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Objective@#To investigate the influence of Brucine on cell apoptosis of pancreatic cancer CFPAC-1 cells and the possible mechanism.@*Methods@#Brucine in different concentrations were used to treat CFPAC-1 cells. Cell proliferation was determined by MTT assay and cell apoptosis was determined by flow cytometer assay. Mitochondrial membrane potential was examined by JC-1 staining. The protein expression of Bax and Bcl-2 was measured by Western Blot.@*Results@#The growth inhibition rates of CFPAC-1 cells after being treated with 0 (control group), 0.4 and 0.8 mmol/L Brucine for 24, 48 and 72 h were 0, (30.23±0.55)%, (40.61±0.15)%, (46.98±1.27)% and(50.17±0.75)%, (61.23±0.91)%, (70.32±0.40)%, increasing with a concentration- and time-dependent increase, which was higher than that in control group; and the differences between either two groups at different time points were statistically significant (P<0.05). CFPAC-1 cell apoptosis rate after being treated with 0, 0.4 and 0.8 mmol/L Brucine for 48 h was (2.92±0.46)%, (4.64±1.31)% and (13.09±0.65)%, which increased gradually with the increased drug concentration. The apoptotic rate in 0.8 mmol/L treatment group was obviously higher than that in control group, and the difference was statistically significant (P<0.05). With the increase of the drug concentration, the red fluorescence gradually decreased, and the green fluorescence gradually increased, indicating that the mitochondrial membrane potential was severely damaged and thus decreased. The protein expression of Bcl-2 in CFPAC-1 cells were(0.92±0.12), (0.67±0.14)and(0.35±0.14)mmol/L, and the expression of Bax in CFPAC-1 cells were(0.56±0.12), (0.85±0.10)and(1.15±0.12)mmol/L. With the increase of brucine concentration, the expression of Bcl-2 was significantly reduced while the expression of Bax was significantly increased; and the difference was statistically significant (P<0.05).@*Conclusions@#Brucine can effectively induce the apoptosis of human pancreatic cancer CFPAC-1 cells through mitochondrial apoptotic pathway by up-regulating the expression of Bax and down-regulating the expression of Bcl-2.
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OBJECTIVE： To establish antibiotics use rationality evaluation model in type Ⅰ incision surgery patients， and to provide reference for prescription review of clinical pharmacists. METHODS： Totally 432 inpatients underwent type Ⅰ surgical incision in a hospital from Jan. 1st- Dec. 31st， 2017 were selected as the research objects. The information of diagnosis and treatment including age， nosocomial infection， the number of kinds of antibiotics used were extracted. Based on the results of clinical pharmacists’ comments on the antibiotics use rationality in patients’ prevention and treatment， non-conditional Logistic regression and support vector machine （SVM） in machine learning method were used to convert clinical pharmacists’ comments into objective index that can be recognized by the machine learning model， using categories of antibiotics （preventive or therapeutic use） as dependent variables and the patient’s diagnosis and treatment information as independent variables. Classification and identification model was established for antibiotics use rationality in type Ⅰ incision surgery patients. Using sensitivity， specificity and Youden index as indexes， established mode was validated on the other 61 samples of type Ⅰ incision surgery patients. The rationality of antibiotics prescriptions in type Ⅰ incision surgery patients before （by manual review， Jan.-Dec. 2017） and after （Jan.-Oct. 2018） using the model were collected， and the effects of the model were evaluated. RESULTS： The sensitivity， specificity and Youden index of non-conditional Logistic regression model were 65.63％， 75.00％ and 40.63％， respectively. Main parameters of the model established by SVM included gamma 0.01， cost 10， sensitivity 92.19％， specificity 87.50％， Youden index 79.69％. The model established by SVM was better than non-conditional Logistic regression. SVM was used to validate established mode， and sensitivity， specificity and Youden index were 100％， 88.57％ and 88.57％， respectively. Compared with before using the model， the evaluation ratio increased from 69.44％ to 100％， the rate of prophylactic use of antibiotics decreased from 23.84％ to 16.43％， the rate of rational drug type selection increased from 37.86％ to 54.39％， and treatment course shortened from 5.01 days to 3.26 days after using the model. CONCLUSIONS： Established antibiotics use rationality evaluation model in typeⅠincision surgery patients by SVM in machine learning method fully covers all the patients， promotes rational use of antibiotics in typeⅠincision surgery patients， and provides a new idea for pharmacist prescription comment.
