BACKGROUND: To assess the association between relevant brain computed tomography (CT) parameters at different time and neurological prognosis in adult comatose survivors after cardiac arrest (CA). METHODS: A total of 94 CA patients who underwent early and late CT scans (within 24 h and 24 h to 7 d respectively after CA) between January 2018 and April 2020 were enrolled in this retrospective study. According to the Cerebral Performance Category (CPC) score at hospital discharge, the patients were divided into either a good outcome (CPC 1-2) group or a poor-outcome group (CPC 3-5). The grey-to-white matter ratio (GWR) and the proportion of cerebrospinal fluid volume (pCSFV) were measured. In predicting poor outcomes, the prognostic performance of relevant CT parameters was evaluated, and the comparison analysis (expressed as the ratio of parameters in late CT to those in the early CT) of different CT time was conducted. RESULTS: Totally 26 patients were in the good-outcome group, while 68 patients were in the poor-outcome group. The putamen density, GWR, and pCSFV in late CT were significantly lower in the poor-outcome group (P<0.05). The ratios of GWR and pCSFV in the poor-outcome group were significantly decreased according to comparison analysis of different CT time (P<0.05), while there was no significant difference in the ratio of putamen density. GWR-basal ganglia <1.18 in late CT showed the best predictive value. The ratio of pCSFV <0.98 predicted unfavorable neurological outcomes with a sensitivity of 65.9% and a specificity of 93.8% (P=0.001). CONCLUSIONS: Brain CT performed >24 h after CA may be a good choice as a neuroimaging approach to evaluating prognosis. To predict neurological prognosis, comparison analysis of different CT time can be used as another promising tool in comatose CA survivors.

The aim of this study is to prepare hyaluronic acid (HA) modified core-shell liponanoparticles (pHA-LCS-NPs) as gene delivery system and investigate its gene transfection efficiency in human retinal pigment epithelium (ARPE-19) cells in vitro. The pHA-LCS-NPs was prepared by firstly hydrating dry lipid film with CS-NPs suspension to get LCS-NPs, then modifying the lipid bilayer with HA by amidation reaction between HA and dioleoyl phosphatidylethanolamine (DOPE). Its morphology, particle size and zeta potential were investigated. XTT assay was used to evaluate the cell safety of different vectors in vitro. The gene transfection efficiency of pHA-LCS-NPs modified with different contents of HA was investigated in ARPE-19 cells with green fluorescent protein (pEGFP) as the reporter gene. The results showed that the obtained pHA-LCS-NPs exhibited a clear core-shell structure with the average particles size of (214.9 +/- 7.2) nm and zeta potential of (-35 +/- 3.7) mV. The 24 h cumulative release of gene from pHA-LCS-NPs was less than 30%. After 48 h incubation, gene transfection efficiency of pHA-LCS-NPs/pEGFP was 1.81 times and 3.75 times higher than that of CS-NPs/pEGFP and naked pEGFP, respectively. Also no obvious cytotoxicity was observed on pHA-LCS-NPs. It suggested that the pHA-LCS-NPs might be promising non-viral gene delivery systems with high efficiency and low cytotoxicity.
Cell Survival ; Gene Transfer Techniques ; Genes, Reporter ; Genetic Vectors ; Green Fluorescent Proteins ; metabolism ; Humans ; Hyaluronic Acid ; chemistry ; pharmacology ; Lipids ; Nanoparticles ; Particle Size ; Phosphatidylethanolamines ; chemistry ; pharmacology ; Retinal Pigment Epithelium ; drug effects ; Transfection

Thyroid emergency is a rare but potent ially life-threatening condition if not recognized early and managed properly. It is usually due to a severe exacerbation of a preexisting thyrotoxicosis, which later leads to decompensation in different organ systems. The treatment of thyroid emergency remains challenging even with the armamentarium of modern intensive care technologies, especially in patients with cardiac failure and major organ dysfunction.[1–3] Herein, the authors described a case of thyroid emergency with cardiac arrest (CA) supported by extracorporeal membrane oxygenation (ECMO).

Objective To optimize and establish the methodology for culturing and inducing differentiation of mouse preadipocytes 3T3-L1. Methods The mouse cells 3T3-L1 were incubated in DMEM medium contained with 10%FBS, during which the incubation medium was refreshed every 2 to 3 days. Two methods were used to introduce differentiation, including three-drug combination group and four-drug combination group. The protocol of mediumⅠin three-drug combination group including insulin 10 mg/L, IBMX 0.5 mmol/L and DEX 1.0μmol/L. The protocol of mediumⅠin four-drug combination group including indometacin 0.1 mmol/L based on those of three-drug combination group. Both of them were incubated for 2 days and continuous for 2 times. And medium Ⅱ included insulin 10 mg/L for 2-day culturing and continuous for 2 times. Oil red O staining was used to observe the morphological changes of two groups of cells before and after treatment under inverted microscope. Results Mouse preadipocytes 3T3-L1 appeared in good conditions and grew in a paving stone fashion. These cells covered homogeneously the bottom of incubators, the culture medium refreshed every 2 days. The results of four-drug combination group were better than those of three-drug combination group. After three-drug combination induced differentiation, there was no significant change in cell morphology. Comparing with three-drug combination induced differentiation, four-drug combination was successfully achieved in over 90% of the cell inducing, which were round-shaped, with jacinth ester droplets by oil-red O staining. Conclusion We have optimized the method for culturing and inducing differentiation of mouse preadipocytes 3T3-L1 by adding indometacin on the basis of the three-drug combination induced differentiation.

