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Combining the abundance and inexpensiveness of their constituent elements with their atomic dispersion, atomically dispersed Fe-N-C catalysts represent the most promising alternative to precious-metal-based materials in proton exchange membrane (PEM) fuel cells. Due to the high temperatures involved in their synthesis and the sensitivity of Fe ions toward carbothermal reduction, current synthetic methods are intrinsically limited in type and amount of the desired, catalytically active Fe-N4 sites, and high active site densities have been out of reach (dilemma of Fe-N-C catalysts). We herein identify a paradigm change in the synthesis of Fe-N-C catalysts arising from the developments of other M-N-C single-atom catalysts. Supported by DFT calculations we propose fundamental principles for the synthesis of M-N-C materials. We further exploit the proposed principles in a novel synthetic strategy to surpass the dilemma of Fe-N-C catalysts. The selective formation of tetrapyrrolic Zn-N4 sites in a tailor-made Zn-N-C material is utilized as an active-site imprint for the preparation of a corresponding Fe-N-C catalyst. By successive low- and high-temperature ion exchange reactions, we obtain a phase-pure Fe-N-C catalyst, with a high loading of atomically dispersed Fe (>3 wt %). Moreover, the catalyst is entirely composed of tetrapyrrolic Fe-N4 sites. The density of tetrapyrrolic Fe-N4 sites is more than six times as high as for previously reported tetrapyrrolic single-site Fe-N-C fuel cell catalysts.
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BACKGROUND: Cerebral small vessel disease (SVD) is the common cause of cognitive decline in the old population. MRI can be used to clarify its mechanisms. However, the surrogate markers of MRI for early cognitive impairment in SVD remain uncertain to date. We investigated the cognitive impacts of cerebral microbleeds (CMBs), diffusion tensor imaging (DTI), and brain volumetric measurements in a cohort of post-stroke non-dementia SVD patients. METHODS: Fifty five non-dementia SVD patients were consecutively recruited and categorized into two groups as no cognitive impairment (NCI) (n = 23) or vascular mild cognitive impairment (VaMCI) (n = 32). Detailed neuropsychological assessment and multimodal MRI were completed. RESULTS: The two groups differed significantly on Z scores of all cognitive domains (all p < 0.01) except for the language. There were more patients with hypertension (p = 0.038) or depression (p = 0.019) in the VaMCI than those in the NCI group. Multiple regression analysis of cognition showed periventricular mean diffusivity (MD) (ß = -0.457, p < 0.01) and deep CMBs numbers (ß = -0.352, p < 0.01) as the predictors of attention/executive function, which explained 45.2% of the total variance. Periventricular MD was the independent predictor for either memory (ß = -0.314, p < 0.05) or visuo-spatial function (ß = -0.375, p < 0.01); however, only small proportion of variance could be accounted for (9.8% and 12.4%, respectively). Language was not found to be correlated with any of the MRI parameters. No correlation was found between brain atrophic indices and any of the cognitive measures. CONCLUSION: Arteriosclerotic CMBs and periventricular white matter disintegrity seem to be independent MRI surrogated markers in the early stage of cognitive impairment in SVD.
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Atenção , Hemorragia Cerebral/psicologia , Doenças de Pequenos Vasos Cerebrais/psicologia , Disfunção Cognitiva/diagnóstico por imagem , Função Executiva , Substância Branca/patologia , Idoso , Hemorragia Cerebral/complicações , Doenças de Pequenos Vasos Cerebrais/complicações , China , Disfunção Cognitiva/etiologia , Estudos de Coortes , Imagem de Tensor de Difusão , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Testes Neuropsicológicos , Prognóstico , Análise de RegressãoRESUMO
In the study, rubber accelerator 3-methylthiazolidine-2-thione (MTT) was synthesized by one-step method firstly. MTT was detected and characterized by XRD, FTIR, TG-DSC. The micro-structure and intrinsic regularity were revealed. Chemical bond types into MTT molecule were revealed by FTIR. MTT phase composition and structure were given by crystallographic data from XRD detecting such as cell parameters, crystal face index. The phase composition and qualitative identification of MTT structure were completed. Two kinds of information were detected by TG-DSC as quality change and thermal effect. MTT phase transition and decomposition temperature were 76.3 and 306.9 â respectively. The decomposition temperature of MTT was very high. It could provided reference with research on rubber vulcanizing properties by MTT on rubber vulcanizing machine. This study can provide the basis experimental data on the enterprises to designate the working standard tracing detection of MTT industrialized production. Performance index of MTT was judged.
