Fibrinogen-to-albumin ratio predicts the outcome of patients with acute ischemic stroke receiving intravenous thrombolysis / 国际脑血管病杂志

Objective:To investigate the correlation and predictive value of fibrinogen-to-albumin ratio (FAR) and clinical outcomes after intravenous thrombolysis in patients with acute ischemic stroke.Methods:Patients with acute ischemic stroke received intravenous thrombolysis treatment at Fuyang People's Hospital from November 2019 to August 2022 were retrospectively included. Their clinical, imaging, and laboratory data were collected. After 3 months of onset, a modified Rankin Scale was used for clinical outcome evaluation and a score >2 were defined as poor outcome. Multivariate logistic regression analysis was used to determine the correlation between FAR and poor outcome. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of FAR on adverse outcomes after intravenous thrombolysis in patients with acute ischemic stroke. Results:A total of 162 patients were included. There were 114 patients (70.4%) in the good outcome group and 48 (29.6%) in the poor outcome group. Univariate analysis showed that the baseline National Institutes of Health Stroke Scale (NIHSS) score, fasting blood glucose, fibrinogen, and FAR in the poor outcome group were significantly higher than those in the good outcome group, while the serum albumin was significantly lower than that of the good outcome group (all P<0.05). Multivariate logistic regression analysis showed that the baseline NIHSS score (odds ratio [ OR] 1.176, 95% confidence interval [ CI] 1.082-1.227; P<0.001), fasting blood glucose ( OR 1.206, 95% CI 1.018-1.430; P=0.030), and FAR ( OR 1.448, 95% CI 1.449-1.824; P=0.002) were the independent risk factors for poor outcome. The ROC curve analysis showed that the area under the curve of FAR for predicting poor outcomes was 0.706 (95% CI 0.616-0.796). When the FAR cutoff value was 8.06, the sensitivity and specificity were 66.7% and 78.2%, respectively. Conclusion:There is a significant correlation between FAR and outcomes after intravenous thrombolysis therapy in patients with acute ischemic stroke. Higher FAR has certain predictive value for poor outcomes of patients.

Preparation of tanshinone IIA self-soluble microneedles and its inhibition on proliferation of human skin fibroblasts / 中草药·英文版

OBJECTIVE@#Hypertrophic scars (HS) are a variety of skin tissue fibrosis disease that occurs in human skin, the effective therapeutic method of which is still inaccessible up to now. As a bioactive constituent of a well-known medical plant, Salvia miltiorrhiza (Danshen in Chinese), tanshinone IIA (TSA) is reported to inhibit cell proliferation in HS. Therefore, the aim of this study was to prepare TSA self-soluble microneedles to strengthen its dermal retention and break through the difficulty of significantly thickening epidermal connective tissue and stratum corneum at the HS site. The possible mechanism of action in suppressing HS was studied using human skin fibroblasts (HSF).@*METHODS@#Tanshinone IIA self-dissolving microneedles (TSA-MN) was prepared using a negative mold casting method. The prescription process of microneedle was optimized by Box-Behnken effect surface method. Different media were selected to investigate the ability of transdermal absorption and in vitro release. Furthermore, according to Cell Counting Kit-8 (CCK8) method as well as the Western blot method, the effect of TSA-MN on the biological characteristics of HSF was investigated.@*RESULTS@#With remarkable slow release effect and dermal retention, the release and transdermal properties of TSA-MN in vitro were better than both TSA and ordinary dosage forms. Its effect of HSF confirmed the essential decrease in cell motility during cell proliferation and cell migration in vitro, which plays a significant role in down-regulating the secretion of transforming growth factor-β1 (TGF-β1) in HSF and increasing the expression level of Smad7.@*CONCLUSION@#The prepared TSA self-soluble microneedles is helpful in solving the problem of hypertrophic scars, with a stable dermal retention effect after process optimization.

Analysis of bleeding characteristics and influencing factors after bariatric surgery / 中华消化外科杂志

