ABSTRACT
【Objective】 To observe the safety and effectiveness of endovascular treatment for mild stroke patients with acute anterior circulation large vessel occlusion. 【Methods】 The retrospective study enrolled 38 mild stroke patients with anterior circulation large vessel occlusion who received endovascular thrombectomy (EVT) at The First Affiliated Hospital of Xi’an Jiaotong University between January 2018 and August 2021. Vascular recanalization rate after endovascular treatment (mTICI≥2b), procedural complications, NIHSS score at discharge, and the rate of good modified Rankin Score (mRS≤2) at 90d were observed. 【Results】 The average age of the 38 patients was 62.89±12.41 years, and there were 21 males (55.3%). The vascular recanalization rate post EVT was 100%, while with three cases of thrombosis escape (7.9%) and one case (2.6%) of sICH of 24 h post EVT. The average NIHSS at discharge was 1 (0-1) point, which significantly decreased compared to the average baseline NIHSS 4 (4-5) points (P<0.01). The 90 d followed-up rate was 89.47%, and among all the followed-up patients, 91.2% of them had mRS≤2. Imaging follow-up showed good vascular flow and no in-stent restenosis. 【Conclusion】 Endovascular treatment for acute anterior circulation large vessel occlusion in mild stroke is safe and effective.
ABSTRACT
Objective:To explore the possible mechanism of exacerbation of anxiety-like behavior in db/db mice after distal middle cerebral artery occlusion (dMCAO).Methods:The db/db mice was used to establish a type 2 diabetes mellitus model. Meanwhile, heterozygous db/+ mice and C57 wild-type (WT) mice were chosen as double control groups. Then a permanent distal middle cerebral artery occlusion model was employed as an acute ischemic stroke model. The blood glucose levels before and post-dMCAO surgery on day1, day3, and day5 were detected. The brain tissue loss at 35 days after stroke was measured by immunofluorescent staining of MAP2. The open-field test was performed to estimate anxiety-like behavior and general motor and exploring ability of the animals. Axons and myelin were immunostained with non-phosphorylated neurofilaments (SMI32) and myelin basic protein (MBP), respectively, to evaluate differences in white matter integrity in WT, db/+ and db/db mice 35 days after stroke. The correlation between SMI32/MBP and open field test parameters (time in center and corner) was analyzed. Flow cytometry was employed to detect the amount of T cells and B cells, including regulatory T cells (Tregs) in the brain tissue.Results:Blood glucose levels in db/db mice were significantly higher than db/+ mice and WT mice in both sham and dMCAO groups ( P<0.01). There was no significant difference in brain tissue loss 35 days post-stroke among db/db mice, db/+ mice, and WT mice. In the open field test, there were significant differences in the total distance of db/db mice, db/+ and WT mice in the sham and dMCAO groups. Db/db mice shorter than db/+ mice ( P<0.05), WT mice ( P<0.01), and db/+ mice shorter than WT mice ( P<0.05). There were significant time differences in the center among db/db, db/+, and WT mice in sham and dMCAO groups. In both the sham and dMCAO groups, db/db mice spent less time in the center area of the open field than WT mice ( P<0.01). In the sham group, db/+ mice spent less time in the center area than WT mice ( P<0.05). In dMCAO group, db/db mice spent less time in the center area than db/+mice ( P<0.05), and db/+ mice spent less time in the center area than WT mice ( P<0.01). For the time in the corner, in both the sham and dMCAO groups, db/db mice and db/+ mice consumed more time than WT mice ( P<0.01 or <0.05). In the dMCAO group, db/db mice spent more time in the corner than db/+ mice ( P<0.05). Referring to white matter injury, an increased SMI32/MBP ratio in EC area and CTX area (data was not shown in this article) after dMCAO in db/db, db/+ and WT mice were detected. In EC area, db/db mice have a higher SMI32 ratio than db/+ mice and WT mice: 4.24 ± 0.37 vs. 1.96 ± 0.37, 1.80 ± 0.36, both have significant differences ( P<0.01). For db/db mice and WT mice, the SMI32/MBP ratio negatively correlates with time in center and positive correlation with time in the corner. Three days after dMCAO, the total cells of CD 3+ T cells, CD 8+ cells, Tregs, in db/db mice group have significantly decreased compared to WT group: 4 079 ± 1 345 vs. 70 055 ± 3 374, 141.30 ± 28.36 vs. 2 714.00 ± 463.20, 148.00 ± 61.15 vs. 3 007.00 ± 639.90 ( P<0.01), while B cell has no change between two groups. Conclusions:By comparing the severity of anxiety-like behavior of db/db mice, the severity of white matter injury, and the number of T cells and B cells in brain tissue after dMCAO, immune-mediated brain white matter injury may aggravate db/db mice′s post-dMCAO anxiety-like behavior. Due to the gene dose effect, db/+ mice are not suitable as a control group for db/db mice in animal experiments involving anxiety-like behavior assessment.
