1.Correlative study of the relationship between hemorrhagic transformation and premorbid antithrombotic therapy after acute cerebral infarction
Yanchao CHEN ; Chunyan LEI ; Ming LIU
Chinese Journal of Cerebrovascular Diseases 2015;(4):174-179
Objective To investigate the impact of using antithrombotic drugs (anticoagulants or antiplatelet aggregation drugs)before the onset of cerebral infarction on hemorrhagic transformation after acute cerebral infarction. Methods The consecutive patients with acute cerebral infarction from Chengdu Stroke Registry Project admitted to the Department of Neurology,West China Hospital,Sichuan University from January 1,2004 to January 1,2014 were enrolled. The baseline data on admission,previous usage of anticoagulants and anti-platelet aggregation drugs,as well as CT/ MRI and other imaging data of all patients were collected. According to the results of CT/ MRI reexamined at 72 h after admission,the patients with hemorrhagic transformation were enrolled into a hemorrhagic transformation group;the patients with non-hemorrhagic transformation were enrolled into a non-hemorrhagic transformation group according to the ratio
of 1 ∶ 1. Their gender and age were matched with the hemorrhagic transformation group. The baseline data and drug used of the patients in both groups were compared. The differences of risk factors between the two groups were analyzed with multivariate Logistic regression analysis. The relationship between hemorrhagic transformation and premorbid use of antithrombotic drugs were observed. Results A total of 6 916 patients with acute cerebral infarction were enrolled,including 433 (6. 3%)hemorrhagic transformation (hemorrhagic transformation group)and 433 non-hemorrhagic transformation. (1)There were significant differences between the patients of the two groups on admission in the National Institutes of Health Stroke Scale (NIHSS)score,atrial fibrillation,previous cerebral infarction,and blood glucose levels on admission (all P < 0. 05). (2)The proportions of using anticoagulants and antiplatelet aggregation agents in the hemorrhagic transformation group were higher than those of the non-hemorrhagic transformation group (anticoagulants:14. 1% [n = 61]vs. 3. 9% [n = 17];P < 0. 01,OR,4. 01,95% CI 2. 303 -6. 993;anti-platelet aggregation drugs:14. 3% [n =62]vs. 8. 3% [n = 36];P = 0. 005,OR,1. 84,95% CI 1. 194 -2. 846). (3)The results of multivariate Logistic regression analysis showed that the use of anticoagu-lants,anti-platelet aggregation drugs,NIHSS score on admission,and random blood glucose on admission were the independent risk factors for hemorrhagic transformation (OR [95% CI]3. 302 [1. 860 -5. 862], 2. 081 [1. 281 -3. 382],1. 047 [1. 026 -1. 069],and 1. 055 [1. 011 -1. 100],respectively (all P <0. 05). Conclusion The NIHSS score and blood glucose levels on admission are the independent risk factors of hemorrhagic transformation. Using anticoagulants or anti-platelet aggregation drugs before symptom onset is independently associated with hemorrhagic transformation,however,its relationship with the long-term prognosis of acute cerebral infarction need to be further studied.
