Objective To determine the effectiveness and safety of antiplatelet and anticoagulant agents in the treatment of extracranial internal carotid artery dissection (eICAD). Methods Antiplatelet and anticoagulant agents were adopted to treat two cases of eICAD in our hospital. The clinical data were retrospectively analyzed and the medical literatures concerning eICAD, which were obtained from Pubmed database, were reviewed. Results Most researches advocated the empirical use of antiplatelet and anticoagulant agents in eICAD. About 30% of occluded eICAD could be reopened in 8 days and about 60% - 80% in 3 months after the onset of the disease. During the period of treatment, the rate of ischemic stroke recurrence, disability or death was 8.3%-14.3% in anticoagulant group, while it was 7% - 23.7% in antiplatelet group. Conclusion Antiplatelet agents can be used in patients with eICAD who are contraindicated to anticoagulants. Anticoagulants should be used as early as possible in patients who are not contraindicated to anticoagulants.

Objective To summarize the perioperative experience of nursing recipients undergoing adult-to-adult living donor liver transplantation (A-ALDLT). Method Twenty-five cases of recipients undergoing A-ALDLT were retrospectively analyzed for summarization of perioperative nursing. Results All operations on the patients were successful with an average time of (5.5 ± 0.5)h. Two cases developed with postoperative bile leakage and another two with postoperative pleural effusion, all cured after treatment. Conclusions Perioperative nursing is one important factor of elements to guarantee the success of A-ALDLT. The actively and effectively perioperative nursing measures are the important insurance for the recipients′recovery from graft operation.

Objective To explore effects of human embryonic stem cells ( hESCs) on proliferation, invasion and migration of SK-Hep1 human hepatoma cells in the co-culture of micro environmen of hESCs and SK-Hep1 . Methods Single cultured SK-Hep1 cells were served as control group while SK-Hep1 which non-contact co-cul-tured with hESCs was regarded as experimental group .The proliferation ability of SK-Hep1 was measured by MTT method; invasion and migration ability of SK-Hep1 cells were detected by Transwell chamber method;the nucle-us variation and cell apoptosis of SK-Hep1 were detected by Hoechst33258 chromosome and flow cytometry. Results The proliferation of SK-Hep1 cells in the experimental group was obviously inhibited as compared with control group ( P<0.05 );the number of SK-Hep1 cells which passed through the Transwell chambers were sig-nificantly reduced as compared with control group in invasion and migration experiment ( P <0.05 ); more nucleus pycnosis and deformation appeared in experimental group than that in control group .And apoptosis rate of SK-Hep1 cells in the experimental group was significantly higher than that of in the control group ( P<0.05 ) .Conclusions Human embryonic stem cells have inhibitory effect on human hepatoma cell line SK-Hep1 .

Objective:To study the inhibitory effect of human embryonic stem cells on the HepG2 cells in vitro.Methods:The co-culture system of Human embryonic stem cells (H9) and liver cancer HepG2 cells was established.The effect of H9 on the biological behavior of HepG2 cells was observed by microscope,the flow cytometry was used to detcct the apoptosis of tumor cells and the cell cycle alteration.Transwell assay was used to detect the migration and invasion of tumor cells.Gene microarray technique was used to examine the change of gene expression profile of HepG2 cells.Results:In the process of co-culture,the growth of hepatoma cells was inhibited.With the extension of the culture time,cells decreased gradually,and occurred signs of aging or apoptosis.Flow cytometry test results showed that the apoptosis rate of hepatoma ceils was significantly increased,and the cell cycle was blocked in the G0/G1 phase.Transwell test results showed that the invasion and migration of HepG2 cells were decreased.The gene chip results showed that the whole genome expression profile of HepG2 cells had a significant change.Conclusion:The human embryonic stem cells had an inhibitory effect on HepG2 cells in vitro.

