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Objective:To Investigate the correlation of eosinophil count and stroke-associated pneumonia (SAP) in patients with acute ischemic stroke.Methods:Patients with acute ischemic stroke within 24 h after onset admitted to the Department of Encephalopathy, Suzhou Integrated Traditional Chinese and Western Medicine Hospital from August 2016 to September 2018 were enrolled prospectively. Their general clinical data and eosinophil counts were collected. National Institutes of Health Stroke Scale (NIHSS) was used to assess the severity of stroke. Multivariate logistic regression analysis was used to determine the independent risk factors for SAP. Results:A total of 521 patients were enrolled, including 106 (20.35%) SAP. Univariate logistic analysis showed that SAP was associated with the classification of eosinophil count (odds ratio [ OR] 0.37, 95% confidence interval [ CI] 0.20-0.68; P=0.001), and tended to be associated with eosinophil count ( OR 0.08, 95% CI 0.01-1.01; P=0.051). Multivariate logistic regression analysis showed that both eosinophil count and eosinophil count classification were not the independent risk factors for SAP, and advanced age ( OR 1.077, 95% CI 1.045-1.109; P< 0.001), chronic obstructive pulmonary disease ( OR 6.931, 95% CI 1.295-37.106; P=0.024) and high baseline NIHSS score ( OR 1.148, 95% CI 1.003-1.314; P=0.045) were significantly independently associated with SAP. Conclusions:Eosinophil count was not an independent predictor of SAP in patients with acute ischemic stroke.
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Objective To explore the effect of macrophages on the expression of vascular cell adhesion molecule 1 (VCAM1) in ovarian carcinoma cells and its mechanism. Methods Phorbol ester and lipopolysaccharide were used to activate the monocyte THP-1 that would become macrophages . Enzyme linked immunosorbent assay (ELISA) was used to detect the cytokines level in the supernatant of macrophages. The effect of macrophages ' supernatant on VCAM1 mRNA expression of ovarian HEY and IGROV1 carcinoma cells was detected by using quantitative real-time and polymerase chain reaction (qRT-PCR). Western blot was used to detect the effect of macrophages ' supernatant on VCAM1 protein expression of ovarian carcinoma cells with VCAM1 over expression (HEY-VCAM1 and IGROV1-VCAM1). Dual-luciferase report gene assay was used to detect the effect of macrophages' supernatant and the cytokines on promoter transcriptional activity in different truncations of human embryonic kidney cells HEK293T VCAM1 gene. Results Compared with the supernatant of THP-1 cells, the release number of tumor necrosis factor α (TNF-α), interleukin (IL)-6 and IL-12 in supernatant from macrophages was increased (all P< 0.05), and IL-10 was decreased (t=3.841, P=0.019). The levels of VCAM1 mRNA in HEY and IGROV1 cells were upregulated by macrophages' supernatant and 1 ng/ml TNF-α, and macrophages' supernatant could promote the expression levels of VCAM1 protein in HEY-VCAM1 cells and IGROV1-VCAM1 cells. Compared with the empty vector (pGV354) control group [(8.6 ±0.2) ×10-3 relative light unit (RLU)], the reporter gene luciferase activity of human embryonic kidney cells HEK293T VCAM1 gene promoter region were upregulated by supernatant from macrophages located at -1641 bp to +12 bp including the transcription binding site of AP-1 [(109.4±3.4)×10-3 RLU], and there was a significant difference (t=29.42, P<0.001). Compared with the negative control group untreated by cytokine [(21.0 ±0.5) ×10-3 RLU], 100 ng/ml TNF-α could promote the transcriptional activity of -1641 bp to +12 bp promoter of VCAM1 in HEK293T cells [(23.4±0.4)×10-3 RLU;t=4.134, P=0.001]. 150 ng/ml IL-6 had no effect on the transcriptional activity of the promoter [(21.4±1.0)× 10-3 RLU; t= 0.328, P= 0.708]. 5 ng/ml IL-12 inhibited the transcriptional activity of the promoter [(14.3 ± 1.0)×10-3 RLU;t= 6.390, P< 0.001]. Conclusion Macrophages can promote VCAM1 expression in ovarian carcinoma cells by secreting inflammatory factors like TNF-α to affect VCAM1 promoter region containing AP1 transcription binding site and can promote VCAM1 mRNA expression in ovarian cancer cells.
