RESUMO
Objective:To investigate the effect of continuous intracranial pressure (ICP) and brain oxygen partial pressure (PbtO 2) monitoring and guiding treatment after the application of standard large bone flap decompression and microhematoma removal in patients with severe traumatic brain injury (TBI). Methods:A retrospective analysis was done of 41 patients with TBI in Department of Neurosurgery in the Inner Mongolia People's Hospital from January 2018 to May 2020. Patients with Glasgow coma scale (GCS)<8 points were treatesd with microscopical removal of hematoma and contusion brain tissue and standard large bone flap decompression. Intraoperative intracranial pressure and brain tissue oxygen partial pressure monitoring probes were placed. Postoperatively, continuous intracranial pressure monitoring and partial oxygen pressure monitoring of brain tissue were performed, and target-based treatment under ICP and PbtO 2 monitoring was performed. According to the Glasgow Outcome (GOS) score after six months, patients were divided into a good outcome group (4-5 scores) and a poor outcome group (1-3 scores). There were 26 cases in good prognosis group and 15 cases in poor prognosis group. Linear regression analysis was used to further evaluate the relationship between PbtO 2, ICP and GOS score. The measurement data of normal distribution were compared by independent sample t-test. The counting data were expressed in cases (%), and the comparison between groups was adopted χ 2 inspection. The general linear bivariate Pearson correlation test was used. Results:The mean value of PbtO 2 (17.42±5.34) mmHg in the poor prognosis group was lower than that in the good prognosis group (24.65±5.61) mmHg, with statistical significance ( t=4.04, P<0.001). The mean value of ICP (22.32±3.45) mmHg in the poor prognosis group was higher than that (17.32±3.23) mmHg in the good prognosis group, with statistical significance ( t=4.15, P<0.001). Using PbtO 2 and ICP as independent variables and GOS score after 6 months as dependent variable, a regression equation was established ( Y=4.040 X+7.497; Y=-2.549 X+28.63). The mean value of PbtO 2 was positively correlated with GOS scores after 6 months in patients with severe head injury ( r=0.75, P<0.001). The mean value of ICP was negatively correlated with the prognosis of patients with severe head injury ( r=-0.87, P<0.001). Conclusion:The treatment guided by ICP combined with PbtO 2 monitoring is valuable in improving the prognosis of patients with severe traumatic brain injury after standard decompressive craniectomy, and may improve the prognosis 6 months after the injury.
RESUMO
Objective:To investigate the effects of continuous monitoring intracranial pressure (ICP) and brain oxygen partial pressure (PbtO 2) on the prognosis of patients with severe craniocerebral injury. Methods:A prospective randomized controlled trial was conducted. Seventy patients with severe craniocerebral injury with a Glasgow coma score (GCS) 4-8 admitted to the neurosurgical intensive care unit (NICU) of the People's Hospital of Inner Mongolia Autonomous Region from January 2017 to May 2020 were enrolled, and they were divided into ICP monitoring group and ICP+PbtO 2 monitoring group by random number table. Patients in ICP monitoring group received ICP monitoring and were given traditional treatment of controlling ICP and cerebral perfusion pressure (CPP), the therapeutic target was ICP < 20 mmHg (1 mmHg = 0.133 kPa) and CPP > 60 mmHg. Patients in ICP+PbtO 2 monitoring group were given ICP and PbtO 2 monitoring at the same time, and oxygen flow was adjusted on the basis of controlling ICP and CPP to maintain the PbtO 2 > 20 mmHg, and the therapeutic target of ICP and CPP was the same as the ICP monitoring group. ICP and PbtO 2 values were recorded during monitoring in the two groups, the results of CPP, GCS and arterial blood gas analysis were recorded, and the prognosis at 3 months and 6 months after injury was compared by Glasgow outcome scale (GOS) score between the two groups. GOS score > 3 was considered as good prognosis. Kaplan-Meier survival curve was drawn, and the 3-month and 6-month cumulative survival rates of the two groups were analyzed. Linear regression analysis was used to further evaluate the relationship