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Objective:To investigate the relationship between the degree of basilar artery stenosis and the short-term prognosis in patients with isolated pontine infarction.Methods:One hundred and thirty-seven patients with isolated pontine infarction within 1 month after symptom onset admitted to our hospital from April 2016 to April 2018 were consecutively included.Based on modified Rankin scale(mRS)socres, patients were divided into the good outcome group(mRS score≤2)and the poor outcome group(mRS score>2). Venous blood samples were taken for biochemical testing on admission or the next day.Baseline National Institutes of Health Stroke Scale(NIHSS)scores and demographic data were recorded and compared between the two groups.The degree of basilar artery stenosis was assessed by magnetic resonance angiography(MRA), and subjects were divided into the non-stenosis, mild stenosis, middle stenosis and severe stenosis subgroups.Results:There were 108 patients in the good outcome group and 29 in the poor outcome group.The baseline NIHSS score(2.71±0.22 vs.7.10±0.59, t=6.99, P<0.01)and total cholesterol[(4.29±0.101)mmol/L vs.(4.76±0.17)mmol/L, t=2.21, P=0.03]were lower in the good outcome group than in the poor outcome group.The proportion of patients without stenosis was higher(76 or 70.4% vs.5 or 17.2%, χ2=26.70, P<0.01)and the proportion of patients with severe stenosis were lower(4 or 3.7% vs.7 or 24.1%, P=0.002)in the good outcome group than in the poor outcome group.Binary logistics regression analysis showed that baseline NIHSS score( OR=1.658, 95% CI: 1.327-2.071, P=0.000)and degree of basilar artery stenosis( OR=2.071, 95% CI: 1.159-3.701, P=0.014)were risk factors for the short-term prognosis. Conclusions:The degree of basilar artery stenosis is a risk factor for the short-term prognosis in patients with isolated pontine infarction, and patients with severer stenosis will have a poorer prognosis.
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Objective To investigate the correlation between serum uric acid level and short-term outcome of acute isolated pontine infarction. Methods From April 2016 to April 2018, consecutive patients with acute isolated pontine infarction admitted to the Department of Neurology, Kaifeng Central Hospital were enrolled. The baseline clinical data were collected. Fasting venous blood was collected on the day of admission or the morning of the next day for blood biochemical tests. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the severity of neurological deficit. According to the modified Rankin Scale score at discharge or 14 dafter onset, the patients were divided into good outcome group (≤2) and poor outcome group ( > 2 ). Multivariate logistic regression analysis was used to determine the independent risk factors for short-term poor outcome. Results A total of 137 patients were enrolled in the study, 108 (78.8% ) had a good outcome, and 29 (21.2% ) had a poor outcome. The baseline NIHSS score (median [ interquartile range]: 2.5 [1.0-4.0] vs. 8.5 [5.5-10.0 ]; Z= 6.092, P< 0.001 ) and total cholesterol levels (4.290 ± 0.101 mmol/L vs. 4.763 ± 0.171 mmol/L; t=2.214, P=0.028] in the good outcome group were significantly lower than those in the poor outcome group, while serum uric acid level (329.769 ± 8.122μmol/L vs. 257.103 ± 14.290μmol/L; t=4.190, P<0.001) was significantly higher than that in the poor outcome group. Multivariate logistic regression analysis showed that high serum uric acid levels were independently associated with short-term good outcomes in patients with isolated pontine infarction (odds ratio [ OR] 0.377, 95% confidence interval [ CI] 0.203-0.702; P=0.002), while high NIHSS score (OR 1.762, 95% CI 1.375-2.258; P<0.001) and hypertension (OR 5. 353, 95% CI 1.333-21.502; P= 0.018 ) were independently associated with short-term poor outcomes. Conclusion High baseline serum uric acid levels are associated with short-term good outcomes in patients with acute isolated pontine infarction.
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Objective To investigate the relationship between serum cathepsin S (Cat S) and cystatin C(Cys C) expression levels with carotid arterial plaque property in the patients with ischemic stroke(IS).Methods A total of 336 cases of atherosclerotic cerebral infarction were divided into the stable plaque and unstable plaque group according to the carotid arterial ultrasound.Contemporaneous 114 individuals undergoing healthy physical examination served as the control group.Fasting blood was collected from all subjects entering the groups for detecting serum Cat S and Cys C.Results The serum Cat S and Cys C levels and Cat S/Cys C ratio (Cat S/Cys C) had statistically significant difference between the two groups (P＜0.05),moreover the Cat S level in the unstable plaque group of the patients with cerebral infarction was increased compared with that in the stable plaque group,while serum Cys C level was decreased compared with that in the stable plaque group (P＜0.05).The Cat S levels were (75.34-±-15.45)pg/mL and (60.12±18.53)pg/mL and the Cys C levels were (0.73±0.62)mg/L and (0.93±0.53)mg/L,the Cat S/Cys C ratios were (103.68±2.52) and (64.64± 9.24) respectively,the difference between the two groups had statistical significance (P＜0.05).The Spearman correlation analysis showed that the serum Cat S level and Cat S/Cys C ratio had obviously positive correlation with carotid arterial unstable plaque (r=0.498,P＜0.05;r=0.753,P＜0.01);while the level of serum Cys C was negatively correlated with the unstable plaque (r=-0.213,P＜0.05).Conclusion Serum Cat S/Cys C level has a certain correlation with carotid arterial plaque property in ischemic stroke patients,which may become the serological indicators for predicting carotid arterial plaque.
