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Objective:To explore the value of video-electroencephalography (VEEG) combined with amplitude-integrated electroencephalography (aEEG) in evaluating the condition and prognosis of neonatal hyperbilirubinemia brain injuries.Methods:A total of 120 children with hyperbilirubinemia treatedin the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from July 2019 to July 2020 were enrolled. According to MRI with or without T 1 weighted imging (T 1WI) hyperintensity changes in the globus pallidus, they were divided into the brain injury group (52 cases) and the normal group(68 cases). According to the severity of brain injury, the brain injury group was divided into bilirubin encephalopathy group (23 cases) and subclinical bilirubin brain injury group (29 cases). According to the scores of Gesell Development Scale, the brain injury group was divided into good prognosis group (37 cases)and poor prognosis group (15 cases). The diagnostic value in brain injury with hyperbilirubinemia, the evaluation of the severity of brain injury and the predictive value of VEEG and aEEG were analyzed. Results:The abnormal rates of VEEG and aEEG in the brain injury group were higher than those in the normal group: 76.92% (40/52) vs. 8.82% (6/68), 80.77% (42/52) vs. 11.76% (8/68), the differences were statistically significant ( χ2 = 57.81 and 57.73, P<0.01). The abnormal rates of VEEG and aEEG in bilirubin encephalopathy group were higher than those in subclinical bilirubin brain injury group: 91.30% (21/23) vs. 65.52% (19/29), 95.65% (22/23) vs. 68.97% (20/29), the differences were statistically significant ( χ2 = 4.80 and 5.88, P<0.05). There was no significant difference in abnormal rates of VEEG and aEEG between the good prognosis group and poor prognosis group ( P>0.05). The results of operating characteristic curve analysis showed that the areas under the curve of VEEG combined with aEEG in the diagnosis of brain injury with hyperbilirubinemia, evaluation of the severity of brain injury, predicting the prognosis of children were higher than those of each examination method used alone ( P<0.05). Conclusions:VEEG combined with aEEG has diagnostic value for neonatal brain injury with hyperbilirubinemia, and has evaluation value for severity and prognosis of the disease.
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Hyperphosphatemia is one of the common complications in maintenance hemodialysis patients and is closely related to cardiovascular disease and related death events. Therefore, the effective management of blood phosphorus is an important link to improve the prognosis of patients with maintenance hemodialysis. This study on maintenance hemodialysis patients with hyperphosphatemia 3Ds management including diet, along with the progress of dialysis and drug related nursing intervention were summarized, discuss how to reasonable dietary phosphorus limited, improve the efficiency of dialysis, and the correct use of problems still existing in phosphate binder, in order to reduce hyperphosphatemia to provide the reference for clinical nursing practice.
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Objective@#To compare the predictive value of 10 prehospital assessment scales for large vessel occlusion in patients with acute ischemic stroke.@*Methods@#From January 2016 to December 2018, patients with acute ischemic stroke within 24 h of onset admitted to the Department of Neurology, Nanfang Hospital, Southern Medical University were enrolled retrospectively. The scores of various scales were calculated based on clinical data, including the National Institutes of Health Stroke Scale (NIHSS), Los Angeles Motor Scale (LAMS), and 3-item stroke scale (3I- SS), Prehospital Acute Stroke Severity Scale (PASS), Ambulance Clinical Triage For Acute Stroke Treatment (ACT-FAST), and Stroke Vision, Aphasia, and Neglect Assessment Scales (VAN), etc. The predictive threshold of the NIHSS score was determined, and the receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to evaluate the effectiveness of various prehospital scales to predict large vessel occlusion.@*Results@#A total of 705 patients with acute ischemic stroke within 24 h of onset were enrolled, including 252 (35.7%) with large vessel occlusion. The best predictive cutoff value for judging large vessel occlusion by the NIHSS score was 9, sensitivity was 81.7%, specificity was 79.7%, positive likelihood ratio was 4.851, and negative likelihood ratio was 0.260. LAMS score ≥4 (sensitivity 88.1%, specificity 81.0%, positive likelihood ratio 4.640, and negative likelihood ratio 0.247), VAN positive (sensitivity 83.7%, specificity 82.3%, positive likelihood ratio 4.741, and negative likelihood ratio 0.198) and NIHSS score ≥9 were more accurate in identifying large vessel occlusion. The AUC values of the 8 quantitative scores were all > 0.7, and the AUC of LAMS was the largest (0.852, 95% confidence interval 0.825-0.878).@*Conclusions@#In patients with acute ischemic stroke within 24 h of onset, the NIHSS score ≥9 can be used as the best cutoff value for predicting large vessel occlusion events. LAMS, VAN, and NIHSS scales are more accurate in predicting large vessel occlusion. The predictive power of the 8 quantitative scales is higher, and the AUC of LAMS is the largest, which can be used for clinical prediction of large vessel occlusion in patients with acute ischemic stroke.
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Objective To explore the mechanism of ZMS regulation of M_2 muscarinic receptor mRNA expression. Methods In vitro cultured CHOm2 cells were divided into ZMS 1 group (treatment with 1 × 10~(-5) mol/L ZMS for 24 h), ZMS 2 group (treatment with 1 × 10~(-5) mol/L ZMS for 24 h and 1 μg/mL cycloheximide for 12 h) and ZMS 3 group (treatment with 1 μg/mL cycloheximide for 4 h and 1 × 10 ~(-5) mol/L ZMS for 24 h), and their corresponding control groups were also established (substitution of ZMS by DMSO). Actinomycin D was added to cultured CHOm2 cells of each group to inhibit the synthesis of mRNA. CHOm2 cell samples were taken at different time points, the relative expression of M_2 receptor mRNA was detected by Real-time PCR, and half life of M_2 receptor mRNA was calculated. Results Compared with corresponding control groups, the half life of M_2 receptor mRNA of CHOm2 cells in ZMS 1 group and ZMS 2 group was significantly prolonged [(4.75h± 0.54) h vs (2.13 ±0.23) h, P<0.05; (5.43 ±1.13) h vs (2.46 ±0.09) h, P<0.05]. There was no significant difference in half life of M_2 receptor mRNA of CHOm2 cells between ZMS 3 group and its corresponding control [ ( 3.06 ±0.23) h vs (3.00 ± 0.20) h, P > 0.05]. Conclusion De novo protein synthesis is required for the enhancement of M_2 receptor mRNA stability regulated by ZMS.
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Objective:To detect the engraftment capability and hematopoietic potential of the expanded cells,establish an optimized project of ex vivo expansion and the SCID mice model of UCB transplantation.Methods:Human cord blood CD34 + cells were clutured in strom free liquid culture system,the sublethally irradiated SCID mice were injected with human expanded cord blood cells by tail vein.Four weeks after inocuration,BM cells of the survived animals are obtained from both femurs and tibias and assessed for the presence of human cells by immunofluorescence staining and PCR.Results:The cells and CFUs of group FL+TPO+SCF+IL 6 were increased significantly,and maintained some proportional CD34 + cells.The CFU of group SCF+IL 6+IL 3+GM CSF+EPO had reduced in week 2,CFC and CD34 + cells and Alu gene were detected in SCID mice BM.Conclusion:The cytokine combination with FL+TPO+SCF+IL 6 can effectively expand UCB CD34 + cells,and the expanded cells can engraft the BM of sublethally irradiated SCID mice and reconstitute hematopoiesis.