Objective To explore the influencing factors on short -term efficacy of intravenous thrombolysis with rt -PA.Methods The clinical data of the 95 acute ischemic stroke(AIS)patients who received thrombolytic therapy were analyze.Multivariate logistic regression analysis was used to determine the possible influencing factors. Results Fifty -six(58.95%)patients had favourable outcomes after thrombolytic therapy for 24 hours.Multivariate logistic regression analysis indicated that diabetes(OR =3.933,95% CI 1.199 ~12.897)and TOAST classification (OR =1.448,95% CI 1.032 ~2.032 )were the independent predictors of short -term outcome.Conclusion Diabetes and TOAST classification are the major influencing factors of short -term efficacy after intravenous thrombolysis with rt -PA.It should pay attention screening patients for intravenous thrombolysis therapy and predicting the efficacy of thrombolysis.

Background and purpose:Remarkable advances have been made in cancer chemotherapy by developing new anticancer drugs and therapy strategies.However,multidrug resistance in human cancers remains a major clinical challenge for cancer treatment.Attempts in several clinical studies to reverse multidrug resistance protein (MDR) by using MDR modulators have not yet generated promising results.Our aim was to explored the mechanism of reversal of multidrug resistance in human leukemia K562 cells by PI3-K inhibitor.Methods:Trypanblue dye exclusion method was used to observe the drug sensitivity and the effect of LY294002 on the drug resistance.Western blot to analyze P-gp and p-Akt phenotypes,and flow cytometer was used to measure the intracellular drug accumulation. Results:K562/D induced by DNR was cross resistant to DNR,ADR,VCR and VP16 (Resistance Index:65,52,134 and 50 respectively).DNR induced over-expressions of P-gp and p-Akt in K562/D cells;LY294002 increased the intracellular drug accumulation,and then reversed the drug resistance to DNR,ADR,VCR and VPI6 in K562/D cells(Resistance Index:23,21,63 and 29 respectively),but not in the sensitive cells (K562/S).Conclusion:The multidrug resistance of K562/D cells can be induced by DNR which is related to the P-gp and p-Akt over-expressions, and LY294002 can reverse multidrug resistance in human leukemia cells in vitro via inhibits PI3-K/Akt pathway.

OBJECTIVETo compare the medium- and long-term effect of pneumatic ballistic extracorporeal shock wave versus ultrasound-guided hormone injection in the treatment of plantar fasciitis.

METHODSThe clinical data were collected from patients with plantar fasciitis admitted to PLA General Hospital pain department from September, 2015 to February, 2017. The patients were randomly divided into ultrasound-guided drug injection group and shock wave group. The therapeutic parameters including the numerical rating scale (NRS) scores in the first step pain in the morning, American Orthopedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Scale, and thickness of the plantar fascia were monitored before and at 1 week, 1 month, 3 months, and 6 months after the treatment. The recurrence rate, effectiveness, and patient satisfaction were compared between the two groups at 6 months after the treatment.

RESULTSThirty-nine patients were enrolled in shock wave group and 38 patients in ultrasound group. The NRS scores in the first step pain in the morning were lowered after treatment in both groups (P<0.05), and the scores were significantly lower in ultrasound group than in shock wave group at 1 week and 1 month (P<0.01), but significantly higher in ultrasound group than in shock wave group at 3 and 6 months after treatment (P<0.05). The AOFAS functional scores were increased in both groups (P<0.05) at 6 months after treatment, was significantly lower in ultrasound group than in shock wave group than group B (90.44∓13.27 vs 75.76∓21.40; P<0.05). The effective rates in shock wave group and ultrasound group were 92.31% and 76.32%, respectively (P<0.05). Recurrence was found in 1 patient (2.56%) in shock wave group and in 8 (21.05%) in ultrasound group (P<0.05). The patient satisfaction scores were significantly higher in shock wave group than in ultrasound group (8.13∓2.67 vs 6.63∓3.75, P=0.048).

