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Objective:To evaluate the clinical value of temporal pole and external capsule white matter hyperintensities (WMHs) on the diagnosie of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) by meta-analysis.Methods:PubMed, Cochrane, Embase, VIP database, China Biomedical Literature database, CNKI, Wanfang Data Service Platform were retrieved. The relevant literature of temporal pole and external capsule WMHs for the diagnosis of CADASIL was collected. The retrieval time limit was from the establishment of the databases to April 1, 2020. Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was used to evaluate the quality of literature. Stata 15.1 software was used for statistical analysis. The fitted Summary Receiver Operating Characteristic (SROC) curve and combined diagnostic effect size were used to evaluate the diagnostic value of temporal pole and external capsule WMHs for CADASIL.Results:A total of 9 articles involving 10 studies were enrolled, including 880 patients. The combined sensitivities of temporal pole and external capsule WMHs for CADASIL were 0.67 (95% confidence interval [ CI] 0.54-0.78) and 0.84 (95% CI 0.72-0.91) respectively, the combined specificities were 0.64 (95% CI 0.47-0.78) and 0.44 (95% CI 0.36-0.53) respectively, the combined positive likelihood ratios were 1.9 (95% CI 1.4-2.6) and 1.5 (95% CI 1.2-1.8) respectively, the combined negative likelihood ratios were 0.51 (95% CI 0.42-0.63) and 0.37 (95% CI 0.20-0.69) respectively, the odds ratios of combined diagnosis were 4 (95% CI 3-5) and 4 (95% CI 2-9) respectively, and the area under the SROC curves were 0.71 (95% CI 0.66-0.74) and 0.62 (95% CI 0.58-0.66) respectively. Conclusions:The temporal pole and external capsule WMHs have limited diagnostic value for CADASIL, and other factors need to be comprehensively considered in the clinical diagnosis process.
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In order to explore the effect of extract (SNE) on skin wound healing in mice and its mechanism, hemostasis effect of SNE was measured, the mouse skin wound model was established by full-thickness excision. The morphological changes of the wound were observed after the treatment with SNE and the healing rate was measured. The changes of wound histology were observed by hematoxylin eosin (HE) staining, Masson staining and transmission electron microscope (TEM). The expression of cell factors and related proteins was detected by quantitative real-time polymerase chain reaction (qRT-PCR). Results showed that the SNE possessed hemostatic function. SNE could obviously improve the healing rate of wound in mouse and shorten time of scab removal compared with the none-treatment (NT) group ( 0.05). These results indicated that SNE possessed obvious activity of accelerating wound healing and inhibiting scar formation, and its mechanism was closely related to hemostatic function, regulation of inflammatory factors, collagen deposition, collagen fiber remodeling and intervening TGF-β/Smads signal pathway. Therefore, SNE may have promising clinical applications in skin wound repair and scar inhibition.
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Objective:To summarize the clinical and imaging features of five patients of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) with cysteine-sparing NOTCH3 gene missense mutations and explore potential pathogenicity of gene mutations.Methods:The clinical data from five patients who were admitted to the People′s Hospital of Zhengzhou University from March 2017 to November 2018 were collected. The patients were found to carry cysteine-sparing NOTCH3 gene mutations through genetic testing and diagnosed pathologically. They were probands confirmed from five unrelated family and all five patients were performed full exon detection and skin biopsy.Results:Genetic testing identified five patients with cysteine-sparing NOTCH3 gene missense mutations, a total of five different mutations, including p.R75Q, p.D80G, p.V237M, p.S1418L and p.R1761H. The first three mutations were found in the epidermal growth factor-like repeats (EGFr), the latter two mutations near the transmembrane domain. Granular osmiophilic material was identified in all cases examined with skin biopsy. The age at initial symptom onset of these five cases was ranged from 22 to 58 years and three cases presented cardiovascular risk factors. The primary clinical manifestations included migraine in one case, ischemic stroke in three cases, psychiatric disturbances in four cases, cognitive dysfunction in five cases, while gait disturbance, pseudobulbar palsy, and seizures accounted for only one case each. Magnetic resonance imaging of five patients all showed white matter hyperintensities (WMLs) and lacunar infarcts, and WMLs involved the anterior temporal pole and external capsules in three cases separately. According to the criteria proposed by Mui?o et al for evaluating the pathogenicity of cysteine-sparing NOTCH3 mutations, all five mutations are potentially pathogenic.Conclusions:Most characteristics of CADASIL patients with cysteine-sparing NOTCH3 gene mutations are similar to those of CADASIL patients with cysteine NOTCH3 gene mutations. Mutations not involving the EGFr may also have potential pathogenicity, and the specific mechanism still needs further study.
