Objective:To investigate the risk factors for 90 d death after endovascular mechanical thrombectomy (MT) in patients with acute anterior circulation large-artery occlusive stroke.Methods:From October 2015 to March 2018, patients with acute anterior circulation large-artery occlusive stroke treated with MT in People's Hospital of Shanghai Pudong New Area and the Second Affiliated Hospital of Soochow University were enrolled retrospectively. The primary outcome events were defined as death within 90 d after operation. Univariate and multivariate logistic regression models were used to identify the independent risk factors for death within 90 d after operation. Results:A total of 116 patients were enrolled, 23 (19.8%) of them died within 90 d after operation. Univariate analysis showed that there were significant differences in age, baseline National Institutes of Health Stroke Scale (NIHSS) score, the Alberta Stroke Program Early CT Score (ASPECTS), and the proportion of the baseline NIHSS score classification (≤8, 9-15, ≥16), ASPECTS ≤7, the number of attempts to pass >3 times, modified Thrombolysis in Cerebral Infarction (mTICI) blood flow grade 2b/3, hemorrhagic transformation (HT), and symptomatic HT in the death group compared with the survival group (all P<0.05). Multivariate analysis showed that after adjusting for age, fasting blood glucose, baseline NIHSS score, number of attempts to pass >3, and mTICI grade 2b/3, lower ASPECTS (odds ratio [ OR] 0.647, 95% confidence interval [ CI] 0.456-0.917; P=0.014), longer time from onset to vascular recanalization ( OR 1.004, 95% CI 1.000-1.007; P=0.046) and symptomatic HT ( OR 13.522, 95% CI 2.719-67.258; P=0.001) were the independent predictors of death within 90 d. Conclusion:The ASPECTS, time from onset to recanalization, and symptomatic HT were the independent risk factors for death within 90 d after MT in patients with acute anterior circulation large-artery occlusive stroke.

Objective To comparatively analyze the safety and efficacy of direct mechanical thrombectomy and bridging therapy for patients with acute anterior circulation large-artery occlusive stroke.Methods A total of 116 patients with acute anterior circulation large-artery occlusive stroke,admitted to our hospitals from October 2015 to March 2018,were chosen in our study;their clinical data were analyzed retrospectively.Among them,63 patients accepted direct mechanical thrombectomy and 53 accepted bridging therapy.The preoperative baseline data and the diagnoses and treatments of the two groups were analyzed;the degrees of modified thrombolysis in cerebral infarction (mTICI),incidences of hemorrhage transformation and symptomatic intracranial hemorrhage,and modified Rankin scale (mRS) scores and mortality rate 90 d after operation were compared between the two groups.Results The preoperative Alberta stroke program early CT scale (ASPECTS) and Glasgow Coma Scale (GCS) scores of the direct mechanical thrombectomy group were significantly lower than those of the bridge therapy group (P＜0.05),and the time from onset to admission was significantly longer than that of the bridging therapy group (P＜0.05).The incidence of postoperative hemorrhage transformation in the direct mechanical thrombectomy group was significantly higher than that in the bridging therapy group (34.9％ vs.17.0％,P＜0.05),but there were no significant differences in the effective recanalization rate (69.8％ vs.79.3％),intracranial symptomatic hemorrhage rate (15.9％ vs.7.6％),favorable outcome rate (28.6％ vs.35.9％) and mortality (22.2％ vs.17.0％) between the two groups (P＞0.05).Conclusion The clinical efficacy and safety of direct mechanical thrombectomy and bridging therapy for patients with acute anterior circulation large-artery occlusive stroke are similar.

