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Objective:To summarize the incidence of acute rejection (AR) after pediatric kidney transplantation (KT) at a single center and examine its impact on graft/patient survival and risk factors for AR.Methods:This is a retrospective cohort study including pediatric recipients who underwent kidney transplantation in past 8 years.After excluding recipients of graft thrombosis within a week post-transplant and lost to follow-ups, a total of 143 cases were ultimately recruited and assigned into two groups of AR (n=29) and non-AR (n=114).Basic profiles of both donors and recipients and graft/patient survival rate were compared between two groups.Relative risk factors for AR episodes were also examined by Logistic regression.Results:Renal grafts for 130/143 cases (90.9%) were harvested from deceased donors and 120(83.9%) cases from children.Twenty-seven transplants (18.9%) were performed in infants and young recipients aged < 3 years.During a median follow-up of 33 months, 34 AR episodes occurred in 29(20.3%) patients.Rate of re-transplantation (27.6% vs. 7.9%), pediatric donor (96.5% vs. 80.7%) and rabbit anti-human thymocyte globulin (rATG) induction (79.3% vs. 36%) were significantly higher in AR group than non-AR group ( P=0.007, P=0.046, P<0.001).Multivariate regression analysis indicated that basiliximab induction caused a significant reduction in the risk of AR incidence as compared with rATG induction (odds ratio 0.13, 95% confidence interval 0.04-0.43, P<0.001).The median time of AR incidence was 1.3 months post-transplantation and 23 episodes (67.6%) were confirmed by biopsy.After anti-rejection treatment, 52.9%(n=18) of the cases achieved a full recovery and 38.3% (n=13) had improved graft function.However, 3 cases (8.8%) developed irreversible graft failure.The 1/3-year graft survival rates were significantly lower in AR group than those in non-AR group (75.3% vs. 95.2%, 68.4% vs. 90.4%, P=0.01), and there was no significant difference in 1-and 3-year patient survival rates between two groups. Conclusions:The incidence of AR is relatively high in pediatric renal transplantation, which has an impact on graft survival.Basiliximab induction can effectively reduce the risk of AR.
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Objective:To explore the clinical features of transplanted renal artery stenosis after pediatric donor kidneys in children.Methods:We retrospectively summarized the clinical data in five cases of transplanted renal artery stenosis undergoing deceased pediatric donor kidney transplantation from May 1, 2014 to June 30, 2021.Donor/receptor characteristics, diagnosis, treatment and prognosis were recorded.The median follow-up period was 29 months.The median age of five donors and recipients was 9 and 132 months respectively.En bloc renal allograft( n=2)and single kidney transplantation( n=3)were performed.End-to-side anastomosis was performed for renal arteries.The median diagnostic time of renal artery stenosis was 10(3-60)months post-transplantation.Except for one 3-year-old recipient with an earlier onset of stenosis, four stenotic cases during a rapid growth period had a maximal height increase of 30 cm post-transplantation.Three of them had a history of surgery at graft site, including previous kidney transplantation( n=1)and transplant urinary tract reconstruction( n=2). All five cases had hypertension and two showed an elevated serum level of creatinine.Ultrasound indicated a significantly elevated flow rate of >300 cm/s( n=4)and CTA/MRA indicated that the degrees of stenosis varied from 50% to 95%( n=5). Results:After balloon dilatation, stenosis either improved( n=2)or relapsed( n=2). Further stenting succeed( n=1)or failed( n=1). One case of stenosis was relieved partially after 6-month observation without any invasive treatment. Conclusions:As a serious complication, transplant renal artery stenosis is common after pediatric donor kidney transplantation.Too small size in donor kidney and rapid recipient growth may be specific risk factors.After diagnosis, balloon dilation is a preferred treatment.Stent placement should be cautiously employed.
