The identification of the specific cause in every patient has important clinical implications, because ischemic stroke is an etiologically heterogeneous disease. The Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification can be used to define the etiology of stroke. However, TOAST classification can not be completed timely on admission of patients with acute stroke, which has impacted early guidance of clinical treatment. This article reviews the biological markers of early differential-diagnostic significance of the TOAST classification.

Four-Dimensional Computed Tomography ; Humans ; Liver Neoplasms ; diagnostic imaging ; radiotherapy ; Lung Neoplasms ; diagnostic imaging ; radiotherapy ; Male ; Prostatic Neoplasms ; diagnostic imaging ; radiotherapy ; Radiotherapy Planning, Computer-Assisted ; methods ; Radiotherapy, Intensity-Modulated ; methods

Objective To study the expression of transforming growth factor -β1 (TGF -β1 )in myocardial tissue and the concentration of serum B -type natriuretic peptide (BNP)in myocardial remodeling of SD rats induced by isoproterenol (ISO)and the effects of carvedilol intervention.Methods According to random number table,30 male SD rats were divided into 3 groups:(1 )after 9 g/L saline was injected with 5 mL/(kg·d)for 1 0 days,9 g/L sa-line was used at the dose of 1 0 mL/(kg·d)by way of gavage for 4 weeks in the control group (n =1 0);(2)after ISO was injected with 5 mg/(kg·d)for 1 0 days,9 g/L saline was used at the dose of 1 0 mL/(kg·d)by way of gavage for 4 weeks in the model group (n =1 0);(3)after ISO was injected with 5 mg/(kg·d)for 1 0 days,carvedilol was used at the dose of 1 0 mg/(kg·d)by way of gavage for 4 weeks in the treatment group (n =1 0).Then,all the rats were killed and the cardiac weight index (CWI)was measured.The pathological changes of myocardial tissue were ob-served through HE staining and Masson staining.The mRNA expression of TGF -β1 was detected by adopting reverse transcription -polymerase chain reaction.The protein of TGF -β1 was detected by means of immunohistochemistry and Western blot.The concentration of serum BNP was tested by adopting enzyme -linked immuno sorbent assay.Results (1 )Pathological changes by light microscope:no significant pathological changes were observed in myocardial tissue of the control group.The denaturization,hypertrophy,edema,necrosis of myocardial cells and collagen fibers increased in myocardial tissue of the model group were more serious than those of the treatment group.(2)CWI:CWI of the model group[(3.31 ±0.07)mg/g]was significantly higher than that of the treatment group[(3.03 ±0.04)mg/g],and CWI of the treatment group was significantly higher than that of the control group[(2.98 ±0.1 0)mg/g].There was significant difference among 3 groups (F =54.383,P =0.000).There was also significant difference between any 2 groups (all P <0.01 ).(3)The level of TGF -β1 of myocardial tissue:the level of TGF -β1 of the model group was significantly higher than that of the treatment group,and the level of TGF -β1 of the treatment group was significantly higher than that of the control group by using three detection methods.There was significant difference among 3 groups (F=1 3.62,P =0.000).There was also significant difference between any 2 groups (all P <0.01 ).(4)The concentration of serum BNP:the concentration of serum BNP of the model group[(61 .1 3 ±2.00)ng/L]was significantly higher than that of the treatment group[(57.08 ±1 .52)ng/L],and the concentration of serum BNP of the treatment group was sig-nificantly higher than that of the control group[(51 .56 ±1 .80)ng/L].There was significant difference among 3 groups (F =72.81 ,P =0.000).There also was significant difference between any 2 groups (all P <0.01 ).Conclusions The expression of TGF -β1 in myocardial tissue was up -regulated and the concentration of serum BNP was increased in my-ocardial remodeling of SD rats induced by ISO.The carvedilol intervention can down -regulate the expression of TGF -β1 and decrease the concentration of BNP,then inhibit myocardial remodeling,and improve cardiac function.

OBJECTIVETo compare the clinical effects of interlocking intramedullary nail and micro-invasive internal fixation with plate for the treatment of multiple segmental tibiofibular fractures.

METHODSThe clinical data of 39 patients with multiple segmental tibiofibular fractures received treatment from January 2010 to June 2013 were retrospectively analyzed. In the 39 patients, 18 cases were treated by the interlocking intramedullary nail (intramedullary nail group), there were 12 males and 6 females with the mean age of (40.6 ± 9.7) years old (ranged, 24 to 60 years);7 cases were type C2.1, 11 were type C2.2 according to the AO classification. The other 21 cases were treated by micro-invasive internal fixation with plate(plate group), there were 13 males and 8 females with the mean age of (41.7 ± 8.1) years old (ranged, 22 to 52 years), 7 cases were type C2.1, 13 were type C2.2, 1 was type C2.3. Preoperative preparation time, operation time, intraoperative blood loss, postoperative complications, fracture healing time were compared between two groups. Johner-Wruhs evaluation criteria was used to evaluate the clinical effect at last follow-up.

