Objective To investigate the relationship between carotid atheromatous plaque and its related biochemical indexes and cerebral infarction.Methods 65 cases with cerebral infarction served as cerebral infarction(CI) group and 35 cases of non-cerebral infarction as control group. In both groups,the location,number and nature of carotid atheromatous plaque and diamete of carotid artery were assessed by Doppler ultrasonography,and the related biochemical indexes such as blood lipid,blood glucose and fibrinogen were evaluated.Results Significant differences of the detectable rate of carotid atheromatous plaque and the diameter of common carotid artery were found between CI group[81.54%,( 7.43? 0.07)mm of left side,(7.52?0.60)mm of right side] and control group[28.57%,(7.75?0.10)mm of left side,( 7.97? 0.75)mm of right side]( P

The article introduces the advances in the evaluation of transient ischemic stroke (TLA) and reviews them from four aspects, including identifying whether the symptoms accord with the diagnosis of TLA, which blood supply area the ischemia is located in, evaluating the pathogenesis of TIA, and predicting its prognosis.

Objective To compare the cardiac structure and function between diabetic and non-diabetic with different peritoneal transport type.Methods A total of 84 patients with continuous ambulatory peritoneal dialysis (CAPD) in our center for 6 months were enrolled in this study.Forty-six patients of subjects were diabetic,another 38 were non-diabetic.Patients were divided into four groups according to the results of peritoneal equilibration test (PET) and the ratio of creatinine concentration in dialysate solution and plasma (D/P creatinine concentration).Patients with D/P creatinine concentration ＞ 0.65 were with high permeability and otherwise were low permeability.The four groups were diabetic-H (high permeability) group,diabetic-L(low permeability) group,non-diabetic-H (high permeability) group,non-diabetic-L (low permeability) group.The levels of left atrial diameter (LAD),left ventricular diameter(LVD),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),left ventricular ejection fraction(LVEF) were measured before and after 6-month peritoneal dialysis by ultrasonic doppler.Results Before peritoneal dialysis,there were no significant difference in the terms of all parameters among four groups(P ＞0.05).After 6 months of peritoneal dialysis,the albumin levels,IVST,LVPWT and LVEF in diabetic-L group,non-diabetic-L,diabetic-H group and non-diabetic-H group were ((36.57 ± 3.34),(37.21 ± 4.12),(34.19 ± 3.98),(34.51 ± 4.52) g/L respectively;F =9.034),((10.45 ± 1.12),(10.17 ± 1.35),(11.32 ± 1.09),(11.46 ± 1.38) mm respectively;F =7.525),((9.58 ± 1.42),(9.47 ± 1.31),(10.71 ± 1.40),(10.15 ± 1.41) mm respectively; F =4.963) and ((63.98 ± 4.73) ％,(63.92 ± 5.17) ％,(60.12 ± 5.12) ％,(61.43 ± 5.57) ％respectively ;F =6.984),and the differences were statistic significant (P ＜ 0.05).Compared to diabetic-H group and non-diabetic-H group,there were significant difference in the terms of all above indexes between diabetic-L group,non-diabetic-L (P ＜ O.05).Conclusion The peritoneal transport.type of diabetic patients is high permeability,which might be an important factor affecting cardiac complications in patients.

