Predictive value of stress-induced hyperglycemia on 28 d risk of all-cause death in intensive care patients / 北京大学学报(医学版)

OBJECTIVE@#To investigate the relationship between stress glucose elevation and the risk of 28 d all-cause mortality in intensive care unit (ICU) patients, and to compare the predictive efficacy of different stress glucose elevation indicators.@*METHODS@#ICU patients who met the inclusion and exclusion criteria in the Medical Information Mart for Intensive Care Ⅳ (MIMIC-Ⅳ) database were used as the study subjects, and the stress glucose elevation indicators were divided into Q1 (0-25%), Q2 (>25%- 75%), and Q3 (>75%-100%) groups, with whether death occurred in the ICU and the duration of treatment in the ICU as outcome variables, and demographic characteristics, laboratory indicators, and comorbidities as covariates, Cox regression and restricted cubic splines were used to explore the association between stress glucose elevation and the risk of 28 d all-cause death in ICU patients; and subject work characteristics [receiver operating characteristic (ROC) and the area under curve (AUC)] were used to evaluate the predictive efficacy of different stress glucose elevation indicators, The stress hyperglycemia indexes included: stress hyperglycemia ratio (SHR1, SHR2), glucose gap (GG); and the stress hyperglycemia index was further incorporated into the Oxford acute severity of illness score (OASIS) to investigate the predictive efficacy of the improved scores: the AUC was used to assess the score discrimination, and the larger the AUC indicated, the better score discrimination. The Brier score was used to evaluate the calibration of the score, and a smaller Brier score indicated a better calibration of the score.@*RESULTS@#A total of 5 249 ICU patients were included, of whom 7.56% occurred in ICU death. Cox regression analysis after adjusting for confounders showed that the HR (95%CI) for 28 d all-cause mortality in the ICU patients was 1.545 (1.077-2.217), 1.602 (1.142-2.249) and 1.442 (1.001-2.061) for the highest group Q3 compared with the lowest group Q1 for SHR1, SHR2 and GG, respectively, and The risk of death in the ICU patients increased progressively with increasing indicators of stressful blood glucose elevation (Ptrend < 0.05). Restricted cubic spline analysis showed a linear relationship between SHR and the 28 d all-cause mortality risk (P>0.05). the AUC of SHR2 and GG was significantly higher than that of SHR1: AUCSHR2=0.691 (95%CI: 0.661-0.720), AUCGG=0.685 (95%CI: 0.655-0.714), and AUCSHR1=0.680 (95%CI: 0.650-0.709), P < 0.05. The inclusion of SHR2 in the OASIS scores significantly improved the discrimination and calibration of the scores: AUCOASIS=0.820 (95%CI: 0.791-0.848), AUCOASIS+SHR2=0.832 (95%CI: 0.804-0.859), P < 0.05; Brier scoreOASIS=0.071, Brier scoreOASIS+SHR2=0.069.@*CONCLUSION@#Stressful glucose elevation is strongly associated with 28 d all-cause mortality risk in ICU patients and may inform clinical management and decision making in intensive care patients.

TRPV4-induced Neurofilament Injury Contributes to Memory Impairment after High Intensity and Low Frequency Noise Exposures / 生物医学与环境科学（英文）

