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Objective:To assess the predictive factors and prognosis of post-stroke seizures.Methods:A total of 315 inpatients with acute anterior circulation cerebral infarction from January 2018 to December 2018 were retrospectively collected, including 95 patients with PSS as observation group and 220 patients without PSS as control group.Clinical characteristics of the patients were recorded, including gender, age, lesion specificity, imaging features, past history, and the time and type of seizures.The Alberta stroke program early CT score (ASPECTS) was used to assess the extent of infarction, the national institutes of health stroke scale (NIHSS) and the modified rankin scale (MRS) were used to assess the severity and prognosis of cerebral infarction.The hemorrhage transformation of cerebral infarction was graded according to the European cooperative acute stroke study Ⅲ(ECASS Ⅲ) classification system.SPSS 21.0 software was used for data analysis.Chi-square test was used for categorical variables and t-test or non-parametric test was used for continuous variables. Results:The observation group had lower ASPECTS scores compared with the control group (5(4, 7), 7 (5, 8)), the presence of atrial fibrillation, hemorrhage transformation, laminar necrosis(LN) and hemosiderin deposition (31.6%, 45.3%, 24.2%, 26.3%) were higher than those of control group (20.9%, 28.2%, 9.1%, 16.4%), and the differences were statistically significant (all P<0.05). In multivariate analysis, ASPECTS score ( OR=0.658, 95% CI=0.556-0.778, P<0.001), hemorrhage transformation ( OR=2.307, 95% CI=1.311-4.059, P=0.004), LN ( OR=2.530, 95% CI=1.250-5.123, P=0.010) and hemosiderin deposition ( OR=2.308, 95% CI=1.201-4.436, P=0.012) were the influencing factors of PSS.Partial secondary generalized seizures was the most common type of seizures, and in this group it accounted for 42.1% (40/95), simple partial seizures and complex partial seizures accounted for 12.6% (12/95)respectively, and generalized seizures accounted for 32.6% (31/95). The mean follow-up time of the two groups was 24.1 months and 24.6 months, respectively.The scores of MRS at the last follow-up and discharge (3(2, 4), 2(1, 4)) of the observation group were better than those of the control group (2(1, 3), 1(1, 3)), and the differences were statistically significant(both P<0.05). Conclusions:PSS after cerebral infarction can affect the prognosis of patients, and the large infarction scope, hemorrhage transformation, LN and hemosiderin deposition are the high risk factors of PSS.
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Objective:To investigate the relationship between serum vascular endothelial growth factor (VEGF) levels and white matter high signal and non-dementia vascular cognitive dysfunction in patients with cerebral small vascular disease (CSVD).Methods:Total 106 patients with CSVD who were admitted to the Department of Neurology of the First Affiliated Hospital of Xinxiang Medical College from April 2019 to December 2020 were enrolled.They were divided into vascular cognitive impairment no dementia group (VCIND group, n=47) and no vascular cognitive impairment group (N-VCI group, n=59)according to mini-mental assessment scale (MMSE), Montreal cognitive assessment (MoCA) scale and activity of daily living scale (ADL). Serum VEGF levels were detected by enzyme-linked immunosorbent assay (ELISA). The baseline data, serum VEGF levels, MoCA score and Fazekas score were compared between the two groups.The correlation between serum VEGF level and white matter high signal and cognitive function was analyzed.SPSS 19.0 software was used for data processing.The statistical methods were t-test, Chi square test, nonparametric test, Logistic regression analysis, Pearson correlation analysis and Spearman correlation analysis. Results:There were significant differences in serum VEGF level((464.18±114.58)pg/mL, (414.17±45.80)pg/mL, F=22.880), MoCA score((13.07±6.48), (20.17±4.06), F=17.920) and Fazekas score (4(3, 5), 3(1, 3), Z=-4.189)between the two groups (all P<0.05). The level of VEGF( β=0.008, OR=1.008, 95% CI=1.001-1.015, P<0.05) was the influencing factor of cognitive function in patients with CSVD .The level of VEGF was negatively correlated with the total score of MoCA, attention and calculation power, and orientation ability ( r=-0.345, -0.373, -0.445, all P<0.05) and it was positively correlated with the total Fazekas score and the Fazekas score of paraventricular and deep white matter ( r=0.392, 0.495, 0.302, all P<0.05). There was a linear trend between the high signal grade of paraventricular and deep white matter and VCIND (both P<0.05). Conclusion:Serum VEGF level is correlated with cognitive function and white matter hyperintensity in patients with CSVD.The increase of VEGF level may be a factor reflecting cognitive dysfunction.In addition, with the increase of white matter hyperintensity level, the risk of VCIND in CSVD is increased.