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Objective To investigate the influence of Brucine on cell apoptosis of pancreatic cancer CFPAC-1 cells and the possible mechanism. Methods Brucine in different concentrations were used to treat CFPAC-1 cells. Cell proliferation was determined by MTT assay and cell apoptosis was determined by flow cytometer assay. Mitochondrial membrane potential was examined by JC-1 staining. The protein expression of Bax and Bcl-2 was measured by Western Blot. Results The growth inhibition rates of CFPAC-1 cells after being treated with 0 (control group), 0. 4 and 0. 8 mmol/L Brucine for 24, 48 and 72 h were 0,(30. 23 ± 0. 55)％,( 40. 61 ± 0. 15 )％, ( 46. 98 ± 1. 27 )％ and ( 50. 17 ± 0. 75 )％, ( 61. 23 ± 0. 91 )％, ( 70. 32 ± 0. 40)％, increasing with a concentration-and time-dependent increase, which was higher than that in control group; and the differences between either two groups at different time points were statistically significant (P<0. 05). CFPAC-1 cell apoptosis rate after being treated with 0, 0. 4 and 0. 8 mmol/L Brucine for 48 h was ( 2. 92 ± 0. 46 )％, ( 4. 64 ± 1. 31 )％ and ( 13. 09 ± 0. 65 )％, which increased gradually with the increased drug concentration. The apoptotic rate in 0. 8 mmol/L treatment group was obviously higher than that in control group, and the difference was statistically significant (P<0.05). With the increase of the drug concentration, the red fluorescence gradually decreased, and the green fluorescence gradually increased, indicating that the mitochondrial membrane potential was severely damaged and thus decreased. The protein expression of Bcl-2 in CFPAC-1 cells were(0.92 ±0.12),(0.67 ±0.14)and(0.35 ±0.14)mmol/L,and the expression of Bax in CFPAC-1 cells were(0. 56 ± 0. 12),(0. 85 ± 0. 10)and(1. 15 ± 0. 12)mmol/L. With the increase of brucine concentration, the expression of Bcl-2 was significantly reduced while the expression of Bax was significantly increased;and the difference was statistically significant (P<0. 05). Conclusions Brucine can effectively induce the apoptosis of human pancreatic cancer CFPAC-1 cells through mitochondrial apoptotic pathway by up-regulating the expression of Bax and down-regulating the expression of Bcl-2.
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@#Respiratory dysfunction is a significant part of disorders associated with stroke. Stroke could impair respiratory center or motor pathway, leading to alter breath pattern or reduced respiratory muscle strength. Pneumonia secondary to stroke and stroke-associated sleep apnea are common respiratory disorder, which are adverse to the prognosis of stroke. Clinical routine physical examination is basic evaluation of respiratory function. Attention should be paid especially in breath pattern, respiratory muscle volume and muscle tone. Multiple quantitative assessments include arterial blood gas analysis, sleep apnea monitoring, dynamical, imaging and electrophysiological tests. Rehabilitation can be used to improve the inspiratory muscle strength, endurance and cough effectiveness, reduce sleep apnea hypoventilation, enhance the cardiorespiratory fitness, finally improve the quality of life in stroke patients.
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Respiratory dysfunction is a significant part of disorders associated with stroke. Stroke could impair respiratory center or mo-tor pathway, leading to alter breath pattern or reduced respiratory muscle strength. Pneumonia secondary to stroke and stroke-associated sleep apnea are common respiratory disorder, which are adverse to the prognosis of stroke. Clinical routine physical examination is basic evaluation of respiratory function. Attention should be paid especially in breath pattern, respiratory muscle volume and muscle tone. Multi-ple quantitative assessments include arterial blood gas analysis, sleep apnea monitoring, dynamical, imaging and electrophysiological tests. Rehabilitation can be used to improve the inspiratory muscle strength, endurance and cough effectiveness, reduce sleep apnea hypoventila-tion, enhance the cardiorespiratory fitness, finally improve the quality of life in stroke patients.
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@#Objective To investigate the application of Montreal Cognitive Assessment (MoCA) and Mini- Mental State Examination (MMSE) in cognitive function evaluation for stroke patients during convalescence. Methods 127 stroke patients were selected and both Mo-CA and MMSE were conducted to assess their cognitive function. Results The detection rate was higher with MoCA (86.61%) than with MMSE (57.48%) (P<0.05). Conclusion Compared to MMSE, MoCA covers a broader scope of cognitive function, and is more sensitive.
