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Objective:To evaluate the benefits and risks of advanced age patients with acute anterior circulation large vessel occlusive stroke (ALVOS) accepted mechanical thrombectomy (MT), and explore the related influencing factors for prognoses in these patients.Methods:Six hundred and eighty patients with acute anterior circulation ALVOS accepted MT in 3 comprehensive stroke centers from January 2014 to December 2020 were sequentially collected. (1) Patients were divided into advanced age group (≥80 years old) and non-advanced age group (<80 years old) according to age, and the differences between the two groups were compared in successful postoperative vascular recanalization rate, incidence of perioperative complications, and good prognosis rate (modified Rankin scale [mRS] scores≤2) and mortality 90 d after onset. (2) Patients were divided into good prognosis group (mRS scores≤2) and poor prognosis group (mRS scores>2) according to the prognoses 90 d after onset; univariate analysis and multivariate Logistic regression analysis were used to investigate the independent factors for prognoses of the patients after MT. (3) According to the prognoses 90 d after onset, the advanced age patients were divided into good prognosis subgroup (mRS scores≤2) and poor prognosis subgroup (mRS scores>2). Univariate analysis and multivariate Logistic regression analysis were used to investigate the independent factors for prognoses of the elderly patients after MT.Results:(1) In these 680 patients, 92 patients (13.5%) were into the advanced age group and 588 patients (86.5%) were in the non-advanced age group; patients in the advanced age group had significantly lower successful recanalization rate (67.4% vs. 77.9%), significantly lower good prognosis rate 90 d after onset (20.7% vs. 50.2%), and statically higher mortality 90 d after onset (40.2% vs. 21.1%) as compared with the non-advanced age group ( P<0.05); however, there was no significant difference between the two groups in the incidences of symptomatic intracranial hemorrhage (sICH, 15.6% vs. 10.6%) and malignant cerebral edema (MCE, 12.2% vs. 17.6%, P>0.05). The baseline data of the advanced age and non-advanced age patients were further matched with propensity score matching analysis (1:1) and statistically analyzed: the 91 elderly patients had significantly lower good prognosis rate 90 d after onset (20.9% vs. 36.3%) and MCE incidence (12.4% vs. 33.3%) than the 91 non-elderly patients ( P<0.05); there was no significant differences in successful vascular recanalization rate (67.0% vs. 71.4%), sICH incidence (15.7% vs. 17.6%) or mortality 90 d after onset (39.6% vs. 37.4%) between the two groups ( P>0.05). (2) Among the 680 patients, 314 (46.2%) had good prognosis and 366 (53.8%) had poor prognosis. As compared with the good prognosis group, the poor prognosis group had significantly higher proportion of patients at advanced age, significantly lower proportion of male patients, significantly higher proportion of patients with hypertension, diabetes or atrial fibrillation, significantly lower baseline Alberta Stroke early CT (ASPECT) scores, significantly higher baseline National Institutes of Health Stroke Scale (NIHSS) scores, statistically higher proportion of patients with cardiogenic embolism, significantly lower incidence of tandem lesions, significantly shorter time from onset to sheathing, statistically higher proportion of internal carotid artery occlusion, significantly lower proportion of patients with grading 2 collateral circulation, and significantly lower proportion of successful vascular recanalization ( P<0.05). Advanced age ( OR=3.144, 95%CI: 1.675-5.900, P<0.001) was an independent factor for prognoses 90 d after MT, in addition to baseline ASPECT scores, baseline NIHSS scores, diabetes mellitus, successful recanalization, and collateral circulation grading. (3) In the advanced age group, there were 19 patients (20.7%) with good prognosis and 73 patients (79.3%) with poor prognosis. As compared with the good prognosis subgroup, the poor prognosis subgroup had significantly lower proportion of male patients, significantly lower proportion of patients with grading 2 collateral circulation or complete recanalization, and significantly higher baseline NIHSS scores ( P<0.05). Baseline NIHSS score ( OR=1.482, 95%CI: 1.187-1.850, P=0.001) was an independent factor for prognoses 90 d after MT in advanced age patients. Conclusion:Although advanced age is an independent risk factor for prognoses of patients with acute anterior circulation ALVOS accepted MT, there are still some advanced age patients benefiting from MT without increased complications, especially for those with low baseline NIHSS scores.
