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Objective:To investigate the correlation between fluid-attenuated inversion recovery vascular hyperintensities(FVH) and prognosis and cognitive dysfunction in patients with internal watershed cerebral infarction(IWI).Methods:Totally106 patients with IWI were selected.According to FVH diagnostic criteria, there were 59 cases in FVH (+ ) group and 47 cases in FVH (-) group.Demographic data and risk factors of cerebrovascular disease were collected to assess the clinical neurological function of the patients at admission and discharge, and the short-term outcome was assessed by modified RANKIN scale (mRS) score at 90 days after discharge.The cognitive function of patients was assessed by MMSE scale.Results:There was no significant difference in NIHSS score between the two groups on admission ( P>0.05). The NIHSS score of FVH (+ ) group((3.37±2.33))at discharge was significantly lower than that of the FVH (-) group ((4.43±2.72))( P<0.05). The rate of neural function improvement and mRS score after discharge 90 days in FVH (+ ) group((42.16±12.20)%, (1.75±1.12)) was significantly higher than that in FVH (-) group((37.58±13.64)%, (2.19±1.38))(both P<0.05). The scores of orientation, recall and language ability of MMSE in FVH (+ ) group ((9.26±0.21), (1.66±0.27), (7.69±0.44) respectively)were significantly lower than those of FVH (-) group((9.43±0.36), (1.83±0.34), (7.85±0.28) respectively)(all P<0.05). There was no significant difference in memory, attention and calculation between the two groups ( P>0.05). Conclusion:FVH has no correlation with the severity of IWI patients when they are admitted to hospital.FVH may be used as an imaging sign for prognosis evaluation of patients with IWI .However, IWI patients with FVH may have more severe cognitive impairment.
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Objective To investigate the effects of betulinic acid on spatial learning and memory in rats with type 2 diabetes mellitus(T2DM) and to explore its underlying mechanisms.Methods Forty-five male Wistar rats were randomly divided into control group (Sham),T2DM group and betulinic acid treatment group (BA) with 15 in each group.The rats in the latter two groups were given a high fat diet plus low dose of streptozotocin (STZ) to induce T2DM,and the rats in BA group was given 10 mg/kg BA for intragastric administration once daily for 12 weeks,the rats in T2DM group and Sham group were given an equal volume of physiological saline.Morris water maze method was used to detect the cognitive function.The mRNA levels of synaptic plasticity related protein GAP-43,SYP and PSD-95 were detected by RT-PCR.The protein expressions of cholinergic neurotransmitter ChAT and Ach were detected by Elisa.Results Compared with the Sham group,the escape latency of the T2DM group was significantly prolonged on days 2-4 ((62.28 ± 2.97)s vs (47.09±2.16)s;(48.52±3.09) s vs (26.18±2.21)s;(42.31±2.80)s vs (13.42±1.23)s),the original platform quadrant time was significantly reduced ((24.60±2.42) s vs (41.85 ± 1.98) s),GAP-43,SYP,ChAT and Ach levels were significantly lower,the differences were statistically significant (the t values were 16.37,22.34,39.78,20.42,116.01,91.35,71.84,21.88 and 21.11,respectively,all P＜ 0.05).Compared with T2DM group,the escape latency of BA group in 2-4 days were significantly shortened ((55.61±2.75)s vs (62.28±2.97)s;(31.35±2.63)s vs (48.52±3.09)s;(42.31±2.80)s vs (16.58± 1.37) s),the original platform quadrant time increased significantly ((37.58± 2.31) s vs (24.60±2.42) s),and GAP-43,SYP,PSD-95,ChAT and Ach levels were significantly higher,and the differences were statistically significant (the t values were 6.80,16.21,33.54,14.55,41.83,35.23,36.20,12.82 and 9.97,respectively,all P＜0.05).Conclusion Betulinic acid can improve the spatial learning and memory of type 2 diabetic rats,and increasing the expression of GAP-43,SYP,PSD-95,ChAT and Ach may be its potential mechanism.
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Objective To explore the application effect of formative assessment on the standardized training in pediatric residents.Methods A total of 36 pediatric residents who attended the standardized training in affiliated hospital of Nantong university were randomly divided into 2 groups (18 in the experimental group and 18 in the control group) and trained in accordance with the standardized training content and standard of the national resident of pediatrics.Residents in the experimental group received formative assessment,with total score including process assessment (35％),graduation examination (50％),medicalethics (5％),reading report (5％) and work attendance (5％).While the other 18 residents in the control group received traditional assessment,with final score of graduation examination.The effectiveness of formative assessment was conducted via analysis of test score and self evaluation.The SPSS 17.0 was used for statistics,independent sample t test was used to perform inter-group comparison and Pearson correlation coefficient was used to demonstrate the correlation.P＜0.05 signifies statistically significant differences.Results In the experimental group,the process evaluation and the graduation examination were both positively related with the total score (r=0.953,r=0.966,P=0.00).In the graduation examination,the scores of clinical practice skills test and case analysis in the experimental group were both higher than those in the control group [(12.03 ± 1.51) vs.(10.83 ± 1.42),(12.03 ± 1.40) vs.(10.83 ± 1.29),P＜0.05],with statistically significant differences.The self evaluation of trainees showed that the clinical-inference and decisionmaking ability,the self-study ability,scores of attitudes and professionalism and total scores in the experimental group were higher than those in the control group,with statistically significant differences (P＜0.05).Conclusion The application of formative evaluation on the standardized training in pediatric residents is beneficial to improve the training effect and is worth popularizing.
