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Objective To construct microRNA (miRNA) -mediated gene regulation of ovarian cancer by establishing regulatory networks of miRNA and long non-coding RNA (lncRNA) database based on bioinformatic analysis.Methods Ovarian cancer-related regulatory miRNAs were obtained via miRwalk 2.0and HMDD v2.0.According to the frequency of miRwalk 2.0software, we screened and identified the corresponding target gene expression.Upon a matching analysis, ovarian cancer matched lncRNAs searched from the lncRNA database were performed to determine miRNAs interacted with lncRNA, and starBase v2.0was used to comprehensively analyze the obtained miRNA and lncRNA.Finally, miRNA-mediated gene regulatory networks of ovarian cancer were mapped by the Cytoscape software.Results MiRNA-mediated gene regulation of ovarian cancer was successfully established regulatory networks of miRNA and lncRNA databases.Hsa-let-7a, hsamir-21, hsa-miR-16, hsa-mir-17, hsa-mir-19b, hsa-mir-29aand hsa-mir-92awere high frequency miRNA of ovarian cancer.According to matching analysis, lncRNA gene symbol X inactive-specific transcript (XIST) played the central role in lncRNA-miRNA interaction in regulation of ovarian cancer.Conclusion The miR-NA-mediated gene regulating network of ovarian cancer was successfully established according to bioinformatic analysis.Databases like miRwalk, HMDD, starBase could be used as effective tools to analyze relationship between miRNA and disease.
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Objective@#To study the efficacy of vitamin E-loaded lipid nanoparticles (VE-DC) in the mouse model to target small interfering RNA (siRNA) for inhibition of hepatitis C virus(HCV) core protein expression. @*Methods@#A high-pressure hydrodynamic method was adopted to construct an animal model of liver-specific expression to inject the plasmid containing HCV core protein into mice tail vein. Western blotting and immunofluorescence techniques were used to evaluote the liver targeting property of VE - DC/siRNA nanoparticles and the effectiveness to repress HCV Core expression. Dual luciferase reporter gene assays and in vivo imaging in mice further confirmed the inhibiting effect of VE-DC/siRNA on gene expression mediated by HCV 5' untranslated region. The adverse reactions of VE-DC/siRNA were reported by detecting serum creatinine, white blood cells and interferon. Student’s t - test and one -way analysis of variance were used to compare the difference between the two groups, and P < 0.05 was considered statically significant. @*Results@#The dual luciferase reporter gene analysis showed that the luciferase activity of the VE-DC/siRNA treated group was 39.67 ± 15.53, which was significantly lower than 77.33±11.06 of the DC/siRNA group and 91.67 ± 13.65 of the siRNA treated group, P < 0.05. The difference was statistically significant, and there was no obvious organ toxicity and obvious immune response to VE-DC/siRNA. Nanoparticle VE-DC has a good liver targeting ability, which can transport siRNA to the liver and effectively inhibit the expression of HCV Core, with an average inhibition rate of 83.01%. @*Conclusion@#VE-DC could target the delivery of siRNA to the liver and inhibit the expression of HCV- related genes in a mouse model, showing high effectiveness and low toxicity.