Objective:To explore the influencing factors for intracranial hemorrhage (ICH) in patients with acute large vessel occlusion stroke (ALVOS) of anterior circulation after mechanical thrombectomy (MT).Methods:From October 2015 to March 2018, the clinical data of 116 patients with ALVOS of anterior circulation accepted MT were analyzed retrospectively in our hospitals. These patients were divided into ICH group ( n=31) and non-ICH group ( n=85) according to whether there was ICH after operation. Univariate and multivariate Logistic regression models were used to analyze the independent influencing factors for ICH after MT. Results:Univariate analysis showed that there were significant differences in preoperative Alberta Stroke Program Early CT (ASPECT) scores, baseline systolic pressure, and preoperative blood glucose level between ICH group and non-ICH group ( P<0.05). Multivariate analysis showed that after adjusting baseline Glasgow coma scale scores, preoperative ASPECT scores ( OR=0.770, 95%CI: 0.610-0.0.971, P=0.027), baseline systolic pressure ( OR=1.029, 95%CI: 1.005-1.054, P=0.017), preoperative blood glucose level ( OR=1.177, 95%CI: 1.010-1.372, P=0.036) were independent influencing factors for ICH. Conclusion:The patients with low preoperative ASPECT scores, high baseline systolic pressure, and high blood glucose are prone to have ICH after MT in patients with ALVOS of anterior circulation.

Objective Using dynamic glucose monitoring system to investigate the influence of dynamic glucose excursion onthe serum cystatin C (Cys-C) in patients with type 2 diabetes mellitus (T2DM).Methods A total of 164 hospitalized patients with T2DM were selected in this study.All the patients underwent continuous 72 hours dynamic glucose monitoring.The parameters of glucose excursion were calculated,including blood glucose standard deviation (SD),and average blood glucose level (MBG).According to the monitoring results,the patients were divided into two groups:high blood glucose excursion groupand low blood glucose excursion group.Cys-C level and other biochemical parameters were detected.Then the correlation of SD and Cys-C was analyzedin the two groups.Results There were significant difference in age,urea nitrogen (BUN),serum uric acid (SUA),glomerular filtration rate (eGFR),and Cys-C levels between the two groups (P＜ 0.05).The mean value of Cys-C and the percentage of high Cys-C level were higher in high blood glucose excursion group than in low blood glucose excursion group.There was a positive correlation between SD and Cys-C (r=0.344,P＜0.01) in the whole group as well as in high blood glucose excursion group and low blood glucose excursion group (r=0.604,0.331,P＜0.01).The incidence of diabetic peripheral arterial disease(PAD),diabetic peripheral neuropathy(DPN),diabetic retinopathy(DR),DKD were higher in high blood glucose excursion groupthan in the low blood glucose excursion group.Multivariate stepwise regression analysis showed that WC,GA,FPG,FIns,SUA,eGFR,and SD were in dependent risk factors for Cys-C,and among them,SD had the greatest contribution(β=0.112,SE=O.025,P=0.000).Conclusion The dynamic glucose excursion is positively correlated with Cys-C in patients with T2DM.The greater the blood glucose excursion,the higher the Cys-C level.

Objective To investigate short term effect of brachypodium total hip arthroplasty for young patients with osteonecrosis, and to provide a reference for clinical treatment. Methods From January 2008 to January 2012, 44 cases of femoral head necrosis patients (46 hips) were selected, with age from 28 to 52, and average age (39.94 ± 5.25) years old; according to prosthesis type they were divided into control group and observation group, control group( 22 cases of 24 hips, using metal-on-polyethylene Duraloc total hip prosthesis replacement treatment), and in the observation group (22 cases of 22 hips, with use of ceramic-on-ceramic Metha Brachypodium total hip prosthesis replacement therapy). Patients were followed up for 12 to 36 months, Harris score, range of motion and other indicators were compared in two groups of patients. Results In observation group and control group, the level of WOMAC score, total Harris score and function, motion range, pain, abnormalities score were significantly improved compared with those before operation:in observation group:(27.46 ± 4.19) scores vs.(66.38 ± 5.84) scores, (92.73 ± 7.68) scores vs.(42.67 ± 7.28) scores, (45.28 ± 5.34) scores vs. (22.19 ± 4.19) scores, (4.46 ± 0.63) scores vs. (3.25 ± 0.66) scores, (39.54 ± 1.54) scores vs. (15.39 ± 2.86) scores, (3.45 ± 0.65) scores vs. (1.84 ± 0.32) scores;in control group:(28.16 ± 4.07) scores vs. (65.67 ± 6.22) scores, (93.03 ± 7.54) scores vs.(43.74 ± 7.57) scores, (44.65 ± 5.26) scores vs. (22.45 ± 4.37) scores, (4.74 ± 0.71) scores vs. (3.17 ± 0.59) scores, (39.87 ± 1.26) scores vs. (16.19 ± 2.55) scores, (3.77 ± 0.73) scores vs. (1.93 ± 0.43) scores, and there were significantly differences (P<0.05). There were no significantly differences between two groups (P>0.05). All patients were follower up for 12-36(23.19 ± 3.66) months. One case in observation group had leg swelling and healed after symptomatic treatment, 1 case in the control group had limb swelling, and 1 case had extensive subcutaneous bleeding .And they were cured after symptomatic treatment 1 case had femoral dislocation, and no secondary dislocation happened after the implementation of manual reduction. Conclusions Brachypodium ceramic ceramic total hip replacement therapy has same effect for young osteonecrosis patients compared to polyethylene and metal prosthesis in improving hip function, but the ceramic-on-ceramic prosthesis brachypodium has better performance in wear resistance with smaller friction coefficient is smaller, and is suitable for young patients.

