ABSTRACT
Objective:To investigate the clinical value of hemoglobin in the assessment of long-term prognosis of stroke after rehabilitation treatment.Methods:A total of 168 patients with stroke who received treatment in Ruian People's Hospital, China between January 2018 and January 2019 were included in this study. All of them received rehabilitation treatment. They were divided into Hb < 120 g/L group ( n = 36 and Hb ≥ 120 g/L group ( n = 132) according to Hb level before rehabilitation treatment. All patients were followed up for 12 months. General data, and simplified Fugl-Meyer Assessment (FMA) score and modified Barthel Index (MBI) before and after treatment were compared between the two groups. Pearson correlation was used to analyze the correlation between Hb level and simplified FMA score and MBI. The area under the receiver operating characteristic (ROC) curve was used to evaluate the efficacy of Hb level in predicting stroke recurrence. Results:There were no significant differences in gender, age and body mass index between the two groups (all P > 0.05). After treatment, simplified FMA score and MBI in the Hb ≥ 120 g/L group were (85.39 ± 8.27) points and (87.14 ± 8.85) points, respectively, which were significantly higher than those in the Hb < 120 g/L group [(79.82 ± 6.18) points, (80.06 ± 6.97) points, t = 5.625, 6.012, both P < 0.05). Pearson correlation results revealed that Hb level before rehabilitation was positively correlated with FMA score and MBI ( r = 0.425, 0.362, both P < 0.05). During the follow-up period, stroke recurred in 27 (16.07%) out of 168 patients. The area under the ROC curve for Hb level before treatment as a predictor of stroke recurrence was 0.915, which was significantly greater than the National Institutes of Health Stroke Scale score 0.630 ( Z = 2.652, P < 0.05). Conclusion:The long-term prognosis of stroke patients with low Hb level before rehabilitation treatment is poor, and monitoring Hb level is highly effective for predicting stroke recurrence. This study is greatly innovative and scientific. Findings from this study deserve further investigation.
ABSTRACT
BACKGROUND: It has been found that drug-coated balloons can reduce the loss of lumen in the advanced stage of coronary small-vessel disease, and the incidence of major adverse cardiovascular events at 6 months after surgery with drug-coated balloons is similar to that of drug-eluting stents. However, clinical studies on the efficacy of drug-eluting stents in older adult patients with type 2 diabetes mellitus complicated by coronary artery small vessel disease are still lacking. OBJECTIVE: To investigate the efficacy and safety of drug-coated balloon versus drug-eluting stent in the treatment of type 2 diabetes mellitus complicated by coronary artery small vessel disease in older adult patients. METHODS: A total of 122 older adult patients with type 2 diabetes mellitus complicated by coronary artery small vessel disease who received treatment in Jiaozuo People’s Hospital between January 2016 and September 2018 were included in this study. These patients were randomly divided into a drug-eluting stent group (n=62) and a drug-coated balloon group (n=60). Patients in both groups underwent coronary artery predilation with a semi-compliant balloon, followed by implantation of corresponding stents. Selective quantitative coronary angiography was performed before surgery, immediately, 6 months and 12 months after surgery. The minimum lumen diameter, residual stenosis, lumen increase and late lumen loss of target lesions were observed in the two groups. At 6 and 12 months after surgery, major adverse cardiovascular events and bleeding events were followed up. This study was approved by the Medical Ethics Committee of Jiaozuo People’s Hospital, China (approval No. 201503). RESULTS AND CONCLUSION: (1) The success rate of surgery in the drug-coated balloon group was significantly higher than that in the drug-eluting group (P=0.028). (2) Immediately after surgery, the minimum lumen diameter and lumen increase in the drug-coated balloon group were less than those in the drug-eluting stent group (both P < 0.01). The residual stenosis in the drug-coated balloon group was significantly greater than that in the drug-eluting stent group (P < 0.01). (3) At 6 months after surgery, late lumen loss of target vessels in the drug-coated balloon group was smaller than that in the drug-eluting stent group (P < 0.001). The rates of target vessel revascularization and major adverse cardiovascular events in the drug-coated balloon group were lower than those in the drug-eluting stent group (P=0.028, 0.010). (4) At 12 months after surgery, the minimum lumen diameter in the drug-coated balloon group was larger than that in the drug-eluting stent group (P=0.033). The residual stenosis and late lumen loss in the drug-coated balloon group were lower than those in the drug-eluting stent group (P=0.008, 0.002, 0.019). (5) These results suggest that drug-coated balloon for treatment of type 2 diabetes mellitus complicated by coronary artery small vessel disease is simple and easy to operate, with a high surgical success rate. Drug-coated balloon can reduce residual stenosis degree and late lumen loss, decrease the revascularization rate of target vessels, and reduce the incidences of major adverse cardiovascular disease and bleeding events. The clinical prognosis of drug-coated balloon is superior to that of drug-eluting stent.
