1.Treatment and prevention of vascular cognitive impairment
International Journal of Cerebrovascular Diseases 2017;25(4):364-370
The incidence of vascular cognitive impairment is increasing year by year.Its medical burden is getting worse, therefore, there is an urgent need to delay and prevent its occurrence and development.Active symptomatic treatment and targeted intervention of vascular risk factors may alleviate the progress of disease to a certain extent.This article reviews the advances in the treatment and prevention of vascular cognitive impairment.
2.Clinical analysis on 6 cases of hematological patients with rhino-orbital-cerebral mucormycosis
Medical Journal of Chinese People's Liberation Army 2017;42(7):643-646
Objectives To explore the clinical characteristics of hematologic disease complicated by rhino-orbital-cerebral mucormycosis (HD-ROCM) and improve the understanding, diagnosis and treatment of M-ROC.Methods For mastering the clinical characteristics, treatment and prognosis of HD-ROCM, the medical records of 6 HD-ROCM patients admitted from 2009 to 2015 were analyzed retrospectively, and related literatures were also retrieved and reviewed.Results All the patients had bone marrow transplantation, 2 out of 6 patients had neutropenia, 5 had endoscopic debridement in a few days to several months after the onset of symptoms, and 1 had open debridement. 3 out of 6 achieved local debridement, and the other 3 had radical debridement. Out of them, one died 8 days postoperation, 1 died at 1 month, 2 at 2 months and 2 at 6 months.ConclusionEarly diagnosis and timely surgical treatment are the key points for improving the survival rate of HD-ROCM patients.
3.Clinical value of remote electrocardiogram monitoring in patients with acute ST-segment elevation myocardial infarction
Xiaolu SUN ; Yan SUN ; Guogan WANG
Chinese Journal of Emergency Medicine 2014;23(4):416-420
Objective To investigate the reliability of electrocardiographic (ECG) signal for the accurate assessment of myocardial ischemia in order to evaluate the clinical value of remote real-time ECG monitoring system based on GPRS in patients with acute ST-elevation myocardial infarction (STEMI).Methods A total of 60 STEMI patients admitted between April 2008 and December 2010 were enrolled.All subjects were given the remote real-time ECG monitoring and routine 12 leads ECG monitoring at the same time.They were divided into remote ECG group and the 12 leads ECG group.The remote real-time ECG monitoring collects electrocardiosignal to imitate V1,V3,V5 lead and Ⅰ lead.P wave duration,PR interval,duration of time limit of QRS wave and T wave,QT interval,and the P wave amplitude,QRS wave amplitude,R-(Q + S),T wave amplitude were measured,and the detectability rate of arrhythmia and the definited diagnosis rate of ST segment elevation in accordance with clinical manifestion were compared in each group with different parameters.The data were analyzed by t test,rank sum test,Pearson correlation analysis,Spearman's rank correlation and the chi-square test.Results In STEMI patients,there were no statistical differences in time limits and amplitude of waves on ECG between the two groups (P > 0.05),and the correlations between parameters of two groups were found to be close (P < 0.01).There was no difference in the detectability rate of cardiac arrhythmia between two groups (P > 0.05),and no difference in the rate of correct diagnosis of elevated ST segment between two groups (P > 0.05),except V1 lead (P < 0.05).Conclusions The sensitivity of the change in ST segment of the two groups is similar,and the remote real-time ECG monitoring can help determine the location of myocardial ischemia.
