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The long-term survival outcomes of radical prostatectomy (RP) in Chinese prostate cancer (PCa) patients are poorly understood. We conducted a single-center, retrospective analysis of patients undergoing RP to study the prognostic value of pathological and surgical information. From April 1998 to February 2022, 782 patients undergoing RP at Queen Mary Hospital of The University of Hong Kong (Hong Kong, China) were included in our study. Multivariable Cox regression analysis and Kaplan-Meier analysis with stratification were performed. The 5-year, 10-year, and 15-year overall survival (OS) rates were 96.6%, 86.8%, and 70.6%, respectively, while the 5-year, 10-year, and 15-year PCa-specific survival (PSS) rates were 99.7%, 98.6%, and 97.8%, respectively. Surgical International Society of Urological Pathology PCa grades (ISUP Grade Group) ≥4 was significantly associated with poorer PSS (hazard ratio [HR] = 8.52, 95% confidence interval [CI]: 1.42-51.25, P = 0.02). Pathological T3 stage was not significantly associated with PSS or OS in our cohort. Lymph node invasion and extracapsular extension might be associated with worse PSS (HR = 20.30, 95% CI: 1.22-336.38, P = 0.04; and HR = 7.29, 95% CI: 1.22-43.64, P = 0.03, respectively). Different surgical approaches (open, laparoscopic, or robotic-assisted) had similar outcomes in terms of PSS and OS. In conclusion, we report the longest timespan follow-up of Chinese PCa patients after RP with different approaches.
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Male , Humans , Retrospective Studies , Prostatic Neoplasms/pathology , Prostate/pathology , Prostatectomy , Prognosis , Neoplasm GradingABSTRACT
Objective:To analyze the predictive factors of GGU between biopsy and radical prostatectomy pathology based on 2014 ISUP grouping system, then establish and evaluate nomogram.Methods:Patients undergoing radical prostatectomy in Shanghai Ruijin Hospital from March 2012 to March 2019 were reviewed, and the clinical and pathological information were collected. Age(68.1±7.2), body mass indes(BMI) (24.2±3.2)kg/m 2, prostate specific antigen(PSA) 11.5(6.7-20.4)ng/ml, prostate specific antigen destiny(PSAD) 0.35(0.20-0.66). Before March 2017, the number of biopsy cores were 6 to 8; After then, all patients toke 12 cores systemic biopsy. Based on 2014 ISUP grouping system, the differences between biopsy and radical prostatectomy grades were counted. The independent predictors of GGU were analyzed by univariate and multivariate logistic regression analysis, then the nomogram for predicting GGU were established and evaluated. Results:429 patients were enrolled. There were 161 (37.5%) patients in GGU group and 268 (62.5%) patients in non-GGU group. After multivariate logistic regression analysis, body mass index (BMI)>28 kg/m 2( OR=2.54, P=0.021), prostate specific antigen density (PSAD)( OR=1.65, P=0.018)and 2014 ISUP grouping sysyem ( OR=0.53, P<0.001) of biopsy specimen were independent impact factors of GGU. The predicting model was established according to BMI, PSAD and 2014 ISUP grouping system. The area under the ROC cure of the model was 0.735 (95% CI 0.681-0.789). The nomogram model was well calibrated, with the mean absolute error of 6.7%, which means the prediction of GGU is fairly consistent with the actual situation. Conclusions:Based on the 2014 ISUP grouping system, BMI>28 kg/m 2, PSAD and 2014 ISUP grouping of biopsy specimen were independent predictors of GGU. The nomogram model for predicting GGU has a good statistical significance.
