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ObjectiveTo compare the functional connectivity of brain networks in stroke patients with upper limb motor dysfunction during unilateral or bilateral upper limb movement using functional near-infrared spectroscopy (fNIRS). MethodsFrom April to June, 2021, 40 stroke patients with upper limb motor dysfunction in Department of Rehabilitation Medicine, Huashan Hospital, finished unilateral (affected) and bilateral upper limb movement. Eight-minute fNIRS data were collected before and after movement, and the functional activities and connectivity of prefrontal cortex (PFC), upper limb and hand functional area (H), primary sensory cortex (S1) were analyzed based on oxygenated hemoglobin. ResultsFunctional activities increased in affected H after unilateral task (t = -3.135, P < 0.05), while the functional connectivity increased between affected H and affected S1, affected H and unaffected S1, and affected S1 and unaffected S1 (|t| > 3.218, P < 0.05). There was no significant difference in the functional activities and connectivity of all the areas after bilateral upper limb task (|t| < 2.385, P > 0.05). The improvement of affected H was more after unilateral task than after bilateral upper limb task (t = 2.026, P < 0.05). ConclusionUnilateral affected upper limb training is more effective on functional activities and connectivity for corresponding brain regions than bilateral task.
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Objective:To compare the prognosis of fluoroucil combined with cisplatin and paclitaxel combined with cisplatin regimens with concurrent radiotherapy in treatment of esophageal squamous cell carcinoma.Methods:A total of 120 patients with esophageal squamous cell carcinoma who were admitted to Anyang Tumor Hospital of Henan Province from December 2012 to November 2018 were randomly divided into group A and group B by using a random number generator. Group A was given cisplatin combined with 5-fluorouracil, and group B was given cisplatin combined with paclitaxel. Both groups had the same radiotherapy regimen, and both used intensity-modulated radiation therapy (IMRT). Completions of 50 Gy radiotherapy and at least one cycle of chemotherapy were considered to be in line with the plan. Survival data was analyzed in the term of intention-to-treat (ITT) and per-protocol (PP) set.Results:Of the 120 patients, 114 patients were treated and the adverse reactions could be evaluated, including 55 cases in group A and 59 cases in group B. The incidence of grade Ⅲ-Ⅳ leukopenia in group B was higher than that in group A [49.2% (29/59) vs. 25.5% (14/55)], and the difference was statistically significant ( χ2 = 6.805, P = 0.012), and there were no statistical differences in the other adverse reactions between the two groups (All P > 0.05). A total of 113 cases can be analyzed for survival. According to ITT analysis, the median progression-free survival (PFS) time in group A and group B was 28.0 months (95% CI 15.5-34.5 months) and 27.0 months (95% CI 17.0-41.0 months), the median overall survival (OS) time was 28.0 months (95% CI 15.8-34.2 months) and not reached, the differences were not statistically significant (both P > 0.05). According to PP analysis, the median PFS time in group A and group B was 28.0 months (95% CI 15.8-34.2 months) and 29.0 months (95% CI 14.9-45.1 months), the median OS time in group A and group B was 28.0 months (95% CI 3.7-52.3 months) and not reached, the differences were not statistically significant (both P > 0.05). Conclusions:The fluorouracil combined with cisplatin regimen and paclitaxel combined with cisplatin regimen with concurrent radiotherapy have similar PFS and OS time in treatment of esophageal squamous cell carcinoma, the adverse reactions are different, but they are all tolerable. In individualized clinical practice, the toxicities and costs of the two regimens can be comprehensively considered.
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@#Objective To explore the effects of transcutaneous electrical acupoint stimulation (TEAS) on paralytic hand and upper limb of stroke patients. Methods 32 patients were randomly divided into the treatment group (n=16) and the control group (n=16). All the patients accepted routine rehabilitation, and the patients in the treatment group accepted TEAS in addition for 6 weeks. They were assessed with Fug1-Meyer Assessment of upper extremities (FMA-UE), motor status scale (MSS) and Modified Barthel Index (MBI) before and 2, 4, 6 weeks after treatment. Results All the measures improved in both groups after 2, 4, and 6 weeks of treatment (P<0.05), while the scores of MBI improved more in the treatment group than in the control group 4 weeks after treatment (P<0.05), and all the measures improved more in treatment group than in the control group 6 weeks after treatment (P<0.05). Conclusion TEAS may promote the recovery of flaccid hand and upper extremity function post stroke.
