0.05). The good prognosis rate of the treatment group (70.8%) was significantly higher than that of the control group (50.0%), and the mortality rate (6.7%) was statistically lower than that of the control group (17.6%, P<0.05). Conclusion:Pre-suture craniotomy combined with controlled decompression under intracranial pressure monitoring can shorten the time of cranial closure and brain tissue exposure, reduce the incidence of acute encephalocele, and ultimately improve the prognosis of patients with posttraumatic acute diffuse brain swelling.

Efficacy of optic canal decompression via lateral supraorbital approach for treatment of traumatic optic nerve injury / 中华创伤杂志

Objective:To investigate the effect of decompression of optic nerve canal for traumatic optic neuropathy (TON) via lateral supraorbital approach.Methods:A retrospective case series study was performed to analyze clinical data of 23 TON patients admitted to First People's Hospital of Huzhou from December 2013 to June 2019. There were 16 males and 7 females, aged 17-51 years [(34.3±2.2)years]. Degree of visual impairment included count fingers in 4 patients, hand motion in 4, light perception in 9 and loss of light perception in 6. Visual evoked potential examination (VEP) was performed in 15 patients before surgery. The amplitude of P100 completely disappeared in 5 patients, and the amplitude of P100 was lower than the lower limit of normal value and the latency prolonged in 10 patients. The time from injury to operation was 3 h-14 days [(3.3±0.6)days]. All patients underwent decompression of optic nerve canal via supralateral orbital approach, and dural repair was performed simultaneously in 11 patients with dural rupture. Intraoperative fractures and meningeal tears, duration of operation, blood loss, and hospitalization duration were recorded. Combined with the classical visual acuity improvement assessment method and the World Health Organization (WHO) low vision and blind grading standard, visual acuity was compared before operation, at 10 days and 3 months after operation. Glasgow Coma Scale (GCS) was used to evaluate patients' state of consciousness in the course of the disease. Glasgow Outcome Scale (GOS) was used to evaluate the prognosis. Incidence of complications was observed as well.Results:All patients were followed up for 12-16 weeks [(13.5±2.4)weeks]. Intraoperative microscopic exploration revealed that all patients had optic nerve canal fracture, 3 patients had frontal fracture with dural rupture, and 8 patients had ethmoid bone fragment with anterior skull base dural rupture. The duration of operation was 108.5-224.3 minutes [(151.8±30.2)minutes], including (32.5±8.4)minutes for craniotomy. The intraoperative blood loss was 90.5-165.3 ml [(121.3±15.5)ml]. The hospitalization was 14-26 days [(19.7±3.4)days]. The visual acuity of 13 patients (57%) improved and 5 patients (39%) relieved from blindness 10 days after operation, showing significant difference compared with the preoperation ( P<0.05). The visual acuity of 17 patients (74%) improved and 9 patients (39%) relieved from blindness at 3 months after operation. There was significant difference in visual acuity examined between 10 days and 3 months after operation ( P<0.05). Six patients were invalid, and 4 of them had no light perception before operation and the amplitude of VEP examination completely disappeared. All patients had GCS of 15 when left the hospital and GOS of 5 at 3 months after operation. One patient had cerebrospinal fluid rhinorrhea and healed after 7 days of supine position. No secondary hematoma, epilepsy or intracranial infection occurred during follow-up. Conclusion:Optic canal decompression via the lateral supraorbital approach can improve visual acuity in early stage and increase the rate of out of blindness, with low postoperative complications and satisfactory functional recovery, which is worthy of clinical application.

Controlled decompression under intracranial pressure monitoring in craniotomy of patients with severe cerebral hemorrhage / 中华神经医学杂志

