Expression pattern of MMP-12 in long-term optic nerve regeneration induced by lens injury / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the expression changes of MMP-12 during the long-term axon regeneration induced by the lens injury after the optic nerve clamp trauma in sprague-dawley(SD)rats.METHODS: The optic nerve injury model and lens injury model of SD rats were established, and the 24 experimental animals were divided into control group; lens injury group; optic nerve injury group; lens injury combined with optic nerve injury group, with 6 rats in each group. Reference transcriptome sequencing was used to analyze the expression changes of differentially expressed genes in the injured optic nerve region, and relevant differentially expressed genes with high expression were screened. Quantitative real-time polymerase chain reaction(qRT-PCR)and enzyme-linked immunosorbent assay(ELISA)were used to quantify the expression changes of matrix metalloproteinase-12(MMP-12)in the injured optic nerve region.RESULTS: The Principal Component Analysis of transcriptome sequencing indicated that lens injury combined with optic nerve injury was the principal component of gene expression change. Analysis of gene expression differences showed that the expression of MMP-12 gene was up-regulated in the lens injury combined with optic nerve injury group. The mRNA expression level of MMP-12 in the lens injury combined optic nerve injury group was up-regulated compared with the control group, the optic nerve injury group and the lens injury group at 14d and 21d after successful modeling(P<0.05). At 7, 28d, there was no difference in expression among all groups. The protein expression level of MMP-12 in the lens injury combined with optic nerve injury group was up-regulated compared with the control group and optic nerve injury group at 7, 14 and 21d after successful modeling(P<0.05), and it was up-regulated in the lens injury group combined with optic nerve injury group compared with optic nerve injury group at 21d(P<0.05). At 28d, there was no difference in expression among all groups.CONCLUSION: The up-regulated expression of MMP-12 may be involved in the long-term regeneration of the optic nerve after lens injury.

An improved association analysis pipeline for tumor susceptibility variant in haplotype amplification area / 南方医科大学学报

OBJECTIVE@#Haplotype amplification on germline variants is suggested to imply potential selective advantages and clonal expansion susceptibility and has become an important signature for seeking cancer susceptibility gene.Here we propose an improved association method that fully considers the haplotype amplification status.@*METHODS@#The haplotype amplification status was estimated by the variant allelic frequencies.We adopted a permutation test on variant allelic frequencies to divide the candidate variants into multiple groups.A likelihood clustering method was then applied to establish the neighborhood system of the hidden Markov random field framework.A filtering pipeline was introduced into the proposed method to further refine the candidate variants, including a Wilson's interval filter and a false discovery rate controller.The final candidate set along with the haplotype amplification status was collapsed into the weighted virtual sites for association tests.@*RESULTS@#Through simulated tests on a series of datasets, we compared the type Ⅰ error rates of different minor allele frequencies, which stably fell within 2%, suggesting good robustness of the algorithm.In addition, we compared another 5 published association approaches for Type-Ⅰ and Type-Ⅱ error rates with the proposed method, which resulted in the error rates all within 2%, demonstrating significant advantages and a good statistical ability of the proposed method.@*CONCLUSIONS@#The proposed method can accurately identify tumor susceptibility variants in haplotype amplification area with good robustness and stability.

Clinical outcomes of vocal fold immobility after tracheal intubation / 北京大学学报(医学版)

