ABSTRACT
Objective@#To investigate the correlation between meteorological factors and short-term outcomes in patients with acute noncardioembolic stroke.@*Methods@#Patients with acute noncardioembotic stroke admitted to the Department of Neurology, the Second Hospital of Tianjin Medical University from March 2009 to February 2012, were enrolled retrospectively. The modified Rankin Scale (mRS) scores were collected at discharge or 14 d after onset, and good outcome was defined as mRS 0-2 , poor outcome as mRS >2. The demographic, baseline clinical data, laboratory findings, and meteorological parameters on the day of onset were compared between the good outcome group and the poor outcome group. Multivariate logistic regression analysis was used to determine the independent risk factors of short-term outcomes.@*Results@#A total of 868 patients with acute noncardioembolic stroke were enrolled, including 535 (61.6%) with good outcome and 333 (38.4%) with poor outcome. Univariate analysis showed that age, baseline National Institutes of Health Stroke Scale score, systolic pressure, fasting blood glucose, daily average wind speed as well as the proportion of ischemic heart disease, history of stroke or transient ischemic attack, and moderate to severe stroke in the poor outcome group were significantly higher than those in the good outcome group; daily average temperature and daily average relative humidity in the poor outcome group were significantly lower than those in the good outcome group (all P<0.05). Multivariate logistic regression analysis showed that lower daily average temperature (odds ratio 0.978, 95% confidence interval 0.959-0.998; P=0.032) and higher daily average wind speed (odds ratio 1.442, 95% confidence interval 1.065-1.953; P=0.018) were independently correlated with the short-term outcomes.@*Conclusion@#Daily average temperature and daily average wind speed were significantly correlated with the short-term outcomes in patients with acute noncardioembolic stroke.
ABSTRACT
Objective To investigate the correlation between meteorological factors and short-term outcomes in patients with acute noncardioembolic stroke.Methods Patients with acute noncardioembotic stroke admitted to the Department of Neurology,the Second Hospital of Tianjin Medical University from March 2009 to February 2012,were enrolled retrospectively.The modified Rankin Scale (mRS) scores were collected at discharge or 14 d after onset,and good outcome was defined as mRS 0-2,poor outcome as mRS ＞ 2.The demographic,baseline clinical data,laboratory findings,and meteorological parameters on the day of onset were compared between the good outcome group and the poor outcome group.Multivariate logistic regression analysis was used to determine the independent risk factors of short-term outcomes.Results A total of 868 patients w ith acute noncardioembolic stroke w ere enrolled,including 535 (61.6％) with good outcome and 333 (38.4％) with poor outcome.Univariate analysis showed that age,baseline National Institutes of Health Stroke Scale score,systolic pressure,fasting blood glucose,daily average wind speed as w ell as the proportion of ischemic heart disease,history of stroke or transient ischemic attack,and moderate to severe stroke in the poor outcome group were significantly higher than those in the good outcome group;daily average temperature and daily average relative humidity in the poor outcome group w ere significantly low er than those in the good outcome group (all P ＜ 0.05).Multivariate logistic regression analysis showed that lower daily average temperature (odds ratio 0.978,95％ confidence interval 0.959-0.998;P =0.032) and higher daily average wind speed (odds ratio 1.442,95％ confidence interval 1.065-1.953;P =0.018) w ere independently correlated with the short-term outcomes.Conclusion Daily average temperature and daily average wind speed were significantly correlated with the short-term outcomes in patients with acute noncardioembolic stroke.
ABSTRACT
Objective To investigate the correlation between anemia and stroke severity and short-term outcome in elderly patients with acute ischemic stroke. Methods Elderly patients with acute ischemic stroke (age≥60 years) admitted to the Department of Neurology, the Second Hospital of Tianjin Medical University between January 2015 and December 2017 were enrolled retrospectively. The demographic and clinical data were collected. The National Institutes of Health Stroke Scale (NIHSS) score at admission was used to evaluate the neurologic deficits, ≤8 was defined as a mild stroke and >8 was defined as moderate to severe stroke. Clinical outcomes were assessed using the modified Rankin Scale (mRS) at discharge or 14 d after onset (whichever occurs first), with 0 to 2 defined as a good outcome and >2 as a poor outcome. Multivariate logistic regression analysis was used to determine the independent influencing factors of the severity and early outcome of stroke. Results A total of 516 patients were enrolled in the study, their age was 74.10 ± 8.64 years, and 291 (56.4% ) were males; 111 (21.5% ) in anemia group and 405 (78.5% ) in non-anemia group, 336 (65.1% ) in mild stroke group, 180 (34.9% ) in moderate to severe stroke group, 303 (58.7% ) in good outcome group, and 213 (41.3% ) in poor outcome group. Univariate analysis showed that the proportion of patients with anemia in the moderate to severe stroke group was significantly higher than that in the mild stroke group (29.4% vs. 17.3% ; χ2 =10.303, P=0.001). The proportion of patients with anemia in the poor outcome group was significantly higher than that in the good outcome group (32.9% vs. 13.5% ; χ2 = 27.687, P< 0.001 ). Multivariate logistic regression analysis showed that anemia was an independent risk factor for stroke severity (odds ratio 3.263, 95% confidence interval 1.446-7.361; P=0.004) and short-term poor outcome (odds ratio 1.928, 95% confidence interval 1.609-2.311; P= 0.029 ). Conclusions Anemia is significantly associated with stroke severity and short-term outcome in elderly patients with acute ischemic stroke.
