[Effect of Acupuncture Combined with Rehabilitation on Immune and Neural Functions in Elderly Patients with Stroke].

OBJECTIVE: To investigate the therapeutic effect of acupuncture combined with rehabilitation and neuro-immune functional activities in elderly patients with stroke. METHODS: A total of 196 elderly stroke patients were randomly divided into control (rehabilitation exercise) and observation(acupuncture＋ rehabilitation exercise)groups (n＝98 in each). Patients of the control group were treated by general healing treatment including good limb placement, timely conversion of body position, joint-motor exercise, sitting balance exercise, sitting-standing-walking, walking up and down stairs, daily life ability exercise, etc. and those of the observation group were treated by using the same methods mentioned in the control group and manual acupuncture stimulation of Sishencong (EX-HN 1), Xuanli (GB 6), the midpoint of EX-HN 1 and GB 6, Baihui (GV 20), Qubin (GB 7), and the midpoint between GV 20 and GB 7 on the affected side (once a day for three 10-day courses). Serum interleukin-2 (IL-2), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and high-sensitive C-reactive protein (hs-CRP) contents were assayed using ELISA, and serum CD 3＋， CD 4＋ and CD 8＋ contents assayed using flow cytometry. The disability severity was assessed by using National Institutes of Health Stroke Scale (NIHSS, for dysneuria), modified Rankin Scale，(mRS, stroke severity), and Barthel Index (BI, performance in activities of daily living), separately. The therapeutic effect was determined according to NIHSS score, clinical symptoms and daily activity ability. RESULTS: On day 30 after the treatment, serum IL-2, IL-6, TNF-α and hs-CRP contents were significantly decreased in the observation group in comparison with its own pre-treatment and day 10 after the treatment, and on day 10 and 30 after the treatment, the above were lower than the control group (P<0.05). On day 30 after the treatment, serum CD 3＋， CD 4＋ and CD 4＋/CD 8＋ levels were significantly increased in both control and observation groups in comparison with their own pre-treatment and 10 days' treatment (P<0.05), while CD 8＋ levels obviously decreased in both groups relevant to their own pre-treatment and 10 days' treatment (P<0.05), and the increased CD 3＋， CD 4＋ and CD 4＋/CD 8＋ levels were significant higher in the observation group than in the control group (P<0.05), and the CD 8＋ level was obviously lower in the control group than in the observation group (P<0.05). On day 30 after the treatment, the NIHSS and mRS scores were significantly decreased in both groups (P<0.05), and significantly lower in the observation group than in the control group (P<0.05); the BI scores were evidently increased in both groups relevant to their own pre-treatment (P<0.05), and the BI level was considerably higher in the observation group than in the control group (P<0.05). The total effective rate was 72.4% (71/98) and 93.9% (92/98) respectively in the control and observation groups, being obviously higher in the latter group than in the former (P<0.05). CONCLUSION: Acupuncture combined with rehabilitation therapy is effective in promoting the recovery of neurological function and in regulating T lymphocyte subsets and the expression of inflammatory factors in elderly patients with stroke.

Combined monitoring of intracranial pressure and bispectral index in patients with severe craniocerebral trauma after operation / 国际外科学杂志

Objective To investigate the value of bispectral index and intracranial pressure monitoring in evaluation of postoperative consciousness and short-term prognosis in patients with severe traumatic brain injury.Methods A simple random sampling method was used in 30 cases of brain trauma coma patients in the People's Hospital of Northern Jiangsu Province from January 2014 to December 2014.Glasgow coma scale (GCS) were evaluated at intervals of 8 hours,GCS were recorded for 3 days after surgery,The bispectral index value and intracranial pressure value are recorded at the same time.According to GCS,the patients were divided into two groups,group A (3≤GCS≤5) and group B(5 ＜ GCS≤8).The 21-days natural survival rate was counted.The Kaplan-Meier Method and Log-rank test were used to analyze the relationship between Bispectral index and intracranial pressure.Results The bispectral index value of group A was 45.3 ± 3.8,the intracranial pressure value of group A was (18.6 ± 2.8) mmHg,The bispectral index value of group B was 32.2 ± 8.2,the intracranial pressure value of group B was (33.4 ±4.6) mmHg.The 21-days survival rate of group A was 55％,and 21-days survival rate of group B was 30％.The Spearman rank correlation method was used to analyze the values.Bispectral index value was positively correlated with coma degree after operation in patients with severe traumatic brain injury,and was negatively correlated with intracranial pressure value (r =0.532,P ＜ 0.05;r =0.521,P ＜ 0.05).The more severer the patient's craniocerebral injury.,the more severer the condition,the higher the intracranial pressure,the lower the bispectral index value,the worse the prognosis is.Conclusion Combined monitoring of bispectral index and intracranial pressure has high application value in evaluating the coma degree and prognosis of patients with severe craniocerebral injury after operation.

