【Abstract】ObjectiveTo investigate the relationship between the expression of urokinase-type plasminogen activator (uPA) mRNA and breast cancer, lymph node metastasis. MethodsSixty patients with breast tumor were selected randomly and the expression of uPA mRNA was detected with RT-PCR. The patients were divided into benign group (18 cases) and malignant group (42 cases) which included 22 cases with lymph node metastasis and 20 cases without lymph node metastasis. The relationship between uPA mRNA expression and breast cancer, lymph node metastasis was analyzed. ResultsAmong these 18 benign tumors, low expression of uPA mRNA was found in 2 cases and the others were negative. While in 42 cases of malignant tumor, uPA mRNA were positive in 22 cases of lymph node metastasis, 16 of which were high expression, 5 of which were moderate expression, and 1 was low expression. uPA mRNA were positive in 18 of 20 cases of nonmetastatic lymph node, 1 of which was high expression, 5 of which were moderate expression and 12 of which were low expression, the other 2 were negative expression. The expression of uPA mRNA had significant difference between benign and malignant tumors (P＜0.05). The expression in lymph node metastasis was much higher than no lymph node metastasis (P＜0.05). ConclusionThe expression of uPA mRNA in malignant breast cancer is obviously higher than that in benign breast tumor. The expression tensity of uPA is highly relevant to lymph node metastasis in malignant breast cancer, which can provide evidence for clinical staging and therapy.
ObjectivesTo systematically review the efficacy and safety of plasminogen activator assist external ventricular drainage in cerebral hemorrhage.MethodsPubMed, EMbase, The Cochrane Library, CNKI, VIP, CBM and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy and safety of plasminogen activator assist external ventricular drainage in cerebral hemorrhage from inception to March 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 23 RCTs involving 1 560 patients were included. The results of meta-analysis showed that, compared with the blank control or placebo, the addition of plasminogen activator urokinase after puncture and drainage could improve the clinical efficacy (RR=1.36, 95%CI 1.26 to 1.47, P<0.000 01), shorten removal time of hematoma (MD=−3.37, 95%CI −3.89 to −2.85, P<0.000 01), reduce postoperative re-bleeding rate (Peto OR=0.30, 95%CI 0.18 to 0.51, P<0.000 01), reduce the incidence of intracranial infection (Peto OR=0.47, 95%CI 0.25 to 0.87, P=0.02), and reduce mortality (Peto OR=0.45, 95%CI 0.27 to 0.76, P=0.003). The differences were statistically significant between two groups.ConclusionsCurrent evidence shows that the combination with urokinase can improve curative effect of hypertension cerebral hemorrhage patients with external ventricular drainage. In reducing hemorrhage, intracranial infection and mortality, urokinase also has great curative effect. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
ObjectiveTo observe and compare the efficacy and safety of intravenous thrombolysis with alteplase or urokinase in the first-ever acute ischemic stroke patients arriving at the hospital 3.5-4.5 h after onset.MethodsClinical data of patients with acute ischemic stroke treated in Shihezi People’s Hospital between January 2019 and October 2020 were prospectively collected. The National Insititutes of Health Stroke Scale (NIHSS) score on the 7th day and the 90th day, the modified Rankin Scale (mRS) score and the Blessed Behavior Scale (BBS) score on the 90th day, and symptomatic bleeding within 36 h after thrombolysis were analyzed and compared between the patients receiving alteplase threatment (the alteplase group) and the ones receiving urokinase treatment (the urokinase group).ResultsTotally 96 patients were treated with intravenous thrombolysis. Among them, 58 patients received alteplase threatment and 38 received urokinase treatment. The difference in NIHSS, mRS, or BBS scores between the two groups before treatment was not statistically significant (P>0.05). On the 90th day after treatment, the NIHSS, mRS, and BBS scores of the alteplase group were 3.59±3.73, 2.26±1.26, and 15.33±8.28, respectively, and those of the urokinase group were 5.95±4.88, 3.00±0.87, and 20.37±11.80, respectively; the differences between the two groups were all statistically significant (P<0.05). There was no significant difference in the rate of symptomatic intracerebral hemorrhage between the two groups within 36 h after treatment (P>0.05). Multiple linear regression analyses showed that the treatment method was related to the NIHSS score on the 7th day, the NIHSS score on the 90th day, the mRS score on the 90th day, and the BBS score on the 90th day (P<0.05), the history of heart disease was related to the mRS score on the 90th day (P<0.05), and the income was related to the BBS score on the 90th day (P<0.05).ConclusionFor the hyperactue ischemic stroke, the overall effect of alteplase treatment may be better than that of urokinase treatment.
