Association of white matter hyperintensities with long-term stroke recurrence in patients with recent subcortical small infarcts / 国际脑血管病杂志

Objective:To investigate the association of white matter hyperintensities (WMHs) with long-term stroke recurrence in patients with recent subcortical small infarcts (RSSIs).Methods:Consecutive patients admitted to the Department of Neurology, Hefei Hospital Affiliated to Anhui Medical University between January 2019 and August 2022 and met the clinical and imaging manifestations of RSSIs were collected. The demographic characteristics, baseline clinical data, and MRI features were collected. Using stroke recurrence as the endpoint event, the recurrence time was recorded, and Cox regression model was used to analyze relevant factors affecting stroke recurrence in patients with RSSIs.Results:A total of 202 patients were enrolled, including 138 males (68.3%), aged 67.9±10.5 years. Seventy-seven patients (38.1%) were mild WMHs, 64 (31.7%) were moderate WMHs, and 61 (30.2%) were severe WMHs. There were statistically significant differences in age, history of stroke, hypertension, hyperlipidemia, total cholesterol, infarct thickness, and infarct distribution among different WMHs severity groups (all P<0.05). The median follow-up time was 40.5 months (interquartile range, 27.7-49.0 months), and a total of 55 patients (27.2%) had stroke recurrence (ischemic stroke 54, occipital hemorrhage 1). Recurrence rates of stroke in the mild, moderate, and severe WMHs groups were 18.2%, 31.3%, and 34.4%, respectively. Cox regression analysis showed that WMHs were an independent risk factor for stroke recurrence (compared to the mild group, the risk ratio of the severe group was 2.225, 95% confidence interval was 1.116-4.436; P=0.023). Conclusion:The risk of long-term stroke recurrence in patients with RSSI is associated with the severity of WMHs.

Design and Feasibility Study of Tracheal Intubation Device Based on Magnetic Navigation Technology / 中国医疗器械杂志

OBJECTIVE@#In the context of coronavirus disease 2019 (COVID-19) pandemic, the subject was designed to develop a new tracheal intubation device based on magnetic navigation technology to improve the success rate of tracheal intubation and reduce the risk of occupational exposure of medical staff.@*METHODS@#The new tracheal intubation device was designed with the uniqueness of the magnetic field environment and magnetic steering of magnetic navigation technology. And preliminary magnetic navigation tracheal intubation experiments were performed on the tracheal intubation simulator.@*RESULTS@#Magnetic navigation tracheal intubation can successfully implement tracheal intubation, and the time required is lower than that of traditional laryngoscopy.@*CONCLUSIONS@#The tracheal intubation based on magnetic navigation technology is feasible, with high efficiency and easy operation. That is expected to be widely used for tracheal intubation during treatment of patients outside the hospital in the future. At the same time, magnetic navigation endotracheal intubation technology will be the key technology for the development of endotracheal intubation robots.

Advances in the diagnosis and treatment of severe acute cholangitis / 临床肝胆病杂志

Severe acute cholangitis, also called acute obstructive suppurative cholangitis (AOSC), has acute onset and rapid progression and is the primary cause of death in patients with benign biliary tract diseases, especially in elderly patients, and it is often complicated by multiple system organ failure. This disease has diversified symptoms and signs, which leads to the inconsistency in diagnostic grading and prognosis criteria. With the development of minimally invasive surgery and endoscopic techniques, the diagnosis and treatment of severe acute cholangitis has been constantly improved. Therefore, judgment and selection of the optimal surgical timing, individualized biliary drainage, and comprehensive, standardized, and timely anti-infective therapy based on prognostic factors have great importance in the treatment of severe acute cholangitis.

Correlation between ipsilateral posterior cerebral artery laterality and outcome in patients with acute ischemic stroke in the middle cerebral artery territory / 国际脑血管病杂志

