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Objective:Upper gastrointestinal bleeding (UGIB) is a common gastrointestinal disease in the emergency department. Identifying low-risk patients suitable for outpatient treatment is the focus of clinical and research. A simple predictive model was developed to identify patients with UGIB who could safely avoid hospitalization, thus providing a feasible basis for triage by emergency physicians.Methods:A retrospective cohort study was conducted on patients with UGIB treated at Zhongda Hospital Southeast University from January 2015 to December 2020. Baseline demographic data and clinical parameters at the initial presentation were recorded. Multivariate logistic regression model was performed to identify predictors of safe discharge.Results:Six hundred and twelve patients (45.9%) were not safely discharged. There were significant differences in age, Charlson comorbidity index, systolic blood pressure, pulse rate, hemoglobin, albumin, blood urea nitrogen, creatinine and international normalized ratio between the safe discharge group and the non-safe discharge group ( P<0.05). Using multivariate logistic regression analysis, a total of 7 variables were included in the clinical prediction model of UGIB risk stratification: Charlson comorbidity index > 2, systolic blood pressure < 90 mmHg, hemoglobin < 10 g/dL, blood urea nitrogen ≥6.5 mmol/L, albumin <30 g/L, pulse ≥100 beats/min and international normalized ratio ≥1.5. The sensitivity, specificity, positive predictive value, and negative predictive value for predicting unsafe discharge were 98.37%, 24.10%, 52.3%, and 94.6%, respectively, with the best cutoff value ≥1. The area under the receiver operating characteristic (AUROC) curve was 0.822, which was significantly higher than Glasgow Blatchford score (GBS) 0.786 (95% CI: 0.752-0.820, P< 0.01) and AIMS65 0.676 (95% CI: 0.638-0.714, P< 0.01). Conclusions:The predictive model has a reliable predictive value, which can provide references for emergency medical staff to triage patients with UGIB, thereby reducing medical expenses and having certain social and economic benefits.
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Objective To investigate the effect of electro-acupuncture pretreatment on content of interleukin (IL)-1βand IL-6 in serum and ischemic penumbra, and apoptosis in ischemic penumbra in rats after cerebral ischemia-reperfusion injury. Methods Thirty-six male Sprague-Dawley rats were randomly divided into sham group (n=12), model group (n=12), and electro-acupuncture pretreatment group (n=12). The middle cerebral arteries were occluded for 120 minutes and reperfused. Twenty-four hours after reperfusion, the level of IL-1βand IL-6 in serum and brain tissue was detected with enzyme-linked immunosorbent, and apoptosis of ischemic penumbra was detected with TU-NEL. Results The content of IL-1βand IL-6 in the serum and brain tissue, and the number of TUNEL-positive cells decreased in the elec-tro-acupuncture pretreatment group compared with that in the model group (P<0.01). Conclusion Electro-acupuncture pretreatment may in-hibit inflammatory response and apoptosis in cerebral ischemia-reperfusion injury.
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Hypoxic-ischemic brain damage is a serious complication of perinatal asphyxia. Enriched environment is the living condi-tions for the promotion of feeling, cognition and behavior. Enriched environment may promote the repairing of hypoxic-ischemic brain dam-age in term of praxiology, morphology and molecular biology, that enriched environment may regulate the secretion and release of various factors, and enhance synaptic plasticity, induce neuron regeneration, inhibit its apoptosis, and result in ethological and morphological recov-ery.
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Objective To study the effect of cluster needling of scalp acupuncture combined with rehabilitation on neurological function and expression of basic fibroblast growth factor (bFGF) and angiostatin (AS) in rats after focal cerebral ischemia. Methods 90 male Sprague-Dawley rats were randomly divided into sham operation group, model group, acupuncture treatment group, rehabilitation treatment group and acupuncture and rehabilitation treatment group, each group was further divided into 3 days, 7 days and 14 days subgroups (n=6). Permanent cerebral ischemia rat model was established according to Longa's method. The model group and the sham operation group accept-ed no treatment, the acupuncture treatment group was treated by cluster needling of scalp acupuncture, the rehabilitation treatment group re-ceived the treadmill training, the acupuncture and rehabilitation treatment group was treated by acupuncture and rehabilitation therapy. 3 days, 7 days, 14 days after operation, the neural function was evaluated with the modified Neurological Severity Score (mNSS), the expres-sion levels of bFGF and AS proteins were detected by Western blotting. Results Compared with the model group, the acupuncture treatment group and the rehabilitation treatment group, mNSS decreased, the expression of bFGF protein increased, and the expression of AS protein decreased in the acupuncture and rehabilitation treatment group 3 days, 7 days, 14 days after operation (P<0.05). Conclusion Acupuncture and rehabilitation therapy can reduce the neurological function defect in rats with focal cerebral ischemia, which may be related to the up-regulation of bFGF protein expression and down-regulation of AS protein expression.
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@#Objective To study the effect of cluster needling of scalp acupuncture combined with rehabilitation on neurological function and expression of basic fibroblast growth factor (bFGF) and angiostatin (AS) in rats after focal cerebral ischemia. Methods 90 male Sprague-Dawley rats were randomly divided into sham operation group, model group, acupuncture treatment group, rehabilitation treatment group and acupuncture and rehabilitation treatment group, each group was further divided into 3 days, 7 days and 14 days subgroups (n=6). Permanent cerebral ischemia rat model was established according to Longa's method. The model group and the sham operation group accepted no treatment, the acupuncture treatment group was treated by cluster needling of scalp acupuncture, the rehabilitation treatment group received the treadmill training, the acupuncture and rehabilitation treatment group was treated by acupuncture and rehabilitation therapy. 3 days, 7 days, 14 days after operation, the neural function was evaluated with the modified Neurological Severity Score (mNSS), the expression levels of bFGF and AS proteins were detected by Western blotting. Results Compared with the model group, the acupuncture treatment group and the rehabilitation treatment group, mNSS decreased, the expression of bFGF protein increased, and the expression of AS protein decreased in the acupuncture and rehabilitation treatment group 3 days, 7 days, 14 days after operation (P<0.05). Conclusion Acupuncture and rehabilitation therapy can reduce the neurological function defect in rats with focal cerebral ischemia, which may be related to the upregulation of bFGF protein expression and down-regulation of AS protein expression.
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A novel system is proposed to control the liquid nitrogen cooling and radio frequency heating of tissue to achieve effective thermal ablation in the treatment using fuzzy logic controller and fuzzy logic PID type controller separately. Results of ex-vivo pig liver experiments demonstrate that this system is useful and could p control the desired treatment procedure.