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Objective:To establish and verify a dynamic web-based nomogram for predicting futile recanalization after thrombectomy in acute ischemic stroke.Methods:Three hundred and four acute ischemic stroke patients admitted to the Second Affiliated Hospital of Soochow University from May 2017 to April 2021 were retrospectively enrolled. All these patients underwent mechanical thrombectomy and obtained successful recanalization. The eligible patients were randomly divided into training group ( n=216) and test group ( n=88) by 7∶3. The nomogram was established and internally validated with the data of the training group, and externally validated with the data of the test group. For the training group, multivariate Logistic regression analysis was performed by including all variables with P<0.05 in univariate analysis, and the independent predictors of futile recanalization were screened out to construct a nomogram. In the training group and the test group, the performance of the nomogram was verified by C-index, calibration chart and decision curve analysis respectively. Results:No significant difference was detected between the training group and the test group in futile recanalization [134/216 (62.0%) vs 56/88 (63.6%), χ 2=0.07, P=0.794]. Multivariate Logistic regression analysis showed that age ( OR=1.04,95% CI 1.00-1.08, P=0.033), National Institutes of Health Stroke Scale (NIHSS) score on admission ( OR=1.11,95% CI 1.04-1.19, P=0.001), neutrophil to lymphocyte ratio ( OR=1.19,95% CI 1.07-1.32, P=0.001), glycated hemoglobins ( OR=2.02,95% CI 1.34-3.05, P<0.001), poor collateral status ( OR=10.87,95% CI 4.08-29.01, P<0.001), postoperative high density ( OR=11.38,95% CI 4.56-28.40, P<0.001) were independent risk factors for futile recanalization. The C-index of this nomogram in the training group and the test group was 0.92 (95% CI 0.877-0.954, P<0.001) and 0.93 (95% CI 0.87-0.98, P<0.001), respectively. Conclusion:This web-based nomogram, including age, NIHSS score on admission, neutrophil to lymphocyte ratio, glycated hemoglobin, poor collateral status and postoperative high density, predicted individual probability of futile recanalization after mechanical thrombectomy with good discrimination and clinical utility.
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Objective:To summarize the clinical characteristics and treatment of cytomegalovirus(CMV)infection in pediatric kidney transplant patients.Methods:From May 2014 to July 2021, a total of 9 cases(8.65%)of 104 pediatric kidney transplant recipients were diagnosed with CMV infection in our centre.Retrospective data was collected for these 9 paediatric recipients.The clinical characteristics of the disease, treatment data and outcomes were summarized.Results:The median age of the 9 children was 10 years(0.25-15 years), 6 of whom were treated with polyclonal antibody for immunity induction.CMV IgG was negative in 4 children before renal transplantation.Only one patient received anti-CMV prophylaxis.The median time from transplant to the diagnosis of CMV infection was 22(7-15)days.Among the 9 children, 7 had fever, pneumonia and diarrhea, 2 had no typical symptoms, three patients were complicated with viral, bacterial or fungal infections.Acute rejection occurred in 3 patients at the same time as CMV infection or after CMV DNA turned negative.Nine patients were cured and discharged after ganciclovir or valganciclovir treatment.Median time of CMV DNA negative transformation was 32(17-90)days.Conclusions:Pediatric transplant recipients are at particularly elevated risk of CMV disease.Antiviral prophylaxis should be initiated early after transplantation.
