Baseline NIHSS score and D-dimer in early prediction of large vessel occlusion in patients with acute ischemic stroke / 中华急诊医学杂志

Objective:Early identification of ischemic stroke patients with large vessel occlusion can improve referral efficiency and shorten reperfusion time. The purpose of this study was to analyze the characteristics of patients with large vessel occlusion and identify factors that could predict large vessel occlusion.Methods:The clinical data of 432 patients with ischemic stroke treated through emergency green channel were retrospectively analyzed, and the differences between the large vessel occlusion group (LVO group) and the non-large vessel occlusion group (non-LVO group) were compared, and two independent risk factors of the LVO group were screened out by logistics regression analysis: baseline NIHSS score and D-dimer value. The predicted cutoff values of NIHSS score and D-dimer were further determined by the receiver operating characteristic (ROC) curve.Results:A total of 432 patients with ischemic stroke had complete imaging data, with a mean age of 68.5±12.4 years, including 275 (63.7%) males, and 245 (56.7%) in the LVO group and 187 (43.3%) in the non-LVO group. Age, hemorrhagic transformation, thrombolytic therapy, endovascular treatment, atrial fibrillation, baseline NIHSS score [14.0 (6.0-20.0) vs. 3.0 (1.0-6.0), P<0.05], and D-dimer value at admission [0.9(0.4-2.3) mg/L vs. 0.3 (0.2-0.5)mg/L, P<0.05] were statistically significant different between the two groups. Multivariate Logistic regression analysis showed that higher baseline NIHSS score( OR=1.22,95% CI: 1.17-1.27)and higher D-dimer value( OR=3.10,95% CI: 2.14-4.47)were independent risk factors for large vessel occlusion. Baseline NIHSS score combined with D-dimer value was a good predictor of large vessel occlusion(AUC 0.85 [0.81-0.89]). ROC curve suggested that NIHSS score >6.5 and D-dimer >0.57 mg/L were the cutoff values for predicting large vessel occlusion. Conclusions:Higher baseline NIHSS score and D-dimer value are valuable for early prediction of large vessel occlusion, patients with NIHSS score >6.5 points and D-dimer >0.57 mg/L should be promptly transported to an advanced stroke center for treatment.

The early toxic effect sensitive index of short-term-repeated exposure to cadmium chloride in male rats / 中国职业医学

OBJECTIVE: To observe the early adverse effect index caused by short-term-repeated exposure to cadmium chloride via oral perfusion in male rats. METHODS: Forty specific pathogen free healthy male SD rats were randomly divided into four groups: control group,low-,middle-and high-dose groups. The rats of low-,middle-and high-dose groups were treated with cadmium chloride 1. 11,3. 51 and 11. 06 mg/kg body weight,respectively,and the control group rats was treated with the same volume of ultra pure water,by gavage once a day for four weeks. During the experimental duration,the body weights of the rats were taken and activity status of the rats was observed. After the experiment,the rats were executed,and some indicators of main organ coefficients,blood routine,serum biochemical indexes,urine related effect indexes and bone mineral density were measured. RESULTS: During the experimental duration,rats of high-dose group showed the symptoms such as decreased activity,increase repose,move slowly and skin duller. Comparing with control group at the same time points,the body masses of the high-dose group of the 1-4 weeks were lower(P < 0. 05).After the experiment,comparing with control group,the weights of kidney and spleen of the high-dose group decreased significantly(P < 0. 05) and the liver coefficient increased significantly(P < 0. 05). The cadmium levels in blood,urine,liver,kidney and thighbone of the middle-and high-dose groups were higher than those of the control group(P < 0. 05).The red blood cell counts of the low-and middle-dose groups increased significantly(P < 0. 05). The level of hemoglobin of middle-and high-dose groups decreased(P < 0. 05),and the activity of alanine aminotransferase in high-dose groups increased significantly(P < 0. 05). Comparing with control group,the levels of urine α_1-microglobulin and urine β_2-microglobulin in urine of the middle-dose group were decreased(P < 0. 05) and the level of urine urea nitrogen increased(P < 0. 05),but there were no significantly changes of the above three indexes in the high-dose group(P >0. 05). There were no significant difference of the levels of N-acetyl-beta-D glucosaminidase in urine between control and treatment groups(P > 0. 05). Simultaneously,in high-dose group,the weight of thighbone,the bone calcium content and bone mineral density reduced significantly than those of the control group(P < 0. 05). CONCLUSION: Skeletal effects can be used as an early toxic effect sensitive index of short-term-repeated experiments exposure to cadmium chloride via oral perfusion in male rats.

Research progress on neuroprotective effects of vitexin and its mechanisms / 中国药理学通报

Vitexin, a natural flavonoid compound, has extensive pharmacological activity. In recent years, many studies have re-vealed that vitexin has significant protective effects on central nervous system and peripheral nervous system, including anti-memory impairment, anti-epilepsy, anti-ischemic hypoxic brain damage, anti-depression, analgesia, etc. Vitexin exerts neuro-protective effects through the mechanisms of multiple pathways and multi-targets, such as reducing free radical level, inhibiting neuronal apoptosis, modulating inflammatory factors and related pathways, and regulating neurotransmitters and related recep-tors. This review mainly discusses the neuroprotective effects of vitexin and its underlying mechanisms.

