ObjectiveTo investigate the risk factors related with the prognosis of patients with acute cerebral infarction after intravenous thrombolysis by alteplase in 90 days.MethodsForty patients with acute cerebral infarction treated by intravenous thrombolysis with aheplase were selected and assigned into good outcome group [modified Rankin scale (mRS) 0-1 score] and poor outcome group (mRS 2-6 scores) according to mRS at 90 days.The risk factors were compared between two groups.ResultsPoor outcome group(22 cases) comparing with good outcome group (18 cases),the values of age[ (64.64±11.30) years vs.(58.94±10.47) years ],onset to therapy time(OTT) [(376.73±316.32)min vs.( 176.00±59.74) min],National Institutes of Health stroke scale (NIHSS) score before thrombolysis [ ( 16.73±8.46)scores vs. (11.22±5.20) scores],maximum of systolic blood pressure (SBPmax) in the first 24 hours after thrombolysis[ ( 186.59±24.79 )mm Hg ( 1 mm Hg =0.133 kPa) vs.( 169.00±23.04) mm Hg] and systolic blood pressure variability (SBPV)[(17.11±3.90) mm Hg vs.(13.33±4.97) mm Hg] had significant differences (P＜ 0.05).ConclusionThe values ofage,OTT,NIHSS score before thrombolysis,SBPmax and SBPV in the first 24 hours after thrombolysis are related with the prognosis of patients with acute cerebral infarction after intravenous thrombolysis by altcplase in 90 days.

Hepatic cavernous hemangioma is the most common benign tumor of liver.Hepatic artery embolism chemotherapy is one of the commonly used treatment methods,but more and more related complications and sequelae have been reported recently,including obstructive jaundice caused by damaged biliary tract.Because the symptoms are not typical,obstructive jaundice might be misdiagnosed as malignant biliary tumor,which brought troubles to subsequent treatment.In this article,the clinical data of 2 patients with obstructive jaundice following transcatheter hepatic arterial chemoembolization for hepatic cavernous hemangioma were retrospectively analyzed,and the experience in the diagnosis and treatment of this disease was summarized.

Objective To study clinical value of a new therapy for tumor thrombus of portal vein.Methods Twenty patients received direct puncture to portal vein or tube insertion under ultrasonographic guide.Among them,16 patients received direct injection and 4 had tube insertion.It provided high concentration of anticancer drugs directly to the tumor thrombus.Results The thrombus disappeared only one case,the mass of tumor thrombus decreased in the portal vein trunk in 3 cases and obviously was controlled in 6 cases.The survival time in the group with treatment was longer than in that the control group.Conclusion This method is an effective,safe and easy procedure,it has active significance for advanced hepatic cancer.

Objective To explore the safe technique of caudate lobectomy for liver cancer in candafe lobe(LCCL).Methods The clinical data of 11 cases of primary liver cancer in caudate lobe who received hepatectomy successfully were retrospectively analyzed. four procedures were used in the operations:(1)selection of appropriate skin incision, so as to obtain excellent exposure of operative field;(2)adequate mobilization of the liver to allow the liver to be displaced upwards to the left or to the right;(3)preparatory placement of tapes for total hepatic vascular isolation,so that this procedure can be used when necessary;(4)selection of the ideal route for hepatectomy based on the condition of the tumor and, if necessary, the combined removal of multiple lobes. Among the 11 cases, simple occlusion of vessels of porta hepatis was used for candate lobectomy in 6 cases, while, in the other cases, the vessels were intermittently occluded several times or total hepatic vlascular isolation was used for the caudate lobectomy. combined partial right hepatectomy was done in 2 cases, combined left lateral lobectomy in 3 cases and caudate lobectomy alone in 6 cases.Results Operation was smooth and successful in all of the 11 cases, and there was no mortality. Conclusions Caudate lobectomy for LCCL can be safely performed when the above procedures are used.

Objective To examine the effects of a peroxisome proliferator-activated receptor γ ligand troglitazone on the proliferation and differentiation of HepG2 cells. Methods After the pretreatment of HepG2 cells with troglitazone, MTT and flow cytometry were used to analyze the proliferation and cell cycle of HepG2 cells, respectively. Immunocytochemistry, bromocresol green dye-binding method and chemiluminessence immunosorbent assay was used to determine E-cadherin, albumin and AFP, respectively. The expression of cyclin D1 and c-myc protein were detected by Western blot. Results Troglitazone inhibited the proliferation of HepG2 cells in a concentration-dependent manner and arrested HepG2 ceils at the G0>/G1> phase. After pretreated with troglitazone, HepG2 cells showed E-cadherin expression, a decreased expression of cyclin D1 and c-myc protein, a reduction of AFP level and a dramatic increase of albumin level. Conclusions Troglitazone inhibits proliferation and induces differentiation of HepG2 cells, the mechanism of which might be attributable to the down-regulation of cyclin D1 and c-myc expression.