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Objective:To summarize the clinical outcomes of en-bloc kidney transplantation from small infant donors to adult recipients at a single center.Methods:A total of 22 en-bloc transplantations from pediatric donors to adult recipients were performed from July 2013 to October 2017 in Institute of Organ Transplantation Affiliated Tongji Hospital Tongji Medical College Huazhong University of Science. Clinical data were retrospectively analyzed. The average age of 22 donors was (2.9±1.7) months with an average weight of (4.9±1.4) kg and 15 of them were aged under 3 months. The average weight of 22 adult recipients was (46.3±5.6) kg and most recipients were female. The causes of early graft failure and recipient death were examined during follow-ups. The recipients with functioning grafts post-transplantation were divided into single kidney survival group and en-bloc kidney survival group based upon the occurrence of unilateral vascular thrombosis. Medium/long-term renal graft function was compared between two groups.Results:Early graft failure occurred in 4 recipients. The causes were bilateral renal vascular thrombosis ( n=2), renal rupture ( n=1) and multiple organ failure followed by death ( n=1). Eighteen recipients were discharged after a recovery of renal graft function. One case had a removal of bilateral renal grafts due to new-onset graft tumor and another two died from interstitial pneumonia and complicate systematic disorder respectively during follow-ups. Among the remaining 15 recipients, 10 achieved bilateral renal survival (median follow-up: 59 months) and 5 unilateral renal survival (median follow-up: 48 months). The average eGFR of bilateral renal survival group was significantly higher than that of unilateral renal survival group at Year 1 post-transplantation (95±27 vs 61±24 ml/min/1.73 m 2, P<0.05) while the gap narrowed at Year 3 and there was no statistical significance (95±21 vs 69±31 ml/min/1.73 m 2, P=0.12). Conclusions:Although en-bloc kidney transplantation from infant donors can expand organ donor pool, there is a higher risk of early graft failure and unilateral renal vascular thrombosis. Nevertheless, satisfactory renal transplant outcomes may be achieved in patients with unilateral renal graft survival.
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Objective:To summarize the clinical characteristics and therapeutic drug selection of post-transplantation diabetes mellitus(PTDM)after kidney transplantation in children.Methods:From May 2014 to March 2021, a total of 5 cases(5.38%)of 93 paediatric kidney transplant recipients with a median follow-up period of 34 months were diagnosed with PTDM in our centre.Retrospective data analysis was performed for these 5 paediatric recipients.The characteristics of the disease, treatment data and outcomes were summarized.Among the five paediatric recipients, one was male and four patients were female, ranging the age from 12 to 17 years.All recipients received a tacrolimus-based immunosuppressive regimen with prednisone discontinued no later than 3 months after kidney transplant.Results:The onset of PTDM ranged from 1 month to 46 months(median: 17 months)after transplantation.The blood glucose of two children returned to normal gradually after tacrolimus conversion to cyclosporine, with one of them was given insulin temporarily.Three children received oral hypoglycaemic agents, including one received acarbose, one received metformin, and one received metformin combined with acarbose.After a median follow-up of 6 months, the levels of blood glucose in five children were stable, and there was no significant change in serum creatinine and urine protein.Conclusions:The treatment of PTDM in children should be individualized with considering of age, gender and immunosuppressive regimen. Switch from tacrolimus to cyclosporine is effective. Metformin or other hypoglycemic agentsis helpful when tacrolimus is maintained.
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Objective:To investigate the correlation between peripheral blood renal function indexes and brain frailty imaging score in patients with mild ischemic stroke or transient ischemic attack (TIA).Methods:Patients with mild ischemic stroke or transient ischemic attack (TIA) admitted to the Department of Neurology, the Second Affiliated Hospital of Soochow University from March 2018 to August 2019 were enrolled retrospectively. General clinical data and peripheral blood renal function indexes, including urea, uric acid and estimated glomerular filtration rate (eGFR), were collected. eGFR <60 ml/(min·1.73 m 2) was used to reflect chronic kidney disease. According to the findings of MRI examination, the imaging score of cerebral frailty was performed. When there were white matter lesions, brain atrophy and lacunar infarction/lacuna, 1 point was given, and the total score was 3. Ordinal multi-class logistic regression analysis was used to evaluate the relationship between renal function indexes and brain frailty imaging score in patients with mild ischemic stroke or TIA. Binary logistic regression analysis was used to evaluate the relationship between renal function indexes and brain frailty imaging score >1. Results:A total of 204 patients with mild ischemic stroke or TIA were enrolled during the study. Their average age was 64.82 years old and 78 (38.2%) were females. There were 28 cases (13.73%), 70 cases (34.31%), 63 cases (30.88%) and 43 cases (21.08%) with brain frailty imaging scores of 0, 1, 2, and 3, respectively. One hundred and six patients (51.96%) were in the brain frailty imaging score >1 group and 98 (48.04%) were in the ≤1 group. Univariate analysis showed that there were significant differences in age, diabetes mellitus, eGFR, eGFR classification, homocysteine, intracranial vascular stenosis, stroke etiology classification and vascular distribution between the group with brain frailty imaging score >1 and those with brain frailty imaging score ≤1 (all P<0.05). Ordinal multi-class logistic regression analysis showed that urea (odds ratio [ OR] 0.67, 95% confidence interval [ CI] 0.51-0.89, P=0.005) and eGFR ( OR 0.98, 95% CI 0.96-0.99; P=0.004) were significantly and independently correlated with brain frailty imaging score. Binary logistic regression analysis showed that eGFR was significantly and independently correlated with brain frailty imaging score >1 ( OR 0.98, 95% CI 0.96-1.00; P=0.016). However, urea, uric acid and eGFR classification were not independently correlated with brain frailty imaging score or brain frailty imaging score >1. Conclusion:Blood urea and eGFR are correlated with the brain frailty imaging score in patients with mild ischemic stroke or TIA.
