Analysis on severity of cerebral edema and prognostic influencing factors after mechanical thrombectomy in patients with acute ischemic stroke due to anterior circulation large vessel occlusion / 重庆医学

Objective To observe the severity of cerebral edema after mechanical thrombectomy in the patients with acute ischemic stroke caused by large vessel occlusion,and to statistically analyze the related fac-tors affecting the prognosis quality of the patients,so as to guide the patients to conduct scientific interven-tion.Methods Ninety-one patients with acute ischemic stroke due to anterior circulation large vessel occlusion treated with mechanical thrombectomy in this hospital from October 2021 to October 2022 served as the ana-lytic subjects.According to the severity of brain edema,they were divided into the group Ⅰ(mild),group Ⅱ(moderate),and group Ⅲ(severe);after 12-week treatment,the improved Rankin scale was used to evaluate the prognosis.The patients with good prognosis were included in the excellent group,and the patients with poor prognosis were included in the poor group.Single factor and multifactor logistic analysis was used to ana-lyze the influencing factors and prognostic related factors of different degrees of brain edema.Results The univariate analysis showed that the percentage of patients with NIHSS score at admission ≥15,time from on-set to thrombolysis ≥6 h,history of hypertension,successful vascular recanalization and good collateral circu-lation were significantly different among the groups Ⅰ,Ⅱ and Ⅲ(P＜0.05);the multivariate logistic regres-sion analysis results showed that the NIHSS score at admission ≥15,time from onset to thrombolysis ≥6 h,and hypertension history were the risk factors leading to severe cerebral edema,while successful recanalization of blood vessels was a protective factor for cerebral edema(P＜0.05).The univariate analysis showed that in the good prognosis group the percentage of patients had good circulation of lateral branches,successful reca-nalization of blood vessels,severe cerebral edema,hypertension,time from onset to thrombolysis ≥6 h,and NIHSS score ≥15 at admission were significantly different from those in the poor prognosis group(P＜0.05).The multivariate logistic regression analysis results showed that severe cerebral edema,time from onset to thrombolysis ≥6 h and NIHSS score ≥15 at admission were the risk factors for poor prognosis,while good collateral circulation and successful recanalization of blood vessels were the positive factors for good prognosis(P＜0.05).Conclusion Mechanical thrombectomy patients with hypertension and time from onset to throm-bolysis ≥6 h and NIHSS score at admission ≥15 have more severe brain edema after treatment;severe brain edema,time from onset to thrombolysis ≥6 h,NIHSS score at admission ≥15 were the adverse factors affect-ing the prognosis of the patients with mechanical thrombectomy.

Clinical features and long-term prognosis of primary biliary cholangitis in patients with past hepatitis B virus infection / 中华肝脏病杂志

Objective: To investigate the clinical features and long-term prognosis of primary biliary cholangitis (PBC) in patients with past hepatitis B virus (HBV) infection. Methods: 353 cases with PBC who visited the Liver Disease Center of Beijing Friendship Hospital Affiliated to Capital Medical University between January 2000 and January 2018 were retrospectively analyzed and were divided into the past HBV infection group (156 cases) and the no HBV infection group (197 cases). The two groups' baseline clinical features were compared. Ursodeoxycholic acid response rate after one year, GLOBE score, UK-PBC score, and long-term liver transplantation-free survival rate were compared through outpatient and telephone follow-up. Results: PBC with past HBV infection had a significantly reduced female proportion compared to the no HBV infection group (91.9% vs. 79.5%, P = 0.001). However, there were no statistically significant differences in age, biochemical indices, immunological indicators, platelet count, cirrhosis proportion, and others. Ursodeoxycholic acid biochemical response rate was reduced in patients with past HBV infection at the end of one year of treatment, but the difference was not statistically significant (65.8% vs. 78.2%, P = 0.068). In addition, there were no statistically significant differences between the GLOBE score (0.57 vs. 0.59, P = 0.26) and UK-PBC 5-year (2.87% vs. 2.87%, P = 0.38), 10-year (9.29% vs. 8.2%, P = 0.39) and 15-year liver transplantation rates (16.6% vs. 14.73%, P = 0.39). Lastly, the overall 5-year liver transplantation-free survival rate had no statistically significant difference between the two groups of patients (86.4% vs. 87.5%, P = 0.796). Conclusion: Primary biliary cholangitis had no discernible effect in terms of age at onset, biochemical indices, immunological indicators, cirrhosis proportion, ursodeoxycholic acid response rate after one year, GLOBE score, UK-PBC score, or overall liver transplantation-free survival rate in patients with past hepatitis B virus infections.

