Objective:To investigate blood glucose variability, National Institutes of Health Stroke Scale (NIHSS) score, Acute Physiology and Chronic Health Evaluation II (APACHE II) score and prognosis in patients with acute and severe cerebrovascular disease, providing a reference for clinical treatment of this disease.Methods:The clinical data of 76 patients with acute and severe cerebrovascular disease who received treatment in Xixi Hospital of Hangzhou between January 2014 and December 2019 were retrospectively analyzed. These patients were divided into a survival group ( n = 51) and a death group ( n = 25) according to the prognosis 28 days after admission. Baseline data, baseline NIHSS score, APACHE II score, standard deviation of blood glucose, mean blood glucose, mean amplitude of glycemic excursions, and blood glucose variability rate were compared between the survival and death groups. The effects of these parameters on the prognosis of acute and severe cerebrovascular disease were analyzed. Results:There were no significant differences in gender, age, history of diabetes, type of disease, and length of hospital stay between the two groups ( χ2 = 1.674, t = 1.048, χ2 = 3.833, 0.263, t = 0.832, all P > 0.05). The proportion of patients with a history of hypertension in the death group was significantly higher than that in the survival group [15.69% (8/51) vs. 52.00% (13/25), χ2 = 11.063, P < 0.05]. There was no significant difference in mean blood glucose between the two groups ( t = 0.118, P > 0.05). The baseline NIHSS score, APACHE II score, standard deviation of blood glucose, mean amplitude of glycemic excursions and blood glucose variability rate in the death group were (24.41 ± 4.14) points, (25.00 ± 6.97) points, (2.72 ± 0.91) mmol/L, (6.27 ± 2.01) mmol/L, (34.83 ± 5.61) %,which were significantly higher than those in the survival group [(17.22 ± 3.63) points, (19.21 ± 5.36) points, (1.69 ± 0.70) mmol/L, (3.72 ± 1.68) mmol/L, (19.54 ± 3.22) %, t = 7.744, 3.999, 5.448, 5.823, 15.095, all P < 0.05]. The proportion of patients with blood glucose variability rate < 20% in the death group was significantly lower than that in the survival group [16.00% (4/25) vs. 74.51% (38/51), χ2= 23.230, P < 0.05]. The proportion of patients with blood glucose variability rate > 30% in the death group was significantly higher than that in the survival group [60.00% (15/25) vs. 13.73% (7/51), χ2 = 17.466, P < 0.05). Logistic regression analysis revealed that baseline NIHSS score, APACHE II score, standard deviation of blood glucose, mean amplitude of glycemic excursions, and blood glucose variability rate were the independent risk factors of death of cerebrovascular disease patients (all P < 0.05). Conclusion:In patients with acute and severe cerebrovascular disease, an obvious blood glucose fluctuation, high baseline NIHSS score, and high APACHE II score help to assess the prognosis of acute and severe cerebrovascular disease and determine the risk of death.

The optic nerve is the only pathway that transduct visual signals into visual centers, and is consisted of retinal ganglion cells and glial cells. Astrocytes, the most abundant neuroglia in center nerve system (CNS), are considered as structural supporter and carrier of metabolic components of neurons. In recent years, astrocytes have become treasure of neurological study due to their dual effects after nerve injury. The neurotoxic reactive astrocytes are termed as A1-type, and the neuroprotective ones are termed as A2-type. For the purpose of reducing neuron loss after optic nerve injury, it is critical to find out proper management methods of astrocyte reactivity. In this paper, we will concentrate on the inducers, mechanisms and influences of astrocyte reactivity in optic nerve and CNS, and then, summarize present possible interference ways to a neuroprotective outcome.

