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Objective:To review the effect of kinesio taping on the lower limb function of stroke survivors.Methods:PubMed, Web of Science, Embase, the Cochrane Library, China′s National Knowledge Internet (CNKI), China Biology Medicine (CBM), Weipu Chinese Science and Technology Periodical Database and the WanFang Database were searched for reports of randomized and controlled trials (RCTs) testing the effect of kinesio taping on the lower limb function of stroke survivors published between January 1st, 2000 and October 1st, 2019. Two reviewers independently screened the reports, extracted data and assessed the risk of bias in the studies included. Version 5.3 of the RevMan software was used to analyze the extracted data.Results:A total of 13 RCTs involving 932 patients were included. Meta-analysis showed that the experimental group was significantly superior to the control group in terms of the improvement in walking speed and function, balance, fall risk, quadriceps strength, leg triceps strength, and general lower limb motor functioning. Their ability in the activities of daily living was also better on average as was their general life quality.Conclusions:Kinesio taping can improve stroke survivors′ balance, motor ability, muscle strength and life quality.
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The efficacy of decompressive craniectomy (DC) in reducing traumatic brain injury mortality has been affirmed,but there are also many serious complications.Syndrome of the trephined (ST) and paradoxical herniation (PH) are rare complications.ST is characterized by a series of neurological deterioration due to skin flaps subsidence from weeks to months after DC.These neurological impairments are closely related to the subsequent repair of skull defects.PH shows progressive decrease in consciousness on the basis of ST,changes in pupils on the side of skull defects,low touch pressure at the defect window,and obvious midline shift and brain stem compression on CT.ST and PH have common inducements in pathophysiology,including cerebrospinal fluid dynamics,atmospheric pressure,cerebral blood flow and brain material metabolism.There is no consensus on the diagnosis of ST and PH,and early cranioplasty is suggested in terms of treatment.This article reviews the clinical manifestations,pathophysiological changes,diagnosis and treatment of ST and PH after DC operation,so as to provide references for clinicians to further understand ST and PH.
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Objective@#To analyze the clinical value of megakaryocytes in the diagnosis and treatment of children with immune thrombocytopenic purpura(ITP).@*Methods@#From June 2014 to January 2018, the clinical data of 110 children with ITP diagnosed and treated in Zhucheng People's Hospital Affiliated to Weifang Medical College were analyzed and followed up for more than 1 year.The children were divided into two groups according to whether the duration of the disease was morethan 12 months(chronic group and non-chronic group). Gender, age, initial course of disease, platelet count, lymphocyte count, megakaryocyte count, white blood cell count, and initial treatment regimen were analyzed and compared between the two groups.Multivariate analysis was used to analyze the independent influencing factors of chronic ITP.The clinical value of the initial diagnosis and lymphocyte counts in evaluation of the effects of chronic ITP and initial treatment were analyzed.The clinical value of megakaryocyte in the assessment of initial treatment was analyzed.@*Results@#The initial course of disease[(5.8±2.26)d]and megakaryocyte count[(210.28±98.67)/piece] in the chronic groupwere higher than those in the non-chronic group[(3.57±2.05)d, (165.26±78.35)/piece], and the lymphocyte count[(2.87±0.90)×109/L] in the chronic groupwas lower than that in the non-chronic group[(3.66±1.12)×109/L], the differences were statistically significant(t=4.824, 2.299, 3.545, all P<0.05). Megakaryocyte count was not an independent factor of chronic ITP(P>0.05). The initial course of disease was a risk factor for chronic ITP(OR=3.826), while lymphocyte count was a protective factor(OR=0.471). The initial course of disease was evaluated as AUC=0.648 for chronic ITP, with an optimal cut-off value of 4.5 days, a sensitivity of 65.4%, and a specificity of 62.5%.Lymphocyte counts was evaluated as AUC(area under the ROC curve)=0.648 for chronic ITP, the optimal cut-off value was 3.01×109/L, the sensitivity was 59.4%, and the specificity was 78.2%.The initial course of disease and lymphocyte count had no significant value in evaluation of the treatment outcome (P<0.05). The initial treatment of patients with increased megakaryocyte counts was better than those with the normal level, and the difference was statistically significant(Z=6.051, P<0.05).@*Conclusion@#The initial course of disease and lymphocyte count can help to assess the duration of ITP in children.Patients with increased bone marrow megakaryocyte counts can achieve better results at initial treatment.