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Objective:To analyze the characteristics of respiratory pathogen spectrum in adult patients with acute exacerbation of bronchiectasis and its correlation with the severity of disease.Methods:A total of 108 patients with stable bronchiectasis from January 2014 to May 2018 in the Third People′s Hospital of Haikou City were enrolled. Sputum bacteria were cultured and common respiratory viruses in sputum and nasal swabs were detected by fluorescence quantitative polymerase chain reaction(PCR). All bronchiectasis patients were followed up for 1 year. Sputum bacteria culture and PCR virus detection were performed again in patients with acute exacerbation, and the differences of respiratory pathogen spectrum in patients with different severity of acute exacerbation were compared.Results:During the follow-up period, there were 53 cases of acute exacerbation events and a total of 91 case-times (up to 5 times per patient). The positive rates of sputum virus and nasal swab virus in patients with acute exacerbation were significantly higher than those in patients with stable period [39.6% (36/91) vs. 15.1% (8/53) , 45.1% (41/91) vs. 9.4% (5/53) ], and there were significant differences ( χ2=8.460, 13.621, P<0.05). However, the total positive rate of sputum bacterial culture in acute exacerbation and stable period had no significant difference ( P>0.05). The positive rate of Pseudomonas aeruginosa [0, 34.6% (9/26) ,52.4% (22/42) ] and rhinovirus [8.7% (2/23) ,3.8% (1/26) ,23.8% (10/42) ] in sputum among mild patients (16 cases, 23 case-times), moderate patients (16 cases, 26 case-times) and severe patients (21 cases, 42 case-times) in acute exacerbation stage were significant differences ( P<0.05). The levels of C-reactive protein (CRP) and interleukin (IL)-8 in patients in mixed infection of bacteria and viruses group in acute exacerbation stage were significantly higher than those in negative group, bacteria group and viruses group [CRP: (45.6 ± 23.0) mg/L vs. (11.2 ± 2.7) , (32.3 ± 10.2) , (21.3 ± 8.0) mg/L; IL-8: (9.0 ± 2.5) ng/L vs. (1.5 ± 0.9) , (1.8 ± 1.1) , (2.0 ± 1.3) ng/L], and there were significant differences ( F=23.012, 9.926, P<0.05). The hospitalization rate of patients in mixed infection of bacteria and viruses group was significantly higher than that in negative group, bacteria group and viruses group [29.6% (8/27) vs. 0, 16.7% (4/24) , 1/18] , and there were significant differences ( χ2=7.691, P<0.05). Conclusions:The positive rate of respiratory viruses in acute exacerbation of bronchiectasis in adults is significantly higher than that in stable stage. Pseudomonas aeruginosa and rhinovirus are the main infections in moderate and severe patients, Haemophilus parainfluenzae and influenza A virus are the main infections in mild patients, and the patients with mixed infection of bacteria and viruses have severe systemic inflammatory reaction and high hospitalization rate.
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To evaluate whether prostate volume (PV) would provide additional predictive utility to the prostate health index (phi) for predicting prostate cancer (PCa) or clinically significant prostate cancer, we designed a prospective, observational multicenter study in two prostate biopsy cohorts. Cohort 1 included 595 patients from three medical centers from 2012 to 2013, and Cohort 2 included 1025 patients from four medical centers from 2013 to 2014. Area under the receiver operating characteristic curves (AUC) and logistic regression models were used to evaluate the predictive performance of PV-based derivatives and models. Linear regression analysis showed that both total prostate-specific antigen (tPSA) and free PSA (fPSA) were significantly correlated with PV (all P 0.05). In conclusion, PV-based derivatives (both PHIV and PHID) and models incorporating PV did not improve the predictive abilities of phi for either PCa or clinically significant PCa.
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@#AIM: To examine and investigate the contrast visual acuity and eyes care habits in Air Force pilot cadets, and analyze the change of contrast visual acuity and the related influencing factors.<p>METHODS: The contrast visual acuity of the students in Grade One and Grade Two at an aviation university was recorded and analyzed, and the visual habits were recorded and analyzed by questionnaire.<p>RESULTS: A total of 117 students in Grade One and 210 students in Grade Two were enrolled. The contrast visual acuity of both eyes over 1.0 were 83 students(70.9%)in Grade One and 174 students(82.9%)in Grade Two respectively(<i>P</i><0.05). Questionnaire survey on the eye care habits by students, showing the second grade students of daily reading time, outdoor sports, sports category, use at night time, with a focus on electronic product knowledge and the degree of attention and when flying cadets were significantly different(<i>P</i><0.05). There were 87.2% students of Grade One and 93.3% students of Grade Two taking less than or equal to 6h to get daily reading and learning time, 34.2% students of Grade One and 13.8% students of Grade Two taking outdoor sports less than or equal to 2h, 57.3% students of Grade One and 90.0% students of Grade Two taking more than One category of exercise,38.5% students of Grade One and 43.3% students of Grade Two using electronic production less than or equal to 2h, 85.5% students of Grade One and 75.7% students of Grade Two using electronic production at night, and 61.5% students of Grade One and 81.0% students of Grade Two paying high attention to the use of scientific knowledge(<i>P</i><0.05). <p>CONCLUSION: The contrast visual acuity of Air Force pilot cadets keeps improving at theoretical study stage, mainly including the following reasons such as the decreasing of reading time, the increasing of outdoor sports, the improving of exercise methods, the reduce using of electronic production and the enhancing of eyes-using knowledge.
