1.Epley maneuver associated with vertigo calming for treating posterior semicircular canal benign paroxysmal positional vertigo in young
Kai WANG ; Liangqun RONG ; Benliang ZHU ; Hu WANG ; Lijie XIAO
Clinical Medicine of China 2015;31(9):795-798
Objective To analyze the efficacy of epley maneuver associated with vertigo calming for treating posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV) in young.Methods Two hundred and fifty-eight cases(age was 18-50 years old) with PC-BPPV were randomly divided into maneuver group(86 cases),betahistine group(86 cases) and vertigo calming group(86 cases).The maneuver group was treated by epley maneuver associated with placebo,2 pills per time,3 times daily for one month and follow up one month.The betahistine group and vertigo calming group were treated by epley maneuver with betahistine(12 mg/ time,Tid) or vertigo calming(2 piles/time,Tid),the same dose,period of treatment and follow-up as maneuver group.Results After one time treatment,199 cases were cured in 258 patients,including 68 cases in maneuver group,66 cases in betahistine group,65 cases in vertigo calming group,and the difference between groups was not statistically significant(x2 =0.308,P>0.05).After treatments and followed up for one month,72 cases were cured,3 cases were effective,11 cases were invalid in maneuver group;74 cases were cured,3 cases were effective,9 cases were invalid in betahistine group;81 cases were cured,4 cases were effective,1 cases were invalid in vertigo calming group.Efficient of betahistine group,maneuver group and vertigo calming group were 89.5%,87.2% and 98.8%,and the difference between maneuver group and betahistine group was not statistically significant(x2=58.65,P>0.05),the difference of vertigo calming group between with other groups was statistically significant(P<0.05).Conclusion The effects of vertigo calming in addition to Epley maneuver is significantly better than both Epley maneuver and Epley maneuver combined with betahistine in young PC-BPPV,while the effects of Epley maneuver combined with betahistine isn't better than Epley maneuver.
2.Advances in anti-inflammatory and anti-tumor effects of the main components of Curcumae Rhizoma
Zhimei ZHAO ; Lijie ZHANG ; Tian XIA ; Zhi XIAO
Drug Evaluation Research 2017;40(1):119-124
Curcumae Rhizoma comes from Curcuma genus,functional breaking blood stasis,detumescence and acesodyne for treatment of Zhengjia accumulation,amenorrhea,traumatic injury and bruising pain.Modem pharmacological studies have shown that the main monomer composition of zedoary turmeric has a good anti-inflammatory and anti-tumor effects.The main monomer composition of zedoary turmeric copies of curcumol,beta etemene,curcumin anti-inflammatory anti-tumor mechanism of review,provide the basis for the further research progress and clinical application of zedoary turmeric.
3.Effect of vitamin D supplement on the outcome of acute ischemic stroke in young patients with vitamin D deficiency
Kai WANG ; Liangqun RONG ; Xiu'e WEI ; Zhonghai TAO ; Lijie XIAO ;
International Journal of Cerebrovascular Diseases 2017;25(6):506-510
ObjectiveTo investigate the effect of vitamin D supplementation on the outcome of acute ischemic stroke in young patients with vitamin D deficiency.MethodsThe prospective controlled study was used to select the consecutive young patients with acute ischemic stroke.Vitamin D deficiency was defined as 25-hydroxyvitamin D (25(OH)D) ≤50 nmol/L.The Patients with vitamin D deficiency were randomly divided into an intervention group and a routine treatment group according to the random number table method.Routine treatment group didn't receive the drug intervention for vitamin D deficiency, and the intervention group received daily oral alfacalcidol 0.5 μg.After 1 year of treatment, the 25(OH)D levels were examined again;the adverse reactions during the drug treatment were monitored;the modified Rankin Scale (mRS) was used to evaluate the functional outcome and 0-2 was defined as good outcome.ResultsThere are 94 patients (53.41%) with vitamin D deficiency among 176 young patients with acute ischemic stroke.They were randomly divided into either an intervention group or a routine treatment group (n=47 in each group).At the end of the follow-up, the good outcome rate (82.98% vs.63.83%;χ2=4.414, P=0.036) and serum 25(OH)D level (85.83±10.53 nmol/L vs.39.10±11.18 nmol/L;t=20.860, P<0.001) in the intervention group were significantly higher than those in the routine treatment group.During the follow-up period, there was no loss to follow-up or death events in both groups.Only 2 cases of nausea and 1 case of dizziness were observed, and the incidence of adverse reaction was 6.38% in the intervention group.ConclusionsVitamin D supplement can increase the vitamin D levels and improve functional outcome in young patients with acute ischemic stroke and vitamin D deficiency.