4.Effects of atorvastatin on the improvement of heart function in mice with viral myocarditis
Jian GUAN ; Yan SUN ; Xiaolu SUN ; Yan LIANG ; Guogan WANG
Chinese Journal of Emergency Medicine 2011;20(11):1149-1152
Objective To investigate the effects of atorvastatin on the improvement of cardiac function of mice with myocarditis.Methods A total of 146 Balb/c mice were divided into four groups randomly(random number).The viral myocarditis(VMC)model was made by Coxsakie virus B3(CVB)injected intra-abdominally.Four groups were normal group(n =18),VMC group(n =60),Control group (n=18)and VMCtreatment group(n =50).The mice of control group were treated with atorvastatin without VMC,and the mice of VMC treatment group were with VMC and were given atorvastatin for 2 weeks.Echocardiograms were used 3,7,10,14,21,and 30 days after virus inoculation.Blood samples were collected for cardiac troponin-Ⅰ detection at the same time.Myocardial inflammation was examined by using histochemistry staining.The changes of myocardial collagen fiber,myocardial cells and various organelles were examined by electron microscope.Results Compared with VMC group,the cumulative survival rate of VMC group treatment group was higher(87.0% vs 59.2%)after treatment with atorvastatin for 30 days (P =0.008),and the improvement of pathological features after treatment with atorvastatin was found 10,14,21 and 30 days after the inoculation.Compared with control group,the cardiac function was decreased in the CVB infected mice 7 days after virus challenge[(69.82 ±5.12)vs(89.23 ±2.01),P <0.01]and compared with VMC group,the EF values of VMC treatment group were significantly higher 7,14,21and 30 days after virus inoculation.The differences in cTnI values between VMC group and CVB treatment group were statistically significant 7,10,14 and 21 days after virus challenge.Conclusions These results demonstrate that atorvastatin improves survival rates and the histological features in CVB3m-induced myocarditis.It can improve the heart function of CVB infected mice.Atorvastatin could be a treatment of choice for VMC.
5.Tremella Polysaccharides attenuated sepsis through inhibiting abnormal CD4+CD25 high regulatory T cells in mice
Zhenwei SHI ; Yan XU ; Xiaolu LI ; Qingyang LIU
Chinese Journal of Immunology 2016;32(3):313-317
Objective:To determine the effects of TPS on peripheral blood Tregs in sepsis mouse induced by burn plus P.aeruginosa infection.Methods: The experimental mice were separated into five groups randomly ,including sham burn group ,burn plus P.aeruginosa infection group ,burn plus P.aeruginosa infection with TPS (50,100,200 mg/kg) treatment group.Peripheral blood Tregs were isolated with Magnetic Microbeads and cultured in vitro from the day after burn (PBD0) to 4 days after burn(PBD4).IL-10, IFN-γ,IL-4 levels in Tregs culture supernatants were determined by sandwich enzyme-linked immunosorbent assays ( ELISA ) . Purification of CD4+CD25high Tregs and CD4+T cells in C57BL/6 mice were administrated by magnetic beads sorting .Tregs and CD4+T cells were cultured in vitro after joining TPS to without TPS cells as a control .The phenotypes of Tregs were analyzed by flow cytometry , and cytokines were measured by ELISA .Results:Vis-a-vis the results of the untreated group ,TPS could markedly decrease IL-4 and IL-10 secretion level and significantly increase the secretion of IFN-γ,and the secretion of IL-10 level and concentration of TPS dose effect.Vis-a-vis the results of the untreated group ,in vitro experiment ,without stimulation of TPS ,CD4+T cell proliferation and IFN-γwere significantly reduced ( P<0.05 ) and IL-4 levels increased significantly;CD4+T cell proliferation and IFN-γwere significantly increased and IL-4 levels were significantly reduced in the group of TPS with antibody-1;there was no significant difference in CD 4+T cell proliferation and the levels of IFN-γand IL-4 in the group of TPS with antibody-2.Conclusion:TPS could inhibit the abnormal ac-tivities of CD4+CD25highTregs in burn with P.aeruginosa infection mice,at least in part via inhibiting IL-10 secretion,and trigger a shift of Th2 to Th1 with activation of CD4+T cells in burn with P.aeruginosa infection mice.
6.The clinical value of serum CA125 in Non-Hodgkin's lymphoma.