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In the study, rubber accelerator 3-methylthiazolidine-2-thione (MTT) was synthesized by one-step method firstly. MTT was detected and characterized by XRD, FTIR, TG-DSC. The micro-structure and intrinsic regularity were revealed. Chemical bond types into MTT molecule were revealed by FTIR. MTT phase composition and structure were given by crystallographic data from XRD detecting such as cell parameters, crystal face index. The phase composition and qualitative identification of MTT structure were completed. Two kinds of information were detected by TG-DSC as quality change and thermal effect. MTT phase transition and decomposition temperature were 76.3 and 306.9 â respectively. The decomposition temperature of MTT was very high. It could provided reference with research on rubber vulcanizing properties by MTT on rubber vulcanizing machine. This study can provide the basis experimental data on the enterprises to designate the working standard tracing detection of MTT industrialized production. Performance index of MTT was judged.
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BACKGROUND AND PURPOSE: To assess the validity of the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) in the detection of vascular mild cognitive impairment (VaMCI) in patients with subcortical ischemic vascular disease (SIVD). METHODS: Among 102 SIVD patients, both cutoff scores of the MMSE and MoCA for differentiating VaMCI from no cognitive impairment (NCI) or differentiating VaMCI from vascular dementia (VaD) were determined by the receiver operator characteristic (ROC) analysis. Optimal sensitivity with specificity of cutoff scores was obtained after the raw scores were adjusted for education. RESULTS: After adjusting for education, the MoCA cutoff score for differentiating VaMCI from NCI was at 24/25 and that for differentiating VaMCI from VaD was at 18/19. After applying the adjusted MoCA scores from 19 to 24 to identify VaMCI in all SIVD patients, sensitivity was at 76.7% and specificity was at 81.4% (κ = 0.579). The adjusted cutoff score of the MMSE for differentiating VaMCI from NCI was at 28/29 and that for differentiating VaMCI from VaD was at 25/26. The sensitivity and specificity of the adjusted MMSE was at 58.1 and 71.2%, respectively, when using the score from 26 to 28 to identify VaMCI in SIVD patients (κ = 0.294). CONCLUSIONS: The MoCA detected subcortical VaMCI better than the MMSE.
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Isquemia Encefálica/complicações , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/etiologia , Testes Neuropsicológicos , Idoso , Idoso de 80 Anos ou mais , Área Sob a Curva , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Sensibilidade e EspecificidadeRESUMO
Photosynthetic and growth characteristics of Angelica dahurica were studied in order to clarity the relations of photosynthesis, growth and root dry weight, and provide a theoretical basis for its cultivation. Photosynthesis and growth indexes were meas- ured every 25 days. The contents of chlorophyll a, b, a + b, soluble protein and the activities of Hill reaction, Ca(2+)-ATPase, Mg(2+)-ATPase had an increasing trend; They had the highest value in leaf high-speed growth period. Then, they were decreased in root high- speed growth period. The root dry weight showed negative corelation with photosynthetic characteristics indexes except stomatal con- ductance, however, the negative corelation only from net photosynthetic rate and Ca(2+)-ATPase were significant. The vegetative growth period of spring sowing A. dahuricia was divided into three phases: seedling period, leaf high-speed growth period and root high-speed growth period. The root dry weight showed a significantly positive corelation with the root diameter, leaf dry weight, shoot dry weight, aboveground dry weight. There was the competitive relation between aboveground and underground, so underground growth could be es- timated from leaf area and shoot dimeter.
