No early improvement after intravenous thrombolysis in patients with acute ischemic stroke:predictive factors and their impact on outcomes / 国际脑血管病杂志

Objective To investigate the predictive factors of no early improvement and their impact on outcomes after alteplase intravenous thrombolysis in patients with acute ischemic stroke.Methods Between March 2015 and March 2016,the clinical data of the patients with acute ischemic stroke admitted to the Department of Neurology,Fengcheng People's Hospital and treated with intravenous thrombolysis were analyzed retrospectively.The National Institutes of Health Stroke Scale score declined ＜4 within 24 h after admission was defined as no early improvement,and the modified Rankin Scale score ＞ 2 at 3 months was defined as poor outcome.Multivariate logistic regression analysis was used to determine predictors of no early improvement and their impact on outcomes.Results A total of 85 patients were enrolled,aged 63.88 ± 11.12 years,63 (74.1％) were males;45 (52.9％) had no early improvement,40 (47.1％) had early improvement;48 (56.5％) had good outcome at 3 months,and 37 (43.5％) had poor outcome.The proportion of hypertension (73.3％ vs.45.0％;x2 =7.083,P =0.008) and diabetes mellitus (33.3％ vs.15.0％;x2 =3.826,P =0.051),as well as the baseline fasting blood glucose (8.74 ± 4.28 mmol/L vs.6.87 ±2.57 mmol/L;t=2.471,P=0.016) in the no early improvement group were significantly higher than those in the early improvement group.Multivariate logistic regression analysis showed that hypertension alone was an independent risk factor for no early improvement after intravenous thrombolysis with ateplase (odds ratio 2.896,95％ confidence interval 1.108-7.570;P =0.030).The proportion of early improvement in the good outcome group was significantly higher than that in the poor outcome group (58.3％ vs.32.4％;x2=5.626,P=0.018).Multivariate logistic regression analysis showed that early improvement might be a independent predictor of good outcome (odds ratio 3.187,95％ confidence interval 1.099-9.242;P =0.033).Conclusion In patients treated with alteplase thrombolytic therapy,hypertension was an independent risk factor for no early improvement,and no early improvement was independently associated with poor outcome.

Clinical significance of plasma miR-24 dysregulation in nasopharyngeal carcinoma / 南方医科大学学报

<p><b>OBJECTIVE</b>To examine the expression level of miR-24 in the plasma of nasopharyngeal carcinoma (NPC) patients and investigate the clinical significance of miR-24 in NPC development.</p><p><b>METHODS</b>Blood samples were from 217 NPC patients admitted in our Department between December, 2007 and June, 2011, with those from 73 patients with chronic purulent otitis media or chronic sinusitis as control. The follow-up data of all the patients were reviewed and the expression of miR-24 in the plasma was examined by qRT-PCR. The correlation of miR-24 expression with clinical staging of NPC was analyzed, and miR-24 levels before and after the treatment were compared.</p><p><b>RESULTS</b>Compared with the control group, the NPC patients showed significantly up-regulated level of miR-24 in the plasma (P<0.001). Plasma miR-24 level differed significantly among patients with different T stages (P=0.007) and was negatively correlated with the N stages (P=0.028) and plasma EBV-DNA (P=0.048). The expression levels of miR-24 were significantly reduced after treatment in the NPC patients and were significantly lowered in patients without relapse or metastasis (P=0.001).</p><p><b>CONCLUSION</b>Plasma miR-24 may serve as a novel molecular biomarker for early diagnosis and prognosis of NPC.</p>

