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The aim of this study was to investigate the harmful effects of acute hypoxia on mouse cerebral cortex and hippocampus and the underlying mechanism. Mouse model of acute hypoxia was constructed by using a sealed glass jar. Laser speckle contrast imaging was used to detect the changes of cerebral blood flow after different time duration of hypoxia. Total superoxide dismutase (T-SOD) and malondialdehyde (MDA) assay kits were used to detect oxidative stress in cerebral cortex and hippocampus. Immunofluorescent staining was used to detect neuroinflammatory response of microglia in the cerebral cortex and hippocampus. One-step TUNEL method was used to detect neuronal apoptosis. The results showed that, compared with non-hypoxia (0 min hypoxia) group, 30 min hypoxia group exhibited decreased cerebral blood flow, higher percentage of CD68+/Iba1+ microglia, and increased neural apoptosis in the cerebral cortex and hippocampus. Compared with 30 min group, 60 min hypoxia group showed significantly decreased cerebral blood flow, increased MDA content in the cortex, as well as greater percentage of CD68+/Iba1+ microglia and neuronal apoptosis in the cerebral cortex and hippocampus. These results suggest that acute hypoxia damages brain tissue in a time-dependent manner and the oxidative stress and neuroinflammation are important mechanisms.
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Animals , Mice , Cerebral Cortex/metabolism , Hippocampus/metabolism , Hypoxia , Malondialdehyde , Oxidative Stress , Superoxide Dismutase/pharmacologyABSTRACT
Objective To investigate the feasibility of combined CT angiography(CTA)of head,neck and aorta in acute type A aortic dissection (ATAAD) and whether the incremental craniocervical information benefits the surgeon and leads to improved clinical outcomes.Methods One hundred and twenty ATAAD patients in a CAC group underwent combined aortic CTA and 123 ATAAD patients in a control group underwent conventional aortic CTA.In the CAC group,the image quality was analyzed and critical CTA findings in craniocervical arteries were determined for further surgery procedure.The radiation dose,intraoperative cerebral protection method,and postoperative intensive care units(ICU)time,in-hospital time,neurologic dysfunction(ND)and all-cause mortality were compared between the two groups.Results The CAC group had all the carotid and cerebral arteries diagnosed successfully. There were 13 patients replaced conventional unilateral antegrade selective cerebral perfusion with bilateral one according to the head and neck CTA images in the CAC group. The CAC group had effective radiation dose,postoperative ND,ICU time and in-hospital time significantly lower than those of the control group (P<0.05).There were no statistical differences between the all-cause morbidities of the two groups (P>0.05).Conclusion A combined CTA of head, neck and aorta in ATAAD is feasible. The incremental craniocervical information may lead to improved clinical outcomes.
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Objective To explore the clinical application and complication management of ultrasound-guided implantation of venous access port via axillary vein in breast cancer patients with chemotherapy.Methods From Sep.2016 to Jan.2017,50 breast cancer patients were implanted implantable venous access ports via the axillary vein under ultrasound guidance in the First Affiliated Hospital of Chongqing Medical University,among whom 25 cases with the left-side breast cancer,the other cases with right-side breast cancer.The effects of the application of implantation method and complication management were observed.Results The success rate of venous access ports via the axillary vein under ultrasound guidance was 98％(49/50).The operation time was (26±4) mins.The number of puncture ≤ 2 times was 96％ (48/50).The incidence of intraoperative complications including pneumothorax (0％,0/50),error arterial puncture rate 4％ (2/50),catheter ectopic incidence 2％(1/50),and intraoperative blood loss 2％(1/50).The long-term postoperative included pinch-off syndrome (POS) (0％,0/50),thromboembolism (2 ％,1/50),infection (2％,1/50) and catheter detachment (0％,0/50).Conclusion Ultrasound-guided implantation of venous access port via axillary vein has features of high success ratio,high safety,and low complication rate,which provides additional venous channel selection of port implantation.