CONCLUSIONPneumatic ballistic extracorporeal shock achieves better medium- and long-term outcomes than ultrasound-guided hormone injection in the treatment of plantar fasciitis.

This study was aimed to explore the change of single nucleotide polymorphism (SNP) of thrombin-activatable fibrinolysis inhibitor (TAFI) and its correlation of 2 sites (505a/g, 1040c/t) in its gene-coding region with venous thromboembolism (VTE). The genotype distribution of TAFI in 80 patients with VTE and 80 normal controls was detected by allele-specific PCR. The results showed that the distribution of each genotype of 505a/g polymorphism was not significantly different between the VTE and control groups (P > 0.05). However, t allele frequency of 1040c/t in VTE group decreased significantly as compared with the control group (40% vs 53.75%, P < 0.05), mainly due to the decrease of the proportion of tt homozygous in VTE group. It is concluded that obvious relationship is found between the polymorphism of 1040c/t in TAFI gene and VTE patients. t allele genotype may paly a protective role in VTE. The polymorphism of TAFI 505a/g may be not associated with VTE.
Adult ; Aged ; Aged, 80 and over ; Carboxypeptidase B2 ; genetics ; Case-Control Studies ; Female ; Gene Frequency ; Genotype ; Humans ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; Venous Thromboembolism ; genetics

Objective:To explore the clinical characteristics of pancreaticobiliary maljunction (PBM) and its disease spectrum, and to evaluate therapeutic endoscopic retrograde cholangiopancreatography (ERCP).Methods:Data of 52 PBM patients who received therapeutic ERCP procedures for abdominal pain, jaundice and fever in Department of Gastroenterology of Peking University Third Hospital from June 2006 to March 2021 were collected. The clinical characteristics, typing, the change of disease spectrum and ERCP procedures were analyzed.Results:Among 52 PBM patients, female was more common. Abdominal pain and jaundice were the most common clinical manifestations, among which 20 were type Ⅰ, 25 type Ⅱ and 7 type Ⅲ. Half patients had the choledochal cyst. The mean timespan from the first onset to the final diagnosis was 12.2 years. Twenty-four cases (46.2%) had changes in PBM disease spectrum. Among 69 ERCP procedures, 5 (7.2%) failed. Difficult cannulation rate was 34.6% (18/52), and 11 patients underwent advanced cannulation techniques, while it was 15.4% (657/4 275) in the conterpart non-PBM patients in the same period, with significant difference between them ( χ2=14.455, P<0.05). Multiple therapeutic ERCP techniques including endoscopic sphincterotomy, pancreatic stent placement, removal of stones from the duct were applied with the successful rate of 92.8% (64/69). The incidence of post-ERCP pancreatitis was 15.4% (8/52). Conclusion:The chief clinical problem may be changed over time in PBM patients. Although ERCP plays an important role in PBM and its disease spectrum, there may be a higher rate of difficult cannulation and postoperative complications.

Objective To study the safety,efficacy and complications of carotid angioplasty and stenting (CAS) in patients with symptomatic carotid artery stenosis,and compare it with medical therapy.Methods Fifty-two patients with symptomatic carotid artery stenosis,admitted to our hospital from May 2005 to May 2010,were performed CAS,and the other 63 patients with symptomatic carotid artery stenosis admitted to our hospital at the same period were adopted medical therapy.Patients of both groups were followed-up for 3,6 and 12 months,and 1 y; the incidence of ischemic stroke or transient ischemic attack (TIA) were compared and the NIHSS scores were noted between the 2 groups.Results The operation was terminated in 1 patient because of poor operation path; carotid sinus reflex occurred in 9 during intraoperative or postoperative periods; vascular spasm occurred in 2; hyperperfusion syndrome occurred in 4 during intraoperative period,but no serious consequences were noted in patients performed CAS after being given timely and effective treatment.Stroke recurred after 3 months in the patient whose operation was failed; no stroke or TIA recurred in the other patients during the 1-y-follow-up period; and 1 recurred after 1 y in patients received CAS.There are 11,9,7 and 12 patients had stroke or TIA attack during the 3,6 and 12 months,and 1 y follow-up period,respectively,in patients given medical therapy.As compared with those in the patients given medical therapy,the NIHSS scores during the 3,6 and 12 months,and 1 y follow-up period in patients received CAS were significantly lower (P＜0.05).Conclusion The CAS is a safe and feasible method in patients with symptomatic carotid artery stenosis;as compared with medical therapy,it can prevent recurrence of stroke more effectively.