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Objective@#To investigate the clinical practicability and prognostic value of Helsinki CT score in patients with traumatic brain injury (TBI).@*Methods@#A retrospective case series study was conducted to analyze the clinical data of 124 TBI patients admitted to First Affiliated Hospital of Xinjiang Medical University from September 2016 to October 2018. There were 91 males and 33 females, aged 14-84 years, with an average age of 49 years. Glasgow coma score (GCS) at admission ranged from 3-8 points in 45 patients, 9-12 points in 42 patients, and 13-15 points in 37 patients. According to Glasgow outcome scale (GOS) at 6 months after injury, 26 patients were classified into the poor prognosis group with GOS of 1-3 points and 98 patients were in the good prognosis group with GOS of 4-5 points. The prognosis-related risk factors were analyzed, and the role of Helsinki CT score to predict the adverse prognosis and mortality of TBI patients in the two groups was investigated. The sensitivity and specificity of Helsinki CT Score for 6-month poor prognosis were evaluated by receiver operation characteristic (ROC) curve and area under the curve (AUC).@*Results@#Univariate analysis suggested that there were significant differences in terms of subdural hematoma, intracranial hematoma, extradural hematoma, hematoma volume >25 cm3, intraventricular hemorrhage and suprasellar cistern pressure between the poor prognosis group and good prognosis group (P<0.05). Multivariate logistic regression analysis showed that the mortality and bad prognosis were related to the hemorrhage of ventricles, the pressure of suprasellar cistern and the disappearance of suprasellar cistern in the poor prognosis group and the good prognosis group (P<0.05), while intracranial hematoma and hematoma volume showed no association with mortality and poor prognosis (P>0.05). The Helsinki CT score could independently predict the adverse prognosis and mortality of TBI patients at 6 months (multivariate logistic regression: ORdeath=1.21, ORadverse prognosis=1.14). Helsinki CT score had a better predictive ability of 6-month mortality (AUC=0.85) than that of 6-month adverse prognosis (AUC=0.76), and had a predictive value for 6-month mortality and adverse prognosis.@*Conclusions@#Subdural hematoma, extradural hematoma, intraventricular hemorrhage and suprasellar cistern state (compression or disappearance) are the risk factors for the poor prognosis of TBI patients. Intraventricular hemorrhage and suprasellar cistern state are the main risk factors for predicting the mortality of 6 months. Helsinki CT score can independently predict the adverse prognosis and mortality of TBI patients at 6 months, and has relatively better value in predicting the mortality.