Association between obstructive sleep apnea and vascular injury in hypertensive patients / 中华心血管病杂志

Objective: To investigate the relationship between obstructive sleep apnea (OSA), apnea hypopnea index (AHI) and vascular injury in hypertensive patients. Methods: This cross-sectional study enrolled patients admitted to the Hypertension Department of TEDA International Cardiovascular Hospital from April 2020 to April 2023, who finished portable sleep monitoring. Sleep monitoring indicators, flow-mediated vasodilation (FMD), carotid artery ultrasound, carotid intima-media thickness, cervical and femoral pulse wave conduction velocity (cfPWV), brachial and ankle pulse wave conduction velocity (baPWV) were analyzed. OSA was classified into mild (5 times/h≤AHI<15 times/h), moderate (15≤AHI<30 times/h), and severe (AHI≥30 times/h) based on AHI levels. FMD<6.0% was defined as vascular endothelial injury, and cfPWV>10 m/s and/or baPWV>18 m/s was defined as arterial stiffness. Multivariate logistic regression analysis was used to explore the correlation between AHI, OSA severity and vascular injury, and subgroup analysis was performed in young (age≤45 years) and middle-to-old patients (age>45 years). Sensitivity analysis was performed by excluding patients with diabetes, cerebrovascular disease and coronary heart disease. The correlation between AHI and vascular injury index was analyzed by restricted cubic spline. Results: A total of 555 adult hypertensive patients were included, the mean age was (39.7±9.2) years, 422 were males (76.0%), and the prevalence of OSA was 66.7% (370/555). Multivariate logistic regression analysis showed that moderate OSA (OR=2.83, P=0.019) and severe OSA (OR=3.40, P=0.016) were positively correlated with vascular endothelial injury after adjusting for age, sex, body mass index and mean arterial pressure. Subgroup analysis showed that log AHI (OR=1.99, P=0.035), moderate OSA (OR=4.83, P=0.010) and severe OSA (OR=4.64, P=0.015) were associated with vascular endothelial injury in young hypertensive patients. The results of sensitivity analysis were similar to the above results. The results of restricted cubic spline analysis showed that AHI was correlated with FMD (P=0.022), and the slope of the curve was the largest when AHI was between 0 and 10 times/h. There was no correlation between log AHI and OSA severity and carotid intima-media thickening and arterial stiffness (all P<0.05). Conclusions: OSA is associated with vascular endothelial injury in hypertensive patients, especially in young patients.

Association between obstructive sleep apnea and vascular injury in hypertensive patients / 中华心血管病杂志

