Effect of negative mood,serum inflammatory factors,miR-155,and brain-derived neurotrophic factor

BACKGROUND Abdominal postoperative patients are susceptible to postoperative depression resulting from pain and stress,which can hinder their rehabilitation.Acupuncture has shown potential to relieve this condition.AIM To analyze the mechanism by which acupuncture relieves postoperative depression in patients post-abdominal surgery.METHODS Abdominal postoperative patients with depression between January 2015 and December 2023 at the First Affiliated Hospital of Heilongjiang University of Chinese Medicine were enrolled.Patients were divided into two groups using the random throwing method:Observation(250 cases,fluoxetine hydrochloride+acupuncture treatment)and control(250 cases,fluoxetine hydrochloride treatment).Changes in negative emotions Hamilton Depression Scale 24,serum inflammatory factors[tumor necrosis factorα,interleukin(IL)-1β,IL-6],miR-155 expression levels,and BDNF levels were assessed.RESULTS Significant improvements were observed in the observation group compared to the control group in all assessed parameters after six weeks(P<0.05).This suggests that the combination of fluoxetine hydrochloride and acupuncture may be more effective in managing postoperative depression than medication alone.CONCLUSION Acupuncture complies with the principle of traditional Chinese medicine syndrome differentiation and ensures the pertinence and effectiveness of treatment.In addition,it not only actively improves depressive symptoms but also effectively regulates the serum level of inflammatory factors.

Clinical effects of nonconvulsive electrotherapy combined with mindfulness-based stress reduction and changes of serum inflammatory factors in depression

BACKGROUND Depression is a common and serious psychological condition,which seriously affects individual well-being and functional ability.Traditional treatment methods include drug therapy and psychological counseling;however,these methods have different degrees of side effects and limitations.In recent years,nonconvulsive electrotherapy(NET)has attracted increasing attention as a noninvasive treatment method.However,the clinical efficacy and potential mechanism of NET on depression are still unclear.We hypothesized that NET has a positive clinical effect in the treatment of depression,and may have a regulatory effect on serum inflammatory factors during treatment.AIM To assess the effects of NET on depression and analyze changes in serum inflammatory factors.METHODS This retrospective study enrolled 140 patients undergoing treatment for depression between May 2017 and June 2022,the observation group that received a combination of mindfulness-based stress reduction(MBSR)and NET treatment(n=70)and the control group that only received MBSR therapy(n=70).The clinical effectiveness of the treatment was evaluated by assessing various factors,including the Hamilton Depression Scale(HAMD)-17,self-rating idea of suicide scale(SSIOS),Pittsburgh Sleep Quality Index(PSQI),and levels of serum inflammatory factors before and after 8 wk of treatment.The quality of life scores between the two groups were compared.Comparisons were made using t and χ^(2) tests.RESULTS After 8 wk of treatment,the observation group exhibited a 91.43%overall effectiveness rate which was higher than that of the control group which was 74.29%(64 vs 52,χ^(2)=7.241;P<0.05).The HAMD,SSIOS,and PSQI scores showed a significant decrease in both groups.Moreover,the observation group had lower scores than the control group(10.37±2.04 vs 14.02±2.16,t=10.280;1.67±0.28 vs 0.87±0.12,t=21.970;5.29±1.33 vs 7.94±1.35,t=11.700;P both<0.001).Additionally,there was a notable decrease in the IL-2,IL-1β,and IL-6 in both groups after treatment.Furthermore,the observation group exhibited superior serum inflammatory factors compared to the control group(70.12±10.32 vs 102.24±20.21,t=11.840;19.35±2.46 vs 22.27±2.13,t=7.508;32.25±4.6 vs 39.42±4.23,t=9.565;P both<0.001).Moreover,the observation group exhibited significantly improved quality of life scores compared to the control group(Social function:19.25±2.76 vs 16.23±2.34;Emotions:18.54±2.83 vs 12.28±2.16;Environment:18.49±2.48 vs 16.56±3.44;Physical health:19.53±2.39 vs 16.62±3.46;P both<0.001)after treatment.CONCLUSION MBSR combined with NET effectively alleviates depression,lowers inflammation(IL-2,IL-1β,and IL-6),reduces suicidal thoughts,enhances sleep,and improves the quality of life of individuals with depression.