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Angelica/crescimento & desenvolvimento , Angelica/metabolismo , Fotossíntese , Adenosina Trifosfatases/metabolismo , Angelica/enzimologia , Clorofila/metabolismo , Proteínas de Plantas/metabolismo , Raízes de Plantas/crescimento & desenvolvimento , Estações do AnoRESUMO
Porcine reproductive and respiratory syndrome (PRRS) is considered to be one of the most important infectious diseases affecting livestock. This study used gene sequence analysis of ORF5 and Nsp2 to determine the molecular epidemiology of PRRSV in different parts of the Guangxi province of China. These genes were selected due to their extensive variation within the genome. Out of 189 samples from animals suspected to have PRRS, 145 were PRRSV RNA positive. ORF5 and Nsp2 gene sequence analysis of 31 of these samples showed that all of the Guangxi isolates were of type 2. A phylogenetic tree analysis based on ORF5 showed that the Guangxi isolates were divided into two groups. Most of these were closely related to highly pathogenic strains, showing a 30 amino acid deletion at positions 481 and 533-561 of Nsp2, but an additional unique isolate (GXNN06) possessed a further four amino acid deletion at positions 485-488 of Nsp2.
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Síndrome Respiratória e Reprodutiva Suína/epidemiologia , Vírus da Síndrome Respiratória e Reprodutiva Suína/classificação , Vírus da Síndrome Respiratória e Reprodutiva Suína/genética , Animais , China/epidemiologia , Análise por Conglomerados , Genótipo , Epidemiologia Molecular , Dados de Sequência Molecular , Filogenia , Polimorfismo Genético , Síndrome Respiratória e Reprodutiva Suína/virologia , Vírus da Síndrome Respiratória e Reprodutiva Suína/isolamento & purificação , RNA Viral/genética , Análise de Sequência de DNA , Deleção de Sequência , Suínos , Proteínas Virais/genéticaRESUMO
OBJECTIVE: To investigate general practitioners (GPs)' attitudes and confidence in handling dementia and its related problems. METHOD: A questionnaire survey was conducted in GPs from Shanghai on 25th Sep, 2012. The questionnaire included the basic information of the GPs and their attitudes toward and confidence in handling dementia and its related problems. RESULTS: A total of 287 GPs from 73 hospitals participated in the survey.78.4% of them responded that they met fewer demented patients during their clinical practice and only 24.7% of them had attended some kinds of dementia-related knowledge training courses.Senior GPs were less enthusiastic than junior GPs in handling dementia and its related problems as they were more likely to think that dementia should be diagnosed by specialist (87.1% vs. 74.8%, OR = 2.28, 95%CI:1.14~4.57, P = 0.02), less likely to actively referral patients (22.0% vs. 10.1%, OR = 2.52, 95%CI:1.24~5.14, P = 0.01), and more likely to think about that GPs have very limited role in care of demented patients (9.7% vs. 0.7%, OR = 15.59, 95%CI:1.96~123.81, P = 0.00). CONCLUSION: The GPs in Shanghai are lack of trainings about the dementia and its' related knowledge and their attitudes toward the care of dementia are pessimistic. Thus, it is necessary to train the GPs more to enhance their confidence and enthusiasm in care of dementia.
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Competência Clínica , Demência/diagnóstico , Clínicos Gerais/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Atitude do Pessoal de Saúde , China , Feminino , Humanos , Masculino , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Classical swine fever virus (CSFV) can evade the immune response and establish chronic infection under natural and experimental conditions. Some genes related to antigen processing and presentation and to cytokine regulation are known to be involved in this response, but the precise mechanism through which each gene responds to CSFV infection remains unclear. RESULTS: In this study, the amplification standard curve and corresponding linear regression equations for the genes SLA-2, TAP1, SLA-DR, Ii, CD40, CD80, CD86, IFN-α, and IFN-ß were established successfully. Real-time RT-PCR was used to quantify the immune response gene transcription in PK-15 cells post CSFV infection. Results showed that: (1) immune response genes were generally down-regulated as a result of CSFV infection, and (2) the expression of SLA-2, SLA-DR, Ii and CD80 was significantly decreased (p < 0.001). CONCLUSION: We conclude that in vitro infection with CSFV inhibits the transcription of host immune response genes. These findings may facilitate the development of effective strategies for controlling CSF.