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Objective@#To observe the efficacy and adverse effect of oxycodone hydrochloride prolonged-release tablets rectal administration in the treatment of cancer pain.@*Methods@#From July 2016 to July 2017, eighty patients with cancer pain in the Second People's Hospital of Jiandewere selected in the research.The patients were randomly divided into control group and observation group according to the digital table, with 40 cases in each group.The two groups were treated with oxycodone hydrochloride prolonged-release tablets, the control group was treated by oral administration, while the observation group was treated by rectal administration.At different time points after administration, the degree of pain(NRS) score, pain remission rate, quality of life before and after treatment, the incidence of adverse reactions were compared between the two groups.@*Results@#After the administration of 1 h, 3 h, the NRS scores of the observation group were (4.49±1.25)points, (3.80±1.13)points, which were lower than those of the control group[(5.56±1.42)points, (5.04±1.10)points], the differences were statistically significant(t=3.58, 4.97, all P<0.05). After administration of 1 d, 1 week and 2 weeks, the NRS scores between the two groups showed no statistically significant difference(P>0.05). The pain relief rate of the observation group was 92.50%, which was significantly higher than 75.00% of the control group, the difference was statistically significant(χ2=4.50, P<0.05). The indicators of quality of life in the observation group were significantly better than those in the control group, the differences were statistically significant(t=2.09, 2.20, 3.16, 3.28, all P<0.05). The incidence rate of adverse reaction of the observation group was 12.50%, which of the control group was 10.00%, there was no statistically significant difference between the two groups(P>0.05).@*Conclusion@#The analgesia effect of oxycodone hydrochloride prolonged-release tablets by rectal administration is similar with oral administration for cancer pain patients, and has less adverse reaction, high safety, and it is worthy of popularization and application.
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Objective To prepare anti-folic acid (FA) polyclonal antibody and develop a new non-balanced competing chemiluminescence analysis for clinical detection of FA.Methods Established the detection method by added FITC-FA-analogs and FAHRP-antibody in the light emitting plate,which coated with anti-FITC antibody,to form the immune response complex of FITC/antibody-FITC-FA-analogs/FA-antibody-HRP.Then methodology evaluation was performed to evaluate the method performance;and further compared the detecting results with non-FITC system detection system and Electrochemiluminescence system (Roche Elecsys 2010).Results The ELISA results showed that the prepared anti-FA antibodies can recognize serum FA specificly.The methodology evaluation indicated that the linear correlation coefficient of the standard curve was 0.990 0;the analytical sensitivity was 1.21 ng/mL;the range of linear detection was 1.21～ 38.80 ng/mL;The coefficient variability of intra-assay was ＜5 ％,which was better than the results of non-FITC detection system;and the correlation coefficient was 0.908 1 compared with the Elecsys-2010 detection system.Conclusion The established chemiluminescence immunoassay for human serum FA has a good sensitivity and specificity,and suitable for clinical serum FA quantitativedetecting.
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Objective@#To confirmed the polymorphisms of HLA-DQ and IFNL4 were associated with HBV infection and clearance in a Chinese population.@*Methods@#The Sequenom MassARRAY MALDI-TOF system was used to genotype the HLA-DQrs9275319 and IFNL4rs368234815, rs12971396, rs12979860, and rs8099917. A binary logistic regression test was conducted to estimate the relative risk of these SNPs with HBV infection and clearance. Haploview4.2 software and PHASE software (v2.0.2) were employed to analyze linkage disequilibrium (LD) and haplotype frequencies. The MDR program was applied to analyze interactions between SNP and SNP.Statistical analysis was performed using SPSS 19.0 and P-values were corrected by Bonferroni’s corrections.@*Results@#A total of 1,069 subjects were recruited and divided into three groups: 238 healthy controls(HC), 397 with HBV-related chronic liver disease (CLD), 434 with spontaneous clearance (SC). The rs9275319TT was most frequently identified among all groups(86.2% in the CLD group, 77.6% in the SC group, and 75.9% in the HC group).Carriage of the rs9275319 C allele was a protective factor for chronic HBV infection (the allele model: P = 0.000 3, OR,0.514; 95% CI, 0.359-0.738) and clearance (the allele model: P = 0.002, OR, 1.659; 95% CI, 1.197-2.300). HLA-DQ rs9275319 showed a significant association with HBV infection (allele model, OR, 0.514; 95% CI, 0.359-0.738, adjusted P = 0.000 3) and spontaneous clearance (allele model, OR, 1.659; 95% CI, 1.197-2.300, adjusted P = 0.002). However, there was no association between IFNL4 polymorphism and HBV infection((allele model: P = 0.082 for rs368234815; P = 0.063 for rs12971396; P = 0.517 for rs12979860; P =0.695 for rs8099917) or spontaneous clearance ((allele model: P = 0.358 for rs368234815; P = 0.105 for rs12971396; P = 0.640 for rs12979860; P = 0.640 for rs8099917;all P > 0.05). The multifactor dimensionality reduction (MDR) test showed there was a three-way interaction (rs12971396, rs12979860, and rs9275319) between IFNL4 and HLA-DQ polymorphisms for HBV infection (permutation P = 0.009 for the best factor model) and clearance (permutation P = 0.014 for the best factor model).@*Conclusion@#The SNP-SNP interaction between HLA-DQ and IFNL4 is associated with the regulation of HBV infection and natural clearance.
