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OBJECTIVES@#The intestinal microbial characteristics of patients with simple cerebral infarction (CI) and CI complicated with Type 2 diabetes mellitus (CI-T2DM) are still not clear. This study aims to analyze the differences in the variable characteristics of intestinal flora between patients simply with CI and CI-T2DM.@*METHODS@#This study retrospectively collected the patients who were admitted to the Affiliated Hospital of Putian University from September 2021 to September 2022. The patients were divided into a CI group (n=12) and a CI-T2DM group (n=12). Simultaneously, 12 healthy people were selected as a control group. Total DNA was extracted from feces specimens. Illumina Novaseq sequencing platform was used for metagenomic sequencing. The Knead Data software, Kraken2 software, and Bracken software were applied for sequencing analysis.@*RESULTS@#At phylum level, the average ratio of Firmicutes, Bacteroidetes, and Proteobacteria in the CI-T2DM group were 33.07%, 54.80%, and 7.00%, respectively. In the CI group, the ratios of each were 14.03%, 69.62%, and 11.13%, respectively, while in the control group, the ratios were 50.99%, 37.67%, and 5.24%, respectively. There was significant differences in the distribution of Firmicutes (F=6.130, P=0.011) among the 3 groups. At the family level, compared with the CI group, the relative abundance of Eubacteriaceae (t=8.062, P<0.001) in the CI-T2DM group was significantly increased, while Corynebacteriaceae (t=4.471, P<0.001), Methanobacteriaceae (t=3.406, P=0.003), and Pseudomonadaceae (t=2.352, P=0.028) were decreased significantly. At the genus level, compared with the CI group, there was a relative abundance of Cutibacterium (t=6.242, P<0.001), Eubacterium (t=8.448, P<0.001), and Blautia (t=3.442, P=0.002) in the CI-T2DM group which was significantly increased. In terms of Methanobrevibacter (t=3.466, P=0.002), Pyramidobacter (t=2.846, P=0.009) and Pseudomonas (t=2.352, P=0.028), their distributions were decreased significantly in the CI-T2DM group. At the species level, compared with the CI group, the relative abundance of Cutibacterium acnes (t=6.242, P<0.001) in the CI-T2DM group was significantly increased, while Pseudomonas aeruginosa (t=2.352, P=0.028) was decreased significantly. Still at the genus level, linear discriminant analysis effect size (LEfSe) analysis showed that the distributions of Pseudomonas and Blautia were determined to be the most significantly different between the CI-T2DM and the CI group. At the species level, the total number of operational taxonomic units (OTUs) in the 3 groups was 1 491. There were 169, 221, and 192 kinds of OTUs unique to the CI-T2DM, CI, and control group, respectively.@*CONCLUSIONS@#From phylum level to species level, the composition of intestinal flora in the patients with CI-T2DM is different from those in the patients simply with CI. The change in the proportion of Firmicutes, Bacteroidetes and Proteus compared with the healthy population is an important feature of intestinal flora imbalance in the patients with CI and with CI-T2DM. Attention should be paid to the differential distribution of Bacteroides monocytogenes and butyrate producing bacteria.
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Humanos , Microbioma Gastrointestinal/genética , Diabetes Mellitus Tipo 2/complicações , Estudos Retrospectivos , Bactérias/genética , Sequenciamento de Nucleotídeos em Larga EscalaRESUMO
Objective:To investigate the relationship between the volume ratio of ischemic leukoaraiosis (LA) and cognitive level and arterial perfusion.Methods:Fifty-four patients, who was hospitalized in Dalian Central Hospital and diagnosed as LA clinically during the time of March to December in 2012, were selected to collect the information of the volume ratio of white matter disease, MoCa score and the average flow rate of carotid artery. The correlation between the volume ratio of white matter disease and MoCa score, cognitive impairment and the average flow rate of carotid artery were analyzed.Results:The volume ratio of LA lesions was negatively correlated with MOCA score ( r = -0.59, P<0.01); the volume ratio of LA lesions was negatively correlated with the mean flow rate of internal carotid artery ( r = -0.37, P<0.01). Quantity order of the area under receiver operating characteristic (ROC) curve of MoCA cognitive subgroup was as following: delayed memory (1.000)> visual space/executive function (0.970) = abstract force (0.970)> language ability (0.960)> attention (0.888). Conclusions:The larger the volume ratio of leukopathy in LA patients, the more serious the cognitive impairment, especially the cognitive impairment of impairment of memory delay, visual space/executive function, abstract ability and language ability.