Serum response factor:Look into the gut

Serum response factor(SRF) is a transcription factor that regulates many genes involved in cellular activities such as proliferation,migration,differentiation,angiogenesis,and apoptosis.Although it has only been known for about two decades,SRF has been studied extensively.To date,over a thousand SRF studies have been published,but it still remains a hot topic.Due to its critical role in mesoderm-derived tissues,most of the SRF studies focused on muscle structure/function,cardiovascular development/maintenance,and smooth muscle generation/repair.Recently,SRF has received more attention in the digestive field and several important discoveries have been made.This review will summarize what we have learned about SRF in the gastrointestinal tract and provide insights into possible future directions in this area.

Serum response factor promotes axon regeneration following spinal cord transection injury

Studies have snown that serum response factor is beneficaial for axonar regeneration of peripheral herves.However,Its role after central nervous system injury remains unclear. In this study,we established a rat model of T9-T10 spinal cord transection injury.We found that the expression of serum response factor in injured spinal cord gray matter neurons gradually increased with time,reached its peak on the 7^(th) day,and then gradually decreased.To investigate the role of serum response factor,we used lentivirus vecto rs to ove rexpress and silence serum response factor in spinal cord tissue.We found that overexpression of serum response factor promoted motor function recovery in rats with spinal cord injury.Qualitative observation of biotinylated dextran amine anterograde tra cing showed that ove rexpression of serum response factor increased nerve fibers in the injured spinal co rd.Additionally,transmission electron microscopy showed that axon and myelin sheath morphology was restored.Silencing serum response factor had the opposite effects of ove rexpression.These findings suggest that serum response factor plays a role in the recovery of motor function after spinal cord injury.The underlying mechanism may be related to the regulation of axonal regeneration.

Serum response factor play a regulative role in the gene expression in heart failure

Objective To investigate the relationship between transcription factor and the change of protein expression levels in heart failure. Methods Bioinformatic method was used to analyze the data of binding-sites on the 5' flaking regions of four genes whose mRNA level changed in failing heart from three databases about nucleic acid-EMBL, transcriptional regulation factor-TRANSFAC and protein-SWISS-PORT. The expression level of selected transcription factor was determined by immunohischemical method. Results Nine transcription factors were inferred to influence the proteins' levels in occurrence and development of heart failure. Serum response factor (SRF) was selected from the nine factors and assayed. The results showed that there was a higher level of SRF in healthy group than in chronic heart failure (CHF), and the level was associated with the degree of CHF. It was also found that there was a relative higher level of SRF in the acute myocardial infarction (AMI) than that in CHF, but which was lower than the healthy. Conclusion It showed that SRF had a quantitative change in the development of heart failure, and suggested SRF might play an important regulative role in heart failure. The expression changes of proteins related to myocardial function might be regulated by the quantitative change of transcription factor(s).

A predictive score for retinopathy of prematurity by using clinical risk factors and serum insulin-like growth factor-1 levels

AIM：To detect the impact of insulin-like growth factor-1（IGF-1）and other risk factors for the early prediction of retinopathy of prematurity（ROP）and to establish a scoring system for ROP prediction by using clinical criteria and serum IGF-1 levels.METHODS：The study was conducted with 127 preterm infants.IGF-1 levels in the 1st day of life,1st,2nd,3rd and4th week of life was analyzed.The score was established after logistic regression analysis,considering the impact of each variable on the occurrences of any stage ROP.A validation cohort containing 107 preterm infants was included in the study and the predictive ability of ROP score was calculated.RESULTS：Birth weights（BW）,gestational weeks（GW）and the prevalence of breast milk consumption were lower,respiratory distress syndrome（RDS）,bronchopulmonarydysplasia（BPD）and necrotizing enterocolitis（NEC）were more frequent,the duration of mechanical ventilation and oxygen supplementation was longer in patients with ROP（P〈0.05）.Initial serum IGF-1 levels tended to be lower in newborns who developed ROP.Logistic regression analysis revealed that low BW（〈1250 g）,presence of intraventricular hemorrhage（IVH）and formula feeding increased the risk of ROP.Afterwards,the scoring system was validated on 107 infants.The negative predictive values of a score less than 4 were 84.3%,74.7%and 79.8%while positive predictive values were 76.3%,65.5%and71.6%respectively.CONCLUSION：In addition to BW〈1250 g and IVH,formula consumption was detected as a risk factor for the development of ROP.Breastfeeding is important for prevention of ROP in preterm infants.

