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Objective:To evaluate the distribution characteristics of postinterventional cerebral hyperdensities (PCHDs) in patients with acute anterior circulation large vessel occlusive stroke after interventional therapy using the Alberta Stroke Program Early CT Score (ASPECTS) and to investigate its predictive value for symptomatic intracranial hemorrhage (sICH).Methods:Consecutive patients with acute anterior circulation large vessel occlusive stroke underwent endovascular mechanical thrombectomy (EMT) in the Stroke Center of Dongguan People's Hospital from January 2018 to December 2020 were retrospectively enrolled. The clinical, imaging and follow-up data were collected. The immediate PCHDs-ASPECTS after endovascular therapy were analyzed. Multivariate logistic regression analysis and receiver operator characteristic (ROC) curve were used to investigate its predictive value for sICH. Results:A total of 161 patients were enrolled in the study, including 115 males (71.4%). The baseline National Institutes of Health Stroke Scale (NIHSS) score was 13.6±5.6; 66 patients (41.0%) developed PCHDs and 35 (21.7%) had sICH. The baseline NIHSS score, the proportion of patients with severe stroke, the number of retrieval attempts and the detection rate of PCHDs in the sICH group were significantly higher than those in the non-sICH group, while diffusion weighted imaging-ASPECTS and PCHDs-ASPECTS were significantly lower than those in the non-sICH group (all P<0.05). Multivariate logistic regression analysis showed that PCHDs had a significant independent positive correlation with sICH (odds ratio 6.036, 95% confidence interval 1.45-25.123; P=0.013), and PCHDs-ASPECTS had a significant independent negative correlation with sICH (odds ratio 0.70, 95% confidence interval 0.496-0.992; P=0.045). ROC analysis showed that the area under the curve predicted by PCHDs-ASPECTS was 0.832 ( P<0.05). When its cut-off value was 8 points, the sensitivity and specificity were 74.3% and 83.3% respectively. Conclusions:In patients with acute anterior circulation large vessel occlusive stroke treated with EMT, the immediate postoperative PCHDs is an independent predictor of sICH, and PCHDs-ASPECTS can early predict the risk of sICH after EMT.
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Atherosclerosis is closely associated with vascular diseases such as ischemic stroke and ischemic heart disease. Its main pathological mechanisms include inflammatory cell infiltration, oxidative stress, and vascular endothelial dysfunction. As an endogenous antioxidant enzyme, heme oxygenase-1 (HO-1) plays an anti-inflammatory, antioxidant and vasodilating role in the process of atherosclerosis, which can inhibit the occurrence of atherosclerosis and prevent the progress of unstable plaques. This article reviews the protective effect and mechanism of HO-1 in atherosclerosis, and discusses the important significance of HO-1 as a potential therapeutic target for atherosclerotic diseases.
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Aim To investigate the anti-inflammatory effects of Aesculetin from Viola tianshanica Maxim in LPS-stimulated RAW 264.7 cells and the underlying mechanism.Methods RAW 264.7 cells were divided into control group, model group( LPS), 0.16, 0.8, 4, 20 μmol·L-1 AESN groups( different concentrations of AESN + LPS)and positive control group(10 μmol·L-1 Indomethacin+LPS).LPS(1 mg·L-1)was used to stimulate RAW 264.7 cells for 24 h to establish inflammatory model.MTS assay was used to detemine cytotoxicity of Aesculetin in RAW 264.7 cells.Griess method was used to detect NO secretion in LPS-stimulated RAW 264.7 cells.ELISA was applied to determine the contents of TNF-α, IL-6 and IL-1β in cell culture supernatant.qRT-PCR was employed to detect the mRNA expression levels of TNF-α, IL-6, IL-1β and iNOS.Immunofluorescence assay was used to evaluated the protein expressions of iNOS, p-NF-κB p65, IκBα, p-p38 and p-ERK1/2.Enzyme assay was used to detect the inhibition activity of Aesculetin on cyclooxygenase 1/2(COX 1/2).Results Aesculetin significantly inhibited the secretion of inflammatory mediator NO, mRNA and protein expression of iNOS in