Treelet transform analysis to identify clusters of systemic inflammatory variance in a population with moderate-to-severe traumatic brain injury

BackgroundInflammatory cascades following traumatic brain injury (TBI) can have both beneficial and detrimental effects on recovery. Single biomarker studies do not adequately reflect the major arms of immunity and their relationships to long-term outcomes. Thus, we applied treelet transform (TT) analysis to identify clusters of interrelated inflammatory markers reflecting major components of systemic immune function for which substantial variation exists among individuals with moderate-to-severe TBI.MethodsSerial blood samples from 221 adults with moderate-to-severe TBI were collected over 1–6 months post-injury (n = 607 samples). Samples were assayed for 33 inflammatory markers using Millipore multiplex technology. TT was applied to standardized mean biomarker values generated to identify latent patterns of correlated markers. Treelet clusters (TC) were characterized by biomarkers related to adaptive immunity (TC1), innate immunity (TC2), soluble molecules (TC3), allergy immunity (TC4), and chemokines (TC5). For each TC, a score was generated as the linear combination of standardized biomarker concentrations and cluster load for each individual in the cohort. Ordinal logistic or linear regression was used to test associations between TC scores and 6- and 12-month Glasgow Outcome Scale (GOS), Disability Rating Scale (DRS), and covariates.ResultsWhen adjusting for clinical covariates, TC5 was significantly associated with 6-month GOS (odds ratio, OR = 1.44; p-value, p = 0.025) and 6-month DRS scores (OR = 1.46; p = 0.013). TC5 relationships were attenuated when including all TC scores in the model (GOS: OR = 1.29, p = 0.163; DRS: OR = 1.33, p = 0.100). When adjusting for all TC scores and covariates, only TC3 was associated with 6- and 12-month GOS (OR = 1.32, p = 0.041; OR = 1.39, p = 0.002) and also 6- and 12-month DRS (OR = 1.38, p = 0.016; OR = 1.58, p = 0.0002). When applying TT to inflammation markers significantly associated with 6-month GOS, multivariate modeling confirmed that TC3 remained significantly associated with GOS. Biomarker cluster membership remained consistent between the GOS-specific dendrogram and overall dendrogram.ConclusionsTT effectively characterized chronic, systemic immunity among a cohort of individuals with moderate-to-severe TBI. We posit that chronic chemokine levels are effector molecules propagating cellular immune dysfunction, while chronic soluble receptors are inflammatory damage readouts perpetuated, in part, by persistent dysfunctional cellular immunity to impact neuro-recovery.     

方丝片段弓治疗儿童前牙外伤60例临床观察

目的评价方丝片段弓在儿童前牙外伤复位固定的临床疗效。方法对60例儿童前牙外伤患者共计86颗外伤前牙,应用方丝片段弓固定,时间4～8周。结果经过24个月追踪随访复查86颗外伤牙中成功44颗,有效39颗,失败3颗,总有效率96.51%。结论方丝片段弓用于儿童前牙外伤复位固定可靠而有效。     

Unpacking the Associations between Traumatic Events and Depression among Chinese Elderly: Two Dimensions of Aging Attitudes as Mediators and Moderators

Traumatic events have been considered significant risk factors for older adults’ mental health, but the mediating mechanism and moderating effect of aging attitudes that underlie this relationship have yet been completely investigated. The attitudes of the elderly toward aging can be divided into two closely related but conceptually different dimensions, including positive and negative. Positive aging attitudes refer to optimistic feelings and experiences about aging, whereas negative attitudes toward aging are related to detrimental thoughts and sensations experienced about the increasing age. The purpose of this study is to explore the mediating and moderating roles of these two dimensions of aging attitudes between traumatic events and depression of the elderly in China. Data for this research come from the China Longitudinal Aging Social Survey (CLASS) of 2014. A nationally representative sample consisting of 11,511 Chinese older adults aged 60 and above was obtained through a stratified, multi-stage probability sampling method. The results revealed that the association between traumatic events and depression was mediated and moderated by positive and negative aging attitudes, controlling for gender, age, spouse, educational level, and ethnicity. Significance, implications, and limitations were discussed.     

