ObjectiveTo investigate the correlation between the gross motor function and the clinical types and complications of children with cerebral palsy (CP).MethodsThe gross motor function of 126 CP children were measured by Gross Motor Function Classification System (GMFCS). Then the correlation between gross motor function, and clinical types and complications was analyzed.ResultsThere was a strong correlation between GMFCS and clinical types and complications ( P<0.001). GMFCS evaluation showed that 55.1% spastic children were categorized into levels Ⅰ and Ⅱ; 53.8% of dyskinetic and 85.7% of mixed children were categorized into levels Ⅳ and Ⅴ; 55.4% of diplegic and total hemiplegic children were categorized into levels Ⅰ and Ⅱ; 67.4% of tetraplegic and 55.6% complex hemiplegic children were categorized into levels Ⅳ and Ⅴ; 100% children with normal developmental quotient (DQ) and 91.6% above borderline of DQ were classified into levels Ⅰ and Ⅱ. The mental impairment was more severe; the levels of GMFCS were more higher. There were more visual impairment, hearing disorder, speech disability, feeding problem and epilepsy in children with levels Ⅲ, Ⅳ and Ⅴ than that with levels Ⅰ and Ⅱ.ConclusionThere is a significant correlation between GMFCS and clinical type and complications of CP, and the categorization of GMFCS is higher, the complications are more.

Endoplasmic reticulum (ER) stress occurs in macrophage-rich areas of advanced atherosclerotic lesions and contributes to macrophage apoptosis and subsequent plaque necrosis. The purpose of the present study was to investigate the effects of caveolin-1 (Cav-1) on ER stress-induced apoptosis in cultured macrophages and the underlying mechanisms. RAW264.7 cells were incubated with thapsigargin (TG) to establish ER stress model. And Cav-1 expression was detected by Western blot. After being pretreated with filipin(III), a caveolae inhibitor, RAW264.7 cells were assayed with flow cytometry and confocal laser scanning microscopy to detect cell apoptosis. Moreover, p38 mitogen-activated protein kinase (MAPK) phosphorylation and C/EBP homologous protein (CHOP) expression were detected with Western blot. The results showed that Cav-1 expression was markedly increased at early stage of TG treatment (P < 0.05) and then decreased with prolonged or high dose TG treatments. The increasing of Cav-1 expression induced by TG in RAW264.7 cells was abolished under inhibition of caveolae by filipin(III) (P < 0.05). The effect of TG on apoptosis of RAW264.7 cells was further augmented after pretreatment with filipin(III) (P < 0.05). Western blotting showed that MAPK phosphorylation induced by TG was inhibited by filipin(III) in RAW264.7 cells (P < 0.05), whereas CHOP remained unchanged (P > 0.05). These results suggest that Cav-1 may play a critical role in suppressing ER stress-induced macrophages apoptosis in vitro, and one of the mechanisms may be correlated with the activation of p38 MAPK prosurvival pathway.
Animals ; Apoptosis ; drug effects ; Caveolin 1 ; genetics ; metabolism ; Cell Line ; Endoplasmic Reticulum Stress ; physiology ; Filipin ; pharmacology ; MAP Kinase Signaling System ; Macrophages ; cytology ; drug effects ; Mice ; Thapsigargin ; pharmacology ; Transcription Factor CHOP ; metabolism ; p38 Mitogen-Activated Protein Kinases ; metabolism

OBJECTIVETo discuss the cause and treatment of acute limb ischemia in endovascular therapy of the lower extremity arterial occlusive disease.

METHODSClinical data of 54 cases of acute limb ischemia in the endovascular treatment of 685 cases of lower extremity arterial occlusive disease from June 2003 to April 2012 was analyzed retrospectively. There were 43 male and 11 female patients, with a mean age of 72.3 years (ranging from 56 to 82 years). The major causes which resulted in acute limb ischemia included: arterial embolization of 43 cases, arterial thrombosis of 8 cases, arterial dissection of 3 cases. The acute limb ischemia occurred in the process of balloon angioplasty/stent in 36 cases, catheter-directed thrombolysis in 17 cases, Silverhawk atherectomy in 1 cases. Thirty-two cases were treated by endovascular treatment, 9 cases by surgical procedures (bypass or embolectomy), 13 cases by the combination of endovascular therapy and surgical procedures.