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Objective To investigate the characteristics,occurrence times and management of cardiac erosion after transcatheter closure of ASD,and to discuss the mechanism and predictive factor of erosion.Methods We analyzed all the cases who received transcatheter ASD closure from September 1997 to September 2016 in our hospital retrospectively.Results 9 cases (9/6903,0.13％) were reported to have cardiac erosion events after device closure ASD of including 2 cases of acute cardiac tamponade needed pericardiocentesis,2 cases of aorta-to right-atrial fistula needed transcatheter closure or operative repair and 5 cases of perforation of the anterior leaflet of mitral valve.1 case with MV anterior leaflet perforation presented with hemolysis and required surgical repair.Cardiac erosion events were found at average 52.9±68.3 days (1-180days) after the ASD closure.Conclusions Cardiac erosion is a rare but serious complication of device closure for ASD.Erosion events are mostly attributed to device over-sizing or deficient retro-aortic rims.It is important for a strict follow-up,early deduction and timely disposition when an erosion event is identified.occurring.
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Objective To develop an autopsy table for the cervical surgery of the small animal to enhance the efficiency by regulating the angles during the operation to expose cervical vertebra adequately.Methods The autopsy table was composed of a table body,a head rack and a foot rack.The head rack was connected with the body by a loose-leaf shaft,which had a screw under a semi-cylindrical cushion put into a sliding slot of the cushion to regulate and fix its position.The table body had four straps at its comers to imobilize the extremities of the experimental animal,and some screws were used to adjust and position the straps to four oblique sliding slots.Results The autopsy table adapted itself to sizes of small animals,which gained advantages in exposure of operating field,short operating time,decreased intraoperative blood loss,head imobilization as well as reduced workload.Conclusion The autopsy table enhances surgery efficiency and safety and has easy operation and low cost,and thus is worthy promoting in the cervical experiment of small animals.
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Objective To develop an autopsy table for the cervical surgery of the small animal to enhance the efficiency by regulating the angles during the operation to expose cervical vertebra adequately.Methods The autopsy table was composed of a table body,a head rack and a foot rack.The head rack was connected with the body by a loose-leaf shaft,which had a screw under a semi-cylindrical cushion put into a sliding slot of the cushion to regulate and fix its position.The table body had four straps at its comers to imobilize the extremities of the experimental animal,and some screws were used to adjust and position the straps to four oblique sliding slots.Results The autopsy table adapted itself to sizes of small animals,which gained advantages in exposure of operating field,short operating time,decreased intraoperative blood loss,head imobilization as well as reduced workload.Conclusion The autopsy table enhances surgery efficiency and safety and has easy operation and low cost,and thus is worthy promoting in the cervical experiment of small animals.
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Objective To explore the incidence and clinical treatment of related complications caused by implantable venous access port(IVAP) in patients with breast cancer during chemotherapy.Methods The data of 755 patients with breast cancer recieved chemotherapy by which caused some related complications in our hospital from January 2014 to March 2016 were retrospectively analyzed.Results 753 patients IVAPs were implanted succussfully.The total placement time of implantable venous access port was from 110 days to 940 days,with median placement 147.33 days.The related complications of IVAP were catheter malposition(0.79％,6/755),catheter-related thrombosis(27.81％,210/755),catheter fracture(0.13％,1/755),port exposure(0.93％,7/755) and IVAP-related bloodstream infection(0.13％,1/755).The IVAP-related complications and thrombosis rate were significant higher when IVAPs implanted in the left internal jugular veincompared with that in right internal jugular vein(34.88％ vs.25.74％,33.10％ vs.24.68％).Conclusion Application of IVAP in patients with breast cancer during chemotherapy is a safe and effective operation.The most common complication is asymptomatic mural thrombus formation around the catheter,which should be paid attention to.
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In order to study the microstructure characteristics of normal lunate bones,eight fresh cadaver normal lunates were scanned with micro-computed tomography.High-resolution images of the micro-structure of normal lunates were obtained and we analyzed the nutrient foramina.Then nine regions of interest (ROI) were chosen in the central sagittal plane so that we could obtain the parameters of trabecular bones of ROIs.The distal lamellar-like compact structure had statistically significant differences when it was compared with the ROIs in the volar and dorsal ends of the distal cortex.The difference of diameter between the volar and dorsal foramina was significant (P＜0.05).However,there was no significant difference regarding the number.The trabecular bones of the volar and dorsal distal ends had lower intensity than those of the distal central subchondral bone plate.The diameters of the nutrient foramina on the volar cortex were larger than those on the dorsal.This research provided more detailed information about microstructure of normal lunate and the nutrient foramina on cortex,and a reference for further study about diseased lunate.