4.Comparison of expression and antibacterial activities of recombinant porcine lactoferrin expressed in four Lactobacillus species.
Hui YU ; Yanping JIANG ; Wen CUI ; Xiao WU ; Jia HE ; Xinyuan QIAO ; Yijing LI ; Lijie TANG
Chinese Journal of Biotechnology 2014;30(9):1372-1380
The coding sequence for the mature peptide of porcine lactoferrin (Plf) was synthesized according to the codon usage of lactobacillus, to establish optimized porcine lactoferrin Lactobacillus expression system. The gene was ligated into the Xho I/BamH I site of Lactobacillus expression vector pPG612.1 and the recombinant plasmid pPG612.1-plf was transformed individually into Lactobacillus casei ATCC393, Lactobacillus pentosus KLDS1.0413, Lactobacillus plantarum KLDS1.0344 or Lactobacillus paracasei KLDS1.0652 by electroporation. After induction with xylose, expression of the recombinant proteins was detected by Western blotting and confocal laser scanning microscopy. Secretion of recombinant Plf proteins from four recombinant species was determined quantitatively by ELISA. The antibacterial activities of recombinant proteins were measured by agar diffusion method. The result shows that Plf was correctly expressed in four species of recombinant lactobacillus, with molecular weight of about 73 kDa. The expression levels in recombinant Lactobacillus casei, Lactobacillus pentosus, Lactobacillus plantarum, Lactobacillus paracasei were 9.6 μg/mL, 10.8 μg/mL, 12.5 μg/mL and 9.9 μg/mL, respectively. Antimicrobial activity experiment shows that the recombinant proteins were active against E. coli, Staphylococcus aureus, Salmonella typhimurium, Listeria, Pasteurella. The recombinant Plf expressed by recombinant Lactobacillus plantarum showed the best antibacterial activity among all recombinant lactobacillus species. These data represent a basis for the development and application of porcine lactoferrin from recombinant lactobacillus.
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5.Effects of rhubarb and ephedra prescription on pulmonary function and blood pressure circadian rhythm in patients with acute exacerbation of chronic obstructive pulmonary disease
Lijie YU ; Fengdan LI ; Bingmao LI ; Hemei XIAO ; Xinfeng LEI ; Weihong HAN ; Xinxia HE ; Li TONG
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2017;24(4):380-384
Objective To investigate the effect of rhubarb and ephedra prescription on the pulmonary function and blood pressure circadian rhythm in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods One hundred and enghty six patients with AECOPD admitted to Department of Integrated Medicine of Harrison International Peace Hospital from December 2013 to Auguest 2016 were enrolled, and they were divided into a control group 90 cases and an experimental group 96 cases by random number talbe method. The patients in control group were treated with conventional therapy, while those in the experimental group were treated with the conventional therapy and additionally rhubarb and ephedra prescription (including rhubarb 6 g, ephedra 5 g, agrimony 15 g, licorice 15 g), taken orally 2 times a day, the therapeutic course in the two groups being 2 weeks. The diference of blood gas analysis, pulmonary function indexes, dyspnea score (mMRC) and ambulatory blood pressure monitoring were compared before and after treatment in the two groups.Results Compared with before treatment, the pH value, arterial partial pressure of oxygen (PaO2), forced vital capacity (FVC), one second forced expiratory volume (FEV1), FEV1/FVC of the two groups were significantly increased after treatment, while the arterial partial pressure of carbon dioxide (PaCO2) and mMRC score were significantly lowered, and the changes in the experimental group were more significant than those in the control group [pH: 7.40±0.04 vs. 7.37±0.03, PaO2 (mmHg, 1 mmHg = 0.133 kPa): 81.09±12.54 vs. 76.27±12.20, PaCO2 (mmHg): 48.01±8.27 vs. 51.91±8.37, FVC (L): 2.37±0.39 vs. 2.13±0.45, FEV1 (L): 2.08±0.38 vs. 1.87±0.41, FEV1/FVC: (69.01±12.04)% vs. (64.02±11.81)%, mMRC: 2.02±0.76 vs. 2.40±0.87, allP < 0.05 orP < 0.01]. Based on the percentage of blood pressure circadian value difference, the blood pressure circadian rhythm was divided into dipper type, non dipper type, super dipper type and anti dipper type, 24.2% patients were of dipper type and 75.8% patients were of non dipper, super dipper and anti dipper types. There was no significant difference in daytime systolic blood pressure (dSBP) between patients with super dipper and dipper types (P > 0.05),and the dSBP (mmHg) in patients with non dipper type was significantly higher than that in patients with dipper, super dipper and anti dipper types (131.55±5.08 vs. 117.78±4.47, 118.26±4.24, 113.37±3.97, allP < 0.05); the daytime diastolic blood pressure [dDBP (mmHg)] of anti dipper, non dipper type, dipper type, super dipper type increased in turn (respectively, 63.27±2.80, 70.24±3.82, 73.98±2.61, 82.96±4.52, allP < 0.05); the night SBP (nSBP) of anti dipper type was the highest (127.38±4.98) mmHg, and the nSBP of super dipper type was the lowest (89.07±3.81) mmHg; the night DBP (nDBP) of dipper type was lower than that of non dipper, anti dipper and super dipper types (mmHg: 63.57±1.37 vs. 68.86±2.12, 67.15±1.56, 67.89±2.04, allP < 0.05). After treatment, the proportion of patients with dipper type [66.7% (64/96) vs. 54.4% (49/90)], no dipper type [11.5% (11/96) vs. 8.9% (8/90)], and super dipper type [5.2% (5/96) vs. 2.2% (2/90)] in experimental group was significantly higher than that in the control group, the proportion of patients with anti dipper type [16.7% (16/96) vs. 34.4% (31/90)] in experimental group were significantly lower than those in the control group (allP< 0.05).Conclusion The Rhubarb and ephedra prescription can obviously improve the blood gas analysis indexes, pulmonary function and blood pressure rhythm in patients with AECOPD.
6.Predictive factors of outcome in young patients with mild acute ischemic stroke treated with intravenous thrombolysis
Kai WANG ; Liangqun RONG ; Xiu'e WEI ; Benliang ZHU ; Hu WANG ; Lijie XIAO ;
International Journal of Cerebrovascular Diseases 2015;(8):584-587
Objective To investigate the predictive factors of outcome in young patients with mild acute ischemic stroke treated with intravenous thrombolysis. Methods Consecutive young patients with mild acute ischemic stroke ( age 18- 45 years ) treated with intravenous thrombolysis were enrol ed retrospectively. According to the modified Rankin Scale (mRS) score at day 90 after onset, they were divided into either a poor outcome group ( mRS ≥2 ) or a good outcome group ( mRS 0- 1 ). The demographic and baseline clinical characteristics were compared. Multivariate logistic regression analysis was used to identify the independent predictive factors of poor outcome in young patients with mild acute ischemic stroke treated with intravenous thrombolysis. Results A total of 57 young patients with acute mild ischemic stroke treated with intravenous thrombolysis were enrol ed, including 41 patients (71. 