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Objective:To explore the efficacy and safety of a novel Tripterygium preparation (Kunxian Capsules)in kidney transplant recipients developing refractory proteinuria after transplantation.Methods:A total of 59 kidney transplant recipients received regular follow-ups from August 2018 to July 2021.Severity of proteinuria, kidney graft function and adverse effects were retrospectively recorded before and at Month 1/2/3/6 months after Kunxian treatment.They were divided into two groups of effective and void to explore the potential effect-related factors.Results:Six-month treatment was completed in 57 patients except for 2 cases of discontinued treatment due to severe adverse effects.A significant reduction in amount of proteinuria was observed at Month 1 [1.09(0.42, 2.59 g/24 h)vs 1.82(1, 2.7 g/24 h, P<0.01)]and the trend continued during subsequent follow-ups.Twenty-nine patients(50.9%)responded remarkably.Eighteen patients(31.6%)showed no response.The overall effective rate was 68.4%.Inter-group comparison revealed strong correlations between treatment efficacy and baseline serum creatinine levels, early initiation of treatment and symptom duration from onset to treatment.Kidney graft IgA nephropathy demonstrated the highest effective rate(11/13, 84.6%). Furthermore, elevated blood concentration of tacrolimus hinted at a potential drug interaction. Conclusions:Kunxian Capsules is efficacious and safe for renal transplant recipients developing moderate-severe proteinuria and not responding to traditional medications.Early initiation of treatment before graft function decline is recommended.Reducing tacrolimus dose cautiously in advance and monitoring adverse events are also essential.
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Objective:To summarize the transplant outcomes of pediatric kidney transplantation at a single center and discuss probable measures of improving the outcomes.Methods:A total of 111 pediatric renal transplantation were performed from September 2002 to September 2019. They were divided into adult-donor group ( n=41) and pediatric-donor group ( n=70). Adult-donor group consisted of two subgroups based upon donor sources: living-donor group ( n=19) and deceased-donor group ( n=22). Pediatric-donor group consisted of two subgroups based upon surgical types: single kidney group ( n=48) and en bloc kidney group ( n=22). Clinical data and outcomes of grafts and recipients were retrospectively analyzed. Results:The average age of recipients was (15.6±1.9) years in adult-donor group. None developed delayed graft function (DGF) in living-donor group whereas 6 patients (27.3%) had DGF in deceased-donor group ( P<0.05). During a follow-up period of 22-181 months, 1-year and 5-year graft survivals were 100% vs 94.1% and 93.8% vs 94.1% in living-donor and deceased-donor groups respectively. There were no statistical differences. In pediatric-donor group, the age of donors was significantly lower in en bloc subgroup than that in single kidney subgroup (median: 0.5 vs 6 months, P<0.05). The age of recipients was similar between two subgroups: (9.5±5.3) years in single kidney group vs. 11.5± 1.8 years in en bloc kidney group. In addition, 7 cases of single kidney were transplanted for infant recipients aged under 1 year. Vascular thrombosis occurred in 3 patients (6.3%) of single kidney group, less than that in 5 patients (22.7%) of en bloc kidney group ( P=0.06). During a follow-up period of 4-54 months, 1-year and 2-year graft survivals were 85% and 80% in single kidney group whereas 75% and 70% in en bloc kidney group. However, there was no statistically significant difference. One-year survival was 98% in single kidney group and 95% in en bloc kidney group. Conclusions:For elder pediatric recipients, excellent kidney transplant outcomes may be achieved with grafts from adult donors. For pediatric kidney recipients, transplant outcomes can be further improved with careful assessments and cautious usage of small grafts, particularly those form neonatal donors.
