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To investigate the risk factors of poor prognosis and recurrence in patients with anti-NMDAR encephalitis. A single center, observational cohort study was used to retrospectively analyze 44 patients with anti NMDAR encephalitis hospitalized in the Department of Neurology of Beijing Tong Ren Hospital from January 2014 to October 2020. The results showed that the interval from onset to immunotherapy in the poor prognosis group was significantly longer than that in the good prognosis group (t=2.045,P=0.047), and the course of disease in the poor prognosis group was significantly longer than that in the good prognosis group (t=4.127,P=0.000 2). The number of patients with clinical manifestations of dyskinesia was significantly increased (Fisher exact test: P=0.014). The patients with abnormal brain MRI in the poor prognosis group were significantly more than those in the good prognosis group (Fisher exact test: P=0.017), and the patients with slow wave>50% in the poor prognosis group were significantly more than those with slow wave <50% (Fisher exact test: P<0.001). Patients with the first onset of immunotherapy time <3 months, long course of disease, high intracranial pressure, and high cerebrospinal fluid protein are prone to relapse. Bivariate logistic regression analysis showed that patients with dyskinesia, abnormal brain MRI, and slow wave EEG more than 50% were risk factors for poor prognosis (OR values were 4.687, 4.978, and 24.500, respectively; P values were 0.018, 0.016, and 0.000, respectively). The time of first-line immunotherapy for the first onset<3 months was the risk factor for recurrence (OR 17.231, P=0.010). In conclusion, dyskinesia, abnormal brain MRI and slow wave of EEG more than 50% may be the risk factors for poor prognosis of patients. The duration of immunotherapy less than 3 months after the first onset might be the risk factor for recurrence.
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Humans , Anti-N-Methyl-D-Aspartate Receptor Encephalitis/cerebrospinal fluid , Retrospective Studies , Neoplasm Recurrence, Local , Risk Factors , DyskinesiasABSTRACT
Objective:To investigate the association between serum trace elements and dyslipidemia in Pudong New Area. Methods:A community-based cross-sectional study was carried out. A stratified， cluster sampling approach was used for sampling. In total 1 814 community residents aged above 35 years old were recruited in Pudong New Area， Shanghai. A face-to-face investigation was conducted and blood samples were collected. Serum levels of 16 trace elements， including boron， vanadium， chromium， manganese， iron， cobalt， nickel， copper， zinc， arsenic， selenium， strontium， molybdenum， tin， antimony， and barium were measured by inductively coupled plasma mass spectrometry （ICP-MS）. The relationship between serum trace elements and dyslipidemia was analyzed with single and multiple Logistic regression models. Results:Prevalence of dyslipidemia is higher among participants of more than 45 years old with high BMI， hypertension or diabetes．Serum iron leveled the highest， followed by copper， zinc， selenium， strontium， boron and other trace elements. After adjusting for potential confounders， the odds ratios of dyslipidemia associated with the highest quartile of trace elements concentrations were 1.41 （95%CI： 1.12-1.78）， 0.77 （95%CI： 0.61-0.96）， 1.65 （95%CI： 1.31-2.09）， 1.27 （95%CI： 1.02-1.58）， and 1.32 （95%CI： 1.06-1.66） for chromium， cobalt， zinc， arsenic， and tin， respectively， compared with that associated with the other three quartiles. Conclusion:Some serum trace elements are potentially associated with dyslipidemia in community residents.
