It was believed that there were only two patterns of cell death named after necrosis and apoptosis in the past.With the progress of research,scholars have found that there also existed other cell death patterns.However,the mechanisms and relationships between cell death patterns are still unclear,especially in the neuronal cell death.This review focuses on the cell death patterns and their relationships during ischemic stroke,in order to provide the theoretical basis and new ideas for the further study of neuronal cell death,and for the treatment of ischemic stroke.

Objective To evaluate the predictive values of ABCD,ABCD2 ,SPI-Ⅱ and ESSEN score models for the patients with high-risk transient ischemic attack (TIA)to develop to cerebral infarction in short and long term. Methods The ABCD, ABCD2 , SPI-Ⅱ and ESSEN scores of 235 cases of TIA patients were retrospectively analyzed.The incidence of cerebral infarction was followed up for 7 d and 1 year, and the receiver operating characteristic curve (ROC)was drawn to calculate the area under curve (AUC)to assess the accuracy of the score models,and compared with the original model and the relative risk (RR)value was calculated.Results The 7 d-incidence and 1 year-incidence of cerebral infarction in the 235 TIA patients were 9.36 % and 20.43%.The AUC of ABCD,ABCD2 ,SPI-Ⅱ and ESSEN models for 7 d were 0.70,0.74,0.67,and 0.62.The AUC of 1 year were 0.62,0.62,0.64,and 0.65.Compared with the orginal models,the RRs for 7 d of ABCD score model of the TIA patients in low,middle,and high risk groups were 0.09,0.92,and 0.72;the RRs of ABCD2 score model were 0.49,0.59,and 0.65;the RRs of SPI-Ⅱ score model were 0.58,0.87,and 0.55;the RRs of ESSEN score model were 0.11,0.18,and 0.55.Conclusion ABCD,ABCD2 ,SPI-Ⅱ and ESSEN score models can be used to assess the risk of cerebral infarction after TIA in Chinese population.The ABCD2 score model is of great value for short-term risk prediction,and the ESSEN score model is more value for long-term risk prediction.

Objective Study of Shuxuening combined with sodium phosphocreatine on acute severe carbon monoxide poisoning with ischemia modified albumin level and its curative effect in patients. Methods 66 cases of ASCOP patients were randomly divided into routine group and treatment group, all patients were detected for myocardial enzymes, cTnI, IMA before treatment, after treatment 6 h and 3 d. Results IMA was significantly decreased before treatment, while no significant changes occurred in myocardial enzymes and cTnIn levels. After treatment for 6 h, IMA in treatment group was higher than conventional group (P < 0.05). Myocardial enzymes and cTnI gradually increased, the two groups had no difference (P>0.05). After treatment for 3d, cTnI level of normal group increased obviously compare with the treatment group (P>0.05). Myocardial enzymes, IMA restored to the normal level (P>0.05). The level of cTnI after treatment for 3 d improved compare with 6 h. Conclusion Treatment of early ASCOP patients by Shuxuening combined with sodium phosphocreatine significantly improve the recovery of myocardial injury poisoning. The level of IMA can be used as evaluation index of myocardial ischemia and drug treatment.

OBJECTIVETo explore HEPACAM mutations in a Chinese family with megalencephalic leukoencephaloptathy with subcortical cysts (MLC).

METHODGenomic DNA samples were extracted from peripheral blood of the proband and her parents. All exons and exon-intron boundaries of HEPACAM and MLC1 were amplified in the MLC family by polymerase chain reaction (PCR) followed by direct DNA sequencing.

RESULTTwo heterozygous mutations of HEPACAM located in exon 2, c.203A > T(p.K68M) and c.395C > A(p.T132N), were identified in the proband. The proband's mother had the heterozygous mutations c.203A > T(p.K68M), and her father had the heterozygous mutation-c.395C > A(p.T132N). There was no variation found in MLC1 gene.

CONCLUSIONThe proband was heterozygous compound MLC patient carrying on one allele with the c.203A > T(p.K68M) mutation inherited from her mother, and the other allele with the c.395C > A(p.T132N) mutation inherited from her father. The parents both are heterozygous carriers with normal phenotype. The disease-causing gene for this family was resulted in HEPACAM mutation other than MLC1 mutation.

Asian Continental Ancestry Group ; genetics ; Base Sequence ; Child ; Cysts ; genetics ; pathology ; DNA Mutational Analysis ; Exons ; Female ; Genotype ; Hereditary Central Nervous System Demyelinating Diseases ; genetics ; pathology ; Heterozygote ; Humans ; Membrane Proteins ; genetics ; Mutation ; Pedigree ; Phenotype ; Proteins ; genetics

The paper dilates upon purpose and meaning of the building of multipath remote consultation platform based on medical alliance,introduces its building scheme,which includes implementation method,technology roadmap and technology feasibility analysis,compares the domestic and overseas situations in the area and discusses its future.