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Objective To analyze the statistical correlation between 25-hydroxyl vitamin D and bone metabolism parameters in-cluding parathyroid hormone(PTH),N-terminal osteocalcin (N-MID),calcitonin(CT),bone alkaline phosphatase(BALP),and dis-cuss the significance in clinical diagnosis,prevention and treatment.Methods 411 cases of hospitalized patients were collected from January to September in 2014,including 316 women,95 men,age arranged from 37 to 96,the average age was(69.29±12.21).Use electro chemiluminescence immunoassay(ECLIA)method to detect the levels of 25-hydroxyl vitamin D,PTH,N-MID,CT,and BALP in hospitalized patients and explore the relationship of 25-hydroxyl vitamin D and serum bone markers in osteoporosis pa-tients.Results It was showed that vitamin D and PTH,BALP were negative correlation(P 0.05 ).Regression analysis showed that regression equation for vitamin D and blood bone markers was:Y =19.02-0.066PTH-0.09BALP.Conclusion There was some correlation between 25-hydroxyl vitamin D and PTH,BALP in patients with osteoporosis.By taking a combination test of these markers,it can provide some basic data for clinical osteoporosis diagnosis,prevention and control.
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Objective To investigate the correlation between autophagy related gene(ATG) locus polymorphism and the pulmonary tuberculosis(PTB) susceptibility according to the frequency distribution characteristics of autophagy related gene in the patients with PTB.Methods Eighteen single nucleotide polymorphism (SNP) loci of autophagy related genes in 202 patients with PTB as the case group and 222 healthy controls were genotyped by SequenomMassArray mass spectrometry array technology.The correlation between the each locus genotype and the PTB susceptibility was statistically analyzed.Results In the PTB patients group and healthy control group,after correcting the factors of sex and age,the binary Logistic regression analysis found that the frequency distribution of genotype and allele had statistical difference between rs5973822 and rs807185 sites in ATG4A gene (P＜0.05).The stratified analysis by body mass index (BMI) found that this difference was more significant in the high BMI population,moreover the distribution frequency in the patient group was lower than that in the control group,and the other 16 SNP loci had no statistical difference.Conclusion ATG4A gene rs5973822 and rs807185 loci polymorphism may be negatively correlated with PTB susceptibility,moreover which is more significant in the high BMI group.
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Objective To detect the expression of BRIT1 in cervical cancer tissues and cervical noncancer tissues ,and to analyze the differences between the two tissues .Methods The expression of BRIT1 mRNA and protein in cervical cancer tissues and the paired cervical noncancer tissues was evaluated by RT‐PCR and immmunohistochemistry .Its correlation with the clinicopathological parameters including age ,tumor types ,size ,tumor pathological grade and clinical stage was analyzed .Results RT‐PCR results showed that the BRIT1 mRNA level in cervical cancer tissues was significantly lower than that in the paired cervical noncancer tis‐sues ,the difference was statistically significant (P<0 .05) .The immmunohistochemistry results showed that the BRIT 1 protein ex‐pression level in 44 cases of 63 (69 .8% ) samples wa slower than that in the paired cervical noncancer tissues ,the difference was statistically significant(P<0 .05);In high pathological grades and high clinical stages ,the decrease of BRIT1 protein expression was more significant .Conclusion The difference of the BRIT1 expression between the cervical cancer tissues and cervical noncancer tis‐sues suggests that BRIT1 may play a certain role in the occurrence and development of cervical cancer .