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The mechanisms involved in virus-induced severe hepatitis have not been fully elucidated.In this study,we investigated the role of gamma delta T cell receptors (γδ) T cells in the pathogenesis of fulminant viral hepatitis (FVH) induced by murine hepatitis virus strain 3 (MHV-3).The model of FVH was established by intraperitoneal injection of MHV-3 into Balb/cJ mice.The survival days of mice,and the serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were examined.The proportions ofγδ T cells in blood,spleen and liver,and cytokines secreted by hepatic γδ T cells were analyzed by flow cytometry.The function of hepatic γδ T cells was examined by cytotoxicity assay.Balb/cJ mice died in 3 to 6 days post MHV-3 infection,with severe hepatic necrosis and significant augmentation of serum ALT and AST levels.The proportions of γδ T ceils in blood,spleen and liver were significantly increased post MHV-3 infection,while those of the early activating molecule CD69-expressing γδ T cells and productions of cytokines tumor necrosis factor-alpha (TNF-α) and interferon-γ (IFN-γ) increased remarkably in the liver.These highly activated liver γδ T cells were cytotoxic to MHV-3-infected hepatocytes in vitro and this effect of liver γδ T cells against hepatocytes might involve the TNF-α and IFN-γ pathway.These results demonstrated that γδ T cells might contribute to the pathogenesis ofMHV-3-induced FVH through the effector cytokines TNF-α and IFN-γ.
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The mechanisms involved in virus-induced severe hepatitis have not been fully elucidated.In this study,we investigated the role of gamma delta T cell receptors (γδ) T cells in the pathogenesis of fulminant viral hepatitis (FVH) induced by murine hepatitis virus strain 3 (MHV-3).The model of FVH was established by intraperitoneal injection of MHV-3 into Balb/cJ mice.The survival days of mice,and the serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were examined.The proportions ofγδ T cells in blood,spleen and liver,and cytokines secreted by hepatic γδ T cells were analyzed by flow cytometry.The function of hepatic γδ T cells was examined by cytotoxicity assay.Balb/cJ mice died in 3 to 6 days post MHV-3 infection,with severe hepatic necrosis and significant augmentation of serum ALT and AST levels.The proportions of γδ T ceils in blood,spleen and liver were significantly increased post MHV-3 infection,while those of the early activating molecule CD69-expressing γδ T cells and productions of cytokines tumor necrosis factor-alpha (TNF-α) and interferon-γ (IFN-γ) increased remarkably in the liver.These highly activated liver γδ T cells were cytotoxic to MHV-3-infected hepatocytes in vitro and this effect of liver γδ T cells against hepatocytes might involve the TNF-α and IFN-γ pathway.These results demonstrated that γδ T cells might contribute to the pathogenesis ofMHV-3-induced FVH through the effector cytokines TNF-α and IFN-γ.
