Increased blood pressure variability predicts poor outcomes from endovascular treatment for aneurysmal subarachnoid hemorrhage / Aumento da variabilidade da pressão arterial prediz resultados ruins de tratamento endovascular para hemorragia subaracnóide aneurismática

ABSTRACT Background: Predictors of outcomes following endovascular treatment (ET) for aneurysmal subarachnoid hemorrhage (aSAH) are not well-defined. Identifying them would be beneficial in determining which patients might benefit from ET. Objective: To identify the predictive factors for poor outcomes following ET for aSAH. Methods: 120 patients with ruptured cerebral aneurysms underwent endovascular embolization between January 2017 and December 2018. Blood pressure variability was examined using the standard deviation of the 24-hour systolic blood pressure (24hSSD) and 24-hour diastolic blood pressure (24hDSD). Predictors were identified through univariate and multivariate regression analysis. All patients were followed up for three months. Results: At follow-up, 86 patients (71.7%) had good outcomes and 34 (28.3%) had poor outcomes. Patients with poor outcomes had significantly higher 24hSSD than those with good outcomes (19.3 ± 5.5 vs 14.1 ± 4.8 mmHg; P < 0.001). The 24hDSD did not differ significantly between patients with good outcomes and those with poor outcomes (9.5 ± 2.3 vs 9.9 ± 3.5 mmHg; P = 0.464). The following were significant risk factors for poor outcomes after endovascular embolization: age ≥ 65 years (odds ratio [OR] = 23.0; 95% confidence interval [CI]: 3.0-175.9; P = 0.002); Hunt-Hess grade 3-4 (OR = 6.8; 95% CI: 1.1-33.7; P = 0.039); Fisher grade 3-4 (OR = 47.1; 95% CI: 3.8-586.5; P = 0.003); postoperative complications (OR = 6.1; 95% CI: 1.1-34.8; P = 0.042); and 24hSSD ≥ 15 mmHg (OR = 14.9; 95% CI: 4.0-55.2; P < 0.001). Conclusion: Elevated 24hSSD is a possibly treatable predictive factor for poor outcomes after ET for aSAH.

RESUMO Antecedentes: Fatores preditores de resultados após tratamento endovascular (TE) para hemorragia subaracnóide aneurismática (HSA) não estão bem definidos. Identificá-los seria útil para determinar quais pacientes podem se beneficiar de TE. Objetivo: Identificar os fatores preditivos de resultados ruins após TE para HSA. Métodos: 120 pacientes com aneurismas cerebrais rompidos foram submetidos à embolização endovascular entre janeiro de 2017 e dezembro de 2018. A variabilidade da pressão arterial foi examinada usando-se o desvio padrão da PA sistólica de 24 horas (DPPAS- 24h) e da PA diastólica de 24 horas (DPPAD-24h). Os fatores preditores foram identificados por meio de análises de regressão univariada e multivariada. Todos os pacientes foram acompanhados por três meses. Resultados: No acompanhamento, 86 pacientes (71,7%) tiveram bons resultados e 34 (28,3%) tiveram resultados ruins. Pacientes com resultados ruins apresentaram DPPAS-24h significativamente maior do que aqueles com bons resultados (19,3 ± 5,5 vs 14,1 ± 4,8 mmHg; P <0,001). O DPPAD-24h não diferiu significativamente entre os pacientes com bons resultados e aqueles com resultados ruins (9,5 ± 2,3 vs 9,9 ± 3,5 mmHg; P = 0,464). Os fatores de risco significativos para resultados ruins após embolização endovascular foram os seguintes: idade ≥ 65 anos (razão de probabilidade [OR] = 23,0; intervalo de confiança de 95% [IC]: 3,0-175,9; P = 0,002); escala de Hunt-Hess 3-4 (OR = 6,8; IC 95%: 1,1-33,7; P = 0,039); escala de Fisher 3-4 (OR = 47,1; IC 95%: 3,8-586,5; P = 0,003); complicações pós-operatórias (OR = 6,1; IC 95%: 1,1-34,8; P = 0,042); e DPPAS 24h ≥ 15 mmHg (OR = 14,9; IC 95%: 4,0-55,2; P <0,001). Conclusão: O DPPAS 24h elevado é um fator preditivo possivelmente tratável para resultados ruins após TE para HSA.