ABSTRACT
Objective: To explore the effect of autophagy on process of high phosphate salt induced vascular smooth muscle cell (VSMC) calciifcation in experimental rats. Methods: Rats’ model of VSMC calciifcation was induced by phosphate incubation. VSMC were divided into 3 groups:①Control group,②Calciifcation group which included 3 subgroups as 4-day subgroup, the cells were cultured by 3.2 mmol/L phosphate for 4 days, 6-day subgroup and 8-day subgroup,③Calciifcation+ 3-MA (autophagy inhibitor) group, in which the 8-day cells were cultured with 5mmol/L 3-MA. Calcium nodule formation and calcium deposition in VSMC were measured by Alizarin red staining and o-cresolphthaleincomplexone method, protein expressions of Runx2, α-SMA and LC3 II were examined by Western blot analysis, autophagosome formation in VSMC was measured by transmission electron microscope and the localization and expression of Runx2 and LC3 II in VSMC were observed by immunolfuorescent microscope. Results: Compared with Control group, the cells at 8-day subgroup showed more calcium nodules, higher calcium deposition, increased protein expressions of Runx2, LC3 II, more autophagosome and decreased α-SMA expression, allP<0.05. Compared with 8-day subgroup, the cells in Calcification+3-MA group presented increased calcium deposition, decreased lfuorescence distribution of LC3 II and more cells with positive Runx2 protein expression, all P<0.05. Conclusion: Autophagy has the protective effect on process of phosphate induced VSMC calciifcation in experimental rats.
ABSTRACT
Objective To investigate the clinical efficacy and treatment method for no midline shift-severe craniocerebral trauma accompanied with post-traumatic acute diffuse brain swelling (PADBS).Methods 60 PADBS patients were randomly divided into conservative treatment group and operation group,30 patients in each group.The operation group was treated with intracranial pressure monitoring by implantation of the probe and decompressive craniectomy,while the conservative treatment group received conservative treatment.The postoperative recovery was observed.Results The GCS scores of operation group postoperative 7d and 15d were (11.21 ± 2.24) and (12.88 ±2.31),which were obviously higher than (7.47 ± 1.51) and (8.19 ± 1.28) of the conservative treatment group (t =2.215,2.321,all P ＜ 0.05).Postoperative long-term follow-up results indicated that,according to GOS score,63.3％ patients in the operation group recovered well,which was significantly higher than 26.7％ in the conservative treatment group.While the percent of patients with coma or dead was 6.7％ and 10.0％ in the operation group,which were significantly lower than the conservative treatment group (x2 =15.721,4.172,3.84,all P ＜ 0.05).Conclusion In general,PADBS could not be cured easliy,the operation methods of using intracranial pressure monitoring and decompressive craniectomy based on conservative treatment could help to evaluate the trauma objectivly,detect the changes of disease earlier,treat in time and assess the prognosis accurately,all which would reduce the mortality.