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Objective To explore the effects of transcutaneous electrical acupoint stimulation (TEAS) on paralytic hand and upper limb of stroke patients. Methods 32 patients were randomly divided into the treatment group (n=16) and the control group (n=16). All the pa-tients accepted routine rehabilitation, and the patients in the treatment group accepted TEAS in addition for 6 weeks. They were assessed with Fug1-Meyer Assessment of upper extremities (FMA-UE), motor status scale (MSS) and Modified Barthel Index (MBI) before and 2, 4, 6 weeks after treatment. Results All the measures improved in both groups after 2, 4, and 6 weeks of treatment (P<0.05), while the scores of MBI improved more in the treatment group than in the control group 4 weeks after treatment (P<0.05), and all the measures improved more in treatment group than in the control group 6 weeks after treatment (P<0.05). Conclusion TEAS may promote the recovery of flaccid hand and upper extremity function post stroke.
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Objective To develop a motor rehabilitation system based on Kinect somatosensory interaction technology to be used in families.Methods The Kinect skeleton real-time tracking technique was applied to develop three motor rehabilitation protocols to instruct patients in how to perform rehabilitation training and to evaluate their performance.Results Five subjects participated in the experiment.They achieved average scores of 79.15 ±4.89 and 98.89±0.67 for 3D movement and arm lifting respectively.In the pose recognition experiment,their average recognition rate was 90.37 ± 5.21％.Conclusion The proposed rehabilitation system can instruct patients in performing training exercises and evaluate their performance at home.
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Objective To research the effects of parenteral nutrition(PN)with high branchedchain amino acid(BCAA)content for critically ill patients in general ICU.Methods A total of60 patientsfrom the general ICU were randomly divided into the control group(30 cases)and treatment group(30 cases).The control group was given PN with balanced amino acids,while the treatment group received PNwith high content of BCAA.Therapeutic outcomes and the blood parameters were measured betweengroups.Results Total protein (TP),albumin (ALB),prealbumin (PA),arm muscle circumference(AMC)and arm circumference(MAC)of the treatment group increased significantly(P <0.05).In thecontrol group,the change of TP,ALB and PA after 7 days was statistically significant(P <0.05).Compared to the control group,the improvement of parameters in the treatment group was more obvious.Conclusion For patients in general ICU,parenteral nutrition with high BCAA content is able to provide effective nutritional support without relative sideeffects.
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Objective To study the effect and toxicity ofgefitinib combined with selected radiotherapy in the treatment of patients with advanced non-small-cell lung cancer (NSCLC). Methods From March 2006 to February 2009,10 of 13 advanced NSCLC patients who got benefit from gefitinib were enrolled to treatment group (gefitinib concurrent selected radiotherapy) and control group (gefitinib only), with 5 cases in each group. The response was evaluated as progression free survival (PFS) and overall survival (OS).Results No patient got complete remission (CR). Ten of 13 patients got partial remission (PR) and stable disease (SD). The 1 year and 2 years survival rate was 53.8%(7/13) and 46.2%(6/13) respectively. The median PFS in treatment group and control group was 24 months and 8 months respectively(P= 0.0019). The median OS was 32 months and 10 months respectively (P= 0.0062). The main toxicities were reversible skin rash and diarrhea,and 3 patients developed asymptomatic radiation pulmonary fibrosis. Conclusions Gefitinib combining with selected radiotherapy is effective and tolerated in patients with advanced NSCLC. It may prolong PFS and OS. It may be a rational choice for the standard and individualized treatment of NSCLC.