Effects of MRI in the diagnosis and prognosis of cervical spinal cord injury without fracture or dislocation / 中国组织工程研究

BACKGROUND: In the elderly, the cervical vertebrae will appear with different degrees of spinal stenosis caused by various factors. Notably, the incidence of cervical spinal cord injury without fracture or dislocation is high, accounting for 3%-16% of cervical spinal cord injury.OBJECTIVE: To explore the efficacy of MRI in the diagnosis and prognosis of cervical spinal cord injury without fracture or dislocation, and to analyze the influencing factors for surgical effectiveness.METHODS: Fifty-one patients with cervical spinal cord injury without fracture or dislocation in Zibo Central Hospital from August 2014 to June 2016 were analyzed retrospectively. All the patients underwent anterior, posteror, or anterior-posterior fusion, respectively, and then the intraoperative ligament injury and MRI images were compared. The age, injury type, spinal cord injury type revealed on MRI, time from injury to hospital, signal length of spinal cord injury,American Spinal injury Association grade, degree of cervical stenosis, whether hormone used or not within 8 hours after injury, time from injury to surgery, and surgical approaches were analyzed based on univariate analysis and multivariate analysis by Logistic regression analysis.RESULTS AND CONCLUSION: (1) MRI showed more comprehensive damage of the spinal cord and intervertebral disc ligament complex than the intraoperative findings (χ2=5.966,P < 0.05), and the cervical spinal cord injury was related to the injury of the corresponding intervertebral disc ligament complex (χ2=1.53, P > 0.05). (2) Univariate analysis results showed that the spinal cord injury type revealed on MRI, signal length of spinal cord injury, American Spinal injury Association grade, degrees of cervical stenosis, whether hormone used or not within 8 hours after injury, and time from injury to surgery were related to the functional recovery of spinal cord (P < 0.01). (3) Multivariate analysis results indicated that the type revealed on MRI, signal length of spinal cord injury and degrees of cervical stenosis were significantly related to the functional recovery of spinal cord (P < 0.05). (4) These results suggest that MRI has a high tissue resolution, so it plays an important role in the diagnosis of cervical spinal cord injury without fracture or dislocation.Moreover, the degrees of spinal cord injury and spinal stenosis, as well as operation time are main factors for curative efficacy.

Spatial distribution of liver cancer incidence in shenqiu county, henan province, china: a spatial analysis / 生物医学与环境科学（英文）

Liver cancer is a common and leading cause of cancer death in China. We used the cancer registry data collected from 2009 to 2011 to describe the spatial distribution of liver cancer incidence at village level in Shengqiu county, Henan province, China. Spatial autocorrelation analysis was employed to detect significant differences from a random spatial distribution of liver cancer incidence. Spatial scan statistics were used to detect and evaluate the clusters of liver cancer cases. Spatial clusters were mapped using ArcGIS 10.0 software in order to identify their physical location at village level. High cluster areas of liver cancer incidence were observed in 26 villages of 7 towns and low cluster areas were observed in 16 villages of 4 towns. High cluster areas of liver cancer incidence were distributed along the Sha Ying River which is the largest of tributary of the Huai River. Role of water pollution in Shenqiu County where the high cluster was found deserves further investigation.

Expressions of tumor necrosis factor-alpha and NF-kappa B in skeletal muscles and its effect on apoptosis in deep tissue injury of rats / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To evaluate the changes of tumor necrosis factor-alpha (TNF-alpha) and nuclear factor-kappaB (NF-kappaB) expression in muscle of pressure ulcer rats and explore the relationship with apoptosis.</p><p><b>METHODS</b>Fifty-four male SD rats were randomly divided into nine groups (n = 6), the experiment groups were pressed 9 circles (3 circles/day, 3 days), then observed on the 1st, 3rd, hematoxylin and eosin staining under the microscope; the expression of TNF-alpha was detected by Western blot; the expressions of NF-kappaB and caspase-3 were determined by immunohistochemistry, and evaluated the relationship of TNF-alpha with NF-kappaB and caspase-3; the number of apoptotic cells in compressed muscle tissue was detected by Hoechst 33258 staining under the fluorescence microscope.</p><p><b>RESULTS</b>Compared with the control group, histology examination showed that the tissue structure in experiment groups was in disorder, inter-space was wider, cell edema and the number of inflammatory cells were increased, the tissue was arranged in order and inflammatory cell recruitment was gradually attenuated. The expressions of TNF-alpha, NF-kappaB and caspase-3 were higher in the experiment groups than those in the control group (P < 0.05), reached their peak on the first day, gradually decreased on the 3nd day, but still had a significantly higher level than that in the control group (P < 0.01) on the 7th day; The number of apoptotic cells of experiment groups had a downward trend after the first rise under the fluorescence microscope; the expressions of TNF-alpha and NF-kappaB caspase-3 were found to have positive correlationship (P < 0.05), the expressions of NF-kappaB and caspase-3 were found to have positive correlationship (P < 0.01).</p><p><b>CONCLUSION</b>Apoptosis is closely correlated with inflammation in deep tissue injury of pressure ulcer, NF-kappaB plays a role not only in the formation of inflammation, but also triggering apoptosis, which may induce the pathological change and clinical progress of pressure ulcer.</p>

