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Objective To investigate the effects of mild hypothermia on post-resuscitation neurological outcome after ventricular fibrillation (VF) in rabbits.Methods Forty-five adult New Zealand rabbits were induced VF by direct current of electricity.The rabbits were randomly(random number) divided into following groups:normothermic resuscitation group (NR),mild hypothermia prearrest group (HP),mild hypothermia resuscitation 30 min group (HRe30),mild hypothermia resuscitation 90 min group (HRe90),normothermic sham group (NS),and hypothermia sham group (HS).The rabbits of NR group were observed for 600 min in room temperature after restoration of spontaneous circulation (ROSC).The mild hypothermia was induced by surface cooling,and maintained for 600 min after the aimed low temperature reached.The arterial blood samples were collected for determining neuron-specific enolase (NSE) and thioredoxin (Trx) and the mean arterial pressure (MAP),left ventricular end-diastolic pressure (LVEDP) and left ventricular pressure raise and fall rate (±dp/dtmax) were observed at 15 min before CA,and 30 min,60 min,120 min,360 min and 600 min after ROSC.After the animals were sacrificed at 600 min after ROSC,the whole brain of animals was harvested and observed under light microscope to calculate the apoptotic index of the hippocampal CA1 neurons by using TUNEL method.One-way ANOVA was used to determine the statistical significance between two groups,a two-tailed value of P＜0.05 was considered statistically significant.Results (1) Hemodynamically compared with normal temperature groups,HR was lower in hypothermia groups.Compared with NR,HRe30,and HRe90 group,LVEDP was higher in HP group at 30 min after ROSC(3.4±0.8 vs.4.6±1.0,4.1±0.5,4.3±0.2,F=9.85,P=0.019).In Hp group,the level of +dp/dtmax was higher than that in NR,HRe30 and HRe90 groups at 30 min and 120 min after ROSC.In HP group,the level of-dp/dtmax was higher than that of NR group at 30 min,60 min,120 min,360 min and 600 min after ROSC.(2) Serologically compared with HP,HRe30 and HRe90 group,NSE levels were higher in NR group at 60 min,120 min and 360 min after ROSC.Compared with NR,HRe30,and HRe90 group,Trx levels in NR group were lower at 60 min,120 min,360 min and 600 min after ROSC.Compared with HP group,Trx levels in HRe30 and HRe90 groups were higher at 60 min,120 min,360 min and 600 min after ROSC.(3) Pathologically compared with NR group,histopathological changes in hippocampus CA1 area were milder found in HP,HRe30 and HRe90 groups.AI (％) was lower in HP,HRe30 and HRe90 groups than that in NR group[(62.25±10.43)％ vs.(20.61±5.02)％,(25.08±3.92)％,(30.33±7.15)％,P=0.001].Concusions This study shows that hypothermia should be initiated as soon as possible,and especially early intra-arrest cooling appears to be significantly better than post-ROSC cooling and normothermia.
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OBJECTIVE@#To explore the correlation between diabetic nephropathy (DN) and cognitive impairment through examining the cognitive function and the metabolism of the cerebrum in Type 2 diabetes mellitus patients at different stages of renal function. @*METHODS@#Eighty six patients with Type 2 diabetes mellitus (T2DM) were enrolled for this study. According to the urinary albumin excretion rate (UAER), the patients were divided into a T2DM without DN group (DM group, n=33), an early DN group (DN-III group, n=26) and a clinical stage group (DN-IV group, n=27). Thirty healthy adults were selected as a control group (NC group). Biochemical indexes and UAER were measured, and glomerular filtration rate (GFR) was detected by single-photon emission computed tomography (SPECT). The cognitive function was measured by Montreal Cognitive Assessment (MoCA, Beijing version) and mini-mental state examination (MMSE). The peak areas of N-acetylasparte (NAA), creatine (Cr), choline-containing compounds (Cho) were detected by proton magnetic resonance spectroscopy (1H-MRS). @*RESULTS@#1) There was no statistical difference in MMSE scores between the DM group and the control group. The scores of MoCA in the DN-III group or in the DN-IV group were significant less than that in the NC group (F=3.66, P<0.05); 2) There was significant difference in left N-acetylaspartate (LNAA), left choline (LCho) among the diabetes groups. Compared with the DM group, the level of LNAA was decreased significantly (t=3.826, P<0.05) while the LCho was increased significantly (t=4.373, P<0.05) in the DN groups, with statistic difference between the 2 groups (t=3.693, P<0.05); 3) The MoCA scores of T2DM patients were negatively correlated with UAER (r=-0.285, P<0.05), while positively correlated with GFR (r=0.379, P<0.05); 4) Logistic regression analysis indicated that UAER and GFR were the major risky factors for diabetic cognitive impairment. @*CONCLUSION@#Diabetic cognitive impairment is closely correlated with the nephropathy in patients with Type 2 diabetes. With the decline in glomerular filtration function, the cognitive disorder tends to be aggravated. The hippocampal brain metabolism may have some changes in left side of Cho/Cr in patients with diabetic nephropathy.