Objective:To investigate the bleeding characteristic and influencing factors after bariatric surgery.Methods:The retrospective case-control study was conducted. The clinical data of 3 371 patients with obesity who underwent bariatric surgery in the First Affiliated Hospital of Nanjing Medical University from May 2010 to August 2021 were collected. There were 903 males and 2 468 females, aged 31(16?65)years. Observation indicators: (1) occurrence, diagnosis and treatment of bleeding after bariatric surgery; (2) analysis of influencing factors for bleeding after bariatric surgery. (3) Follow-up. Follow-up was conducted through outpatient examinations, telephone interview or WeChat to detect total weight loss rate, resolution of hypertension and remission of type 2 diabetes of the patients with bleeding after bariatric surgery. The follow-up was up to August 2021. Measurement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were represented as M(range). Count data were represented as absolute numbers or percentages, and comparison between groups was analyzed by the chi-square test. Ordinal data were analzyed by the non-parametric rank sum test. Univariate analysis was conducted using the corresponding statistical methods based on data type. The binary Logistic regression was used for multivariate analysis. Results:(1) Occurrence, diagnosis and treatment of bleeding after bariatric surgery. There were 27 of 3 371 patients diagnosed with postoperative bleeding, including 13 males and 14 females. There were 18 cases of abdominal bleeding and 9 cases of gastrointestinal bleeding. Among the 27 patients with postoperative bleeding, 8 cases were diagnosed with bleeding on the day after operation, 13 cases were diagnosed on the first day after operation, 4 casess were diagnosed on the second day, and 2 cases were diagnosed on the third day or later. Among the 27 patients with postoperative bleeding, 24 cases had tachycardia as the main clinical manifestation, 11 patients had abnormal abdominal drainage with the drainage volume as 300(range, 100?600)mL, 6 cases had hematocheziain with the volume as 500(range, 120?1 000)mL, 5 cases were manifested as hypotension, 3 cases had hematemesis with the volume as 300(range, 50?800)mL, 2 cases had a significant decrease in hemoglobin on the first day after operation. One patient may have multiple clinical manifestations. Among the 27 patients with postoperative bleeding, 6 cases with abdominal bleeding received emergency laparotomy due to continuous increase of abdominal drainage or hemorrhagic shock, of which one patient died of heart failure after emergency reoperation. The time between primary and secondary operation was 13.5(range, 2.0?45.0)hours, and the volume of blood accumulation was 1 000(range, 600?7 000)mL. The bleeding sites were identified in 5 patients during reoperation, including 2 cases of staple line bleeding after sleeve gastrectomy, 1 case of lesser sac bleeding after Roux-en-Y gastric bypass, 1 case of short gastric vessel bleeding and 1 case of trocar site bleeding. One patient had no obvious active bleeding during reoperation. The remaining 12 cases of abdominal bleeding and 9 cases of gastrointestinal bleeding were treated by conservative therapy. The duration of bleeding lasted for (2.1±0.7)days. (2) Analysis of influencing factors for bleeding after bariatric surgery. Results of univariate analysis showed that gender, hypertension, type 2 diabetes, surgical type were the related factors that affected the bleeding after bariatric surgery ( χ2=6.33, 42.16, 4.49, 14.09, P<0.05). Results of multivariate analysis indicated that surgical type was a independent factor affecting postoperative bleeding in patients undergoing bariatric surgery ( odds ratio=1.69, 95% confidence interval as 1.18?2.41, P<0.05). (3) Follow-up. All the 27 patients were followed up for 16(1?62)months. Eighteen patients reached or exceeded the 12 months follow-up time point. The 1-year total weight loss rate was 36%±12%, the resolution proportion of hypertension was 8/11, and the complete remission proportion of type 2 diabetes was 6/7. Six patients reached or exceeded the 36 months follow-up time point. The 3-year total weight loss rate was 35%±12%, the resolution proportion of hypertension was 4/5, and the complete remission proportion of type 2 diabetes was 1/1. Conclusions:The incidence of post-operative bleeding after bariatric surgery is low. Tachycardia, abnormal abdominal drainage and hypotension have sentinel functions. Surgical type is a independent factor affecting bleeding after bariatric surgery.

Resveratrol alleviates Kawasaki disease-induced myocardial injury via inhibition of apoptosis and autophagy / 中南大学学报(医学版)

OBJECTIVES@#To explore the effect of resveratrol (Res) on Kawasaki disease (KD)-induced myocardial injury and to evaluate its effect on apoptosis and autophagy.@*METHODS@#Forty-eight juvenile male Sprague Dawley rats were randomly divided into a control group, a Res group, a lactobacillus casei cell wall extract (LCWE)-induced Kawasaki disease group (KD group), and a LCWE-induced Kawasaki disease + Res treatment group (Res+KD group). The control group was intraperitoneally injected with saline. The Res group was intraperitoneally injected with resveratrol (100 mg/kg). The KD group was intraperitoneally injected with 0.5 mL LCWE (1 mg/mL). The Res+KD group was intraperitoneally injected with 0.5 mL LCWE (1 mg/mL) and resveratrol (100 mg/kg). After 4 weeks, the left ventricular ejection fraction (LVEF) and short axis shortening rate (LVFS) were detected by echocardiography. The apoptotic rate was detected by terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL) staining. The levels of B-cell lymphoma-2 (Bcl-2), Bcl-2-associated X protein (Bax), microtubule-associated protein 1 light chain 3β (LC3B), Beclin-1, autophagy related 5 (Atg5) and sequestosome-1 (p62) were detected by Western blotting. The formation of autophagosome was observed under transmission electron microscope.@*RESULTS@#There was no significant difference in the above-mentioned indexes between the control group and the Res group (all @*CONCLUSIONS@#Res can attenuate the KD-induced myocardial injury via inhibiting the apoptosis and autophagy.

