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Objective To construct a prediction model for the risk of ischemic stroke (IS) by classification tree model, and evaluate its application value. Methods By cluster sampling, 858 IS patients with perfect clinical data from January to December 2017 in the Affiliated Hospital of Guilin Medical College (IS group) were enrolled, and 844 health checkups matched with the gender and age of IS patients in the same period were enrolled as controls (healthy control group). The metabolic characteristics of the two groups were compared and analyzed. The classification tree model was used to construct the prediction model of the risk of IS, and the gain diagram, index chart, risk value of misclassification probability and receiver operating characteristic curve (ROC) were used to evaluate the application value of the model. Results Compared with the healthy control group, body mass index (BMI), fasting blood glucose (FPG), triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) in IS group were significantly increased [BMI (kg/m2): 25.34±3.70 vs. 24.24±3.10, FPG (mmol/L): 6.79±2.89 vs. 5.73±1.17, TG (mmol/L):1.62±1.06 vs. 1.44±1.06, TC (mmol/L): 4.70±2.73 vs. 4.35±0.79, LDL-C (mmol/L): 3.18±0.94 vs. 2.73±0.73, all P < 0.01], high density lipoprotein cholesterol (HDL-C) was significantly decreased (mmol/L: 1.12±0.33 vs. 1.35±0.36, P < 0.01), and the proportion of hypertension, smoking and drinking were significantly increased (69.0% vs. 41.9%, 23.1% vs. 16.8%, 19.2% vs. 13.4%, all P < 0.01). By assigning values to each factor [IS: No = 0,Yes = 1; BMI: < 24.0 kg/m2=0, ≥ 24.0 kg/m2= 1; FPG : < 7.0 mmol/L = 0, ≥7.0 mmol/L = 1; TG: < 2.26 mmol/L = 0, ≥2.26 mmol/L = 1; TC: <6.22 mmol/L = 0, ≥6.22 mmol/L = 1; LDL-C: < 4.14 mmol/L = 0, ≥4.14 mmol/L = 1; HDL-C: < 1.04 mmol/L = 0, ≥1.04 mmol/L = 1; hypertension: No = 0,Yes = 1; smoking: No = 0,Yes = 1; drinking: No = 0,Yes = 1], a classification tree model was established to analyze the risk factors of IS. The classification tree model consisted of 4 layers and 17 nodes: the first layer was hypertension, the second layer was FPG and HDL-C, the third layer was HDL-C and FPG, and the fourth layer was LDL-C and smoking. There were five explanatory variables screened out in the model, including hypertension, FPG, HDL-C, LDL-C and smoking. The first layer of the tree showed that the incidence of IS in hypertensive population (62.6%) was significantly higher than that in non-hypertensive population (35.2%). The second layer of the tree showed that the incidence of IS in people with hypertension with HDL-C≥1.04 mmol/L (53.6%) was lower than that in people with HDL-C < 1.04 mmol/L (78.5%). However, in the population without hypertension, the probability of IS occurrence in the population with FPG ≥ 7.0 mmol/L (71.1%) was significantly higher than that in the population with FPG < 7.0 mmol/L (28.3%). The third layer of the tree showed that the IS incidence of HDL-C ≥1.04 mmol/L (21.8%) was lower than that of HDL-C < 1.04 mmol/L (48.7%) in the population without hypertension and FPG < 7.0 mmol/L. However, in the population with hypertension and HDL-C ≥ 1.04 mmol/L, the probability of IS occurrence in the population with FPG ≥ 7.0 mmol/L (78.6%) was significantly higher than that in the population with FPG < 7.0 mmol/L (46.7%). The fourth layer of the tree showed that the IS incidence of people with LDL-C ≥4.14 mmol/L (53.8%) was higher than that of people with LDL-C < 4.14 mmol/L (19.0%) in the population without hypertension, FPG < 7.0 mmol/L and HDL-C ≥ 1.04 mmol/L. In the population without hypertension, the incidence of IS in smokers (76.9%) was higher than that in non-smokers (39.1%) of people with FPG < 7.0 mmol/L and HDL-C <1.04 mmol/L. In the population with hypertension, the probability of IS occurrence in the population with LDL-C ≥4.14 mmol/L (72.5%) was higher than that in the population with LDL-C < 4.14 mmol/L (44.4 %) of people with HDL-C ≥ 1.04 mmol/L and FPG < 7.0 mmol/L. The gain diagram of IS classification tree model shown that the gain value increased rapidly from 0% to 100% and then tended to be stable. The index chart shown that the index value kept stable in the moving direction from above 100% and then dropped rapidly to 100%, indicating the model was very well. The risk value of misclassification probability of the classification tree model was 0.291, and the correct rate of risk factor for IS patients was 70.90%. The area under ROC curve (AUC) was 78.0% [95% confidence interval (95%CI) =75.9%-79.9%, P < 0.001], the sensitivity was 62.5% (95%CI = 59.1%-65.7%) and the specificity was 79.4% (95%CI =76.5%-82.1%). Conclusion Classification tree model can properly predict the risk factor of IS, and the most important risk factors are hypertension, hyperglycemia, high LDL-C and smoking.