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OBJECTIVE@#The significance of lymph node dissection in the VI area of cN0 thyroid papillary carcinoma.@*METHOD@#Collect 150 cases of patients diagnosed with cNO thyroid papillary carcinoma and they were performed thyroid gland lobe and isthmic portion excision including lateral VI area lymph node cleaning. The specimens were pathologic examined to determinate the size, the position, invasion of thyroid papillary carcinoma,the number and metastasis of lymph node, etc.@*RESULT@#In the 150 patients performed the lymph node VI area groups cleaning, 93 cases had VI area of lymph node metastases, so the transfer rate was 62.0%. In the VI area, metastasis rate of tracheal side lymph nodes was 62.0% (93/150), lymph node before throat group was 4.67% (7/150), lymph node before trachea group was 3.33% (5/150), lymph nodes near the trachea laryngeal recurrent nerve ventral group was 52.0% (78/150), and next to the trachea laryngeal recurrent nerve dorsal lymph node group was 21.33% (32/ 150).@*CONCLUSION@#In CN0 thyroid papillary carcinoma, VI zone of lymph node metastasis rate is high, and region VI lymph node metastasis rate from high to low in order for: paratracheal lymph node, prelaryngeal lymph node, pretracheal lymph node. The metastasis rate of paratracheal throat back nerve ventral lymph node was the highest in central lymph node.
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Humans , Carcinoma , Pathology , General Surgery , Carcinoma, Papillary , Pathology , General Surgery , Lymph Nodes , Pathology , Lymphatic Metastasis , Neck , Neck Dissection , Recurrent Laryngeal Nerve , Thyroid Cancer, Papillary , Thyroid Neoplasms , Pathology , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To prepare antibodies (pAbs) against phosphorylated Y-box binding protein 1 (pYB-1), perform qualitative detection of the ascites/pYB-1 ratio in patients with hepatocellular carcinoma with pulmonary metastasis (HCC-PM), and assess the clinical significance of the ascites/pYB-1 ratio as a diagnostic biomarker for HCC-PM.</p><p><b>METHODS</b>Bioinformatic prediction and chemical synthesis was used to identify and generate the YB-1 polypeptide with phosphorylation at serine position 102 (KYLRSVGDG). Rabbits were immunized with the YB-1 polypeptide coupled to a carrier protein. Protein A affinity chromatography was used to prepare highly-purified pAbs.ELISA and SDS-PAGE were used to determine concentration and purity of the pAbs. A total of 109 ascites specimens were collected from patients (36 cases of HCC,44 cases HCC-PM, and 29 cases of liver cirrhosis) and concentrated to obtain the pYB-1. Western blotting was used to qualitatively detect pYB-1 in ascites. Regression analysis and receiver operating characteristic (ROC) curve analysis were used to assess the qualitative data.</p><p><b>RESULTS</b>The prepared pAbs had a concentration of more than or equal to 1:1 * 106 and high purity. The pAbs/YB-1S102 specifically recognized endogenous pYB-1S102. The pYB-1S102 detected in ascites specimens from patients with HCC and HCC-PM, and the positive rate of detection was 30.6% and 77.3% respectively (P < 0.01).The pYB-1S102 showed sensitivity of 77.3% and a accuracy rate of 73.8% for diagnosis of HCC-PM.</p><p><b>CONCLUSION</b>Detection of pYB-1S102 in ascites could be a useful biomarker for diagnosis and metastasis monitoring in patients with HCC.</p>
