Objective To study the effect ofT-786C polymorphism of endothelial NO synthase gene on cerebral circulation in smokers with aneurysmal subarachnoid hemorrhage. Methods Three hundred and ninety-four patients with aneurysmal subarachnoid hemorrhage were adopted in our study;smokers and nonsmokers were defined by 200 and 0, respectively, according to the smoking index (quantity of cigarettes per year). Transcranial color-coded Doppler (TCCD) was employed to detect the alterations of flow velocity of cerebral arteries. Genotyping ofT-786C was performed by using a newly developed allele-specific polymerase chain reaction. Degree of oxidative stress of these patients were evaluated by measuring the level of F2-isoprostane excretion in the urine. Results The mean flow velocity (Vm) of middle cerebral artery (MCA) and internal carotid artery (ICA) was obviously increased as compared with that of the other normal ones in most of the smokers. The Vm of MCA and ICA in nonsmokers was not obviously different as compared with the normal values. The 3 genotypes ofT-786C in smokers showed significant difference in Vm of MCA and ICA (P＜0.05); the Vm of CC genotype ([60.73±63.58] cm/s) was obviously increased as compared with that of TT ([95.8±53.5] cm/s) and TC ([93.6±51.6] cm/s) genotypes (P＜0.05). The 3 genotypes ofT-786C in nonsmokers did not show significant difference in Vm of MCA and ICA (P＞0.05). The level of F2-isoprostane excretion in smokers was significantly higher than that in nonsmokers (P＜0.05). Conclusion The T-786C polymorphism of endothelial NO synthase gene can increase cerebrovascular Vm by enhancing the cerebrovascular circulation of smokers with aneurysmal subarachnoid hemorrhage.

Objective To explore the effect of Rhubarb and Polygonum cuspidatum and their combination on blood stasis model rats.Methods Forty female SPF rats were chosen and were randomly divided into blank,model,test I,test Ⅱ,test Ⅲ groups,8 rats in each group.The rats of test I,test Ⅱ,test Ⅲ groups were given 30 mg · kg-1 Rhubarb drug,Polygonum,Rhubarb Polygonum cuspidatum (1:1),qd;blank and model groups were given 0.9％ NaCl at 5 mL · kg-1 dose,qd.The rats were treated for consecutive 10 days.After lavage for 1 h,except the blank group,the rats in other groups were given adrennaline hydrochloride 1mg · kg-1 by intraperitoneal injection.After 24 h,they were injected the same dose of adrenaline again.After the acute blood stasis model was prepared,the rats were anesthetized to collect blood from the abdominal aorta After anticoagulation treatment,the hemorheology index and lipid index of all samples were tested by automatic blood rheology tester and automatic biochemical analyzer.Results The blood biscosity in blank and test Ⅲ I groups were (3.26±1.33) and (4.51 ±1.15) mPa · s at 200/s,(4.21 ±1.41) and (5.80 ±1.44) mPa · s at 50/s,(9.75 ±2.97) and (13.27 ±3.14) mPa · s at 5/s,(25.58 ±7.24) and (34.49 ±7.95) mPa · s at 1/s,with significant difference (all P ＜ 0.05).The erythrocyte aggregation index in the blank,test Ⅰ,test Ⅱ groups were (8.04 ± 0.80),(7.39 ± 0.31) and (7.18 ± 0.62),respectively.The difference between the blank and test Ⅰ groups was statistically significant (P ＜ 0.05).The difference between the blank and test Ⅱ groups were highly statistically significant (P ＜0.01).Triglyceride in model,test Ⅱ groups were (0.92 ±0.39) and (0.61 ±0.15) mmol · L-1,with significant difference (P ＜ 0.05).Conclusion Rhubarb,Polygonum cuspidatum,and Rhubarb-Polygonum cuspidatum combination all had good effect on the rats with blood stasis syndrome,but Rhubarb-Polygonum cuspidatum combination (1:1) did not show the obvious synergistic effect.Polygonum cuspidatum can significantly reduce triglycerides,while Rhubarb alone didn't show the role of significant reduction of blood lipids,and in reducing blood lipids,rhubarb and in this regard,Polygonum cuspidatum compatibility didn't show the synergistic effect.

OBJECTIVETo study whether endothelial nitric oxide synthase gene (eNOS) polymorphisms is implicated in the development of cerebral vasospasm following subarachnoid hemorrhage.

METHODSThree groups of patients with subarachnoid hemorrhage were selected to test this hypothesis, including 98 patients with cerebral vasospasm following aneurysmal subarachnoid hemorrhage (ASAH), 96 with cerebral vasospasm following traumatic subarachnoid hemorrhage (TSAH), and 195 patients without cerebral vasospasm following aneurysmal or traumatic subarachnoid hemorrhage. The parents of 194 patients and 100 control subjects were also examined for transmission disequilibrium test according to a family-based study design to test the associations.

