ABSTRACT
Objective:To investigate the influence of trimethylamine N-oxide(TMAO)on the development of early neurological deterioration(END)in diabetic patients with acute ischemic stroke.Methods:In this cross-sectional study, 108 type 2 diabetes patients with acute ischemic stroke treated at the Department of Neurology in the Affiliated Wuxi People’s Hospital of Nanjing Medical University between October 2019 and November 2020 were consecutively recruited.END was defined as an increase in the National Institutes of Health Stroke Scale(NIHSS)≥ 2 points and exclusion of intracranial hemorrhage or bleeding transformation in cranial imaging evaluation within 5 days of initial deterioration of neurological dysfunction.The patients were divided into 2 groups, an END(n=36)group and a non-END group(n=72). Fasting plasma TMAO was measured using isotope dilution liquid chromatography coupled to tandem mass spectrometry.Results:Of the 108 patients, 36(33.3%)were diagnosed with END, and their plasma TMAO levels were significantly higher compared with patients without END( Z=-3.500, P<0.001). For prediction of END, the area under the ROC curve for plasma TMAO levels was 0.707(95% CI: 0.603-0.811, P<0.001). The frequencies of END in subjects grouped via tertiles of TMAO were 22.2%, 19.4% and 58.3%, respectively, with significant differences between the 3 groups( χ2=14.979, P=0.001). Univariate analysis showed that elevated TMAO( OR=1.160, 95% CI: 1.050-1.282, P=0.004)was associated with END.A multivariate logistic regression model further confirmed the association between TMAO and END( OR=1.145, 95% CI: 1.033-1.269, P=0.010). Conclusions:Increased plasma TMAO levels are associated with END in diabetic patients with acute ischemic stroke.
ABSTRACT
Biotin-thiamine-responsive basal ganglia disease is a rare treatable autosomal recessive neurometabolic disorder caused by mutations in SLC19A3 gene, encoding a transporter of thiamine across the plasma membrane. In the present study, a 29-year-old male patient with epilepsy as the first symptom, accompanied by hypokinesia, extraocular muscle paralysis and delayed dystonia was reported. The brain magnetic resonance imaging revealed abnormal symmetrical signals of bilateral caudate nucleus and lenticular nucleus. The patient was diagnosed as biotin-thiamine-responsive basal ganglia disease by gene detection. After treatment with biotin and thiamine, the symptoms were relieved and the brain lesions subsided.
ABSTRACT
Objective To investigate the impact of four different collimator angle optimization techniques on the planning target volume (PTV) and organ at risk (OAR) during intensity-modulated radiotherapy (IMRT) for gastric cancer.Methods Ten patients with gastric cancer undergoing IMRT in Zhongnan Hospital of Wuhan University from 2015 to 2016 years were recruited in this study.All IMRT plans were designed by conventional five fields (330°,10°,45°,90°and 180°).In the Eclipse treatment planning system,four different collimator angle optimization techniques with consistent planning optimization parameters were employed to design the IMRT plan.Collimator angle optimization techniques included the following aspects.The collimator angle was set at 0 degree (CL0),collimator angle was set at 90 degree (CL90),Eclipse automatic collimator angle optimization (CLA) was adopted and collimator angle was set as the angle when the distance between X-Jaws and PTV (CLx) was the shortest.The dosimetric parameters mainly included the conformal index (CI) of PTV,the homogeneity index (HI),the mean dose (Mean),and the dosage of OAR.The treatment time (Time),monitor unit (MU),control point (CP),split field (SF) and conformal distance (Fx) were also considered.Results Regarding CL0 as the control,the CI,HI and Mean did not significantly differ among four collimator angle optimization techniques (all P＞0.05),whereas CLx could significantly increase the average dose of PTV in the target area (P＜0.05);CLx optimization reduced the liver (V30 reduction by 1.54％),left kidney (V12 decrease by 1.46％),right kidney and other OARs,whereas it slightly increased the maximum dose of the small intestine and spinal cord (＜1％).CLgo and CLA optimization elevated the dose of OAR in gastric cancer.Among four different collimator angle optimization techniques,CLx optimization reduced the MU (25.02％),CP (26.03％),Fx (20.27％) and SF (by 1.3separate fields on average) and treatment time (10.03％).CLgo and CLA optimization could decrease the MU,CP,Fx and SF.CL90 optimization had certain advantages in shortening the treatment time,whereas CLA optimization could prolong the treatment time by 5.04％.Conclusions During IMRT for gastric cancer,CL90,CLA and CLx collimator angle optimization techniques can obtain comparable dosimetry distribution to CL0 optimization technique,which can reduce the MU,decrease the radiation leakage,shorten the treatment time and improve treatment efficiency.