LPS-induced RAW 264.7 at 0.16, 0.8, 4 and 20 μmol·L-1.The contents of TNF-α, IL-6 and IL-1β in supernatant significantly decreased, and the mRNA expression levels of TNF-α, IL-6 and IL-1β were also reduced by Aesculetin.Aesculetin also obviously inhibited the protein degradation of IκBα and inhibited the nuclear translocation of p-NF-κB p65, p-p38, p-ERK1/2.In addition, Aesculetin had significant inhibitory activities on COX-1 and COX-2, and the IC50 was 28.1 μmol·L-1, 2.3 μmol·L-1, respectively.Conclusions AESN has good anti-inflammatory effect, and its mechanism is closely related to the inhibition of NF-κB and MAPK signaling pathways
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The brain tissue of patients with chronic internal carotid artery occlusion is in a state of hypoperfusion for a long time, which often presents as asymptomatic cognitive impairment. Even with the best medical treatment, patients with chronic internal carotid artery occlusion still have a higher risk of stroke and cognitive impairment. Recent studies have shown that recanalization can reduce the incidence of stroke in patients with chronic internal carotid artery occlusion, but whether it can improve the cognitive function remains controversial. This article reviews the treatment of chronic internal carotid artery occlusion and its effect on cognitive function.
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Objective:To observe the effect of modified Wuzi Yanzongwan periodic staging treatment on the outcome of assisted pregnancy in patients with poor ovarian response (POR) and kidney deficiency syndrome. Method:One hundred and four patients were randomly divided into observation group and control group, with 52 cases in each group. Both groups received gonadotropin releasing hormone (GnRH) antagonist regimen. The patients in control group additionally took Bushen Yutaiwan orally, 5 g/time, 3 times/day. The patients in observation group additionally took modified Wuzi Yanzongwan during pre-ovulation and post-ovulation periods, 1 dose/day. The treatment courses were 3 menstrual cycles (or termination after clinical pregnancy) in both groups. The number of eggs obtained, the number of available embryos, the number of fertilization, the number of high-quality embryos, the number of embryos implanted, the number of cycles cancelled, and the clinical pregnancy were recorded. Human chorionic gonadotropin (HCG) was injected, and then follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrogen (E<sub>2</sub>), anti-Müllerian hormone (AMH), basal antral follicle count (AFC) and endometrial thickness were measured daily. The number of days and dosage of Gn used, scores of kidney deficiency syndrome were recorded before and after treatment, and the adverse reactions during the study period were recorded. Result:The number of eggs captured, rate of harvested eggs, number of available embryos, rate of available embryos, number of high-quality embryos, rate of high-quality embryos, and fertilization rate in observation group were higher than those in control group (<italic>P</italic><0.05 or <italic>P</italic><0.01). The cycle cancellation rate was lower than that in the control group; the embryo implantation rate and clinical pregnancy rate were superior than those in control group, but the difference was not statistically significant. The FSH level and FSH/LH ratio in observation group were lower than those in control group during HCG day (<italic>P</italic><0.01), while E<sub>2</sub>, AMH, AFC and endometrial thickness were higher than those in control group (<italic>P</italic><0.01). Simultaneously, the number of days and amount of Gn used in observation group was lower than that in control group (<italic>P</italic><0.01). Conclusion:The Modified Wuzi Yanzongwan periodic staging treatment combined with GnRH antagonist scheme for patients with POR kidney deficiency syndrome, can regulate the level of endocrine hormones, promote follicular development, improve ovarian reserve, increase the number of eggs obtained, improve egg quality, help improve pregnancy outcomes, and increase the chances of successful pregnancy with assisted reproductive technology. It is worthy of further clinical research.