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Objective:To investigate the effect of hemorrhagic transformation (HT) and its different subtypes on the clinical outcome of patients with acute ischemic stroke (AIS).Methods:Patients with AIS within 24 h of onset treated in Henan Provincial People's Hospital from January 2018 to January 2021 were retrospectively enrolled. HT was defined as intracranial hemorrhage found by CT reexamination within 7 d after the onset of AIS, and further divided into hemorrhagic infarction (HI) and parenchymal hematoma (PH) according to the classification standard of European Cooperative Acute Stroke Study (ECASS)-Ⅱ. The modified Rankin Scale was used to evaluate the outcome at 90 d after onset. 0-2 was defined as good outcome and 3-5 were defined as poor outcome. Multivariate logistic regression analysis was used to determine the independent influencing factors of the outcomes. Results:A total of 822 patients were enrolled, including 478 males (58.2%), aged 60.6±10.6 years. The median score of the baseline National Institutes of Health Stroke Scale (NIHSS) was 8 (interquartile range: 6-12). Two hundred and eighty-two patients (34.4%) developed HT and 447 (54.4%) had poor outcomes. Multivariate logistic regression analysis showed that PH-1 (odds ratio [ OR] 2.461, 95% confidence interval [ CI] 1.285-4.712; P=0.007), PH-2 ( OR 5.291, 95% CI 1.178-23.758; P=0.030), blood glucose at admission ( OR 1.063, 95% CI 1.018-1.109; P=0.005) and baseline NIHSS score ( OR 1.124, 95% CI 1.076-1.175; P<0.001) were the independent influencing factors of the poor outcomes. Conclusion:Different HT subtypes have different effects on the outcomes of patients with AIS, among which PH-1 and PH-2 are the independent risk factors for poor outcomes.
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Objective:To investigate the monocyte to high-density lipoprotein cholesterol (HDL-C) ratio (MHR) for the predictive value of early neurological deterioration (END) and poor outcome in patients with acute anterior circulation ischemic stroke (AACIS).Methods:Patients with AACIS admitted to Henan Provincial People's Hospital from January 2021 to January 2022 were included retrospectively. END was defined as the National Institutes of Health Stroke Scale (NIHSS) score within 7 d of onset increase ≥2 compred with baseline or the increase of motor function score ≥1. The patients were divided into END group and non-END group according to the presence or absence of END. The patients were also divided into good outcome group (0-2 points) and poor outcome group (3-6 points) according to the modified Rankin Scale score 3 months after onset. Multivariate logistic regression analysis was used to determine the independent risk factors for END and poor outcome, and the predictive value of MHR for END and poor outcome was evaluated by receiver operating characteristic (ROC) curve. Results:A total of 522 patients were enrolled, including 338 male (64.8%), aged 61.99±11.39 years old. One hundred and five patients (20.1%) had END, 123 (23.6%) had poor outcome. Multivariate logistic regression analysis showed that baseline NIHSS score (odds ratio [ OR] 1.075, 95% confidence interval [ CI] 1.017-1.137; P=0.010) and MHR (with the lowest quartile as the reference, the third quartile: OR 2.778, 95% CI 1.255-6.151, P=0.012; the fourth quartile: OR 12.645, 95% CI 5.942-26.912; P<0.001) were the independent risk factors for END; the baseline NIHSS score ( OR 1.075, 95% CI 1.021-1.132; P=0.006), END ( OR 2.306, 95% CI 1.010-6.261; P=0.047) and MHR (with the first quartile as reference, the fourth quartile: OR 2.769, 95% CI 1.167-6.569; P=0.021) were the independent risk factors for poor outcomes. ROC curve analysis showed that area under the curve of MHR for predicting END and poor outcome in patients with AACIS were 0.805 (95% CI 0.750-0.860; P<0.001) and 0.747 (95% CI 0.690-0.803; P<0.001) respectively. The best cutoff value was 0.435, the sensitivity was 73.3% and 64.2%, and the specificity was 79.6% and 78.7% respectively. The area under the curve of MHR for predicting END and poor outcome was higher than that of monocyte and HDL-C alone. Conclusion:MHR can be used as a predictor of END and poor outcome in patients with AACIS, and its predictive value is higher than that of monocytes or HDL-C.
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Cerebral small vessel disease (CSVD) refers to a series of clinical, imaging and pathological syndromes of cerebral arterioles, capillaries, venules, as well as perivascular brain parenchyma caused by various etiologies, and is one of the important causes of vascular cognitive impairment and dementia. The onset of CSVD is insidious, and the early diagnosis mainly depends on imaging examination. This article reviews the effects of different imaging markers of CSVD on cognitive function and their pathophysiological mechanism.