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Vírus da Febre Suína Clássica/imunologia , Genes MHC da Classe II , Interações Hospedeiro-Patógeno , Transcrição Gênica , Animais , Linhagem Celular , Perfilação da Expressão Gênica , Evasão da Resposta Imune , Tolerância Imunológica , Reação em Cadeia da Polimerase em Tempo Real , SuínosRESUMO
OBJECTIVE: To analyze the factors affecting on early efficacy of intravenous thrombolysis with alteplase. METHODS: The clinical data of 100 acute cerebral infarction patients treated by intravenous thrombolysis with alteplase were retrospectively analyzed. The patients were divided into early effective group and ineffective group, which assessed by National Institute of Health Stroke Scale (NIHSS) with criteria of whether there were > 3 or not at 24 hours after therapy. Univariate analysis and multivariate logistic regression analysis were used to determine the differences of clinical data between the two groups. RESULTS: Univariate analysis revealed that the early improvement was significantly associated with favorable outcome at 3 month (P = 0.000). Multivariate logistic analysis revealed that the systolic pressure at baseline was moderately positively associated with early improvement (OR 1.031, 95%CI 1.008 - 1.056, P = 0.009). CONCLUSION: Moderately lower baseline systolic pressure is associated with early improvement after thrombolytic therapy which is associated with favorable outcome at 3 month.
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Fibrinolíticos/uso terapêutico , Acidente Vascular Cerebral/tratamento farmacológico , Terapia Trombolítica/métodos , Ativador de Plasminogênio Tecidual/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Feminino , Fibrinolíticos/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Ativador de Plasminogênio Tecidual/administração & dosagem , Resultado do TratamentoRESUMO
OBJECTIVE: To compare distribution difference in risk factors of patients with first-ever ischemic stroke (IS) of different age and gender. METHODS: A total of 1027 patients admitted to the neurological department in Shanghai Renji Hospital with first-ever IS were recruited and divided into young adult group (< 50 years old), middle-aged group (50 - 80 years old), and very old group (> 80 years old) according to their ages. Risk factor analysis included history of smoking, high alcohol consumption, hypertension (HT), diabetes mellitus (DM), heart diseases, atrial fibrillation (AF) and family history of cardiovascular diseases. RESULTS: Female patients were globally older than male patients (71.1 vs 65.7, P < 0.001) at the first attack of IS and having higher prevalence of DM (26.8% vs 19.2%, P = 0.004), heart diseases (28.8% vs 19.2%, P < 0.001) and AF (7.6% vs 3.9%, P = 0.009). However, female patients were less likely to drink heavily (1.0% vs 31.6%, P < 0.001) or smoke (4.4% vs 59.9%, P < 0.001) than the male patients. The rates of smoking and heavy drinking in young adult group were higher than that in other two groups. Patients in very old group had higher prevalence of heart diseases and AF but lower proportion of positive family cardiovascular diseases history than patients in other two groups. HT and DM were equally frequent among three groups. In young adult group, female patients were more likely to have heart diseases and family history of heart diseases (P = 0.015 and P = 0.048). In middle-old group, HT, DM, heart disease and AF were more common in women than in men (P = 0.021, P = 0.004, P = 0.001 and P = 0.039). CONCLUSION: There are differences in risk factor distribution in patients with first-ever IS of different age and gender. Therefore, screening and health education should be performed in allusion to different risk factors.