OBJECTIVE@#To assess the incidence of postoperative vocal cord immobility in patients following endotracheal intubation underwent general anesthesia.@*METHODS@#We retrospectively enrolled patients who underwent surgical procedures with endotracheal intubation under general anesthesia from January 2014 to December 2018 in Peking University First Hospital. Demographic and treatment data were obtained for patients with hoarseness and vocal cord fixation. The incidence of postoperative hoarseness and vocal cord fixation were presented and clinical outcomes were further analyzed.@*RESULTS@#A total of 85 998 patients following tracheal intubation and general anesthesia were enrolled in this study. Hoarseness was observed in 222 (0.26%) patients postoperatively. Sixteen patients (73%) were accomplished with symptoms of choking on water, dysphonia and sore throat. Twenty-nine patients with persistent hoarseness on the third postoperative day needed further treatment by otolaryngologists. Among them, seven patients had pharyngolaryngitis and twenty-two patients (0.026%) were demonstrated postoperative vocal cord immobility. There were seventeen patients (77%) with left-side vocal cord fixation and five patients (23%) with right-side vocal cord fixation. Nine patients were identified with arytenoid dislocation. Seven patients had left vocal cord fixation and two patients had right-side vocal cord fixation. Seven patients were intubated under the guidance of visual laryngoscope. One patient was confirmed difficult airway and intubated with light wand. One patient was inserted with laryngeal mask airway. One patient was suspected to have hoarseness caused by gastric tube before anesthesia. One patient showed simultaneously left recurrent laryngeal nerve abnormality on laryngeal electromyography result. The symptom of hoarseness ranged between 6 and 31 days. Three patients underwent closed reduction under local anesthesia and one patient demonstrated spontaneous recovery. Among the remaining thirteen patients with vocal cord immobility, two patients were demonstrated vocal cord paralysis. Eleven patients underwent neck surgery, thyroid surgery and cardiothoracic surgery and further examinations including laryn-geal electromyography and computed tomography help to determine the diagnosis were not performed. All patients were treated with inhaled corticosteroid conservatively. Five patients had significant improvement of symptom and almost regained normal voice. One patient had slight improvement and sixteen patients were not relieved before discharge.@*CONCLUSION@#Patients with hoarseness and vocal fold immobility after endotracheal intubation should be treated properly and immediately.

Mechanistic advancement in chemotherapeutic agents modulated antitumor immune response / 药学学报

Chemotherapeutic agents, also known as cytotoxic anticancer agents, inhibit the cancer cell proliferation via interrupting DNA replication, transcription and microtubule stability etc. Chemotherapeutic agents have been used in clinical cancer treatment for decades. Recently, with the tremendous advancement in immuno-oncology, chemotherapeutic agents have aroused renewed interest for their great potential to sensitize tumor cells to immunotherapy. Meanwhile, it is worth noting that the effects of chemotherapeutic agents on the immune system involve multiple aspects with complex mechanisms. Currently, there still lacks guidance for the combined use of chemotherapy and immunotherapy, and the clinical benefits remain obscure, impelling a better understanding of the impact of chemotherapeutic agents on the antitumor immunity. This article reviews the mechanistic insights into chemotherapy-modulated antitumor immune responses, with major focus on the direct effect on immune cells and the immunogenic remodeling of tumor cells. The review is particularly interested in the chemotherapy-trigged signaling that contributes to the immunogenic cell death. This review may provide useful insights into the immunomodulatory effects of chemotherapeutic agents and the implications in exploring therapeutic opportunities of chemotherapy in cancer immunotherapy.

The prediction of recurrent cerebral infarction by the neovascularization grade of carotid plaque using contrast enhanced ultrasonography: a Logistic regression model analysis / 中华医学超声杂志（电子版）

Objective To evaluate the utility of neovascularization grade of carotid plaque using contrast enhanced ultrasonography in the prediction of recurrent cerebral infarction by Logistic regression model analysis. Methods Eight-nine patients with first cerebral infarction were studied by conventional and contrast enhanced ultrasonography, then the two-dimensional echoic grade and neovascularization grade of carotid plaque was assessed. The condition of recurrent cerebral infarction in next year was followed up. The independent risk and predictive factors of recurrent cerebral infarction were analyzed by Logistic regression model and the utility of the independent risk and predictive factors in the prediction of recurrent cerebral infarction was evaluated by ROC curve. Results Both two-dimensional echoic grade of carotid plaque (P=0.028) and neovascularization grade of carotid plaque (P=0.006) were the risk and predictive factors of recurrent cerebral infarction in single-factor Logistic regression model. However, only the neovascularization grade of carotid plaque was the independent risk and predictive factor in multiple-factor Logistic regression model (P=0.043) with an OR value of 1.916. The sensitivity and specificity of the neovascularization grade of carotid plaque in prediction of recurrent cerebral infarction (cut-off value>Ⅱ) were 67.74% and 70.69% respectively and the area under ROC curve was 0.684(95%CI:0.577~0.779,P=0.0017).Conclusion The neovascularization grade of carotid plaques on contrast enhanced ultrasonography is the independent risk and predictive factor in prediction of recurrent cerebral infarction.