Elevated serum growth differentiation factor 15 in multiple system atrophy patients:A case control study

BACKGROUND Multiple system atrophy(MSA) is a serious progressive neurodegenerative disease. Early diagnosis of MSA is very difficult, and diagnostic biomarkers are limited. Growth differentiation factor 15(GDF15) is involved in the differentiation and progression of the central nervous system, and is widely distributed in peripheral blood, which may be a novel biomarker for MSA.AIM To determine serum GDF15 levels, related factors and their potential diagnostic value in MSA patients, compared with Parkinson’s disease(PD) patients and healthy controls.METHODS A case-control study was conducted, including 49 MSA patients, 50 PD patients and 50 healthy controls. Serum GDF15 levels were measured by human enzymelinked immunosorbent assay, and the differences between the MSA, PD and control groups were analyzed. Further investigations were performed in different MSA subgroups according to age of onset, sex, clinical subtypes, diagnostic criteria, and disease duration. Receiver-operating characteristic curve analysiswas used to evaluate the diagnostic value of GDF15, especially for the differential diagnosis between MSA and PD.RESULTS Serum GDF15 levels were significantly higher in MSA patients than in PD patients and healthy controls(P = 0.000). Males and those with a disease duration of more than three years showed higher serum GDF15 levels(P = 0.043 and 0.000;respectively). Serum GDF15 levels may be a potential diagnostic biomarker for MSA patients compared with healthy controls and PD patients(cutoff: 470.42 pg/m L, sensitivity: 85.7%, specificity: 88.0%;cutoff: 1075.91 pg/m L, sensitivity:51.0%, specificity: 96.0%;respectively).CONCLUSION Serum GDF15 levels are significantly higher in MSA patients and provide suggestions on the etiology of MSA.

DIAGNOSTIC VALUE OF SERUM INSULIN- LIKE GROWTH FACTOR BINDING PROTEIN- 3 IN CHILDREN WITH OR WITHOUT GROWTH HORMONE DEFICIENCY

OBJECTIVE: To study the value of serum insulin-like growth factor binding protein-3 (IGFBP-3) levels in differential diagnosis of growth hormone deficiency (GHD). METHODS: To measure serum IGFBP-3 levels by RIA in normal children and adolescents, GHD children and short-stature children without GHD. RESULTS: Serum level of IGFBP-3 in 129 children with untreated GHD and with no pubertal development was 1.6 +/- 0.9 mg/L, which was less than that in normal group of the same age, but overlapped with the normal children in Tanner stage I. After six-month treatment with recombinant human growth hormone (rhGH), serum level of IGFBP-3 in 59 GHD significantly increased from 1.3 +/- 0.7 mg/L to 2.7 +/- 0.9 mg/L, accompanied by an increase of body heights, growth velocities and serum level of IGF-1. Serum level of IGFBP-3 in 55 short-stature children without GHD was 3.3 +/- 2.2 mg/L, which was not significantly different from that in normal group. CONCLUSION: Serum IGFBP-3 level can reflect the status of GH secretion in children with GHD and is a useful marker for differential diagnosis of GHD.

Effects of Intravenous Thrombolytic Therapy with Alteplase on Neurological Function,Coagulation Function and Serum Inflammatory Factors in Patients with Acute Cerebral Infarction

Objective:To investigate the effects of intravenous thrombolysis therapy with alteplase on neurological function,coagulation function and serum inflammatory factors in patients with acute cerebral infarction.Methods:A total of 96 patients with acute cerebral infarction admitted to our hospital from September 2017 to October 2019 were randomly divided into two groups,with 48 patients in each group.The control group(n=48)received routine treatment,and the observation group received intravenous thrombolysis therapy with alteplase on the basis of routine treatment.The neurological deficit score,prothrombin time(PT),activated partial thromboplastin time(APTT),tumor necrosis factor-a level(TNF-α),and high-sensitivity C-reactive protein(hs-CRP)were compared between the two groups after 15 days of treatment.Results:After treatment,NIHSS scores in both groups were lower than those before treatment;PT levels were increased,while APTT,TNF-αand hs-CRP levels were all decreased in both groups,and the changes in the observation group were greater than those in the control group,with statistically significant difference(P<0.05).Conclusions:Intravenous thrombolysis therapy with alteplase can improve the neurological function,coagulation function and serum levels of inflammatory factors in patients with acute cerebral infarction,which is worthy of clinical application.

