ABSTRACT
Objective:To explore the common risk factors of intracerebral hemorrhage(ICH) in young people and to establish a predictive model of nomogram.Methods:The relevant data of young patients with ICH (≤45 years ) hospitalized in the Department of Neurosurgery of Dezhou people's Hospital from January 2014 to August 2021 were retrospectively studied, and the young group who underwent physical examination in the Physical Examination Center of Dezhou people's Hospital at the same time were randomly selected as the control group. Analyze the risk factors that may affect cerebral hemorrhage in young people, screen the risk factors with statistical differences through single factor analysis, screen the independent risk factors according to multi factor Logistic regression analysis, construct the risk nomogram model of cerebral hemorrhage in young people, and test the efficiency, goodness of fit and benefit of the constructed model through internal validation.Results:Compared with the control group, there were statistically significant differences in family history (χ 2=115.66, P<0.001), hypertension grade( Z=17.67, P<0.001), smoking history (χ 2=33.91, P<0.001), drinking grade ( Z=4.84, P<0.001), body mass index (BMI) ( t=11.76, P<0.001), low density lipoprotein ( t=4.78, P<0.001), high density lipoprotein cholesterol ( t=5.83, P<0.001),blood glucose ( Z=5.68, P<0.001) and homocysteine ( Z=2.22, P<0.001) in the case group. Binary Logistic regression analysis showed that hypertension grade ( OR=3.457, 95%CI: 2.809-4.254, P<0.001), family history ( OR=2.871, 95%CI:1.868-4.413, P<0.001), BMI ( OR=1.093, 95%CI:1.040-1.148, P<0.001), high density lipoprotein cholesterol ( OR=0.230, 95%CI:0.111-0.480, P<0.001), blood glucose ( OR=3.457, 95%CI:2.809-4.254, P<0.001), homocysteine (O R=3.457, 95%CI:2.809-4.254, P<0.001) was an independent risk factor for intracerebral hemorrhage in young adults. The nomogram prediction model showed that BMI was 96 points, hypertension grade was 100 points, family history was 30 points, high density lipoprotein cholesterol was 76 points, homocysteine was 48 points, blood glucose was 52 points,homocysteine was 48 points and blood glucose was 52 points, respectively. The consistency coefficient of the prediction model was 0.874. The nomogram dependent ROC curve AUC was 0.891, and the corresponding sensitivity and specificity were 74.5% (263/353) and 89.7% (437/487), respectively, a nomogram model was established with good diagnostic efficiency. Conclusion:The nomogram model established in this study can predict the probability of intracerebral hemorrhage in high-risk population, and take intervention measures as early as possible to prevent the occurrence of intracerebral hemorrhage in young people.
ABSTRACT
Objective To analyze and investigate clinical characteristics, pathogenesis and treatment of urinary tract infection and aseptic meningitis. Methods Clinical features and laboratory tests of a two-month-old baby girl with urinary tract infection and aseptic meningitis were reported. Results The patient complained of fever, neck stiffness and a bulging fontanel, accompanied by congestion and abnormal secretion of urethra. The cerebrospinal lfuid (CSF) white blood cell count was 30×106/L. The blood culture and the CSF culture were both negative. And the urine culture was positive for Enterococcus faecium. The patient received a 10-day course of intravenous antibiotic therapy. The prognosis is good with no recurrence of the disease. Conclusions Aseptic meningitis can be concomitant with urinary tract infection, The probable hypothesis may be that sterile CSF pleocytosis is mediated by urinary tract infection. Knowledge of this may prevent unnecessary antibiotics therapy for presumed bacterial meningitis.
ABSTRACT
Objective To evaluate the relationship between stenosis of intra- or extra-cranial cerebral large artery and capsular warning syndrome(CWS). Methods Eleven consecutive CWS patients hospitalized during period of time from November 2008 to December 2009 were retrospectively analyzed.Result In these 11 patients with CWS, 5 patients had motor symptoms only, 4 patients had pure sensory symptoms, and 2 patients had sensorimotor symptoms. Ten patients underwent cervical contrast-enhanced MRA and intracranial MRA examination. The results showed no sign of arterial stenosis. Seven CWS patients eventually had strokes, 1 progressed to stroke despite receiving the therapy of antiplatelet and anticoagulation. All stroke lesions were located in the capsula interna. All the CWS patients had vascular risks: 7 were smoker, 8 had hypertension, 1 had diabetes mellitus, and 5 had hyperlipidemia. One patient had a history of previous stroke; no patient had a history of ischemic heart disease or atrial fibrillation. At follow-up(10. 2 ±3.4)mouths, the average modified Rankin scale score for all patients was 0. 73 ± 1.20.Conclusion CWS was not associated with stenosis of the intra and extra-cranial large cerebral arteries.CWS may be associated with small-vessel single-penetrator disease.
ABSTRACT
Objective: To investigate whether insulin stimulates the translocation of glucose transporter-4 (GLUT4) and glucose uptak e in ischemic myocardium. Methods: Plasma concentration of gluc ose, lactate, free fatty acid and insulin were determined by autoanalyser, and G LUT4 was studied by Western blotting analysis. Results: Insulin increased GLUT4 significantly in sarcolemma of ischemic myocardium ［(25±4)% vs (40±6)%］, and GLUT4 content in intracellular membrane decreased proporti onally. The glucose uptake increased significantly in insulin-ischemic myocardi um. The uptake of insulin-ischemic myocardium was almost 2 times that of ischem ic myocardium. Conclusion: Insulin stimulation results in GLUT4 translocation and increases glucose uptake in ischemic myocardium. When myocardi al ischemia occurs, insulin is helpful in increasing myocardial glucose uptake a nd utilization.