Objective To investigate the effect of cystatin C (CysC) concentration on outcome of intravenous thrombolysis in patients with acute ischemic stroke.Methods The consecutive patients with acute ischemic stroke who underwent intravenous thrombolysis were enrolled retrospectively.They were divided into a good outcome group (≤2) and a poor outcome group (＞2) according to the Rankin scale.They were also divided into a hemorrhagic transformation (HT) group and a non-HT group according to whether they had HT or not.Their demographic data and clinical data were compared.Results A total of 103 patients with acute ischemic stroke treated with intravenous thrombolysis were enrolled,44 in the good outcome group,59 in the poor outcome group; 23 in the TH group,and 80 in the non-HT group.The age (62.34 ± 13.41 years vs.68.09 ± 9.74 years; t-2.521,P =0.013),baseline CysC concentration (1.008±0.28 mg/L vs.1.27±0.86 mg/L; t=2.237,P=0.027),incidence of HT (14％ vs.34.9％; x2 =6.016,P =0.014) and National Institutes of Health Stroke Scale (NIHSS) score (10.39 ± 3.11 vs.18 ±2.65; t =13.35,P ＜0.001) in the good outcome group were significantly lower than those in the poor outcome group.Multivariate logistic regression analysis showed that there was no significant independent correlation between CysC and clinical outcome (odds ratio 1.783,95％ confidence interval 0.443-7.185 ; P =0.416).The baseline CysC concentration (1.41 ± 0.54 mg/L vs.0.96± 0.18 mg/L; t =3.941,P=0.001) and the NIHSS score (15.96 ± 3.7 vs.13.05 ±4.87; t =3.017,P =0.004) in the non-HT group were significantly lower than those in the HT group.Multivariate logistic regression analysis showed that the plasma CysC concentration ＞ 1.03 mg/L (odds ratio 9.050,95％ confidence interval 2.384-34.359; P =0.001) was an independent risk factor for HT.Conclusions The increased baseline plasma CysC concentration was associated with the occurrence of HT in patients with acute ischemic stroke after intravenous thrombolysis therapy,but it was not associated with the outcomes.

Objective To investigate the value of clinical parameters in predicting the initiation of renal replacement therapy(RRT) in acute kidney injury (AKI) patients with cardiorenal syndrome (CRS).Methods A total of 75 AKI patients hospitalized with CRS were enrolled.All patients received pharmacologic therapy on the beginning 3 days.The patients whose heart function improved were divided into control group (n=39),and the patients whose heart function worsened were divided into RRT group (n=36).Clinical and laboratory data on the first day and the fourth day were collected and analyzed.The factors on the first day were labeled asⅠ ,and those on the fourth day were labeled asⅡ. The ratio of some parameters calculated were labeled asⅡ/Ⅰ .Area under curve (AUC) of receiver operating characteristic curve (ROC) of these factors was used to evaluate the sensitivity and specificity in predicting the initiation of RRT.Results The patients in RRT group had significantly higher levels of BNP-Ⅱ,BNP Ⅱ / Ⅰ and creatinine Ⅱ / Ⅰ (P ＜ 0.01),and lower levels of 24 hours urine volume-Ⅰ and 24 hours urine volume-Ⅱ (P ＜ 0.01).From ROC curve analysis,the AUC of 24 hours urine volume-Ⅰ,24 hours urine volume-Ⅱ,creatinine Ⅱ / Ⅰ,BNP-Ⅱ levels and BNP Ⅱ/Ⅰ to predict RRT were 0.736,0.875,0.747,0.779 and 0.894 respectively.When the cutoff values of 24 hours urine volume-Ⅰ,24 hours urine volume-Ⅱ,BNP-Ⅱ levels,BNP Ⅱ / Ⅰ and creatinine Ⅱ / Ⅰ were 905 ml (sensitivity 75％,specificity 94.9％),1450 ml (sensitivity 75％,specificity 100％),3360 ng/L (sensitivity 72.2％,specificity 100％),1.37 (sensitivity 75％,specificity 100％) and 1.25 (sensitivity 72.2％,specificity 94.4％) respectively,the value of the parameters to predict RRT was high.Conclusions The 24 hours urine volume,BNP levels after treatment and the dynamic changes of BNP levels and creatinine levels can be used as predictors of the initiation of RRT in the AKI patients with CRS.