FACTORS INFLUENCING SERUM PEPSINOGEN LEVELS IN A CHINESE POPULATION AT HIGH RISK OF STOMACH CANCER

The relationships between serum pepsinogen (PG) levels and age, sex, ABO blood type, cigarette smoking and diet were studied among over 3, 000 residents selected at random in an area with high risk of stomach cancer in Shandong Province, China. Males had significantly higher median PG Ⅰ and Ⅱ levels than feamles. PG Ⅰ tended to decrease and PG Ⅱ to rise with age. Subjects with blood type A had a higher PG Ⅱ level than subjects with other blood types. Both PG Ⅰ and Ⅱ levels rose with dally consumption of cigarettes. Alcohol consumption was not related to PG levels. The PG Ⅰ/Ⅱ ratio declined with increasing consumption of sour pancakes, a fermented staple food found to contain N-nitroso compounds and to be a risk factor for stomach cancer in this population.

Increased serum levels of soluble CD146 and vascular endothelial growth factor receptor 2 in patients with exudative age-related macular degeneration

AIM: To investigate serum levels of soluble CD146(s CD146) and vascular endothelial growth factor receptor 2(VEGFR2) in patients with age-related macular degeneration(AMD). METHODS: Eighty-eight patients with exudative AMD and 45 sex-and age-matched healthy controls were enrolled in this study conducted in China. Serum samples was obtained from the patients with exudative AMD and from the controls. Serum sCD146 and VEGFR2 protein levels were measured using an enzyme-linked immunosorbent assay.RESULTS: We found that serum sCD146 and VEGFR2 protein levels were significantly higher in the patients with exudative AMD group than in the controls(t=3.859, P<0.001 and t=3.829, P<0.001, respectively). Serum sCD146 levels were significantly higher in patients with classic choroidal neovascularization(CNV) than in those with occult CNV(t=9.899, P<0.001). There was a significant difference in the trend for exudative AMD in the highest versus lowest quartile of circulating sCD146 levels(χ2=10.29, P=0.001). The receiver operating characteristic curve analysis showed that the area under the curve was 0.696 for s CD146(95%CI: 0.601-0.791) with an optimum diagnostic cut-off value of 157.16 ng/mL, a sensitivity of 55.7%, and a specificity of 82.2%.CONCLUSION: The serum sCD146 level increases and may be a biomarker for exudative AMD.

Evaluation of serum and pleural levels of endostatin and vascular epithelial growth factor in lung cancer patients with pleural effusion

Objective:To evaluate the diagnostic value of endostatin(ES),vascular endothelial growth factor (VEGF) and careinoembryonie antigen(CEA) in both serum and pleural effusion of lung cancer patients.Methods:Levels of ES,VEGF and CEA in 52 malignant pleural effusion due to lung cancer and 50 patients with non-malignant disease were measured by using sandwich enzymelinked immunosorbent assay and microparticle enzyme immunoassay.Results:The ES.VEGF and CEA levels in pleural effusion and serum,and their ratio(F/S) were higher in lung cancer group than that in benign group,and the differences were statistically significant(P【0.05).The diagnostic efficiency of ES+VEGF for lung cancer was superior to either single detection.The diagnostic efficiency of ES+VEGK+CEA was superior to either ES+VEGF or ES+CEA.Conclusions: The results suggest that ES,VEGF and CEA might be useful in the differentiation between benign and malignant pleural effusion due to lung cancer.In comparison with either single determination of concentration in serum or pleural fluid,the couiljined detection of two or three markers is of important clinical significance in the diagnosis of lung cancer.