Retrospective analysis of clinical features of chronic obstructive pulmonary disease complicated with pulmonary thromboembolism / 中国基层医药

Objective@#To analyze the clinical features of patients with chronic obstructive pulmonary disease(COPD) complicated with pulmonary thromboembolism(PTE).@*Methods@#The clinical data of 21 patients with COPD and PTE and 26 patients with acute exacerbation of COPD(AECOPD) from June 2015 to March 2018 in Taiyuan Central Hospital were retrospectively analyzed.The SSPS 22.0 statistical software was used to analyze the clinical data.General data, blood gas analysis results, lung function, hemoglobin, coagulation parameters, combined disease were analyzed.@*Results@#There were no statistically significant differences in age, gender and lung function grading between the COPD complicated with PTE group and AECOPD group (all P>0.05). The incidence rates of chest pain(8 cases, 38.1%) and syncope(2 cases, 10.5%) in the COPD complicated with PTE group were higher than those in the AECOPD group[chest pain(3 cases, 11.5%), syncope(1 case, 3.8%)](χ2=7.645, 9.413, all P<0.05). There was no statistically significant difference in carbon dioxide partial pressure(PaCO2)retention between the two groups(P>0.05). The blood oxygen partial pressure(PaO2) of the COPD complicated with PTE group was (62.86±15.10)mmHg, which was lower than that of the AECOPD group [(74.83±17.59)mmHg](t=4.642, P<0.05). The hemoglobin, activated partial thromboplastin time(APTT), fibrinogen(FIB), D-dimer levels in the COPD complicated with PTE group were (146.78±21.40)g/L, (35.62±5.93)s, (4.34±1.18)g/L, (5.02±3.63)mg/L, respectively, which were higher than those in the AECOPD group [(137.45±15.15)g/L, (29.38±3.16)s, (3.62±1.08)g/L, (0.92±0.42)mg/L] (t=4.375, 4.654, 3.869, 18.653, all P<0.05). There were no statistically significant differences in the proportion of comorbidities such as diabetes, hypertension, hyperlipidemia and lower extremity(all P>0.05).@*Conclusion@#COPD patients complicated with PTE have the following characteristics: elderly and male patients accounted for a high proportion, chest pain and syncope symptoms occurred in a high proportion, severe hypoxia, hemoglobin and D-dimer increased significantly.

Retrospective analysis of clinical features of chronic obstructive pulmonary disease complicated with pulmonary thromboembolism / 中国基层医药

Objective To analyze the clinical features of patients with chronic obstructive pulmonary disease (COPD) complicated with pulmonary thromboembolism (PTE).Methods The clinical data of 21 patients with COPD and PTE and 26 patients with acute exacerbation of COPD(AECOPD) from June 2015 to March 2018 in Taiyuan Central Hospital were retrospectively analyzed.The SSPS 22.0 statistical software was used to analyze the clinical data.General data,blood gas analysis results,lung function,hemoglobin,coagulation parameters,combined disease were analyzed.Results There were no statistically significant differences in age,gender and lung function grading between the COPD complicated with PTE group and AECOPD group (all P ＞ 0.05).The incidence rates of chest pain(8 cases,38.1％) and syncope(2 cases,10.5％) in the COPD complicated with PTE group were higher than those in the AECOPD group [chest pain (3 cases,11.5 ％),syncope (1 case,3.8 ％)] (x2 =7.645,9.413,all P ＜0.05).There was no statistically significant difference in carbon dioxide partial pressure (PaCO2)retention between the two groups(P＞0.05).The blood oxygen partial pressure(PaO2) of the COPD complicated with PTE group was (62.86 ± 15.10)mmHg,which was lower than that of the AECOPD group [(74.83 ± 17.59)mmHg] (t =4.642,P ＜ 0.05).The hemoglobin,activated partial thromboplastin time (APTT),fibrinogen (FIB),D-dimer levels in the COPD complicated with PTE group were (146.78 ± 21.40) g/L,(35.62 ± 5.93) s,(4.34 ± 1.18) g/L,(5.02 ± 3.63)mg/L,respectively,which were higher than those in the AECOPD group [(137.45 ± 15.15)g/L,(29.38 ±3.16) s,(3.62 ± 1.08) g/L,(0.92 ±0.42) mg/L] (t =4.375,4.654,3.869,18.653,all P ＜0.05).There were no statistically significant differences in the proportion of comorbidities such as diabetes,hypertension,hyperlipidemia and lower extremity (all P ＞ 0.05).Conclusion COPD patients complicated with PTE have the following characteristics:elderly and male patients accounted for a high proportion,chest pain and syncope symptoms occurred in a high proportion,severe hypoxia,hemoglobin and D-dimer increased significantly.