Rhein induces apoptosis of human gastric cancer SGC-7901 cells via an intrinsic mitochondrial pathway

Rhein is a primary anthraquinone found in the roots of a traditional Chinese herb, rhubarb, and has been shown to have some anticancer effects. The aim of the present study was to investigate the effect of rhein on the apoptosis of the human gastric cancer line SGC-7901 and to identify the mechanism involved. SGC-7901 cells were cultured and treated with rhein (0, 50, 100, 150, and 200 µM) for 24, 48, or 72 h. Relative cell viability assessed by the MTT assay after treatment was 100, 99, 85, 79, 63% for 24 h; 100, 98, 80, 51, 37% for 48 h, and 100, 97, 60, 36, 15% for 72 h, respectively. Cell apoptosis was detected with TUNEL staining and quantified with flow cytometry using annexin FITC-PI staining at 48 h after 100, 200 and 300 µm rhein. The percentage of apoptotic cells was 7.3, 21.9, 43.5%, respectively. We also measured the mRNA levels of caspase-3 and -9 using real-time PCR. Treatment with 100 µM rhein for 48 h significantly increased mRNA expression of caspase-3 and -9. The levels of apoptosis-related proteins including Bcl-2, Bax, Bcl-xL, and pro-caspase-3 were evaluated in rhein-treated cells. Rhein increased the Bax:Bcl-2 ratio but decreased the protein levels of Bcl-xL and pro-caspase-3. Moreover, rhein significantly increased the expression of cytochrome c and apoptotic protease activating factor 1, two critical components involved in mitochondrial pathway-mediated apoptosis. We conclude that rhein inhibits SGC-7901 proliferation by inducing apoptosis and this antitumor effect of rhein is mediated in part by an intrinsic mitochondrial pathway.

Using interrupted time series design to analyze changes in hand, foot, and mouth disease incidence during the declining incidence periods of 2008-2010 in China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To identify patterns of hand, foot and mouth disease (HFMD) incidence in China during declining incidence periods of 2008, 2009, and 2010.</p><p><b>METHODS</b>Reported HFMD cases over a period of 25 months were extracted from the National Disease Reporting System (NDRS) and analyzed. An interrupted time series (ITS) technique was used to detect changes in HFMD incidence rates in terms of level and slope between declining incidence periods of the three years.</p><p><b>RESULTS</b>Over 3.58 million HFMD cases younger than 5 years were reported to the NDRS between May 1, 2008, and May 31, 2011. Males comprised 63.4% of the cases. ITS analyses demonstrated a significant increase in incidence rate level (P<0.0001) when comparing the current period with the previous period. There were significant changes in declining slopes when comparing 2010 to 2009, and 2010 to 2008 (all P<0.005), but not 2009 to 2008.</p><p><b>CONCLUSION</b>Incremental changes in incidence rate level during the declining incidence periods of 2009 and 2010 can potentially be attributed to a few factors. The more steeply declining slope in 2010 compared with previous years could be ascribed to the implementation of more effective interventions and preventive strategies in 2010. Further investigation is required to examine this possibility.</p>

Spatial clustering and changing trend of hand-foot-mouth disease during 2008-2011 in China / 中华流行病学杂志