Keratinocyte growth factor-2 and autologous serum potentiate the regenerative effect of mesenchymal stem cells in cornea damage in rats

AIM:To investigate the healing process after severe corneal epithelial damage in rats treated with mesenchymal stem cells(MSCs)cultured with or without keratinocyte growth factor(KGF-2)and autologous serum(AS)on amniotic membrane(AM).Many patients are blind and devastated by severe ocular surface diseases due to limbal stem cell deficiency.Bone marrow-derived MSCs are potential sources for cellbased tissue engineering to repair or replace the corneal tissue,having the potential to differentiate to epithelial cells.METHODS:The study included 5 groups each including 10 female'Sprague Dawley'rats in addition to20 male rats used as bone marrow donors.Group I rats received AM+MSCs,Group II rats AM+MSCs cultured with KGF-2,Group III rats AM+MSCs cultured with KGF-2+AS,Group IV rats only AM and Group V rats,none.AS was derived from blood drawn from male rats and bone marrow was obtained from the femur and tibia bones of the same animals.Therapeutic effect was evaluated with clinical,histopathological and immunohistochemical assessment.MSC engraftment was demonstrated via detection of donor genotype(Y+)in the recipient tissue(X)with polymerase chain reaction.RESULTS:Corneal healing was significantly better in Groups I-III rats treated with MSC transplantation compared to Group IV and Group V rats with supportive treatment only.The best results were obtained in Group III rats with 90%transparency,70%lack of neovascularization,and 100%epithelium damage limited to less than 1/4 of cornea.CONCLUSION:We suggest that culture of MSCs with KGF-2 and AS on AM is effective in corneal repair in case of irreversible damage to limbal stem cells.

Effect of Combination of Bushen Jianpi Recipe (补肾健脾方) and Erythropoietin on Serum Tumor Necrosis Factor a in Patients with Anemia

Objective: To study the effect of treatment of renal anemia by combination of Bushen Jianpi Recipe (补贤健脾方, BJR, a Chinese experienced recipe for supplementing Shen and supporting Pi) and low dosage erythropoietin (EPO), and the influence of treatment on change of serum tumor necrosis factor α (TNF-α) so as to explore the possible mechanism of integrative Chinese and Western medicine (ICWM) in treating renal anemia. Methods: Patients with renal anemia were randomly divided into two groups, the ICWM group and the control group, supporting treatment such as dialysis, supplementing of ferrous, foliac acid and vitamin B12, was given to both groups. Additionally, to the ICWM group, 50 IU/kg of EPO subcutaneous injection for twice every week, and oral intake of BJR, one dose per day taken in two parts, were given, and to the control group, EPO alone, 50IU/kg by subcutaneous injecting, 3 times perweek, was given. The therapeutic course for two groups was 3 months. Blood levels of hemoglobin (Hb), hematocrit (Hct), TNF-α were measured before treatment and the therapeutic effect was observed. Results: After treatment, the levels of Hb and Hct increased significantly in both groups (P<0. 01) , comparison between the two groups in Hb and Hct after treatment for 3 months showed significant difference (P<0. 05). The serum level of TNF-α was markedly higher than normal range in both groups before treatment, it significantly lowered after treatment in the ICWM group (P< 0.05), but unchanged in the control group. Conclusion: Combination of BJR and EPO could significantly inhibit the production of TNF-α, this may be an important factor for ICWM in effectively improving sensitivity to EPO.Original article on CJITWM (Chin) 2004;24 (2): 106

Functional assessment and influencing factors after staged functional training in patients with ankle fractures

BACKGROUND The recovery of limb function after ankle fracture surgery is a gradual process.The main purpose of implementing early functional exercise,joint mobility,muscle contraction function,passive ankle flexion and extension exercises,or physical factor therapy techniques is to achieve the rapid recovery of normal physiological limb function.However,currently the most effective rehabilitation training method is staged limb functional exercise,which promotes rapid recovery of limb function while preventing adverse consequences caused by overwork or insufficient training.Staged limb functional exercise divides the rehabilitation process into multiple stages,each of which has specific training objectives and contents.This method helps patients gradually restore limb function.Nevertheless,some patients still exhibit poor limb function after standardized exercise.Therefore,a functional evaluation should be performed to analyze the impact of staged functional training after ankle fracture surgery.AIM To perform a functional evaluation and determine the influencing factors of staged functional training in patients with ankle fracture.METHODS A retrospective study enrolled 150 patients who underwent surgical treatment for ankle fracture from May 2020 to May 2022 at our hospital.Univariate and multivariate linear regression analyses were performed on general data,functional exercise compliance scale for orthopedic patients,Social Support Rating Scale(SSRS),American Orthopedic Foot and Ankle Score(AOFAS)Ankle-Hindfoot Score,and pain factors[serum bradykinin(BK),prostaglandin E2(PGE2),5-hydroxytryptamine(5-HT)].RESULTS Based on the AOFAS Ankle-Hindfoot Scale,the cases were divided into the excellent function(n=111)and ordinary function(n=39)groups.Univariate analysis revealed that monthly family income,education level,diabetes mellitus,functional exercise compliance scale of orthopedic patients score,SSRS,BK,PGE2,and 5-HT significantly influenced limb function after ankle fracture(P<0.05);Multiple linear regression analysis showed that the functional exercise compliance scale score,SSRS,BK,PGE2,and 5-HT were independent risk factors affecting functional performance after staged functional exercise(P<0.05).CONCLUSION Exercise compliance,SSRS,and pain level are the independent risk factors affecting functional performance after staged functional training following ankle surgery.Clinical nursing care after ankle surgery should include analgesic and health education measures to ensure optimal recovery of limb function.