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Adult , Humans , Aspartic Acid , Metabolism , Case-Control Studies , Cerebrum , Metabolism , Choline , Metabolism , Cognition , Cognition Disorders , Epidemiology , Creatine , Metabolism , Diabetes Mellitus, Type 2 , Diabetic Nephropathies , Epidemiology , Glomerular Filtration Rate , Neuropsychological TestsABSTRACT
Objective In-hospital mortality rate in patients undergoing percutanous transhepatic biliary drainage for malignant obstructive jaundice remained high.This study aimed to assess pre-,intra-and post-procedure risk factors which were independently associated with increased in-hospital mortality.Methods One hundred and fifty-five consecutive patients with malignant obstructive jaundice received initial PTBD drainage.Twenty-five pre-procedure,4 intra-procedure and 6 post-procedure factors potentially related with in-hospital mortality were assessed by univariate and multivariate analysis.Results In-hospital mortality rate was 16.8％ (26/155).Of 25 pre-procedure variables analysed,Child-Pugh classification C,creatinine (≥ 6.93 μmol/L) and quality of life (≤ 30) were found to be significant in univariate and multivariate analysis.Increased mortality was seen in this study with two or more risk factors,significantly different from patients who had none or one risk factor(P ＜0.01).None of the intra-procedure factors were important in identifying patients at risk of death.Multivariate analysis indicated post-PTBD cholangitis and unsuccessful drainage as post-procedure risk factors that correlated with in-hospital death.Conclusions Three pre-procedure and two post-procedure risk factors were identified associated with in-hospital mortality.
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ObjectiveTo investigate the risk factors for percutaneous transhepatic biliary drainage (PTBD) related cholangitis in patients with malignant obstructive jaundice.MethodsOne hundred and fifty-four consecutive patients with malignant obstructive jaundice and without leukocytosis,fever and other manifestations of biliary tract infection received initial PTBD drainage.They were enrolled in this study.An uncontrolled prospective study was conducted of cholangitis occurrence within 30 days after PTBD.Twenty potential preoperative risk factors were assessed by univariate and multivariate analysis.ResultsFifty-five patients (55/154,35.7％ ) developed PTBD-related cholangitis,which composed of cholangitis group.Other patients composed of non-cholangitis group (99/154).The cholangitis-related mortality rate was 2.6％ (4/154).Intraoperative bile culture were performed for 131 patients (131/154),including 45 in cholangitis group and 86 in non-cholangitis group.Positive result occurred in 26 patients (26/45) in cholangitis group and 17 patients (17/86) in non-cholangitis group.There was statistical significant difference between these two groups ( x2 =19.357,P ＜ 0.01 ).By univariate analysis,diabetes ( x2 =10.470,P ＜ 0.01 ),Child-Pugh C grade ( x2 =36.324,P ＜ 0.01 ),undrained biliary duct ( x2 =9.540,P ＜0.01 ),external-internal drainage ( x2 =9.856,P ＜ 0.01 ),history of ERCP or cholangiojejunostomy (x2 =14.196,P＜0.01),QOL (t =-3.288,P ＜0.01),KPS(t =-2.099,P＜0.05),ALT (t =-2.112,P＜0.05),PT (t =-3.648,P ＜0.01),albumin (t =-2.071,P ＜0.05),WBC (t =2.022,P ＜ 0.05 ),proximal obstruction ( x2 =6.190,P ＜ 0.05 ) and cirrhosis ( x2 =5.439,P ＜ 0.05 )were significantly different between cholangitis group and non-cholangitis group.By multivariate analysis,diabetes ( OR =5.093,P ＜0.01 ),Child-Pugh C grade ( OR =13.412,P ＜0.01 ),undrained biliary duct ( OR =3.348,P ＜ 0.05 ),external-internal drainage ( OR =3.168,P ＜ 0.05 ) and history of ERCP or cholangiojejunostomy (OR =8.330,P ＜ 0.01 ) remained significant difference.ConclusionsPTBD is an effective and safe palliative treatment for patients with malignant obstructive jaundice.Sufficient preoperative preparation and effective control of risk factors may reduce the incidence of cholangitis after PTCD.
