Renin-angiotensin system inhibitor is associated with the reduced risk of all-cause mortality in COVID-19 among patients with/without hypertension / 医学前沿

Consecutively hospitalized patients with confirmed coronavirus disease 2019 (COVID-19) in Wuhan, China were retrospectively enrolled from January 2020 to March 2020 to investigate the association between the use of renin-angiotensin system inhibitor (RAS-I) and the outcome of this disease. Associations between the use of RAS-I (angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB)), ACEI, and ARB and in-hospital mortality were analyzed using multivariate Cox proportional hazards regression models in overall and subgroup of hypertension status. A total of 2771 patients with COVID-19 were included, with moderate and severe cases accounting for 45.0% and 36.5%, respectively. A total of 195 (7.0%) patients died. RAS-I (hazard ratio (HR)= 0.499, 95% confidence interval (CI) 0.325-0.767) and ARB (HR = 0.410, 95% CI 0.240-0.700) use was associated with a reduced risk of all-cause mortality among patients with COVID-19. For patients with hypertension, RAS-I and ARB applications were also associated with a reduced risk of mortality with HR of 0.352 (95% CI 0.162-0.764) and 0.279 (95% CI 0.115-0.677), respectively. RAS-I exhibited protective effects on the survival outcome of COVID-19. ARB use was associated with a reduced risk of all-cause mortality among patients with COVID-19.

Clinical features and treatment in patients with renovascular hypertension caused by renal arterial fibromuscular dysplasia / 中华普通外科杂志

Objective:To analyze the clinical characteristics and treatment of patients with renovascular hypertension (RVH) caused by renal arterial fibromuscular dysplasia (FMD).Methods:Clinical data and treatment result of 38 patients with renal arterial FMD and RVH admitted to our hospital from Jan 2014 to Dec 2020 were reviewed.Results:A total of 38 patients were enrolled in this study. Renal artery CTA showed that 40 renal arteries were involved, among these 6 branches had multifocal stenosis, and 34 branches had focal stenosis. Thity-three patients received surgical treatment, of which 32 patients underwent percutaneous transluminal renal angioplasty (PTRA), and 1 patient with renal aneurysm underwent renal artery stent implantation combined with aneurysm coil embolization. Postoperative blood pressure was significantly lower than that before the operation [(129.79±17.63) mmHg vs. (178.52±28.63) mmHg, t=-11.42, P<0.001]. The mean follow-up time was 35.5 months. Renal artery restenosis occurred in 4 patients and underwent reintervention. Conclusion:For patients with renal arterial FMD and RVH, PTRA is safe and effective, especially for patients with focal lesions, with fair short and mid-term prognosis.

Research progress of role of berberine in Alzheimer's disease / 国际中医中药杂志

Berberine (BBR) is a natural isoquinoline alkaloid extracted from coptis chinensis.Berberine has several pharmacological activities,including disease-resistant microorganisms,anti-inflammatory,anti-tumor,heart protection,hypoglycemia,regulation of lipid metabolism and immunomodulatory properties.However,BBR's effects on neurodegenerative diseases remained relatively unexplored until its ability to stunt AD progression was characterized.Substantial studies suggest that berberine may be beneficial to AD by limiting the pathogenesis of extracellular amyloid plaques and intracellular neurofibrillary tangles.The studies in recent years have also found that berberine can additionally treat AD by affecting neurotransmitter,anti-oxidative stress,metabolism and other multi-target pathways.This article discusses the treatment pathway of berberine on AD,and summarizes the inhibition mechanism of berberine on AD.

Analysis of clinical features and prognosis of 163 cerebral venous sinus thrombosis / 中华神经科杂志

