The Role of MMP-9 in Regulating Degradation of the Splenic Microvascular Basement Membrane Induced by High Altitude Hypoxia / Rol de la MMP-9 en la Regulación de la Degradación de la Membrana Basal Microvascular Esplénica Inducida por Hipoxia de Altura

SUMMARY: To investigate changes of MMP-9 in the rat spleen and hypoxia-induced microvascular basement membrane under high altitude hypoxia. Thirty male specific pathogen-free Sprague Dawley rats were randomly divided into control and hypoxia groups, with 15 rats in each group. The rats in the control group were placed in Dingxi City, Gansu Province (2080 m above sea level) for 30 days. Rats in the hypoxia group were raised in a hypoxic environment in Maduo County, Qinghai Province (4300 m above sea level), for 30 days to establish a hypoxic rat model. Routine blood tests, MMP-9 mRNA, MMP-9 protein, and the spleen microvascular basement membrane were detected. (1) Compared with the control group, the red blood cell count, hemoglobin, and hematocrit levels of the rats in the hypoxia group were all increased; thus, a hypoxia model was successfully established. (2) Compared with the control group, the expression of MMP-9 mRNA and protein was significantly higher in the spleen of rats in the hypoxic group, and the difference was statistically significant (P <0.05). (3) Compared with the control group, the blood vessel basement membrane in the spleen of the hypoxia group was degraded. Under natural low air pressure and high altitude conditions, the expression of MMP-9 in rat spleen tissue increases and participates in the degradation of the microvascular basement membrane.

El objetivo de este trabajo fue investigar los cambios de la MMP-9 en el bazo de la rata y la membrana basal microvascular inducida bajo hipoxia a gran altura. Treinta ratas macho Sprague Dawley, libres de patógenos específicos, se dividieron aleatoriamente en dos grupos de 15 ratas cada uno, un grupo control y un grupo hipoxia. Durante 30 días las ratas del grupo control estuvieron en la ciudad de Dingxi, provincia de Gansu (2080 m sobre el nivel del mar). Las ratas del grupo de hipoxia se criaron en un entorno hipóxico en el condado de Maduo, provincia de Qinghai (4300 m sobre el nivel del mar), durante 30 días para establecer un modelo de rata hipóxica. Se realizaron análisis de sangre de rutina, ARNm de MMP-9, proteína MMP-9 y de la membrana basal microvascular del bazo. En comparación con el grupo control, el recuento de glóbulos rojos, la hemoglobina y los niveles de hematocrito de las ratas del grupo de hipoxia aumentaron; por lo tanto, se estableció con éxito un modelo de hipoxia. En comparación con el grupo control, la expresión de ARNm y proteína de MMP-9 fue significativamente mayor en el bazo de las ratas del grupo hipóxico, siendo la diferencia estadísticamente significativa (P <0,05). En comparación con el grupo control, la membrana basal de los vasos sanguíneos estaba degradada en el bazo del grupo hipoxia. En condiciones naturales de baja presión atmosférica y gran altitud, la expresión de MMP-9 en el tejido del bazo de la rata aumenta y participa en la degradación de la membrana basal microvascular.

Neoadjuvant therapy with anlotinib in a locally advanced and pulmonary metastasis PTC patient harboring TERT promoter and BRAFV600E mutations: a case report

SUMMARY A 71-year-old woman with recurrent papillary thyroid carcinoma (PTC) was referred to our hospital. A computed tomography scan revealed extensive recurrence in the neck, invading sternocleidomastoid muscle, internal jugular vein, sternal end of the clavicle, strap muscle and skin; and lateral compartment and subclavian lymph nodes were also involved. Multiple pulmonary micrometastases also noticed. The tumor was considered unresectable; however, the patient was unwilling to accept highly invasive surgery. Therefore, we initiated neoadjuvant therapy with anlotinib, 12mg p.o. daily with a 2-week on/1-week off regimen. The tumor shrunk to resectable state after 4 cycles of treatment, and after 3 weeks of withdrawal, successful surgical resection without gross tumor residual was performed. Pathology confirmed as classic PTC harboring coexistent TERT promoter and BRAFV600E mutations by NGS. After anlotinib therapy, apoptosis induction was observed, and proliferation increased, which was due to three weeks of anlotinib withdraw. Structual recurrence was recorded at 6 months after operation due to no further treatment was taken. Our finding suggests that anlotinib could represent as a good treatment option for patients with locally advanced (with or without distant metastasis) PTC; Anlotinib treatment resulted in sufficient reduction of the tumor mass to enable total thyroidectomy and radioactive iodine treatment, providing long-term control of the disease.