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In this study, we developed a sensitive and rapid HPLC-MS/MS method for the determination of trans-ferulic acid (trans-FA) in plasma samples, and investigated the pharmacokinetics characteristics in healthy volunteers. The plasma samples were extracted with acetic ether, and then separated on a Hedera ODS-2 column with a mobile phase of methanol and 5 mmol·L-1 ammonium acetate buffer solution containing 0.05% acetic acid (34:66) at a flow rate of 0.4 mL·min-1. Electrospray ionization source was applied and operated in the positive ion mode using MRM. The method exhibited a good linearity over the concentration range of 0.1-5 ng·mL-1 (r ≥ 0.9992). The values on both the occasions (intra-and inter-day) were all within 9.2%, and the accuracy was 95.4%-111.4%. No matrix effect and carry-over effect were observed. Trans-FA was stable in human plasma under different storage conditions. The developed HPLC-MS/MS method is rapid, sensitive, accurate, and reproducible, and suitable for the pharmacokinetic study of trans-FA in healthy Chinese volunteers.
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Objective To investigate the relationship between evidence-based nursing tactics and quality of life of breast cancer patients so as to provide the reference for the best nursing strategy .Methods 87 patients who were diagnosed with breast cancer received surgical treatment were randomly divided into experimental group (44 cases) and control group (43 cases) .Patients in control group were given general nursing ,while those in experimental group were given evidence-based nursing tactics on the ba-sis of general nursing .Both groups were asked to fill in the quality of life questionnaire after 4 months breast cancer treatment and before treatment .Results The quality of life in experimental group was significantly improved after treatment compared with that of before treatment(P< 0 .05) ,the quality of life in the experimental group received evidence-based nursing tactics is significantly better than that of in control group (P< 0 .05) .Conclusion Evidence-based nursing tactics can improve the quality of life in breast cancer patients .
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<p><b>BACKGROUND</b>In order to improve the clinical treatment level of urinary system injury, it is necessary to build up an animal model of urinary system wound, which is not only analogous to real clinical practice, but also simple and practical.</p><p><b>METHODS</b>We have developed the third generation of firearm fragment wound generator based on the first and the second producer. The best explosive charge of the blank cartridge was selected by gradient powder loading experiments. The firearm fragment injuries were made to the bulbous urethra of 10 New Zealand male rabbits. One week preoperatively and 2, 4 and 8 weeks postoperatively, all the animals underwent urethroscopy and urethrography. At 2, 4 and 8 weeks postoperatively, two animals were randomly selected and killed, and the urethra was cut off for pathological examination.</p><p><b>RESULTS</b>The shooting distance of the third generation of firearm fragment wound generator is 2 cm. The best explosive charge of the blank cartridge is 1 g of nitrocotton. All rabbits survived the procedures and stayed alive until they were killed. Injuries were limited to bulbous urethra and distal urethra. Round damaged areas, 1-1.5 cm in length, on the ventral wall were observed. Ureteroscopy results showed that canal diameter gradually shrank by over 50% in 9 rabbits. The rate of success was 90%. Urethrography result noted that a 1-1.3 cm stricture was formed at the bulbous urethra. Histology results of injured stricture urethra showed that fibrous connective tissue hyperplasia and hyaline degeneration caused further stricture in the canal.</p><p><b>CONCLUSIONS</b>The third generation of firearm fragment wound generator imitates the bullet firing process and is more accurate and repeatable. The corresponding rabbit model of traumatic complex urethral stricture simulates the real complex clinical conditions. This animal model provides a standardized platform for clinical researches on treating traumatic injuries to the urinary system.</p>
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Animals , Male , Rabbits , Disease Models, Animal , Penis , General Surgery , Urethra , General Surgery , Urethral Stricture , General SurgeryABSTRACT
The study aims to develop an LC-MS/MS method for the simultaneous determination of amygdalin and paeoniflorin in urine samples, and to investigate their urinary excretion characteristics in healthy volunteers after intravenous infusion administration of Huoxue-Tongluo lyophilized powder for injection (HTLPI). The urine samples were extracted by methanol, and then separated on a Hedera ODS-2 column with a mobile phase of acetonitrile and 5 mmol · L(-1) ammonium acetate buffer solution containing 0.05% formic acid (20:80). Electrospray ionization source was applied and operated in the positive ion mode using MRM. The method exhibited good linearity over the concentration range of 0.03 -40 µg · mL(-1). The values on both the occasions (intra- and inter-day) were all within 15% at three concentration levels. No matrix effect and carry-over effect were observed. Amygdalin and paeoniflorin were stable in human urine under different storage conditions. Approximately 79.6% of the administered amount of amygdalin was excreted unchanged in urine within 24 h and which was 48.4% for paeoniflorin. The developed LC-MS/MS method can be applied to evaluate the urinary excretion of amygdalin and paeoniflorin.
