Recent studies have demonstrated that hyperhomocysteinemia is an independent risk factor for stroke,which may cause vascular endothelial injury by multiple mechanisms,destroy blood coagulation and fibrinolytic systems,and influence on lipid metabolism.Methylenetetra hydrofolate reductase(MTHFR)is a key enzyme of homocysteine metabolic pathway in the human body.If it is insufficient or its activity decreases,it will directly result in the accumula tion of homocysteine in the human body,and callse hyperhomocysteinemia.Although a number of studies have found that MTHFR gene mutation is the main cause of MTHFR insufficient and its activity decrease,the correlation between MTHFR gene mutation and ischemic cerebral vascular disease is quite controversial now.This article reviews the relationship between MTHFR gene polymorphisms and ischemic stroke.

Objective To investigate the association between promoter polymorphisms of interferon-alpha receptor-1 (IFNAR1) gene and the treatment response to interferon-alpha (IFN-α) in patients with chronic hepatitis B (CHB). Methods Sixty-one CHB patients who consented to receive IFN-a therapy were enrolled in this study. The subjects were treated with recombinant IFN-α2b 500 MU intramuscular injection qod for 48 weeks. The treatment responses were monitored.Meanwhile, the promoters of IFNAR1 gene in these patients were sequenced. Measurement data were analyzed by t test and enumeration data were analyzed by Chi square test. Results Twenty-two treated patients achieved complete response. Eight patients achieved partial response and 31 had no response. Polymorphisms were identified in the promoter of IFNAR1 gene, which included C/T substitution at locus -408, C/T substitution at locus-3 and GT microsatellite repeat sequence at locus-77 [-77(GT)n]. The three polymorphisms were in linkage and composed some haplotypes,such as - 408C/-77(GT)5/-3C. The response rate to IFN-α in CHB patients with genotypes -408C/-77(GT)5/-3C, -408C/-77(GT)5/-3C, and-408C/-77(GT)5/-3C, non -408C/ - 77(GT)5/-3C in IFNAR1 gene promoter was higher than that in patients with genotype non -408C/-77(GT)5/-3C, non-408C/- 77(GT)5/- 3C (61. 0% vs 25. 0%, x2=6. 961, P =0.008). Conclusions CHB patients with genotype-408C/ - 77(GT)5/ - 3C, -408C/-77(GT)5/-3C and -408C/ -77(GT)5/ -3C, non -408C/ -77(GT)5/-3C in the promoter of the IFNAR1 gene are prone to have better response to IFN-a treatment. Polymorphisms in the promoter of IFN-αgene are associated with the treatment response to IFN-α in CHB patients.

Acute Disease ; Female ; Humans ; Infant ; Infant, Newborn ; Propionates ; blood ; Pyruvate Carboxylase Deficiency Disease

BACKGROUND: Nerve growth factor (NGF) and myelin-associated glycoprotein (MAG) can promote the repair of peripheral nerve. However, increasing the expression of NGF and MAG in the injured peripheral nerve by transgene technology has not been reported.OBJECTIVE: To investigate the expression of NGF and MAG after adenovirus (Ad) mediated transfection in the injured sciatic nerve in rats.METHODS: Forty Sprague-Dawley rats were randomly divided into normal, model, Ad, NGF and NGF-MAG groups. Sciatic nerve injury models were established in the latter four groups by cutting and suturing the right sciatic nerve. Afterwards, the rats in each group were subject to the intramuscular injection of normal saline, normal saline, Ad (1×108 PFU), Ad-NGF (1×108 PFU), and Ad-NGF-MAG (1×108 PFU), respectively, once every 2 days, for consecutive three times.RESULTS AND CONCLUSION: The expression level of NGF in the rat sciatic nerve in the Ad and normal groups was significantly higher than that in the NGF and NGF-MAG groups (P < 0.05). Compared with the Ad, NGF and normal groups, the expression level of MAG in the NGF-MAG group was significantly increased (P < 0.05). To conclude, the Ad-mediated NGF and MAG after double gene transfection were expressed effectively in the injured sciatic nerve in rats.