OBJECTIVE@#Exposure to high intensity, low frequency noise (HI-LFN) causes vibroacoustic disease (VAD), with memory deficit as a primary non-auditory symptomatic effect of VAD. However, the underlying mechanism of the memory deficit is unknown. This study aimed to characterize potential mechanisms involving morphological changes of neurons and nerve fibers in the hippocampus, after exposure to HI-LFN.@*METHODS@#Adult wild-type and transient receptor potential vanilloid subtype 4 knockout (TRPV4-/-) mice were used for construction of the HI-LFN injury model. The new object recognition task and the Morris water maze test were used to measure the memory of these animals. Hemoxylin and eosin and immunofluorescence staining were used to examine morphological changes of the hippocampus after exposure to HI-LFN.@*RESULTS@#The expression of TRPV4 was significantly upregulated in the hippocampus after HI-LFN exposure. Furthermore, memory deficits correlated with lower densities of neurons and neurofilament-positive nerve fibers in the cornu ammonis 1 (CA1) and dentate gyrus (DG) hippocampal areas in wild-type mice. However, TRPV4-/- mice showed better performance in memory tests and more integrated neurofilament-positive nerve fibers in the CA1 and DG areas after HI-LFN exposure.@*CONCLUSION@#TRPV4 up-regulation induced neurofilament positive nerve fiber injury in the hippocampus, which was a possible mechanism for memory impairment and cognitive decline resulting from HI-LFN exposure. Together, these results identified a promising therapeutic target for treating cognitive dysfunction in VAD patients.

Trends in cardiovascular death related to mechanical complications of cardiac electronic devices in the United States from 1999 to 2020

Background@#While cardiac implantable electronic devices (CIED) are increasingly used, real-world data on the mortality rate due to mechanical complications of CIED is scarce. @*Objective@#This study aimed to determine longitudinal trends in mortality attributed to mechanical complications of CIED. @*Methods@#We queried the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research and performed serial cross-sectional analyses of national death certificate data for mechanical complications of CIED-related mortality among the United States population aged ≥ 35 years from 1999 to 2020. Cardiovascular disease (ICD-10: I00–I99) was listed as the underlying cause of death, and mechanical complication of the cardiac electronic device (ICD-10: T82.1) was stated as the contributing cause of death. We calculated age-adjusted mortality rates (AAMRs) per 1,000,000 individuals. Linear regression was used to calculate for the significance of the annual percent of changes in AAMRs. @*Results@#1237 cardiovascular deaths related to mechanical complications of CIED were identified between 1999 and 2020. The AAMR dropped significantly from 0.45 per 1,000,000 individuals in 1999 to 0.21 per 1,000,000 individuals in 2020 (p < 0.01). Cumulative AAMRs were higher in males than females (0.39 per 1,000,000 individuals vs. 0.26 per 1,000,000 individuals, p < 0.01), higher in White populations than African American populations (0.32 per 1,000,000 individuals vs. 0.30 per 1,000,000 individuals, p < 0.01), and higher in the rural areas than in the urban areas (0.50 per 1,000,000 individuals vs. 0.27 per 1,000,000 individuals, p < 0.01). @*Conclusion@#While the cardiovascular deaths related to mechanical complications of CIED were decreasing over the past decades, disparities in the AAMRs across sex, races and geographical region still present.

Application of 3D printed model assisted network teaching in clinical probation of neurosurgery / 中华医学教育探索杂志

Objective:To explore the effect of the 3D printed model assisted network teaching of neurosurgery.Methods:Seventy-six probation students were divided into: 3D printed model assisted online course teaching group (test group) and traditional teaching group (control group). After 1-month online teaching, quantitative assessment and satisfaction survey were carried out. SPSS 17.0 was used for statistical analysis of variance.Results:The department graduation test (theory and operation) scores of students in the test group were (86.7±7.4) points, which was significantly higher than those in the control group (78.2±8.2) points ( t=5.56, P<0.01). The teaching satisfaction survey showed that the test group had significantly higher scores in self-evaluation of spatial imagination ( t=3.81, P<0.01), deepening understanding of neuroanatomy ( t=5.29, P<0.01), and increasing interest in clinical learning ( t=5.12, P<0.01) than those of the control group. Conclusion:Compared with the conventional online teaching methods, 3D printed model assisted online teaching helps to improve teaching quality and students' satisfaction.