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Objective:To observe clinical efficacy of Shengma Biejia Tang combined with Shenfutang on sepsis-induced myocardial dysfunction (SIMD) and study the controlling effect on inflammatory reaction. Method:Eighty-eight patients with SIMD were randomly divided into control group (44 cases) and observation group (44 cases) by random number table. Patients in control group received the early bundle therapy of sepsis, including fluid resuscitation, anti-infection treatment and vasoactive drugs. In addition to the therapy of control group, patients in observation were also given Shengma Biejia Tang combined with Shenfutang, 1 dose/day. And a course of treatment was 7 days. Before and after treatment, levels of troponin (cTnI), creatine kinase isoenzyme (CK-MB), N terminal brain natriuretic precursor (NT-proBNP), calcitonin (PCT), hypersensitivity C reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukins-6 (IL-6) and blood lactic acid (LAC) were detected. And color Doppler ultrasound examination of the heart was performed to record left ventricular ejection fraction (LVEF), blood flow velocity of early mitral valve diastole and ratio of blood flow velocity at atrial systolic peak (E/A) and stroke volume (SV). And lactate clearance rate (LCR) was calculated. And sequential (sepsis-related) organ failure assessment (SOFA), acute physiology and chronic health (APACHEⅡ) and traditional Chinese medicine(TCM)syndromes were scored. Result:After treatment, levels of cTnI, NT-ProBNP, CK-MB, Hs-CRP, IL-6, PCT, TNF-α and LAC in observation group were lower than those in control group (PPPConclusion:In addition to the integrated western medicine, Shengma Biejia Tang combined with Shenfutang can control inflammatory reaction, relieve myocardial inhibition and myocardial damage, and protect and improve heart function, and alleviate the symptoms.
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Objective To evaluate the treatment effect of bladder instillation chemotherapy on glandular cystitis. Methods The clinical data of glandular cystitis of 54 cases were retrospectively analyzed, all cases were treated individually and the applications of chemotherapeutic drugs bladder instillation were not adopted. Results Follow-up period ranged from 2.5 to 9.0 years, and the average was 4.6 years. Lower urinary tract symptoms score before treatment, 3 month , 6 month, 2 years , 4 years after treatment was (8.5 ± 3.7), (5.7 ± 2.3), (3.9 ± 1.3), (4.0 ± 1.9), (4.2 ± 1.9) scores, and the scores after treatment were improved significantly compared with that before treatment (P < 0.05). Recurrence rate 3 months , 6 months, 2 years and 4 years after treatment was 3.7%(2/54), 13.0%(7/54), 5.6%(3/54) and 1.9%(1/54). Conclusions Eliminating the inducements and improvement of symptoms provides a significantly curative effect in glandular cystitis. Postoperative bladder instillation chemotherapy is not recommended.
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Objective To investigate the predictive significance of thromboelastography ( TEG) for early neurological deterioration ( END) in patients with acute cerebral infarction. Methods This was a case-control study. From March 2016 to August 2017,a total of 195 consecutive patients with acute mild to moderate cerebral infarction (National Institute of Health stroke scale [NIHSS] score <16) within 24 h after onset were registered prospectively. The demography, clinical data, and laboratory test results were collected. The TEG examinations were completed after admission. According to whether having END or not within 3 d after admission,they were divided into either a END group (n=60) or a non-END group (n=135). A logistic regression model was established to analyze the relationship between TEG parameters and END. Results Of the 195 eligible patients,60 (30. 8%) experienced END. TEG reaction time (RT) and kinetic time ( RT) in patients of the END group were significantly less than those of the non-END group (4. 1 ± 1. 1 min vs. 4. 4 ± 1. 2 min;1. 3 ± 0. 3 min vs. 1. 5 ± 0. 4 min,t=3. 395 and 3. 093,respectively;all P<0. 01). The proportions of the shortened RT and KT in patients of the END group were significantly higher than those of the non-END group (80. 0% [48/60] vs. 63. 0% [85/135],18. 3% [11/60] vs. 8. 1% [11/135]). There were significant differences (χ2 =5. 560 and 4. 305,all P <0. 05). After adjusting for the factors of age,sex,diabetes mellitus,smoking,baseline NIHSS score,and serum hypersensitive C-reactive protein, logistic regression analysis showed that the shortened RT was independently correlated with END (OR,1. 612,95% CI 1. 094-2. 376,P=0. 016). Conclusion The shortened TEG coagulation time RT on admission has a certain predictive value for END within 3 d after onset of acute mild to moderate cerebral infarction.
