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Early identification and intervention is very important in pediatric delirium.The pediatric confusion assessment method for the ICU and the cornell assessment of pediatric delirium are recommended to screen and evaluate pediatric delirium.We can also choose the appropriate tool according to children′s age, anesthesia status and drug use.Objective evaluation tool has been investigated as well, including biomarkers, imaging studies, electroencephalogram and so on.Electroencephalogram has some typical features, which is related to the occurrence of delirium.For the further research, we should look deep into quantitative electroencephalogram and multimodality model to evaluate and predict delirium.
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Objective:To observe any effect of transplanting bone marrow mesenchymal stem cells (BMSCs) on microglia and neuron expression in newborn mice with hypoxic-ischemic brain damage (HIBD).Methods:Sixty 10-day-old C57BL/6 mice were randomly divided into a sham operation group, a hypoxic-ischemia group, a placebo group and a stem cell group, each of 15. The hypoxia-ischemia model was induced in the hypoxia-ischemia, placebo and stem cell groups, while the sham operation group was sutured after the neck incision. After successful modeling, the rats in the stem cell group were injected with BMSCs into the bregma while those in the placebo group received phosphate buffered saline. Seven days later, brain tissue was resected and its structure was observed using transmission electron microscopy. Immunofluorescence staining was performed to observe the expression of microglia and neurons in the left cerebral cortex.Results:Seven days after stem cell transplantation, the neuron morphology had improved and nerve fiber swelling was relieved in the stem cell group. The average expression of neurons was significantly greater in the stem cell group compared with the hypoxic-ischemia and placebo groups, while the expression of microglia was significantly lower.Conclusions:Bone marrow mesenchymal stem cells may induce neuron regeneration and reduce inflammatory response by inhibiting the expression of microglia, at least in neonatal rats modeling hypoxic-ischemic brain injury.
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Objective:To study the efficacy of low-intensity focused ultrasound (LIFU) on neuropathic pain (NP) in mice, and its effect on the activation of astrocytes and the expression of pro-inflammatory cytokines were discussed.Methods:Thirty-six male C57BL/6J mice were randomly divided into three groups: sham operation (Sham) group and chroinc constriction injury (CCI) model group and treatment (CCI+ LIFU) group, 12 mice in each group.NP model was established by CCI on the sciatic nerve. The group of CCI+ LIFU received LIFU treatment for the anterior cingulate cortex (ACC) on the 7th day after surgery, the mechanical withdrawal threshold (MWT) on the affected side of mice was measured at preoperation 3, 6, 12, 18, 24, and 27 days after operation, respectively, H&E staining was used to observe pathological morphological changes in the ACC region, the expression levels of ACC region AQP4 and GFAP protein were detected by Western Blot and immunofluorescence, and the expression levels of ACC region pro-inflammatory cytokines IL-1β and TNF-α were detected by enzyme-linked immunosorption assay.Results:Compared with Sham group, MWT in the CCI group decreased from the 3rd day until the 27th day after surgery( P<0.05); Compared with the CCI group, the MWT in the CCI+ LIFU group increased on the 24th day after surgery, and was significantly higher than that of the CCI group on the 24th and 27th day after surgery ( P<0.05); LIFU stimulation did not produce significant pathological changes in the ACC region; Western Blot and immunofluorescence showed that AQP4 and GFAP protein expression in the ACC region were upregulated ( P<0.05) after peripheral nerve injury, while AQP4 and GFAP protein expression was downregulated after LIFU treatment ( P<0.05); Enzyme-linked immunosorbents showed that the expression of pro-inflammatory cytokines IL-1β and TNF-α in the region of ACC was upregulated ( P<0.05) after peripheral nerve injury, while the expression of IL-1β and TNF-α was downregulated after LIFU treatment ( P<0.05). Conclusions:LIFU can effectively relieve mechanical pain sensitivity symptoms in mice induced by CCI, possibly by inhibiting activation of astrocytes and neuro-inflammatory responses.
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Objective:To evaluate the clinical efficacy of hydrotherapy in the treatment of children with spastic cerebral palsy (CP).Methods:The China National Knowledge Infrastructure, Wanfang databases, CQVIP databases, PubMed and the Cochrane library were electronically searched for reports published before November 2018 of randomized and controlled trials (RCTs) of hydrotherapy for treating children with spastic CP. Two researchers screened the literature independently, extracted data and assessed the risk of bias in the included studies. The meta-analysis was performed using version 5.3 of the RevMan software.Results:A total of 6 RCTs were included, covering 464 patients. It was found that hydrotherapy combined with conventional rehabilitation was significantly more effective than conventional rehabilitation alone.Conclusions:It has been proved that hydrotherapy can improve the symptoms of children with spastic CP, relieve their spasticity and promote better motor function.