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Isquemia Encefálica/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Distribuição por SexoRESUMO
OBJECTIVE: The present study aimed to observe and discuss the effectiveness and safety of the UreTron single-probe ultrasonic intracorporeal lithotripter in ureteroscopic lithotripsy. METHODS: The clinical data of patients with unilateral solitary ureteral calculi treated with ureteroscopic lithotripsy who were hospitalized at the Department of Urology (West District) of Beijing Chaoyang Hospital between March 2016 and August 2020 were selected for retrospective analysis. The patients were divided into the UreTron group (group U) and holmium laser group (group H) according to the lithotripsy method adopted. The operation duration, length of hospital stay, stone clearance rate, proportion of patients requiring flexible ureteroscopy-assisted lithotripsy, and complications were compared between the groups. RESULTS: There was no statistical difference between the groups in terms of the general characteristics, operation duration, or length of hospital stay (P > 0.05). Regarding the stone clearance rate (group U=93.5%; group H=75%), proportion of patients requiring flexible ureteroscopy-assisted lithotripsy (group U=6.5%; group H=27.8%), and incidence of surgical complications (group U=1 case; group H=9 cases), group U was superior to group H, and the differences between the groups were statistically significant (P < 0.05). However, the differences in other complications (cardiocerebral complications and lower extremity thrombosis) were not statistically significant between the groups (P > 0.05). CONCLUSION: The UreTron system is a new lithotripsy apparatus that is safe and effective for ureteroscopic lithotripsy and has certain advantages in terms of the stone clearance rate, proportion of patients requiring flexible ureteroscopy-assisted lithotripsy, and surgical complications, making it worthy of clinical application.
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INTRODUCTION: Laparoscopic renal cyst decortication is currently the best choice for the treatment of simple renal cysts and is widely used in clinical practice. AIM: To investigate the safety and clinical efficacy of two-trocar mini-laparoscopic decortication of adult renal cysts. MATERIAL AND METHODS: A total of 90 patients were enrolled in the study and randomly divided into two groups: a two-trocar mini-laparoscopic treatment group (M group) and a three-trocar standard laparoscopic treatment group (S group), with 45 patients in each group. RESULTS: The average length of hospital stay was shorter, and the demand for postoperative analgesics was less in the M group than in the S group (p < 0.05). The proportion of "very satisfied" patients in the patient physical recovery satisfaction survey was significantly higher in the M group than in the S group (p < 0.05). Of the 45 patients in the M group, 40 successfully underwent surgery. In 3 patients, the two-trocar procedure was converted to a three-trocar procedure due to difficulty in separating perirenal adhesion for visualization. Mini-laparoscopic surgery was converted to classic laparoscopic surgery in 2 patients. In the S group, 44 patients successfully underwent the renal cyst decortication procedure. One patient underwent partial renal resection due to an intraoperative diagnosis of multilocular cystic renal cell carcinoma. Postoperative urine leakage was reported in 3 patients in the M group and two in the S group. CONCLUSIONS: Two-trocar mini-laparoscopic treatment of renal cysts is as safe and effective as traditional laparoscopy but is associated with less cosmetic damage, leading to a better physical appearance.
