ABSTRACT
Objective:To analyze serum levels of complement 1q (C1q) in patients with acute ischemic stroke (AIS) and transient ischemic attack (TIA), and to assess the association of serum C1q with the neurological deficit severity of AIS and the subsequent stroke risk after TIA, and to investigate the predictive and discriminative values of serum C1q for AIS and TIA.Methods:Clinical case-control study. Serum C1q levels were determined in 65 AIS, 61 TIA patients and 66 healthy controls from Jinling Hospital affiliated to Medical School of Nanjing University during January 2016 to March 2017. Their serum levels of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, glucose, high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6) and procalcitonin (PCT) were also detected. The NIHSS scores of AIS patients and ABCD3-I scores of TIA patients were calculated. Spearman correlation analyses and stepwise linear regression analyses were performed to investigate the association of serum C1q levels with NIHSS and ABCD3-I scores. Logistic regression analyses were performed to investigate the predictive and discriminative values of serum C1q for AIS and TIA patients. Results:Compared with controls [C1q:175.50(164.00-196.50)mg/L, TG: 0.91(0.71-1.19)mmol/L, HDL-C:(1.43±0.23)mmol/L], serum levels of C1q [AIS: 199.00(180.00-218.00)mg/L; TIA: 184.00(174.50-202.75)mg/L) and TG(AIS: 1.36(0.91-2.00)mmol/L; TIA: 1.31(0.90-2.01) mmol/L] were significantly increased in AIS and TIA patients(all P<0.05), while HDL-C[AIS: (1.08±0.41) mmol/L; TIA: (1.08±0.42) mmol/L] were significantly decreased(all P<0.001). Levels of C1q, hs-CRP[AIS:4.10(2.15-15.05)mg/L; TIA:1.40(0.63-3.88)mg/L],IL-6 [AIS: 10.88(7.21-32.96) ng/L; TIA: 7.07(6.18-9.82)ng/L] and PCT [AIS: 0.06(0.04-0.11)μg/L; TIA: 0.20(0.20-0.04)μg/L] in AIS patients were significantly higher than that in TIA patients(all P<0.05). C1q levels [AIS:203.00(183.25-219.75)mg/L; TIA: 181.00(1 666.50-206.00)mg/L] in severe AIS patients (NIHSS≥6) were significantly higher than that in mild AIS patients (NIHSS<6)( P=0.031). C1q levels[AIS:197.00(180.00-219.00)mg/L; TIA: 182.00(167.50-195.50)mg/L] in high-risk TIA patients (ABCD3-I>3) were significantly higher than that in low-risk TIA patients (ABCD3-I≤3)( P=0.018). After adjusting for age, gender, other lipid/lipoprotein and glucose parameters, C1q levels in AIS patients were independently linked(adjusted R2=0.704) to TC (β=0.524, P=0.078),TG (β=0.0.439, P=0.0.017) levels and NIHSS (β=0.372, P=0.039); C1q levels in TIA patients were independently linked (adjusted R2=0.505) to TG (β=0.535, P<0.001) levels and ABCD3-I (β=0.406, P<0.001); high C1q levels were closely associated with AIS( OR=1.035, 95 %CI1.014-1.056, P=0.001) and TIA ( OR=1.023, 95 %CI1.003-1.044, P=0.025) presence, and could also clearly differentiate between AIS and TIA( OR=1.013, 95 %CI1.000-1.026, P=0.049). Conclusions:Serum C1q levels were significantly elevated in AIS and TIA patients, especially in AIS patients. Serum C1q were independently linked to NIHSS of AIS patients and ABCD3-I of TIA patients, and may be function as a novel risk biomarker for predicting and differentiating AIS and TIA.
ABSTRACT
Objective To discuss the application experience of Da Vinci Surgical System ( DVSS)-assisted laparoscope in partial ne-phrectomy. Methods Nursing methods for the 170 patients to receive partial nephrectomy with laparoscope in the Urinary Surgery and the measures taken against the complications. Results The operations for the 170 patients were finished smoothly, with the average time of oper-ation being 130 min, the average warm ischemic time being less than 25 min, the average amount of bleeding being 100 mL, the average time of renal artery blocking being 36 min and the average intestinal recovery time after operation being 1. 9d;in addition, no conversion to open cholecystectomy occurred due to mechanical failure or other cause. After operation, the average hospital stay was 6d and there were no adverse reactions such as bleeding, leakage of urine, deep venous thrombosis and pulmonary embolism. Through clinical follow-up in 1 month, 3 months and 6 months, no significant change was found in renal function, no delayed renal hemorrhage and no acute renal failure. Conclusion In addition to common characteristics as traditional operation, the robot-assisted operation has its own characteristics. Prepara-tion for special surgical articles, effective communication with the patients, active cooperation and communication among the operation team before operation, cooperation during operation and care after operation, as well as mastery of the subsystems of the robot are the key to ensure a successful operation.
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Aim To investigate the expression and im-plication of HIF-1α, ROCK-2 , FoxM1 in PC12 cell in-jury induced by lead acetate. Methods PC12 cells were treated with lead acetate at the doses of 100 , 200 and 400 μmol·L-1 . The cell viability was determined by MTT reduction assay and LDH assay, the intracellu-lar production of oxygen species was measured by as-sessing SOD and MDA levels, cell apoptosis was deter-mined by Hoechst 33342 staining, the expressions of HIF-1α, ROCK-2 , FoxM1 , Bcl-2 and Bax were deter-mined by immunoblotting analysis. Results Lead ac-etate induced cell injury in PC12 cells in a dose-de-pendent manner, and it potentiated oxygen radical pro-duction and cell apoptosis. In addition, lead acetate enhanced HIF-1α and ROCK-2 expressions, increased Bax/Bcl-2 ratio and decreased FoxM1 expression. Conclusion Lead acetate can induce PC12 cell apop-tosis, which may be related with the expressions of HIF-1α, ROCK-2 and FoxM1 . Cellular oxidative stress may contribute to the injury as well.