Substance P receptor-like immunoreactive (SPR-LI) structures and changes following intravenous injection of vasopressin in the medullary visceral zone (MVZ) of the rat were studied by using immunohistochemical methods. In normal control rats the distribution of SPR-LI structure in MVZ generally matched with that of immunostaining against substance P (SP-LI) except in some areas. SPR-LI neurons and dendrites differed in size and shape in different areas of MVZ. Their dendrites could be classified into three types, i.e, wool-shaped, smooth and varicose. Some SPR-LI neurons were also positive for tyrosine hydroxylase-like immunoreactivity (TH-LI) . After administration of vasopressin SPR-LI structures became denser, especially at levels of pyramidal decussation (PYX) and area postrema (AP). The dendrites of motor dorsal nucleus of X (NMDX) in the dorsal part of MVZ appeared thin and straight in morphology instead of curl and thick outlooks. These results implicate that some SPR-LI neurons might be involved in the modulation of the cardiovascular stress induced by vasopressin.
Abstract Background Pediatric left lateral lobe living donor liver transplantation (LDLT) is a lifesaving procedure for children with end-stage liver diseases. Understanding the factors that influence and predict the recipients' early liver regeneration rate (LRR) after LDLT is crucial for optimizing post-transplant outcomes. This study aims to predict the recipients' early LRR after pediatric LDLT using CT texture analysis and clinical information. Methods A total of 181 donor-recipient pairs who underwent pediatric left lateral lobe LDLT surgery were retrospectively collected. Preoperative CT of the donors and postoperative CT of the recipients (3 months after LDLT) were performed. The graft LRRs were calculated and compared. CT texture parameters and clinical information were compared between high and low LRR groups. Univariate and multivariate linear regression analysis were used to investigate the correlation between clinical, texture parameters and LRR, and to create the optimal LRR prediction equation. Results The postoperative early graft LRR was 24.38 ± 30.84% (-42.99% -107.11%). There were significant differences in 9 clinical parameters and 8 CT texture features between the two groups (all P < 0.05). There were significant correlations between graft-to-recipient weight ratio (GRWR), donor gender, original_shape_Maximum2DDiameterColumn, recipient’s body surface area (BSAr) and LRR. The regression equation predicting LRR was following: LRR(%) = 104.50-24.77×GRWR(%) − 0.134×original_shape_Maximum2DDiameterColumn + 38.16×BSAr(m2) + 10.52(if the donor is male). Conclusions Preoperative CT texture analysis combined with clinical information can non-invasively predict early graft regeneration after pediatric left lateral lobe LDLT. GRWR, donor gender, original_shape_Maximum2DDiameterColumn, and BSAr are independent influencing factors of LRR.
Objective
To clear the coping process of ischemic stroke patients and their families before the onset, explain its response rules and the influence factors, and provide scientific basis for the construction of comprehensive stroke pre-hospital intervention program.
Methods
A semi-structured interviews were conducted with 10 cases. Data were analyzed using the grounded theory.
Results
Ischemic stroke patients and their families at the onset process experienced recognition, reaction, alert and action stage.
Conclusion
Health education should be combined with the whole process of ischemic stroke patients and their families before hospital, building a comprehensive intervention program.
Key words:
Ischemic stroke; Pre-hospital delay; Coping; Trajectory; Qualitative research
Abstract Background Non-pharmaceutical interventions (NPIs) have been widely utilised to control the COVID-19 pandemic. However, it is unclear what the optimal strategies are for implementing NPIs in the context of coronavirus vaccines. This study aims to systematically identify, describe, and evaluate existing ecological studies on the real-world impact of NPIs in containing COVID-19 pandemic following the roll-out of coronavirus vaccines. Methods We conducted a comprehensive search of relevant studies from January 1, 2021, to June 4, 2023 in PubMed, Embase, Web of science and MedRxiv. Two authors independently assessed the eligibility of the studies and extracted the data. A risk of bias assessment tool, derived from a bibliometric review of ecological studies, was applied to evaluate the study design, statistical methodology, and the quality of reporting. Data were collected, synthesised and analysed using qualitative and quantitative methods. The results were presented using summary tables and figures, including information on the target countries and regions of the studies, types of NPIs, and the quality of evidence. Results The review included a total of 17 studies that examined the real-world impact of NPIs in containing the COVID-19 pandemic after the vaccine roll-out. These studies used five composite indicators that combined multiple NPIs, and examined 14 individual NPIs. The studies had an average quality assessment score of 13 (range: 10–16), indicating moderately high quality. NPIs had a larger impact than vaccination in mitigating the spread of COVID-19 during the early stage of the vaccination implementation and in the context of the Omicron variant. Testing policies, workplace closures, and restrictions on gatherings were the most effective NPIs in containing the COVID-19 pandemic, following the roll-out of vaccines. The impact of NPIs varied across different time frames, countries and regions. Conclusion NPIs had a larger contribution to the control of the pandemic as compared to vaccination during the early stage of vaccine implementation and in the context of the omicron variant. The impact of NPIs in containing the COVID-19 pandemic exhibited variability in diverse contexts. Policy- and decision-makers need to focus on the impact of different NPIs in diverse contexts. Further research is needed to understand the policy mechanisms and address potential future challenges.