between PbtO 2 and GOS score. Results:Finally, a total of 70 patients with severe craniocerebral injury were enrolled in the analysis, 34 patients received ICP combined with PbtO 2 monitoring and guided therapy, and 36 patients received ICP monitoring alone. The average ICP of ICP+PbtO 2 monitoring group was significantly lower than that of ICP monitoring group (mmHg: 13.4±3.2 vs. 18.2±8.3, P < 0.01). Although the CPP in both groups was great than 60 mmHg, the average CPP of ICP+PbtO 2 monitoring group was significantly higher than that of ICP monitoring group (mmHg: 82.1±10.5 vs. 74.5±11.6, P < 0.01). No significant difference was found in average GCS score or arterial partial pressure of carbon dioxide (PaCO 2) between the ICP+PbtO 2 monitoring group and ICP monitoring group [GCS score: 5.3±2.3 vs. 5.2±2.2, PaCO 2 (mmHg): 33.5±4.8 vs. 32.6±5.2, both P > 0.05]. The average arterial partial pressure of oxygen (PaO 2) of ICP+PbtO 2 monitoring group was obviously higher than that of ICP monitoring group (mmHg: 228.4±93.6 vs. 167.3±81.2, P < 0.01). Compared with the ICP monitoring group, the good outcome rates of 3 months and 6 months after injury in the ICP+PbtO 2 monitoring group were significantly higher (3 months: 67.6% vs. 38.9%, 6 months: 70.6% vs. 41.7%, both P < 0.05). Kaplan-Meier survival curve showed that the 3-month and 6-month cumulative survival rates of ICP+PbtO 2 monitoring group were significantly higher than those of ICP monitoring group (3 months: 85.3% vs. 61.1%, Log-Rank test: χ2 = 5.171, P = 0.023; 6 months: 79.4% vs. 55.6%, Log-Rank test: χ2 = 4.511, P = 0.034). Linear regression analysis showed that PbtO 2 was significantly correlated with GOS score at 3 months and 6 months after injury in patients with severe craniocerebral injury ( r values were 0.951 and 0.933, both P < 0.01). Conclusions:PbtO 2 compared with ICP monitoring guiding therapy is valuable in improving the prognosis of patients with severe craniocerebral injury. It can improve the prognosis at 3-6 months after injury.
RESUMO
To construct a bait expression vector containing the duck circovirus Cap gene for use in the yeast two-hybrid system, the whole cap codon-optimized gene was inserted into pGBKT7 vector and confirmed by PCR, restriction enzyme digestion, and sequence analysis. After transformation into a Y2HGold yeast strain, the expression of Cap protein was analyzed by Western blotting. Toxicity and self-activation of the bait protein were detected using different dropout minimal base. PCR reaction, restriction enzyme digestion, and sequencing analyses indicated that the duck circovirus Cap gene was correctly inserted into pG- BKT7. Western blotting showed that the whole Cap protein was expressed. The recombinant bait protein had no toxicity and self-activation. Therefore, the bait vector with the Cap gene was constructed successfully, providing a foundation for future screening for interacting proteins in the yeast two-hybrid system.
Assuntos
Animais , Proteínas do Capsídeo , Genética , Metabolismo , Circovirus , Classificação , Genética , Clonagem Molecular , Patos , Vetores Genéticos , Genética , Metabolismo , Proteínas Recombinantes de Fusão , Genética , Metabolismo , Saccharomyces cerevisiae , Genética , Metabolismo , Técnicas do Sistema de Duplo-HíbridoRESUMO
Objective To investigate the clinical efficacy of combined use of acupuncture and medicine in treating functional gastric acid regurgitation. Methods Ninety-eight patients with functional gastric acid regurgitation were randomly allocated to treatment and control groups, 49 cases each. The control group received routine medication and the treatment group, acupuncture plus Chinese herbal medication in addition. The symptom severity and frequency were scored in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups. Results There were statistically significant post-treatment differences in the symptom severity score and the symptom frequency score between the treatment and control groups (P＜0.05). The total efficacy rate was 95.9% in the treatment group and 83.7% in the control group; there was a statistically significant difference between the two groups (P＜0.05). Conclusion Combined use of acupuncture and medicine is an effective way to treat functional gastric acid regurgitation.
