Stent implantation for ruptured aneurysms complicated with hemorrhage:a risk factors analysis / 中国脑血管病杂志

Objective To analyze and investigate the risk factors for intraoperative and postoperative bleeding complications of stent implantation for ruptured intracranial aneurysms(from rupture to operation time ≤14 d). Methods A total of 249 consecutive patients with aneurysmal subarachnoid hemorrhage (aSAH)treated with stent intravascular interventional therapy at the Department of Neurosurgery,Tangdu Hospital,the Second Hospital Affiliated to Air Force Medical University(the Fourth Military Medical University)from August 2014 to July 2017 were enrolled retrospectively.According to whether having intraoperative and postoperative bleeding complications,they were divided into either a hemorrhage complication group(n=33)or a non-complication group(n=216).The baseline data,clinical data,and aneurysm characteristics,including age,sex,hypertension,Glasgow Coma Scale(GCS)score,aSAH to the patients were documented and analyzed,and multivariate logistic regression analysis was used to analyze the risk factors for bleeding complications. Results (1)The incidence of perioperative bleeding complications was 13. 3% (33 /249). (2)There was significant difference in GCS scores between the bleeding complication group and the non-complication group (P < 0. 05). There were no significant differences in age,male,hypertension,and aSAH to operation time between the two groups (all P >0. 05). (3)There were significant differences in Hunt-Hess grade (χ2 = 10. 392,P = 0. 001),Fisher score (χ2 = 7. 370,P =0. 007),number of aneurysms (χ2 = 4. 825,P = 0. 028),and aneurysm location (χ2 = 6. 818, P = 0. 033)between the bleeding complication group and the non-complication group. There were no significant differences in Raymond grade between the two groups (P > 0. 05). (4)Taking the occurrence of bleeding complications as a dependent variable,a further multivariate logistic regression analysis on Hunt- Hess grades Ⅲ-Ⅴ and multiple aneurysms was performed after variable screening,the results showed that Hunt-Hess grades Ⅲ-Ⅴ(OR,3. 658,95% CI 1. 660 -8. 061)and multiple aneurysms (OR,2. 667,95% CI 1.178-6.036)were the independent risk factors for stent placement in the treatment of bleeding complications of ruptured intracranial aneurysms(all P <0.05). Conclusions The single stent and stent-assisted coils can be used for endovascular treatment of rupture intracranial aneurysms,but preoperative Hunt-Hess grades Ⅲ-Ⅴ and multiple aneurysms are easy to cause perioperative bleeding complications in patients with aSAH.

Analysis of deafness-related gene mutations in 100 non-syndromic hearing loss patients in Henan province / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To preliminarily determine the gene mutation frequency and the hotspots in Henan province, we analysed the deafness-related gene mutation in patients with non-syndromic hearing loss (NSHL).@*METHOD@#Genomic DNA samples of 100 patients with NSHL in Henan province were extracted from peripheral blood after clinical history inquiry and clinical examination, Four common deafness genes GJB2, SLC26A4, mitochondrial 12SrRNA, and GJB3 were detected by Sanger sequencing method,and then data analysis were conducted.@*RESULT@#Among 100 patients with NSHL. the gene mutation frequency was 44%. In these patients, 29 cases had GJB2 mutations, 13 cases had SLC26A4 gene mutations, and 3 cases had mitochondrial 12SrRNA mutations.@*CONCLUSION@#Among the patients with NSHL in Henan province, the most frequent mutation causing hereditary deafness was mutation in GJB2, followed by SLC26A4,and it will provide a theoretical basis to determine the etiology of deafness in Henan Province.

Risk analysis of coronary artery disease in type 2 diabetes / 中国组织工程研究

BACKGROUND: Coronary artery disease (CAD) risk in type Ⅱ diabetics is one of the hot topics in clinical research.OBJECTIVE: By using electron-beam tomography(EBT) technology, heart scans were performed to investigate coronary artery lesion in type Ⅱ diabetics and their CAD risks were evaluated as well.DESIGN: Comparative study based on type Ⅱ diabetics complicated with coronary artery lesion.SETTING: Gerontology department in a hospital affiliated to a military medical university of Chinese PLA.PARTICIPANTS: From January 2002 to June 2004, 93 inpatients between the ages of 36 and 78 in the Gerontology Department of Xijing Hospital, an affiliation to the Fourth Military Medical University of Chinese PLA, were selected(male 80, female 13) . Totally 25 of all the patients proved normal by physical examinations were set as normal control(male 22, female 3) group; other inpatients were divided into the abnormal blood glucose group and the coronary heart disease (CHD) group respectively according to their examination results. Of the 57 patients in the abnormal blood glucose group,49 were male and 8 were female. This group was divided into two subgroups:the impaired glucose tolerance group(IGT) containing 29 patients and the diabetes group containing 28 patients. In this group, 44 patients have had heart symptom of different extent. Of the 11 patients in the CHD group, 9 were male and 2 were female. Inclusion criteria: patients with type Ⅱ diabetes were defined by American Diabetes Association in 1979; patients with CHD were defined in the report of the Joint International Society and Federation of Cardiology/World Health Organization Task Force on the standardization of clinical nomenclature and criteria for diagnosis of ischemic heart disease in 1979, and they were all confirmed by coronary angiography. Exclusion criteeases.METHODS: Both plain EBT heart scanning and contrast-enhanced heart scanning were performed on the 93 patients to evaluate the occurrence of coronary artery calcification(CAC), the number of stenosed coronary arterie,and the number of soft plaques. Additionally, other examination results including blood glucose, blood HbA1c and blood lipid were also collected for comparison between the conditions of coronary artery and assessment of the CHD risk among groups.MAIN OUTCOME MEASUREMENTS: In all the groups, the occurrence of CAC, the number of stenosed coronary arteries and the number of plaques were compared, and the CHD risk was analyzed.RESULTS: The occurrence of coronary artery calcification was significantly increased in all the study groups as compared with the control group(x2 = 18.88, P < 0. 01 ). Increasing trend was also observed in the study groups when calculating the number of branches with coronary stenosis and plaques ( F = 10. 758, P < 0. 01; F = 9. 991, P < 0.01 ). CHD risk in diabetes was estimated to be 7. 514 (95% confidence interval, 1. 885 -63. 778).CONCLUSION: Coronary artery lesion can be easily observed in type Ⅱ diabetics,and high CHD risk is predicted in this population. Early diagnosis of CAD and early rehabilitation intervention in grade 2 are extremely important in improving the quality of life and reducing the disability ratio of type Ⅱ diabetics.Huang C, Gao JY, Wong XM, Li R, Yang AL, Zheng MW, Xue FB. Risk analysis of coronary artery disease in type Ⅱ diabetics.