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Objective: The aim of the study is to validate whether the Recognition Of Stroke In the Emergency Room (ROSIER) scale can be used by general practitioners (GPs) in an emergency medical service (EMS) protocol to transfer stroke patients from primary care center to advanced hospital with acute stroke center. Methods: GPs prospectively performed the ROSIER scale and the Cincinnati Prehospital Stroke Scale (CPSS) on suspected stroke patients as a transfer protocol. All patients were immediately transferred to the Level-II hospital for further treatment. Results: 468 of the 512 suspected stroke patients met the inclusion criteria in this study. The ROSIER scale showed a diagnostic sensitivity of 83.13% (95% confidence intervals [CI] 79.74-86.52%) and specificity of 80.88% (95% CI 77.32- 84.44%). The CPSS showed a diagnostic sensitivity of 78.01% (95% CI 74.26-81.76%) and specificity of 70.59% (95% CI 66.46-74.72%). The Kappa statistic value of the ROSIER scale and the CPSS were 0.601 and 0.454, respectively. The area under the curve (AUC) of ROSIER scale was large than the CPSS (AUC 0.855 vs. 0.791). However, the difference was not significantly different. Conclusions: This study suggest that ROSIER and CPSS could be used in an EMS protocol to transfer stroke patients from a primary care center to an advanced hospital offering thrombolysis service
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StrokeABSTRACT
BACKGROUND:Bone marrow stromal cel s can differentiate into nerve cel s to promote nerve tissue repair, but the exact mechanism has not been ful y elucidated. OBJECTIVE:To explore the influence of adenovirus-mediatedβnerve growth factor transfection on bone marrow stromal stem cel transplantation fighting against brain injury in rats. METHODS:(1) Rat bone marrow stromal stem cel s were cultured in vitro, transfected with the adenovirus-mediatedβnerve growth factor and directional y induced usingβ-mercaptoethanol. (2) A total of 210 Sprague-Dawley rats were randomized into induction+tranfection group, induction+non-transfection group, induction+medium group, model group, and sham group (n=42 per group). Rat skul injury models were made, and given corresponding treatments at different time points (12, 24, 36, 48, 72 hours). Neurological function of rats was evaluated based on neurological severity scores on the day that the rats were given transplantation, and 1, 2, 3, 4 weeks after transplantation. (3) Another 75 Sprague-Dawley rats were also divided into five groups (n=15 per group) as above, fol owed by model establishment and corresponding treatments at 24 hours after modeling. Neurological severity scores were recorded at the same day, 1, 2, 3, 4 weeks after transplantation. Five rats from each group were sacrificed to detect levels of malondialdehyde and superoxide dismutase in the rat brain at the same day, 2 and 4 weeks after transplantation, respectively. RESULTS AND CONCLUSION:If the cel s were transplanted within 48 hours after modeling, the neurological severity scores in the induction+transfection group decreased significantly compared with the induction+non-transfection group and model group at 1 and 2 weeks after transplantation (P<0.05). If the cel s were transplanted at different time, the neurological severity scores in the induction+transfection group were decreased significantly compared with the induction+non-transfection group and model group at 3 and 4 weeks after transplantation (P<0.05). If the cel s were transplanted within 24 hours after modeling, the neurological severity scores in the induction+transfection group decreased significantly compared with the model group at 1 week after transplantation (P<0.05), and the neurological severity scores in the induction+transfection group and induction+non-transfection group both were significantly lower than those in the model group (P<0.05). Two weeks after cel transplantation, the level of superoxide dismutase was significantly higher in the induction+transfection group than the induction+medium group and model group (P<0.05), but the level of malondialdehyde was significantly lower (P<0.05). Al these findings indicate that adenovirus-mediatedβnerve growth factor transfer plays a certain neuroprotective role in bone marrow stromal stem cel transplantation for brain injury in rats.
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BACKGROUND:Choosing an effective means to label and trace the distribution, differentiation and migration of celsin vivo help to further explore the specific mechanism of cels that exert a therapeutic effect. OBJECTIVE:To understand the migration and localization of BrdU-labeled human umbilical cord mesenchymal stem cels in brain injury model rats. METHODS:Human umbilical cord blood samples were obtained, and the isolation of human umbilical cord mesenchymal stem cels was carried out. The primary and passage culture were performed. The phenotype of cels was detected by flow cytometry. Passage 3 human umbilical cord mesenchymal stem cels were labeled using BrdU, and the cel proliferation was detected using MTT method. BrdU-labeled cels were injected into brain injury ratsvia the tail vein. At 14 days after transplantation, brain tissues in the injury region were cut into sections and the migration and location of the umbilical cord mesenchymal stem cels were observed under inverted fluorescence microscope. RESULTS AND CONCLUSION: Cel surface specific markers CD45 and CD34 were detected by flow cytometry, but the cels could not express CD44, CD105 and CD29. Based on the cel growth curve, the cels came into a conditioning period at 1-3 days of seeding and came into a logarithmic phase at 3-5 days. BrdU-positive cels were visible at the injury region after 14 days, indicating that in the rats, transplanted human umbilical cord mesenchymal stem cels migrated from the peripheral blood to the site of brain injury to achieve the effective repair of injured parts. Cite this article:Liu HL, Liu ZJ, Chen XB, Hu WZ, Ding BQ. Migration and localization of umbilical cord mesenchymal stem cels implanted into brain injury model rats. Zhongguo Zuzhi Gongcheng Yanjiu. 2016;20(1):31-35.
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Objective To improve the preoperative diagnosis accuracy of cerebellopontine angle tumors through analyzing MRI findings. Methods Ninety-six cases with cerebellopontine angle tumors, confirmed by pathology and surgery, were collected and underwent MRI scan plus enhanced MRI. Among the 96 capes, we observed acoustic neurinoma in 55 cases, meningioma in 20 cases, cholesteatoma in 9 cases, trigeminal neuroma in 7 cases,cavernous hemangioma in 3 cases,arachnoid cyst in 2 cases. The MRI characteristics of all cases were analyzed retrospectively. Results The chief type of tumor happened in the cerebellopontine angle zone was acoustic neurinoma,followed in order by meningioma,cholesteatoma,trigeminal neuroma,cavernous hemangioma and arachnoid cyst. The accuracy of preoperative localization and qualitative diagnosis were 100% and 94.7%respectively.Conclusion MRI has a high value in the diagnosis and differential diagnosis of cerebellopontine angle tumors,which can be used as a preferred preoperative examination method in cerebellopontine angle tumors.
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Objective To investigate the effects and significance of neuronavigation and electrocorticography monitoring in resection of eloquent brain glioma. Methods Thirty-six cases with intracranial tumors accepted microneurosurgery resection under neuronavigation and electrocorticography monitoring. The clinical data and postoperative outcome were analyzed. Results The mean registration error was (2.0 ±0. 5)mm in all operations and all skin flaps and bone windows designed by neuronavigation could fit the operation demands. Total resectin of the tumor was achieved in 31 cases and subtotal resection in 5 cases. Neurological symptoms improved and no severe complications or death happened in all patients. Conclusion Neuronavigation combined with electrocorticography monitoring can accurately locate the eloquent glioma and retrieve the brain shift. This method is a real-time technique and has functional test ability. It can improve the total removal rate and decrease the mortality and disabled rate.