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Objective:To investigate the risk factors of early neurological deterioration (END) in patients with minor ischemic stroke caused by large vessel occlusion (LVO) and the impact of rescue endovascular thromboectomy (REVT) on clinical outcomes of patients with END at discharge.Methods:Consecutive patients with acute minor ischemic stroke caused by LVO within 24 h of onset in the Third Affiliated Hospital, Soochow University from January 2021 to March 2023 were retrospectively enrolled. Minor ischemic stroke was defined as baseline National Institute of Health Stroke Scale (NIHSS) score ≤5 at admission. END was defined as an increase of ≥4 in the NIHSS score within 24 h after the best medical management. The modified Rankin Scale was used to evaluate the clinical outcomes of patients with END at discharge. 0-2 was defined as a good outcome. Multivariate logistic regression analysis was used to identify the independent risk factors for END and the impact of REVT on clinical outcomes in patients with END. Results:A total of 75 patients with minor ischemic stroke caused by LVO were included, of which 31 (41.3%) developed END and 13 (41.9%) underwent REVT after END. Multivariate logistic regression analysis showed that internal carotid artery occlusion was an independent risk factor for END (odds ratio 4.304, 95% confidence interval 1.213-15.270; P=0.024), and REVT was an independent protective factor for good outcomes in patients with END (odds ratio 0.068, 95% confidence interval 0.006-0.774; P=0.030). Conclusions:The incidence of END is higher in patients with minor ischemic stroke caused by LVO, and internal carotid artery occlusion is an independent risk factor for the occurrence of END. Providing REVT after END may improve the clinical outcomes of patients with END at discharge.
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@#Objective To investigate the predictive value of TOAST（Trial of Org 10172 in Acute Stroke Treatment） and lipoprotein-associated phospholipase A2（Lp-PLA2） for early recurrence of ischemic cerebrovascular disease after transient ischemic attack（TIA）and minor ischemic stroke of anterior circulation. Methods A total of 190 patients with TIA and minor ischemic stroke of anterior circulation were selected and the general information and supplementary examinations were recorded. The patients were classified etiologically into large-artery atherosclerotic stroke（LAA） group and non-LAA group according to TOAST. According to the recurrence of ischemic cerebrovascular disease within 30 days，the patients were divided into positive event group and negative event group，and the differences between the two groups were compared. ROC curve was used to determine the best cutoff value of Lp-PLA2 for predicting positive event. Multivariate analysis was performed to identify potential predictors of recurrence. Finally，ROC curve was used to analyze the predictive value of Lp-PLA2 and LAA alone or in combination for recurrent ischemic cerebrovascular disease in the early stage of TIA and minor ischemic stroke of anterior circulation. Results For positive event group，the age，proportion of TIA or cerebral infarction history，proportion of LAA and the level of Lp-PLA2 were higher than those of negative event group（P<0.05）.The best cutoff value of Lp-PLA2 was 304.50 ng/ml（sensitivity and specificity were 0.645 and 0.711 respectively）. LAA and Lp-PLA2 ≥ 304.50 ng/ml were independent risk factors for recurrent ischemic cerebrovascular disease within 30 days after TIA and minor ischemic stroke of anterior circulation. The area under ROC curve of LAA，Lp-PLA2≥ 304.50 ng/ml and combination of both were 0.671，0.678 and 0.729 respectively. The area under ROC curve of combined prediction of LAA and Lp-PLA2 was the largest. Conclusion LAA combined with Lp-PLA2≥304.50 ng/ml could predict the risk of early recurrence of ischemic cerebrovascular disease in TIA and minor ischemic stroke of anterior circulation.
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Objective To evaluate thetherapeutic effect of sodium deoxyribonucleotide injection at Zusanli point for chemotherapy-induced leukopenia in patients with lung cancer.MethodsA total of 116 chemotherapy-induced leukopenia patients with lung cancer were randomly divided into a therapy group and a control group, 60 in the treatment group and 56 in the control group. The patients in the treatment group were treated with sodium deoxyribonucleotide injection atZusnlipoint, and those in the control group were treated with vein injection of sodium deoxyribonucleotide.Results The total effective rate in the treatment group was significant higher than that in the control group (91.7%vs.76.8%;χ2=4.890,P=0.032). The effective rates on days 3,5,7 and 10 in the treatment group were also significant higher than those in the control group (on day 3: 51.7%vs. 32.1%,χ2=4.530,P=0.036; on day 5: 76.7%vs. 53.6%,χ2=6.840,P=0.018; on day 7: 85.0%vs. 67.9%,χ2=4.770,P=0.026; on day 10: 78.3%vs. 53.6%,χ2=7.960,P=0.011).Conclusion Sodium deoxyribonucleotide injection atZusanlipoint has definite efficacy for chemotherapy-induced leukopenia in patients with lung cancer.