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Objective To investigate the effect of precondition with Toll-like receptor 4 monoclonal antibody (TLR4mAb) on lipopolysaccharide (LPS) -induced acute lung injury in mice.Methods A total of 45 male BALB/c mice were randomly divided into 3 groups:the control group ( group C),the sepsis group (group S) and the pretreatment group (group P).Mice in the group P and group S were injected intraperitoneally with LPS ( 10 mg/kg) to produce acute lung injury models.Mice in the group P was injected intraperitoneally with TLR4mAb (5 μg/g) 1 h before the injection of LPS.Expression of TLR4mRNA in lung tissue,expression of TNF-α and IL-6 in serum,water content of lung,and the pathomorphologic changes of lung were detected after 6 h,12 h and 24 h.One-way ANOVA was used for inter-group comparison and two-way ANOVA was used for intra-group comparison.Results Compared to group C,water content significantly increased at 12 h and 24 h in group S and group P; compared to group S,water content significantly decreased in group P at 12 h and 24 h.Compared to group C,the expression of IL-6 and TNF-α significantly increased in group S and group P at 6 h,12 h and 24 h; compared to group S,the expression of IL-6 and TNF-α significantly decreased at 6 h,12 h and 24 h in group P.Compared to group C,the expression of TLR4 mRNA increased significantly in group S and group P at 6 h,12 h and 24 h; compared to group S,the expression of TLR4 mRNA decreased significantly in group P at6 h,12 h and 24 h.Compared to group S,pathological damage of the lung was improved significantly in group P.Conclusions Precondition with TLR4mAb can attenuate LPS-induced acute lung injury,suppress the expression of inflammatory factors.Regulation of TLR4 pathway may be a promising therapeutic strategy for ALI.
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[Objective] To explore the variety of matrix metalloproteinase 9 (MMP9) and blood brain barrier (BBB) in cardiopulmonary resuscitation rats.[Methods] Eighty rats were randomly divided into 2 groups:the sham-operated group (n ＝ 40) and the resuscitation group (n ＝ 40).The two groups were anaesthetized and endotracheally intubated,the resuscitation group was also induced to cardiac arrest by aphysia.Then the rats were put to death and samples were taken at immediate,3 h,9 h,24 h,and 48 h.After that,the expression of MMP9,MMP9 mRNA,water content and Evans blue content in brain tissue were detected.Ultramicrostructure of brain tissue was observed with electron microscope.[Results] Compared to the sham-operated group,at 3 h,9 h,24 h and 48 h,the expression of MMP9 of resuscitation group was significantly changed.MMP9mRNA significantly increased.Water content statistically increased and so was Evans blue content.The change of ultramicrostructure in the resuscitation group at 3 h,9 h,24 h,and 48 h was obvious.[Conclusion] The expression of MMP9 and MMP9mRNA obviously increased in the cerebral ischemia model with CPR rats,and got to peak at 24 h.Water content and Evans blue content in brain tissue obviously increased in the cerebral ischemia model with CPR rats,BBB was destroyed,and the peak was 24 h.The injury of ultramicrostructure of brain tissue with electron microscope was obvious,and the peak was 24 h.
