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Objective To study the association between blood glucose control and mild cognitive impairment (MCI) in patients with diabetes mellitus and small-artery occlusion (SAO).Methods A screening study of cognitive impairment was conducted in the 676 patients diagnosed with SAO who had been treated at Department of Neurology,Huanhu Hospital from January 2010 through June 2017.They were divided into a normal cognition group (n=629) and an MCI group (n=47) according to the screening results.They were also divided into 4 groups according to their history of diabetes and levels of hemoglobin Alc:normal blood glucose group (n=398),stringent goals group (n=59),general goals group (n=46) and goals-not-met group (n=173).The differences were compared in terms of Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment Scale (MoCA) scores between the normal blood glucose,stringent goals,general goals and goals-not-met groups.We also analyzed the general clinical data and risk factors between the normal cognition and MCI groups.Variables of confounders that were identified as significant were entered into logistic regression.Results There were significant differences in MMSE and MoCA scores between the 4 groups (P＜0.05).Between the normal cognition and MCI groups,significant differences were found in proportion of smokers,blood glucose level and severity of stroke (P＜0.05).Logistic regression analysis showed that compared with the normal blood glucose group the incidence of MCI was 2.707-fold higher in the stringent goals group (OR=2.707,95％ CI:1.035～7.083,P=0.042),2.963-fold higher in the general goals group (OR=2.963,95％ CI:1.064～8.277,P=0.038) and 2.604-fold higher in the goals-not-met group (OR=2.604,95％ CI:1.269～5.341,P=0.009).Conclusions MCI is more likely to occur in acute phase in patients with diabetes and SAO stroke.The patients can benefit from joint managements of diabetes,stroke and cognitive dysfunction in clinical practice.
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We report here a case of myelitis of the cervical spinal cord in a 59-year-old woman presented with right arm weakness and numbness. Cervical myelitis developed three weeks after the eruption of zoster rash from the C2 to C5 dermatomes. The serum aquaporin-4 antibody was detected using the cell based transfection immunofluorescence assay. MRI of the cervical spine revealed abnormal cord signal. Cerebrospinal fluid analysis demonstrated varicella-zoster virus DNA was not detected. The patient was diagnosed with neuromyelitis optica spectrum disorder, supporting the hypothesis that the pathogenesis of neuromyelitis optica spectrum disorders is triggered by infection.
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Invasive aspergillosis ( IA) is a systemic infection disease caused by aspergillus , which attacks the deep tissue organs with poor prognosis .Early accurate diagnosis and timely antifungal treatment have great significance to improve the prognosis of patients with IA and reduce the mortality rate .Currently , the diagnosis of IA mainly depends on laboratory examination because the clinical manifestation of IA is almost lack of specificity , and easily masked by primary diseases .The main detection techniques of IA applied in clinic and diagnostic techniques with great potential application in the future were introduced and evaluated in this paper , so as to promote the IA diagnosis technology research and development .
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Objective To assess the outcomes of ischemic stroke patients with atrial fibrillation (AF).Methods Six thousand six hundred and ninety-five patients with acute ischemic stroke,admitted to our hospital from May 2005 to December 2013,were recruited consecutively.These patients were divided into combined AF group (n=583) and non-combined AF group (n=6112).The clinical data,including stroke subtypes,stroke severity,risk factors of stroke,NIHSS scores and Barthel index,and outcomes,including mortality,unfavourable prognosis and recurrence at 3,12,and 36 months after stroke were analyzed.Results The prevalence rate of AF in the patients enrolled in this study was 8.7％ (583/6695).There was a higher frequency of AF in female than that in male,with significant difference (45.8％ vs.33.0％,P＜0.05).The patients from combined AF group were older than those without AF.The percentage of severe stroke in AF patients (34.8％) was significantly higher than that in non-combined AF group (8.3％,P＜0.05).The patients with AF were less likely than the patients without AF to have hypertension (63.8％ vs.73.3％),diabetes (24.9％ vs.32.3％),dyslipidemias (26.1％ vs.31.5％),artery stenosis (17.2％ vs.23.4％),current smoking (22.6％ vs.39.0％),and alcohol consumption (7.5 ％ vs.18.9％),with significant differences (P＜0.05).After adjusting age,gender,stroke subtype,and severity,and risk factors,multivariate analysis showed that there was a higher recurrence risk in combined AF group at 3 months after stroke than that in non-combined AF group (P＜0.05);patients with AF had significantly higher mortality,dependency,and recurrence rates at 12 and 36 months after stroke than those without AF (P＜0.05).Conclusion The long-term prognosis of patients with stroke complicated with AF is poor;therefore,normalized anticoagulant therapy should be taken to decrease the recurrence rate and burdens of stroke in China.
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Objective To establish a method of gold nanoprobe-based solution hybridization (GNBSH) to detect nucleic acid sequence-based amplification (NASBA) products for the rapid diagnosis of invasive aspergillosis (IA).Methods The Aspergillus specific 18S rRNA was amplified by NASBA and then the amplified products were hybridized with the gold nanoprobes which were modified with thiol compounds at the 5'end.Serum samples from 106 patients,including 14 with a definite IA,32 with suspected IA and 60 without IA,were detected by the established method,and the obtained results were compared with that of galactomannan (GM) test to evaluate its accuracy.Results The gold nanoprobes only hybridized with Aspergillus NASBA products but not other non-Aspergillus strains.The sensitivity,specificity and the area under the ROC curve (AUCROC) of the established GNBSH method for detecting 106 clinical samples were 82.61％ (38/46),81.67％ (49/60) and 0.890,respectively.The sensitivity,specificity and AUCROC of GM test were 56.52％ (26/46),83.33％ (50/60) and 0.723,respectively.Conclusion The established GNBSH method to detect Aspergillus NASBA products has high sensitivity and specificity and simple operation,which may be used to detect the infection of Aspergillus by clinical laboratories.
