ABSTRACT
Objective To construct a risk prediction model of post-traumatic stress disorder(PTSD)after hypertensive intracerebral hemorrhage in elderly patients and analyze the correla-tion of PTSD with rs806377 polymorphism of cannabinoid receptor 1(CNR1)gene.Methods A total of 215 elderly patients with hypertensive cerebral hemorrhage admitted to the Department of Neurology of Geriatric Hospital of Hainan and Department of Neurosurgery of the First Affiliated Hospital of Hainan Medical University from January 2020 to August 2022 were enrolled in this study.According to the results of PTSD scale(scoring＞50 or 0～50)after surgical treatment,they were divided into PTSD group(43 cases)and non-PTSD group(172 cases).The rs806377 polymorphism of CNR1 gene was detected in both groups by gene sequencing.Univariate and mul-tivariate logistic regression analyses were used to analyze the susceptibility to PTSD among the elderly after hypertensive intracerebral hemorrhage.Another 103 elderly patients with hyperten-sive intracerebral hemorrhage during the same period were also subjected and served as verifica-tion set.A prediction model was constructed.Results There were significant differences in age,family annual income,blood loss amount,psychological resilience score and social support score between the PTSD group and non-PTSD group(P＜0.05,P＜0.01).The PTSD group had obvi-ously larger proportion of TT genotype carriers and higher T allele frequency than the non-PTSD group(P＜0.05,P＜0.01).Logistic regression analysis showed that age(OR=2.020,95％CI:1.115-3.658),family annual income(OR=1.799,95％CI:1.232-2.626),blood loss(OR=1.507,95％CI:1.243-1.826),psychological resilience score(OR=2.059,95％CI:1.068-3.969),social support score(OR=1.664,95％CI:1.122-2.467),rs806377 TT genotype(OR=1.861,95％CI:1.485-2.331)and rs806377 T allele(OR=3.777,95％CI:2.049-6.962)were the influencing fac-tors of postoperative PTSD in these patients(P＜0.05,P＜0.01).ROC curve analysis indicated that the sensitivity was 69.57％,the specificity was 71.25％,and the AUC value was 0.762(95％CI:0.708-0.813)in the verification group,indicating a certain accuracy of our model.Conclusion CNR1 gene rs806377 locus polymorphism is an influencing factor for PTSD susceptibility,and rs806377 TT genotype and rs806377 T allele can predict PTSD in elderly patients after hyperten-sive intracerebral hemorrhage.
ABSTRACT
Objective Using CT three-dimensional image technique to observe the pulmonary vein stenosis of circumferential pulmonary vein ablation (CPVA) for atrial ifbrillation (AF) on the structure of pulmonary vein before and after radiofrequency ablation. Methods 28 patients with AF who underwent CPVA were followed-up for a mean (6.5±3.9) months.The results of Pulmonary vein morphology study was compared with analysis of preablation, after following up radiofrequency catheter alation (6.5±3.9) months. Pulmonary vein diameters, cross-sectional area and left atrial volume were measured before and after CPVA using 64-slice multidector computed tomography (CT). Results Mild stenosis of pulmonary vein maximum diameter and pulmonary minimum diameter were 61.6%and 56.3%after CPVA. Moderate stenosis of pulmonary vein maximum diameter and pulmonary minimum diameter were 3.6%and 5.4%. All patients does not present symptoms of pulmonary vein stenosis at rest on during excercise during follow up. Conclusions Mild and moderate asymptomatic pulmonary vein stenosis may present in some patients after CPVA.