Association between carotid artery perivascular fat density and cerebral small vessel disease.

Studies aiming to identify the significance of the carotid artery perivascular fat density are limited. The present study investigated the distribution pattern of pericarotid fat and its association with imaging markers of cerebral small vessel disease (CSVD). In total, 572 subjects who underwent both neck computed tomography angiography and cranial magnetic resonance imaging were analyzed. The pericarotid fat density near the origin of the internal carotid artery (ICA) and imaging markers of CSVD, such as lacunes, white matter hyperintensities (WMHs) and dilated perivascular spaces (PVSs), were assessed. We found that an increased pericarotid fat density was associated with the presence of lacunes and a higher WMH grade in all subjects, but in the patients with acute ischemic stroke, there was a difference only among the WMH grades. There was no significant difference in the pericarotid fat density in different grades of PVSs. The patients with acute ischemic stroke had a significantly higher mean pericarotid fat density than those without stroke. In conclusion, our study provides evidence suggesting that an increased pericarotid fat density is associated with the presence and degree of WMHs and lacunes. Our findings suggested that features that appear to extend beyond the vessel lumen of the ICA may be linked to CSVD.

Prognostic factors affecting the short-term efficacy of non-surgical treatment of chronic periodontitis: a multilevel modeling analysis.

BACKGROUND: This study is aimed to analyze the prognostic factors affecting the short-term efficacy of non-surgical treatment of patients in periodontitis from stage II to stage IV by the multilevel modeling analysis. MATERIALS AND METHODS: A total of 58 patients with chronic periodontitis were included in this study. Patients were clinically explored before and 3 months after the treatment and the difference in probing depth was determined [Reduction of probing depth (Δ PD) = baseline PD - finial probing depth (FPD)] which is considered as the therapeutic evaluation. Three different levels were analyzed: patients, teeth and sites to construct a multi-layer linear model. RESULTS: Probing depth (PD) improved significantly compared with that before treatment (p < 0.05), in which FPD was (3.90 ± 1.39) mm, and the ΔPD was (1.79 ± 0.97) mm. Compared with the mesial sites and distal sites of the multi-rooted teeth, the number of PD ≥ 5 mm or PD < 5 mm after the treatment was significantly different (P < 0.05), and the proportion of PD < 5 mm was higher in mesial sites. The null model showed that Δ PD varied greatly between groups at various levels (P < 0.001), with prediction variable of site level, tooth level, and patient level accounted for 66%, 18%, and 16% of the overall difference, respectively. The complete model showed that the Δ PD of smokers was significantly lower than that of non-smokers (P < 0.001). The Δ PD of the mesial and distal sites was larger than that of the buccolingual central site (P < 0.001). The Δ PD of single-rooted teeth was larger than that of multi-rooted teeth (P < 0.001). The baseline PD, tooth mobility (TM), bleeding index (BI), clinical attachment loss (CAL) were significantly negatively correlated with Δ PD (P < 0.001). CONCLUSIONS: Patients with periodontitis from stage II to stage IV, who were non-smoking, have good compliance, good awareness of oral health, and low percentage sites with PD ≥ 5 mm at baseline, single-rooted teeth with hypomobility, less clinical attachment loss and lower bleeding index and sites of mesial or distal can obtain an ideal short-term efficacy of non-surgical treatment.

The prognostic role of nutrition risk score (NRS) in patients with metastatic or recurrent esophageal squamous cell carcinoma (ESCC).

The purpose of this study was to elucidate the prognostic value of nutritional risk score (NRS) in patients with metastatic or recurrent ESCC. A total of 187 patients who undergoing S1 based or paclitaxel based salvage chemotherapy were enrolled in this retrospective study. Nutritional status was evaluated by NRS. The relationship between NRS and clinicopathological variables and post-treatment outcomes were assessed by univariate and multivariate analysis. NRS was significantly associated with weight loss (P<0.001), BMI (P<0.001), chemotherapy regimens (P=0.038) and treatment response (P=0.013). The Kaplan-Meier survival curves indicated that patients with NRS ≥ 3 had worse overall survival (OS) compared to patients with NRS < 3 (P<0.001). Multivariable regression revealed that weight loss, NRS and treatment response were three prognostic factors (P<0.05). These results suggest that NRS is a promising indicator of poor prognosis in patients with metastatic or recurrent ESCC who received S1 based or paclitaxel based salvage chemotherapy.

