Clinical characteristics and risk factors of ischemic stroke in young adults / 中国综合临床

Objective:To analyze the clinical characteristics and risk factors of ischemic stroke in young adults.Methods:A retrospective analysis was conducted on 80 ischemic stroke patients (age ≤45 years) admitted to Beijing Tiantan Hospital from March 2019 to October 2019 as the young stroke group, and 117 ischemic stroke patients (age >45 years) hospitalized during the same period as the middle-aged and elderly stroke group. The blood test indexes of the two groups were compared, and the risk factors related to stroke, including smoking history, drinking history, hypertension, hyperlipidemia and diabetes history, were compared and analyzed. Two sets of independent sample t-test, Mann-Whitney U-test or χ2 test were used to compare the above indicators of patients in the two groups. Results:The activated partial prothrombin time, protein S, uric acid, homocysteine and D-dimer levels in middle-aged and elderly stroke group were (29.73±3.40) s, (105.58±27.23) %, (297.29±85.99) μmol/L, (17.58±14.45) μmol/L and (2.75±3.08) mg/L, respectively. Compared with the middle-aged and elderly stroke group, the young stroke group had higher activated partial thrombin time (31.51±6.75) s, protein S (115.20±26.97) %, uric acid (326.82±93.51) μmol/L, homocysteine (22.63±16.98) μmol/L and lower D dimer level of (1.19±2.88) mg/L compared with the elder group, the difference between the two groups was statistically significant ( t values were 2.17, 2.01, 2.20, 2.14 and 2.13, respectively, P values were 0.032, 0.046, 0.029, 0.039 and 0.034, respectively). The positive rate of lupus anticoagulant in young stroke group was 12.5% (4/32), which was higher than 1.8% (1/57) in middle-aged and elderly stroke group, and there was significant difference between the two groups (χ 2=4.46, P=0.035). The proportions of smoking and drinking in young stroke group were 63.8% (51/80) and 62.5% (50/80), respectively, which were higher than 49.6% (58/117) and 47.9% (56/117) in middle-aged and elderly stroke group, and there was significant difference between the two groups (χ 2 values were 3.86 and 4.09; P values were 0.04 and 0.04). The proportion of hypertension and diabetes in young stroke group was 48.8% (39/80) and 17.5%(14/80), respectively, which were lower than 63.2%(74/117) and 30.8%(36/117) in middle-aged and elderly stroke group, and there was significant difference between the two groups (χ 2 values were 4.08 and 4.56; P values were 0.043 and 0.033). According to the levels of uric acid and homocysteine, young stroke was divided into different subgroups and compared.The creatinine level of high uric acid group (≥416 μmol/L) was (90.08±28.46) mmol/L, which was higher than that of normal uric acid group (<416 μmol/L) of (63.37±22.2) mmol/L. There was significant difference between the two groups ( t value was 2.23, P value was 0.046). The levels of fibrinogen and creatinine in high homocysteine group (≥15 μmol/L) were (3.27±1.09) g/L and (72.13±28.69) mmol/L, respectively which were significantly higher than those in normal homocysteine group (<15 μmol/L) of (2.78±0.67) g/L and (58.92±12.08) mmol/L, There was significant difference between the two groups (the t values were 2.32 and 2.51; P values were 0.023 and 0.014). Conclusions:Compared with middle-aged and elderly stroke, young ischemic stroke has higher levels of prothrombin time, protein S, uric acid and homocysteine, lower levels of D dimer and higher positive rate of lupus anticoagulant. At the same time, the proportion of smoking and drinking was higher in young stroke group, but the proportion of hypertension and diabetes was relatively lower.