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Objective At present, the risk factors for cognitive impairment in epilepsy patients are not quite clear.This study was to explore the impacts of the clinical features, emotional health and quality of life (QOL) on the cognitive function of the adult patients with mild cognitive impairment (MCI).Methods Using the Montreal Cognitive Assessment (MoCA) and Mini Mental State Examination (MMSE) scales, we evaluated the cognitive functions of the 109 adult epileptics of the outpatient clinic of neurology in Jinling Hospital.We assessed their emotional health with Hamilton Depression Scale-24 (HAMD-24), estimated their QOL with Quality Of Life in Epilepsy-31 (QOLIE-31), and collected their baseline clinical data by questionnaire survey.Results There were 67 cases of MCI (61.5%) among the 109 patients.The residential area was the strongest predictor of MCI in the adult epileptics (OR=0.226, 95% CI: 0.082-0.627).Among other risk factors of post-epileptic MCI were the total scores of HAMD-24 (OR=0.770, 95% CI: 0.644-0.921) and QOLIE-31 (OR=0.712, 95% CI: 0.575-0.880), QOL (OR=1.070, 95% CI: 1.015-1.128), cognitive function (OR=1.120, 95% CI: 1.043-1.203), and social function (OR=1.103, 95% CI: 1.035-1.175).Conclusion The incidence of MCI is high in adult patients with epilepsy.The development and progression of post-epileptic MCI can be delayed by more emphasis on the evaluation of cognitive function, emotional health, and quality of life.
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To analyze and summarize the clinicopathological features of renal inflammatory lesions which were easily misdiagnosed as renal tumors.Methods The cases from March 2006 to August 2015 in the Department of Pathology at Xijing Hospital were analyzed,retrospectively.Due to the diagnosis made by clinicians that these were renal (including renal pelvic) tumors,all cases had undergone radical nephrectomy or tumor enucleation.Among them,several inflammatory lesions were confirmed,and were combined with the patients' clinicopathological data and literature review to investigate the diagnosis and differential diagnosis.Results Of the 1 195 cases,only 6 cases (less than 1％) were renal inflammatory lesions,named as xanthogranulomatous pyelonephritis (2 cases),renal malakoplakia (1 case),renal tuberculosis (1 case),IgG4-related tubulointerstitial nephritis (1 case),and renal Wegener's granulomatosis (1 case).These diseases occurred in two males and four females (aged 14 to 55 years).All patients underwent radical nephrectomy due to the detected unilateral solitary renal mass in the imaging examination.Conclusion Renal inflammatory lesions are very rare,which show masses that are easily misdiagnosed as neoplastic lesions.Some of them have similar histological features.As the differences of treatment,a sufficient understanding of the clinicopathological features of these diseases is important to make a correct diagnosis.
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Objective:To explore the expression of N-cadherin and its correlations with the clinicopathological features of human ovarian carcinoma.Methods:The expression of N-cadherin in 281 cases of ovarian carcinoma tissues were determined by immunohistochemical method.The correlations of N-cadherin expression with the clinicopathological features of human ovarian carcinoma were analyzed.Results:There was higher expression of N-cadherin in the metastatic lesions than its paired primary lesions (P =0.018).The expression level of N-cadherin in ovarian carcinoma was correlated with the FIGO stage (P =0.034),histological type (P ＜0.001) and tumor grade (P =0.004).Conclusions:High expression of N-cadherin might positively correlate with the invasion and migration ability of ovarian carcinoma cells,which was more common in the the advanced (FIGO Ⅱ-Ⅳ) ovarian carcinoma,high-grade serous carcinoma,and high grade ovarian carcinoma.N-cadherin might be useful in estimating the biological behavior of human ovarian carcinoma.