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Humans , Amygdalin , Urine , Chromatography, Liquid , Drugs, Chinese Herbal , Glucosides , Urine , Monoterpenes , Urine , Tandem Mass SpectrometryABSTRACT
<p><b>BACKGROUND</b>Optimizing treatment outcomes for depression requires understanding of how evidence-based treatments are utilized in clinical practice. Antipsychotic medications concurrent with antidepressant treatment are frequently used in major depression, but few studies have investigated trends and patterns of their use over time. This study aimed to examine the prescription patterns of antipsychotic medications for major depression in China from 2002 to 2012 and their association with treatment satisfaction and quality of life (QOL).</p><p><b>METHODS</b>A total of 3655 subjects with major depression treated in 45 Chinese psychiatric hospitals/centers nationwide were interviewed between 2002 and 2012. Patients' socio-demographic and clinical characteristics including psychopathology, medication side effects, satisfaction with treatment and QOL were recorded using a standardized protocol and data collection.</p><p><b>RESULTS</b>The frequency of antipsychotic use was 24.9% in the whole sample; the corresponding figures were 17.1%, 20.3%, and 32.8% in 2002, 2006, and 2012, respectively (χ2 = 90.3, df = 2, P < 0.001). Multiple logistic regression analyses revealed that patients on concurrent antipsychotics had significantly more delusions or hallucinations, longer illness duration, greater side effects, and more likely to be treated as inpatients and in major hospitals (i.e., Level-III hospital). Antipsychotic use was associated with lower treatment satisfaction while there was no significant difference with respect to physical and mental QOL between the antipsychotic and nonantipsychotic groups.</p><p><b>CONCLUSIONS</b>Concurrent antipsychotic use was found in about one in four treated depressed patients in China, which has increased over a 10-year period. Considering the association of drug-induced side effects and the lack of patients' and relatives' satisfaction with antipsychotic treatment, further examination of the rationale and appropriateness of the use of antipsychotics in depression is needed.</p>
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Adult , Female , Humans , Male , Middle Aged , Antipsychotic Agents , Therapeutic Uses , Depressive Disorder, Major , Drug Therapy , Personal Satisfaction , Psychotropic Drugs , Therapeutic Uses , Quality of LifeABSTRACT
Objective To explore the influence of life quality for the breast cancer patients receiving chemotherapy after the cog-nitive ,behavioral and psychological intervention to their spouse .Methods 120 breast cancer patients received standardized chemo-therapy and their spouses ,and divided into control and intervention groups .The intervention group receive the routine care and health guidance .Before and after chemotherapy ,the life quality of patients was investigated .The data was analyzed statistically .Re-sults The result by the breast cancer patients Quality of Life Questionnaire in Chinese (FACT-B) show that ,the scores of the con-trol and intervention groups in the physiological status ,social/family status ,emotional status ,functional status ,additional attention andtotalscorewere(18.77±4.18,16.48±4.60,17.35±4.41,16.04±4.80,20.81±6.02,89.45±6.34 ;22.46±3.57,19.03± 4 .83 ,18 .58 ± 3 .96 ,18 .59 ± 4 .48 ,24 .73 ± 5 .63 ,103 .39 ± 8 .91) .The scores of intervention groups was increased significantly than the control group .The data was analyzed statistically .Conclusion The quality of life of patients was improved by the cognitive ,be-havioral and psychological guidance and intervention to the spouse of breast cancer chemotherapy patients.