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Objective To investigate the clinical practicability and prognostic value of Helsinki CT score in patients with traumatic brain injury(TBI).Methods A retrospective case series study was conducted to analyze the clinical data of 124 TBI patients admitted to First Affiliated Hospital of Xinjiang Medical University from September 2016 to October 2018.There were 91 males and 33 females,aged 14-84 years,with an average age of 49 years.Glasgow coma score(GCS)at admission ranged from 3-8 points in 45 patients,9-12 points in 42 patients,and 13-15 points in 37 patients.According to Glasgow outcome scale(GOS)at 6 months after injury,26 patients were classified into the poor prognosis group with GOS of 1-3 points and 98 patients were in the good prognosis group with GOS of 4-5 points.The prognosis-related risk factors were analyzed,and the role of Helsinki CT score to predict the adverse prognosis and mortality of TBI patients in the two groups was investigated.The sensitivity and specificity of Helsinki CT Score for 6-month poor prognosis were evaluated by receiver operation characteristic(ROC)curve and area under the curve(AUC).Results Univariate analysis suggested that there were significant differences in terms of subdural hematoma,intracranial hematoma,extradural hematoma,hematoma volume＞25 cm3,intraventricular hemorrhage and Suprasellar cistern pressure between the poor prognosis group and good prognosis group(P＜0.05).Multivariate logistic regression analysis showed that the mortality and bad prognosis were related to the hemorrhage of ventricles,the pressure of suprasellar cistern and the disappearance of suprasellar cistern in the poor prognosis group and the good prognosis group(P＜0.05),while intracranial hematoma and hematoma volume showed no association with mortality and poor prognosis(P＞0.05).The Helsinki CT score could independentiy predict the advetse prognosis and mortality of TBI patients at 6 months(multivariate logistic regression: ORdealth=1.21,ORadvene prognosis = 1.14).Helsinki CT score had a better predictive ability of 6-month mortality(AUC = 0.85)than that of 6-month advetse prognosis(AUC = 0.76),and had a predictive value for 6-month mortality and advetse prognosis.Conclusions Subdural hematoma,extradural hematoma,intraventricular hemorrhage and suprasellar cistern state(compression or disappearance)are the risk factots for the poor prognosis of TBI patients.Intraventricular hemorrhage and suprasellar cistern state are the main risk factots for predicting the mortality of 6 months.Helsinki CT score can independently predict the advetse prognosis and mortality of TBI patients at 6 months,and has relatively better value in predicting the mortality.
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With the rapid development of economy and society and the progress of health care,the requirements of the head nurses＇core competence are also changing.The head nurse,as the manager of nursing work ,has gradually raised the requirements on the head nurse in the new era.The development of core competence is the basic requirement of the head nurse,which is of vital importance to the development of the head nurse.This paper introduces the requirements of head nurse ,the role of head nurse,the core competence of head nurse and the methods to cultivate the core competence of head nurse in the new era.
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Objective To investigate the effect of bone flap reduction on unilateral acute subdural hematoma (ASDH) under intracranial pressure monitoring.Methods A retrospective case control study was conducted to analyze the clinical data of 139 patients with unilateral ASDH admitted to the First Affiliated Hospital of Xinjiang Medical University from July 2014 to December 2017.There were 84 males and 55 females,aged 19-87 years (mean,53 years).At the time of admission,the Glasgow Coma Score (GCS) was 3-5 points in 63 patients and 6-8 points in 76.There were 40 patients with unilateral cavity dilation and 16 cases with bilateral pupil dilation.According to the different surgical methods,the patients were divided into study group (n =61) and control group (n =78).The study group removed the cranial hematoma under cranial pressure monitoring and determined whether to perform bone flap reduction according to the actual intracranial pressure.The control group was treated with craniotomy hematoma removal and standard large bone decompressed craniectomy (DC).The success rate of bone flap reduction in the study group was recorded.The complications at postoperative 3 months and the Glasgow Outcome Score (GOS) at postoperative 6 months were compared.Results All patients were followed up for 1-6 months,average 5.5 months.In the study group,23 patients underwent bone flap reduction,and the bone flap reduction rate was 38％.At postoperative 3 months,the study group showed better efficacy in subdural effusion (9:25),hydrocephalus (7 ∶19),and brain swelling in the skull defect area(5 ∶ 18) than the control group (P ＜0.05).Based on the GOS at 6 months after operation,in the study group,25 patients were with good results,nine with moderate disability,10 with heavy disability,seven with plant survival,and 10 died;in the control group,six patients were with good results,21 with moderate disability,15 with heavy disability,10 with plant survival,and 26 died.The number of patients with good prognosis (good and moderate disability) and the number of deaths in the study group were statistically different from those in the control group (P ＜ 0.05).Conclsion In the treatment of unilateral ASDH,bone flap reduction under intracranial pressure monitoring can reduce the incidence of complications and improve the life quality of patients.