The choice and curative effect analysis of early postoperative nutritional support for severe traumatic brain injury patients / 国际外科学杂志

Objective To explore the differences of curative effect and short-term prognosis to severe traumatic brain injury patients with three different early postoperative nutritional supports.Methods A retrospective study was performed on 60 severe traumatic brain injury patients received in Neurosurgical Intensive Care Unit of Northern Jiangsu People's Hospital from July 2014 to July 2016.A total of 60 cases were randomly divided into the early enteral nutrition support therapy group,the early parenteral nutrition group,and the early compound nutrition group.The clinical indicators such as basic clinical characteristics before treatment,the nutrition data in two weeks,the length of stay in the Neurosurgical Intensive Care Unit,complications and GCS scores between the three groups were observed and analyzed.Results The indicators of early compound nutrition group were fasting blood-glucose (5.74 ± 0.64) mmol/L,prealbumin(203.80 ± 10.45) mg/L,total serum protein(61.99 ± 1.34) g/L,blood hemoglobin (114.53 ± 2.69) g/L,C-reactive protein(0.37 ± 0.06) mg/dl.The length of stay in Neurosurgical Intensive Care Unit was (11.6 ± 0.42) days in the compound nutrition group while those in the early enteral nutrition group was (13.20 ±0.42) days and those in the early parenteral nutrition group was(14.65 ± 0.42) days.The postoperative complications of the compound nutrition group were significantly lower than other two groups.The GCS scores of early compound nutrition group was(11.40 ± 1.60),which was the best in three groups.The differences were statistically significant (P ＜ 0.05).Conclusions Early compound nutrition support has an exact curative effect on postoperative severe traumatic brain injury patients in Neurosurgical Intensive Care Unit.It can obviously improve the nutrition status of patients with less complications,shorter length of stay in Neurosurgical Intensive Care Unit,higher safety and lower degree of coma,worth clinical promotion.

Impact of super early tracheotomy in prognosis of patients with massive cerebral hemorrhage: a comparative study / 中华神经医学杂志

Objective To study the impact of super early tracheotomy in the prognosis of patients with primary massive cerebral hemorrhage (＞50 mL).Methods A retrospective analysis was conducted on the clinical data of 100 patients with primary massive cerebral hemorrhage who underwent the comprehensive treatment of craniotomy operation plus tracheotomy from January 2010 to December 2013.The patients underwent tracheotomy before brain operation were classified as super early tracheotomy (SET) group,and the patients accepted tracheotomy within 3 days or 4-7 days after brain operation were classified,respectively,as early tracheotomy (ET) group or late tracheotomy (LT) group.Clinical variables such as age,gender,Glasgow coma scale (GCS) scores,postoperative re-bleeding rate,tracheal cannula indwelling time,hospitalization time,improvement rate and mortality were analyzed contrastively among the 3 groups.Results There was no statistical difference in primary clinical characteristics among 3 groups (P＞0.05).The postoperative re-bleeding rate of ET group (14.28％) was higher than one of SET group (5.55％) and LT group (10.34％).The tracheal cannula indwelling mean time of SET group was significantly shorter than one of ET group and LT group (P＜0.05).Significant differences existed among the 3 groups in the mean hospitalization time (SET group＜ET group＜LT group,P＜0.05).There was no significant difference in the improvement rate between SET group and ET group,however,the improvement rate of LT group was significantly lower than one of the other two groups (P＜0.05).No statistical difference in the mortality existed among 3 groups (P＞0.05).Conclusion It is effective and feasible to perform SET to reduce the postoperative re-bleeding rate,shorten the hospitalization time,improve the prognosis of the patients with primary massive cerebral hemorrhage.

A rare case of penetrating brain injury by crossbow in a 22-month-old child.

Nonmissile penetrating brain injuries are exceedingly uncommon among civilian population and are most often associated with inflicted injury. They show specific characteristics different from that of missile wounds. In this article, we describe a rare case of a 22-month-old child who experienced accidental penetrating head trauma caused by a crossbow. We document neuroimaging studies and review the management concerning this pathology. To our knowledge, this is the youngest survived case of penetrating brain injury by a crossbow with such radiological findings reported in the literature.

