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Objective:To explore the effect of different pregnancy termination timings on the delivery safety of maternal women with pernicious placenta previa after 34 weeks.Methods:A total of 84 patients with pernicious placenta previa in Laoshan Campus of the Affiliated Hospital of Qingdao University from March 2018 to March 2019 were selected. The time of admission for delivery was more than 34 weeks. Forty women who pregnant from 34 weeks to 36 weeks of pregnancy was in the study group, 44 women who pregnant over 36 weeks was in the control group, and the pregnancy outcomes of the maternal fetuses of the two groups were compared.Results:The postpartum hemorrhage and the incidence of interventional surgery in the study group were less than those in the control group: (754.58 ± 20.35) ml vs. (1 449.26 ± 512.32) ml, 17.5%(7/40) vs. 52.27%(23/44), the differences were statistically significant ( P<0.05). The changes in hematocrit after delivery and before delivery, the amount of hemoglobin after delivery and before delivery, the rate of uterine gauze packing, the rate of Xinmupei, the rate of hysterectomy, the incidence of blood transfusion, the rate of postoperative ICU transfer between two groups hand no significant differences ( P>0.05). The incidence of neonatal birth weight less than 2 500 g and the proportion of transfer to neonatology in the study group were higher than those in the control group: 75.0%(30/40) vs. 11.36%(5/44), 80.0%(32/40) vs. 11.36%(5/44), the differences were statistically significant ( P<0.05). There was no significant differences in Apgar scores and mortality rate of newborns after birth between the two groups ( P>0.05). Conclusions:When the pernicious placenta previa is delivered after 34 weeks, the termination of pregnancy before 36 weeks of gestation is more secure for maternal and fetal health. If the fetal development rate is slow, it is necessary to appropriately extend the delivery time, but don′t exceed 36 weeks.
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Endogenously eliminating the hematoma is a favorable strategy in addressing intracerebral hemorrhage (ICH). This study sought to determine the role of retinoid X receptor-α (RXR-α) in the context of hematoma absorption after ICH. Our results showed that pharmacologically activating RXR-α with bexarotene significantly accelerated hematoma clearance and alleviated neurological dysfunction after ICH. RXR-α was expressed in microglia/macrophages, neurons, and astrocytes. Mechanistically, bexarotene promoted the nuclear translocation of RXR-α and PPAR-γ, as well as reducing neuroinflammation by modulating microglia/macrophage reprograming from the M1 into the M2 phenotype. Furthermore, all the beneficial effects of RXR-α in ICH were reversed by the PPAR-γ inhibitor GW9662. In conclusion, the pharmacological activation of RXR-α confers robust neuroprotection against ICH by accelerating hematoma clearance and repolarizing microglia/macrophages towards the M2 phenotype through PPAR-γ-related mechanisms. Our data support the notion that RXR-α might be a promising therapeutic target for ICH.
Subject(s)
Humans , Anilides/pharmacology , Cerebral Hemorrhage/drug therapy , Hematoma/drug therapy , Macrophages , Microglia , Neuroprotection , PPAR gamma , Retinoid X Receptor alphaABSTRACT
Endogenously eliminating the hematoma is a favorable strategy in addressing intracerebral hemorrhage (ICH). This study sought to determine the role of retinoid X receptor-α (RXR-α) in the context of hematoma absorption after ICH. Our results showed that pharmacologically activating RXR-α with bexarotene significantly accelerated hematoma clearance and alleviated neurological dysfunction after ICH. RXR-α was expressed in microglia/macrophages, neurons, and astrocytes. Mechanistically, bexarotene promoted the nuclear translocation of RXR-α and PPAR-γ, as well as reducing neuroinflammation by modulating microglia/macrophage reprograming from the M1 into the M2 phenotype. Furthermore, all the beneficial effects of RXR-α in ICH were reversed by the PPAR-γ inhibitor GW9662. In conclusion, the pharmacological activation of RXR-α confers robust neuroprotection against ICH by accelerating hematoma clearance and repolarizing microglia/macrophages towards the M2 phenotype through PPAR-γ-related mechanisms. Our data support the notion that RXR-α might be a promising therapeutic target for ICH.
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Objective:To investigate the effect of edaravone combined with early enteral nutrition on intestinal mucosal barrier function and inflammatory factors in patients with severe craniocerebral trauma.Methods:From January 2017 to December 2018, 80 patients with severe craniocerebral trauma admitted to Lanxi People's Hospital were divided into observation group(40 cases) and control group(40 cases) according to the random digital table method.The control group was given early enteral nutrition treatment, and the observation group was treated with edaravone on the basis of the control group.The course of treatment in both two groups was 4 weeks.Glasgow coma index(GCS), intracranial pressure, NIHSS, intestinal mucosal barrier function and inflammatory factors before and after treatment were compared between the two groups.Results:The GCS score of the observation group[(12.32±1.02)points] was higher than that of the control group[(9.87±1.45)points], while the intracranial pressure[(169.84±10.19)mmH 2O] and NIHSS score[(10.73±1.98)points]of the observation group were lower than those of the control group [(203.24±15.69)mmH 2O and (16.52±3.07)points], the differences were statistically significant( t=8.740, 11.291, 10.024, all P<0.05). The levels of DAO [(0.64±0.12)U/L], endotoxin [(2.54±0.48)U/mL] and D-lactate [(3.64±1.09)μg/L] in the observation group were lower than those in the control group [(1.32±0.30)U/L, (3.64±0.61)U/mL and (5.73±1.18)μg/L] ( t=13.310, 8.963, 8.229, all P<0.05). The levels of IL-6[(27.39±5.64)pg/L], hs-CRP[(10.38±3.24)mg/L] and TNF-α[(7.83±1.79)μg/L] in the observation group were lower than those in the control group [(39.98±9.97)pg/L, (15.64±3.19)mg/L and (13.24±3.21)μg/L] ( t=6.951, 7.317, 9.310, all P<0.05). The good prognosis rate of the observation group(80.00%) was higher than that of the control group(57.00%)(χ 2=4.713, P<0.05). Conclusion:Edaravone combined with early enteral nutrition has good effect on the patients with severe craniocerebral trauma.It can improve the intestinal mucosal barrier function, reduce the inflammatory response and improve the prognosis.