Effect of anesthesia selection on endovascular treatment for anterior circulation major vessel occlusion stroke / 中华神经科杂志

Objective To evaluate the effect of anesthesia selection on endovascular treatment for anterior circulation major vessel occlusion stroke. Methods The clinical data of patients undergoing endovascular treatment in our hospital from January 2016 to August 2016 were retrospectively reviewed. The patients were divided into general anesthesia group and conscious sedation group. Comparison of the differences in time, symptomatic intracranial hemorrhage, and 90-day functional outcome between the two groups was made. Results A total of 73 patients were included in the analysis, 34 (46.6％) in the general anesthesia group, and 39 (53.4％) in the conscious sedation group. The baseline clinical data were balanced in both groups. There was no statistically significant difference in door-to-puncture time, puncture-to-recanalization time and onset-to-recanalization time between the two groups. The postoperative systolic blood pressure was significantly decreased in the general anesthesia group ((126.29 ± 20.07) vs (139.95 ± 21.22) mmHg (1 mmHg=0.133 kPa), t=2.81, P=0.01), whereas the rate of successful reperfusion (modified thrombolysis in cerebral infarction ≥ 2b) (94.1％(32/34) vs 87.2％(34/39), χ2=0.33, P=0.57), symptomatic intracranial hemorrhage rate (17.6％(6/34) vs 10.3％(4/39), χ2=0.33, P=0.57) and good outcome (modified Rankin Scale (mRS) score≤2) at 90 days (41.2％(14/34) vs 53.8％(21/39),χ2=1.17, P=0.28) did not show statistically significant difference between the two groups. Conclusions The selection of general anesthesia or conscious sedation had no significant effect on the outcome of endovascular treatment for anterior circulation major vascular occlusion stroke. The results of the study still need to be verified by large-scale randomized controlled trial.

Risk factors associated with retinal vein occlusion / 眼科新进展

Objective To perform a risk factor analysis of central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO),and compare the difference in risk factors between CRVO and BRVO.Methods Retrospective observational casecontrol study included 46 CRVO patients,33 BRVO patients and 79 control subjects with senile cataract or refractive error,the risk factors and blood lipid spectrum analysis were performed and compared.Results Multivariate linear regression analysis showed that higher serum levels of homocysteine (P ＜ 0.000 1),total cholesterol (P =0.003 0),lipoprotein (a) (P =0.027 0),hypertension (P =0.022 0) and shorter axial length (P ＜0.000 1) were significantly correlated with CRVO.BRVO was associated with higher serum levels of homocysteine (P ＜0.000 1),total cholesterol (P =0.008 0),hypertension (P =0.002 0),body mass index (P =0.004 0) and shorter axial length (P =0.001 0).There was no significant difference in risk factors between CRVO and BRVO patients on multivariate analysis.Conclusion Multiple systemic (hyperlipidemia,hypertension and hyperhomocystinemia) and ocular (shorter axial length) risk factors are associated with both CRVO and BRVO,but these risk factors are not different between CRVO and BRVO.

The Predictive Value of Carotid Plaque Score for Evaluating the Severity of Coronary Artery Lesions / 中国循环杂志

Objective:To study the predictive value of carotid plaque score for evaluating the severity of coronary artery lesions.Methods:A total of 152 patients with coronary angiography diagnosed coronary artery disease (CAD) in our hospital from 2016-01 to 2016-05 were selected.According to coronary branch involvement,the patients were divided into 3 groups:Single branch lesion group,n=72,Double branch lesion group,n=38 and Multi branch lesion group,n=42.The basic conditions as plaque detection rate,high-density lipoprotein cholesterol (HDL-C),body mass index (BMI) were collected and carotid ultrasound examination was conducted in all patients.Carotid plaque condition and coronary lesion degree were calculated by semi-quantitative score and Gensini score methods;the relationship between semi-quantitative score and Gensini score was compared.Results:Total cholesterol (TC),HDL-C,LDL-C and BMI were similar among different groups,P＞0.05.Compared with Single branch lesion group,Double branch lesion group and Multi branch lesion group had more smokers and the higher plaque detection rate,P＜0.05.Semi-quantitative score and Gensini score were elevating as coronary lesion branch increasing accordingly.Conclusion:The severity of coronary lesions could be evaluated and predicted by semi-quantitative calculation of carotid integral.