Objective: To investigate the relationship between obstructive sleep apnea (OSA), apnea hypopnea index (AHI) and vascular injury in hypertensive patients. Methods: This cross-sectional study enrolled patients admitted to the Hypertension Department of TEDA International Cardiovascular Hospital from April 2020 to April 2023, who finished portable sleep monitoring. Sleep monitoring indicators, flow-mediated vasodilation (FMD), carotid artery ultrasound, carotid intima-media thickness, cervical and femoral pulse wave conduction velocity (cfPWV), brachial and ankle pulse wave conduction velocity (baPWV) were analyzed. OSA was classified into mild (5 times/h≤AHI<15 times/h), moderate (15≤AHI<30 times/h), and severe (AHI≥30 times/h) based on AHI levels. FMD<6.0% was defined as vascular endothelial injury, and cfPWV>10 m/s and/or baPWV>18 m/s was defined as arterial stiffness. Multivariate logistic regression analysis was used to explore the correlation between AHI, OSA severity and vascular injury, and subgroup analysis was performed in young (age≤45 years) and middle-to-old patients (age>45 years). Sensitivity analysis was performed by excluding patients with diabetes, cerebrovascular disease and coronary heart disease. The correlation between AHI and vascular injury index was analyzed by restricted cubic spline. Results: A total of 555 adult hypertensive patients were included, the mean age was (39.7±9.2) years, 422 were males (76.0%), and the prevalence of OSA was 66.7% (370/555). Multivariate logistic regression analysis showed that moderate OSA (OR=2.83, P=0.019) and severe OSA (OR=3.40, P=0.016) were positively correlated with vascular endothelial injury after adjusting for age, sex, body mass index and mean arterial pressure. Subgroup analysis showed that log AHI (OR=1.99, P=0.035), moderate OSA (OR=4.83, P=0.010) and severe OSA (OR=4.64, P=0.015) were associated with vascular endothelial injury in young hypertensive patients. The results of sensitivity analysis were similar to the above results. The results of restricted cubic spline analysis showed that AHI was correlated with FMD (P=0.022), and the slope of the curve was the largest when AHI was between 0 and 10 times/h. There was no correlation between log AHI and OSA severity and carotid intima-media thickening and arterial stiffness (all P<0.05). Conclusions: OSA is associated with vascular endothelial injury in hypertensive patients, especially in young patients.

Connective tissue diseases and the liver injury / 中华肝脏病杂志

Connective tissue disease (CTD) are closely related to liver abnormality. CTD can affect the liver causing various degrees of liver injury, coexist with other liver diseases, especially autoimmune liver disease (ALD). Medications for CTD can also lead to liver injury or reactivate the hepatitis B virus. CTD patients can also be positive for ALD-related autoantibodies without corresponding manifestation; and vis versa. The diagnosis and differential diagnosis should be made on integrating clinical presentation, laboratory, imaging, and histological studies, not solely relying on autoantibody positivity.

Effect of Computerized Cognitive Remediation Therapy on Cognitive Function in Female Schizophrenia Patients in Remission / 中国医科大学学报

Objective To investigate the effect of computerized cognitive remediation therapy (CCRT) on cognitive function in female schizophrenia patients in remission. Methods This study included 42 female schizophrenia patients in remission who were treated at Shenyang Mental Health Center between September 2016 and September 2017. Patients were randomly divided into combined therapy and simple drug treatment groups. Patients in the combined therapy group were treated with oral olanzapine plus CCRT, which was used as cognitive therapy for 12 weeks. Those in the simple drug treatment group only received oral olanzapine for 12 weeks. The MATRICS consensus cognitive battery (MCCB) was used to evaluate cognitive function before treatment and 6 and 12 weeks after treatment. Results At12 weeks after treatment, significant differences were observed in symbol coding, digital sequence, spatial span, semantic fluency, continuous operation, speech memory, visual memory, maze, and total scores in the combined therapy group, while significant differences in symbol coding, semantic fluency, spatial span, speech memory, visual memory, and total scores were observed in the simple drug treatment group (all P ＜ 0.05). The MCCB scores in the combined therapy group were higher than those in the simple drug treatment group at 12 weeks after treatment, with statistically significant differences in continuous operation, digital sequence, speech memory, visual memory, maze, and total scores (P ＜ 0.05). Conclusion CCRT can significantly improve cognitive function in female schizophrenia patients in remission.

Effects of bacterial lipopolysaccharide and normobaric hyperoxia on immature brain development of neonatal rat / 中华实用儿科临床杂志

