Combination of High-Density Lipoprotein Cholesterol and Lipoprotein(a) as a Predictor of Collateral Circulation in Patients With Severe Unilateral Internal Carotid Artery Stenosis or Occlusion

Background@#and Purpose Collateral circulation is considered an important factor affecting the risk of stroke, but the factors that affect collateral circulation remain unclear. This study was performed to identify the factors associated with collateral circulation, especially blood lipids. @*Methods@#The study involved patients who had undergone digital subtraction angiography and were confirmed as having severe unilateral stenosis or occlusion of the internal carotid artery (ICA). We classified the collateral circulation status of each patient as good (Grade 3 or 4) or poor (Grade 0, 1, or 2) according to the grading system of the American Society of Interventional and Therapeutic Neuroradiology/American Society of Interventional Radiology. We collected data on patients’ characteristics and identified the factors that affect collateral circulation. @*Results@#This study included 212 patients. The multivariate logistic regression analysis showed that the high-density lipoprotein cholesterol (HDL-C) concentration and a complete anterior half of the circle of Willis were independent protective factors for good collateral circulation, whereas elevated lipoprotein(a) [Lp(a)] and serum creatinine concentrations were independent risk factors for good collateral circulation. The area under the receiver operating characteristics curve (AUC) was 0.68 (95% confidence interval [CI], 0.61–0.76) for HDL-C and 0.69 (95% CI, 0.62–0.76) for Lp(a). A binary logistic regression model analysis of the joint factor of HDL-C and Lp(a) yielded an AUC of 0.77 (95% CI, 0.71–0.84). @*Conclusions@#In patients with severe unilateral ICA stenosis or occlusion, the combination of HDL-C and Lp(a) is a useful predictor of collateral circulation.

Significance of cytokine imbalance in systemic onset juvenile idiopathic arthritis combined with macrophage activation syndrome / 中国医师进修杂志

Objective:To analyze cytokine pattern of systemic onset juvenile idiopathic arthritis (SOJIA) combined with macrophage activation syndrome (MAS) in children, and study the early diagnostic value in MAS.Methods:The clinical data of 157 children with SOJIA from January 2013 to March 2018 in Taizhou Hospital of Zhejiang Province were retrospectively analyzed. Among them, SOJIA combined with MAS was in 15 cases (SOJIA combined with MAS group), and simple SOJIA was in 142 cases (simple SOJIA group). The peripheral blood levels of interleukin (IL)-2, IL-4, IL-6, tumor necrosis factor (TNF)-α and interferon (IFN)-γ were measured by flow cytometry cytometric beads array. The characteristics of cytokine pattern was analyzed.Results:The IL-10 and IFN-γ in SOJIA combined with MAS group were significantly higher than those in simple SOJIA group: 40.5 (7.9, 236.9) ng/L vs. 4.1 (2.0, 98.7) ng/L and 55.8 (18.5, 500.0) ng/L vs. 4.4 (1.4, 30.1) ng/L, and there were statistical differences ( P<0.01); there were no statistical difference in IL-2, IL-4, IL-6 and TNF-α between 2 groups (P>0.05). Pearson correlation analysis result showed that IL-10 was positive correlated with IFN-γ in SOJIA children with MAS ( r = 0.638, P = 0.011). Receiver operating characteristic curve analysis result showed that the area under the curve (AUC) of IFN-γ in predicting MAS was 0.991, 95% CI 0.974 to 1.000, the optimal critical value was 18.45 ng/L, the sensitivity was 92.5%, and the specificity was 95.1%; the AUC of IL-10 in predicting MAS was 0.944 (95% CI 0.893 to 0.996), the optimal critical value was 7.75 ng/L, the sensitivity was 91.7%, and the specificity was 81.7%. Conclusions:The significant increased IL-10 and IFN-γ is helpful for the early diagnosis MAS in children with SOJIA.

Value of procalcitonin and high sensitivity C reactive protein detection in diagnosing hyperbilirubinemia premature infant complicating infection / 国际检验医学杂志

Objective To investigate the value of procalcitonin (PCT ) and high sensitive C reactive protein (Hs-CRP) in the diagnosis of hyperbilirubinemia premature infant complicating infection .Methods A total of 192 cases of hyperbilirubinemia premature infants in our hospital were selected as the research subjects and divided into the infection group and non-infection group ac-cording to the clinical diagnostic results .The levels of WBC ,Hs-CRP ,PCT and total bilirubin(TB) were measured and performed the comparative analysis .Results The Hs-CRP ,PCT and TB levels in the infection group were significantly higher than those in the non-infected group ,the difference was statistically significant (P＜0 .05);while there was no significant difference in WBC count between the two groups(P＞0 .05) .PCT had higher sensitivity and specificity than Hs-CRP in the diagnosis of infection .The positive rates of PCT and Hs-CRP in the infection group were significantly higher than those in the non-infection group ,the difference was statistically significant (P＜0 .05) .Conclusion PCT and Hs-CRP can guide the early diagnosis of hyperbilirubinemia premature infant complicating infection and are conducive to early treatment and rehabilitation of the neonatal patients .