ABSTRACT
Objective@#To analyze the distribution of the regulator of G protein signaling 2 (RGS2) gene C1114G polymorphism in children with vasovagal syncope (VVS) and the associated clinical classification groups, and to explore the association between RGS2 C1114G and VVS.@*Methods@#This was a prospective case-control study. A head-up tilt test (HUT) was performed in 300 children visiting Children's Hospital Affiliated to Shanghai Jiaotong University from August 2010 to December 2015 for unexplained syncope. A total of 150 children with positive HUT and a diagnosis of VVS were enrolled and assigned to the VVS group. The VVS group was further divided into 3 subgroups based on characteristics of the heart rate and blood pressure measured during the HUT. A total of 150 children with negative HUT were enrolled and assigned to the HUT-negative group. A total of 150 healthy children were enrolled as the normal control group for genetic polymorphism detection. The clinical characteristics of patients in the VVS group and the HUT-negative group were recorded. Peripheral blood samples of each case were collected. RGS2 C1114G polymorphism was evaluated using high-resolution melting curve and polymerase chain reaction together with gene sequencing. The genotype and allele frequency were analyzed and compared among different groups (VVS, HUT-negative, and normal control) and VVS subgroups. Comparisons among groups were performed using Chi-square test.@*Results@#Patients in the VVS group (48 males and 102 females, aged (10.1±3.2) years) were more frequently female (68.0% vs. 57.3%;χ2=5.090, P=0.024) compared with patients in the HUT-negative group (67 males and 83 females, aged (10.8±2.2) years). No significant difference was found regarding the distribution of the CC genotype, CG genotype and GG genotype among the VVS group (n=98, 65.3%; n=36, 24.0%; n=16, 10.7%), the HUT-negative group (n=112, 74.7%; n=28, 18.7%; n=10, 6.7%) and the normal control group (n=108, 72.0%; n=31, 20.7%; n=11, 7.3%) (χ2=3.632, P=0.458). There was no significant difference in the frequencies of C allele and G allele in the VVS group (n=232, 77.3%; n=68, 22.7%), the HUT-negative group (n=252, 84.0%; n=48,16.0%) and the normal control group (n=247, 82.3%; n=53, 17.7%) (χ2=4.659, P=0.097). The 150 children in the VVS group were further divided into the mixed-response subgroup (n=83), vasodepressor-response subgroup (n=42) and cardioinhibitory-response subgroup (n=25). The CC genotype, CG genotype and GG genotype in the mixed-response subgroup, the vasodepressor-response subgroup and the cardioinhibitory-response subgroup were (n=65, 78.3%; n=16, 19.3%; n=2, 2.4%), (n=20, 47.6%; n=11, 26.2%; n=11, 26.2%) and (n=13, 52.0%; n=9, 36.0%; n=3, 12.0%), respectively. The frequencies of C allele and G allele in the mixed-response subgroup, the vasodepressor-response subgroup, and the cardioinhibitory-response subgroup were (n=146, 88.0%; n=20, 12.0%), (n=51, 60.7%; n=33, 39.3%) and (n=35, 70.0%; n=15, 30.0%), respectively. The percentages of the GG genotype and G allele were significantly higher in the vasodepressor-response subgroup than the other two subgroups (χ2=21.698, 25.345, all P=0.000).@*Conclusions@#No significant association was found between RGS2 C1114G polymorphism and VVS in children. Due to the higher distribution of GG genotype and G allele in the vasopressor-response subgroup, RGS2 C1114G may be associated with the regulation of blood pressure during the onset of VVS in children.
