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Objective:To explore the value of pre- and postoperative red cell distribution width-to-lymphocyte count ratio (RLR) in predicting the disease-free survival (DFS) for non-metastatic colorectal cancer patients.Methods:The data of 108 patients pathologically diagnosed with non-metastatic colorectal adenocarcinoma after surgery from December 2012 to January 2020 in Hainan Hospital of PLA General Hospital were retrospectively analyzed. RLR was calculated and its differences in patients with varied clinicopathological characteristics were analyzed. The receiver operating characteristics (ROC) curve was applied to analyze the value of pre- and postoperative RLR in predicting DFS of patients, and the cut-off value was determined by Youden index. DFS of patients with different stratification stratified by a cut-off value of RLR was analyzed by using Kaplan-Meier method followed by log-rank test. Cox proportional hazards model was used to make univariate and multivariate analysis.Results:Youden index of pre- and postoperative RLR in predicting DFS was 8.86%, 9.15%; based on the above index, the patients were divided into the preoperative RLR<8.86% group (73 cases) and preoperative RLR≥8.86% group (35 cases), postoperative RLR<9.15% group (48 cases) and postoperative RLR≥9.15% group (60 cases). According to ROC curve, the area under the curve (AUC) of preoperative RLR in predicating DFS was 0.66 (95% CI 0.55-0.77, P = 0.01), and AUC of postoperative RLR in predicating DFS was 0.62 (95% CI 0.51-0.74, P = 0.04). Pre- and postoperative RLR cut-off values were used to predict 3-year DFS rate of patients with the sensitivity of 51.60% and 71.00%, respectively, and the specificity of 76.60% and 50.60%, respectively. Kaplan-Meier analysis showed that patients in preoperative RLR<8.86% group had a better DFS compared with those in preoperative RLR≥8.86% group ( χ2 = 7.35, P < 0.01); there was no statistical difference in DFS between postoperative RLR<9.15% group and postoperative RLR≥9.15% group ( χ2 = 3.69, P = 0.06). Preoperative RLR was an independent affecting factor for DFS of patients ( HR = 1.13, 95% CI 1.04-1.22, P <0.01). Conclusions:Pre- and postoperative RLR could be useful in predicating 3-year DFS for patients with non-metastatic colorectal cancer. Preoperative RLR is an independent affecting factor for DFS, and the patients with low RLR have a better prognosis.
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Objective:To observe the effect of hyperbaric oxygen (HBO) therapy on the pituitary function of patients with subacute traumatic brain injury.Methods:Sixty-six patients with subacute traumatic brain injury and hypopituitarism were randomly divided into a control group ( n=33) and an HBO group ( n=33). Patients in both groups were given conventional treatment including dehydration to reduce intracranial pressure, anti-infection medication, epilepsy and bed sores prevention measures, neurotrophic treatment, fluid replacement and rehabilitation. The HBO group was additionally given HBO at 0.2MPa (2.0ATA), once a day, 6 times a week for a total of 20 administrations. Before and after the treatment, serum adrenocorticotropic hormone (ACTH), growth hormone (GH), thyroid stimulating hormone (TSH), prolactin (PRL), luteinizing hormone (LH), follicle stimulating hormone (FSH), cortisol, insulin-like growth factor 1, free tetraiodothyronine, testosterone, and estradiol levels were detected using chemical immunoluminescence. The ACTH, GH, TSH, PRL, LH and FSH values were used to calculate general pituitary hormone scores. Results:After the treatment, the average PRL, LH and testosterone levels and the general pituitary hormone score in the HBO group were significantly higher than among the controls.Conclusions:HBO treatment can increase the levels of various hormones in patients with subacute traumatic brain injury and promote the recovery of pituitary function.
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Objective To observe any effect of hyperbaric oxygen therapy on cognitive dysfunction caused by traumatic brain injury,and to explore possible neural mechanisms.Methods Sixty-four patients with cognitive impairment after a traumatic brain injury were randomly divided into a hyperbaric oxygen group (n =32) and a control group (n=32) using a random number table.Both groups accepted routine medical therapy and cognitive rehabilitation training,but the hyperbaric oxygen group additionally received hyperbaric oxygen treatment.Both groups' cognitive functioning was assessed using the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) before and after the treatment.Fifteen patients were randomly selected from both groups to receive T1WI and diffusion tensor imaging scans.The correlation between the two evaluation resuhs was analyzed.Results After the intervention,improvement was observed in the average MMSE and MoCA scores of both groups,with the improvement in both average scores in the hyperbaric oxygen group significantly greater than among the control group.There was no significant correlation between the fractional anisotropy (FA) values of damaged white matter and the average MMSE or MoCA score in the controi group,but in the hyperbaric oxygen group there were significant positive correlations between the FA values of the corpus callosum,the anterior limb of the internal capsule and the left superior longitudinal fasciculus and the average MMSE and MoCA scores.Conclusions Hyperbaric oxygen therapy combined with rehabilitation training can further improve cognition after a traumatic brain injury.This is probably due to its adjusting the structure and function of the corpus callosum,of the anterior limb of the internal capsule and of the left superior longitudinal fasciculus.