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Objective:To investigate the effect of microinvasive craniopuncture scavenging technique(MPST) in the treatment of hypertensive intracerebral hemorrhage, and its influence on the expression of serum matrix metalloproteinase-9 (MMP-9), interleukin-8 (IL-8) and neuron specific enolase (NSE).Methods:From January 2017 to December 2018, 60 cases with hypertensive cerebral hemorrhage in Lanxi People's Hospital of Zhejiang province were divided into observation group (30 cases) and control group (30 cases) according to the digital table method.The control group was treated with conventional therapy, while the observation group was treated with MPST on the basis of the control group.The therapeutic effects of the two groups were compared, and the changes of Barthel index (BI) score, NIHSS score, perihematoma edema, MMP-9, IL-8 and NSE levels were compared.Results:The total effective rate in the observation group(93.33%) was higher than that in the control group (70.00%) (χ 2=5.455, P<0.05). The BI score[(60.19±5.87)points] of the observation group was higher than that of the control group[(49.83±4.56)points], while the NIHSS score[(7.93±1.42)points] was lower than that of the control group[(12.87±2.10)points]( t=7.634, 10.673, all P<0.05). The amount of edema around hematoma in the observation group [(6.20±1.27)mL] was lower than that in the control group [(9.83±1.76)mL] ( t=9.161, P<0.05). The levels of MMP-9 [(103.24±17.38)μg/L], IL-8 [(137.28±25.46)μg/L] and NSE [(8.98±2.16)μg/L] in the observation group were lower than those in the control group [(168.39±15.42)μg/L, (195.31±39.71)μg/L and (13.13±2.63)μg/L] ( t=15.358, 6.738 and 6.679, all P<0.05). Conclusion:MPST is effective in the treatment of hypertensive intracerebral hemorrhage, and it can reduce the serum levels of MMP-9, IL-8 and NSE.
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BACKGROUND:It is a great potential study that calcium sulfate product loaded with antibiotics is developed, but this product is not systematicaly studied and its biocompatibility and security need to be further studied. OBJECTIVE:To evaluate the biocompatibility and safety of vancomycin- or gentamicin-loaded calcium sulfate bone. METHODS: (1) Hemolysis test: vancomycin-loaded, gentamicin-loaded calcium sulfate extracts, double distiled water and saline were added into rabbit anticoagulant blood samples. (2) Micronucleus test: vancomycin-loaded and gentamicin-loaded calcium sulfate extracts, cyclophosphamide and normal saline solution were intraperitonealy injected to mice, respectively. (3) Acute toxicity test: vancomycin-loaded and gentamicin-loaded calcium sulfate extracts, and normal saline solution were intraperitonealy injected to mice, respectively. (4) Pyrogen test: the mice were injected vancomycin-loaded and gentamicin-loaded calcium sulfate extractsvia the ear vein. (5) Intradermal stimulation test: vancomycin-loaded and gentamicin-loaded calcium sulfate extracts were respectively injected into the unilateral spine of rabbits, respectively. (6) Intramuscular implantation test: vancomycin-loaded and gentamicin-loaded calcium sulfate extracts were respectively injected to the dorsal muscle of rabbits. (7) Intraosseous implantation test: vancomycin-loaded and gentamicin-loaded calcium sulfate were implanted into the necrotic femoral bone of rabbits. RESULTS AND CONCLUSION:Both vancomycin-loaded and gentamicin-loaded calcium sulfate products, which have no hemolytic reaction, genetic toxicity, acute toxicity, pyrogen reaction and skin irritation, are considered to have good biocompatibility and safety.
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Objective To observe the adipose-derived cytokine changes and aggravate cognitive impairment in olanzapine-induced obese rats caused by glucose metabolic disorder.Methods 20 rats fed with ordinary fodder were used as normal control group,olanzapine group of 20 rats fed with olanzapine(1.2 mg · kg-1) and ordinary fodder for 4 weeks.Successfully established experimental model rats induced by olanzapine after 4 weeks.Serum tumor necrosis factor α(TNF-α),interleukins 6 (IL-6) and C-reactive protein (CRP) contents were measured by Elisa.Serum glucose contents were determined by biochemical colorimetric method and blood lipid contents determined with automatic biochemical analyzer.Learning,memory capacity and escape latency were detected with Maze test.Results After administration 4 weeks,the levels of body weight,blood glucose and blood lipid in olanzapine group were higher than those in control group.The serum TNF-α((1.57±0.04) ng/ml),IL-6((127.47±11.38) pg/ml) and CRP ((2.68±0.06) mg/ml) in olanzapine group rised,compared with control group ((0.59±0.03) ng/ml,(96.58± 8.77) pg/ml and (1.86±0.04) mg/ml respectively),the differences were statistically significant(P＜0.05).Electric shocks and escape latency in olanzapine group were higher than those in control group (P＜0.05).The FBS had positive correlation with hs-CRP,IL-6 and TNF-α respectively (r=0.385,0.260,1.280; all P＜0.05).Conclusion Olanzapine can induce metabolic disturbance of blood glucose,blood hpid,and the increase of serum TNF-α,IL-6 and CRP levels in rats.Positive correlation is showed between TNF-of and FBS.Hyperglycemia can promote cell toxicity and leads to cognitive dysfunction in rats.