ABSTRACT
Objective To investigate the predictive value of red blood cell distribution width (RDW) for no early improvement after intravenous thrombolysis in patients with acute ischemic stroke.Methods Patients with acute ischemic stroke received intravenous thrombolysis in the Department of Neurology,the Second Hospital of Tianjin Medical University between January 2017 and December 2018 were enrolled retrospectively.The National Institutes of Health Stroke Scale (NIHSS) score declined ≥4 or the NIHSS score 0-1 in 24 h after thrombolytic therapy was defined as early improvement,and the NIHSS score declined＜4 was defined as no early improvement.Multivariate logistic regression analysis was used to determine the independent risk factors for no early improvement.Receiver operator characteristic (ROC)curve was used to analyze the predictive value of RDW for no early improvement after intravenous thrombolysis in patients with acute ischemic stroke.Results A total of 119 patients were enrolled in the study,46 (38.7％) had early improvement and 73 (61.3％) had no early improvement.Hypersensitive C-reactive protein,RDW,the time from onset to thrombolysis,and the proportion of complicated hypertension and fasting blood glucose in the no early improvement group were higher or longer than those in the early improvement group,and the differences were statistically significant (all P ＜0.05).Multivariate logistic regression analysis showed that the elevated RDW was an independent risk factor for no early improvement (odds ratio 3.119,95％ confidence interval 1.584-6.141;P =0.001).ROC curve analysis showed that the best cut-off value of RDW for predicting no early improvement after intravenous thrombolysis in acute ischemic stroke was 13.35％.The area under the curve was 0.737 (95％ confidence interval 0.645-0.828).The sensitivity and specificity were 64.4％ and 87.0％,respectively.Conclusion Elevated RDW has certain predictive value for no early improvement after intravenous thrombolysis in patients with acute ischemic stroke.
ABSTRACT
Objective To explore the relationship between ambient temperature variation and blood pressure fluctuations in acute ischemic stroke patients.Methods Clinical data of 5 730 ischemic stroke patients hospitalized at the Departments of Neurology and Geriatrics of The Second Hospital of Tianjin Medical University and air temperature data during the corresponding period were retrospectively analyzed.The relationship between air temperature and blood pressure in patients with acute ischemic stroke was analyzed.Results Of 5 730 patients,4 428 (77.28％)had hypertension and most of them were male(56.26％ 3 362 cases).The systolic and diastolic blood pressure levels were higher in hypertensive males than in hypertensive females[(153.9 ± 21.7) mmHg vs.(150.7 ± 23.6)mmHg,(85.9±13.3)mmHg vs.(83.0±12.5)mmHg,1 mm Hg=0.133 kPa,both P＜0.05].The systolic pressure tended to increase and diastolic pressure tended to decrease with increasing age (both P ＜ 0.05).The systolic and diastolic blood pressure levels of patients were slightly higher in autumn and winter than in spring and summer (P ＜ 0.05).The mean monthly maximum and minimum temperature had negative correlations with the systolic blood pressure of patients.There was a linear positive correlation between the average monthly diurnal temperature range and the systolic and diastolic blood pressure.The systolic or diastolic blood pressure increased by 0.088 mmHg or 0.076 mmHg respectively with each 1 ℃ drop in the mean monthly maximum and minimum temperature.The systolic or diastolic blood pressure increased by 1.043 mmHg or 0.654 mmHg respectively with each 1 ℃ increase in the average monthly diurnal temperature range.Conclusions Hypertension is a risk factor for ischemic stroke,and ambient temperature variation is related to baseline blood pressure fluctuations in hypertensive patients with acute ischemic stroke.The temperature reduction and the increase of average diurnal temperature rang can lead to the elevation of blood pressure,which is more obvious in autumn and winter,especially in elderly patients.