Objective To investigate the diagnostic efficiency of 64-slice CT coronary angiography (CTCA) to myocardial ischemia of coronary stenosis. Methods ~(99m) Tc-MIBI myocardial perfusion imaging (MPI) and 64-slice CTCA were performed in 30 patients with myocardial ischemia of coronary stenosis. Three coronary arteries were divided in to 12 segments in each patient, the diagnostic efficiency of CTCA to myocardial ischemia of coronary stenosis were eveluated taking MPI as diagnostic standard, and stenoses ≥50% and ≥75% as the cutoff value. Results In 9 patients, perfusion defected were found (6 reversible, 3 fixed) on MPI. A total of 327 coronary arteries' segments were analyzed, quantitative CTCA revealed stenoses ≥50% in 25 segments (7.65%) and stenoses ≥75% in 12 segments (3.67%). When the cut-off was ≥50%, the sensitivity, specificity, negative and positive predictive value (NPV, PPV) and accuracy of CTCA by the abnormal images of MPI as diagnostic standard to observe abnormal arteries was 68.42%, 96.14%, 99.01%, 52.00% and 95.41%, respectively; and 66.67%, 99.04%, 98.73%, 66.67% and 97.55%, respectively, when cut-off at ≥75%. Taking abnormal MPI as diagnostic standard to observe the patients, the sensitivity, specificity, NPV, PPV and accuracy of CTCA was 66.67%, 57.14%, 80.00%, 40.00% and 60.00% respectively, with the cut-off at ≥50%; and was 55.56%, 85.71%, 81.82%, 62.50% and 76.67%, respectively, with the cut-off at ≥75%.Conclusion Sixty-four-slice CTCA is a reliable tool to rule out functionally relevant myocardial ischemia of coronary artery disease. However, further examination is necessory for patients with abnormal CTCA.

Objective To discuss the clinicopathologic characteristics and risk factors for lung metastasis of early-stage cervical cancer after radical hysterectomy. Methods The complete clinicopathologic data of patients with lung metastasis of cervical cancer after radical surgery from January 2008 to December 2013 admitted in Zhejiang Cancer Hospital were retrospectively analyzed by univariate and multivariate analysis. Results (1)There were 38 cases of early cervical cancer suffered from lung metastasis after radical hysterectomy during the period. The median age at diagnosis of cervical cancer was 46 years, the average lung metastasis time was 13 months after operation, 50.0%(19/38) cases occurred in the first year. Thirty-one cases were squamous cell carcinoma and 7 cases were non-squamous cell carcinoma.(2)Univariate analysis showed that age,clinical stage, manner of tumor growth, tumor grade, perineuronal invasion, para-aortic lymph node metastasis were not significant effect on postoperative lung metastasis(all P>0.05). But tumor size, histologic types, depth of stromal invasion, uterine body infiltration, lympho-vascular space invasion,pelvic lymph node metastasis, positive margin and abnormal tumor markers were significantly correlated with postoperative lung metastasis(all P<0.05). Multivariate analysis showed that only tumor size, histologic types and pelvic lymph node metastasis were independent risk factors for lung metastasis of cervical cancer(P<0.05). Conclusions Patients of early-stage cervical cancer with lung metastasis mostly occurs within 1 year after radical hysterectomy. Local large tumor lesions (tumor size>4 cm), non-squamous cell carcinoma and pelvic lymph node metastasis were more likely to have lung metastasis.