Objective The relationship between hypertension ( HTN) and ischemic stroke recurrence is unclear , but there may be different effects of HTN on the risk of recurrence .This study aims to explore whether HTN contributes differently to the recur-rence among subtypes of ischemic stroke ( IS) . Methods We eventually enrolled 1114 patients with ischemic stroke from Jul 2008 to Dec 2012 registered in Nanjing Stroke Registry Program (NSRP) in this study.All the patients were classified according to Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria: 315 (28.3%) patiwnts were classified as Large-artery atheroselerosis (LAA), 212 (19.0%) as cardioembolism (CE), 266 (23.9%) as small-artery occlusion (SAO), and 321 (28.8%) as other de-termined and undetermined etiologies ( Other) .The association between HTN and stroke recurrence in patients with different IS sub-types was analyzed using multivariate Cox regression analysis . Results The average follow-up duration was (19.4 ±10.3) months. Of 1114 patients with IS, 158 (14.2%) patients experienced a recurrent stroke .Patients with HTN had a significantly higher stroke recurrence rate than those without (16.5%vs 10.5%, P<0.05).Multivariate Cox regression analysis indicated that HTN increased the risk of ischemic stroke recurrence (HR=1.722, 95%CI:1.181-2.512, P=0.005).After stratification by TOAST subtypes, analysis revealed an association between HTN and stroke recurrence in LAA( HR=3 .767, 95%CI:1.866-7.585, P=0.001) and SAO (HR=3.530, 95%CI:1.156-12.740, P=0.028), but not in the other subtypes (CE: HR=0.773, 95%CI:0.370-1.615, P=0.493;Other:HR=1.498, 95%CI:0.590-3.807, P=0.395). Conclusion HTN is an independent risk factor for recurrent ischemic stroke and is related to the recurrent ischemic stroke in patients with large-artery and small-vessel disease .

Objective To explore the effect of mesenchymal stem cells(MSCs) on nervous function in rats with focal cerebral ischemia.Methods The MSCs were cultivated,purified,and proliferated in vitro by density gradient and adherence to plastic dishes method.The models of Wistar rats were prepared after middle cerebral artery occlusion(MCAO) of right lasted 90 min and reperfusion 1 h.Wistar rats were randomly divided into normal control group(A,n=10),sham operation group(B,n=10),no-handle group after cerebral ischemia/reperfusion (C,n=10),free-serm DMEM transplantation group after cerebral ischemia/reperfusion(D,n=10),MSCs transplantation group after cerebral ischemia/reperfusion(E,n=10).After identified by flow cytometry,5 ?L 5-bromo-2-deoxyuridine(BrdU) labeled MSCs(4?105? ?L-1) and 5 ?L serum-free DMEM were respectively injected intracerebraly into ischemic boundary zone of right in D and E groups.Immunohistochemical method was used to detect the expression and survival of BrdU-labeled MSCs in vivo.Nervous function behavioral tests were performed on 1st,3th,7th and 28th day after transplantation by forelimb use asymmetry test and postural reflex test.Results MSCs were successfully purified and proliferated in vitro.The MSCs expressed CD29,CD44,but didn't expressed CD34,CD45,CD31 identified by flow cytometry.transplanted MSCs survived and were localized to the ischemic boundary zone.Behavioral tests of every group were improved with time prolonged.However,MSCs transplantation group was significantly better than any other groups(P

Objective:To investigate the efficacy of hemodiafiltration combined with hemoperfusion in the treatment of secondary hyperparathyroidism (SHPT) in patients undergoing maintenance hemodialysis (MHD).Methods:A total of 40 patients with SHPT undergoing MHD who received treatment at the Blood Purification Center of The First Affiliated Hospital of Anhui University of Science and Technology from February 2021 to March 2023 were included in this prospective cohort study. They were randomly divided into a control group and an observation group ( n = 20/group).The control group received a single high flux hemodialysis, while the observation group used a combination of hemodialysis filtration and hemoperfusion for 3 months. In both groups, the changes in hemoglobin, blood urea nitrogen, serum creatinine, serum calcium, serum phosphorus,and parathyroid hormone levels were compared before and after dialysis. Results:After dialysis, the hemoglobin level in the observation group was (119.45 ± 5.27) g/L, which was significantly higher than (106.30 ± 6.52) g/L in the control group ( t = -7.02, P < 0.001). The serum phosphorus level in the observation group was (1.18 ± 0.17) mmol/L, which was significantly lower than (1.52 ± 0.22) mmol/L in the control group ( t = 5.49, P < 0.001). The parathyroid hormone level in the observation group was (122.14 ± 40.57) ng/L, which was significantly lower than (168.78 ± 78.27) ng/L in the control group ( t = 2.39, P = 0.023). Conclusion:Hemodiafiltration combined with hemoperfusion can reduce clinical symptoms, increase hemoglobin level, and reduce phosphorus and parathyroid hormone levels in patients with SHPT undergoing MHD, which deserves clinical promotion.