Antibiotic resistance of the Staphylococcus aureus strains isolated from sputum / 中国感染与化疗杂志

Objective A retrospective analysis was conducted to review the distribution and antibiotic resistance in the Staphy-lococcus aureus strains isolated from sputum and provide evidence for effective prevention and control of infections.Methods The 276 strains of S .aureus isolated during the period from January to September of 2009 were included in this analysis.The isolates were identified and tested for susceptibility using VITEK 2 Compact Automatic Culture and Identification System. Results The prevalence of methicillin-resistant S .aureus (MRSA)was 79.0% (218/276).The S .aureus strains were mainly isolated from Department of Neurology (27.5%,76/276),ICU (25.4%,70/276),Neurosurgery (18.1 %,50/276),and Re-spiratory Medicine (9.1 %,25/276).Vancomycin,teicoplanin and quinupristin-dalfopristin were the most active agents against these S .aureus .The resistant strains were less than 0.5%.MRSA showed lower resistance rate to trimethoprim-sulfamethox-azole than MSSA.MRSA strains were more resistant than MSSA to most other antibacterial agents.Conclusions The MRSA i-solates from sputum are highly prevalent and resistant to antibiotics.Antimicrobial agents should be selected appropriately ac-cording to the results of susceptibility testing.

Interleukin-22 promotes Th17 cells differentiation through up-regulating IL-6 production by rheuma-toid arthritis synovial fibroblasts / 中华微生物学和免疫学杂志

Objective To investigate the effects of interleukine-22 ( IL-22 ) on the expression of interleukin-6 (IL-6) by rheumatoid arthritis synovial fibroblasts (RASF), and to analyze their association with IL-17+CD4+T (Th17) cells differentiation.Methods RASF were isolated from six patients with rheu-matoid arthritis ( RA) and cultured in vitro.The expression of IL-6 at mRNA and protein levels by RASF were detected by qRT-PCR analysis and ELISA after treatment with different concentrations of IL -22 for dif-ferent periods of time.Anti-IL-22R1 blocking antibody and inhibitor assay were used to analyze the specific receptor and its downstream signaling pathways associated with IL-6 production.IL-22 pre-treated RASF and CD4+T cells were co-cultured for 3 days in the presence or absence of anti-IL-22R1 or anti-IL-6 to measure the percentage of Th 17 cells by flow cytometry .Results The expression of IL-6 by RASF was increased up-on IL-22 stimulation in a dose and time dependent manner (P<0.05), and that was closely related to IL-22R1 and its downstream signaling pathways of p38 and JAK2 (P<0.05).Co-culturing CD4+T cells with RASF and Transwell system indicated that the percentage of Th 17 cells was increased in IL-22 pre-treated group as compared with that in IL-22 untreated group , but it could be down-regulated by either blocking IL-22R1 or IL-6.Conclusion IL-22 promoted the expression of IL-6 by RASF and further enhanced Th 17 dif-ferentiation.Neutralizing IL-22 in synovium of patients with RA might be an effective therapeutic strategy for RA treatment.