ABSTRACT
Objective To evaluate the clinical effect of the homemade traditional Chinese medicine bathing prescription combined with Thymalfasin and Isotretinoin treatment for Verruca Plantaris.Methods A total of 120 patients with Verruca Plantaris were randomly divided into 3 groups according to the random number table method (each group 40). The drug therapy group was given Thymalfasin and Isotretinoin to treatment; and the Chinese medicine washing group was given traditional Chinese medicine wash-out on the basis of drug therapy; and the physical therapy group was given liquid nitrogen freezing treatment on the basis of drug therapy. All the groups were treated 12 weeks and follow-up 3 months. Four weeks were a course, and a total of 3 courses. After the treatment, the symptom grading scores (number of skin lesions, the size of skin lesions, the degree of pain and the quality of life) was compared, and the clinical effect rate was evaluated and the recurrence rate was observed.Results Twelve weeks after treatment, Chinese medicine washing group total effective rate was 97.5% (39/40), drug treatment group 87.5% (35/40), and physical treatment group 90.0% (36/40). The Chinese medicine washing group total effective rate was superior to the drug therapy and physicaltherapy groups (Z values were -3.463,-3.122,P values were 0.001, 0.002). after treatment, the number of lesions scores (2.0 ± 1.1 vs. 2.8 ± 1.5, 2.7 ± 1.6,F=3.787), the size of the lesion scores (2.3 ± 1.7 vs. 3.2 ± 1.3, 3.1 ± 1.3, F=4.657), pain degree and the quality of life scores (0.4 ± 0.5 vs. 1.0 ± 1.2, 1.0 ± 1.0,F=5.353) in the Chinese medicine washing group were significantly higher than those in the drug therapy and physical therapy groups (P<0.01). After follow-up period, the recurrence rate of Chinese medicine washing group was 10.3% (4/39), the drug treatment group 25.7% (9/35), the physical therapy group 41.7% (15/36). The difference among 3 groups was statistically significant (Z=-3.188,P<0.01).Conclusions The traditional Chinese medicine combined with Thymalfasin and Isotretinoin could reduce the number of skin lesions, narrow the range of skin lesions and reduce the degree of pain, and improve the quality of life.
ABSTRACT
Objective Investigating the relationship between the incidence of Primary Acute Cerebral Infarction (PACI) and seasonal variation to employ measures to prevent PACI with climate change. Methods A retrospective analysis of patients diagnosed with PACI between 2009 and 2013 in the department of Neurology of Second hospital of Tian Jin Medi-cal University (n=1 198 patients) was carried out. Combined with the general clinical data, we analyzed seasonal, monthly and weekly variation among PACI incidents. Results The incidence of PACI increases over years between 2009 to 2013 (P ＜ 0.01). Significant difference of incidents of PACI was observed between each season (P=0.047). Incidence of PACI peaked in winter(30.33 ± 9.63/month), while bottomed in spring(21.83 ± 5.36/month). Significant difference of incidents of PACI was also observed between each months(P=0.010). The monthly incidence was highest in January and February (33.25 ± 9.62/month)and lowest in March and April(20.75 ± 4.89/month). The seasonal variation was only found in the pa-tients who are complicated with pulmonary infection (P＜0.01) regardless of the presence or absence of other risk factors, such as smoking, drinking ,hypertension, coronary heart disease, and diabetes mellitus. The weekly variation of PACI was on-ly significant in patients younger than 65 years old(P=0.043). The peak incidence among a week was Monday(17.86%),and incidence bottomed on Friday (13.36%). Conclusion Our study revealed that the incidence of PACI increase over year be-tween 2009 to 2013 and it shew a characteristic variation with respect to season, month and week. Based on these results, we can formulate prevention measures accordingly.
ABSTRACT
Objective To explore the influence of seasonal variations on acute cerebral infarction outcome. Meth-ods We collected data from acute cerebral infarction patients in the Second Hospital of Tianjin Medical University from January 2009 to February 2012. All cases were classified by months and seasons into different groups to analyze the season-al variations retrospectively. Results (1) The percentage of good outcome of acute cerebral infarction show significant dif-ference between each month(P<0.01). The percentage of good outcome was highest in August(92.1%), lowest in Decem-ber(78.1%), second lowest in April(81.9%). The percentage of good outcome in summer(91.6%)was higher than spring (87.2%), autumn(86.4%)and winter(83.9%)(P<0.05). (2) Among those patients converted to bad outcome more pa-tients was attacked by cerebrovascular accident in winter(68.3%)than in summer(43.2%), and more patients was combined with a pulmonary infection in winter(69.5%)than in summer(48.6%)and in autumn(49.3%)(P<0.05). (3) Seasonal effect in acute cerebral infarction outcome was obvious in those≥65 years of age(P<0.05). Conclusion Seasonal changes are associated with the outcome and severity of acute cerebral infarction.