Clinical effect of early rehabilitation nursing intervention after lumbar intervertebral disc operation / 重庆医学

Objective To study the clinical effect of early rehabilitation nursing intervention in the patients who underwent lum-bar intervertebral disc operation .Methods 80 patients with lumbar disc herniation were selected and divided them into observation group and control group randomly ,each group contains 40 patients .The control group received conventional nursing while the ob-servation group underwent early rehabilitation nursing intervention after operation .Comparison was made in respects of pain ,func-tion rebuild and clinical effect after operation between two groups .Results There was no significant difference in the preoperative Japanese Orthopaedic Association(JOA) score between two groups .The differences in postoperative JOA scores were significant from 2 weeks after operation to 1 year .The observation group has better clinical effect than that of control group .And the percent-age of back pain or leg pain ,the positive rate of straight leg raising in observation group was less than the control group in 12 months after operation .Conclusion The early rehabilitation nursing intervention can help lumbar disc operation patients recover faster ,maintain the clinical effect and prevent the postoperative complications .

Distribution and drug resistance of major pathogens for urinary tract infections / 中华临床感染病杂志

Objective To investigate the distribution and drug resistance of major pathogens for urinary tract infections in the First Affiliated Hospital of Nanjing Medical University.Methods Strains from midstream urine culture of patients with urinary tract infections were collected during January 1 and December 31,2011.All strains were identified by API system,and disk diffusion method was used for drug sensitivity test.Results Totally 1129 strains were isolated,in which 667 (59.1％ ) were Gram-negative strains,266 (23.5％) were Gram-positive strains,and 196 (17.4) were Candida.Among Gram-negative strains,Escherichia coli,Klebsiella pneumoniae and Proteus mirabilis were highly sensitive to carbapenem antibiotics; while Acinetobacter baumannii and Pseudomonas aeruginosa were highly resistant to most antibiotics including cephalosporins and penicillinase inhibitor,and the resistance rates were over 50％.Among Gram-positive strains,the major strains Enterococcus avium and Enterococcusfaecalis were completely sensitive to vancomycin and teicoplanin,and highly sensitive to linezolid (resistance rate below 10％ ).Candida albicans and Candida glabrata were highly resistant to voriconazole and fluconazole (with the resistance rates of 47.2％ - 60.0％ ), but were completely sensitive to amphotericin and nystatin.Conclusion Gram-negative strains account for most urinary tract infections in the First Affiliated Hospital of Nanjing Medical University with high drug resistance rates.

Study of quantitative detection of circulating DNA in the plasma of patients with cervical lesion / 中华妇产科杂志

Objective To quantitatively detect circulating DNA levels in the plasma of patients withcervical lesion and to determine the value for diagnosis of cervical lesion and cervical cancer . Methods Preoperative blood samples were collected from 53 cases of low-grade lesions, 49 cases of high-grade lesions, 44 cases of cervical invasive cancer and 70 cases of healthy women. Plasma DNA was extracted by magnetic bead method (BILATEST DNA kit). The quantity of plasma DNA was determined by duplex real-time quantitative PCR. Results Median plasma DNA level of invasive cervical cancer patients was 61. 59 mg/L (32. 06 - 162. 16 mg/L) , which was significantly higher than that of healthy women [16. 35 mg/L(11. 98 -22.71 mg/L), P 0. 05). Median plasma DNA level of stage I patients was lower than that of stage Ⅱ- Ⅲ patients (46. 02 versus 71. 35 mg/L, P <0. 05). Conclusion Quantitatively detecting plasma circulating DNA may be with some application prospect in the diagnosis of cervical diseases.

Immune regulation of IL-10 to Schistosoma japonicum infection in p47 GTPase deficient mouse model / 中国血吸虫病防治杂志

Objective To investigate the immune response of IL-10 to Schistosoma japonicum infection in the early infectioin model and SEA immunization model of the IGTP~(-/-) and IRG-47~(-/-) mice.Methods In the early infection model,the IGTP knock out (IGTP~(-/-)) mice,IRG-47 knock out (IRG-47~(-/-)) mice and wild-type (WT) C57BL/6J mice were exposed to 300 S.japonicum cercariae via the pinna and sacrificed on day 7 post-infection.Each mouse pinna section was stained with hematoxylin-eosin (HE) to detect the pathological lesions,and the culture supernatant of pinna was used to test the levels of Th1/Th2 cytokines by indirect ELISA.In the SEA immunization model,IGTP~(-/-) IRG-47~(-/-) and WT mice were immunized with SEA twice and sacrificed in 3 weeks after the initial immunization.SEA-specific IgG antibody in sera was detected by indirect ELISA;the levels of Th1/Th2 cytokines were tested in culture supernatant of splenocytes by indirect ELISA;the proportions of CD4~+ T cells,CD8~+ T cells,B cells,Th1 and Th2 cells in the spleen were assayed by FACS.Results Although no obvious differences on the pathology of pinna were observed among the three mouse groups,the level of IL-10 in the culture supernatant of pinna of IRG-47~(-/-) mice was lower than that of IGTP~(-/-) mice in 7 days after the exposure.Following SEA immunization,the level of SEA-specific IgG antibody in sera of IGTP~(-/-) mice was lower than that in WT mice,the level of IL-10 in the culture supernatant of splenocytes of IRG-47~(-/-) mice was higher than that of IGTP~(-/-) and WT mice with the stimulation of SEA.However,the proportion of Th2 cells in the spleen of IRG47~(-/-) mice was the lowest among the three mouse groups.Conclusions SEA is the stimulus of IRG-47 deficiency mice to defend Schistosoma japanicum infection and promote the host to produce a protective response,and IL-10 may play an important role in immune regulation in this process.