ABSTRACT
Objective To preliminarily verify the feasibility of utilizing TG119 report to commission the volumetric modulated arc therapy (VMAT) plans.Methods Based on the test cases mentioned in TG119 report,7-/9-field intensity-modulated radiation therapy (IMRT) and dual-arc VMAT plans were devised by using two types of beam energy (6 MV and 10 MV) in the Eclipse TPS system according to the requirement of this report.All the plans were verified using 0.125cc semiflex thimble ionization chamber,MatriXX and Delta 4,respectively.The final results were statistically compared with the results measured by multiple institutions in the TG119 report.Results The resuhs of both IMRT and VMAT plans met the requirement of the TG119 report.The discrepancy of point dose in the high/low dose region of VMAT plans using different photon beams was ranged from-2.55％ to 2.55％,and ± 1.85％ for the IMRT plans.The percentage of γ passing points (±3％/3 mm) for the IMRT plans using 6 MV and 10 MV photon beams was 99.38％ and 99.53％,99.32％ and 99.46％ for the VMAT plans.The γ passing rate of the compound field exceeded 98％.Conclusions The VMAT plans with 6 MV and 10 MV photon beams meet the requirement of the TG119 report.TG119 report provides certain guidance for establishing a benchmark for dosimetry verification of the VMAT plans.
ABSTRACT
Objective To investigate the clinical and pathologic features of patients with gastric neuroendocrine neoplasms (g-NENs).Methods A total of 50 cases of g-NENs diagnosed by pathology in the First Hospital of Jilin University from May 2012 to January 2016 were retrospective analyzed to summarize the clinical manifestations and pathological features.The location of lesion,gross morphology,maximum diameter,lymph node metastasis rate,distant metastasis rate,and survival time between patients with neuroendocrine tumors and neuroendocrine carcinomas were compared.Results Among the 50 patients,34 were males and 16 were females with a male to female ratio of 2.125 ∶ 1.Their age ranged from 33 to 77 years with an mean age of 60± 11 years.There were 13 cases (26％) of neuroendocrine tumors,31 (62％) neuroendocrine carcinomas,and 6 (12％) mixed adenoneuroendocrine carcinomas.The maximum diameter of lesion was less than 2 cm in 8 cases (16％),and equal or greater than 2 cm in 42 cases (84％).There was single lesion in 48 cases (96％) and multiple lesions in 2 cases (4％).There were 19 cases (38％) located in gastric antrum,16 (32％) in gastric body,11 (22％) in gastric fundus or cardia,3 (6％) in gastric angle,and 1 (2％) in the junction of gastric antrum and body.Thirty-two patients (64％) had metastasis,including 20 cases of lymph node metastasis and 12 cases of distant metastasis.The clinical symptoms of the patients were different,mainly were digestive system symptoms and tumor occupying symptoms,and no carcinoid syndrome was reported.The gross morphology (x2 =24.446.P =0.000).maximum diameter (t =-4.044,P =0.001),lymph node metastasis rate (x2=4.435,P =0.035),and survival time (t =2.925,P =0.000) were significantly differences between 13 cases of neuroendocrine tumors and 37 cases of neuroendocrine carcinoma.But the location of lesion (x2 =6.921,P=0.082) and distant metastasis rate (x2 =0.715,P =0.389) were no statistically different between the two groups.Conclusion Gastric neuroendocrine neoplasms can occur in any part of stomach,majority of tumor is single lesion and lack of specific clinical manifestations.The mostly gross morphology of gastric neuroendocrine carcinoma and mixed adenoneuro-endocrine carcinoma are ulcer type with a large diameter and poor prognosis.