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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 feasibility and safety of kidney transplantation in highly sensitized recipients by using ABO incompatible (ABOi) and yet human leucocyte antigen (HLA) supremely matched deceased donor kidneys and summarize the literatures as well .Methods A kidney graft from a deceased donor of blood type B was transplanted to a highly presensitized recipient of blood type O to achieve a HLA matching number of 7 /8 in May 2018 .Donor specific antibody (DSA) against HLA was negative and baseline anti-B IgM 1 : 16 . Plasmapheresis (PP) plus intravenous immunoglobulin (IVIG) plus anti-CD20 antibodies were offered on operation day .Clinical data was retrospectively analyzed .Results Renal graft functioned immediately and achieved a normal level of serum creatinine (SCr) at d2 after transplantation .However ,the value of SCr increased to 131 μmol/ l at d9 with a simultaneously elevated level of anti-B IgM from 1:2 at d7 to 1:16 .A renal graft biopsy at d11 showed mild inflammation in peritubular capillaries and focal tubulitis with minimal interstitial infiltration .No de novo DSA was detected .Then PP plus IVIG were then given twice ,followed by an administration of IVIG alone for another 2 days (20 g/d) .After treatments ,SCr had a range of 120- 140 μmol/l and anti-B IgM level decreased to 1:4 at d21 post-transplantation .During a follow-up of 6 months ,there was no onset of proteinuria or infection and the last value of SCr was 114 μmol/L . Conclusions In HLA highly sensitized recipients awaiting for transplant opportunities , successful prevention of HLA antibodies-mediated rejection may be achieved by using ABO incompatible and yet HLA compatible deceased donors .
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Objective To compare the surgical effects between minimally invasive anterior ondontoid screw fixation assisted by our self-designed odontoid guider and open anterior ondontoid screw fixation in the treatment of odontoid fractures of Anderson-D'Alonzo type Ⅱ.Methods From July 2011 to July 2016,28 adults with odontoid fracture of Anderson-D'Alonzo type Ⅱ were treated at Department Ⅱ of Spinal Surgery,Hospital of 89 Army Group of Chinese PLA.Of them,15 were treated by minimally invasive anterior ondontoid screw fixation assisted by our self-designed odontoid guider (guider group) while the other 13 by open anterior ondontoid screw fixation (open group).All the patients were male,aged from 31 to 59 years (average,42.7 years).The 2 groups were compared in terms of incision length,operation time,intraoperative bleeding,intraoperative fluoroscopic frequency and hospital stay.Results There were no significant differences between the 2 groups of patients in their preoperative general data,indicating they were compatible (P ＞ 0.05).All the patients were followed up for 12 to 45 months (average,22.1 months).The internal fixation was in good place and clinical union achieved in all the 28 patients.The incision length (2.2 ± 0.1 cm),operation time (45.0 ± 3.1 min),intraoperative bleeding (29.0 ± 2.3 mL) and intraoperative fluoroscopic frequency (15.5 ± 1.9 times) for the guider group were all significantly less than those (2.9 ±0.7 cm,61.6±3.8 min,51.6±3.9 mL and 21.7±3.2 times,respectively) for the open group (P ＜0.05),but there was no significant difference between the 2 groups in hospital stay (6.5 ± 0.5 d versus 6.5 ± 0.6 d) (P ＞ 0.05).Conclusion In the treatment of odontoid fractures of Anderson-D'Alonzo type Ⅱ,compared with open anterior ondontoid screw fixation,the minimally invasive anterior ondontoid screw fixation assisted by our self-designed odontoid guider may lead to a smaller incision,shorter operation time,less blood loss and a lower fluoroscopic frequency.