Xiaolu SUI ; Yan LI ; Ran GAO ; Meiyun FANG
Chinese Journal of Practical Internal Medicine 2001;0(03):-
Objective To investigate the level of serum CA125 in patients with non-Hodgkin's lymphoma(NHL) and its clinical value.Methods All the data of this study was collected from the first affiliated hospital of China Medical University,during September 2004 to March 2006.Serum CA125 levels were measured in 42 patients with NHL.The association with gender,clinical stages,B symptoms,effusions,International Prognostic Score(IPI),serum LDH(lactate dehydrogenase),beta 2 microglobulin(?2-MG) levels and response to treatment was evaluated.Results High level of CA125 was found to be obviously correlated with B symptoms,effusions,IPI score,serum LDH(P
7.One case report of autoantibody-associated congenital heart block
Zongtai FENG ; Xiaolu YANG ; Zuming YANG ; Yan CAI ; Sannan WANG
Journal of Clinical Pediatrics 2015;(10):880-882
ObjectiveTo explore the pathogenesis, clinical manifestations, diagnosis, and treatment of autoanti-body-associated congenital heart block.MethodsThe clinical data of one child with autoantibody-associated congenital heart block was retrospectively analyzed.ResultsIn 24 week gestation, fetal bradycardia had been found by routine fetal echocar-diography. After birth, the anti-SSA/Ro antibodies and anti-SSB/La antibodies were positive in both infant and her mother. The diagnosis of autoantibody-associated congenital heart block was conifrmed. Intravenous immunoglobulin at 1 g/kg was adminis-trated. At 6 months follow-up, the electrocardiogram suggested type I second degree atrioventricular block.ConclusionIn the fetus or neonates found to have bradycardia and excluded the cardiac structural abnormalities, the autoimmune antibody should been tested and early intervention should been promoted.
8.Effect of dietary fat acids on incretin and islet function
Zhe GAO ; Xiaolu YAN ; Guangyao SONG ; Huijuan MA ; Chunxia DONG
Military Medical Sciences 2015;(10):769-772,786
Objective To explore the effect of dietary fat acids on incretin and islet function in healthy adults .Methods Before each test, healthy subjects received a 1-week pre-experiment eucaloric diet .Fifteen subjects consumed two meals containing different fat acids , including high saturated fat acid ( HSF) and high monounsaturated fat acid ( HMF) .On two separate occasions,they underwent a minimum of 1-week washout between meals .At 0,30,60,120,180 and 240 min following meal intake, the plasma concentrations of gastric inhibitory polypeptide (GIP), glucagon-like peptide-1(GLP-1) and serum concentrations of glucose, insulin, triglycerides ( TG) and free fatty acid ( FFA) were measured.Results Postprandial glucose did not increase significantly following HSF and HMF meals (P>0.05).Compared with HMF meal, significant increase in AUCins240min,AUCTG240min and AUCFFA240minwas observed following HSF meal (P<0.05).Compared with HMF meal,a significant decrease in AUCGIP30min, AUCGIP240min, AUCGLP-1 30min and AUCGLP-1 240min was found following HSF meal (P<0.05).No significant difference was observed inΔI30/ΔG30 following HSF and HMF meals (P>0.05). AUCI/AUCG was significantly lower following HMF meal as compared with HSF meal (P<0.05).Conclusion This study demonstrates that the function of GIP ,GLP-1 andβcell is affected by the dietary fat acids in healthy adults .The HMF meal may stimulate GIP and GLP-1 secretion to a greater extent than HSF meal .