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Objective:To investigate the relationship between serum matrix metalloproteinase-9 (MMP-9) level and the location and severity of bleeding in patients with cerebral microbleeds(CMBs).Methods:A total of 60 CMBs patients admitted to the Department of Neurology of the First Affiliated Hospital of the Xinxiang Medical University from January 2019 to August 2020 were selected as subjects as the CMBs group, and 60 healthy controls without nervous system diseases in outpatient physical examination during the same period were selected as the control group. The clinical data and biochemical indicators of the two groups were collected. Serum MMP-9 levels were measured by enzyme linked immunosorbent assay (ELISA). According to susceptibility weighted imaging (SWI), CMBs patients were divided into grade 1 group ( n=24), grade 2 group ( n=19) and grade 3 group ( n=17), and according to the micro analytical rating scale (MARS), the CMBs patients were divided into the lobar group ( n=19), the deep or infratentorial group ( n=17) and the mixed group ( n=24).The relationship between serum MMP-9 level and the location and severity of CMBs was analyzed. SPSS 19.0 software was used for data statistical analysis.One-way ANOVA, t-test and rank sum test were used for comparison. Logistic regression analysis was used to analyze the influencing factors. Pearson correlation analysis and Spearman correlation analysis were used for correlation analysis. Results:The level of MMP-9 in CMBs group was significantly higher than that in control group (208.13(142.25, 285.88) μg/L, 149.50(93.40, 186.51)μg/L), and the difference was statistically significant ( P<0.05). Serum MMP-9 level was a risk factor of CMBs ( β=1.322, OR=3.750, 95% CI=2.038-7.997, P=0.002). The difference of level of MMP-9 in different severity of CMBs was statistically significant (147.55(109.25, 266.47)μg/L, 242.12(147.55, 288.80)μg/L, 270.42(203.43, 364.27)μg/L, P=0.017). Serum MMP-9 level was positively correlated with the number of CMBs ( r=0.371, P=0.003). The difference of MMP-9 level of CMBs in different locations were statistically significant (249.77(158.43, 338.46)μg/L, 188.83(138.52, 243.15)μg/L, 210.65(144.25, 255.78)μg/L, P=0.013). The increased serum MMP-9 level was a risk factor for CMBs( β=0.401, OR=1.122, 95% CI=1.004-1.204, P=0.036). Conclusion:The increased level of serum MMP-9 may be a risk factor of CMBs, especially for CMBs in cerebral lobesand, and the level of MMP-9 is positively correlated with the severity of CMBs.
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Objective:To observe the clinical and imaging features of cortical laminar necrosis (CLN) after acute cerebral infarction, and to explore its possible mechanism.Methods:Five hundred and three patients were recruited into study with acute anterior circulation cerebral infarction confirmed by magnetic resonance imaging in People′s Hospital of Zhengzhou University from June 2019 to June 2020. They were divided into 24 patients with CLN (CLN group) and 479 patients without CLN (NCLN group). The general information and clinical manifestations of the patients were recorded. National Institutes of Health Stroke Scale (NIHSS) and Montreal Cognitive Assessment Scale (MoCA) scores and cranial magnetic resonance imaging characteristics were compared between the two groups, and the possible mechanism was discussed.Results:After acute cerebral infarction, the incidence of CLN was 4.77% (24/503). CLN group had more cognitive impairment (MoCA total score 15.17±2.67; NCLN group 18.12±2.49) and less neurological impairment (NIHSS total score 6.93±3.63; NCLN group 8.86±3.26),and there were significant differences between the two group ( t=-5.58, t=-2.75; P<0.05). In the CLN group, the proportion of perfusion-weighted imaging showing hyper-perfusion in the laminar necrosis area (increased relative cerebral blood volume) was 87.5% (21/24), while in the NCLN group, the proportion of hyper-perfusion was lower [1.25% (6/479)]. There was statistically significant difference in the perfusion between the two groups (χ2=143.06, P<0.01). In the CLN group, CT angiography or magnetic resonance angiography showed common atherosclerotic stenosis or occlusion of the large intracranial arteries. Conclusion:CLN after cerebral infarction is relatively rare in clinical practice, and its occurrence may be related to local cortical hyper-perfusion.
