Safety and efficacy of umbilical cord mesenchymal stem cell therapy in hereditary spinocerebellar ataxia.

Hereditary spinocerebellar ataxia (SCA) is a devastating, incurable disease. Stem-cell-based therapies represent new promise for clinical research in neurology. The objectives of this study were to assess the feasibility, efficacy, and potential toxicity of human umbilical cord mesenchymal stem cells (UCMSCs) therapy in patients with SCA. Sixteen genomically diagnosed SCA patients were enrolled and received intravenous and intrathecal infusion of UCMSCs. Clinical, laboratory, and radiographic evaluations were conducted to assess the safety of UCMSC therapy. Efficacy was evaluated by the Berg Balance Scale (BBS) and International Cooperative Ataxia Rating Scale (ICARS) scores. Among the 16 cases, there were no serious transplant-related adverse events happened in 12 months follow-up. The majority of patients showed improved BBS and ICARS scores continuing for at least 6 months which indicated UCMSC therapy could alleviate SCA symptoms. This study suggested that UCMSC transplantation was safe and might delay the progression of SCA. This may represent a new therapeutic strategy for SCA and other genetic neurological diseases.

Serum bilirubin after acute ischemic stroke is associated with stroke severity.

Elevated serum bilirubin was prevalent in the acute ischemic stroke (AIS), which was induced in response to oxidative stress and could display the intensity of oxidative stress. As more severe stroke is linked with higher level of oxidative stress, we hypothesized that bilirubin may be associated with the severity of stroke. In this study, bilirubin and other biochemical indexes were measured in 531 enrolled patients with AIS, and NIH Stroke Scale (NIHSS) scores were assessed simultaneous with blood collection. The association between bilirubin and the severity of stroke was performed by Spearman correlation analyze, and the level-risk relationship of bilirubin in different level of NIHSS score was performed through Multinomial logistic regression analysis. We performed multivariable logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI) of severe stroke dichotomized as NIHSS≥8 with adjustment for other stroke risk factors, the level-risk relationship of severe stroke in different level of bilirubin was also performed through Multinomial logistic regression analysis. We found that NIHSS score was significantly positively correlated with both serum direct bilirubin (Dbil, R=0.229 and P=0.000) and total bilirubin (Tbil, R=0.224 and P=0.000), higher level of serum bilirubin linked to the higher NIHSS score with OR(95% CI) in upper level of NIHSS score group was 1.12(1.01-1.24), 1.23(1.11-1.36), 1.31(1.15-1.51) in Dbil and 1.01(0.99-1.31), 1.05(1.03-1.08), 1.07(1.03-1.11) in Tbil compared to the lowest level group. In unadjusted or adjusted logistic regression analyses, serum Dbil and Tbil still have a significant association with the severe stroke. When both the Dbil and Tbil concentrations were grouped into 4 levels, participants with higher levels of bilirubin showed higher risk with severe stroke compared with the lowest level of bilirubin, with OR(95% CI) 1.881(1.04-3.404) of Dbil in level 3 and 3.702(1.979-6.927) of Tbil, 3.352(1.572-7.147) of total bilirubin in level 4. As a conclusion, serum bilirubins were in significant correlation with severity of AIS, which may be served as useful markers to reflect the degree of illness.

[Management of symptomatic cerebral arterial stenoses with coincidental intracranial aneurysms].

OBJECTIVE: To explore the clinical features and management strategies of patients with symptomatic intracranial stenosis associated with unruptured intracranial aneurysms. METHODS: From 2005 to 2011, 24 patients of symptomatic intracranial stenosis with coincidental intracranial aneurysm were divided into two groups of angioplasty and aneurysm embolization (A, n = 12) and non-embolization (B, n = 12). All patients were followed up by phone or at outpatient services. Ten patients were re-assessed with digital subtraction angiography (DSA). RESULTS: The patients of group A were followed up without stroke or death, but one patient had restenosis asymptomatically. Two patients of group B died of subarachnoid hemorrhage. CONCLUSION: Angioplasty or antiplatelet therapy may increase the rupturing risk of aneurysm. Dissecting aneurysms should be handled by coiling positively and in a timely manner by coiling to prevent rebleeding. Coincidental intracranial aneurysms should be handled by coiling actively.

[Granulocytic sarcoma of oral cavity: report of two cases].

Granulocytic sarcoma of oral cavity is a kind of isolated tumor constructed by immature myeloid cells. Two cases of granulocytic sarcoma of oral cavity were analyzed. The literatures about granulocytic sarcoma were overviewed.