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Objective:To investigate the association between sleep quality and the risk of acute exacerbation in mild and moderate chronic obstructive pulmonary disease （COPD） patients in Pudong New Area of Shanghai. Methods:This was a prospective study involving eligible mild and moderate COPD patients from 10 communities randomly selected in Pudong New District of Shanghai. A structured questionnaire was used to collect demographic characteristics， clinical information and information on acute exacerbation. Sleep quality was assessed using the Pittsburgh Sleep Quality Index （PSQI） in Chinese. Multiple negative binomial regression was used to estimate the association between sleep quality and risk of exacerbation. Results:Altogether 212 mild/moderate COPD patients participated and completed the entire survey， of whom the majority （95.8%） were mild COPD patients， 110 persons female and over half （54.2%） over 65 years old. 32.9% of the patients had poorer sleep quality at baseline. 18.9% of the patients reported exacerbation over the past year during follow-ups. Multiple negative binomial regression suggested that increased PSQI was related to higher risk of exacerbation （RRad=1.12， 95%CI：1.02-1.24）， and patients with poorer sleep efficiency had a higher risk of exacerbation （RRad=1.66， 95%CI：1.17-5.43）. Conclusion:Poorer sleep quality is associated with a higher risk of exacerbation in community mild/moderate COPD patients， especially in those with problem of sleep efficiency. More attention to sleep disorders is warranted in community management or self-management of patients with COPD.
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OBJECTIVE: To discuss the real world effect of bupropion hydrochloride sustained-release tablets and psychological intervention as well as WeChat publicity and follow-up on smoking cessation. METHODS: Totally 283 subjects were divided into two groups according to their own wishes: 84 people chose WeChant and psycholigical intervention, and were defined as control group; 199 people chose bupropion hydrochloride and WeChant and psycholigical intervention, and were defined as treatment group. The one-month smoking cessation rate and weight changes of the two groups in 3 months was compared, and the factors affecting the smoking cessation rate were analyzed. RESULTS: The success rate was 57.8% in treatment group, and the success rate of the control group was 10.7%. There was a statistically significant difference between the two groups. The average weight gain was 2.6 kg in the treatment group, and in the control group it was 3.5 kg, with no statistically significant difference. The presence of depression, intervention pattern, smoking-related disease, the number of cigarettes smoked per day, and the need to quit smoking for family members and the readiness to quit were statistically siginificant factors. The faliure rate of smoking cessation in depressed smokers was 7.772 times that of non-derpessed smokers, and it was4.492 times that of people with smoking related deseases. The failure rate of smoking cessation in people smoking more than20 cigarettes a day was 4.090 times that of pepople smoking less than 20. The failure rate in smokers without family requests of quiting smoking was 0.463 times that of those with requests; the failure rate in smokers without readiness was0.274 times that of those with proper readiness. The failure rate in control group was 14.292 times that of the treatment group. CONCLUSION: Bupropion hydrochloride sustained-release tablets + psychological intervention + WeChat platform promotion can significally increase the rate of sucessful smoking cessation. Factors affecting the success rate of smoking cessation are depression, intervention methods, smoking-related deseases, the number of cigarettes smoked, family requirements and smoking cessation preparations.
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In recent years, as the level of economic life has improved, the incidence of gestational diabetes mellitus has increased year by year. Gestational diabetes mellitus (GDM) has been a serious threat to maternal and newborn health. The pathogenesis of gestational diabetes is not very clear, and may be closely associated with insulin resistance, genetic susceptibility, inflammatory response, metabolic disorders. According to the gestational diabetes diagnostic standard,24-28 weeks pregnant women keep an empty stomach over 8 h, taken 75 g oral glucose directly, and then receive the oral glucose tolerance test. GDM is diagnosed as fasting blood-glucose> 5.1 mmol · L-1,1-hour postprandial blood glucose>10.0 mmol · L-1,and 2-hour postprandial blood glucose>8.5 mmol · L-1. Western medicine treatment is mainly based on diet, exercise, drugs, education, monitoring and insulin therapy according to blood glucose. Meanwhile, GDM is a type of diabetes in traditional Chinese medicine. GDM is prevented and treated with diets and traditional method sports and Chinese herbs. Therefore, integrated Chinese and western medicine therapy can maximize the curative effect, reduce the incidence of gestational diabetes mellitus, and effectively improve the adverse outcome and prognosis of patients with gestational diabetes mellitus from mother to child.
