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Objective To investigate the effect of blood glucose levels at admission on the outcomes and hemorrhagic transformation in patients with acute ischemic stroke (AIS) after intravenous thrombolysis. Methods From December 2013 to January 2017, patients with AIS treated with intravenous thrombolysis at the Department of Neurology, Xuzhou Central Hospital were enrolled retrospectively. According to the blood glucose levels on admission, they were divided into non-hyperglycemic group ( ≤8 mmol/L ) and hyperglycemic group ( > 8 mmol/L). The functional outcome was assessed with the modified Rankin Scale score at 90 d after onset, and 0-2 was defined as good outcome and > 2 was defined as poor outcome. From 24 h to 7 d after treatment, CT scan was performed again to determine whether there was intracranial hemorrhage or not. Multivariate logistic regression analysis was used to identify the independent influencing factors of outcomes after intravenous thrombolysis. Results A total of 323 patients with AIS were enrolled, including 237 (73. 4％) in the non-hyperglycemic group and 86 (26. 6％) in the hyperglycemic group; 238 (73. 7％) in the good outcome group, and 85 (26. 3％) in the poor outcome group; 25 (7. 7％) in the hemorrhagic transformation group, and 298 (92. 3％) in the non-hemorrhagic transformation group. Univariate analysis showed that there were significant differences in the proportions of patients with ischemic heart disease, atrial fibrillation, past history of stroke or TIA, as well as age, baseline National Institutes of Health Stroke Scale (NIHSS) score, and baseline blood glucose between the poor outcome group and the good outcome group (all P < 0. 05). There were significant differences in the proportion of hypertensive patients and baseline NIHSS score between the hemorrhagic transformation group and the non- hemorrhagic transformation group ( all P < 0. 05 ). Multivariate logistic regression analysis showed that hyperglycemia at admission (odds ratio [OR] 2. 239, 95％ confidence interval [CI] 1. 210-4. 143; P = 0. 010)and baseline NIHSS score (OR 3. 528, 95％ CI 2. 451-5. 078; P < 0. 001) were the independent influencing factors of poor outcome; hypertension (OR 0. 410, 95％ CI 0. 173-0. 972; P = 0. 043 ) and baseline NIHSS score (OR 2. 283, 95％ CI 1. 382-3. 772, P = 0. 001 ) were the independent influencing factors of hemorrhagic transformation. Conclusion Hyperglycemia at admission was an independent risk factor for poor outcome in patients with AIS after intravenous thrombolytic therapy, but it was not associated with the risk of hemorrhagic transformation.
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Objective To review the phenylalanine(Phe) and thyrotropin(TSH) results of national external quality assessment(EQA)in neonatal screening laboratory for 7 years,evaluate qualitity control level and summarize the problems in the screening measurement.Methods The Phe and TSH values in dried blood spot specimens on filter paper distributed by national center for clinical laboratory were measured by fluorometrie method and time-resolved fluorescence immunoassay respectively.The Phe and TSH EQA results from 2010 to 2016 year were analyzed.Results Five specimens were distributed by EQA organizer each time,and 3 times each year.(1) In the 105 specimens of 21 batches,the bias ranges of Phe and TSH measurement were wide and their average values were 2.21% and 0.98% respectively.(2) Quantitative results analysis :Six quantitative results of Phe measurement and two quantitative results of TSH measurement were out of aunty control(bias ≥30% or ≤-30%),accounting for 5.71%(6/105)and 1.9%(2/105) respectively.(3)Qualitative results analysis:The Phe and TSH qualitative analysis of specimens conformed to the expected results(100%).The result of every batch was up to 80%.Conclusion It is useful to evaluate the measurement competence,find out the problems in the Phe and TSH measurement in neonatal screening laboratory and resolve them in time.Consequently,it is useful to improve the quality of measurement,reduce the error and ensure the accuracy of results.