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OBJECTIVE To explore the drug resistance of the infection caused by meticillin-resistant Staphylococcus aureus(MRSA) in ICU and the effect of linezolid in the treatment on MRSA.METHODS The collection of sputum,blood,urine,cerebrospinal fluid,the top and local drainage of central venous needle in 3 years(2006 to 2009) in ICU was carried out,and the bacteriological culture and drug susceptibility testing were executed.Fifteen cases of MRSA infection patients were treated with linezolid.RESULTS There were 72 cases of MRSA infection in 3 years in ICU,most of them were drug-resistant.The sensitivity for MRSA infection was high to 100% by used with vancomycin,teicoplanin and linezolid.The trend of MRSA infection in ICU had increased in the past 3 years.The efficiency and recovery rates of linezolid group(73.3% and 33.3%,respectively) were higher than the vancomycin group(66.7% and 28.6%,respectively)(P
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Objective To explore the effect of glutamine on changes in the expression of intercellular adhesion molecule-1(ICAM-1)and E-selectin and the characteristics of pulmonary vascular endothelial cells(VECs)in sepsis rats.Method Totally 56 Sprague-Dawley rats were randomly divided into three groups:a control group,a sepsis group and a treatment group.All experiments were performed at the animal research center at Sun Yat-sen University in Guangzhou.Sepsis was induced by injecting 4 mg/kg lipopolysaccharide(LPS).The treatment group was injected with 4 mg/kg LPS and 0.3 g/kg glutamine.The control group was not injected with either LPS or glutamine.The rats were killed at 6,12 or 24 h after treatment and pulmonary tissue samples were obtained.The expression of ICAM-1 and E-selectin in VECs was detected by reverse transcription-polymerase chain reaction and immunohistochemistry.Apoptosis of VECs lung tissue was analyzed by Hoechest-33258 staining.The ultramicrostructure of VECs was observed under an electron microscope.Data were analyzed using analysis of variance using SPSS 13.0.Results At 6,12 and 24 h,the expression of ICAM-1 and E-selectin was significantly higher in the sepsis group(relative expression;ICAM-1:0.0864 ± 0.0101,0.141 ± 0.0147 and 0.1677 ± 0.0127,respectively;E-selectin:0.1535 ±0.0180,0.0811 ±0.0107 and 0.0505 ± 0.0031,respectively)compared with the control group(ICAM-1:0.021 ±0.0032,0.0228±0.0042 and 0.0204±0.0059,respectively;E-selectin:0.0423 ±0.0108,0.0412 ±0.0066 and 0.0418 ±0.0092,respectively)(all:P＜0.01).Glutamine treatment significantly decreased(P＜0.01)the expression of ICAM-1(0.0646±0.0136,0.1202±0.0143 and 0.1378 ±0.0085,respectively)and E-selectin(0.1071 ±0.0189,0.0628±0.0088 and0.0463±0.0049,respectively)at all time points compared with the sepsis group.However,the expression of ICAM-1 and E-selectin remained significantly higher than that in the control group(all:P＜0.05).There were similar changes in the expression of pulmonary ICAM-1,E-selectin mRNA and the results of VEC apoptosis.Electron microscopy confirmed these findings.Conclusions The expression of ICAM-1 and E-selectin was significantly increased in sepsis rats,leading to necrosis and apoptosis of VECs,and the onset of acute lung injury.Glutamine had a protective effect in VECs against lipopolysaccharide-induced sepsis.
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Objective:To observe the changes and significance of pulmonary vascular endothelial cells (VEC),ICAM-1 and E-selectin in sepsis rats.Methods:60 SD rats were randomly divided into 2 groups:the control group and the sepsis group.The sepsis model was prepared by injection of lipopolysaccharide(4 mg/kg).The expression of ICAM-1 and E-selectin in pulmonary VEC of rats was detected by reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemical method.The VEC apoptosis in lung was analyzed with Hoechest-33258 staining.The ultramicrostructure of pulmonary VEC was observed under electron microscope.Results:Compared with the control group,the expression of ICAM-1 was significantly increased in the sepsis group (P<0.01),the expression of ICAM-1 was increased gradually and achieved the peak value at 24 h.The expression of E-selectin was achieved the peak value at 6 h and decreased gradually during 24 h.The apoptosis and necrosis of pulmonary VEC was increased gradually and achieved the peak value at 24 h (P<0.01).Conclusion:The expression of ICAM-1 and E-selectin in sepsis rats is significantly increased,probably leading to both necrosis and apoptosis of pulmonary VEC,resulting in the occurrence of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS).