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Objective@#To establish a rat model of paraquat (PQ) -induced pulmonary fibrosis and observe the changes in thrombospondin-1 (TSP-1) and its receptor CD47 in lung tissue, and to investigate their roles in the pathogenesis of PQ-induced pulmonary fibrosis.@*Methods@#Fifty-four clean adult male Sprague-Dawley rats were randomly divided into normal control group (n=6) and 2 h, 12 h, 1 d, 3 d, 7 d, and 14 d PQ poisoning groups (n=8 per group). A rat model of PQ poisoning was established by a single gavage of 20 wt.% PQ solution (50 mg/kg). Flow cytometry was used to determine the concentration of reactive oxygen species (ROS) in blood and lung tissue. Enzyme-linked immunosorbent assay was used to determine the concentrations of hydroxyl radicals, malondialdehyde, and hydroxyproline in lung tissue. HE staining and Masson staining were used to observe the pathological damage of lung tissue after PQ poisoning. The expression of TSP-1 and CD47 in lung tissue was measured by Immunohistochemistry.@*Results@#Compared with the normal control group, the 2 h to 7 d PQ poisoning groups showed significant increases in ROS fluorescence intensity in red blood cells and lung tissues and the concentrations of malondialdehyde and hydroxyl radicals in lung tissue (P<0.05) , and the 14 d PQ poisoning group had a significant increase in the concentration of hydroxyproline in lung tissue (P<0.05). HE staining showed that the 2 h to 7 d PQ poisoning groups had significantly higher semiquantitative pathological scores of pulmonary alveolitis than the normal control group (P<0.05). The Masson staining showed that the 7 d and 14 d PQ poisoning groups had significantly higher semiquantitative pathological scores of pulmonary fibrosis than the normal control group (P<0.05). Compared with the normal control group, all PQ poisoning groups (except the 12 h group) had significantly increased expression of TSP-1 in lung tissue (P<0.05) , and all PQ poisoning groups (except the 1 d group) had significantly increased expression of CD47 in lung tissue (P<0.05). Within 2 h after PQ poisoning, the expression of TSP-1 and CD47 was positively correlated with the concentrations of ROS, hydroxyl radicals, and malondialdehyde and the degree of pulmonary alveolitis (P<0.01) ; at 1 d after PQ poisoning, the expression of TSP-1 and CD47 was positively correlated with the concentration of hydroxyproline in lung tissue (P<0.01) .@*Conclusion@#The expression of TSP-1 and CD47 is closely related to oxidative stress and subsequent pulmonary fibrosis, and they may be involved in the development and progression of pulmonary alveolitis and subsequent pulmonary fibrosis in rats with PQ poisoning.