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Objective To observe the effect of parecoxib united with local anaesthesia analgesia system on analgesia after radical resection of liver cancer. Methods Ninety patients undergoing elective radical resection of liver cancer were randomly assigned to three groups, with 30 patients in each group. The patients in parecoxib group (P group) received parecoxib 40 mg through vein before the end of operation for 30 min, and were injected parecoxib 40 mg at 12 h, 24 h and 46 h after operation. The patients in local anethsia analgesia system group (L group) received embedding hypodermic pervasion canal in incision subcutaneously, then connected the pump with 0.25% ropivacaine 250 ml, with infusion speed of 4 ml/h.The patients in united group(U group)receiced the same methods with those in P group and L group. When the patients'visual analogue scale (VAS) scores were higher than 5 scores, they were given muscle injection of pethidine 50 mg. The VAS scores and Ramsay sedation scores at the time of tracheal extubation (T0), postoperative 2 h(T1), 6 h(T2), 12 h(T3), 24 h(T4) and 48 h(T5), the adverse reaction rate, dosage of pethidine, and analgesia satisfaction were compared. Results The resting and movement of VAS scores and Ramsay sedation scores at each time in P group and L group had no significant difference (P>0.05). The resting and movement of VAS scores and Ramsay sedation scores at each time in U group were significantly better than those in P group and L group (P 0.05). The rate of drowsiness in U group was significantly lower than that in P group and L group:6.67%(2/30) vs. 26.67%(8/30) and 23.33%(7/30), P < 0.05. The analgesia satisfaction in U group was significantly higher than that in P group and L group:93.33%(28/30) vs. 56.67%(17/30) and 53.33%(16/30), P<0.05. Conclusions The analgesia effect of the parecoxib united with local anaesthesia analgesia system for radical resection of liver cancer is perfect.
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Objective To evaluate the quality of intraoperative wake?up test in the patients undergoing scoliosis correction surgery under etomidate?based anesthesia. Methods Thirty patients of both sexes, aged 13-32 yr, weighing 40-65 kg, of ASA physical statusⅠorⅡ, undergoing elective scoliosis correction surgery, were randomly assigned into etomidate group ( group E, n=15 ) or propofol group (group P, n=15) using a random number table. Anesthesia was induced with etomid 0.3 mg∕kg (group E) or propofol 2mg∕kg ( group P ) injected intravenously, midazolam, fentanyl and rocuronium. The patients were mechanically ventilated after naso?tracheal intubation. Etomidate 0.6-1. 2 mg · kg-1 · h-1 and propofol 8- 10 mg·kg-1 ·h-1 were infused intravenously during surgery in E and P groups, respectively. Both remifentanil and cisatracurium were used for maintenance of anesthesia in the two groups. Cisatracurium infusion was stopped before wake?up test. The infusion rate of propofol was adjusted to 4 mg·kg-1 ·h-1 at 15 min before wake?up test. After the scoliotic angle was corrected, infusion of etomidate and propofol was stopped, and the infusion rate of remifentanil was adjusted to 0.025μg·kg-1 ·min-1 in both groups. The wake?up time was recorded, and the quality of wake?up was assessed. Mean arterial pressure (MAP) and heart rate were recorded before anesthesia ( T0 ) , immediately before the patients were awakened ( T1 ) , when the patients responded to commands from doctors ( T2 ) , and after anesthesia was deepened ( T3 ) . At T0 , the end of surgery ( T4 ) , and 24 h after surgery ( T5 ) , blood samples were collected from the internal jugular vein for determination of plasma cortisol concentrations. Results The patients were awakened successfully in the two groups, and there were no significant differences in the wake?up time, quality of wake?up, and MAP, HR and plasma cortisol concentrations at each time point between the two groups. MAP and HR were significantly higher at T2 than at T0 in the two groups. MAP and HR were within the normal range during wake?up test, and no patients developed severer cardiovascular events in the two groups. Conclusion Etomidate?based anesthesia provides better quality of intraoperative wake?up test in the patients undergoing scoliosis correction surgery, which is similar to that of propofol?based anesthesia.
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<p><b>OBJECTIVE</b>This study aimed to explore further the mechanisms of tongue squamous cell carcinoma (TSCC) cell recurrence, metastasis, and diffusion, as well as to establish the experimental basis for the molecular biology research on TSSC. We intend to complete our objective through differential proteomics and preliminary analysis protein expression of exosomes derived from TSCC and normal mucosa cells.</p><p><b>METHODS</b>We acquired cultured supernatant fluid in vitro in the laboratory by culturing TSCC (tongue cancer Tca8113 cell line) and human normal mucosa cells (HOK cell line). The exosomes were separated and purified through differential centrifugation. Furthermore, the different protein expressions were identified through dielectrophoresis and mass spectrometry. The functions of the different protein expressions were identified through an online database search.</p><p><b>RESULTS</b>TSCC and human normal mucosa cells secrete a large amount of capsule bubble structure substances in vitro, as confirmed by electron microscopy and surface markers heat shock protein-70 and major histocompatibility complex class 1. A total of 16 oral cancer cell-derived exosomes that expressed quantity more than two times, twelve that increased their expression levels, and four that cut their expressions were identified through the differential proteomics research on the two groups.</p><p><b>CONCLUSION</b>Differential proteins that were verified through the online database serve an important function in exosome formation and in the progress of cancer.</p>