Objective:To investigate whether the overexpression of Numb gene can effectively intervene the progression of cholestatic liver fibrosis (CLF) in adult liver.Methods:Twenty-four SD rats were randomly divided into sham operation (Sham, n=6), common bile duct ligation (BDL, n=6), empty vector plasmid (Numb-EV, n=6) and numb gene overexpression group (Numb-OE, n=6). The CLF model was prepared by common bile duct ligation. Simultaneously, the model was established, and the adeno-associated virus (AAV) carrying the cloned numb gene was injected into the rats' spleens. Samples were collected at the end of four weeks. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (Alb), serum total bilirubin (TBil), serum total bile acid (TBA), liver histopathology, liver tissue hydroxyproline (Hyp) content, and alpha smooth muscle actin (α-SMA), cytokeratin (CK) 7, and CK19 expression conditions were determined in liver tissue. An analysis of variance was used to compare the means of multiple groups. Results:Compared with the Sham group, the Numb mRNA level in the rat liver tissue was significantly decreased in the BDL group (0.872±0.237 vs. 0.452±0.147, P=0.003). Compared with the Numb-EV group, the Numb mRNA level in the liver tissue was significantly increased in the Numb-OE group (0.487±0.122 vs. 1.094±0.345, P＜0.01). Compared with the Sham group, the Hyp content (μg/L) (288.46±49.49 vs. 901.98±271.85, P＜0.01) and the α-SMA mRNA level (0.858±0.234 vs. 8.976±1.398, P＜0.01) were significantly higher in the BDL group. Compared with the Numb-EV group, the Hyp content (864.32±113.54 vs. 580.44±171.77, P=0.039), the α-SMA mRNA level (6.138±1.443 vs. 1.322±0.859, P＜0.01) and the protein levels were significantly reduced in the Numb-OE group. Compared with the Sham group, the serum ALT, AST, TBil, and TBA levels were significantly increased in the BDL group ( P＜0.01), and the ALB content was significantly decreased ( P＜0.01). Compared with the Numb-EV group, AST and TBil levels were significantly reduced in the Numb-OE group ( P＜0.01), as were the ALT and TBA levels ( P＜0.05); however, the ALB content was significantly increased ( P＜0.01), and the differences were statistically significant. Compared with the Sham group, the mRNA expression levels of CK7 and CK19 were significantly increased in the BDL group (1.40±0.42 vs. 43.78±7.56; 1.11±0.51 vs. 363.81±134.84, P＜0.01). The mRNA expression levels of CK7 and CK19 were significantly reduced in the OE group (343.19±81.22 vs. 3.22±2.34; 40.53±14.02 vs. 15.68±9.36, P＜0.01). Conclusion:Overexpression of the Numb gene can inhibit CLF progression in the adult liver, which may become a new target for CLF therapy.

OBJECTIVE To establish the quality standards of medicinal materials in light of related methods in the general principles of part four of Chinese Pharmacopoeia(2020 Edition), and to conduct systematic research on the Tibetan medicine "Yajima"(Chrysosplenium axillare). METHODS The powder characteristics of medicinal materials were described by microscopic identification method. Silica gel GF254 thin-layer plate was employed to establish a TLC identification method with 5-O-demethylapulein and oxyayanin A as reference substances. Loss on drying, total ash, acid-insoluble ash and ethanol-soluble extractives of 10 batches of Chrysosplenium axillare were determined according to the general principles of part four of Chinese Pharmacopoeia(2020 Edition). HPLC was used to establish the characteristic chromatogram of Chrysosplenium axillare, and the content determination method was established with chrysosplenoside I(CI) and chrysosplenoside A(CA) as the quality control index components of Chrysosplenium axillare. RESULTS The water content, total ash, acid-insoluble ash, ethanol-soluble extractive and the content of CI and CA of all samples varied in the ranges of 9.17%−12.52%, 14.11%−16.74%, 1.50%−4.72%, 32.77%−40.30%, 0.30%−0.99% and 0.28%−0.88%, respectively. CONCLUSION The identification and content determination methods of Yajima(Chrysosplenium axillare) are established for the first time. The methods are easy to operate and exclusive, which is of great significance to accurately evaluate the internal quality of medicinal materials and ensure the quality of drug used.