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Humans , Antibodies , Biomarkers, Tumor , Blotting, Western , Carcinoma, Hepatocellular , Liver Cirrhosis , Liver Neoplasms , Neoplasm Metastasis , Phosphorylation , ROC CurveABSTRACT
Objective To investigate the distribution of carbapenemase-resistant genes carried by multi-drug resistant Acineto-bacter baumannii .Methods 80 strains of multi-drug resistant Acinetobacter baumannii were collected .Polymerase chain reaction (PCR)wasusedtodetectcarbapenemase-resistantgenes,suchasOXA-23,OXA-24,OXA-51,OXA-58,SIM,IMP,VIM ,GIMand SPM ,in multi-drug resistant Acinetobacter baumannii .Results Drug resistant gene OXA-23 [49 (61 .3% )] ,OXA-51 [73 (91 .3% )] ,OXA-58[7(8 .8% )] ,OXA-24[1(1 .3% )] ,IMP[17(21 .3% )] and VIM[2(2 .5% )] were found in 80 strains of multi-drug resistant Acinetobacter baumannii ,while GIM ,SIM and SPM gene were not found .Conclusion IMP ,OXA ,VIM is the main genotypes carried by multi-drug resistant Acinetobacter baumannii .
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Objective To investigate the effect of progesterone pretreatment of focal cerebral ischemic and reperfusion injury (fCIRI) and underlying molecular mechanisms.Methods A single intraperitoneal injection of progesterone (8 mg/kg) given 1 h,48 h and 96 h before fCIRI was established in male Sprague-Dawley rats.The number of survival of neurons in hippocampal CA1 region of the ischemiaside,as well as spatial memory function,was detected on days 3-8 after fCIRI.Extracellular-signalregulated kinase 1/2 phosphorylation (p-ERK1/2) and nuclear translocation of p-ERK1/2 in hippocampal CA1 region were examined using western blot.Results The number of survival of neuronal cells was significantly increased in ischemic groups treated with progesterone at 1 h and 48 h pre-fCIRI (164.3 ± 11.0,218.5 ± 9.1 and 142.7 ± 12.1,F =29.4,P ＜ 0.01) compared with fCIRI group treated with vehicle.Likewise,the escape-latency to reach the hidden-platform recorded in day 5 of Morris water maze test was reduced markedly in fCIRI-treatment groups compared with the vehicle group(10.3 ± 11.1,19.2 ±9.6 and 32.4 ± 14.3 ;F =35.8,P ＜0.01).The level of p-ERK1/2 was elevated notably during 24 h to 48 h postprogesterone by western blot,while restored to the baseline at 96 h post-progesterone.Improved nuclear translocation of p-ERK1/2 was observed from 2 h to 48 h post-progesterone.The progesterone receptor antagonist RU486 blocked the exaltation of either intracellular level or nuclear translocation of p-ERK1/2,which was induced by progesterone.Conclusions The pretreatment with progesterone exerts a neuroprotective effect against the ischemia-induced neuronal death and ameliorates the deficits in spatial memory through enhancing the activation of ERK1/2.The neuroprotection derived from pretreatment with progesterone achieves a time window of not less than 48 h,which is progesterone receptor-mediated ERK1/2 signaling pathway-dependent.
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Tumor markers can reflect tumor existence,and open an entrance to diagnose tumor at early stage.Recent researches reveal that gastric cancer related tumor markers such as microRNAs,enzymes,cytokines and antibodies-antigens are significant for the diagnosis,treatment,relapse surveillance,prognosis evaluation of gastric cancer.