9.Maternal thyroid function during the first half of pregnancy
Yan LONG ; Juanjuan SHI ; Xiaolu ZHANG ; Li LIN
Chinese Journal of Perinatal Medicine 2012;(12):737-742
Objective To analyze the changes of thyroid function of healthy primipara before 20 weeks of gestation to establish normal gestational age-specific reference interval of thyroid hormones,and to investigate the prevalence of maternal thyroid disorders during the first half of pregnancy.Methods A total of 1605 healthy primipara without risk factors of thyroid diseases before 20 gestational weeks and 200 non-pregnant healthy women who accepted pre-conception care in Beijing Friendship Hospital from September 2010 to June 2011 were tested for serum thyroid stimulating hormone (TSH),free thyroxine (FT4) and thyroid peroxidase antihody (TPOAb) by chemiluminometric immunoanalysis.One thousand two hundred and fourty-three pregnant women among them with negative thyroid antibooly and without previons thyroid diseases were selected as the standard population for normal interval.Gestational age-specific percentile categories for TSH and FT4 were calculated.The prevalence of maternal thyroid disorders was examined by gestational agespecific intervals.Results (1) Compared with non-pregnant women,the median value of serum TSH in pregnant women decreased by 29.56% to the value of 0.91 mU/L; while that of FT4 rose by 7.79% to the value of 11.33 pmol/L before 12 weeks; and TSH increased while FT4 decreased during 13 to 20 weeks.(2) The median values and reference intervals (2.5th percentile,97.5th percentile) for TSH were 1.59 mU/L (0.15 mU/L,5.19 mU/L) in no-pregnant women,1.12 mU/L (0.03 mU/L,3.67 mU/L) at 8-12+6 gestational weeks,1.21 mU/L (0.05 mU/L,3.74 mU/L) at 13-16+6 gestational weeks,1.50 mU/L (0.31 mU/L,4.33 mU/L) at 17-19+6 gestational weeks; and the median values and reference intervals (2.5th percentile,97.5th percentile) for FT4 were 9.91 pmol/L (6.69 pmol/L,14.03 pmol/L),10.68 pmol/L (7.98 pmol/L,18.66 pmol/L),10.04 pmol/L (6.18 pmol/L,16.22 pmol/L),9.40 pmol/L (6.44 pmol/L,13.51 pmol/L) respectively.(3) According to gestational age-specific reference intervals,the general prevalence of maternal thyroid disorders,including hyperthyroidism,hypothyroidism,subclinical hypothyroidism and hypothyroinemia,was 3.55% (57/1606).At 8-12+6 gestational weeks,13-16+6 gestational weeks and 17 19+6 gestational weeks,the occurrence of hyperthyroidism was 0.00%,0.13% and 0.00%;that of hypothyroidism was 0.00%,0.13% and 0.00%; the incidence of subclinical hypothyroidism was 3.60%,2.76% and 3.00%; the occurrence of hypothyroxinemia was 0.16%,0.26% and 0.86%,respectively.The positive rate of TPOAb at 8-12+6,13-16+6 and 17-19+6 gestational weeks were 22.91% (140/611),16.56% (126/761) and 15.45%(36/233),and the total positive rate of TPOAb was 18.82% (302/1605).The median level of TPOAb was 38.90,41.87 and 39.10 mU/L,respectively.Conclusions Before 20 gestational weeks,specific changes occur in maternal thyroid function.TSH level decreases during 8 to 12 gestational weeks,and then increases gradually; while FT4 level increases during 8 to 12 weeks,and then decreases gradually.Thyroid dysfunction during pregnancy is common and subclinical hypothyroidisum is the leading problem in thyroid disorders.Screening for thyroid function during early pregnancy is suggested.
10.Clinical obser ration of interferon α-2b on the treatment of viral keratitis:476 cases study
Yan LIU ; Xiaolu SHEN ; Xiaodong SUN ; Xun XU
Chinese Journal of Primary Medicine and Pharmacy 2009;16(9):1578-1579
Objective To observe the clinical effect of interferon on the treatment of virus keratitis. Meth-ods Review and analysis was made of 476 patients with virus keratitis who was treated with high concentration of an-ti-virus eyedrops and one million unit of α-2b interferon, the clinical safety and effect was evaluated. Result The total cure rate was 59. 1%, and the type from high to low is interstitial、endothelial、epithelial and the total cornea. The total recurrence rate is 23.5% ,and the type from high to low is epithelial,the total cornea,endothelial and inter-stitial. The incidence rate of the adverse effect is 10. 7%. Condusion Systemic administration of interferon has a direct anti-virus effect, and it can raise the cure rate of virus keratitis as well as decrease recurrencerate. One million unit of interferon has a high clinical safety and effect.