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ObjectiveTo investigate the changes in cerebral blood perfusion in patients with acute cerebral infarction after taking Tongnaoyin， a traditional Chinese medicine， based on head and neck computed tomography （CT） angiography （CTA） combined with brain CT perfusion imaging （CTP）. MethodA total of 240 patients with cerebral infarction of phlegm and blood stasis syndrome treated in Jiangsu Province Hospital of Traditional Chinese Medicine from March 2018 to September 2023 were randomly divided into a control group （99 cases） and a Tongnaoyin group （141 cases）. Based on the guidelines， the control group was treated with conventional treatment such as anti-aggregation， anticoagulation， lipid-lowering and plaque stabilization， brain protection， and supportive treatment. The Tongnaoyin group was treated with Tongnaoyin of 200 mL in warm conditions in the morning and evening on the basis of the control group. Both groups underwent CTA combined with CTP within 24 hours after admission， and they were reexamined by CTA and CTP in the sixth month after admission. The degree of intracranial artery stenosis was determined according to the North American Symptomatic Carotid Endarterectomy Trial （NASCET） method. The relative cerebral blood volume （rCBV）， relative cerebral blood flow （rCBF）， mean transit time （MTT）， and time to peak （TTP） of the lesion area before and after treatment were compared. The adverse outcomes of the two groups within six months after discharge were compared. ResultCompared with the group before treatment， the degree of vascular stenosis in the Tongnaoyin group was significantly reduced， and the difference was statistically significant （Z=105.369，P<0.05）. Compared with the control group after treatment， the improvement rate of vascular stenosis in the Tongnaoyin group was higher （χ2=84.179，P<0.01）， and the curative effect was better.After treatment， the rCBV and rCBF of patients in the Tongnaoyin group were significantly increased， and the difference was statistically significant （P<0.01）. MTT and TTP showed a trend of shortening， but the difference was not statistically significant. There was no statistically significant difference in rCBV， rCBF， MTT， and TTP in the control group. Compared with those in the control group after treatment， the rCBV and rCBF in the Tongnaoyin group were significantly increased， while MTT and TTP were significantly reduced （P<0.01）. After six months of discharge， the risk of poor prognosis in the Tongnaoyin group was significantly reduced compared with the control group （P<0.05）. ConclusionTongnaoyin has a good effect on improving cerebral blood perfusion in patients with acute cerebral infarction. It can be used as an effective supplement for the conventional treatment of ischemic stroke to improve clinical efficacy.
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Objective:To investigate the predictive value of mean platelet volume (MPV) for early neurological deterioration (END) after intravenous thrombolysis in patients with acute ischemic stroke.Methods:Patients with acute ischemic stroke treated with intravenous thrombolysis in the Department of Neurology, Jiangsu Provincial Hospital of Chinese Medicine from September 2016 to December 2019 were enrolled retrospectively. Immediately after admission, hematology analyzer was used to detect the MPV level. END was defined as the National Institutes of Health Stroke Scale (NHISS) score at any time point within 7 d after the admission increased by ≥2 from baseline. Univariate analysis was used to compare the differences in baseline data between the END group and the non-END group, and multivariate logistic regression analysis was used to determine the independent risk factors for END. The receiver operator characteristic (ROC) curve was used to evaluate the predictive value of MPV for END. Results:A total of 103 patients were enrolled. Their age was 68.0±13.3 years old, and 80 were male (77.7%). There were 28 patients (27.2%) in the END group and 75 (71.8%) in the non-END group. The proportion of ischemic heart disease (28.6% vs. 9.3%; χ2=6.065, P=0.014), baseline NIHSS score (8.5 [4.0-16.5] vs. 5.0 [3.0-11.0]; Z=2.198, P=0.028), symptomatic intracranial hemorrhage (1.9% vs. 0%; χ2=5.463, P=0.019), low-density lipoprotein cholesterol (2.9 [2.2-3.4] mmol/L vs. 2.4 [1.8-3.1] mmol/L; Z=2.165, P=0.030), high-sensitivity C-reactive protein (7.0 [1.2-36.0] mg/L vs. 2.1 [1.0-6.0] mg/L; Z=2.159, P=0.031) and MPV levels ( 10.4±1.3 fl vs. 9.5±1.2 fl, t=2.771, P=0.007) of the END group were significantly higher than those of the non-END group. Multivariate logistic regression analysis showed that after adjusting for the confounding factors, the larger MPV was an independent predictor of END (odds ratio 1.668, 95% confidence interval 1.079-2.579; P=0.021). ROC curve analysis showed that MPV had a certain predictive value for END (area under the curve, 0.653, 95% confidence interval 0.533-0.774). Its optimal cutoff value was 102 fl, and the sensitivity and specificity at this time were 57.4% and 70.3%, respectively. Conclusion:A larger baseline MPV had a certain predictive value for END after intravenous thrombolysis in patients with acute ischemic stroke.
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@#A long chain structure of DNA(polyaptamer)composed of multiple aptamer units was synthesized by rolling circle amplification and used for the construction of polyaptamer-doxorubicin system in the treatment of leukemia cells. It was found that the system was significantly more effective than monoaptamer in targeting and killing leukemia cells as it provided 35-fold enhanced binding affinity and 10-fold greater drug loading via multivalent effects. Drug release and cell viability also proved that the conjugates could gain entrance into the cells and rapidly release doxorubicin under the action of lysosome, leading to the tumoricidal effect.
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Retrospective analysis was performed for 68 sacroiliac joint pain patients treated at our hospital from June 2007 to March 2012.And 27 patients received sacroiliac joint ozone injection,and others anti-inflammatory and analgesic solution.Both methods can significantly relieve sacroiliac joint pain (P ＜ 0.05).However there was no inter-group difference (P ＞ 0.05).No difference existed in efficacy [(0.51 ±0.03) vs.(0.34 ±0.06) cm],treatment frequency (1.98 ±0.94) vs.(1.82 ±0.88) or hospitalization duration [(14.6 ± 7.0) vs.(14.9 ± 6.4) days] between two groups (P ＞ 0.05).Thus sacroiliac joint ozone injection can significantly relieve sacroiliac joint pain and its effect is similar to anti-inflammatory analgesic injection.