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Objectives: To compare regional cerebral tissue oxygen saturation (rScO2) changes during cardiac surgery in children with ventricular septal defect (VSD) and tetralogy of Fallot (TOF). Methods: A total of 60 children aged 3~36 months were enrolled (28 in VSD group 32 in TOF group). rScO2was monitored by Fore-Sight near-infrared spectroscopy device. rScO2, pulse oxygen saturation (SpO2), systolic pressure, diastolic pressure, heart rate, stroke volume index, cardiac index, systemic vascular reststance index the maximal slope of systolic upstroke (dp/dt max) were obtained at following time points: after anesthesia induction (t0), pericardium opening (t1), 5 min after cardiopulmonary bypass (CPB) initiation (t2), 5 min before separation from CPB (t3), separation from CPB (t4), post-modified ultrafiltration (t5), end of surgery (t6). Results: (1) The lowest rScO2value was observed at separation from CPB (t4), and which was significantly lower than that at t0(P<0.05) for both groups; rScO2, stoke volume index, cardiac index, and dp/dt max at t5were significantly higher than at t4(all P<0.001) for both groups. (2) rScO2and SpO2were significantly higher at t5and t6than at t0(both P<0.05) in TOF group. rScO2at t0-t2was significantly lower in TOF group than in VSD group (both P<0.05). rScO2increased more significantly after modified ultrafiltration and rScO2was positively correlated with SpO2at t0and t1(r=0.35, P<0.05 and r=0.64,P<0.01) in TOF group. (3) In the total cohort, rScO2was positively correlated with age, weight at t0, t1, t3, t4, t5, t6(all P<0.01). After modified ultrafiltration, the increase in cardiac index was positively correlated with increase in rScO2(r=0.41, P<0.05), and the amount of cardiac index and rScO2increases were negatively correlated with age (r=-0.30;r=-0.34, both P<0.05). Conclusions: rScO2is closely related with age and weight. Cerebral oxygen delivery before biventricular surgical correction is lower in TOF group than in VSD group, and the cerebral oxygenation improves significantly after surgical repair. Modified ultrafiltration could significantly improve systemic hemodynamics and rScO2, and TOF children and younger children benefit more from modified ultrafiltration. Pre- and post-separation from CPB period is vulnerable to cerebral desaturation, it is therefore of importance to maintain the cerebral oxygen delivery-consumption balance at these periods for children with TOF and VSD undergoing surgical repair.
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Objective To investigate the risk factors for recurrence of cerebral infarction and to propose secondary prevention methods . Methods Data of 628 patients with cerebral infarction from Jan.2012 to Dec.2014 were collected by the community reported network into a cohort study .The prevalence of recurrence and associated risk factors of cerebral infarction were investigated . Results Recurrence rate of cerebral infarction was 9.08%.History of hypertension (OR=4.797, P=0.001), long term of tobacco use ( OR=2 .844 , P=0 .005 ) , abdominal obesity or overweight ( OR=2 .421 , P=0.041) and farming(OR=3.723, P<0.001)were the independent risk factors for recurrence of cerebral infarction. Conclusion The recurrence rate of cerebral infraction is high , which is affected by various factors.
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Objective To evaluate different hypertension management models in communities and their impact on incidence of cardio-cerebrovascular disease in hypertensive patients. Methods A total of 1 578 hypertension patients in several communities in Pudong New Area were recruited in the study ( August 2008 to December 2012 ) according to the inclusion criteria and randomly divided into two groups.The control group was given routine hypertension management and the study group was given detailed hypertension management, while health commissioners and community physicians were in charge of the follow-up and data collection. Results The incidence of cardio-cerebrovascular disease (1.33%) in study group (1.33%) was significantly lower than that of the control group (4.22%) ( P <0.05). Multivariate logistic regression analysis showed that age, male, course-of-disease, patients with hypertension family history, increase in SCr and LDL-C increased the risk for getting ardio-cerebrovascular disease (P <0.05).The risk of study group was 0.348 times the control group ( P <0.05). Conclusion Compared with control group, detailed hypertension management model conducted in study group has the advantages that effectively reduced the rate of cardio-cerebrovascular disease.
