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Objective:To explore the predictive value of thrombomodulin (TM) for venous thromboembolism (VTE) in patients with lung cancer.Methods:The clinical data of 356 patients with lung cancer from March 2020 to March 2021 in Honghu People′s Hospital were retrospectively analyzed. Among them, 71 cases were diagnosed as VTE (VTE group) and 285 cases without VTE (non-VTE group). The D-Dimer (DD), fibrinogen degradation product (FDP), prothrombin time (PT), activated partial prothrombin time (APTT), thrombin time (TT) and TM were detected. Multivariate Logistic regression analysis was used to analyze the independent risk factors of VTE in patients with lung cancer, and the receiver operating characteristic (ROC) curve was used to analyze the predictive value of TM for VTE in patients with lung cancer.Results:There were no statistical differences in FDP, PT, APTT and TT between 2 groups ( P>0.05); the TM and DD in VTE group were significantly higher than those in non-VTE group: (11.61 ± 3.22) U/L vs. (7.70 ± 2.59) U/L and (5.42 ± 2.15) mg/L vs. (2.57 ± 0.96) mg/L, and there were statistical differences ( P<0.01). Multivariate Logistic regression analysis results showed that TM and DD were independent risk factors for VTE in patients with lung cancer ( OR = 0.27 and 0.66, 95% CI 0.19 to 0.39 and 0.56 to 0.78, P<0.01). ROC curve analysis result showed that the areas under curve of TM and DD for prediction VTE in patients with lung cancer were 0.830 and 0.892 (95% CI 0.772 to 0.889 and 0.842 to 0.941), and there was no statistical difference ( Z = 1.617, P>0.05); the optimum cut off values of TM and DD were 9.39 U/L and 3.83 mg/L, the sensitivity was 77.46% and 76.06%, and the specificity was 73.33% and 91.58%. Conclusions:The TM can be used as prediction index for VTE in patients with lung cancer.
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Objective:To clarify the pathogenicity and further explore the association between genotype and clinical phenotype of this variant, analyzing a novel variation of SPAST gene in hereditary spastic paraplegia (HSP) family from Changzhi city, Shanxi Province.Methods:A family with HSP was tracked and collected in Neurology Department of Heping Hospital Affiliated to Changzhi Medical College in October 2019. Peripheral venous blood of 2 ml was extracted from the proband and 8 other members of the family, genomic DNA was extracted from the blood samples, and the genes of spastic paraplegia were screened by next-generation sequencing (NGS). HGMD, 1000G, OMIM databases and PolyPhen2, SIFT and other software were used for bioinformatics analysis of suspected mutations. Multiplex ligation-dependent probe amplification (MLPA) was used to further screen for total deletions/duplications in patients who remained negative after targeting NGS, and Sanger sequencing was performed to verify the suspected pathogenic mutation sites in the family to determine co-isolation of the mutation sites in the family members. Finally, it is necessary to refer to the latest version of The American College of Medical Genetics and Genomics (ACMG) sequence variation interpretation guidelines to interpret the mutation sites to determine pathogenicity.Results:The HSP family consist 47 members of 4 generations and 10 patients, with onset ages ranging from 2 to 44 years. The proband′s daughter only showed positive bilateral Babbitt signs on physical examination, and the rest of the patients showed spasticity and weakness of lower limbs with varying severity on this basis. Preliminary screening by next-generation sequencing technology showed that the proband had frame-shift variation of SPAST gene c.1057_1058insCC (p.Leu354HisfsTer11) and missense variation of DCTN1 gene c.2213A>G (p.Gln738Arg). Then, Sanger sequencing was used for in-family verification, which showed SPAST gene c.1057_1058insCC (p.Leu354HisfsTer11) was detected in the affected members include father, brother, son and daughter, and not detected in the unaffected normal members, the proband′s wife, mother, sister and sister-in-law. However, the unaffected of mother detected missense variation of DCTN1 gene c.2213A>G (p.Gln738Arg), while the remaining members did not detect this variation. The results of MLPA showed that no large fragment variation was found.Conclusions:The genetic pattern of the HSP family was autosomal dominant, and the clinical characteristics were consistent with hereditary spastic paraplegia type 4 (SPG4). Co-segregation of SPAST gene c.1057_1058insCC (p.Leu354HisfsTer11) was found in the HSP family and was the pathogenicity cause of this SPG4 family, and it was a newly discovered mutation locus.
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Patients with mild stroke and transient ischemic attack (TIA) have a high risk of early recurrence or deterioration. Antiplatelet therapy has been recognized to reduce the risk of ischemic vascular events. All guidelines recommend antiplatelet therapy for patients with ischemic stroke. Dual antiplatelet therapy (DAPT) refers to the application of two drugs with different mechanisms to block platelet aggregation and prevent thrombosis. There are many combinations of DAPT, and its safety and effectiveness are still uncertain. This article reviews the efficacy and safety of DAPT in patients with mild stroke and TIA.