The Predictive Value of Carotid Plaque Score for Evaluating the Severity of Coronary Artery Lesions / 中国循环杂志

Objective:To study the predictive value of carotid plaque score for evaluating the severity of coronary artery lesions.Methods:A total of 152 patients with coronary angiography diagnosed coronary artery disease (CAD) in our hospital from 2016-01 to 2016-05 were selected.According to coronary branch involvement,the patients were divided into 3 groups:Single branch lesion group,n=72,Double branch lesion group,n=38 and Multi branch lesion group,n=42.The basic conditions as plaque detection rate,high-density lipoprotein cholesterol (HDL-C),body mass index (BMI) were collected and carotid ultrasound examination was conducted in all patients.Carotid plaque condition and coronary lesion degree were calculated by semi-quantitative score and Gensini score methods;the relationship between semi-quantitative score and Gensini score was compared.Results:Total cholesterol (TC),HDL-C,LDL-C and BMI were similar among different groups,P＞0.05.Compared with Single branch lesion group,Double branch lesion group and Multi branch lesion group had more smokers and the higher plaque detection rate,P＜0.05.Semi-quantitative score and Gensini score were elevating as coronary lesion branch increasing accordingly.Conclusion:The severity of coronary lesions could be evaluated and predicted by semi-quantitative calculation of carotid integral.

LPL gene Pvu II polymorphism and hypertriglyceridemia: a meta-analysis involving 1,640 subjects

BACKGROUND/AIMS: Although lipoprotein lipase (LPL) gene Pvu II polymorphism has been associated with an increased risk of hypertriglyceridemia (HT), there is no clear consensus within the scientific community. METHODS: A meta-analysis of 1,640 subjects from six individual studies was conducted to better elucidate the potential relationship between the LPL gene Pvu II polymorphism and HT within the Chinese population. Pooled odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were evaluated by using fixed effect models. RESULTS: Our analysis indicated a significant association between LPL gene Pvu II polymorphism and HT within the Chinese population under allelic (OR, 1.550; 95% CI, 1.320 to 1.830; p = 1.158 × 10-7), recessive (OR, 0.540; 95% CI, 0.390 to 0.750; p = 0.0002), dominant (OR, 1.889; 95% CI, 1.501 to 2.377; p = 5.960 × 10-8), homozygous (OR, 2.167; 95% CI, 1.531 to 3.067; p = 1.242 × 10-5), heterozygous (OR, 1.810; 95% CI, 1.419 to 2.309; p = 1.842 × 10-6), and additive genetic models (OR, 1.553; 95% CI, 1.320 to 1.828; p = 1.158 × 10-7). CONCLUSIONS: Because LPL gene Pvu II restriction fragment length polymorphism polymorphism was associated with an elevated risk of HT, the P+ allele carriers of the LPL gene might be predisposed to HT.

p22phox C242T gene polymorphism and overt diabetic nephropathy: a meta-analysis of 1,452 participants

BACKGROUND/AIMS: The p22phox C242T gene polymorphism (rs4673) may be linked to an increased susceptibility for overt diabetic nephropathy (ODN), but the study results are still inconclusive. METHODS: To explore the relationship between p22phox C242T gene polymorphism and ODN, the current meta-analysis of 707 ODN patients and 745 controls from five individual studies was conducted. The pooled odds ratio (OR) and its corresponding 95% confidence interval (CI) were evaluated by either a random or fixed effect model. RESULTS: In our meta-analysis, a significant relationship between the p22phox C242T gene polymorphism and ODN was found under allelic (OR, 2.760; 95% CI, 1.400 to 5.450; p = 0.004), recessive (OR, 5.080; 95% CI, 1.020 to 25.430; p = 0.05), dominant (OR, 1.700; 95% CI, 1.167 to 2.477; p = 0.006), homozygous (OR, 3.900; 95% CI, 1.022 to 14.889; p = 0.046), heterozygous (OR, 1.523; 95% CI, 1.167 to 1.986; p = 0.002), and additive genetic models (OR, 2.019; 95% CI, 1.232 to 3.309; p = 0.005). CONCLUSIONS: A positive correlation between p22phox C242T gene polymorphism and ODN risk was found. The T allele carriers of p22phox C242T gene polymorphism might be predisposed to ODN.