2.Otinulation of osteolytic cytokine expression by micrometer-diameter wear particles
Ming CHEN ; Qirong DONG ; Yu LEI
Basic & Clinical Medicine 2006;0(04):-
Objective To evaluate the impact osteolytic cytokines of expression induced by micrometer-diameter wear particles(Ti-6Al-4V and UHMWPE).Methods Filtration air was subcutaneously injected into rats'back 6 times(3 mL q?d).After a week,wear particles suspension(group A: Ti-6Al-4V,group B: UHMWPE) or physiological saline(group C) was injected into air pouch tissues.After 14 days,pouch tissues were obtained from killed rats,and were weighted,wax embedded and stained with hematoxylin and eosin, observed under microscope.AKP of serium with Automated Biochemical Analyzer,IL-6 and TNF-? expression with immunohistochemical method,and mRNA expression of extracellular matrix metalloproteinase inducer(EMMPRIN) with real-time Polymerase Chain Reaction method were detected.Results Air pouch tissues were similar to limiting membrane of periprothesis tissue in the cases of aseptic loosening.As to pouch tissue weight,there was a significant increase in group B than in group C(P
3.Preventing the recurrence of condyloma acuminatum with different treatment courses of imiquimod cream
Dong-Yan HU ; Lei CHEN ; Ming LI ;
Chinese Journal of Dermatology 1994;0(05):-
Objective To evaluate the efficacy and safety of imiquimod 5% cream applied with different treatment courses for preventing the recurrence of condyloma acuminatum lesions.Methods A randomized,controlled clinical trial was conducted.Patients with condyloma acuminatum were divided into 3 groups (Group A,B and C).Group A was treated with CO2 laser only.Group B was given topical im- iquimod 5% cream three times a week over 4 weeks after laser treatment of visible warts.Group C was giv- en topical imiquimod 5% cream three times a week over 8 weeks after laser treatment of visible warts.All patients were followed up for 6 months.Results A total of 90 patients with anogenital warts were enrolled in,and finished the study.The recurrence rates of the Group A,B,and C were 64.29%,50%,21.88%,re- spectively,in 6 months of follow-up.The recurrence rate was statistically lower in Group C than in Group A and B (P=0.0033),and in Group C than in Group B (P=0.0457).Adverse reactions occurred in 73.33% and 84.38% of patients in Group B and C,respectively,which included erythema,itching,pain, burning,erosion,ulceration and flu-like symptoms.There was no significant difference of the frequencies of adverse reactions between Group B and C (P>0.05).Conclusion The recurrence rate of anogenital warts declines significantly in patients treated with imiquimod 5% cream for 8 weeks,but not in the 4 weeks group,after laser therapy.The frequencies of adverse reactions are not significantly different in both groups.
5.Three scales in predicting prognosis of patients with heat stroke
Bozhi LI ; Huaiqiang HU ; Ming CHEN ; Lei ZHANG ; Bingzhen CAO
Journal of Medical Postgraduates 2016;29(5):518-521
Objective The scale lists applied in the diagnosis and treatment of heat stroke generally draw on other specialty scales, and there is no specific scoring system on heat stroke verified by large-scale clinical trials.The paper compared common acute physiology and chronic health evaluationⅡ( APACHEⅡ) , dissolved inorganic carbon score( DIC score) , multiple organ dysfunction score( MOD score) for the prognostic evaluation of heat stroke patients, the sum of three scores and the sum of the percentages of three scores to the score sum on prognostic evaluation of heat stroke patients in order to find a scoring method with higher clinical value. Methods APACHEⅡ, MOD score, DIC score, the sum of three scores and the sum of three scores were applied on 43 patients with heat stroke admitted in our neurological intensive care unit ( NICU) or in intensive care unit ( ICU) .The analysis of the area under the receiver operating characteristic ( ROC) curve( AUC) analysis was made among five scores. Results The weighted sum of three scores has the largest AUC ( 0.896 ) in predicting the death of HS patients according to AUC.The optimal MOD score was 5.5 in predicting the death of HS with a sensitivity of 72.7%and a specifici-ty of 99.69%.The optimal DIC score was 1.5 in predicting the death of HS with a sensitivity of 100%and a specificity of 56.2%.The op-timal score of the sum of the percentages of three scores to the score sum was 0.727 in predicting the death of HS with a sensitivity of 72.7%and a specificity of 100%. Conclusion All the five scores can predict the prognosis of patients with heat stroke.However, due to the deficiency in the prognosis value, a more specific scoring system needs to be developed.
6.Comparison of the clinical efficacy between two kinds of ceramic veneer restoration
Run CHEN ; Lei JIANG ; Hao YU ; Ming ZHENG ; Hui CHENG
Journal of Practical Stomatology 2016;32(4):542-546
Objective:To evaluate the clinical efficacy between preparation porcelain veneer(PPV)and no-preparation porcelain veneer(NPPV).Methods:44 patients with 97 PPVs and 23 patients with 57 NPPVs were followed up for 3 years.Mental tension, postoperative dentin sensitivity and satisfaction of the patients,survival rate of the veneers,sulcus bleeding index(SBI)of preopera-tive and postoperative 3 years were evaluated.A comparative analysis was taken to examine the clinical indicators of 2 groups accord-ing to the modified CDA /Ryge criteria.Results:Survival rates of PPVs and NPPVs were 96.91 % and 96.49%(P >0.05),satisfac-tion rates of the 2 group patients were 95.45% and 95.65%(P >0.05),respectively.Mental tension and the postoperative dentin sensitivity of patients in PPV group was higher than those in NPPV group.Preoperative and postoperative SBI were not statistically dif-ferent between the 2 groups(P >0.05).Marginal adaptation in PPV group was better than that in NPPV group.Color matching, Porcelain surface and Marginal stain were not statistically different between 2 groups.Conclusion:Preparation porcelain veneers and no-preparation porcelain veneers both are effective in clinical application.
