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Objective:To explore the correlations of moderate to severe leukoaraiosis (LA) with hemorrhagic transformation (HT) and prognoses of patients with acute ischemic stroke after intravenous thrombolysis.Methods:Clinical data of 144 patients with acute ischemic stroke who underwent intravenous thrombolysis in our hospital from August 2017 to November 2018 were retrospectively collected. Van Swieten scale (vSS) was used to determine the leukoaraiosis degrees in these patients based on CT findings of the head before treatment. According to the CT results of head re-examination within 24 h of treatment, HT appearance of the patients was judged. The prognoses of these patients were evaluated according to modified Rankin scale (mRS) scores 90 d after discharge. Multivariate Logistic regression analysis was performed to determine the independent risk factors for HT and prognoses of patients with acute ischemic stroke after intravenous thrombolysis.Results:Among 144 patients, 23 patients (15.97%) had HT and 121 (84.03%) had non-HT; 61 patients (42.36%) were with poor prognosis and 83 (57.64%) were with good prognosis. As compared with patients in the non-HT group, patients in the HT group had significantly higher proportion of patients with moderate to severe LA, D-dimer level and urine specific gravity ( P<0.05). Multivariate Logistic regression analysis showed that moderate to severe LA ( OR=0.281, 95%CI: 0.105-0.753, P=0.012) and D-dimer ( OR=1.654, 95%CI: 1.100-2.489, P=0.016) were independent risk factors for HT. As compared with the patients in the good prognosis group, the patients in the poor prognosis group had significantly advanced age, statistically higher baseline NIHSS scores and proportion of patients with HT and positive urine sugar, significantly higher levels of random blood glucose and D-dimer, significantly higher plasma fibrinogen content, significantly higher international normalized ratio, and significantly longer plasma prothrombin time before treatment ( P<0.05). The TOAST etiological types of patients between good prognosis group and poor prognosis group were significantly different ( P<0.05). Multivariate Logistic regression analysis showed that baseline NIHSS scores ( OR=1.395, 95%CI: 1.213-1.605, P=0.000) and white blood cell count ( OR=1.292, 95%CI: 1.040-1.606, P=0.021) were independent risk factors for poor prognosis. Conclusions:Acute ischemic stroke patients with moderate to severe LA and high D-dimer are prone to HT after intravenous thrombolysis. Acute ischemic stroke patients with higher baseline NIHSS scores and peripheral white blood cell count are prone to have poor prognosis.
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Objective To investigate the effects of rapamycin on the expression of glioma patients tumor helicase RECQ1.Methods 50 glioma patients admitted to the department of neurosurgery in second hospital of hebei medical university were selected and randomly divided into 2 groups,25 patients in control group,were treated with routine admission surgical treatment;25 cases in the experimental group,firstly were given rapamycin capsule 1 mg,1 times/day orally,took 14 days in a row,and had surgical treatment after stopping drug a week.Glioma tissue samples were taken during the operation,mRNA and protein expression of tumor helicase RECQ1 were detected by reverse transcriptase polymerase chain reaction(RT-PCR)and Western blot.Results Glioma tumor helicase RECQ1 mRNA expression in the control group increased more significantly than experimental group,the optical density value in control group was(1.657 ±0.748),while the experimental group optical density value was(1.059 ±0.894),and the difference was statistically significant(P<0.05 );all organizations had the expression of tumor helicase RECQ1 protein,but gliomas tumor helicase RECQ1 protein expression in the experimental group patients(0.952 ±0.021)was significantly lower than that in the control group(1.211 ±0.024),and the difference was statistically significant(P<0.05).Conclusion Rapamycin capsule could reduce the expression of mRNA helicase RECQ1,inhibit DNA glial tumor cells of brain replication,effectively kill cancer cells,control the the progress of brain glioma,and improve prognosis,worth clinical promotion.
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The biobank for medical researchers is a resource of significant utility , which also causes a series of ethical issues. For example, the question of what kind of informed consent should be adopted for the biobanking tissue residue, whether related study can be conducted without the donors' consent and how to accomplish the biobank research. Based on ethical principles of donation, individual rights of donor and common interest of the society, this study suggested the informed consent that to which extent can be accepted for biobank and which type should be adopted in different scenes with two feasible choices. One is the irreversible, and the other is the reversible anonymization process for samples. The necessity and rationality of informed consent for biobank con-struction were also evaluated in order to provide references for the ethical practice of biobank research.
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Issues related to bioethics research often involve four basic principles , which are the value and integri-ty of the research, respect for human being, risk to benefit ratio, and the justice in subject selection. These prin-ciples contribute to the basis of bioethics for human-involved studies and they are capable of being applied to other relevant fields including complementary and alternative medicine (CAM) researches. The World Health Orga-nization (WHO) guidelines related to CAM studies clarify that the consideration should be taken for the human rights based on different value systems caused by social, cultural and historical problems, and the ethical prob-lem involved in CAM clinical studies should be properly handled in the further studies. Based on the four prin-ciples and Chinese traditional culture, the author attempted to discuss controversial bioethical issues such as the understanding and setting of informed consent, risk and benefit in western culture bioethics in order to analyze possible issues in the ethical review of Chinese medicine clinical research. We hoped that these considerations can provide references to the bioethical understanding of Chinese medicine clinical studies and ethical review on Chinese medicine practice .
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Objective: Patient-reported outcome (PRO) method was used to evaluate clinical effects of acupuncture for cervical spondysosis. Methods: With RCT method used, 162 cases were adopted, and 150 cases finished the whole course (treatment group: 76 cases, control group: 74 cases). Treatment group cases were treated by real-acupuncture while control group cases treated by sham-acupuncture. Northwick Park Pain Questionnaire(NPQ)was used as main outcome index, while SF-36 as secondary index. Both groups’ patients were evaluated before and after treatment course, plus one month and 3 months after the end of the treatment course. Results:Treatment group cases got lower NPQ Scores and higher mental health dimensions scores than the control group cases at any evaluation time-point. At the point of one month after the end of the treatment course, the treatment group cases got better social function scores than the control group cases. At the point of three months after the end of the treatment course, the treatment group cases got better body pain and energy scores than the control group cases. Multiple regression analysis showed that three dimensions of SF-36 (social function scores body pain and energy scores) had close relationship with NPQ scores. Conclusion: Acupuncture had satisfactory long-term effect for cervical spondylosis.