1.Initial Rotterdam CT score may predict prognosis of the patients after unilateral decompression craniectomy for treating severe traumatic brain injury
Jianli WANG ; Guoliang JIN ; Zigang YUAN
Chinese Journal of Emergency Medicine 2014;23(2):168-173
Objective To identify the factors enhancing the contusive brain hemorrhage following unilateral decompression craniectomy in patients with severe traumatic brain injury (TBI),and to explore the relationship between the initial Rotterdam CT score and clinical outcomes.Methods A prospective study of 291 consecutive patients with TBI admitted from Jan 2008 through Dec 2012 was carried out.Patients treated with unilateral decompression craniectomy were enrolled for study.Patients without preoperative or postoperative cranial CT imaging were excluded.Of them,235 patients were followed up.Gender,age,the causes of injury,preoperative general condition including Glasgow Coma Scale (GCS) score,pupillary response,laboratory data and the initial CT scans before operation,contusion hematoma size in CT scans following operation and Glasgow Outcome Scale (GOS) score were recorded.With t test,x2 test and nonparametric rank sum test,differences in the above listed variables were compared between patients with enlarged hematoma size group and those without change in hematoma size.A Classification And Regression Tree (CART) was used to predict the size of hematoma.Correlation analysis was used to find the relationship between the Rotterdam CT scores and GOS scores.Results The differences in age (t =2.034,P =0.043),first Rotterdam CT score (Z =4.838,P < 0.01),GCS score (Z =4.440,P < 0.01),pupillary response (Z =3.235,P =0.001),the length of time elapsed between the trauma occurred and the decompressive craniectomy (Z =3.874,P < 0.01),glucose level (Z =3.880,P < 0.01) and cerebrum hernia magnitude (Z =2.529,P =0.012) were significant between the patients with hematoma expanded (n =120) and those without change in hematoma size (n =115).The results of the CART indicated that Rotterdam score got from the initial head CT,glucose level and the length of time elapsed between trauma occurred and decompressive craniectomy were strong predictors of the risk for expanded hemorrhagic contusions following decompressive craniectomy.Both age and size of the removed bone-flap also could predict the risk of postoperative expansion of hemorrhagic contusions.The overall predictive accuracy of the CART model was 83.3%.Correlation analysis results indicated that Rotterdam CT score was negatively correlated with GOS (r =-0.333,P < 0.01).Conclusions Initial Rotterdam CT scores,glucose level and the length of time between trauma and decompressive craniectomy may predict the risk of contusions expansion following decompressive craniectomy.Rotterdam CT score was negatively correlated with GOS.
2.Cloning,fusion expression and identification of thioredoxin encoding gene from Toxoplasma gondii
Zigang ZHANG ; Xiaomei CHEN ; Danhua SU ; Yuan LIU ; Tao FU ; Jiamiao DUANMU ; Liang WU ; Xugan JIANG ; Shengxia CHEN ; Jianping CAO
Chinese Journal of Schistosomiasis Control 2016;28(3):289-292
Objective To clone and express the thioredoxin(Trx)from RH strain tachyzoites of Toxoplasma gondii,estab?lish the prokaryotic expression vector and purify the recombinant protein,then produce the polyclonal anti?Trx antibody in rab?bits. Methods Trx fragment was amplified by PCR and cloned into the pET?28a(+)vector,and the recombinant protein was in?duced with IPTG and purified by Ni?NTA affinity chromatography. The polyclonal antibody specificity was detected by Western blotting. Results The trx gene was amplified from T. gondii cDNA by PCR. The recombinant plasmid trx/pET?28a(+)was use?fully constructed,and the recombinant TRX protein was expressed and purified. The TRX polyclonal antibody was also ob?tained. The specific band of TRX was detected by Western blotting. Conclusion Western blotting can detect the specificity of polyclonal anti?Trx antibody,which will facilitate the biological functions of Trx.
