Search

Objective To summarize the clinical characteristic of stroke in the plateau area with altitude of 4000 m above, and to screen the risk factors of hemorrhagic stroke. Methods The clinical data of 103 stroke patients (including 71 hemorrhagic stroke and 32 ischemic stroke) admitted to Ngari Prefecture People's Hospital of Tibet Autonomous Region from January 2017 to December 2018 were retrospectively analyzed, and the clinical characteristic of hemorrhagic stroke and ischemic stroke were compared. Univariate and multivariate Logistic regression analyses were used to screen the risk factors of hemorrhagic stroke. Results The age of hemorrhagic stroke patients was lower than that of ischemic stroke patients [(57.48 ± 10.81) years vs. (64.03 ± 10.96) years; t = 2.836, P = 0.006], and the systolic blood pressure at admission [(171.92 ± 28.95) mm Hg vs. (141.81 ± 23.24) mm Hg; t = 5.174, P = 0.000], diastolic blood pressure [(107.58 ± 18.76) mm Hg vs. (93.44 ± 14.94) mm Hg; t = 3.757, P = 0.000], hemoglobin [(189.54 ± 28.12) g/L vs. (165.35 ± 25.42) g/L; t = 4.111, P = 0.000] and total cholesterol [(4.60 ± 0.88) mmol/L vs. (4.04 ± 0.82) mmol/L; t = 3.118, P = 0.002] were higher than those of ischemic stroke patients. Logistic regression analysis showed that systolic blood pressure on admission (OR = 1.048, 95%CI: 1.024-1.073; P = 0.000) and hemoglobin (OR = 1.043, 95%CI: 1.015-1.072; P = 0.002) elevation were risk factors of hemorrhagic stroke. Conclusions Hemorrhagic stroke is the main type of stroke in the plateau area with altitude of 4000 m above. Patients with high systolic blood pressure on admission and hemoglobin are more likely to have hemorrhagic stroke.

BACKGROUND Studies on soil, water and other media in the Western Sichuan Plateau show that the selenium content in this area is very low. The selenium concentrations of the natural soil profile, surface soil, sediment, surface water, and groundwater are 0.06-0.16μg/g, 0.075-0.204μg/g, 0.069-0.310μg/g, nd-0.096μg/L and nd-0.058μg/L, respectively, which are all lower than the average selenium content in the corresponding environmental media in China, affecting the health of local people. OBJECTIVES To explore the geochemical characteristics of selenium in rocks in the study area and to find the influencing factors for low selenium in rocks. METHODS Eighty rock samples were collected from the Western Sichuan Plateau, and six core samples were collected at the same time. These samples were mainly slate, sandstone, limestone and shale. Atomic fluorescence spectrometry (AFS) was used to determine the selenium content, and the geochemical characteristics of selenium in rocks and core samples in the Aba area of the Western Sichuan Plateau were studied. RESULTS The selenium content of rocks ranged from 0.030 to 0.282μg/g, with an average value of 0.09μg/g, which was lower than the crustal abundance of selenium. The content of selenium in different types of rocks was:shale > limestone > slate > sandstone. The selenium content in the rock also showed large differences in different regions:Songpan > Aba > Land Pond > Maerkang > Jiuzhaigou > Ruoergai > Hongyuan, which may be caused by rock type, organic matter and geological environment. The minimum, maximum and average selenium content in each section of the core was 0.02-0.07μg/g, 0.21-0.34μg/g and 0.06-0.17μg/g, respectively. Moreover, the selenium content of each borehole was significantly lower than the crustal abundance of selenium. CONCLUSIONS The distribution of selenium in rocks is significantly affected by organic matter, lithology and rock compactness. Low selenium in rocks is mainly due to low selenium in environmental media in Western Sichuan.

