[Iopromide-Induced Encephalopathy: A Case Report and Literature Review].

A 42-year-old male was admitted for paroxysmal syncope for 10 + months, chest tightness for 20 + days and chest pain for 10 + days. The patient was diagnosed with hypertrophic cardiomyopathy. The patient did not have a history of hypertension or diabetes. Coronary angiography and left ventricular cardiac catheterization were done in order to examine the coronary artery and the pressure gradient of the left ventricular outflow tract. The cardiac catheterization was performed via a right radial artery approach and a total of 200 mL of 370 mg I/mL iopromide was injected. The patient developed contrast-induced encephalopathy following the cardiac catheterization procedure, displaying severe headache, cortical blindness and neuropsychiatric symptom as the main clinical manifestations. The patient was then given symptomatic and supportive treatment, including decreasing intracranial pressure, analgesics and sedatives, and the patient recovered.

Acute myocardial injury is common in patients with COVID-19 and impairs their prognosis.

OBJECTIVE: We sought to explore the prevalence and immediate clinical implications of acute myocardial injury in a cohort of patients with COVID-19 in a region of China where medical resources are less stressed than in Wuhan (the epicentre of the pandemic). METHODS: We prospectively assessed the medical records, laboratory results, chest CT images and use of medication in a cohort of patients presenting to two designated covid-19 treatment centres in Sichuan, China. Outcomes of interest included death, admission to an intensive care unit (ICU), need for mechanical ventilation, treatment with vasoactive agents and classification of disease severity. Acute myocardial injury was defined by a value of high-sensitivity troponin T (hs-TnT) greater than the normal upper limit. RESULTS: A total of 101 cases were enrolled from January to 10 March 2020 (average age 49 years, IQR 34-62 years). Acute myocardial injury was present in 15.8% of patients, nearly half of whom had a hs-TnT value fivefold greater than the normal upper limit. Patients with acute myocardial injury were older, with a higher prevalence of pre-existing cardiovascular disease and more likely to require ICU admission (62.5% vs 24.7%, p=0.003), mechanical ventilation (43.5% vs 4.7%, p<0.001) and treatment with vasoactive agents (31.2% vs 0%, p<0.001). Log hs-TnT was associated with disease severity (OR 6.63, 95% CI 2.24 to 19.65), and all of the three deaths occurred in patients with acute myocardial injury. CONCLUSION: Acute myocardial injury is common in patients with COVID-19 and is associated with adverse prognosis.

Genetic polymorphisms of DNA repair pathways influence the response to chemotherapy and overall survival of gastric cancer.

We aimed to evaluate the clinical response to platinum-based chemotherapy and treatment outcome of gastric cancer patients in the present of ERCC1, ERCC2, NBN, RAD51, and XRCC3 gene polymorphisms. A number of 415 patients of gastric cancer that received platinum-based chemotherapy were enrolled in the present study. The presence of ERCC1 rs11615 and rs2298881, ERCC2 rs1799793 and rs13181, NBN rs1805794, rs709816, and RAD51 rs1801321 and XRCC3 rs1799794 were determined using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Conditional regression analysis identified that CC genotype of ERCC1 rs11615 and AA genotype of ERCC2 rs1799793 was associated with a better response to chemotherapy in gastric cancer patients, and the odds ratio (ORs)(95% confidence interval (CI)) were 2.70(1.33-5.70) and 3.12(1.52-6.84), respectively. By the Cox analysis, the CC genotype of ERCC1 rs11615, AA genotype of ERCC2 rs1799793, and CC genotype of NBN rs1805794 were significantly associated with a longer overall survival (OS) of gastric cancer. In conclusion, our results suggest that ERCC1 rs11615, ERCC2 rs1799793, and NBN rs1805794 polymorphisms in the DNA repair pathways may influence the response to chemotherapy and OS of gastric cancer.

Colorectal cancer mortality in Inner Mongolia between 2008 and 2012.

AIM: To determine the extent of colorectal cancer (CRC) mortality and the association between demographic characteristics and CRC mortality in Inner Mongolia. METHODS: Data were collected from the Death Registry System, maintained by the Inner Mongolia Centers for Disease Control and Prevention, from 2008 to 2012. Deaths were classified according to the International Classification of Disease, 10(th) Revision. Years of life lost, average years of life lost (AYLL), and mortality were calculated over the five years between 2008 and 2012. A conditional logistic regression model was used to analyze the association between marital status, occupational status, education level, area of residence, and the risk of CRC. RESULTS: The AYLL of CRC was 17.39 years. The average mortality of CRC was 5.6/100000. People living in urban areas and having a higher education level had a significantly higher risk of CRC (OR = 1.74 and 95%CI: 1.29-2.35, P < 0.001 and OR = 2.39, 95%CI: 1.76-3.25, P < 0.001, respectively). People who were employed had a lower risk of CRC (OR = 0.64, 95%CI: 0.48-0.86, P = 0.003). The mortality of CRC was positively correlated with the education level (P < 0.001). No statistically significant association was observed between marital status and CRC risk (P = 0.259). CONCLUSION: Living in urban areas, higher education level and unemployment are associated with CRC mortality in Inner Mongolia.

Future application of hair follicle stem cells: capable in differentiation into sweat gland cells.

