Visualization Analysis of Artificial Intelligence Literature in Forensic Research / 法医学杂志

Objective To analyze the literature on artificial intelligence in forensic research from 2012 to 2022 in the Web of Science Core Collection Database,to explore research hotspots and developmen-tal trends.Methods A total of 736 articles on artificial intelligence in forensic medicine in the Web of Science Core Collection Database from 2012 to 2022 were visualized and analyzed through the litera-ture measuring tool CiteSpace.The authors,institution,country(region),title,journal,keywords,cited references and other information of relevant literatures were analyzed.Results A total of 736 articles published in 220 journals by 355 authors from 289 institutions in 69 countries(regions)were identi-fied,with the number of articles published showing an increasing trend year by year.Among them,the United States had the highest number of publications and China ranked the second.Academy of Forensic Science had the highest number of publications among the institutions.Forensic Science Inter-national,Journal of Forensic Sciences,International Journal of Legal Medicine ranked high in publica-tion and citation frequency.Through the analysis of keywords,it was found that the research hotspots of artificial intelligence in the forensic field mainly focused on the use of artificial intelligence technol-ogy for sex and age estimation,cause of death analysis,postmortem interval estimation,individual identification and so on.Conclusion It is necessary to pay attention to international and institutional cooperation and to strengthen the cross-disciplinary research.Exploring the combination of advanced ar-tificial intelligence technologies with forensic research will be a hotspot and direction for future re-search.

Recent advance in neuroprotectants combined with reperfusion in acute ischemic stroke / 中华神经医学杂志

Acute ischemic stroke (AIS) is a kind of central nervous system disease that seriously threatens human health and life. Current treatment for AIS is mainly reperfusion. However, the time-sensitive of reperfusion limits its clinical application, and a considerable part of patients within the time window cannot achieve the expected effect after reperfusion; related complications of reperfusion have not been completely solved. So far, some clinical trials have confirmed that neuroprotectants are useful supplements and adjuncts to reperfusion. This paper reviews the recent advance in neuroprotectants combined with reperfusion in AIS to provide references for AIS treatment.

Dihydromyricetin improves Parkinson's disease-like lesions in T2DM rats by activating AMPK/ULK1 pathway / 生理学报

The purpose of this study was to explore the effect and mechanism of dihydromyricetin (DHM) on Parkinson's disease (PD)-like lesions in type 2 diabetes mellitus (T2DM) rats. The T2DM model was established by feeding Sprague Dawley (SD) rats with high-fat diet and intraperitoneal injection of streptozocin (STZ). The rats were intragastrically administered with DHM (125 or 250 mg/kg per day) for 24 weeks. The motor ability of the rats was measured by balance beam experiment, the changes of dopaminergic (DA) neurons and the expression of autophagy initiation related protein ULK1 in the midbrains of the rats were detected by immunohistochemistry, and the protein expression levels of α-synuclein (α-syn), tyrosine hydroxylase (TH), as well as AMPK activation level, in the midbrains of the rats were detected by Western blot. The results showed that, compared with normal control, the rats with long-term T2DM exhibited motor dysfunction, increased α-syn aggregation, down-regulated TH protein expression, decreased number of DA neurons, declined activation level of AMPK, and significantly down-regulated ULK1 expression in the midbrain. DHM (250 mg/kg per day) treatment for 24 weeks significantly improved the above PD-like lesions, increased AMPK activity, and up-regulated ULK1 protein expression in T2DM rats. These results suggest that DHM may improve PD-like lesions in T2DM rats by activating AMPK/ULK1 pathway.

Nonalcoholic fatty liver disease and bilirubin: correlation, mechanism, and therapeutic perspectives / 中华肝脏病杂志

Non-alcoholic fatty liver disease (NAFLD) is a metabolic-related disorder induced by multiple factors and mainly characterized by excessive fat buildup in hepatocytes. With the consumption of a Western-style diet and obesity prevalence in recent years, the incidence of NAFLD has gradually increased, becoming an increasingly serious public health problem. Bilirubin is a heme metabolite and a potent antioxidant. Studies have demonstrated that bilirubin levels have an inverse correlation with the incidence rate of NAFLD; however, which form of bilirubin plays the main protective role is still controversial. It is considered that the main protective mechanisms for NAFLD are bilirubin antioxidant properties, insulin resistance reduction, and mitochondrial function. This article summarizes the correlation, protective mechanism, and possible clinical application of NAFLD and bilirubin.