7.Anti - inflammatory Effect of Qianlie Tai Granule on Chronic Prostatitis
Rong SUN ; Ming CHEN ; Lili LEI ; Ping WANG ; Xilin ZHANG
Traditional Chinese Drug Research & Clinical Pharmacology 1993;0(02):-
Objective To observed the and - inflammatory effect of Qianlie Tai Granule (QTG) on chronic prostatitis. Methods Three models, asepsis and chronic aseptic prostatitis rat model, acute inflammation mouse model and chronic inflammation rat model, were adopted to observe the pharmacocynamic action of QTG. Results QTG decreased the number of WBC, inhibited the increasing of prostate tissue weight and improve the inflammatory lesion in prostate tissue of chronic aseptic inflammation rats. QTG also had an obvious inhibitory effect on early exudative auricular swelling induced by 2% compound croton oil and late proliferative granuloma induced by 2% agar. Conclusion QTG has an obvious effect for prostatitis. It can inhibit the early and late inflammation .
8.Analysis on 56 Cases of Ketamine-associated Urinary System Dysfunction
Lei CHEN ; Chaoxiong ZHANG ; Qiangli GAO ; Ming ZHOU
China Pharmacist 2014;(5):831-833
Objective:To explore the diagnosis and treatment of ketamine-associated urinary system dysfunction. Methods:Total-ly 56 cases of urinary tract symptoms with the history of ketamine abuse in recent years were retrospectively analyzed. The routine ex-amination and the examination related to the urinary system were given, and individual treatment was undertaken according to different situation. Results: The main symptom of ketamine-asscociated urinary tract dysfunction was lower urinary tract symptom (LUTS). Bladder pathologic biopsy showed different degree of inflammatory change. Imaging examination showed various degree of pathological changes, including reduced bladder capacity, thickened bladder wall, bladder contracture, ureteral stricture and hydronephrosis. Three patients had increased serum creatinine level. Conclusion: Ketamine-asscociated urinary system dysfunction is a disease with LUTS as the main clinical symptom. At the early stage, the disease is reversible with promising treatment outcome. In the progression of the disease, some patients develop irreversible histological changes in the urinary tract, which should be brought to the forefront.
9.Influencing factors analysis of hemorrhagic transformation in non-thrombolysis patients after acute cerebral infarction
Ge TAN ; Ming LIU ; Chunyan LEI ; Yanchao CHEN ; Zilong HAO
Chinese Journal of Cerebrovascular Diseases 2015;(8):409-414
Objective To investigate the influencing factors of hemorrhagic transformation in non-thrombolysis patients after acute cerebral infarction. Methods According to Chengdu Stroke Registry Project,2598 consecutive patients with acute cerebral infarction admitted to the Department of Neurology,West China Hospital within 1 week of attack from January 2010 to December 2013 were enrolled prospectively. The patients were divided into a hemorrhagic transformation group and a non-hemorrhagic transformation group according to whether they had hemorrhagic transformation or not. As for patients with hemorrhagic transformation,they were divided into a symptomatic hemorrhagic transformation (SHT)group and an asymptomatic hemorrhagic transformation (ASHT)group according to whether they had aggravation of symptom and sign. The baseline data of all patients were collected and compared between the groups. The P<0. 1 variables of the univariate analysis result were enrolled in multivariate logistic regression analysis in order to identify the independent influencing factor of hemorrhagic transformation. Results In 2598 patients,249 (9. 6%)had hemorrhagic transformation,28 of them (1. 1%)were SHT and 221 (8. 