1.The clinical efficacy of recombinant tissue plasminogen activator for the treatment of ischemic cerebrovascular disease caused by cerebral thrombosis
Zhonglan TIAN ; Lingling XU ; Yong ZHANG ; Chun YANG ; Gaiping HE
Tianjin Medical Journal 2017;45(9):961-964
Objective To study the clinical efficacy of intra-arterial thrombolysis with recombinant tissue plasminogen activator (rt-PA) for the treatment of ischemic cerebrovascular disease caused by cerebral thrombosis. Methods A total of 245 patients accepted by our hospital during May 2013 and July 2015 were divided into the observation group (n=148) and the control group (n=97). All patients were given conventional process for controling blood pressure and blood lipids. Patients in observation group received intra-arterial thrombolysis with rt-PA, while patients in control group accepted conventional treatment. At the time of admission, the demographic characteristic, vascular influencing factors, baseline clinical findings, laboratory findings and neurological deficits were collected. The improvement of neurological function was evaluated by the modified Rankin scale 3 months after treatment. The levels of fibrinogen (FIB), D-Dimer, activated partial thromboplastin time (APTT) and thrombin time (PT) were measured before and 24 h after the treatment. Results There were no significant differences in demographic characteristic and general clinical data between the two groups ( P>0.05). The proportion of patients with improved neurological function was significantly higher in observation group than that of the control group (83.11%vs. 53.61%, P<0.05). There were no significant difference in coagulation index and fibrinolysis index before treatment between the two groups (P>0.05). Twenty-four hours after the treatment, the levels of FIB, D-Dimer, APTT and PT were significantly improved in the observation group compared with those before treatment. The level of FIB was significantly decreased, D-Dimer was significantly increased, APTT and PT were significantly prolonged in observation group compared with those of control group (P<0.05). Conclusion The rt-PA can effectively dissolve thrombosis and correct the coagulation system and fibrinolytic system.
2.Efficacy of clopidogrel and fluvastatin in cerebral infarction and its effect on quality of life
Zhonglan TIAN ; Yong ZHANG ; Gaiping HE ; Bin ZHANG
Chinese Journal of Biochemical Pharmaceutics 2016;36(9):65-67
Objective To investigate the clinical effect and quality of life of clopidogrel combined with atorvastatin in the treatment of cerebral infrction.Methods 74 patients with cerebral infarction were randomly divided into study group and control group, 37 cases in each group.The control group applied the traditional treatment methods, and the study group were treated with drug combination therapy ( clopidogrel +fluvastatin) on the basis of the control group.After 1 course (6 months), the scores of neurological function and activity, clinical efficacy and quality of life of the two groups were observed and compared.Results National Institutes of Health Stroke Scale ( NIHSS) and Fugl-Meyer were significantly improved in the two groups at discharge (P<0.05), but the improvement degree of the study group was significantly better than the control group (P<0.05).In the control group, 7 cases were ineffective, the effective rate was 81.1%, while the study group was 3 cases, the effective rate was 91.9%, with statistically significant differences(P<0.05), The study group were significantly better than the control group (P<0.05) in the physiological, environmental, health status and quality of life, but the difference was not statistically significant in the psychological and social dimensions.Conclusion Clopidogrel combined with fluvastatin in treating cerebral infarction could significantly improve the treatment efficiency, effectively control blood lipid levels of patients, and improve nerve function and activity ability of patients, and ultimately improve the quality of life of patients.