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Objective To investigate the effect of the perioperative cluster nursing on the postoperative infections in children patients after ventriculo-peritoneal shunt. Methods 92 patients with hydrocephalus from January 2016 to March 2017 in our hospital were included in the study.The control group who hospitalize from January to June 2016 were managed with routine nursing during the perioperative period.After the implementation,the cluster nursing measures constructed by the focus group interviews were added in the intervention group who hospitalized from July 2016 to March 2017. Results Compared with the pre-implementation,the positive rate of PCT was insignificantly different on days 2 and 4 after the operation (P>0.05).However the difference was statistically significant on the 6th day (P<0.05),the postoperative infection rate significantly lower than that of the control group and so it was with the hospital stay. Conclusion The cluster nursing by focus group interviews can lower the infectious rate and shorten the hospital stay,worthy of clinical promotion.
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Objective To analyze the TCM principles of herbal prescriptions given by professor Zhang Shishun for esophageal cancer by using traditional Chinese medicine inheritance support system (V2.0). Methods The herbal prescriptions from professor Zhang were collected and used for esophageal cancer, and then were recorded into the traditional Chinese medicine inheritance support system. The date mining methods were used such as principle analysis and revised mutual information. Results A total of 166 prescriptions for esophageal cancer were collected, which involved 316 Chinese medicines. The medicines with high frequency were Ganoderma, Caulis Marsdeniae Tenacissimae, Fructus Trichosanthis, Herba Rabdosiae Rubescentis, and Agaricus Blazei Murrill. The combinations of medicines included Ganoderma and Ramulus Juglandis, Radix et Rhizoma Sophorae Tonkinensis and Caulis Marsdeniae Tenacissimae, and Herba Rabdosiae Rubescentis and Caulis Marsdeniae Tenacissimae. The prescription rules of drug combination mode were obtained. Conclusions The Professor Zhang advocated the theory of determination of treatment based on pathogenesis through differentiation of symptoms and signs, patho-examination, patho-location. He also stressed on the therapy of relieving both primary and secondary symptoms. The Ganoderma, Ramulus Juglandis and Agaricus Blazei Murril were used to strengthen the body resistance. Radix et Rhizoma Sophorae Tonkinensis, Caulis Marsdeniae Tenacissimae and Herba Rabdosiae Rubescentis were used to eliminate pathogenesis. The Endothelium Corneum Gigeriae Galli, Fructus Crataegi Praeparata, Massa Medicata Fermentata Praeparata were used to protect stomach-qi. The Fructus Trichosanthis, Bulbus Allii Macrostemonis and Folium Ginkgo wereused to dilate the esophagus. The Fructus Trichosanthis was often combined with Radix Scutellariae to serve all medicines on the esophagus.
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BACKGROUND:Deep vein thrombosis is a common postoperative complication after spinal surgery in clinical department of neurosurgery anddepartment of orthopedics. Deep vein thrombosis is mostly related to vein intima injury, stasis and activation of blood coagulation factor. Early effective prediction can effectively avoid the adverse effects on the prognosis of patients with deep vein thrombosis. D-dimer used in the prediction of deep venous thrombosis has high sensitivity and specificity, andcan be used as a sensitive predictor for deep vein thrombosis. OBJECTIVE:To explore the relationship between plasma D-dimer mass concentration and deep vein thrombosis after spinal surgery. METHODS:A total of 83 patients treated with spinal surgery colected fromDepartment of Neurosurgery, First Affiliated Hospital of Xinjiang Medical University from April 2014 to August 2015 were retrospectively analyzed. They were divided into two groups according to postoperative plasma D-dimer mass concentration:D-dimer positive group (n=48) and D-dimer negative group (n=35). We monitored D-dimer mass concentration in both groups preoperatively and postoperatively 1, 3, 5, 9 and 14 days, and analyzed the relationship between D-dimer mass concentration and deep vein thrombosis. RESULTS AND CONCLUSION:(1) No significant difference in D-dimer mass concentration was determined between the two groups (P> 0.05). D-dimer mass concentration was significantly higher in the D-dimer positive group than in the D-dimer negative group 1, 3, 5, 9, and 14 days postoperatively (P<0.05). (2) After operation, plasma D-dimer of 28 cases was positive, with persistent increasing. Double lower limb deep vein color Doppler ultrasound demonstrated that seven patients experienced deep vein thrombosis and four patients suffered from pulmonary embolism in D-dimer positive group. There was no deep vein thrombosis and pulmonary embolism in the D-dimer negative group. (3) These results indicate that positive D-dimer concentration of patientsafter spinal surgery suggests the possibility of deep vein thrombosis. If the concentration of D-dimer is persistently high, we should highly alert to the occurrence of deep vein thrombosis.
