Clinical Features of Trousseau's Syndrome with Acute Multiple Cerebral Infarction as the First Manifestation / 中国康复理论与实践

Objective:To investigate the clinical features of Trousseau's syndrome with acute multiple cerebral infarction (AMCI) as the first manifestation. Methods:From January, 2012 to January, 2019, a retrospective study was conducted on 19 patients with AMCI diagnosed as the first manifestation of Trousseau's syndrome. The clinical data, imaging features, laboratory results, treatment, and prognosis data were collected and analyzed. Results:They were (71.05±10.59) years old, with ten males and nine females. MRI-diffusion weighted imaging (DWI) showed numerous small lesions with or without large area cerebral infarction in multiple vascular territories. Fifteen cases (78.95%) showed bilateral infarction, eleven cases (57.89%) showed multiple small lesions (< 20 mm) in multiple vascular territories, nine cases showed cerebral artery stenosis, in which seven cases (77.78%) of cerebral infarction lesions were not consistent with stenotic vessels. All patients had elevated levels of D-dimer with a median of 3.08 mg/L (0.79~7.00 mg/L). Cardiac troponin I (cTnI) increased in eight cases. CA125 increased in 17 cases. Among the 15 cases treated with antiplatelet therapy, five cases (33.3%) were combined with anticoagulation therapy. Nine cases (47.37%) developed early neurological function deterioration or recurrent cerebral infarction during hospitalization. After the follow-up, five cases died within 30 days, and six recurrent thrombotic events occurred within 90 days, including three events for cerebral infarction and three events for lower limb venous thrombosis, and finally 13 cases (68.42%) died within 90 days. Conclusion:AMCI can be the first manifestation of Trousseau's syndrome. The image features including bilateral small infarction or multiple lesions being not consistent with the stenotic vessels, combined with the elevated levels of D-dimer, cTnI and CA125, can be the clues to Trousseau's syndrome caused by hypercoagulability due to cancer. Timely screening for occult cancer and active anticancer therapy may be helpful to improve their outcome.

Isolation of endophytic fungi from Dendrobium officinale and preliminary evaluation of in vitro biological activity / 中草药

Objective: To study the distribution of endophytic fungi from Dendrobium officinale and screen the distinctive fungi with antimicrobial and antitumor activities. Methods: Endophytic fungi were isolated by the conventional method and cylinder-plate method with Staphylococcus aureus, Escherichia coli, and Bacillus subtilis as subjects. The metabolites of ethyl acetate extracts with antitumor activity were identified based on MTT assay. Results: A total of 28 strains of the endophytic fungi were isolated from D. officinale. By analyzing the data of molecular identity, there were 10 species in D. officinale, in which Fusarium Link is a dominant. The ethyl acetate extracts of the fermentation broth had different antibiotic activities on the indicator microorganisms, and had antitumor effect on HepG2 cells. Conclusion: Endophytic fungi isolated from D. officinale have rich diversity and have antimicrobial and antitumor activities, which could be potential for developing antimicrobial and antitumor reagents.

Study on the relationship between Chinese medicine constitutive susceptibility and diversity of syndrome in diabetic nephropathy / 中国结合医学杂志

<p><b>OBJECTIVE</b>To explore the relationship between Chinese medicine (CM) constitutive susceptibility and syndrome diversity in diabetic nephropathy (DN).</p><p><b>METHODS</b>Epidemiologic investigation on constitution adopting the "Constitution in Chinese Medicine Questionnaire" (CCMQ), and survey on syndrome type by CM syndrome scale (preliminary) were carried out in 180 DN patients. Cluster analysis on symptom items was used to determine the syndrome type, and canonical correlation analysis was used to analyze the relationship between patients' constitution and syndrome.</p><p><b>RESULTS</b>Baseline levels in all enrolled patients were not different statistically. Cluster analysis showed 8 syndromes existed in DN patients, namely: I, qi-yin deficiency with qi-stagnancy type; II, yin-yang deficiency with heat-water-blood stasis type; III, qi-yin deficiency with dampness-heat type; IV, yin-yang deficiency with blood-stasis and heat type; V, qi-yin deficiency with stagnant heat type; VI, yin-yang deficiency with inner dampness-heat stagnancy type; VII, yin deficiency with heat stagnancy type; and VIII, Kidney (Shen)-Spleen (Pi) deficiency with stagnant heat type. Correlation analysis on the 8 syndromes and the 9 constitutions showed statistical significant correlations between syndrome III and dampness-heat constitution (P=0.0001); syndrome IV and blood-stasis constitution (P=0.0001); and syndrome VII and yin-deficiency constitution (P=0.0180).</p><p><b>CONCLUSION</b>Certain relationship revealed between CM constitutions and syndrome types; constitution decides the disease genesis, its syndrome type and prognosis, as well as the change of syndromes.</p>