RESULTSTreatment were successfully accomplished in 50 of 54 cases, and failed in 4 cases which had surgical amputation. There were no deaths in all the patients. Forty-five of 54 cases were followed up for the average of 40.3 months. Six cases had ischemic symptoms recurrence in 43 artery embolization patients, in whom 4 cases were cured by endovascular treatment, 2 cases were cured by toe amputation. One case of bypass anastomotic stenosis and one case of stent restenosis were successfully cured by endovascular treatment in 8 arterial thrombosis patients. One cases of below-knee artery stent occlusion in 3 arterial dissection patients was cured by medical treatment. Four cases of amputation patients were followed up in good condition.

CONCLUSIONSMost patients of acute limb ischemia complicated in endovascular therapy could be treated by endovascular therapy. Surgical procedures in time is still the best choice for the patients in whom the endovascular therapy was not satisfied.

Acute Disease ; Aged ; Aged, 80 and over ; Arterial Occlusive Diseases ; therapy ; Atherectomy ; Female ; Humans ; Intraoperative Complications ; prevention & control ; Ischemia ; etiology ; prevention & control ; Lower Extremity ; blood supply ; Male ; Middle Aged ; Retrospective Studies ; Stents

BACKGROUNDIliac vein compression syndrome (IVCS), the symptomatic compression of the left common iliac vein between the right common iliac artery and the vertebrae, is not an uncommon condition. The aim of this research was to retrospectively evaluate long-term outcome and the significance of endovascular treatment in patients with left IVCS.

METHODSBetween January 1997 and September 2008, 296 patients received interventional therapy in the left common iliac vein. In the second stage, 170 cases underwent saphenous vein high ligation and stripping. Two hundred and thirty-one cases were followed up over a period of 6 to 120 months (average 46 months) and evaluated for symptom improvement with color ultrasound and ascending venography.

RESULTSThe stenotic or occlusive segments of the left iliac vein were successfully dilated in 285 cases, of whom 272 received stent implantation therapy. Most of the patients achieved satisfactory results on discharge. During the follow-up period, varicose veins were alleviated in 98.7% of the patients, and leg swelling disappeared or was obviously relieved in 84% of cases. About 85% of leg ulcers completely healed. The total patency rate was 91.7% as evaluated with color ultrasound and 91.5% with ascending venography.

CONCLUSIONSEndovascular treatment of IVCS provides effective symptomatic improvement and good long-term patency in most patients.

Adolescent ; Adult ; Angioplasty, Balloon ; Female ; Humans ; Iliac Vein ; pathology ; Male ; Middle Aged ; Peripheral Vascular Diseases ; pathology ; therapy ; Phlebography ; Stents ; Young Adult

BACKGROUNDInterventional therapy is widely accepted as the first choice for the treatment of the Budd-Chiari syndrome, but the use of radical correctional therapy should not be discarded. This study describes radical correction by controlling bleeding from distal end of pathological segment of the inferior vena cava (IVC) and discusses potential surgical errors and postoperative complications.

METHODSOf the 216 patients in the study, 78 were treated with simple membranectomy, 64 with dissection of the pathological segment of the IVC and vascular prosthesis or pericardial patch plasty, 60 with resection of the pathological segment of the IVC and orthotopic graft transplantation with vascular prosthesis, and 14 with resection of the occlusive main hepatic vein and its upper IVC, hepatic venous outflow plasty and vascular prosthesis orthotopic graft transplantation from the hepatic venous entrance to the IVC of right atrial ostium.

RESULTSExcept 14 cases who were discharged after hepatic vein outflow plasty, four cases died postoperatively, and 198 patients were discharged without complications. The symptoms of 15 patients were relieved partially and 2 without any change. There were no deaths intraoperatively. Of the 112 cases who were followed up for 72 months, 13 suffered from a relapse.

CONCLUSIONSRadical correction is a beneficial therapy in the treatment of Budd-Chiari syndrome.