RESULTSAll the patients were followed up from 10 to 28 months with an average of 15.2 months. Operative time, intraoperative blood loss in intramedullary nail group were (62.1 ± 5.8) min, (70.9 ± 7.1) ml, respectively; in plate group were (64.3 ± 7.7) min, (74.1 ± 8.5) ml,respectively. There was no significant difference in operation time and intraoperative blood loss between two groups (P > 0.05). However, preoperative preparation time, fracture healing time in intramedullary nail group were (5.3 ± 0.7) days, (11.1 ± 1.9) months, in plate group were (7.1 ± 0.8) days, (14.1 ± 2.2) months, respectively. No postoperative complications were found in intramedullary nail group, and five cases developed with complications in plate group. There was significant difference in preoperative preparation time, postoperative complications and fracture healing time between two groups (P < 0.05). According to Johner-Wruhs criteria at last follow-up, 11 cases got excellent results, 4 good, 3 fair in intramedullary nail group; 11 excellent, 5 good, 2 poor in plate group.

CONCLUSIONInterlocking intramedullary nail has advantages of shorter preoperative preparation time, less postoperative complications and faster fracture healing time in treating multiple segmental tibiofibular fractures. But the application scope of interlocking intramedullary nail was inferior to micro-invasive internal fixation with plate , and its indications should be strictly controlled.

Adult ; Bone Plates ; Case-Control Studies ; Female ; Fibula ; injuries ; surgery ; Fracture Fixation, Internal ; instrumentation ; Fracture Fixation, Intramedullary ; methods ; Fracture Healing ; Humans ; Male ; Middle Aged ; Operative Time ; Retrospective Studies ; Tibial Fractures ; surgery

In this study, the human umbilical vein endothelial cell model was used to study the regulating effect of lipophilic components in Salvia miltiorrhiza on angiogenesis, and explore its possible mechanism. The cell model was established to determine the effect of lipophilic components in S. miltiorrhiza on the proliferative activity and migration capacity of endothelial cells. Then the realtime fluorescence quantification PCR technology was applied to detect the changes in the gene expressions of angiogenesis-related cytokines VEGF-A, VEGF-C and MMP-9. The results showed that 5 mg x L(-1) lipophilic components in S. miltiorrhiza could inhibit the proliferation and migration of endothelial cells, and reduce the expression of VEGF-A and MMP-9 genes. It indicated that lipophilic components in S. miltiorrhiza may inhibit the proliferation and migration of endothelial cells by inhibiting the expression of VEGF-A and MMP-9 genes, so as to show the inhibitory effect on angiogenesis.
Angiogenesis Inhibitors ; chemistry ; pharmacology ; Cell Movement ; drug effects ; Cell Proliferation ; drug effects ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Human Umbilical Vein Endothelial Cells ; cytology ; drug effects ; metabolism ; Humans ; Matrix Metalloproteinase 9 ; genetics ; metabolism ; Salvia miltiorrhiza ; chemistry ; Vascular Endothelial Growth Factor A ; genetics ; metabolism

Objective To explore the effect of iron chelators on labile iron pool and expression of apoptosis associated genes in cells of K562, an erythroleukemia cell line.Methods K562 cells were incubated at 37 ℃ in RPMI 1640 containing 10% heat-inactived fetal bovine serum in an saturated humidity and 5% CO_2 incubator. K562 cells were incubated with different concentrations of desferro-(xamine(DFO)). The study groups were divided as following: DFO group, iron+DFO group and the control group. Following indices were detected which included apoptosis by flow cytometry (FCM) assay, expression of Rb, c-myc, bax mRNA by RT-PCR. The intracellular LIP was measured with a fluorimetric assay using the metalsensitive probe calcein-AM.Results 1. The viability of K562 cells incubated with different concentrations of DFO was lower than that of control group at 12 h,24 h and 48 h (P

Objective To construct and apply a cell line screening Mycobacterium tuberculosis (Mtb)-specific tetramers of CD4+α/β T cell receptor(TCR). Methods The β chains of HLA class Ⅱ (DR) were amplified from tuberculosis patients by PCR. The pMT-HLA-DRB expression vectors that carries the HLA-DR 13 chain and pMT-HLA-DRA-P expression vectors which carries the genes of HLA-DR α chain loaded with Mtb antigen were transfected into S2 cells with the method of calcium phosphate transfection. The expressed Mtb peptide/HLA-DR complexes were primarily identified by the method of cell immunohistochemistry. The cell lines expressing Mtb peptide/HLA-DR complexes were used to screen tetramers of CD4+ TCR by flow cytometry. Results S2 cell lines expressing Mtb peptide/HLA-DR complexes on the cell surface were obtained, two kinds of Mtb specific tetramers of CD4+α/β TCR were screened. Conclusion S2 cell lines expressing Mtb peptide/HLA-DR complexes on the cell surface provide the solid basis of the further research on the TCR tetramers and are helpful for exploring new diagnostic study methods about tuberculosis and developing new vaccines.

