Progress in nursing research to assist patients with severe neurological diseases to turn over and prevent pressure sore / 中国实用护理杂志

This article reviews the nursing care of recent years to assist neurotic patients to turn over to prevent pressure sore. The present situation of nursing research on the prevention effect of pressure sore with different turn over method, different turn over angle, different turn over interval time combined with the nature of mattress and patient's condition were introduced, and the effect of preventing pressure sore with different turn over auxiliary appliance was introduced in order to provide a reference for the development of individual nursing guidelines for neurocritical patients.

Progress in nursing research to assist patients with severe neurological diseases to turn over and prevent pressure sore / 中国实用护理杂志

[Absrtact] This article reviews the nursing care of recent years to assist neurotic patients to turn over to prevent pressure sore. The present situation of nursing research on the prevention effect of pressure sore with different turn over method, different turn over angle, different turn over interval time combined with the nature of mattress and patient's condition were introduced, and the effect of preventing pressure sore with different turn over auxiliary appliance was introduced in order to provide a reference for the development of individual nursing guidelines for neurocritical patients.

Therapeutic effect of transplantation of ApoJ-modified bone marrow mesenchymal stem cells on intracere-bral hemorrhage in rats and its action mechanism / 医学研究生学报

Objective The nerve-protective effect of Apoli-poprotein J ( ApoJ) in intracerebral hemorrhage ( ICH) is not yet clarified.This study aimed to explore the therapeutic effect of trans -plantation of bone marrow mesenchymal stem cells (BMSCs) carrying the ApoJ gene on intracerebral hemorrhage in rats and its possible ac -tion mechanism. Methods Rat BMSCs were isolated, cultured in vitro, and transfected with the recombinant plasmid pEGFP -N1-ApoJ mediated with lipofectamine.Ninety-six SD rats were randomly divided into groups A, B and C, and ICH models were established by two -step autologous intracranial blood injection .At 24 hours after model-ing, the rats in groups A, B, and C were transplanted with the same volume of ApoJ-transfected BMSC suspension, BMSC suspension and normal saline, respectively.At 1, 3, 5 and 7 days after transplantation, the neurofunction recovery of the rats were evaluated with modified Neurological Severity Scores (mNSS), the brain water content measured by the dry -wet weight method, and the expression level of complement component 3 (C3) in the brain tissue detected by Western blot . Results The mNSS exhibited no statistically significant differences among the three group of rats on the 1st day after transplantation (P>0.05), but was remarkably lower in group A than in B and C on the 3rd (8.13±0.99 vs 9.25±1.28 and 10.88±0.84, P<0.05), 5th (6.75±1.04 vs 8.50±1.41 and 9.75±0.89, P<0.05) and 7th day (5.63±0.52 vs 7.00±0.54 and 7.88±1.25, P<0.05), and markedly lower in group B than in C (P<0.05).The water content in the brain tissue was also significantly lower in group A than in B and C on the 1st (78.17±0.82 vs 78.83±0.56 and 80.38±0.35, P<0.05), 3rd (78.68±0.55 vs 79.12±0.26 and 81.47±0.26, P<0.05), 5th (77.00±0.58 vs 78.13±0.46 and 79.74± 0.41, P<0.05) and 7th day (75.89±0.46 vs 76.86±0.29 and 78.44±0.44, P<0.05), and remarkably lower in group B than in C (P<0.05).Western blot showed that the expression of the C 3 protein in the brain tissue was markedly decreased in group A as compared with B and C on the 1st (0.096±0.011 vs 0.212±0.014 and 0.440±0.006, P<0.05), 3rd (0.083±0.005 vs 0.164±0.013 and 0.604± 0.011, P<0.05), 5th (0.064±0.009 vs 0.105±0.010 and 0.333±0.010, P<0.05), 7th day (0.045±0.007 vs 0.091±0.004 and 0.141± 0.003, P<0.05), and significantly lower in group B than in C (P<0.05). Conclusion ApoJ can promote the recovery of the neuro-logical function of ICH rats by inhibiting complement activation -mediated secondary brain damage and alleviating cerebral edema .