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We observed the effect of Combivent combined with glucocorticoids in the treatment of patients with AECOPD to explore a better drug treatment for AECOPD. The clinical observation of two clinical curative effective was carried out. Firstly, 100 patients were equally divided into treatment group and control group, who were given basic treatment. The control group was treated with inhalation of salbutamol sulfate and the other was with inhalation of Combivent and glucocorticoid. The clinical effect, dyspnea score, PaO[2], PaCO[2] and pulmonary function index were observed and compared. The second, 100 patients with AECOPD were divided into the conventional group, the short range group and the long range group, all of that were treated with inhalation of Combivent. The short and the long were treated with glucocorticoid for 7d and 15d. Pulmonary function index was monitored at sixth and fifteenth days after treatment. The incidence of AECOPD was compared with the incidence of complication. Firstly, after 10 days of treatment, the treatment group's total efficiency, dyspnea score, PaO[2], PaCO[2], were significantly better than the control group and the treatment in the two groups after the above indexes were significant better than those before treatment. The differences were statistically significant [P<0.05]. The second time, the short and the long's VC, FVC, FEV1 were higher than the conventional, the recurrence rate was decreased, the incidence of complications in the short was significantly lower than that in the long and the difference was statistically significant [P<0.05]. The effect of Combivent combined with glucocorticoid was exactly and the short's complication was low, which is worth to be popularized
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Objective Ischemic stroke with elevated serum immunoglobulin E ( IgE) in some young patients is regarded as cerebral vasculitis clinically though without sufficient pathological evidence .This study was to investigate the characteristics of vascular lesions in these patients by temporal artery biopsy . Methods We performed histopathologic examinations on the temporal arteries of 32 young ischemic stroke patients with unknown etiology , 16 with normal and the other 16 with elevated serum IgE .We observed inflammatory cells infiltration and mast cells by HE staining and toluidine blue stai-ning respectively and determined the expressions of matrix metalloproteinase -9 (MMP-9), monocyte chemotaxis protein -1 (MCP-1) and serum IgE by immunohistochemistry . Results Compared with the patients with normal IgE , those of the elevated IgE group showed a significantly higher rate of inflammatory cells infiltration (12.5%vs 62.5%, P0.05).Nor was any signifi-cant difference observed in the number of the mast cells between the normal and elevated IgE groups (2.8 ±1.5 vs 3.6 ±2.3, P>0.05). Conclusion The infiltration and necrosis of inflammatory cells and fibrin exudation in the temporal artery of the young pa-tient with elevated serum IgE are likely to be the manifestations of vasculitis , and MCP-1 may play a role in the pathogenesis of the disease.
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Therapeutic hypothermia has been shown to improve neurological outcomes after global ischaemia/hypoxia in patients who have had cardiac arrest. Therapeutic hypothermia is one of the most extensively studied and influential therapeutic strategies of acute ischemic stroke. Previous studies of therapeutic hypothermia mainly focused on whole-body cooling. However, delayed induction and systemic complications have limited the clinical application of whole-body cooling. As a selective cerebral hypothermia, the selective intra-arterial brain hypothermia treatment has the characteristics of rapid and even induction of hypothermia, and less affecting the core body temperature. Therefore, it has become a promising treatment modality. This article reviews the application of selective intra-arterial brain hypothermia in acute ischemic stroke and its advantages and limitations in order to provide reference for further experimental studies and future clinical trials.
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Objective Inflammation response is involved in the whole pathological process of acute cerebral infarction ( ACI) , but few reports are seen on its clinical implication in ACI patients .The purpose of this study was to investigate the predictive value of the differential count of leukocytes for stroke severity and early clinical outcomes in the acute phase of cerebral infarction . Methods We collected the clinical and laboratory data of 635 patients diagnosed with ACI within 72 hours of symptom onset and eval-uated the association between the differential count of peripheral blood leukocytes and stroke severity at admission and within 3 days af-ter admission as well as the clinical outcomes at discharge .The neural function impairment scores of the patients were obtained with The NIH Stroke Score ( NIHSS) at admission and on the third day after admission , and the therapeutic results evaluated with the modi-fied Rankin Scale ( mRS) , mRS >2 as poor prognosis .Analyses were performed on the correlation of the differential count of leuko-cytes with NIHSS and mRS scores and its influence on the ACI patients . Results At discharge , the mRS related influencing factors included the total count of leukocytes (OR=1.147, 95% CI:1.038-1.268), count of neutrophil cells (OR=1.227, 95% CI:1.00-1.369 ), count of lymphocytes ( OR =0.508, 95% CI:0.342-0.753), and neutrophil to lymphocyte ratio (NLR) (OR=1.150, 95%CI:1.008-1.314).the NIHSSs were correlated with the counts of leucocytes (r=0.078, P=0.024), neutrophil cells (r=0.083, P=0.019), and lymphocytes (r=0.010, P=0.004) at admission, and with the counts of leucocytes ( r =0.238, P <0.001), neutrophil cells (r=0.335, P<0.001), lymphocytes (r=-0.269, P<0.001), and NLR (r=0.423, P<0.001) on the third day after admission. Conclusion In the acute phase of cer-ebral infarction , the differential count of leukocytes and NLR are valuable for predicting the severity of neurologic impairment and early poor functional outcome .