Short-term outcome of kidney transplantation from deceased donors with nephrolithiasis / 中南大学学报(医学版)

Objective: Shortage of kidney allografts is a major barrier to end-stage renal disease patients receiving kidney transplantation, and it is necessary to enlarge the donor pool and find better ways of using available allografts. The global incidence of nephrolithiasis is increasing, nephrolithiasis affects approximately 10％ of adults worldwide, and it also affects the kidney donors. However, there is little information about the use of cadaveric kidney allografts with nephrolithiasis. This study aims to evaluate the safety and outcome of kidney transplantation with allografts from the deceased donors with nephrolithiasis. Methods: A total of 520 deceased donors who was at least 10 years old, and 945 adult recipients with single kidney transplantation at the Department of Kidney Transplantation, the Second Xiangya Hospital from 2016 to 2020 were included in this study. The donors were divided into 2 groups according to nephrolithiasis diagnoses: The donors with nephrolithiasis (D+) and the donors without nephrolithiasis (D?). The recipients were assigned into 3 groups according to their donors and the allografts they received: The allografts from donors without nephrolithiasis (D?K?), the allografts without nephrolithiasis from donors with nephrolithiasis (D+K?), and the allografts with nephrolithiasis (D+K+). The demographic and clinical data of enrolled subjects were retrospectively analyzed. The allograft discard ratio between different donors were analyzed. The one-year survival of allografts and recipients, as well as the allograft function and the complications of kidney transplantation were compared. Results: Fifty out of 520 donors had nephrolithiasis, and the nephrolithiasis incidence was 9.6％. We recovered 1040 kidneys, and total discard rate was 4.4％ (46/1040). The D+ group had a rate of 7％ discard. The donors with kidney discard accounted for 12％ in the D+ group, and this was higher than that of donors in the D? group (5.1％, P<0.05). The total incidence of delayed graft function (DGF) was 7.5％, and there were no significant differences in the incidence of DGF in recipients among the D?K?, D+K?, and D+K+ group (7.5％ vs 6.5％ vs 8.2％, P>0.05). During the one-year follow-up, 8 allografts lost function and 19 recipients died with a functional allograft. Recipients in the D?K?, D+K?, and D+K+ groups also had no significant difference between a one-year allograft and patient survival rate (P>0.05). However, recipients in the D+K+ group had a higher level of serum creatinine [(139.2±62.46) μmol/L vs (117.19±51.22) μmol/L, P<0.05] and lower estimated glomerular filtration rate [eGFR; (56.67±23.31) mL/(min·1.73 m?2) vs (66.86±21.90) mL/(min·1.73 m?2), P<0.05] compared with recipients in the D?K? group at 12 months after transplantation. During the first year after transplantation, 4 recipients developed urolithiasis, and recipients who received allografts from the D+ group donors had a higher incidence of urolithiasis than those who received allografts from the D? group donors (2.2％ vs 0.2％, P<0.05). There were no significant differences in the incidence of urinary tract infections and ureteral strictures at 1 year between recipients of D+ and D? donors (both P>0.05).Conclusion: The cadaveric kidney allografts with nephrolithiasis could be safely used for transplantation, and the short-term outcome is acceptable. However, nephrolithiasis in donors may increase the rate of kidney discard, disturb the short-term function of allografts, and increase the risk of urolithiasis in recipients. Further research with a long-term study is needed to verify the long-term outcome of kidney transplantation using cadaveric kidney allografts with nephrolithiasis.

Heterogeneity of non-cystic-fibrosis bronchiectasis in multiethnic Singapore: A prospective cohort study at a tertiary pulmonology centre

INTRODUCTION@#Non-cystic fibrosis bronchiectasis (NCFB) is a highly heterogenous disease. We describe the clinical characteristics of NCFB patients and evaluate the performance of Bronchiectasis Severity Index (BSI) in predicting mortality.@*METHODS@#Patients attending the bronchiectasis clinic between August 2015 and April 2020 with radiologically proven bronchiectasis on computed tomography were recruited. Clinical characteristics, spirometry, radiology, microbiology and clinical course over a median period of 2.4 years is presented.@*RESULTS@#A total of 168 patients were enrolled in this prospective cohort study. They were predominantly women (67.8%), Chinese (87.5%) and never-smokers (76.9%). Median age of diagnosis was 64 years (interquartile range 56-71) and the most common aetiology was "idiopathic" bronchiectasis (44.6%). Thirty-nine percent had normal spirometries. Compared to female patients, there were more smokers among the male patients (53.8% versus 8.5%, @*CONCLUSION@#The NCFB cohort in Singapore has unique characteristics with sex differences. Over half the patients had a history of haemoptysis. The BSI score is a useful predictor of mortality in our population.