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Chronic hepatitis B virus (HBV) infection remains a major global health issue.At present,nucleos(t) ide analogues (NAs) and interferon (IFN) or pegylated interferon (PEG-IFN) are used as the antiviral therapy.NA therapy is generally safe and well tolerated,but it has a high virological recurrence rate after drug withdrawal and a long course of treatment which may require lifelong medication.PEG-IFN therapy has the advantages of relatively shorter course of treatment,longer response,and lower rate of resistance;however,only some patients can achieve sustained response to IFN,and IFN has a high rate of adverse events,which limits the wide application of IFN in clinical practice.Since HBV covalently closed circular DNA and the integrated HBV genome stably exist in the nuclei of infected hepatocytes,it is difficult to achieve the elimination (complete cure) of HBV.The ideal endpoint of antiviral therapy for chronic hepatitis B recommended by most guidelines is the sustained disappearance of HBsAg,with or without HBsAb seroconversion (functional cure).Theoretically,a combination of antiviral agents with different anti-HBV mechanisms,including the drugs for viral suppression and immune modulation,is a promising strategy for the treatment of chronic hepatitis B.Latest studies have demonstrated that compared with NA alone,NA given concurrently or sequentially with PEG-IFN has certain advantages in virologic and serological response.Our articles published in Journal of Hepatology in 2015 and Journal of Infectious Diseases in December 2017 introduce the research advances in treatment strategies for chronic hepatitis B and put forward our thoughts on clinical cure of chronic hepatitis B and related clinical routes,with reference to research findings in China and foreign countries.This article provides some updated information.
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Objective Based on CT imaging measurements to investigate the relevant parameters of 3D positioning that are used for the puncturing of trigeminal nerve via foramen rotundum route, and to discuss the influences of gender, age, and BMI on the measurements of these parameters in order to improve the success rate of puncturing. Methods A total of 64 patients with trigeminal neuralgia (second branch), who were successfully treated with CT - guided radiofrequency thermocoagulation of trigeminal nerve via foramen rotundum route during the period from August 2015 to March 2017, were included in this study. Their CT images were retrospectively analyzed. The line from the opening of the external auditory canal to the root of the nose (ear-nose line) was used as the base line on sagittal plane, and the angle between the ear-nose line and the puncture needle (angle α) was measured. On transverse section drawing a line between the midpoint of nose bridge and the midpoint of the posterior edge of the ethmoid sinus (M line), the angle between M line and the puncture needle (angle β) was determined. The vertical distance from the midpoint of the foramen rotundum to M line(D1), the vertical distance from needle puncture point to M line(D2), and the puncture depth (D3) were respectively measured. Results The angle α varied from 44. 10° to 63. 50° with a mean of (55. 05°±5. 48°). The angle β ranged from 26. 42° to 68. 37° with an average of (38. 19°±8. 58°). The distance of D1 was (19. 55±2. 67) mm, the distance of D2 was (58. 50±5. 41) mm, and the depth of D3 was (64. 89+8. 21) mm. The gender, age and BMI value showed a close correlation with the puncture angle and the puncture depth (P＜0. 05), and no statistically significant differences in these indexes existed between the left side and the right side (P＞0. 05). Conclusion The angle a and the other puncture parameters can roughly determine the three dimensional spatial orientation of foramen rotundum, which can be further adjusted according to patient's gender, age and BMI value. (J Intervent Radiol, 2018, 27: 234-237)
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SUMOylation is a dynamically reversible process that needs to be modified by a specific ligase, while its inverse reaction deSUMOylation is catalyzed by a group of SUMO-specific proteases (SENPs). SUMO-modified target protein molecules are closely related to development and disease, especially tumor, metabolism, inflammation and immunity. SENPs play an important role in SUMO protein maturation and deSUMOylation. This review discussed the functions of SENPs in the development and progression of tumors and related mechanisms.