Laryngeal Mask Airway for Cesarean Delivery: A 5-Year Retrospective Cohort Study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The laryngeal mask airway (LMA) is the most commonly used rescue airway in obstetric anesthesia. The aim of this retrospective cohort study was to evaluate the application of the LMA in parturients undergoing cesarean delivery (CD) for 5 years in our hospital. As a secondary objective, we investigated the incidence of airway-related complication in obstetric general anesthesia (GA).</p><p><b>METHODS</b>We collected electronic data for all obstetric patients who received GA for CD between January 2010 and December 2014 in Peking University First Hospital. Based on the different types of airway device, patients were divided into endotracheal intubation (ET) group and LMA group. The incidences of regurgitation and aspiration, as well as maternal and neonatal postoperative outcomes were compared between groups.</p><p><b>RESULTS</b>During the 5-year study, GA was performed in 192 cases, which accounted for 2.0% of all CDs. The main indications for GA were contraindication to neuraxial anesthesia or a failed block. Among these, ET tube was used in 124 cases (68.9%) and LMA in 56 cases (31.1%). The percentage of critical patients above the American Society of Anesthesiologists' Grade II was 24/124 in ET group and 4/56 in LMA group (P = 0.036). The emergent delivery rate was 63.7% for ET group and 37.5% for LMA group (P = 0.001). None of the patients had regurgitation or aspiration. There were no significant differences in terms of neonatal Apgar scores, maternal and neonatal postoperative outcomes between the two groups.</p><p><b>CONCLUSIONS</b>Our results suggested that GA was mainly used for contraindication to neuraxial anesthesia or a failed block, and emergent CDs accounted for most cases. The second-generation LMA could be used for obstetric anesthesia, but correct position to achieve a good seal is the key to prevent reflux and aspiration. Whether they could replace the tracheal tube in routine practice needs further large prospective studies.</p>

Elevated Levels of Very Low-density Lipoprotein Cholesterol Independently Associated with In-stent Restenosis in Diabetic Patients after Drug-eluting Stent Implantation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>High rate of in-stent restenosis (ISR) remained an unsolved clinical problem in clinical practice, especially among patients with diabetes mellitus (DM). Diabetic patients often had hypertriglyceridemia with elevated levels of very low-density lipoprotein cholesterol (VLDL-C). Increasing evidence suggested that VLDL-C was known as a significant risk factor for atherosclerosis and had been recommended as a treatment target by current dyslipidemia guidelines. However, the role of VLDL-C in the occurrence and development of ISR in coronary artery disease (CAD) patients with DM had not been studied. The aim of this study was to evaluate the association between the elevated levels of VLDL-C and the risk of ISR in CAD patients with DM.</p><p><b>METHODS</b>A total of 1390 diabetic patients, who underwent coronary drug-eluting stent (DES) implantation at Beijing Anzhen Hospital and followed up by angiography within 6-24 months, were consecutively enrolled. Patients' demographic and clinical characteristics, including age, gender, CAD risk factors, family history, life style, medical history, and coronary angiographic information, were collected carefully at baseline percutaneous coronary intervention and follow-up angiography. Multivariate Cox's proportional hazards regression modeling using the step-wise method (entry, 0.05; removal, 0.05) was used to determine the independent risk associated with ISR in diabetic patients.</p><p><b>RESULTS</b>Finally, 1206 of patients were included in this study. ISR occurred in 132/1206 diabetic patients (10.9%) by follow-up angiography. Patients with ISR had elevated median serum VLDL-C levels compared with those without ISR (0.65 mmol/L vs. 0.52 mmol/L, P = 0.030). The multivariate regression analysis showed that VLDL-C was significantly associated with the risk of ISR in diabetic CAD patients (hazard ratio [HR] = 1.15, 95% confidence interval [CI]: 1.03-1.29, P = 0.017). The HR for the risk of ISR associated with VLDL-C level ≥0.52 mmol/L was 3.01 (95% CI: 1.24-7.34, P = 0.015).</p><p><b>CONCLUSION</b>The elevated level of serum VLDL-C was a significant and independent risk factor for ISR in diabetic CAD patients after coronary DES implantation.</p>