Effect of Acupuncture plus Rehabilitation on Neurologic Deficit and VEGF Protein Expression in Cortex on the Infarction Side in Rats with Focal Cerebral Infarction / 上海针灸杂志

Objective To observe the effect of acupuncture plus rehabilitation on neurologic deficit and the expression of vascular endothelial growth factor (VEGF) protein in cortex on the infarction side in rats with focal cerebral infarction, and to explore the action mechanism of acupuncture plus rehabilitation in promoting the recovery of impaired function in rats.Method Ninety healthy male Sprague-Dawley (SD) rats were randomized into a model group, an acupuncture group, a rehabilitation group, an acupuncture-rehabilitation group, and a sham operation group, and the five groups were further divided into three subgroups, i.e. 3 d, 7 d, and 14 d subgroups, 6 rats in each subgroup. The modified Zea-Longa method was adopted to prepare the model of middle cerebral artery occlusion (MCAO) on theright side. Rats in the acupuncture group received simulant scalp-points cluster needling; the rehabilitation group was intervened by treadmill exercise; the acupuncture-rehabilitation group was intervened by scalp-points cluster needling plus treadmill exercise; the model group and sham operation group didn't receive any interventions. The modified Neurological Severity Score (mNSS) was adopted to evaluate the rat's neurologic deficit, and Western blotting was used to detect the expression of VEGF protein in cortex on the infarction side.Result Neurologic deficit wasn't found in rats in the sham operation group. After 3-day treatment, the mNSSs in the acupuncture group, rehabilitation group, and acupuncture-rehabilitation group were insignificantly different from the score in the model group (P>0.05), while the differences were statistically significant respectively after 7-day and 14-day treatment (P0.05). After 3-day treatment, the expression of VEGF protein in each treatment group was insignificantly different from that in the model group (P>0.05), while the expression of VEGF protein in each treatment group was significantly higher than that in the model group respectively after 7-day and 14-day treatment (P0.05).Conclusion Scalp-points cluster needling and rehabilitation both can improve the neurologic function in rat models of focal cerebral infarction, and enhance the expression of VEGF protein in infarction cortex, and the integration of acupuncture and rehabilitation can achieve a better result; the action mechanism is possibly related to the high expression of VEGF which can better promote the reconstruction and regeneration of the vessels in cerebral infarction area.

Effects of celecoxib on expression of protein Apaf-1 and function of mobility after severe craniocerebral injury in rats / 天津医药

Objective To investigate effects of celecoxib on the expression of cyclooxygenase-2 (COX-2), apoptotic protease activation factor-1 (Apaf-1) and function of mobility in rat model of severe craniocerebral trauma. Methods For?ty-eight adult male Wistar rats were randomly divided by random number table into four groups. Normal group was given no manipulation. Sham group was given scalp incision and sutured. The severe closed craniocerebral injury model was estab?lished via Foda method in rats of injury group. Treatment group was given intraperitoneal injection of celecoxib [ 250 mg/(kg·6 h)] on the basis of injury group. The intraperitoneal injection of same volume of normal saline was given in the other three groups. Samples were taken altogether after 72 hours. Changes of COX-2 and Apaf-1 were detected by immunohistochemis?try and Western blot assay. Ten days after the restoration, six rats were taken from each group for assessing neurological im?pairment scale (NSS). Results The expression levels of COX-2 and Apaf-1 were significantly higher in injury group than those of other groups. The expression levels of COX-2 and Apaf-1 were significantly lower in treatment group than those of injury group but the levels were significantly higher than those of sham group and normal group (P < 0.05). NSS scores showed that rats in treatment group improved mobility compared with that of injury group (P<0.05), but there was difference compared with Sham group and control group (P<0.05). Conclusion Celecoxib, with its specific inhibitoty effect on pro?tein COX-2, can effectively reduce inflammatory reactions lower the expression of Apaf-1 and reduce apoptosis of neurons, improving the prognosis of dysfunction of mobility after craniocerebral injury.

Nitric Oxide Metabolite Concentration in Cerebrospinal Fluid: Useful as a Prognostic Marker?