Serum lipid levels and their risk factors in theGuangxi Mu Lao Zu population

Objectives Mu Lao Zu population.Methods A total of 1055 subjects of Mu Lao Zu were studied by a stratified randomized cluster sampling.Blood pressure,body height, body weight,waist circumference and serum lipid and apolipoprotein(Apo) levels were measured.The data were compared with those in 969 subjects of Han Chinese from the same region.In order to evaluate the association of hyperlipidemia with nine possible riks factors,multivariate logistic regression analysis was also performed in the combined population of Mu Lao Zu and Han,Mu Lao Zu,and Han;respectively. Results The levels of total cholesterol,triglyceride, low-density lipoprotein cholesterol and ApoB in Mu Lao Zu were significantly higher than those in Han(P【0.05-0.001); but the levels of high-density lipoprotein cholesterol,ApoA1 and ApoA1/Apo were significantly lower than those in Han (P【0.001 ).The prevalence of hyperlipidemia and Hypercholesterolemia was also significantly higher in Mu Lao Zu than in Han(53.0%vs.46.1%,P【0.001) and(44.5%vs. 37.5%,P【0.001).There was no difference in the prevalence of hypertriglyceridemia between the both ethnic groups (22.8%vs.19.4%,P】0.05).Hyperlipidemia was positively correlated with age,BMI,and systolic blood pressureMu Lao Zu(P【0.05),whereas it was positively correlated with BMI and hypertension in Han(P【0.05 for each).Conclusions The serum lipid profiles,the prevalence of hyperlipidemia and the risk factors are different between the Mu Lao Zu and Han populations.The differences in serum lipid profiles between the two ethnic groups might result from different dietary habit,life style,as well as genetic factors,in ? To determine the serum lipid levels and their risk factors in the Guangxi.

The effect of polymorphism in gene of insulin-like growth factor-Ⅰ on the serum periparturient concentration in Holstein dairy cows

Objective:To investigate the relationship between polymorphism within the 5'-untranslated region(5'-UTR)of IGF-I gene and its periparturient concentration in Iranian Holstein dairy cows.Methods:Blood samples(5 mL,n=37)were collected by caudal venipuncture from each animal into sample lubes containing the EDTA and DNA was extracted from blood.In order to measure ICF-I concentration the collection of blood samples(n=111)was also done at 14 d before calving(prepartum),25 and 45 d postpartum.Results:We found evidence for a significant effect of C to T mutation in position 512 of IGF-I gene on its serum concentration in dairy cows in Iran.Cows with CC genotype had significantly higher concentration(Mean-SD)of IGF-I at 14 d prepartum(91.8±18.1)μg/L compared to those with TT genotype(73.3±14.4)μg/L(P=0.04).A significant trend(quadratic)was found for IGF-I concentration,as higher in CC cows compared to ones with TT genotype,during the 14 d before calving to 45 d postpartum(P=0.01).Conclusions:We concluded that C/T transition in the promoter region of IGF-I gene can influence the serum concentration of ICF-I in periparturient dairy cows.