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Objective:To investigate the association between cerebral hypoperfusion and cognitive function decline in patients with asymptomatic middle cerebral artery stenosis.Methods:Sixty patients with moderate or severe stenosis of middle cerebral artery were diagnosed by magnetic resonance angiography (MRA) in the Department of Neurology, Henan Provincial People′s Hospital from November 2017 to November 2018. All patients were divided into perfusion weighted imaging (PWI) normal group （ n=14）, PWI compensated group ( n=26) and PWI decompensated group ( n=20) according to the results of PWI of magnetic resonance imaging. All patients were assessed for cognitive function using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment scale (MoCA). Results:The cognitive scores of the PWI decompensated group (MMSE score: 19.35±3.26; MoCA score: 16.06±2.59) were significantly lower than the PWI normal group (MMSE score: 26.29±3.12; MoCA score: 24.27±2.85) and the PWI compensated group (MMSE score: 23.78±1.77; MoCA score: 20.69±2.73), and the differences were statistically significant ( F=5.257, 4.134; P<0.05). The visual space and executive ability, language, delayed recall in the PWI compensated group (3.27±0.97, 1.45±0.73, 2.47±1.73, respectively) and the PWI decompensated group (1.96±0.79, 0.97±0.59, 1.49±1.38, respectively) were significantly lower than those of the PWI normal group (4.25±1.29, 2.57±1.24, 3.57±1.51, respectively), and the differences were statistically significant ( F=6.371,5.394,4.989, P<0.05). Patients in the PWI decompensated group had atrophy in the narrow hemisphere. Conclusion:Low cerebral perfusion induced by asymptomatic moderate-to-severe stenosis of the middle cerebral artery is associated with extensive cognitive impairment and local brain atrophy.
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Objective:To investigate the characteristics of cognitive impairment caused by solitary cerebellar infarction.Methods:From January 2017 to January 2019, 76 inpatients with acute cerebellar infarction treated at our hospital were continuously enrolled as the infarction group and 88 outpatients without cerebral infarction at our hospital during the same period were collected as the control group.The patients in the two groups were evaluated by the Montreal Cognitive Assessment Scales(MoCA)and Mini-Mental State Examination(MMSE)Scale at 14 days, 1 month and 3 months after the onset of solitary cerebellar infarction, respectively.Results:The MoCA and MMSE scores were lower in the infarction group than in the control group at 14 days, 1 month and 3 months after the onset of solitary cerebellar infarction(MoCA: 23.9±6.13 vs.28.1±2.51, 22.6±6.07 vs. 28.2±2.28 and 22.5±6.19 vs. 28.2±2.15, t=5.88, 8.03 and 8.09, P<0.001; MMES: 25.7±4.54 vs.28.3±2.25, 24.9±4.63 vs.28.2±2.14 and 24.6±4.43 vs.28.3±2.16, t=4.74, 5.99 and 6.94, all P<0.001). Cognitive function scores showed that three major recognition domains of visual space and executive function, attention and memory had statistically significant difference between the two groups( P<0.05), and the differences in three recognition domain of naming, calculating force, directional force between the two groups were not statistically significant( P<0.05). Conclusions:There is a clear correlation between cerebellar infarction and cognitive impairment, which is mainly manifested in three aspects of visual space and executive function, attention and memory.The great attention should be paid to screening and intervention on the three aspects in clinical work, which is of great significance for improving the quality of life and prognosis of patients.
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Objective:To investigate the relationship between serum matrix metalloproteinase-9(MMP-9) level and vascular cognitive impairment with no dementia (VCIND) in patients with cerebral small vessel diseases (CSVD).Methods:A total of 374 patients with CSVD treated in the First Affiliated Hospital of Xinxiang Medical University from January 2016 to January 2020 were collected and 150 healthy subjects in the same period were used as general data of the control group. All subjects were detected for serum MMP-9 level using enzyme linked immunosorbent assay and received cognitive function scoring using Montreal cognitive assessment (MoCA). The 374 patients with CSVD were divided into the Group A(186 cases with vascular cognitive impairment with no dementia) and the Group B(188 cases without cognitive impairment). The general data, serum MMP-9 level and cognitive function score were compared among the three groups and the correlation between MMP-9 level and cognitive function was analyzed.Results:The MMP-9 levels of Groups A and B ( (335.10±105.10)μg/L, (261.62±80.32)μg/L) were higher than those of the control group ( (168.23±48.85)μg/L), and the MMP-9 level of Group A was higher than that of Group B ( P<0.05). The MoCA scores of Groups A and B ( (18.45±5.24), (28.31±1.52) ) were lower than those of the control group (29.49±0.90), and the MoCA scores of Group A were lower than those of Group B ( P<0.05). The serum MMP-9 level, a risk factor for VCIND in patients with CSVD ( β=1.505, OR=1.323, 95% CI=1.149-1.527, P<0.05), was negatively correlated with total score of MoCA scale, visual-spatial and executive function, naming, language, abstract thinking, delayed recall, and directive force factor score ( r=-0.299, r=-0.155, r=-0.383, r=-0.358, r=-0.192, r=-0.259, r=-0.246 respectively, all P<0.05). Conclusion:The increased level of MMP-9 may be a risk factor of VCIND in CSVD patients, and it is closely related to cognitive impairment.