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A new target in cancer treatment involves tumor-associated macrophages (TAMs) which are infiltrated in microenvi-ronment. By secreting a wide range of cancer-promoting cytokines, such as vascular endothelial growth factor, interleukins, and matrix metalloproteinase, TAMs can promote the proliferation, invasion, and metastasis of cancer cells. Cyclooxygenase-2 (COX-2), an inflam-matory factor that is significant for angiogenesis and immunoregulation within the local microenvironment, may also contribute to can-cer progression and act as a novel target for breast cancer therapy. Several COX-2 inhibitors, such as celecoxib, have shown potential as suppressors of TAMs and the microenvironment. Hence, the current study discusses the crosstalk between TAMs-delivered important cytokines and COX-2 in the breast cancer microenvironment, and then analyzes the value of homologous antagonists alone or in combi-nation with COX-2 inhibitors. This paper aims to provide the theoretical principle of multi-target selection in TAMs blockage, and offer a new direction for biological targeted therapy in breast cancer treatment.
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Objective To establish and validate a modified rat thromboembolic stroke model.Methods After taking femoral arterial blood and mixing it with thrombin,they were injected into PE-50 catheter for preparing in vitro thrombosis in 60 Sprague-Dawley rats.A thromboembolic cerebral ischemia model induced by catheterization of the right external carotid artery and the small blood clot emboli were injected into the internal carotid arteries.Thirty rats were randomly divided into a large number of emboli group (n =10 with 12 emboli),a median number of emboli group (n =10 with 10 emboli) and a small number of emboli group (n =10 with 8 emboli).Two hours after embolus injection,the neurological deficit score was performed and the success rate of the model was compared in all groups.Twenty-four hours after embolus injection,the rats were sacrificed and the brains were removed for 2,3,5-triphenyltetrazolium chloride staining.The hemorrhage,infarct volume,bleeding incidence and mortality after cerebral infarction were evaluated.The high success rates of the modeling in the emboli groups were selected and they were randomly divided into either a normal saline group (n =12) or a recombinant tissue-type plasminogen activator (rtPA) group (n =12).The rats were given normal saline and rtPA at 3 hours after embolus injection.Before embolus injection and 2,6,12 and 24 hours after embolus injection,the neurological scores were performed respectively; 24 hours after embolus injection,the rats were sacrificed and the brains were removed for 2,3,5-triphenyltetrazolium chloride staining.The hemorrhage rate,infarction size,degree of cerebral edema,and blood-brain barrier permeability were evaluated.Results Only 40％ of rats had neurological deficits in the small number of emboli group,and the infarct volume was only 10.54 ± 2.82％.The success rates in the median and large number of emboli groups were 80％ and 100％ respectively.They were all significantly higher than those in the small number of emboli group (P =0.011 ).The infarct volume was also significantly greater than that in the small number of emboli group (F =40.897,P =0.000).After administration of rtPA,the mean survival time of the rats in the large number of emboli group was less than 24 hours,so the median number of emboli group was selected to study the thrombolytic effect of rtPA.The infarct volume and neurological function score in the rtPA group were improved significantly compared to the normal saline group (t =7.728,P =0.000),while there were no significant differences in the hemorrhage rate,degree of brain edema and blood-brain barrier permeability between the 2 groups.Conclusions The stability and reproducibility were good in the modified thromboembolic cerebral ischemia model injected with 10 emboli,the neurological function was improved significantly after thrombolysis,and it was applicable to the experimental study of pathophysiology of cerebral ischemia and thrombolytic therapy.