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BACKGROUND:Matrix protein is an essential component of the vascular wal , provides a necessary frame for the integrity of the vessel wal and physiological function of vascular wal cel s, and regulates cel s and smooth muscle. OBJECTIVE:To construct rat model of early aneurysm, and to evaluate differences in the expression of matrix structural proteins during cerebral aneurysm formation. METHODS:Twenty-eight healthy male Sprague-Dawley rats were randomized into control group (n=8) and model group (n=20). Aneurysm model was established by ligation of the left common carotid artery and right renal artery-induced hypertension in the model group. In the control group, only the left carotid artery bifurcation and bilateral carotid were exposed in rats. Rats in the model group were sacrificed at 15 and 30 days after model establishment. Right anterior cerebral artery in rats and olfactory artery bifurcation received immunohistochemical staining. The expressions of fibronectin,α-smooth muscle actin and col agen III were analyzed. RESULTS AND CONCLUSION:Compared with the control group, no significant difference in fibronectin expression was detected in right anterior cerebral artery and olfactory artery bifurcation in rats of the model group at 30 days after model establishment (P>0.05). However,α-smooth muscle actin and col agen III expressions were significantly reduced (P<0.05). These data confirmed that expression of structural proteins had differences and dynamic changes during early aneurysm formation in rats. Degradation of matrix structural protein in cerebral artery may be one of the key mechanism of aneurysm formation.
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BACKGROUND:At present, scholars general y believe that the physical and chemical properties of titanium mesh are fine as easy plastic, easy cutting, good corrosion resistance and wear resistance, non-magnetic, less effect on CT or MRI results, good histocompatibility and resistance to stress. The titanium mesh is regarded as an ideal material for cranioplasty. ＜br> OBJECTIVE:To explore the clinical feasibility of primary reconstruction of comminuted and open skul fracture with titanium mesh. ＜br> METHODS:Sixty-two cases of comminuted and open skul fracture were analyzed retrospectively, including 49 males and 13 females, aged 7-69 years. Among these 62 patients, 30 patients underwent debridement and then after 6-12 months, they received titanium mesh reconstruction, serving as control group. Another 32 cases underwent debridement and titanium mesh reconstruction in the same time as observation group. Al the cases were fol owed-up for 1-2 years to observe wound healing, complications and hospitalization cost. ＜br> RESULTS AND CONCLUSION:During the fol ow-up, no wound infection and intracranial infection occurred in the two groups. The incidence of intracranial hematoma, epilepsy, and other complications was higher in the control group than the observation group (P＜0.05), and the hospitalization cost was also higher in the control group than the observation group (P＜0.05). These findings indicate that primary reconstruction with titanium mesh is feasible in the treatment of comminuted and open skul fracture and can significantly reduce the incidence of complications and hospitalization costs.
