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Objective:To investigate the effect of infliximab (IFX) on neurological function in mice after traumatic brain injury (TBI) and the role of nuclear factor-κB (NF-κB)/inducible nitric oxide lyase (iNOS) signaling in it.Methods:Seventy-two healthy adult male C57BL/6 mice were randomly divided into sham-operated group, TBI group, and TBI+IFX group ( n=24). The mouse TBI models were established by controlled cortical impact method. IFX (dissolved in normal saline at a concentration of 2.5 mg/mL and a dose of 10 μg/g) was administered intraperitoneally into the mice of TBI+IFX group 30 min after modeling once daily for 3 d; mice in the sham-operated group and TBI group were given the same amount of saline intraperitoneally at the same time points for 3 d. Neurological deficits (Garcia scores) were assessed one, 3 and 7 d after modeling; blood-brain barrier permeability was detected by Evans blue staining, and brain tissue water content was measured by dry and wet weight method; Nissl staining was used to detect the percentage of injured neurons in brain tissues; the percentage of apoptotic neurons was detected by Tunel staining; immunofluorescent double-labeling was used to detect the expressions of caspase-3 and neuronal nuclear antigen (NeuN) in neurons; immunohistochemical staining was used to detect the microglia marker ionized calcium binding adaptor molecule-1 (IBa-1) expression; ELISA was used to detect the expressions of inflammatory factors (tumor necrosis factor [TNF]-α, interleukin [IL]-1β, IL-6, interferon [IFN]-γ) and free radicals (oxygen free radicals [ROS], nitrogen free radicals [RNS]) in the brain tissues; and immunofluorescent staining and Western blotting were used to detect the expressions of nuclear factor (NF)-κB/inducible nitric oxide synthase (iNOS). Results:(1) One, 3 and 7 d after modeling, the Garcia scores showed significant differences among the three groups ( P<0.05); as compared with the TBI group, the TBI+IFX group had significantly increased Garcia scores 3 and 7 d after modeling ( P<0.05). (2) Three d after modeling, as compared with those in the TBI group, Evans blue leakage ([18.45±1.32] μg/g vs. [16.38±1.25] μg/g), brain water content ([81.56±0.96]% vs. [79.97±0.79]%), percentage of injured neurons ([79.50±5.85]% vs. [68.81±7.47]%), and percentage of apoptotic neurons ([41.93±7.49]% vs. [30.59±8.60]%) in mice of the TBI+IFX group were significantly deceased ( P<0.05). Three d after modeling, immunofluorescent double labeling showed that the relative caspase-3 expression in the TBI+IFX group (0.76±0.16) was significantly decreased as compared with the TBI group (1.11±0.23, P<0.05). Immunohistochemical staining and ELISA results showed that as compared with those in the TBI group, the Iba-1 staining scores, TNF-α, IL-1β, IL6 and IFN-γ levels, and ROS and RNS contents in TBI+IFX group were significantly decreased ( P<0.05). Immunofluorescent staining and Western blotting showed that as compared with the TBI group, the TBI+IFX group had significantly decreased expressions of NF-κB p65, iNOS and phosphorylated nuclear factor-κB inhibitor-α, and statistically inhibited nuclear translocation of NF-κB ( P<0.05). Conclusion:IFX can reduce inflammatory response and oxidative stress response, and play a neuroprotective role, which is related to its inhibition of downstream NF-κB/iNOS pathway activation.
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Objective To evaluate carotid sinus block (CAS) in preventing the low hemodynamic state in the perioperative period of carotid artery stenting (CAS).Method A prospective single-center randomized controlled study was conducted on 172 patients with internal carotid artery stenosis receiving CAS from May 2015 to May 2018.Patients were randomly divided into group A treated with local anesthesia of the carotid artery sinus of the trouble side under the guidance of ultrasound preoperatively and group B without local block anesthesia.The carotid artery stenosis rate,the maximum intraoperative reduction of blood pressure and heart rate,the use of atropine and vasopressor were monitored and compared between the two groups.Results There were no significant differences between the two groups in preoperative general data,degree of stenosis,plaque nature,degree of residual stenosis (P ＞ 0.05).The maximum reduction of intraoperative blood pressure and heart rate in group A was significantly lower than that in group B,and the number and dose of intraoperative atropine were smaller than those in group B (P ＜ 0.05).The number of postoperative patients with low hemodynamic status in group A and the time period of vasopressor use were significantly less than those in group B (P ＜ 0.05).Conclusion Preoperative carotid sinus block anesthesia is safe and effective in preventing low hemodynamic status in perioperative period of CAS.