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BACKGROUND:Rheumatoid arthritis is a common chronic systemic autoimmune disease which is characterized by synovial lesions and bone erosion. The clinical treatment is stil a difficulty. OBJECTIVE:To explore the effect of exogenous hydrogen sulfide on the articular lesions in rheumatoid arthritis rats. METHODS:Sprague-Dawley rats were divided into four groups:control group, model group, high concentrations of hydrogen sulfide intervention group, low concentrations of hydrogen sulfide intervention group. At 2 and 4 weeks after intervention, the arthritis index, levels of serum inflammatory cytokines (tumor necrotic factor-αand interleukin-1β), pathological change of synovial tissue, average absorbance of knee joint specimens using col agen-II immunohistochemical staining were measured. RESULTS AND CONCLUSION:The arthritis index, levels of serum inflammatory cytokines and inflammatory infiltration of synovial staining in the model group and two intervention groups were higher than that in control group, the high concentrations of hydrogen sulfide intervention group was significantly higher than the model group (P<0.05) while the low concentrations of hydrogen sulfide intervention group was lower than the model group (P<0.05). The average absorbance of knee cartilage specimens using col agen-II immunohistochemical staining was lower in the model group and two hydrogen sulfide intervention groups compared with the control group, the high concentrations of hydrogen sulfide intervention group was significantly lower than the model group (P<0.05) while low concentrations of hydrogen sulfide intervention group was higher than the model group (P<0.05). Hydrogen sulfide has a regulatory effect on rheumatoid arthritis, high concentrations of hydrogen sulfide aggravate arthritis and cartilage degradation, low concentrations of hydrogen sulfide reduce arthritis and protect cartilage.
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BACKGROUND:The current fixation methods for clavicle fracture are mainly anatomy plate or reconstruction plate. The specific devices for maintaining fracture alignment and fixation are rarely reported. The majority of physicians prefer reduction forceps to maintain fracture alignment and retain plate for internal fixation. However, reduction forceps have many disadvantages, such as large damage, instable fixation and difficult to bend or mould plates. OBJECTIVE:To compare the clinical effect of new-style bone holder and reduction forceps in treatment of clavicular fractures. METHODA total of 75 patients with clavicular fractures were recruited from Department of Orthopedics, Huai’an First Hospital, Affiliated to Nanjing Medical University, between December 2011 and December 2013. The involved patients were randomly divided into two groups, new-style bone holder (39 cases) and reduction forceps (36 cases). In new-style bone holder group, the wounds were opened and reduced using reduction forceps, then new-style bone holder was applied to maintain fracture alignment and internal fixation;in reduction forceps group, the wounds were opened and reduced using reduction forceps, then reduction forceps was applied to maintain fracture alignment and internal fixation. The length of incision, the time of operation, intraoperative blood loss, fracture healing time and clinical efficacy in two groups were compared. RESULTS AND CONCLUSION:Al cases were fol owed up for over half a year. There was no significant difference between the two groups in the length of incision (P>0.05). The new-style bone holder group was obviously better than reduction forceps group in the time of operation, intraoperative blood loss and fracture healing time, with significant difference (P<0.01). The clinical efficacy was significantly higher than reduction forceps group. Experimental findings indicate that, new-style bone holder is characterized by simple operation, few trauma, stable fixation, short operation time, and rapid fracture healing.
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Objective To study the relationship of interleukin-18 (IL-18)gene-137G/C polymorphisms in the promoter region with cerebral infarction(CI) and the effect of integrin gene polymorphisms on plasma lipid and lipoprotein levels. Methods Polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) were used for the detection of integrin genotypes in 190 patients with CI and 210 healthy controls. The plasma lipid and lipoprotein levels were measured by routine method. Results The distributions of IL-18 gene -137G/C polymorphism was significantly different between CI group and control group(P ＜0. 05＝ ,The relative risk suffered from CI of C allele was 1.624 times of the G allele (OR = 1.624,95% CI: 1.134 ～ 2.324), The level of plasma lipid C allele carriers was significantly higher than no carriers(P ＜0.05＝. Conclusion IL-18 gene-137G/C polymorphism was associated with CI, C allele may be genetic susceptibility gene for CI.
