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Objective To study the predictive value of continuous amplitude-integrated electroencephalogram (aEEG) monitoring for the neurodevelopment outcome in infants with hypoxic-ischemic encephalopathy (HIE) receiving hypothermia treatment.Method From April 2014 to May 2016,neonates admitted to our NICU with HIE receiving hypothermia treatment were continuously monitored using aEEG for 96 h,and assigned into moderately and severely abnormal groups according to aEEG results.The aEEG results before hypothermia treatment,within 24 h,48 h,72 h and 96 h after hypothermia treatment were recorded.The Bayley Scales of Infant Development Ⅱ examination was performed at 6 months of age.The sensitivity,specificity,positive and negative predictive values and Youden's index of aEEG for poor outcome at these timepoints was compared.Result A total of 30 neonates were enrolled.Among them 13 were moderately abnormal and 17 were severely abnormal.The gender,gestational age,birth weight and delivery method between two groups were similar (P ＞ 0.05).The 1 min Apgar score,arterial pH,base excess (BE) were significantly lower in the severely abnormal group (P ＜ 0.05).The neurodevelopment assessment at 6 months of age showed unfavorable outcomes in 16 cases,while the remaining 14 cases had generally good outcomes.The sensitivity and specificity of aEEG before hypothermia treatment for the prediction of poor outcome was 81.3％ and 71.4％ respectively.The sensitivity and negative predictive values of aEEG within 24 and 48 after hypothermia treatment for poor outcome was 100％.The Youden's index of aEEG within 72 h after hypothermia treatment for abnormal outcome was the highest 0.661.Conclusion The aEEG before hypothermia treatment alone is not a reliable indicator of poor outcomes in HIE neonates.The aEEG within 72 h after hypothermia is better.Continuous aEEG monitoring during hypothermia in HIE infants is very important because it provides reliable prediction of outcome.
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Objective To study the effects of hypothermia therapy on coagulopathy in neonates with hypoxic-ischemic encephalopathy(HIE) of different degrees.Methods Twenty-five newborns with HIE were divided into 2 groups (moderate HIE group and severe HIE group) by amplitude integrated electroencephalogram(aEEG).The platelet (PLT) count,activated partial thromboplastin time (APTT),prothrombin time(PT),thrombin time(TT),fibrinogen (Fbg) and international normalized ratio (INR) were measured before hypothermia therapy and those after 24 hours,48 hours,72 hours after hypothermia therapy were collected.The hematological parameters of 2 groups were analyzed by repeated measurement analysis of variance.Results The APTT(t=2.239,P0.05)showed no statistically significant difference between 2 groups after hypothermia therapy.The differences in INR(F=12.470,P0.05) between 2 groups.The differences in PLT(F=32.420,P0.05).But the degree of brain injury and time had interactive effects in PT(F=3.374,P0.05).Conclusion The coagulopathy function is worse in neonates with severe HIE in hypothermia therapy which may aggravate the hemorrhage risk.And the effect of hypothermia on neonates with moderate HIE is less evident.So hierarchical intervention on coagulopathy in neonates with HIE during hypothermia should be adopted to relieve the hemorrhage risk.
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Objective To investigate the high risk factors of persistent pulmonary hypertension (PPHN) in preterm and full-term neonates.Methods Fifty-six newborns with PPHN were divided into preterm neonates group and the full-term neonates group according to their gestational ages.The relationship between PPHN and high risk factors such as the primary diseases,mother's complications during pregnancy,and the prognosis were analyzed retrospectively in each group.A retrospective review of lung samples of 3 neonates who died of respiratory failure were carried out.Results Thirty-one (55.36％) out of 56 neonates with PPHN including 27 preterm and 29 full-term newborns had parenchyma diseases.The first and the second primary diseases were meconium aspiration syndrome (MAS,9/29 cases,31.03％) and congenital heart diseases (8/29 cases,27.59％) in the full-term group,and respiratory distress syndrome (RDS,16/27 cases,59.26％) and infection (8/27 cases,29.63％) in preterm group,respectively.There were 15 cases (55.56％) whose mothers had complications during pregnancy among the 27 preterm neonates,and 8 ca ses (27.59％) among the 29 full-term neonates.The morbidity of mothers' complications during pregnancy in preterm neonates was higher than that in full-term neonates (x2 =4.519,P =0.034).The mortality rate was 33.33％ (9/27cases) in the preterm neonates group while 27.59％ (8/29 cases) in the full-term neonates group.There was no significant difference in mortality rate between each group (x2 =0.218,P =0.640).The primary diseases were RDS (9/9cases,100％) and MAS (4/8 cases,50％) in preterm and full-term neonates who died of PPHN,respectively.One case of pulmonary hypertensive vascular remodeling,1 case of alveolar capillary dysplasia (ACD) and 1 case of interstitial pneumonia were found in 3 lung samples of neonates died of PPHN.Conclusions The ratio of preterm increased in neonates with PPHN.RDS and infection were the first two primary diseases in preterm neonates with PPHN.MAS was the first primary disease in full-term neonates with PPHN.Primary pulmonary hypertension should be considered for neonates with severe PPHN.