BACKGROUND:According to the core functional zone of amino acid sequence of the osteoinduction in bone morphogenetic proteins, our research group synthesized bone morphogenetic protein (BMP) active polypeptides Ⅰ and Ⅱ by artificial solid-state synthesis method. OBJECTIVE: To evaluate the osteoinductive ability of BMP active polypeptides Ⅰ and Ⅱ in animals. METHODS:Forty-two Sprague-Dawley rats were randomly divided into seven groups, and respectively implanted with hydroxyapatite/polylactic acid carrying 0.2, 0.4, 0.8 g/L BMP active polypeptides I, hydroxyapatite/polylactic acid carrying 0.2, 0.4, 0.8 g/L BMP active polypeptides Ⅱ, and hydroxyapatite/polylactic acid alone. At 3 and 5 weeks postoperatively, X-ray, CT and histological detection were conducted to evaluate osteoinductive conditions in the seven groups. RESULTS AND CONCLUSION:At 3 and 5 weeks postoperatively, there were better local osteoinductive effects in the groups hydroxyapatite/polylactic acid carrying BMP active polypeptides Ⅰ and Ⅱ than the group of hydroxyapatite/polylactic acid, indicating both two kinds of BMP active polypeptides possessed a certain osteoinductive ability. Moreover, this osteoinductive ability became stronger with time. At 5 weeks postoperatively, the osteoinductive effect in the 0.4 and 0.8 g/L BMP active polypeptides I groups was better than that in the 0.2 g/L BMP active polypeptides I group and the 0.2, 0.4 and 0.8 BMP active polypeptides Ⅱ groups (P < 0.05). In addition, there was no difference in the osteoinductive effect of 0.4 and 0.8 g/L BMP active polypeptides I groups. These results indicate that BMP active polypeptides I has a stronger osteoinductive ability than BMP active polypeptides Ⅱ.

BACKGROUND: 5-lipoxygenase protein (ALOX5AP) has been recognized as a susceptibility gene for stroke and coronary artery diseases. The present study was to explore the role of this gene in the eastern Chinese patients with ischemic stroke.METHODS: Using a case-control design, we studied 658 patients with ischemic stroke and 704 unrelated population-based controls who were age- and sex-matched. The 658 patients were classified by the Trial of Org 10172 in Acute Stroke Treatment (TOAST). Two single-nucleotide polymorphisms (SNPs) covering ALOX5AP were genotyped.RESULTS: The genotype frequencies of TG of the SNPs rs17222919 located in the promoter of the ALOX5AP gene were significantly higher in patients with ischemic stroke than in controls (OR*=1.34, 95％CI*=1.02-1.75), especially in patients with ischemic stroke caused by small-artery occlusion (SAO) (OR*=1.40, 95％CI*=1.02-1.93). Meanwhile, the genotype frequencies of TG and TG/GG were higher in female patients than in the controls. After specification, the genotype frequencies of TG and TG/GG were higher in the patients than in controls with hypertension. The genotype frequencies of AG and AG/GG of the SNPs rs9579646 located in the intron of the ALOX5AP gene were higher in the controls than in the patients. After specification, the genotype frequencies of TG were higher in the controls than patients without hypertension.CONCLUSION: The present study suggests that sequence variants in the ALOX5AP gene are significantly associated with ischemic stroke.

BACKGROUND: Genetic variations of the 5-lipoxygenase activating protein and leukotriene A4 hydrolase genes that confer an increased risk of ischemic stroke have implicated the family of leukotrienes as potential mediators of ischemic stroke. This study aimed to explore the association of ALOX5,LTA4H andLTC4S gene polymorphisms with ischemic stroke risk in a cohort of Chinese in east China.METHODS: This case-control study consisted of 690 patients with ischemic stroke and 690 controls. Polymorphisms ofALOX5 rs2029253 A/G,LTA4H rs6538697 T/C, andLTC4S rs730012 A/C were genotyped by the polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) analysis. The multivariate logistic regression model was used to exclude the effects of conventional risk factors on ischemic stroke.RESULTS: Carriers of C allele in rs730012 were more susceptible to ischemic stroke (OR: 1.37; 95%CI: 1.08-1.73;P=0.009). The rs2029253 GG genotype showed a risk-reducing effect on ischemic stroke (OR: 0.72; 95%CI: 0.55-0.93;P=0.013) while the rs6538697 CC genotype had an increased risk of ischemic stroke (OR: 1.77; 95%CI: 1.09-2.89;P=0.022). The rs730012 variant was not associated with ischemic stroke risk after adjusting confounding factors (P>0.05).CONCLUSION: The present study suggested that gene polymorphisms in the leukotrienes pathway may exert infl uences, with independent genetic effects, on ischemic stroke susceptibility in a cohort of Chinese in east China.

