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Objective To compare the predictive value of 5 scoring systems for hemorrhagic transformation risk after intravenous thrombolysis in patients with acute ischemic stroke (AIS) in different therapeutic windows.Methods A single-center and retrospective study was performed for 243 AIS patients who underwent intravenous thrombolysis using recombinant tissue plasminogen activator (rt-PA) in different therapeutic windows in our department during January 2014 and December 2016.Five scoring systems,including HAT model (hemorrhage after thrombolysis),MSS model (multicenter stoker survey),GRASPS model (glucose at presentation,race,age,sex,systolic blood pressure at presentation,severity of stroke at presentation),SEDAN model (baseline blood sugar,early infarct signs,hyperdense cerebral artery sign on admission CT,age,NIHSS on admission),and SITS model (safe implementation of thrombolysis in strokemonitoring study) were used to evaluate the risks for hemorrhagic transformation.The relationships between the 5 scoring systems and incidence rate of hemorrhagic transformation were analyzed among the patients in different therapeutic windows.The predictive values of the 5 scoring systems were compared using the areas (AUC) under the receiver operating characteristic (ROC) curve.Results When the AIS patients were treated by intravenous thrombolysis within 3 h,the AUC of GRASPS and HAT models were 0.698 and 0.619,respectively,higher than those of the other 3 systems.When the therapeutic window was between 3 to 4.5 h,HAT model and SEDAN model had highest AUC (0.719,0.744) than the other 3 systems (P ＜0.05).When the windows were ＞4.5 ～6 h,the HAT model had the highest AUC (0.676).Conclusion The 5 scoring systems show better predictive value for hemorrhagic transformation after intravenous thrombolysis.For the therapeutic window within 4.5 h,HAT model presents best predictive value than the other 4 scoring systems.
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Objective To observe microstructural changes of white matter in Alzheimer's disease (AD),and to find out the relationship between white matters lesion and declined cognition.Methods Twenty-four AD patients and 24 controls with normal cognition performed diffusion tensor imaging MR scan.Tract-based spatial statistical analysis (TBSS) was used to investigate microstructural change of white matter,and then its correlation with Mini-Mental State Examination (MMSE) scores was analyzed.Results Fractional anisotropy (FA) values were decreased in corpus callosum,fornix,left corticospinal tract,bilateral cerebral peduncle,superior cerebellar peduncle,internal capsule,corona radiata,posterior thalamic radiation,sagittal stratum including inferior longitidinal fasciculus and inferior fronto-occipital fasciculus,external capsule,cingulate gyrns,hippocampus,superior longitudinal fasciculus and uncinate fasciculus,while mean diffusivity (MD) values were increased in fornix,left hippocampus,bilateral internal capsule,corona radiata,posterior thalamic radiation,sagittal stratum including inferior longitidinal fasciculus and inferior fronto-occipital fasciculus,external capsule,cingulate gyrus,superior longitudinal fasciculus,superior fronto-occipital fasciculus and uncinate fasciculus (all P ＜ 0.05,threshold-free cluster enhancement corrected).MMSE scores had a positive correlation with decreased FA values of left sagittal stratum (r =0.535,P =0.007) and negative correlations with increased MD values of left sagittal stratum (r =-0.427,P =0.037),left superior longitudinal fasciculus (r =-0.424,P =0.039) and left uncinate fasciculus (r =-0.505,P =0.012).Conclusions There exist widespread white matter lesions in AD with impairment of white matter connections of intra-and inter-hemispheres.Impaired white matters in left hemisphere may have close relationships with cognition decline.
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Primary biliary cirrhosis (PBC) is an autoimmune liver disease characterized by chronic and progressive cholestasis, which has a tendency to develop cirrhosis. The pathogenesis of PBC is complicated and still unclear. This paper reviews the latest research progress in immunological mechanisms and therapies for PBC in recent years, which focuses on the relationship between the development of PBC and autoantibodies, immune cells, and important cytokines. The review indicates that immunological factors play a key role in pathogenesis of PBC, and further research on immunological mechanisms might be quite important for the identification of pathogenesis and clinical treatment of PBC.