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Objective To investigate the correlation betw een visit-to-visit blood pressure variability and long-term stroke recurrence in patients w ith ischemic stroke. Methods Consecutive patients w ith first-ever acute ischemic stroke w ere registered. The demographic and clinical data w ere documented. The patients w ere follow ed up every month after discharge. Visit-to-visit blood pressure w as measured, and its mean value and blood pressure variability parameters w ere calculated.A 12-month follow-up period w as completed and the recurrent stroke events w ere documented.Univariate analysis w as used to compare the demographic and clinical data in the recurrent and non-recurrent groups.Multivariate logistic regression analysis w as used to identify the correlation betw een visit-to-visit blood pressure variability and stroke recurrence. Results A total of 556 patients completed the follow-up, including 62 (11.2%) w ith recurrent stroke. The standard deviation (16.5 ±4.7 mmHg vs.13.4 ±4.2 mmHg, 1 mmHg=0.133 kPa; t=1.953, P=0.042) and coefficient of variation (11.9 ±3.1 vs.9.8 ±2.4; t=2.287, P=0.001) of visit-to-visit systolic blood pressure in the recurrent group w ere significantly higher than those in the non-recurrent group.Multivariable logistic regression analysis show ed that visit-to-visit coefficient of variation of systolic pressure w as independently associated w ith stroke recurrence (odds ratio 1.305,95% confidence interval 1.004-7.491;P=0.017). Conclusion The visit-to-visit blood pressure variability w as independently associated w ith long-term stroke recurrence in patients w ith acute ischemic stroke.
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This report presents the endemic status of schistosomiasis in the People's Republic of China at national level in 2016,and analyzes the data collected from the national schistosomiasis prevention and control system and 454 national schisto-somiasis surveillance sites. Among the 12 provinces(municipality and autonomous region)of endemic of schistosomiasis japoni-ca in P. R. China,5 provinces (municipality and autonomous region),i. e.,Shanghai,Zhejiang,Fujian,Guangdong and Guangxi,had achieved elimination,and 7 provinces of Sichuan,Yunnan,Jiangsu,Hubei,Anhui,Jiangxi and Hunan had achieved transmission control by the end of 2016. There are 451 endemic counties(cities,districts)covering 257 million peo-ple,specifically including 29692 endemic villages of 69.39 million people at risk. Among the 451 endemic counties(cities,dis-tricts),35.25%(159/451),42.35%(191/451)and 22.39%(101/451)reached the criteria of elimination,transmission inter-ruption and transmission control,respectively in 2016. By the end of 2016,it was estimated of 54454 infections of schistosome, decreased by 29.46%compared with 77194 in 2015. No acute schistosomiasis case was reported in 2016. There were 30573 ad-vanced schistosomiasis cases documented in 2016. A total of 8500710 individuals received schistosomiasis examinations and 600 individuals were parasitologically diagnosed,decreased by 83.36%compared with 3606 in 2015. The Oncomelania hupen-sis snail survey was performed in 22140 endemic villages and O. hupensis snails were found in 7106 villages,accounting for 32.109%of the total villages,with 20 newly detected villages with snails. The snail survey covered area of 813963.91 hm2 and snails were found in an area of 235096.04 hm2,including a newly detected area of 1346.48 hm2. No schistosome-infected snails were found in 2016. A total of 881050 bovines were raised in the schistosomiasis endemic area. Of them,510468 bovines re-ceived examinations,resulting in 8 schistosome-infected bovines. There were 147642 schistosomiasis cases receiving drug treat-ment in 2016,with 2303555 individuals undergoing expanded chemotherapy;there were 9 bovines with schistosomiasis receiv-ing drug treatment,with 439857 bovines undergoing expanded chemotherapy;a total of 139483.84 hm2 area with snail control by using molluscicides,with actual molluscicide-treated area of 73941.75 hm2;and 3101.52 hm2 snail habitants were treated by environmental modification. Based on the data from the 454 national schistosomiasis surveillance sites,the mean Schistosoma japonicum infection rate was 0.02% and 0.0078% in humans and bovines,respectively. No schistosome-infected snails were found in all the surveillance sites. The results demonstrate a decline in the endemicity of schistosomiasis in P. R. China com-pared with the level of 2015. However,the distribution area of snails in China is still large and the infection source of schistoso-miasis still exists to some extent in some endemic areas;in some regions,the task to reach the standard of transmission interrup-tion is still arduous. There are still objective factors of epidemic and transmission and risk factors of endemic reversal and re-bound for schistosomiasis. So,further control and effective surveillance as well as accurate prevention and control should be im-plemented to promote the elimination process on schistosomiasis in P. R. China.
