简介：AbstractPurpose:Patients’ gender, which can be one of the most important determinants of traumatic brain injury (TBI) outcomes, is also likely to interact with many other outcome variables of TBI. This multicenter descriptive study investigated gender differences in epidemiological, clinical, treatment, mortality, and variable characteristics in adult TBI patients.Methods:The selection criteria were defined as patients who had been diagnosed with TBI and were admitted to the hospital between January 1, 2016 and December 31, 2018. A total of 4468 adult TBI patients were enrolled at eight University Hospitals. Based on the list of enrolled patients, the medical records of the patients were reviewed and they were registered online at each hospital. The registered patients were classified into three groups according to the Glasgow coma scale (GCS) score: mild (13 -15), moderate (9-12), and severe (3-8), and the differences between men and women in each group were investigated. The risk factors of moderated and severe TBI compared to mild TBI were also investigated.Results:The study included 3075 men and 1393 women and the proportion of total males was 68.8%. Among all the TBI patients, there were significant differences between men and women in age, past history, and GCS score. While the mild and severe TBI groups showed significant differences in age, past history, and clinical symptoms, the moderate TBI group showed significant differences in age, past history, cause of justice, and diagnosis.Conclusion:To the best of our knowledge, this multicenter study is the first to focus on gender differences of adult patients with TBI in Korea. This study shows significant differences between men and women in many aspects of adult TBI. Therefore, gender differences should be strongly considered in TBI studies.

简介：AbstractBackground:Insufficient cerebral perfusion is suggested to play a role in the development of Alzheimer disease (AD). However, there is a lack of direct evidence indicating whether hypoperfusion causes or aggravates AD pathology. We investigated the effect of chronic cerebral hypoperfusion on AD-related pathology in humans.Methods:We enrolled a group of cognitively normal patients (median age: 64 years) with unilateral chronic cerebral hypoperfusion. Regions of interest with the most pronounced hypoperfusion changes were chosen in the hypoperfused region and were then mirrored in the contralateral hemisphere to create a control region with normal perfusion. 11C-Pittsburgh compound-positron emission tomography standard uptake ratios and brain atrophy indices were calculated from the computed tomography images of each patient.Results:The median age of the 10 participants, consisting of 4 males and 6 females, was 64 years (47-76 years). We found that there were no differences in standard uptake ratios of the cortex (volume of interest [VOI]: P = 0.721, region of interest [ROI]: P = 0.241) and grey/white ratio (VOI: P = 0.333, ROI: P = 0.445) and brain atrophy indices (Bicaudate, Bifrontal, Evans, Cella, Cella media, and Ventricular index, P > 0.05) between the hypoperfused regions and contralateral normally perfused regions in patients with unilateral chronic cerebral hypoperfusion.Conclusion:Our findings suggest that chronic hypoperfusion due to large vessel stenosis may not directly induce cerebral β-amyloid deposition and neurodegeneration in humans.

简介：Anumberofpreviousstudiesofacupunctureacupointspecificityhaveusedshamacupoints,shamacupunctureormeridianacupointsatagreatdistancefromeachotherascontrolsinfunctionalMRI(fMRI)experiments.However,fewstudieshavecompareddifferentmeridianacupointswithinthesamesegment,whichareassociatedwithsimilarlyintenseneedlesensations.WeperformedfMRIon12healthyyoungvolunteersandobserveddifferencesinbrainactivationelicitedbyacupunctureoftheTaixi(KI3)andQiuxu(GB40)acupoints.AcupuncturewasappliedattheTaixiandQiuxuacupoints,usingamultiple-blockfMRIdesignwiththreeblocks,involvingthreealternationsofrestingandtaskphases.Afterscanning,needlesensationwasassessed.ThebehavioralresultsrevealedthatthesubjectiveneedlesensationwassimilarbetweentheTaixiandQiuxuacupoints.ThefMRIresultsrevealedthatacupunctureattherightTaixiacupointactivatedtherightsuperiortemporalgyrus(BA22),leftmiddlefrontalgyrus(BA46)andinferiorfrontalgyrus(BA45),bilateralparietallobepostcentralgyrus(BA2),rightparietallobe(BA3),andleftparietallobe(BA40).AcupunctureattherightQiuxuacupointactivatedtheleftsuperiortemporalgyrus(BA42),rightparietallobepostcentralgyrus(BA40,BA43),rightinferiorfrontalgyrus(BA47),bilateralsuperiortemporalgyrus(BA22),andrightinsulaBA13.TheseresultssuggestthattherightTaixiandQiuxuacupointsactivateddifferentbrainareas.

