Objective To review the status and appl ication prospect in repair of spinal cord injury by stem cells. Methods The related articles in recent years were extensively reviewed, the biological characteristics of stem cells, the experimental and cl inical studies on repair of spinal cord injury by stem cells, the mechanism of the therapy and the problem were discussed and analyzed. Results The foundational and cl inical study indicated that the great advance was made in repair of spinal cord injury, the stem cells could immigrate in the spinal cord, and differentiate into neuron and secrete neurotrophic factors. So it could promote the repair effects. Conclusion Repair of spinal cord injury by stem cells is an effective therapystrategy, but many problems remain to be resolved.
Objectives To investigate the risk factors, clinical features, and clinical outcomes of severe cerebral infarction (SCI), and explore the association between different risk factors and outcomes in SCI. Methods We prospectively registered consecutive cases of acute ischemic stroke at the neurological wards of West China Hospital, Sichuan University from January 1st, 2008 to May 27th, 2013. Patients with ischemic stroke within 30 days of symptom onset were included. SCI was defined as the score of National Institutes of Health Stroke Scale greater than 15. Data were collected on clinical and biological variables, risk factors for stroke and the presence of comorbidities. The data management and analysis were performed with the SPSS 16.0 package. Univariate and multivariate analysis were used to analyze the predictors of SCI and its outcomes. Results Of the 3 364 enrolled cases, 348 (10.3%) were SCI. Compared with non-SCI (NSCI), SCI patients were older, with a lower proportion of males, higher NIHSS scores, lower Glasgow Coma Scale (GCS) scores, and higher proportions of previous heart disease history and previous stroke history, and lower hemoglobin levels on admission. SCI group had a greater proportion of large-artery atherosclerosis (LAA) and cardioembolism (CE) and less proportion of small artery occlusive infarction. After adjustment for the confounders, age [odds ratio (OR)=1.020, 95% confidence interval (CI) (1.010, 1.031), P<0.001], LAA [OR=1.442, 95%CI (1.062, 1.958), P=0.019], and CE [OR=1.919, 95%CI (1.319, 2.793), P=0.001] were independently associated with SCI. The case fatality and case fatality or disability with SCI were 32.1% and 83.3% at the end of 3 months, and 41.8% and 79.3% at the end of 1 year. Among different types, patients with undetermined type had the highest mortality rate, with patients with LAA being the lowest (P≤0.001). There was no significant association between TOAST type and the rate of fatality or disability. Multiple factor analysis showed that the most important independent predictive factor of prognosis was age. Meanwhile, sex and previous stroke history were also the independent predictive factors for death at the 3rd month. Hyperlipidemia, valvular heart disease, and GCS score on admission were independent predictive factors for death/disability at the 3rd month. Conclusions Our study indicates that patients with SCI accounted for 10.3% of acute ischemic stroke. The case fatality or disability in SCI patients are higher than those in NSCI patients. The old age, LAA and CE are independent predictive factors of SCI. Age is the most important prognostic factor of patients with SCI.
With the development of photothermal nanomaterials, photothermal therapy based on near-infrared light excitation shows great potential for the bacterial infected wound treatment. At the same time, in order to improve the photothermal antibacterial effect of wound infection and reduce the damage of high temperature and heat to healthy tissue, the targeted bacteria strategy has been gradually applied in wound photothermal therapy. In this paper, several commonly used photothermal nanomaterials as well as their targeted bacterial strategies were introduced, and then their applications in photothermal antibacterial therapy, especially in bacterial infected wounds were described. Besides, the challenges of targeted photothermal antibacterial therapy in the wound healing application were analyzed, and the development of photothermal materials with targeted antibacterial property has prospected in order to provide a new idea for wound photothermal therapy.