Objective To observe the effects of salvianolate injection on blood levels of high sensitively C-reactive protein (hs-CRP),pregnancy associated plasma protein-A (PAPP-A) and brain natriuretic peptide (BNP) in elderly patients with acute myocardial infarction.Methods The elderly patients with AMI (AMI group,n=160) and healthy controls (control group.n=30) were enrolled in this study and their blood concentrations of PAPP A,hs CRP and BNP were detected before and two weeks after treatment.The elderly patients in AMI group were randomized into conventional treatment group (n =80) and salvianolate group (n =80).Results The levels of PAPP-A,hs-CRP and BNP were significantly higher in AMI patients [(12.88±2.56) mg/L,(20.13 ±5.35) mU/L,(412.0±69.5) ng/L,respectively] than in healthy subjects[(1.20±0.88) mg/L,(1.90±0.46) mU/L,(89.0±5.6) ng/L,respectively] (t=24.670,3.780,11.939,respectively,P ＜0.01).But,before treatment there were no significant differences in the levels of PAPP-A,hs-CRP and BNP between the AMI group and control group (t=0.864,0.712,0.985,all P＞0.05).After two weeks of treatment,as compared with control group,AMI group showed that the serum concentrations of PAPP-A,hs-CRP and BNP were decreased significantly (P＜0.05).The levels of PAPP A,hs-CRP and BNP were (3.83±1.20) mg/L,(1.33±0.38) mU/L,(105.0±31.2) ng/L in salvianolate group and (5.71± 1.93) mg/L,(1.81±0.72) mU/L,(150.0±36.7) ng/L in conventional treatment group respectively,and the decrements in levels of PAPP-A,hs CRP and BNP were greater in the former than in the latter(t=7.399,5.273,8.356,respectively,all P＜0.05).Conclusions The dynamic serum concentrations of PAPP-A,hs CRP and BNP can be used as clinical indexes for the prognosis of acute myocardial infarction.Salvianolate injection can significantly decrease the serum levels of PAPP A,hs CRP and BNP.The salvianolate injection may have anti inflammatory effect and improve cardiac function in elderly patients with acute myocardial infarction,but the mechanism is still to be further discussed.

PURPOSE: The association of ischemic stroke and metabolic syndrome (MetSyn) with or without diabetes mellitus (DM) is not clear. The present study aimed to identify the impact of diabetes or hyperglycemia on the risk of MetSyn-associated ischemic stroke. MATERIALS AND METHODS: This study comprised an Asian population of 576 patients with acute nonembolic cerebral infarction and 500 controls. MetSyn was defined according to the criteria of the International Diabetes Federation. MetSyn patients were further subgrouped according to their glucose levels: MetSyn with DM, MetSyn with impaired fasting glucose (IFG) and MetSyn with normal glucose tolerance (NGT). The impact of MetSyn on cerebral infarction was then evaluated. RESULTS: At baseline, the prevalence of MetSyn in patients with cerebral infarction was higher than that of the controls (57.29% vs. 10.00%, p<0.01). In the stroke group, the prevalences of MetSyn with DM, IFG, and NGT were 25.69%, 8.85% and 22.74%, respectively, all of which were higher than that of the controls (all p-values <0.05). By multiple logistic regression analysis, we discovered that MetSyn was associated with an increased risk of cerebral infarction (odds ratio: 5.73, p<0.01). After adjustment for all the components of MetSyn, the odds ratios of MetSyn with DM, IFG, and NGT were 5.70, 2.24 and 2.19 (all p-values <0.05), respectively. CONCLUSION: In Asian population, patients with MetSyn accompanied by T2DM are at the greatest risk for acute non-embolic stroke. Additionally, IFG was not observed to be associated with an increased risk for MetSyn-related ischemic stroke.
Aged ; Cerebral Infarction/*complications ; Diabetes Complications/epidemiology ; Female ; Glucose Intolerance/complications/epidemiology ; Humans ; Hyperglycemia/*complications ; Logistic Models ; Male ; Metabolic Syndrome X/*complications/epidemiology ; Middle Aged ; Odds Ratio ; Prevalence ; Risk Factors

