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Objective To explore the therapeutic effect of intravenous transplantation of human amniotic mesenchymal stem cells (hAMSCs) on protection of motor behaviors in hSOD1-G93A mouse models of amyotrophic lateral sclerosis (ALS).Methods Amnion membranes were obtained from placentas delivered by healthy mother donors.The hAMSCs were gradually isolated and purified from amnion membranes using tissue culture method.Immunophenotypes of the isolated hAMSCs were analyzed using fluorescence activated cell sorter (FACS).Transgenic mice harboring a high copy number of hSOD1-G93A (B6SJL-TgN [SOD1-G93A] 1Gur) transgene were used in this study.Hemizygous transgenic progenies were maintained by mating the transgenic males with F1 hybrid wild-type (WT)females.The progenies were genotyped by polymerase chain reaction (PCR) using genomic DNA isolated from mouse tail after birth.The study included hSOD1-G93A mice transplanted with hAMSCs,PBS-injected transgenic mice,and normal WT mice (n=12).The hAMSCs were administered intravenously in jugular vein of the mice under anesthesia.The cells (1 ×106) in 200 μL PBS were delivered over 10 min.Animals received cells or PBS at 12,14,and 16 weeks old,respectively.The disease onset and progression of ALS mice models were monitored using rotarod performance test,PaGE test,and CatWalk gait analysis since 8 weeks old every week.Results (1) The immunophenotype of the isolated hAMSCs was conformed using FACS.These cells were positive for CD29,CD44,CD73,CD90,and CD166,but negative for CD14,CD34,CD45,CD123,and human leukocyte (site) DR antigen.Interestingly,stage specific embryo surface antigen 4 and octuber binding transcription factor 4 were detected in hAMSCs.(2) ALS mice in the hAMSCs transplantation group had significantly improved motor functions than those in the PBS treatment group:motor performance on the rotarod test (from 14 to 18 weeks old),PaGE test (from 15 to 18 weeks old) and CatWalk gait analysis (from 15 to 19weeks old) in hAMSCs-injected ALS mice was significantly improved as compared with that in the PBS treatment group (P＜0.05).Conclusions The multiple transplantation of hAMSCs by intravenous delivery can bring amelioration of the disease phenotype,as evidenced by improved motor function in hSOD1-G93A mouse models.The hAMSCs transplantation can be considered as a promising cellular treatment for ALS.
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Objective To assess the early prognosis of 117 patients after carduopulmonary resuscitation (CPR) in ICU by using the markers of inflammation,Glasgow Coma Scale (GCS) and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores.Methods A total of 117 CPR patients admitted between 2010 January to 2012 December were enrolled for study.Within 24 h after admission,inflammatory markers,blood routine items,hepatorenal function,electrolytes of blood were measured.The GCS and APACHE Ⅱ scores were recorded.Arterial blood gas analyses were performed at 0,12,and 24 h after hospitalization,and the 12-h and 24-h lactate clearance rates were calculated.Seven days after treatment,according to the outcomes,the patients were divided into survival group and death group,and the clinical data of two groups were analyzed.Results (1) Of them,73 patients died and 44 survived.Factor analysis showed that age,time elapsed from resuscitation to ICU admission,D-dimer,arterial oxygenation index (FiO2),arterial blood pH,arterial blood lactate concentration upon ICU admission,GCS score and APACHE Ⅱ score were significantly different between the two groups (P ＜ 0.05or P ＜ 0.01); (2) Two classification logistic regression analysis showed that D-Dimer,GCS score and APACHE Ⅱ score significantly correlated with the mortality risk of the patients in the wake of CPR with relative odds ratios of 1.000,2.091,and 0.531,respectively (P ＜ 0.05 or P ＜ 0.01) ; (3) Receiver operating characteristic curve analysis indicated that the area under the curve of GCS (0.821) and APACHE Ⅱ (0.869) had higher predictive value than D-dimer (0.655).The highest accuracy (84.6％) in predicting patient survival was achieved when the GCS score was 6.5.Meanwhile,the highest accuracy (82.1％) in predicting patient death was achieved when the APACHE Ⅱ score was 17.5.Conclusions Both GCS score and APACHE Ⅱ score has obvious correlation with the prognosis of the critically ill patients after CPR and could be used to predict prognosis at early stage.
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A male patient undergoing extracorporeal ultrasound lithotripsy developed the symptoms of dyspnea, low blood pressure, palpitations, chest tightness, and sweating, and a clinical diagnosis of pulmonary capillary leak and hypovolemic shock was made. Pulse indicator continuous cardiac output (PiCCO) technique was used for resuscitation according to the measurements of extravascular lung water index (EVLWI) and global end-diastolic volume index (GEDI). The patient showed low levels of cardiac output (CO) and GEDI with a peak EVLWI of 32 ml/kg and profuse pink and thin sputum overflow from the trachea. The high ventilator support parameters failed to correct low oxygen saturation. Restricted fluid infusion was used to reduce pulmonary edema. Colloidal solution was given when GEDI was below 500 ml/m(2), and the volume and fluid infusion rate were reduced for a GEDI higher than 500 ml/m(2). Pulmonary edema was gradually reduced after the treatments with improvement of lactic acid level and liver and kidney functions. Vasopressors were withdrawn 6 days later, mechanical ventilation was discontinued 10 days later, and tracheal intubation was removed 25 days later, after which the patient was discharged. In the treatment of the patient, PiCCO monitoring played an important role.
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Adulto , Humanos , Masculino , Síndrome de Fuga Capilar , Terapéutica , Fluidoterapia , Litotricia , Edema Pulmonar , Terapéutica , Choque , TerapéuticaRESUMEN
Objective To evaluate the genetic factors for sporadic Alzheimer's disease(SAD) among a Chinese population in Beijing. Gene polymorphisms was studied: apolipoprotein E,ps-1 gene E318G missense mutation,alpha(2)-macroglobulin gene Val1000/Ile1000,mtDNA4336G mutation and methylene tetrahydro-fulek reduclase (MTHFR) C677T mutation. Methods The polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)technique was used to analyze the genotype of 127 SAD patients and 138 non-dementia elderly controls. Results There was a significant difference in the frequency of apoE allele gene between SAD and control group. The freguencies with 2 of apoE4 ,1 of apoE4 and none of apoE4 in SAD were 2.4%,18.1%,79.5% respectively,and in normal control were 0.7%,10.1%,89.2% respectively. mtDNA4336 mutation and ps-1 E318G missense mutation were not found in either Alzheimer's disease or age-matched controls. The frequency of A2M Val1000 (GTC)/Ile1000 (ATC),G/G genetype was 0.02 in SAD and 0.01 in NC . The frequency of MTHFR C677T mutation was 46.3% in SAD and 43.8% in NC respectively, The mutation frequency of cases was not significantly increased than that of controls. Conclusions Our study indicates that apoE?4 allele gene is risk factor for SAD.
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Objective To study the distribution of Apolipoprotein E(ApoE) gene polymorphism and mtDAN*!4336 mutation in patients with sporadic Alzheimer's disease(AD),and analyse the difference of frequency of ApoE genotype from some other studies.Methods The polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) technique was used to analyze the ApoE allele genotype and mtDAN mutation of 127 AD patients and 138 healthy elderly controls.Results In AD group, we found 2.4% of the patients with 2 ApoE4 allele gene, 18.1% of the patients with 1 ApoE4 allele gene, and 79.5% of the patients without ApoE4 allele gene. However, in control group, the frequency was 0.7%, 10.1% and 89.2% respectively. There was a significant difference between the two groups( P