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Objective To analyze the correlation between clinical features and renal dysfunction in patients of acute lacunar infarction with progressive cerebral microbleeds (CMBs). Methods Two hundred and sixty-five patients with first-episode acute lacunar infarction were selected. The serum creatinine was measured within 24 h of admission and the estimated glomerular filtration rate (eGFR) was calculated. The brain MRI (including gradient-echo images) was examined within 2 d of admission and after 1 years of follow-up, respectively. The progressive CMBs was assessed with microbleeds anatomical rating scale (MARS), and the patients were divided into progressive CMBs group (progressive group, 42 cases) and non progressive CMBs group (non progressive group, 223 cases). The clinical features of 2 groups were compared and the correlation between progressive CMBs and renal dysfunction was analyzed. Results The age, 24 h pulse pressure, incidences of renal dysfunction and CMBs in progressive group were significantly higher than those in non progressive group: (69.8 ± 5.8) years vs. (61.5 ± 4.9) years, (63.3 ± 3.1) mmHg (1 mmHg=0.133 kPa) vs. (51.8 ± 4.2) mmHg, 69.0％(29/42) vs. 39.9％(89/223) and 57.1％(24/42) vs. 25.1％(56/223), and the platelet was significantly lower than that in non-progression group:(168 ± 35) ×109/L vs. (189 ± 40) ×109/L, and there were statistical differences (P<0.05 or<0.01). The Logistic regression analysis result showed that renal dysfunction and CMBs were Independent risk factors of progressive CMBs (OR = 1.571 and 1.054, 95％ CI 1.042 - 2.493 and 1.010 - 1.142, P<0.05). Conclusions The rate of renal dysfunction is higher in patients of acute lacunar infarction with progressive CMBs, and progressive CMBs are associated with renal dysfunction.
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Objective:To investigate the relationship between FA,ET-1,Hcy and VEGF in patients with pregnancy induced hypertension.Methods:Selected 80 cases of patients with pregnancy induced hypertension who were treated in our hospital from January 2013 to September 2016,divided into A group (40 cases),and preeclampsia and preeclampsia B group (40 cases),60 cases of normal late pregnant women as C group,60 cases of normal non pregnant women as D group.The plasma levels of FA,ET-1,Hcy and VEGF in each group were detected,and the correlation analysis was performed.Results:The plasma levels of FA and VEGF of group B were lowest in the four groups (P＜0.05),the plasma ET-1 and Hcy levels of group B were highest (P＜0.05).The plasma FA and VEGF levels of women with pregnancy induce hypertension were lower than those of the healthy late pregnant women.The plasma ET-1 and Hcy levels were higher (P＜0.05).The multivariate logistic regression analysis showed that FA,ET-1,Hcy and VEGF levels were risk factors for pregnancy induce hypertension.Conclusion:The elevation of plasma Hcy level caused by FA deficiency in pregnancy might be related to the development of the disease and the incidence of pregnancy induced hypertension syndrome,VEGF might be an important factor in the occurrence and development of pregnancy induced hypertension syndrome.
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Objective To investigate the mental health and its correlated factors for senile dementia caregivers in nursing homes in Shenyang. Methods Questionnaire survey was conducted among 174 senile dementia caregivers recruited from the Nursing Home of Shenyang and Shenyang Social Welfare Institute by using Symptom Check-List-90 (SCL-90), Social Support Rating Scale (SSRS) and self-designed general information questionnaire and to analyze the scores of self rating scale of nursing staff, the total score of social support scale, and the factors affecting the mental health status of nursing staff. Results The SCL-90 scores of senile dementia caregivers with education levels from illiteracy, primary school or junior high school, high school or secondary school, college or above were 130.50 ± 10.11, 132.70±12.55, 135.06±9.15, 129.24±8.83, the difference was statistically significant (F=15.05, P<0.01). The SCL-90 scores of senile dementia caregivers with poor, general and good perceived health status were 133.40±10.52, 132.60±11.32, 128.00 ±10.02, the differences were statistically significant (F=9.07, P<0.01). The SCL-90 scores of family monthly income of 1001 to 3000 yuan, 3001 to 5000 yuan and more than 5001 yuan were 132.90 ± 10.39, 132.80 ± 11.52, 131.50 ± 8.20, the difference was statistically significant (F=12.11, P<0.01). The multivariate linear regression analysis showed that the regression coefficient of perceived health status was-0.168 (t=2.880, P<0.01), monthly family income was-0.145 (t=-2.512, P<0.05), SSRS was 0.121 (t=2.112, P<0.05). Conclusions Mental health status of senile dementia caregivers in Shenyang is poor. The health sector should take some measures to improve the degree of social support, nursing staff wages and to ensure their health in order to promote physical and mental health of nursing staff and the nursing level so as to improve the quality of life of the senile dementia elderly.
