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Objective To assess the relationship between hemoglobin A1c (HbA1c) and hemorrhagic cerebral infarction (HI) in patients with acute cerebral infarction.Methods From January 2014 to June 2016,in the Lianyungang Hospital Affiliated to Xuzhou Medical University,426 patients with acute anterior circulation infarction were included.The blood sugar status before stroke was expressed by HbA1c.HbA1c and fasting blood glucose (FBG) were measured on the second day after admission.The National Institutes of Health Stroke Scale (NIHSS) was used to assess the severity of neurological function at admission.The modified Rankin scale (mRS) was used to evaluate the prognosis at discharge.CT or MRI/SWI examination was performed to determine whether there was HT.Logistic regression was used to evaluate the risk factors for HT and short-term prognosis after cerebral infarction.Results Of the 426 patients enrolled,93 (21.8％) appeared HT,60 (14.1％) had hemorrhagic cerebral infarction (HI) and 33 (7.7％) had parenchymal hemorrhage (PH).Multivariate analysis showed that HbA1c and infarct volume were independent predictor of HT.When patients were grouped according to fasting blood glucose (FBG ＜ 7.8 mmol/L or ≥ 7.8 mmol/L),the predictive effect of HbA1c on HT was found in both groups.In multiple Logistic regression analysis,HbA1c was also a predictor of poor prognosis after stroke (OR =1.482,95％ CI 1.228-1.788).Conclusions In patients with ischemic stroke,elevated HbA1c is independently associated with post-infarction HT,and this result doesn't change even in patients with well-controlled blood glucose.HbA1c is also a predictor of poor prognosis after stroke.These findings are important for blood glucose management in patients with diabetes and acute anterior circulation infarction.
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Objective@#To assess the relationship between hemoglobin A1c (HbA1c) and hemorrhagic cerebral infarction (HI) in patients with acute cerebral infarction.@*Methods@#From January 2014 to June 2016, in the Lianyungang Hospital Affiliated to Xuzhou Medical University, 426 patients with acute anterior circulation infarction were included. The blood sugar status before stroke was expressed by HbA1c. HbA1c and fasting blood glucose (FBG) were measured on the second day after admission. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the severity of neurological function at admission. The modified Rankin scale (mRS) was used to evaluate the prognosis at discharge. CT or MRI/SWI examination was performed to determine whether there was HT. Logistic regression was used to evaluate the risk factors for HT and short-term prognosis after cerebral infarction.@*Results@#Of the 426 patients enrolled, 93 (21.8%) appeared HT, 60 (14.1%) had hemorrhagic cerebral infarction (HI) and 33 (7.7%) had parenchymal hemorrhage (PH). Multivariate analysis showed that HbA1c and infarct volume were independent predictor of HT. When patients were grouped according to fasting blood glucose (FBG<7.8 mmol/L or ≥ 7.8 mmol/L), the predictive effect of HbA1c on HT was found in both groups. In multiple Logistic regression analysis, HbA1c was also a predictor of poor prognosis after stroke (OR=1.482, 95% CI 1.228 -1.788).@*Conclusions@#In patients with ischemic stroke, elevated HbA1c is independently associated with post-infarction HT, and this result doesn′t change even in patients with well-controlled blood glucose. HbA1c is also a predictor of poor prognosis after stroke. These findings are important for blood glucose management in patients with diabetes and acute anterior circulation infarction.
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OBJECTIVE:To investigate the effects of TanshinoneⅡA sodium sulfonate injection on levels of P-selectin,glial fi-brillary acidic protein (GFAP),vascular endothelial growth factor (VEGF) and neurological function in patients with acute cere-bral infarction. METHODS:A total of 114 patients with acute cerebral infarction selected from Lianyungang First People's Hospi-tal during Apr. 2013-Apr. 2016 were divided into control group and observation group according to random number table,with 57 cases in each group. Control group was given routine treatment. Observation group was additionally given Tanshinone ⅡA sodium sulfonate injection 40 mg 0.9％ sodium chlonride injection 250 mL,ivgtt,qd. A treatment course lasted for 7 d,and both received 2 courses of treatment. NIHSS scores,the levels of serum P-selectin,GFAP and VEGF were compared between 2 groups before treatment and after 7,14 d of treatment. The occurrence of ADR was also compared. RESULTS:Before treatment,there was no statistical significance in above indexes between 2 groups(P>0.05). Compared to before treatment,NIHSS score,the levels of se-rum P-selectin and GFAP in 2 groups were decreased significantly after 7,14 d of treatment,while the serum level of VEGF was increased significantly. These indexes of 2 groups after 14 d of treatment were significantly better than 7 d of treatment,except for NIHSS score. Above indexes of observation group was significantly better than those of control group during corresponding period, with statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:For acute cerebral infarction, Tanshinone ⅡA sodium sulfonate injection can significantly reduce the levels of serum P-selectin and GFAP,improve VEGF level and promote the recovery of neurological damage with good safety.
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ObjectiveToinvestigatethecorrelationbetweenbloodpressurevariabilityandcognitive impairment in ischemic stroke. Methods The inpatients with acute ischemic stroke were enroled. The demographic and clinical data were colected. The coefficient of variation of blood pressure within 7 days after onset w as calculated. Montreal Cognitive Assessment w as used to evaluate the cognitive function at three month after onset. Multivariate logistic regression analysis w as used to identify the relationship betw een the coefficient of variation of blood pressure w ithin 7 days and the cognitive impairment at 3 months after onset. Results A total of 708 patients w ith acute ischemic stroke w ere enrol ed in the study. At 3-month folow-up, 510 patients (72.0%) had cognitive impairment and 198 (28.0%) had normal cognitive function. The coefficient of variation for systolic blood pressure ( 8.3 ±1.2 vs.8.7 ±1.4; t= -3.299, P=0.001) and coefficient of variation for diastolic blood pressure ( 7.8 ±1.3 vs.8.0 ±1.5; t= -2.529, P=0.012) in the cognitive impairment group w ere significantly higher than those in the normal cognitive function group. With the first quintile as a reference, after adjusting other confounding factors, multivariate logistic regression analysis show ed that cognitive impairment at 3 months after onset w as significantly associated w ith coefficient of variation for systolic blood pressure. The odds ratios and 95 % confidence intervals for the 2-5 quantile groups w ere 2.33 (1.18-4.6), 2.31 (1.15-4.66), 2.70 (1.29-5.65), and 4.82 (1.92-12.1), respectively ( al P<0.05 ). Conclusion Systolic blood pressure variability in the acute phase of ischemic stroke is associated w ith cognitive impairment.
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Renal cell carcinoma (RCC) in a solitary kidney presents a unique clinical challenge to urological surgeons. Partial nephrectomy (PN) or nephron-sparing surgery in this condition provides good oncological and renal functional outcomes with an acceptable complication rate. Long-term renal function remains stable in most patients with solitary kidneys after a reduction of more than 50% in renal mass.PN is a surgical procedure reserved for patients with a tumor in a solitary kidney, bilateral renal tumors, or renal function impairment. The challenge of preserving renal parenchyma is significantly complicated with the discovery of multiple masses in a solitary kidney because any subsequent complications may result in a significant decline in quality of life. Particularly in the case of postoperative renal failure, dialysis becomes necessary.