Objective To investigate the effect of peptide Tat-GluR6-9c on phosphorylations and protein expressions of mixed-lineage kinase 3 (MLK3),mitogen-activated protein kinase kinase 7 (MKK7) and c-Jun NH2-terminal kinase (JNK),and its effect on hippocampus CA1 region neuronal cell injury induced by cerebral ischemia followed by reperfusion.Methods Twenty four adult male SD rats were randomly divided into sham-operated group,ischemia-reperfusion group (I/R),Tat-GluR6-AA treatment group and Tat-GluR6-9c treatment group (n=6).Four-vessel occlusion method was employed to establish the cerebral ischemia models in the later 3 groups.The effects of peptide Tat-GluR6-9c on the phosphorylations and protein expressions of MLK3 (6 h after the reperfusion) and JNK (3 d after the reperfusion) were detected by Western blotting; the effects ofpeptide Tat-GluR6-9c on the phosphorylation and protein expression of MLK7 (1 d after the reperfusion) were detected by Western blotting and immunohistochemistry.Cresyl Violet (CV) staining was employed to examine the survival of CA1 pyramidal cells in the hippocampus.Results The phosphorylation of MLK3,MKK7 and JNK in Tat-GluR6-9c treatment group was significantly less than that in I/R group and Tat-GluR6-AA treatment group (P＜0.05).As compared with I/R group and Tat-GluR6-AA group,peptide Tat-GluR6-9c group could obviously increase the number of neuron cells (P＜0.05).Conclusion Peptide Tat-GluR6-9c has a protective effect on neuron in CA1 region of hippocampus following cerebral ischemia-reperfusion by significantly decreasing the phosphorylations ofMLK3,MKK7 and JNK.

OBJECTIVEGenetic factors are thought to be involved in the development of vitiligo. The aim of this study is to explore the possible genetic model of vitiligo by analyzing the genetic characteristics of 815 patients from Zhejiang province.

METHODSData for 815 patients with vitiligo together with their first- and second-degree relatives were obtained using a standardized questionnaire. All these information was requested to confirm the answers about family history in order to reduce the possibility of 'recall' bias. The 815 probands would include 411 (50.43%) males and 404 (49.57%) females with a varied age from 2 months to 71 years old. Since the information on general prevalence of vitiligo in this area was absent, a control group was set up to facilitate the calculations of heritability degree. 468 persons of the control group were from non-vitiligo population with a sex ratio of 241(male): 227(female) with varied age of 4 months to 80 years old. Both gender and age were comparable between the vitiligo and the control population. The inheritance pattern estimation, heritability calculation and complex segregation analysis were performed with Penrose method, Falconer regression method and SAGE-REGTL program.