93%) had good outcome and 16 (28. 07%) had poor outcome. There were significant differences in the proportion of the patients with previous stroke or transient ischemic attack (TIA) (25. 00% vs. 4. 88%; P=0. 046), smoking (56. 25% vs. 19. 51%; P=0. 010 ), atrial fibril ation (31. 25% vs. 7. 32%; P=0. 032 ), diabetes (62. 50% vs. 21. 95%;χ2 =8. 515, P=0. 004), large artery atherosclerotic stroke (68. 75% vs. 21. 95%;χ2 =11. 067, P=0. 001 ), and receiving antiplatelet therapy before symptom onset (6. 25% vs. 34. 15%;P=0. 044) and the age (Z=2. 396, P=0. 020) between the poor outcome group and the good outcome group. Multivariate logistic regression analysis showed that the age (odds ratio [OR] 2. 64, 95% confidence interval [CI] 1. 28-5. 36;P=0. 038), history of previous stroke or TIA (OR 2. 25, 95% CI 1. 22-4. 31;P=0. 042), atrial fibril ation (OR 5. 12, 95% CI 1. 58-19. 23; P=0. 032), and large artery atherosclerotic stroke (OR 5. 89, 95% CI 1. 78-19. 92; P=0. 002) were the independent risk factors for poor outcome after mild acute ischemic stroke thrombolytic therapy. Conclusions Age, history of stroke or TIA, atrial fibril ation, and large artery atherosclerotic stroke were the predictive factors of poor outcome at day 90 in young patients with mild acute ischemic stroke treated with intravenous thrombolysis.
7.Association of synovial cyclic citrullinated peptide expression with Th17/Treg imbalance and synovitis in rheumatoid arthritis patients
Hongbin LI ; Ning TIE ; Yongfeng JIA ; Lin SHI ; Yan SU ; Guizhi ZHANG ; Yong WANG ; Lijie BAI ; Jing ZHAO ; Jing WANG ; Zen XIAO
Chinese Journal of Rheumatology 2012;16(4):224-228,封3
Objective To assess the association of synovial cyclic citrullinated peptide(CCP)expression with T helper 17(Th17) cells/Regulatory T cells (Treg) imbalance,the histological and clinical features of synovitis in rheumatoid arthritis (RA).Methods CCP expression in synovial specimens from 39 patients with RA and 35 controls was detected by immunohistochemistry assay(IH) using 6×His tagged anti-CCP single chain fragment V (ScFv) antibodies,which were generated by pHEN2 phagemid recombinant antibodies display system.The frequencies of Th17/Treg cells in the peripheral blood mononuclear cells (PBMCs) were determined by flow cytometry (FCM).Th17/Treg cells associated cytokines were analyzed by enzyme-linked immunosorbent assay (ELISA).The histological scores and clinical features of synovitis were included in the study.Chi-square test and ANOVA were used for statistical analysis.Results ① The prevalences of synovial C CP expression were significantly different between RA group and the control(76.9% and 11.4% respectively,X2=31.9,P<0.01).② The frequencies of Th17 cells,Th17/Treg ratio,Th17 cells associated cytokines as IL-6,IL-17a,IL-23,TNF-α,and the Treg cells associated cytokines TGF-31,the serum and synovial fluid anti-CCP antibodies in the RA patients with synovial CCP positive expression were significantly higher in RA patients with CCP positive than those with CCP negative.Disease activity score DAS28 index and histological features quantified variations of the synovial biopsy specimens (synoviocyte hyperplasia,focal aggregates of lymphocytes,and diffuse infiltrat(e)s of lymphocytes) in RA were higher in synovial CCP positive expression patients than in the negative.Conclusion Synovial CCP expression is strongly associated with the Th17/Treg imbalance and synovitis,which may play a crucial role in the pathogenesis of RA.