5%)were ASHT. There were significant differences in male,hypertension,dyslipidemia,atrial fibrillation,drinking and smoking ratio,blood glucose,cholesterol,low density lipoprotein cholesterol, National Institutes of Health Stroke Scale (NHISS)scores,and the trial of Org 1072 in acute stroke treatment (TOAST)classification between the HT group and the non-HT group (all P<0. 05). There were no significant difference in the related influencing factors between the SHT group and the ASHT group (all P>0. 05). The results of multivariate logistic regression analysis showed that dyslipidemia (OR,0. 588, 95%CI 0. 374-0. 924,P=0. 021)was negatively correlated with hemorrhagic transformation. Atrial fibrillation (OR,3. 188,95%CI 2. 159-4. 707,P<0. 001),blood glucose (OR,1. 081,95%CI 1. 044-1. 119,P<0.001),and NHISS score (OR,1. 305,95%CI 1. 170-1. 455,P<0. 001)were positively correlated with hemorrhagic transformation. In TOAST classification,relative to the large atherosclerotic stroke,the small artery occlusive cerebral infarction was negatively correlated with hemorrhagic transformation (OR,0. 315, 95%CI 0. 167-0. 596,P<0. 001). After removing the influencing factor of atrial fibrillation,compared with the large artery atherosclerotic stroke,cardioembolism stroke was positively correlated with hemorrhagic transformation (OR,2. 823,95%CI 1. 946-4. 095,P<0. 001). Conclusion Dyslipidemia,atrial fibrillation,blood glucose,NHISS score and TOAST classification were independently associated with hemorrhagic transformation in non-thrombolysis patients after acute cerebral infarction.
10.Abnormality and significance of monocyte subsets in peripheral blood of patients with rheumatoid arthritis
Lei QIAN ; Xin LIN ; Wei CHEN ; Ming LI ; Yuehong YU
Chinese Journal of Immunology 2016;32(10):1519-1523,1531
Objective:To explore the role of peripheral blood monocyte subsets in the pathogenesis of rheumatoid arthritis (RA),we therefore decided to compare the percentage of monocyte subpopulations in peripheral blood,as well as cytokines secretion function,to that of healthy controls. Methods:22 patients with RA and 22 cases of healthy controls ( HC) were drew 3 ml fresh venous blood into a tube containing heparin. The percentage of monocyte subsets,expression of Toll-like receptor(TLR)2,HLA-DR,triggering receptor expressed on myeloid cells-1(TREM-1) on intermediate monocyte and mean fluorescence intensity(MFI) of intracellular tumor necrosis factor-α ( TNF-α) were evaluated with the methods of flow cytometry ( FCM ) . The correlation between percentage of monocyte subsets and serum cytokines was explored. Statistical significance between parametric data was determined by the students't-test. Results:Compared to HC controls, the percentages of intermediate monocytes were significant higher in RA patients [ ( 11. 7 ± 1. 6)% vs (4. 6±1. 2)%,P<0. 05],as well as the expression(MFI) of TLR2 (750. 2±110. 3 vs 526. 8±98. 6) and TREM-1 (58. 4± 12. 1 vs 40. 3±10. 2) on intermediate monocytes (P<0. 05). The expression of HLA-DR on intermediate monocytes of RA patients had no difference with HC controls (P>0. 05),while MFI of intracellular TNF-αin intermediate monocytes of RA patients were significant higher than that of HC controls (46. 3±6. 4 vs 36. 7±8. 3,P<0. 05). In addition,RA patients showed a positive correlation between the percentage of CD14highCD16+ monocytes and DAS28 scores(r=0. 538,P=0. 009),as well as the serum levels of TNF-α,IL-17 ( r=0. 471,P=0. 027;r=0. 593,P=0. 003). Conclusion:Monocyte subpopulations from RA patients are abnormally skewed toward to in-termediate monocytes which has high expression of TLR2 , TREM-1 and the function of TNF-α secretion. Therefore, intermediate monocytes may play a role in the pathophysiology of RA. By modulating polarization or blocking monocyte cell surface receptors could be a new treatment of RA.