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OBJECTIVE: To assess and compare the performance of fluorine-18-labeled fluorodeoxyglucose positron emission tomography (18 F-FDG-PET/ CT) and gallium-68-labeled tetraazacyclododecanetetraacetic acid-DPhe1-Tyr3-octreotate (68 Ga- DOTATATE) PET/CT in the targeted imaging of culprit tumors causing osteomalacia. METHODS: This was a clinical retrospective analysis. We analyzed 13 patients (five men, eight women; mean age, 49 years; range, 19-55 years) with suspicion of tumor-induced osteomalacia (TIO) between March 2017 and October 2019. All patients underwent two functional imaging methods to locate the culprittumors. Studies were performed on a PET/CT scanner. The injection doses of 18 F- FDG and 68 Ga-DOTATATE were 0.5mCi/kg and approximately 5.0mCi, respectively. In the two scans, the whole body was captured from head to toe 45 to 60 min after intravenous tracer injection. 68 Ga-DOTATATE PET/CT and 18 F-FDG PET/CT imaging results locate culprit tumors according to the following criteria: (i) abnormal foci uptake concentration was observed locally, and the uptake level was higher than the background level of the right lobe of the liver; (ii) combined CT showed or did not have obvious abnormal density changes; and (iii) non-specific ingestion lesions due to fracture, arthritis, necrosis of femoral head are excluded. Compared with the results of pathological examination and clinical follow-up, the sensitivity, specificity and accuracy of 68 Ga-DOTATATE PET/CT imaging and 18 F-FDG PET/CT imaging for TIO were analyzed. RESULTS: All patients had symptoms of osteomalacia and hypophosphatemia. The lag time (symptoms to PET diagnosis) ranged from 2 to 12 years. There were eight cases of TIO patients and five cases of non-TIO patients confirmed by surgery, pathology and follow-up. Among the eight TIO patients, there were six cases (75.0%) of PMTs, one case (12.5%) of giant cell tumor, one case (12.5%) of hemangiopericutoma. Most (n = 6, 75.0%) of the confirmed tumors in our patient population were in the lower extremities, followed by craniofacial regions (n = 1, 12.5%), and torso (n = 1, 12.5%), respectively. Among the five non-TIO patients, there were two cases of Fanconi syndrome, one case of rickets, and two cases of sporadic osteomalacia hypophosphorus. The culprit tumors could be located either in the bone (n = 5, 62.5%) or the soft tissue (n = 3, 37.5%). 18 F-FDG PET/CT was able to localize the tumor in six (6/13, 46.1%) patients. 68 Ga-DOTATATE PET/CT detected tumor in 8 (83.3%) of 13 patients. The sensitivity of 68 Ga-DOTATATE PET/CT imaging and 18 F-FDG PET/CT imaging in the evaluation of TIO in our patient population were 100% (8/8) vs 75% (6/8). The specificity of the two different methods was 80% (4/5). The overall accuracy was 92.3% (12/13) vs 76.9% (10/13). CONCLUSIONS: 68 Ga-DOTATATE PET/CT is very effective in assessing hypophosphatemia patients with TIO typical symptoms compared with 18 F-FDG. Therefore, in clinically suspected cases of hypophosphatemic osteomalacia, 68 Ga-DOTATATE PET/CT should be preferred as an imaging modality investigation to avoid delay in the treatment of this disease.
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Osteomalacia/diagnóstico por imagem , Síndromes Paraneoplásicas/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Adolescente , Adulto , Feminino , Radioisótopos de Flúor , Humanos , Masculino , Pessoa de Meia-Idade , Octreotida/análogos & derivados , Compostos Organometálicos , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Adulto JovemRESUMO
Objective: To investigate the safety and efficacy of a vascular prop device for laparoscopic orthotopic kidney transplantation (LOKT) in swine. Material and Methods: Twenty swine were randomly divided into two groups. A vascular prop device was used in the observation (VP) group, and the vein beltization technique was used in the control (VB) group. The right kidney, as a donor graft, was laparoscopically transplanted to the location of the left kidney after a left nephrectomy. Data on the operative time, venous anastomotic time, vein stenosis, etc., and the survival of the swine in the two groups were recorded. Results: The mean transplant operative time, the mean cold ischemia time, and the venous anastomotic times in the VP group were significantly shorter than those in the VB group. Seven swine in the VP group and three swine in the VB group survived for 7 days. Autopsy results showed the occurrence of one artery stenosis and one vein stenosis in the VP group and one artery stenosis and five vein stenoses in the VB group. The median survival time was 6.25 days for the swine in the VP group and 4.40 days for those in the VB group. Conclusions: The vascular prop device is safe and feasible for LOKT in swine and may accelerate venous anastomosis and ensure the quality of venous anastomotic stoma.
