ABSTRACT
Objective To investigate the correlation between urinary 8-iso-prostaglandin F2α (8-iso-PGF2α) level and carotid atherosclerotic plaque stability in patients with acute ischemic stroke.Methods The patients with acute ischemic stroke were enrolled consecutively.According to the findings of carotid artery ultrasound,they were divided into either a non-plaque group or a plaque group,and then the plaque group was redivided into a stable plaque subgroup and an unstable plaque subgroup.Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of urinary 8-iso-PGF2α.Multivariate logistic regression analysis and Spearman correlation analysis were used to investigate the relationship between 8-iso-PGF2α and carotid artery plaques.Results A total of 150 patients with acute ischemic stroke were enrolled,including 104 had carotid artery plaque (30 were stable plaques and 74 were unstable plaques) and 46 had no carotid artery plaque.The urinary 8-iso-PGF2α level (86.45 ± 6.20 ng/mmol creatinine vs.45.70 ±6.19 ng/mmol creatinine; t =37.136,P=0.001) and intima-media thickness (IMT) (2.89 ± 1.03 mm vs.0.86 ±0.53 mm; t =3.518,P =0.002) in the plaque group were significantly higher than those in the nonplaque group.Multivariate logistic regression analysis showed that urinary 8-iso-PGF2α level (odds ratio [OR] 1.183,95％ confidence interval [CI] 1.087-1.276; P=0.001) and IMT (OR 28.642,95％ CI 8.276-137.231; P =0.001) were the independent risk factors for carotid artery plaque.Pearson correlation analysis showed that there was no significant correlation between urinary 8-iso-PGF2α level and carotid artery IMT (r =0.075,P =0.264).The urinary 8-iso-PGF2α level of the unstable plaque subgroup was significantly higher than that of the stable plaque subgroup (97.30 ± 7.20 ng/mmol creatinine vs.69.17 ±9.25 ng/mmol creatinine; t =16.506,P =0.001).Multivariate logistic regression analysis showed that urinary 8-iso-PGF2α level (OR 4.652,95％ CI 1.732-12.643; P =0.001) was an independent risk factor for unstable plaque.Conelusions The urinary 8-iso-PGF2α level is associated with the existence of carotid atherosclerotie plaque and instability,its increased level is an independent risk factor for carotid plaque instability in patients with ischemic stroke.
ABSTRACT
ObjectiveTo discuss the management of chronic thyroid abscess in children. MethodsThe diagnosis and management of 16 children with chronic thyroid abscess admitted from Jul. 2007 to Jun. 2010 in Department of Thyroid Surgery of Sun Yat-ssn Memorial Hospital of Sun Yat-sen University were retrospectively analyzed. All the patients were checked by Doppler ultrasound. ResultsOf the patients, 6 were males and 10 were females. The time of onset was from 3.2 years to 8.5 years, with 4. 6 years as the median. Hypoechoic or mixed echoic lesions in thyroid were seen on Doppler ultrasound scan in all patients. Abscess was found on the left side of thyroid in 11 cases (68.8％), and on the right side in 5 cases (31.2％). Abscess in 12 cases (75％) occupied the whole thyroid and began encroaching the adjacent tissues. Hypodermic fistula was found in 7 cases (43.75％). 12 cases (75％) underwent part resection of thyroid gland, and 4 cases (25％) underwent total resection of thyroid gland and debridement. All patients recovered and no complication like vocal hoarseness occurred. No recurrence happened within the follow-up of 3 months to 5 years. ConclusionsThe effective diagnosis of chronic thyroid abscess in children is to perform Doppler ultrasound scan of thyroid gland before operation. Abscess and fistula resection, partial or total resection of the affected side of thyroid gland are needed. Wound drainage and postoperative antibiotc are also helpful.