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Objective To study the effect of procyanidin on neural cell apoptosis and the expression of Caspase-3 of cerebral ische-mia reperfusion(I/R) injury in rats. Methods 40 rats were randomly divided into 4 groups, which were sham operated group, I/R group, low dose procyanidin treated group and high dose procyanidin treated group. The focal middle cerebral artery occlusion (MCAO) model was made by suture-occluded method. After MCAO for 90min following 24h of reperfusion, neural cell apoptosis and the expression of caspase-3 was investigated with TUNEL and immunohistochemistry. HE staining and Trc staining was also used. Result Compared with sham opera-ted group, neural cell apoptosis rate and the expression of caspase-3 were increased at the 24th hour of reperfusion in the ischemic territory(P < 0.05) . Compared with I/R group, low and high dose procyanidin treated group reduced expression of caspase-3 and neural cell apopto-sis rate in a dose-dependent manor (P <0.05). The change of ischemic impairment in procyanidin treated group was less than that of I/R group, and the change of high dose procyanidin treated group was less than that of low dose procyanidin treated group. Compared with that of I/R group, cerebral infarction volume of procyanidin treated group was decreased in a dose-dependent manor (P < 0.05). Conclusion Procyanidin may reduce cerebral ischemia-reperfusion injure by reducing expression of caspase-3 and neural cell apoptosis.
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@#Objective To study the effect of Tanshinone ⅡA(Tan ⅡA) on the contents of nitrous oxide(NO) and the activities of nitric oxide synthase(NOS) and immunologic NOS(iNOS) following cerebral ischemia reperfusion(I/R)injury in rats.Methods 40 Wistar rats were randomly divided into 4 groups,which were sham group,I/R group,low dosage Tan ⅡA treated group and high dosage Tan ⅡA treated group.The focal middle cerebral artery occlusion(MCAO) model was made.Rats were pretreated with Tan ⅡA for 3 d respectively before MCAO.After 90 min MCAO following 24 h of reperfusion,HE staining was investigated.The contents of NO and the activities of NOS and iNOS were also investigated.Results The change of ischemic impairment in low or high dosage Tan ⅡA treated group was lighter than that of I/R group,and high dosage Tan ⅡA treated group was lighter than that of low dosage Tan ⅡA treated group.Compared with the sham group,the contents of NO and the activities of NOS and iNOS increased in the ischemic territory(P<0.05).Compared with I/R group,low and high dose Tan ⅡA treated group reduced the contents of NO and the activities of NOS and iNOS dose-dependently(P<0.05).Conclusion Tan ⅡA may reduced cerebral ischemia-reperfusion injure by reducing the contents of NO and the activities of NOS and iNOS dose-dependently.
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Objective To study the effect of tanshinone ⅡA on the expression of P-selectin and ICAM-1 after cerebral ischemia reperfusion (I/R)injury in rats. Methods Rats were randomly divided into 4 groups: Sham operated group, I/R group, low dose Tan ⅡA treated group and high dose Tan ⅡA treated group. The focal middle cerebral artery occlusion (MCAO) model was made by suture-occluded method. Rats were pretreated with Tan ⅡA, ig for 3d,respectively before MCAO. After 90min MCAO following 24 hours of reperfusion, the expression of P-selectin and ICAM-1 was detected with using immunohistochemistry method. Result Compared with sham operated group, the expression of P-selectin and ICAM-1 increased after reperfusion for 24 hours in the ischemic territory(all P＜0.01).Compared with I/R group, the expression of P-selectin and ICAM-1 decreased in a dose dependent manner in low and high dose Tan ⅡA treated group(P＜0.01).Compared with that of I/R group, cerebral infarction volume was decreased in a dose dependent manner in low dose Tan ⅡA treated group and high dose Tan ⅡA treated group(all P＜0.01).The change of ischemic impairment in low or high dose Tan ⅡA treated group was less than that in IR group, and the change of ischemic impairment in high dose Tan ⅡA treated group was less than that in low dose Tan ⅡA treated group. Conclusion Tan ⅡA may reduce cerebral ischemia-reperfusion inflammation injure by decreasing the expression of p-selectin and ICAM-1.Tan ⅡA plays protective effect on cerebral ischemia injury, especially when high dose of Tan ⅡA(30mg/kg)was used.