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Objective:To compare the safety and efficacy of dabigatran and warfarin in the treatment of cerebral venous thrombosis (CVT).Methods:The medical records of patients with CVT admitted to the Department of Neurology, Henan Provincial People's Hospital from January 2017 to December 2018 were analyzed respectively. According to the drug use, they were divided into dabigatran group and warfarin group. The main outcome measure was good functional outcome at 6 months after treatment, defined as the modified Rankin Scale score of 0-2. The secondary outcome measures included the rate of recanalization of the affected venous sinus and the incidence of bleeding.Results:A total of 152 patients with CVT were included, including 34 in the dabigatran group and 118 in the warfarin group. There were no significant differences in demographic and baseline data between the two groups. At 6 months after treatment, the rate of good functional outcomes (94.1% vs. 93.2%; χ2=0.043, P=0.836) and the affected venous sinus recanalization (94.1% vs. 93.2%; χ2=0.043, P=0.836) in the dabigatran group and the warfarin group were not statistically significant. The bleeding rate of the dabigatran group was significantly lower than that of the warfarin group (8.8% vs. 27.1%; χ2=4.985, P=0.026). There was no significant difference in the incidence of minor bleeding between the two groups (8.8% vs. 16.1%; χ2=0.618, P=0.432), but the incidence of severe bleeding in the dabigatran group tended to be lower than that in the warfarin group (0% vs. 11.0%; Fisher's exact test P=0.074). There were no deaths in the dabigatran group and 2 deaths in the warfarin group, of which 1 pregnant woman died of recurrence of CVT at 4 months after treatment, and 1 male patient died of acute myocardial infarction at 2 months after treatment. There was no significant difference in mortality between the two groups (0% vs. 1.7%; Fisher's exact test P=1.000). Conclusions:Dabigatran is as effective as warfarin in the treatment of CVT, and the risk of bleeding complications is lower.
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Objective To analyze the change in transmissibility of novel coronavirus pneumonia and predict the trend of the incidence, and to provide a reference for the government to better respond to the novel coronavirus pneumonia epidemic. Methods The EpiEstimof R language software was used to estimate the change of effective basic reproduction number, and the Richards model was run by Matlab7.0 software to fit the cumulative number of confirmed cases and the number of suspected cases. The coefficient of determination and root mean squared error were used to evaluate the fitting effect of the model. Results A total of 75 confirmed cases and 107 suspected cases were reported in Ningxia. The strict implementation of various prevention and control measures gradually reduced the effective basic reproduction number from 3.82 to less than 1, indicating that the epidemic was under control. The Richards model was used to fit the cumulative confirmed cases and suspected cases, which revealed that the natural growth rates were 0.16 and 0.23, and the coefficients of determination were 0.991 and 0.998, respectively. Conclusion Combined with the effective basic reproduction number, the Richards model fitted the trend of novel coronavirus pneumonia, which can be used to predict the trend of incidence of new coronavirus pneumonia.