Research and Engineering Evaluation Practice of Medical Equipment Purchase Decision Model Based on Improved Markov Model / 中国医疗器械杂志

In view of the inherent drawbacks of traditional medical equipment procurement mode, a decision-making model of medical equipment procurement based on Improved Markov model is proposed and the engineering evaluation practice is carried out. The data pool of medical equipment procurement of big data level is constructed, the core constraint factors of medical equipment procurement are perceived by deep learning, the decision model of medical equipment procurement under multi-dimensional constraints is constructed, and the Improved Markov model is introduced, and the observable decision-making scheme of medical equipment procurement is given. The results show that the model can give the decision-making scheme of medical equipment procurement with global optimal attribute under multi-dimensional constraints. It has obvious advantages in the balance of long-term demand and immediate demand, the optimization of procurement decision-making scheme, and the accuracy of patient demand prediction in a long period.

Risk factors for calcaneal fracture combined with vertebral fracture / 中华创伤骨科杂志

Objective:To analysis the risk factors for calcaneal fracture combined with vertebral fracture.Methods:A retrospective study was performed of the 745 calcaneal fractures which had been surgically treated from May, 2005 to September, 2020 in Nanjing Drum Tower Hospital Affiliated to Medical School, Nanjing University. There were 651 males and 94 females, aged from 11 to 89 years (mean, 43.8 years). The incidence of calcaneal fracture combined with vertebral fracture was recorded. The risk factors were screened out by univariate analysis from gender, age, body mass index, unilateral or bilateral calcaneal fractures, injury severity score (ISS), cause of injury, fall height, classifications of calcaneal and number of vertebral fracture; binary logistic regression analysis was used to determine independent risk factors from the rtsk factors with P<0.05. Results:Vertebral fracture occurred in 70 of the 745 patients with calcaneal fracture (9.40%). Univariate analysis showed significant differences in gender, body mass index, unilateral or bilateral calcaneal fractures, ISS and fall height between patients with simple calcaneal fracture and patients with calcaneal fracture combined with vertebral fracture ( P<0.05); Binary logistic regression analysis showed that gender ( OR=0.225, 95% CI:0.095~0.532, P=0.001), unilateral or bilateral calcaneal fractures ( OR=3.582, 95% CI:1.705~7.526, P=0.001), ISS ( OR=5.229, 95% CI:1.605~17.035, P=0.006), and fall height ( OR=49.820, 95% CI:23.068~107.597, P<0.001) were the independent risk factors for calcaneal fracture combined with vertebral fracture. Conclusion:A more likely combined vertebral fracture should be taken into consideration in male patient with bilateral calcaneal fractures, a falling height > 3 m, or a high ISS.

Research progress on pharmacological action of notoginsenoside R1 / 中国药理学通报

Sanqi in Chinese herbal medicine is the root and rhi-zoma of Panax notoginseng (Burk.)F.H.Chen. As the effects of strengthening with tonics, promoting blood circulation to re-move blood stasis,relieving swelling and pain and hemostasia,it is widely used as a tonic medicine in the traditional Chinese medicine. The main active constituents of Sanqi are panax noto-ginseng saponins,including ginsenoside Rg1,Rb1 and notogin-senoside R1. Notoginsenoside R1 is one of the unique monomer compositions of panax notoginseng,which is often used as an in-gredient indicator in new drug research and development.In cur-rent years, the scientists have been conducted tremendous fun-damental studies to research the pharmacological activities of no-toginsenoside R1, to reveal its protective effects on the cardio-vascular system,central nervous system as well as to many other aspects. It is hoped that the relevant study about the pharmaco-logical action of notoginsenoside R1 would help its further clini-cal application. This paper mainly reviews the research on the pharmacological mechanism of notoginsenoside R1 in recent years.