3.Correlation between the disease condition and dyslipidemia in patients with coal-burning-borne endemic arsenic poisoning
Haidong TIAN ; Wenjuan WANG ; Zhonglan ZOU ; Baofei SUN ; Jingyuan YANG ; Aihua ZHANG
Chinese Journal of Endemiology 2021;40(5):363-367
Objective:To understand the relationship between the disease condition of patients with coal-burning-borne endemic arsenic poisoning (abbreviated as coal-burning-borne arsenic poisoning) and serum lipid metabolism indicators.Methods:Using a case-control study method, in the coal-burning-borne arsenic poisoning village of Yuzhang Town, Qianxinan Prefecture, Guizhou Province, 204 patients with arsenic poisoning diagnosed according to the standard of "Diagnosis of Endemic Arsenicosis" (WS/T 211-2015) were included in case group, including 87 males and 117 females, aged(53.37 ± 8.06) years old; and they were divided into mild arsenic poisoning group (71 cases), moderate arsenic poisoning group (59 cases) and severe arsenic poisoning group (74 cases) according to the clinical grading. Another 63 residents were selected into control group in a non-arsenic-exposed village about 12 km away from the diseased village, including 23 males and 40 females, aged (53.78 ± 9.10) years old. A face-to-face questionnaire survey was conducted for each group of people, including basic information such as general demographic characteristics, smoking status, and drinking status; fasting peripheral blood was collected, and an automatic biochemical analyzer was used to detect serum total cholesterol (TC) and triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels.Results:There were significant differences of serum TC [(4.94 ± 1.00), (5.00 ± 0.99), (5.27 ± 0.94), (5.57 ± 1.07) mmol/L], TG [(2.17 ± 0.90), (2.25 ± 1.31), (2.66 ± 1.43), (2.78 ± 1.40) mmol/L], LDL-C [(2.51 ± 0.79), (2.74 ± 0.64), (2.97 ± 0.66), (3.15 ± 0.80) mmol/L], and HDL-C levels [(1.57 ± 0.55), (1.42 ± 0.43), (1.36 ± 0.42), (1.30 ± 0.38) mmol/L] in control group, mild, moderate and severe arsenic poisoning groups ( F = 5.83, 3.64, 9.72, 4.41, P < 0.01 or < 0.05). Among them, the serum TC level in severe arsenic poisoning group, serum TG and LDL-C levels in moderate and severe arsenic poisoning groups were significantly higher than those in control group ( P < 0.05); the serum HDL-C level in moderate and severe arsenic poisoning groups were lower than that in control group ( P < 0.05); the serum TC, TG and LDL-C levels in severe arsenic poisoning group were significantly higher than those in mild arsenic poisoning group ( P < 0.05). After linear trend test, serum TC, TG and LDL-C levels all showed an upward trend with the degree of arsenic poisoning ( Ftrend = 15.77, 10.14, 29.15, P < 0.05), and serum HDL-C level showed a downward trend with the degree of arsenic poisoning ( Ftrend = 12.75, P < 0.05). There were significant differences in the abnormal rates of serum TC, TG and LDL-C levels among control group and mild, moderate and severe arsenic poisoning groups (χ 2 = 21.16, 16.60, 8.29, P < 0.01 or < 0.05). Among them, the serum TC and TG levels abnormal rates in moderate and severe arsenic poisoning groups and serum LDL-C level abnormal rate in severe arsenic poisoning group were higher than those in control group ( P < 0.05), the serum TC, TG and LDL-C levels abnormal rates in severe arsenic poisoning group were higher than those in mild arsenic poisoning group ( P < 0.05). There was no significant difference of the serum HDL-C level abnormal rate among four groups (χ 2 = 2.11 , P > 0.05). The results of trend chisquare analysis showed that the abnormal rates of serum TC, TG and LDL-C levels presented an increasing trend with the degree of arsenic poisoning (χ 2trend = 19.90, 15.25, 7.63, P<0.05). The results of logistic regression analysis showed that the risk of abnormal serum TC level in patients with severe arsenic poisoning was 2.90 times that in control group [odds ratio ( OR) = 2.90, 95% confidence interval ( CI): 1.43 - 5.91], and the risk of abnormal serum LDL-C level in patients with severe arsenic poisoning was 2.87 times that in control group ( OR = 2.87, 95% CI: 1.22 - 6.71). Conclusion:There is a correlation between the disease condition of patients with coal-burning-borne arsenic poisoning and their dyslipidemia.