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Objective:To observe the changes in visual field defect before and after treatment in patients with acute solitary occipital lobe cerebral infarction.Methods:From January 2017 to May 2019, 59 patients with hemianopsia who were diagnosed as acute occipital lobe cerebral infarction in Henan Provincial People's Hospital were selected. There were 35 males (59.3%) and 24 females (40.7%); aged from 50 to 72 years, with an average age of 62.86±6.10 years. There were 23 patients of right occipital cerebral infarction and 36 patients of left occipital cerebral infarction. Lesions involved 41 patients in the striated area, 8 patients involved the occipital pole, and 23 patients involved visual radiation. All patients underwent standard medical treatment. All patients underwent visual field examination before treatment, and modified rankin scale (mRS) was used to evaluate the level of visual disability after cerebral infarction. At 1, 3, and 6 months after treatment,54 patients underwent at least one visual field examination in outpatient or inpatient follow-up visits, and 5 patients were lost to follow-up; 49 patients received repeated mRS scores. The visual field defect and mRS score of patients before and after treatment were compared and analyzed. The improvement of visual field defect in the horizontal direction exceeding 10°or the vertical direction exceeding 15°was defined as improvement, otherwise it was defined as no improvement. According to the type of visual field defect, the patients were divided into two groups: complete homonymous hemianopia and incomplete homonymous hemianopia. The cumulative visual field improvement rate of the two groups of patients was calculated. An mRS score of 0 to 2 was defined as a good prognosis, and >2 was defined as a poor prognosis.Results:Before treatment, of the 59 patients, 47 were complete homonymous hemianopsia and 12 were incomplete. Of the 47 patients with complete homonymous hemianopia, 26 patients had hemianopia on the right side of both eyes, 21 patients had hemianopia on the left side of both eyes; 32 patients with macular avoidance (72.3%). Among the 12 patients of incomplete homonymous hemianopia, 10 patients of quadrant blindness included 6 patients of upper quadrant and 4 patients of lower quadrant; 2 patients of partial isotropic hemianopia on one side. Of the 54 patients reviewed after treatment, the visual field improved at the last follow-up of 25 patients (46.3%), and there was no improvement in 29 patients (53.7%). The cumulative visual field improvement rate of 47 patients with complete hemianopia hemianopia before treatment was 37.2% (16/43). The cumulative visual field improvement rate of 11 patients with incomplete isotropic hemianopia before treatment was 81.8% (9/11). There was a statistically significant difference in cumulative visual field improvement between the two groups of patients ( χ2 = 7.011, P<0.05). Before treatment, 59 patients had mRS scores of 1 to 2 points in 15 patients (25.4%), and 44 patients with 2 points or more (74.6%). Of the 49 patients reviewed after treatment, 28 (57.1%) had a good prognosis and 21(42.9%) had a poor prognosis. Conclusions:The visual field defect of patients with homonymous hemianopsia after acute occipital infarction may be improved after treatment. The improvement mostly occurs within 1 m after treatment, and patients with incomplete homonymous hemianopsia have more significant improvements than those with complete homonymous hemianopsia.
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The oral microbiota is associated with oral diseases and digestive systemic diseases. Nevertheless, the causal relationship between them has not been completely elucidated, and colonisation of the gut by oral bacteria is not clear due to the limitations of existing research models. The aim of this study was to develop a human oral microbiota-associated (HOMA) mouse model and to investigate the ecological invasion into the gut. By transplanting human saliva into germ-free (GF) mice, a HOMA mouse model was first constructed. 16S rRNA gene sequencing was used to reveal the biogeography of oral bacteria along the cephalocaudal axis of the digestive tract. In the HOMA mice, 84.78% of the detected genus-level taxa were specific to the donor. Principal component analysis (PCA) revealed that the donor oral microbiota clustered with those of the HOMA mice and were distinct from those of specific pathogen-free (SPF) mice. In HOMA mice, OTU counts decreased from the stomach and small intestine to the distal gut. The distal gut was dominated by Streptococcus, Veillonella, Haemophilus, Fusobacterium, Trichococcus and Actinomyces. HOMA mice and human microbiota-associated (HMA) mice along with the GF mice were then cohoused. Microbial communities of cohoused mice clustered together and were significantly separated from those of HOMA mice and HMA mice. The Source Tracker analysis and network analysis revealed more significant ecological invasion from oral bacteria in the small intestines, compared to the distal gut, of cohoused mice. In conclusion, a HOMA mouse model was successfully established. By overcoming the physical and microbial barrier, oral bacteria colonised the gut and profiled the gut microbiota, especially in the small intestine.
