Efficacy and safety of endovascular therapy after 24 h from ischemic stroke onset in patients with acute anterior circulation ischemic stroke / 中华内科杂志

Objective:To explore the effectiveness and safety of endovascular treatment (EVT) for patients with acute anterior circulation ischemic stroke with symptom onset exceeding 24 h.Methods:In this retrospective cohort study, data were extracted from patients who underwent endovascular treatment for acute anterior circulation ischemic stroke at the First Hospital of Jilin University from February 2019 to April 2022. A total of 569 patients were included, with a mean age of 63 (54-70) years. Among them, 398 (69.9%) were male. The patients were divided into two groups based on symptom onset time:>24 h group and≤24 h group. Propensity score matching (PSM) was used to match the patients in a 1︰1 ratio between the>24 h group and the≤24 h group. Logistic regression was used to evaluate the impact of symptom onset time on outcome events.Results:Before PSM, compared with≤24 h group, the>24 h group had a younger age [56 (48, 64) vs. 64 (55, 70), Z=-3. 60, P<0.001]; lower proportion of prior atrial fibrillation [1.8% (1/57) vs. 21.1% (108/512), χ2=12.39, P<0.001]; lower proportion of wake-up stroke [7.0% (4/57) vs. 27.7% (142/512), χ2=11.54, P<0.001]; lower baseline NIHSS score [11.0 (7.5, 14.0) vs. 13.0 (10.0, 16.0), Z=-3.22, P<0.001]; and a higher American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology(ASITN/SIR) grading ( P<0.001). After PSM, there were no significant differences in baseline characteristics between the two groups. There was no significant difference in the proportion of patients with a modified Rankin Scale (mRS) score≤2 at 90 days after surgery between the two groups (before matching: 42.0% vs. 40.4%, OR=0.745, 95% CI 0.407-1.362, P=0.339; after matching: 51.8% vs. 39.3%, OR=0.511, 95% CI 0.212-1.236, P=0.136). No significant differences were observed in the incidence of any safety outcomes between the>24 h group and the≤24 h group. Conclusion:For patients with acute anterior circulation ischemic stroke with symptom onset exceeding 24 h, EVT is feasible after strict radiological screening and has similar safety and effectiveness as for patients with symptom onset under 24 h.

Safety and efficacy of endovascular treatment in patients with acute posterior circulation ischemic stroke over 24 hours from onset:a propensity score matched cohort study / 中国脑血管病杂志

Objective To explore the safety and efficacy of endovascular treatment(EVT)in patients with acute posterior circulation ischemic stroke over 24 hours from onset.Methods This retrospective study retrospectively analyzed patients with acute posterior circulation ischemic stroke who received EVT in the Department of Neurology,First Hospital of Jilin University from June 2018 to June 2023.The patient's gender,age and other related demographic information were collected.The related examination results of patients were collected,including admission rapid blood glucose,admission systolic blood pressure,admission diastolic blood pressure.The related risk factors of stroke of patients were collected,including previous transient ischemic attack,hypertension,diabetes,atrial fibrillation,and history of drinking,smoking history,etc.;other related indicators were collected,including intravenous thrombolysis,tandem lesions,awakening stroke,baseline National Institutes of Health stroke scale(NIHSS)score,and baseline posterior circulation Alberta stroke program early CT score(pc-ASPECTS),collateral circulation grade of American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology(ASITN/SIR),onset to EVT puncture time,the trial of org 10172 in acute stroke treatment(TOAST)classification and outcome indicators(efficacy indicators included 90 days Modified Rankin scale[mRS]score≤3 after EVT,successful recanalization[extended cerebral infarction thrombolytic recanalization class 2b-3];security indexes included symptomatic intracranial hemorrhage[sICH]within 24 h after EVT and 90 d mortality after EVT).According to the symptom onset to EVT puncture time,the patients were divided into two groups:≤24h group and＞24h group.The patients with onset time＞24 h and those with onset time≤24 h were matched at a ratio of 1:1 by propensity score matching(PSM).All patients were divided into poor prognosis group(mRS score＞3)and good prognosis group(mRS score ≤ 3)according to mRS score at 90 days after EVT.Using univariate and multivariate Logistic regression was used to analyze the effect of onset time on clinical outcomes at 90 days after EVT.Results A total of 366 patients were enrolled in this study,including 284 males and 82 females.The median age was 61(55,68)years old,ranging from 25 to 91 years old.Before PSM,the＞24h group had lower prevalence of atrial fibrillation(2.02％[2/99]vs.9.74％[26/267],P=0.025)and lower baseline NIHSS score(10.0[5.0,19.0]vs.14.0[10.0,35.0],P＜0.01)and higher ASTIN/SIR collateral grade(P=0.018).After PSM,we did not find statistical difference between the two groups in baseline characteristics except for the onset to EVT puncture time.Before and after PSM,there was no significant difference in efficacy and safety between the onset time＞24 h group and the onset time ≤24h group.Univariate binary Logistic regression analysis showed that hypertension(OR,0.613,95％CI 0.391-0.942,P=0.025),intravenous thrombolysis(OR,3.235,95％CI 1.316-9.237,P=0.010),baseline NIHSS score(OR,0.975,95％CI 0.957-0.988,P＜0.01),baseline pc-ASPECTS(OR,1.281,95％CI 1.101-1.482,P=0.001)and sICH within 24 h after EVT(OR,0.070,95％CI 0.000-0.330,P＜0.01)were significantly correlated with prognosis.Gender,age,hypertension,baseline NIHSS score,intravenous thrombolysis,baseline pc-ASPECTS,ASTIN/SIR collateral grade,onset time＞24 h and sICH within 24 h after EVT were included in the multivariate binary Logistic regression analysis.The multivariate binary Logistic regression analysis showed that the onset time＞24 h was not associated with poor prognosis 90 d after EVT(aOR,1.635,95％CI 0.936-2.893,P=0.087).Conclusion EVT for acute posterior circulation ischemic stroke more than 24 hours after onset is feasible under strict imaging screening,and its safety and efficacy are similar to those in patients with onset under 24 hours.