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Dihydroflavanol-4-reductase (Dfr) is a key enzyme that regulates the synthesis of anthocyanin and proanthocyanidin in the flavonoid biosynthesis pathway. To investigate the difference of dfr gene in Scutellaria baicalensis Georgi with different colors in the same ecological environment, three complete full-length sequences of dfr gene were cloned from the cDNA of S. baicalensis with white, purple-red and purple colors using homologous cloning and RACE techniques. The three genes were named Sbdfr1, Sbdfr2 and Sbdfr3, respectively, and their corresponding structures were analyzed. The results showed that all three Dfr proteins have highly conserved NADPH binding sites and substrate-specific binding sites. Phylogenetic analysis showed that they are closely related to that of the known S. viscidula (ACV49882.1). Analysis of key structural domains and 3D models revealed differences in the catalytically active regions on the surface of all three Dfr proteins, and their unique structural characteristics may provide favorable conditions for studying the substrate specificity of different Dfr proteins. qRT-PCR analysis shows that dfr was expressed at different level in all tissues except the roots of S. baicalensis in full-bloom. During floral development, the expression level of dfr in white and purple-flowered Scutellaria showed an overall upward trend. In purple-red-flowered Scutellaria, the expression first slowly increased, followed by a decrease, and then rapidly increased to the maximum. This research provides a theoretical basis for further exploring the mechanism and function of Dfr substrate selectivity, and are of great scientific value for elucidating the molecular mechanism of floral color variation in S. baicalensis.
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Anthocyanins , Cloning, Molecular , Color , Phylogeny , Scutellaria baicalensis/geneticsABSTRACT
Objective:To investigate the predictive value of plasma myeloperoxidase (MPO) level for malignant arrhythmia (MA) in elderly patients with valvular heart disease.Methods:The clinical data of 92 elderly patients with valvular heart disease (valvular heart disease group) who underwent valve replacement surgery in Honghu People ′s Hospital in Hubei Province from May 2019 to May 2020 were retrospectively analyzed. The plasma MPO and serum N-terminal brain natriuretic peptide (NT-proBNP), lipoprotein a were detected and compared with those of 60 healthy examination people (healthy control group) during the same period. The independent risk factors of MA in elderly patients with valvular heart disease were analyzed by multivariate Logistic regression analysis method. Predictive value of MPO, NT-proBNP and lipoprotein a for MA in elderly patients with valvular heart disease were analyzed by receiver operating characteristic (ROC) curve. Results:The MPO, NT-proBNP and lipoprotein a in valvular heart disease group were significantly higher than those in healthy control group: (128.36 ± 39.25) mg/L vs. (89.16 ± 26.09) mg/L, (698.97 ± 154.65) ng/L vs. (47.95 ± 9.05) ng/L and (315.82 ± 79.96) mg/L vs. (153.37 ± 42.38) mg/L, and there were statistical differences ( P<0.01). The 92 elderly patients with valvular heart disease were followed up for 1 year. MA occurred in 36 cases (MA subgroup), and MA did not occur in 56 cases (non-MA subgroup). The MPO, NT-proBNP and lipoprotein a in MA subgroup were significantly higher than those in non-MA subgroup: (163.37 ± 29.11) mg/L vs. (105.86 ± 26.32) mg/L, (797.79 ± 113.54) ng/L vs. (635.45 ± 144.45) ng/L and (369.86 ± 45.27) mg/L vs. (281.08 ± 78.32) mg/L, and there were statistical differences ( P<0.01). Multivariate Logistic regression analysis result showed that the MPO, NT-proBNP and lipoprotein a were independent risk factors for MA in elderly patients with valvular heart disease ( OR = 0.937, 0.994 and 0.982; 95% CI 0.904 to 0.972, 0.988 to 0.999 and 0.968 to 0.996; P<0.01 or <0.05). ROC curve analysis result showed that the area under the curve of MPO for predicting MA in elderly patients with valvular heart disease was significantly greater than that of NT-proBNP and lipoprotein a (0.934 vs. 0.813 and 0.830, Z = 2.441 and 2.299, P<0.05). Conclusions:Plasma MPO is abnormally elevated in elderly patients with valvular heart disease, which has a good predictive value for the occurrence of postoperative MA in elderly patients with valvular heart disease.
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Despite the extremely high mortality and disability rates of intracerebral hemorrhage, there are currently no effective interventions to improve the outcomes. More and more research shows that statins may be a new method for treating intracerebral hemorrhage. However, there is still much controversy about the relationship between statins therapy and intracerebral hemorrhage. This article reviews the recent studies on the relationship between statins and intracerebral hemorrhage.
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Despite the extremely high mortality and disability rates of intracerebral hemorrhage,there are currently no effective interventions to improve the outcomes.More and more research shows that statins may be a new method for treating intracerebral hemorrhage.However,there is still much controversy about the relationship between statins therapy and intracerebral hemorrhage.This article reviews the recent studies on the relationship between statins and intracerebral hemorrhage.