8.Stroke-associated pneumonia in young patients with acute ischemic stroke: the microbiological data, risk factors, and effect on outcomes
Kai WANG ; Xiu'e WEI ; Liangqun RONG ; Zhonghai TAO ; Lijie XIAO
International Journal of Cerebrovascular Diseases 2017;25(12):1066-1072
Objective To investigate the microbiology,risk factors,and impact on outcomes of stroke-associated pneumonia (SAP) in young patients with acute ischemic stroke.Methods Young patients with acute ischemic stroke were enrolled prospectively.Their microbiological data and risk factors for SAP were identified.The outcomes at 90 d after onset were evaluated with the modified Rankin Scale (mRS) scores,and mRS > 2 was defined as poor outcome.The demography and baseline clinical characteristics were compared.Multivariate logistic regression analysis was used to identify the effect of SAP on the outcomes.Results A total of 418 young patients with ischemic stroke were enrolled,including 108 (25.84%) in the SAP group and 310 (74.16%) in the non-SAP group;16 were lost to follow-up,146 (36.32%) were in the poor outcome group and 256 (63.68%) were in the good outcome group.The results of pathogen test showed that the positive rate was 52.78% and 19.30% was mixed infection.The main pathogens were community-acquired pathogens (such as Staphylococcus aureus,Streptococcus pneumoniae and Klebsiella pneumoniae),followed by multidrug-resistant nosocomial pathogens (such as Pseudomonas aeruginosa,Acinetobacter Baumanii,and methicillin-resistant Staphylococcus aureus).Multivariate logistic regression analysis showed that smoking (odds ratio [OR] 4.328,95% confidence interval [CI]2.847-6.442;P =0.014),chronic obstructive pulmonary disease (OR 3.927,95% CI 2.419-5.253;P=0.017),dysphagia (OR 6.782,95% CI 4.378-9.553;P=0.003),tracheal intubation or mechanical ventilation (OR 7.632,95% CI 5.394-12.376;P=0.001),procalcitonin (OR 2.980,95% CI 2.234-4.118;P =0.027),antibiotics (OR 6.321,95% CI 4.362-8.376;P =0.007) were the independent risk factors for SAP,and age < 35 years old was an independent protective factor of SAP (OR 0.582,95% CI 0.329-0.719;P =0.028);history of previous stroke or transient ischemic attack (OR 3.854,95% CI 2.645-5.023;P=0.014),tracheal intubation and mechanical ventilation (OR 3.501,95% CI 2.329-4.614;P =0.016),large artery atherosclerosis (OR 5.274,95% CI 3.342-7.246;P =0.006),baseline National Institutes of Health Stroke Scale score (OR 2.248,95% CI 1.482-2.821;P=0.031),onset to admission time (OR 1.245,95% CI 1.184-1.698;P=0.048),SAP (OR 3.347,95% CI 2.275-4.338;P =0.018) were the independent risk factors for poor outcomes,and age <35 years old (OR 0.340,95% CI 0.147-0.420;P =0.042) and thrombolytic therapy (OR 0.582,95% CI 0.329-0.719;P =0.028) were the independent protective factors of good outcomes.Conclusion SAP was more common in young patients with acute ischemic stroke,and had its own characteristics in microbiological data and risk factors.SAP was closely associated with poor outcomes.