RESUMO
Objective To evaluate the effect of slow-release microcapsules of HCF( hepatocyte growth factor) on angiogenesis in infracted myocardium.Method Myocardial infarction was induced in 30 New Zealand rabbits by ligating the middle of left descending coronary artery. Group Ⅰ ( n = 10) was served as a control group, group Ⅱ ( n =10) as a blank microcapsule group, group Ⅲ ( n = 10) as experimental group with each microcapsule contains 1 μgHGF as HCF group. In group Ⅱ andⅢ, 5 blank microcapsules or FGF slow-release microcapsules were implanted into myocardium under epicedium between the left descending coronary artery and left circumflex branch. The heart function of each rabbit was evaluated with echocar-diography and cheterization, angiogenesis was evaluated by immunohistochemical technique 6 weeks later.Result As compared with group Ⅰ and Ⅱ , rabbits treated with HGF had higher microvessel counts ( P < 0. 01), and LVFS and EF were significantly increased [ (101. 28±19. 50,105. 28 ±18. 28,161. 28 ±15. 85, P <0.01 ]. Conclusion Subepicardial implantation of HGF slow release microcapsule in the infracted rabbit model can enhance effective angiogenesis and improve left ventricular function.
RESUMO
Objective: To observe the clinical effect of treating remission-stage cerebral infarction with mind-refreshing and orifice-opening needling method. Method: Six hundred cases of cerebral infraction were randomized on the basis of disease phase. The 234 cases in remission stage were randomized into treatment group (116 cases) and control group (118 cases). Besides routine Western therapies, the cases in the treatment group were combined mind-refreshing and orifice-opening needling method and the cases in the control group were combined with conventional needling method. The treatment was done once every day for 4 weeks. The follow-up was done for six months. Result: the baseline material in the two groups has good compatibility (P>0.05) and the treatment group is better than the control group (P<0.05). Conclusion: the mind-refreshing and orifice-opening method is safe and act to improve symptoms of patients during remission stage, reduce disability, prevent disease progression and improve quality of life.
RESUMO
Objective To investigate the effects of ketamine on Na+ -K+ -ATPase and Ca2+ -ATPase activity Of cerebro cortex and thalamus in rats. Methods Thirty-two SD rats of both sexes weighing 200-300 g were randomly divided into 4 Groups: 1 control group; 2 anesthesia group; 3 recovery group 1 and 4 recovery group II . In control group normal saline 10 ml?kg-1 was administered intraperitoneally (ip) while in the 3 ketamine groups ketamine 100mg?kg-1 was administered ip. The animals were killed by decapitation when righting reflex was lost (group 2) or recovered (group 3) or when the animals were fully awake (group 4). Brain was immediately removed on ice. Bilateral cortex and thalamus were isolated homogenized and centrifuged. Na+ -K+ -ATPase and Ca2+-ATPase activity were assessed by spectrophotometric analysis. Results The Na+-K+-ATPase and Ca2+ -ATPase activity of cerebrocortex decreased by 32.8% and 26.2% and of thalamus decreased by 31.4% and 24.5% respectively in group 2 as compared with those in group 1. The Na+-K+-ATPase and Ca 2+-ATPase activity of the cerebrocortex and thalamus were recovered in group 3 and 4. Conclusions The Na+ -K+ -ATPase and Ca2+ -ATPase may play an important role in the mechanism of ketamine anesthesia.