To evaluate the feasibility and efficacy of transcatheter closure of perimembranous ventricular septal defects (pmVSD) with aneurysmatic formation and muscular ventricular septal defects (mVSD) with Amplatzer duct occluder II.This retrospective analysis included 48 cases received transcatheter closure of pmVSD aneurysmatic formation or mVSD from February 2011 to March 2012 in our hospital (42 pmVSD with aneurysmatic formation and 6 mVSD). Median age was 5.2 years (range: 1.8 - 15 years), and median weight was 20.2 kg (range: 12 - 44 kg). Amplatzer duct occluder II was selected depending on the condition of ventricular septal defect. The device was implanted by antegrade or retrograde approach. Complications such as residual shunt, valvular regurgitation and arrhythmia were evaluated by echocardiography or angiography. Median follow-up was 9.5 months (range: 1 - 13 months).The mean ratio of pulmonary (Qp) to systemic (Qs) blood flow was 1.35 ± 0.15 before transcatheter closure. The diameter of exit hole of ventricular septal defects was (2.46 ± 0.53) mm measured by transthoracic echocardiography, and (2.35 ± 0.40) mm by angiography. Successful implantation of the device was achieved in 46 patients (96%) and unsuccessful in two cases due to acute aortic insufficiency. Forty-two (92%) patients were closed successfully, and trivial residual leak was evidenced in four patients and remained unchanged during follow-up. One patient with mVSD still had trivial residual shunt at 6 months post procedure. New trivial tricuspid insufficiency was observed in 1 patient (2.1%) during follow-up. Two patients developed procedural related left anterior fascicular block and remained unchanged during follow-up.pmVSD with aneurysm and mVSD could be successfully treated with Amplatzer duct occluder II. However, the long waist and large disc of the device could interfere with tricuspid valve function and cause tricuspid insufficiency.
Zhao, Hui, Wei Chai, Wei Gao, Lixian Xu, Hui Zhang, and Yonghui Yang. Hyperoxygenated solution: effects on acute hypobaric hypoxia-induced oxidative damage in rabbits. High Alt. Med. Biol. 10:283–291, 2009.—High altitude (HA) exposure disrupts the efficiency of the antioxidant system and can lead to oxidative damage in various organs and tissues. The present study investigated the effect of hyperoxygenated solution (HOS) intravenous infusion therapy on oxidative damage induced by acute hypobaric hypoxia. Experimental rabbits were exposed to a simulated high altitude (HA), equivalent to 8500 m, in an animal decompression chamber for 3 h. HOS infusion attenuated the rise in malondialdehyde (MDA) levels and the decrease of the reduced oxidized glutathione (GSH/GSSG) ratio. HOS also increased the activity of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px); the arterial partial pressure of oxygen (Pao2); and arterial blood oxygen saturation (Sao2) levels. Animals treated with HOS had higher Pao2 compared with those subjected to airway oxygen therapy (p < 0.01) during HA exposure. These observations suggest that HOS intravenous infusion exerts protective effects against acute hypobaric hypoxia-induced oxidative damage.
Objective To evaluate the technique and clinical outcomes of supra-acetabular external fixation in treating pelvic fractures associated with injuries of abdominal organs.Methods There were 17 cases of pelvic fractures associated with injuries of abdominal organs.Nine were males and 8 were females,with the average age of 42 years (range,21-75 years).The injury was caused by traffic accident in 9 cases,fall-down from height in 4,and crush by heavy objects in 6.According to Tile classification of pelvic fractures,7 were type B1,3 were type B2,2 were type B3,4 were type C1 and 1 was type C2.Fifteen cases suffered with hemorrhagic shock,2 with perineal injury and 12 with fractures of the limbs.All patients were treated with supra-acetabular external fixation and the outcomes were evaluated by Cole's clinical scoring,Matta and Tornetta's radiographic standards.Results All 17 cases were followed up with the mean period of 6.5 months (range,2-18 months).The average time of operation was 15 min (range,9-25 min).The mean blood loss was 17 ml (range,5-25 ml).All fractures healed and the mean healing period was 9.2 weeks (range,8-12 weeks).Three had transient palsy of lateral femoral cutaneous nerve.Five had soft tissue infection while the bony structures were not involved.According to Cole's scoring for pelvic fractures,15 cases were excellent,1 case was good and 1 case was fair,with the good-excellent rate of 94.12％.According to Matta and Tornetta's standards of fracture reduction,12 were excellent,3 were good and 2 were fair,with the good-excellent rate of 88.24％.Conclusion Supra-acetabular external fixation is a minimal invasive and convenient method for treating pelvic fractures with abdominal organs injury which is mechanically stronger than traditional external fixation via iliac crest.
Key words:
Pelvis; Fractures, bone; External fixators
Objective To investigate the therapeutic effect of Meta-nailing for tibial fractures via the supra-patellar approach.Methods Eighteen patients,11 males and 7 females,were enrolled in this study who had been treated in our department from September 2011 to November 2012 for tibial metaphyseal or segmental fracture.Their average age was 39 years (range,20 to 58 years).All the fractures were closed unilateral ones which were treated with closed reduction and internal fixation with TRIGENTM META-NAILTM via the supra-patellar approach.Muscular strength training and functional exercise without weight bearing commenced 3 days postoperatively.Results The average operating time was 70.6 minutes (range,60 to 90 minutes).No postoperative complications like infection,embolism or necrosis occurred.The patients were followed up regularly with a mean time of 8.5 months (range,6 to 10 months).Bony callus was shown on X-ray films 6 weeks postoperation on average.No nonunion,infection or osteomyelitis was observed.Partial atrophy of the calf occurred in 4 cases (from 0.4 to 0.8 cm).There was no complaint of anterior knee pain among all the patients.The pain scores in Lysholm knee scoring system ranged from 21 to 25 points (average,23.8 points) and the total scores ranged from 82 to 93 points (average,89 points).Conclusions As a mini-invasive method,Meta-nailing via the supra-patellar approach is superior to traditional tibial nailing because of its simplicity in reduction and fixation for tibial segmental and metaphyseal fractures.It can be an effective option for special types of tibial fracture.
Key words:
Tibia; Fracture; Fracture fixation, internal; Bone nails; Supra-patellar approach
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