Current status and influencing factors of oral healthrelated quality of life among senior primary school students in Bengbu / 中国学校卫生

Objective@#To investigate oral health related life quality and associated factors of senior primary school students in Bengbu City, so as to provide scientific basis for targeted oral health education for children.@*Methods@#A stratified cluster random sampling method was adopted to select 1 760 senior students (grade 5 to 6) from 12 primary schools in 4 districts of Bengbu City from September to November 2022. A cross sectional survey was conducted on the oral health of students through questionnaires related to oral health. The effect of oral problems on quality of life was assessed by the Child Daily Life Oral Influence Scale (Child-OIDP). Chi square test, non parametric test and binary Logistic regression model were used to analyze the influencing factors of oral health related quality of life in senior primary school students.@*Results@#The prevalence of oral problems affecting the quality of daily life was 70.00%, and the severe impact rate was 15.06%. Oral feeding was the most affected (57.95%). The Child-OIDP score was (7.49±8.57). Binary Logistic regression analysis showed that mother s education level, self rated teeth and oral conditions, bruised tooth, toothache in the past year, and gingival bleeding in the past 2 weeks were significantly associated with the incidence of Child-OIDP ( OR=1.86-5.00, P <0.05).@*Conclusion@#It is common that oral problems affect the quality of daily life of senior primary school students in Bengbu. Families and schools should strengthen oral health knowledge education and behavior guidance, so as to reduce the impact of oral problems on daily life among senior primary school students.

Combination immunotherapy of glioblastoma with dendritic cell cancer vaccines,anti-PD-1 and poly I:C / 药物分析学报

Glioblastoma(GBM)is a lethal cancer with limited therapeutic options.Dendritic cell(DC)-based cancer vaccines provide a promising approach for GBM treatment.Clinical studies suggest that other immu-notherapeutic agents may be combined with DC vaccines to further enhance antitumor activity.Here,we report a GBM case with combination immunotherapy consisting of DC vaccines,anti-programmed death-1(anti-PD-1)and poly I:C as well as the chemotherapeutic agent cyclophosphamide that was integrated with standard chemoradiation therapy,and the patient remained disease-free for 69 months.The patient received DC vaccines loaded with multiple forms of tumor antigens,including mRNA-tumor associated antigens(TAA),mRNA-neoantigens,and hypochlorous acid(HOCl)-oxidized tumor lysates.Furthermore,mRNA-TAAAs were modified with a novel TriVac technology that fuses TAAs with a destabilization domain and inserts TAAs into full-length lysosomal associated membrane protein-1 to enhance major histo-compatibility complex(MHC)class Ⅰ and Ⅱ antigen presentation.The treatment consisted of 42 DC cancer vaccine infusions,26 anti-PD-1 antibody nivolumab administrations and 126 poly I:C injections for DC infusions.The patient also received 28 doses of cyclophosphamide for depletion of regulatory T cells.No immunotherapy-related adverse events were observed during the treatment.Robust antitumor CD4+and CD8+T-cell responses were detected.The patient remains free of disease progression.This is the first case report on the combination of the above three agents to treat glioblastoma patients.Our results suggest that integrated combination immunotherapy is safe and feasible for long-term treatment in this patient.A large-scale trial to validate these findings is warranted.

Investigation and molecular identification of Anisakis infection in marine fish sold in Fuxin, Liaoning Province / 中国热带医学