RESULTSIn 815 vitiligo probands, 128 had and 687 had not family histories, with a heritability rate of 15.7%. The vitiligo prevalence in proband's first degree relatives was 2.580%, higher than the prevalence of 0.618% in second degree relatives, and both of them were higher than general prevalence: 0.192%. By Penrose method, the rates on different catagories were as follows: sibling prevalence rates s = 0.080 18; population prevalence rate q = 0.001 92; s/q = 41.76. The ratio of s/q did not approach 1/2q (260.42) or 1/4q (130.21), but approached 1/square root of q(22.82), suggesting vitiligo was consistent with a mode of polygenic inheritance. Using Falconer's method, heritabilities of vitiligo in first-and second degree relatives of probands were 59.61% (95% confidence interval 65.37-53.84) and 55.20% (95% confidence interval 43.88-66.52), respectively. The weighted average of heritability in all relatives was 58.7% (95% confidence interval 53.56-63.83). The results of complex segregation analysis suggested that major gene model including the Mendelian dominant, recessive and additive hypotheses were not rejected (P > 0.05). Purely environmental model and no transmission model were rejected at a 0. 001 significance level. According to AIC, Mendelian dominant inheritance was the best-fitted hypothesis.

CONCLUSIONGenetic factors played an important role in the occurrence of vitiligo, and the genetic model of vitiligo could serve as the polygenetic or multifactorial inheritance with major gene trait.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Male ; Middle Aged ; Models, Genetic ; Vitiligo ; epidemiology ; genetics ; Young Adult

BACKGROUND:The angiogenesis may be related to the proliferation of neural stem ceils,but there is still no unified view.OBJECTIVE:To observe the influence of angiogenesis on neural stem cell proliferation in the subventricular zone of rats after focal cerebral ischemia/reperfusion.METHODS:Male Sprague-Dawley rats were randomly divided into normal group,sham group,vascular endothelial growth factor (VEGF)+cerebral ischemia/reperfusion group,normal saline (NS)+cerebral ischemia/reperfusion group.The injection was done via the lateral cerebral ventricle.Then,each group was subdivided into four groups (1,2,7,14 days after ischemia/reperfusion).Focal cerebral ischemia/reperfusion models were made by the thread method.After modeling,the corresponding intervention was given in each group.The expression changes of Nestin and vWF mRNA in the subventricular zone were detected in all groups by immunohistochemical staining and real-time PCR,respectively.RESULTS AND CONCLUSION:There was a certain increase in vWF and Nestin positive expression in the subventricular zone after cerebral ischemia/reperfusion.At 7 days after ischemia,the expression of vWF mRNA and Nestin reached the peak,indicating the proliferation of neural stem cells in the subventricular zone after cerebral ischemia/reperfusion is associated with the time of angiogenesis.In addition,the expression of vWF mRNA and Nestin was significantly higher in the VEGF+cerebral ischemia/reperfusion group than the other two groups,indicating angiogenesis could promote the proliferation of neural stem ceils in the subventricular zone of rats after cerebral ischemia/reperfusion.

The study was aimed to investigate the correlation of tissue factor promotor polymorphism -1208I/D with the venous thromboembolism in patients. Tissue factor promotor polymorphism -1208 was detected by polymerase chain reaction (PCR) and DNA sequencing in 96 cases of DVT, 14 cases of PE and 59 nonthrombosis normal individuals. The results showed that the allele containing a 18-bp nucleotides insertion at -1208. 67.8% of normal individuals exhibited D/D, 25.4% were heterozygous I/D, and 6.8% were homozygous for I/I. DVT group and PE group exhibited a similar distributions (62.5%D/D, 29.8% I/D, 8.3% I/I and 57.1% D/D, 35.7% I/D, 7.1% I/I). The allele frequencies of D and the allele frequencies of I in the normal control, DVT and PE groups were 80.5%, 77.1%, 75.0% and 19.5%, 22.9%, 25.0% respectively. There was no significant difference in the TF-12081/D genotype frequency between the groups of patients and normal individuals. In conclusion, there is no correlation of the tissue factor promotor polymorphism -1208I/D in the patients with venous thromboembolism. The gene of promoter -1208I/D may not be a major susceptible gene of VTE in Chinese Han. Further investigations would be necessary to define accurately tissue factor gene polymorphisms.
Adult ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Polymorphism, Genetic ; Promoter Regions, Genetic ; Thromboplastin ; genetics ; Venous Thromboembolism ; genetics