BACKGROUND: Sweat glands (SGs) can not regenerate after complete destruction in the severe skin injury, so it is important to find a ideal stem cell source in order to regenerate functional SGs. Hair follicle stem cells (HFSCs) possess the obvious properties of the adult stem cells, which are multipotent and easily accessible. In this research, we attempted to direct the HFSCs suffered from the sweat gland cells (SGCs) special differentiation by a co-operative coculture system in vitro. METHODS: The designed co-culture microenvironment in the transwell was consist of two critial factors: heat shocked SGCs and dermis-like mesenchymal tissue, which appeared independently in the two control groups; after induction, the purified induced SGC-like cells were transplanted into the full-thickness scalded wounds of the nude mice, after 4 weeks, the reconstructed SG-like structures were identified by immunohistochemical and immunofluorescence analysis. RESULTS: A part of HFSCs in experimental group finally expressed SGCs phenotypes, by contrast, the control group 1 which just containing dermis-like mesenchymal tissue failed and the control group 2 consisted of heat shocked SGCs was in a poor efficiency; by immunofluorescence staining and flow cytometry analysis, the expression of HFSCs special biomarkers was down regulated, instead of the positive efficiency of SGCs special antigens increased; besides, the induced SGCs displayed a high expression of ectodysplasin A (EDA) and ectodysplasin A receptor (EDAR) genes and proteins; after cell transplantation, the youngest SG-like structures formed and be positive in SGCs special antigens, which never happened in untreated wounds (P < 0.05). CONCLUSION: The HFSCs are multipotential and capable in differentiating into SGCs which promise a potential stem cells reservoir for future use; our special co-culture microenvironment is promising for HFSCs differentiating; the induced SGCs are functional and could work well in the regeneration of SGs.

[A follow-up study on the post-traumatic stress disorders among middle school students in Wenchuan earthquake region].

OBJECTIVE: This study was to identify the post-traumatic stress disorder (PTSD) changes and the relative risk factors within one year after Wenchuan earthquake among middle school students in the disaster area. METHODS: A total of 1966 students from 3 schools in Wenchuan earthquake region were selected as the target population. For each student, personal basic information and standard psychological scale (PCL-C, PSSS) were investigated by a self-administrated questionnaire in the 3rd, the 6th, the 9th and the 12th month after the earthquake, respectively. PTSD trends over the time and the associated risk factors were analyzed through the establishment of multi-level random coefficient model. RESULTS: There were 1677 middle school students fully participated in the PTSD follow-up study by turning in the valid questionnaires. The averaged scores of PTSD at the time of the 3rd, the 6th, the 9th and the 12th month after the earthquake were 35.14 ± 11.08, 32.90 ± 11.03, 30.67 ± 11.28 and 29.75 ± 11.22, respectively. Meanwhile, the general incidences of PTSD were 36.6% (613/1677), 30.7% (515/1677), 24.8% (416/1677)and 22.2% (373/1677), respectively. The median score of perceived social support system was 60.00 and the general incidences of PSS was 17.20% (289/1677). The PTSD scores for the students had a decreasing trend during the period of our observation (ß(time) = -1.879, χ(2) = 47.03, P < 0.05). The averaged scores for boys for the 4 follow-up studies were 33.71, 31.61, 29.66, 28.83; for girls were 36.33, 33.98, 31.51, 30.52; for junior school students were 35.46, 33.28, 30.18, 29.22; for senior school students were 34.89, 32.62, 31.04, 30.15. Moreover, two factors, gender and grade, were related with the decreasing trend (the trend for girls and senior school students was sharper than that for boys and junior school students) (ß(gender-time) = -0.354, χ(2) = 4.83, P < 0.05; ß(grade-time) = 0.622, χ(2) = 11.30, P < 0.05). CONCLUSIONS: The prevalence of PTSD was high. Meanwhile, there was a trend of self-recovery for adolescent's PTSD during the first year of post-earthquake, but boys and junior school students recovered more slowly.

The effects of demographic features on differences in sensitivity between PCL-C and SCL-90 scores in a follow-up study in secondary school students in the Wenchuan earthquake region.

OBJECTIVE: To analyze the sensitivity of effect factors between the PCL-C and the SCL-90, to provide evidence for social psychological crisis screening and post-trauma interventions. METHODS: We administered the PCL-C and SCL-90 to screen for PTSD and other psychological problems among students who survived the disaster and continued their school studies. The surveys were carried out 3, 6, 9, and 12 months after the earthquake. A bivariate 2-level logistic model was used to explore the different levels of sensitivity among students. The factors influencing the relationships between PTSD and depression, and between PTSD and anxiety were examined. RESULTS: We analyzed data from 1 677 students, revealing that female students in higher grades were more likely to exhibit symptoms of depression, rather than PTSD, compared with the control group (males in lower grades), and the difference was significant (P<0.05). In contrast, ethnic minorities were more likely to exhibit PTSD symptoms compared to the others. In addition, female students were more likely to exhibit symptoms of anxiety than PTSD. Other effects that did not reach statistical significance were suggested to have a similar influence on PTSD, depression, and anxiety. CONCLUSION: After a natural disaster, specific aspects of depression and anxiety should be examined, avoiding an overemphasis on PTSD in social psychological crisis interventions.