Objective To investigate the effects of lipopolysaccharide (LPS) and / or normobaric hyperoxia on brain development of neonatal rat and the possible mechanisms.Methods One hundred and twenty postnatal day 2 (P2) SD rats were randomly assigned into 4 groups:air group,LPS group,hyperoxia group,LPS + hyperoxia group.General condition and body weight of the rats in each group were observed and recorded every day.The expression of active Caspase-3 and nuclear factor-κappaB P65 (NF-κB P65) in the brain were detected by immunohistochemistry staining on P7,and the level of IL-6 and 8-iso-PGF2α in the brain homogenate were measured by enzyme-linked immunosorbent assay(ELISA).The expression of myelin basic protein (MBP) in the brain was detected by immunohistochemistry staining on P12.Results The expressions of Caspase-3 and NF-κB P65 had the same trends:the number of positive cells from high to low was in LPS + hyperoxia group,LPS group/hyperoxia group,air group.There were significant differences between the first three groups and air group(all P ＜ 0.05).There were also significant differences between LPS + hyperoxia group and LPS group or hyperoxia group(all P ＜0.01).MBP in the brain had the completely reverse expression:from high to low order was in air group,hyperoxia group,LPS group,LPS + hyperoxia group.There were significant differences between the last three groups and air group (all P ＜ 0.05).There were also significant differences between LPS + hyperoxia group and LPS group or hyperoxia group(all P ＜0.01).The level of IL-6 in the brain from high to low order respectively was in LPS + hyperoxia group,LPS group,hyperoxia group,air group;and 8-iso-PGF2α was also in LPS + hyperoxia group,hyperoxia group,LPS group,air group,Significant differences were found among the four groups (all P ＜ 0.05).Conclusions Both postnatal infection and normobaric hyperoxia may induce premature rat brain injury,and increase the number of apoptosis cell and reduce the expression of MBP.The combination of infection and normobaric hyperoxia may aggravate the degree of brain damage of neonatal rat.NF-κB pathway mediated by Toll-like receptor may be involved in inflammation and oxidative stress,and may mediate Caspase-3 related apoptosis of nerve cell and white matter injury.

Risk factors of bronchopulmonary dysplasia in preterm infants with different severities / 中华实用儿科临床杂志

Objective To improve the prevention and treatment of bronchopulmonary dysplasia(BPD) in preterm infants,and the clinical risk factors of premature neonates with different severities of BPD were investigated.Methods A total of 139 cases among preterm infants who were admitted to NICU in the Third Affiliated Hospital of Zhengzhou University from Jan.2007 to Dec.2011 were analyzed retrospectively.The history of birth and mother pregnancy,clinical treatment,prognosis and complication of mild,moderate and severe BPD according to clinical diagnostic criteria were analyzed,respectively.Results Of the total 139 premature neonates,61 cases were diagnosed as mild BPD,48 cases as moderate BPD and 30 cases as severe BPD.No significant differences were found in gender,birth times,fertilization,delivery mode,the percentage of fetal distress and neonatal resuscitation,maternal age,the percentage of pregnancy-induced hypertension,the percentage of antenatal corticosteroids administration and postnatal pulmonary surfactant and combined with patent ducts arteries among the different groups(all P ＞ 0.05).With the increasing severity of BPD,the birth weight and gestational age were decreasing,the percentage of the infants with Apgar 1 minute score ≤7,premature rupture of membranes ≥ 8 hours,maternal perinatal infection,meconium-stained amniotic fluid were increasing(all P ＜ 0.05).And mechanical ventilation,the time of using oxygen,and the percentage of trachea cannula intubation ≥2 times,indwelling gastric tube and red blood cells transfusing,the positive rate of sputum cultures and the blood culture were also increased with the increasing severity of BPD(all P ＜ 0.05).Conclusions Preventing of preterm delivery,control and reduce antenatal and postnatal infection,shorten the duration of mechanical ventilation and usage of oxygen are key factors to reduce BPD and severities in neonatal infants.