@#Abstract: Objective　To investigate the infection of Anisakis in marine fish sold in Fuxin, and conduct molecular identification and evolutionary tracing of third-stage larvae to determine Anisakis species. Methods　From 2018 to 2021, marine fish sold in the market were collected randomly, and the third stage larvae of Anisakis were detected in marine fish sold in the market by direct dissection, and the morphological characteristics were used to preliminarily identify species by microscopy; the total DNA was extracted, the internal transcribed spacer sequence of the ribosomal DNA of Anisakis was amplified, and the sequence alignment and evolution analysis were carried out. Results　A total of 289 market-sold sea fish samples of marine fish sold in the market were dissected and 84 samples of Anisakis were detected with a detection rate of 29.1%, of which the infection rates of hairtail and small yellow croaker were higher, at 41.4% and 41.2%, respectively. BLAST comparison of 28 sequences revealed eight species of anisakids, including Anisakis pegreffii, Anisakis simplex, Anisakis typical, Raphidascaris trichiurid, Contracaecum muraenesoxi, Hysterothylcaium zhoushanensis, Hysterothylacium amoyense and Hysterothylcaium fabri,belonging to the genera Anisakis and Hysterothylacium. The phylogenetic tree constructed from 28 sequences generally formed two topological branches, with Anisakis pegreffii, Anisakis simplex, and Anisakis typical forming three separate clusters as the topology branch of Anisakis genus. However, meanwhile, Hysterothylacium, Contracaecum, and Raphidascaris formed a separate topological branch. Conclusions　The marine fish sold in Fuxin City have severe anisakid infection, with a wide variety of anisakid species, the dominant species being Anisakis pegreffii.

Analysis of 50 cases of bloodstream infection with Listeria monocytogenes / 中国热带医学

@#Abstract: Objective　To analyze the characteristics of bloodstream infection of Listeria monocytogenes and provide basis for the diagnosis and treatment of the disease. Methods　We retrospectively analyzed the cases of Listeria monomyrhosi bloodstream infection in Peking Union Medical College Hospital (PUMCH) from April 2012 to April 2022. The age, sex, onset time, underlying disease, symptoms, diagnosis, treatment and prognosis of the patients were analyzed, as well as the changes of white blood cells (WBC), neutrophils, lymphocytes, and C-reactive protein (CRP) before and after anti-infection treatment. Results　Fifty cases of Listeria monocytogenes bloodstream infection confirmed by blood culture were involved. The age of patients ranged from 0 to 82 (43.7±20.0) years old, among whom 20.0% were over 60 years old. The onset time of patients was the highest in spring (44.0%), followed by winter (24.0%), and relatively fewer in summer and autumn (14.0%-18.0%). The median diagnosis time was 3 days (1-60 days). After the etiological diagnosis, 45 patients (90.0%) had underlying diseases or pregnancy status, and 45 patients were adjusted to the target antibacterial treatment mainly with carbapenems (48.9%) and penicillins (44.4%). The level of WBC, neutrophils, lymphocytes, monocytes, and CRP after treatment were significantly lower than those pre-treatments (P<0.05). Among all patients, 36 cases (72.0%) were treated according to the Antimicrobial Treatment Guidelines for Fever Sanford, of which 26 cases (72.2%) were discharged from the hospital, two cases died, one case was transferred to other hospitals, and 7 cases had a poor prognosis. Conclusions　Autoimmune diseases, tumor diseases, pregnant patients are susceptible to Listeria monocytogenes infection. Penicillins are the first choice for effective empiric therapy. For the patients allergic to penicillins, trimethoprim/sulfamethoxazole or meropenem could be used.

Clinical characteristics and serum IgG, IgM antibody manifestations of patients infected with SARS-CoV-2 B.1.1.529 (Omicron) variant strain / 中国热带医学

@#Abstract: Objective　To analyze the clinical characteristics and changes of serum IgG, IgM antibodies in patients infected with the SARS-CoV-2 B.1.1.529 (Omicron) variant. Methods　The clinical data of 82 patients with SARS-CoV-2 B.1.1.529 variant was analyzed retrospectively. Based on the presence of pneumonia on chest CT, the patients were divided into pneumonia group and non-pneumonia group. Serum IgG, IgM antibodies were observed at 5 time points T1 (1~<4 d), T2 (4~<8 d), T3 (8~<15 d), T4 (15~<22 d) and T5 (22~<30 d) after admission. Results　Among the 82 patients infected with the SARS-CoV-2 B.1.1.529 variant strain, there were 62 cases of cough, 31 cases of fever, 33 cases of throat discomfort, 5 cases of muscle soreness and 3 cases of diarrhea. The serum IgG antibody levels at 5 time points were 50.22 (142.20) AU/mL, 326.50 (220.63) AU/mL, 368.23 (76.21) AU/mL, 368.65 (79) AU/mL, and 385.26 (113.10) AU/mL, respectively. The level of serum IgG antibody in the pneumonia group was lower than that of the non-pneumonia group at T1 and T4 time points, and the differences were statistically significant (P<0.05) , the positive rate of serum IgG antibody in the pneumonia group was lower than that of the non-pneumonia group at the T1 time point, and the difference was statistically significant (P<0.05) . The serum IgM antibody levels at 5 time points were 0.41 (0.81) AU/mL, 0.95 (1.62) AU/mL, 1.09 (2.42) AU/mL, 0.74 (3) AU/mL, and 0.81 (3.10) AU/mL respectively, and there was no significant difference between the two groups. Conclusion　The clinical symptoms of patients infected with the SARS-CoV-2 B.1.1.529 variant strain are mild. Serum IgG antibodies increased after infection, but there are some differences between the pneumonia group and the non-pneumonia group, whether serum IgG has a protective effect needs further research; the serum IgM antibodies do not increase highly after infection, there are some differences between individuals.