Objective To investigate the correlation between ipsilateral posterior cerebral artery laterality (PCAL) and the outcomes in patients with ischemic stroke in the middle cerebral artery (MCA) territory. Methods From June 2015 to December 2016, patients with acute ischemic stroke in the MCA territory admitted to the Second People's Hospital of Hefei were enrolled. Magnetic resonance angiography (MRA) was used to assess PCAL. The outcome was evaluated by the modified Rankin scale at 3 months after onset. 0-2 was defined as good outcome and > 2 was defined as poor outcome. Multivariate logistic regression analysis was used to determine the independent influencing factors of clinical outcome. Results A total of 111 patients with ischemic stroke in MCA territory were enrolled, including 47 (42. 3％) PCAL and 30 (27. 0％) poor outcomes. The baseline NIHSS score in the PCAL group was significantly lower than that in the non-PCAL group (5. 13 ± 3. 29 years vs. 7. 03 ± 5. 676 years, t = 2. 058; P = 0. 042). There were significantly differences in the proportion of diabetes mellitus (29. 6％ vs. 10. 0％; χ2 = 4. 583, P = 0. 032), PCAL (51. 9％ vs. 16. 7％;χ2 = 11. 101, P = 0. 001) and smoking (25. 9％ vs. 13. 3％; χ2 = 4. 943, P = 0. 026), as well as age (63. 9 ± 11. 8 years vs. 71. 0 ± 6. 7 years; t = 2. 688, P = 0. 007), baseline diastolic blood pressure (89 ± 13 mmHg vs. 82 ± 10 mmHg; t = -2. 249, P = 0. 025; 1 mmHg = 0. 133 kPa) and baseline NIHSS score (5. 02 ± 3. 67 vs. 9. 47 ± 6. 20; t = 3. 883, P < 0. 001) between the good outcome group and the poor outcome group. Multivariate logistic regression analysis showed that PCAL was associated independently with good outcome (odds ratio [OR] 0. 272, 95％ confidence interval [CI] 0. 083-0. 888; P = 0. 031), while advanced age (OR 1. 088, 95％ CI 1. 022-1. 157; P = 0. 008) and high baseline NIHSS score (OR 1. 224, 95％ CI 1. 077-1. 391; P = 0. 002) were associated independently with poor outcome. Conclusion PCAL is associated independently with good outcome in patients with ischemic stroke in MCA territory.

Clinical analysis of 18 patients with portal vein stenosis after liver transplantation / 器官移植

Objective To summarize the experience of clinical diagnosis and treatment of portal vein stenosis after liver transplantation. Methods Clinical data of 18 patients presenting with portal vein stenosis after undergoing liver transplantation were retrospectively analyzed. The incidence, treatment and prognosis of portal vein stenosis were summarized. Results Seventeen patients had a medical history of liver cirrhosis before liver transplantation, 7 cases with a medical history of portal vein thrombosis and 8 cases with a medical history of devascularization or shunt with splenectomy. Three cases received the pediatric liver grafts. Eighteen patients suffered from portal vein stenosis from postoperative 23 d to 24 months with a median time of 2.2 months, which was detected by color Doppler ultrasound (CDU) and diagnosed by CT angiography (CTA) of the portal vein or interventional therapy. After the diagnosis was confirmed,all cases received anticoagulant treatment by warfarin. Five patients with portal hypertension underwent balloon dilatation,and one of them received endovascular stent implantation simultaneously. The remaining 13 patients received conservative therapy. After corresponding treatment, 9 cases were mitigated, 7 patients remained unchanged and 2 cases were aggravated. Conclusions For the recipients with a medical history of liver cirrhosis before liver transplantation, portal vein stenosis should be monitored by conventional CDU and diagnosed by CTA or interventional therapy after transplantation. Patients without clinical symptoms can receive conservative treatment. Those complicated with portal hypertension can undergo interventional therapy. Favorable clinical prognosis is obtained in most cases.

Wake-up stroke / 国际脑血管病杂志

Wake-up stroke accounts for about 25％ of all new ischemic stroke.Many patients with wake-up stroke can not receive thrombolytic therapy because the uncertainty of onset time.Recent studies have shown that the multimodal imaging may screen suitable patients with wake-up stroke for early thrombolysis treatment.

Multi-slice spiral CT diagnosis of complex congenital heart diseases / 中国介入影像与治疗学

Objective To investigate scanning and reconstruction techniques of multi-slice spiral CT (MSCT) in patients with complex congenital heart diseases (CCHD).Methods One hundred eighty-four patients suffering from CCHD underwent 16-detector MSCT scanning without ECG-gating.Multi-planar reconstruction (MPR),maximum intensity projection (MIP),curved-planar reconstruction (CPR) and volume rendering (VR) were used to reconstruct images.CT findings were compared with those of surgical operation or angiocardiography.Results A total of 616 cardiac deformities were found with MSCT and proved by angiocardiograms or surgical operation.The diagnostic accuracy of extracardiac malformation with MSCT was 100%,of atrial septal defect was 54.65%,and of ventricular septal defect was 78.62%.MSCT failed to display heart valve disease well.Conclusion MSCT can accurately detect extracardiac malformations of CCHD.

The Imaging Findings of Severe Acute Respiratory Syndrome(SARS) in Death Case / 实用放射学杂志

Objective To evaluate the Imaging diagnosis of SARS in death case.Methods 11 death patients of SARS in keeping with criteria from April to May 2003 were enrolled into the study. Imaging characteristics of chest x-ray film and CT in these patients were analysed.Results All cases were positive on chest X-ray film and CT,the lung shadows were marked.The extent of the pathological changes in lungs was 80%～90% in 6 cases and 90% above in 5 cases,multilobcs of bilateral lungs were involved in all cases.The lesions were diffuse spotty shadow or shaggy cloudy shadow in 8 cases,ground-glass opacification in one case and bronchogram structures could be seen.Conclusion Imaging findings in the cases with severe SARS mostly manifest as effusion,consolidation and interstitial inflammation in multilobes of bilateral lungs.