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Objective To investigate the correlation and clinicopathological features of ATAD2 and E-cadherin expression in human hepatocellular carcinoma (HCC),and role of ATAD2 in HCC cells invasion and metastases.Methods The expressions of ATAD2 and E-cadherin in 90 HCC specimens and 16 specimens collected from peritumoral tissue were detected by immunohistochemistry (IHC) test.The correlations between ATAD2 and E-cadherin expression and clinicopathological features were analyzed.The lentiviral vector of sh-ATAD2 RNA was used to interfere with ATAD2 expression.Western blot was performed to evaluate the changes of E-cadherin and Vimentin expression in HCC cells after ATAD2 expression interference.The role of ATAD2 in HCC cells invasion and metastasis was assessed by Transwell analysis.Results ATAD2 protein expression was obviously upregulated in HCC tissue compared to peritumoral tissue (56.7％ vs.31.3％,P ＜ 0.05).Meanwhile,E-cadherin expression was significantly downregulated in HCC tissue (43.3％ vs.68.7％,P ＜0.05).ATAD2 and E-cadherin expressions were both correlated with HCC metastasis (P ＜ 0.05).Correlation analysis demonstrated that the ATAD2 expression was negatively correlated with E-cadherin (r =-0.263,P ＜ 0.05).After interfering ATAD2 expression,cell migration and invasion of HCCLM3 cells were suppressed (migration,42.5 ± 2.6 vs.78.1 ± 3.8,P ＜ 0.05;invasion,33.0 ± 4.7 vs.72.7 ± 5.6,P ＜ 0.05).Meanwhile,the E-cadherin expression was remarkably upregulated (P ＜ 0.05).However,the Vimentin expression downregulated (P ＜ 0.05).Conclusions ATAD2 expression was upregulated in HCC,and silencing ATAD2 could upregulate E-cadherin expression and downregulate Vimentin expression,and inhibit the invasion and metastasis of HCC cells.Modulating E-cadherin expression may be the potential mechanism of ATAD2 in HCC invasion and metastasis.
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<p><b>OBJECTIVE</b>To observe the association between high-density lipoprotein cholesterol (HDL-C) level and rate of ischemic stroke recurrence.</p><p><b>METHODS</b>A total of 1 059 patients with ischemic stroke were enrolled from 5 community health centers and underwent baseline surveys during the period of January 2003 to December 2006. After baseline surveys, patients were followed up every 6 months until December 31, 2008. The new stroke events were recorded as the primary study endpoint. The association between HDL-C, HDL-C/TC and ischemic stroke recurrence was analyzed by Cox regression analysis.</p><p><b>RESULTS</b>The proportions of stroke patients with high ( ≥ 1.55 mmol/L), moderate (1.04-1.54 mmol/L) and low (<1.04 mmol/L) HDL-C levels were 15.58% (165/1 059) , 54.58% (578/1 059) and 29.84% (316/1 059) respectively. During a mean of (3.21 ± 1.04) years follow-up, recurrent ischemic stroke was recorded in 137 patients. Compared with HDL-C ≥ 1.40 mmol/L group, multivariate Cox regression analysis showed that stroke recurrence rates of patients with HDL-C ≤ 1.00 mmol/L and ranged from 1.01 to 1.19 mmol/L increased by 0.944 (HR = 1.944, 95%CI:1.033-3.659, P = 0.039) and 1.027 (HR = 2.027, 95%CI:1.116-3.682, P = 0.020)fold , respectively. Recurrence rates increased 1.237 (HR = 2.237, 95%CI:1.208-4.144, P = 0.010) fold in patients with HDL-C/TC ≤ 0.19 mmol/L compared to patients with HDL-C/TC ≥ 0.28 mmol/L.</p><p><b>CONCLUSION</b>The risk of ischemic stroke recurrence increases with decreasing HDL-C level or HDL-C/TC ratio.</p>
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Aged , Female , Humans , Male , Middle Aged , Cholesterol, HDL , Blood , Follow-Up Studies , Recurrence , Risk Factors , Stroke , Blood , EpidemiologyABSTRACT
A 48-year-old female presented with a one-week history of painful and enlarged lymph nodes in the left neck.One-week systemic treatment with antibiotics resulted in no obvious improvement.Skin examination revealed palpable lymph nodes between the left lateral cervical papillae and clavicle,which appeared as a string of beads with a little mobility and obvious tenderness.The largest diameter of enlarged lymph nodes was about 2 cm.No enlarged lymph nodes were palpable in the other body sites.Histopathologically,histiocytes of various shapes,immunoblasts and plasmacytoid monocytes markedly proliferated with different degrees of karyorrhexis.Immunohistochemistry revealed that the lesions were positive for CD3,CDS,CD68,mouse macrophage inflammatory protein,and CD20.A diagnosis of histiocytic necrotizing lymphadenitis was made.