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Objective To investigate the relationship between different topographic locations and neurological deteriorations (ND) in patients with acute new isolated pontine infarction.Methods One hundred sixty-eight patients with acute new isolated pontine infarction during arch 2012 to March 2016 were identified by diffusion weighted imaging (DWI) for retrospective review.Patients were divided into two groups according to their clinical symptoms:patients with ND and patients without ND.According to neuroimaging of DWI,the topographic location of pontine infarction was divided into three types:The upper,middle,and lower ones,and the correlations of ND with risk factors,laboratory examination results,clinical manifestations and different topographic locations were explored by statistical tests.Results Of 168 patients,26.8％ (45/168) were diagnosed with ND,and 73.2％ (123/168) were diagnosed without ND.Univariate analysis showed that there were differences in female ratio [62.2％ (28/45) vs 41.5％ (51/ 123)],smoking ratio [13.3％ (6/45) vs 26.0％ (32/123)],mean length of hospital stay [(22.83 ± 7.12)d vs (19.31 ± 7.65)d],ratio of worse short-term clinical outcomes [77.8％ (35/45) vs 33.3％ (41/123)],and ratio of lower pontine infarction [55.6％ (25/45) vs 26.0％ (32/123)] between two groups (P ＜ 0.05).Logistic regression analysis showed that lower pontine infarction was the independent risk factor of ND (OR =1.953,95％ CI:1.092-3.535,P =0.029).Conclusions Topographic location of lower pons lesions may be reliable predictor of ND in acute new isolated pontine infarction.
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Objective To identify the association between body temperature and neurological outcome in post-arrest patients.Methods This was a multicenter,retrospective cohort study.In the period 1990-2011,a total of 184 patients resuscitated from IHCA with ROSC for more than 20 min were included.Data were collected according to Utstein style.The primary endpoint was hospital dis-charge with good neurological function (Cerebral Performance Category,CPC,1-2).Multivariate Lo-gistic regression was performed to determine the association between body temperature and neurologi-cal outcome.Results Among the 184 enrolled patients,37.0% (68/184)survived to hospital dis-charge,19.6% (36/184)survived to discharge with favorable neurological outcome(CPC,1-2).Mul-tivariate Logistic regression revealed that maximal body temperature between 35.5℃ and 38.4℃ was associated with favorable neurological outcomes (OR=8.986,95% CI 1.156-69.882;P =0.036). Conclusion For IHCA patients achieving spontaneous circulation, maximal body temperature between 35.5℃ and 38.4℃ in the initial 24 h following admission to ICU was associated with favora-ble neurological outcome.
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<p><b>OBJECTIVE</b>To investigate the correlation between uncoupling protein 2 (UCP2) expression and myocardial mitochondria injury in rats with sepsis induced by lipopolysaccharide (LPS).</p><p><b>METHODS</b>The rat model of sepsis was established through an intraperitoneal injection of LPS. Forty male Sprague-Dawley rats were randomly and equally divided into control group (an intraperitoneal injection of normal saline), sepsis 6 h group (LPS-6 h group), sepsis 12 h group (LPS-12 h group), sepsis 24 h group (LPS-24 h group), and sepsis 48 h group (LPS-48 h group). The serum and heart tissues were harvested at corresponding time points and myocardial mitochondria was extracted. The microplate reader was applied to measure creatine kinase (CK), creatine kinase-MB (CK-MB), and reactive oxygen species (ROS). Flow cytometry was applied to measure the degree of mitochondrial swelling and mitochondrial membrane potential (MMP). Western blot was used to measure the expression level of UCP2. Electron microscopy was applied to observe the morphological changes in heart tissues and myocardial mitochondria.