4.Prevalence of diabetes among residents in coal-burning arsenic poisoning area of Yuzhang Town Guizhou Province
Xuan RUAN ; Zhonglan ZOU ; Yu TIAN ; Jingyuan YANG ; Baofei SUN ; Shaofeng WEI ; Aihua ZHANG
Chinese Journal of Endemiology 2020;39(8):573-575
Objective:Comparative analysis of diabetes was carried out in coal-burning arsenic poisoning areas and non-arsenic exposed villages of Yuzhang Town, so as to explore the relationship between arsenic exposure and diabetes.Methods:Data of basic information of 594 people who were diagnosed and included in the diabetes management in Central Health Center of Yuzhang Town in Qianxinan Prefecture Guizhou Province in 2018 were collected. According to the "Standards for the Determination and Classification of Endemic Arsenic Poisoning Areas" (WS 277-2007), 11 administrative villages in the town were divided into 5 arsenic poisoning villages and 6 non-arsenic exposure villages. The prevalence (%) was used for statistical description.Results:In 2018, the prevalence of diabetes in Yuzhang Town was 1.74% (594/34 218), 1.38% (243/17 665) for men and 2.12% (351/16 553) for women, the gender difference was statistically significant (χ 2=27.794, P < 0.05). The prevalence of standardized diabetes in arsenic poisoning villages was 3.38%; the prevalence of standardized diabetes in non-arsenic exposure villages was 3.13%. After sex stratification analysis, the non-arsenic exposed villages were used as reference. The OR and 95% CI of diabetic patients in arsenic poisoning villages were 0.65 (0.50-0.81) for males and 1.35 (1.09-1.67) for females. Conclusions:The association between arsenic exposure and diabetes is related to gender. The risk of diabetes mellitus in women is higher than that in men.
5.Th17 Cells and IL-17 are Increased in Patients with Brain Metastases from the Primary Lung Cancer
HE GAIPING ; ZHANG BIN ; ZHANG BAOWEN ; QIAO LIANGJIE ; TIAN ZHONGLAN ; ZHAI GUOYAN ; XIN XIANWEI ; YANG CHUN ; LIU PEIGANG ; ZHANG YONG ; XU LINGLING
Chinese Journal of Lung Cancer 2013;(9):476-481
Background and objective Th17 cells are important T helper cells, which are characterized by their production of IL-17. hT17 cells play an important role in host defense against microbial infections, autoimmune diseases and cancer. hTe aim of this study is to investigate the percentage of hT17 in peripheral blood lymphocyte and the level of IL-17 in serum and cerebrospinal lfuid (CSF) in patients with brain metastases from lung cancer. Methods Twenty-two patients with brain metastases from lung cancer and 20 health controls were analyzed. hTe percentage of hT17 cell was detected with lfow cytometry using CD3+CD4+IL-23R+marker, the level of IL-17 was measured with ELISA method. Results hTe percentage of hT17 cells in patients with brain metastases from lung cancer was 4.65%±0.72%, which was remarkably higher than that in con-trols (2.71%±0.54%, P=0.04). hTere was no signiifcant difference between non-small cell lung cancer (NSCLC) patients and small cell lung cancer (SCLC) patients. Serum IL-17 was remarkably increased in patients with brain metastases from lung can-cer (117.4±16.43 pg/mL vs 72.55±8.19 pg/mL, P=0.02). No signiifcant difference of the serum IL-17 was observed between NSCLC and SCLC patients. hTe level of IL-17 in CSF from patients with brain metastases from lung cancer was signiifcant higher than that from lung cancer patients without brain metastases (73.21±7.52 pg/mL vs 50.25±8.04 pg/mL, P=0.04). Con-clusion hT17 cells and IL-17 increase in patients with brain metastases from lung cancer. It may involve in the pathogenesis of brain metastases from lung cancer.