Association of Chinese medicine constitution susceptibility to diabetic nephropathy and transforming growth factor-β1 (T869C) gene polymorphism / 中国结合医学杂志

<p><b>OBJECTIVE</b>To explore the association of Chinese medicine constitution susceptibility to diabetic nephropathy (DN) and transforming growth factor (TGF)-β1 (T869C) gene polymorphism.</p><p><b>METHODS</b>TGF-β1 gene polymorphism detected with polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was screened for 180 DN cases and 180 type 2 diabetic mellitus (T2DM) cases without combined DN. Patients with DN were surveyed epidemiologically with constitution in the Chinese medicine questionnaire (CCMQ). Binary logistic regression analysis was utilized to study the correlation between nine types of Chinese medicine constitution and TGF-β1 (T869C) gene polymorphisms.</p><p><b>RESULTS</b>The DN group has a higher frequency of TGF-β1 (T869C) gene polymorphism than the T2DM group, and CC/CT genotypes than the T2DM group [CC, CT, TT (DN group): 88, 87, 5 (cases) versus (T2DM group) 71, 73, 36 (cases), P<0.05]. The phlegm-dampness constitution, damp-heat constitution, and blood stasis constitution have correlations with TGF-β1 (T869C) gene polymorphism.</p><p><b>CONCLUSION</b>Chinese medicine constitutions were associated with TGF-β1 (T869C) gene polymorphism, a potential predictor of susceptibility to DN in T2DM patients.</p>

Relationship between hepatitis B virus YMDD mutation and serum viral DNA loadings / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the relationship between lamivudine-resistant mutants of hepatitis B virus (HBV) and serum HBV DNA loading before antiviral therapy.</p><p><b>METHODS</b>This study involved 106 patients with hepatitis B receiving lamivudine treatment for an average of 32 months (rang 12-48 months). Serum HBV DNA loadings were measured with PCR before and every 4 to 6 months during lamivudine therapy. HBV YMDD mutants were detected using mismatched PCR-restriction fragment length polymorphism (PCR-RFLP) during lamivudine treatment.</p><p><b>RESULTS</b>HBV DNA loading was significantly higher in patients infected with HBV YMDD mutants during lamivudine therapy than those infected with HBV without YMDD mutation.</p><p><b>CONCLUSION</b>High viral loading in hepatitis B patients before treatment is associated with high likeliness of HBV YMDD mutation during lamivudine treatment. HBV DNA loading may be indicative for the occurrence of YMDD mutation during lamivudine therapy.</p>

Application of cerebral protection to carotid endarterectomy at perioperation, intraoperation, and postoperation / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the significance of cerebral protection applied at carotid endarterectomy (CEA) at perioperation, intraoperation, and postoperation.</p><p><b>METHODS</b>Thirty patients underwent CEA with application of cerebral protection at perioperation, intraoperation, and postoperation in our hospital from January 2002 to August 2005. Perioperative carotid Doppler ultrasound and computed tomography angiography (CTA) were applied in 29 patients and carotid angiography applied in only one patient. The key methods of intraoperative cerebral protection included general anaesthesia, selective shunting, monitoring of transcranial Doppler, and careful manipulation. The methods of postoperative cerebral protection included leaving tracheal cannula and brain ice-bag, maintaining normal blood pressure, and applying dehydrant under guidance by monitoring of transcranial Doppler.</p><p><b>RESULTS</b>Among all the 30 patients, shunts were used in 10 patients (33%), and angioplasty by patch was applied in 17 patients (57%). No cranial nerve-associated complications or death was documented.</p><p><b>CONCLUSION</b>Application of cerebral protection at CEA at perioperation, intraoperation, and postoperation can effectively prevent the occurance of cranial nerve-associated complications.</p>