Effects of rituximab on lymphocytes and immunoglobulin in the treatment of glomerular disease / 中华肾脏病杂志

Objective:To investigate the effects of rituximab on lymphocytes and immunoglobulin in the treatment of focal segmental glomerulosclerosis (FSGS) and minimal change disease (MCD).Methods:The subjects were FSGS and MCD patients admitted to Ruijin Hospital affiliated to Shanghai Jiaotong University on July 1, 2014 and July 1, 2019. All the enrolled patients were confirmed by clinical examination and renal biopsy, and received rituximab treatment (4 infusions of 375 mg/m 2 with the interval of 7-14 d). The levels of immunoglobulin IgA, IgG, IgM, and lymphocytes of CD19 +, CD20 +, CD3 +, CD3 +CD4 +, CD3 +CD8 + and natural killer cells (CD56 +CD16 +) were compared between baseline and the third month, the sixth month, the ninth month and the twelfth month after treatment. Results:Ninety-six patients with FSGS or MCD were enrolled in this study. The midian age was 28 years old (14-77 years old). The ratio of men to woman was 1.8∶1. There were 65 cases of MCD and 31 cases of FSGS. After rituximab treatment, the 24 h-proteinuria was significantly lower than that before treatment, and the serum albumin level was increased (both P<0.05). After rituximab treatment of 3 months, 6 months, 9 months and 12 months, CD19 + and CD20 + lymphocyte counts were significantly decreased (all P<0.01), and gradually recovered after 6 months. Compared with baseline, at 3, 6, 9, 12 months after rituximab treatment, the level of blood IgG was significantly increased ( P=0.004,<0.001,<0.001,<0.001, respectively), and the level of blood IgM was significantly decreased ( P<0.001, =0.008, =0.005,<0.001, respectively) but the median level still within the normal range (400-3 450 mg/L). The level of blood IgA was not significantly changed (all P<0.05). T lymphocytes (CD3 +, CD3 +CD4 + and CD3 +CD8 +) and natural killer cells (CD56 +CD16 +) showed no significant difference from baseline (all P>0.05). Conclusions:Rituximab can effectively eliminate CD19 + and CD20 + lymphocytes, and has little influence on peripheral blood lymphocyte count and immunoglobulin level except CD19 + and CD20 + lymphocytes. The standard administration of rituximab is safe for patients with FSGS and MCD.

Advances in research on gene and cell therapy for type IV collagen related hereditary kidney diseases / 中华医学遗传学杂志

Type IV collagen is a component of the extracellular matrix in the basement membrane. Abnormal secretion or assembly of type IV collagen may lead to kidney lesions resulting in numerous nephropathy symptoms, e.g., Alport syndrome, thin basement membrane nephropathy, and focal segmental glomerulosclerosis. Treatment for type IV collagen-related nephropathy includes drugs, kidney transplantation, gene and cell therapy. However, drugs are not always effective, and kidney transplantation is hindered by the shortage of donors. Moreover, basement membrane nephritis often occurs after kidney transplantation. Therefore, gene and cell therapy probably is the most promising treatment for type IV collagen related nephropathies.

Electrospun materials applied in drug delivery system / 中国组织工程研究

BACKGROUND:Recently, electrospun materials have been extensively applied in the drug delivery system. OBJECTIVE:To overview the application prospect of electrospun materials in drug delivery systems. METHODS:A computer-based search of PubMed and NCBI databases was performed for literatures about the research progress of electrospinning in tissue engineering and chemotherapy published within the past 10 years using the keywords of“electrospinning, drug delivery system, nanofibers, electrospun materials”.RESULTS AND CONCLUSION:Compared with traditional materials, electrospun stents hold good versatility and control able parameters, thus granting its unique advantage under various physiological conditions. Current drug-loaded materials composed of natural products, synthetic polymers and blended materials;as to drugs, there are antibiotics, chemotherapy medication, DNA and protein. Electrospun materials have been used in tissue engineering, cancer chemotherapy and wound healing. We focus on not only the application progress of electrospun materials in traditional treatments, but also its usage, condition-control ed drug release and living-cel carrying. Electrospun materials combined with various drug-loaded present a broad prospect.