Epidemiology and factors predicting survival of amyotrophic lateral sclerosis in a large Chinese cohort / 中华医学杂志(英文版)

BACKGROUND@#Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder associated with loss of motor neurons. Our objective was to explore the epidemiology, clinical features, and survival factors of 1809 patients with ALS.@*METHODS@#We analyzed 1809 ALS patients, who were recruited from the Peking University Third Hospital from January 2005 to December 2015. Demographic data and disease-related parameters were collected. Kaplan-Meier curves were used to compare survival time. Cox proportional hazards function and the hazard ratio were used to identify adjusted prognostic predictors.@*RESULTS@#The results showed that the average annual incidence in Beijing alone was 0.38 cases/100,000 person-years and the mean age of onset was 48.88 ± 11.35 (95% confidence interval [CI]: 48.17-49.85) years. The median survival time from onset to death/tracheostomy was 58.89 ± 33.03 (95% CI: 51.46-63.84) months. In the adjusted Cox proportional hazard model, age of onset, diagnosis delay, rate of disease progression (Amyotrophic Lateral Sclerosis Functional Rating Scale Revised decline [points/month]), and body mass index all had an independent effect on survival in ALS.@*CONCLUSIONS@#Our study provides information on epidemiology, clinical features, and survival factors of patients with ALS in China. These results can be helpful in clinical practice, clinical trial design, and validation of new tools to predict disease progression.

An updated meta-analysis of the relationship between glutathione S-transferase T1 null/presence gene polymorphism and the risk of lung cancer

Aim of Study: There were many reports published on the relationship between glutathione S-transferase T1 (GSTT1) null/presence gene polymorphism and the risk of lung cancer in these years. In previous, we conducted a meta-analysis to evaluate the relationship between GSTT1 null/presence gene polymorphism and the risk of lung cancer. This study was conducted to update it. Materials and Methods: The association studies were identified from PubMed and Cochrane Library on March 1, 2016. Results: Sixty-three reports were recruited into this meta-analysis for the association of null genotype of GSTT1 with lung cancer susceptibility, consisting of 21,220 patients with lung cancer and 21,496 controls. There was a marked association between GSTT1 null genotype and lung cancer risk in overall populations and in Asians (overall populations: Odds ratio [OR] = 1.17, 95% confidence interval [95% CI]: 1.07–1.28, P = 0.006; Asians: OR = 1.41, 95% CI: 1.23–1.62, P < 0.00001). However, GSTT1 null genotype was not associated with the risk of lung cancer in Caucasians, Brazilian population, and Africans. Conclusion: GSTT1 null genotype is associated with the lung cancer risk in overall populations and in Asians

The use of high-resolution MRI to detect thrombosis and lipid-rich carotid artery plaques in a patient with homozygous familial hypercholesterolemia

