Objective To investigate the incidence rate and risk factors for spontaneous hemorrhagic transformation(HT) in acute cerebral infarction(ACI) patients.Methods We retrospectively reviewed the clinical records of 216 ACI patients undergoing drug conservative treatment in the First People's Hospital of Changde City from January 2018 to January 2019.According to the occurrence of the spontaneous HT in each person within 14 days after onset,all patients were divided into two groups:the HT group and none-HT group,the clinical data between each group were be compared,univariate and multivariate logistic regression were used to analyze the relevant risk factors,the association between the risk factor and the spontaneous HT were further assessed by linear regression models and smooth curve fitting in addition to threshold effect analysis.Results Among 216 patients with ACI,27 cases(12.5%) had spontaneous HT during hospitalization.Multivariate logistic regression analysis showed that the etiological types in the trial of Org10172 in acute stroke treatment(TOAST)of cardiac embolism(CE)(OR=11.05,95%CI 1.97~61.98;P=0.0063),high National Institutes of Health Stroke Scale (NIHSS) score on the first day of admission (OR=1.6,95%CI 1.3~2.0;P<0.001),and excessive peripheral leukocyte counts excluding inflammatory response at admission (OR=1.41,95%CI 1.01~1.95;P=0.0408) were independent risk factors for the spontaneous HT after ACI.Smooth curve fitting analysis showed that the peripheral white blood cell count and the occurrence of the spontaneous HT were positively correlated.Conclusion TOAST classification of CE,high NIHSS score on the first day of admission and excessive peripheral leukocyte counts excluding inflammatory response at admission were independent risk factors of spontaneous HT after ACI.The excessive peripheral leukocyte counts after acute cerebral infarction,independently of the occurrence of infections,could be a potential predictor of the spontaneous HT after ACI.

Objective: To explore the application and choice of latissimus dorsi musculocutaneous flap and thoracodorsal artery perforator flap in different wound repair. Methods: From March 2012 to February 2018, 8 cases of different wounds were repaired with island latissimus dorsi myocutaneous flap pedicled with dorsal thoracic artery, free latissimus dorsi myocutaneous flap, or thoracodorsal artery perforator flap combined with scapular flap. The patients includes 4 cases of trauma, 2 cases of tumor and 2 cases of osteomyelitis. Among them, 5 cases received pedicled grafting, 2 cases had anastomotic vascular free grafting combined with antibiotic bone cement chain bead, 1 case had thoracodorsal artery perforator flap combined with scapular flap. Results: All 9 flaps of 8 patients survived. The size of the flaps ranged from 22.0 cm×7.5 cm to 28.0 cm×21.0 cm. All the donor and recipient areas healed well. After 2 months to 2 years follow up, all flaps have good blood supply, and the limbs′ function was normal. The appearance of flaps were satisfactory, with fully treated osteomyelitis, and no recurrence of the tumor was observed. Conclusions According to wound characteristics, selective application of thoracodorsal artery perforator flap, pedicled or free latissimus dorsi myocutaneous flap is effective for the repair of muscle, skin and soft tissue defects, as well as osteomyelitis, after tumor resection.

The study is to investigate the brain pharmacokinetics change of nasal tetramethylpyrazine phosphate (TMPP) pH-sensitive in situ gel in normal and model rats. Acute cerebral ischemia rat model was successfully established by middle cerebral artery occlusion (MCAO) method. Both normal and model rats were given nasal TMPP pH-sensitive in situ gel (10 mg x kg(-1)). Perfusates of brain striatum area were collected at each time point by microdialysis. The content of TMPP was determined by HPLC. The pharmacokinetics parameters were calculated by Kinetica 4.4 software at each time point of the brain drug concentration. The main pharmacokinetics parameters of TMPP were fitted with compartments 2. After nasal TMPP pH-sensitive in situ gel the values of C(max) and AUC of both components in brain showed as follows: the value of model group > that of normal group. Significant difference can be observed in the process of brain pharmacokinetics in normal and model rats after giving nasal TMPP pH-sensitive in situ gel.
Administration, Intranasal ; Animals ; Area Under Curve ; Brain ; metabolism ; pathology ; Brain Ischemia ; metabolism ; Chromatography, High Pressure Liquid ; Gels ; Hydrogen-Ion Concentration ; Infarction, Middle Cerebral Artery ; Male ; Microdialysis ; Phosphates ; administration & dosage ; pharmacokinetics ; Pyrazines ; administration & dosage ; pharmacokinetics ; Rats ; Rats, Sprague-Dawley