3.Production and clinical application of 3D printing models of intracranial aneurysms
Guoliang JIN ; Jianli WANG ; Zigang YUAN ; Wuqiao BAO ; Chulei ZHONG ; Ge WANG ; Changming DONG
Chinese Journal of Neuromedicine 2017;16(1):75-77
Objective As the intracranial aneurysm diagnosed by digital subtraction angiography (DSA) examination,the patient's cerebral vessels models of intracranial aneurysms were built by 3D Printer.According to the models,the size,shape,orientation of the aneurysms,as well as the relationship between the parent artery and the branch vessels were analyzed to provide reference for craniotomy.Methods The 11 patients with intracranial aneurysms diagnosed by DSA were prospectively selected in this study from May 1,2016 to June 30,2016.The DSA data of the patients were output in DICOM format,after format conversion and three-dimensional reconstruction by MIMICS software,the selected target regions were modeled by 3D printers in different proportions (1∶1 and 1∶3).Results The cerebral vascular 3D printing models could reflect the shape,size and distribution of the cerebral vascular and orientation of the intracranial aneurysms.It could also show the relationship between the aneurysm and parent arteries along with vascular branches.It was showed that the original size and different amplified model could provide reference for the aneurysm clipping surgery.Conclusion The 3D printing technology can be used into the production of human cerebral vascular models,which can provide a physical model for diagnosis and treatment of intracranial aneurysms,and it can also provide useful reference for preoperative and intraoperative aneurysm clip selection and clamping method decision during the aneurysm clip surgery.
4.Janus kinase inhibitors for the treatment of five children with severe alopecia areata
Yuanxiang LIU ; Yuan LIANG ; Xinrong ZHAO ; Yujuan SUN ; Lin MA ; Zigang XU
Chinese Journal of Dermatology 2023;56(9):849-852
Objective:To evaluate the efficacy of Janus kinase (JAK) inhibitors in the treatment of 5 children with severe alopecia areata, especially those with complicated nail damage.Methods:A total of 5 children with severe alopecia areata were enrolled and treated with oral JAK inhibitors (tofacitinib or baricitinib). The improvement of hair loss was assessed by using the severity of alopecia tool (SALT) at 12, 24, 36, and 48 weeks after the start of treatment. For 3 children with complicated nail damage, the improvement of diseased nails and toenails was evaluated by using the modified nail psoriasis severity index after treatment. During the treatment, adverse reactions were monitored.Results:The 5 children with severe alopecia areata were aged 2 - 11 years, with the disease duration ranging from 5 to 120 months, and the treatment with JAK inhibitors lasted 24 - 48 weeks. After 12-week treatment, 2 children achieved a 50% improvement in SALT (SALT50) ; after 24-week treatment, 3 achieved SALT95, and 1 achieved SALT75 and then withdrew baricitinib for personal reasons; after 36-week treatment, 3 achieved SALT99, and then received half-dose treatment; after 48-week treatment, 1, 1, 1 and 1 patient achieved SALT99, SALT83, SALT31, and SALT0, respectively, and 2 of them experienced gradually aggravated hair loss 1 - 2 months after the start of half-dose treatment. Among the 3 children with complicated nail damage, the improvement rates of nail severity index scores were 67.5%, 45.4%, and 25% respectively, and the improvement rates of toenail severity index scores were 42.5%, 71.4%, and 5% respectively after 12-week treatment; after 48-week treatment, the improvement rate of nail severity index scores were 100%, 100%, and 50% respectively, and the improvement rate of toenail severity index scores were 96.2%, 100%, 50% respectively. During the treatment, the uric acid level increased in 2 children, and one of them was accompanied by increased serum levels of low-density lipoprotein cholesterol and high-density lipoprotein cholesterol; 1 suffered from respiratory tract infections twice during the treatment, and was recovered after symptomatic treatment; there were no adverse reactions leading to drug withdrawal.Conclusion:JAK inhibitors can be used as a treatment option for severe alopecia areata in children.
5.Clinical Features and Genetic Analysis of Autosomal Dominant and Recessive Hyperimmunoglobulin E Syndrome
Shan WANG ; Ying LIU ; Zigang XU ; Zhaoyang WANG ; Lei JIAO ; Yuan LIANG ; Zhe XU ; Lin MA
JOURNAL OF RARE DISEASES 2022;1(3):268-277