The value of late-phase enhancement of carotid artery plaques in patients with cerebral infarction by contrast-enhanced ultrasonography / 中华医学超声杂志（电子版）

ObjectiveTo evaluate the late-phase enhancement of carotid artery in patients with cerebral infarction by contrast-enhanced ultrasonography.MethodsSixty-eight patients whose bilateral carotid artery plaques were both wider than 1.5 mm with treatment in Zhejiang Provincial People?s Hospital from April to July in 2013 were enrolled in this study. Among the enrolled patients, there are 50 patients with cerebral infarction including 30 patients with unilateral cerebral infarction and 20 patients with bilateral cerebral infarction, and 18 patients without cerebral infarction. The enrolled patients underwent conventional and contrast-enhanced ultrasonography. The time-intension curve was obtained till 6 minutes after the injection of contrast agent. The late-phase enhancement intensity and relative intensity of maximal carotid plaque was measured and calculated. The differences of late-phase enhancement intensity and relative intensity between patients with cerebral infarction and patients without cerebral infarction, and between ipsilateral and contralateral side of cerebral infarction in patients with cerebral infarction were compared using two samplet test.ResultsThe late-phase enhancement intensity of carotid plaque in patients with cerebral infarction and in patients without cerebral infarction was (6.0±1.5) and (4.9±1.2) dB, respectively, and the relative late-phase enhancement intensity of carotid plaque was 0.9±0.2 and 0.8±0.2, respectively. The late-phase enhancement intensity and the relative intensity of carotid plaque was higher in patients with cerebral infarction compared with patients without cerebral infarction, and the differences had statistical significance (value oft was 2.132 and 2.258 respectively, value ofP were both less than 0.05). The late-phase enhancement intensity of carotid plaque in ipsilateral and contralateral side of cerebral infarction was (7.1±1.8) and (4.9±1.2) dB, respectively, and the relative late-phase enhancement intensity of carotid plaque was 1.2±0.3 and 0.8±0.2, respectively. The late-phase enhancement intensity and the relative intensity of carotid plaque was higher in ipsilateral side of cerebral infarction compared with contralateral side of cerebral infarction in patients with cerebral infarction, and the differences had statistical signiifcance (value oft was 3.132 and 2.953 respectively, value ofP were both less than 0.01).ConclusionThe late-phase enhancement of carotid plaque in patients with cerebral infarction is significantly different from that in patients without cerebral infarction.

Effectiveness and safety of intravenous recombinant tissue plasminogen activator thrombolysis therapy for acute ischemic stroke patients with atrial fibrillation / 中华急诊医学杂志

Objective To study the effectiveness and safety of intravenous recombinant tissue plasminogen activator (rt-PA) thrombolysis therapy for acute ischemic stroke in patients with atrial fibrillation (AF).Methods A total of 94 patients treated with intravenous rt-PA thrombolysis within 4.5 hours after cerebral stroke onset were analyzed and divided into two groups:a non-AF group (n =64) and an AF group (n =30).Another 30 acute ischemic stroke patients with AF without thrombolytic therapy were selected as a control group.The prognosis of the three groups was compared.The National Institute of Health Stroke Scale (NIHSS) was used for comparison among the three groups before therapy and 7 days after therapy.The incidences of intracerebral hemorrhage (ICH) and symptomatic ICH (SICH) were recorded.The patients were followed up for 90 days and their clinical outcomes were assessed by using the modified Rankin scale (mRS).Results There were no significant differences in the NIHSS scores among three groups before treatment (P ＞ 0.05).The NIHSS scores were significantly lower in the AF and non-AF groups 7 days after thrombolysis therapy than those before thrombolysis therapy (P ＜0.05 and P ＜0.01),and no significant difference in the NIHSS scores was found in the control group before and after therapy (P ＞ 0.05).The incidence of ICH was significantly higher in the AF group than in the non-AF group (26.7％ vs.9.4％,P ＜ 0.05).No significant difference in the incidence of SICH was found between the AF and non-AF groups (13.3％ vs.6.3％,P ＞ 0.05).The favorable prognosis rate was higher in the AF and nonAFgroups than in control group (40.0％ vs.16.7％,P＜0.05; 45.3％ vs.16.7％,P＜0.01).No significant difference in very unfavorable prognosis rate was found between the AF and non-AF groups (20.0％ vs.18.8％,P ＞0.05).Conclusions It is effective and safe of rt-PA thrombolysis therapy for acute ischemic stroke patients with AF.