A preliminary study on the assessment of swallowing function after supracricoid partial laryngectomy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate a reliable and easy assessment method for swallowing function by evaluating objectively the recovery process of swallowing function in patients six months after supracricoid partial laryngectomy.</p><p><b>METHODS</b>The swallowing function of patients who underwent supracricoid partial laryngectomy was evaluated six months after operation in Nanfang Hospital of Southern Medical University between January 2013 and February 2014 with two methods, the modified barium swallow (MBS) and fiberoptic endoscopic evaluation of swallowing (FEES), combined with modified penetration aspiration scale (MPAS). Furthermore, the feasibility, reliability and accuracy of these two methods were compared.</p><p><b>RESULTS</b>Eleven patients were enrolled. MPAS equals score 1 for solid food, semiliquid food, and liquid food was defined as a criteria of normal swallowing function. By MBS evaluation, the numbers of patients with normal swallowing function were two cases at day 16-30 postoperation, two cases at day 31-45 postoperation, five cases at day 46-90 postoperation, and six cases at day 91-180 postoperation, respectively. By FEES evaluation, the above numbers were three cases, four cases, six cases and eight cases, respectively. When the aspiration was minimal and ejected completely and MPAS was less than or equal to score 4 for solid food, semiliquid food, and liquid food, the gastric tube could be removed. According to this standard, the gastric tube was removed in all cases, and the mean time was (21.7 ± 9.8) days. A good correlation was obtained between these two methods when evaluating solid and semiliquid food, and the Kappa values were 0.802 and 0.844, respectively. However, a little agreement was obtained between these two methods when evaluating liquid food, and the Kappa value was 0.529.</p><p><b>CONCLUSIONS</b>Patients who underwent supracricoid partial laryngectomy could restore good swallowing function in six months after the operation. Both the MBS and FEES are valuable procedures for evaluating objectively the swallowing function in patients after supracricoid partial laryngectomy. The FEES is much better than MBS, because FEES is a simple operation performed alone by otolaryngologists with no radiation.</p>

Evaluation of efficacy of esomeprazole treatment in patients with laryngopharyngeal reflux / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the efficacy of proton pump inhibitor (PPI) therapy with esomeprazole on laryngopharyngeal reflux (LPR) by pepsin immunoassay in the sputum.@*METHOD@#From June 2009 to March 2010, patients in the ENT outpatient department of Nanfang hospital with a reflux finding score (RFS) >7 and a reflux symptom index (RSI) >13 were selected. Their sputum was obtained in the morning for pepsin assay. Twenty-six patients with positive results of pepsin assay were enrolled and received esomeprazole 20 mg twice daily for two months. They paid return visits every two weeks. RSI, RFS and pepsin concentration in the sputum were assessed at baseline and after two months. Pepsin in the sputum was measured by enzyme linked immunoadsorbent assay.@*RESULT@#After 8 weeks, 24 patients got symptom improvements except 2. All got improved results of laryngoscope exams. RSI and RFS scores before and after PPI treatment reached statistical signification by paired t-test (t= 8.152, P<0.01; t=9.704, P<0.01). 21 patients' pepsin concentrations decreased except 5. Nonparametric tests were used because the reduction of pepsin concentrations before and after PPI treatment were not normally distributed (Z=-3.213, P<0.01). Reductions of total RSI and RFS scores as well as pepsin concentrations were significantly higher after two months.@*CONCLUSION@#Twice-daily PPI treatment for two months demonstrated a significantly greater improvement in laryngeal appearance and LPR symptoms for most patients in this study, which can result in significantly decreased levels of pepsin in sputum.

The development of animation courseware for medical statistics based on flash / 中华医学教育探索杂志

This paper mainly discusses the development of animation courseware for medical statistics from the following aspects:courseware design,some related technologies in courseware making and the evaluation of courseware. The animation courseware for medical statistics can enhance self-regulated learning ability of students,from passive acceptance to initiative exploration,stimulate students'learning interest,raise their learning efficiency,and then enhance the quality of teaching.

Determination of Berberine Hydrochloride in Weichangning Granules by HPLC / 中药新药与临床药理

Objective To establish a method for the determination of berberine hydrochloride in Weichangning granules.Methods RP-HPLC method was set up,using Merck-LiChrospher RP-18 column(4 mm ? 250 mm,5?m);the mobile phase was methnd-water(including 0.18 % phosphoric acid and 0.22 % sodium laurylsulfonate)(68 ∶ 32),flow rate being 1.0 mL / min;column temperature was 35 ℃ and the detection wavelength was 345nm.Results A good linearity was obtained in the range of 0.30 ~ 1.80 ?g(r = 0.9995).The average recovery was 98.32 %,with RSD 0.83 %.Conclusion The method is simple,rapid and with good reproducibility for the determination of berberine hydrochloride in Weichangning granules.