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Objective:To explore the risk factors of thrombocytopenia in children with patent ductus arteriosus (PDA) after transcatheter closure, and to establish a prediction model of thrombocytopenia after transcatheter closure of PDA.Methods:A total of 39 PDA children with thrombocytopenia after transcatheter closure treated in Children′s Hospital of Nanjing Medical University from November 2016 to January 2020 were selected.During the same period, 138 PDA children without thrombocytopenia after transcatheter closure were included in the control group. Logistic regression model was used to explore the possible risk factors of thrombocytopenia after transcatheter closure in PDA children, and a random forest model was established to predict the occurrence of thrombocytopenia after transcatheter closure of PDA. Results:After transcatheter closure of PDA, children developed thrombocytopenia within 1 to 7 days, and the platelet count recovered within 2 to 22 days. Logistic regression model suggested that the diameter of pulmonary artery end of arterial catheter ( OR=9.54, 95% CI: 2.08-48.84, P=0.004)and preoperative platelet count( OR=0.99, 95% CI: 0.98-0.99, P=0.001)were correlated with the occurrence of thrombocytopenia after transcatheter closure of PDA.The random forest model indicated that PDA inner diameter was the most important factor for predicting the occurrence of thrombocytopenia after transcatheter closure of PDA. Conclusions:A large diameter of arterial duct is an important risk factor and increased preoperative platelet count is a protective factor for thrombocytopenia after transcatheter closure of PDA.Diameter is of the greatest significance in predicting the occurrence of thrombocytopenia after transcatheter closure of PDA.
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Clinical data and follow-up of a case of congenital disorder of glycosylation type Ia (CDG-Ia) combined with dilated cardiomyopathy admitted to the Department of Cardiology, Children′s Hospital of Nanjing Medical University were analyzed retrospectively.The 5-year-old female patient was admitted in December 2016 due to recu-rrent shortness of breath for 2 months.Clinical symptoms and signs included repeated attacks of shortness of breath, physical retardation, malnutrition, binocular esotropia, multiple episodes of hypoglycemia, hepatosplenomegaly, hypotonia and other multi-system damages.Cardiac echocardiography suggested the feature of dilated cardiomyopathy, including the significant enlargement of the left ventricle, and decreased systolic function.Genetic testing revealed a compound heterozygous mutation in the PMM2 gene, and as a result, the patient was diagnosed as CDG-Ia.The patient′s condition improved after symptomatic treatments such as Cedilanid, Dopamine, Dobutamine, Furosemide, as well as support treatments like myocardium nutrition, blood sugar maintenance, liver protection, etc.After discharge, the patient was given oral Digoxin, Betaloc, Captopril and diuretics, and hypoglycemia-controlling agents.The patient was followed up every 3-6 months.After more than 2 years of follow-up, the heart function and heart enlargement gradually returned to normal.During the Corona Virus Disease 2019 outbreak, self-withdrawal continued for 2 months.Re-examinations showed decreased cardiac function and enlarged left ventricle again.Medications were resumed again, and the patient was followed up closely.This case report suggested that CDG-Ia may be associated with dilated cardiomyopathy, and the cardiac phenotype may be improved by symptomatic supportive treatment.
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Objective To evaluate the role of activation of astrocytes in the spinal cord in myocardial ischemia-reperfusion (I/R) injury in rats.Methods Eighteen healthy adult male Sprague-Dawley rats,in which intrathecal catheters were successfully implanted,weighing 250-300 g,were divided into 3 groups (n =6 each) using a random number table method:sham operation group (group Sham),myocardial I/R group (group I/R) and an astrocyte inhibitor fluorocitrate group (group I/R+FC).Myocardial ischemia was induced by 30 min occlusion of left anterior descending branch of coronary artery followed by 120 min reperfusion in chloral hydrate-anesthetized rats.Fluorocitrate 10 μl (1 nmol) was intrathecally infused at a constant rate starting from 30 min before ischemia in group I/R+ FC.Arrhythmia was scored according to the results of electrocardiography during I/R.Arterial blood samples were collected at 120 min of reperfusion to determine the serum cardiac troponin Ⅰ (cTnⅠ) concentration by chemiluminescence assay.The animals were then sacrificed,myocardial specimens were taken for measurement of the infarct size,and T2-6 segments of the spinal cord were harvested for determination of the expression of glial fibrillary acidic protein (GFAP) (by Western blot).Results Compared with group Sham,the serum cTnⅠ concentration,arrhythmia score,and myocardial infarct size were significantly increased,and the expression of GFAP was up-regulated in I/R and I/R+FC groups (P＜0.05).Compared with group I/R,the serum cTnⅠ concentration,arrhythmia score,and myocardial infarct size were significantly decreased,and the expression of GFAP was down-regulated in group I/R+FC (P＜0.05).Conclusion The activation of astrocytes in spinal cord is involved in myocardial I/R injury in rats.