ABSTRACT
Objective To observe the contrast sensitivity (CS) of patients with branch retinal vein occlusion (BRVO) without involving the macular region.Methods 92 BRVO patients (93 eyes) and 56 cases (112 eyes) without eye diseases (control group) were included in the study.According to different region,BRVO patients were divided into the nasal BRVO group (31 eyes) and temporal BRVO (62 eyes) group,and the average corrected visual acuity was 1.02 ± 0.13 and 0.98 ± 0.12 respectively.According to the type of ischemia,BRVO patients were divided into the nonischemic BRVO group (58 eyes) and ischemic BRVO group (35 eyes),the average corrected visual acuity was 1.01 ± 0.14 and 0.99 ± 0.12 respectively.The average corrected visual acuity of the control group was 1.03 ± 0.11.There was no statistically significant difference of the average corrected visual acuity between nasal BRVO group,temporal BRVO group and control group (F=3.03,P =0.06),and between nonischemic BRVO group,ischemic BRVO group and control group (F=1.60,P=0.20).Contrast sensitivity (CS) was measured by OPTEC 6500 vision tester (Stereo Company,USA) under the standard lighting conditions and different spatial frequencies including low (1.5 and 3.0 c/d),medium (6.0 c/d) and high frequencies (12.0 and 18.0 c/d).Results The CS under each spatial frequency of the nasal BRVO group was the same as the control group (t=4.25,9.48,3.08,5.86,0.94;P＞0.05),but the CS under each spatial frequency of the temporal BRVO group was different from the control group (t=8.59,19.11,10.38,17.28,6.01;P＜0.05).The CS under high spatial frequency of the temporal and nasal BRVO group was statistically different (t=11.42,6.95;P＜0.05).The CS under each spatial frequency of the ischemic BRVO group was different from the control group (t=8.88,10.56,11.64,19.06,6.67;P＜0.05).The CS under 6,12 and 18 c/d spatial frequency of the nonischemic BRVO group was statistically different with the control group (t =10.14,11.54,2.82;P＜0.05).The CS under 12 and 18 c/d spatial frequency of the nonischemic BRVO group was statistically different with the ischemic BRVO (t=7.52,3.84;P＜0.05).Conclusions The CS of the temporal BRVO and ischemic BRVO decreased more significantly under each spatial frequency.CS is a better indicator to evaluate the visual function than the visual acuity in BRVO without involving the macular region.
ABSTRACT
In this paper, fourteen new L-proline derivatives were designed and synthesized, and their acetlcholinesterase (AChE) inhibitory activities were also investigated in vitro. New L-proline derivatives were prepared from substituted 2-bromo-1-acetophenones through four-step reaction; and their bioactivities as AChE inhibitors were measured by Ellman spectrophotometry. The results showed that the target compounds had a certain AChE inhibitory activity to in vitro. The bioactivity of compound 8b was the best of them, and its IC50 value was 5.45 µmol.L-1, which was better than that of rivastigmine. So the acetylcholinesterase inhibitory activities of new L-proline derivatives were worth to be further studied.
ABSTRACT
Pseudoexfoliation syndrome (PEX) is an age-related systemic disease,with the features of fibrous stripped content widely deposit on the eye and other systemic organizations,which is associated with a rapid progress of cataract and secondary glaucoma in partial patients.The present study showed that the basement membrane injury,autoimmune disorders,and genetic factors were related to PEX,but the exact pathogenesis of PEX is still unclear.The purpose of this review was to discuss the recent progress in the pathogenesis and histopathology,expecting to contribute to the prevention and treatment of PEX.
ABSTRACT
<p><b>BACKGROUND</b>Allogeneic peripheral blood stem cell transplantation from unrelated donors (UR-PBSCT) is an alternative treatment for many hematologic diseases due to lack of human leukocyte antigen (HLA)-identical sibling donors. This study aimed to evaluate the impact of the degree of the HLA match on the clinical efficacy of UR-PBSCT.</p><p><b>METHODS</b>Patients who underwent UR-PBSCT from September 2003 to September 2012 were retrospectively investigated. They were divided into three groups according to high-resolution molecular typing. SPSS version 17.0 was used to analysis and compare the statistics of engraftment, incidence of GVHD, other complications and survival among the groups.</p><p><b>RESULTS</b>One hundred and eleven patients received UR-PBSCT, 60 of them with an HLA matched donor (10/10), 36 of them with a one locus mismatched donor (9/10), and 15 of them with a two loci mismatched donor (8/10). Similar basic characteristics were found in the three groups. No differences were found in engraftment of myeloid cells or platelets in the three groups (P > 0.05). Two-year cumulative incidence of relapse, overall survival (OS) and disease-free survival (DFS) among those three groups were similar (P > 0.05). The cumulative incidence of 100-day III-IV aGVHD in the HLA matched group and the one HLA locus mismatched group were significantly lower than that in the two HLA loci mismatched group (3.3%, 8.6%, and 26.7%, P = 0.009). The occurrence rate of new pulmonary infections in the HLA matched group was lower than in the two HLA mismatched groups (26.67%, 52.78%, and 41.18%, P = 0.035). The cumulative incidence of 100-day and 2-year transplantation related mortality (TRM) in two HLA loci mismatched group was higher than in the HLA matched group and in the one HLA locus mismatched group, (8.4%, 11.8% and 33.3%, P = 0.016) and (12.3%, 18.7% and 47.5%, P = 0.002).</p><p><b>CONCLUSIONS</b>HLA mismatch will not significantly impact the engraftment or 2-year survival after UR-PBSCT, but two mismatched HLA loci may increase the cumulative incidence of severe aGVHD and TRM.</p>