Adolescent ; Adult ; Budd-Chiari Syndrome ; pathology ; surgery ; Child ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Vascular Surgical Procedures ; methods ; Vena Cava, Inferior ; surgery

BACKGROUNDCatheter-directed thrombolysis (CDT) for deep venous thrombosis (DVT) of the lower extremity has good effect, but whether iliac vein stent placement after thrombolytic therapy is still controversial. The goal of this study was to evaluate the efficacy of stent placement in the iliac vein following CDT in lower extremity DVT.

METHODSThis was a single-center, prospective, randomized controlled clinical trial. After receiving CDT, the major branch of the distal iliac vein was completely patent in 155 patients with lower extremity DVT, and 74 of these patients with iliac vein residual stenosis of >50% were randomly divided into a control group (n = 29) and a test group (n = 45). In the test group, stents were implanted in the iliac vein, whereas no stents were implanted in the control group. We evaluated the clinical indicators, including patency of the deep vein, C in CEAP classification, Venous Clinical Severity Score (VCSS), and Chronic Venous Insufficiency Questionnaire (CIVIQ) Score.

RESULTSAll patients had postoperative follow-up visits for a period of 6-24 months. Venography or color ultrasound was conducted in subjects. There was a significant difference between the patency rate at the last follow-up visit (87.5% vs. 29.6%) and the 1-year patency rate (86.0% vs. 54.8%) between the test and control groups. The change in the C in CEAP classification pre- and post-procedure was significantly different between the test and control groups (1.61 ± 0.21 vs. 0.69 ± 0.23). In addition, at the last follow-up visit, VCSS and CIVIQ Score were both significantly different between the test and control groups (7.57 ± 0.27 vs. 0.69 ± 0.23; 22.67 ± 3.01 vs. 39.34 ± 6.66, respectively).

CONCLUSIONThe stenting of iliac vein obstruction following CDT in lower extremity DVT may increase the patency of the deep vein, and thus provides better efficacy and quality of life.

Adolescent ; Adult ; Aged ; Catheterization, Peripheral ; methods ; Female ; Humans ; Iliac Vein ; Lower Extremity ; pathology ; Male ; Middle Aged ; Stents ; Thrombolytic Therapy ; methods ; Venous Thrombosis ; therapy ; Young Adult

In 2016, a severe leaf spot disease was found on Iris ensata Thumb. in Nanjing, China. The symptom was elliptical, fusiform, or irregularly necrotic lesion surrounded by a yellow halo, from which a small-spored Alternaria species was isolated. The fungus was identified as Alternaria iridiaustralis based on morphological characteristics. The pathogenicity tests revealed that the fungus was the causal pathogen of the disease. Phylogenic analyses using sequences of ITS, gpd, endoPG, and RPB2 genes confirmed the morphological identification. This study is the first report of A. iridiaustralis causing leaf spots on I. ensata in China.
Alternaria* ; China* ; Fungi ; Iris* ; Sequence Analysis ; Thumb ; Virulence

Objective·To investigate the predictive value of the Clinical Frailty Scale(CFS)in the long term outcomes in acute myocardial infarction(AMI)patients who completed in-hospital cardiac rehabilitation(CR).Methods·A total of 501 AMI patients treated in the Cardiology Center of Shanghai Sixth People's Hospital,Shanghai Jiao Tong University of Medicine from May 2020 to May 2022 were prospectively enrolled,with their baseline clinical data collected.The patients completed graded in-hospital CR and were assessed by CFS based on their completion of CR before discharge.Patients were then categorized into three groups(norm group,vulnerable group and frail group)according to their CFS level.The difference in 1-year major cardiovascular event(all-cause death and re-hospitalization for heart failure)rates among the three groups was investigated.Logistic regression analysis was performed to explore the effective risk factors relevant to the outcomes,and receiver operator characteristic(ROC)curves were generated to analyze the prognostic value.Finally,an optimal prediction model was developed.Results·The CFS level in AMI patients who completed CR was positively correlated with age and peak pro-B-type natriuretic peptide(peak proBNP),and inversely correlated with gender difference(P<0.05).Accompanied with the elevated CFS level,the incidence of both outcomes increased,and there were significant differences in all-cause death(2.6%,5.6%and 15.2%,P=0.002),and while no significant differences in re-hospitalization for heart failure among the three groups(19.6%,22.2%and 24.2%).All-cause death of the frail group was significantly higher than that of the norm group(P=0.004),while there was no significant difference between the vulnerable group and the norm group.CFS could sensitively predict the 1-year all-cause death in AMI patients(β=1.89,OR=6.61,P=0.001),and the risk model combined with CFS had the best predictive effect(AUC=0.845,P=0.000).Conclusion·Assessment by CFS in AMI patients who completed in-hospital CR contributes to identifying AMI patients with high risk of all-cause death in 1 year.