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Objective To investigate epidemic characteristics and risk factors of hypertension among residents aged above 15 years in Pudong New Area of Shanghai. Methods We selected the subjects through a multistage stratified cluster sampling procedure; all thirty towns of Pudong New Area were stratified into three levels according to their economic status and 10 657 people selected as survey subjcets from each economic level.A questionnaire survey was conducted in conjunction with measurements of body height and weight, fasting plasma glucose, 2-hour postprandial blood glucose, blood lipid and blood pressure among 10 657 inhabitants aged above 15 years.Multivariate unconditional regression model was employed to analyze the influence factors of hypertension. Results The crude prevalence rate of hypertension in the residents was 41.3%.The prevalence rates of male was high than female (P<0.001). With the increment of age, the hypertension prevalence rate of all residents were obviously elevated.The residents with lower education had a higher hypertension prevalence rate.There was no significant difference in hypertension prevalence between rural and urban.The results of logistic regresssion showed that the risk factors of hypertension were age,gender,educational level,family history of hypertension,central obesity, body mass index, C-reactive protein, 2-hour postprandial blood glucose and urinary albumin/creatinine ratio(P<0.05). Conclusion The results indicated that hypertension was highly prevalent in Pudong New Area.Body mass index ( BMI) and central obesity were related factors for hypertension which were changeable.
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<p><b>OBJECTIVE</b>To research the effect and route of celastrol on Akt signaling pathway of human leukemia cell line K562 apoptosis.</p><p><b>METHODS</b>The activities of K562 proliferation cells were detected by MTT assay; cell apoptosis was detected by Hoechst 33258 staining assay, DNA fragmentation assay, and Annexin V/PI double-labeled cytometry; the expression and phosphorylation level of Caspase family members and AKT signaling pathway related proteins were determined by Western blot before and after celastrol treatment, and further the effect of AKT signaling pathway on celastrol-induced-apoptosis was analyzed.</p><p><b>RESULTS</b>K562 cell proliferation was inhibited by celastrol in a time- and dose-dependent manner, with the IC50 value for 24 h of (2.15 +/- 0.11) micromol/L. Celastrol induced K562 cells apoptosis in a dose-dependent manner, apparent DNA fragmentation and typical apoptotic morphological changes, and accompanied Caspase-3, 8 activation in the apoptosis process were shown after cells were treated with 2.0 micromol/L celastrol for 24 h. And the celastrol induced apoptosis could be blocked by 50 micromol/L z-VAD-fmk (caspase inhibitor), but augmented by 25 micromol/L WORT (PI3K-Akt inhibitor). Moreover, Celastrol decreased the expressions of p-Akt, survivin and Bcl-2 in the Akt signaling pathway.</p><p><b>CONCLUSIONS</b>Celastrol inhibited the proliferation of K562 cells and induced cell apoptosis by way of activating caspase cascade. The decreased level of Akt phosphorylation during celastrol-induced-apoptosis process suggested that celastrol acted synergistically with PI3K-Akt inhibitors in K562 cell apoptosis inducing.</p>
Subject(s)
Humans , Apoptosis , Caspase 3 , Metabolism , Caspase 8 , Metabolism , K562 Cells , Proto-Oncogene Proteins c-akt , Metabolism , Signal Transduction , Triterpenes , PharmacologyABSTRACT