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Objective To investigate the effects of recombinant tissue plasminogen activator (rt-PA)intravenous thrombolysis on blood-brain barrier (BBB) permeability,the expressions and the activities of MMP-2 and MMP-9 after cerebral ischemia in rats.Methods A total of 40 adult male Sprague-Dawley rats were allocated into 3 groups:Sham operation group (n =10),middle cerebral artery occlusion (MCAO) group (n =18),and rt-PA thrombolysis group (n =18).A MCAO model was established by using autologous thromboembolism.The sham operation group did not inject any thromboembolus,the MCAO group only made MCAO,and the rt-PA thrombolysis group received intravenous thrombolysis with rt-PA at 3 hours after MCAO.Brain infarct volume was determined by 2,3,5-triphenyl tetrazolium chloride staining BBB permeability was measured by Evans blue dye leakage.The activities and the expressions of MMP-2 and MMP-9 in brain tissue were detected by Gelatin zymography and Western blot,respectively.Results Compared to the MCAO group,the neurological function was improved significantly in the rt-PA thrombolysis group,and the infarct volume was also reduced significantly (t =7.365,P =0.005).However,the hemorrhage score (t =-3.286,P =0.017) and BBB permeability (t =-3.947,P =0.029) were increased significantly.The activities and the expressions of MMP-2 and MMP-9 in the sham operation group were lower.The activities and the expressions of MMP-2 (t =-45.121,P =0.000; t =-11.624,P=0.000) and MMP-9 (t=-71.849,P=0.000; t=-8.992,P=0.000) in the MCAO group were increased and upregulated significantly.Compared to the MCAO group,the activities and the expressions of MMP-2 (t =-28.792,P =0.000; t =-3.809,P =0.013) and MMP-9 (t =-53.506,P =0.000; t =-2.640,P =0.046) in the rt-PA thrombolysis group were increased and upregulated significantly.Conclusions After rt-PA intravenous thrombolytic therapy,the BBB permeability was increased.The activities and the expressions of MMP-2 and MMP-9 were increased and upregulated.MMP-2 and MMP-9 might participate in the increased BBB permeability,and thus inducing hemorrhagic transformation after rt-PA intravenous thrombolytic therapy in rats with cerebral ischemia.
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Oxygen free radical, an important risk factor for cerebral infarction, plays an important role in the formation of atherosclerosis, and it is one of the major factors of cerebral isehemia-reperfusion injury after cerebral infarction. Glutathione peroxidase (GPx) is a crucial antioxidant enzyme, its main role is to scavenge the excessive oxygen free radicals produced from metabolism or during the oxidative stress. The deficiency of GPx will increase the risk of cerebral infarction. This article reviews the biological characteristics of GPx and its correlation with cerebral infarction.
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<p><b>OBJECTIVE</b>To identify valid measures for preventing outbreaks of severe acute respiratory syndrome (SARS) among protected healthcare workers in isolation units.</p><p><b>METHODS</b>Architectural factors, admitted SARS cases and infection of healthcare workers in different isolation wards between January 30 and March 30, 2003 were analyzed.</p><p><b>RESULTS</b>Four types of isolation wards were analyzed, including the ward where the thirty-first bed was located on the twelfth floor, the laminar flow ward in the Intensive Care Unit where the tenth bed was located on the fifteenth floor, the ward where the twenty-seventh bed was located on the thirteenth floor of the Lingnan Building, and thirty wards on the fourteenth to eighteenth floors of the Zhongshan Building. The ratios (m(2)/m(3)) of the area of the ventilation windows to the volume of the rooms were 0, 0, 1:95 and 1:40, respectively. Numbers of SARS cases in the wards mentioned above were 1, 1, 1 and 96, respectively. Total times of hospitalization were 43, 168, 110 and 1272 hours, respectively. The infection rates of the healthcare workers in the areas mentioned above were 73.2%, 32.1%, 27.5% and 1.7%, respectively. The difference in the infection rates was of statistical significance.</p><p><b>CONCLUSIONS</b>Isolating SARS cases in wards with good ventilation could reduce the viral load of the ward and might be the key to preventing outbreaks of SARS among healthcare workers along with strict personal protection measures in isolation units.</p>