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Objective To explore the changes of matrix metalloproteinase-9 and blood brain barrier in cardiopulmonary resuscitation rats and effects of MMP-9 inhibitor on them.Method One hundred and twenty Sprague-Dawley(SD) rats were randomly divided into 3 groups:the sham-operated group,the resuscitation with treatment group and the resuseimfion without treatment group as control.The experiment was made in the animal experiment center of Sun Yat-sen University in Gtlangzhou.The rat eardiopulmonary resuscitation model was made by clipping trachea until asphyxia,and the restoration of spontaneous circulation(ROSC)Was defined by restoration of superventricular rhythm and mean artery pressure (MAP)≥60 mmHg for more than 5 min utes.The rats of sham-operated group were anesahetized only and endotracheal intubation WaS performed.In the resuscitation with treaUnent group ss-3cr(25,ng/ks body weight)Was given intraperitoneally after ROSC.The rats were sacrificed and samples of the brain tissue were taken inmaediately and 3 h,9 h,24 h and 48 h later.After that,the expression of MMP-9 and MMP-9 mRNA in brain tissue were detected.Water oontent and Evans blue in brain tissue Were observed.The uhmmicrostructure of brain tissue was observed under electron microscope.Analysis ofvariance wilE, done with Spssll.0 software.Results 11le expressions of MMP.9 and MMP-9m RNA ofbraintissueiUthe shanloperated group didn't show significant changees in all specimens taken at different intervals and neither the water content and tvans blue did.The Pvalue were 1.0000,0.6831,0.7124 and 0.99r75,respectively.There was no u1.tramicrostruclure change in the sham-operated group.The expressions of MMP_9 and MMP-9 mRNA in the resuscitation control group obviously increased after eardiopulmonary resuscitation,80 did the water content and Evans blue content.Compared with sham-operated group,the P value were 0.0264,0.0163,0.0000 and 0.0412,respee.tively.111e elge of ultmmicrostmeture in the resuscitation control group at different intervals were obvious.The changes of obove biomarkers in the resuscitation treatment group Was siroilar to but less in magnitude than those in the resuscitation control group.The P valHe were 0.0392,0.0373,0.O004 and 0.0180,respectively.Conclusions The expressions of MMP-9 and MMP.9 mRNA obviously increases in the cerebral ischemia model of rats with CPR,and reaches peak at 24 h.Water content and Evans blue content in brain risque obviously increases in the cerebral ischemia model of rats with CPR.BBB iS destroyed.and the peak time iS at 24 h.The injury of ultrami.crostructure of brain tissue under electron microscope iS obvious,and the peak time is at 24 h.The SB-3CT.specif-iC inhibitor of MMP-9 could decrease the expression of MMP-9 and decrease cerebral edema in the cerebral is.chemia modeJ of rats with CPR,and the protection from cerebral isehemia/reperfusion injury after CPR is obvious.
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AIM: To determine the changes of the serum levels of tumor necrosis factor ? (TNF-?), interleukin-6 (IL-6), IL-10, C reactive protein (CRP) and D-dimer in the patients with multiple organ dysfunction syndrome (MODS) and compare the relationship between the levels of cytokines in early stage and MODS. METHODS: The serum values of TNF-?, IL-6, IL-10, CRP and D-dimer were measured in 27 patients with MODS in 1 d, 3 d and 5 d after undergoing disease, and compared with the adult peripheral blood of 15 normal controls. The levels in the first undergoing day between the lived group (n=19) and died group (n=8) were compared. RESULTS: The serum levels of TNF-?, IL-6, IL-10, CRP and D-dimer in MODS group were higher than that in control (P
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AIM: To investigate the protective effect of ulinastatin on rats with hemorrhagic shock. METHODS: A prospective, controlled animal study was designed. The model of hemorrhagic shock in rats was produced by Chaudry method. After 60 min, rats were resuscitated by transfusion of shed blood and normal saline, but a half of them were treated with ulinastatin. At different time points after reperfusion, the levels of tumor necrosis factor-alpha (TNF-?), interleukin-6 (IL-6), malondialdehyde (MDA) and superoxide dismutase (SOD) in serum were detected. RESULTS: The levels of TNF-?, IL-6 and MDA significantly increased and the activity of SOD decreased. In the ulinastatin-treated groups, the blood pressure and heart rate were obviously improved; the levels of TNF-?, IL-6 and MDA significantly decreased and the activity of SOD had little change after hemorrhagic shock and reperfusion. CONCLUSION: Ulinastatin has a protection effect on rats with hemorrhagic shock by suppressing the production of inflammatory factors and reducing oxidative damage.