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Objective To explore the role of Orexin in pathogenesisepilepsy and treatment of epilepsy based on the literatures published from 1998 to 2014 at home and abroad.Methods Searched the literatures from the online database including Pubmed,CNKI and Wanfang Datebases in July 2014.The words Orexin,epilepsy,Orexin receptor,epilepsy treatment were used as search terms.Analyze the effect Orexin and its receptors in the occurrence,development and treatment of epilepsy.Results 102 related literatures were retrieved and 30 were adopted into analysis.It was showed Orexin is a kind of excitatory neuropeptides and it can increase the excitability of cerebral cortex.Epilepsy can be induced bv excessive expression of Orexin.Conclusion Excessive expression of Orexin can cause epileptic seizure.Inhibiting the excessive activation of Orexin neurons is of important to control seiznres in clinical practices.
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Objective To observe ganglioside and rehabilitation care to early rehabilitation of patients with severe traumatic brain injury.Methods 66 patients with brain injury were randomly divided into the control group and the rehabilitation group with 33 cases in each group.Both groups were given conventional medication and ganglioside treatment.The control group was given routine care.In addition to the usual care,the rehabilitation group received the implementation of systematic and standardized early rehabilitation nursing.Oxidative stress status,Barthel index score,and quality of life were compared between two groups.Results Oxidative stress parameters of the two groups showed no significant difference.After hospital treatment,Barthel index score and quality of life in the rehabilitation group were significantly higher than those of the control group.Conclusions Rehabilitation care can reduce disability rates of head injury,and improve the quality of life of patients.
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ObjectiveTo investigate the executive functions of the frontal and temporal lobe epilepsy patients.MethodsFifty-five epilepsy patients (twenty-five frontal lobe epilepsy patients and thirty temporal lobe epilepsy patients) and fifty age,gender and education matched healthy controls were evaluated by means of Mini Mental State Examination ( MMSE ).Executive function was assessed using Stroop color words test and trail making test.ResultsMMSE total score of frontal and temporal lobe epilepsy patients were ( 26.02 ± 0.30) and (25.82 ± 0.67 ),respectively.There was significant abnormality between epilepsy patients and the controls (P ＜0.05).Compared with normal control group,FLP group and TLP group took longer time and their score was lower in stroop color words test (P＜0.05).There were significant difference between FLP and TLP on card B and C's reading time,correct number and strcop interference effects (P＜0.05).The epilepsy patients performed significantly worse than the controls in whole trail making test (P＜0.05).The scores indicate that the TLE group outperformed the FLE group on all analysis values (P ＜ 0.05 ).ConclusionThe frontal and temporal lobe epilepsy patients have executive function deficit.The FLE group has prominent deficits in executive functioning.
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Objective To investigate the effects of orexin-A on learning and memory of pentyleneterazol (PTZ)-kindled epileptic rats.Methods Adult Wistar rats were randomly divided into control group(normal saline,NS)and PTZ group.The PTZ-kindled rats were randomly divided into,orexin-A group and NS group administrated by intracerebroventricular(i.c.v.)injection of 10μl orexin-A(1.4 nmol/μl)or 10μl NS.Using Morris water msze experiment,the ability of learning and memory was measured in all rats.Results Eighty percent of rats in PIZ group were kindled successfully after intraperitoneal injection of 35mg/kg PTZ every day for 30 days.Compared to control group,the escape latency in the PTZ-kindled rats was significantly increased in place navigation test(PNT)(F=200.956,P<0.01),whereas a remarkable reduction of time spent in the target quadrant and number of pool circlings in 120 seconds Was observed during probe trials.Following injection of orexin-A,the latency of escape platform was significantly declined in both PTZ-kindled((39.73±2.03)8,(33.76±2.96)s)and NS rats,increased the number of crossing the platform(10.83±1.80)vs(4.67±3.34).In addition,the treatment with orexin-A markedly increased swim velocity and number of pool circlings in beth groups(P<0.01),particularly to the PTZ-kindled rats.Conclusion Spatial learning and memory in the PIZ-kindled rats can be improved by treatment with orexin-A.
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OBJECTIVE To explore disinfection effect of ventilator circuits and monitor the best one from two methods for sampling bacterial culture of pre-and post-mechanical physical disinfection ventilator circuit as well as different culture media.METHODS Pre-and post-disinfection ventilator circuits were sampled and cultured by the direct smudge method and the dilution method respectively which simultaneously the ordinary nutrient agar and the blood cultures used.RESULTS Bacterical positive rate of the direct smudge method was significantly higher than that of the dilution method in pre-and post-disinfection ventilator circuits(P0.05).CONCLUSIONS The direct smudge method is superior to the dilution method in monitoring the disinfection effect of ventilator circuit,it can effectively reduce the false negative rate and make the disinfection effect examination to be more accurate.