Establishment and application of a risk prediction model for ICU acquired weakness / 中国实用护理杂志

Objective:To analyze the risk factors of Intensive Care Unit-Acquired Weakness, and to develop and verify the model.Methods:A total of 247 patients admitted to ICU patients from November 2018 to October 2019 were selected, and risk factors between ICU acquired weakness group ( n=106) and non-ICU acquired weakness group( n=141)were compared using logistic regression for model construction.The Hosmer-Lemeshow test was used to verify the goodness of fit of the model. The area under the ROC curve was used to test the model to predict the effects. From November 2019 to May 2020, 106 patients were recruited for application of the model. Results:The incidence of ICU acquired weakness in this study was 42.91%(106/247), and 44.34%(47/106),the study finally included age ( OR=1.043) ,mechanical ventilation time ( OR=1.140) , APACHE II score ( OR=1.081) , blood sugar ( OR=1.117) , lactic acid( OR=1.459) ,and neuromuscular blockers ( OR=3.499) to construct the risk prediction. The model formula was P=1/1+exp (- Z) =1/1+exp (8.808-0.042×age -1.252×neuromuscular blockers-0.078×APACHE II score -0.110×blood sugar -0.378×lactic acid -0.131×mechanical ventilation time. The area under the ROC curve of this model was 0.896 (95% CI: 0.824-0.914) , the maximum value of the Youden index was 0.577, and the corresponding sensitivity was 0.754,the specificity was 0.823,the cutoff value was 0.503. The model verification results the sensibility of 70.2%, the specificity of 88.1%, and the accuracy of 80.2%. Conclusion:The predictic model of ICU acquired weakness couducted in this study has satisfactory prediction effect, which can provide a reference for clinical screening of high-risk patients.

Study on the structure of retina in Parkinson′s disease with cognitive impairment / 中华神经科杂志

Objective:To observe the intrinsic association between cognitive function in patients with Parkinson′s disease (PD) and retinal structural changes in retina nerve fiber layer thickness, macular volume and macular thickness.Methods:A total of 36 patients with PD and 12 normal controls matched with age and sex were selected randomly. Examinations of Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), Unified Parkinson′s Disease Rating Scale Ⅲ (UPDRS-Ⅲ), Hoehn-Yahr stage were performed in all subjects. The PD patients were divided into three groups according to the score of MoCA: PD without cognitive impairment (PD-NCI; n=12), PD with mild cognitive dysfunction (PD-MCI; n=13) and PD dementia (PDD; n=11). The retinal nerve fiber layer thickness, macular volume and thickness which were corrected with body mass index (BMI) were determined and analyzed by optical coherence tomography imaging. Results:The total RNFL thickness (μm/BMI) of the PD with cognitive impairment group (PD-MCI group: 3.55±0.12 ( t=2.552, P=0.014), PDD group: 3.07±0.18 ( t=4.122, P=0.000)) was thinner than that of the normal control group (4.05±0.16). The RNFL thickness in each quadrant of the PD with cognitive impairment group (PD-MCI group and PDD group) was thinner than those of the normal control group. The RNFL thickness gradually became thinner with the cognitive impairment increasing ( r=0.558 3, P<0.001). The macular volume (mm 3/BMI) of PD group (PD-NCI group: 0.274±0.010 ( t=2.523, P=0.015), PD-MCI group: 0.268±0.010 ( t=2.848, P=0.007), PDD group: 0.266±0.010 ( t=2.604, P=0.013)) was smaller than that in the normal control group (0.316±0.010), and the macular volume gradually decreased with the severity of cognitive impairment ( r=0.234 1, P=0.024). The macula thickness in each subgroup of PD was thinner than that of the normal control group. The macula thickness gradually became thinner with the cognitive impairment increasing ( r=0.283 9, P<0.001). The macular thickness (normal controls: (10.67±0.12) μm/BMI, PD group: (9.51±0.07) μm/BMI, t=8.312, P<0.001) and volume (normal controls: (0.316±0.010) mm 3/BMI, PD group: (0.270±0.010) mm 3/BMI, t=3.570, P<0.001) became thinner and smaller in patients with PD. Conclusions:In patients with PD, the thickness of the retina nerve fiber layer, the volume and thickness of the macula become thinner/smaller with the severity of cognitive impairments increasing. Macular thickness and volume in patients with PD appear thinner/smaller, which can be used as a valuable biological marker in the early stage of PD. The retina nerve fiber layer thickness in patients with PD becomes thinner, which may be accompanied by cognitive impairment.

Effects of enriched environment on immature neurons in piriform cortex of a rat model of vascular dementia / 中国组织工程研究

BACKGROUND:Researches showed that the enriched environment could improve the cognitive dysfunction of rats with vascular dementia. However, there are few reports regarding its mechanism of action. OBJECTIVE:To explore the effect of enriched environment on the cognitive dysfunction of rats with vascular dementia from the behavioral level. METHODS:Vascular dementia models weremade by permanent ligation of bilateral common carotid arteries and were divided into vascular dementia group (n=8) and enriched environment group (n=12). Vascular dementia group was taken care under conventional breeding environment for 30 days, while the enriched environment group was subjected to the enriched environment for 30 days. Morris water maze test was adapted to test the cognitive function of rats between two groups. Immunohistochemistry and immunoblotting were applied to observe the number ofDCX+cels and DCX protein level in both groups. The number of DCX-labeled cels co-expressing NeuN was observed using immunofluorescence technique. RESULTS AND CONCLUSION:(1) The escape latency in the vascular dementia group was longer than that in the enriched environment group (P< 0.05). The times across the platform was less in the vascular dementia group than that in the enriched environment group (P< 0.05). (2) In comparison with the enriched environment group, the number of DCX-positive cels andits protein level in the piriform cortex were significantly decreased in the vascular dementia group (P< 0.05). (3) The number of DCX/NeuN co-labeled cels in the piriform cortex was significantly less in the vascular dementia group than in the enriched environment group (P< 0.05). (4) These findings suggested that enriched environment could improve the cognitive dysfunction of rats with vascular dementia through promoting the expression and differentiation of the immature neurons.

Unilateral olfactory functional deprivation model in the left peripheral nostrils by electric cautery injury:olfactory bulb neurogenesis and transformation / 中国组织工程研究

BACKGROUND:Olfactory bulb neurogenesis, transformation and maturation have been considered the hot topic. Olfactory bulb experience and nervous activity can influence olfactory bulb neurogenesis. However, no study reports that olfactory bulb functions can affect olfactory bulb neurogenesis in guinea pigs. OBJECTIVE:To investigate the effect of unilateral olfactory functional deprivation on doublecortin, calbindin and parvalbumin expression in olfactory bulb of juvenile guinea pigs. METHODS:Total y 24 guinea pigs were randomly divided into two groups, which were kil ed after establishing olfactory functional deprivation model through electric cautery injury at the left peripheral nostrils. At 3 and 6 weeks after modeling, the specimens were harvested. The expression change of doublecortin, calbindin and parvalbumin in two sides’ olfactory bulb of juvenile guinea pigs was detected by immunohistochemistry. RESULTS AND CONCLUSION:The number of doublecortin, calbindin and parvalbumin positive cells in olfactory bulb at the un-deprived side was significantly higher than that at the deprived side at 3 and 6 weeks (P<0.05). This finding indicates that olfactory neural activities can affect neurogenesis and transformation in guinea pigs.