SUMMARY Homozygous familial hypercholesterolemia is a rarely agentic disorder of the lipoprotein metabolism intimately related to premature atherosclerotic cardiovascular disease that can lead to high disability and mortality. Homozygous familial hypercholesterolemia typically affects not only the aortic root, compromising the coronary ostia, but also affects other territories such as the carotid, descending aorta, and renal arteries. Multi-contrast high-resolution magnetic resonance imaging (MRI) provides a validated and useful method to characterize carotid artery atherosclerotic plaques quantitatively. However, very few studies have been done on assessing plaque composition in patients with Homozygous familial hypercholesterolemia using high-resolution MRI. This report is to evaluate the value of MRI in accessing carotid artery disease in patients with Homozygous familial hypercholesterolemia. We describe a 28-year-old patient from Beijing, China, who presented to the Neurology Clinic with intermittent blurred vision of the right eye, headache, nausea, and vomiting for eight years without obvious causes. Familial hypercholesterolemia was suspected based on medical history and laboratory examination. Carotid Doppler ultrasound showed bilateral common carotid artery, internal carotid artery, and external carotid artery wall thickening with hyperechoic signals. Subsequently, high-resolution multi-contrast MRI of the carotid showed calcification with hypo-intense areas located at the middle layer of the plaque, with moderate stenosis. The plaque located at the right bifurcation of the common carotid artery extended to the internal carotid artery, causing lumen stenosis close to occlusion. The patient was treated with right carotid artery endarterectomy. At a 6-month follow-up, there had been no recurrence of the patient's symptoms.

RESUMO A hipercolesterolemia familiar homozigótica, uma doença patogênica rara do metabolismo da lipoproteína intimamente relacionada com a doença cardiovascular aterosclerótica prematura, pode conduzir a uma elevada deficiência e mortalidade. A hipercolesterolemia familiar homozigótica afeta tipicamente não só a raiz aórtica, comprometendo os óstios coronários, mas também outros territórios, como a carótida, a aorta descendente e as artérias renais. Imagens de ressonância magnética multicontraste de alta resolução (RM) fornecem um método validado e útil para caracterizar quantitativamente as placas de aterosclerose da artéria carótida. No entanto, muito poucos estudos foram feitos sobre a avaliação da composição da placa em doentes com hipercolesterolemia familiar homozigótica utilizando ressonância magnética de alta resolução. Este trabalho deve avaliar o valor da ressonância magnética no acesso à doença da artéria carótida em doentes com hipercolesterolemia familiar homozigótica. Descrevemos um paciente de 28 anos de Pequim, China, que se apresentou à clínica neurológica com visão turva intermitente do olho direito, dor de cabeça, náuseas e vômitos por oito anos sem causas aparentes. Suspeitava-se de hipercolesterolemia familiar com base no histórico médico e no exame laboratorial. O ultrassom Doppler carotídeo mostrou uma artéria carótida bilateral comum, artéria carótida interna e parede da carótida externa espessando-se com sinais hiperecoicos. Posteriormente, a ressonância multicontraste de alta resolução da carótida mostrou calcificação com áreas hipointensas localizadas na camada média da placa, com estenose moderada. A placa localizada na bifurcação direita da artéria carótida comum estendia-se até a artéria carótida interna, causando estenose do lúmen próxima à oclusão. O paciente foi tratado com endarterectomia da artéria carótida direita. Em seis meses de acompanhamento, não houve recorrência dos sintomas do paciente.

Lapiferin protects against H1N1 virus-induced pulmonary inflammation by negatively regulating NF-kB signaling

H1N1 virus-induced excessive inflammatory response contributes to severe disease and high mortality rates. There is currently no effective strategy against virus infection in lung. The present study evaluated the protective roles of a natural compound, lapiferin, in H1N1 virus-induced pulmonary inflammation in mice and in cultured human bronchial epithelial cells. Initially, Balb/C mice were grouped as Control, H1N1 infection (intranasally infected with 500 plaque-forming units of H1N1 virus), lapiferin (10 mg/kg), and H1N1+lapiferin (n=10/group). Lung histology, expression of inflammatory factors, and survival rates were assessed after 14 days of exposure. Administration of lapiferin significantly alleviated the virus-induced inflammatory infiltrate in lung tissues. Major pro-inflammatory cytokines, such as interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α, were decreased at both mRNA and protein levels by lapiferin administration in the lung homogenate. Lapiferin also reduced inflammatory cell numbers in bronchoalveolar fluid. Mechanistically, lapiferin suppressed the transcriptional activity and protein expression of NF-κB p65, causing inhibition on NF-κB signaling. Pre-incubation of human bronchial epithelial cells with an NF-κB signaling specific activator, ceruletide, significantly blunted lapiferin-mediated inhibition of pro-inflammatory cytokines secretion in an air-liquid-interface cell culture experiment. Activation of NF-κB signaling also blunted lapiferin-ameliorated inflammatory infiltrate in lungs. These results suggested that lapiferin was a potent natural compound that served as a therapeutic agent for virus infection in the lung.