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BACKGROUND/AIMS: To investigate whether diffusion tensor imaging (DTI) is more sensitive than conventional MRI at detecting cognitive deterioration in patients with subcortical ischemic vascular disease (SIVD). METHODS: Forty-two SIVD patients had a diagnosis of no cognitive impairment (NCI), vascular cognitive impairment/no dementia or vascular dementia (VaD). Whole-brain DTI histography and routine MRI were performed on these participants. RESULTS: There were significant differences between cognitively impaired patients and NCI subjects in mean diffusivity and fractional anisotropy in either whole-brain white matter (WBWM) or in normal-appearing white matter (NAWM). All DTI indices within either WBWM or NAWM were found to be significantly correlated with both the attention-executive and memory measures in SIVD subjects. Lacune numbers and T2-weighted lesions correlated only with attention-executive measures, whereas hippocampal volumes correlated only weakly with memory measures. Whole-brain gray matter volumes correlated with Z scores for all cognitive domains but language. After VaD patients had been excluded from the analysis, cognitive measures remained significantly correlated with some of the DTI indices, but not with conventional MRI findings. CONCLUSIONS: Compared with conventional MRI, whole-brain DTI is a more reliable and sensitive technique for the early detection of cognitive impairment in SIVD patients.
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Encéfalo/diagnóstico por imagem , Infarto Cerebral/patologia , Transtornos Cognitivos/patologia , Demência Vascular/patologia , Imagem de Tensor de Difusão , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Atenção , Encéfalo/patologia , Estudos de Casos e Controles , Infarto Cerebral/complicações , Infarto Cerebral/diagnóstico por imagem , Cognição , Transtornos Cognitivos/complicações , Transtornos Cognitivos/diagnóstico por imagem , Demência Vascular/complicações , Demência Vascular/diagnóstico por imagem , Função Executiva , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Rememoração Mental , Pessoa de Meia-Idade , RadiografiaRESUMO
OBJECTIVE: To describe the impact of stroke clinic on the usage of statins for secondary prevention of ischemic stroke. METHODS: Data about the demography, social economic status, personal histories, blood lipid profiles, and the status of the usage of statins from 568 serial ischemic stroke patients were retrospectively analysed. RESULTS: A total of 51.3% patients followed up in stroke clinic (306 patients) and 7.6% patients followed up in general clinic (262 patients) were treated with statins. 71.6% patients with and 44.8% patients without hyperlipidemia in stroke clinics were taking statins, which were higher than that patients in the general clinics (27.1% and 2.0% respectively). The patients in the stroke clinics with high LDL-C level (>3.4 mmol/L) were more likely to be treated with statins than those with lower level (25.6% vs 14.7%, P=0.017). CONCLUSIONS: The rate of statins usage is extremely low in stroke patients followed up in a general clinic, but it can been improved greatly in a stroke clinic. Stroke clinic can narrow the gap between the clinical practice and the guideline for secondary prevention of ischemic stroke.
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Assistência Ambulatorial , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Prevenção Secundária , Acidente Vascular Cerebral/tratamento farmacológico , Adulto , Idoso , Uso de Medicamentos , Feminino , Humanos , Ataque Isquêmico Transitório/tratamento farmacológico , Ataque Isquêmico Transitório/prevenção & controle , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Acidente Vascular Cerebral/prevenção & controleRESUMO
OBJECTIVE: To evaluate the efficacy of donepezil for post-stroke aphasia. METHODS: Sixty patients with acute post-stroke aphasia were divided into treatment group and a control group. All patients had been treated for secondary prevention according to the guideline. The treatment group received donepezil hydrochloride (5 mg/d) for 12 weeks. The efficacy of treatment was measured by comparing the changes of scores of Western Aphasia Battery (WAB) between baseline and 12 weeks later. RESULTS: Compared with the baseline, the changes of scores of all items of WAB and Aphasia Quotient (AQ) in both group after 12 weeks follow-up were great, however, the change of AQ was significantly greater in donepezil group (34.14 +/- 17.70)than that in control group (20.69 +/- 17.26)(P = 0.004). The patients in donepezil group also showed significant recovery in spontaneous speech, comprehension, repetition, and naming than those in control group (P < 0.05). The rate of significant improving in donepezil group was 60.0% which was significantly greater than that in control group (26.7%) (P = 0.009). CONCLUSION: There are spontaneous recovery of post-stroke aphasia within 3 months. Donepezil may facilitate the recovery in spontaneous speech, comprehension, repetition, and naming functions.