ABSTRACT
Objective To explore the value of transesophageal atrial pacing (TEAP) and temporary cardiac pacing in the treatment of acute intractable tachyarrhythmia in children. Method The clinical data of children with acute intractable tachyarrhythmia treated with TEAP (48 cases) or temporary cardiac pacing (6 cases) from January 2014 to December 2017 were retrospectively analyzed. Results In the 48 cases aged 1 day to 13 years (28 males and 20 females) treated with TEAP, 25 cases had paroxysmal supraventricular tachycardia, in which there were 15 cases of rapid atrial flutter, 5 cases of atrial tachycardia and 3 cases of left ventricular idiopathic bundle branch reentrant tachycardia. The rates of successful cardioversion to sinus rhythm through TEAP were 84％, 80％, 20％ and 100％ respectively. In the 6 cases aged 2 to 10 years (1 male and 5 females) treated with temporary cardiac pacing, there were 5 cases of fulminant myocarditis and 1 case of noncompaction of the ventricular myocardium and their conditions were well controlled after treatment. Conclusion TEAP and temporary cardiac pacing have good curative effect in the treatment of acute intractable tachyarrhythmia in children. However, temporary electricity therapy can only temporarily rectify the hemodynamic abnormality threatening the life of children, and active comprehensive treatment for the primary diseases should be carried out simultaneously.
ABSTRACT
Objective To explore clinical characteristics of J wave syndromes. Methods Clinical data was retrospectively analyzed in a child with fainting and showing big J wave in ECG. Meanwhile, related literatures were reviewed. Results A 10-year-old boy was admitted to hospital with fainting. ECG showed J point up, reflecting Osbron wave. There was no abnormality in EEG and cranial CT. Ultrasound cardiograph showed approximately normal heart structure and left ventricular systolic function. Fainting was frequently occurred during follow-up and accompanied by malignant arrhythmia. Conclusions Patients with J wave syndromes has high risks of malignant arrhythmia and sudden cardiac death.
ABSTRACT
Objective To survey an outbreak of surgical site infections in a neurosurgery ward of a tertiary hospital. Methods The patients of surgical site infection were investigated individually based on a uniformly designed epidemiological survey form. The distribution of cases was analyzed by characteristic epidemiology,and a case-control study was carried to explore the risk factors. Results A total of 9 patients with surgical site infections from February 5 to March 7,2014 were identified in 68 patients who had received surgery in a neurosurgery ward,yielding a prevalence of 13.24%. The infections occurred in 7 of 14 patients who had used surgicel,a hemostatic agent,and in 2 of 54 patients who had not used surgicel. (χ=16.637,P<0.001). Conclusion The use of surgicel may be the cause of this surgical site infection outbreak.
ABSTRACT
Objective To investigate the epidemiological characteristics of children with epilepsy in the people's hospital of Guizhou province.Methods The clinical data of 860 children ( below 14 years old ) with epilepsy diagnosed by the people's hospital of Guizhou province was collected.After followed-by for 1 year, the curative effect was evaluated according to the change of seizure frequency after treatment.And the results were statistically analyzed.Results The clinical characteristics of children in the people's hospital of Guizhou province showed main part of children were 1-3 years old, and most of them were male;neonatal asphyxia and fetal distress were the leading perinatal causes in children with epilepsy, 5.26%children had family history of epilepsy.The result showed that 57.23% children came from rural areas, and the related indexes which had significant differences in children age, history of birth, birth method, fetal distress function, elderly primiparous and pregnancy medication history between rural and city children ( P<0.05 -0.01).Poor compliance of therapy was the risk factor of prognosis in children with epilepsy (OR=0.06, 95%CI:0.023-0.152, P<0.01).Conclusions Children in the people's hospital of Guizhou province are mainly 1 -3 years old, and most of them were male and rural.Good medication compliance is the key factor to affect the prognosis.Improvement of rural production conditions and enhanced health education during pregnancy may reduce the incidence of rural children with epilepsy.
ABSTRACT
OBJECTIVE:To investigate the clinical efficacy and safety of rh-endostatin combined with cantharidin sodium vita-min B6 in the treatment of advanced non-small cell lung cancer (NSCLC). METHODS:180 patients diagnosed as advanced NSCLC were divided into group A,group B and group C ,with 60 cases in each group according to random number table meth-od. 3 groups were all given gemcitabine+cisplatin(GP)chemotherapy plan;Group B additionally received Rh-endostatin injection 7.5 mg/m2 intravenously for 3 h,d1-14;group C was additionally given Cantharidin sodium vitamin B6 injection 40 ml intrave-nously,qd,d1-14,on the basis of group B. every 21 days for a cycle,evaluation of therapeutic effect after 2 cycles. The clinical benefit rate,quality improvement rate of life,time to progression (TTP) and the occurrence of ADR were observed in 3 groups. RESULTS:The clinical benefit rate of groups A,B and C were 40.0%,58.3%,71.6% respectively,the quality improvement rate of life in 3 groups were 28.3%,41.7%,56.7% respectively,the differences were statistically significant among those groups(P0.05). The rates of leukopenia,thrombocytopenia,nausea and vomiting in group C were significantly lower than those of group A and B,with statistical significance(P0.05). CONCLU-SIONS:Rh-endostatin combined with cantharidin sodium vitamin B6 can significantly improve the effectiveness of chemotherapy in patients with advanced NSCLC on the basis of the GP chemotherapy,while reduce the toxicity of chemotherapy drugs,improve the quality of life and prolong the survival time.