【Objective】 To identify the risk factors for recurrence and malignant transformation (MT) in patients with low-grade glioma (LGG) after surgery. 【Methods】 The data of 163 patients who underwent LGG resection and subsequent follow-up from March 2009 to April 2019 were retrospectively collected. Patients who did not experience recurrence or MT after surgery were included in the control group (85 cases), those who experienced recurrence after surgery were included in the observation 1 group (44 cases), and those who experienced MT after surgery were included in the observation 2 group (34 cases). Based on the clinical data of the three groups of patients, their clinical characteristics were analyzed, and the risk factors and predictive value for recurrence and MT were explored using Logistic regression model and receiver operating characteristic (ROC) curve. 【Results】 There were significant differences between the control group and the observation 1 group in preoperative seizure, preoperative Karnofsky performance status (KPS) score, and surgical approach (P<0.05). There were significant differences between the control group and the observation 2 group in gender, preoperative KPS score, tumor size, and surgical approach (P<0.05). There were significant differences between the control group and the observation 1 group in isocitrate dehydrogenase (IDH) mutation, proliferating cell nuclear antigen (PCNA), matrix metalloproteinase-9 (MMP-9), cancer-testis antigen OY-TES-1, OY-TES-1 mRNA protein, tumor suppressor protein p53, mouse double minute 2 (MDM2), vascular endothelial growth factor (VEGF), or epidermal growth factor receptor (EGFR) (P<0.05). There were significant differences between the control group and the observation 2 group in PCNA, MMP-9, cancer-testis antigen OY-TES-1, OY-TES-1 mRNA protein, or VEGF (P<0.05). Logistic regression analysis showed that IDH mutation, MMP-9, and PCNA were independent risk factors for LGG recurrence (P<0.05), while VEGF, MMP-9, and PCNA were independent risk factors for LGG MT (P<0.05). The area under curve (AUC) of PCNA, MMP-9 and IDH mutation for predicting LGG MT after surgery was 0.744, 0.790, and 0.799, respectively. The AUC of PCNA, MMP-9, and VEGF for predicting LGG recurrence after surgery was 0.729, 0.750, and 0.900, respectively. 【Conclusion】 This study found that IDH mutation, MMP-9 and PCNA were independent risk factors for LGG recurrence, while VEGF, MMP-9 and PCNA were independent risk factors for LGG MT by retrospectively analyzing the clinical data and protein expression of 163 patients with LGG after surgery. These proteins have high accuracy in predicting LGG recurrence and MT after surgery. Therefore, the proteins may play an important role in the biological behavior and treatment effect of LGG, and can be used as reference indicators for prognosis evaluation and individualized treatment of LGG patients after surgery.