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Objective:To explore the influence of blood pressure (BP) profiles 24 h after early endovascular treatment (EVT), including mean blood pressure and blood pressure variability, in clinical prognoses of patients with acute large vessel occlusion stroke (ALVOS) of anterior circulation 90 d after EVT.Methods:Clinical data and blood pressure profiles of patients with ALVOS of anterior circulation who received EVT in our hospital from July 2014 to February 2019 were prospectively collected. The 90-d modified Rankin scale (mRS) scores were used as clinical prognosis evaluation, and modified thrombdysis in cerebral infarction (mTICI) was used as evaluation criteria for recanalization of postoperative occlusive blood vessels. Multivariate Logistic regression analysis was used to determine the independent influencing factors for prognoses 90 d after EVT.Results:(1) Two hundred and sixteen patients were collected; 159 patients were with successful recanalization and 57 patients were with unsuccessful recanalization; 90 d after EVT, 95 patients (44%) had good prognosis and 121 patients (56%) had poor prognosis. As compared with patients in the good prognosis group, patients in the poor prognosis group had signficantly advanced age, signficantly higher proportion of patients with atrial fibrillation, signficantly higher baseline NIHSS scores, and signficantly lower baseline ASPECT scores ( P<0.05); and the differences of occlusion locus were statistically significant between patients from the good and poor prognosis groups ( P<0.05). Patients in the poor prognosis group had significantly higher baseline systolic blood pressure (SBP), mean SBP, max SBP, and significantly higher standard deviation, variable coefficient, and continuous variation of SBP, and statistically higher standard deviation, variable coefficient, and continuous variation of diastolic blood pressure (DBP) as compared with those in the good prognosis group ( P<0.05). Multivariable Logistic regression analysis showed that the standard deviation and continuous variation of SBP were independent influencing factors for clinical prognoses 90 d after EVT ( OR=1.116, 95%CI: 1.002-1.243, P=0.047; OR=1.116, 95%CI: 1.016-1.227, P=0.022). (2) In patients with successful recanalization, as compared with patients in the good prognosis subgroup, patients in the poor prognosis subgroup had signficantly advanced age, statistically higher proportions of patients with diabetes mellitus and atrial fibrillation and baseline NIHSS scores, and statistically lower baseline ASPECT scores ( P<0.05); and the differences of occlusion locus and first choices of treatment were statistically significant between patients in the good and poor prognosis subgroups ( P<0.05). Patients in the poor prognosis subgroup had significantly higher baseline SBP and max SBP, and significantly higher standard deviation, variable coefficient, and continuous variation of SBP, and statistically higher variable coefficient of DBP as compared with those in the good prognosis subgroup ( P<0.05). Multivariable Logistic regression analysis showed the standard deviation, variable coefficient, and continuous variation of SBP were independent influencing factors for clinical prognoses 90 d after EVT ( OR=1.164, 95%CI: 1.021-1.326, P=0.023; OR=1.191, 95%CI: 1.007-1.409, P=0.041; OR=1.141, 95%CI: 1.018-1.279, P=0.024). However, in patients with unsuccessful recanalization, there were no significant differences in blood pressure proliles between the good prognosis subgroup and poor prognosis subgroup ( P>0.05). Conclusion:The blood pressure variability 24 h after EVT is correlated with the clinical prognoses of patients with ALVOS of anterior circulation 90 d after EVT.
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Objective To observe the effect of supplemental Revolvin D1 (RvD1) on Toll-like receptor 4 (TLR4) in skeletal muscle of type 2 diabetic mice.Methods 35 male C57BL/6 mice were randomly divided into control group (NC group) and high glucose and high fat diet group.After 8 weeks,mice in high glucose and high fat diet group were given intraperitoneal injection of streptozotocin (STZ) 100 mg/ kg.Then they were randomly divided into two groups:Type 2 diabetes group (T2DM group) and type 2 diabetes + RvD1 intervention group (T2DM + RvD1 group).Mice in T2DM group mice were injected with phosphate buffer saline 0.2 ml and T2DM + RvD1 group mice were injected with Revolvin D1 100 ng/day respectively.The levels of fasting blood glucose,serum insulin and inflammatory factors were detected.The mRNA expression level of TLR4 was detected by real-time quantitative polymerase chain reaction (RT-qPCR) method,and the expression of TLR4 protein was detected by Western blot.Results The levels of insulin resistance index,interleukin(IL)-6 and tumor necrosis factor-α (TNF-α) in T2DM group and T2DM + RvD1 group increased (P ＜ 0.05).Compared with the T2DM group,the levels of insulin resistance index,IL-6 and TNF-α in T2DM + RvD1 group decreased (P ＜0.05).The expression of TLR4 protein in T2DM group and T2DM + RvD1 group was higher than that in NC group (P ＜ 0.05).The expression of TLR4 protein in T2DM + RvD1 group,was lower than that in T2DM group (P ＜0.05).The mRNA level of TLR4 in mice was consistent with the above results by RT-qPCR.Conclusions Moderate supplementation of RvD1 can not only decrease the level of inflammatory factors in type 2 diabetic mice,but also reduce the expression of TLR4 and insulin resistance in skeletal muscle of type 2 diabetic mice.