Objective The article was to speed up the dissolution rate of poorly soluble drugs, reduce the configuration time and improve the allocative efficiency by analysis on factors influencing dissolution and adoption of proper allocative approaches accord-ing to different characteristics of insaluble drugs. Methods 5 insaluable drugs were chosen for the study, which were ornithine as-partate, mezlocillin sodium and sulbactam sodium, teicoplanin, omeprazole sodium injection and imipenem and cilastatin sodium.The control group were allocated by routine configuration approach, while the experiment group were improved by increasing the amount of solvent, loosing the powder inside the bottle before configuration, reducing the bubble, adopting special solvent and increasing the dis-solution temperature.Observation and comparative experiment were made on two groups along with the timing from configuration to com-plete dissolution into clear transparent liquid. Results As to the average complete dissolution time of 5 drugs, significant difference was found between two groups([42±5]s vs [246±35]s, [3±1]min vs [30±3]min, [5±1]min vs [10±3]min, [5±3]min vs [10± 5]min, [2±1]min vs [10±1]min, P<0.05).Compared with the control group, the dissolution time of 5 drugs was cut down by 83%, 90%, 50%, 50%, 80%in experiment group. Conclusion Appropriate increase of solvent, loose powder, bubble reduction, special solvent and increased solution temperature contribute to shortening the dissolution time of insoluble drugs and improving the configura-tion efficiency of pharmacy intravenous admixture.

BACKGROUND: The proliferation and differentiation of mesenchymal stem cells (MSCs) lack of regulatory functions. Following combining with suitable vectors, MSCs cannot highly effectively proliferate and differentiate, which are keys to prevent MSCs entering the clinic. It is of great importance to effectively regulate the differentiation of stem cells into osteoblasts using pulse electromagnetic field.OBJECTIVE: To investigate the differentiation of mouse MSCs into osteoblasts in vitro following stimulation of pulse electromagnetic field.DESIGN, TIME AND SETTING: The cytological in vitro controlled study was conducted at the Laboratory of Department of Orthopaedics, Puai Hospital of Tongji Medical College, Huazhong University of Science and Technology from May 2004 to October 2007.MATEIRALS: Totally 20 BALB/C mice were supplied by the Experimental Animal Center of Tongji Medical College. Pulse electromagnetic field deviser was designed and made by the Department of Electric Machine, Naval University of Engineering.METHODS: Mouse bilateral femur was sterilely isolated. BMSCs were harvested by the Percoll density gradient centrifugation,and purified and proliferated by the adherent method. Cells at the third passage (2×10~7/L) were incubated in a 6-well plate, and then divided into 4 groups. Cells in the blank control group were incubated in the complete medium. Cells in the pulse electromagnetic field underwent pulse electromagnetic field radiation of 50 Hz, sinusoidal wave, and 1 mT, twice a day, once 30 minutes, with an interval of 12 hours, totally 10 days. Cells in the osteogenic induction group were incubated in the complete medium, supplemented with dexamethasone, sodium glycerophosphate and VitC. Cells in the pulse electromagnetic field + osteogenic induction group were subjected to the same pulse electromagnetic field radiation and then incubated in the complete medium.MAIN OUTCOME MEASURES: The differentiation of BMSCs was measured.RESULTS: Results of alkaline phosphatase staining showed that cells were negative in the blank control group, but weakly positive in the pulse electromagnetic field group, positive in the osteogenic induction group, and strongly positive in the pulse electromagnetic field + osteogenic induction group 10 days following intervention. Compared with the blank control group,absorbance value of type I collagen immunohistochemistry was significantly greater in the osteogenic induction group, pulse electromagnetic field + osteogenic induction group (P < 0.05, P < 0.01).CONCLUSION: Pulsed electromagnetism fields of 50 Hz, waves of sine, with the intensity of 1 mT could promote alkaline phosphatase and type I collagen expression and enhance the differentiation of mouse BMSCs into osteoblasts in vitro.