Objective To investigate the effects of transplantatation human endothelial progenitor cells onneurological functional recovery from spinal cord injury model in rats,survival of transplanting cells and differentia-tion. Method The human endothelial progenitor cells were provided by Shanghai Developmental Biology Labora-tory.Forty SD rats were made for the animal model of spinal cord complete transection.Thirty survival SD rats wererandomly divided into three groups:sham operation gronp(group A, n = 10),operation/cell group(greup B, n =10) and operation/DMEM group (group C, n = 10).Suspension containing (hEPCs 6×106) was transplanted in-to the vertebral canal around injured spinal cord. In group C, equal volume of DMEM was injected insbead in the same way as in the group B. The BBB score was obtained 2,4,6,8 weeks after injection, Immunohistochemistry andin-situ hybridization were used to observe the cells survival and differentiation in the spinal cord. The BBB test wasperformed to study the functional improvement of cells. The SAS version. 1.3 software for statistics was to studyethology and functional improvement. The sum of ranks was checlced with Kruskal-Wallis Test and Nemenyi test.Results There were statistically significant differences in BBB scoring between group A and group B as well asgroup C after operation (P<0.05). The BBB score in group B was higher than that in group C after 2,4,6 and8 weeks,but lower than in group A. The hybridization in-situ and immunohistochemistry showed that transplantedcells survived for 8 weeks after transplantation and expressed specific characteristics for ancestral cell and differentiated into vascular endothelial cell (VEC). Conclusions After transplantation, hEPCs can survive, differenti-ate into vascular endothelial cell,and improve spinal cord function as compared with control group.

AIM: Some researches show that stem cell transplantation for damaged spinal cord can improve the function of damaged spinal cord. But the studies about bone marrow mononuclear cell transplantation for injuried spinal cord are seldom. We transplanted fresh bone marrow mononuclear cells isolated from rats into rat models of injured spinal cord to explore the effect of bone marrow mononuclear cells for injured spinal cord functions, nerve regeneration, neovascuarization and long-term effect. METHODS: Experiments were performed in the Experiment Center of Developmental Biology of Shanghai Second Medical University from October 2005 to April 2006. The laboratory is Specific-pathogen free grade. ①Female clean SD rats aged 8 weeks weighting 200-220 g were offered by Animal Experimental Centre of Chinese Academy of Sciences. Animal intervention met the animal ethical standard. ②Rat bone marrow mononuclear cells were isolated from the tibia and the femur by Ficoll-Paque density gradient centrifugation. Rat models of spinal injury were established. The 22 successfully established rat models were divided into 2 groups. Rat models in a model plus cell group (n =11) received the complete T9-10 transection of spinal cord, and then bone marrow mononuclear cells were transplanted into the vertebral canal. Rat models in a model plus DMEM group (n =11) received the complete T9-10 transection of spinal cord, and then DMEM was injected into adjacent region. Rat models in a sham operation group (n =9) received T9-10 spinous process and lamina of vertebra incision and then the incision was sutured. ③Hybridization in situ and immunohistochemistry technique were used to determine the survival of implanted cells in host spinal cord. BBB scale system was applied to assess the functional recovery of spinal cord nerves. RESULTS: ①There was no significant difference in postoperative score at each time point in the sham operation group. The score was 0 point in the model plus DMEM group. The function of spinal cord did not recover. The function of spinal cord became better at weeks 2, 4, 6 and 8 in the model plus cell group. There were significant differences as compared with the model plus DMEM group and the sham operation group (P