Timing of intravenous thrombolysis with rt-PA combined with edaravone dexborneol in super elderly patients with moderate to severe acute ischemic stroke / 中华神经医学杂志

Objective:To investigate the efficacy and safety of recombinant tissue plasminogen activator (rt-PA) intravenous thrombolysis combined with edaravone dexborneol at different timing in super elderly patients (aged≥85 years) with moderate to severe acute ischemic stroke (AIS).Methods:A prospective study was performed. Seventy-one super elderly patients with moderate to severe AIS treated with rt-PA intravenous thrombolysis combined with edaravone dexborneol from December 2020 to March 2023 in Department of Neurology, Affiliated Fourth Central Hospital of Nankai University were selected and randomly divided into early group ( n=35) and advanced group ( n=36); patients in the early group were given edaravone dexborneol immediately after rt-PA intravenous thrombolysis, and patients in the advanced group were given edaravone dexborneol 24 h after rt-PA intravenous thrombolysis. In addition, 31 patients with moderate to severe AIS received rt-PA intravenous thrombolysis only in Department of Neurology of the hospital from August 2018 to December 2020 were selected as control group. Differences in efficacy and safety indexes among the 3 groups were compared. Results:After 7 d of treatment, the improvement rate of neurological function in early group was significantly higher than that in control group and advanced group ( P<0.05). After 90 d of treatment, modified Rankin scale (mRS) scores in early group were statistically lower than those in control group and advanced group ( P<0.05); good prognosis rate in early group was statistically higher than that in control group and advanced group ( P<0.05). The incidences of intracranial hemorrhage and symptomatic intracranial hemorrhage in early group were significantly lower than those in control group and advanced group ( P<0.05). After 30 and 90 d of treatment, the advanced group had significantly lower mortality than the control group, but significantly higher mortality than the early group ( P<0.05). Conclusion:Edaravone dexborneol immediately after rt-PA intravenous thrombolysis is the optimal timing for super elderly patients with moderate to severe AIS, which can improve the efficacy and safety.

Outcomes and its influencing factors of ischemic stroke patients with lung cancer / 国际脑血管病杂志

Objective:To investigate the outcomes and its influencing factors of ischemic stroke patients with lung cancer.Methods:Patients with acute ischemic stroke complicated with lung cancer admitted to the Department of Neurology, Ninghe District Hospital of Tianjin from January 2017 to December 2020 were retrospectively enrolled. The demographic and baseline clinical data were collected. The main outcome measure was the clinical outcome evaluated by the modified Rankin Scale at 90 days after the onset of ischemic stroke. 0-2 was defined as a good outcome, and 3-6 was defined as a poor outcome. The secondary outcome measures were bleeding events within 90 d after the onset of ischemic stroke, including hemorrhagic transformation and hemoptysis.Results:A total of 37 patients were enrolled, including 25 males (68%) and 12 females (32%); age 72.6±8.0 years; 23 patients (62.2%) had a good outcome and 14 (37.8%) had a poor outcome. The baseline National Institutes of Health Stroke Scale (NIHSS) score and the proportions of patients with stage Ⅳ lung cancer, cerebral infarction due to other causes, moderate and severe stroke, anterior + posterior circulation cerebral infarction, bilateral cerebral infarction and multiple cerebral infarction in the poor outcome group were significantly higher than those in the good outcome group, while the proportion of patients with minor stroke, stage Ⅲ lung cancer and intravenous thrombolysis were significantly lower than those of patients with good outcomes (all P<0.05). Multivariate logistic regression analysis showed that the high baseline NIHSS score (odd ratio [ OR] 1.342, 95% confidence interval [ CI] 1.219-1.586; P=0.018], stage Ⅳ lung cancer ( OR 1.180, 95% CI 1.088-2.187; P=0.042), severe stroke ( OR 1.216, 95% CI 1.008-2.136; P=0.037) and multiple cerebral infarction ( OR 1.508, 95% CI 1.005-1.516; P<0.001) were independently associated with the poor outcomes, while intravenous thrombolytic therapy ( OR 0.572, 95% CI 0.262-0.802; P=0.001) was independently associated with the good outcomes. In addition, the incidence of hemorrhagic transformation and hemoptysis in intravenous thrombolytic patients was significantly higher than that in the non-intravenous thrombolytic patients (all P<0.05). Conclusions:Higher baseline NIHSS scores, multiple cerebral infarction and advanced lung cancer are associated with the poor outcomes in patients with lung cancer and ischemic stroke; intravenous thrombolytic therapy is associated with good outcomes, although it increased the risk of bleeding.