Objective:To observe the preventive effects of infliximab in autoimmune hepatitis (AIH) and to explore its mechanism.Methods:The mice AIH model was established by injecting concanavalin A (Con-A) into the caudal vein. Forty mice were divided into prevention group and control group, with 20 mice in each group. The mice of prevention group were injected intravenously with infliximab (20 mg/kg) one hour before Con-A injection and the mice of control group were administrated with 200 μL phosphate buffered saline (PBS). Serum was collected 3, 8, 12 and 24 h after Con-A/PBS injection. The serum level of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) was detected by colorimetry. The level of cytokine interleukin (IL)-6, IL-1β, interferon gamma (IFN-γ), IL-4, IL-17A, IL-10 and chemokine C-X-C motif ligand 10 (CXCL10) was measured by enzyme-linked immunosorbent assay (ELISA). Liver samples were taken 12 h after Con-A/PBS injection for hematoxylin-eosin staining. Liver infiltrated lymphocytes were assessed by flow cytometry. The expression of T-box transcription factor 21 ( TBX21), GATA binding protein 3 ( GATA3), RAR related orphan receptor C ( RORC) and CXCL10 at mRNA level was evaluated by quantitative real-time polymerase chain reaction (qRT-PCR). The expression of CXCL10 in liver was detected by Western blotting. Paired t test and one-way analysis of variance were used for statistic analysis. Results:At 8, 12, and 24 h after Con-A injection, the serum ALT level, AST level, IL-1β and IFN-γ of prevention group were all lower than those of control group ((545.8±190.3) U/L vs. (865.8±237.7) U/L, (947.6±267.9) U/L vs. (1 448.0±403.5) U/L, (508.6±131.1) U/L vs. (976.6±207.6) U/L; (620.7±132.0) U/L vs. (952.9±106.8) U/L, (801.6±212.0) U/L vs. (1 424.8±236.0) U/L, (632.1±117.8) U/L vs. (1 008.3±187.5) U/L; (31.38±10.12) ng/L vs. (48.12±11.53) ng/L, (39.34±11.40) ng/L vs. (60.00±14.17) ng/L, (29.49±8.22) ng/L vs. (46.89±5.50) ng/L; and (432.93±66.82) ng/L vs. (674.66±97.88) ng/L, (655.09±169.17) ng/L vs. (937.90±166.36) ng/L, (263.40±54.97) ng/L vs. (410.74±86.64) ng/L), and the differences were statistically significant ( t = 2.350, 2.308, 4.263, 4.374, 4.860, 3.806, 2.440, 2.541, 3.939, 4.560, 2.660 and 3.210; all P<0.05). The serum IL-6 levels 3, 8, 12 and 24 h after Con-A injection of prevention group were all lower than those of control group ((1 075.79±303.77) ng/L vs. (1 914.48±317.80) ng/L, (1 945.97±271.85) ng/L vs. (2 100.80±378.42) ng/L, (1 578.60±504.54) ng/L vs. (2 525.40±406.55) ng/L, (1 020.64±280.03) ng/L vs. (1 582.00±311.96) ng/L), and the differences were statistically significant ( t=4.266, 2.903, 3.267 and 2.994; all P < 0.05). At 3 h after Con-A injection, serum CXCL10 level and CXCL10 mRNA expression in liver tissues of prevention group were both lower than those of control group ((1 755.8±148.1) ng/L vs. (2 102.0±334.0) ng/L and 7.20±3.00 vs. 27.60±1.90), and the differences were statistically significant ( t=2.356 and 2.623, both P<0.05). At 3 and 8 h after Con-A injection, T- bet expression at mRNA level in liver tissues of prevention group was lower than that of control group (6.94±2.29 vs. 15.20±3.48 and 9.38±3.48 vs. 18.17±4.48), and the differences were both statistically significant ( t = 4.427 and 3.673, both P<0.05). However, 3, 8, 12 and 24 h after Con-A injection, there were no statistically significant differences in serum IL-4, IL-17A, IL-10, or GATA3 or RORC expression at mRNA level between prevention group and control group (all P > 0.05). Conclusions:Infliximab has certain preventive effects in mice AIH model, which may be achieved by antagonizing TNF-α and decreasing the expression of CXCL10 in liver, reducing the infiltration of T-helper 1 cells and CD8 + T cells into liver, and by reducing T lymphocyte activation induced by inflammatory cytokines thus alleviating the damage of T lymphocytes to hepatocytes.

Objective The aim of this study was to investigate the effect of Ca2+ /calmodulin - dependent kinase II (CaMKII)γ RNA interference on the expression of nuclear factor of activated T-cells cytoplasmic 1(NFATc1),tyrosine kinase(c-Src)and tartrate resistant acid phosphatase(TRAP)genes,and its role and molecular mechanism in osteoclast differentiation. Methods The CaMKII γ RNA interference vector was constructed by lentivirus and transfected into RAW264. 7 cells. The experiment was di-vided into three groups:A,B and C,which were the control group,negative vector group and interference vector group. After transfec-tion for 12 hours,osteoclasts induced by 50 ng/mL RANKL and the cells were harvested after induction for 5 days. Real-time quanti-tative PCR,Western blot and immunofluorescence were used to detect the expression of NFATc1,TRAP and c-Src genes in three groups. Results The mRNA levels of NFATc1,TRAP and c-Src in the group C decreased by 49. 86% ,43. 65% and 53. 57% ,re-spectively(P<0. 001),and the protein levels decreased by 54. 22% ,46. 75% and 45. 86% ,respectively(P<0. 001). There was no significant difference between the A and the B groups(P>0. 05). The fluorescence intensity of the above genes in the group C was significantly weaker than that in the A and B groups,and the formation of osteoclasts was significantly less than that in the A and B groups. Conclusion CaMKIIγ RNA interference significantly inhibited the expression of NFATc1,TRAP and c-Src genes,sugges-ting that CaMKIIγ plays a key regulatory role in osteoclast differentiation.