BACKGROUND: Embryonic stem cells can be induced to differentiate into neural precursors under certain conditions, and they can effectively integrate with host cells after transplanted into healthy or injured central nervous system, and then repair and rebuild the injured nerve tissue.OBJECTIVE: To observe the effects of transplantation of neural precursors induced by embryonic stem cells on the recovery of neurological function in mice with spinal cord injury.DESIGN: A randomized controlled animal trial.SETTING: Research Center of Developmental Biology, Shanghai Second Medical University.MATERIALS: Twenty-eight C57/BL6J mice of 6-8 weeks old, both sexes, were used. Mice embryonic stem cell strain S8 and carrier LacZ labeling genes were provided by Shanghai Research Center of Developmental Biology. High-glucose Dulbecco's modified Eagle media (DMEM), β-mercaptoethanol (BME), mice leukemia inhibitory factor (LIF) and mitocin-C were all from GIBCO attachment induction medium, which were provided by Shanghai Research Center of Developmental BiologyMETHODS: The experiment was carried out in the central laboratory of developmental biology of Shanghai Second Medical University from April 2003 to April 2004. The embryonic stem cells were cultured and induced to differentiate into neural precursors by means of attachment induction. The mice were anesthetized and made into models of spinal cord hemisection on the T9-T10 plan. The mice were randomly divided into three groups: sham operated group (n =9): Only T9-T10 spinous process and corresponding lamina of vertebra were removed, then the skin was sutured layer by layer;ransplantation group (n =10): After spinal cord hemisection, embryonic stem cells were injected into the vertebral canal about 1 cm away from the injured site; model group (n =9): DMEM was injected into the region around the injured site.The mice were evaluated with Basso, Beattie, Bresnahan (BBB) locomotor rating scale to observe the recovery of neurological function at 1, 2, 4, 6 and 8 weeks (the score ranged from 1 to 21 points, the higher the scores, the better the recovery of neurological function). At 8 weeks, the survival and differentiation of embryonic stem cells at the injured site of spinal cord were observed using X-Gal staining in each group. The positively stained sections with X-Gal at the injured site of spinal cord were detected with fluorescent immunohistochemical staining.MAIN OUTCOME MEASURES: ① Recovery of neurological function; ② Survival and differentiation of embryonic stem cells at the injured site of spinal cord; ③ Results of fluorescent immunohistochemical staining.RESULTS: ① The BBB scores in the transplantation group at 1, 2 and 4 weeks were higher than those in the model group (P ＜ 0.01). ② Survival and differentiation of embryonic stem cells at the injured site of spinal cord: In the transplantation group, there were X-Gal positively stained cells in the tissue sections of the injured spinal cord of mice,the cytoplasm was blue with nucleoli in it, i.e. the cells derived from embryonic stem cells, which were not observed in the sham-operated group and model group. In the transplantation group, the cells derived from embryonic stem cells, which were implanted to the injured spinal cord, distributed around the injured sites, and integrated with the surrounding tissue and had similar form with the surrounding cells. ③ At the injured site, X-Gal positively stained cells in the transplantation group aiso expressed neurofilaments (the specific marker of neurons), but did not express GFAP.CONCLUSION:The embryonic stem cells were cultured and induced to differentiate into neural progenitors, and they could survive, migrate and differentiate into neurons after transplantation, but there was no obvious improvement of neurological function.

BACKGROUND: Embryonic stem cell (ESC) is a kind of highly undifferentiated totipotent cell. It can proliferate and maintain its totipotency in the system cultured in vitro. It is one of most promising stem cells in thetreatment of central nerve injury.OBJECTIVE: To observe the survival and migration of induced transplanted ESC in mice with spinal injury and hypoxic-ischemic encephalopathy.DESIGN: A completely randomized grouping design, controlled animal experiment.SETTING: Laboratory of Developmental Biology Research Center of Shanghai Second Medical University.MATERIALS: Sixty C57/BL6J mice, of clean grade and either gender, aged 6 to 8 weeks (n =30) and 7 days (n =30)were provided by the Shanghai Experimental Animal Center, Chinese Academy of Sciences [Permission No, SCXK (hu)2003-0003]. This animal experiment was approved by Animal Ethics Committee. Mouse ESC strain S8, labeled LacZ marker gene (Provided by Shanghai Developmental Biology Research Center). X-gal dyeing reagent (Sigma Company).METHODS: This experiment was carried out in the laboratory of Shanghai Developmental Biology Research Center (Shanghai Key Laboratory) from October 2002 to December 2003. ① Experimental grouping of spinal injury: Sixteen C57/BL6J successful mice models, aged 6-8 weeks, were randomized into 2 groups: experimental group (n =8), in which, following right spinal semi-sectioning, derivated cell suspension for inducing the in vitro differentiation of ESC was injected at 1 cm away from injury through vertebral canal, and control group (n =8), in which, following right spinal semi-sectioning, phosphate buffer solution (PBS) was injected at the peripheral region of injury. ② Hypoxic-ischemic encephalopathy experimental grouping: Sixteen successful C57/BL6J mice models, aged 7 days, were randomized into 2 groups: experimental group (n =8), following ligation of right common carotid artery, mice were placed in the closed container containing 0.08 volume fraction of oxygen and 0.92 volume fraction of Nitrogen gas, and taken out 1.5 hours later; 3 μL ESCs were injected into the right cerebral ventricle at about 1 week, and control group (n =8), in which, the same amount of PBS was injected into the right cerebral ventricle. ③ At 12 weeks after transplantation, the survival and migration of induced ESCs labeled by Lac-Z in the spinal cord and brain were observed by zymologic method.MATN OUTCOME MEASURES: Survival and migration of ESCs in the central nervous system.RESULTS: ①After being induced in vitro and transplanted to spinal injured region, ESCs differentiated into neural precursor cells. Neural precursor cells could survive in the injured region and migrate to 5 mm away from injured region.Immunohistochemistry proved that the neural precursor cells of transplanted ESCs could differentiate into neurons.Morphologically, it was proved that neural precursor cells-derived from ESCs could well integrate peripheral tissue. ② The induced ESCs were injected into the lateral cerebral ventricle of mice. Derived ESCs widely distributed in the injured hippocampal region, cerebral cortex ventricle choroid plexus, vascular endothelium and other regions, and integrated peripheral tissue, which were similar to adjacent cells in morphology, suggesting that induced ESCs also could survive for long time and far migrate.CONCLUSION:The induced ESC can survive and migrate in the host injured brain and spinal cord, and the migration of ESCs is more obvious in the brain than in the spinal cord.