Neuroimaging features of hemorrhagic transformation after intravenous thrombolysis in patients with acute ischemic stroke / 国际脑血管病杂志

Objective:To investigate the neuroimaging features of hemorrhagic transformation (HT) after intravenous thrombolysis in patients with acute ischemic stroke.Methods:Patients with acute ischemic stroke received intravenous thrombolysis with a standard dose of alteplase in the Department of Neurology, Ninghe District Hospital from April 2018 to May 2022 and had HT within 24 h after treatment were retrospectively included. Demography, clinical data and neuroimaging findings of HT were recorded. The clinical data of symptomatic intracerebral hemorrhage (sICH) group and asymptomatic intracerebral hemorrhage (asICH) group, as well as HT in the infarct group and HT outside the infarct group were compared. Multivariate logistic regression analysis was used to determine independent risk factors for HT types. Results:A total of 63 patients with HT were enrolled (40 males and 23 females, aged 73.5±8.95 years). There were 42 patients with sICH (66.7%), 21 (33.3%) with asICH, 37 (58.7%) with HT in the infarct (ECASS classification: hemorrhagic infarction [HI]-1, 5 cases [7.9%]; HI-2, 6 cases [9.5%]; parenchymal hematoma [PH]-1, 11 cases [17.5%]; PH-2, 15 cases [23.8%]), 17 (27.0%) with HT outside the infarct, and 9 cases (14.3%) with HT both inside and outside the infarct. Heidelberg classification: 1a HI-1, 5 cases (7.9%); 1b HI-2, 6 cases (9.5%); 1c PH-1, 11 cases (17.5%); 2, 15 cases (23.8%); 3a, 14 cases (22.2%); 3b, 6 cases (9.5%); 3c, 4 cases (6.3%); and 3d, 2 cases (3.2%). Multivariate logistic regression analysis showed that lower baseline National Institutes of Health Stroke Scale (NIHSS) score (odds ratio [ OR] 1.413, 95% confidence interval [ CI] 1.216-1.447; P=0.001), small vessel occlusion ( OR 1.378, 95% CI 1.134-1.429; P=0.002), minor stroke ( OR 1.447, 95% CI 1.120-1.467; P<0.001), and HT outside the infarct ( OR 1.335, 95% CI 1.131-1.363; P=0.007) were independently associated with sICH. Higher baseline NIHSS scores ( OR 1.737, 95% CI1.102-1.801; P<0.001), cardiogenic embolism ( OR 1.789, 95% CI 1.095-1.881; P<0.001), and severe stroke ( OR 1.648, 95% CI 1.110-1.672; P<0.001) were independently associated with HT in the infarct. Conclusions:The most common neuroimaging feature of HT after intravenous thrombolysis in patients with acute ischemic stroke is PH in the infarct, while HT outside the infarct and HT both inside and outside the infarct are rare. For patients with cardiogenic embolism with higher baseline NIHSS score, the HT after thrombolysis was mostly asICH, and its imaging features were mostly multiple punctuate hemorrhage in the infarct. In patients with small vessel occlusion with lower baseline NIHSS score, most of the HT after thrombolytic therapy is sICH, and their imaging features are mostly PH outside the infarct.

Screening Biomarkers of Sudden Coronary Death Based on mRNA Expression Profile of Rat Myocardial Tissues / 法医学杂志

OBJECTIVES@#To explore the differential expression of messenger RNA (mRNA) in myocardial tissues of rats with sudden coronary death (SCD), and to provide ideas for the forensic identification of SCD.@*METHODS@#The rat SCD model was established, and the transcriptome sequencing was performed by next-generation sequencing technology. Differentially expressed genes (DEGs) in myocardial tissues of SCD rats were screened by using the R package limma. A protein-protein interaction (PPI) network was constructed by using the STRING database and Cytoscape 3.8.2 on DEG, and hub genes were screened based on cytoHubba plug-in. Finally, the R package clusterProfiler was used to analyze the biological function and signal pathway enrichment of the selected DEG.@*RESULTS@#A total of 177 DEGs were associated with SCD and were mainly involved in the renin-angiotensin system and PI3K-Akt signaling pathway. The genes including angiotensinogen (AGT), complement component 4a (C4a), Fos proto-oncogene (FOS) and others played key roles in the development of SCD.@*CONCLUSIONS@#Genes such as AGT, C4a, FOS and other genes are expected to be potential biomarkers for forensic identification of SCD. The study based on mRNA expression profile can provide a reference for forensic identification of SCD.

