Clinicopathologic Characteristics and Prognosis of Oligodendroglioma with IDH Mutation and 1p/19q Codeletion / 肿瘤防治研究

Objective To analyze the clinicopathological characteristics and prognosis of oligodendroglioma with IDH mutation and 1p/19q codeletion. Methods We collected the data of 54 oligodendroglioma patients with IDH mutation and 1p/19q codeletion.The patients'clinicopathological data, including age, histological grade, and tumor site, were analyzed for the effects on progression-free and overall survival. Results Among the 54 patients, 46 cases were with tumor sites in one lobe, and eight cases involved tumor sites in more than two lobes.A total of 12 and 42 cases had WHO grades 2 and 3 oligodendroglioma, respectively.Detection by fluorescence in situ hybridization showed 1p/19q co-deletion in all cases.Immunohistochemical tests revealed diffuse and strong positive results for Olig2.All glial fibrillary acidic proteins were positive.p53 was strongly positive in six cases.ATRX was expressed in all 48 cases.Ki-67 proliferation index ranged from 5% to 60%.Sanger sequencing showed that all 54 cases had IDH gene mutations (40 cases were IDH1 mutations, and 14 were IDH2 mutations), and 33 cases had telomerase reverse transcriptase promoter mutations.Relapse and metastasis occurred in 16 patients during treatment.Univariate analysis indicated that the postoperative recurrence and metastasis interval of more than two years can prolong the progression-free and overall survival of patients.All 54 patients had a mean progression-free survival of 33.5 months and the mean overall survival of 40.7 months. Conclusion For oligodendroglioma with IDH mutation and 1p/19q codeletion, precision chemoradiotherapy after surgery can reduce the risk of progression, and the postoperative recurrence and metastasis interval is associated with the prognosis.

Value of ultrasonic inferior vena cava parameters in predicting cesarean section subarachnoid obstruction and supine hypotension syndrome / 中国医师杂志

Objective:To explore the clinical value of ultrasonic inferior vena cava parameters in predicting supine hypotension syndrome after subarachnoid block.Methods:80 cases of cesarean section under subarachnoid block in singleton pregnancy treated in Beijing Maternity Hospital from August 2019 to March 2020 were selected retrospectively. According to the occurrence of supine hypotension syndrome after anesthesia, they were divided into two groups (group A had supine hypotension syndrome and group B did not), with 40 cases in each group. The changes of related parameters of inferior vena cava in supine position and left 30 ° lying position were compared between the two groups. The correlation between the maximum end expiratory diameter (IVCe), the minimum end inspiratory diameter (IVCi) and the collapse index (IVC-CI) of inferior vena cava and the changes of systolic blood pressure in supine hypotension syndrome were analyzed, and the value of IVCe, IVCi and IVC-CI in predicting supine hypotension syndrome were compared.Results:Under the condition of supine position and left 30 ° lying position, the levels of IVCe and IVCi in group A were significantly lower than those in group B ( P<0.05), and the levels of IVC-CI were higher than those in group B ( P<0.05). Spearman analysis showed that the levels of IVCe and IVCi were positively correlated with the changes of systolic blood pressure in the occurrence of supine hypotension syndrome ( P<0.05), and the levels of IVC-CI were negatively correlated with the changes of systolic blood pressure in the occurrence of supine hypotension syndrome ( P<0.05). IVC-CI had the highest yoden index and the highest sensitivity in predicting the occurrence of supine hypotension syndrome, and IVCe had the highest specificity in predicting the occurrence of supine hypotension syndrome. Conclusions:Cava collapse index has high sensitivity to predict supine hypotension syndrome, while the maximum end-expiratory diameter of inferior vena cava has high specificity to predict supine hypotension syndrome.

Expression of Prostaglandin E2 Receptors in Acquired Middle Ear Cholesteatoma

OBJECTIVES: To investigate the expression of prostaglandin E2 receptor subtypes, E-prostanoid (EP) 1–4 receptors, in acquired cholesteatoma and its possible role in the pathologic process of this disorder. METHODS: Specimens of human acquired cholesteatoma were obtained from 29 patients and 19 skin biopsies of normal external auditory canal were as controls. The mRNA and protein expression of EP receptors was assessed by quantitative real-time polymerase chain reaction, immunohistochemistry and Western blot. RESULTS: In acquired cholesteatoma, EP1–EP4 receptors were mainly expressed on squamous epithelium and subepithelial infiltrated inflammatory cells. In external auditory canal skin, EP1–EP4 receptors were mainly expressed on squamous epithelium and glandular epithelium. The expression of EP4 receptor on mRNA and protein levels were significant lower in acquired cholesteatoma compared with controls. EP1–EP3 receptors had no significant difference between the experimental and control group. CONCLUSION: Low expression of EP4 may play a crucial role in the pathologic process of inflammation reaction and bone destruction in acquired cholesteatoma, but not EP1, EP2, or EP3 receptors.

