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Objective: To characterize the value of carotid wall shear stress (WSS) following carotid artery stenting (CAS) in patients with carotid stenosis. Methods: Twenty-eight patients with carotid stenosis treated with CAS between March 2021 to May 2022 in the eighth medical center of the PLA General Hospital were selected for our study. Carotid ultrasound was performed before the operation, one week post-operation, and six months post-operation. Carotid artery WSS was detected by blood flow vector imaging, and the changes in WSS before and after the operation were collected. Genetic testing of drugs was detected for patients with restenosis. Results: Pre-operative WSS of the proximal, narrowest region, and distal carotid arteries in patients with ischemic carotid artery stenosis was 7.88 ± 3.18Pa, 14.36 ± 6.66Pa, and 1.55 ± 1.15Pa, respectively. Comparatively, pre-operative WSS of the proximal, narrowest region and distal carotid arteries in patients without ischemic symptoms was 5.02 ± 1.99Pa, 9.68 ± 4.23Pa, and 1.10 ± 0.68Pa, respectively, with a significant difference between the two groups (p < 0.001). Overall WSS of the proximal, narrowest region, and distal carotid arteries in patients before CAS was 6.68 ± 3.0Pa, 12.47 ± 5.98Pa, and 1.39 ± 0. 96Pa. WSS of the proximal, narrowest region, and distal carotid was 4.15 ± 1.42Pa, 6.71 ± 2.64Pa, and1.86 ± 1.13Pa one week after CAS, compared to 4.44 ± 1.91Pa, 7.90 ± 4.38Pa, and 2. 36 ± 1.09Pa six months after CAS. WSS of the proximal and narrowest region of the carotid artery was reduced after carotid stenting, and the difference was statistically significant (p < 0.001). There was no statistically significant difference in WSS between one week and six months after stenting (P > 0.05). Conclusion: We employed early carotid WSS as a means of evaluating the efficacy of carotid artery stenting. Changes in carotid WSS are closely associated with carotid artery stenosis, providing valuable hemodynamic information for CAS treatment. This technique holds great application value in pre-operative evaluation and long-term follow-up.
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Objective To identify the 2- year recurrence- related factors in patients with myasthenia gravis (MG) after treatment of low-dose tacrolimus. Methods The clinical data of 100 MG patients treated with low- dose tacrolimus from February 2011 to February 2016 were retrospectively analyzed. All patients were followed up at least 2 years, and the risk factors affecting the recurrence of MG patients were analyzed. Results At the end of follow-up, there were 49 cases who had recurrence, and the recurrence rate was 44.5％ (49 / 110). Logistic regression analysis result showed that reducing dosage or withdrawal, MG crisis and diabetes mellitus were the independent risk factors for recurrence of MG patients (OR = 134.113, 8.850 and 6.652; P < 0.01 or <0.05). Conclusions The rate of recurrence with low- dose tacrolimus treatment in patients with MG during 2 years is higher. Reducing dosage or withdrawal should be avoided, especially in patients with a history of MG crisis. Patients with diabetics mellitus need to control blood glucose stability to avoid recurrence.
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Objective To research the clinical characteristics of cerebral infarction involving the anterior and posterior circulation in the same time. Methods Collected the clinical data of 11 patients with cerebral infarction involving the anterior and posterior circulation in the same time, who was confirmed by clinical and radiographic examination. Results In the majority of 11 patients, they had multiple risk factors in the same time. By Chinese Ischemic Stroke Subclassification (CISS) criteria, there were 3 patients with large-artery atherosclerotic brain infarction (aortic arch atherosclerosis and intracranial and extracranial large arteries atherosclerosis coexist), 3 patients with cardiogenic stroke, 3 patients with undetermined etiology (intracranial and extracranial large arteries atherosclerosis and cardiogenic stroke maybe coexist), 2 patients with other etiologies(1 patient with Moyamoya disease, 1 patient with polycythemia vera). There were multiple vascular stenosis in the 3 patients with large artery atherosclerosis, and the posterior communicating artery was open. Conclusions Cerebral infarction involving the anterior and posterior circulation in the same time is rare, cardiogenic stroke is more often, the relevant examinations should be perfect to definite the rare cause.
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Objective To measure the clinical significance of serum Titin antibody measurement in patients with myasthenia gravis (MG) crisis.Methods Twenty six patients with MG crisis,30 patients with other neurologieal diseases (ONDs) and 30 health controls,collected in our hospital from July 2008 to August 2010,were chosen in our study; the sera level oftitin antibody was deetected by enzyme-linked immunosorbentassay (ELISA); correlations of titin antibody level with the clinical features and prognosis of the patients with MG crisis were analyzed.Results The positive rate of titin antibodies in MG crisis group and ONDs group was 73.1％ and 3.3％,and it was negative in health control group; significant differece was noted (x2=51.922,P=0.000).The positive rate of titin antibodies in patients older than 50 years of the MG crisis group was signifcantly higher than that in patients younger than 50 years (x2=5.052,P=0.014); the positive rate of titin antibodies in MG crisis group was negatively correlated to the gender of the patients,the types of Osserman and the pathological types (P＞0.05).The titin antibody titer after treatment was significantly decreased as compared with that before treatment (P＜0.05).Conclusion Positive titin antibody is mostly found in MG crisis and it's level is related to the severity of MG crisis,indicating that it might be beneficial for evaluating prognosis of MG patients.