Objective To explore the value of controlled decompression under intracranial pressure monitoring in craniotomy of patients with severe cerebral hemorrhage.Methods One hundred and six patients with severe cerebral hemorrhage,admitted to our hospital from January 2015 to July 2018,were prospectively enrolled.These patients were divided into control group (n=5 l) and treatment group (n=55) according to their families' wishes.The patients in the control group were treated with traditional craniotomy and hematoma removal;the patients in the treatment group were treated with controlled decompression combined with craniotomy and hematoma clearance under intracranial pressure monitoring,and intracranial pressure monitoring and management were carried out after operation.The rate of bone flap acceptance during operation,incidences of complications such as re-bleeding,scalp exudation,intracranial infection and cerebral infarction after operation,rate of re-operation and Glasgow outcome scale scores 6 months after injury were compared and analyzed between the two groups.Results Five patients had midway withdrawal (2 from the control group and 3 from the treatment group),and 101 patients (49 from the control group and 52 from the treatment group) were included in the statistical analysis.The rate of bone flap acceptance in the treatment group (69.2％) was significantly higher than that in the control group (24.5％,P＜0.05).The incidences of complications such as bleeding,scalp exudation,intracranial infection and cerebral infarction (11.5％,7.7％,3.8％,and 13.5％) were significantly lower than those in the control group (30.6％,22.4％,16.3％,and 34.7％,P＜0.05).The re-operation rate (3.8％) was significantly lower than that in the control group (16.3％,P＜0.05).Good recovery rate in the treatment group (76.9％) was significantly higher than that in the control group (55.1％,P＜0.05).The mortality rate (7.7％) was significantly lower than that of the control group (22.4％,P＜0.05).Conclusion For patients with severe cerebral hemorrhage,controlled decompression under intracranial pressure monitoring combined with craniotomy and hematoma removal can significantly improve the rate of bone flap acceptance,reduce the rate of second-stage cranioplasty,reduce the incidence of complications and re-operation rate,and more effectively improve the quality of life and prognosis of patients.

Pulse index continuous cardiac output combined with intracranial pressure monitoring in patients with severe craniocerebral injury / 中华神经医学杂志

Objective To explore the value of pulse index continuous cardiac output (PICCO) combined with intracranial pressure monitoring in patients with severe craniocerebral injury.Methods One hundred and thirty-eight patients with severe craniocerebral injury accepted controlling decompression surgical treatment in our hospital from February 2015 to February 2019 were prospectively chosen.According to patients' families will,postoperative application of PICCO combined with intracranial pressure monitoring for fluid management was performed in 72 patients (treatment group) and application of central venous pressure combined with intracranial pressure monitoring for fluid management was performed in 66 patients (control group).All patients were adjusted according to the monitoring results.The intracranial pressure and cerebral perfusion pressure one week after surgery,incidences of new traumatic cerebral infarction,neurogenic pulmonary edema,pulmonary infection,scalp exudation,and intracranial infection,average hospitalization days,total hospitalization costs,intensity of antimicrobial use,and Glasgow coma scale scores two weeks after operation were compared and analyzed between the two groups.Glasgow outcome scale was used to evaluate the prognoses of the patients 6 months after injury.Results There were 7 patients (3 from the control group and 4 from the treatment group) dropped out of the study due to various reasons and 131 patients (63 from the control group and 68 from the treatment group) included in the final statistical analysis;there was no significant difference in drop-out rate of the two groups (P＞0.05).The intracranial pressure in the treatment group ([14.28±2.98] mmHg) was significantly lower than that in the control group ([18.99±2.78] mmHg) and cerebral perfision pressure ([66.72±2.25] mmHg) was significantly higher than that in the control group ([52.96±3.12] mmHg) one week after operation (P＜0.05).During hospitalization,the incidences of new traumatic cerebral infarction,neurogenic pulmonary edema,pulmonary infection,scalp exudation and intracranial infection in the treatment group (8.8％,13.2％,11.8％,7.4％,and 2.9％) were significantly lower than those in the control group (22.2％,27.0％,25.4％,19.0％,and 12.7％,P＜0.05).The average hospitalization days,total hospitalization expenses and intensity of antimicrobial use in the treatment group were significantly shorter/lower than those in the control group (P＜0.05).Glasgow coma scale scores (11.88±1.78) and good recovery rate (76.5％) in the treatment group were significantly higher than those in the control group (8.06±1.12,54.0％) two weeks after operation (P＜0.05).Good recovery rate (76.5％) in the treatment group was significantly higher than that in the control group (54.0％,P＜0.05).The mortality rate (5.9％) was significantly lower than that in the control group (17.5％,P＜0.05).Conclusion PICCO combined with intracranial pressure monitoring can effectively improve intracranial pressure,optimize cerebral perfusion,reduce complications such as traumatic cerebral infarction,neurogenic pulmonary edema,pulmonary infection and intracranial infection in patients with severe craniocerebral injury,thereby improving prognosis and reducing mortality;besides that,it can reduce patients' exposure to anti-brain infection,and the breadth and intensity of bacterial drugs can reduce the length of hospitalization and total cost of hospitalization,thereby reducing the burden of family and society.

