Correlation between serum vascular endothelial growth factor, miR-126 and cerebral microbleeds / 国际脑血管病杂志

Objective:To investigate the relationship between serum vascular endothelial growth factor (VEGF), peripheral blood microRNA-126 (miR-126) and the number and distribution of cerebral microbleeds (CMBs).Methods:Consecutive patients with non-acute ischemic cerebrovascular disease admitted to the Department of Neurology, the First Affiliated Hospital of Baotou Medical College from June 2019 to June 2020 were enrolled. The clinical data were collected, 3.0 T MRI examination was performed, and susceptibility-weighted imaging was used to detect CMBs. The serum VEGF concentration was detected by enzyme-linked immunosorbent assay, and miR-126 was detected by fluorescence quantitative polymerase chain reaction. Multivariate logistic regression analysis was used to determine the independent influencing factors of CMBs. Multiple linear regression analysis was used to determine the correlation between serum VEGF concentration, miR-126 in peripheral blood and the number of CBMs. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of serum VEGF concentration and relative expression of miR-126 in peripheral blood for CMBs. Results:A total of 193 patients with non-acute ischemic cerebrovascular disease were enrolled, including 110 patients (57.0%) in the non-CMBs group, 20 (10.4%) in the strictly lobar CMBs group and 63 patients (32.6%) in non-strictly lobar CMBs group. The comparison among the three groups showed that age might be a risk factor for strictly lobar CMBs, while higher VEGF, higher cystatin C level, lower relative expression of miR-126 in peripheral blood, hypertension and previous stroke or transient ischemic attack might be the risk factors for non-strictly lobar CMBs. Multivariate logistic regression analysis showed that higher serum VEGF concentration was an independent risk factor for non-strictly lobar CMBs (odds ratio 1.186, 95% confidence interval 1.035-1.358; P=0.014), while the higher relative expression of miR-126 was an independent protective factor for non-strictly lobar CMBs (odds ratio 0.154, 95% confidence interval 0-0.269; P=0.026). Multiple linear regression analysis showed that higher serum VEGF concentration ( r=0.848, P<0.001) and the lower relative expression of miR-126 ( r=-0.043, P=0.035) significantly increased the number of CMBs. ROC curve analysis showed that the area under the curve of serum VEGF for predicting non-strictly lobar CMBs was 0.803 (95% confidence interval 0.741-0.865), the optimal cut-off value was 120.55 ng/L, the sensitivity was 70.7%, and the specificity was 75.5%. Conclusions:In patients with non-acute ischemic cerebrovascular disease, there is a significant correlation between serum VEGF concentration and the relative expression of miR-126 in peripheral blood and the number and distribution of CMBs. Serum VEGF can be used as a biomarker for predicting the presence of non-strictly lobar CMBs.

Prenatal diagnosis of two cases of paternal uniparental disomy of chromosome 6 / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To report on prenatal diagnosis and follow up of two patients with paternal uniparental disomy of chromosome 6 (pUPD6).</p><p><b>METHODS</b>Fetal cells were subjected to in situ culturing and G-banded chromosomal analysis. DNA samples of the fetuses and their parents were also analyzed with single nucleotide polymorphism microarray (SNP array).</p><p><b>RESULTS</b>Both fetuses had a normal male karyotype. SNP array analysis showed both have carried pUPD6.</p><p><b>CONCLUSION</b>pUPD6 can lead to transient neonatal diabetes mellitus type 1. Homozygous status of recessive mutations, disorder of gene imprinting, and its influence on placental function are the main factors to be considered during prenatal diagnosis and genetic counseling for pUPD6.</p>

Laboratory analysis in patients with severe acute respiratory syndrome after ten years of convalescence in Tianjin / 天津医药