【摘要】 目的 探讨急性脑梗死溶栓治疗的疗效及安全性。 方法 2004年1月-2009年5月58例急性脑梗死患者，按接受尿激酶治疗时已发病时间分为3组，均接受尿激酶150万U加生理盐水150 mL静脉滴注溶栓治疗。分别在治疗后0、1、3、9 h进行神经功能评价，1、3、7 d进行神经功能评价及复查头颅CT。 结果 发病3 h内与发病3~6 h内溶栓治疗效差异无统计学意义（Pgt;0.05）；发病3 h内、3~6 h内与发病6~9 h尿激酶溶栓治疗疗效差异均有统计学意义（Plt;0.05）；发病6~9 h尿激酶溶栓治疗疗效差，多例并发脑出血，安全性差。 结论 发病6 h内的脑梗死患者，只要无禁忌证均应尽快行尿激酶溶栓治疗；发病6 h后的脑梗死患者，不宜尿激酶溶栓治疗；伴房颤者的溶栓治疗因样本量过小研究无意义，有待进一步研究。【Abstract】 Objective To discuss the efficacy and safety of thrombolytic therapy for acute cerebral infarction. Methods A total of 58 patients with acute cerebral infarction from January 2004 to May 2009 were enrolled in this study. Based on the onset time before accepting urokinase treatment, the patients were divided into three groups. All of them accepted thrombolytic treatment with 1.5 million U of urokinase and 150 ml of saline solution intravenously. Neurological function evaluation was carried out 0, 1, 3, and 9 hours after the treatment. Another neurological function evaluation and skull CT were done 1, 3, and 7 days later, respectively. Results There was no statistical difference between the efficacy of the treatment within 3 hours and between the 3rd hour and the 6th hour after the onset of the disease. However, there was a significant difference between the efficacy within 3 hours and between the 6th and 9th hour, and between the efficacy from the 3rd hour and 6th hour and from the 6th hour and the 9th hour after the onset of the disease. Between the 6th and the 9th hour after the onset, the efficacy and safety were poor with many cases of combined cerebral bleeding. Conclusions For patients within 6 hours after the onset of cerebral infarction, as long as no contraindications exists, thrombolytic therapy should be carried out as soon as possible; 6 hours after the onset, patients should not be treated with thrombolytic therapy. Further study is needed for patients combined with atrial fibrillation due to the small sample size in this study.
ObjectiveTo evaluate the therapeutic effects of super-selective arterial catheterization with thrombolysis for central retinal artery occlusion (CRAO).MethodsThe clinical data of 16 patients with CRAO were collected. Aortic arch angiography with the catheterization through femoral artery firstly, and then the selective internal carotid artery angiography had been performed on all of the patients, including 12 ones who had undergone the urokinase thrombolysis therapy.ResultsIn the 16 patients, 3 with the severe straitness of the internal carotid artery and 1 with occlusion of incision of the ocular artery had not been treated by thrombolysis; and the others with occlusion of arterial trunk and CRAO had undergone thrombolysis therapy successfully. After the treatment, the visual acuity of the patients had improved in different degree and no systemic side effect had been found during the treatment.ConclusionsSuper-selective arterial catheterization with thrombolysis for CRAO may improve the visual acuity of the patients. The effects and risks of this treatment should be evaluated in further study.(Chin J Ocul Fundus Dis, 2005,21:20-21)