Changes of D-dimer, cTnI and VIS after Stanford type A aortic dissection and their predictive effect on death outcome / 中国医师杂志

Objective:To investigate the change of D-Dimer (D-D), cardiac troponin I (cTnI) and vasoactive-inotropic score (VIS) after Stanford type A aortic dissection (TAAD) and thier predictive effect on death outcome.Methods:120 patients with TAAD who were treated in the Affiliated Hospital of Jining Medical College from January 2019 to January 2022 were retrospectively selected and divided into death group ( n=17) and survival group ( n=103) according to the 28-day survival after operation. The difference of clinical data between the two groups was compared, and the influencing factors of postoperative death in TAAD patients were analyzed by logistic regression method. Results:The age, deep hypothermic circulatory arrest time, D-D and cTnI of the patients in the death group were (60.50±5.42)years old, (30.40±9.92)min, (15.65±5.52)g/L and (3.32±0.82)mg/L, respectively, which were significantly higher than those in the survival group (all P<0.05). The VIS score and change of VIS score in the death group at 24 hours after operation were (9.66±1.10)points and (4.50±0.91)points respectively, which were significantly higher than those in the survival group (all P<0.05). Logistic regression analysis showed that age, D-D, cTnI and change of VIS score were the influencing factors of death after TAAD (all P<0.05). The area under the receiver operating characteristic (ROC) curve predicted by the D-D, cTnI and change of VIS score for death in TAAD patients was 0.718, 0.691 and 0.789 respectively (all P<0.05). Conclusions:Postoperative death of TAAD patients is affected by their age, D-D, cTnI and change of VIS score. The D-D, cTnI and change of VIS score have certain application value in predicting postoperative death of patients.

Efficacy of laminoplasty and bone graft in the treatment of multilevel intraspinal tumor / 国际外科学杂志

Objective To investigate the clinical effect of laminoplasty technique with bone grafting in the treatment of multiple segmental intraspinal tumors.Methods Retrospectively review the clinical data of 35 patients suffering multiple segmental intraspinal tumors,who underwent the laminoplasty with bone grafting for intraspinal tumor resection in Department of Neurosurgery,Clinical Medical College of Yangzhou University,from June 2013 to May 2016.Observation indicators:(1) surgical and postoperative recovery situations,including tumor resection,number of lamina reset,tumor pathological results,clinical efficacy evaluation,complications,etc;(2) follow-up situations,including spinal stability evaluation,rate of bone graft fusion,tumor recurrence.Follow-up using outpatient examination and telephone interview was performed by the end of December 2017.Results (1) Surgical and postoperative recovery situations:of the 35 patients,31 achieved total tumor resection,3 subtotal tumor resection and 1 partial tumor resection.There were no spinal dura mater injuries when laminectomy was performed,and 84 laminae were repositioned and implanted.The neurological function of the spinal cord was evaluated based on McCormick scoring system:32 cases were improved and 3 cases were controlled.Incision healing was bad in 2 patients,and cerebrospinal fluid leakage occurred in 1 case,which all recovered after treatment.(2) Follow-up situations:all the 35 patients were followed up for 8 to 36 months,with a median time of 14.2 months.Imaging examination more than 6 months after operation:no spinal instability was found in standing spine X-ray examination;CT scan showed a total of 142 sides in the 84 vertebral plates (168 sides) had achieved bone fusion,the fusion rate was 84.5％,and no titanium nail removal and connecting piece shift was found;MRI showed no tumor recurrence in all patients.Conclusion Use of the laminoplasty technique with bone grafting in the treatment of multiple segmental intraspinal tumors can achieve good clinical efficacy,high fusion rate for resected laminae and satisfactory spinal stability.

Effects of apigenin on self-renewal and uPAR expression in NCI-H446 cell line / 中南大学学报(医学版)

To investigate the effect of apigenin on self-renewal for sphere-forming cells in human small cell lung cancer cell line NCI-H446 and the underlying mechanisms.
 Methods: Sphere-forming cells from NCI-H446 cell line were cultured in stem cell-conditioned culture medium with ultra-low attachment surface plates. The rate of sphere-forming cells in the second passage sphere-forming cells was used to evaluate the inhibitory effects of apigenin on the self-renewal for sphere-forming cells. The protein level of urokinase-type plasminogen activator receptor (uPAR) in spheroids was analyzed by Western blot.
 Results: Apigenin signifcantly inhibited the self-renewal of the second passage sphere-forming cells [0, 5.0, 10.0, 20.0 μmol/L apigenin: (18.2±1.9)%, (13.6±1.7)%, (10.6±1.6)%, (6.9±1.3)%, respectively] and down-regulated uPAR expression in a concentration-dependent manner (P<0.05).
 Conclusion: Apigenin inhibits the self-renewal capacity of sphere-forming cells in NCI-H446 cells, which may be associated with down-regulation of uPAR expression.

Analysis of clinical phenotype and genetic mutations of a pedigree of familial hemophagocytic lymphohistiocytosis / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To analyze mutations in a pedigree of familial hemophagocytic lymphohistiocytosis (FHLH) from Sichuan and provide genetic counseling for the family.</p><p><b>METHODS</b>Clinical data of a case with FHLH diagnosed at West China Second Hospital was retrospectively analyzed. Genomic DNA was extracted from peripheral blood samples of the proband and his family members. Eight candidate genes for primary HLH were amplified with PCR and analyzed by direct sequencing.</p><p><b>RESULTS</b>The proband was diagnosed as HLH based on clinical manifestations of recurrent fever for 2 months, hepatosplenomegaly, lymphadenopathy, pancytopenia, hyperferritinemia, and decreased fibrinogen and hemophagocytosis in bone marrow. Genetic testing for primary HLH was carried out considering the relapse of illness after hormone therapy for 8 weeks and the family history. The results of gene sequencing showed that the proband has carried compound heterozygous mutations in PRF1 gene (c.1349C> T in exon 3 and c.445G> A in exon 2). His father has carried a heterozygous mutation (c.445G> A in exon 2) and nonsense mutation (c.900C> T in exon 3), and his mother carried a heterozygous mutation (c.1349C> T in exon 3). Both c.1349C> T and c.445G> A have been previously reported as pathogenic mutations.</p><p><b>CONCLUSION</b>The family has been diagnosed as familial HLH type 2 based on clinical and laboratory examinations and molecular genetic testing. Gene sequencing has indicated that is was a recessive type familial HLH.</p>