Task-driven basic nursing probation based on the action research / 中国实用护理杂志

Objective To discuss the application effect of task-driven basic nursing probation based on the action research. Methods Using the frame of Lewin's action research, with random sampling, we selected a class for the study, for the first time in the traditional training model, and the second time in the task-driven model based on the action research. and information was collected according to the interviews and diary records, narrative description was used for records of the results. Results Action research promoted changes in basic nursing probation model, constructed knowledge, ability and improved various kinds of ability of nursing students. Conclusions The task-driven probation model improved the quality of clinic practice, which proved to be effective.

Cord blood stem cells for ischemic stoke / 国际脑血管病杂志

At present, ischemie stroke is one of the main diseases of the highest mortality and disability in the world. However, the traditional treatment methods (for example, thrombolytic therapy) have some disadvantages, such as narrow time window, and poor efficacy. As a cell therapy, cord blood stem cell transplantation has brought hope to the treatment of refractory nervous system diseases.

Thrombolytic strategies for acute ischemic stroke / 国际脑血管病杂志

Thrombolytic therapy is a main treatment method for ischemic stroke.Intravenous recombinant tissue-type plasminogen activator (rtPA) is the only FDA-approved therapy for acute stroke; however,its clinical application has been limited because the narrow therapeutic time window and the presence of the risk of hemorrhagic complication.In order solve these problems,a large number of clinical trials have started to focus on the studies of intra-arterial thrombolysis,mechanical thrombolysis and sonothrombolysis.

THE MEASUREMENT AND OBSERVATION OF THE TRANSVERSE FORAMINA OF THE CERVICAL VERTEBRAE AND THE CALIBRE OF THE VERTEBRAL ARTERY / 解剖学报

1.The sagittal and transverse diameters of 1,456 transverse foramina in 728cervical vertebrae were measured.The data are as follows:transverse diameter(mm) sagittal diameter (mm)Left Right Left RightMale(702 cases) 6.0?1.0 5.9?1.1 5.4?1.2 5.3?1.1Female(754 cases) 5.9?1.0 5.8?1.1 5.3?1.1 5.1?1.12.Among the 710 transverse foramina of 357 cervical vertebrae observed,mostof them are of the elliptical type.3.19.3% of double transverse foramen were found in 710 transverse foraminawhich were mostly encountered at the 6 th cervical vertebra.4.The mean value of the external diameter of the cervical part of the vertebralartery is 4?0.7mm.in 40 sides of specimens.5.63.1% of the vertebral artery in the 710 transverse foramina were foundmedial to its accompanying vein.6.According to the relationship between the sagittal(X_1)and transversediameter(X_2)of the transverse foramen and the diameter(Y)of the vertebralartery,a formula,(?)=1.859+0.172 X_1+0.24 X_2,of multiple regression was formulatedThus,the estimated diameter of the vertebral artery from the sagittal diameter X_1and transverse diameter X_2 of the transverse foramen could be obtained and it maybe helpful for clinical practice.7.In case of arthrosis,the vertebral artery could be compressed by the unco-vertebral joint which are found mostly at the level of the 4～5th cervicalvertebrae.

THE SAGITTAL AND TRANSVERSE DIAMETERS OF CHINESE SPINAL CANAL / 解剖学报

The sagittal and transverse diameters of spinal canal were measured from 344 cases including dry specimens,preserved vertebral colomns and X-ray films.Based on these data several conclusions have been drawn. (1)The morphology of spinal canal is consistent with the external feature of spinal cord. (2)The mean values of various measurement of cervical(C),thoracic(T),and lumbar(L)vertebrae of spinal canal in dry specimens are as follows: Transverse diameter(mm.) Sagittal diameter(mm.) C T L C T L Male 23.6 16.7 23.4 14.4 14.9 16.5 Eemale 23.1 16.1 22.4 13.7 14.2 16.0 (3)The mean values of measurement of spinal canal in X-ray films are as fol- lows: Transverse diameter(mm.) Sagittal diameter(mm.) L C L Male 27.8 16.5 19.8 Female 27.0 15.7 19.1 The data measured from X-ray films are approximately 20% larger than those from the actual specimens. (4)The ratio between the sagittal diameters of the cervical canal and vertebral body is 80～90% in male and 90～100% in female.The normal ratio between the products of sagittal and transverse diameters of the lumbar spinal canal and of the vertebral body is 1:4.Ratios lower than this value is considered to denote a diagnostic significance for spinal stenosis.