Clinical Observation of Vinpocetine Combined with Xueshuantong in the Treatment of Cerebral Infarction / 中国药房

OBJECTIVE:To observe the clinical efficacy and safety of vinpocetine combined with xueshuantong in the treatment of cerebral infarction.METHODS:56 patients with acute cerebral infarction were randomly divided into control group (28 cases) and observation group (28 cases).On the basis of routine treatment,control group was given Vinpocetine for injection 20 mg,once a day.Observation group was additionally given Xueshuantong for injection (lyophilized) 150 mg,intravenously,once a day,on the basis of control group.Both groups received treatment for 2 weeks.Clinical efficacies of 2 groups were observed.The levels ofNIHSS score、VEGF,vWF,sVCAM-1,sICAM-1,CRP and IL-8,the occurrence of ADR were observed before and after treatment.RESULTS:Total response rate of observation group (96.43％) was significantly higher than that of control group (78.57％),with statistical significance (P＜0.05).After treatment,the serum levels of VEGF in 2 groups were significantly higher than before treatment,and the observation group was significantly higher than the control group.The serum levels of NIHSS score、vWF,sVCAM-1,sICAM-1,CRP and IL-8 in 2 groups were significantly lower than before treatment,and the observation group was significantly lower than the control group,with statistical significance (P＜0.05).There was no statistical significance in the incidence of ADR between 2 groups (P＞0.05).CONCLUSIONS:Based on routine treatmem,vinpocetine combined with xueshuantong show good therapeutic efficacy and safety for cerebral infarction.

The relationship of expressions of ERP57 and ERAP1 and clinicopathological features in patients with breast cancer / 天津医药

Objective To observe the expressions of endoplasmic reticulum chaperone (ERP57) and endoplasmic reticulum aminopep-tidase (ERAP1) in female breast cancer, and to explore their relationship with clinical pathological parameters of breast cancer. Methods A total of 124 samples of breast cancer and 24 samples of breast fibroadenoma were collected in the Affiliated Tumor Hospital of Xinjiang Medical University from January 2011 to December 2015. The expressions of ERP57 and ERAP1 were detected by immunohistochemistry SP method. The patients were divided into two groups according to the clinicopathological parameters. The differences of ERP57 and ERAP1 expression were analyzed between the groups. Results The positive expression rates of ERP57 were 58.8% (73/124) and 100% (24/24) in breast cancer and breast fibroadenoma samples, respectively. The difference was statistically significant (χ2=15.061, P14%, and which was significantly higher in patient with non-triple negative than that in patients with the triple negative (P<0.05). Conclusion The low expression levels of ERP57 and ERAP1 may play an important role in the carcinogenesis of breast cancer, and which may be valuable in judging the malignant degree and prognosis of breast cancer.

Comparison of two Methods for the Modeling of Tympanosclerosis in Rat / 听力学及言语疾病杂志

Objective To establish a rat model of tympanosclerosis(TS) by myringotomy and inoculation of streptococcus pneummoniae, and to observe the morphological change in the tympanic membrane (TM) and middle ear mucous.Methods Forty Sprague-Dawley rats were randomly divided into two groups (n=20/group) and then ten in each group were chosen to serve as the control and the other ten were set up for the TS model.Group A (myringotomy): myringotomy was performed on the bilateral TMs of all rats except the control group.Group B (bacterial inoculation): streptococcus pneumoniae was inoculated into the bilateral middle ear cavity of all rats except the control group.The condition of the TMs and the middle ears in the two groups were respectively examined at 2 weeks after myringotomy and at the five time points (1 week, 2 weeks, 4 weeks, 6 weeks, and 8 weeks) after bacterial inoculation.Then the rats were decapitated and the morphological changes were observed by hematoxylin and eosin staining.Results One rat in group B died two weeks after the inoculation.In the two experimental groups, the calcifications were observed in 70%of the TMs (14/20) in group A and in 33.33%of the TMs (6/18) at 8 weeks in group B.At the same time, the inflammatory infiltration and hyaline degeneration markedly appeared in the tympanic membrane and middle ear mucous membrane.In the two control groups, neither morphological changes nor calcifications occurred.Conclusion The current study indicated that the animal model of TS was successfully accomplished by myringotomy and inoculation of streptococcus pneummoniae, and their morphological changes were basically consistent.However, the method of myringotomy is easier to use and can obtain a higher modeling rate in a relatively short time.