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OBJECTIVE:To investigate the protective effects of insulin-glucose on myocardium in patients receiving cardiac valve replacement under cardiopulmonary bypass. METHODS:Totally 120 patients receiving combined cardiac valve replacement under cardiopulmonary bypass were divided into control group and observation group according to random number table,with 60 cases in each group. All patients were given routine operation. Control group was given Thomas cardioplegia and oxygenated blood with a ratio of 1:4(V:V)to protect myocardium at 4 ℃. Besides that,the observation group was additionally given Insulin injec-tion 10 IU/L and Glucose injection 10 g/L added into Thomas cardioplegia at 4 ℃ to protect myocardium. The levels of plasma brain natriuretic peptide(BNP)and cardiac troponinⅠ(cTnⅠ)before anesthesia induction(T0),at the end of cardiopulmonary by-pass(T1),12 h(T2),24 h(T3),48 h(T4),and 72 h(T5)after surgery,the rate of recovery of automatic heartbeat after opening aor-ta,the application of vasoactive agent(dopamine)at T1 and the occurrence of postoperative complications were observed and com-pared between 2 groups. RESULTS:At T0,there was no statistical significance in the levels of plasma BNP and cTnⅠ between 2 groups(P>0.05). The levels of plasma BNP and cTnⅠin 2 groups at T1-5 were significantly higher than T0,with statistical signifi-cance(P0.05). The dos-age of dopamine (at T1) and the incidence of complications in observation group were statistically lower than control group,with statistical significance(P<0.05). No severe ADR was found in 2 groups during or after surgery. CONCLUSIONS:Insulin-glucose can alleviate myocardial damage, reduce the dosage of vasoactive agent and the incidence of postoperative complications in pa-tients receiving combined cardiac valve replacement under cardiopulmonary bypass with significant protective effect on myocardium with good safety.
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Objective To analyze contrastly the effect of 89SrCl2 for bone metastasis in Uygur and Han patients with prostate cancer.Methods The curative effects in 75 Uygur and 82 Han patients with prostate cancer bone metastasis were investigated after intravenous injection with 89SrCl2,including palliation of pain.SPECT was used to detect the change of metastasis,level of prostate-specific antigen (PSA) and interleukin-6 (IL-6) were detected by electrochemiluminescence immunoassay.Results After treated with 89SrCl2,the palliation rate,the bone metastases and the level of IL-6 were higher in Uygur patients [82.67 ％ (62/75),75 ％ (56/75),(4.24±1.74) pg/ml] than those in Han patients [60.98 ％ (50/82),52.44 ％ (43/82),(2.81±2.38) pg/ml],and there were statistically significant (P ＜ 0.05).Conclusion 89SrCl2 is more effective for the Uygur patients with prostate cancer bone metastasis than the Han patients,clinical workers should pay more attention to this.
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Objective To analyze the effect on prostate cancer bone metastasis of Uygur and Han people treated with strontium-89-chlovide.Methods The curative effects in 36 cases of Uygur and 40 cases of Han patients with prostate cancer bone metastasis were investigated after intravenous injection with strontium-89-chloride,including palliation of pain,change of metastatic focus,level of prostate-specific antigen (PSA) and interleukin-6 (IL-6).Results After treated with strontium-89-chlovide,compared with the han patients with prostate cancer bone metastasis,the palliation rate (83.33 ％) F-PSA [(29.29 ± 8.69) μg/L] and T-PSA [(3.73 ± 1.48) ml/L] were higher,the bone metastases and the level of IL-6 were more significantly reduced of Uygur patients,and there were statistically significant (x2 =4.113,t =1.359,t =1.849,all P ＜ 0.05).Conclusion It is more effective treated with 89 SrCl-chloride for the Uygur patients with prostate cancer bone metastasis metastases than the Han patients.
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Objcetive To evaluate the clinical significance of bone biochemical metabolic markers in osteoporosis( OP),and investigate the clinical application value of the determination.Methods BMD at various skeletal sites was measured by XR-36 dual energy X-ray absorptiometry for 65 patients.Enzyme linked immunosorbent assay (ELISA) were used to determine bone biochemical metabolic markers in sera of 65 patients with osteoporosis and 62healthy controls.Results The levels of serum TRACP5b and 25-OH-VD3/25-OH-VD2 in OP group were higher than that in control group( P ＜0.05),meanwhile the level of BGP,BAP and Ca were varying degrees higher than that in control group,but the level of P was lower than that in control group.Conclusion TRACP5b,BGP,BAP,VD3/2 and other bone metabolic markers can be used as indicators of early detection of osteoporosis,in order to provide valuable data for early treatment of osteoporosis.
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Objective To investigate the clinical significance and relationship of preS1, HBV DNA and HBV-M. Methods PreS1 and HBV-M was detected by ELISA method,and HBV DNA was detected by PCR. Then the results were analyzed. Results In HBV patients,the positive rates of preS1 and HBV DNA had no statistically significant ,they had fine dependability. The detection rate of preS1 in HBeAg(+) group(80.3%) and HBeAg(+)group( 56.3% ) had statistically significant. In some patients,though HBeAg had become negative, HBV still replicated. In HBV DNA replicated patients(≥103 copies/ml) ,the detection rate of HBeAg and preS1 were 51.5% and 70.9% ,they had statistically significant. Conclusion HBV DNA and PreS1 had fine dependability,preSl could reflect the replication of HBV sensitively than HBeAg,it could be used as a reliable new marker of HBV replication in vivo.