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Afasia , Acidente Vascular Cerebral , Estudos de Casos e Controles , HumanosRESUMO
OBJECTIVE: To test a new method to manufacture a maxillary applicator containing radioactive seeds for brachytherapy of malignant neoplasms based on computer aided design (CAD) and rapid prototyping (RP). METHODS: Six patients with maxillary malignancy which had eroded the inferior wall of orbit and skull base were included in this study. After excision of the tumors, head CT data of these patients were transmitted into the computer. Three-dimensional digital image of the patient's defected region was then obtained with special software processing based on Mimics 8.11 and Geomagic 7.0 and the resin cast of the defected region was manufactured by rapid prototyping. The elastic obturator was then made on this resin cast which can duplicate the undercut tissue of the defected region. After the obturator was completed, the radiotherapy plan was made. (125)I radioactive seeds were implanted into the tissues, and they were also implanted into the target area of the obturator which was used as a maxillary applicator at the same time. The number of radioactive seeds was then counted and the stability of radioactive seeds was determined by CT examination. All these 6 patients were followed-up for 12 months. RESULTS: All the obturators had good retention and stability and fitted the designed target tissue very well. (125)I radioactive seeds in the form of the obturator applicator were stable. For all patients, the total number of radioactive seeds used was 189. Among them, 105 seeds, 55.6% of the total, were contained in obturator applicators. After the obturator applicators were used, the amount of radioactive seeds irradiating the target regions was significantly increased when compared with that of before. After follow-up of 12 months, there was no recurrence nor severe complications. CONCLUSION: (125)I radioactive seeds contained maxillary applicator made by computer aided design and rapid prototyping can effectively improve the brachytherapy of (125)I when it is used for the post-operation radiotherapy of maxillary malignant tumors.
Assuntos
Braquiterapia/instrumentação , Desenho Assistido por Computador , Neoplasias Maxilares/radioterapia , Modelos Anatômicos , Planejamento da Radioterapia Assistida por Computador/métodos , Adulto , Idoso , Braquiterapia/métodos , Simulação por Computador , Feminino , Humanos , Radioisótopos do Iodo/uso terapêutico , Masculino , Neoplasias Maxilares/diagnóstico por imagem , Neoplasias Maxilares/cirurgia , Pessoa de Meia-Idade , Radioterapia Assistida por Computador/instrumentação , Radioterapia Assistida por Computador/métodos , Tomografia Computadorizada Espiral , Adulto JovemRESUMO
OBJECTIVE: To evaluate the clinical characteristics of patients with depressive disorders at Department of Neurology in general hospitals. METHODS: A total of 596 consecutive patients with depressive symptoms, such as insomnia, or somatic symptoms were collected prospectively and those who were unable to answer the questionnaire were excluded. Data of demography and clinical characteristics were obtained from a questionnaire. The 17-item Hamilton depression rating scale (HDRS17) was used to identify the presence of depressive disorders. Case control method was employed to evaluate the clinical characteristics of patients with depressive disorders. RESULTS: Among all patients, 347 were diagnosed as depressive disorders (58.1%). The mean score of HDRS17 was 21.9 ± 3.4. Fewer psychological symptoms were complained by patients with depressive disorder. The depressive mood was found in 146 (41.2%), a loss of interest or pleasure 161 (46.4%)and depressive mood plus a loss of interest or pleasure 108 (31.3%). The factors of manual worker, lower education level, worse marital status, lower economic status, irregular lifestyle and coexisting medical conditions were associated with depressive disorders. The most frequent complaints of somatic symptoms were as follows: hard to fall asleep 254 (73.2%), early awakening 218 (76.0%), poor memory 219 (63.1%), fatigue 181 (52.2%), palpitation 179 (51.6%), dizziness 170 (49.0%), headache 160 (46.1%) and dyspnea 140 (40.3%). The mean number of somatic symptoms was 6.87 ± 2.78. The patients complaining of multiple somatic symptoms (≥ 4) was 322 (92.8%). The number of somatic symptoms was correlated with depressive disorders. CONCLUSIONS: More minor depression and somatic symptoms are the main characteristics of patients with depressive disorder in general hospitals.