Impact of traumatic brain injury on social cognition in adolescents and contribution of other higher order cognitive functions

Social cognition impairments can contribute to social participation difficulties following traumatic brain injury (TBI). However, little attention has been given to these impairments during adolescence, a period of life when peer relationships are central. The aim of the current study was to examine the impact of a moderate to severe TBI sustained in adolescence on multiple facets of social cognition. Twenty-three adolescents who had sustained a moderate-to-severe TBI were compared with a group of 23 typically developing peers. The Integrated Social Cognition Battery (mentalising, social knowledge, emotion recognition) and the Interpersonal Reactivity Index were administered, along with non-social cognition tests (selective attention, working memory, executive functions), IQ estimation, and a socio-demographic questionnaire. Adolescents with TBI reported having a significantly lower ability to take other people's perspectives versus controls. They also presented significantly lower levels of mentalising. After controlling for non-social higher-order cognitive variables, the group effect on mentalising remained marginally significant, whereas the effect on perspective taking remained significant. Our findings suggest the presence of primary deficits in social cognition following TBI in adolescence. These deficits could partially underlie the social reintegration difficulties encountered following TBI. A systematic assessment of social cognition in clinical practice is necessary.     

The impact of eye movements and tones on disturbing memories involving PTSD and other mental disorders

BackgroundA wide array of experimental studies are supportive of a working memory explanation for the effects of eye movements in EMDR therapy. The working memory account predicts that, as a consequence of competition in working memory, traumatic memories lose their emotional charge.MethodThis study was aimed at investigating (1) the effects of taxing the working memory, as applied in EMDR, during recall of negative memories in 32 patients with posttraumatic stress disorder (PTSD), and 32 patients with other mental disorders, and (2) whether the results would differ between both groups. In a therapeutic session patients were asked to recollect a crucial upsetting memory while, in counterbalanced order (a) performing eye movements, (b) listening to tones and (c) watching a blank wall (‘recall only’), each episode lasting 6 min.ResultsEye movements were found to be more effective in diminishing the emotionality of the memory than ‘recall only’. There was a trend showing that tones were less effective than eye movements, but more effective than ‘recall only’. The majority of patients (64%) preferred tones to continue with. The effects of taxing working memory on disturbing memories did not differ between PTSD patients and those diagnosed with other conditions.ConclusionsThe findings provide further evidence for the value of employing eye movements in EMDR treatments. The results also support the notion that EMDR is a suitable option for resolving disturbing memories underlying a broader range of mental health problems than PTSD alone.     

Direct hippocampal injection of pseudo lentivirus-delivered nerve growth factor gene rescues the damaged cognitive function after traumatic brain injury in the rat

Traumatic brain injury (TBI) treatment is a long-term process and requires repeated medicine administration, which, however, can cause high expense, infection, and hemorrhage to patients. To investigate how a long-term expression of nerve growth factor (Ngf) gene affects the injured hippocampus function post-TBI, in this study, a pseudo lentivirus carrying the β-Ngf fusion gene, with green fluorescence protein (GFP) gene, was constructed to show the gene expression and its ability of protecting cells from oxidative damage in vitro. Then, the pseudo lentivirus-carried β-Ngf fusion gene was directly injected into the injured brain to evaluate its influence on the injured hippocampus function post-TBI in vivo. We found that the expression of the pseudo lentivirus-delivered β-Ngf fusion gene lasted more than four-week after the cell transduction and the encoded β-NGF fusion protein could induce the neuron-like PC12 cell differentiation. Moreover, the hippocampal injection of the pseudo lentivirus-carried β-Ngf fusion gene sped the injured cognitive function recovery of the rat subjected to TBI. Together, our findings indicate that the long-term expression of the β-Ngf fusion gene, delivered by the pseudo lentivirus, can promote the neurite outgrowth of the neuron-like cells and protect the cells from the oxidative damage in vitro, and that the direct and single dose hippocampal injection of the pseudo lentivirus-carried β-Ngf fusion gene is able to rescue the hippocampus function after the TBI in the rat.     

循证护理在脑外伤偏瘫患者常见并发症预防中的实践

目的探讨循证护理在脑外伤偏瘫患者常见并发症预防中的实践。方法对2008年8月～2009年12月入住我病房的脑外伤偏瘫患者105例通过成立循证护理小组、确定循证问题、寻找循证支持进行循证护理。结果经过以上措施,患者出院时,无一例发生压疮及坠积性肺炎,1例发生尿路感染,2例发生便秘。结论对本病房脑外伤偏瘫患者恢复期常见问题的预防进行循证护理,效果满意。