Objective:To investigate the expression and clinical significance of PD-L1 in colorectal cancer (CRC). Methods:A total of 210 CRC patients who accepted radical surgery in our hospital from January 2015 to January 2016 were divided into three groups, namely, high-frequency microsatellite instability (MSI-H), low-frequency microsatellite instability (MSI-L), and microsatellite stable (MSS). The expression of PD-L1 was detected by immunohistochemistry, and the expression characteristics of PD-L1 in different types of CRC were analyzed. Results:CRC cases with low differentiation had a higher expression of PD-L1 than CRC patients with high differ-entiation (P<0.05). PD-L1 had a positive rate of 75.8%in the MSI-H group and a rate of 9.3%in the MSI-L and MSS groups, wherein the difference between the two groups was statistically significant (P<0.05). Conclusion:PD-L1 was positively expressed in some CRC tu-mor tissues, and its positive rate was significantly higher in MSI-H than in MSI-L and MSS. The therapeutic effect of a PD-L1 blocker for patients with MSI-H CRC might be preferable.

Carcinoma ; diagnosis ; Granuloma, Plasma Cell ; diagnosis ; Humans ; Laryngeal Neoplasms ; diagnosis ; Larynx ; pathology

Objeetive To investigate the risk of hemorrhagic transformation (HT) and the outcome as well as its influencing factors at 3 months after thrombolytic therapy in acute ischemic stroke patients with non-valvular atrial fibrillation (NVAF).Methods Consecutive acute ischemic stroke patients with NVAF were enrolled retrospectively.Their demography,vascular risk factors and other clinical data were collected.The modified Rankin Scale (mRS) was used to evaluate the outcome at 3 months after symptom onset.The mRS score ≤ 2 was defined as good outcome,and ＞ 2 was defined as poor outcome.Results A total of 119 acute ischemic stroke patients with NVAF were enrolled,including 63 males (52.9％) and 56 females (47.1％); their mean age was 72.1± 10.0; 45 (37.81％) were treated with recombinant tissue type plasminogen activator (rtPA),55 (46.2％) had a good outcome and 27 (22.7％) combined with HT.Compared with the poor outcome group,the mean age was younger in the good outcome group (P =0.028).The proportions of the patients with ischemic heart disease and the time from onset to treatment ＞ 4.5 h were lower (P ＜0.05).The baseline systolic blood pressure and diastolic blood pressure,as well as the National Institutes of Health Stroke Scale (NIHSS) score were lower (P ＜0.05),while the proportion of patients receiving intravenous thrombolysis with rtPA was higher (P =0.019).Multivariate logistic regression analysis showed that the patients with ischemic heart disease (odds ratio [OR] 4.572,95％ confidence interval [CI] 1.392-15.014; P =0.012),systolic blood pressure before treatment (OR 1.028,95％ CI 1.007-1.049; P =0.009),baseline NIHSS score (OR 1.058,95％ CI 1.002-1.117; P =0.042) were the independent risk factors for poor outcome,while intravenous thrombolysis with rtPA (CI 0.264,95％ CI 0.102-0.683; P =0.006) was an independent protective factor for poor outcome.The proportions of the baseline systolic blood pressure,fasting blood glucose and NIHSS score,as well as the patients with a history of previous stroke or transient ischemic attack (TIA) in the HT group were significantly higher than those in the non-HT group (all P ＜ 0.05).Multivariate logistic regression analysis showed that the baseline NIHSS score (OR 1.147,95％ CI 1.068-1.231; P＜0.001),baseline systolic blood pressure (OR 1.951,95％ CI 1.921-1.982; P =0.002),and blood glucose level (OR 1.191,95％ CI 1.095-1.294; P ＜ 0.001) were the independent risk factors for HT.Compared with the non-thrombolysis group,the mean age of the thrombolysis group was younger (P =0.021),the baseline systolic blood pressure,fasting glucose and NIHSS scores,as well as the proportions of patients with hyperlipidemia,previous stroke or TIA history,and using antihypertensive drugs before admission were higher (all P ＜ 0.05).The proportion of patients with ischemic heart disease were lower (P =0.035),but the proportion of the patients with a good outcome was higher (P =0.019).Conclusions Patients with ischemic heart disease,systolic blood pressure and higher baseline NIHSS score before treatment were the independent risk factors for poor outcome,while intravenous thrombolytic therapy with rtPA was an independent protective factor for poor outcome; the high baseline NIHSS score,baseline systolic blood pressure and glucose level were the independent risk factors for HT.For acute ischemic stroke patients with NVAF,such as no obvious contraindications for thrombolytic therapy,might benefit from intravenous thrombolytic therapy,and it could not increase the risk of HT,but the blood pressure and glucose level of the patients should be controlled appropriately.