STUDY DESIGN: Prospective study. PURPOSE: To establish the significance of cerebrospinal fluid (CSF) nitric oxide metabolite (NOx) concentration in acute spinal cord injury (SCI) patients to assess the neurological severity and prognosis. OVERVIEW OF LITERATURE: Quantitative analysis of specific biomarkers in CSF will assess neurological severity more accurately and permit the formulation of a more precise management plan. METHODS: Forty SCI patients represented the cases and 20 lower limb injury patients were the controls. NOx concentration in CSF was measured at week 1, 2, and 4 by Griess method. Magnetic resonance imaging (MRI, T2-weighted) done in each case to measure cord edema and neurological severity was assessed using the Frankel classification. RESULTS: CSF NOx concentration peaked at week 2 and declined to normal by week 4. The concentration remained normal in controls. Mean NOx concentration was directly proportional to the severity of acute SCI as correlated with cord edema seen in MRI and neurological severity assessed. CONCLUSIONS: CSF NOx concentration can be considered a specific quantitative biomarker in acute stage of SCI to predict the severity and prognosis of SCI patients.

A forced running wheel system with a microcontroller that provides high-intensity exercise training in an animal ischemic stroke model

We developed a forced non-electric-shock running wheel (FNESRW) system that provides rats with high-intensity exercise training using automatic exercise training patterns that are controlled by a microcontroller. The proposed system successfully makes a breakthrough in the traditional motorized running wheel to allow rats to perform high-intensity training and to enable comparisons with the treadmill at the same exercise intensity without any electric shock. A polyvinyl chloride runway with a rough rubber surface was coated on the periphery of the wheel so as to permit automatic acceleration training, and which allowed the rats to run consistently at high speeds (30 m/min for 1 h). An animal ischemic stroke model was used to validate the proposed system. FNESRW, treadmill, control, and sham groups were studied. The FNESRW and treadmill groups underwent 3 weeks of endurance running training. After 3 weeks, the experiments of middle cerebral artery occlusion, the modified neurological severity score (mNSS), an inclined plane test, and triphenyltetrazolium chloride were performed to evaluate the effectiveness of the proposed platform. The proposed platform showed that enhancement of motor function, mNSS, and infarct volumes was significantly stronger in the FNESRW group than the control group (P<0.05) and similar to the treadmill group. The experimental data demonstrated that the proposed platform can be applied to test the benefit of exercise-preconditioning-induced neuroprotection using the animal stroke model. Additional advantages of the FNESRW system include stand-alone capability, independence of subjective human adjustment, and ease of use.

Impact of CHADS2 Score on Neurological Severity and Long-Term Outcome in Atrial Fibrillation-Related Ischemic Stroke

BACKGROUND AND PURPOSE: The CHADS2 (an acronym for congestive heart failure, hypertension, age > or =75 years, diabetes mellitus, and prior stroke or transient ischemic attack or thromboembolism) score is a widely used system for estimating the risk of stroke in patients with atrial fibrillation. However, how the CHADS2 score is related to stroke severity and outcome in patients with strokes due to atrial fibrillation has not yet been elucidated. METHODS: We enrolled patients with atrial fibrillation who visited our stroke center within 7 days after the onset of acute ischemic stroke between October 2002 and September 2008. CHADS2 scores were categorized into three groups: 0 points, low risk; 1 or 2 points, intermediate risk; and 3-6 points, high risk. Poor neurological state was defined as follows: a National Institutes of Health Stroke Scale (NIHSS) score of > or =2, and a modified Rankin Scale (mRS) score of > or =3 at discharge. Mortality information was ascertained as at December 2008. RESULTS: A cohort of 298 patients with atrial-fibrillation-related stroke was included in this study. A high-risk CHADS2 score at admission was a powerful predictor of poor neurological outcome [for NIHSS: odds ratio (OR), 4.17; 95% confidence interval (CI), 1.76-9.87; for mRS: OR, 2.97; 95% CI, 1.23-7.16] after controlling for all possible confounders. In addition, a high-risk CHADS2 score was an independent predictor of all causes of death during the follow-up [hazard ratio (HR), 3.01; 95% CI, 1.18-7.65] and vascular death (HR, 12.25; 95% CI, 1.50-99.90). CONCLUSIONS: Although the CHADS2 score was originally designed to distinguish patients with a future risk of stroke, our study shows that it may also be used to predict poor neurological outcome after atrial-fibrillation-related stroke.