Objective To investigate the changes of blood test indexes in patients with severe acute respiratory syndrome (SARS) after 10 years of rehabilitation, and to evaluate the effects of SARS on blood system. Methods Twenty-five cases of SARS confirmed in our hospital (SARS group) and 25 healthy personnel (control group) were included in this study. Values of blood routine test, liver and kidney function, blood lipids, blood glucose, thyroid function, tumor marker and T cell subset index were compared between two groups. Results The serum level of calcium was higher in SARS group than that of control group (mmol/L:2.32 ± 0.08 vs. 2.29 ± 0.08,t=2.072,P<0.05). The level of thyroxine was also higher in SARS group than that of control group (nmol/L: 119.95 ± 29.09 vs. 96.39 ± 14.26, t=3.681,P<0.05), but the results were in the normal range, there was no clinical significance. The level of neuron specific enolase (NSE) was higher in SARS group than that of control group (μg/L, 10.368 ± 3.684 vs. 3.282 ± 1.828, t=9.012, P<0.05), in which only 2 cases were slightly higher than the normal range, but did not exceed more than 1 times of the normal value. The imaging was only part of the old change, and there was no clinical significance. There were no significant differences in other results between two groups. Conclusion Virus of SARS cause no long-term effects on blood system, liver and kidney function, thyroid function and immunity in patients with SARS, and do not increase the probability of cancer.

Bronchial artery embolization for hemoptysis: a retrospective observational study of 344 patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Hemoptysis is a significant clinical entity with high morbidity and potential mortality. Both medical management (in terms of resuscitation and bronchoscopic interventions) and surgery have severe limitations in these patients population. Bronchial artery embolization (BAE) represents the first-line treatment for hemoptysis. This article discusses clinical analysis, embolization approach, outcomes and complications of BAE for the treatment of hemoptysis.</p><p><b>METHODS</b>A retrospective analysis of 344 cases, who underwent bronchial arteriography at Tianjin Haihe Hospital between 2006 and 2013. Several aspects of outcome were analyzed: Demographics, clinical presentation, radiographic studies, results, complications and follow-up of BAE.</p><p><b>RESULTS</b>Three hundred and forty-four consecutive patients underwent bronchial arteriography, 336 of 344 patients (97.7%) performed BAE; there were 1530 coils for 920 arteries embolized; the main responsible sources for bleeding were right bronchial artery (29.7%), left bronchial artery (21.6%), combined right and left bronchial trunk (18.4%), right intercostal arteries (13.3%); 61 patients (17.7%) had recurrent hemoptysis within 1 month after undergoing BAE, 74 patients (21.5%) had recurrent hemoptysis over 1 month after undergoing BAE; The common complications of BAE included subintimal dissection, arterial perforation by a guide wire, fever, chest pain, dyspnea, etc. The follow-up was completed in 248 patients, 28 patients had been dead, 21 patients still bleed, 92 patients had lost to follow-up.</p><p><b>CONCLUSIONS</b>The technique of BAE is a relatively safe and effective method for controlling hemoptysis . The complications of BAE are rare. Although the long-term outcome in some patients is not good, BAE may be the only life-saving treatment option in patients who are poor surgical candidates.</p>

Karyotype analysis of amniotic fluid cells and comparison of chromosomal abnormality rate during second trimester / 中华妇产科杂志