Distribution and therapy strategy of culture microorganisms of kidney perfusion fluid / 中华器官移植杂志

Objective To analyze the distribution of microorganisms in kidney perfusion fluid and perirenal drainage of the renal allografts,and provide evidence to guide clinical practice.Methods The clinical data from the kidney donors and the recipients,the microbiologic culture results of kidney perfusion fluid and perirenal drainage were retrospectively analyzed.Results Ninety-one kidney perfusion fluid samples and 91 perirenal drainage samples were collected from 61 individual renal allografts,and 48 renal allografts were paired.Fourteen (15.4％,14/91) cultured kidney perfusion fluid samples were positive,17 strains were confirmed including 13 strains of bacteria and 4 strains of fungal,and 9 (69.2％,9/13) of bacterial strains were multidrug-resistance with 7 strains resistant to carbapenems,but there was no significant heterogeneity in the outcome of recipients with positive or negative culture results of kidney perfusion fluid samples.Eight (8.8％,8/91) perirenal drainage samples from different recipients were positive,5 of 8 bacterial strains were multidrug-resistance and 3 of them were resistant to carbapenems including meropenem or imipenern.There was no significant correlation between the length of donors' hospital stay and the culture results (P＞0.05),and there was also no significant correlation between the length of recipients' hospital stay after transplantation and the culture results (P＞0.05).Conclusion The kidney with positive perfusion fluid microbiologic culture can be transplanted safely using the prophylaxis or preemptive anti-infection therapy.

Rare Clinical Presentation of Tuberculous Meningitis: A Case Report

Introduction: Tuberculosis is the second leading cause of death under the category of infectious diseases, after the human immunodeficiency virus (HIV). Tuberculous meningitis (TBM) constitutes about 5% of all extrapulmonary disease worldwide. This report describes a case of Tuberculous meningitis with rare presentation in a 28-year-old woman, who was treated based on a collection of her social background, clinical findings and Multiplex PCR of tuberculosis. Case presentation: A 28-year-old Malay woman with no significant medical history presented to HUSM with one month history of on and off fever, two weeks history of generalised limbs weakness and one week history of dysphagia. She was reported to have experienced visual hallucination and significant weight loss. Her laboratory result is significant for leukocytosis, elevated ESR and hypernatremia. Non-enhanced and contrast CT scan of the brain showed severe bilateral frontal cerebral atrophy. Cerebral spinal fluid (CSF) for multiplex PCR for Mycobacterium tuberculosis complex was positive. She was promptly started on anti-TB regime combined with dexamethasone. Subsequent follow-up showed significant improvement. Conclusion: This is a rare clinical manifestation of Tuberculous meningitis that demonstrates the importance of recognising and initiating the treatment early to reduce disabilities and improve clinical outcome.

Clinical efficacy of 37 cases of kidney transplantation from donors with acute kidney injury / 中华器官移植杂志

Objective To compare the clinical efficacy of kidney transplantations from donors with acute kidney injury (AKI) and without AKI,and summarize the experience of evaluation and application.Methods The clinical data of 240 kidney transplantations from donation after citizen's death (DCD) performed in our hospital between November 2011 and March 2015 were retrospectively analyzed.The recipients were classified into AKI group (n =37) and non-AKI group (n =203) according to donors' renal function and urine output.Basic characteristics and evolution of the donors and recipients were compared between the two groups.Results The donor serum creatinine was significantly higher in the AKI group than that in the non-AKI group (P＜0.01).Most transplant recipients accepted ATG for immune induction therapy in the AKI group,while Basiliximab was given in the non-AKI group,which was significantly different (P＜0.01).Delayed graft function developed more frequently and longer in the AKI group than in the non-AKI group (P＜0.01).However,patient and graft survival rates did no differ between the AKI and non-AKI groups (P＞0.05).There was no significant difference in other indexes between the two groups (P＞0.05).Conclusion The transplants from donors with AKI showed higher incidence of delayed graft function but no effect on 1-year allograft and patient survival.This type of kidney transplantation is safe and effective.