Progressive motor deficit caused by isolated unilateral pontine infarction extending to the pontine surface / 中华神经科杂志

Objective To analyze the causes,neuroimaging and clinical manifestations of isolated unilateral pontine infarction and to discuss its relationship to progressive motor deficit(PMD).Methods All 58 patients with isolated acute unilateral pontine infarction confirmed by magnetic resonance imaging (MRI) were recruited in this study for retrospective review.Thirty-one patients of them had brain and neck multi-slice spiral CT angiography(CTA) within 1 week after admission.PMD severity was accessed using the dynamic National Institutes of Health Stroke Scale (NIHSS) within 5 days after onset.All 58 patients were divided into two groups:patients with PMD (23 cases) in group 1 and patients without PMD (35 cases) in group 2.Two groups were compared for the risk factors,initial NIHSS scores,modified Rankin Scale (mRS) scores at 1 month after onset,clinical manifestations,infarction distribution,size and morphology of infarctions and basilar artery lesions.Results The major cause was pathologic changes in basilar artery branch in both groups(6/12 in group 1 and 10/19 in group 2).The proportion of patients with infarction extending to the pontine surface in group 1 was higher than that in group 2 (21/23,91.3％ vs 20/35,57.1％,x2 =7.817,P =0.005).Initial NIHSS score in group 1 was higher than that in group 2(6.7 ±2.9 vs 4.5 ± 2.4,t =3.121,P =0.003).mRS score at 1 month after onset in group 1 was higher than that in group 2(2.2 ± 1.1 vs 1.5 ± 0.8,t =2.909,P =0.004).The Logistic regression analysis showed that isolated unilateral pontine infarction extending to the pontine surface was positively related to PMD (odds ratio 9.670,95％ confidence interval 1.171-79.856,P =0.035).Conclusions Progressive isolated unilateral pontine infarction is mostly caused by pathologic changes in basilar artery branch.Patients with PMD have a more severe initial clinical manifest and they have a worse short-term prognosis than patients without PMD.Isolated unilateral pontine infarction extending to the pontine surface may be a risk predictor in stroke evolution.

Analysis of allergen variation for 3292 patients with allergic rhinitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the variation of common allergens in patients with allergic rhinitis in recent 4 years in Tianjin First Center Hospital.</p><p><b>METHODS</b>The medical records of skin prick test on 3292 patients with allergic rhinitis between 2009 and 2012 were restrospectively analyzed. The changing trend of various allergens in 4 years and distribution differences were compared. The differences of the top 5 allergens in under age group, adult group and different gender group were further analyzed by SPSS 19.0 software.</p><p><b>RESULTS</b>The positive rate of dermatophagoides farinae was increasing year by year, from 45.1% in 2009 to 66.3% in 2012, and the positive rate of dermatophagoides pteronyssinus increased from 42.0% in 2009 to 58.6% in 2012, the difference was statistically significant (χ(2) value was 68.70, 41.55, all P < 0.01). The positive rate of dermatophagoides farinae and dermatophagoides pteronyssinus in adult group and male group showed significant upward trend year by year (χ(2) value was 75.85, 69.93, 274.25, 42.62, all P < 0.01), but not in adult group and female group. The positive rate of quinoa, mugwort and humulus scandens decreased year by year between 2009 and 2011(χ(2) value was 22.08, 11.64, 203.19, all P < 0.01), but increased again in 2012(χ(2) value was 21.55, 29.38, 12.40, all P < 0.01).</p><p><b>CONCLUSIONS</b>There is a tendency of change of allergens in patients with AR. This phenominon may be helpful for doctors to choose the type of skin prick liquid.</p>