ABSTRACT
Objective To examine the effects of intravenous thrombolysis with Tissue-type plasminogen activator (rt-PA) combined with mild hypothermia therapy on patients with acute cerebral infarction and further investigate under?lying mechanism for the treatment of cerebral infarction. Methods Sixty cases of cerebral infarction patients were random?ly divided into three groups with 20 patients in each group:①The control group was given rt-PA intravenous thromboly?sis;②The treatment group 1:intravenous thrombolytic therapy combined with local mild hypothermia treatment for 12 h;③The treatment group 2:intravenous thrombolytic therapy and local mild hypothermia in the treatment of 24 h. We col?lected NIHSS score before and after thrombolytic therapy, patient monitoring (ICP) changes during thrombolytic therapy, March (MRS) score and complications during follow-up after thrombolysis, The serum levels of SOD and MDA were as? sessed before and after thrombolytic therapy. Results NIHSS score was lower in both treatment group 1 and treatment group 2 than in the control group (P0.05). Conclusion Rt-PA intravenous thrombolysis combined with mild hypothermia treatment can improve the prognosis of patients with cerebral infarction without increasing the inci?dence of adverse reactions. In addition, thrombolysis combined with mild hypothermia 24 h has better effect than with mild hypothermia 12 h. The beneficial effects may be accomplished by reducing oxidative stress reaction.
ABSTRACT
Objective To explore the factors related to vasovagal syncope (VVS) in children. Methods The clinical data of 125 children with conifrmed VVS were collected. According to the frequency of syncope during the ifve years from ifrst episode to the time of head-up tilt test, the children with 2 or 3 episodes of syncope were assigned into the low episode group, and the children with 4 or more episodes of syncope were assigned into the high episode group. The two groups were analyzed and compared. Results Among the 125 children, 84 children (67.2%) were in the low episode group and 41 children (32.8%) were in the high episode group. The single factor analysis showed that the age at head-up tilt test, onset of syncopal, causes of syncope, history of carsickness, and positive family history were associated with high attack frequency. The results of non-conditional logistic regression analysis showed that causes of syncope (OR?=?3.723, 95%CI:1.163-11.918, P?=?0.027), history of carsickness (OR?=?5.929, 95%CI:2.066-17.015, P?=?0.001), and positive family history (OR?=?6.794, 95%CI:2.006-23.013, P?=?0.002) were the independent risk factors of high attack frequency. Conclusions The causes of syncope (excluding persistent standing), history of carsickness, and positive family history have important clinical signiifcance in predicting high attack frequency of VVS in children.
ABSTRACT
ObjectiveTo explore the relation of heart rate variability (HRV) in neonatal asphyxia with myocardial injury.MethodsContinuous electrocardiographic monitoring by 24-hour Holter recordings was performed in 53 neonates with asphyxia and 40 healthy newborn.The difference of HRV with sinus rhythm was analyzed.Time-domain indexs included standard deviation of R-R intervals (SDNN) ; standard deviation of all mean 5-minute R-R intervals (SDANN) ;standard deviation of all R-R intervals for all 5-minute segments of 24 hours (SDNNindex ) ;root mean squared successive difference (rMSSD) ;percent of NN50 in the total number R-R intervals ( PNN50 ).Results( 1 ) Maximum heart rate,minimum heart rate and average heart rate of 24-hour Holter in healthy newborn were faster than those in newborn with neonatal asphyxia ( P ＜ 0.05 ).And the heart rate was faster in newborn with mild neonatal asphyxia than that in newborn with serious neonatal asphyxia ( P ＜ 0.05 ).(2) SDNN,SDANN of HRV index analysis showed significantly difference between healthy newborn and asphyxia newhom ( P ＜ 0.05 ).There were no difference of SDNN,SDANN,SDNNindex,rMSSD and PNN50 between mild and serious neonatal asphyxia (P ＞ 0.05 ).No significant differences of SDNNindex,rMSSD and PNN50 were found among three groups.ConclusionMyocardial injury caused by neonatal asphyxia can lead to damage of cardiac autonomic nevous and affect heart rate changes.The degree of myocardial injury is related to the degree of neonatal asphyxia.