Construction of recombinant lentivirus containing human mir-7-3 like sequence and its inhibitory effects on human glioma proliferation / 中华神经医学杂志

Objective To construct a lentiviral vector containing mir-7-3 gene and study the function of mir-7-3 gene and its role in glioma gene therapy.Methods The plasmid Lenti-GFP-mir-7-3 and packaging plasmids pRsv-REV,pMDlg-pRRE and pMD2G were co-transfected into the human embryonic kidney epithelial cell line 293T cells,and then,recombinant lentiviral FIV-CMV-GFP-mir-7-3 carried mir-7-3 gene and GFP gene was obtained; fluorescence expression of 293T cells was observed under fluorescence microscope.The supematant was collected,concentrated and identified,and then,it was used to transfect into the U251 glioma cells (positive transfection group); and blank control group (cells transfected with empty vector) and negative control group (parental cells) were also employed.Real time-PCR was used to examine the relative contents of mir-7-3 in U251 cells; Westem blotting was employed to detect the epidermal growth factor (EGFR) and serine/threonine kinase (AKT2) protein expressions; cell cycle was analyzed by flow cytometry and cell proliferative activities were measured by MTT method.Results Recombinant lentiviral FIV-CMV-GFP-mir-7-3 carried mir-7-3 gene and GFP gene was successfully constructed in 293T cells; electrophores showed that the sequence of RT-PCR product was consistent with the data ofmir-7-3 by DNA sequence analysis,indicating that the mir-7-3 gene was successfully cloned; strong green fluorwscence was observed by fluorwscent microscopy.The supernatant of lentivirus-transfected 293T cells was effectively infected into U251 cells and the relative content of mir-7-3 could be observed in the transfected U251 cells.As compared with those in the parental cells and the cells transfected with empty vector,the protein expressions of EGFR and AKT2 in the transfected group decreased significantly,reaching 38％ and 42％,respectively (P＜0.05).As compared with those in the parental cells and the cells transfected with empty vector,the cells at G0/G1 phase increased,the S phase fiaction was lower and the survival rates dramatically dropped in the mir-7-3 transfected cells 3,4,5 and 6 d after implanation.Conclusions The lentiviral vector containing mir-7-3 gene was constructed successfully.Mir-7-3 could specifically suppress EGFR and AKT2 expressions,induce gene silencing,inhibit cell growth,indicating that this way should be a new strategy in glioma gene therapy.

Research progress of microRNA-21 in chemoradiotherapy of glioma / 国际外科学杂志

Glioma is an important cause of death in adults and children among the most common neural malignancies,with high morbidity and mortality in primary brain tumors.Despite advances in radiation and chemotherapy following surgical resection of the tumor,the median survival time of glioma remains poor.The effects of miR-21expression on tumor growth and invasion via regulating the pathways in human glioma cells,which regulate the expression of some small molecule.This review is mainly focused on the discovery of the correlation between microRNA-21 (miR-21) and glioma and the important role in the resistance of cancer cells to radiation and chemotherapeutic agents.

Clinical application of endoscopic surgery in extra sheath in minimally invasive neurosurgery / 中华神经医学杂志

Objective To explore the experience and methods of neuro-endoscopy in minimally invasive treating intracranial diseases.Methods The surgery effect and complications of minimally invasive treatment under neuro-endoscopy on 52 patients with intracranial diseases,admitted to our hospital from October 2010 to March 2013,were retrospectively summarized; in these 52 patients,20 had pituitary adenoma,20 had hypertensive intracerebral hemorrhage,1 had intracranial hematoma followed arteriovenous malformation,2 had intracranial hematomas after brain injury,2 had cholesteatoma,2 had optic canal decompression,2 had cerebrospinal fluid rhinorrhea,1 had multi-separated subacute subdural hematoma and the last 2 had arachnoid cyst.Results Except for 1 patient having cholesteatoma appeared bleeding of the petrosalvein intraoperatively,which resulted in cerebellum hemorrhage following postoperative venous hemorrhagic infarction and unfavourable prognosis,the rest of the patients recovered well; in 20 patients having hypophysoma,15 (75％) achieved total resection of the pituitary adenoma,and no postoperative cerebrospinal fluid rhinorrhea occurred; in 23 cases of intracranial hematomas,22 were cleared satisfactorily,and the left one occurred rehemorrhage in one side but craniotomy hematoma removal was successfully performed again.The eyesight of 2 patients with optic canal decompression was improved obviously.The repair effects of 2 patients with cerebrospinal fluid leakage were very good without intracranial infection or recurrence.The 2 patients with arachnoid cyst recovered satisfactorily without other complications.One patient with multi-separated subacute subdural hematoma recovered with hematoma clear postoperative satisfactorily; and one patient with cholesteatoma postoperative recovered satisfactorily with tumor resection.Conclusion Neuro-endoscopy has many advantages such as exposed wide range,good deep lighting,minimally invasive and high efficiency in endoscopic transnasal transsphenoidal skull base surgery and intracranial hematomas removal.

