ABSTRACT
Objective To investigate the predictive value of thromboelastography (TEG) parameters for hematoma enlargement after intracerebral hemorrhage.Methods Patients with primary intracerebral hemorrhage within 6 h after onset admitted to the Second People's Hospital of Changshu between March 2016 and March 2018 were enrolled prospectively.Hematoma enlargement was defined as the volume of hematoma detected by CT within 48 h after onset increased by ＞ 12.5 cm3 or ＞ 33％ compared with that at admission.The baseline data in the hematoma enlargement group and the non-hematoma enlargement group were compared.Multiple logistic regression analysis was used to determine the independent correlation between TEG parameters and hematoma enlargement.The receiver operating characteristic (ROC) curve was used to analyze the predictive value of TEG parameters for hematoma enlargement.Results A total of 141 patients with intracerebral hemorrhage were enrolled,of which 38 (27.0％) had hematoma enlargement.Compared with the non-hematoma enlargement group,the baseline National Institutes of Health Stroke Scale score (P =0.001),thrombin time (P =0.022),fasting blood glucose (P =0.007),hematoma ruptured into the ventricle (P =0.001),baseline hematoma volume (P =0.001),and coagulation reaction time measured by TEG (P=0.002) were significantly increased in the hematoma enlargement group,while the baseline Glasgow Coma Scale score (P =0.001) and α angle measured by TEG (P =0.021) were significantly decreased.Multivariate logistic regression analysis showed that after adjusting confounding factors,the prolonged coagulation reaction time (odds ratio [OR] 3.436,95％ confidence interval [CI] 1.083-9.905;P =0.036) and decreased α angle (OR 0.777,95％ CI0.656-0.921;P =0.004) were the independent predictors of hematoma enlargement after intracerebral hemorrhage.The area under the curve of coagulation reaction time predicting hematoma enlargement was 0.680 (95％ CI 0.588-0.772;P =0.004),and the sensitivity and specificity were 84.2％ and 52.4％ when 4.0 min was the cut-off value.The area under the curve of α angle predicting hematoma enlargement was 0.636 (95％ CI 0.534-0.738;P =0.007).The sensitivity and specificity were 73.7％ and 57.3％ when the cut-off value was 65.1 °.Conclusion The prolonged coagulation reaction time and the decrease of α angle detected by TEG had certain predictive value for hematoma enlargement after cerebral hemorrhage.
ABSTRACT
Objective To systematically review the short-term and long-term efficacy of eversion carotid endarterectomy (eCEA) and patch carotid endarterectomy (pCEA) for the treatment of carotid artery stenosis.Methods The published literature on eCEA and pCEA control studies in medline,PubMed,Ovid,CNKI and CBM (1970.5-2016.10) databases were retrieved by computers.Two reviewers selected literature and extracted data independently according to the inclusion and exclusion criteria.Cochrane Collaboration Network Special Software Rev Man 5.2 was used to analyze the meta-analysis of short-term and long-term outcome measures.Results A total of 1 137 articles were retrieved.Ten studies were included and analyzed (3 of them were randomized controlled trial).A total of 3 213 patients were enrolled,including surgical intervention 3 299 case/time (1 512 in the eCEA group and 1 787 in the pCEA group).The results of meta-analysis showed that:(1) the mean operative time in the pCEA group was shorter 22±8 min than that in the pCEA group.The intraoperative utilization ratio of shunt tube,eCEA was significantly lower than pCEA,they were 12.6 %(53/421) and 50.2% (357/711) respectively (OR,0.11,95%CI 0.08-0.15,P<0.01).The postoperative incidence of stroke within 30 d (OR,0.42,95%CI 0.23-0.76,P=0.004) and the incidence of stroke after 30 d in eCEA were lower than those in pCEA (OR,0.26,95%CI 0.09-0.78,P=0.02).There was significant difference.(2) eCEA reduced the incidence of restenosis at day 30 after procedure (OR,0.57,95%CI 0.38-0.86,P=0.008).Conclusion Compared with pCEA,eCEA has the advantages of reducing the operation time and lowering the utilization rate of shunt tube.At the same time,eCEA can reduce the occurrence of stroke within 30 d and 30 d after procedure,and significantly reduce the incidence of restenosis.
ABSTRACT
Objective:To explore changes of central retinal vascular caliber and fractal dimension (Df) and their cor‐relation with blood pressure in hypertensive population .Methods :A total of 2169 subjects>30 years old were en‐rolled in this cross‐sectional study .They were divided into hypertension group (n=819) and non‐hypertension group (n=1350) .Fundus photos were collected in all subjects ,and semi‐automatic software was used to quantitatively ana‐lyze central retinal vascular caliber and Df ,and they were compared between two groups .Results:Compared with non- hypertension group ,there were significant reductions in central retinal arteriolar equivalent [CRAE ,(135.2 ± 10.72) μm vs .(132.25 ± 11.56) μm] ,central retinal venular equivalent [CRVE ,(184.95 ± 16.29) μm vs . (182.52 ± 17.07)μm] and Df [ (1.38 ± 0.05) vs .(1.34 ± 0.05)] in hypertension group , P5 years group was significantly lower than that of ≤5 years group [ (1.33 ± 0.05) vs .(1.35 ± 0.05)] , P<0.01. Conclusion:CARE ,Df are significantly in‐versely correlated to SBP ,DBP and PP in hypertensive population ,while correlation of Df is most .