Objective To investigate the clinical features,prognosis and its influencing factors of cerebral venous sinus thrombosis (CVST).Methods The clinical data of 163 patients with CVST were analyzed retrospectively.The outcome was assessed with the modified Rankin Scale (mRS).The influencing factors on prognosis were analyzed by logistic regression model.Results Among the 163 CVST cases,headache was found in 140 cases,motor and (or) sensory deficits in 16 cases,coma in 6 cases,serious intracranial hypertension (＞ 350 mm H2O,1 mm H2O＝0.0098 kPa) in 68 cases,lateral sinus thrombosis in 129 cases,straight sinus thrombosis in 11 cases and intracranial hemorrhage in 21 cases.Follow-up data was obtained by telephone in 150 cases (92％).The mRS scores were 0-1 in 89 cases,2 in 13 cases,3-5 in 44 cases,and 6 in 4 cases respectively.Poor outcome (mRS score ＞ 2) was found in 29.4％(48/163) patients.The total mortality rate was 2.7％ (4/150).Univariate analysis identified factors associated with poor outcome were motor and (or) sensory deficits,straight sinus thrombosis,serious intracranial hypertension (＞ 350 mm H2O) and intracranial hemorrhage.In logistic regression analysis,serious intracranial hypertension(＞ 350 mm H2O; OR =0.169,95％ CI 0.053-0.541,P =0.003) and intracranial hemorrhage (OR =0.075,95％ CI 0.018-0.311,P =0.000) were identified as independent predictors of poor prognosis.Conclusions The clinical manifestations of CVST are complicated and nonspecific.It is still a disease that may lead to death or disability.Serious intracranial hypertension(＞ 350mm H2O) and intracranial hemorrhage were independent predictors of poor prognosis.

A retrospective study of clinical features of migraine / 中华内科杂志

Objective To observe the clinical features of migraine based on out-patient clinic data and provide help for the diagnosis and treatment of migraine. Methods In a retrospective study of 309 patients with migraine, we investigated the clinical characteristics of migraine of both genders and different types, and the risk factors for MOH transformed from migraine. Results The female to male ratio was about 3:1,76.1% of the patients had triggering factors. The most common characteristics of headache were moderate to severe intensity of the pain (97.7%), aggravation by routine physical activity (75.1%), and association with nausea (90.9%) and/or vomiting (70.6%). There were significant differences in some clinical characteristics of migraine in females as compared with these in males and in patients with migraine without aura (MWOA) as compared with those with aura (MWA). The risk factors for MOH transformed from migraine were elder age of onset, high attack frequency and the analgesics frequently used (P < 0.05).Conclusion It is suggested that carefully collecting the characteristics of headache, triggering factors and therapeutic history is the foundation of correct diagnosis and effective treatment for migraine.

Determining the mRNA expression of lysophosphatidic acid receptors in vascular smooth muscle cells / 中国组织工程研究

BACKGROUND:Lysophosphatidic acid (LPA) had 3 kinds of receptors in vitro. Some researches had showed that LPA1, LPA2 and LPA3 receptors distributed widely in mouse cerebral cortex, nephritic external medulla layer and internal medulla layer, spermary, thymus, heart, lung, stomach, spleen, whereas less in liver, small intestine and skeletal muscles. Whether there are various LPA receptors in mouse VSMC membrane deserves further study.OBJECTIVE: To observe the mRNA expression of LPA receptors in vascular smooth muscle cells (VSMC).DESIGN: Observational comparative experiment.SETTING: Tongji Medical College, Huazhong University of Science and Technology.MATERIALS: A total of 24 C57BL/6 mice aged 7-8 weeks, of either sex, with the body mass of approximately (25±3) g,were purchased from the Animal Department of Tongji Medical College, Huazhong University of Science and Technology. Trizol was purchased from America Invitrogen; dNTP Mix, Rnasin were obtained from TaKaRa; M-MLV reverse transcriptase and buffer system were from Promega; Taq DNA-polymerase and buffer system were from Biostar.Oligo(dT)18 primer were from Sangon, Shanghai. Primer sequences were designed referring to literature and nucleotide sequence database and synthesized by Sangon, Shanghai.METHODS: The experiment was conducted at the Comprehensive Laboratory, Tongji Medical College, Huazhong University of Science and Technology between August 2005 and January 2006. Mice were anaesthetized by abdominal cavity with 20 g/L ketamine (5 mL/kg). Thoracic aorta was obtained sterilely, and VSMC was cultured with adherence method. The 4th-6th passage cells were used in the trial. Cell purity was over 95%. Reverse transcriptase-polymerase chain reaction (RT-PCR) was applied to determine the mRNA expression of LPA receptors gene in mouse VSMC.MAIN OUTCOME MEASURES: Detection of mRNA expression of LPA receptors in mouse VSMC and comparison of receptor types.RESULTS: There were no significant differences between the expressions of LPA1 receptors and LPA2 receptors (P ＞ 0.05). Compared with LPA1 receptors and LPA2 receptors (0.79±0.05,0.82±0.06), the LPA3 receptor expression was lower (0.53±0.05, q =23.78,26.53, P＜ 0.01 ).CONCLUSION: There are 3 kinds of LPA receptors in VSMC, and their molecular masses are 600 bp, 463 bp and 899 bp,respectively. There are no differences for the expressions between LPA1 receptors and LPA2 receptors, while the LPA3 receptor expression is less.