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@#Objective To investigate the characteristics of Montreal Cognitive Assessment (MoCA) and analyze the influence of age, coma or not, injury side, and injury area on the scores of MoCA. Methods 135 stroke patients were evaluated with MoCA. Results The scores were poor in delayed recalling, abstraction, verbal fluency, view space and executive function, and were less poor in naming, attention and orientation. There was significantly difference in the total score, attention, verbal fluency, delayed recalling and orientation of MoCA between older and younger patients (P<0.05). There was significantly difference in the total score, view space and executive function, attention, orientation between patients with coma and without coma (P<0.05). There was significantly difference in the total score, attention, verbal fluency, abstraction, delayed recalling and orientation between thoses with left side injury and right side injury (P<0.05). Compared with basal ganglia injury, front lobes injury tended to impact the total scores, attention, abstraction and delayed recalling (P<0.05); frontal, temporal and parietal lobes tended to impact the total score, naming, abstraction and delayed recalling (P<0.05). Conclusion The total scores of MoCA do reflect the cognitive impairment in patients with stroke, while the age, coma or not, injury side and injury area of the brain may impact the cognitive impairment in patients.
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@#Neurological rehabilitation involves the most functional impairments. The students of rehabilitation medicine are required to master diagnosis and treatments of diseases, and assessments and rehabilitation of disabilities in neurological field during practice. This article introduced the experience of teaching for the students practised neurological rehabilitation.
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Objective To analyze the distribution and drug resistance of pathogens causing hospital-acquired pneumonia (HAP) in stroke patients,and provide references for proper clinical application of antibiotics.Methods A retrospective investigation was performed to analyze the pathogens and the drug resistance of 143 stroke patients with HAP.Results Among 168 strains of isolated pathogens,the Gram-negative bacteria accounted for 61.90％ (104/168),including Klebsiella pneumoniae,Pseudomonas aeruginosa,Escherichia coli,Acinetobacter baumannii,Enterobacter cloacae and so on.Gram-positive bacteria accounted for 25.60％ (43/168).Staphylococcus aureus ranked the first,followed by Coagulase negative staphylococcus and Enterococcus faecalis.Fungi accounted for 12.50％(21/168),mainly including Candida albicans.They had varying degrees of resistance to commonly used antibiotics.Conclusions Gram-negative bacteria is predominant in stroke patients with HAP.Drug resistance is very serious,and the antibiotics should be selected in clinic according to the result of drug susceptibility test.
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Objective To investigate the incidence of spasticity 6 months after first stroke. Methods 355 patients hospitalized from March 2012 to December 2013 were assessed with the modified Ashworth Scale 1 month, 3 months, and 6 months after stroke. Results The incidence of spasticity was 42.7%in the 1st month, and increased to 63.7%and 65.7%3 and 6 months after stroke, respectively. The inci-dence of spasticity was the most 3 months after stroke both in arms and legs. The incidence of moderate to severe spasticity was more in the arms than in the legs. There was no significant difference at incidence of spasticity among foci and ages. Conclusion Spasticity usually oc-curs within 3 months after stroke, and more frequent in the upper limb than lower limb.
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Objective To investigate the application of Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) in cognitive function evaluation for stroke patients during convalescence. Methods 127 stroke patients were selected and both Mo-CA and MMSE were conducted to assess their cognitive function. Results The detection rate was higher with MoCA (86.61%) than with MMSE (57.48%) (P<0.05). Conclusion Compared to MMSE, MoCA covers a broader scope of cognitive function, and is more sensitive.
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Neurological rehabilitation involves the most functional impairments. The students of rehabilitation medicine are required to master diagnosis and treatments of diseases, and assessments and rehabilitation of disabilities in neurological field during practice. This arti-cle introduced the experience of teaching for the students practised neurological rehabilitation.
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Objective To observe the effect of Botulinum toxin-A (BTX-A) injection on upper limb pain after stroke. Methods A case with upper limb pain after stroke was reported. The symptom, the location and dosage of injection, and the prognosis were recorded. Results The pain relieved after injection, and disappeared 4 weeks after injection. Conclusion BTX-A injection is effective on upper limb pain after stroke.