BACKGROUND: MicroRNAs (MiRNA) are a novel class of non-coding RNAs involved in the regulation of gene expression post-transcriptionally by cleavage or translational repression of their specific target miRNAs. Numerous studies have demonstrated that circulating miRNAs are stable and abundant in blood and aberrantly expressed under pathological conditions, including cardiovascular diseases. The implications of circulating miRNAs in acute myocardial infarction have recently been recognized. This review will highlight the potential role of miRNA as a novel class of biomarkers in acute myocardial infarction. METHODS: This systemic review is based on our own work and other related reports. RESULTS: During diseases circulating miRNAs are derived from not only circulating blood cells but also other tissues affected by ongoing diseases. These disease-related miRNAs in the blood can serve as potential biomarkers. CONCLUSION: The circulating miRNAs can be used as novel biomarkers potentially offering more sensitive and specific tests than those currently available for diagnosis of acute myocardial infarction.

BACKGROUND: This meta-analysis aimed to determine whether extracorporeal cardiopulmonary resuscitation (ECPR), compared with conventional cardiopulmonary resuscitation (CCPR), improves outcomes in adult patients with cardiac arrest (CA). DATA RESOURCES: PubMed, EMBASE, Web of Science, and China Biological Medicine Database were searched for relevant articles. The baseline information and outcome data (survival, good neurological outcome at discharge, at 3–6 months, and at 1 year after CA) were collected and extracted by two authors. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using Review Manager 5.3. RESULTS: In six studies 2260 patients were enrol ed to study the survival rate to discharge and long-term neurological outcome published since 2000. A significant effect of ECPR was observed on survival rate to discharge compared to CCPR in CA patients (RR 2.37, 95%CI 1.63–3.45, P<0.001), and patients who underwent ECPR had a better long-term neurological outcome than those who received CCPR (RR 2.79, 95%CI 1.96–3.97, P<0.001). In subgroup analysis, there was a significant difference in survival to discharge favoring ECPR over CCPR group in OHCA patients (RR 2.69, 95%CI 1.48–4.91, P=0.001). However, no significant difference was found in IHCA patients (RR 1.84, 95%CI 0.91–3.73, P=0.09). CONCLUSION: ECPR showed a beneficial effect on survival rate to discharge and long-term neurological outcome over CCPR in adult patients with CA.

OBJECTIVETo establish the role of psychological factors in the etiology and symptomatology of chronic prostatitis / chronic pelvic pain syndrome (CP/CPPS), analyze the influence of the psychological obstacles and other relative factors on the prognosis of CP/CPPS by univariate and multivariate Cox regression analyses, and provide a scientific basis for psychotherapy of the problem.

METHODSA total of 291 CP/CPPS patients and 100 normal controls were investigated in age, education, occupation, character, disease course, NIH chronic prostatitis syndrome index (NIH-CPSI) and leukocyte count in EPS and by self-rating anxiety scale (SAS) and self-rating depression scale (SDS) to establish the psychological factors related with CP/CPPS. Then, all the CP/CPPS patients were treated with the same method and followed up for 6 weeks. Based on the therapeutic results, the influence of psychological and other relative factors on the prognosis of CP/CPPS was analyzed with univariate and multivariate Cox regression.

RESULTSAll together 258 valid questionnaires were collected from the patients and 87 from the normal controls. Of the 258 CP/CPPS patients, the mean scores on SAS and SDS were 42.8 +/- 11.43 and 48.15 +/- 11.49 respectively, both significantly higher than those of the controls (32.12 +/- 9.68 and 35.12 +/- 10.81) (P < 0.01). The rates of anxiety, depression and anxiety and/or depression in the CP/CPPS group were 25.97, 21.71 and 34.50 % respectively, all significantly higher than in the control group (P < 0.01). The rate of introversion was significantly higher while that of extroversion significantly lower in the former than in the latter (P < 0.01). The total effectiveness rate of treatment was 70.54 % in the CP/CPPS patients. Univariate and multivariate analyses with Cox regression revealed that anxiety, depression and disease course were the definite factors that negatively affected the prognosis of CP/CPPS, while the other factors, such as age, CPSI, character and leukocyte count in EPS had no influence.

CONCLUSIONSuch psychological obstacles as anxiety and depression play an important role in the pathogenesis, development and prognosis of CP/CPPS. In the treatment of CP/ CPPS, importance should be attached to the patients'psychological status and proper psychological intervention is sometimes necessary.

Adolescent ; Adult ; Anxiety ; etiology ; psychology ; Chronic Disease ; Depression ; etiology ; psychology ; Humans ; Male ; Middle Aged ; Pelvic Pain ; etiology ; psychology ; Prognosis ; Proportional Hazards Models ; Prostatitis ; complications ; psychology ; Regression Analysis ; Surveys and Questionnaires ; Syndrome ; Young Adult