ABSTRACT
Objective To investigate the application of jugular bulb oxygen saturation (SjvO2) in the treat-ment of patients with severe traumatic brain injury (sTBI).Methods From August 2016 to August 2017,fifty-three patients with sTBI admitted to intensive care unit ( ICU) of Zhoupu Hospital Affiliated to Shanghai University of Medicine & Health Sciences were randomly divided into the intracranial pressure - guided treatment group ( ICP group) and the SjvO2 -guided treatment group (SjvO2 group) by draw lots method.The patients in ICP group ( n=25) were treated according to the routine regimen,and the SjvO2 group (n=28) was dynamically detected SjvO2,and the SjvO2 was maintained at the target range of 55% -75% by adjusting the treatment scheme in addition to the routine treatment regimen.The early GCS score,GOS score and the mortality rate were compared between the two groups three months after injury.Results A total of 36% (9/25) patients had SjvO2 <55% events within 3 days after injury.On the fourth day after injury,the GCS score in the SjvO2 group was better than that in the ICP group [(7.17 ± 1.41)points vs.(6.91 ± 1.10)points,t=1.78,P=0.03],and there was no statistically significant difference in mortality between the two groups at 90 days after injury ( P=0.80).The SjvO2 group had a better prognosis rate compared with ICP group (24.00% vs.10.70% ,χ2 =2.31,P=0.05).Conclusion The treatment strategy of sTBI patients guided by SjvO2 can improve early consciousness level and improve the overall prognosis of sTBI patients.
ABSTRACT
Objective To explore more satisfactory results in correcting the aesthetically short nose combined with low and blunt nasal tip by using autologous cartilage grafts.Methods External rhinoplasty approach was preferred.Nasal septal cartilage and auricular cartilage or rib cartilage of patients were adopted,as necessary,various shapes of grafts were carved,such as septal extention graft,columella strut and shift graft.Then we used these autologous cartilage grafts with suture and removal techniques to correct the aesthetically short nose combined with low and blunt nasal tip.The length of the nose (n-prn) and the projection of nasal tip (sn-prn) were measured before and after the operation.Paired t-test was adopted to evaluate the results.Results Thirty-one patients accepted the nasal tip rhinoplasty with autologous cartilage whose nasal tip was over rotation,blunt and low.All the patients were followed up for 3 months.Thirty patients satisfied with the results,accounting for 96.7 ％ of the total.()ne (3.3 ％) patient dissatisfied with the result because of postoperative asymmetry nostrils.Nose length before and after surgery was significantly different (P＜0.05).Nasal tip projection before and after surgery was also significantly improved (P＜0.05).Conclusions It is an effective method to use autologous cartilage graft for correcting the aesthetically short nose combined with low and blunt na sal tip,with low complications.
ABSTRACT
Objective To investigate the activation of nuclear factor-κB(NF-κB),which was stimulated by angiotensin-Ⅱ(AngⅡ)through classical pathway in human pulmonary microvascular endothehal cells(HPMEC).Method The experiment was divided into two groups:in Ang Ⅱ group,HPMECS were incubated with 10-6mol/L AngⅡ for 0,0.5,1,2 and 4 hours,respectively;in losartan group,HPMEC was pretreated with 10-6mol/L losartan(inhibitor of AngⅡ type 1 receptor)for 1 hour,and then stimulated with 10-6mol/L AngⅡ for 2 hours,and the nucleax protein and the cell plasma protein were prepared by lysis and centrifugation.Electrophoretic mobility shift assay(EMSA)was used to detect the NF-κB DNA binding activity.The inhibitor of κBa(IκBα)was detected by Western blotting.The data were expressed as(x±s)and analyzed with one way analysis of variance.A P value less than 0.05 indicated significant difference.Results Compared with the activity of NF-κB at 0 h (100.0±25.1)after AngⅡstimalation,the activity increased significantly at 0.5 hour(144.5±16.1,P＜0.05),and reached peak value at 2 hours(270.1±27.2,P＜0.05).The concentration of IκBα at 0 hours was 44.4%±2.1%,decreased markedly at 0.5 hours(38.9%±3.6%,P＜0.05),and to the lowest level at 2hours(32.6%±2.3%,P＜0.05).The activity of NF-κB(115.4±10.7)and the concentration of IκBα(43.6%±3.7%)in losartan group had ilo significant difference with AngⅡ group at 0 h(P＞0.05).The activity of NF-κB and the concentration of IκBα in losartan group had significant difference with AngⅡ group at 2hours.Conclusions NF-κB can be activated through classical pathway,which stimulated by AngⅡ in HPMEC.