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Objective To analyze the pathogens distribution and drug resistance in acute stroke with stroke associated pneumonia (SAP) patients,and provide references for proper clinical application of antibiotics.Methods A retrospective investigation was performed to analyze the pathogens and the drug resistance of 131 acute stroke with SAP patients.Results Among 148 strains of isolated pathogens,the Gram-negative bacteria accounted for 66.22％ (98/148),including Klebsiella pneumoniae,Pseudomonas aeruginosa,Escherichia coli,Acinetobacter baumannii,Enterobacter cloacae and so on.Gram-positive bacteria accounted for 26.35％ (38/148).Staphylococcus aureus ranked the first,followed by Coagulase negative staphylococcus and Enterococcus faecalis.Fungi accounted for 7.43％ (12/148),mainly including Candida albicans.They had varying degrees of resistance to commonly used antibiotics.Conclusions Gram-negative bacteria are predominant in SAP.Drug resistance is very serious,and the antibiotics should be selected in clinic according to the result of drug susceptibility test.
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@# Objective To explore the effect of low frequency repetitive transranial magnetic stimulation (rTMS) on unilateral spatial neglect (USN). Methods 40 stroke patients with USN were divided into treatment group (n=20) and control group (n=20). Patients in the treatment group were treated with low frequency rTMS for 2 weeks. The USN degree of these groups were evaluated before and after the treatment. Results There was no significant difference of USN degree between these groups before the treatment (P>0.05); Compared with the control group, the treatment group improved significantly after the treatment (P<0.05). The USN degree of patients in the treatment group decreased significantly after the treatment (P<0.05), while patients in the controlled group had no difference (P>0.05). Conclusion USN induced by stroke could be improved obviously through low frequency rTMS.
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Objective To discuss comfort nursing effect for rehabilitation exercise compliance of hip replacement patients. Methods 76 cases of senile hip replacement patients were retrospecrively analyzed and divided into the control group and the research group with 38 cases in each group, each received rourine nursing and comfort nursing. The nursing effect was compared between two groups. Results The research group was better in nursing satisfaction degree, comfort degree, complications such as infection and prosthesis dislocation and recovery exercise compliance compared with those of the control group. Conclusions Comfort nursing has considered patients' requirement and aiming to these requirements. So it can help patients to elevate the comfort degree, improve prognosis and satisfaction degree.
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@#The rehabilitation and nursing for the complication and secondary disturbance are the important partition of treatment for patients with traumatic brain injury(TBI).Understanding the category,mechanism,prevention and treatment of complications can efficaciously decrease the incidence rate of them,relieve the distress of patients,increase the ablity of ADL and the quality of life,improve the effect of rehabilitation,and reduce the economic burden of family and society.It also can promote patients back to family and society as earlier as possible.
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@#The rehabilitation and nursing for the complication and secondary disturbance are the important partition of treatment for patients with traumatic brain injury(TBI).Understanding the category,mechanism,prevention and treatment of complications can efficaciously decrease the incidence rate of them,relieve the distress of patients,increase the ablity of ADL and the quality of life,improve the effect of rehabilitation,and reduce the economic burden of family and society.It also can promote patients back to family and society as earlier as possible.
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@#Objective To observe the effects of electroacupuncture at Zusanli (ST36) on lower limbs motor function in patients with stroke. Methods 63 patients were evenly randomized into electroacupuncture group and control group. All the patients received routine rehabilitation training and at the same time,patients in electroacupuncture group, received electroacupuncture at zusanli (ST36). They were assessed with Fugl-Meyer Assessment (lower limb, hip, knee and ankle), gait analysis (gait frequency, gait speed and step length of both sides) and lower limb Composite Spasm Scale (CSS) before and after treatment. Results The scores of Fugl-Meyer Measure, gait analysis, and CSS improved in both groups, and more significantly in electroacupuncture group. Conclusion Electroacupuncture at zusanli (ST36) can significantly improved lower limb motor function without worsening the spasm.
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@# Various central nerve system lesions involved cerebral hemisphere and nerve fiber tract such as cerebral infarction and hemorrhage can cause Wallerian degeneration,which is similar to the pathological change of peripheral nerve cut.There is a clear correlation between the degree of recovery and the degree of Wallerian degeneration.This article reviews the advances in feature of poststroke Wallerian degeneration and the correlation between post-stroke Wallerian degeneration and rehabilitation outcome.