Objective The purpose of this study was to explore the spatial clustering,specific clustering areas,as well as changing trend of clustering areas of hand-foot-mouth disease (HFMD).Methods Exploratory spatial data analysis (ESDA) was used to conduct spatial statistical analyses for the HFMD using 2008-2011 data at both provincial and county/district levels.Results The Global Moran' s I coefficients appeared to be 0.3336,0.6074,0.3372,0.4620 and 0.4367 for 2008-2011and for the combined 4 years,respectively.The corresponding P-values were 0.002,0.001,0.004,0.001 and 0.001 respectively,when using the Monte Carlo tests with all the P-values less than 0.05.Moran' s Ⅰ coefficients ranged between 0.3 and 0.7,showing the appearance of moderate or higher clustering nature.Based on the results from nationwide analyses on clustering areas at the county/district levels between 2008 and 2011 (Moran' s I=0.5198,P=0.001),it appeared a moderate clustering nature.When local autocorrelation analysis was applied at the provincial level,3 hot spot areas in Beijing,Tianjin and Shanghai cities in 2008；7 hot spot areas in Beijing,Tianjin,Hebei,Shanxi,Shanghai,Jiangsu and Shandong in 2009; four hot spot areas:Beijing,Tianjin,Guangdong and Guangxi; five hot spot areas:Fujian,Jiangxi,Hunan,Guangdong and Guangxi in 2011,were discovered.390 hot-spot counties/districts were found through local autocorrelation analyses using the three-year data of 2008 to 2010.Conclusion Spatial clustering nature of HFMD incidence between 2008 and 2011 in China appeared to be moderate or high,with the clustered areas a north to south shifting trend.However,further investigation was in need to address this changing trend.

Influence of 1, 2-dichloroethane on open field behavior and levels of neurotransmitters in brain of mice / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the effects of 1,2-dichloroethane (1,2-DCE) on the behavior and the brain neurotransmitter levels in mice.</p><p><b>METHODS</b>Thirty mice were randomly divided into four groups, which were control group and groups of low, middle and high exposure (225, 450 and 900 mg/m3) to 1,2-DCE for 10 days (3.5 h a day) by inhalation. After the last exposure, the open field test was performed immediately. After exposure all mice were killed and the brain tissues were taken up rapidly. The levels of aspartate (Asp), glutamate (Glu) and gamma-aminobutyric acid (GABA) in the brain were detected by high performance liquid chromatography (HPLC).</p><p><b>RESULTS</b>Levels of Asp and Glu in all exposure groups increased with doses. As compared to the control group, levels of Glu in all exposure groups increased significantly (P < 0.05). Levels of GABA in the low exposure group were significantly lower than those in control group, but those in the high exposure group were significantly higher than those in control group. The results of the open field test showed that effect of low exposure to 1,2-DCE on the behavior was stimulant, but the high exposure to 1,2-DCE inhibited behavior of exploration, excitement and sport.</p><p><b>CONCLUSIONS</b>Subacute exposure to 1,2-DCE could result in the change of amino acid neurotransmitter content and ratio in the brain, thereby change the behavior of mice appeared, which might be the mechanism of neurotoxicity caused by 1,2-DCE in part.</p>

Determination and evaluation of arsenic speciation and glutathione level in lever and blood of mice subchronically exposed to inorganic arsenic / 中国地方病学杂志

Objective To explore the distribution of arsenic speciafion and to estimate the effect of arsenic on glutathione(GSH)levels in the blood and liver of mice exposed to different concentrations of inorganic AsⅢ through drinking water.Methods Mice drank water containing arsenite at concentrations of iAsⅢ of 0(contr01),25,50,100 ms/L for 6 weeks.Blood and liver were sampled to asses$the levels of inorganic arsenic(iAs),monomethylarsenic acid(MMA),dimethylarsenic acid(DMA)by the method of hydride generation trapping and ultra-hypothermia coupled with atomic absorption spectrometry,and the level of GSH by the method of 5,5'-Dithio-bis (2-Nitrobenzoic acid).Results Leveh of iAs.MMA and DMA in blood and in liver increased along with the increase of iAs concentrations in drinking water.Primary methylated index(PMI)and secondary methylation index (SMI)of liver and blood were significantly higher in exposed groups than those in control group(P＜0.05).SMI of liver in 50 mg/L exposed group[(50.45±2.94)%]was significantly higher than those in 25 mg/L and 100 mg/Lgroups[(41.68±7.09)%and(41.19±8.87)%,respectively],the difference being statistically significant(P＜0.05).The ratio of iAs.MMA and DMA in blood and liver in exposed group were 2:3:5 and 4:3:3,the percentage of level of organic arsenic(MMA+DMA)were 80%and 60%.GSH in blood and liver in exposed group decreased along with iAs concentrations in drinking water and had significant differences compared with those in control group (P＜0.05).However,levels of GSH in liver and blood did not differ significantly between exposed groups and control group(P＞0.05).Conclusions Membolism of iAs in liver is maximized when the iAs concentrations in drinking water increases to a certain level.However,the percentage of arsenic speciation in blood is different from that in liver,suggesting that other organs and tissues may be capable of methylation of inorganic arsenic.The level of GSH in liver and blood in mice is a good mark tO reflect the toxicity of arsenic.