Characterization of fowl adenoviruses isolated between 2007 and 2014 in China.

Forty-three fowl adenovirus (FAdV) strains were isolated in China from 2007 to 2014 from poultry and ostriches with inclusion body hepatitis (IBH) and hydropericardium syndrome (HPS). Phylogenetic analysis showed that 28/43 strains clustered into Fowl aviadenovirus D (FAdV-D) and 9/43 strains clustered into FAdV-E. FAdV-C included three isolates of ostrich origin, one of goose origin and two of chicken origin. Based on hexon loop 1 gene sequencing analysis, these viruses were genetically related to FAdV-4, FAdV-8a, FAdV-8b and FAdV-11, of which FAdV-11 was dominant. The isolation in 2014 of three FAdV strains belonging to serotype 4 from ostrich flocks is to our knowledge the first finding of FAdV-4 infection and HPS cases in ostriches. Epidemiological analysis showed that FAdV has been circulating in northern and eastern China, where more than 50% of layers and broilers are raised. The hosts of this pathogen included broilers, layers, geese and ostriches. IBH and HPS cases had a sporadic or cluster distribution from 2007 to 2013; however, since 2014 the number of cases has increased sharply. To control FAdV, strict biosecurity protection measures are necessary and a multivalent vaccine may be needed.

Spontaneous internal carotid artery dissection / 国际脑血管病杂志

Spontaneous internal carotid artery dissection is a group of (c)linical uncommondiseases,but it is a potentially catastrophic non-traumatic acute critical illness.The improvement of knowledge and understanding of the disease by clinicians will help to take preventive measures and improve the levels of diagnosis and treatment.This article reviews the advances in clinical features,diagnosis and treatment of spontaneous internal carotid artery dissection.

Clinical diagnosis and treatment for intracranial vertebrobasilar artery dissection / 国际脑血管病杂志

Intracranial vertebrobasilar artery dissection (VBAD) is not uncommon in clinical practice. Its onset form primarily manifested as subarachnoid hemorrhage or posterior circulation ischemia. It is very easy to be misdiagnosed because lack of the specific symptoms and signs. This article reviews the clinical manifestation, imaging characteristics and treatment of intracranial VBAD in order to improve the early diagnostic rate of the disease, reaching the purposes of early treatment, reducing complications and improving the prognosis.

Acute ischemic stroke patients without angiographically revealed arterial occlusion / 介入放射学杂志

Approximately 20%-30% of the patients with acute ischemic stroke do not have an angiographically demonstrable arterial occlusion. This article reviews the possible explanations for the absence of angiographically documented occlusion, the risk and the occurrence rate of cerebral infarction, the prognosis, and the effectiveness as well as the safety of thrombolytic therapy.

Ballon angioplasty and stenting for acute ischemic stroke / 国际脑血管病杂志

Thrombolytic agents for the treatment of acute ischemic stroke have some limitations. Balloon angioplasty and stenting have become the research hotspot in the treatment of acute ischemic stroke. 1his article reviews the effectiveness and safety of balloon angioplasty and stenting in the treatment of acute ischemic stroke.