Objective To explore the association between chronic periodontitis and hypertension in rural adult Uygur residents.Methods A total of 1415 Uygur residents aged 18 and over were selected by random multistage and probability proportional to size from 364 villages in Moyu county of Xinjiang Uygur autonomous region,all subjects received questionnaire,physical examination and biochemical analysis and oral examination.The subjects were categorized as periodontitis group and no periodontitis group,the periodontitis group was further categorized as mild,moderate and severe periodontitis subgroup.The relationship between chronic periodontitis with hypertension was analyzed by Spearman correlation.Binary logistic regression was used to calculate the influential factors for hypertension.Results The prevalence rates of chronic periodontitis and hypertension were 66.0％ (934/1415) and 33.8％ (478/1415),respectively.The prevalence rates of hypertension were 18.7％ ( 90/481 ),35.1％ ( 131/373 ),32.3％(62/192),52.8％ (195/369) in no periodontitis,mild,moderate and severe periodontitis groups,respectively.Spearman correlation showed an association of chronic periodontitis with hypertension (rs =0.273,P ＜ 0.01 ).After adjustment for age,gender,body mass index,waist circumference,glycometabolism disorder,hyperlipidemia,chronic kidney disease,multiple logistic regression analysis showed that periodontitis was significantly associated with hypertension ( OR = 1.75,95％ CI:1.30 - 2.36,P ＜0.01 ).Compared with no periodontitis,mild ( OR = 1.76,95％CI:1.26 -2.48,P ＜0.01 ) and severe ( OR = 2.26,95％ CI:1.57 - 3.26,P ＜ 0.01 ) periodontitis were significantly associated with hypertension while moderate periodontitis was not significantly associated with hypertension ( OR = 1.21,95％ CI:0.80 - 1.84,P ＞ 0.05 ).Conclusion This study showed an independent association of periedontitis with hypertension in this study cohort.

Objective Throush identify biochemical characteristics and virulence factors of 2 strains suspected Yersinia pestis(Y.pestis)isolated from the dead Marmota himalayana(M.himalayana)to confirm the nature epidemic focus in Dege County,Sichuan Province.Methods Y.pestis was analyzed by specific staining and shape,culturing characteristics,splitting-test by bacteriophage,test of biochemical characteristics and glycolysis ability,virulence factors,virulence,nutritional requirement,plasmid,genetic test and genetic type. Results The tested strains were Gram staining bacilus.The main biochemical characteristics were Arabinose(+)、 Rhamnose(-),Maltose(+),Melibiose(-),Glycerol(+),Denitrification(+).The virulence factors with FI+.VW+, Pgm+,Pst I+;and with the common 6.0×106,45.0×106,65.0×106 plasmids,also with the virulence-relative plasmid gene.Both their absolutely lethal dose(LD100)in mice were 50 bacteria.The nutritional requirement appeared which were depended on Phenylalanine and Methionine.With the Genomovar 5 genotype characteristics of M.himalayana plague foci of Qinghai-Tibet plateau.The difference between tested strains and Yersinia pseudotubercuosis on the 3 different culture medium was obvious.The tested strains had a Y.pestis' specific 3a fragment,Pst I and FI-Ag,at 22 ℃,the strains could be split by bacteriophage completely.Conclusions According to the diagnostic criteria of plague in China,the 2 suspected strains isolated from Dege County,Sichuan Province ale confirmed as Y.pestis.both with powerful virulenceand with the characteristics of the Y.pestis of M.himahtyana in Qinghai-Tibet plateau plague natural focus.