Objective:To investigate the clinical value of liquid based cytology in the diagnosis of early non-small cell lung cancer (NSCLC).Methods:From October 2018 to October 2019, 120 patients with early NSCLC who were confirmed diagnossis by histopathology were selected from Xixi Hospital of Hangzhou and Tongde Hospital of Zhejiang Province.All patients underwent fiberbronchoscopy.All the specimens were performed liquid-based cell wax block and HE staining.Two or more experienced histopathological doctors read the histological samples and then gave pathological reports.The cytological samples were first screened by the primary cytological diagnosis doctors, and then read by the deputy director or chief physician.The cytological pathological reports were given in combination with the clinical practice.Results:HE staining in liquid-based cytology showed that squamous cell carcinoma had many different sizes and shapes, single scattered, polygonal and round, even distribution of chromatin, and no obvious nucleolus.HE staining of adenocarcinoma in liquid-based cytology often gathered solid mass, rich cytoplasm, regular cell size, round nucleus, fine chromatin, and obvious nucleolus.HE staining of small cell cancer in liquid-based cytology mostly scattered, the cytoplasm was rare as naked nucleus, the nucleus was deeply stained, some were angular or short shuttle shaped.The sensitivity and specificity of liquid based cytology in the diagnosis of NSCLC were higher than those of traditional smear (χ 2=4.874, 4.512, all P<0.05). The positive rates of squamous cell carcinoma (72.88%) and adenocarcinoma (85.29%) in liquid based cytology were significantly higher than those in traditional cytology (54.24% and 61.76%) (χ 2=4.427, 6.031, all P<0.05), but there was no statistically significant difference in positive rate of small cell cancer between the two groups (χ 2=1.333, P>0.05). The positive rate of stage Ⅰa in liquid based cytology (86.48%) was higher than that in traditional cytology (64.86%), there was statistically significant difference (χ 2=4.698, P<0.05), but there were no statistically significant differences in the positive rates of stage Ⅰb and stage Ⅱa between the two groups (all P>0.05). Conclusion:Liquid based cytology is of great value in the diagnosis of early NSCLC, which can increase the sensitivity and specificity of diagnosis.

Objective: To explored the bio-compatibility and cartilage regeneration of the rabbits genipin cross-linked decellularized scaffold, to provide experimental and theoretical support for the clinical application of genipin cross-linked decellularized scaffold. Methods: Detergent-enzyme method was used to prepare decellularized tracheal scaffolds. Cellular content of native trachea and decellularized trachea were compared by 4′, 6-diamidino-2-phenylindole(DAPI) staining. Masson trichrome staining was used to compare the histological structure of the progenitor tube, decellularized trachea, and genipin cross-linked decellularized trachea. Nine adult New Zealand white rabbits were randomly divided into autologous tracheal transplantation group (negative control group), allogeneic tracheal transplantation group (positive control group), and genipin cross-linked decellularized tracheal transplantation group (experimental group). Autologous bone marrow mesenchymal stem cells were implanted on the surface of trachea in each group. The blood cells and type II collagen were detected to compare the inflammatory response and chondrocyte regeneration after tracheal orthotopic transplantation in the three groups. Results: After DAPI staining and light microscope observation (×200), the cell content of the acellular 7-cycle trachea [(143.0 ± 71.1) cells/field] was significantly lower than that of the native trachea [(853.5 ± 149.6) cells/field], and the difference was statistically significant (P<0.001). Masson′s trichrome staining showed that the tissue structure of genipin cross-linked decellularized trachea was more complete. Blood cell analysis and type II collagen test results showed that genipin cross-linked decellularized trachea transplanted with bone marrow mesenchymal stem cells after transplantation in situ has little rejection and can be converted into chondrocytes by the action of related growth factors in vivo. Conclusions Genipin cross-linked decellularized tracheal scaffold combined with stem cell transplantation can successfully construct a tracheal in situ replacement model. This study provides a strong support for the research of tissue engineering trachea.

