ABSTRACT
Objective:To investigate the evaluation value of optical coherence tomography (OCT) for carotid atherosclerotic plaques.Methods:Patients with carotid atherosclerotic stenosis underwent digital subtraction angiography (DSA) and OCT in the Affiliated Hospital of Jining Medical College from January 2020 to January 2022 were retrospectively enrolled. The demographics, baseline clinical data, DSA and OCT imaging data of the symptomatic group and the asymptomatic group were compared. Multivariate logistic regression analysis was used to determine the independent risk factors for symptomatic carotid atherosclerotic stenosis. Results:A total of 39 patients were enrollded, including 21 in the symptomatic group and 18 in the asymptomatic group. The detection rate of fibrous plaque in the symptomatic group was significantly lower than that in the asymptomatic group (38.1% vs. 77.78%; P=0.023), while the detection rate of plaque rupture (38.1% vs. 5.56%; P=0.023) and macrophage infiltration (42.86% vs. 11.11%; P=0.037) was significantly higher than that in the asymptomatic group. Multivariate logistic regression analysis showed that plaque rupture (odds ratio 6.982, 95% confidence interval 1.068-45.660; P=0.043) and macrophage infiltration (odds ratio 6.480, 95% confidence interval 1.009-41.625; P=0.049) were significantly independently associated with the symptomatic carotid atherosclerotic stenosis. Conclusions:OCT is of value in evaluating the plaque characteristics of carotid atherosclerotic stenosis. Plaque rupture and macrophage infiltration are the independent risk factors for symptomatic carotid atherosclerotic stenosis.
ABSTRACT
Rickettsia felis is a Gram-negative prokaryotic organism that is obligatorically parasitic in cells. Cat fleas are the main vector of Rickettsia felis. Clinical symptoms of human infection with Rickettsia felis include fever, fatigue, headache, macular papules, and eschar. There are few reports of serious complications or deaths due to infection of Rickettsia felis. A confirmed case of severe encephalitis caused by Rickettsia felis infection was admitted to neurology department of Affiliated Hospital of Jining Medical University on January 29, 2020. After comprehensive treatment of antiviral by acyclovir, mannitol dehydration to reduce intracranial pressure, human immunoglobulin to regulateimmunity, minocycline hydrochloride capsule, levofloxacin mesylate and sodium chloride against Rickettsia felis infection, control of seizure and pulmonary infection, the patient's condition was improved and then discharged. By summarizing the experience and lessons in the treatment of this patient, we hope to remind everyone to strengthen the understanding of Rickettsia felis infection.
ABSTRACT
Objective To evaluate the clinical significance of cortical laminar necrosis (CLN) on diffusion-weighted imaging at acute stage of cerebral infarction.Methods 41 patients were retrospectively investigated who were diagnosed acute cerebral infarction in area of middle cerebral artery,and they got diffusion weighted imaging ( DWI ),magnetic resonance angiography ( MRA ) and colored ultrasonic inspection of cervical arteries within 48 hours after onset,with exclusion of cardioembolism,and 5 patients also had digital subtraction angiography (DSA).The patients were classified into CLN positive group or negative group.The stenosis or occlusion of ipsolateral MCA,intracranial and extracranial ICA were compared between the two groups.Results 9 patients'DWI had CLN,among whom 7 patients present moderate or more severe stenosis of feeding artery,and 5 patients who only had CLN signal presented severe stenosis or occlusion.32 patients'DWI had not CLN,among whom 12 patients present moderate or more severe stenosis of feeding artery.The CLN positive group had a high incidence of ipsilateral intracranial ICA and(or) MCA moderate or severe stenosis or occlusion(55.6％ vs 21.9％,x2 =3.85,P ＜ 0.05 ).The 5 patients who only had CLN signal had ipsilateral feeding artery severe stenosis.A positive correlation was found between CLN and moderate or severe stenosis or occlusion of ipsilateral intracranial ICA and(or) MCA(OR:4.5,95％ CI:1.0 ～ 20.2).Conclusion Patients with acute cerebral infarction and CLN on DWI were more likely to suffer from moderate or severe stenosis or occlusion of feeding large artery,and these patients should be evaluated vessel condition.