</p><p><b>RESULTS</b>Compared with the control group, the LPS groups had significantly increased serum levels of CK, CK-MB, and myocardial ROS, as well as a significantly increased degree of mitochondrial swelling (P<0.05), and these values reached their peaks at 24 hours after LPS injection. The LPS groups had a significant decrease in MMP (P<0.05), which reached the lowest level at 24 hours after LPS injection. Western blot showed that the LPS groups had a significant increase in the expression level of myocardial UCP2 compared with the control group (P<0.05), which reached its peak at 24 hours after LPS injection. The results of electron microscopy showed mitochondrial swelling, partial rupture of the mitochondrial membrane, and cavity formation in rats in the LPS groups. The most severe lesions occurred in the LPS-24 h group. In rats with LPS, the ROS level in the myocardial mitochondria and the degree of mitochondrial swelling were positively correlated with the expression level of UCP2 (r=0.796 and 0.893, respectively; P<0.05), while MMP was negatively correlated with the expression level of UCP2 (r=-0.903, P<0.05).</p><p><b>CONCLUSIONS</b>In the rat model of sepsis, the myocardium and myocardial mitochondria have obvious injuries, and the expression level of UCP2 is closely correlated with mitochondrial injury. Therefore, UCP2 might play an important role in myocardial mitochondrial injury in sepsis.</p>
Subject(s)
Animals , Humans , Male , Rats , Cardiomyopathies , Genetics , Metabolism , Disease Models, Animal , Ion Channels , Genetics , Metabolism , Lipopolysaccharides , Mitochondria, Heart , Metabolism , Mitochondrial Proteins , Genetics , Metabolism , Myocardium , Metabolism , Rats, Sprague-Dawley , Sepsis , Genetics , Metabolism , Uncoupling Protein 2ABSTRACT
Objective To investigate the clinical features of moyamoya disease complicated with Graves′disease and the efficacy of extra-and intra-cranial revascularization. Methods The clinical data of 4 patients with moyamoya disease complicated with Graves′disease were analyzed retrospectively. Among them,three were females and one was a male. Their mean age was 32 ± 7 years. After medical treatment, their thyroid function was normal. The patients were treated with superficial temporal artery-middle cerebral artery bypass grafting. Results (1) Three patients showed cerebral infarction and one showed frequent transient ischemic attack. DSA confirmed that 2 patients had unilateral moyamoya disease and 2 had bilateral moyamoya disease. Head MRI revealed brain infarcts. (2) The thyroid function was normal after drug treat-ment,the symptoms of moyamoya disease were stable in 3 cases. One patient had high metabolic symptoms, such as high fever and accelerated heart rate within one week after procedure. The patients were followedup for 6 to 18 months,one was good,3 were excellent,and there was no recurrence of Graves′disease. Postoperative head MRI revealed that the 4 patients did not have new brain infarcts. MRA showed that the arterial filling in cerebral sulci in the ischemic lesion areas was obviously improved compared with that before procedure. Retrograde filling of the ipsilateral middle cerebral artery M2-M3 segment was observed in 2 patients. Postoperative single photon emission computed tomography perfusion imaging revealed that the ischemic perfusion lesions on the operated sides were obviously improved compared with those before procedure. Conclusion When complicated with Graves′ disease,the symptoms of moyamoya disease will aggravate. It manifests as acute and chronic cerebral ischemia. After controlling the symptoms of hyperthyroidism,most cerebral ischemic symptoms can be alleviated. Superficial temporal artery-middle cerebral artery bypass grafting may establish an effective collateral circulation and improve the clinical symptoms.