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Objective@#To research and analysis the effect of continued nursing support on speech intelligibility and the quality of life in postoperative patients with tongue cancer.@*Methods@#A total of 80 patients treated in our hospital with tongue cancer from May 2014 to August 2016 were selected and randomly divided into the intervention group and the control group in accordance with the convenience sampling method, 40 cases in each group. All patients received the same health guidance education after discharge according to care routine.At the same time, the patients in the intervention group received the continued nursing support. Intervention effects were observed in two groups by using the Chinese speech intelligibility test table and the University of Washington Quality of Life Questionnaire (UW-QOLv4).@*Results@#One day before the operation, the speech intelligibility (94.8±4.9) scores, the survival quality (1 076.3±51.9) scores in the intervention group compared to the scores (96.0±3.2, 1 084.7±46.5) in the control group,there were no statistical difference (t=-1.297,-0.762, both P>0.05). Two weeks after the operation, there were also no statistical difference (t=1.136,P>0.05) on the speech intelligibility scores between the intervention group (33.7±3.1) and the control group(32.9±3.2). One month,three months and six months after the operation, the scores in the intervention group(61.2±2.7,79.5±4.3,90.9±2.4 respectively) were much higher than that in the control group(49.6±2.4,63.6±3.8, 78.6±3.5) with significant difference (t=20.309,17.524,18.331, all P<0.05).Six months after the operation,the scores in the intervention group(786.4±67.1) were much higher than that in the control group (597.6±58.2) with significant difference(t=13.443,P<0.05).@*Conclusions@#The implementation of continued nursing support can effectively improve speech intelligibility and the quality of postoperative survival in patients with tongue cancer.
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Objective To investigate any therapeutic effect of combining hyperbaric oxygen with mesenchymal stem cells (MSCs) in treating traumatic brain injury (TBI).Methods Eighty healthy adult rats were randomly divided into a control group,a hyperbaric oxygen group,a stem cell group and a combination group,each of 20.TBI was introduced into the rats of all 4 groups.Twenty-four hours after the modelling,the hyperbaric oxygen group received hyperbaric oxygen therapy,the stem cell group received MSCs transplantation,the combination group was given the hyperbaric oxygen therapy an hour after the MSCs transplantation,while the control group was not given any treatment.All of the rats were evaluated using neurological severity scores (NSSs) after the modeling and again after the treatment.They were then sacrificed for HE staining and the expression of nuclear factor kappa B (NF-kB) and brain-derived neurotrophic factor (BDNF) were observed.Results On the 3rd,5th,10th and 20th day after the modeling,the average NSS of the combination group was significantly lower than those of the other three groups.However,the average NSS of the combination group on the 20th day was significantly superior to that on the 3rd and the 5th days.Compared with the control group,the edema of brain cells was less severe in the other 3 groups.The average expression of NF-kB and BDNF in the combination group was significantly higher than in the other 3 groups on the 3rd,5th,10th and 20th day after the modeling.Conclusion Hyperbaric oxygen,especially long term treatment combined with stem cell transplantation,can significantly improve nerve function in the brain after trauma,relieve inflammation and edema in and around the damaged area,and promote the expression of the NF-kB and BDNF.
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Objective To investigate the effects of hyperbaric oxygen (HBO) on homing of exogenous bone marrow mesenchymal stem cells (BMSCs) after traumatic brain injury (TBI) in rats. Methods BMSCs were isolated and cultured with Ficoll density gradient centrifuga-tion, and the surface markers (CD29, CD90, CD45, CD11b) of the third generation were identified with flow cytometry. The authenticated BM-SCs were processed by the cell membrane fluorescent probe CM-DiI before transplantation. Thirty-six Sprague-Dawley rats were divided in-to Sham group (n=6), TBI group (n=6), BMSCs group (n=12), HBO+BMSCs group (n=12). The number and locations of homing of tracing BMSCs were observed under fluorescent microscope after frozen sections, and the expression of stromal cell-derived factor 1 (SDF-1) and CXC chemokine receptor type 4 (CXCR4) proteins were detected with Western blotting one and three days after BMSCs transplantation. Re-sults The fluorescence-labeled BMSCs focused on the injured hemisphere, especially around the damaged brain tissue. The number of hom-ing was more in HBO+BMSCs group than in BMSCs group at the same time (P<0.01), and increased in both groups three days after trans-plantation compared with those of one day after transplantation (P<0.01). The expression of SDF-1 and CXCR4 protein were more in HBO+BMSCs group than in BMSCs group (P<0.05). Conclusion HBO can promote the exogenous BMSCs homing to damaged brain tissue in rats after traumatic brain injury, which is related to the enhancement of SDF-1/CXCR4 axis.