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Objective To investigate the incidence,etiology and risk factors of activity of daily life (ADL) deterioration during recovery in patients with ischemic stroke.Methods Consecutive inpatients with acute ischemic stroke from Dongguan area were enrolled prospectively.The demographic,clinical and imaging data were documented,and the patients were followed-up for 6 months.The modified Rankin Scale (mRS) 9Q was used to evaluate ADL.The mRS score 0-2 was defined as independency,and the mRS score >2 was defined as dependency,and the ADL deterioration was defined as transition from independency to dependency.A multivariate logistic regression model was established to analyze the factors associated with ADL deterioration.Results A total of 362 patients completed the 6-month follow-up,50 patients (13.8%) had ADL deterioration,among them,14 (3.9%) attributed to early stroke recurrence and 12 (3.3%)attributed to cognitive impairment after ischemic stroke.Multivariate logistic regression analysis showed that advanced age (odds ratio [OR] 1.099,95% confidence interval [CI] 1.049-1.152;P <0.001),female (OR] 2.026,95% CI 1.068-6.437;P =0.035),previous stroke history (OR 1.251,95% CI 1.024-1.530;P=0.029),and higher baseline National Institutes of Health Stroke Scale (NIHSS) score (OR 1.167,95% CI 1.016-1.284;P =0.001) were the independent risk factors for ADL deterioration.Conchtsions The ADL deterioration deterioration during recovery in patients with ischemic stroke is not uncommon.Advanced age,female,previous stroke history and higher baseline NIHSS score are the independent risk factors for ADL deterioration during recovery in patients with ischemic stroke.
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Objective To investigate the incidence,etiology and risk factors of activity of daily life (ADL) deterioration during recovery in patients with ischemic stroke.Methods Consecutive inpatients with acute ischemic stroke from Dongguan area were enrolled prospectively.The demographic,clinical and imaging data were documented,and the patients were followed-up for 6 months.The modified Rankin Scale (mRS) 9Q was used to evaluate ADL.The mRS score 0-2 was defined as independency,and the mRS score >2 was defined as dependency,and the ADL deterioration was defined as transition from independency to dependency.A multivariate logistic regression model was established to analyze the factors associated with ADL deterioration.Results A total of 362 patients completed the 6-month follow-up,50 patients (13.8%) had ADL deterioration,among them,14 (3.9%) attributed to early stroke recurrence and 12 (3.3%)attributed to cognitive impairment after ischemic stroke.Multivariate logistic regression analysis showed that advanced age (odds ratio [OR] 1.099,95% confidence interval [CI] 1.049-1.152;P <0.001),female (OR] 2.026,95% CI 1.068-6.437;P =0.035),previous stroke history (OR 1.251,95% CI 1.024-1.530;P=0.029),and higher baseline National Institutes of Health Stroke Scale (NIHSS) score (OR 1.167,95% CI 1.016-1.284;P =0.001) were the independent risk factors for ADL deterioration.Conchtsions The ADL deterioration deterioration during recovery in patients with ischemic stroke is not uncommon.Advanced age,female,previous stroke history and higher baseline NIHSS score are the independent risk factors for ADL deterioration during recovery in patients with ischemic stroke.