Determination of chemical consituents in Lycii Fructus from Qaidam Basin / 中成药

AIM To determine the contents of chemical consituents in Lycii Fructus from Qaidam Basin.METHODS Spectrophotometry was adopted in the content determination of polysaccharides,total flavonoids and carotenoid.HPLC was applied to the content determination of betaine and scopoletin.Kjeldahl method was used for the content determination of protein.Then principal component analysis was performed.RESULTS The contents of carotenoid,betaine and scopoletin in samples from six growing areas showed obvious differences (P ＜ 0.05),while those of polysaccharides,total flavonoids and protein exhibited no obvious differences (P ＞ 0.05).The contents of various constituents in samples at three picking time also had no obvious differences (P ＞ 0.05).The comprehensive score of principal components of samples from Delingha City was the highest,followed by that from Ulan County.CONCLUSION The quality of Lycii Fructus from Qaidam Basin from Delingha City is the best.

Effect of Shuwel Decoction on Enteric Nervous System-Interstitial Cells of Cajal-Smooth Muscle Network Structure Injury in Deep Muscle Nerve Plexus of Functional Dyspepsia Rats / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe morphological changes of enteric nervous system (ENS)-interstitial cells of Cajal (ICC)-smooth muscle cell (SMC) structure injury in deep muscle nerve plexus offunctional dyspepsia (FD) rats, and the repair of Shuwei Decoction (SD) on it, and to explore its effecton FD.</p><p><b>METHODS</b>Totally 72 rats were randomly divided into the control group, the model group, the lowdose SD group, the medium dose SD group, and the high dose SD group, the Mosapride group, 12 ineach group. Rats in the low dose SD group, the medium dose SD group, and the high dose SD group were intragastrically fed with SD at 0.767, 1.534, 3.068 g/mL, respectively. Rats in the Mosapride group were intragastrically fed with Mosapride (1.37 mg/kg). FD rat model with Gan depression Pi deficiency syndrome (GDPDS) was established using complex pathogenic factors. Corresponding liquors were respectively administered to rats in corresponding groups from the 3rd day after modeling. Distilled water(10 mL/kg) was administered to rats in the control group and the model group, once per day for 14 successive days. Rats were sacrificed and small intestine tissues collected for observing ENS-ICC-SMC structure injury using immunofluorescence double labeling, laser scanning confocal microscope, and transmission electron microscope at day 15. Repair of SD on it was also observed.</p><p><b>RESULTS</b>ENS-ICC SMC structure was incomplete, with obvious injury in mutual link of ICC, ICC, SMC, and connecting structure. ENS-ICC-SMC structure was more complete in high, medium, and low dose SD groups, with close link of ICC and SMO. Their connecting structures were in good conditions.</p><p><b>CONCLUSION</b>SD could keep the integrity of ENS-ICC-SMC structure by promoting regeneration and morphology of ICC, thereby, improving gastrointestinal movement disorder and showing therapeutic effect on FD.</p>

Impulse control behaviours in a Malaysian Parkinson’s disease population

Background: Impulse control behaviours are repetitive and excessive activities that may be subsyndromal and not fulfil the criteria for impulse control disorder. These activities have potential to negatively impact on the daily lives of sufferers. We conducted a study to investigate the prevalence of impulse control behaviours and its associated features in Parkinson’s disease in our population. Methods: We conducted a prospective cross-sectional study on consecutive patients attending neurology clinic. Inclusion criteria include idiopathic Parkinson’s disease patients with Hoehn & Yahr stage I-IV. Eighty patients were enrolled and screened for impulse control behaviours using the Questionnaire for Impulsive-Compulsive Disorder for Parkinson’s disease (QUIP). Results: Prevalence of impulse control behaviours among our cohort was 11.3%; the features significantly associated with it were higher level of education (p=0.02), advanced stage of disease (p=0.03) and higher levodopa dosage (p= 0.01). The commonest impulse control behaviour in our cohort was compulsive medication use (7.5%), followed by hobbyism (6.3%), hypersexuality (5%), compulsive buying (3.75%), punding (2.5%), walkabout (2.5%), compulsive eating (1.25%) and pathological gambling (1.3%). Conclusions: There is an association between impulse control behaviour and higher levodopa dosage in a study on patients with Parkinson’s disease in Malaysia. We also found a low prevalence of pathological gambling as compared to studies performed in the West.