Objective:To investigate the related risk factors for biliary anastomotic stenosis after liver transplantation (LT) from donation after cardiac death(DCD) and therapeutic strategies.Methods:The data of 192 patients who received LT from DCD in First Hospital of Kunming from Jan 2010 to Jun 2018 were retrospectively analyzed. A total of 145 patients were enrolled, 85 males and 60 females, with average age 45 years. There was a biliary anastomotic stenosis in 8 cases and no stenosis in 137 cases. Their Chinese criterion for biliary anatomic stenosis, age, body mass index, liver fat, cold/warm ischemia time, unschedule cardiac arrest time, usage of vasopressors, high sodium in the donor were compared, and stenosis related factors were analysed by Spearman correlation analysis.Results:The stenosis was positively correlated with age ( r=0.229), body mass index ( r=0.204), lipoidosis ( r=0.239), duration of hot ischemia ( r=0.214), total duration of unplanned cardiac arrest ( r=0.401), use of booster drugs ( r=0.237), and preoperative donor hypernatremia ( r=0.557) (all P<0.05). Endoscopic biliary stent implantation is effective in the treatment of biliary anastomotic stenosis and has a high success rate. Conclusions:There are many factors related to biliary anastomotic stenosis after DCD liver transplantation, but the better donor maintenance, shorten cold/ warm ischemia time, improved anastomosis will be helpful to reduce biliary complications.As the same time, endoscopic biliary stent placement is the preferred way to treat biliary anastomotic stenosis.

OBJECTIVE: To investigate the effects of propofol combined with hypoxia on cognitive function of immature rats and the possible role of p38 pathway and tau protein in mediating such effects. METHODS: Ninety 7-day-old (P7) SD rats were randomized for daily intraperitoneal injection of propofol (50 mg/kg) or lipid emulsion (5.0 mL/kg) for 7 consecutive days. After each injection, the rats were placed in a warm box (38 ℃) with an oxygen concentration of 18% (hypoxia), 21% (normal air), or 50% (oxygen) until full recovery of the righting reflex. Another 90 P7 rats were similarly grouped and received intraperitoneal injections of p-p38 blocker (15 mg/kg) 30 min before the same treaments. The phosphorylated tau protein, total tau protein and p-p38 content in the hippocampus were detected using Western blotting. The spatial learning and memory abilities of the rats were evaluated with Morris water maze test. RESULTS: Compared with lipid emulsion, propofol injection resulted in significantly increased levels of p-p38, phosphorylated tau and total tau proteins in rats with subsequent hypoxic or normal air treatment ( < 0.05), but propofol with oxygen and injections of the blocker before propofol did not cause significant changes in the proteins. Without subsequent oxygenation, the rats receiving injections of propofol, with and without prior blocker injection, all showed significantly prolonged latency time and reduced platform-crossing times and third quadrant residence time compared with the corresponding lipid emulsion groups ( < 0.05). With oxygen treatment, the rats in propofoland blocker-treated groups showed no significant difference in the performance in Morris water maze test from the corresponding lipid emulsion group. The results of Morris water maze test differed significantly between blocker-propofol group and propofol groups irrespective of exposures to different oxygen levels ( < 0.05), but not between the lipid emulsion and blocker group pairs with exposures to different oxygen levels. CONCLUSIONS Propofol combined with hypoxia can affect the expression of tau protein through p38 pathway to impair the cognitive function of immature rats, in which oxygen plays a protective role.
Animals ; Cognitive Dysfunction ; etiology ; metabolism ; Hippocampus ; chemistry ; Hypnotics and Sedatives ; pharmacology ; Hypoxia, Brain ; complications ; metabolism ; MAP Kinase Signaling System ; Maze Learning ; drug effects ; physiology ; Memory ; drug effects ; physiology ; Propofol ; pharmacology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; tau Proteins ; analysis

OBJECTIVE: To compare the median effective dose (ED) of intranasal dexmedetomidine for procedural sedation in uncooperative pediatric patients with acyanotic congenital heart disease before and after cardiac surgery. METHODS: We prospectively recruited 47 children (22 in preoperative group and 25 in postoperative group) who needed sedation for transthoracic echocardiography (TTE). A modified up-and-down sequential study design was employed to determine dexmedetomidine dose for each patient with a starting dose of 2 μg/kg in both groups; dexmedetomidine doses for subsequent subjects were determined according to the responses from the previous subject using the up-and-down method at a 0.25 μg/kg interval. The ED was determined using probit regression. The onset time, examination time, wake-up time and adverse effects were measured, and the safety was evaluated in terms of changes in vital signs every 5 min. RESULTS: The ED value of intranasal dexmedetomidine for sedation was 1.84 μg/kg (95% : 1.68-2.00 μg/kg) in children with congenital heart disease before cardiac surgery, and 3.38 μg/kg (95% : 3.21-3.54 μg/kg) after the surgery. No significant difference was found between the two groups in the demographic variables, onset time, examination time, wake-up time, or adverse effects. CONCLUSIONS In children with acyanotic congenital heart disease, the ED of intranasal dexmedetomidine for TTE sedation increases to 3.38 μg/ kg after cardiac surgery from the preoperative value of 1.84 μg/kg.
Administration, Intranasal ; Cardiac Surgical Procedures ; Child ; Dexmedetomidine ; Heart Defects, Congenital ; surgery ; Humans ; Hypnotics and Sedatives