Prenatal ultrasonic diagnosis of fetal isolated levocardia / 中华超声影像学杂志

Objective To investigate the clinical application valve of prenatal ultrasound in diagnosis of fetal isolated levocardia ( IL ) . Methods Thirty-eight IL fetuses diagnosed in three prenatal diagnosis centers from 2000 to 2016 were reviewed with their prenatal ultrasound features and cardiac and extracardiac malformations . Results Thirty-eight IL cases included 19 cases of left isomerism ( LI) ,14 cases of right isomerism( RI) and 5 non-classified cases . The overall incidence of malformations in IL patients was 97 .4％with 94 .7％ in LI patients and 100％ in RI patients . The incidence of cardiac malformations was 92 .1％with 84 .2％ in LI patients and 100％ in RI patients . The most common congenital heart diseases were:right ventricle outlet obstruction , univentricular physiology and atrioventricular septal defect . Anomalous pulmonary venous connection was more commonly seen in LI patients than in RI patients . The most common extracardiac malformation was duodenal obstruction( 86 .9％ ) . Inferior vena cava interruption and polysplenia were more commonly seen in LI patients .Juxtaposition of aorta and inferior vena cava and asplenia were more commonly seen in RI patients . Conclusions IL is very rarely seen in population with high incidence of congenital heart diseases and extracardiac malformations .

Application of terminal ileum suspension in laparoscopic operation for low rectal cancer / 实用医学杂志

Objective To explore the value of terminal ileum suspension in the treatment of low rectal cancer.Methods 80 patients with low rectal cancer who underwent laparoscopic operation in our hospital from June 2015 to February 2017,were randomly divided into two groups:the control group (group C) and the test group (group T),40 cases in each group.In group C,laparoscopic radical resection of rectal cancer (Dixon) was performed and in group T Dixon was combined with terminal ileum suspension.Peripheral blood nutritional indicators (total plasma protein,albumin,pre-albumin,transferrin) and major electrolytes of two groups were observed 1 day before operation and 1,3 and 7 days after operation.The two groups were compared in terms of first exhaust time,postoperative hospital stay,total costs for hospitalization,postoperative discomforts and complications.Results There were no statistical differences in the levels of nutrition indicators and electrolytes between them (P ＞ 0.05) and neither it was with first exhaust time,hospital stay,total costs of hospitalization,incidence of postoperative discomforts and complications (P ＞ 0.05).The re-operation rate of group T with anastomotic leak was significantly lower than group C (P ＜ 0.05).Conclusion Terminal ileal suspension does not affect patients' postoperative recovery without increasing the patient's suffering and economic burden,and can effectively reduce the reoperation rate caused by anastomotic leak.It is easy to operate.

Therapeutic effect and long-term follow-up of the Jinling procedure for refractory constipation: a series of 1 100 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the safety, effectiveness and long-term results of Jinling procedure.</p><p><b>METHODS</b>A total of 1 100 patients with refractory constipation were admitted to the Institute of General Surgery between February 2000 and December 2013 and received Jinling procedure. There were 217 male and 883 female patients with an average age of (45±15) years and an average duration of (275±159) months. The Jinling procedure modifies the classic procedure of subtotal colectomy with colorectal anastomosis by adding a new side-to-side cecorectal anastomosis. The general clinical data, postoperative complications, gastrointestinal quality of life index (GIQLI), Wexner constipation score, satisfaction rate, body composition, nutritional status, homeostasis, anal manometry and defecography during follow-up were collected. Statistical analysis was performed by t-test analysis, χ(2) test or Fisher's exact probability.</p><p><b>RESULTS</b>The postoperative follow-up rate were 96.73%, 94.36%, 93.00% and 92.55% at 1, 3, 6, and 12 months. The satisfaction rate were 62.50%, 72.45%, 93.16% and 94.70% respectively during 1, 3, 6 and 12 months follow-up. The postoperative 1 month, GIQLI was lower than that of preoperative (P=0.038), but significantly better at postoperative 3 month than the preoperative (P=0.022), and gradually improve after then. Wexner score was significantly lower at postoperative 1 month than the preoperative (P=0.018), and with the gradually reduce. Compared to the preoperative baseline, all body composition and serum protein parameters decreased significantly at the one-month follow-up and then increased gradually over the remaining follow-up period. Weight and prealbumin were significantly higher than the preoperative at postoperative 12 month. Jinling procedure had no effect on electrolytes. All patients were detected in defecography before surgery, but these abnormal indicators were improved after surgery. Anal function, coordinated movement anorectal function, anorectal reflex and rectal sensation were injured at early postoperative, but as time goes on, these indicators gradually returned to preoperative levels, some indicators better than the preoperative level. Postoperative surgical site infection, anastomotic bleeding , anastomotic leakage, urinary retention, sexual dysfunction, recurrent constipation, bowel obstruction, anastomotic stricture and mortality rates were 4.36%, 5.45%, 6.00%, 6.91%, 0.64%, 0.45%, 8.82%, 4.00% and 0.27% respectively.</p><p><b>CONCLUSIONS</b>Jinling procedure is a safe and effective surgical procedure for refractory constipation. It can improve defecation function and quality of life significantly, and has a high follow-up satisfaction rate.</p>

