ABSTRACT
Objective To investigate the clinical value of multimodal ultrasonography combined with clinical indicators in predicting the progression of ischemic stroke(IS).Methods A total of 134 patients with IS admitted to Third People's Hospital of Yunnan Province from January 2020 to October 2022 were selected as study objects and were divided into progressive ischemic stroke(PIS)group(n=20)and non-progressive ischemic stroke(NPIS)group(n=114)according to the National Institutes of Health Stroke Scale(NIHSS)score.The clinical indicators,multi-modal ultrasonic image manifestations and related parameters of the two groups were counted,the influencing factors of PIS were screened by Logistics,the nomogram model was drawn,and the predictive efficiency of the nomogram model was evaluated by ROC curve and calibration curve.Results There were significant differences in age,baseline nutritional risk index(GNRI)score,baseline homocysteine(Hcy)and baseline uric acid(UA)between the two groups(P<0.05).The peak time(TTP),peak intensity(PI),the area under the curve(AUC),carotid plaque enhancement mode,the mean value of maximum elastic modulus(MEmax)and mean value of minimum elastic modulus(MEmin)were compared between the two groups,and the differences were statistically significant(P<0.05).Logistic analysis showed that baseline GNRI score,baseline UA,TTP,PI,AUCTC,carotid plaque enhancement pattern,MEmax and MEmin were the influencing factors of PIS(P<0.05).Based on the above factors,the nomogram model was drawn.ROC curve and calibration curve showed that the model had good prediction efficiency,and the prediction efficiency was in good agreement with the reality.Conclusion The influencing factors of PIS include baseline GNRI score,baseline UA,TTP,PI,AUCTC,carotid plaque enhancement pattern,MEmax,MEmin,and the neagram model based on the above factors has good differentiation and accuracy.
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Objective To explore the therapeutic effectiveness and pathways of human umbilical cord mesenchymal stem cells (hUCMSCs) transplantation for acute hepatic failure in rats.Method hUCMSCs were isolated from umbilical cord with attachment culture method,and the surface antigens were tested by flow cytometry.Forty-eight male Sprague Dawley rats were randomly divided into four groups.The animal model of acute liver failure was induced by injecting intraperitoneally with 50％ olive oil solution of carbon tetrachloride (2.5 ml/kg).The treatment groups were injected with hUCMSCs suspension separately through the tail vein or injected into the liver 24 h post-modeling.Blood serum and liver tissues were collected at several time points to analyze the improvement of liver function and histological repair.Real-time PCR was used to detect the expression of human CK8,CK18 and AFP mRNA in liver tissues.Immunohistochemistry was used to detect the expression of human CK18 in liver tissues.Result There were statistically significant differences among liver functions after transplantation (P＜0.05).hUCMSCs improved histological status through enhancing hepatocellular regeneration and reducing inflammatory cells.Real-time PCR results showed that the expression of CK8,CK18 and AFP mRNA was obviously increased in the tail vein transplantation group and hepatic lobe injection transplantation group as compared with the model group (P＜0.05).Immunochemistry results revealed that transplanted hUCMSCs in animal liver could differentiate into functional hepatocyte-like cells that expressed human CK18 as hepatocyte-specific marker in the tail vein transplantation group and hepatic lobe injection transplantation group.No significant differences in histological repair and grade of differentiation were examined between the tail vein transplantation group and hepatic lobe injection transplantation group (P＞0.05).Conclusion hUCMSCs can prompt the repair of acute liver failure and enhance pathological repair.Transplanted cells in animal liver can differentiate into functional hepatocyte-like cells that expressing hepatocyte-specific markers.Transplantation of hUCMSCs via the tail vein or direct injection into the liver had the similar therapeutic effects.
ABSTRACT
Objective To study the clinical features of Crohn's disease(CD)at different location,I.e.small intestine.colon and ileocolon,to facilitate the knowledge of the disease.Methods Data of 103 patients,hospitalized to our department from 2000 to January 2008,were retrospectively analyzed,including general status,clinical manifestations,laboratory findings and pathological changes.Results The cohort included 70 males and 33 females,with the age when the diagnosis was confirmed ranging from 12 to 70,with a peak at 20-29 yr.The location of the main lesion was at small bowel(L1)in 39(38%),at colon (L2)in 16(16%)and at ileum-colon(L3)48(46%).There was no significant difference between each group,regarding the age of onset or the when the diagnosis was confirmed.The incidence of intestinal obstruction was higher in L1 patients than that in L3(P＜0.05).In group L1,12(30.8%)were diagnosed by capsule endoscopy,and 17(44%)were confirmed by colonoscopy.Diagnostic rates of L2 and L3 with reference to clinical manifestations.combined with colonoscopy and pathology were 87.5%and 83.3%,respectivelv.In this cohort,there were 23(22.3%)mild cases,58(56.3%)moderate cases and 22 (21.4%)severe cases,according to simplified CD activity index(CDAI).The rate of severe case in L3 was 59.0%(13/48),which was significantly higher than that in L1(P＜0.05).Conclusion In patients with CD,L1 is characterized by delayed diagnosis and need of emergent surgery,while L3 is featured with extensive involvement.severe complications and systemic manifestations.Severe case is common in 13 patient,capsule endoscopy and Colonoscopy are important in early detection of the disease to decrease operation rate and delay the time of first operation.