ABSTRACT
Objective To study the regulation effect of estrogen in expression of matrix metalloproteinase-9 (MMP-9) in the central nervous system (CNS) in mice with experimental autoimmune encephalomyelitis ( EAE).Methods The 60 mice were overiectomized and 2 weeks later EAE was induced with MOG35-55 peptide in these mice.They were divided into a treatment group and a control group.The treatment group was treated with estrogen and the control group was given PBS.Clinical symptoms in these two groups were scored and compared.HE staining was used to observe inflammation in the brain and spinal cord.The MMP-9 expression in the CNS was examined by quantitative real-time PCR and immunofluorescence staining.Results The incidence of disease was lower (treatment and control group were 8/30 and 28/30 respectively) and clinical symptoms were milder (treatment and control group were 3.23±0.83 and 1.62 ±1.00 respectively,t=3.811 and P＜0.05) in the treatment group than those in the control group.HE staining showed the decreased infiltration of inflammatory cell in the treatment group (Treatment group:inflammatory score were 0.895 ±0.206,0.752 ±0.302,0.732 ±0.183 in acute,relief and chronic phase respectively;Control group:inflammatory score were 3.472 ±0.635,2.881 ±0.662,1.891 ± 0.482 in acute,relief and chronic phase respectively.t = 8.622,6.543 and 5.027,all P ＜ 0.05).The quantitative real-time PCR and immunofluorescence staining showed that the expression of MMP9 in the CNS was decreased in the treatment group.Conclusion Estrogen may decrease MMP-9 expression in the CNS,reduce inflammation and clinical symptoms in mice with EAE.
ABSTRACT
Ohjective To investigate the associations between the Arg389Gly polymorphism of the β_1-adrenergiecreceptor gene (ADRB1) and vasovagal syncope (VVS) in Chinese children. Methods Genotype of ADRB1 was determined by polymerase chain reaction-restriction fragment length pelymorphism analysis. Case-control studies and quantitative trait analysis were carried out by comparing between carriers (one or two copies of the Gly389 allele) and non-carriers (Arg389 genotype) of the ADRBI in 54 patients with unexplained syncope and in 54 healthy control subjects. Patients were subdivided into two groups according to head up tilt test (HUTT) : positive HUTT, known as VVS group and negative HUTT group. Distribution of Arg389Gly genetype in VVS group and the relationship to three clinical patterns were also analyzed. Results An allele frequency of Arg389 was 73.15% and Gly389 was 26.85% in healthy subjects. Higher Gly389 allele frequency was found in VVS group (n = 30) than that in negative HUTT group (33.33% vs. 14.58%, P < 0.05). In VVS group, the frequencies of the Gly389 allele in cardioinhibitory pattern (n = 6), mixed pattern (n = 9) and vasodepressor pattern (n = 15) was 66.67%, 33.3% and 23.33%, respectively, which had significant differences between the cardioinhibitory pattern from any of the other two patterns (both P < 0.05). Conclusions An association of positive HUTT with a single nucleotide pelymorphism of Gly to Arg switch at position 389 of the ADRB1 was found. This polymorphism may contribute to susceptibility to VVS.
ABSTRACT
Objective To control medical expenses in a rational and effective way by analyzing the main factors influencing hospitalization expenses in TCM hospitals. Methods Based on ICD 10 codes, the top 50 disease entities causing hospitalization, as had been accumulated over the years, were extracted from the hospitalization record data warehouses of the national TCM supervision networks using nationally representative medical record databases, the main factors influencing hospitalization expenses were identified using multi layer BP neural network, and further analyses were made by disease entities and hospital grades. Results When disease entity mix analyses were conducted, it was found that the variables most influencing hospitalization expenses/days were hospital code and disease entity while variables specific to TCM had little influence on the expenses. The results were also true of analyses made by hospital grades and disease entities. Conclusion Under the current circumstances in China, the influence on hospitalization expenses resulting from the difference between hospitals is far greater than any other factor; it is even greater than that resulting from the difference between disease entities. It is therefore imperative to pay attention to the extensiveness and coverage of data sources when conducting research on the control of medical expenses.