Objective To investigate effects analysis of joint function and MMP-7 and MMP-9 measurement after synovial ar-throscopic debridement for knee synovitis.Methods 72 patients with knee synovitis method based on a random draw were e-qually divided into the treatment group and the control group,the control group were given the traditional synovial planing surgery.The treatment group were given the arthroscopic debridement synovium.Results After treatment,the response rates in the treatment group and the control group were 97.2% and 80.6% respectively.The response rate of the treatment group were significantly better than the control group.The difference was statistically significant (P <0.05).The postopera-tive Lysholm scores were increased significantly,while the pain scores were significantly reduced,and the postoperative Ly-sholm score and pain scores difference compared between the two groups were also statistically significant.The difference was statistically significant (P <0.05).The postoperative synovial tissue MMP-7 and MMP-9 expression rates were in the two groups significantly lower.The difference was statistically significant (P <0.05),while the postoperative MMP-7 and MMP-9 expression rates of the treatment group were ignificantly lower than the control group (P <0.05).Conclusion Syn-ovial arthroscopic debridement for knee synovitis can relieve pain and improve knee function,reduce the expression of MMP-7 and MMP-9,thereby enhance the overall efficacy of the treatment.

The purpose of this study is to investigate the effect of superparamagnetic chitosan FGF-2 gelatin microspheres (SPCFGM) on the proliferation and differentiation of mouse mesenchymal stem cells. The superparamagnetic iron oxide chitosan nanoparticles (SPIOCNs) were synthesized by means of chemical co-precipitation, combined with FGF-2. Then The SPCFGM and superparamagnetic chitosan gelatin microspheres (SPCGM) were prepared by means of crosslinking-emulsion. The properties of SPCFGM and SPIONs were measured by laser diffraction particle size analyser and transmisson electron microscopy. The SPCFGM were measured for drug loading capacity, encapsulation efficiency and release pharmaceutical properties in vitro. The C3H10 cells were grouped according to the different ingredients being added to the culture medium: SPCFGM group, SPCGM group and DMEM as control group. Cell apoptosis was analyzed by DAPI staining. The protein expression level of FGF-2 was determined by Western blot. The proliferation activity and cell cycle phase of C3H10 were examined by CCK8 and flow cytometry. The results demonstrated that both of the SPIOCNs and SPCFGM were exhibited structure of spherical crystallization with a diameter of (25 ± 9) nm and (140 ± 12) μm, respectively. There were no apoptosis cells in the three group cells. Both the protein expression level of FGF-2 and cell proliferation activity increased significantly in the SPCFGM group cells (P < 0.05). The SPCFGM is successfully constructed and it can controlled-release FGF-2, remained the biological activity of FGF-2, which can promote proliferation activity of C3H10 cells, and are non-toxic to the cell.
Animals ; Cell Differentiation ; Cell Line ; Cell Proliferation ; Chitosan ; Fibroblast Growth Factor 2 ; pharmacology ; Gelatin ; Magnetite Nanoparticles ; Mesenchymal Stromal Cells ; drug effects ; Mice ; Microspheres ; Plasmids