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Objective To test the reliability and validity of Chinese version of Stressful Life Events Questionnaire and the influence of preinjury stressful life events on the life quality and mood symptoms of the patents following cerebral concussion.Methods 285 patients with cerebral concussion were assessed by Stressful Life Events Questionnaire(SLESQ),PTSD Checklist civilian version(PCL-C),Thirty-Six-Item Short-Form Health Survey (SF-36),Hamilton Depression Rating Scale(HDRS),Hamilton Anxiety Scale(HAMA) at baseline.The patients had been reassessed with the HDRS,HAMA,SF-36 at 3 months after cerebral concussion.The hierarchical regression analyses were used to determine the influence of Stressful Life Events for the life quality and mood symptoms of the patient with cerebral concussion.Results The incidence of stressful life events was 42.8％.The multiple regression analysis showed the experience of stressful life events were the influence factor of scores on the SF-36,HDRS,HAMA after adjusted by the age,gender,education,income,social support,the scores of anxiety and depression before injury and the R 2 value of SLESQ to SF-36 physical health factor,mental health factor,HDRS,HAMA was 0.064,0.111,0.145,0.028,respectively.Conclusion The history of stressful events is the influence factor of the patient with cerebral concussion to have poor life quality and mood disorder.
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CXCR4, a receptor for stromal cell-derived factor-1 (SDF-1, also know as CXCL12) and a member of the chemokine receptor family, has been shown to play an important role in the proliferation, migration, invasion and metastasis of breast cancer cells. CXCR4 expression is an early event in breast cancer development and may serve as a biomarker for early detection and diagnosis of breast cancer. Expression of CXCR4 has been demonstrated to correlate with metastasis and poor prognosis in breast cancer. Inhibition of CXCR4 expression may be a potential target of breast cancer treatment.
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Objective To investigate inhibitory effect of Telmisartan on carotid arterial intima-media thickness in patients with essential hypertension. Methods 104 patients with mild or mid essential hypertension were randomly divided into three groups, which include telmisartan group( telmisartan 80 mg/d PO), ramipril group( ramipril 5 mg/d PO), and control group( other anti-hypertension agents). Blood pressure was monitored during treatment. Carotid arterial intima-media thickness(CIMT) were measured in all patients at beginning and patients who had the 12 months course. Results There were 91 patients who had the 12 months course,which include telmisartan group33 cases,ramipril group28 cases, and control 30 cases. The CIMT was significantly decreased in telmisartan group and ramipril group ( all P < 0. 05 ), and not changed in control while blood pressure fall effectively. In ramipril, group5 cases were ceased the course because of severe cough. Conclusion Both telmisartan and ramipril could decrease blood pressure and CIMT effectively, and there were less side effects in telmisartan group.
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Objective Chronic atrial fibrillation (AF) results in dedifferentiation of atrial cardiomyocytes that plays an important role in the perpetuation of AF.In this study,we aimed to investigate the changes of titin and α-smooth muscle actin (α-SMA) after long time of AF reversal.Methods Twenty-four goats were randomized into four groups:(1) sinus rhythm (SR),(2) 3 months AF (3-mo AF),(3) 3 months SR after 3 months AF (3-mo post AF),(4) 6 months SR after 3-mo AF (6-mo post AF),with 6 in each group.By pacing on the anterior bottom of left atria appendage (LAA),we established a goat model of chronic AF.Atria effective refractory period (AERP) was measured with electrophysiological methods.Ultra-structure was studied with echocardiography,light and electron microscopy.Titin and α-SMA protein expressions were determined by Western blot.Results The animals underwent high rate pacing on LAA for a mean of 42.23±21.70 days before presenting AF.Electrophysiological analysis revealed that AERP completely resumed in 3-mo post AF goats.Echocardiography displayed that the size of left atrium resumed almost in 6-mo post AF goats (P＜ 0.01).Pathological and electron microscopic examination revealed the disorder of myofibrils,augmentation of intercellular space,myolysis,accumulation of glycogen,and numerous bigger mitochondria among atrial cardiomyocytes in 3-mo AF goats.They recovered mostly in 6-mo post AF goats.Western blot showed that the band density of titin significantly reduced in 3-mo AF goats compared to SR ones [1826±319 vs 5012±854,P＜0.01].In 3-and 6-mo post AF goats,titin increased gradually and it reversed completely in 6-mo post AF goats (3841±601 and 4523±833 respectively,P ＜ 0.01).Conversely,the band density of α-SMA was significantly higher in 3-mo AF goats (5324±948) than in SR ones (1619± 271,P＜0.01).In 3-and 6-mo post-AF goats,α-SMA decreased gradually,and it recovered mostly in 6mo post AF goats (4437± 792 and 2205±540 respectively,P＜0.01,).Conclusions These data indicate that the reversal of dedifferentiation of atrial cardiomyocyts is a very slow process,and it is definitely essential for normal cardiac function.