ABSTRACT
Objective To investigate and evaluate the clinical value of trepanation and drainage in bilateral chronic subdural hematoma aged patients.Methods Chose 52 bilateral chronic subdural hematoma aged patients received trepanation and drainage for objects of study,and analyzed the clinical data of these patients.Results The procedure was successful in all 52 patients and no death was related to the procedure.Only 5 patients recurred after operations.Conclusion Trepanation and drainage possesses high application value in bilateral chronic subdural hematoma aged patients,due to its slight injury,high success rate and low complication.
ABSTRACT
Objective To study the CT signs of bronchotracheal transparent foreign body and its diagnostic value.Methods The X-ray and CT findings of bronchotracheal trasparent foreign body in 46 cases were analysed comparativly.Results Among 46 cases,9 cases of trachea foreign body,13 cases of right bronchial foreign body,7 cases of left bronchial foreign body,2 cases of both sides of bronchial foreign body were showed directly by CT,and 8 cases of right bronchia foreign body,6 cases of left bronchia foreign body,1 case of both sides of bronchia foreign body showed indirectly on CT,the sensitivity was 100 percent,while the foreign body and its anatomical location could not be showed on X-ray film,but the indirect signs just like pulmonary emphysema,obstructive pulmonitis and drowned lung etc,could be showed by X-ray films in 34 cases.In another 12 cases were negative,the sensitivity was 73.9 percent.Conclusion The transparent foreign body can not be showed but indrect signs by X-ray film;While CT scan can not only shows the anatomical location of foreign body,but also the shape and size of the foreign body,it offers more information than X-ray films and has important refering value to clinicians to take out the foreign body.
ABSTRACT
Objective To evaluate the diagnostic value and technique advantage of 16-slice CT angiography(16SCTA) in aortic dissection.Methods 39 cases of aortic dissection underwent 16SCTA.The data were reconstructed by multiplanar reconstruction(MPR),curved planar reconstruction(CPR),volume rendering(VR),maximum intensity projection(MIP),virtual endoscopy(VE),and generally analyzed in combination with original axial images.Results According to DeBakey's classification,DeBakey's type Ⅰ in 5 cases,type Ⅱ in one case and type Ⅲ in 33 cases were founed in the 39 cases.16SCTA clearly showed that including the ture and false lumen(39 cases,100%),intimal flaps(39 cases,100%),intimal tear(25 cases,64.1%),and thrombus inside the false lumen(17 cases,43.6%).Conclusion 16SCTA may be as the first choice method in diagnosis of aoric dissection,and which is considered as having great value.
ABSTRACT
Objective To evaluate CT staging and resectability of esophageal carcinoma.Methods The esophageal barium examination,esophagoscopy and CT scan were performed in 42 cases with esophageal carcinoma.CT findings were put the stress on analyzed.Results CT clearly demonstrated the location, thickness, actual length and extent of esophageal carcinoma as well as its relation with surrounding structures in all 42 cases.According to staging standard of Moss and Reining there were four stages,Ⅰ stage 0 case,Ⅱ stage 33 cases,Ⅲ stage 6 cases,Ⅳ stage 3 cases.In all cases,operations were in 34 cases,detecting were in 3 cases,no-operations were in 5 cases.Conclusion CT imaging playes an important role in preoperative diagnosis,staging and the evaluation of resectability of esophageal carcinoma.
ABSTRACT
Objective To explore the applied value of the super-short exposure time of the DR adjustable control in radiography of infant chest.Methods 100 chest radiographic films of infant in adjustable control group and fixed control group respectively were selected randomly.The quality of all films was evaluated by 4 technicians in charge in 4 grades(A,B,C and waste)and the detective rate of the tiny parts of the images was also evaluated.Results DR adjustable control:the rate of grade A,B,C and waste was 70%,20%,10% and 0% respectively.DR fixed control:the rate of grade A,B,C and waste was 42%,41%,15% and 2% respectively.The detective rate of tiny parts was 100% and 90% in DR adjustable control group and DR fixed control group respectively.Conclusion DR adjustable control chest film in infant is better than DR fixed control in image quality.DR adjustable control system is good for radiographic diagnosis.