Risk analysis of intravenous thrombolysis in acute cerebral infarction with cerebral microbleeds by SWI / 实用放射学杂志

Objective To investigate the risk factors and the influence of intravenous thrombolysis of acute cerebral infarction with cerebral microbleeds(CMBs)by SWI.Methods 1 64 patients with acute cerebral infarction were enrolled in this study.All pa-tients were scanned with routine MRI and SWI.According to the presence of CMBs on SWI,the patients were classified into two groups:CMBs group(73 cases)and non-CMBs group(91 cases).Past history was recorded and risk factors of CMBs were explored. 76 cases patients(including 35 cases of CMBs group and 41 cases of non-CMBs group)were treated by intravenous thrombolysis and rescanned with routine MRI and SWI to compare the changes in the number of CMBs and hemorrhage transformation 24 hours after thrombolysis.Results The difference age,hypertension,lacunar infarction and leukoaraiosis between the two groups were significant (P 0.05).Conclusion Acute cerebral infarction with CMBs are influenced by age,hypertension,lacunar infarction and leu-koaraiosis.Thrombolysis in acute cerebral infarction with CMBs can not augment the incidence of hemorrhagic transformation.

The changes of body composition in patients with acromegaly after pituitary adenoma surgery / 基础医学与临床

Objective To identify the changes of body composition with acromegaly before and after pituitary adeno-ma surgery,and to evaluate the relationship between these changes and serum growth hormone(GH),insulin-like growth factor-1(IGF-1).Methods Serum GH with OGTY,IGF-1 levels,BMI,fat percentage,FFM and total body water(TBW) in patients were measured in active and relieved period of the disease.Results The BMI and FFM with active acromegalic males were significantly higher,but fat percentage was significantly lower than that of healthy males.After the disease was relieved by surgery,serum GH and IGF-1 concentrations of patients were sig-nificantly reduced to normal level,but their BMI was still significantly higher,the fat percentage increased and the FFM decreased was correlated with serum nadin GH and IGF-1 levels.The BMI and FFM with active acromegalic females were significantly higher than healthy females,but the fat percentage had not significant change after sur-gery,and FFM decrease was correlated with reduced serum GH level.The fat percentage did not change signifi-cantly.Conclusion There was significant change of body composition with acromagely before and after treatment,and a relationship between these changes and serum GH and IGF-1 levels was identified.

Langerhans cell histiocytosis of the thyroid / 基础医学与临床

Langerhans cell histiocytosis is an uncommon disease, involvement of the thyroid by langerhans cell histiocytosis is rare. Two cases of Langerhans cell histiocytosis of the thyroid confirmed by pathology were reported in this paper. The main clinical feature was enlargement of the thyroids. One patient had hypothyroidism. Meanwhile, the lungs and pituitaries of the two patients were affected. Langerhans cell histiocytosis of the thyroid had no typical symptoms and specific laboratory examination, and might be clinically diagnosed as chronic lymphocytic thyroiditis, benign or malignant thyroid tumors. Thyroid fine needle aspiration cytology might be useful in confirming the diagnosis. The effective treatments include systemic chemotherapy, local radiation therapy and surgical excision. The chemotherapy is still the major technological approach. Most patients can relieve partially after receiving the systemic chemotherapy.