Evaluation urinary trehalase in patients with renal proximal tubular damage / 中华检验医学杂志

Objective To investigate the value of urinary trehalase (T) in patients with renal proximal tubular damage.Methods 134 patients with kidney disease (male:66 female:68 age:18-59 ; 31cases with acute renal failure,30 cases with chronic renal failure,20 cases with drug-induced renal impairment,21 cases with renal transplantation and 32 cases with nephritic syndrome) and 101 healthy controls (58 males and 43 females) were selected.Urinary T,N-acetyl-D-glucosaminidase (NAG),β2-MG,gamma-glutamyl transferase (GGT) were detected.Data were analyzed by SPSS 11.5,including nonparametric rank test,ROC analysis.Results The level of urinary trehalase in control group was normally distributed (7.1 ± 4.1) μmol/h · g Cr (0-25 μmol/h · g Cr).There was no significant difference between men and women (t =0.63,P =0.53).Urinary T levels were significant higher in all kidney disease groups than in control group (Z =6.80,5.90,5.23,6.00,8.04,P ＜0.01).According to ROC curve,the area of urinary T under the ROC curve (AUC) in 134 patients was 0.9,significantly different with NAG,β2-MG,GGT area (P ＜ 0.01),the AUCs of T were 0.94,0.85,0.90,0.90,0.91 in acute and chronic renal failure group,drug-induced renal impairment group,renal transplantation group and nephritic syndrome group,respectively; Youden index were 0.85,0.65,0.77,0.66,0.72 respectively.Corresponding to the Youden index,sensitivity and specificity were 90.3％ and 95.1％,73.3％ and 92.1％,85.0％ and 92.1％,81.0％ and 85.2％,87.5％ and 84.2％ respectively.Conclusions The Urinary trehalase is better than other markers in the diagnosis of the proximal renal tubular damage.It was better to evaluate the proximal tubular function early in time.The diagnostic value of urinary trehalase played a key role in diagnosis,treatment and prognosis of kidney diseases.

Association study of RANKL rs7984870 polymorphism and risk of rheumatoid arthritis / 中华微生物学和免疫学杂志

ObjectiveTo elucidate the association between RANKL rs7984870 C ＞G polymorphism and the susceptibility to rheumatoid arthritis in a Chinese Han population.MethodsGenotypes were determined by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) method in 214 rheumatoid arthritis cases and 478 controls.ResultsThe RANKL rs7984870 C＞G genotype frequencies were 27.3% ( CC),51.2% ( CG),21.5% (GG) in the rheumatoid arthritis group and 25.3% (CC),49.1% (CG),25.7% (GG) in the control group respectively; Logistic regression analyses revealed that the risk associated with RANKL rs7984870 C＞G variant genotype was 0.78 (95% CI =0.49-1.24) for RANKL rs7984870 GG compared with its wild-type homozygote.ConclusionRANKL rs7984870 polymorphism may not serve as a risk factor of rheumatoid arthritis susceptibility.Further functional studies are warranted to verify our findings.

Clinical Meanings of Measurement of Urinaemia Patients'Parameters on Pletelet and Hemoglobin / 医学研究杂志

Objective To observe changes on those parameters on pletelet and hemoglobin of urinaemia patients by treatments of dialysis.Methods candidators are divided into three groups respectively-a control group,two case groups.The two case groups are consist of patients who are treated through dialysis on not.In the three groups,the parameters on pletelet,hemoglobin,MPV and PDW are measured on hemocytometer in our laboratory. Results Dramatic difference is made in the parameters on PLT,Hb,MPV and PDW between the formers of dialysis and the control group.(P

Clinical significance and hematologic features of CD56~+ acute myeloid leukemia / 中国癌症杂志

Purpose:To study the clinical significance and hematologic features of CD56 + Acute Myeloid Leukemia(AML). Methods:The expression of differentiation antigens on the acute myeloid leukemia cells were detected by flow cytometry(FCM);the Epstein-Barr Virus(EBV) mRNA in CD56 + AML leukemic cells by Rt-PCR assay;the ultrastructure of the CD56 + AML leukemia cells were showed by electron microscope and immuno-electron-microscope. The hematologic features and clinical characteristics at the first visit retrospectively analysed as well as the effect of chemotherapy.Results:CD56 expression rate in AML was 30.62%(79/258).EBV-mRNA were negative in all CD56 + AML cells detected.The ultrastructural characteristics showed 1-2 masses floccose objects in nucleus of CD56 + AML leukemic cells,CD56 expression had no correlation with age,sex,WBC,Hb,BPC,Leukemic cell count in BM,CR rate and CR duration(P value is 0.128,0.877,0.181,0.866,0.629,0.407,0.998 and 0.096,respectively),but there was correlation with higher extramedullary involvement(77.78% v 61.11%,P=0.019)?higher expression of CD34 (66.67% v 46.48%,P=0.03),higher expression of P170(51.79% v 34.94%,P=0.048) and shorter survival(Median,11.5 months v 18 months,P=0.0478). Conclusions:AML was a specific subtype of AML,with a poor prognosis.It may be useful to have more detailed classification with appropriate therapy for this subtype.