An outbreak of Guillain-Barré syndrome from Shuangyang district of Changchun, China / 中华神经科杂志

Objective To clearify the features of an outbreak of Guillain-Barré syndrome (GBS) from Shuangyang district of Changchun city, Jilin province, China.Methods Serum samples obtained were tested serologically for antibodies to chlamydia, coxsackie virus, cytomegalovirus, and hepatitis B virus.Stool samples obtained were cultivated to search Campylobacterjejuni.Electrudiagnostic studies were done 1 day after onset to 10 days.Results Twenty-two patients (12 males and 10 females, aged 15-71 years) were from Shuangyang district, a suburb of Changchun, during a 2-week period in June to July 2007.An illness in the preceding 4 weeks was reported in 17 patients, 16 gave a history of diarrhoea, 1 patient had symptoms consistent with an "upper respiratory infection" and 1 patient had both.Limb weakness were the earliest symptoms.Respiratory assistance was needed by 3 patients.Tendon reflexes were lost as weakness developed.Eleven patients had raised concentrations of protein in the cerebrospinal fluid ((0.74±0.32) g/L), and the averaged cell count was 3×106/L There were 3 kinds of antibodies of hepatitis B virus positive above 17 GBS patients.Electrodiagnostic studies showed severe reductions in motor evoked amplitudes from distal stimulation in 12 patients.Sensory action potentials were normal.Conclusions The distinctive epidemiologicai, clinical and electromyography characteristics of these patients suggest that the disorder, different from acute inflammatory demyelinating polyneuropathy, is concordant with acute motor axonal neurupathy.The features of Shuangyang GBS was similar to those previously reported in several aspects.

Therapeutic Window Concentration of Tacrolimus: Survey of 56 Cases of Renal Transplant Recipients / 中国药房

OBJECTIVE: To explore the therapeutic window concentration of tacrolimus(FK506) suitable for Chinese renal transplant recipients. METHODS: The whole blood valley concentration level in 56 renal transplant recipients 12h after oral administration with FK506 was determined by MEIA (Microparticle Enzyme Immunization). The rejections and the renal toxic reaction were observed as well. RESULTS: The recommended therapeutic window concentration of FK506 for Chinese renal transplant recipients were the following: 9～14?g/L during the first month; 8～12?g/L during the second to the third month; 6～10?g/L during the fourth to the sixth month; 4～6?g/L during the seventh to the twelfth month. CONCLUSION: FK506 has a satisfactory immune suppression effect while reducing incidences of rejections and renal toxic reactions if used within the above therapeutic window concentration.

Discussion on Therapeutic Window Concentration of Digoxin / 中国药房

0.05),the toxi?cation rate of the low dose group was lower than that of the routine group(P0.05),the effective concentration of the low dose digoxin group was significantly lower than the routine group(P

Cost - effectiveness Analysis of Levof loxacin in Treating Lower Respiratory Tract Infections: Survey of 2 Dose Regimen / 中国药房

0.05), respectively; the costs were 640.50yuan and 1 151.21yuan, respectively; the cost-effectiveness ratios were 7.01 and 12.28, respectively; the incremental cost-effectiveness ratio of Group B versus Group A was 220.1. CONCLUSION: The sequential therapy of levofloxacin is preferable in the treatment of lower respiratory infection.

Monitoring of Peak Blood Concentration in Renal Transplant Recipients 2h after Oral Administration of Cyclosporine A and Study on Therapeutic Window Concentration / 中国药房

OBJECTIVE:To study the therapeutic window of peak blood concentration at different time in domestic renal transplant recipients2h after administration with cyclosporine A(CsA).METHODS:The valley bottom levels(C 0 )and the peak levels(C 2 )were determined simultaneously by fluorescence polarization immunoassay(FPIA)in92patients2h after oral administration with CsA,the rejection and the hepatic and renal drug toxicities were observed.RESULTS:The recommended therapeutic window concentration of CsA(C 2 )in Chinese renal transplant recipients was1000～1300?g/L within the first month,950～1250?g/L within the second to third month,900～1100?g/L within the fourth to sixth month,750～1000?g/L within the seventh to twelfth month,600～800?g/L from the twelfth month after renal transplantation.CONCLUSION:Within the above therapeutic window concentration range,CsA is of ideal immuno-suppressive action meanwhile it can less rejection and minimize the hepatic and renal drug toxicities.

The effect of yizhi oral liquid on the learnign and memory of chronic cerebral inchemic dementia rat / 中国组织工程研究

Objective To explore treatment effect of (chinese drog)Yizhi oral liquid on chronic cerebral ischemic dementia rat.Methods Dementia rat model was made by ligating bilateral comon carotid artery and detect the ability to learning and memory in the therapeutic group,ischemic group and control group. Results The scores of water maze experiment in therapeutic were more higher than in ischemic group. Conclusion Yizhi oral liquid can improve the ability of learning and memory of rats.