Clinical Characteristics and Adverse Events in Acute Coronary Syndrome Patients with a History of Peripheral Arterial Disease / Características Clínicas e Eventos Adversos em Pacientes com Síndrome Coronariana Aguda e História de Doença Arterial Periférica

Abstract Background: In clinical observation, patients with acute coronary syndrome complicated with peripheral artery disease have poor prognosis, so the relationship between the diseases and clinical characteristics need to be further explored. Objective: This study aims to investigate clinical characteristics and independent risk factors for in-hospital adverse events in acute coronary syndrome patients with a history of peripheral arterial disease (PAD). Methods: A total of 5,682 patients with acute coronary syndrome were included into this study. These patients were divided into two groups according to the presence or absence of a history of PAD: PAD group (n = 188), and non-PAD (control) group (n = 5,494). Then, the clinical characteristics and incidence of in-hospital adverse events were analyzed; p < 0.05 was considered statistically significant. Results: The age of PAD patients was higher than that in the control group (65.5 ± 10.3 years vs. 58.6 ± 11 years, p < 0.001), and the proportion of PAD patients with diabetes history and stroke history was higher than that in the control group (73 [39%] vs. 1472 [26.8%], p = 0.018; 36 [19.3%] vs. 396 [7.2%], p < 0.001). The multivariate logistic regression analysis between groups based on in-hospital adverse events revealed that a history of PAD (OR = 1.791, p = 0.01), a history of diabetes (OR = 1.223, p = 0.001), and age of > 65 years old (OR = 4.670, p < 0.001) were independent risk factors for in-hospital adverse events. Conclusion: A history of PAD, advanced age, and a history of diabetes are independent risk factors for in-hospital adverse events in patients with acute coronary syndrome.

Resumo Fundamento: Na observação clínica, os pacientes com síndrome coronariana aguda com doença arterial periférica têm prognóstico ruim, portanto, a relação entre as doenças e as características clínicas precisa ser mais explorada. Objetivos: Este estudo tem o objetivo de investigar características clínicas e fatores de risco independentes para eventos adversos hospitalares em pacientes com síndrome coronariana aguda e história de doença arterial periférica (DAP). Métodos: Foram incluídos no estudo 5682 pacientes com síndrome coronariana aguda. Os pacientes foram divididos em dois grupos de acordo com a presença ou ausência de DAP prévia: grupo DAP (n = 188) e grupo sem DAP (n = 5494, grupo controle). Em seguida, foram analisadas características clínicas e a incidência de eventos adversos hospitalares nesses grupos; um p < 0,05 foi considerado estatisticamente significativo. Resultados: A idade dos pacientes com DAP foi maior que a idade do grupo controle (65,5 ± 10,3 anos vs. 58,6 ± 11 anos, p < 0,001), e a proporção de pacientes com história de diabetes ou acidente vascular cerebral foi maior no grupo DAP que no grupo controle [73 (39%) vs. 1472 (26,8%), p = 0,018; 36 (19,3%) vs. 396 (7,2%), p < 0,001). A análise de regressão logística multivariada para eventos adversos hospitalares mostrou que história de DAP (OR = 1,791, p = 0,01), história de diabetes (OR = 1,223, p = 0,001), e idade >65 anos de idade (OR = 4,670, p < 0,001) foram fatores de risco independentes para eventos adversos hospitalares. Conclusão: DAP prévia, idade avançada, e história de diabetes são fatores de risco independentes para eventos adversos hospitalares em pacientes com síndrome coronariana aguda.

White matter hyperintensities and prognosis of patients with acute cerebral infarction treated by intravenous thrombolysis with alteplasejan analysis of influencing factors / 中国脑血管病杂志