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Animals , Humans , Mice , Bacteria , Gastrointestinal Microbiome , Germ-Free Life , Microbiota , RNA, Ribosomal, 16SABSTRACT
Objective@#To investigate the effects of macrophage colony-stimulating factor (M-CSF) on the polarization and infiltration of M2 macrophages and the invasion and metastasis of tumor cells in ovarian cancer microenvironment. @*Methods@#A co-culture system consisting of ovarian cancer cells (A2780 and SKOV3) and THP-1 derived macrophages was established in vitro. The M-CSF levels in culture medium and M-CSF mRNA levels in cancer cells and macrophages were detected by ELISA and qRT-PCR, respectively. The proportion of CD68+CD163+ M2 macrophages (polarization cells) was determined by flow cytometry. The invasive and metastatic ability of A2780 and SKOV3 cells after co-culturing with M2 macrophages were analyzed using Transwell assay. The expression levels of M-CSF, CD68+, CD163+ and E-cad in paraffin sections of 52 patients with ovarian cancer and 18 patients with benign ovarian tumor were detected by the immunohistochemistry staining, and their correlations and the relationship between M-CSF and clinicopathological features of ovarian cancer patients were analyzed. @*Results@#The M-CSF levels in culture medium of the co-culture group (A2780 and SKOV3 cells co-cultured with M2 macrophages) were significantly higher than that of A2780 and SKOV3 cells alone (t=14.315 and 12.338, P＜0.01). Fluorescence quantitative PCR results showed that the increased M-CSF originated from the secretion of co-cultured ovarian cancer cells (t=29.915 and 36.826, P＜0.01). The proportions of CD68+CD163+ M2 macrophages in the A2780 cells co-cultured with M2 macrophages group and SKOV3 cells co-cultured with M2 macrophages group were (6.14±0.50)% and (7.32±0.67)%, respectively, which were significantly higher than that in the M2 macrophages alone group ([1.82±0.34]%, t=12.289 and 12.711, P＜0.01). Transwell assay showed that the co-culture environment enhanced the invasion of A2780 and SKOV3 cells (24.00±4.81 vs 75.20±6.42, t=11.058; 18.40±2.31 vs 61.60±9.66, t=7.537, P＜0.01). The expression levels of M-CSF in ovarian cancer tissues were positively correlated with the number of CD68+ cells and CD163+ cells (r=0.690 and 0.596, P＜0.01), and negatively with the expression levels of E-cad (r=-0.566, P＜0.01). Moreover, the expression levels of M-CSF and the number of CD68+ cells and CD163+ cells in ovarian cancer tissues were significantly higher than that in benign ovarian tumor tissues, however, the expression levels of E-cad were on the contrary. The expression levels of M-CSF in ovarian cancer tissues were significantly correlated with tumor stage, differentiation and lymphatic node metastasis (χ2=6.240, 6.612 and 4.544, respectively, P＜0.05). @*Conclusion@#The increased expression of M-CSF in ovarian cancer microenvironment may induce the polarization and infiltration of CD68+CD163+ M2 macrophages, and then promote the invasion and metastasis of ovarian cancer cells.
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Objective@#To provide reference for clinical screening of individualized therapy by detecting the drug susceptibility of primary tumor cells derived from malignant pleural effusion (MPE) of the patients with non-small cell lung cancer (NSCLC). @*Methods@#MPE specimens were collected from 20 patients diagnosed as NSCLC by histopathology. They were separated by density gradient centrifugation cultured in vitro to remove non-tumor cells, and then primary cell lines were established. The half-inhibitory concentrations (IC 50 ) of conventional anti-tumor chemotherapy drugs on primary tumor cells were determined by the MTT method, and an absolute predictive value (R) was obtained by comparing the IC 50 with the theoretically calculated value of maximum plasma concentration (IC 50m ). Last, the R value was compared with the actual clinical efficacy of the NSCLC patients. @*Results@#After 20 MPE samples were pretreated and cultured for 4 generations, the primary tumor cell lines passaged stably in vitro were established successfully. Papanicolaou staining confirmed that these tumor cell lines had the characteristics of cancer cells, and their purity was nearly 100% under the microscope. The MTT results showed that the invalid IC 50 values beyond the upper limit of test concentration could be further included in the following evaluation on the therapeutic effect of patients when R values were used. When R values between 0.5 and 2.0 and more than 2.0 were used for predicting the actual therapeutic effect as disease stability and disease progression, respectively, the overall consistency between R value and actual therapeutic effect was 77% (10/13) in six patients with complete history of chemotherapy. @*Conclusion@#The primary culture of tumor cells in MPF and the detection of drug sensitivity have the clinical application value in predicting the actual therapeutic effect of NSCLC patients.
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Objective To explore the application of 3D printing technology in clinical apprenticeship teaching in spinal surgery. Methods 38 eight-year clinical medical students admitted to the Department of Spine Surgery were randomly divided into experimental group (19 patients) and control group (19 patients). Taking odontoid fracture as an example. The traditional method is used for teaching, and the experimental group is taught with traditional teaching method combined with 3D printing technology . After the apprenticeship, the students of the two groups were tested in theory and simulated operation to evaluate the teaching effect. SPSS 17.0 was used for statistical analysis. The measurement data was expressed as mean ± standard deviation, and the t-test was used to compare the measurement data between two groups. Results The results showed that the scores of immediate examination and one month after class in the control group were (82.23 ±7.52) and (72.36 ±6.39) points respectively. The scores of immediate examination and one month after the class in the experimental group were (85.58 ±6.32), (80.87 ±6.23). The scores of the two examinations in the experimental group were significantly higher than those in control group , and the differences were statistically significant (P<0.05). Conclusion The 3D printing technology can significantly improve the teaching effect in the clinical apprenticeship teaching of spine surgery, and it has a bright prospect for application.