简介：Similarlytootheradulttissues,ahierarchicalstructurehasbeenestablishedforthebrain,wherethedifferentiatedcelltypes(neurons,oligodendrocytesandastrocytes)aregeneratedfromprimaryprogenitorcells,knownastypeB

简介：Theliteratureshowsthatimprovementsincognitiveperformancemaybeobservedfollowinganacuteboutofexercise.However,evidenceinsupportofthebiologicalmechanismsofthiseffectisstilllimited.Findingsfrombothrodentandhumanstudiessuggestbrain-derivedneurotrophicfactor(BDNF)asapotentialmechanismoftheeffectofacuteexerciseonmemory.ThemolecularpropertiesofBDNFallowthisproteintobeassessedintheperiphery(pBDNF)(i.e.,bloodserum,bloodplasma),makingmeasurementsofacuteexercise-inducedchangesinBDNFconcentrationrelativelyaccessible.StudiesexploringtheacuteexerciseepBDNFecognitiveperformancerelationshiphavehadmixedfindings,butthismaybemorereflectiveofmethodologicaldifferencesbetweenstudiesthanitisastatementabouttheroleofBDNF.Forexample,significantassociationshavebeenobservedbetweenacuteexercise-inducedchangesinpBDNFconcentrationandcognitiveperformanceinstudiesassessingmemory,andnon-significantassociationshavebeenfoundinstudiesassessingnon-memorycognitivedomains.ThreesuggestionsaremadeforfutureresearchaimedatunderstandingtheroleofBDNFasabiologicalmechanismofthisrelationship:1)Assessmentsofcognitiveperformancemaybenefitfromafocusonvarioustypesofmemory(e.g.,relational,spatial,long-term);2)MorefinegrainedmeasurementsofpBDNFwillallowfortheassessmentofconcentrationsofspecificisoformsoftheBDNFprotein(i.e.,immature,mature);3)StatisticaltechniquesdesignedtotestthemediatingroleofpBDNFintheacuteexercise-cognitiveperformancerelationshipshouldbeutilizedinordertomakecausalinferences.

简介：Objective:Tostudytheeffectofelectroacupuncture(EA)andVerapamilandNifedipine(calciumchannelinhibitors)onfreecalciumconcentrationsofcellsandintrasynaptosomesinhypothalamus(HT),periaqueductualgreymatter(PAG)andhippocampus(HIP)ofmice.Methods:ThefemaleICRmicewererandomlydividedintocontrol,EA,CaCl2andCaCl2+EAgroups(n=8ineachgroup).Painthresholdwasdetectedbyusingradiation-heatirradiation-inducedtailflickmethod.EA(8Hz,asuitablestimulatingstrength,dense-sparsewavesanddurationof30min)wasappliedto'Shuigou'(水沟GV26)and'Chengjiang'(承浆CV24).CaCl2(10μL,0.2μmol/L)wasinjectedintothelateralcerebralventricleofmiceafterEA.Theconcentrationsofcytosolicfreecalcium([Ca2+]i)inHIP,PAG,HTcellsuspensionspecimenandhippocampalintrasynaptosomesuspensionofmiceweredeterminedbythefluorescentcalciumindicatorFura-2-AMandaspectrofluorometer.Results:DuringEAanalgesia,theintracellularfree[Ca2+]iinHTandPAGspecimensandintrsynaptosomal[Ca2+]iofthe3cerebralregionsdecreasedconsiderably(P<0.05～0.01),butthatinhippocampalcellsuspensionincreasedsignificantly(P<0.01)incomparisonwithcontrolgroup.Theconcentrationsofhippocampalintrasynaptosomalfree[Ca2+]idecreasedsignificantlyafteraddingVerapamilandNifedipinetotheextractedhippocampalintrasynaptosomalspecimen.MicroinjectionofCaCl2intolateralventriclehadnoapparentinfluenceondegreeofanalgesia(DA)%andintracellularandintrasynapsotomal[Ca2+]i,butsignificantlylowerDA%andreducechangesofcytosolicandintrasynaptosomal[Ca2+]iinducedbyEAstimulation.Conclusion:CalciumionintheneuronsandintrasynaptosomeofHT,PAGandHIPisinvolvedinelectroacupunctureanalgesia.