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Objective To compare the traditional electrophysiological testing with modified methods for differential diagnosis of Radial Tunnel Syndrome (RTS).Methods A total of 87 selected patients were initially diagnosed as Lateral Epicondylitis (LE) or Tennis Elbow (TE) by doctors from the Outpatient Department of Orthopedics and Rehabilitation.Medical history was asked.Patients received physical examination and examinations for the sensory nerve action potential (SNAP) of superficial radial nerve,the compound muscle action potential (CMAP) of radial nerve and needle electromyography (EMG) to record the muscle Motor Unit Action Potentials (MUAPs).Then,the modified methods for CMAP of radial nerve were conducted on the forearm in the neutral,pronation and supination positions.Three values of CMAP latency were compared.RTS was diagnosed when the difference value ≥0.3 ms.The x 2 test was used to compare the positive detectable rates of the two methods for the RTS diagnosis.Results Thirteen out of 87 patients were diagnosed as RTS,among which three had interosseous nerve lesion and one had superficial radial nerve lesion.The traditional EMG failed to diagnose the remaining 9 RTS cases.These patients were finally diagnosed due to their latency difference of radial nerve CMAP ≥0.3ms when their forearms were examined in three positions.Conclusion The modified electrophysiology method shows a higher positive rate for the diagnosis of RTS.(P<0.05).
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Objective To explore the influence of the lactation exposure to fluoxetine on offspring's behavior and serotonin transporter (SERT) and tryptophan hydroxylase (TPH). Methods Six SD pregnant rats were randomly divided into 2 groups (n=3 each group). Experimental maternal rats were intraperitoneally injected with fluoxetine at a dose of 12 mg/kg from postnatal day 5 to 21. The control group were injected with the same amount of normal saline. In infancy, the offspring's weight, hair length, eye opening and auditory development were measured. The free suspension test and bur?ied food pellets test were applied to evaluate the offspring's behaviors. After postnatal day 21, all the offspring were wean. At early childhood (P35d) and adulthood (P75d), 6 offspring rats from each group were executed to examine SERT and TPH in the prefrontal cortex by immunohistochemistry. Results The offspring's weight of experimental group was significantly lower than control group (P<0.05). The sensitivity of auditory in experimental group was significantly higher than control group (P<0.01). The time of free suspension in experimental group significantly was decreased comparing to control group (P<0.01). The SERT and TPH in prefrontal cortex was significantly lower in experimental group than those in control group either at childhood (P35d) or at adulthood (P75d) (P<0.05). Conclusion Lactation exposure to fluoxetine re?sults in offspring's abnormal development and behaviors through down-regulation of SERT and TPH in the prefrontal cor?tex.
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BACKGROUND:At present, spinal cord injury treatment is stil the worldwide difficult problem. Using the method of stem cells transplantation to treat the spinal cord injury is one of the hotspots of spinal cord injury repair research in recent years. OBJECTIVE:To summarize the progress and application prospects of stem celltransplantation in the treatment of spinal cord injury. METHODS:A computer-based search of PubMed and CNKI was retrieved for relevant articles concerning stem celltransplantation for treatment of spinal cord injury published after 2000. The keywords were“spinal cord injury, stem cell, celltherapy”in English and Chinese, respectively. Meta-analysis and secondary literature were excluded as wel as repetitive or old literature. Final y, 52 articles were included in result analysis. RESULTS AND CONCLUSION:This article summarizes types and biological characteristics of stem cells, basic mechanism, techniques and therapeutic efficacy of stem celltransplantation in the treatment of spinal cord injury, and proposes the issues and prospects concerning the stem cells transplantation for treatment of spinal cord injury.
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Objective To investigate the effect of Botulinum toxin type A(BTXA)and rehabilitation intervention on upper limb Brunnstrom stages and ADL performance of stroke patients. Methods In a randomized controlled trial, 30 patients were allocated to either an experimental group (n=15) that received BTXA injection into muscles of the affected arm or to a controlled group (n=15). All patients' Brunnstrom stage and MAS stage were ≥gradeⅡ. All the patients were treated with rehabilitative techniques. The intervention was applied for 3 months. All were evaluated for the severity of spasticity (Modified Ashworth Scale,MAS),the level of impairment (Brunnstrom assessment and Fugl-Meyer upper limb test) and disability(Functional Independence Measure,FIM) before and after 1 week, 1,2,3 months of treatment. Results Patients who received BTXA had significant reduction of muscle tone (P