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Objective To explore the of value steady-state susceptibility contrast-enhanced MRI (SSCE-MRI) in assessment of anti-angiogenesis therapy in rat C6 glioma. Methods Seventeen rats with the bearing-tumor were randomly divided into the therapy group (n=8) and the contrast group (n=9). Human-recombination endostatin (10 mg/kg) was injected to animals in therapy group, and saline of the same dose was injected to the contrast group for 7 days. Blood volume (BV) and vessel size index (VSI) were measured of tumors in peripheral, central and normal areas with MR pre- and post-therapy. Results After therapy of endostatin, the tumor volume was obviously different between therapy group and contrast group (t=5.26, P<0.05). BV and VSI_(MRI) of tumor decreased in both peripheral and central areas, particularly in the peripheral area (t=4.14, 3.66, all P<0.01). Conclusion Assessment of therapeutic effect of anti-angiogenesis in C6 glioma is feasible with SSCE-MRI, and it can reflect the changes of BV and VSI_(MRI) pre- and post-therapy.
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Objective To observe changes of the structure and function of microvessels during the formation and development of the rat cerebral glioma with steady-state susceptibility contrast-enhanced MR imaging. Methods A total of 30 bearing-tumor rats were divided into 3 groups (1-week group, 2-week group and 3-week group) and underwent MR examination. Blood volime (BV) and vessel size index (VSI_(MRI)) of peripheral tumor areas, central tumor areas and normal cerebral tissue in the opposite side were measured, and compared with histologic findings. Results With time of bearing-tumor increasing, BV of central tumor area present an up-and-down curve-like change, which related to the host blood vessel regression in tumor central area, the decreasing of blood vessel density and histopathologically obvious necrosis. BV of peripheral tumor areas increased because of active blood angiogenesis in this area, while VSI_(MRI) increased gradually, especially in the central tumor area. There was obviously correlation between the VSI_(MRI) and VSI _(histo) (P<0.01). Conclusion BV and VSI_(MRI) can exactly reflect the morphology and functional information of microcirculation of tumor during the growth and development of gliomas.
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Purpose:To explore the value of MSCT-3D in stomatology through comparing with COPT.Materials and Methods:Both MSCT 117 patients and COPT 117 patients in stomatology were selected at a particular period,COPT imaging was using computed post-processing,MSCT imaging was processed according to 3D information through work station,then to analyze the imaging results according to metal tooth、damaged tooth and broken tooth,later to compare the photograph 、the technique of computed post-processing、the photograph condition and exposure of MSCT and COPT.Results:Normal COPT patients were 9 cases ( 0.24% ),normal teeth were 3160 (84.4% ),unusual teeth were 551 (15.6%),normal MSCT-3D patients were llcases ( 0.29% ),normal teeth were 3138 (83.8% ),and unusual teeth were 606 (16.2% ).COPT belonged to COPT photograph,the emphasis was 2D,MSCT-3D belonged to spiral photograph,the emphasis was 3D,and MSCT imaging could be processed according to 3D reformation.The 3D effect of MSCT was batter than that of COPT.The radiation dosage was much higher than that of COPT.Conclusions: COPT could get 2D effects: MSCT-3D could improve 3D results on 2D basis,but the radiation dosage of MSCT is much higher than that of COPT in stomatology.
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Objective To identify and classify six isolates of swine-originated Trichinella from China. Methods Five specific pairs of primers were synthesized based on DNA sequence of expansion segment V region and internal tran-scribed spacers (ITS1 and ITS2) of ribosomal DNA repeat from Trichinella. International reference strains of five Trich-inella species [Trichinella spiralis (T1), T. nativa (T2), T. britovi (T3), T. pseudospiralis (T4) and T. nelsoni(T7)] were used as control. Six swine Trichienlla isolates from Henan, Yunnan, Harbin, Tongjiang of Heilongjiang, Hubei and Tianjin were identified by multiplex PCR and its effecting factors of PCR amplification were observed. Results Electrophoresis results of multiplex PCR products of Trichinella larvae showed that the band (173 bp) of the six isolates was the same as T. spiralis(T1). The specific band (173 bp) was detected by multiplex PCR through amplification from issues of single T. spiralis larva, the larvae conserved in 80% ethanol for 6 months, the larvae stored in 10% formaldehyde, in 0.05% formaldehyde, 0.2% sodium azide or 0.05% merthiotate for 2 weeks,or fresh mouse muscle with larvae. Conclusion All the six swine Trichinella isolates are identified as T. spiralis (T1) by multiplex PCR.
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Seventy male mice (Kunming strain) were randomly divided into 7 groups(10 mice per group), each mouse was orally inoculated with 30, 25, 20, 15, 10, 5 or 3 muscle stage larvae of Trichinella spiralis, respectively. All infected mice were sacrificed 6 weeks post-inoculation, number of larvae per gram (LPG) of diaphragm were counted by compression method (trichinelloscopy), the carcass was digested by artificial digestion method and LPG was counted. The larval detection rate by trichinelloscopy and digestion method was 100%(10/10) in all mice infected with 30, 25, 20, 15 or 10 larvae, but 70% (7/10) and 100% in mice infected with 5 larvae, respectively. No larva was found by either method in mice infected with 3 larvae. There is a positive correlation between the larval burden (of diaphragm and muscle) and the infecting dose ( r=0.759, P