Objective To evaluate the efficacy of bladder hydredistention and resiniferatoxin(RTX)on treating female interstitial cystitis(IC).Methods A total of 16 patients with IC were included.All patients received cystoscopie hydrodistention and RTX under anesthesia.The O'Leary-Sant Interstitial Cystitis Symptom Index(ICSI),Problem Index(ICPI),voiding frequency and the maximum bladder capacity were recorded before and after the therapy.Results All patients were followed up for 1 or 6 months.Fourteen of 16patients'symptoms were relieved,2 patients symptoms disappeared or significantly relieved.Conclusion Bladder hydrodistention and RTX effectively relieve symptoms and improve quality of life in patients with IC in the short term.

Objective To investigate the effect of 5-hydroxytryptamine serotonin receptor-1A (5-HT1 A) agonists on micturition dysfunction in rats with chronic spinal cord injury (SCI).Methods Female SD rats weighing 175 -200 g were used.Seven of the rats were modified for a spinal cord injury model (transsection at T10).Eight weeks later,control rats and SCI rats were tested.Rats were anesthetized with urethane ( 1.3 g/kg ).A polyethylene (PE) -50 catheter was placed in the left jugular vein for intravenous drug administration.A PE-90 catheter was inserted through the bladder dome,and the other end of the bladder catheter was connected to a syringe pump for continuous infusion of saline and to a pressure transducer for intravesical pressure monitor.Dose-response curves for 8-OH-DPAT were followed by the WAY-100635 test.The capacity,residual volume,micturition volume,and EUS-EMG were measured.Results With an increasing dose of 8-OH-DPAT,the capacity of the bladder decreased from 33.2 ± 8.3 ml to 22.8 ± 2.4 ml.The micturition volume was increased from 0.14 ± 0.08 ml to 0.38 ± 0.09 ml.The residual volume decreased from 3.68 ± 1.36 ml to 1.84 ± 0.21 ml,and peak intravesical pressure changed from 27.1 ± 3.6 mm Hg to 22.8 ± 2.4 mm Hg.Control rats showed little significant change in the cystometric variable.Effects of 8-OH-DPAT were reversed by WAY-100635.That 8-OH-DPAT induced phasic relaxation occured in spinal cord-injured rats but the control group showed no significant change.ConclusionsThe 5-HTIA/7 receptor agonist 8-OH-DPAT may induce periodic EUS relaxation during voiding in urethane-anesthetized chronic spinal cordinjured rats.And this could result in an increase in micturition volume,a decrease in bladder capacity,and thus an increase in voiding efficiency.

The objective of this study was to assess the clinical evidence for or against mood stabilizers as a treatment for Alzheimer's disease (AD). We searched 5 databases from their inception to January 2010. Five randomized clinical trials of mood stabilizers to treat human patients suffering from AD were included. These trials assessed the effectiveness of mood stabilizers as an adjunct treatment to conventional anti-dementia drugs on behavioral and psychological symptoms, especially on agitation. Methodological quality was assessed using the Jadad score. The results suggested a significant effect in favor of placebo on the Mini-Mental Status Examination [n=270, weight mean difference (WMD), -0.89; 95% confidence intervals (CIs) -1.69 to -0.09, P=0.03] and on the Neuropsychiatric Inventory total (NPI total) (n=51, WMD, 3.71; 95% CIs 0.15 to 7.26, P=0.04). There were no significant differences in change scores on total Brief Psychiatric Rating Scale (BPRS total), NPI/BPRS agitation, Cohen-Mansfield Agitation Inventory total and Physical Self Maintenance Scale between mood stabilizers and placebo. Only one of these studies was free of methodological limitations (Jadad score=5). In conclusion, based on the existing evidence, mood stabilizers are ineffective or even harmful as a treatment for AD.