Objective To analyze the therapeutic effect of emergency surgery in the treatment of severe valvular heart disease and its influence on heart function.Methods 87 cases with severe valvular heart disease were selected,and they were given emergency surgical treatment.Before and after treatment,the cardiac function index[end -diastolic volume (EDV),end-systolic volume (ESV),left ventricular end systolic volume index (LVESVI),left ventricular end-diastolic volume index (LVEDVI),left ventricular ejection fraction (LVEF)],postoperative complications and survival rate were compared.Results After treatment,the EDV [(125.78 ± 31.67) mL],ESV [(71.30 ± 16.58) mL] and LVESVI [(50.39 ± 13.30) mL/m2],LVEDVI [(88.74 ± 13.51) mL/m2],LVEF [(51.48 ± 12.73) ％] were better than those before treatment [(116.48 ± 28.94) mL,(63.26 ± 15.47) mL,(33.27 ± 8.54) mL/m2,(64.47 ± 12.69)mL/m2,(47.53 ± 11.20)％],the differences were statistically significant (t =2.022,2.022,3.307,12.213,2.173,all P ＜ 0.05).The incidence rate of complications was 24.14％ (21/87),included arrhythmia in 4 cases,low cardiac output syndrome in 8 cases,acute renal failure in 9 cases.Postoperative 1 year,2 years,the survival rates were 91.95％ (80/87),85.06％ (74/87),respectively.Conclusion Emergency surgical treatment for severe valvular heart disease can effectively improve cardiac function index,improve the survival rate.

OBJECTIVE To discuss the diagnosis and treatment of cholesterol granuloma of the middle ear and the choice and effect of surgical methods. METHODS A retrospective analysis was conducted on 18 cases of cholesterol granuloma of the middle ear confirmed by surgery and pathology. Different choices of surgical methods were made according to the lesion extension of this disease. RESULTS All patients were followed up for at least 6 months. Two cases with eustachian tube obstruction had ventilation tube inserted for a long time. One case who had recurrence and metastasis of nasopharyngeal carcinoma in the middle ear was transferred to oncology department for further treatment. Post-operative dry ears were obtained in the other cases whose pure tone thresholds were improved to different degrees. CONCLUSION Etiology of cholesterol granuloma of middle ear remains controversial. It's supposed to result from the bleeding, occlusion of ventilation and disturbance of drainage of the air cavity because of the middle ear inflammation, and bone marrow exposure. The middle ear and mastoid surgery can completely remove the disease tissues, and establish ventilation system of mastoid-tympani-eustachian, which is the key point of the middle ear surgery.

BACKGROUND:Acel ular tracheal matrix is similar to the native trachea with structure and biological performance preserved after decel ularization, and it is an important aim in tissue engineering to find an effective method of decel ularization.
OBJECTIVE:To select the optimal decel ularization method through comparing chemical extraction method with detergent-enzymatic method for preparing rabbit tissue engineering trachea matrix.
METHODS:Thirty tracheas from New Zealand white rabbits were randomly divide into three groups. Twenty of rabbit tracheas were subjected to decel ularization using 2%TritonX-100 combined with deoxyribonuclease I and ribonuclease (chemical extraction method group), and sodium deoxycholate combined with deoxyribonuclease I (detergent-enzymatic group), respectively. The other ten were given no intervention as controls. Samples were col ected and observed by hematoxylin-eosin staining, Masson-trichrome staining, safranin O staining, DAPI staining and scanning electronic microscope.
RESULTS AND CONCLUSION:Hematoxylin-eosin staining demonstrated that compared with the control group, almost al cel ular components of the mucosal epithelium were removed in the detergent-enzymatic and chemical extraction groups, and there were few remnant chondrocytes. Masson-trichrome staining indicated that compared with the control group, components of the mucosal layer chondrocytes in the chemical extraction and detergent-enzymatic groups were completely removed, with only part of remained chondrocytes in the cartilage zone. Glycosaminoglycan was slightly decreased both in the chemical extraction and detergent-enzymatic groups shown by Safranin O staining, but more reduction was found in the chemical extraction group. DAPI staining reveled that only a smal amount of cartilage cel s remained in the dense layer of cartilage and lacuna both in this two methods. Scanning electronic microscope showed that using the detergent-enzymatic method there were the hierarchical structures of native trachea, but slight disruption using the chemical extraction method. In conclusion, decel ularized rabbit trachea matrix obtained by detergent-enzymatic method is better, with little disruption to the matrix.