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Objective To study the value of oxygen treatment on elderly patients with acute ischemic stroke.Methods From April 2010 to March 2012,a total of 140 cases of elderly patients with acute ischemic stroke for oxygen therapy combined with drug and rehabilitation were divided into two groups,outside high-flow oxygen group of 71 cases,hyperbaric oxygen group of 69 cases.The neurological functional defects scale was used to evaluate the effect.Two groups of patients were given conventional drug therapy including improving the microcirculation,vegetative neural drugs,and rehabilitation treatment.Results The total effectiveness respectively was 98.6％ (70/71),91.3％ (63/69),and there was significant difference (P ＜ 0.05).After treatment,the nerve function damage grades of two groups respectively was (10.4 ± 1.7),(15.6 ± 1.8) scores,and there was significant difference compared with that before treatment [(28.2 ± 2.5),(28.7 ± 2.6) scores] (P ＜ 0.05).There was significant difference in treatment adherence between two groups (P ＜ 0.05).Conclusion For patients of elderly patients with acute ischemic stroke,oxygen therapy is necessary,while outside high-flow oxygen therapy is better than hyperbaric oxygen therapy.
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Objective To observe the efficacy, benefits and shortcomings of pressurized air therapy for neo- natal hypoxic ischemic encephalopathy (HIE). Methods One hundred and nine neonates with HIE were treated with hyperbaric oxygen (HBO) with a continuing oxygen supplement from an improved oxygen mask plus a 2.5-1itre breathing sacculus proprius in a large air-pressurized oxygen chamber. Among them there were 70 cases treated with 3-6 courses of HBO + drug therapy, 39 cases treated with a single session of HBO + drug therapy, and 32 treated with drug therapy alone. Motor development was assessed using the Chinese infantile intelligence development test scale at the ages of 3, 6 and 12 months. Results The sequential HBO + drug group achieved significantly better average motor development than the single session group or the drug only group. There was mo significant difference between the single treatment group and the drug only group. The proportion of abnormal CT results 12 months after treatment was significantly higher in the drug only group than in the sequential HBO + drug group. Conclusion Sequential HBO + drugs therapy with the improved oxygen mask is preferable to a single session of HBO + drug treatment or drug therapy alone.
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Applying the specialized Master of Public Health (MPH) degree education is one of the most important parts of our nation's medical degree system innovation. It has a positive effect on the development of health care in our country. To ensure the quality of the MPH degree, we should be more careful with course studies, do better in field and social practice, be stricter with degree dissertation rejoining, and supervise and control the process of the training.
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Objective To explore the effects of brain derived neurotrophic factors (BDNF) on concentrations of cerebral endogenous opioid peptides(EOP)in neonatal rats subject to with hypoxic ischemic brain injury (HIBI). Methods Seven day old Sprague Dawley rats were randomly divided into a HIBI+BDNF group (group A),a HIBI group (group B) and a sham operation group (group C). Models of HIBI were established by use of permanent ligation of the left common carotid artery followed by 2.5 hours ofinhalation of 8%O 2+92%N 2, then 0.5 ?g BDNF was injected into the parietal cerebral ventricle in group A immediately. Contents of dynorphin A 1 13 like, ? endorphin like and leu enkaphalin like immunoreactivities (ir DynA 1 13 , ir ? EP and ir LEK) in cortex and hippocampus were measured at 0, 60, 120 min after administration of BDNF. Results The concentrations of ir DynA 1 13 and ir ? EP in the cortex and hippocampus in group B were increased significantly than those in group C at most time points( P
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Objective To explore the effects of hyperbaric oxygen(HBO) on brain derived neurotrophic factor(BDNF) and the changes of neuron structure after cerebral ischemia-reperfusion(CIR) in mice. Methods Twenty-seven mice were randomly and evenly divided into three groups : a HBO group, a control group and a sham-operation group (SO group). CIR models were established by clamping both carotid arteries in mice for 30 min,and then, untying clamps. 0.20 MPa HBO was applied once a day for 10 days after establishment of models in HBO group,but not in the control and SO groups. Following sacrifice after treatment and acquirement of cortex and hippocamal tissues, HE stain and immunohistochemistry technique were used to observe the changes of neuron structure and expression of BDNF. Results The neural degeneration and necrosis in cortex and hippocampus (issues) were observed under light microscope after CIR, and the amount of abnormal cells in the control group was more than that in HBO group (P
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AIM To observe the effects of different interval administration of exogenous brain derived neurotrophic factor (BDNF) on hypoxic ischemic encephalopathy in neonatal rats. METHODS BDNF (0 5 ?g) was microinjected intracerebroventricularly at 0, 1 and 4 h after the hypoxic ischemic encephal opathy in 7 d neonatal Sprague Dawley rats undergone by ligation of left common carotid artery followed by a 2 5 h inhalation of humidified 8% O 2+92% N 2 at 37℃ immediately after the injury, respectively. Changes of brain edema, levels of malondialehyde (MDA) and neuronal apoptosis at the left cortex and hippocampus were investigated 24 h after the injury. RESULTS The most prominent effect of BDNF was seen in 0 h group with a marked decreases in brain edema and levels of MDA and a significantly alleviated neuronal apoptosis while it was lowered obviously when administered at 4 h after the insult. CONCLUSION BDNF exerts a prominent protective effect on hypoxic ischemic encephalopathy in neonatal rats when given as early as possible after the injury rather than later administration.