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Adult , Female , Humans , Male , Middle Aged , Disease Outbreaks , Facility Design and Construction , Hospital Units , Infectious Disease Transmission, Patient-to-Professional , Patient Isolation , Severe Acute Respiratory Syndrome , VentilationABSTRACT
<p><b>OBJECTIVE</b>To explore digestive system manifestations in patients with severe acute respiratory syndrome (SARS).</p><p><b>METHOD</b>The clinical data of 96 cases with SARS admitted into our hospital from February 6, 2003 to March 28, 2003 were retrospectively analyzed.</p><p><b>RESULTS</b>Among the 96 cases, 26 cases (27%) had diarrhea, 17 (18%) had nausea, 6 (6%) had vomiting, 16 (17%) had bellyache, and 8 (8%) had ALT elevation.</p><p><b>CONCLUSIONS</b>Patients with SARS may have digestive system manifestations; diarrhea is the most common symptom.</p>
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Adolescent , Adult , Female , Humans , Male , Middle Aged , Diarrhea , Digestive System Diseases , Retrospective Studies , Severe Acute Respiratory SyndromeABSTRACT
<p><b>OBJECTIVE</b>To describe a hospital outbreak of severe acute respiratory syndrome (SARS) and summarize its clinical features and therapeutic approaches.</p><p><b>METHODS</b>The outbreak started with a SARS patient from the community, and a total of 96 people (76 women and 20 men, mean age (29.5 +/- 10.3) years, 93.8% of whom were health care workers) who had exposure to this source patient became infected in a short time. Clinical data in this cohort were collected prospectively as they were identified.</p><p><b>RESULTS</b>(1) The incubation period ranged from 1 to 20 (mean: 5.9 +/- 3.5) days. The duration of hospitalization was (17.2 +/- 8.0) days. (2) The initial temperature was (38.3 +/- 0.6) degrees C, while the highest was (39.2 +/- 0.6) degrees C (P < 0.001), with fever duration of (9.0 +/- 4.2) days. (3) Other most common symptoms included fatigue (93.8%), cough (85.4%), mild sputum production (66.7%), chills (55.2%), headache (39.6%), general malaise (35.4%) and myalgia (21.9%). (4) The radiographic changes were predominantly bilateral in the middle or lower lung zones. The number of affected lung fields was 1.2 +/- 0.8 on presentation, which increased to 2.9 +/- 1.4 after admission (P < 0.001). The interval from the beginning of fever to the onset of abnormal chest radiographs was (3.5 +/- 2.3) days, which increased in size, extent, and severity to the maximum (6.7 +/- 3.5) days later. The time before the lung opacities were basically absorbed was (14.9 +/- 7.8) days. (5) Leukopenia was observed in 67.7% of this cohort. The time between the onset of fever and leukopenia was (4.4 +/- 2.3) days, with the lowest white blood cell count of (2.80 +/- 0.72) x 10(9)/L. (6) The lowest arterial oxygen saturation was (94.8 +/- 3.1)% with supplementary oxygen. (7) Antibiotical therapies included tetracyclines (91.0%), aminoglycosides (83.3%), quinolones (79.2%); 18.8% of the patients received a combination of tetracyclines and aminoglycosides, while 11.5% received a combination of tetracyclines and quinolones, and 63.5% received a combination of tetracyclines, aminoglycosides and quinolones. Vancomycin was used in 13.5% of the patients. (8) 68.8% of the patients were treated with methylprednisolones for a mean interval of (4.9 +/- 2.4) days. The initial dose was (67.3 +/- 28.2) mg/d and the maximal dose was (82.4 +/- 30.5) mg/d. (9) Human gamma-globulin, interferon-alpha, antiviral drugs (oral ribavirin or oseltamivir) were used respectively in 68.6%, 46.9% and 92.7% of the patients. (10) Ninety-five patients (99.0%) had a complete clinical recovery, and only 1 patient (1.0%) died.</p><p><b>CONCLUSIONS</b>SARS appears to be quickly infectious and potentially lethal among health care workers, characterized by acute onset and rapid progression, and mostly bilateral lung involvement on chest radiographs. Proper administration of glucocorticosteroids seems to be of some benefits. Antibiotics, human gamma-globulin, interferon-alpha, and antiviral drugs, although empirically, might be useful to shorten the clinical course.</p>