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简介：ObjectiveThebrainTXA_2andPGl_2levelsinanewrodentmodelofimpactaccelerationdiffusebraininjuryaloneandwithhypotentionandhyperthermiaincombinationwereob-servedtolookintotherelationshipbetweenTXA_2,PGI_2levelsanddifferenttypesofheadinjury.MethodsThirty-twoSDratswereran-

简介：Therearecurrentlynofederallyapprovedneuroprotectiveagentstotreattraumaticbraininjury.Progesterone,ahydrophobicsteroidhormone,hasbeenshowninrecentstudiestoexhibitneuroprotectiveeffectsincontrolledcorticalimpactratmodels.Aktisaproteinkinaseknowntoplayaroleincellsignalingpathwaysthatreduceedema,inflammation,apoptosis,andpromotecellgrowthinthebrain.ThisstudyaimstodetermineifprogesteronemodulatesthephosphorylationofAktviaitsthreonine308phosphorylationsite.Phosphorylationatthethreonine308siteisoneofseveralsitesresponsibleforactivatingAktandenablingtheproteinkinasetocarryoutitsneuroprotectiveeffects.ToassesstheeffectsofprogesteroneonAktphosphorylation,C57BL/6miceweretreatedwithprogesterone(8mg/kg)at1(intraperitonally),6,24,and48hours(subcutaneously)postclosed-skulltraumaticbraininjury.Thehippocampuswasharvestedat72hourspostinjuryandpreparedforwesternblotanalysis.TraumaticbraininjurycausedasignificantdecreaseinAktphosphorylationcomparedtoshamoperation.However,micetreatedwithprogesteronefollowingtraumaticbraininjuryhadanincreaseinphosphorylationofAktcomparedtotraumaticbraininjuryvehicle.Ourfindingssuggestthatprogesteroneisaviabletreatmentoptionforactivatingneuroprotectivepathwaysaftertraumaticbraininjury.

简介：AbstractPurpose:Malnutrition is a common problem among hospitalized patients, especially among traumatic brain injury (TBI) patients. It is developed from hypermetabolism and the condition may worsen under the circumstance of underfeeding or incompatible dietary management. However, the data of nutrient intake especially calorie and protein among TBI patients were scarce. Hence, this study aimed to determine the calorie and protein intake among acute and sub-acute TBI patients receiving medical nutrition therapy in hospital Sultanah Nur Zahirah, Terengganu.Methods:This observational study involved 50 patients recruited from the neurosurgical ward. Method of 24 h dietary recall was utilized and combined with self-administered food diaries for 2-8 days. Food consumptions including calorie intake and protein intake were analyzed using Nutritionist PRO™ (Woodinville, USA) and manual calculation based on the Malaysian food composition database (2015).Results:Patients consisted of 56% males and 44% females with the median age of 28.0 (IQR = 22.8-36.5) years, of which 92% were diagnosed as mild TBI and the remaining (8%) as moderate TBI. The Glasgow coma scale (GCS) was adopted to classify TBI severity with the score 13-15 being mild and 9-12 being moderate. The median length of hospital stay was 2 (IQR = 2.0-3.3) days. Calorie and protein intake improved significantly from day 1 to discharge day. However, the intake during discharge day was still considered as suboptimal, i.e. 75% of calorie requirement, whilst the median protein intake was only 61.3% relative to protein requirement. Moreover, the average percentages of calorie and protein intakes throughout hospitalization were remarkably lower, i.e. 52.2% and 41.0%, respectively.Conclusion:Although the calorie and protein intakes had increased from baseline, hospitalized TBI patients were still at a risk to develop malnutrition as the average intakes were considerably low as compared to their requirements. Optimum nutrient intakes especially calorie and protein are crucial to ensure optimum recovery process as well as to minimize risks of infection and complications.