Objective Under different standard uptake value(SUV),to assess gross tumor volume (GTV) definition for non-small cell lung cancer(NSCLC) with 18-fluoro-deoxy-glucose positron emission tomography (~(18)FDG PET) both under definite threshold (42 percent threshold) and various relative threshold (threshold SUV/maximum SUV) derived from the linear regressive function,threshold SUV=0.307?(mean target SUV)+0.588,with computer tomography (CT).Methods Of 20 patients with non-small cell lung cancer,the CT GTV (GTV_(?)).PET GTV with 42 percents threshold (GTV_(42%)) and PET GTV with relative threshold (GTV_(?)) were obtained and compared.Results The mean GTV_(42%),,mean GTV_(?) and mean GTV_(CT) was (13 812.5?13 841.4),(24 325.3?22 454.7) and (28 350.9?26 079.8)mm~3,respectively,with the difference in mean GTV among these three methods significant (F =10,P＜0.01).The GTV_(42%) was smaller than the GTV_(?) and the GTV_(CT)(P＜0.01),with i(?)significant difference between GTV_(?) and GTV_(CT)(P=0.125).Conclusion The relative threshold is more suitable to define the gross tumor volume than the definite threshold.

Objective To investigate the dynamic characteristic changes of gastrointestinal mucosa and its relationship with disease progression in rats with acute cerebral infarction. Methods Fifty-six male Wistar rats were selected as the study subjects, and they were divided into three groups: normal control, sham operation and cerebral infarction model groups by random number table method. The middle cerebral artery occlusion (MCAO) model was prepared by the modified Longa thread embolic method. The levels of gastrin (GAS) were monitored in each group after modeling for 24 hours, 4 days and 7 days; after the rats were killed, the sections of gastric antrum and small intestine were taken and stained with hematoxylin-eosin (HE) staining method, the histopathological changes of gastric and small intestinal mucosa were observed under light microscope, in the mean time the gastric and small intestinal mucosal pathological scores were also performed, and the differences of pathological scores among the three groups were compared. Results There were no statistical significant differences in GAS, gastrointestinal mucosa and small intestinal mucosal pathological scores between the normal control group and sham operation group at each time point (all P > 0.05); the GAS level in cerebral infarction model group was decreased gradually with time prolongation, reaching the lowest level 7 days after modeling, but the GAS level in cerebral infarction model group was significantly higher than that in normal group and shamoperation group (ng/L: 205.02±7.68 vs. 130.51±8.03, 145.29±7.68, both P < 0.05). The pathological scores of gastrointestinal mucosa and small intestinal mucosa in the cerebral infarction model group were increased first and then decreased with time prolongation, peaked on 4th day and decreased significantly on 7th day, the pathological scores of gastrointestinal mucosa and small intestinal mucosa in the cerebral infarction model group at each time point were significantly higher than those in the normal control group and sham-operated group (gastric mucosal pathological score: 82.50±2.95 vs. 21.38±1.57, 36.10±3.41; small intestinal mucosal pathological score: 62.00±2.78 vs. 18.25±1.39, 25.55±1.75, all P < 0.05). Under light microscopy, the normal control group showed complete normal morphological appearance, normal structure, orderly arrangement of villi and no infiltration of inflammatory cells; in shamoperation group, inflammatory cells infiltrated the lamina propria at each time point, and there were villi slightly uneven, enlarged stroma, congestion, edema occasionally seen and no obvious ulcer; in cerebral infarction model group, the various layers of gastrointestinal mucosal were not very clear, the glands were arranged irregularly and the capillaries dilated, and in part of tissues, congestion, hemorrhage, edema and inflammatory cell infiltration were seen obviously. Conclusion The injury of gastrointestinal mucosa in acute stage of cerebral infarction should be related to the stress stimulation and disease progress of cerebral infarction itself, not due to the abnormal secretion of GAS.

Tumor immune checkpoint therapy is a clinical treatment strategy developed based on the new principle of the inhibition of negative immune regulation. In this article, the tumor immune checkpoint therapy and the drug delivery strategies were reviewed, mainly including immunity and tumor therapy, tumor immune checkpoint therapy and its mechanism of action, clinical application of tumor immune checkpoint therapy and therapeutic drugs, immune resistance of programmed cell death protein 1 (PD1)/programmed cell death ligand 1 (PDL1) treatment and countermeasures, drug delivery strategies for tumor immune checkpoint therapeutic agents, etc. As a revolutionary new immunotherapy strategy, tumor immune checkpoint therapy has shown obvious superior therapeutic efficacy in a variety types of tumor. However, tumor immune checkpoint therapy is also faced with a big challenge, namely, immunotherapy resistance. With the discovery of new mechanism, the continuous development of new therapeutic drugs and delivery strategies, tumor immune checkpoint therapy is expected to further improve the clinical efficacy of tumor.