The application of intermttent oro-esphageal tube feeding in dementia patients with dysphagia / 中华物理医学与康复杂志

Objective:To explore the clinical application of intermttent oro-esphageal (IOE) tube feeding in the treatment of dementia patients with dysphagia.Methods:Sixty dementia patients with dysphagia were randomly divided into an IOE group and an nasogastric tube feeding (NGT) group, each of 30. Both groups were given conventional treatment, but the group members were fed through IOE or NGT respectively. Both groups′ swallowing and nutritional condition were evaluated 24 hours after admission and 30 days after the end of the treatment. The incidence of complications within 30 days, the average hospital stay and hospitalization cost were compared between the 2 groups.Results:No significant differences were observed between the two groups in any of the measurements before the intervention. During the intervention, the number of malnourished subjects decreased and the average body mass index (BMI), albumin (ALB) level, hemoglobin (HB) level and FOIS score improved significantly in both groups. Significantly better improvements in the incidence of malnutrition and the FOIS scores was observed in the IOE group. By the 30th day the average effective swallowing rate in the IOE group (90%) was significantly higher than in the NGT group (70%).Conclusions:IOE can improve the nutrition and swallowing of dementia patients with dysphagia. It can reduce the incidence of complications, shorten hospital stays and reduce hospitalization cost.

Summary of molecular mechanisms of spontaneous remission in gouty inflammation / 中国药理学通报

Acute gout subsides spontaneously within a certain period of time after onset, a process known as spontaneous remission of gouty inflammation. Its pathophysiological mechanism is related to the dynamic interaction of various components in the immune system, i. e. through the phagocytosis of autoimmune cells, the negative regulation of inflammatory mediators such as NLRP3 inflammasome, 1L-1R and Toll-like receptors, the recruitment of neutrophil extracellular traps at the site of crystal deposition and the formation of local chronic granuloma, to alleviate the necrotizing inflammation mediated by monosodium urate crystals. This review summarizes the molecular mechanism of spontaneous remission of gouty inflammation.

Effect of Compatibility of Alcohol Extract of Magnoliae Officinalis Cortex and Alcohol Extract of Polygalae Radix on Fecal Metabolites of Rats / 中国实验方剂学杂志

Objective:To investigate the effect of alcohol extract of Magnoliae Officinalis Cortex,alcohol extract of Polygalae Radix and their compatibility on fecal metabolites of rats,analyze its potential metabolic pathways,and provide experimental basis for exploring the possible mechanism of Magnoliae Officinalis Cortex relieving gastrointestinal motility disorders induced by Polygalae Radix. Method:Forty male SD rats were randomly divided into the normal group,alcohol extract of Magnoliae Officinalis Cortex group(3.50 g·kg-1),alcohol extract of Polygalae Radix group(1.75 g·kg-1) and compatibility group (3.5 g·kg-1 of alcohol extract of Magnoliae Officinalis Cortex+1.75 g·kg-1 of alcohol extract of Polygalae Radix).Fecal samples were collected within 24 h after continuous gavage for 3 days.The fecal metabolites in each group was detected by ultra-high performance liquid chromatography-quadrupole-time of flight-mass spectrometry(UPLC-Q-TOF-MS),mobile phase was acetonitrile-0.1%formic acid solution for gradient elution,data collection range was m/z 50-1 200 under positive and negative ion mode of electrospray ionization.The characteristic biomarkers and corresponding metabolic pathways were analyzed or screened by Progenesis QI v2.0,SIMCA-P 14.0,SPSS 20.0,MetaboAnalyst 4.0 and other softwares. Result:A total of 17 characteristic metabolic markers were screened out,including 5-formiminotetrahydrofolic acid,L-3-hydroxykynurenine,7,8-dihydropteroic acid,etc.The main related pathways included biosynthesis of unsaturated fatty acids,linoleic acid metabolism,vitamin B6 metabolism,etc. Conclusion:The mechanism of Magnoliae Officinalis Cortex relieving gastrointestinal motility disorders induced by Polygalae Radix may be related to purine metabolism,folate biosynthesis,tryptophan metabolism and primary bile acid biosynthesis.