ObjectiveTo investigate the karyotypes of amiotic fluid cells and compare the incidence of chromosomal abnormality as well as to evaluate the clinical significance of abnormal karyotypes. MethodsA total of 13 648 pregnant women came to Shanghai Jiai Genetics and IVF Institute, Obstetrics and Gynecology Hospital, Fuclan University to do amniocentesis from September 1998 to November 2010, and 13 795 amniotic fluid specimens were successfully extracted and cultured, thus 13 795 fetuses received karyotype diagnosis. These fetuses were grouped according to different indications. If maternal age was ≥ 35, the fetuses were grouped into the advanced maternal age group (4065) ; and if maternal serum screening test revealed high-risk of trisomy 18 or trisomy 21, the fetuses were grouped into the high-risk serum screening group (6462) ; and those with abnormal signs of ultrasound screening were grouped into the abnormal ultrasound signs group (1539); and if either of the parents was with chromosome abnormalities, the fetus was grouped into the paternal/maternal abnormality group ( 108 ) ; whereas the remainder were grouped in other factors group ( 1621 ). The amniotic fluid cells were in-situ cultured on coverslips, harvested by conventional G-banded methods, and then analyzed by two doctors. In order to get rapid diagnosis, some pregnant women whose gestational age ≥26 weeks accepted fluorescense in situ hybridization (FISH). FISH was done on 78 uncultured amniotic fluid specimens using probes located at chromosome 13,18,21, X,Y. Some parents were required to analyze lymphocyte karyotype to help judging the origin of abnormal karyotype. Results( 1 ) Classification and composition of abnormal karyotypes in each group : a total of 388 abnormal karyotypes were found among 13 795 fetuses, and the abnormal rate was 2. 813％ (388/13 795).Of the 388 fetuses, aneuploidy was the most common pattern which was up to 59. 8％(232/388);autosomal structural abnormality rate was 24. 7％ ( 96/388 ) ; mosaicism was 12.4％ (48/388). Other uncommon abnormal karyotypes included marker chromosome (5/388,1.3％), sex chromosomal structural abnormality (4/388,1.0％) and triploid (3/388, 0. 8％ ). Aneuploidy was the most common in most groups except the patemal/matemal abnormality group. There were four cases of rare aneuploid in the advanced maternal age group,the high-risk serum screening group and the abnormal ultrasound signs group respectively. Every type of abnormality could be found in the abnormal ultrasound signs group, and autosomal structural abnormalities were concentratedin paternal/maternalabnormality group. Mosaicism mainly distributed in the high-risk serum screening group, accounting for 20. 0％ (29/145) of abnormalities in this group. (2) Abnormal types and the incidence: the most common type was trisomy 21 ( 138/388,35.6％ ),followed by autosomal balanced structural rearrangements( 80/388, 20. 6％ ), mosaicism(48/388,12. 4％ )and trisomy 18 (44/388,11.3％ ). Others included non-balanced autosomal structural rearrangements (16/388,4. 1％ ), 45 ,X0 ( 16/388,4. 1％ ) and 47 ,XXY( 15/388,3.9％ ). (3) Lymphocyte karyotype analysis of the couples: parents of 153 fetuses were analyzed to determine the origin of abnormal karyotype. Fifty-eight familial and 95 de novo abnormalities were found. FISH results were the same with G-banding karyotype, and two of these were trisomy 21. Conclusions Abnormal karyotype composition is different according to different maternal amniocentisis indications. There is a variety of abnormal karyotypes in the second trimester pregnancy, and the risk of fetal malformation is related with the kind of abnormal karyotype.

Probe into sleep quality in the patients with irritable bowel syndrome / 中华内科杂志

Objective To investigate the sleep features in the patients with irritable bowel syndrome (IBS) and compare the sleep quality between those IBS patients who were with and without anxiety and depression.Methods Pittsburgh sleep quality index questionnaire (PSQI), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were measured in the 145 IBS patients and 59 regular physical examination volunteers.IBS patients were also divided into two subgroups-patients with or without anxiety and depression based on cutoff scores of SAS and SDS.Comparisons of sleep quality were made between subgroups, and between IBS patients and volunteer controls.Results Compared with the controls,the SAS raw score, SDS raw score and SAS positive incidence in IBS patients were shown statistically significant differences (P ＜ 0.05 ), while the SDS positive incidence had no statistically significant difference(P ＞ 0.05 ).PSQI total scores were significantly higher in the IBS patients without anxiety and depression (P ＜ 0.05), 3 domains (sleep quality, sleep disturbances and daytime function disorder) were also found statistically significant differences ( P ＜ 0.05 ), compared with the controls.The IBS patients with anxiety and depression were statistically significantly different from the controls ( P ＜ 0.05 ) in 6 domains (sleep quality, sleep latency, sleep efficiency, sleep disturbances, sleep time and daytime function disorder) and significantly higher PSQI total scores( P ＜ 0.05 ).Statistically significant differences (P ＜0.05) were also found in all 7 domains and with higher PSQI total scores in IBS patients with anxiety and depression, compared with IBS patients without anxiety and depression.Conclusions IBS patients were more likely to have sleep abnormality, mainly in sleep quality, sleep disturbances and daytime function disorder and PSQI total scores.The abnormalities of these factors were independent of emotional disorder.However, emotional disorder worsened the sleep disorder in IBS patients.

Prevention and treatment of cerebral vasospasm with free radical scavengers after subarachnoid hemorrhage / 国际脑血管病杂志

Cerebral vasospasm is a common complication after subarachnoid hemorrhage, and its pathophysiological mechanism is poorly understood. A growing body of research suggests that free radicals play an important role in inducing cerebral vasospasm. In recent years, the research about free radical scavengers in the prevention and treatment of cerebral vasospasm after subarachnoid hemorrhage is continuing to increase, This article reviews the roles of many types of free radical scavengers in the prevention and treatment of cerebral vasospasm after subarachnoid hemorrhage.