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<p><b>OBJECTIVE</b>To preliminarily investigate the long-term structural and functional injuries of mitochondria in rat brain caused by sepsis.</p><p><b>METHODS</b>Wistar rats were randomly assigned into sepsis and control groups. A rat model of sepsis was prepared by an intraperitoneal injection of 10 mg/kg lipopolysaccharide (LPS) of gram-negative bacteria, and the survival assay was performed. Eight rats in the sepsis group were sacrificed at 12, 24, 48, or 72 hours after LPS injection, while rats in the control group were sacrificed after an intraperitoneal injection of an equal volume of normal saline. Mitochondria were extracted from rat brain tissue. Mitochondrial membrane potential (MMP) and mitochondrial swelling level were determined by flow cytometry, and the activities of electron transport chain complexes (I-V) were measured using enzyme assay kits. Hematoxylin-eosin (HE) staining and electron microscopy were used to observe morphological changes in brain tissue and mitochondria.</p><p><b>RESULTS</b>The sepsis group had a significantly lower survival rate than the control group (P<0.01). The MMP and activities of electron transport chain complexes (I-V) in the sepsis group, which were significantly lower than those in the control group (P<0.05), were reduced to the lowest levels at 48 hours and partially recovered at 72 hours. The mitochondrial swelling level in the sepsis group, which was significantly higher than that in the control group (P<0.05), increased to the peak level at 48 hours and partially recovered at 72 hours. Hematoxylin and Eosin staining revealed substantial damages in the structure of brain tissue, and electron microscopy showed mitochondrial swelling, and vacuolization in a few mitochondria.</p><p><b>CONCLUSIONS</b>In the rat model of LPS-induced sepsis, both structural and functional injuries are found in cerebral mitochondria, and achieve the peak levels probably at around 48 hours.</p>
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Animals , Male , Rats , Brain , Pathology , Lipopolysaccharides , Toxicity , Membrane Potential, Mitochondrial , Mitochondria , Physiology , Rats, Wistar , Sepsis , MortalityABSTRACT
Objective To investigate the application value of identification of the scalp surface locations of cerebral ischemia lesions before direct revascularization for moyamoya disease and to design surgical approaches according to this by using the fusion of single photon emission computed tomography ( SPECT) cerebral perfusion imaging with CT imaging. Methods The clinical data of 13 adult patients with ischemic-type moyamoya disease underwent superficial temporal artery-middle cerebral artery bypass surgery were analyzed retrospectively. SPECT cerebral perfusion imaging was fused with CT imaging of the same machine before procedure. The lesions of ischemia were located on the cortical surface. The surgical approaches were designed at the center of the ischemic lesions. The patients were followed up for 6 to 12 months after procedure. The improvement of clinical symptoms and cerebral perfusion of the patients were observed after operation. Results One patient had perioperative cerebral hyperperfusion syndrome,and the others did not have any perioperative complications. At one-month follow-up, the improvement of symptoms in 4 patients were excellent,in 5 were good,in 4 were fair,and none was poor. At 6 to 12 month follow-up,the improvement of symptoms in 9 patients were excellent,in 4 were good,and none was poor. The postoperative visual SPECT cerebral perfusion imaging analysis suggested that the cerebral perfusion was improved significantly as compared with before procedure in all patients. Quantitative analysis:There was significant difference in target ischemic lesions between preoperative Fb and postoperative Fb ([2. 13±1. 06]% vs. [4. 13±2. 09]%;P50%) , which indicated that the efficacy of the procedure was remarkable. The superficial temporal arteries fed to brain of the patients were observed after procedure by using the head CT angiography. The postoperative head MRI reexamination showed no new infarcts occurred at 6 months. Conclusion Combine SPECT cerebral perfusion imaging with CT imaging to design surgical approach for superficial temporal artery-middle cerebral artery bypass surgery may improve the efficacy and reduce the risks of operation.
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Objective To observe the clinical effects of modified Shengxian decoction in the treatment of thyroid cancer postoperative hypothyroidism patients.Methods 60 patients of thyroid cancer postoperative hypothyroidism due to deficiency of spleen and kidney were randomly divided into a control group and a treatment group.The control group (28 cases) was by levothyroxine sodium tablets conventional treatment,while the treatment group (32 cases) was treated with Shengxian decoction based on thecontrol group.The changes of the symptom integral and HAMD-17 were observed between two groups before and after treatment.Results After treatment,the total effective rate was 87.5％ in the treatment group and 64.3％ in the control group,the clinical effect of treatment group was significantly better than the control group (x2=4.499,P＜ 0.05).After treatment,the total score of HAMD-17 was 6.8±2.3 in the treatment group and 15.8±2.1 in the control group,both significantly improved than that before the treatment (which were 19.4±1.45 and 18.9± 1.32 respectively).Compared with the control group,the treatment group improved significantly (P＜ 0.01).Conclusion Shengxian decoction plus western medicine has remarkable curative effect in the treatment of thyroid cancer postoperative hypothyroidism,it can improve the depressive state of patients and improve the quality of life.