Role of target controlled infusion of remifentanil for the prevention of etomidate induced myoclonus during general anesthesia / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the preventive effect of etomidate-induced myoclonus by different concentrations of target-controlled infusion of remifentanil.</p><p><b>METHODS</b>A total of 120 cases undergoing general anesthesia were randomly divided into 4 groups according to different concentrations of target controlled infusion of remifentanil using plasma target controlled infusion ( Minto model) , in which the target concentration was set as 1 f.Lg/L ( group A) , 2 f.Lg/L ( group B) , 3 f.Lg/L ( group C) , and 4 f.Lg/L ( group D) . Five minutes after the balance of effect compartment, induction with etomidate 0. 3 mglkg was conducted intravenously. The intensity and duration of myoclonus was recorded.</p><p><b>RESULTS</b>The incidence of etomidate-induced myoclonus was 70.9%, 33.3%, 26.7%, and 0 in groups A, B, C, and D, respectively. Along with the increase of the remifentanil concentration, the incidence of severe myoclonus gradually reduced, which was significantly lower in group B and C than in group A ( P < 0. 05). When the concentration reached 4 f.Lg/L, bradycardia and apnea appeared.</p><p><b>CONCLUSION</b>Myoclonus induced by etomidate under general anesthesia can be prevented by target controlled infusion of remifentanil, with 2-3 f.Lg/L being the optimal concentration.</p>

Influence of methylenetetrahydrofolate reductase gene polymorphisms on antidepressant response / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To assess the influence of polymorphisms of methylenetetrahydrofolate reductase (MTHFR) gene on response to antidepressant treatment.</p><p><b>METHODS</b>Two hundred and eight one Chinese Han patients have received single antidepressant drugs for at least 6 weeks, among whom 275 were followed up for 8 weeks. Hamilton depression scale 17 (HAMD-17) was used to evaluate the severity of depressive symptoms and therapeutic effects. Single nucleotide polymorphisms (SNPs) of the MTHFR gene were determined using gene chips. Associations of single loci and haplotypes with response to treatment were analyzed using an Unphased 3.0.13 software.</p><p><b>RESULTS</b>No significant differences in gender, age, year of education, family history, episode times, and antidepressant agents were found between responders and non-responders (all P U+003E 0.05), while the baseline scores of HAMD-17 was significantly different(t=2.891, P=0.004). There was also no significant difference between age, years of education, family history, baseline scores of HAMD-17 and antidepressant agents between remitters and non-remitters (both P U+003E 0.05), while proportion of male patients was significantly higher in non-remission group than remission group (t=2.381, P=0.018), and episode times in non-remission group was significantly higher (t=-1.983, P=0.049). Single locus association analysis has found no significant association between SNPs rs1801131 and rs1801133 in the MTHFR gene with antidepressant response (P U+003E 0.05). On the other hand, haplotype A-C of MTHFR gene (rs1801131 and rs1801133) was significantly associated with antidepressant response in total group (U+03C7 2=11.39, P=0.0007), male subgroup (U+03C7 2=8.767, P=0.003) and serotonin noradrenaline reuptake inhibitors (SNRIs) subgroup (U+03C7 2=10.51, P=0.001).</p><p><b>CONCLUSION</b>Particular haplotype of MTHFR gene may be related with antidepressant effect, in which the haplotype (rs1801131, rs1801133) A-C type may be associated with better antidepressant efficacy, particularly in males and patients receiving SNRIs drugs.</p>

Determination of 1, 1-dichloro-l-nitroethane in air of workplaces by gas chromatography / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To establish a gas chromatography method for detecting the concentration of 1,1-dichloro-1-nitroethane in air of workplaces.</p><p><b>METHOD</b>1,1-dichloro-1-nitroethane in air of workplaces was collected by activated charcoal tube, absorbed using carbon disulfide and analyzed by Gas Chromatography (FID) with FFAP capillary column.</p><p><b>RESULTS</b>The linear rang of 1,1-dichloro-1-nitroethane in this method was 4.0-858.2 microg/ml, the linear regression formula was Y = 283X-1076, the correlation coefficient was 0.9999, the lowest detection concentration was 0.4 mg/m3 (3L sampling air), the relative standard deviation (RSD) was 1.8%-4.1%, the desorption efficiency was 88.5%-90.6%, the breakthrough volume was > 0.7 mg, the sampling efficiency was 100%, the samples could be kept at ambient temperature for at least 7 days.</p><p><b>CONCLUSION</b>The indicators of this method were conformed to the requirements of "Guide for establishing occupational health standards--Determination methods of air chemicals in workplace". This method could be used to detect 1,1-dichloro-1-nitroethane in air of workplaces.</p>