RESULTSWe examined four eNOS gene polymorphisms, and two of these polymorphisms, the T to C substitution in the promoter at position -786 and the a-deletion/b-insertion in intron 4, were found to associate with cerebral vasospasm in subarachnoid hemorrhage in the case-control comparisons. For the former polymorphism, the risk of cerebral vasospasm was higher in C allele homozygotes than in the other two genotypes (odds ratio: 2.8, 95% CI: 1.4 to 5.6); for the latter polymorphism, the a-deletion carriers were exposed to a increased risk (odds ratio: 2.3, 95% CI: 1.3 to 4.0) in comparison with the noncarriers. The two polymorphisms were analyzed together as haplotypes in a family-based study using the transmission disequilibrium test. The C/a-deletion haplotype was transmitted from the heterozygous parents to cases of cerebral vasospasm in subarachnoid hemorrhage with a significantly higher frequency than expected (P=0.005).

CONCLUSIONThe findings of the case-control and family-based studies clearly demonstrate that DNA sequence differences in eNOS gene influence the risk of cerebral vasospasm in subarachnoid hemorrhage.

Adolescent ; Adult ; Case-Control Studies ; Female ; Genotype ; Humans ; Male ; Middle Aged ; Nitric Oxide Synthase Type III ; genetics ; Polymorphism, Genetic ; Risk Factors ; Subarachnoid Hemorrhage ; complications ; enzymology ; genetics ; Vasospasm, Intracranial ; enzymology ; etiology ; Young Adult

Empty Sella Syndrome ; diagnosis ; Female ; Humans ; Middle Aged ; Petrosal Sinus Sampling ; methods ; Pituitary Neoplasms ; diagnosis

OBJECTIVES: To study the early clinical efficacy of combined therapy of stage 4 neuroblastoma. METHODS: A retrospective analysis was performed on the medical data and follow-up data of 14 children with stage 4 neuroblastoma who were diagnosed in Hong Kong University-Shenzhen Hospital from January 2016 to June 2021. RESULTS: The median age of onset was 3 years and 7.5 months in these 14 children. Among these children, 9 had positive results of bone marrow biopsy, 4 had N-Myc gene amplification, 13 had an increase in neuron-specific enolase, and 7 had an increase in vanilmandelic acid in urine. Based on the results of pathological examination, differentiated type was observed in 6 children, undifferentiated type in one child, mixed type, in one child and poorly differentiated type in 6 children. Of all the children, 10 received chemotherapy with the N7 regimen (including 2 children receiving arsenic trioxide in addition) and 4 received chemotherapy with the Rapid COJEC regimen. Thirteen children underwent surgery, 14 received hematopoietic stem cell transplantation, and 10 received radiotherapy. A total of 8 children received Ch14.18/CHO immunotherapy, among whom 1 child discontinued due to anaphylactic shock during immunotherapy, and the other 7 children completed Ch14.18/CHO treatment without serious adverse events, among whom 1 child was treated with Lu177 Dotatate 3 times after recurrence and is still undergoing chemotherapy at present. The median follow-up time was 45 months for all the 14 children. Four children experienced recurrence within 2 years, and the 2-year overall survival rate was 100%; 4 children experienced recurrence within 3 years, and 7 achieved disease-free survival within 3 years. CONCLUSIONS Multidisciplinary combined therapy is recommended for children with stage 4 neuroblastoma and can help them achieve better survival and prognosis.
Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Child ; Child, Preschool ; Combined Modality Therapy ; Humans ; Infant ; Neuroblastoma/drug therapy* ; Positron-Emission Tomography ; Radionuclide Imaging ; Retrospective Studies ; Treatment Outcome

Objective To investigate the effect of Vibrant Soundbridge ( VSB) implantation.Methods In accordance with the indications for VSB implantation,surgeries were done for two patients who suffered from either a sensorineural or conductive hearing loss ( microtia).Their preoperative auditory thresholds(0.5,1,2 and 4 kHz) were 56 dB HL and 61 dB HL.The VSB was turned on and adjusted seven weeks after surgery.Results Postoperative auditory thresholds of the two patients were improved.Their pure tone thresholds were 32 dB HL and 40 dB HL,and the respective improvement was 24 dB HL and 21 dB HL.There was no facial paralysis,vertigo and tinnitus.Conclusion Patients with a sensorineural or conductive hearing loss may benefit from VSB implantation.