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Rathke's Cleft Cyst is a common benign pituitary lesion.Its common clinical signs include headache,visual disturbance and pituitary dysfunction.Progressive cysts can be found in some cases,and diabetes insipidus in a few.MRI is the most valuable imageological examination for these lesions.Transsphenoidal surgery is suitable for a proportion of the patients while follow-up observation is proper for most of the patients.
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Objective To evaluate the performance of automated blood cell analysis parameters for differential diagnosis of myelodysplastic syndromes (MDS) and aplastic anemia (AA).Methods Data of automatic blood cell analysis parameters at diagnosis of confirmed patients with MDS and AA from December 2002 to February 2011 in Peking University Shenzhen Hospital were retrospectively reviewed.Results 33 cases of MDS and 36 cases of AA were recruited in this study.Based on the evaluable data,mean corpuscular hemoglobin concentration (MCHC) (328.58 ± 17.24 g/L vs 342.47±18.75 g/L,n=33/36) was significantly lower (P=0.002 1),while monocyte percentage (MONO％) (11.48±9.99 vs 6.94±2.50,n=32/34),platelet distribution width (PDW％) (13.51±4.24 vs 10.62±3.68,n=20/22) and platelet hematocrit (PCT％)(0.11 ±0.10 vs 0.04±0.07,n=11/15) were markedly higer (all P＜0.05) in patients with MDS than that of AA.No significantly differences for other blood cell analysis parameters were seen between patients with MDS and AA.Under the condition of best cut-off value,areas under the ROC curve of MCHC,MONO％,PDW and PCT were 0.706 (95％ confidence interval:0.584～0.809),0.666 (0.540～0.778),0.668 (0.506～0.805) and 0.745 (0.538～0.894) respectively.MONO％ and MCHC had high specificities (97.06％ and 88.89％) and positive predictive values (93.3％ and 80.0％) for differential diagnosis of MDS from AA.Conclusion MONO％ and MCHC may be used as simple indicators for differential diagnosis of MDS and AA.
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<p><b>OBJECTIVE</b>To establish the median of serum markers for second trimester screening in Qingdao region and to assess the influence of median correction on the performance of screening.</p><p><b>METHODS</b>Maternal serum alpha-fetoproteins (AFP), human chorionic gonadotrophin, free beta subunit (β -HCG) and unconjugated oestriol (uE3) were assayed for prenatal screening of 18 188 singleton pregnancies at 15-20(+ 6) weeks gestation from January 2009 to July 2010. The median of serum markers was calculated based on above results and applied for risk estimation in screening for fetal aneuploidy from August 2010 to March 2011. The screening performance, specified in terms of detection rates (DRs), false positive rates (FPRs) and odds of being affected given a positive result (OAPR) were compared between the two groups. The risks of 45 affected pregnancies detected during the study were estimated with both Caucasian and corrected medians.</p><p><b>RESULTS</b>The average level of AFP in local pregnancies was similar to that of the Caucasian population, whilst β -HCG and uE3 were respectively 11% and 33% higher than those of Caucasians. The multiple of median (MoM) value was between 0.94 and 1.02 for the dataset based on the corrected median. At a cut-off of l in 270, FPR has decreased from 5.2% to 4.9%, and DR of Down syndrome has increased from 60% to 69.2%, and OAPR has increased from 1:79 to 1:59 when evaluating risk based on the corrected median. For the 45 affected pregnancies, three Down syndrome pregnancies could be missed because their risk estimates were lower than the cut-off level based on Caucasian median.</p><p><b>CONCLUSION</b>It is useful to establish and apply population and laboratory-specific medians in order to improve the performance of prenatal screening and diagnosis.</p>