Effect of intermittent oro-esophageal tube feeding on dysphagia in acute stroke patients with bulbar or pseudobulbar palsy / 国际脑血管病杂志

Objective To investigate the effect of intermittent oro-esophageal rube feeding (IOE) on dysphagia in acute stroke patients with bulbar or pseudobulbar palsy.Methods From May 2016 to December 2018,patients with acute stroke complicated with bulbar or pseudobulbar palsy admitted to the Department of Neurobgy,Ninghe District Hospital of Tianjin were enrolled retrospectively.They were divided into IOE group and nasogastric gavage tube (NGT) group.The baseline clinical data,swallowing function and nutritional indicators before and after treatment,and the incidence of aspiration pneumonia were collected and compared.Kubota's water swallow test was used to evaluate the swallowing function,and Grade ≥ 3 was defined as poor swallowing function after 30 days of treatment.Multivariate logistic regression analysis was used to determine the independent influencing factors of poor outcomes of swallowing function.Results A total of 92 patients were enrolled,58 were males (63％),and aged 64.3-± 11.2 years;the National Institutes of Health Stroke Scale (NIHSS) score 5.98 ±-2.29;76 patients (82.6％) had cerebral infarction,16 (17.4％) had cerebral hemorrhage;16 (17.4％) had bulbar palsy,and 76 (82.6％) had pseudobulbar palsy.There were 46 cases in each of the IOE group and the NGT group.The improvement of swallowing function and nutritional status at 30 d in the IOE group were significantly better than those in the NGT group (all P ＜0.01),while the incidence of aspiration pneumonia was significantly lower than that in the NGT group (19.6％ vs.39.1％;x2 =4.246,P =0.039).The dysphagia of 70 patients (76.1％) had good outcomes,and that of 22 (23.9％) had poor outcomes.Multivariate logistic regression analysis showed that the NIHSS score on admission (odds ratio [OR] 1.225,95％ confidence interval [CI] 1.221-1.445;P=0.030),bulbar palsy (OR 1.428,95％ CI 1.327-1.545;P＜0.001),and left lesions (OR 1.424,95％ CI 1.352-1.565;P＜0.001) were independently associated with the poor outcomes of swallowing function,while IOE (OR 0.351,95％ CI 0.075-0.643;P ＜0.001) was independently associated with the good outcomes of swallowing function.Conclusion IOE can improve the swallowing function of stroke patients with bulbar or pseudobulbar palsy,and reduce the incidence of aspiration pneumonia while providing good nutritional support.

Simultaneous determination of 10 active components in Xintong Oral Liquid by HPLC-MS/MS / 中草药

Objective: To establish an HPLC-MS/MS method for the simultaneous determination of ferulic acid, tetrahydroxystilbene glucoside, puerarin, calycosin-7-glucoside, naringin, protocatechuic aldehyde, salvianolic acid B, icariin, tanshinone IIA, and synephrine in Xintong Oral Liquid (XOL). Methods: The analysis was performed on Phenomenex Luna-C18 column (250 mm × 4.6 mm, 5 μm) by gradient elution of acetonitrile-mehanol-0.02 mol/L ammonium acetate. The flow rate was 0.9 mL/min. MS conditions: electrospray ionization (ESI) and multiple reaction monitoring (MRM) were adopted, the detected peak areas of ion pairs were used for quantitative determination. Results: The linear ranges of ferulic acid, tetrahydroxystilbene glucoside, puerarin, calycosin-7-glucoside, naringin, protocatechuic aldehyde, salvianolic acid B, icariin, tanshinone IIA, and synephrine were 15.22-15 220 (r = 0.999 3), 19.52-19 520 (r = 0.999 4), 25.41-25 410 (r = 0.999 5), 35.27-35 270 (r = 0.999 2), 30.28-30 280 (r = 0.999 4), 50.11-50 110 (r = 0.999 3), 20.33-20 330 (r =0.999 2), 25.22-25 220 (r = 0.999 6), 25.36-25 360 (r = 0.999 3), and 30.29-30 290 ng/mL (r = 0.999 2). The average recoveries (n = 6) were 98.15% (RSD = 1.04%), 101.84% (RSD = 0.98%), 99.86% (RSD = 0.75%), 101.08% (RSD = 0.87%), 100.52% (RSD =1.31%), 100.67% (RSD = 1.27%), 100.46% (RSD =1.64%), 99.43% (RSD =1.48%), 100.81% (RSD = 0.67%), and 98.37% (RSD =1.16%), respectively. The contents of 10 batches of the 10 active components were 0.294-0.319, 0.640-0.665, 4.671-4.699, 0.244-0.264, 2.211-2.231, 0.180-0.201, 0.306-0.324, 1.540-1.564, 0.504-0.522, and 0.809-0.829 mg/mL. Conclusion: This method is simple and rapid, and can be used for the quality control of XOL with satisfactory separation and repeatability.