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Objective To investigate the imaging changeof cerebral ischemireperfusion injury (CIRI) afteinterventional therapy in acute middle cerebral artery occlusion .Method32 patientwith acute middle cerebral artery occlusion in ouhospital from January 2013 to Novembe2014 were selected .16 casewere performed the recanalization therapy aftearterial thrombolysiand/omechanical thrombectomy(recanalization group) and 16 casewere notreated by thrombolytitherapy (non-recanalization group) .The differenceof brain imaging changes(onse,on 3 ,7 d afteonset) were analyzed and compared between the two group. ResultThe proportion of lateral ventricle compression degree and the shifdegree of brain midline on 3 d afteonsein the reca-nalization group were greatethan those in the non-recanalization group ,the differencebetween the two groupwere statistically significant[0 .50 ± 0 .11 v.0 .58 ± 0 .10 ,0 .57(0 .18 ,0 .83)cm v.0 .22(0 ,0 .57)cm ,P＜0 .05] ,while which on 7 d of onsein the recanalization group were lesthan those in the non-recanalization group[0 .80 ± 0 .11 v.0 .55 ± 0 .12 ,0(0 ,0 .13) v.0 .46(0 , 0 .88)cm ,P＜0 .055] .Conclusion Although the interventional therapy ian importanmeasure foearly treatmenof ischemistroke ,buiaggravatethe early brain edem,therefore CIRI induced by the interventional therapy should be paid more attention to.
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Objective To investigate the effect of gemcitabine on the cell cycle and apoptosis of the human pancreatic cancer cell line MiaPaCa-2 with Beclinl gene silencing.Methods siRNA targeting at Beclinl gene was constructed,then it was inserted into an expression vector and transfected into MiaPaCa-2 cells.The Beclinl mRNA and protein expression were detected by RT-PCR and Western blot.Gemcitabine was used to treat MiaPaCa-2 with Beclinl gene silencing,then the cell cycle and apoptosis were detected by flow cytometry.Results The MiaPaCa-2 cells with Beclinl gene silencing were successfully constructed,and the expression of Beclin1 mRNA was decreased from 1.0 in control group to 0.295,and number of cells in S and G2 phase was decreased,but number of cells in G1 phase was increased,and there was no change in apoptosis.After gemcitabine treatment,number of cells in S phase was further decreased,but number of cells in G1,G2 phase was increased,and apoptosis was inhibited.Conclusions Beclinl gene silencing can change the cell cycle of pancreatic cancer cells MiaPaCa-2,and influence the effects of gemcitabine on cell cycle and apoptosis.
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Objective To discuss the relationship between matrix metalloproteinases 9 (MMP-9) and the pathogenesis of preeclampsia , birth weight and placental weight , through detecting the expression of MMPS-9 in the placenta of the patients with preeclampsia. Methods The levels of MMP-9 in the placenta were detected by immunohistochemical SP method in 60 patients with preeclampsia and 30 pregnancy women. Results (1) The optical density value of MMP-9 in preeclampsia group was lower than the control group , the optical density value of MMP-9 in SPE group was lower than the MPE group (P < 0.05). (2) The placenta weight and birth weight in preeclampsia group were lower than the control group , the placenta weight and birth weight in SPE group was lower than the MPE group (P < 0.05). (3) The expression level of MMP-9 were positively correlated with placental weight and birth weight (P < 0.05) in the control group. (4) The average optical density value of MMP-9 in neonatus with weight < 2 500 g was lower than neonatus with weight≥2 500 g (P < 0.05). Conclusion The MMP-9 in the placenta of patients with preeclampsia was down-regulated , and its expression was abate when the illness grew worse. The MMP-9 may be involved in the pathogenesis of preeclampsia , and it is associated with fetal growth restriction.