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Objective To evaluate the relationship between excitability of neurons in hypothalamic paraventricular nucleus (PVN) and central nervous regulatory mechanism of myocardial ischemia-reperfusion (I/R) injury in rats.Methods Clean-grade healthy adult male Sprague-Dawley rats,in which PVN catheters were successfully implanted,aged 6-8 weeks,weighing 260-300 g,were divided into 4 groups (n =6 each) using a random number table method:sham operation group (S group),myocardial I/R group (I/R group),γ-aminobutyric acid group (GABA group) and L-glutamic acid group (L-Glu group).Myocardial ischemia was induced by occlusion of the left anterior descending coronary artery for 30 min followed by 120-min reperfusion.Normal saline 2.4 μl/h was infused for 50 min via the PVN catheter starting from 10 min before ischemia in S and I/R groups.GABA 30 μmol/L and L-glutamic acid 30 μmol/L were infused for 50 min via the PVN catheter at a rate of 2.4 μl/h starting from 10 min before ischemia in GABA and L-Glu groups.The heart rate (HR) and mean arterial pressure (MAP) were recorded at 10 min before ischemia (T0),beginning of ischemia (T1),30 min of ischemia (T2) and 120 min of reperfusion (T3).Rate-pressure product (RPP) was calculated.Blood samples were collected at T3 for determination of plasma cardiac troponin I (cTnI) concentrations by chemiluminescence assay.Rats were then sacrificed and myocardial specimens were obtained for measurement of myocardial infarct size (IS) and area at risk (AAS),and IS/AAR percentage was calculated.PVN tissues were taken to detect the expression of cfos by Western blot.Results No myocardial infarction was found in group S,and myocardial infarction was marked in the other three groups.Compared with group S,the plasma cTnI concentrations were significantly increased,and the expression of c-fos in PVN was up-regulated in I/R,GABA and L-Glu groups (P＜0.05),and MAP,HR and RPP were significantly decreased at T1-3 in I/R and GABA groups and at T3 in group L-Glu (P＜0.05).Compared with group I/R,IS and IS/AAR percentage were significantly decreased,the plasma cTnI concentrations were decreased,the expression of c-fos in PVN was down-regulated,and HR,MAP and RPP were decreased at T1,2 in group GABA,and IS and IS/AAR percentage were significantly increased,the plasma cTnI concentrations were increased,the expression of c-fos in PVN was up-regulated,and HR,MAP and RPP were increased at T1,2 in group L-Glu (P＜0.05).Conclusion Excitability of neurons in hypothalamic PVN is involved in central nervous regulatory mechanism of myocardial I/R injury in rats:decreased excitability can attenuate myocardial I/R injury and increased excitability aggravates myocardial I/R injury.
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ObjectiveTo observe the effect of parathyroid hormone on expression of matrix GLA protein (MGP) in ovariectomized SD rats and primary osteoblast,and to study the role of MGP on the possible mechanism of postmenopausal osteoporosis.MethodsThirty-six Sprague-Dawley female rats were allocated into 3 groups,12 in each:sham operation group,ovariectomized group( OVX group),ovariectomized and parathyroid hormone treatment group.Animals in the parathyroid hormone group were injected parathyroid hormone (20 μg/kg,three times a week for 12 weeks) three weeks after ovariectomy.All rats were sacrificed after 18 weeks.Urine and serum were collected every three weeks.Lumbar vertebral bones were observed by immunohistochemistry.Bone mineral density (BMD) of lumbar vertebra of rats was determined.The content of MGP in serum and urine was determined by enzyme-linked immunosorbent assay (ELISA).Expression of undercarboxylated Matrix GLA Protein (ucMGP) was detected by immunochistochemistry.Relative quantification of MGP mRNA expression in lumbar vertebra bone was detected by Fluorescent real-time quantitative polymerause chain reaction.Results ( 1 ) 18 weeks after ovariectomy,BMD of lumbar vertebra in OVX group was lower than those in sham group and parathyroid hormone group significantly ( P＜0.05 ).(2) The content of MGP in serum and urine was dynamic variation after treatment hy parathyroid hormone,and it was significant compared with OVX group ( P＜0.05 ).( 3 ) Immunohistochemical localization of ucMGP was seen in lumbar vertebra in OVX group.(4) Relative quantification of MGP mRNA expression in lumbar vertebra in OVX group was increased significantly compared with other groups ( P＜0.01 ).( 5 ) parathyroid hormone ( 1-34 ) in 10-7mol/L,10-8mol/L,10-9 mol/L up-regulated MGP mRNA expression in primary osteoblasts about 6.78,5.31,and 2.23 times than control respectively.It was in a dose-dependent manner.ConclusionThe effect of parathyroid hormone on the expression of matrix gla protein may play an important role in mechanism of postmenopausal osteoporosis