Controlled decompression under intracranial pressure monitoring for patients with hypertensive intracerebral hemorrhage and long-term aspirin use treated with soft channel puncture and drainage / 中华神经医学杂志

Objective To explore the application of controlled decompression under intracranial pressure (ICP) monitoring for the patients with hypertensive intracerebral hemorrhage and long-term aspirin use in the treatment with soft channel puncture and drainage.Methods This prospective study enrolled 87 patients with hypertensive intracerebral hemorrhage and long-term aspirin use from the Department of Neurosurgery,The First People's Hospital of Huzhou from February 2013 to February 2017.They were divided into a control group (43 cases) and a treatment group (44 cases) according to their wishes.The control group was treated by conventional soft channel puncture and drainage while the treatment group by controlled depression under ICP monitoring in addition to soft channel puncture drainage.Results In the treatment group,the volume ofhematoma aspiration (ICP) was (10.38±3.24) mL,accounting for about 20％ of the initial hematoma.The time for retention of endovascular drainage tube in the treatment group (90.0±4.2 h) was significantly longer than that in the control group (73.0±3.8 h),and the hematoma clearance rate in the treatment group (80.0％±1.2％) was significantly lower than that in the control group (91.0％± 1.9％) (P＜0.05).The incidences of such postoperative complications as rebleeding,scalp leachate and intracranial infection (11.4％,9.1％ and 4.5％,respectively) in the treatment group were significantly lower than in the control group (34.9％,25.6％ and 11.6％,respectively) (P＜ 0.05).The recovery rate in the treatment group (77.3％) was significantly higher than in the control group (60.5％);the mortality rate in the former (9.1％) was significantly lower than in the latter (18.6％) (P＜ 0.05).Conclusion For patients with hypertensive intracerebral hemorrhage and long-term aspirin use,controlled decompression combined with soft channel puncture drainage under ICP monitoring can effectively improve their quality of life and prognosis.

Role of pulse index continuous cardiac output monitoring in treatment of patients with traumatic acute diffuse brain swelling / 中华神经医学杂志

Objective To explore the role of continuous pulse output (PICCO) monitoring in treatment of patients with traumatic acute diffuse brain swelling (PADBS). Methods Eighty-six PADBS patients, admitted to our hospital from January 2014 to October 2017, were routinely given brain invasive intracranial pressure (ICP) monitoring after admission. At the same time, the patients were given bone flap decompression and hematoma clearance according to the condition of the diseases. After surgery, according to the wishes of family members, patients were divided into two groups (n=43):patients from treatment group accepted PICCO monitoring on the basis of ICP monitoring, and the treatment plan was adjusted according to the monitoring results; and the treatment plan in patients from control group was adjusted according to traditional central venous pressure (CVP) monitoring results on basis of ICP monitoring. Results One week after operation, the ICP in the treatment group was (14.36±2.82) mmHg when the cerebral perfusion pressure (CPP) was controlled between 50 and 70 mmHg, which was significantly different from the ICP in the control group (18.58±2.25) mmHg (P<0.05). Two weeks after treatment, Glasgow Coma Scale (GCS) scores of the treatment group (10.87±1.72) were significantly higher than those of the control group (8.18±1.16, P<0.05). The incidences of posttraumatic cerebral infarction (PTCI) and neurogenic pulmonary edema (NPE) in the treatment group (11.6％, 18.6％) were significantly lower than those of the control group (25.6％, 34.9％, P<0.05); the recovery rate (76.7％) in the treatment group was significantly higher than that in the control group (60.5％, P<0.05); the mortality rate (9.3％) was significantly lower than that in the control group (18.6％, P<0.05). Conclusion On the basis of intraventricular ICP monitoring, combined PICCO monitoring can effectively control ICP, improve cerebral perfusion, reduce the incidence of PTCI and NPE, improve the prognosis, and reduce the mortality in PADBS patients.

Preventive effect of Taohong Siwu decoction on the formation of lower extremity deep vein thrombosis in patients with cerebral hemorrhage / 中国中西医结合急救杂志

Objective To observe the preventive effect of Taohong Siwu decoction on the formation of lower extremity deep vein thrombosis (DVT) in patients with cerebral hemorrhage.Methods Eighty patients with cerebral hemorrhage admitted to the Department of Neurosurgery in Huzhou First People's Hospital from November 2014 to January 2016 were enrolled, and they were divided into an observation group and a control group according to the difference in treatment methods, each group 40 cases. Both groups were given routine treatment and nursing care, the patients of observation group were additionally given Taohong Siwu decoction (composition:Radix Angelicae Sinensis (stir-fried with wine) 10 g,Radix Rehmanniae Preparata 10 g,Radix Paeoniae Alba10 g,Ligusticum Chuanxiong Hort 6 g,Semen Persicae 6 g,Carthami Flos 4 g), once a day for consecutive 2 weeks.Results The D-dimer level in the observation group was significantly lower than that in the control group (mg/L: 1.47±0.91 vs. 1.88±0.79,t = 1.991,P = 0.035); the incidence of DVT in the observation group was obviously lower than that in the control group [5.0% (2/40) vs. 20.0% (8/40), χ2 = 4.114,P = 0.043].Conclusion Taohong Siwu decoction can effectively reduce the incidence of DVT in patients with cerebral hemorrhage.