Objective To investigate the influencing factors of intravenous thrombolysis with altepla.se on acute cerebral infarction patients with different degrees of white matter hyperintensity( WMH). Methods From September 2016 to January 2019,consecutive 326 acute cerebral infarction patients who had WMH and were treated with alteplase for intravenous thrombolysis at Department of Neurology,Xuzhou Central Hospital were retrospectively recruited. All patients completed cranial MRI examination after onset. Fazekas scale was used to evaluate WMH. National Institute of Health stroke scale ( N1HSS) score was used to evaluate the pre-thromkolytic neurological deficiency of the patients. The modified Rankin scale (MRS) was used to evaluate the prognosis at 90 days. According to the niRS score, patients were divided into the good prognosis group ( MRS 2,79 cases). Age,gender, previous risk factors related with cerebrovascular diseases, the pathogenesis of cerebral infarction, related biochemical indexes and NIHSS score before thrombolysis were compared between the two groups. Through the binary Logistic regression analysis, risk factors for poor prognosis of rt-PA intravenous thrombolysis in patients with acute cerebral infarction were identified. Results There was significant difference in age ([ 65 ± 12[ years old vs. [70 ± 12[ years old, t-2. 984, P = 0. 003), history of atrial fibrillation ( 10. 1% [25/247] w.21.5% [ 17/79]= 6. 928, P = 0. 008), history of coronary atherosclerotic disease ( 8. 1 % [ 20/247[ vs. 21.5% [ 17/79[ = 10. 717 , P-0. 001 ) , pre-thrombolylic N1HSS score ( median score 6 [4,10] r$. 12 [8,19],/=-7. 183.Pc0.01) and WMH (no WMH, mild WMH, moderate WMH, severe WMH:5.3% [ 13/247[, 55. 9% [ 138/247], 24. 3% [60/247], 14. 6% [36/247] vs. 0,36.7% [29/79] ,34. 2% [ 27/79[, 29. 1 % [23/79],∗' = 17. 631 ,P <0. 01 ).The binary Logistic regression analysis shoved that moderate and severe WMH (OR, 2. 145,95% CI 1. 17-3.49,/' = 0.014) and pre-thrombolytic NIHSS score 9 (OR, I. 131 ,95% CI 1.08-1. 18,/' <0. 01 ) were the independent risk factors for poor prognosis in patients with acute cerebral infarction with alteplase intravenous thrombolysis. Conclusion Moderate and severe WMH and pre-thrombolytic NIHSS score were independent risk factors for poor prognosis in acute cerebral infarction patients treated with intravenous alteplase.

Mutation and clinical relevance in a large cohort of unrelated Chinese patients with hypertrophic cardiomyopathy / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the genetic basis and phenotypic correlation with disease severity in a large cohort of Chinese patients with hypertrophic cardiomyopathy (HCM).</p><p><b>METHODS</b>A total of 179 unrelated Chinese HCM patients admitted to our department from 2002 to 2011 were enrolled in this study. Direct gene sequencing of β-myosin heavy chain (MYH7), myosin binding protein-C ( MYBPC3), and cardiac troponin T (TNNT2) were performed and clinical data were obtained in these patients.</p><p><b>RESULTS</b>A total of 34 mutations were identified in 40 patients (22.3%), 79.4% (27/34) mutations occurred only once and a possible hot spot, A26 in MYH7, was found. Distribution of mutations was 52.9% (18/34) (MYBPC3), 35.3% (12/34) ( MYH7) and 11.8% (4/34) (TNNT2) respectively. Double mutations were identified in 2.2% (4/179) patients. Genotype-positive patients were associated with an earlier symptom onset, severer left ventricular hypertrophy, a higher incidence of syncope, and were more likely to have positive family history of HCM or sudden cardiac death (SCD) , and were more likely to progress into heart failure (24.2% vs. 5.0%, P = 0.002) and at a higher risk of SCD (9.1% vs. 0, P = 0.009) during the 6.5-year follow-up. No statistical difference in any clinical parameters and outcomes was found between patients carrying MYBPC3 and MYH7 mutations. Double mutations were associated with malignant clinical progression in this cohort. Different phenotype severity could be seen in HCM patients with same genotype (e. g. MYH7-1736T, TNNT2-R92W).</p><p><b>CONCLUSION</b>MYBPC3 is the most predominant gene mutation in this HCM cohort. The presence of a sarcomere mutation in patients with HCM is associated with poor clinical outcome, although no specific genes or mutations can exactly predict the severity of clinical phenotypes.</p>