Since embryonic heart development is a complex process and acquisition of human embryonic specimens is challenging, the mechanism by which the embryonic conduction system develops remains unclear. Herein, we attempt to gain insights into this developmental process through immunohistochemical staining and 3D reconstructions. Expression analysis of T‐box transcription factor 3, cytoskeleton desmin, and nucleoskeleton lamin A protein in human embryos in Carnegie stages 11–20 showed that desmin is preferentially expressed in the myocardium of the central conduction system compared with the peripheral conduction system, and is co‐expressed with T‐box transcription factor 3 in the central conduction system. Further, lamin A was first expressed in the embryonic ventricular trabeculations, where the terminal ramifications of the peripheral conduction system develop, and extended progressively to all parts of the central conduction system. The uncoupled spatiotemporal distribution pattern of lamin A and desmin indicated that the association of cytoskeleton desmin and nucleoskeleton lamin A may be a late event in human embryonic heart development. Compared with model animals, our data provide a direct morphological basis for understanding the arrhythmogenesis caused by mutations in human DES and LMNA genes. [ABSTRACT FROM AUTHOR]

To study the efficacy and safety of hematoma puncture catheter drainage under CT real-time guide for treatment of intracerebral hemorrhage (ICH). Methods A total of 80 ICH patients with hematoma volume 15-30 ml were given conservative treatment (control group, 40 cases including 6 cases with hematoma volume 15-20 ml and 34 cases with hematoma volume > 20-30 ml) and hematoma puncture and catheter drainage under CT real-time guide (operation group, 40 cases with hematoma volume > 20-30 ml). Conscious states were evaluated by Glasgow Coma Scale (GCS) on admission and 3 d after onset. Neurological deficits of patients were evaluated by National Institutes of Health Stroke Scale (NIHSS) on admission and discharge. Hospitalization days and complications (including rebleeding, epilepsy, intracranial infection, severe pulmonary infection and bleeding caused by digestive tract stress ulcer) were recorded. Results The GCS scores 3 d after onset (P = 0.000) and NIHSS scores on discharge (P = 0.000) of 2 groups were significantly lower than those on admission. The GCS score of operation group was significantly higher (P = 0.003) and NIHSS score was significantly lower (P = 0.000) than that of control group. The hospitalization time of operation group was significantly lower than those of control group [(10.53 ± 2.64) d vs. (17.30 ± 4.92) d; t = 7.673, P = 0.000]. Complications including rebleeding, intracranial infection, severe pulmonary infection and bleeding caused by digestive tract stress ulcer did not occur in patients of 2 groups. Conclusions For supratentorial hemorrhage patients with hematoma volume 15-30 ml, in comparison with conservative treatment, operation with hematoma puncture and catheter drainage under CT real-time guide can save hospitalization days, relieve edema peak response and improve the prognosis. [ABSTRACT FROM AUTHOR]

Rationale: Patients with relapsed and refractory Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) with the T315I mutation are at higher risk of relapse and have shorter overall survival., Patient Concerns: A 31-year-old man presented to the hematology department with intermittent fever and pancytopenia. He was diagnosed with Ph+ acute lymphoblastic leukemia and experienced 2 relapses during treatment. A drug-resistant T315I mutation was detected in the ABL kinase region during review., Diagnoses: Morphological examination of the bone marrow revealed approximately 93.5% lymphoid blast. Flow cytometric analysis confirmed the diagnosis of common B-cell ALL with the following phenotype: CD34, CD45dim, CD19, CD10, cCD79a, CD58dim, CD81dim, cTdT, HLA-DR, CD22dim, CXCR4, CD33dim, CD20, CD25, CD13, CD123. The examination of the ABL kinase region mutation suggested a T315I mutation., Interventions: Olverembatinib, a third-generation TKI drug, was administered in combination with inotuzumab ozogamicin to treat the disease., Outcomes: The patient achieved morphological remission with a negative flow cytometry MRD test, and the quantification of BCR-ABL transcripts was 0% after 1 cycle of therapy., Lessons: The third-generation TKI olverembatinib has been proven to be effective in CML patients with the T315I mutation, and it may also be effective in Ph+ acute lymphoblastic leukemia. Some new immune drugs have also shown improvement in the remission rate. Combination therapy with olverembatinib and Ino can achieve a complete molecular response in patients with relapsed and refractory Ph+ ALL with the T315I mutation., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Qualitative measurement of the infective level is relatively difficult in experimental vaginal candidiasis. Female BALB/c mice aged 8 to 10 weeks were randomly divided into E1, E2 and E0 groups, which received subcutaneous injection of 0.05 mg, 0.1 mg of estradiol benzoate or 0.1 ml soybean oil 3 days before vaginal inoculation, respectively, and hormone treatment continued every other day thereafter. Each group was further divided into infected and noninfected subgroups. The infected mice were inoculated intravaginally with 10 μl (5 × 10(4) conidia) of Candida albicans suspension, while the noninfected mice were inoculated with 10 μl phosphate-buffered saline. Direct microscopic examination, colony count and vaginal histopathology including infection degree and inflammation extent were performed at 3, 7 and 14 days post inoculation. Estrogen treatment increased the vaginal fungal burden and extent of infection and inflammation compared with the control group, and 0.3 mg/week estrogen generally induced more severe infection and inflammation than 0.15 mg/week estrogen did. Colony count peaked on day 3 and decreased remarkably after 7 days. Infection score increased gradually during the first 7 days and decreased on day 14, while inflammation extent exacerbated progressively over the course of 14 days. This study demonstrates that the modified histological scoring system might be more feasible than colony count for evaluation of infectivity and dynamic change in experimental vaginal candidiasis.