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Objective To investigate the change rule of common coagulation indicators and platelet parameters in the patients with chronic viral hepatitis,liver cirrhosis and liver failure.Methods One hundrend and twenty patients with liver diseases in our hospital from January 2015 to June 2016 were selected and divided into chronic viral hepatitis group (46 cases),liver cirrhosis group (Child-Pugh class A,B,C,44 cases) and liver failure group (30 cases).Contemporaneous 30 persons undergoing healthy physical examination served as the healthy control group.The coagulation indicators (PT,PTA,APTT,TT, Fg,D-D) and platelet parameters (PLT,MPV,PDW, PCT) were detected in all subjects.Results Except TT,Fg and D-D had no statistical difference between the healthy control group and chronic viral hepatitis group (P>0.05),PT,APTT and TT in the chronic viral hepatitis group,liver cirrhosis group (Child-Pugh class A,B,C) and liver failure group were gradually extended,PTA and Fg were decreased and D-D value was increased,the difference in pairwise comparison was statistically significant (P<0.05).The PLT value in the chronic viral hepatitis group,liver cirrhosis group (Child-Pugh class A,B,C) and liver failure group was decreased gradually,while the MPV and PDW values were gradually increased,showing significantlystatistically significant difference (P<0.05),the PCT value in the liver cirrhosis group and liver failure group was lower than that in the chronic viral hepatitis group(P<0.05).Conclusion The regularity change of coagulation indicators and platelet parameters occurs in different periods of chronic liver disease progression,which provides some reference for clinical diagnosis,treatment and prognosis judgment.
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Increasing demand for health services brings an opportunity for the development of health service industry, and the development is based on qualified talent support from Traditional Chinese Medicine (TCM) education. This article expounded that developing health service is the realistic demand for deepening TCM education reform from the direction, number and quality of talent cultivation, and proposed the measures of deepening TCM education to train TCM health services: establish mechanism for co-ordination of supply and demand of TCM talents under the direction of market and guidance of government; form and optimize multilevel, multi-standard and multi-grade talent cultivation system; build talent evaluation mechanism and cultivation goals focusing on post competency.
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Objective To observe the effects of family cognitive training on patients with vascular cognitive impairment but without dementia.Methods Sixty patients with non-dementia type vascular cognitive impairment were divided at random into a group which received family cognitive training (30 cases) and a control group (30 cases).The 2 groups all took routine drugs and exercise.The family cognitive training group received cognitive training additionally.Before treatment and after 1 and 6 months of treatment,all of the patients of both groups were assessed using the mini-mental state examination (MMSE),the Montreal cognitive assessment (MoCA) and the modified Barthel index (MBI).Results After 1 month of treatment there was no significant difference between the 2 groups in any of the assessments.After6 months the scores on each item of the MMSE,MoCA and MBI had improved significantly more in the family cognitive training group than in the control group.Conclusion Family cognitive training is effective in treating non-dementia type vascular cognitive impairment.It can delay disease progression and improve cognitive function and ability in the activities of daily living.
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Objective To study the clinical manifestation and MRI feature of toxic encephalopathy after inhaling caffeine and sodium benzoate. Methods Three patients with toxic encephalopathy induced by inhaling caffeine and sodium benzoate were observed clinically and with MRI. Results The 3 patients were male. They all had definite addiction histories (the time of addiction for 3 years to 7 years ). There were special language and retropulsive dystonia besides the common characteristics of toxic encephalopathy:reaction retardation and disturbance of intelligence. MRI showed the change of generalized demyelination in bilateral symmetrical cerebral hemisphere, posterior limbs of internal capsule, corpus callosum, medial lemniscus, and cerebellum hemisphere dentate nucleus. The clinical symptoms of 3 patients were significantly improved 40 days after the adrenocortical steroid and neurotrophic treatment. The mild mood disorder remained in case 1. Conclusion Clinical manifestation and MRI of toxic encephalopathy after inhaling caffeine and sodium benzoate are known, so we could diagnose the patients of the disease in time.
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A retrospective study was conducted in 8 patients with reversible posterior encephalopathy syndrome to analyze the clinical and MRI findings and follow-up outcomes of the disease.The participants clinically presented with elevated blood pressure(n=8),blurred vision(n=6),severe headache(n=4),dysphofia(n=4),impaired shon-term memory(n=2),and seizure(n=6).The most important imaging finding Was vasogenic edema,which showed better prognosis.
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Serum Cardiac troponin Ⅰ (cTn Ⅰ) and lactic acid were measured in 128 neonatal patients with hypoxic-ischemic encephalopathy and 38 healthy neonates (control group). Serum cTn Ⅰ and lactic acid levels were higher in neonates with hypoxic-ischemic encephalopathy than those in healthy neonates (P < 0. 05 ); and the differences of these values were also statistically significant between the serious patients and the mild patients (P<0.05). Serum cTn Ⅰ and lactic acid are two sensitive markers for degree of myocardial injury and hypoxia in neonatal patients with hypoxic-ischemic encephalopathy.
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Objective To explore the relationship between the timing of functional training and its therapeutic effects on patients with cerebral infarction. Methods One hundred and fifty-six patients with cerebral infarction of internal carotid artery system were randomly and equally divided into three groups (groups A, B and C), and the functional training was initiated within 7d, 7～30d or over 30d after cerebral infarction in groups A, B, C, respectively. The effects were evaluated at 91d after the functional training. Results Compared with those of group C, the therapeutic effects in groups A and B were significantly better (P