Concentration Detection of Ethanol in HuaiShi Ye by Headspace GC / 中国药师

Objective:To establish a detection method for ethanol in HuaiShi province Ye. Methods:Ethanol in HuaiShi Ye was determined by GC with a DB-ALC1 capillary column(30 m × 0. 53 mm,3. 0 μm), an FID detector and nitrogen as the carrier gas. The injector temperature was 200℃, the detector temperature was 250℃ and the column temperature was 80℃. The flow rate of N2 was 5 ml·min-1 . Tertbutyl alcohol was used as the internal standard, and 1. 0μl sample was injected by a headspace injector. Results:The solvents were completely separated, and the calibration curve of ethanol had good linear relationship within the range of 3. 177 0-15. 885 0 mg(r=0. 999 6), and the recovery was 98. 7%. The intra-day precision of different concentrations was less than 2. 5%. Conclusion:The method is sensitive, rapid, accurate and reliable, and can be used for the determination of ethanol in HuaiShi Ye.

An unusual presentation of thoracic para-aortic hematoma due to blunt trauma.

An 11-yr-old boy was admitted to the hospital with gradually aggravating acute abdominal pain along with nausea, vomiting and constipation for 5 days. The pain started after blunt trauma on the superior abdomen. He had normal laboratory tests and abdominal examination, but his chest radiograph showed infiltration in the right lung and an abnormal mass on the left diaphragm. Further investigation like computed tomography (CT) and magnetic resonance MR angiography, revealed an abnormal para-aotic mass located a mass located para-aortic above posterior to the left diaphragm with a well-defined margin. The abnormal mass was finally confirmed to be a hematoma with exploratory thoracotomy. The rarity of this kind of presentation is discussed for making an early and correct diagnosis.

Expression and regulation of HES1 in sperms with low motility from asthenospermia patients / 基础医学与临床

Objective To analyze the expression and regulation of HES1 in sperms with low motility.Methods Thirty semen samples from asthenospermia patients and 20 semen samples from healthy and fertile adults were collected,total RNAs were extracted to produce cDNAs probes.Hybridization with Phalanx OneArray~(TM) containing 30 968 probes was carried out after the labeled cDNAs were purified by PCR product purification kit.Realtime RT-PCR was used to analyze the expression of hsa-miR-487a and hsa-miR-193b;the expression of the target genes of hsa-miR-487a and hsa-miR-193b were searched from gene-expression profiles in asthenospermia patients' sperms.Results The expression level of HES1 in low motility sperms was up-regulated.The expression level of hsamiR-193b in low motility sperms was 2.19 times higher than that in high motility sperms,hsa-miR-487a was 0.43% of that in high motility sperms.Conclusion The expression level of HES1 in low motility sperms was up-regulated.Hsa-miR-487a and hsa-miR-193b may affect the expression of HES1 and so regulate sperm motility.

Effects of precondition of acupoint embedding thread on-enterokinesia and lactation in the postcesarean parturient / 中国针灸

<p><b>OBJECTIVE</b>To observe the restoring time of enterokinesia and changes of lactation amount in the postcesarean parturient and to probe into effects of acupoint embedding thread.</p><p><b>METHODS</b>Three hundred postcesarean parturients were randomly divided into an observation group and a control group. The control group and the observation group were treated with routine obstetric treatment, with catgut embedding at Zusanli (ST 36) and Shangjuxu (ST 37) added in the observation group.</p><p><b>RESULTS</b>The observation group in the restoring time of enterokinesia, the time of first exsufflation from the anus, the time of secretion of foremilk, the time of milk meeting the need of the new-born and the breast-feeding rate of 42 days all were better than the control group with a very significant difference between the two groups (P < 0.01).</p><p><b>CONCLUSION</b>Catgut embedding at Zusanli (ST 36) and Shangjuxu (ST 37) has a benign regulative action on enterokinesia and lactation in the postcesarean parturient.</p>

Immune responses induced by a Leishmania (Leishmania) amazonensis recombinant antigen in mice and lymphocytes from vaccinated subjects

A resposta imune induzida por uma proteina recombinante de Leishmania (Leishmania) amazonensis de 33 kD (Larp33) foi avaliada em linfocitos de individuos vacinados com a Leishvacin e em camundongos atraves de vacinacao. Larp33 foi expressa em Escherichia coli apos clonagem de um fragmento genomico de L. (L.) amazonensis de 2,2 kb no vetor pDS56-6His. Larp33 foi reconhecida por anticorpos IgG presentes no soro de individuos vacinados com Leishvacin e induziu proliferacao em linfocitos desses individuos em niveis comparaveis ao antigeno total de Leishmania...