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<p><b>BACKGROUND</b>Low back pain (LBP) is a major medical and social problem among working populations and is associated with high medical expense, loss of productivity, and disability. The aim of this study is to investigate the prevalence of LBP among soldiers and evaluate the possible causative factors in military training. The results may provide an insight into changes needed in military training that will reduce the occurrence of LBP among soldiers.</p><p><b>METHODS</b>A cross-sectional survey was conducted in a group of young soldiers in China to estimate the prevalence of LBP and evaluate possible causative factors in military training.</p><p><b>RESULTS</b>The survey was distributed to 1659 soldiers, of whom 1624 responded. LBP was reported by 425 of the 1624 (26.2%) soldiers. The prevalence of LBP was higher in the armored force (51.3%) than in the artillery (27.5%) or infantry (11.9%). A multivariate logical regression analysis identified night training, 5 km cross-country race, and grenade-throwing training as military training risk factors for LBP.</p><p><b>CONCLUSIONS</b>The relatively high incidence of LBP among soldiers was related to night training, 5 km racing, and grenade throwing. Modifications in these training methods should enhance the health of recruits and lower the incidence of LBP.</p>
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Adolescent , Adult , Humans , Male , Young Adult , Cross-Sectional Studies , Low Back Pain , Epidemiology , Military Personnel , Prevalence , Risk Factors , Surveys and QuestionnairesABSTRACT
<p><b>OBJECTIVE</b>To investigate the value of susceptibility weighted imaging(SWI)in the diagnosis of hemorrhagic foci early after blast injury and its role in the outcome prediction.</p><p><b>METHODS</b>Totally 30 rabbits with blast-induced cerebral blast injury were used in this study. After routine CT/MRI and SWI scanning,quantified analysis was performed in regions of interest using post-processing technology. After dissecting the brains of the experimental rabbits,the cerebral histopathological changes were observed,and the results were compared with SWI findings.</p><p><b>RESULTS</b>In these 30 rabbits,22,102,221,and 738 hemorrhagic foci were detected by CT,T1WI,T2WI,and SWI,respectively. The number of cerebral microbleeds detected by SWI was significantly larger than those revealed by conventional T1WI and T2WI(Χ(2)=10.00,P<0.01). Furthermore,the SWI imaging displayed the punctiform(n=315,42.7%),lamellar(n=218,29.5%),slinar(n=205,27.8%)hypointense foci,with clear margin. The number of hemorrhagic foci detected by SWI was positively correlated with survival(r=-0.667,P<0.05).</p><p><b>CONCLUSIONS</b>SWI remarkably increases the detection rate of hemorrhagic foci(particularly microbleeds)in rabbits with cerebral blast injury. The number of cerebral microbleeds and location of foci are closely related with the outcomes and therefore may facilitate clinical managment.</p>
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Animals , Female , Male , Rabbits , Blast Injuries , Diagnosis , Brain , Pathology , Brain Injuries , Diagnosis , Cerebral Hemorrhage , Diagnosis , Image Enhancement , Magnetic Resonance Imaging , Methods , PrognosisABSTRACT
Objective To synthesize relevant data and to analyze the benefit-cost ratio on strategies related to preventing the maternal-infantile transmission of hepatitis B virus infection and to explore the optimal strategy.Methods A decision tree model was constructed according to the strategies of hepatitis B immunization and a Markov model was conducted to simulate the complex disease progress after HBV infection.Parameters in the models were drawn from meta-analysis and information was collected from field study and review of literature.Economic evaluation was performed to calculate costs,benefit,and the benefit-cost ratio.Sensitivity analysis was also conducted and a tornado graph was drawn.Results In view of the current six possible strategies in preventing maternal-infantile transmission of hepatitis B virus infection,a multi-stage decision tree model was constructed to screen hepatitis B surface antigen (HBsAg) or screen for HBsAg then hepatitis B e antigen (HBeAg).Dose and the number of injections of HBIG and hepatitis B vaccine were taken into consideration in the model.All the strategies were considered to be cost-saving,while the strategy of screening for HBsAg and then offering hepatitis B vaccine of 10 μg × 3 for all neonates with hepatitis B immunoglobulin (HBIG) of 100 IU × 1 for the neonates born to mothers who tested positive for HBsAg appeared with most cost-saving.In the strategies,the benefit-cost ratio of using 100 IU HBIG was similar to 200 IU HBIG,and one shot of HBIG was superior to two shots.Results from sensitivity analysis suggested that the rates of immunization and the efficacy of the strategy in preventing maternal-infantile transmission were the main sensitive variables in the model.Conclusion The passive-active immune-prophylaxis strategy that using 10μg hepatitis B vaccine combined with 100 IU HBIG seemed to be the optimal strategy in preventing maternal-infantile transmission,while the rates of immunization and the efficacy of the strategy played the key roles in choosing the ideal strategy.