Objective To study the inhibitory effect of T lymphocytes secreting EphrinAl-Caspase-3 in vivo and on the growth of cancer cells in nude mice with breast cancer. Methods Nude mice (n = 35) were inoculated with breast cancer cells to construct a nude mouse model of breast cancer. When the tumor volume reached 0. 1 cm3, 30 nude mice with average size tumor tissue were randomly divided into PBS group, uninfected adenovirus group, T lymphocyte infected with Ad-EphrinAl-Caspase-3 group, and intratumoral transplantation. Tumor size was measured every day 2 to 3. Three groups of tumor-bearing nude mice were selected. After the above-mentioned cell transplantation, the subcutaneous tumor tissue homogenate was obtained every day 2 to 3, and the content of EphrinAl-Caspase-3 was detected by ELISA. At the end of the experiment, the animals in each group were sacrificed by cervical dissection and sliced. The presence of T lymphocytes expressing green fluorescent protein was observed under a fluorescence microscope, and Caspase-3 and Ki-67 were detected by immunofluorescence. Results After one week of inoculation of breast cancer cells into nude mice, the presence of subcutaneous tumors could be touched by hand, which proved that the tumor-bearing animals of breast cancer cells were successfully modeled. On the 8th day after inoculation, the tumor volume of the nude mice in each group became larger, and the difference between the treatment group and the PBS group/T lymphocyte group was extremely significant ( P<0.05). Although the tumor volume of the T lymphocyte transplantation group was slower than that of the PBS control group, there was no statistically significant difference between the two. The expression of EphrinAl-Caspase-3 was detected in the EphrinAl-Caspase-3 treatment group on the 2nd day, reached the peak on the 8th day, and then the secretion decreased gradually. No expression of EphrinAl-Caspase-3 was detected in the PBS control group and the T lymphocyte group. The presence of dispersed green fluorescent protein-labeled EphrinAl-Caspase-3-T lymphocytes was observed in the tumor tissues of the treatment group, while the presence of green fluorescent protein was not detected in the PBS group and the T lymphocyte groups. In the infected cells of the treatment group, the proportion of Caspase-3 positive cells was up- regulated, and the proportion of Ki-67 positive cells was down-regulated. No expression of EphrinAl-Caspase-3 was detected in the PBS group and the T lymphocyte group. Conclusion EphrinAl-Caspase-3 can significantly inhibit the growth of breast cancer cells, thereby exerting an anti-tumor effect.

OBJECTIVE: To investigate the mechanism of self-efficacy between self-management ability and self-management behavior and its differences among patients with different disease courses through mediation tests. METHODS: In the study, 489 patients with type 2 diabetes who attended the endocrinology departments of four hospitals in Shanxi Province and Inner Mongolia Autonomous Region from July to September 2022 were enrolled as the study population. They were investigated by General Information Questionnaire, Diabetes Self-Management Scale, Chinese version of Diabetes Empowerment Simplified Scale, and Diabetes Self-Efficacy Scale. Mediation analyses were performed using the linear regression model, Sobel test, and Bootstrap test in the software Stata version 15.0 and divided the patients into different disease course groups for subgroup analysis according to whether the disease course was > 5 years. RESULTS: In this study, the score of self-management behavior in the patients with type 2 diabetes was 6.16±1.41, the score of self-management ability was 3.99±0.74, and the score of self-efficacy was 7.05±1.90. The results of the study showed that self-efficacy was positively correlated with self-management ability (r=0.33) as well as self-management behavior (r=0.47) in the patients with type 2 diabetes (P < 0.01). The mediating effect of self-efficacy accounted for 38.28% of the total effect of self-management ability on self-management behaviors and was higher in the behaviors of blood glucose monitoring (43.45%) and diet control (52.63%). The mediating effect of self-efficacy accounted for approximately 40.99% of the total effect for the patients with disease course ≤ 5 years, while for the patients with disease course > 5 years, the mediating effect accounted for 39.20% of the total effect. CONCLUSION Self-efficacy enhanced the effect of self-management ability on the behavior of the patients with type 2 diabetes, and this positive effect was more significant for the patients with shorter disease course. Targeted health education should be carried out to enhance patients' self-efficacy and self-management ability according to their disease characteristics, to stimulate their inner action, to promote the development of their self-management behaviors, and to form a more stable and long-term mechanism for disease management.
Humans ; Diabetes Mellitus, Type 2/therapy* ; Self Efficacy ; Self-Management ; Blood Glucose Self-Monitoring ; Blood Glucose ; Self Care