Effect of trehalose on survival rate for fat cells after cryopreservation / 中南大学学报(医学版)

Objective:To explore effects of trehalose as a cryopreserve agent on survival rate of fatty tissue after cryopreservation.Methods:The liposuction was used on the abdomen of adult female.After centrifugation and purification,adipose was randomized into the following three groups,the trehalose group,the fetal bovine serum (FBS)+ 10％DMSO group and the physiological saline group.The specimens were cryopreserved at-196 ℃ for 3 months and then the HE staining,glucose transfer method and CK method were used to detect the cell survival rate in each group.Results:The activity of adipose in the trehalose group and FBS+10％DMSO group adipose was higher than that in the physiological saline group (P＜0.05);while there was no significant difference between the trehalose group and FBS+10％DMSO group (P＞0.05).Conclusion:As cryoprotectant,trehalose could keep fat cell viability,and adipose tissue can be used for clinical transplantation after 3 months' freezing.

Autologous tissue reconstruction of tarsal plate combined with temporal flap in repairing full-thickness lower eyelid defect / 中南大学学报(医学版)

Objective:To evaluate the clinical effect of combination of autologous tissue reconstruction of tarsal plate with temporal flap on repair of full-thickness lower eyelid defect.Methods:Eleven patients (11 eyes) underwent hard palate mucosa or ear cartilage combined the emporal flap with the orbicularis oculi muscle to repair full-thickness defect ofpalpebra inferior.Of the 11 patients,6 had more than 75％ eyelid defect area,and 5 had more than 50％ eyelid defect area.Results:All 11 eyes closed completely,with no entropion or ectropion,and returned to normal basically.Postoperative follow-up was performed for 6 months to 5 years,3 years and 4 months on average.The function and form of eyelid remained stable.Infection,leakage or contracture was not found on reconstruction tarsus.Conclusion:Reconstruction of eyelid with autogenous hard palate mucosa or ear cartilage combined the emporal flap with the orbicularis oculi muscle is a simple,convenient and effective method.

Impact for Family History of Hypertension on Masked Hypertension Morbidity With Relevant Cardiac Damage / 中国循环杂志

Objective: To investigate the impact for family history of hypertension on masked hypertension (MH) morbidity with relevant cardiac damage. Methods: Our research included in 3 groups: MH group, n=250 consecutive patients treated in our hospital from 2010-01 to 2015-04, Hypertension group, n=250 and Control group, n=250 subjects with normal blood pressure. The family history of hypertension, general clinical information, routine biochemical indexes and the findings of echocardiography were studied and compared among different groups. Results: ① There were 70 (28%) patients with family history of hypertension in MH group, 87 (34.8%) in Hypertension group and 26 (10.4%) in Control group. The ratio of family history of hypertension in MH group was higher than Control group, P0.05. Logistic regression analysis presented that family history of hypertension and body mass index were positively related to the morbidities of MH (r=1.468, r=0.173) and hypertension (r=1.195, r=0.086). ② Compared with Control group, MH group had increased left ventricular mass index (85.64 ± 17.7) g/m2 vs (80.50 ± 15.53) g/m2 and the maximum blood flow velocity of aortic valve (115.74 ± 16.54) cm/s vs (112.40±14.21) cm/s, all P<0.05. In MH group, compared with those without family history of hypertension, the patients with family history had the higher left ventricular mass index (89.22 ± 19.08) g/m2 vs (84.25 ± 16.99) g/m2 and the maximum blood flow velocity of aortic valve (119.19 ± 14.97) g/m2 vs (114.39 ± 16.96) g/m2, all P<0.05. Conclusion: The subjects with family history of hypertension had the higher risk of MH morbidity with more severe cardiac damage.