Primary culture of human preadipocyte in a serum-free medium / 基础医学与临床

Objective To establish a method of primary culture of human preadipocyte in a serum-free medium. Methods Collangenase digestion was used to dispart preadipocyte.The cells were identified by microscopy stained by oil red O and determination of the activity of Glycerol-3-phosphate dehydronase(G-3-PDH). Results The primary cultured human preadipocyte proliferated in the aserum-free medium successfully.In the differential serum-free medium the cells turned to be round on the 4 th day.The adipose drops began to cumulate in the cells,and to the most quantity until the 21 st day.Conclusion The human preadipocyte can be primarily cultured and induced to differentiate in serum-free medium,which is the base for researching the effects of hormones and factors to the proliferation and differentiation of preadipocyte.

Steroid 5?-reductase and 5?-reductase type 2 deficiency / 基础医学与临床

Two types of steroid 5?-reductase isozymes were found in human and rats.5?-reductase type 2 deficiency in male lead to male pseudohermaphroditism and other related phenotypes.The content of this review includes:① The progress in the fields of 5?-reductase research;②Biochemical characteristics and physiological effects of 5?-reductase.③ Gene structure and mutation in 5?-reductase genes,clinical and chemical features of 5?-reductase type 2 deficiency syndrome.④Inhibitory agents of 5?-reductase and their mechanism and clinical use.The investigation in 5?-reductase help to illuminate physiological effect and sexual differentiation of androgen.The development of new inhibitory agents for 5?-reductase creats new strategy for diseases caused by imbalance of androgen action.Their mechanism and long effects of clinical use need further investigation and observation.

Diagnostic value of serum insulin-like growth factor binding protein-3 in children with or without growth hormone deficiency / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To study the value of serum insulin-like growth factor binding protein-3 (IGFBP-3) levels in differential diagnosis of growth hormone deficiency (GHD).</p><p><b>METHODS</b>To measure serum IGFBP-3 levels by RIA in normal children and adolescents, GHD children and short-stature children without GHD.</p><p><b>RESULTS</b>Serum level of IGFBP-3 in 129 children with untreated GHD and with no pubertal development was 1.6 +/- 0.9 mg/L, which was less than that in normal group of the same age, but overlapped with the normal children in Tanner stage I. After six-month treatment with recombinant human growth hormone (rhGH), serum level of IGFBP-3 in 59 GHD significantly increased from 1.3 +/- 0.7 mg/L to 2.7 +/- 0.9 mg/L, accompanied by an increase of body heights, growth velocities and serum level of IGF-1. Serum level of IGFBP-3 in 55 short-stature children without GHD was 3.3 +/- 2.2 mg/L, which was not significantly different from that in normal group.</p><p><b>CONCLUSION</b>Serum IGFBP-3 level can reflect the status of GH secretion in children with GHD and is a useful marker for differential diagnosis of GHD.</p>

Clinical analysis of 124 patients of GH-secreting pituitary adenoma with hyperprolactinaemia / 中华内分泌代谢杂志

Objective To study the clinical characteristics of the patients of GH-secreting pituitary adenoma with hyperprolactinaemia. Methods The clinical data of 124 cases of GH-secreting pituitary adenoma with hyperprolactinaemia treated in Peking Union Medical College Hospital from 1984 to 2004, including 87 cases followed up for over one year , were analyzed retrospectively. Results Of 124 patients, there are 88 females and 36 males and the course of disease in males (8.0?7.3) years was longer than that in females (5.5?4.3)years (P