9.Correlation between cerebral microbleeds and early neurological deterioration in patients with acute ischemic stroke
Kai WANG ; Liangqun RONG ; Xiu'e WEI ; Zhonghai TAO ; Lijie XIAO
International Journal of Cerebrovascular Diseases 2018;26(6):428-433
Objective To investigate the correlation between cerebral microbleeds (CMBs) and early neurological deterioration (END) in patients with acute ischemic stroke. Methods Consecutive patients with acute ischemic stroke were enrolled prospectively. The clinical data, imaging data, and laboratory data were collected. END was defined as the National Institutes of Health Stroke Scale (NIHSS) score increased ≥2 within 7 d compared with the baseline. Susceptibility-weighted imaging was used to detecte CMBs. Multivariate logistic regression analysis was used to identify the independent correlation between CMBs and END. Results A total of 246 patients with acute acute ischemic stroke were enrolled. The incidence of END was 38. 21% (94/246), 72. 34% (68/94) occurred within 72 h and 21. 28% (20/94) occurred from 72 h to 7 d. The detection rate of CMBs in the END group was 72. 34% (68/94) and that of CMBs in the non-END group was 43. 42% (66/152). There was significant difference between the two groups (χ2 = 19. 587, P < 0. 001). Multivariate logistic regression analysis showed that previous stroke or transient ischemic attack (odds ratio [ OR ] 1. 883, 95% confidence interval [ CI ] 1. 284- 2. 277; P = 0. 033 ), large artery atherosclerosis (OR 4. 119, 95% CI 2. 564-5. 771; P = 0. 003), baseline NIHSS score (OR 1. 682, 95% CI 1. 320-1. 876; P = 0. 042), severe stroke (OR 4. 228, 95% CI 2. 634-5. 917; P = 0. 003), onset to admission time (OR 2. 070, 95% CI 1. 454-2. 582; P = 0. 029), and number of CMB ≥10 (OR 2. 728, 95% CI 1. 834- 3. 217; P = 0. 016) were the independent risk factors for END. Conclusions END is common in patients with acute ischemic stroke, most of them occurred within 72 h. It is closely associated with the number of CMB, but it is not associated with the location of CMB lesions.
10.Investigation on pathogenesis and influencing factors of poor outcome in patients with wake-up stroke
Kai WANG ; Xiue WEI ; Liangqun RONG ; Zhonghai TAO ; Lijie XIAO
Chinese Journal of Neurology 2019;52(4):273-280
Objective To explore pathogenesis and influencing factors of poor outcome in patients with wake-up stroke.Methods In this prospective study,patients with acute ischemic stroke who were hospitalized in the Department of Neurology of the Second Affiliated Hospital of Xuzhou Medical University from October 2016 to December 2017 were continuously collected.All patients were divided into wake-up stroke group and non-wake-up stroke group according to the onset time.The clinical data of demographics,vascular risk factors,imaging examination,laboratory examination of the two groups were collected to identify the pathogenesis of wake-up stroke.Followed up to six months of onset,the patients were divided into poor outcome (modified Rankin Scale (mRS) score >2) and good outcome (mRS score 0-2) subgroups according to mRS score.Multivariate Logistic regression analysis was used to determine the influencing factors of poor outcome in patients with wake-up stroke.Results A total of 178 patients with acute ischemic stroke were enrolled in the study,including 42 patients (23.60%) in the wake-up stroke group and 136 patients (76.40%) in the non-wake-up stroke group.Followed up to six months of onset,11 patients lost,and 167 patients were followed up finally.There were 40 patients (23.95%) in the wake-up stroke group,including 17 patients (42.50%) with poor outcome and 23 patients (57.50%) with good outcome.There were 127 patients (45.64%) in the non-wake-up stroke group,including 32 patients (25.20%) with poor outcome and 95 patients (74.80%) with good outcome.The difference of poor outcome between the two groups was statistically significant (x2=4.393,P=0.036).Comparison of the demographic and baseline data of the wake-up stroke group and the non-wake-up stroke group showed that the differences between variables such as atrial fibrillation and double-dose hypertension were statistically significant.Univariate analysis showed that there were statistically significant differences in vascular risk factors,Trial of Org 10172 in Acute Stroke Treatment etiology,stroke severity,number of stroke lesions,treatment patterns,and number of cerebral microbleeds between the poor and good outcome subgroups.Multivariate Logistic regression analysis showed that the moderate to severe stroke (odds ratio (OR)=3.838,95% confidence interval (Co 2.162-5.890,P=0.018),the number of lesions in cerebral microbleeds (OR=2.113,95%CI 1.291-2.868,P=0.049) were independent risk factors for poor outcome of wake-up stroke.Intravenous thrombolysis (OR=0.427,95%CI 0.242-0.615,P=0.036) was an independent protective factor for poor outcome of wake-up stroke.Conclusions The onset of wake-up stroke is closely related to atrial fibrillation and reverse scoop hypertension with higher incidence of poor outcome.Early adequate imaging screening and stroke severity assessment have important reference to guide clinical treatment and predict outcome.