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Objective To evaluate the effects of early tracheostomy and late tracheostomy on the prognosis of patients with cervical spinal cord injury,so as to provide evidence based guidance for the timing of tracheostomy.Methods Relevant literatures studying the timing of tracheostomy in patients with cervical spinal cord injury were searched in PubMed,Embase,Medline,Cochrane Library,Chinese Biological Medical Literature database (CBM),China National Knowledge Infrastructure database (CNKI),and VIP journal database with time range from journal establishment to March 2018.The retrieved articles were screened according to the inclusion and exclusion criteria.The article quality was rigorously evaluated according to the Newcastle-Ottawa scale (NOS).Meta analysis was conducted using Review Manager 5.3 software to compare the mechanical ventilation time,ICU stay,incidence of pneumonia,incidence of complications,and mortality between early and late tracheostomy in patients with cervical spinal cord injury.Results A total of eight articles of cohort study including 466 patients were included,with 241 patients in the early tracheostomy group and 225 patients in the late tracheostomy group.The eight articles were all determined as high quality studies according NOS.The results of Meta analysis showed that there were significant differences between the two groups in terms of the total mechanical ventilation time (MD =-12.28,95％ CI-20.09--4.47,P ＜ 0.01),post tracheostomy mechanical ventilation time (MD =-9.92,95％ CI-14.27--5.57,P ＜ 0.01),total ICU stay (MD =-10.30,95％ CI-17.12--3.47,P ＜ 0.01),post tracheostomy ICU stay (MD =-5.79,95％ CI -6.53--5.05,P ＜ 0.01),incidence of complications (RR =0.56,95％ CI 0.38-0.83,P ＜ 0.01),and mortality (RR =0.34,95％ CI 0.15-0.78,P ＜ 0.05).However,no significant differences were detected between the two groups in the incidence of total pneumonia (RR =0.77,95％ CI 0.57-1.05,P ＞0.05) and the incidence of post tracheostomy pneumonia (RR =0.80,95％ CI 0.51-1.26,P ＞0.05).Conclusion Early tracheostomy can shorten the mechanical ventilation time,ICU stay,incidence of complications,and mortality,but it cannot reduce the incidence of pneumonia.
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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 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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Objective To determine the relationship between cervical cancerous and precancerous lesions and human papilloma virus(HPV) infection.Methods 158 female patients with abnormal pap smears underwent colpo- scopically directed biopsies and hybrid captureⅡtest.Results HPV infection was distributed in 8.7 % of cervitis, in 34.7 % of low-grade squamous intraepithelial lesion(LSIL) ,in 68.9 % of high-grade squamous intraepithelial le- sion(HSIL) and in 83.3 % of cervical cancer.Conclusion HPV infection was correlated with cervical(cancerous and intraepithelial neoplasia) lesions and increased wi.th the serious degrees of lesions.Hybrid captureⅡtest can work ef- ficiently as a triage of patients with ASCUS,LSIL and HSIL before colposcopically directed biopsies.
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Objective To study the signal transduction pathway for myocyte contraction induced by Substance K (SK) in rats. Methods The fluorescent Ca 2+ indicator Fluo 3AM was used to quantitate the calcium signal directly in the primary cultured myocardial cells. Changes of free Ca 2+ concentration in cardiac myocytes were detected by flow cytometry. The phospholipase C (PLC) inhibitor, neomycin and IP3 receptor antagonist, heparin, were used to block signal system of phosphates Ca 2+ in order to investigate whether they took part in the SK induced changes of [Ca 2+ ]i in myocytes. Results SK(1.78?10 -5 mol/L) elevated [Ca 2+ ]i in myocytes. The effects could be blocked by neomycin and heparin. Conclusion SK can elevate [Ca 2+ ]i in myocyte, which may be mediated by a signal system of phosphates Ca 2+ .