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Objective To study the effect of typical middle ear diseases on sound compensation of round window (RW) stimulation, so as to provide references for the optimal design of middle ear implants by RW stimulation. Methods The finite element model of the middle ear and cochlea was built by CT scanning and reverse engineering technique, and its reliability was also verified. On the basis of the model and by changing material properties of corresponding tissues, three typical middle ear diseases were simulated: hardening of stapedial annular ligaments, abnormal stapedial bone growth and hardening of anterior mallear ligaments. Then the response from displacement of basilar membrane (BM) was compared to analyze the impact of 3 types of middle ear diseases on sound compensation of RW stimulation. Results The stapes with abnormal bone growth severely deteriorated the equivalent sound pressure (ESP) of RW stimulation at higher frequencies, while the hardening of stapedial annular ligaments and the hardening of anterior malleus ligaments prominently decreased ESP of RW stimulation at lower frequencies. Among the 3 types of middle ear diseases, hardening of stapedial annular ligaments affected the sound compensation of RW stimulation more significantly with the amount of the ESP reduction up to 17 dB. Conclusions Middle ear diseases can deteriorate the sound compensation of RW stimulation seriously with large deterioration, Therefore, the output stimulation of the actuator should be targeted to improve the design of the middle ear implants by RW stimulation.
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Objective To elucidate whether 24-hour blood pressure (BP) variability in the acute phase of ischemic stroke is associated with functional outcomes.Methods Case-control study was performed in patients with acute ischemic stroke admitted to our hospital from January 2013 to December 2015.Clinical data and 24-hour continuous BP monitoring data right after admission were recorded,and BP variability profiles were subsequently calculated.Functional outcomes were evaluated with modified Rankin scale (mRS) on discharge and at 6 months after discharge respectively (favorable outcome:mRS scores <2;poor outcome:mRS scores>2).BP variability profiles were compared with distinctive functional outcomes.Logistic regression models were established to investigate factors contributing to poor outcome on discharge and at 6 months after discharge.Results Of 188 eligible patients,67 (35.6%) discharged with poor outcome and 95 (50.5%) were reported poor outcome at 6 months follow-up.Patients with poor outcome on discharge had significantly higher 24-hour mean systolic blood pressure (SBP,[149.6±20.0] mmHg vs.[137.6±20.2] mmHg) and SBP standard variation (SBP-SD,[13.4±3.8] mmHg vs.[12.1±3.8] mmHg,P<0.05).After adjusting for crude variables,the increase of 24-hour mean SBP and SBP-SD was independently associated with poor outcome on discharge (OR=1.284,95%CI=1.067-1.544,P=0.008;OR=1.098,95%CI=1.016-1.188,P=0.019).Patients with poor outcome at 6 month after discharge had significantly higher 24-hour mean SBP ([146.6±20.6] mmHg vs.[137.1 ± 20.2] mmHg,P<0.05).Conelusion Increased 24-hour BP variability after admission is associated with early functional outcome in patients with acute ischemic stroke,but not with midterm outcome.
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[ABSTRACT]OBJECTIVE To obser ve t he pathological changes of nasal mucosa in rats after instillation of 37℃ normal saline. METHODS Forty-eight qualified rats were given instillation of 37℃ nomal saline 30 times, once per minute. Another 2 qualified rats served as control. After instillation, in the 15, 30 minutes and 1st, 3rd, 7th, 14th, 42th, 28th day respectively, the nasal septum mucosa of 6 rats was observed by light and electron microscopy. The corresponding area of the mucosa of control group was also observed by light and electron microscope. RESULTS Under light microscope, the arrangement of cell was disordered in the 1st, 3rd, 7th days. But there is no damage of vascular gland structure. After 14 days, the disorder recovered. With electron microscope, edema of cells, expansion of perinuclear gap, disorder of cilia and microwilli was found in the 30 minutes, 1st, 3rd day. All these began recover in the 7th days, and completely restored in the 28th day. CONCLUSION 37℃ nomal saline drip can damage nasal mucosa, but the damage is light, which is characterized by disorder and shortage of cilia and microvilli, edema of the epithelial cells. And the damage can recover quickly. It began in the 30 minutes after instillation, reached its peak in the 3rd day. And the recovery began in the 7th day, and completed in the 28 day.