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Objective It is to observe the influence of atorvastat on the clinical therapeutic effect in the patients with cerebral infarction and lipid lowering, C-reactive protein level. Methods 60 patients with cerebral infarction are admined by atorvastatin 20mg,orally taking, 1 time per day,course of treatment for 4 weeks. Observing the variation of the high sensitivity C-reactive protein(hs-CRP) and concentration of blood fat in the circa about treatment. Results Treatment group's excellence rate is 70.0 %, total effective rate is 86.7 % after 4 weeks' atorvastatin treatment. It obviously outweighs the control group(43.3 % and 66.7 % ) ( P＜0.05 ) without evident adverse effect; TC, LDL-C significantly step clown and HDL-C(P＜0.05 ) significantly steps up comparing pretherapy. They also obviously outweigh the control group(P＜0.05 and P＜0.01 ). The blood serum hs-CRP level obviously decreases( P＜0.01 ). Conclusion Atorvastat can not only lower the lipid, but also degrade the concentration of CRP.It has significant clinical therapeutic effect while without evident adverse effect. The early use of atorvastatin can prevent and control ischemic cerebrovascular disease preferably. It can also reduce the genesis of cerebrovascular disease and improve the prognosis of cerebrovascular disease.
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Objective To study effect of Tanshinone ⅡA (Tan ⅡA) on the content of NO and the activities of NOS and iNOS in cerebral ischemia reperfusion (I/R) injury rats,and explore its protective mechanism. Methods Rats were randomly divided into 4 groups,which were sham operated group,I/R group,low dose Tan ⅡA treated group and high dose Tan ⅡA treated group. The focal middle cerebral arterymocclusion (MCAO) model was made by suture-occluded method. Rats were pretreated with Tan ⅡA,ig for 3 d before MCAO. After 90 min MCAO following 24 h of reperfusion,pathomorphologic changes was investigated with HE staining. The content of NO and the activities of NOS and iNOS was also determined. Result The change of ischemic impairment in low or high dose Tan ⅡA treated group was lighter than that of I/R group,and high dose Tan ⅡA treated group was lighter than that of low dose Tan ⅡA treated group. Compared with sham operated group,the content of NO and the activities of NOS and iNOS increased at 24 h of reperfusion in the ischemic territory (P
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Objective To compare the clinical effect of tube bone fractures with a modified bone holding and the traditional three -claw bone holding. Methods 94 cases of tube bone fractures were compared based on their sequence,the odd number (group A) were treated with the modified bone holding; the even number (group B) were treated with the traditional three-claw bone holding; and then the length of incision,the time of operation,the lost blood during the operation,the reduction of those fractures,the time for those fractures to get cicatrization were compared. Results All cases were followed up over half a year,which was no significant difference between the two groups in the reduction of those fractures. The group A had significant advantages than group B in the length of incision,the time of operation,the lost blood during the operation,the time for those fractures to get cicatrization. Conclusion The modified bone holding is better than the traditional three-claw bone holding in the length of incision,the time of operation,the lost blood during the operation,the time for those fractures to get cicatrization.
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Objective To approach the effects of Gingkgo biloba extra(GBE)on expression of P-selectin and myeloperoxidase(MPO)activity of cerebral ischemia-reperfusion injury in rats.Methods The rats were randomly divided into sham operated group,ischemia-reperfusion group,low dose GBE group and high dose GBE group.The models of ischemia-reperfusion were established by focal middle cerebral artery occlusion(MCAO)method.Rats were given high or low dose GBE intraperitoneally,30 min before MCAO.The expression of P-selectin was tested by immunohistochemistry and the MPO activity by chromatometry in the rat brain.The volume of cerebral infarction and the pathologic changes were observed by HE staining and TTC staining.Results(1)Compared with sham operated group,the expression of P-selectin and MPO activity were increased in models of ischemia-reperfusion(allP