The effects of hyperbaric oxygen on the hemodynamics and intracranial pressure of patients with severe brain injury: A systematic review of randomized and controlled trials / 中华物理医学与康复杂志

Objective@#To systematically evaluate the effects of hyperbaric oxygen on the hemodynamics and intracranial pressure of patients with severe craniocerebral injury (STBI).@*Methods@#Reports of randomized and controlled trials applying hyperbaric oxygen in the treatment of STBI were retrieved from the Pubmed, Cochrane Library, Embase, CBM, CNKI, VIP and Wan Fang databases. Each report found was evaluated by two researchers independently applying pre-defined inclusion and exclusion criteria. The data were extracted and combined and a meta-analysis was performed.@*Results@#Eight trials involving 725 patients were included in the meta-analysis. They combined to demonstrate that intracranial pressure, oxygen uptake and scores on the Glasgow coma scale improved significantly more in the hyperbaric oxygen group than in the control group after between 3 and 10 days of treatment.@*Conclusion@#Hyperbaric oxygen therapy is effective in treating severe craniocerebral injury and it is worthy of clinical application.

The safety among acute ischemic stroke patients with asymptomatic intracranial aneurysm after the administration of intravenous thrombolysis / 中华神经科杂志

Objective To assess the safety among acute ischemic stroke patients with asymptomatic intracranial aneurysm after the administration of intravenous thrombolysis.Methods We searched database including Wanfang,CNKI,VIP,Pubmed,EMBASE,EBSCO HOST and Metstr data for all the cohort studies on the use of thrombolysis for acute ischemic patients with asymptomatic intracranial aneurysm,and ascended the correlated references listed on the articles.Meta-analysis was conducted based on the methods recommended by the Cochrane collaboration.The outcomes of the meta-analysis were intracerebral hemorrhage (ICH),symptomatic intracerebral hemorrhage (sICH),subarachnoid hemorrhage (SAH).Results Four cohort studies included 707 patients,of whom 48 patients had asymptomatic cerebral aneurysms.The risk ratio prevalence of ICH among those patients did not differ statistically with those without aneurysms (RR =1.17,95％ CI 0.69-1.99,P =0.56).No statistical differences were found in both odds ratio prevalence of sICH (OR =1.70,95％ CI 0.44-6.59,P =0.45) and SAH (OR =1.13,95％ CI 0.20-6.27,P =0.89) between the patients with asymptomatic cerebral aneurysms and those without.Conclusion Current evidence did not indicate that the risk of hemorrhage increased in acute ischemic stroke patients with asymptomatic intracranial aneurysm after the administration of intravenous thrombolysis.

Expression of EphB4 and VEGF in esophageal cancer tissues and their relationship with microvessel density and the curative effect under thoracoscope / 重庆医学

Objective To explore the expression of EphB4 and VEGF in esophageal cancer tissues and their relationship with microvessel density (MVD ) ,and analysis the curative effect of postoperative esophageal cancer radical under thoracoscope . Methods Theexpression of EphB4 and VEGF was detected by immunohistochemistry in tumor specimens from 76 cases of esopha-geal squamous cell carcinoma and paratumor normal specimens ,used CD34 as marker to count MVD .According to the situation of expression of EphB4 and VEGF ,we analysis their relationship with lymph node metastasis rate ,recurrence and 5-year survival rate . Results The positive expression rate of EphB4 and VEGF in cancerous tissue (57 .89% and 61 .84% ) ,were significantly higher than that in tissue adjacent to carcinoma(0 and 7 .89% )(P<0 .05) .The positive expression rate ofEphB4 and VEGF in high MVD values of patients (67 .44% and 76 .19% ) ,were significantly higher than thatin low MVD values of patients (45 .45% and 44 .11% )(P<0 .05) .The positive expression rate ofEphB4 and VEGF in the patientswith lymph node metastasis group and associ-ated with recurrence ,were significantly higher than that of group without lymph node metastasis and group without recurrence (P<0 .05) .The positive expression rate of EphB4 and VEGF in patients of greater than or equal to 5 years of survival rate(45 .00% and 45 .45% ) ,were significantly lower than in patientsof Less than 5 years of survival rate (80 .36% and 85 .19% )(P<0 .05) .Conclu-sion EphB4 and VEGF are highly expressed in esophageal cancer tissue ,which may be closely associated withmicrovessel density , and lymph node metastasis ,recurrence and 5 years survival rate ;the curative effect of positive expression rate of EphB 4 and VEGF is poor .

Early management of severe chest trauma with multiple organ injury / 第三军医大学学报

Objective To investigate the effective methods for treatment of severe chest trauma with multiple organ injury. Methods The injury conditions and the early treatment measures in 87 cases of severe chest trauma with multiple organ injury (especially within 48 h after injury) were analyzed retrospectively. Results Of the 78 patients, 61 patients survived, and 26 died (including 2 patients who abandoned treatment). The total mortality was 29 89%. Primary operation was performed on 37 patients with multiple organ injury, but 7 died (18 92%). Conclusion Diagnosis while rescuing, effective countershock treatment, early operation, protection of visceral functions, and preventive mechanical ventilation may be the important measures to guarantee the success of treatment of severe chest trauma with multiple organ injury.