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ObjectiveTo monitor the treatment effect of acute leukemia by multiparmeter flow cytomtry(MPFC), MethodsThe patientswith acute leukemia all achieved complete remission after remission induction therapy.Before the chemotherapy,the bone marrow cell morphology and MPFC inspection were used for each patient. Through statistical analysis, the relationship between morphological feature andrecurrence,as well as time duration till recurrence were obersved. ResultsThe 122 specimens from 30 patients were observed.The specimens were analyzed by morphological examination of bone marrow cells,and the other 61 specimen through MPFC. There were 8 positive specimen(13.11％)through morphological examination,while 18 positive specimen(29.51％ )through MPFC. There was a significant difference between the two groupes by x2 test (x2=4.33,P＜0.05).The 18 MPFC-positive specimens were from 10 patients.In the follow-up period, there were 6 patients whose morphological examination also prompted the recurrence in 1-4 months. Three patients were failed to follow up because of 2 patients became negative and 1 patient died. ConclusionMPFC is more sensitive and able to assess the effect of acute leukemia treatment more objectively and detect the recurrence earlier than morphological examination.
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A 73-year-old man developed a skin-colored granule-sized papule on the scrotum 10 years prior to the presentation,which had increased in size and number without obvious symptoms.Histopathological examination showed multiple enlarged intradermal cysts.The cyst wall consisted of one or two layers of flat or columnar cells.Decapitation secretion was seen in the inner layer cells,and the out layer of cysts was formed by flat or cubic myoepithelial cells.A diagnosis of apocrine hidrocystoma of the scrotum is made.
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OBJECTIVE@#To evaluate the clinical efficacy of the intratympanic methylprednisolone perfusion for patients of intractable Meniere's disease (MD).@*METHOD@#Ten cases (10 ears), collected from Janu 2008 to Janu 2010, of intractable MD were studied retrospectively. The micro-catheter was placed into the tympanum of the affected ear, then methylprednisolone was imported into the tympanum once a day for 10 days. The average followed-up duration was (15. 4 +/- 5. 4) months after the perfusion. The treatment effect of vertigo, hearing loss and activity capacity was evaluated with Diagnostic Criteria for MD set by the Guiyang Meeting in 2006. The efficacy of tinnitus was analyzed by comparing the score of tinnitus handicap inventory (THI) before and after treatment.@*RESULT@#The vertigo was absolutely controlled in 7 patients (grade A), partially controlled in 2 patients (grade B) and no efficiency in 1 patient (grade C). The 2 patients in grade B had a vertigo again in 9 months and 11 months after intratympanic perfusion, respectively, while the frequency, severity and duration of their vertigo softened obviously. Puretone threshold average (PTA) at the affected frequencies was decreased to within the level of 20 dB in one patient and was improved more than 30 dB in another one (grade A), improved 15 dB to 30 dB in 4 patients (grade B), and improved less than 15 dB in the other 4 patients. The average score of THI was 48.80 +/- 7.25 and 41.9 +/- 7.78 before and after perfusion respectively. The ability capacity of all the 10 patients after treatment was as normal (grade A), i. e. All of them could lead an independent life. There was no irreversible tympanic perforation in the operated ear and there was no other complications left.@*CONCLUSION@#Intratympanic methylprednisolone perfusion through the micro-catheter is a safe and effective method for the intractable Meniere's disease.
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Female , Humans , Male , Middle Aged , Ear, Middle , Meniere Disease , Drug Therapy , Methylprednisolone , Therapeutic Uses , Retrospective Studies , Treatment OutcomeABSTRACT
Purpose To produce enzymatic hydolysates with angiotensin Ⅰ-converting enzyme (ACE) inhibitory activity and antihypertensive activity from Acetes chinensis. Methods ACE inhibitory activity of the hydrolysates of Acetes chinensis by five commercial proteases were determined in vitro to select a protease as the enzyme used in the preparation of enzymatic hydrolysate of Acetes chinensis, and orthogonal trials were employed to optimize its hydrolysis parameters, spontaneously hypertensive rats (SHR) were used to assess in vivo the hypotensive effects of hydrolysate under optimized condition. Results The hydrolysate with IC50 being0.65 mg/ml was obtained under the optimized condition of pH 2.4, 41℃, 3 h hydrolysis time, 3% enzyme/substrate ratio (E/S) and 8 % substrate concentration, and a recorded SBP reduction of 3 886.3 Pa (29mmHg) at 4 h after administration (1.0 g/kg BW) was observed. Conclusion Peptic hydrolysate of Acetes chinensis shows significant ACE inhibitory activity and antihypertensive activity.