Relationship between levels of serum C-reactive protein, leucocyte count and carotid plaque in patients with ischemic stroke / 华中科技大学学报（医学）（英德文版）

In order to study the relationship between serum C-reactive protein (CRP) levels, leukocyte count and carotid plaque in patients with ischemic stroke, carotid duplex examination was performed by high-definition imaging (HDI) 5000 triplex system. Serum CRP was measured by nephelometry within 72 h after index ischemic stroke. A lesion was considered a plaque in the presence of a maximum intimal-medial wall thickness (IMT) 1.2 mm. Results of carotid ultrasonography were divided into two groups: M1, normal (IMT < 1.2 mm) and M2, abnormal (IMT > or = 1.2 mm). The results showed that the mean age of M2 was significantly older than that of M1 (69.7 +/- 10.4 versus 62.5 +/- 9.6, P = 0.001). The patients with hypertension and diabetes mellitus (78%, 35% respectively) in M2 were significantly more than those (52%, 18% respectively) in M1 (P < 0.01, P < 0.05). There were 32 (65%) patients with elevated CRP levels in M2, but 33 (46%) patients with elevated CRP levels in M1, with the difference being significant between the two groups (P < 0.05). The levels of serum glucose and leukocyte count (8.1 +/- 5.5, 10.3 +/- 4.0, respectively) in abnormal CRP group were significantly higher than that of normal CRP group (6.4 +/- 2.8, 8.7 +/- 3.4) (P < 0.05, P < 0.05); elevated CRP levels was found in 42 (62%) patients with territory infarction and 23 (43%) patients with lacunar infarction respectively, with the difference being significant between these two groups (P < 0.05). It was concluded that the elevation of CRP levels was an significant clinical index for carotid plaque in patients with acute cerebral infarction.

Basic study of biodegradable controlled release chemotherapy / 生物医学工程学杂志

This study sought to assess the biocompatibility of P(DA-SA)-Adriamycin, a new controlled-release chemotherapy system, in rabbit brain, and to examine its controlled release effect both in vitro and in vivo and its curative effects in vitro. The reaction of animal brain to the implanted P(DA-SA) or P(DA-SA)-Adriamycin was observed. The controlled-release profiles in phosphate buffer solutions and in rabbit brain were measured by UV spectrometry. Then, through flow cytometer, the rate of apoptosis in cultured glioma cells was tested. The reaction of rabbit brain to P(DA-SA) polymer was moderate and not significantly different from that to Gelfoam. The controlled-release rate of P(DA-SA)-Adriamycin in vitro and in vivo was stable and the duration of controlled-release of P(DA-SA)-Adriamycin spanned three weeks. The rate for apoptosis of glioma cells of P(DA-SA)-Adriamycin group was 69.9%, which was significantly higher than that of the control group. In conclusion, P (DA-SA)-Adriamycin controlled release chemotherapy system that bears curative effect has favorable controlled-release effect and good biocompatibility in rabbit brain. This system has potential value in treatment of malignant brain tumor.

Relationship between the carotid plaque and serum C-reactive protein,leucocytes count in patients with acute cerebral infarction / 临床神经病学杂志

Objective To investigate the relationship between carotid plaque and serum C reactive protein(CRP) levels, leukocyte count in patients with acute cerebral infarction(ACI) Methods Carotid duplex examination was performed in 121 patients with ACI by an Advanced Technology Laboratories HDI (high definition imaging) 5000 triplex system Serum CRP was measured by nephelometry Results of carotid ultrasonography were divided into two groups: M1: normal (IMT 0 05) The number of patient with elevated CRP levels was increased in the M2 group( P