Effect of cattle encephalon glycoside and ignotin injection on brain protection in rats with traumatic brain injury / 中华创伤杂志

Objective To investigate the neuroprotective effect of cattle encephalon glycoside and ignotin injection on the rat model of traumatic brain injury (TBI).Methods Three hundred and six SD rats were randomly divided into sham group,TBI group,high dose group,middle dose group and low dose group according to the random number table.Rats received 1.8,0.6 and 0.2 ml/kg of cattle encephalon glycoside and ignotin injection for 28 days in high,middle and low dose groups,respectively.TBI was induced by the modified Feeney' s weight-drop method.Rat mortality,neurological function score and learning and memory ability were recorded.Brain morphological changes were evaluated with 7.0 T small animal nuclear magnetic resonance and HE staining.Evans blue was applied to assess blood brain barrier (BBB) permeability and hydrocephalus was evaluated by the brain water content.Results Mortality in high dose group decreased significantly compared to that in TBI group (22.40％ vs.28.14％,P ＜ 0.05).Defects in neurological function and learning and memory induced by TBI were significantly mitigated in middle and high dose groups (P ＜ 0.05).Pathological damage and contralateral hippocampal atrophy in middle and high dose groups were reduced significantly compared to TBI group (P ＜ 0.05).Hippocampus neuroapoptosis in middle and high dose groups was significantly improved compared to TBI group (P ＜ 0.05).BBB damage was less severe in middle and high dose groups than in TBI group (P ＜ 0.05).The treatment was preventive against secondary hydrocephalus.Conclusion Middle or high dose cattle encephalon glycoside and ignotin injection over a 28-day period has significant neuroprotective effect on the TBI rats.

Simultaneous determination of gastrodin and eight nucleosides and nucleobases in Tibet cultured gastrodia elata by HPLC method / 中国中药杂志

This study aims to establish an HPLC method for simultaneous determination of gastrodin and eight nucleosides and nucleobases components in Gastrodia elata. The separation was carried out on an Agilent Zorbax Bonus-RP (4.6 mm x 250 mm, 5 μm) column with a methanol-(0.04% acetic acid) water solution gradient elution program at a flow rate of 1.0 mL x min(-1). The column temperature was 36 degrees C, and the detection wavelength was 254 nm. The volume of injection was 20 μL. The nine components including gastrodin, cytosine, uracil, cytosine, adenine, thymine, uridine, guanosine and adenosine were well separated. The calibration curve was well linear in the range of 2.04-262.00 mg x L(-1), 0.20-24.67 mg x L(-1), 0.18-23.75 mg x L(-1), 0.20-25.83 mg x L(-1), 0.20-26.67 mg x L(-1), 0.16-20.00 mg x L(-1), 0.22-27.71 mg x L(-1), 0.20-24.29 mg x L(-1), 0.24-30.58 mg x L(-1), respectively, and the correlation coefficient was between 0.998 9-0.999 9. The average recovery of gastrodin and eight nucleosides and nucleobases were 96.4%-99.6%, RSD less than 2.7% (n = 6). The contents of gastrodin in all the seven Tibet cultured Gastrodia elata samples were over 2 mg x g(-1). Further, all samples contain higher contents of adenosine, guanosine, uridine and cytidine compared to low contents of cytosine, uracil, adenine and thymine. The established method is accurate, reproducible and suitable for the determination of gastrodin and eight nucleosides and nucleobases comppnents in Gastrodia elata.