<p><b>BACKGROUND AND OBJECTIVE</b>Leukemia is a malignant tumor highly dependent on nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kappaB), which is relevant for the occurrence, metastasis, proliferation, apoptosis, and drug resistance of tumor cells. Research has confirmed that the NF-kappaB family is one of the target genes in the Notch signaling pathway. This study investigated the effects of Celastrol on the apoptosis of U937 cells and the expression levels of Notch1 and NF-kappaB in these cells.</p><p><b>METHODS</b>U937 cells were treated with various concentrations Celastrol (0.5-16.0) micromol/L for 12-60 h. MTT assay was performed to examine the effect of Celastrol on growth inhibition of U937 cells. Cell apoptosis was detected through both Annexin-V FITC/PI double-labeled cytometry and transmission electron microscopy (TEM). Cell cycle regulation was studied by propidium iodide. Western blot analysis and reverse transcription-polymerase chain reaction (RT-PCR) technologies were applied to assess the expression level of Notch1 in U937 cells. Subcellular distributions of NF-kappaB/p65 were detected through confocal microscopy.</p><p><b>RESULTS</b>Celastrol presented striking growth inhibition and apoptosis induction potency on U937 cells in vitro in a time- and dose-dependent manner. The IC50 value of Celastrol for 24 h was (6.21 +/- 0.242) micromol/L. Moreover, Celastrol induced apoptosis in U937 cells in a cell-cycle dependent manner, which means that Celastrol could arrest U937 cells in the G0/G1 phase. Through TEM, apoptotic bodies containing nuclear fragments were found in Celastrol-treated U937 cells. Overexpression of Notch1 was found in U937 cells, while Celastrol could downregulate it at both the protein and mRNA level in a dose-dependent manner, and expression of NF-kappaB decreased in nuclei and increased in the cytoplasm (P < 0.05).</p><p><b>CONCLUSIONS</b>Celastrol inhibited cell proliferation and induced apoptosis in U937 cells in a concentration-dependent manner. The possible mechanism might be involved in the regulation of a survival signaling pathway, such as Notch or NF-kappaB.</p>
Subject(s)
Humans , Antineoplastic Agents, Phytogenic , Pharmacology , Apoptosis , Cell Cycle , Cell Proliferation , Dose-Response Relationship, Drug , Down-Regulation , Gene Expression Regulation, Neoplastic , RNA, Messenger , Metabolism , Receptor, Notch1 , Genetics , Metabolism , Signal Transduction , Transcription Factor RelA , Genetics , Metabolism , Tripterygium , Chemistry , Triterpenes , Pharmacology , U937 CellsABSTRACT
<p><b>OBJECTIVE</b>To investigate the expression of CD147, matrix metalloproteinase (MMP)-2, MMP-9, Transforming growth factor (TGFbeta1) and TGFbetaRI proteins and their relationships to breast cancer.</p><p><b>METHODS</b>The expression of CD147, MMP-2, MMP-9, TGFbeta1 and TGFbetaRI proteins was examined on tissue chips containing 160 cases of breast carcinomas by S-P immunohistochemical method.</p><p><b>RESULTS</b>The positive rates of CD147, MMP-2, MMP-9, TGFbeta1 and TGFbetaRI proteins were 87.5% (140/160), 96.9% (155/160), 95.0% (152/160), 73.7% (118/160) and 60.6% (97/160), respectively. The expression of CD147 was positively correlated with axillary lymph node metastasis, TNM staging and HER2 over expression (P < 0.01, P < 0.05 and P < 0.01, respectively), and inversely correlated with PR expression (P < 0.05). The patients' relapse-free survival was shorter in TGFbeta1-positive group than in TGFbeta1 negative group (P < 0.05). Both the expression of MMP-2 and MMP-9 were positively correlated with CD147 expression; and both the expression of TGFbeta1 and TGFbetaRI were positively correlated with CD147 expression (P < 0.01 and P < 0.05, respectively).</p><p><b>CONCLUSION</b>The expression of CD147 is considered closely correlated with tumor invasion, metastasis and prognosis in breast cancer, and has also a close correlation with MMP-2, MMP-9, TGFbeta1 and TGFbetaRI expression.</p>