Use of Hospital-Based Rehabilitation Services and Hospital Readmission Following Ischemic Stroke in the United States

ObjectiveTo examine the association between hospital-based rehabilitation service use and all-cause 30-day hospital readmission among patients with ischemic stroke.DesignSecondary analysis of inpatient Medicare claims data using Standard Analytical Files.SettingAcute hospitals across the United States.ParticipantsFrom nationwide data, Medicare fee-for-service beneficiaries (N=88,826) aged 66 years or older hospitalized for ischemic stroke between January to November 2010.InterventionsHospital-based rehabilitation services were quantified using Medicare inpatient claims revenue center codes for evaluation (occupational therapy [OT] and physical therapy [PT]), as well as the number of therapy units delivered. Therapy minutes for both OT and PT services were categorized into none, low, medium, and high.Main Outcome MeasuresAll-cause 30-day hospital readmission. A generalized linear mixed model was used to examine the effect of hospital-based rehabilitation services on 30-day hospital readmission, after adjusting for patient and hospital characteristics.ResultsIn fully adjusted models, compared to patients who received no PT, we observed a monotonic inverse relationship between the amount of PT and hospital readmission. For low PT (30 minutes), the odds ratio (OR) was 0.90 (95% confidence interval [CI], 0.83-0.96). For medium PT (>30 to ≤75 minutes), the OR was 0.89 (95% CI, 0.82-0.95). For high PT (>75 minutes), the OR was 0.86 (95% CI, 0.80-0.93).ConclusionHospital-based PT services were associated with lower risk of 30-day hospital readmission in patients with ischemic stroke.     

松树皮提取物对小鼠脑缺血再灌注损伤的保护作用及机制研究

目的 探讨IL-6/STAT3/miR-21在松树皮提取物对脑缺血再灌注损伤小鼠的神经治疗作用和机制。方法 将120只KM小鼠随机分为正常对照组、假手术组、14 d及28 d模型组、14 d及28 d治疗组,每组20只,采取双侧颈总动脉夹闭法制作脑缺血再灌注损伤模型;治疗组在处死前7 d给予松树皮提取物原花青素灌胃治疗,对照组和假手术组采用等量生理盐水灌胃。检测各组小鼠学习、记忆能力的差异及海马组织病理学改变、白介素6、STAT3、p-STAT3蛋白、miR-21的表达水平。结果 同时间节点治疗组小鼠比模型组小鼠学习记忆能力强;治疗组尼氏体排列紊乱,其中一部分细胞形态不规则,胞质着色相对较浅,但比模型组好;28 d模型组IL-6表达水平低于14 d模型组,同时间点治疗组海马组织中的IL-6较模型组明显减少;海马组织中STAT3总蛋白含量各组间差异无显著性（P>0.05）,同时间点治疗组p-STAT3含量低于模型组;海马组织中miR-21在14、28 d治疗组的表达低于同时间点模型组,且随时间的延长而降低。结论 松树皮提取物原花青素能通过有效抑制IL-6,显著降低STAT3磷酸化水平,最终降低miR-21表达,从而发挥减轻小鼠脑缺血再灌注脑损伤的作用。     

松针不同提取物镇静催眠作用及对脑神经递质的影响

目的:研究比较松针不同提取物的镇静、催眠及对脑神经递质的作用。方法:通过直接诱导小鼠睡眠,观察比较松针不同提取物对戊巴比妥钠阈上、阈下剂量致小鼠睡眠的协同作用;采用HPLC法测定给药后小鼠脑海马中γ-氨基丁酸和谷氨酸的含量。结果:松针正丁醇提取物和乙酸乙酯提取物能明显延长阈上剂量戊巴比妥钠致小鼠睡眠时间(P<0.01),增加阈下剂量戊巴比妥钠致小鼠睡眠只数(P<0.01);有效提取物可增加海马中γ-氨基丁酸含量(P<0.05)。结论:松针正丁醇提取物和乙酸乙酯提取物均具有明显的镇静催眠作用。     

Deposition of Organochlorine Pesticides,PCBs (Aroclor 1268), and PBDEs in Selected Plant Species from a Superfund Site at Brunswick,Georgia, USA

Deposition of organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs) and polybrominated diphenyl ethers (PBDEs) were measured in Loblolly pine needles (Pinus taeda) collected in and around a Linden Chemicals and Plastics (LCP) Superfund Site at Brunswick, Georgia, USA. For the comparison, foliage of eastern red cedar (Juniperus virginiana) was also collected to monitor contaminant levels. This study revealed that concentrations of OCPs, PCBs and PBDEs ranged from 0.75–10, 3.4–15 to 0.05–3, ng/g wet wt, respectively in both plant species. Total OCPs concentrations in pine needles decreased from 10 to 2.3 ng/g; and total PCBs decreased from 28 to 9.3 ng/g between 1997 and 2006. To our knowledge, this is the first report on PBDEs concentrations in pine needles and red cedar foliage samples from the Superfund Site at Brunswick, Georgia, USA.