Objective: To evaluate the outcomes and prognostic factors of myelodysplasia syndrome (MDS) patients who received allogeneic hematopoietic stem cell transplantation (allo-HSCT) . Methods: 165 cases of MDS who underwent allo-HSCT from Jan. 2010 to Mar. 2018 were analyzed retrospectively, focusing on the overall survival (OS) , disease free survival (DFS) , relapse, non-relapse mortality (NRM) and their related risk factors. Results: Of all the 165 cases, 105 were male and 60 were female. The 3-year OS and DFS rate were 72.5% (95%CI 64.9%-80.1%) and 67.4% (95%CI 59.17%-75.63%) , respectively. The 3-year cumulative incidence of relapse and NRM were 12.11% (95%CI 7.03%-18.65%) and 20.44% (95%CI 14.15%-27.56%) , respectively. HCT-comorbidity index (P=0.042, HR=2.094, 95%CI 1.026-4.274) was identified as independent risk factor for OS by the multivariate analysis. Intensive chemotherapy before HSCT or hypomethylation agents treatment had no effects on OS[ (67.0±7.5) %vs (57.7±10.9) %, χ²=0.025, P=0.874]. Conclusions allo-HSCT is a promising means for MDS, and NRM is the major cause of treatment failure. MDS with refractory anemia with excess blasts and secondary acute myeloid leukemia patients may not benefit from intensive chemotherapy or hypomethylation agents treatment before HSCT.

Objective:To investigate the influencing factors of the survival in infants with congenital diaphragmatic hernia (CDH) and to develop a prediction model for CDH.Methods:Clinical data of 252 infants with a prenatal diagnosis of CDH in Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2010 to December 2018 were retrospectively analyzed. Adverse outcomes were defined as neonatal death on discharge. Chi-square and t test were used for univariate analysis of 16 perinatal and five postnatal risk factors. Regression analysis was used to determine the independent predictors of survival. The receiver operating characteristics (ROC) curves of the risk factors for predicting the survival of CDH were drawn. A prediction model based on the combination of risk factors for predicting adverse outcomes of CDH was established using the cut-off value. ROC curves of the model were drawn and the area under curve (AUC), sensitivity, and specificity were calculated. Results:Out of the 252 patients, 173(68.7%) survived on discharge. Univariate analysis showed that lung-to-head ratio (LHR), polyhydramnios, right diaphragmatic hernia, liver herniation, intrathoracic stomach, premature birth, low birth weight, 5 min Apgar score <7, and amniotic fluid index (AFI) were significantly associated with the survival of CDH. Regression analysis showed that polyhydramnios ( OR=11.19,95% CI:2.83-45.33), liver herniation ( OR=2.81,95% CI:1.32-11.92), intrathoracic stomach ( OR=5.02, 95% CI:1.29-17.13), low birth weight ( OR=8.58,95% CI:1.59-45.01) and AFI ( OR=3.68, 95% CI:1.37-14.72) were independent risk factors for survival at discharge in children with CDH, while LHR ( OR=0.36, 95% CI:0.01-0.69) were protective factors. The predictive cut-off values of LHR, polyhydramnios, liver herniation, intrathoracic stomach, low birth weight, and AFI were 1.6, 1.0, 1.0, 1.0, 1.0, and 232.5 mm, respectively. The model based on the combination of the above indicators for predicting CDH adverse outcomes was shown with an AUC value of 0.904, predictive sensitivity of 0.747, and specificity of 0.896. Conclusions:In this study, LHR, liver herniation, intrathoracic stomach, polyhydramnios, low birth weight, and AFI are independent risk factors for CDH survival. The combination of prenatal and postnatal indicators is noted for a higher accuracy for predicting CDH survival.