Application of brachial-ankle pulse wave velocity in arteriosclerosis detection in elderly population / 中华老年医学杂志

Objective To analyze the distribution characteristics and influencing factors of brachial-ankle pulse wave velocity (baPWV) in elderly population in order to direct the early diagnosis and prevention of arteriosclerosis in the elderly.Methods A total of 927 cases of elderly residents were randomly selected from 19 villages in Shengze area,Jiangsu Province.The indexes such as age,gender,height,weight,waist circumference,hip circumference and blood pressure were collected through standardized questionnaire and physical examination.The biochemical indicators including serum bilirubin,creatinine,uric acid,fasting blood glucose and blood lipids were measured,and baPWV was tested by automatic arteriosclerosis measurement system.Results The differences in age,systolic blood pressure,heart rate,serum bilirubin,creatinine,uric acid,triglycerides levels and baPWV were statistically significant between the male and female (all P＜0.05).BaPWV rised with the increase of age.Overall,baPWV was faster in the female than in male (P＜0.01).Blood pressure (r=0.36,0.59,P＜0.001),age (r=0.26,0.30,P＜0.001) and heart rate (r=0.30,0.33,P＜ 0.001) were correlated with baPWV,while uric acid had a correlation with baPWV (r=0.12,0.21,P＜0.01).A correlation was found between total cholesterol and baPWV (r=0.09,0.11,P＜0.05) Multi-variable linear stepwise regression analysis showed that systolic blood pressure,heart rate and age were the influencing factors for baPWV,of which systolic blood pressure had the greatest influence on baPWV (β＞0.5,P＜0.001).Conclusions With the increase of age,the baPWV shows rising trend.The monitor of baPWV may be useful in the elderly,especially in females.Blood pressure control,especially the control of systolic blood pressure can slow the progression of atherosclerosis.

Retrospective Analysis on Implement Effect of Traditional Chinese Medicine Clinical Pathway for Wind-warm Lung-heat Disease (Non-severe Community-acquired Pneumonia) / 世界科学技术-中医药现代化

This study was aimed to evaluate the feasibility of wind-warm lung-heat disease (non-severe community-acquired pneumonia, CAP) from the clinical curative effect, hospitalization days, medical expenses and other aspects. This study selected 198 wind-warm lung-heat disease (non-severe CAP) inpatients from January, 2012 to December, 2012 with the conventional therapy in the Respiratory Department, Wuhan Integrated Traditional Chinese Medicine (TCM) & Western Medicine Hospital as the control group. And another 179 wind-warm lung-heat disease (non-severe CAP) inpatients were selected from January, 2013 to December, 2013 with the TCM clinical pathway treatment in the Respiratory Department of the same hospital as the treatment group. Retrospective analysis was used to compare the clinical curative effects, hospitalization days, and medical cost differences. The results showed that TCM clinical pathway for wind-warm lung-heat disease (non-severe CAP) can shorten the hospitalization days and reduce patients’ medical costs, and ensure the clinical curative effects. It was concluded that the standardized TCM clinical pathway had positive effect on wind-warm lung-heat disease (non-severe CAP). Therefore, the formulation and implementation of TCM clinical pathway was of great significance in the treatment of wind-warm lung-heat disease (non-severe CAP).

SDF-1/CXCR4 axis modulates bone marrow mesenchymal stem cell apoptosis, migration and cytokine secretion

Bone marrow mesenchymal stem cells (MSCs) are considered as a promising cell source to treat the acute myocardial infarction. However, over 90% of the stem cells usually die in the first three days of transplantation. Survival potential, migration ability and paracrine capacity have been considered as the most important three factors for cell transplantation in the ischemic cardiac treatment. We hypothesized that stromal-derived factor-1 (SDF-1)/CXCR4 axis plays a critical role in the regulation of these processes. In this study, apoptosis was induced by exposure of MSCs to H(2)O(2) for 2 h. After re-oxygenation, the SDF-1 pretreated MSCs demonstrated a significant increase in survival and proliferation. SDF-1 pretreatment also enhanced the migration and increased the secretion of pro-survival and angiogenic cytokines including basic fibroblast growth factor and vascular endothelial growth factor. Western blot and RT-PCR demonstrated that SDF-1 pretreatment significantly activated the pro-survival Akt and Erk signaling pathways and up-regulated Bcl-2/Bax ratio. These protective effects were partially inhibited by AMD3100, an antagonist of CXCR4.We conclude that the SDF-1/CXCR4 axis is critical for MSC survival, migration and cytokine secretion.

Changes in the drug resistance of E.coli induced by fluoroquinolones in vitro / 医学研究生学报

Objective:The drug resistance of E.coli to fluoroquinolones is getting stronger in the recent years.This study aimed at the drug resistance of E.coli induced by fluoroquinolones in vitro,so as to provide a guidance for the rational use of antibiotics and effective control of nosocomial infections.Methods: Drug resistance was induced in vitro by a multi-step method in 10 strains of E.coli from clinical isolates with Ciprofloxacin,Levofloxacin and Gatifloxacin.The minimal inhibition concentration(MIC) of the E.coli was determined by the agar dilution method before and after the induction.Results: After in vitro induction,the E.coli acquired a high resistance(MIC ≥ 128 ?g/ml).And one drug could induce different degrees of resistance to the other two.Conclusion: The MIC of the E.coli induced by fluoroquinolones in vitro was increased by 8 to 8 205 folds compared with that before induction,which demonstrated a gradually developed resistance of E.coli strains to fluoroquinolones.