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BACKGROUND:Vascular endothelial growth factor and transforming growth factor play a crucial role in embryonic development, wound healing, inflammation, cancer, ischemic hypoxia and other physiological and pathological processes, and participate in the development and progression of brain damage. OBJECTIVE: To evaluate the differences in the expression of vascular endothelial growth factor and transforming growth factor-α during the early phase of cerebral aneurysm formation in rats. METHODS:Twenty-eight healthy Sprague-Dawley rats were randomized into three groups. Sham operation group (n=8): the left carotid artery bifurcation and bilateral renal artery were only exposed, without ligation, and rats were kiled that day. 15 days group (n=10) and 30 days group (n=10): the left common carotid artery, internal carotid artery, external carotid artery and bilateral renal artery were ligated, to establish aneurysm model, and rats were kiled at 15 and 30 days, respectively. The bilateral sides of the anterior cerebral artery/olfactory artery bifurcations were harvested and observed under light microscopy for pathological changes. Immunohistological staining was performed to detect the expression of vascular endothelial growth factor and transforming growth factor-α. RESULTS AND CONCLUSION:The results showed that, no aneurysm formed in the sham operation group and 15 days group. In the 30 days group, one saccular aneurysm and five early aneurysm-like changes were found in the right anterior cerebral artery/olfactory artery bifurcations. In the sham operation group and 15 days group, no vascular endothelial growth factor was expressed. In the 30 days group, the positive rate of vascular endothelial growth factor was up to 80%, indicating that vascular endothelial growth factor is possibly involved in the formation of aneurysm. Transforming growth factor-α expression in the sham operation group and 15 days group was more apparent than that in the 30 days group, indicating that transforming growth factor-α is damaged or secretion is reduced in this process, which was possibly related to the formation of aneurysm.
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Objective To investigate the correlation between platelet-associated antibody and platelet infusion effects.Methods SEPSA was used to detect the platelet-associated antibody of 79 patients with multiple transfusions of platelet,the platelet count before and after platelet infusion was monitored and the corrected count increment (CCI) in lh and 24h were calculated,for those judged to be ineffective platelet infusion,the platelet cross-matching was first done and then received matching infusion again and the infusion effects were analysed. Results 47 cases were detected with platelet antibody positive in 79 patients,accounting for 59.5％ ,the CCI of lh and 24h after infusion in platelet antibody positive group were significantly lower than the negative group, the difference was statistically significant( t = 2. 462、2. 583, all P ＜ 0. 05 ) ;40 cases in positive group had the invalid with the invalid rate of 85.1％which was significantly higher than the negative group, the difference was statistically significant ( x2 = 34. 46, P ＜0. 05 ) ;the CCI of 1h and 24h after infusion in matching success group were significantly higher than the unsuccessful group, the difference was statistically significant( t = 2. 152、2. 230, all P ＜ 0. 05) ;27 cases in matching success group had the effective infusion with the effective rate of 87. 1％ ,which was significantly higher than the unsuccessful group, the difference was statistically significant ( x2 = 4. 34, P ＜ 0. 05). Conclusion The production of anti-platelet antibody was a major immune factor which lead to platelet transfusion refractoriness ,the blood platelet cooperative infusion could be a good solution for the platelet transfusion refractoriness.
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<p><b>OBJECTIVE</b>To investigate spontaneous metastasis, micrometastasis and genetic stability in human breast carcinoma xenografts in nude mice.</p><p><b>METHODS</b>Intact tissue from surgical specimens from breast carcinoma patients was xenografted into nude mice and transplanted from generation to generation. Cells from the xenografts were cultured in vitro and retransplanted into nude mice. Microsatellite DNA in the genome of human breast carcinomas, xenotransplanted tumors and metastases in nude mice were analyzed at three microsatellite loci.</p><p><b>RESULTS</b>The tumorigenicity of orthotopic xenotransplantation was 88.6% (31/35), with a metastatic rate of 41.9% (13/31). Cells from xenotransplants were successfully cultured in vitro. The taking rate of retransplantation into nude mice and the spontaneous lung metastasis rate were both 100% (10/10). Microsatellite DNA sequences in the genome of xenotransplanted tumors and metastases in nude mice were identical with that of the original human breast carcinoma at three microsatellite loci.</p><p><b>CONCLUSIONS</b>Tumorigenicity and metastatic potential can be improved in human breast carcinoma xenografts using intact fresh tumor tissue and orthotopic grafts. Xenotransplanted tumors and tumors after serial passage maintained the genetic stability. The detection of microsatellite DNA may identify micrometastases in a nude mouse model.</p>