OBJECTIVE: To investigate method established and system evaluated in the model of SD rat with AR. METHOD: To establish AR model of SD rats by ovalbumin (OVA), 20 cases of SD rats were randomly divided into two groups, namely control group (10 cases) and AR group (10 cases). AR models were sensitized and challenged by OVA. Control group were used with normal saline instead of OVA. The score of pathology and praxiology were observed when the SD rats in AR group appeared typical symptom of allergic rhinitis, and levels of IL-4, IFN-γ, IgE in the serum were examined by ELISA. According to the behavioral score, nasal histology and content of IL-4, IFN-γ, IgE of serum, Rat allergic rhinitis model were judged successfully established or not. RESULT: Behavioral scores were significantly increased in OVA-challenged rats compared with the control group, P<0.05. Nasal epithelial goblet cells, eosinophils and lymphocytes in nasal mucosa in the AR rats exhibited obvious increase relative to the control group. IL-4, IgE levels in the AR rat exhibited obvious increase relative to control group while INF-γ levels exhibited obvious reduction (P<0.05). CONCLUSION The allergic rhinitis models in SD rat by OVA were successfully established. The levels of IgE, INF-γ and IL-4 in Serum can be used as objective evaluation of animal models of allergic rhinitis established successfully or not.
Animals ; Disease Models, Animal ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; immunology ; Goblet Cells ; immunology ; Immunoglobulin E ; blood ; Interferon-gamma ; blood ; Interleukin-4 ; blood ; Nasal Mucosa ; cytology ; pathology ; Ovalbumin ; Rats ; Rats, Sprague-Dawley ; Rhinitis, Allergic ; physiopathology

OBJECTIVE: To explore the clinical features and treatments of contact granuloma of larynx. METHOD: To find the best treatments by analyzing the clinical features, related causes and the treatments of the 13 contact granuloma of larynx cases, which have complete data, of our department from Jan 2005 to Dec 2012, also by comparing the effect of conservative treatment and operation treatment. RESULT: Contact granuloma of larynx is more common in men (84.6%). The main causes are gastro esophageal reflux, chronic cough, habitual hawk and endotracheal intubation disease. However, a big part (38.4%) gets the disease without any other disease history. The main clinical feature of the disease includes: sensation of foreign matter in throat, easy to get exhausted when talking and voice hoarse, but also 30.7% without any feature in throat. Among the 13 cases, 6 were treated by operation and the first recurrence was 66.6%. The cure rate was 50% after one or two operations. The other 7 were treated in conservative way, including anti- Gastro esophageal reflux, avoiding excessive talking, reducing habitual hawk ,or without any medical treatment. The cure rate was 57.1%. The total cure rate was 53.8%. However, it is nonsense to comparing the two different treatments (Chi2 = 0.066, P > 0.05). CONCLUSION There is still no standard treatment for contact granuloma of larynx and the effect is not good enough. The treatment should be depending on individual case. Conservative treatment is the first choice. However, operation should be considered if the patient has obviously hoarse and his granuloma is too large to breathe well.
Chronic Disease ; Female ; Gastroesophageal Reflux ; complications ; Granuloma, Laryngeal ; etiology ; therapy ; Hoarseness ; etiology ; Humans ; Intubation, Intratracheal ; Male ; Recurrence

OBJECTIVE: To explore the expression and significance of Eotaxin and RANTES in the rat model of allergic rhinitis (AR). METHOD: 20 female SD rats in 6-7 weeks were randomly divided into control group and AR group (n = 10, respectively). AR rat model was made with ovalbumin stimulation. To detect pathological changes in mucosa and chemokine Eotaxin, RANTES in their nasal and lung tissues after execution. RESULT: Compared with the control group, Lung EOS cell counted higher in AR group and the difference was significant (P < 0.01); the AR rats nasal mucosa and lung tissue of Eotaxin, RANTES expression was significantly increased (P < 0.01). CONCLUSION There exist high expression of Eotaxin, RANTES, infiltration of eosinophils in nasal and lung tissue of model rats with allergic rhinitis, inferring that the upper and lower respiratory tract inflammatory response has obvious consistency.
Animals ; Chemokine CCL11 ; metabolism ; Chemokine CCL5 ; metabolism ; Disease Models, Animal ; Female ; Lung ; metabolism ; Nasal Mucosa ; metabolism ; Rats ; Rats, Sprague-Dawley ; Rhinitis, Allergic ; metabolism