[The relationship between the levels and variability of blood glucose and the prognosis of massive cerebral infarction].

OBJECTIVE: To investigate the relationship between the levels and variability of blood glucose and the prognosis of massive cerebral infarction. METHODS: A retrospective study involving 72 massive cerebral infarction patients without diabetes mellitus admitted to Taizhou Enze Medical Centre Luqiao Hospital from January 2012 to June 2013 was conducted. The mean blood glucose level (GluAve), standard deviation of blood glucose level (GluSD), and coefficient of variation of blood glucose level (GluCV) during the first 72 hours were monitored. Complications such as cerebrocardiac syndrome, pulmonary infection, stress ulcer bleeding, urinary system infection, decubitus sore, electrolyte disturbances, and epileptic seizures were also recorded. According to the 28-day outcome after admission, patients were divided into survivor group (n=60) and non-survivor group (n=12). The values of GluAve, GluSD and GluCV were compared between the two groups. The patients were again divided into three groups based on the level of GluAve (<7.8, 7.8-11.1, >11.1 mmol/L). Finally, patients were divided into four groups based on the level of GluCV (<15%, 15%-30%, 30%-50%, >50%). Acute physiology and chronic health evaluation II (APACHEII) score, mortality, and complications were compared among groups. RESULTS: The levels of GluAve, GluSD and GluCV in non-survivor group were significantly higher than those in survivor group [GluAve: 17.91 ± 5.33 mmol/L vs. 12.41 ± 3.12 mmol/L, t=3.145, P=0.002; GluSD:2.87 ± 1.96 mmol/L vs. 1.83 ± 1.08 mmol/L, t=2.611, P=0.017; GluCV: (27.56 ± 14.73)% vs. (20.12±10.97)%, t=2.020, P=0.043]. With the gradual increase of GluAve level, the mortality and total complication rate were elevated significantly [28-day mortality: 5.00% (1/20), 13.89% (5/36), 37.50% (6/16), χ²=7.16, P=0.028; total complication rate: 35.00% (7/20), 55.56% (20/36), 93.75% (15/16), χ²=12.85, P=0.002]. But there was no significant difference in APACHEII score (9.80 ± 4.17, 12.11 ± 5.81, 13.69 ± 6.57, F=2.241, P=0.114) and stress ulcer incidence rate [5.00% (1/20), 11.11% (4/36), 31.25% (5/16), χ²=5.59, P=0.061]. With the gradual increase of GluCV level, APACHEII score, 28-day mortality, the incidence of various complications, and total complication rate were all raised significantly [APACHEII score: 7.00 ± 1.56, 10.08 ± 1.88, 13.14 ± 5.76, 16.76 ± 7.17, F=12.486, P=0.000; mortality: 0 (0/15), 8.70% (2/23), 23.81% (5/21), 38.46% (5/13), χ²=9.27, P=0.026; total complication rate: 40.00% (6/15), 47.83% (11/23), 57.14% (12/21), 100.00% (13/13), χ²=12.42, P=0.006]. CONCLUSIONS: Both the GluAve level and GluCV level are significantly correlated with the outcome of patients suffering from massive cerebral infarction. The change in GluCV level seems to be more sensitive in predicting the prognosis of massive cerebral infarction than GluAve.

[Study on expression of matrix metalloproteinase-2 and matrix metalloproteinase-9 in brain tissue adjacent to hemorrhage after brain hemorrhage in human].

OBJECTIVE: To investigate the expression and significance of matrix metalloproteinase-2 (MMP-2) and MMP-9 in peri-hematoma brain tissues after acute brain hemorrhage in human. METHODS: Forty-two patients with acute brain hemorrhage received surgery, the brain tissues adjacent to hemorrhagic site were obtained during surgery, and positive expressions of MMP-2 and MMP-9 were determined with immunohistochemical staining. Brain tissues from 30 patients with cerebral trauma were obtained to serve as controls. RESULTS: The positive expressions of MMP-2 and MMP-9 in focal brain tissues were significantly elevated in early acute brain hemorrhage. Compared with 28 and 27 cases with MMP-2 and MMP-9 positive expression respectively in control group, there were 39 and 37 cases with MMP-2 and MMP-9 positive expression respectively in acute brain hemorrhage group. There were no significant differences between two groups (both P>0.05). CONCLUSION: MMP-2 and MMP-9 might contribute to brain edema formation in the acute intra-cerebral hemorrhage of human.