Objective To understand the dynamic changes of inflammatory indicators in the peripheral blood of patients with malignant cerebral edema at different time points after acute cerebral infarction, and provide a basis for early prediction and prevention of malignant cerebral edema. Methods Consecutive patients with acute cerebral infarction within 24 h of onset who were admitted to the Department of Neurology, West China Hospital of Sichuan University between January 1st, 2017 to December 31st, 2018 were collected. The basic clinical data of the patients were collected, and the data of inflammatory cells (white blood cell count, absolute neutrophil count, absolute lymphocyte count, and neutrophil to lymphocyte ratio) and acute phase reactants (blood glucose, fibrinogen, albumin, and fibrinogen to albumin ratio) were dynamically collected at admission and 1, 3, and 7 d after admission, respectively. Differences between groups were compared using generalized estimating equations. Results A total of 798 patients with acute cerebral infarction were included, of whom 93 (11.65%) developed malignant cerebral edema. At all time points examined, the white blood cell counts, absolute neutrophil counts, and neutrophil to lymphocyte ratios were higher in the malignant cerebral edema group than those in the non-malignant cerebral edema group (Wald χ2=63.737, P<0.001; Wald χ2=91.848, P<0.001; Wald χ2=75.197, P<0.001); 1 and 3 d after admission, the absolute lymphocyte counts were lower in the malignant cerebral edema group than those in the non-malignant cerebral edema group (Wald χ2=18.580, P<0.001). The blood glucose levels were higher in the malignant cerebral edema group compared with the non-malignant cerebral edema group 1, 3, and 7 d after admission (Wald χ2=16.722, P<0.001); no significant between-group effect was found in the albumin levels (Wald χ2=3.643, P=0.056); the fibrinogen levels were significantly different between groups 3 d after admission (Wald χ2=8.923, P=0.003), and the fibrinogen to albumin ratios differed between the two groups 3 and 7 d after admission (Wald χ2=6.739, P=0.009). Dynamic analysis of multiple time points in the malignant cerebral edema group found that these inflammatory markers mostly reached their extreme values 3 d after admission. Conclusions Compared with the non-malignant cerebral edema group, the inflammatory cell-related indicators (except lymphocytes) and the acute phase inflammatory reactant-related indicators in malignant cerebral edema patients are significantly higher, and the absolute lymphocyte count is significantly lower. Three days after admission to hospital is probably the most significant time point for the change of each inflammatory indicator.
Objective To explore the association between C-reactive protein (CRP) change and the prognosis of patients with stroke. Methods Individuals who were diagnosed with stroke from the 2011 China Health and Retirement Longitudinal Study (CHARLS) registry were included. The baseline characteristics in 2011, blood tests in 2011 and 2015, and follow-up data in 2018 were collected. The patients were divided into three groups according to their CPR change from 2011 to 2015, and the cut-off values of CRP change were 0 and 5 mg/L. Logistic regression analysis was performed to evaluate the association between CRP change and the risk of death after stroke. Results A total of 1065 participants diagnosed in 2011 were enrolled. There were 383 participants in the CRP decreased group (CRP change ranging from –74.30 to –0.01 mg/L), 584 participants in the CRP stable group (CRP change ranging from 0 to 4.98 mg/L), and 98 participants in the CRP increased group (CRP change ranging from 5.00 to 79.27 mg/L). By 2018, the numbers (rates) of deaths in CRP decreased group, CRP stable group, and CRP increased group were 25 (6.53%), 33 (5.65%), and 13 (13.27%), respectively, and the difference in the mortality among the three groups was statistically significant (P=0.020). Logistic regression analysis showed that the CRP change≥5 mg/L was associated with a higher risk of death after stroke [odds ratio=2.332, 95% confidence interval (1.099, 4.946), P=0.027]. Conclusions Increasing CRP levels over time may indicate an increased risk of death in stroke patients. A 4-year increase in CRP greater than 5 mg/L may be an independent predictor of the risk of long-term death in stroke patients.