Long noncoding RNA and tumor / 国际外科学杂志

There has been increasing evidence that transcription of non-coding genome sequence is important to life:Relative to the protein coding sequence and a variety of small molecule RNA.IncRNA research is still only in its infancy.Its function and regulation need to be of further studied.In this paper,the current relationship between the tumor and the IncRNA is reviewed.IncRNA may provide new basis and targets for cancer diagnosis and treatment.

Construction of recombinant lentivirus containing human mir-7-3 like sequence and its expression in gliomas / 肿瘤研究与临床

Objective To construct a lentiviral vector containing mir-7-3 gene and green fluorescent protein (GFP) gene,and to detect the expression of mir-7-3 gene in U251 cells.Methods The fragments containing all the mir-7-3 gene were amplified by RT-PCR and were cloned into the lentivirus vectors labeled with GFP,which was transfected together with the packaging plasmids into 293T cells by CaC12.The supernatant was collected,concentrated,identified,and was transfected to U251 cells of gliomas.Fluorescent microscopy was used to observe the fluorescence in the 293T cell,and real time RT-PCR was used to examine the relative contents of mir-7-3 in U251 cells.Results Electrophores was shown that the sequence of the RT-PCR product was consistent with the data of mir-7-3 by DNA sequence analysis,indicating that the mir-7-3 gene was successfully cloned,and strong green fluorescence was observed by fluorescent microscopy.The supernatant of lentivirus-transfected 293T cells effectively infected U251 cells and the relative content of mir-7-3 was observed in the transfected U251 cells.Conclusion It is concluded that the lentiviral vector containing mir-7-3 gene was constructed successfully,which provides a basis for further study of mir-7-3 function.

3-Amino-4,6-dimethyl-thieno[2,3-b]pyridine-2-carbonitrile.

The mol-ecule of the title compound, C(10)H(9)N(3)S, is almost planar, with a dihedral angle of 1.38 (4)° between the thio-phene and pyridine rings. In the crystal packing, mol-ecules are linked into layers parallel to the ab plane by inter-molecular N-H⋯N hydrogen bonds and by π⋯π stacking inter-actions involving adjacent pyridine and thio-phene rings with a centroid-centroid distance of 3.537 (3) Å.

Study on the expression of epidermal growth factor receptor and p53 in astrocytic gliomas: evidence for a distinct genetic pathway / 中华病理学杂志

<p><b>OBJECTIVE</b>To study further the most important and frequent genetic alterations of p53 and epidermal growth factor receptor (EGFR) in astrocytic gliomas.</p><p><b>METHODS</b>(1) EGFR expression was examined in samples collected from 37 astrocytic gliomas and 6 normal brain tissue using reverse transcriptase polymerase chain reaction and immunohistochemical staining. (2) p53 gene mutation and accumulation were detected simultaneously in the same specimens using PCR-SSCP, DNA sequencing and immunohistochemical staining.</p><p><b>RESULTS</b>The frequency of p53 mutation in diffuse astrocytomas, anaplastic astrocytomas, primary glioblastomas and secondary glioblastomas was 1/10, 4/19 (21.1%), 4/6 and 2/2, respectively and the frequency of EGFR overexpression was 5/10, 10/19 (52.6%), 5/6 and 2/2, respectively. Both p53 accumulation and EGFR overexpression increased accompanied by a successive increase of degree of the glioma malignancy.</p><p><b>CONCLUSIONS</b>EGFR overexpression is not infrequently seen, however, p53 mutation is rarely seen in the low grade gliomas. Both p53 gene mutation and EGFR overexpression are often associated with primary and secondary glioblastoma. Consequently, EGFR overexpression and p53 gene mutation are not mutually exclusive in astrocytic gliomagenesis but synergistically to promote the glioma progression.</p>

Construction and expression of siRNA expression constructs targeting epidermal growth factor receptor / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To construct the small interfering RNA (siRNA) expression constructs targeting epidermal growth factor receptor(EGFR) and express them in TJ905 human malignant cells.</p><p><b>METHODS</b>Two target sequences from Receptor L domain and catalytic domain were selected to create two expression constructs using psiRNA-NeoG2. Furthermore, the siRNA constructs were transfected into TJ905 cells as mediated by Lipofectamin. Meanwhile, an antisense EGFR construct p-anti-hEGFR was set as control. Immunofluorescence and Western blot were performed to detect EGFR expression.</p><p><b>RESULTS</b>With the successful construction of the two siRNA expression plasmids and the stable transfection to TJ905 cells, the expression of EGFR was down-regulated to 90% and 92% respectively, but to 82% in the anti-sense EGFR group.</p><p><b>CONCLUSION</b>The siRNA expression constructs targeting EGFR could specifically inhibit EGFR expression, and should be a new strategy in glioma gene therapy targeting EGFR.</p>