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Objective To investigate the correlation betw een the short-term blood pressure variability and the recent outcome in patients w ith noncardioembolic ischemic stroke. Methods The patients w ith acute noncardioembolic ischemic stroke admitted to hospital betw een January 1, 2013 to June31, 2015 w ere enrol ed consecutively. The demographic and clinical data w ere col ected, and 24 h ambulatory blood pressure monitoring w as performed and each blood pressure variability parameter w as calculated. The modified Rankin scale (mRS) w as used to evaluate recent neurological outcome at the time of discharge or the fourteenth day in hospital. The mRS score 0-2 w as defined as good outcome, and >2 w as defined as poor outcome. Multivariate logistic regression analysis w as used to determine the correlation betw een the blood pressure and the short-term blood pressure variability indicators and recent neurological outcome. Results A total of 229 patients w ith acute noncardioembolic ischemic stroke w ere enrol ed, and 40.2% of them had recent poor functional outcome. The mean systolic pressure ( 147.8 ±19.6 mmHg vs.137.7 ± 19.1 mmHg; t=3.868, P<0.001; 1 mmHg=0.133 kPa) and the actual variation value of the mean systolic pressure (median, interquartile 11.7 [10.0-14.0] mmHg vs.10.6 [8.2-12.5] mmHg;Z=3.544, P<0.001) of the recent poor outcome group w ere significantly higher than those of the good functional outcome group. Multivariate logistic regression analysis show ed that after adjusting other confounders, the increased mean systolic pressure ( each 10 mmHg increase: odds ratio 1.189, 95% confidence interval 1.013-1.369; P=0.034) and the enlarged actual variation of systolic blood pressure (each 1 mmHg increase:odds ratio 1.182, 95% confidence interval 1.046-1.336; P=0.008) w ere associated w ith the recent poor functional outcome. Conclusions The increased short-term blood pressure variability w as associated w ith the recent poor functional outcome in patients w ith acute noncardioembolic ischemic stroke.
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Objective To explore the relationship between 24-hour blood pressure variability after admission and early neurological deterioration in patients with acute non-cardioembolic ischemic stroke.Methods This was a case-control study.Patients with acute non-cardioembolic ischemic stroke within 72 hours after stroke onset were prospectively registered.Clinical and 24 -hour continuous blood pressure monitoring data were recorded, and subsequently compared with regard to whether early neurological deterioration ( END) occurred within 7 days after admission.Factors contributing to END were investigated by logistic regression model.Results Of 221 eligible patients, 59 cases ( 26.7%) exhabited END.Patients with END had higher 24-hour mean systolic blood pressure ( SBP) (145.8 ±18.2 mmHg vs.139.9 ± 20.3 mmHg, P=0.014) and SBP coefficient of deviation (SBP-CV) [9.0(7.3 -11.2) vs.8.4(6.9-10.2), P=0.011].After adjusting for crude variables, multivariate analysis showed that the increase in mean SBP (10 mmHg mean SBP,OR=1.285,95%CI(1.059~1.559) and SBP-CV [1 unit of SBP-CV, OR=1.206,95%CI(1.050~1.384)] was associated with higher risk of END.Conclusions Increased 24-hour blood pressure variability after admission is an independent risk factor for occurrence of END in patients with acute non-cardioembolic ischemic stroke.