Objective. To demonstrate the role of Wnt/ β -catenin canonical pathway in postmenopausal osteoporosis by evaluating serum β -catenin levels in patients with postmenopausal osteoporosis and analyzing their possible relationship with serum OPG, RANKL, the ratio of RANKL/OPG, sclerostin, and bone turnover markers. Methods. 480 patients with postmenopausal osteoporosis and 170 healthy postmenopausal women were enrolled in the study. Serum β -catenin, OPG, RANKL, and sclerostin levels were measured by enzyme-linked immunosorbent assay. Bone status was assessed by measuring bone mineral density and bone turnover markers. Estradiol levels were also detected. Results. Serum β -catenin levels were lower in postmenopausal osteoporotic women compared to nonosteoporotic postmenopausal women (26.26 ± 14.81 versus 39.33 ± 5.47 pg/mL, P < 0.001). Serum β -catenin was positively correlated with osteoprotegerin (r = 0.232, P < 0.001) and negatively correlated with the ratio of RANKL/OPG, body mass index, and sclerostin (r = -0.128, P = 0.005; r = -0.117, P = 0.010; r = -0.400, P < 0.001, resp.) in patients with postmenopausal osteoporosis. Conclusion. The results indicate that lower serum β -catenin and concomitantly higher ratio of RANKL/OPG may be involved in the pathogenesis of postmenopausal osteoporosis. Functional communication between RANKL/RANK/OPG system and Wnt pathways plays an important role in postmenopausal osteoporosis.

Background: Studies on human, rat and chicken embryos have demonstrated that during the period of outflow tract septation, retraction of the distal myocardial margin of the outflow tract from the junction with aortic sac to the level of semilunar valves leads to the shortening of the myocardial tract. However, the mechanism is not clear. So we investigated the mechanism of outflow tract shortening and remodeling and the spatio-temporal distribution pattern of alpha-SMA positive cells in the outflow tract cushion during septation of the outflow tract in the embryonic mouse heart., Methods: Serial sections of mouse embryos from embryonic day 9 (ED 9) to embryonic day 16 (ED 16) were stained with monoclonal antibodies against alpha-SCA, alpha-SMA, or desmin, while apoptosis was assessed using the terminal deoxyribonucleotidy transferase-mediated dUTP-digoxigenin nick-end labeling (TUNEL) assay., Results: Between ED 11 and ED 12, the cardiomyocytes in the distal portion of the outflow tract were observed losing their myocardial phenotype without going into apoptosis, suggesting that trans-differentiation of cardiomyocytes into the cell components of the free walls of the intrapericardial ascending aorta and pulmonary trunk. The accumulation of alpha-SMA positive cells in the cardiac jelly began on ED 10 and participated in the ridge fusion and septation of the outflow tract. Fusion of the distal ridges resulted in the formation of the facing walls of the intrapericardial ascending aorta and pulmonary trunk. Fusion of the proximal ridges was accompanied by the accumulation of alpha-SMA positive cells into a characteristic central whorl, in which cell apoptosis could be observed. Subsequent myocardialization resulted in the formation of the partition between the subaortic and subpulmonary vestibules., Conclusions: The shortening of the embryonic heart outflow tract in mice may result not from apoptosis, but from the trans-differentiation of cells with cardiomyocyte phenotype in the distal portion of the outflow tract into the cell components of the free walls of the intrapericardial ascending aorta and pulmonary trunk. The primary roles of alpha-SMA positive cells in the septation and remodeling of the outflow tract may assure proper fusion of the outflow ridges and form the facing walls of the intrapericardial ascending aorta and pulmonary trunk.