Transplantation of en bloc kidneys from cardiac deceased small pediatric donors: 2 case reports and literature review / 中南大学学报(医学版)

OBJECTIVE@#To gain an insight into the transplantation with donor kidneys from extended criterion donation after cardiac death (DCD) and to improve the management during and after renal transplantation@*METHODS@#Renal transplantation in 2 patients who used organs from small pediatric donors (<3 years) was performed. The graft kidneys were procured from 1 donor aged 11 months and the other 1 year and 7 months. The 2 donors were diagnosed as brain death caused by serious infantile hepatitis syndrome and severe craniocerebral injury, respectively. After the cardiac death, en bloc organ resection was performed. En bloc kidneys were transplanted to 2 adult recipients who were 37 and 41 years old, respectively.@*RESULTS@#The recipients were followed-up for 6 months. Both of them developed large volume of bloody drainage in the early post-operational period and relieved after relevant treatment. The kidney grafts functioned well and no other surgical complications or acute rejections happened during the follow-up.@*CONCLUSION@#Based on modified peri-operative techniques, it is safe to perform renal transplantation with kidneys procured from cardiac death donors who are younger than 3 years old, an important source to increase the number of organs available for transplantation, yet the vascular complications require attention.

Renal transplantation with kidneys procured from cardiac deceased post-liver transplantation donor: 2 cases report and literature review / 中南大学学报(医学版)

OBJECTIVE@#To better understand the pre-operation evaluation of donor kidneys from extended criteria donation after cardiac death and to improve the management during and after renal transplantation.@*METHODS@#Both of the donor kidneys were from the donor who underwent liver transplantation 5 years ago in the Center of Organ Transplantation of Central South University. The donor was admitted because of liver function deterioration which led to hepatic coma, brain death, hepatorenal syndrome and cardiac death sequentially. Deceased donor score (DDS) and "zero point" kidney biopsy were applied to evaluate the donor kidney. After thorough examination of the donor and the renal function, renal transplantation was performed on 2 recipients.@*RESULTS@#The recipients were followed up by 6 months, both of whom developed pulmonary infection and relieved after treatments. The kidney grafts functioned well and no surgical complication and no acute rejection occurred during the follow-up.@*CONCLUSION@#Proper evaluation of the donor organs ensures the safety of renal transplantation with kidneys from cardiac death donors who underwent liver transplantation, which is an important way to increase the number of organs for transplantation, yet the long-term effects need further observation.

Comparison of diagnostic value between DR and MSCT in fracture and dislocation of foot and ankle / 中国骨伤

<p><b>OBJECTIVE</b>To compare the diagnostic value between digital photography (DR) and multi-slice spiral CT (MSCT) in fracture and dislocation of foot and ankle.</p><p><b>METHODS</b>From August 2010 to August 2012, the DR and MSCT data of 52 patients with fracture and dislocation of foot and ankle were compared according to results of surgery or discharge diagnosis. There were 37 males and 15 females, aged from 15 to 49 years old. Wilcoxon signed rank test was used for statistical analysis.</p><p><b>RESULTS</b>The results of 52 cases of MSCT were matched with the postoperative or discharge diagnosis. A total of 172 fractures were found on MSCT and 98 fractures were found on DR, the results had significant difference in detecting fracture (V=1 081, P<0.05); A total of 24 dislocations were found on MSCT and 16 dislocations were found on DR,the results also had significant difference in detecting dislocation (V=21, P<0.05). Fractures of 6 cases with DR diagnosis were corrected and located by MSCT.</p><p><b>CONCLUSION</b>MSCT is significantly better than DR in diagnosis of fracture and dislocation of foot and ankle. The examination of two parts should be performed in DR. MSCT and multi-planar reconstruction (MPR) examination should be further performed if DR results are unclear or do not match with clinical symptoms, missed diagnosis and misdiagnosis can be avoided.</p>