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简介：AbstractBackground:Globally, severe traumatic brain injury (TBI) has been the principal cause of mortality among individuals aged 45 and below. The incidence of road traffic accidents in Malaysia is one of the highest in the world with thousands of victims sustaining severe disabilities. The aim of this study is to determine the association between leucocytosis and extended Glasgow Outcome Scale (GOSE) scores as well the relationship of other factors and the outcomes of severe TBI.Methods:This was a retrospective observational study. A total of 44 consecutive patients who were admitted to Sarawak General Hospital from January 1, 2018, to September 30, 2018, with severe TBI were included. Data were collected from discharge summaries and hospital medical records. Chi-square and t test were used. SPSS was employed.Results:Of a total of 44 patients with severe TBI, 18 patients (41%) died during the same admission. The mean age of patients was 37.1 years with 93.2% of affected patients being male. 56.9% of patients presented with a Glasgow Coma Scale (GCS) of 6 and less. A large percentage (86.3%) were discharged with a GOSE of less than 7. Older age and low admission GCS (6 and less) were significantly associated with poor GOSE scores on discharge and after 6 months (p < 0.05) on multivariate analysis. Leucocytosis on admission was also associated with poor outcomes where patients with higher total white counts on presentation attaining lower GOSE scores (p < 0.05).Conclusion:We concluded that leucocytosis was significantly associated with poor outcomes in severe TBI patients in addition to other factors such as advanced age and poor GCS on arrival.

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简介：Thesurfacedielectricbarrierdischarge(SDBD)plasmaactuatorhasshowngreatpromiseasanaerodynamicflowcontroldevice.Inthispaper,theencapsulatedelectrodewidthofaSDBDactuatorischangedtostudytheairflowaccelerationbehavior.Theeffectsofencapsulatedelectrodewidthontheactuatorperformanceareexperimentallyinvestigatedbymeasuringthedielectriclayersurfacepotential,time-averagedionicwindvelocityandthrustforce.Experimentalresultsshowthattheairflowvelocityandthrustforceincreasewiththeencapsulatedelectrodewidth.Theresultscanbeattributedtothedistinctplasmadistributionatdifferentencapsulatedelectrodewidths.

简介：WeinvestigatethesurfacestructureandcompositionofaYBa2Cu3Oy(YCO)thinfilmodifiedbyCF4plasmafluorination.Inadditiontotheabsorptionofhydrocarbons,chemicalreactionsoftheYBCOsurfacetakeplaceduringCF4plasmatreatment.Variousx-rayphotoelectronspectroscopicdataarereportedanddiscussed.Theexistenceofathinbarrierisconfirmed,whichhomogeneouslycoverstheedgeofthebaseYBCOfilminourinterfaceengineeringJosephsonjunction.MeasurementsofAugerelectronspectroscopicdataandtheresistanceversustemperatureindicatethatthebarrierisacontrollable-insulatinglayer.

简介：Objective:TostudytheexpressionofFasandBcl-2proteinsonTlymphocytesubsetsintheperipheralbloodofrelapsingpatientswithcondylomaacuminatum(CA)andhealthycontrols.Methods:Flowcytometry(permeabizationandstainingprocedurewithconjugatedantibodies)wasused.Results:WeobservedthattheexpressionofFasproteinonCD4^+TlymphocytesubsetofCApatientswassignificantlyhigherthanthatofhealthycontrols(P<0.01).Conclusions:IncreasedexpressionofFasproteinonCD4^+Tlymphocytesubsetmaybeacauseofde-creasedpercentageofCD4^+Tlymphocytesubset.ThisinducestheincreasedratioofCD4^+/CD8^+.

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