ABSTRACT
Objective: To explore the relationship of plasma apelin and angiotensin II (Ang II) with hypertension and hypertension caused early renal damage in order to provide the information for hypertension treatment. Methods: A total of 671 participants were enrolled in this cross-sectional community investigation. All participants were above 30 years of age with local residency longer than 5 years and were divided into 2 groups: Control group,n=354 non-hypertension subjects and Hypertension group,n=317 patients with essential hypertension. The levels of apelin, Ang II, urine creatinine and urinary albumin were examined. The relationship between blood pressure and the ratio of urinary albumin to urine creatinine (UACR) and the relationship between blood pressure and apelin, Ang II were studied by Pearson correlation analysis and multi linear regression analysis. Results: Compared with Control group, Hypertension group had the lower levels of apelin and higher UACR, both P<0.01. The mean arterial pressure (MAP) was negatively related to Ln (apelin), positively related to Ln (Ang II), bothP<0.01. With adjusted gender, age and blood lipids, the above relationship still existed. In Hypertension group, the patients combining with the early renal damage had the lower level of apelin and higher level of Ang II, bothP<0.01. The relevant analysis indicated that Ln (UACR) was negatively related to Ln (apelin), positively related to Ln (Ang II), bothP<0.01. With adjusted gender, age, MAP and blood lipids, the above relationship still existed. Conclusion: The patients with hypertension or hypertension caused early renal damage have decreased apelin. Apelin is negatively related to Ang II, therefore, apelin might be used as a target for hypertension treatment in clinical practice.
ABSTRACT
Objective]To measure and compare the MRI artifacts caused by common metal ic dental materials and common ceramic dental materials on different field-strength magnets.[Methods] A total of 3 common metal ic dental materials and 2 common ceramic dental materials were tested with 0.35T, 1.5T and 3.0T MR imagers. The artifact areas on these 3 different field-strength magnets were measured and statistical y compared. [Results]Zirconia in three field magnetic resonance(NMR) in T1 and T2 as no artifacts, casting porcelain, metal al oy, nickel chromium al oy and CoCr-al oy in three fields magnetic resonance(NMR) in T1 and T2 as al can produce different degree of artifacts, and artifacts area increased in turn. Cobalt chromium al oy and nickel chromium al oy measurements on the high side, the cobalt chromium al oy than other four kinds of materials on the high side( P<0.05),high nickel-chromium al oy was precious metal al oy, casting porcelain( P<0.05). [Conclusions]Commonly used metal ic dental materials could cause MR artifacts and image degradation. Compared with that on 0.35T, the artifact was increased on 1.5T magnet. Compared with that on 1.5T, the artifact was increased on 3.0T magnet.
ABSTRACT
Objective To investigate the association of urinary albumin-to-creatinine ratio (UACR) and the diameter of retinal vessel in population with essential hypertension in Fujian coastal area.Methods Central retinal artery and vein equivalents (CRAE and CRVE) were measured from the avoiding mydriatic digitized photographs and semi-automatic fundus analysis software,as well as albumin and urine creatinine.Results There were significant differences in CRAE levels among the normal control group,normoalbuminuria with essential hypertension group and microalbuminuria with essential hypertension group [(135.68 ± 10.10) μm,(129.79 ± 10.48) μm,(125.29 ± 11.17) μm,all P values ＜0.01].The CRAE levels were significantly negative correlated with UACR (r =-0.29,P ＜ 0.01).Linear regression analysis showed CRAE was associated with UACR in the patients with hypertension(β =-5.0,P ＜ 0.01).Logistic regression analysis showed,systolic blood pressure (β =1.08,P =0.02) was risk factor for CRAE abnormality.The CRAE abnormality was increased in turn in the normal control group,normoalbuminuria with the essential hypertension group and microalbuminuria with essential hypertension group (P ＜ 0.01).Conclusion The reduction of central retinal artery diameter are associated with the hypertensive renal damage.UACR and CRAE could be used to evaluate the microvascular lesions and be used as an indicator to assess the target organs damage in essential hypertension patients.
ABSTRACT
Two hundred and five patients with hypertensive intracerehral hemorrhage (HICH) received mini-puncture hematoma scavenging technique (MPST; n=80), traditional craniotomy operation (TCO; n=78), or medicine expectant treatment (MET; n=47), respectively. Clinical data demostrated that consciousness level and Glasgow Coma Scale (GCS) was more obviously improved in the MPST group,while postoperative complication rate was relatively lower. The MPST group and TCO group saw no significant difference in over-all matality, although both were significantly lower than the MET group. Severe disability rate in the MPST group was significantly decreased. In comparison with the TCO or MET group, 1 to 3 class activity of daily life score, language function recovery and response rate in the MPST group significantly improved (all P<0.05). We suggest that because of lower severe disability rate, less postoperative complications, and improved quality of life, MPST should be a better treatment of choice for HICH patients.