Risk factors of hemorrhagic transformation in 335 patients with acute cerebral infarction / 重庆医学

Objective To investigate the risk factors of hemorrhagic transformation(HT) in patients with acute cerebral infarction(ACI).Methods A total of 335 patients with ACI from June 2013 to September 2016 was enrolled in this study,including 47 patients in hemorrhagic transform group(HT group) and 288 patients in non-hemorrhagic transformation group(NHT group).The general clinical situation,laboratory indexes,imaging features and treatment measures of the two groups were collected and compared,and then the risk factors of HT in the patients with ACI were analyzed by Logistic regression analysis.Results Univariate analysisshowed that there were significant differences between the two groups in the history of diabetes mellitus,hìstory of atrial fibrillation,NHISS score,systolic blood pressure at admission,fasting blood glucose,glycosylated hemoglobin,low density lipoprotein cholesterol,fibrinogen,infarct location,large area infarction and thrombolytic therapy(P＜0.05).Logistic regression analysis showed that history of atrial fibrillation(OR =2.703,95 ％ CI 1.169-6.250),high fasting blood glucose(OR =2.098,95 ％ CI 1.532-2.875),large area infarction(OR=9.999,95％CI 4.648-21.510) and thrombolytic therapy(OR=6.557,95％CI 1.954-22.003) were independent risk factors for HT.Conclusion The history of atrial fibrillation,high fasting blood glucose,large area infarction and thrombolytic therapy are the risk factors for HT in patients with ACI.Corresponding nursing measures should be arranged to facilitate the disease treatment.

Comparison of effects of two anesthetic approaches on infections of immunol-ogical parameters during splenectomy in hepatocellular carcinoma / 中国免疫学杂志

Objective:To investigate the impacts of two anesthesia approaches on infections of immunological parameters during splenectomy in hepatocellular carcinoma patients .Methods: Sixty hepatocellular carcinoma patients were divided into two groups randomly,each groups was thirty (liver function Child-Pugh grade was A-B).Total intravenous anesthesia with pmpofol group (group A,n=30 ) and combined intravenous inhalational anesthesia with sevoflurane group (group B,n=30 ).Before induction of anesthesia , at the end of operation ,and after operation 24 hours.blood samples were collected to determined with the level of CD 3+,CD4+,CD8+, CD4+/CD8+and TNF-α, IL-2, IL-6 of hepatocellular carcinoma patients .Results: The perioperative physiological index MAP , HR, SpO2,RR each point had no obvious difference between two groups (P>0.05).The levels of CD3+,CD4+,CD8+,CD4+/CD8+had no significant difference between two groups before anesthesia (P>0.05).There was no significant changes in CD3+,CD8+with two groups in all moments.Compared with the T0,A,B two groups of CD4+,CD4+/CD8+were lower (P0.05 ) .Compared with the T0 moment,there was no significant change in group A of TNF-αlevel (P>0.05),while group B increased significantly in postoperative day ( P0.05 ) . Conclusion: Both total intravenous anesthesia with pmpofol and combined intravenous inhalational anesthesia with sevoflurane inhibit the immune function of the patients with hepatocellular carcinoma cell immune reaction .The inhibitory effect of sevoflurane inhalation anesthesia on cell immune function is less affected .

Prognosis Effect of Shengmai Injection to the rt-PA Thrombolysis on Broadened Therapeutic Window Pa-tients of Mild-to-moderate Cerebral Infarction / 中国药房