Objective To explore the association between triglyceride glucose-waist circumference (TyG-WC) index and the risk of stroke among the middle-aged and older people, and compare the differences among TyG-WC, triglyceride glucose (TyG), and waist circumference (WC) in the prediction of stroke. Methods The data of adults aged 45 years or older enrolled in the China Health and Retirement Longitudinal Study registry in 2011 were collected, and the endpoint was self-reported or physician-diagnosed new stroke event by 2015. According to the baseline TyG-WC tertile, individuals were divided into three groups: TyG-WC tertile 1, tertile 2, and tertile 3 groups. Multiple logistic regression analyses were performed to analyze the associations of TyG-WC, TyG, and WC with the risk of stroke. The area under the curve (AUC) of receiver operating characteristic (ROC) curve, integrated discrimination improvement (IDI) score, and net reclassification improvement (NRI) score were calculated to evaluate the predictive value of TyG-WC, TyG, and WC in stroke. Results A total of 5847 participants were finally included, with 1949 in each group. After 4 years of follow-up, there were 252 cases of new stroke. There was significant difference in the incidence of stroke among the three groups (TyG-WC tertile 1 group: 2.57%, TyG-WC tertile 2 group: 4.16%, TyG-WC tertile 3 group: 6.21%; P<0.05). The results of multiple logistic regression analyses showed that the risk of new stroke in the third tertile group of TyG-WC and WC was higher than that in the first tertile group, respectively [TyG-WC: odds ratio (OR)=1.465, 95% confidence interval (CI) (1.033, 2.078), P=0.032; WC: OR=1.717, 95%CI (1.190, 2.478), P=0.004], while TyG was not the risk factor of stroke (P>0.05). The ROC curve analysis showed that the AUC of WC (0.566) was slightly higher than that of TyG-WC (0.556) and TyG (0.527). The IDI of TyG-WC (0.25%) was slightly higher than that of WC (0.22%), and the both were higher than that of TyG (0.07%). The NRI of WC (25.04%) was slightly higher than that of TyG-WC (19.68%), and the both were high than that of TyG (12.02%). Conclusions Compared with TyG, higher TyG-WC and WC are associated with the increased risk of new stroke among the middle-aged and older people. The predictive value of TyG-WC and WC for the risk of new stroke in the middle-aged and elderly is similar, and is better than that of TyG.
Objective To explore the association between procalcitonin (PCT) level and the development of malignant brain edema (MBE) after acute cerebral infarction. Methods The data on patients with stroke admitted to the Department of Neurology of West China Hospital, Sichuan University between January 1, 2017 and December 31, 2018 were retrospective collected. Patients were divided into MBE group and non-MBE group based on whether MBE had occurred. The basic information and neuroimaging data of two groups of patients were compared and analyzed. Results A total of 798 patients were included. Among them, there were 93 cases of MBE (11.65%) and 705 cases of non-MBE (88.35%). The median time of MBE occurrence (lower quartile, upper quartile) was 29 (24, 54) hours after onset. The difference in the National Institutes of Health Stroke Scale, large-scale middle cerebral artery infarction, dysarthria, low fever, consciousness status, chronic heart failure, TOAST typing, mechanical ventilation, gastric tube placement, PCT on the first and third day of admission between the two groups were statistically significant (P<0.05). There was no statistically significant difference in the other indicators between the two groups (P>0.05). The results of multivariate logistic regression analysis showed that both day 1 PCT and large-scale middle cerebral artery infarction were associated with MBE. Conclusions Elevated PCT within 24 hours from onset is independently associated with the development of MBE after acute cerebral infarction. Patients with elevated PCT after cerebral infarction may require careful clinical management.
Objective To review the application progress of non-biological meshes for breast reconstruction (BR). Methods The related home and abroad researches in BR were reviewed and summarized. Results Non-biological meshes can be divided into degradable and nondegradable. The former has many types, whether its degradation rate can match with the grow rate of repair tissue will significantly affect the wound healing and tissue intergradation. TiLOOP, on behalf of the latter, has a good postoperative performance due to its nano TiO2 layer, lightness and flexibility. Non-biological meshes have been gradually used to cover and fix implant in BR. Compared with biological meshes, non-biological meshes are cheaper and have a more positive postoperative performance generally, but definite comparison can’t be concluded due to the limited data. Conclusion As non-biological meshes are applied to BR preliminarily, their effectiveness are still needed to be observed further.