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Objective To compare the clinical curative effect of allogeneic bone ring and titanium mesh in repairing adolescent spinal tuberculosis kyphosis.Methods Forty-four cases of kyphosis after adolescent spinal tuberculosis operation in this hospital from January 2012 to January 2015 were selected as the study subjects and divided into the control group and observation group ac-cording to the treatment types,22 cases in each group.The control group was repaired with titanium mesh,while the observation group was given allogeneic bone ring fusion repair.Postoperative follow up lasted for 2 -5 years.The perioperative indexes,repair material and vertebral fusion and neurological score,preoperative and postoperative Cobb angle,ESR,CRP and postoperative com-plications occurrence were compared between the two groups.Results There was no statistically significant difference in periopera-tive indexes between the two groups(P>0.05).The fusion time,occurrence rate of local pain and motion limitation had statistical differences between the two groups(P<0.05).The occurrence rate of material loosening had no statistical difference(P>0.05). No grade A and B spinal injury appeared in both groups.The incidence rate of grade D and E in the observation group was signifi-cantly lower than that in the control group,the difference was statistically significant(P<0.05).The postoperative Cobb angle, ESR and CRP had no statistical difference between the two groups(P>0.05),moreover no significant adverse reactions and post-operative tuberculosis recurrence occurred.Conclusion Allogeneic bone ring and titanium mesh have satisfactory effect for repairing juvenile spinal tuberculosis kyphosis,allogeneic bone ring fusion time is longer,early stability is worse than the titanium mesh,the brace protection is needed in the early time,but the clinical effect of patients is more significant,which is worthy of being promoted and applied in clinical treatment.
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Objective To investigate the clinical effects of therapeutic hypothermia on the mortality and neurological function recovery in patients with acute large hemispheric infarction (LHI).Methods Seventy-three acute LHI patients (within 24 hours of symptom onset) admitted to our hospital from February 2015 to July 2016 were randomized to the hypothermia group (37 patients)and the control group (36 patients).Patients in the hypothermia group were given standard medical treatment and the surface cooling with a target temperature between 32-35 ℃ lasting for 5-7 days.Patients in the control group were given standard medical treatment and maintained a target temperature of normothermia.All patients were observed the primary end points including mortality and the modified Rankin Scale (mRS) score at 3 months.Results At three months,nine patients of survivors in the hypothermia group had good outcome (mRS score 0-3),whereas only five patients of survivors in the control group,though there was no significant difference (9/17 vs 5/19,x2 =2.676,P＞ 0.05)between the two groups.Twenty patients (54.1％)died in the hypothermia group,while 17 patients(47.2％) in the control group(x2 =0.341,P ＞0.05).Conclusion Therapeutic hypothermia is safe and feasible to patients with acute LHI,but may neither reduce mortality nor improve the neurological outcome in survivors.
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Objective To evaluate the effect of continuous infusion of dexmedetomidine on the oxidative stress in patients undergoing percutaneous coronary intervention (PCI).Methods Fifty patients, with acute myocardial infarction who required for emergency PCI, 39 males, 11 females, aged 47-79 years, weighting 45-83 kg, ASA physical status Ⅲ or Ⅳ, were selected and randomly divided into two groups (n=25 each) using a random number table: the control group (group C) and the dexmedetomidine group (group D).In group D, a loading dose of dexmedetomidine 0.5 μg/kg was infused intravenously for 10 min before surgery, and then dexmedetomidine was infused at a rate of 0.2-1.0 μg·kg-1·h-1 during the operation until the end of operation.Patients in group C received the same dose saline in the same way.RASS score was maintained at-2-2 scores in the two groups.Blood samples were collected before the anesthesia induction (T0), at the end of the operation (T1), 6 h after the operation (T2) and 24 h after the operation (T3) to determine the observed changes of PMN, SOD and MDA.The intraoperative adverse reactions including hypotension, bradycardia and hypoxemia were recorded.Results Compared with T0, the number of PMN and the serum concentration of MDA at T1-T3 significantly increased, while effective serum SOD at T1-T3 significantly decreased (P＜0.01 or P＜0.05).The serum concentration of MDA and the number of PMN at T1-T3 in group D were significantly lower than those in group C, while the effective serum SOD was significantly higher than that in group C (P＜0.05).There was no significant difference of intraoperative adverse reactions including hypotension, bradycardia and hypoxemia between the two groups.Conclusion Continuous infusion of dexmedetomidine can decrease oxidative stress thus to alleviate myocardial reperfusion injury.