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Objective To explore the clinical application value of combined detection of serum brain natriuretic peptide (BNP),homocysteine(HCY) and blood lipids in the patients with heart failure.Methods The levels of serum BNP,HCY,TC,TG,HDL-C,LDL-C,ApoA,ApoB and Lpa were detected in 100 patients with heart failure (observation group) and contemporaneous 100 persons (control group) undergoing healthy physical examination.Then the comparative analysis was performed.Results Compared with the control group,the BNP and HCY levels in the observation group were significantly increased(P＜0.05);among 7 indicators of the blood lipid,the Lpa level in the observation group was increased compared with the control group,while the TC,HDL-C and LDL-C levels were significantly decreased(P＜0.05),and the TG,ApoA and ApoB levels had no statistical differences between the two groups(P＞0.05).Conclusion Serum BNP,HCY,TC,HDL-C,LDL-C and Lpa levels have close correlation with heart failure,especially the combined detection of BNP,HCY and Lpa,which has predictive and diagnostic value in heart failure and is worthy of clinical popularization and application.
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Objective To investigate the status and influencing factors of fear of falling (FOF) in patients with first ever cerebral infarction. Methods A sample of 105 inpatients with cerebral infarction were recruited from two tertiary hospitals in Tianjin (Tianjin Huanhu Hospital, the First Affiliated Hospital of Tianjin University of TCM) to complete this research. They were investigated with the simplified Chinese version of Falls Efficacy Scale International-short (FES-Is), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Barthel Index Rating Scale (BI) and Functional Ambulation Category Scale (FAC). Results The total score of FES-Is was 15.38±7.45. Multiple stepwise regression analysis showed that age, marital status, fall history, walking ability and anxiety were important factors of FOF. Conclusions Clinical staff should guide the patients with first cerebral infarction especially who had a history of falling to take active and effective measures to deal with their FOF, and pay more attention on patients who was elderly, without a spouse, assisted walking and anxiety, to release their FOF, prevent the falling and promote the functional recovery of patients.
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Objective To detect the change of interleukin-18 (IL-18) level in the serum of patients with acute leukemia (AL) in children, and explore the clinical significance of IL-18. Methods The level of IL-18 was measured by sandwich enzyme-linked immuno-sorbent assay (ELISA) in 45 patients with AL in children. Results The leverof IL-18 in pre-treatment AL group was 719.35±358.21pg/mL and significantly higher than that of normal-control group [(311.80±146.64)pg/mL P 0.05). According to the clinical sub-group with risk factors in pre-treatment AL, the level of IL-18 in high risk(HR) and middle risk(MR) group was significantly higher than low risk(LR) group (P<0.05). The level of IL-18 in T-ALL group was significantly higher than that in B-ALL group (P<0.05). The levels of IL-18 in pre-treatment AL were markedly correlated to the count of blast cells in bone marrow (r=0.411, P=0.005). Conclusion The level of IL-18 in the patients of childhood AL was in a high expression, and related to the clinical treating effect and the count of blast cells in bone marrow, which would be taken as an index of treating effect. The level of IL-18 was closely related to the clinical risk factors in pre-treatment AL.
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Objective To establish hybridization method by using the DNA-modified colloid gold nanopartieles probes for rapid and specified detection of methicillin resistant Staphylococcus aureus (MRSA). Methods DNA-modified nanoparticles probes were prepared by using two mereapto-modified mecA gene-specific oligonucleotide probes bounding with 6Ohm-diameter colloid gold nanoparticles through covalent binding. Genomic DNA of Staphylococcus aureus strains were extracted and then fragmented by ultrasonic waves. The fragmentized DNA was hybridized with the DNA-modified colloid gold nanoparticles probes. The reaction products were centrifuged and then detected by reversed-phase thinlayer chromatography plate to observe any colloid gold nanoparticles precipitation. The results of mecA gene detected by the colloid gold nanoparticles probes hybridization were compared with the results of PCR and the accuracy of the hybridization method was evaluated. Results Of total 95 tested strains, 71 strains were confirmed as MRSA and 24 swains were confirmed as methicillin susceptible Staphylococcus aureus (MSSA) by PCR. Of 71 MRSA strains, 69 strains were positive by colloid gold nanoparticles probes hybridization, the sensitivity of this method was 97.2%. All of the 24 MSSA strains were negative by using this technique. The specificity of this method was 100%. Of total 95 test strains ,93 strains were detected correctly. The accuracy was 97.9%. Conclusions Colloid gold nanoparticles probes hybridization test is well consistent with the gold standard method of PCR in detection of MRSA. Detection of MRSA by using the technique of the DNA-modified colloid gold nanopartichs probes hybridization is rapid, simple and accurate. It is potent to be a new method for rapid diagnosis of MRSA infection.
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Objective To investigate whether p53 expression is involved in human telomerase reverse trans-criptase (hTERT) regulation. Methods HepG2 cells and pPUR/U6/hTERT HepG2 cells were treated with the p53 antisense oligonucleotide respectively and p53 expression plasmid were introduced to HepG2 cells. The decreased or increased p53 level and the hTERT expression levels were analyzed by Western blotting. Results Down-regulation of p53 expression had no obvious effect on hTERT expression, but over-expression of p53 could significantly repress hTERT level. Conclusion p53 interacts with hTERT and inhibits hTERT expression in HepG2 cells.