Objective To translate the English version of the Nursing Profession Self-Efficacy Scale into Chinese,and to test the reliability and validity of the Chinese version. Methods The reliability and validity of the Chinese version of scale was tested among 480 nurses from Tianjin First Central Hospital. Results The revised Chinese version of the Nursing Professional Self-Efficacy Scale contained 19 entries, the Cronbach′s α coefficient was 0.95, the test-retest reliability was 0.91. Conclusions The revised Chinese version of the Nursing Profession Self-Efficacy Scale has acceptable reliability and validity. It can be used to measure the Nursing Profession Self-Efficacy among nurses in China.

OBJECTIVE: To observe the effect of curing-injury cataplasma on the expression of aquaporin protein 3 (AQP-3) in skeletal muscle of rat model with acute injury in soft tissues. METHODS: A total of 54 SD rats were randomly divided into 3 groups, and by using 10% sodium sulfide the depilating treatment was made in the thigh lateral of each left hind leg 1 day before modeling. The depilatory area in the control group was merely marked with striking range, not attacked for modeling. In the depilatory area of the modeling group, the blowing apparatus was used to attack the marked range to establish the model of soft tissue swelling with acute injury, to which none medication was given. In the drug treatment group, immediately after establishing the model of soft tissue swelling with acute injury, curing-injury cataplasma was scattered on the stricken area, and fixed with bandage. After the modeling, the rats were killed at 1 h, 6 h, 1 d, 3 d, 5 d, and 7 d, 3 rats in each group at each time point. In the marked area some tissue was taken, and the dry/wet proportion method was used to detect the water content in the skeletal muscle. Western blot and qPCR method were used for the AQP-3 protein and the level of gene expression. RESULTS: At the six time points, for the modeling and drug treatment groups, the water content of skeletal muscle was higher than that of the control group (P<0.05). At 3 d, 5 d and 7 d, the water content in the drug treatment group was lower than that of the modeling group (P<0.01); for the modeling and drug treatment groups, AQP-3 protein and the level of gene expression were higher than those of the control group. There was significant difference between the drug treatment group and the modeling group (P<0.01). CONCLUSION Curing-injury cataplasma can relieve soft tissue swelling with acute injury, and accelerate the repair process after the injury.
Animals ; Aquaporin 3 ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Hindlimb ; injuries ; Male ; Muscle, Skeletal ; metabolism ; Rats ; Rats, Sprague-Dawley ; Soft Tissue Injuries ; drug therapy ; metabolism