Risk factors for periventricular-intraventricular hemorrhage in premature infants treated with mechanical ventilation / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study risk factors for periventricular-intraventricular hemorrhage (PVH-IVH) in premature infants treated with mechanical ventilation.</p><p><b>METHODS</b>A total of 205 premature infants who were admitted to the neonatal intensive care unit (NICU) and treated with mechanical ventilation between January 2009 and December 2011 were enrolled. They were classified into PVH-IVH and non-PVH-IVH groups according to the results of head ultrasonography performed at 3 to 7 days after birth. Single factor and multivariate logistic regression analysis were used to identify risk factors for PVH-IVH.</p><p><b>RESULTS</b>Single factor analysis indicated 9 factors associated with the development of PVH-IVH, including a gestational age of <32 weeks, a birth weight of <1500 g, intrauterine distress, severe asphyxia, vaginal delivery, maternal perinatal infection, premature rupture of membranes (PROM) at ≥8 hours, mechanical ventilation duration of ≥7 days and ventilator-associated pneumonia (VAP) (P<0.05). Multivariate logistic regression analysis showed that a birth weight of <1500 g (OR=2.665), intrauterine distress (OR=2.177), severe asphyxia (OR=5.653), maternal perinatal infection (OR=4.365) and VAP (OR=2.299) were independent risk factors for the development of PVH-IVH (P<0.05).</p><p><b>CONCLUSIONS</b>Very low birth weight, intrauterine distress, severe asphyxia, maternal perinatal infection and VAP are closely associated with an increased risk of PVH-IVH in premature infants treated with mechanical ventilation. These clinical risk factors should be given more attention in the prevention of PVH-IVH.</p>

Clinical analysis of organic acidemia in neonates from neonatal intensive care units / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the clinical features of organic acidemia in neonates admitted to the intensive care unit.</p><p><b>METHODS</b>The clinical features of neonates from 15 neonatal intensive care units of Henan Province, who were diagnosed with congenital organic acidemia by gaschromatography-mass spectrometry (GC-MS) between June 2008 and August 2011 were retrospectively reviewed.</p><p><b>RESULTS</b>Fifty neonates of 287 high risk neonates were confirmed as having or highly suspected to have inborn errors of metabolism. Of the 50 cases, 32 cases were diagnosed with organic acidemia disease, including 28 cases of methylmalonic acidemia, 2 cases of propionic acidemia, 1 case of maple syrup urine disease and 1 case of isovaleric acldemla. In most cases, disease onset occurred in the first week after birth in most of cases (75%). Neonates whose symptoms occurred immediately after or within a few hours of birth presented with serious conditions. Clinical manifestations were various and mainly related to neurologic, respiratory and gastrointestinal symptoms such as poor response, coma, drowsiness, abnormal muscle tone, convulsions, polypnea, dyspnea, milk refusal, diarrhea and jaundice. Initial symptoms were non-specific and included dyspnea, poor response, milk refusal, lethargy and seizures.</p><p><b>CONCLUSIONS</b>Methylmalonic acidemia is a common inherited metabolic disease in the neonatal period. Clinical manifestations of organic acid metabolism abnormalities in neonates are atypical and early onset is associated with more serious conditions.</p>

Perinatal conditions of preterm infants with different severities of respiratory distress syndrome / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To understand the risk factors for respiratory distress syndrome (RDS) by comparing the perinatal conditions of preterm infants with different severities of RDS.</p><p><b>METHODS</b>A total of 667 preterm infants with RDS were classified into 4 groups according to the chest X-ray severity: grade I (217 cases), grade II (225 cases), grade III (126 cases) and grade IV (99 cases). The perinatal conditions of the preterm infants were reviewed retrospectively.</p><p><b>RESULTS</b>There were no significant differences in the gender, the percentage of twins, the percentage of the younger one in twins, maternal age, the percentage of using antenatal corticosteroids, the percentage of premature rupture of membranes, the percentage of placental abruption, the delivery mode and the fertilization mode in preterm infants with different severities of RDS. With the increasing severity of RDS, the birth weight and the gestational age decreased, and the percentage of the infants with Apgar score ≤7 or maternal pregnancy-induced hypertension increased (P<0.05).</p><p><b>CONCLUSIONS</b>The severity of RDS is related to gestational age, birth weight and perinatal asphyxia in preterm infants.</p>

The clinical profiles of primary biliary cirrhosis with a suboptimal biochemical response to ursodeoxycholic acid / 中华肝脏病杂志