The blood homocysteine level and distribution analysis of Ganzhou city people / 重庆医学

Objective We analysed the homocysteine level and distribution of ganzhou city crowd ,learned about its elevatory sit‐uation ,and provided theory basis for the intervention of high homocysteine level crowd and the prevention of heart and head blood vessel disease .Methods We detected the blood homocysteine level of 6419 adults who had physical examination in our hospital dur‐ing 2012 by enzymatic methods ,and analyzed the diagnose rate of HHcy and the distributions of Hcy in different age and gender . Results The total detection rate of high homocysteine level in 6419 adults was 39 .11% ,among which 47 .30% in male and 22 .49% in female ,the comparison was statistically significant (χ2 = 424 .28 ,P< 0 .05) ;the detection rate of male was higher than female .In different ages ,the detection rates were statistically significant comparatively (P< 0 .05) .The detection rate of homocys‐teine level in both gender rises with age .At the same time ,homocysteine levels in males of 25 - 34 years old age group and 35 - 44 years old age group ,45 - 54 years old age group and 55 - 64 yeas old age group were not statistically significant ;while there were statistical differences of Hcy level in the rest age groups of male ,different age groups of female and same age different gender groups (P< 0 .05) .Conclusion The HHcy detection rate and the blood Hcy distribution of Ganzhou city crowd has its regional characteristics compared with other regions ,and it may be associated with the main population distribution of hakka people and oth‐er geological factors .The detection rate of HHcy was relatively high ,and it′s advisable to take early prevention to lower the risk of heart and head blood vessel disease .

Preparation and characterization of polyurethane/polyethylene glycol/copper nanocomposite / 生物医学工程学杂志

A novel Cu-IUDs material, PU/PEG/Cu nanocomposite, was prepared by melt blending method with thermoplastic polyurethane (PU) as the matrix, with polyethylene glycol (PEG) as a hydrophilic modifier, and with nanometer particles of copper as active matter instead of copper wire or copper tube. The structure, morphology, mechanical properties, thermal stability and water absorption were investigated by using FT-IR, XRD, SEM and so on. The results indicated that the nanometer particles of copper were uniformly dispersed in the matrix in PU/PEG/ Cu nanocomposites. It can be seen that the water absorption ability of this nanocomposite was obviously improved while mechanical properties and thermal stability were at high levels. These results provided a good basis for the studies on the cupric ions release of the nanocomposites in future.

Effect of soy isoflavone on incretion of female rats / 中国基层医药

Objective To observe the effect of soy isoflavones on incretion of female rats. Methods 42 fe-male rots of 12 weeks old were divided into 3 groups at random. Low dose group were perfused with 40mg · kg-1·d-1 into stomach per day;high dose group were perfused with 80mg·kg-1·d-1 into stomach per day;control group were perfused with physiological saline into stomach. After 14 days,collected blood via jugular vein and tested 4 inde-xes-FSH, LH,E2 and P with chemoluminescence method. Results In 3 groups of soy isoflavones low doee group,soy isoflavones high dose group and control group,FSH were (0.13±0.021) mIu/ml, (0.12±0.018) mIu/ml, (0.15 ±0.024) mIu/ml respectively; LH were (0.17±0.032) mIu/ml, (0.15±0.043) mIu/ml, (0.18±0.047) mIu/ml respectively, which has no obvious differences (P > 0.05) ; E2 were (0.09±0.03) nmol/L, (0.03±0.03) nmol/L, (0.12±0.04) nmol/L respectively; P were (1.43±0.27) ng/ml, (2.82±0.37) ng/ml, (0.67±0.56) ng/ml re-spectivdy. Compare those 3 groups, E2 activeness of soy isoflavones group decreased obviously; but P activeness of soy isoflavones group increased obviously. Conclusion Soy isoflavones has no obvious effect on hypophysis hormone of rat, but the soy isoflavones of different dosages may measure the secretion of female rat ovary hormones by estrogen ac-tivity and antiestrogen activity.