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The integrated courses in pathophysiology have been implemented for clinical medicine in Nanfang Medical University with experimental contrast method since 2006 to compare the advantages of the teaching effect of the integrated courses with traditional learning in pathophysiology with the questionnaire. The results have showed that the students on the integrated track are more positive in the knowledge learning,problem analysis and solving as well as the subsequent clinical knowledge learning.
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Objective To evaluate angiographic and clinical outcomes of ≥ 20mm long stents or overlapped stent implantation in diffuse coronary lesions for octogenarians, in comparison with patients under sixty. Methods Two groups (Group O: 47 lesions in 44 octogenarians, aged 81± 3 years; Group Y: 64 lesions in 58 patients under sixty, aged 54 ± 4 years) were compared with a 6-month follow-up. Results Success rate of the procedures was 100%. None had in-hospital major adverse cardiac events (MACE). There was no significant difference in angiographic restenosis between the groups at follow-up (Group O vs Group Y, 29.8 % vs 26.6 %, P = NS). The revascularization of target vessel and MACE was less in Group Y, but these showed no statistical significance (15.6% vs 23.4% and 20.7% vs 25.0%, respectively). Conclusions Long stent implantation for diffuse coronary lesions in octogenarians appears safe and feasible, with high procedural success and favorable long-term outcomes.
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0.05). Conclusions Long stent implantation for diffuse lesions in octogenarians appears safe and feasible, with high procedural success and favorable long-term outcomes.
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AIM:To observe the protective effect of Nano-Se on myocardium of experimental diabetes mice.METHODS:Sixty healthy male KM mice were chosen,ten of which were selected randomly as the normal control group.After fasted for 24 h,the rest 50 mice were injected with streptozotocin(STZ,50 mg/kg)intraperitoneally for 5 d.At 7th d,the blood-sugar was measured from vena caudalis,40 mice,of which blood-sugar exceeded 16.65mmol/L,were selected and randomized into 4 groups:the positive control group,low dose(25 ?g/kg)Nano-Se group,mid dose(50 ?g/kg)Nano-Se group,high dose(50 ?g/kg)Nano-Se group.All mice were given intragastric administration of 0.2 mL normal saline and corresponding dose of Nano-Se.The body weights were measured every week,and the dose of which was adjusted according to the change of the body weights.8 weeks later,the mice were killed and cardiac muscle of the left ventricle was taken.The myocardium was prepared to 10% homogenate for measuring SOD,GSH-Px activity and MDA content.The myocardial cell apoptosis was measured by TUNEL.The expressions of Bc1-2 and Bax proteins were determined by immunohistochemistry.RESULTS:Compared to normal group,the SOD and GSH-Px activities in positive control group decreased,MDA level increased,the rate of myocardial cell apoptosis increased significantly,Bc1-2 protein expression deceased and Bax protein expression increased.Compared to positive control group,the SOD and GSH-Px activities in low and mid dose Nano-Se groups expression increased,MDA level decreased,myocardial cell apoptosis rate decreased,Bc1-2 protein expression increased and Bax protein expression decreased.Moreover,the SOD and GSH-Px activities in high dose Nano-Se group decreased obviously compared to those in mid dose Nano-Se group.MDA level and myocardial cell apoptosis rate increased,Bc1-2 protein expression decreased and Bax protein expression increased,no significant difference in SOD,GSH-Px activity,MDA level and myocardial cell apoptosis rate was observed compared with positive control group.CONCLUSION:The damage of cardiac muscle is alleviated when a certain dose of Nano-Se is supplied to diabetes mice.The protective mechanism may be related to antioxidation,blood-sugar adjustment and the increase of Bc1-2 expressing.
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AIM: To study the role of androgen receptor (AR) in hormone-dependent and hormone-independent prostate cancer cell proliferation by knocking down AR expression with adenovirus-delivered siRNA. METHODS: Four well-designed siRNAs were synthesized and inserted into the adenovirus plasmid pShuttle-H1-Ri. The recombinant pShuttle-H1-Ri-AR plasmid was then co-transfected with pcDNA-AR to HEK293 cell line and Western blot was used to detect the inhibitory efficiency of different siRNAs on AR expression. Recombinant adenovirus containing more efficient siRNAs were prepared and used to infect three different humane prostate cancer cell lines including LNCapC4-2B and CWR22Rv1. The efficiency of knocking down AR expression was detected by Western blot. The effect of AR-knocking down on cell proliferation was detected by MTT colorimetric assay. RESULTS: All of the four designed siRNAs could knock down AR expression in transient co-transfection. Infecting with recombinant adenovirus containing more efficient siRNAs in hormone-dependent and hormone-independent prostate cancer cell lines specifically knocked down AR expression with high efficiency. Knocking down AR expression significantly decreased the proliferation rate in all these prostate cancer cells. CONCLUSION: The suppressed expression of AR in prostate cell lines mediated by siRNA could efficiently inhibit the cell proliferation, and these results show that AR plays an important role in the proliferation of hormone-dependent and hormone-independent prostate cancer cells. AR is an important therapeutic target for the treatment of prostate cancer.