Objective To investigate the spatiotemporal distribution characteristics and potential influencing factors of newly diagnosed echinococcosis cases in Qinghai Province from 2016 to 2022, so as to provide insights into the formulation of the echinococcosis control strategy in Qinghai Province. Methods The number of individuals screened for echinococcosis, number of newly diagnosed echinococcosis cases, number of registered dogs and number of stray dogs were captured from the annual reports of echinococcosis control program in Qinghai Province from 2016 to 2022, and the detection of newly diagnosed echinococcosis cases was calculated. The number of populations, precipitation, temperature, wind speed, sunshine hours, average altitude, number of year-end cattle stock, number of year-end sheep stock, gross domestic product (GDP) per capita, and number of village health centers in each county (district) of Qinghai Province were captured from the Qinghai Provincial Statistical Yearbook, and county-level electronic maps in Qinghai Province were downloaded from the National Platform for Common Geospatial Information Services. The software ArcGIS 10.8 was used to map the distribution of newly diagnosed echinococcosis cases in Qinghai Province, and the spatial autocorrelation analysis of newly diagnosed echinococcosis cases was performed. In addition, the spacetime scan analyses of number of individuals screened for echinococcosis, number of newly diagnosed echinococcosis cases and geographical coordinates in Qinghai Province were performed with the software SaTScan 10.1.2, and the spatial stratified heterogeneity of the detection of newly diagnosed echinococcosis cases was investigated with the software GeoDetector. Results A total of 6 569 426 residents were screened for echinococcosis in Qinghai Province from 2016 to 2022, and 5 924 newly diagnosed echinococcosis cases were found. The detection of newly diagnosed echinococcosis cases appeared a tendency towards a decline over years from 2016 to 2022 (χ² = 11.107, P < 0.01), with the highest detection in Guoluo Tibetan Autonomous Prefecture in 2017 (82.12/10⁵). There were spatial clusters in the detection of newly diagnosed echinococcosis cases in Qinghai Province from 2016 to 2018 (Moran’s I = 0.34 to 0.65, all Z values > 1.96, all P values < 0.05), and the distribution of newly diagnosed echinococcosis cases appeared random distribution from 2019 to 2022 (Moran’s I = −0.09 to 0.04, all Z values < 1.96, all P values > 0.05). Local spatial autocorrelation analysis showed high-high clusters and low-low clusters in the detection of new diagnosed echinococcosis cases in Qinghai Province from 2016 to 2022, and space-time scan analysis showed that the first most likely cluster areas of newly diagnosed echinococcosis cases in Qinghai Province from 2016 to 2022 were mainly distributed in Yushu Tibetan Autonomous Prefecture and Guoluo Tibetan Autonomous Prefecture. GeoDetector-based analysis of the driving factors for the spatial stratified heterogeneity of detection of newly diagnosed echinococcosis cases in Qinghai Province showed that average altitude, number of village health centers, number of cattle and sheep stock, GDP per capita, annual average sunshine hours, and annual average temperature had a strong explanatory power for the spatial distribution of newly diagnosed echinococcosis cases, with q values of 0.630, 0.610, 0.600, 0.590, 0.588, 0.537 and 0.526, respectively. Conclusions The detection of newly diagnosed echinococcosis cases appeared a tendency towards a decline in Qinghai Province over years from 2016 to 2022, showing spatial clustering. Targeted control measures are required in cluster areas of newly diagnosed echinococcosis cases for further control of the disease.

Objective: Several COVID-19 patients have overlapping comorbidities. The independent role of each component contributing to the risk of COVID-19 is unknown, and how some non-cardiometabolic comorbidities affect the risk of COVID-19 remains unclear. Methods: A retrospective follow-up design was adopted. A total of 1,160 laboratory-confirmed patients were enrolled from nine provinces in China. Data on comorbidities were obtained from the patients' medical records. Multivariable logistic regression models were used to estimate the odds ratio ( Results: Overall, 158 (13.6%) patients were diagnosed with severe illness and 32 (2.7%) had unfavorable outcomes. Hypertension (2.87, 1.30-6.32), type 2 diabetes (T2DM) (3.57, 2.32-5.49), cardiovascular disease (CVD) (3.78, 1.81-7.89), fatty liver disease (7.53, 1.96-28.96), hyperlipidemia (2.15, 1.26-3.67), other lung diseases (6.00, 3.01-11.96), and electrolyte imbalance (10.40, 3.00-26.10) were independently linked to increased odds of being severely ill. T2DM (6.07, 2.89-12.75), CVD (8.47, 6.03-11.89), and electrolyte imbalance (19.44, 11.47-32.96) were also strong predictors of unfavorable outcomes. Women with comorbidities were more likely to have severe disease on admission (5.46, 3.25-9.19), while men with comorbidities were more likely to have unfavorable treatment outcomes (6.58, 1.46-29.64) within two weeks. Conclusion Besides hypertension, diabetes, and CVD, fatty liver disease, hyperlipidemia, other lung diseases, and electrolyte imbalance were independent risk factors for COVID-19 severity and poor treatment outcome. Women with comorbidities were more likely to have severe disease, while men with comorbidities were more likely to have unfavorable treatment outcomes.
Adult ; Aged ; COVID-19/virology* ; China/epidemiology* ; Comorbidity ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Severity of Illness Index ; Treatment Outcome