Growth hormone regulate the function of T lymphocytes / 中国免疫学杂志

To study the effects of growth hormone on function of T lymphocytes. Methods: Tne expression plasmid PcDNA-GHcDNA was constructed,then the plasmids were transfected into Jurkat cells,on the other hand,Jurkat cells were treated with different doses ofrhGH, to investigate the effect of overexpression GH and rhGH on function of T lymphocytes. Results: Overexpression GH could increase the ex-pression of IL-2R(140％) and secretion of IL-2(160％) and IFN-γ( 198% ) in Jurkat cells after PHA activation,but these data were broughtdown by the treatment of GH antibody. rhGH could also enhancer the function of T lymphocytes after PHA activation. Conclusion: These resultssupport the idea that GH is an autocrine and paracrine factor, and can regulate the function of T lymphocytes.

Emphasis on the cause-effect deduction in clinical studies——Discussion of association factors,predicting factors and risk factors / 中华内分泌代谢杂志

Cause-effect deduction is the basis of both natural and social sciences. Both wealthy knowledge and logical design are essential in obtaining the true causality among medical studies. Though association analysis provides important information for cause-effect deduction, it does not mean causality itself. Before the existence of the causality between two variables being identified, rigorous criteria must be followed. A number of indexes, such as the significance and the degree of the association, the dose-response relationship, the biology-based possibility, as well as the consistency and specificity, all should be examined very carefully. Clear verifiable hypotheses, rational selection of subjects, reliable experimental methods, appropriate statistical analysis and correct logical deductions, all are the integral parts that finally constitute a faithful deduction.

Efficacy and safety of orlistat in Chinese obese patients / 中华内分泌代谢杂志

Objective To evaluate the clinical efficacy and safety of orlistat in Chinese overweight and obese patients. Methods In six research centers, 444 overweight and obese patients (body mass index 25～40 kg/m 2) were divided into orlistat group (296 patients) and placebo group (148 patients) with a low-energy diet for 24 weeks by a randomized, double-blinded, placebo-controlled study. Results For intent-to-treat analysis, 286 orlistat-treated and 142 placebo-treated subjects were evaluated. After 24 weeks, orlistat-treated patients lost more weight 〔(6.1?3.6)kg,( x ?s)〕 than placebo-treated patients did (3.0?3.5)kg (P

Effects of hormones on expressional regulation of growth hormone(GH) gene in T lymphocyte / 中国免疫学杂志

Objective:To study the effects of hormones on expression of GH gene in T lymphocyte.Methods:PGL2 GH Lucaluciferase reporter gene expression plasmid with hGH gene promotor was constructed and was transfected into Jurkat cells,Hormones were put into the medium of cell culture.Results:The expression of luciferase in Jurkat cells could be inhibited by different doses of hGH and GHRH (P

Prolactin and immune system / 中华内分泌代谢杂志

Prolactin (PRL) is a multi-functional hormone mainly from pituitary gland. PRL receptors exist ubiquitously in all tissues and organs of immune system and PRL modulates local and systemic immune activities. PRL is involved in many physiological and pathological immune responses. The function of PRL in autoimmune diseases, organ transplantation and tumor occurrence has been explored in recent years. This article is to review the progress of prolactin in the immunology-related field.

Preliminary clinical significance of determination for serum insulin-like growth factor binding protein-3 protease activity / 中华内分泌代谢杂志

Objective To evaluate the clinical significance of determination for serum insulin like growth factor binding protein 3 (IGFBP 3) protease activity. Methods Serum IGFBP 3 protease activity in normal persons, parturient pregnant women, acromegalic patients and patients with growth hormone deficiency (GHD) was determined by Western blot technique. Results Serum IGFBP 3 protease activity in parturient pregnant women, acromegalic patients,normaladultsanduntreatedGHDpatientswere (75.2?2.2)%, (68.6?3.9)%, (22.7?3.1)% and (13.4?4.2)% respectively. Serum IGFBP 3 protease activity in GHD increased to (29.0?6.8)% after treatment with recombining human somatropin (rhGH) for six months. Conclusions Serum IGFBP 3 protease activity is modulated by GH and affects serum levels of members of GH IGF Ⅰ axis.