Objective To study the effect of atorvastatin on serum cystatin C and urinary microprotein in patients with early diabetic nephropathy (DN).Methods Sixty-eight cases of early DN were divided into control group and observation group with 34 cases each by random digits table,the control group was treated with the conventional treatment,the observation group was treated with atorvastatin on the basis of conventional treatment,then blood lipids,serum cystatin C,urinary albumin excretion rate (UAER),microalbuminuria( MAU ),α1-microglobulin(MG),β 2-MG between the two groups were compared.Results After intervention,the levels of total cholesterol (TC),triacylglycerol (TG),serum cystatin C,UAER,MAU,αt 1-MG,β 2-MG were significantly decreased compared with those before treatment in the observation group [ (4.32 ± 1.26) mmol/L vs.(5.65 ± 1.38 ) mmol/L,( 1.67 ± 0.64) mmol/L vs.(2.53 ± 0.96 ) mmol/L,( 1.29 ± 0.38 ) mg/L vs.( 1.74 ± 0.51 ) mg/L,(61.09 ± 18.45 ) μ g/min vs.( 86.42 ± 21.34) μ g/min,( 5.73 ±4.81) mg/L vs.(23.16 ±9.73) mg/L,(1.41 ± 1.21) mg/L vs.(4.76 ± 1.24) mg/L,(1.21 ±0.13) mg/L vs.(2.58 ± 0.26) mg/L ] (P ＜ 0.01 or ＜ 0.05 ).In the control group,the levels of TC,TG,serum cystatin C were lower than those before treatment,but there were no significant differences (P＞0.05),but the levels of UAER,MAU,α 1-MG,β 2-MG had significant differences compared with those before treatment (P ＜ 0.01or ＜ 0.05 ) and the same time of the observation group (P ＜ 0.05 or ＜ 0.01 ).Conclusion Atorvastatin can significantly reduce serum cystatin C and urinary micro-protein levels in patients with early DN,which plays an important role in kidney protection.

Objective:To observe therapeutic effects of dexmedetomidine combined metoprolol on subarachnoid hemorrhage (SAH) complicated myocardial injury (MI) .Methods:According to random number table , a total of 131 SAH + MI pa‐tients were divided into control group (n=31) ,metoprolol group (n=34) ,dexmedetomidine group (n=32) and combined treatment group (n=34 ,received metoprolol combined dexmedetomidine ) .Plasma levels of norepinephrine (NE) ,epi‐nephrine (E) ,brain natriuretic peptide (BNP) and cardiac troponin I (cTnI ) were measured ,echocardiography etc .were used to assess MI recovery condition before and after treatment in all groups .Results:Compared with before operation , there was significant rise in LVEDd on 1d after operation ,significantly reduced on 3d after operation and recovered to nor‐mal on 7d after operation ( P<0.05 all);significant reduction in LVEF on 1d after operation ,significantly rose on 3d after operation and recovered to normal on 7d after operation ( P<0.05 all);significant rise in levels of cTnI ,BNP ,NE and E on 1d after operation ,started to reduce on 3d after operation and recovered to normal on 7d after operation in metoprolol group ,dexmedetomidine group and combined treatment group , P< 0.05 all;compared with control group ,metoprolol group and dexmedetomidine group on 7d after operation ,there was significant reduction in LVEDd ,and significant rise in LVEF and significant improvement in cardiac function ;significant reductions in plasma levels of NE [ (1.37 ± 0.08) pmol/L ,(1.05 ± 0.09) pmol/L ,(1.19 ± 0.07) pmol/L vs .(1.01 ± 0.06) pmol/L] ,E [ (6.17 ± 0.41) pmol/L ,(6.02 ± 0.34) pmol/L ,(6.06 ± 0.29) pmol/L vs .(5.26 ± 0.26) pmol/L] ,cTnI [ (0.22 ± 0.02)μg/L ,(0.11 ± 0.03)μg/L ,(0.17 ± 0.02)μg/L vs .(0.09 ± 0.01)μg/L] and BNP [ (1126.81 ± 11.27) ng/L ,(1014.09 ± 14.29) ng/L ,(1154.09 ± 16.52) ng/L vs .(954.09 ± 9.31) ng/L] in combined treatment group ,P<0.05 all .Conclusion:Either dexmedetomidine or meto‐prolol ,or their combination can effectively inhibit SAH complicated myocardial injury ,improve cardiac function ,but com‐bined treatment possesses the best effective effect .