Effect of glutathione and sodium selenite on the metabolism of arsenic in mice exposed to arsenic through drinking water / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the effect of glutathione (GSH) and sodium selenite on the metabolism of arsenic in the liver, kidney and blood of mice exposed to iAsIII through drinking water.</p><p><b>METHODS</b>The mice were randomly divided into control, arsenic, GSH and sodium selenite group, respectively. And each group had eight mice and the mice were exposed to 50 mg/L arsenite by drinking water for 4 weeks. Mice were intraperitoneally injected with GSH (600 mg/kg) and sodium selenite (1 mg/kg) for seven days from the beginning of the fourth week. At the end of the fourth week, liver, kidney and blood were sampled to assess the concentrations of inorganic arsenic (iAs), monomethylarsenic acid (MMA), dimethylarsenic acid (DMA) by hydride generation trapping by ultra-hypothermia coupled with atomic absorption spectrometry.</p><p><b>RESULTS</b>The liver DMA (233.76 +/- 60.63 ng/g) concentration in GSH group was significantly higher than the arsenic group (218.36 +/- 42.71 ng/g). The concentration of DMA (88.52 +/- 30.86 ng/g) and total arsenic (TAs) (162.32 +/- 49.45 ng/g) in blood of GSH group was significantly higher than those [(45.32 +/- 12.19 ng/g), (108.51 +/- 18.00 ng/g), respectively] of arsenic groups(q values were 3.06, 6.40, 10.72 respectively, P < 0.05). The primary methylated index (PMI) (0.65 +/- 0.050) and secondary methylated index (SMI) (0.55 +/- 0.050) in liver sample of GSH group were significantly higher than those (0.58 +/- 0.056, 0.44 +/- 0. 093) in arsenic group. In blood samples, the PMI (0.85 +/- 0.066) in GSH group was significantly higher than that (0.54 +/- 0.113) in arsenic group (q values were 3.75, 5.26, 4.21 respectively, P < 0.05). However, no significant difference was identified between sodium selenite and arsenic groups in liver, kidney or blood samples. And no significant difference was detected in kidney samples among all arsenic exposing groups.</p><p><b>CONCLUSION</b>Exogenous GSH could promote the methylated metabolism of iAsIII, but sodium selenite showed no significant effects.</p>

Safety and immunogenicity of Bilive combined hepatitis A and B vaccine / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the safety and immunogenicity of the Bilive combined hepatitis A and B vaccine produced by Sinovac Biotech Co., Ltd.</p><p><b>METHODS</b>Samples were selected from first year students of a senior high school (adults group) and first to fifth grade 1-5 students of 3 primary schools (children group). Those who were susceptible to both hepatitis A virus (HAV) and hepatitis B virus (HBV), HAV only or HBV only were assigned to group AB, A and B respectively and were vaccinated with three doses (0, 1 and 6 month schedule) of Bilive combined hepatitis A and B vaccine, inactivated hepatitis A vaccine and recombined hepatitis B vaccine respectively. The dosage for adult group was 500 U hepatitis A antigen and/or 10 micro g hepatitis B surface antigen and the dosage for children group was half the dosage of adult group. The potential adverse effects were observed within 72 hours after vaccination. Serum samples were collected for testing anti-HAV and anti-HBs at month 2 and 7 after the initial dose.</p><p><b>RESULTS</b>The rates of local adverse effects were 0.58% and 2.56% in children AB group and adults AB group and the general adverse effects rates were 9.88% and 5.45% respectively. Both local and general adverse effect rates were not significantly different to the control group. The sero-conversion rate of anti-HAV in children and adults AB group reached 100%, one month after 3 doses. The geometric mean titer (GMTs) reached 33,910 mIU/ml and 23,435 mIU/ml respectively, significant higher than that in control group (group A). The sero-conversion rates of anti-HBs were 97.30% and 96.63%, and GMTs were 103 mIU/ml and 102 mIU/ml in children and adults AB group respectively. No significant difference on sero-conversion and GMT was observed when compared with control group.</p><p><b>CONCLUSION</b>The Bilive combined hepatitis A and B vaccine had good safety profile, and the immunogenicity both on anti-HAV and anti-HBs was similar to that of separated components.</p>