Significance of P53 and high mobility group box 1 protein in different levels of liver fibrosis in chronic hepatitis B / 中南大学学报(医学版)

OBJECTIVE@#To investigate the role of P53 and high mobility group protein 1 (HMGB1) protein expression in liver fibrosis stages in chronic hepatitis B patients.
@*METHODS@#According to the pathological grades, 103 patients were divided into 3 groups: no fibrosis group (n=18), low fibrosis group (n=49) or high fibrosis group (n=36). Serum HMGB1 levels were determined and receiver operating characteristic (ROC) curve was made based on the HMGB1 level and liver fibrosis score. Liver fibrosis model was developed by CCl4 in 60 male SD rats, which were sacrificed 6 or 12 weeks later. The degree of fibrosis was examined by Masson staining; HMGB1 and P53 protein expression were analyzed by Western blot; histone deacetylase (HDAC) activity, TNF-α, IL-1β and IL-6 levels in serum were measured.
@*RESULTS@#The serum levels of HMGB1 level in low and high fibrosis groups were significantly higher than that in no fibrosis group (P<0.01, respectively). ROC curve showed that serum HMGB1 in the diagnosis of hepatic fibrosis with cut off at 74 pg/mL, specificity at 65% and sensitivity at 87%. Compared with the control group, HMGB1 expression in both low and high fibrosis group was decreased in nucleus but was increased in cytoplasm, accompanied by the elevated P53 expression, increased HDAC activity and inflammatory cytokine levels (all P<0.01, respectively).
@*CONCLUSION@#P53 and HMGB1 expression was significantly increased in chronic hepatitis B patients with liver fibrosis; serum HMGB1 level was positively correlated with the degree of liver cirrhosis and HMGB1 could be used as a sensitive and specific index for liver fibrosis prognosis.

Association between Helicobacter pylori infection and stages of liver pathology in patients with chronic hepatitis B / 临床肝胆病杂志

ObjectiveTo investigate the association between Helicobacter pylori (Hp) infection and stages of liver pathology in patients with chronic hepatitis B (CHB). MethodsSeventy-nine patients who were hospitalized in the People’s Hospital of Liuzhou from February 2008 to December 2014 were selected, and liver biopsy was performed for all patients to determine the liver inflammation grade (G) and fibrosis stage (S). Meanwhile, 14C urea breath test (14C-UBT) was performed to detect Hp infection. The patients were divided into Hp-positive group and Hp-negative group based on the results of 14C-UBT, and liver inflammation grade and fibrosis stage were compared between the two groups. The t-test was applied for comparison of continuous data between the two groups, and χ2 test was applied for comparison of categorical data between the two groups. ResultsThere were no differences in liver inflammation grade or fibrosis stage between Hp-positive group and Hp-negative group (t=-1.622 and -1.263, respectively; both P＞0.05); there was no difference in the proportion of patients ≥G2 between the two groups (χ2=1.58; P＞0.05); there was no difference in the proportion of patients ≥S2 between the two groups (χ2=0.02; P＞0.05). ConclusionHp infection may not be associated with liver inflammation grade or fibrosis stage in patients with CHB.

Viral load and cytokines in the pathogenesis of severe fever with thrombocytopenia syndrome / 中华传染病杂志