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Objective The purpose of this study was to establish a rat model of thromboembolism for the study of hemorrhag -ic transformation after intravenous thrombolysis with the recombinant tissue plasminogen activator ( rtPA) . Methods Sixty Sprague-Dawley rats were randomly divided into a sham operation , a cerebral embolism, and an rtPA group.Thrombus was prepared in vitro with the rat femoral artery blood and injected into the internal carotid artery of the rats in the cerebral embolism and rtPA groups to es -tablish a model of embolic focal cerebral ischemia , while the animals of the sham operation group injected with BSA .Five hours later , the rats in the rtPA group received rtPA and those in the cerebral embol-ism and sham operation groups the injection of isotonic saline solu-tion.At 24 hours after embolus injection , the neurological deficit score was obtained .The rats were sacrificed after cardiac perfusion and their brains removed for triphenyltetrazolium chloride staining , assessment of the infarct volume and cerebral edema , and calculation of the hemorrhage volume by spectrophotometric hemoglobin assay . Results The hemorrhage volume was significantly higher in the rtPA than in the cerebral embolism group ([17.55 ±2.20] μL vs [3.82 ±0.86] μL, P<0.01), but there were no statistically significant differences between the two groups in the infarct volume ([29.29 ±4.204] %vs [27.89 ±3.91] %, P=0.810), cerebral edema ([12.43 ±1.66] % vs [7.13 ±2.04] %,P=0.063 2), and neurological deficit score (3.35 ±0.27 vs 2.80 ±0.28, P=0.174). Conclusion The rat model of thromboembolism, with a high stability and reproducibility , can be used for the pathogenesis-related studies of hemorrhagic transformation after thromboly-sis with rtPA.
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<p><b>OBJECTIVE</b>To investigate the microbiological transformation of paeoniflorin and albiflorin.</p><p><b>METHOD</b>The bacteria strains able to transform paeoniflorin and albiflorin were screened from 18 strains of microorganisms. The products were isolated by chromatography method and their structures were elucidated by spectral technology.</p><p><b>RESULT</b>It was found that Cunninghamella blakesleana (AS 3.970) and Syncephalastrum racemosum (AS 3.264) could convert paeoniflorin and albiflorin efficiently, respectively. C. blakesleana could convert paeoniflorin to produce albiflorin, while S. racemosum could convert albiflorin to produce paeoniflorin.</p><p><b>CONCLUSION</b>Paeoniflorin and albiflorin could be converted each other in definited condition.</p>
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Benzoates , Metabolism , Biotransformation , Bridged-Ring Compounds , Metabolism , Cunninghamella , Metabolism , Glucosides , Metabolism , Monoterpenes , Mucorales , MetabolismABSTRACT
AIM: To investigate the application of microemulsion TLC to separation and identification of(Z)-and(E)-resveratrol and piceid in Polygonum cuspidatum based on polyamide film as stationary phase.METH-ODS: SDS-n-butane-n-heptane-aqueous microemulsion as the development in combination with aminic acid and methonal as the modifier,the influence of the change in components of microemulsion on the resolution was exam-ined to search for the optimal separation condition of Polygonm cuspidatum extract collected from 6 production places.RESULTS: The best mobile phase was the microemulsion containing 4% SDS,80% water-methyl acid-methanol(1.0 ∶ 2.0 ∶ 1.0).As compared with conventional TLC,resolution of microemulsion TLC for resveratrol and piceid were improved markedly.CONCLUSION: Microemulsion TLC is an efficient,simple and new method for separating and identifing(Z)-and(E)-diastereomers of resveratrol and piceid in Polygonum cuspidatum.