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OBJECTIVE: Clozapine is one of the most commonly used antipsychotic drugs in China. To date, few studies have investigated the patterns the prescription of clozapine nationwide. The present study examined these patterns in China in 2006 and identified the demographic and clinical characteristics associated with the use of clozapine. METHODS: Using a standardized protocol and data collection procedure, we surveyed 5,898 patients with schizophrenia in 10 provinces with differing levels of economic development. RESULTS: Overall, clozapine had been prescribed for 31.9% (n=1,883) of the patients; however we found considerable variation among the 10 provinces. The frequency of clozapine use was highest in Sichuan (39.3%) and lowest in Beijing (17.3%). The mean daily dose of clozapine was 210.36+/-128.72 mg/day, and 25.1% of the patients were treated with clozapine in combination with other antipsychotics. Compared with the group not receiving clozapine, clozapine-user had been treated for longer durations and had experienced a greater number of relapses and hospitalizations. Furthermore, those in the clozapine-user had lower family incomes, were less able to seek psychiatric services, and more likely to be male and have a positive family history of schizophrenia. A multiple logistic regression analysis revealed that age, sex, professional help-seeking behaviors, duration of illness, economic status, educational level, and clinical manifestations were associated with the use of clozapine. CONCLUSION: Clozapine use is common in China. However, use of the antipsychotic varies among provinces, and demographic and clinical factors play important roles in the prescription of clozapine.
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Humans , Male , Antipsychotic Agents , China , Clozapine , Data Collection , Educational Status , Hospitalization , Logistic Models , Prescriptions , Recurrence , Sampling Studies , SchizophreniaABSTRACT
ObjectiveTo observe anatomy of the blood vessel arches and their blood circulation in the ileum and further establish surgical strategy for preventing excessive tonicity and ischemia of the ileum after anastomosis of the ileum pouch and the anal canal.MethodsThe blood vessel arches were dissected in the ileum of 45 corpses and their blood circulation routes were observed.ResultsThe 2-tier blood vessel arches were found in 2 cases (4％), the 3-tier blood vessel arches in 35 cases (78％), the 4-tier blood vessel arches in 5 cases (11％), and the 5-tier blood vessel arches in 3 cases (7％).ConclusionsUnder the right colic artery, curing the superior mesenteric artery and vein can release the length of the small intestines, prevent tonicity and ischemia of the ileum after anastomosis of the ileum pouch and the anal canal, and supply enough blood to the ileum by the 2 -5 tier blood vessels.
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OBJECTIVE: To investigate the patterns of antipsychotic use in China and to analyze the factors that influence antipsychotic prescriptions. METHODS: A standardized survey was conducted from May 20 to 24 2002 in five different regions of China with varying economic levels. The patterns of antipsychotic medication use were analyzed in a sample of 4,779 patients with schizophrenia. The survey gathered information on demographic characteristics, clinical profiles, and antipsychotic medications prescribed. Multiple logistic regression was used to analyze factors related to patterns of antipsychotic medication use. RESULTS: A plurality of patients with schizophrenia was treated with clozapine (39%); this was followed by risperidone, sulpride, chlorpromazine, perphenazine, and haloperidol. More than 56.3% of patients were treated with only one atypical antipsychotic. The mean daily dose of chlorpromazine was 365+/-253 mg (mean+/-standard deviation), and 6.5% of patients were treated with depot injections of typical antipsychotic medications. A total of 73.7% (n=3,523) of patients with schizophrenia received monotherapy, 24.8% (n=1,183) received two antipsychotics, 1.1% (n=52) received three antipsychotics, and one received four different antipsychotics. Patients often simultaneously received other classes of medications including anticholinergic agents, benzodiazepines, beta-blockers, antidepressants, and mood stabilizers. Economic status and clinical symptoms were the main factors that contributed to the patterns of antipsychotic prescription. CONCLUSION: The present study suggests that atypical antipsychotic medications, especially clozapine, are the primary psychiatric treatments of choice in the management of schizophrenia in China. Moreover, the economic status and clinical profile of the patient are the major factors affecting the prescription of antipsychotic medication.