The pathogenesis of HBsAg (+)/HBsAb (+) double positive hepatitis B virus infection was investigated by simulating HBsAg/HBsAb coexistence in vitro and establishing HBsAg/HBsAb double positive model in vivo. Eukaryotic expression plasmids PCI-SY, PCI-adw, PCI-adr, PCI-ayw, which expressed S gene product of different serotypes, were constructed and transfected into HepG2 cells. Recombinant proteins were purified from the transfected cells. At the same time, HBsAg mouse antiserum was obtained by immunizing mice with PCI-SY plasmid. HBsAg/HBsAb coexistence was simulated using these antigens and antiserum. Furthermore, the expression plasmids expressing different serotypes of S gene product including PCI-adw, PCI-adr, and PCI-ayw were injected into mice via tail vein. HBsAg and HBsAb in mice sera were tested at the first and 7th day respectively after antigen plasmids injection. Both in vitro simulation and in vivo animal models demonstrated that HBsAg antigen and HBsAb of the same serotypes could not coexist, but HBsAg antigen and HBsAb of different serotype could coexist. HBsAg/HBsAb double positive hepatitis B virus infection could be due to infection of viruses of different serotypes.

[ ABSTRACT] AIM: To explore whether autophagy is involved in the excessive death of renal tubular epithelial cells in subtotal nephrectomy ( SNx) rats and the relationship between autophagy and necroptosis in the kidney of SNx rats. METHODS:Male Sprague-Dawley rats were randomly assigned to control group ( n=6 ) and SNx group ( n=42 ) .The rats in SNx group were subjected to SNx.Sham surgery was performed in the rats in control group.The rats in SNx group were divided into subgroups at 0, 4, 8 and 12 weeks ( n=6) and the other rats in SNx group were divided into SNx+vehi-cle group, SNx+necrostatin-1 (Nec-1) group and SNx+3-methyladenine (3-MA) group.The expression of RIP1, RIP3, LC3 and beclin-1 at mRNA and protein levels was measured at 0, 4, 8 and 12 weeks by qPCR and immunohistochemistry. The effects of Nec-1 or 3-MA on the protein expression of LC3-I, LC3-II and beclin-1, and production of reactive oxygen species ( ROS) in the rat kidney were determined by Western blot and DCFH-DA staining.The death of renal tubular epi-thelial cells in the SNx rats was observed by TUNEL staining and electron microscopy.Finally, the effects of Nec-1 and 3-MA on blood urea nitrogen ( BUN) , serum creatinine ( SCr) and the pathological changes of the renal tissues were ana-lyzed.RESULTS:The highest mRNA and protein levels of RIP1, RIP3, LC3 and beclin-1 appeared at the 8th week after SNx (P<0.01).Compared with the rats in SNx+vehicle group, the protein over-expression of LC3-II/I and beclin-1, re-nal tubular epithelial cells with typical morphological features of necroptotic cell death and TUNEL-positive renal tubular
cells were decreased in the SNx rats treated with Nec-1 and 3-MA (P<0.01), but 3-MA did not reduce the increased con-centration of ROS.In addition, treatment with Nec-1 and 3-MA obviously reduced BUN, SCr (P<0.05), glomeruloscle-rosis index and tubulointerstitial injury score (P<0.01).CONCLUSION:Autophagy participates in the excessive death of renal tubular epithelial cells in SNx rats.Inhibition of autograph prevents necroptotic cell death of renal tubular cells, and alleviates chronic renal injury in SNx rats.