To observe the characteristics of primary biliary cirrhosis (PBC) with a suboptimal biochemical response to ursodeoxycholic acid. A total of 38 Chinse PBC patients (5 male patients, 33 female patients, average age 55 years old) with treatment of ursodeoxycholic acid in our hospital from January 1999 to January 2009 were erolled and studied retrospectively. 17 suboptimal biochemical responders mainly presented with liver diseases related symptoms including jaundice (41.1%), fatigue, anorexia (23.5%), edema and abdominal distension (11.7%). 21 good biochemical responders mainly presented with abnormal liver function tests without symptoms. The suboptimal biochemical responders had significantly higher baseline levels of total serum bilirubin, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, immunoglobulin G and globulin as compared to the good biochemical responsers. There were no differences in gender, age and the dose of UDCA. PBC patients with liver diseases related symptoms, marked abnormal liver tests and characteristics of autoimmune hepatitis may have a suboptimal biochemical response to ursodeoxycholic acid treatment.

Integrin 3 mRNA changes after orthodontic teeth movement in periodontitis rats / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To study the integrin beta3 mRNA changes after orthodontic treatment on normal teeth and periodontitis teeth in rats.</p><p><b>METHODS</b>96 adult SD rats of 10 weeks old were randomly divided into normal tooth move-ment group and periodontitis tooth movement group. The rats in the two groups were sacrificed after 0 d, 12 h, 1 d, 3 d, 5 d and 7 d of tooth movement. The alveolar specimens were prepared. The integrin beta3 mRNA were detected using in situ hybridization in the specimens. The OD index of positively stained osteoclasts for integrin beta3 mRNA after orthodontic tooth movement in the two groups were measured and compared.</p><p><b>RESULTS</b>There were weak positive signals on the cytoplasm of osteoclasts in periodontum in both groups after 12 hours and 3 days force activation. No positive signals were detected in the rest samples. There was no difference in the OD of positive stained osteoclasts between normal and periodontitis groups. Strong expressions were present on cells with one or two nuclei in the alveolar marrow.</p><p><b>CONCLUSION</b>It is suggested that integrin beta3 mRNA is related with osteoclasts maturation and migration in orthodontic tooth movement.</p>

Effects of orthodontic force on tumor necrosis factor alpha protein expression in the inflammatory periodontal tissues / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To explore the combined effects of orthodontic force and inflammation on the remodelling of periodontal tissues.</p><p><b>METHODS</b>The upper first molars underwent mesial orthodontic force on 48 rats suffering experimental periodontitis and 48 rats injected lipopolysaccharide, respectively.</p><p><b>RESULTS</b>The TNF-alpha protein expression in the compressed periodontal tissues fluctuated during 0, 2, 12 hours and 2, 7, 14 days stages, the OD value got to the peak in the compressed periodontal tissues in 2 days.</p><p><b>CONCLUSION</b>The mechanical remodelling effects were hindered due to the circumstance of acute or chronic inflammation. The research suggests that the orthodontic treatment to adult patients with periodontal inflammation should be taken carefully.</p>

The integrin beta1 mRNA changes after orthodontic movement of teeth in periodontitis rats / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To study the integrin beta1 mRNA changes after orthodontic tooth movement in normal teeth and periodontitis teeth of rats.</p><p><b>METHODS</b>The OD of positively stained osteoclasts for integrin beta1 mRNA using in situ hybridzation was detected after orthodontic tooth movement in normal teeth and periodontitis teeth groups.</p><p><b>RESULTS</b>Integrin beta1 mRNA expression were detected on all osteoclasts in tooth movement samples of normal and periodontitis teeth. There were stronger positive signals after given orthodontic force in both of the two groups. But no differences were found after 0.5, 1, 2, 3, 5, 7, 10 days since orthodontic tooth movement. The integrin beta1 mRNA signals in normal tooth movement group were not different from that in periodontitis group.</p><p><b>CONCLUSION</b>The integrin beta1 of osteoclasts may play a role in the stability and remodeling of periodontal ligament in orthodontic tooth movement. There were no difference in the OD of integrin beta1 mRNA staining in orthodontic tooth movement between normal teeth group and periodontitis teeth group.</p>