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Objective To evaluate the value of stroke prognostication using age and National Institute of Health Stroke Scale index (SPAN) for outcome after early endovascular treatment for anterior circulation large vessel occlusion.Methods The patients who underwent early endovascular treatment were prospectively,sequentially collected in Yijishan Hospital of Wannan Medical College from December 2014 to September 2017 and Jinling Hospital from March 2014 to March 2017.Individuals whose age in years plus NIHSS score was greater than or equal to 100 were designated as SPAN-100-positive patients,while those with a score less than 100 were designated as SPAN-100-negative patients.We compared the baseline data and perioperative data between the two groups.The 90 days modified Rankin Scale score≤2 was regarded as favorable outcome.Single factor and multivariable Logistic regression analyses were used to determine the association between SPAN-100 and outcomes.Results One hundred and ninety patients were enrolled,20 (10.5％) of which were SPAN-100 positive,and 170(89.5％) were SPAN-100 negative.There were no significant differences between the two groups on postoperative intracerebral hemorrhage and 90 days mortality.Ninety days independence rates were higher in SPAN-100-negative patients (77/170,45.3％) than in SPAN-100 positive patients (4/20,20.0％;x2 =4.681,P =0.030).Multi-factor Logistic regression analysis showed that the higher preoperation systolic pressure (OR =1.030,95％ CI 1.008-1.052,P =0.007),the lower Alberta Stroke Program Early CT Score (OR =1.609,95％ CI 1.056-2.453,P =0.027) and poor collateral circulation(OR =5.714,95％ CI 1.668-19.570,P =0.006) were the independent risk factors of outcomes.Conclusion SPAN-100 is not an independent predictor of favorable outcome after adjusting for factors of outcomes in patients with anterior circulation large vessel occlusion.
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<p><b>OBJECTIVE</b>To investigate the effect of emodin on proliferation and cell cycle distribution of human oral squamous carcinoma cells in vitro.</p><p><b>METHODS</b>Cultured human oral squamous carcinoma Tca8113 cells were treated with 2.5, 5, 10, 20, 40, 60 and 80 µmol/L emodin for 24, 48 or 72 h, with the cells treated with 0.1% DMSO as control. MTT assay and flow cytometry were used to evaluate the changes in cell proliferation and cell cycle distribution, respectively. Western blotting was employed to analyze the changes in the expression levels of the cell cycle-related proteins CDK2, cyclin E and P21 after emodin treatment.</p><p><b>RESULTS</b>Emodin significantly inhibited the growth and proliferation of Tca8113 cells within 72 h in a time- and dose-dependent manner, and caused cell cycle arrest in G0-G1 phase. Western blotting revealed that emodin treatment significantly lowered the expression levels of CDK2, cyclin E and P21 proteins in Tca8113 cells (P<0.05).</p><p><b>CONCLUSION</b>Emodin can inhibit the proliferation of Tca8113 cells and affect their cell cycle distribution possibly by inhibiting the signaling pathways of cell cycle regulation.</p>
Subject(s)
Humans , Carcinoma, Squamous Cell , Pathology , Cell Cycle , Cell Line, Tumor , Cell Proliferation , Cyclin E , Metabolism , Cyclin-Dependent Kinase 2 , Metabolism , Cyclin-Dependent Kinase Inhibitor p21 , Metabolism , Emodin , Pharmacology , Mouth Neoplasms , Pathology , Oncogene Proteins , Metabolism , Signal TransductionABSTRACT
Objective:To investigate the relationship of H pylori with cholecystolithiasis,to collect the evidence of Hp existing in biliary tract,and to study the detective method of Hp DNA in billiary tract.Methods:Hp which existing in bile,mucosa and gallstone of 120 cholecystolithiasis patients were cultured according to the literature.Then they were amplified by the primer of Ure A and cagA.Amplified products were analyzed.Results:All of the 120 samples were negative.No Hp grew in the medium.No Hp DNA and Hp Cag A antibody were found with PCR method.Conclusion:(1) It was restricted by many factors that Hp DNA in bile and gallstone wereexamined with PCR.(2) Hp maybe entered biliary tract regressively through Oddi's sphincter andhad no relationship with cholecystolithiasis.
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Objective:To investigate the effects of Genistein and Tyrphostin AG1478 on the proliferation of colon cancer cell HT-29 and its possible mechanism.Methods:The effect of two tyrosine kinase inhibitors (TKIs) on HT-29 cell lines was studied by using MTT assay.Immunocytochemical staining was performed with PCNA polyclonal antibody in HT-29 cells.Western blot assay was used to detect the expression of ERK-1 and pERK.Results:Both Genistein and Tyrphostin AG1478 significantly inhibit the growth of HT-29 cells and showed concentration dependence.Two tyrosine kinase inhibitors suppressed PCNA expression.Western blot revealed that Genistein and Tyrphostin not inhibit ERK-1 expression but inhibit phosphorylation of ERK.Conclusion:Tyrosine kinase inhibitors Genistein and Tyrphostin AG1478 can inhibit the growth of HT-29 colon cancer cells,the anti-proliferation mechanism may be related to down-regulate the expression of pERK.