OBJECTIVE:To explore the prognosis effect of Shengmai injection to the rt-PA thrombolysis on broadened thera-peutic window patients of mild-to-moderate cerebral infarction under the guidance of computer tomography(CT). METHODS:168 patients with mild-to-moderate cerebral infarction were randomly divided into control group (84 cases) and observation group (84 cases). Control group received rt-PA(0.9 mg/kg),and 10% of the total rt-PA was mixed and injected into patients within 1 min, the rest 90% adding into 250 ml 0.9% Sodium chloride injection (no less than 1 h),CT was performed after 24 h thrombolytic therapy,and the patients with no intracerebral hemorrhage in re-examination received 300 mg/d aspirin for 10 d,then 100 mg/d for 90 d,and appropriate statins,calcium antagonists,β-blockers and nitrates;observation group additionally received 40 ml Sheng-mai injection,adding into 250 ml 5% Glucose injection,intravenous infusion,once a day,for 28 d. National Institutes of Health Stroke Scale (NIHSS) score,Rankin score,daily living-Barthel Index (Barthel) score,rate of symptomatic intracranial hemor-rhage,rate of secondary hemorrhage,hospitalization time,3-month postoperative mortality and incidence of adverse reactions in 2 groups were observed. RESULTS:Before treatment,there were no significant differences in the NIHSS score,Rankin score and Barthel score(P>0.05). The NIHSS score in 2 groups after 6 h,24 h and 7 d were significantly lower than before,and observa-tion group was lower than control group after 24 h and 7 d;Rankin score after 3 months was significantly lower than before,and observation group was lower than control group;Barthel score after 3 months was significantly higher than before,and observation group was higher than control group,The differences were statistically significant (P<0.05). The hospitalization time in observa-tion group was significantly shorter than in control group,and 3-month postoperative mortality was significantly lower than control group,the differences were statistically significant(P<0.05). There were no obvious adverse reactions during treatment. CONCLU-SIONS:Based on conventional treatment,Shengmai injection has improvement in the rt-PA intravenous thrombolysis on broadened therapeutic window patients of mild-to-moderate cerebral infarction under the guidance of CT,it can reduce NIHSS score and Rankin score,increase Barthel score,shorten hospitalization time and reduce the 3-month postoperative mortality,with good safety.

Efficacy comparison of three therapeutic approaches in patients with acute posterior-circulation infarction / 中华神经医学杂志

Objective To investigate the therapeutic effects of intravenous thrombolysis,intral-arterial thrombolysis,basilar artery embolectomy combined with stent implantation on patients with posterior-circulation infarction.Methods Fifty-seven patients with acute posterior circulation infarction (onset time within 6 to 72 h),admitted to our hospital from March 2005 to February 2013,were chosen; All subjects were randomly divided into three groups:group A,accepted intravenous thrombolysis (within 6 h of onset),group B,accepted intral-arterial thrombolysis (within 6-24 h of onset),and group C,accepted basilar artery embolectomy and stent implantation (over 24 h of onset).US National Institutes of Health Stroke Scale (NIHSS) was used to observe the clinical symptom improvement,and evaluate the results before and 24 h and 7 d after treatment.Three months after treatment,modified Rankin Scale (mRS) was employed to evaluate the clinical prognosis.Results Significant differences were noted in the treatment efficacy 24 h and 7 d after treatment among the three approaches (P＜0.05):that in group B was obviously higher than that in group A; that in group C was obviously higher than that in group A and B.The mRS scores were significantly different among the three groups (P＜0.05):the clinical outcome improvement in group B was obviously higher than that in group A; that in group C was obviously higher than that in group A and B.Conclusion Different treatments should be adopted based on the specific circumstances of the patients; for those with long time window of thrombolysis,basilar artery embolectomy combined with stent implantation might be more effective in improving the prognosis of the patients.

Influencing factors for the short-term prognosis in elderly patients with posterior circulation infarction after intravenous thrombolysis / 中华老年医学杂志

Objective To investigate the influencing factors for the short-term prognosis in elderly patients with posterior circulation infarction after intravenous thrombolysis.Methods We retrospectively analyzed the clinical data of 67 elderly patients with posterior circulation infarction treated with thrombolysis from March 2011 to December 2012.Clinical data of age,sex,hypertension,hyperlipidemia,glucose abnormalities,and thrombolysis,National Institute of Health stroke scale (NIHSS) score on admission,hyperhomocystinemia,the infarction area,anticoagulation and antiplatelet treatment were collected.All patients were followed up after discharge.The prognosis was assessed by the Rankin scale (mRS) after 3 months of thrombolysis.Patients were divided into good (MRS score ≤2) prognosis group and poor (mRS＞2) prognosis group.Results There were 43 cases (64.2％) in good prognosis group and 24 cases (35.8％) in poor prognosis group.Logistic regression analysis showed that NIHSS score＞12 (95％CI:1.087-1.569,P=0.005),thrombolysis time＞4.5 h (95％CI:1.362-2.258,P=0.004),high homocysteine levels (95％CI:0.612-0.956,P =0.000),platelet after 24 h (95％ CI:0.785 1.133,P=0.001) were the independent risk factors for the poor prognosis of posterior circulation infarction in elderly patients after intravenous thrombolysis.Conclusions Early thrombolysis and timely anticoagulant treatments have certain significances in improving the short-term prognosis in patients with posterior circulation infarction.