Objective To observe the relationship of viral load,serum cytokines and tissue damage after severe fever with thrombocytopenia syndrome virus (SFTSV)infection,and to explore the impact of SFTSV levels on tissue injury and prognosis.Methods Twenty-four ambulatory and hospitalized patients who were infected with SFTSV were enrolled between May 2011 and July 2012 at Department of Infectious Disease, First Affiliated Hospital with Nanjiang Medical University. According to their prognosis,they were divided into cure and death group,while 32 healthy blood donators were also enrolled from center blood station in Nanjing as control.The serum SFTSV load was detected using fluorescence quantitative polymerase chain reaction (PCR).The serum T helper (Th)1/Th2/Th17 cytokines in patients with severe fever with thrombocytopenia syndrome (SFTS)were determined dynamically and quantitatively by flow cytometry.The relationships between viral load,cytokines and serum enzymes, white blood cell (WBC),platelet (PLT)counts were analyzed.Comparisons among groups were achieved by rank sum test and correlation analysis among serum cytokines,blood cell counts and tissue damage was done by Spearman correlation test.Results All of the 24 patients showed a positive reaction to SFTSV RNA.The SFTSV loads of 21 cured cases,those of 2 were > 7.0 lg copy/mL,and those of 3 death patients were 6.7 lg copy/mL,8.8 lg copy/mL and 9.8 lg copy/mL,respectively.Serum level of interleukin (IL)-6 (21 .76 pg/mL in day 5 and 7.12 pg/mL in day 7)and IL-10 (14.33 pg/mL in day 5 , 14.13 pg/mL in day 7 and 3.01 pg/mL in day 9)of cured patients were significantly higher than those of healthy controls (IL-6:2.82 pg/mL and IL-10:1 .56 pg/mL)(P <0.05 ).At day 7 and day 9,serum levels of IL-6 of death cases were 137.61 pg/mL and 1 450.83 pg/mL,respectively and serum levels of IL-10 were 50.26 pg/mL and 49.43 pg/mL,respectively.Both of the indicators in the death group were significantly higher than those of cure group (P <0.05 ).However,serum levels of IL-2 and IL-4 were significantly lower than those in healthy control group (P <0.05 ).In the cure group,WBC and PLT counts were lowest during the early course of the disease,and serum alamine aminotransferase (ALT), aspartate aminotransferase (AST ), lactic dehydrogenase (LDH ) and creatine kinase (CK ) were significantly higher than their upper limits of normal.The correlation analysis showed that serum IL-6, IL-10 levels were negatively correlated with PLT count (r=-0.390 and -0.608,respectively;both P <0.01),and positively correlated with SFTSV load (r=0.560 and 0.758,respectively),ALT (r=0.412 and 0.390,respectively),AST (r = 0.686 and 0.764,respectively),LDH (r = 0.633 and 0.677, respectively)and CK (r =0.527 and 0.636,respectively)(all P <0.01 ).Conclusions SFTSV load, IL-6,IL-10 and serum enzyme levels are closely related to the severity of the disease.The inflammatory and anti-inflammatory cytokine storm after SFTSV infection may be involved in the immune pathological injury in patients with SFTS.

Risk factors for perioperative pulmonary infection in patients with senile hip fracture / 中国组织工程研究

BACKGROUND:At present, few studies concerned pulmonary infection after treatment of senile fracture. For special parts of senile patients, there are no studies on complications of pulmonary infection in perioperative period after hip fracture. OBJECTIVE:To study risk factors for pulmonary infection in patients with senile hip fractures in perioperative period. METHODS:The data of 46 senile hip fracture patients with perioperative pulmonary infection were retrospectively analyzed. A matched case-control study was conducted in 46 senile hip fracture patients without pulmonary infection in the same hospital and the same period. The difference in perioperative various clinical indexes was compared between the two groups. Risk factors of pulmonary infection received Logistic regression analysis. RESULTS AND CONCLUSION:Multivariate analysis screened out 14 possible perioperative pulmonary infection factors:chronic obstructive pulmonary disease, smoking, diabetes mel itus, heart disease, mechanical ventilation, intraoperative bleeding amount, erythrocyte infusion, operation time, preoperative low body mass index (body mass index<18.5 kg/m2 ), serum albumin<35 g/L, electrolyte disturbance, time of entering intensive care unit and length of stay. Logistic regression analysis displayed that chronic obstructive pulmonary disease (OR=23.317;95%CI:2.702-60.312;P=0.000), entering intensive care unit (OR=7.890;95%CI:2.624-76.012;P=0.008), mechanical ventilation (OR=35.210;95%CI:8.464-131.203;P=0.017) and operation time (OR=12.122;95%CI:5.154-99.098;P=0.012) were independent risk factors for perioperative pulmonary infection in patients with senile hip fracture. These data indicated that one should be alert to the possible occurrence of pulmonary infection in senile hip fracture patients with the presence of chronic obstructive pulmonary disease, entering intensive care unit and mechanical ventilation.