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<p><b>OBJECTIVE</b>To observe the effect of Compound Shenhua Tablet (, SHT) on the sodium-potassium- exchanging adenosinetriphosphatase (Na(+)-K(+)-ATPase) in the renal tubular epithelial cells of rats with acute ischemic reperfusion and to investigate the mechanisms underlying the effects of SHT on renal ischemic reperfusion injury (RIRI).</p><p><b>METHODS</b>Fifty male Wistar rats were randomly divided into the sham surgery group, model group, astragaloside group [150 mg/(kg·d)], SHT low-dose group [1.5 g/(kg·d)] and SHT high-dose group [3.0 g/(kg·d)], with 10 rats in each group. After 1 week of continuous intragastric drug administration, surgery was performed to establish the model. At either 24 or 72 h after the surgery, 5 rats in each group were sacrificed, blood biochemistry, renal pathology, immunoblot and immunohistochemical examinations were performed, and double immunofluorescence staining was observed under a laser confocal microscope.</p><p><b>RESULTS</b>Compared with the sham surgery group, the serum creatinine (SCr) and blood urea nitrogen (BUN) levels were significantly increased, Na(+)-K(+)-ATPase protein level was decreased, and kidney injury molecule-1 (KIM-1) protein level was increased in the model group after the surgery (P<0.01 or P<0.05). Compared with the model group, the SCr, BUN, pathological scores, Na(+)-K(+)-ATPase, and the KIM-1 protein level of the three treatment groups were significantly improved at 72 h after the surgery (P<0.05 or P<0.01). And the SCr, BUN of the SHT low- and high-dose groups, and the pathological scores of the SHT high-dose group were significantly lower than those of the astragaloside group (P<0.05). The localizations of Na(+)-K(+)-ATPase and megalin of the model group were disrupted, with the distribution areas overlapping with each other and alternately arranged. The severity of the disruption was slightly milder in three treatment groups compared with that of the model group. The results of immunofluorescence staining showed that the SHT high-dose group had a superior effect as compared with the astragaloside group and the SHT low-dose group.</p><p><b>CONCLUSIONS</b>The SHT effectively alleviated RIRI caused by ischemic reperfusion, promoted the recovery of the polarity of renal tubular epithelial cells, and protected the renal tubules. The therapeutic effects of SHT were superior to those of astragaloside as a single agent.</p>
Subject(s)
Animals , Male , Rats , Acute Disease , Blood Urea Nitrogen , Cell Adhesion Molecules , Metabolism , Chromatography, Liquid , Creatinine , Blood , Drugs, Chinese Herbal , Pharmacology , Therapeutic Uses , Fluorescent Antibody Technique , Immunoblotting , Kidney Function Tests , Kidney Tubules , Pathology , Low Density Lipoprotein Receptor-Related Protein-2 , Metabolism , Rats, Wistar , Reperfusion Injury , Drug Therapy , Pathology , Saponins , Sodium-Potassium-Exchanging ATPase , Metabolism , Staining and Labeling , TabletsABSTRACT
A retrospective analysis of 3 patients with nasal sinus foreign body caused by debris flow admitted to our department. All of the three patients showed foreign odor and mucopurulent discharge in nasal cavity after the debris flow blast injury. CT examination found high density soft tissue shadow or calcification in the nasal sinus. All the diagnoses were nasal sinus foreign body in three patients. The nasal sinus foreign bodies was dislodged through endoscopic sinus surgery. Three patients are all well-healed.
Subject(s)
Adult , Female , Humans , Male , Foreign Bodies , Paranasal SinusesABSTRACT
Objective To investigate the correlation between urinary calculi and upper urinary tract infections.Methods Twenty-six patients underwent lithiasis in upper urinary tract accompanied with infectious symptoms were enrolled in this study (test group).Blood culture was obtained in peak temperature before lithotrity,urine sample was obtained for bacterial culture.Thirty patients with calculi in upper urinary react accompanied no infectious symptoms in the same period were enrolled in control group.Calculi were pestled for bacterial culture and analyzed the components after the calculi were removed.Results In test group,the positive of blood,urine,calculi culture were 4,23,18 patients.The prominent component of calculi was hexahydrate magnesium ammonium phosphate.Bacteria in 13 positive urine sample had the same property with the calculi samples which came from the same cases.In control group,the positive of urine,calculi culture were 4,4 patients.The prominent component of calculi were calcium oxalate calculi and uricite calculi.The morbidity of upper urinary tract infections in test group was significantly higher than that in control group [69.2%(18/26) vs.13.3%(4/30)] (P < 0.05).The coincidence of urine culture and calculi culture in test group was significantly higher than that in control group [72.2%(13/18) vs.25.0%(1/4)](P<0.05).Conclusions Infectious calculi can easily result in upper urinary tract infections.Hexahydrate magnesium ammonium phosphate can make the prominent component in infectious calculi.