依达拉奉联合丹红注射液对急性脑梗死神经功能及血清炎症因子的影响

目的 分析依达拉奉联合丹红注射液对急性脑梗死患者神经功能及血清炎症因子的影响。方法 选取我院2021年7月至2023年6月期间收治的96例急性脑梗死患者为研究对象,采用随机数字表法将其分为参照组与实验组,每组48例。参照组给予依达拉奉治疗,实验组给予依达拉奉联合丹红注射液治疗。观察两组治疗前后神经功能评分以及日常活动能力、血清炎症因子、血脂水平、疗效及不良反应。结果 治疗后,实验组神经功能和日常活动能力改善效果优于参照组,且实验组血清炎症因子水平、血脂水平低于参照组,P<0.05。实验组治疗有效率95.83%,高于参照组的79.17%,P<0.05。实验组不良反应发生率8.33%,与参照组的12.50%比较,差异无统计学意义,P>0.05。结论 在急性脑梗死治疗中,依达拉奉联合丹红注射液治疗更利于挽救濒死脑细胞,改善神经功能,促进患者日常生活能力提高,同时更有助于降低炎症反应,改善血脂代谢,提高治疗有效性,且不会增加用药不良反应,具有推广价值。

预后营养指数、血清白蛋白对肝切除术病人术后感染风险的预测价值及护理指导意义

目的:探究预后营养指数、血清白蛋白对肝切除术病人术后感染风险的预测价值及护理指导意义。方法:选取2020年2月—2023年9月江西省赣州市人民医院肝胆胰外科收治的110例肝切除术病人为研究对象,采用自制一般资料问卷收集病人信息,统计术后感染病人例数,通过单因素、多因素Logistic回归分析筛选肝切除术病人术后感染的危险因素,绘制受试者工作特征(ROC)曲线,分析预后营养指数、血清白蛋白对肝切除术后感染的预测效能,探究其对临床护理的指导意义。结果:统计显示,术后感染病人16例,多因素Logistic回归分析显示,肝切除术后感染危险因素有年龄≥60岁、合并糖尿病、术中低体温、术中失血量>1 000 mL、术前血清白蛋白、术前预后营养指数、引流管留置时间>7 d(P<0.05);预后营养指数预测肝切除术后感染的ROC曲线下面积为0.731[95%CI(0.651,0.794)],术前预后营养指数最佳截断值为47.18,对应灵敏度、特异度分别为0.902,0.749,血清白蛋白预测肝切除术后感染的ROC曲线下面积为0.817[95%CI(0.747,0.874)],血清白蛋白最佳截断值为32.08 g/L,对应灵敏度、特异度分别为0.873,0.752。结论:肝切除术病人术后存在感染风险,其发生的危险因素复杂,而预后营养指数、血清白蛋白对肝切除术后感染风险有一定的预测价值,临床应加强对病人预后营养指数、血清白蛋白的监测、分析,据此实施感染风险分级管理。

丁苯酞联合多奈哌齐对老年帕金森病患者自主神经功能、认知功能及血清神经导向因子-1水平的影响

目的 探讨丁苯酞联合多奈哌齐对老年帕金森病患者自主神经功能、认知功能及血清神经导向因子-1(neuron towards axon guidance factor-1,Netrin-1)水平的影响。方法 选取135例老年帕金森病患者,按照治疗方法分为多奈哌齐组(采用多奈哌齐治疗)、丁苯酞组(采用丁苯酞治疗)和联合组(采用丁苯酞联合多奈哌齐治疗),每组45例,比较3组的疗效及患者治疗前、后的自主神经功能、血清Netrin-1水平的变化情况。结果 联合组的总有效率为91.11%(41/45),较多奈哌齐组的73.33%(33/45)及丁苯酞组的75.56%(34/45)明显升高(P<0.05);治疗后联合组患者的帕金森综合评定量表(unified Parkinson’s disease rating scale,UPDRS)、帕金森症状评分(Wechsler intelligence scale,Webster)均较治疗前降低,且较多奈哌齐组及丁苯酞组降低得更加明显(P<0.05);自主神经功能、认知功能及智力状况等方面比较,治疗后联合组的患者自主神经症状量表(the scales for outcomes in parkinson’s disease-autonomic,SCOPT-AUT)评分低于多奈哌齐组及丁苯酞组(P<0.05),认知功能评估量表(montreal cognitive assessment,MoCA)及简易智力量表(mini-mental state examination,MMSE)评分均高于多奈哌齐组及丁苯酞组(P<0.05);治疗后,联合组的血清Netrin-1、脑源性神经营养因子(brain derived neurotrophic factor,BDNF)水平均高于多奈哌齐组及丁苯酞组(P<0.05)。结论 帕金森患者进行丁苯酞联合多奈哌齐治疗,可修复自主神经功能,升高血清Netrin-1水平,安全性高,具有临床推广价值。