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Multidrug resistance (MDR) mediated by ATP binding cassette subfamily B member 1 (ABCB1) is significantly hindering effective cancer chemotherapy. However, currently, no ABCB1-inhibitory drugs have been approved to treat MDR cancer clinically, mainly due to the inhibitor specificity, toxicity, and drug interactions. Here, we reported that three polyoxypregnanes (POPs) as the most abundant constituents of
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Objective:To Investigate the correlation of eosinophil count and stroke-associated pneumonia (SAP) in patients with acute ischemic stroke.Methods:Patients with acute ischemic stroke within 24 h after onset admitted to the Department of Encephalopathy, Suzhou Integrated Traditional Chinese and Western Medicine Hospital from August 2016 to September 2018 were enrolled prospectively. Their general clinical data and eosinophil counts were collected. National Institutes of Health Stroke Scale (NIHSS) was used to assess the severity of stroke. Multivariate logistic regression analysis was used to determine the independent risk factors for SAP. Results:A total of 521 patients were enrolled, including 106 (20.35%) SAP. Univariate logistic analysis showed that SAP was associated with the classification of eosinophil count (odds ratio [ OR] 0.37, 95% confidence interval [ CI] 0.20-0.68; P=0.001), and tended to be associated with eosinophil count ( OR 0.08, 95% CI 0.01-1.01; P=0.051). Multivariate logistic regression analysis showed that both eosinophil count and eosinophil count classification were not the independent risk factors for SAP, and advanced age ( OR 1.077, 95% CI 1.045-1.109; P< 0.001), chronic obstructive pulmonary disease ( OR 6.931, 95% CI 1.295-37.106; P=0.024) and high baseline NIHSS score ( OR 1.148, 95% CI 1.003-1.314; P=0.045) were significantly independently associated with SAP. Conclusions:Eosinophil count was not an independent predictor of SAP in patients with acute ischemic stroke.
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Pulmonary fluid refers to a thin and continuous liquid layer mainly consisting of airway mucus and lining liquid on the inner surface of alveoli, which is essential for maintaining a healthy lung. The clinical significance of rheological properties of pulmonary fluid in airway stability, pulmonary barrier and clearance functions, ventilator induced lung injury and surfactant replacement therapy in infant respiratory distress syndrome was introduced in this paper. Furthermore, a variety of classical methods for measuring surface tension and liquid viscosity, such as Langmuir-Wilhelmy balance, captive bubble method, glass capillary viscometer and rotational viscometer, and emerging techniques (e.g. particle tracking microrheometer and axisymmetric drop shape analysis) were reviewed, and their advantages and drawbacks were also compared, in order to provide an important reference for the assisted diagnosis and treatment of lung diseases in clinical practice.
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Objective To observe the thyroid hormone (TH) changes in patients with acute cerebral infarction in acute phase and convalescence,and to explore its clinical value.Methods Fifty cases of acute cerebral infarction patients from March 2015 to May 2016 in Heilongjiang Provincial Hospital were selected as observation group,at the same time 30 cases of healthy check-up people as control group.Serum levels of triiodothyronine (T3),thyroxine (T4),free triiodothyronine (FT3),free thyroxine (FT4) and thyroid stimulating hormone (TSH) were measured in 50 cases of acute cerebral infarction patients on the 2nd day (acute phase) and the 14th day (recovery) after onset of the disease,by using chemiluminescence method,and 30 cases of people underwent healthy physical check-up were treated the same way.Neurological injury and recovery of patients with cerebral infarction were evaluated using NIHSS.According to the recovery level of FT3,patients with cerebral infarction were divided into low FT3 group (FT3 ＜ 3.10 pmol/L) and normal FT3 group (FT3 ≥ 3.10 pmol/L).Prognosis of the patients was judged according to the NIHSS scores 90 days after discharged from the hospital,and NIHSS score improving acuity of 2 was judged as good prognosis.Results The T3 and FT3 levels in patients with acute cerebral infarction were significantly lower than those of people underwent healthy physical examination,the differences were statistically significant [(0.68 ± 0.22) vs(1.82 ± 0.31) nmol/L,(2.08 ± 0.31) vs (4.19 ± 0.75) pmol/L,all P ＜ 0.05].The T4,FT4 and TSH levels in patients with acute cerebral infarction were increased significantly,the differences were statistically significant [(142.56 ± 20.78) vs (109.89 ± 12.37) nmol/L,(12.88 ± 1.15) vs (9.77 ± 0.96) pmol/L,(5.15 ± 1.16) vs (2.95 ± 1.31) mU/L,all P ＜ 0.05].Compared with the acute phase,convalescence of cerebral infarction patients' serum T3 and FT3 levels [(1.75 ± 0.19) nmol/L,(3.97 ± 0.61) pmol/L] increased significantly,the differences were statistically significant (all P ＜ 0.05),and T4,FT4 and TSH [(115.64 ± 14.38) nmol/L,(10.05 ± 1.02) pmol/L,(3.16 ± 0.98) mU/L] obviously decreased,the differences were statistically significant (all P ＜ 0.05).Compared with control group,convalescence of cerebral infarction patients' serum T3,T4,FT3,FT4 and TSH were not statistically different (all P ＞ 0.05).There was a negative correlation between FT3 levels and NIHSS scores on admission (r =-0.586,P ＜ 0.05).Ninety days after discharge,7 cases (38.89％) of the patients had a good prognosis in low FT3 group,and normal FT3 group had 22 cases (68.75％) of patients with good prognosis,and the difference was statistically significant (x2 =7.186,P ＜ 0.05).Conclusions The thyroid hormone has a protective stress reaction in patients with acute cerebral infarction.The thyroid hormone level has changed significantly in the acute phase,and returned to normal level with improvement of the patients.As a biochemical indicator thyroid hormone detection can be used to estimate the prognosis of patients with acute cerebral infarction.
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ObjectiveToanalyzetheclinicalandimagingcharacteristicsinpatientswithcarotidsteal syndrome ( CSS ) and to investigate its compensatory pathw ays, diagnosis, and treatment. Methods The medical history and imaging data of the patients with CSS were colected. Their vascular lesions, colateral circulation, treatment, and prognosis w ere analyzed. Results A total of 11 patients w ith CSS (8 males and 3 females, mean age 66.7 ±5.1 years) were enroled in the study. Their clinical manifestations were posterior circulation transient ischemic attack (TIA) ( n=9, 81.8%), posterior circulation infarction ( n=1, 9.1%), and anterior circulation TIA ( n=1, 9.1%). A total of 19 pathological arteries w ere found:12 (63.1%) w ith occlusion, 2 (10.5%) w ith subtotal occlusion, 4 (21.0%) w ith severe stenosis and 1 (5.2%) w ith artery dissection. Seven patients (63.6%) w ere bilateral internal carotid artery lesions, 3 (27.2%) w ere unilateral bilateral internal carotid artery lesions, and 1 (9.1%) w as bilateral common carotid artery occlusion. Eleven patients had primary col ateral circulation, including posterior communicating artery patency in 10 patients (90.9%) and anterior communicating artery patency in 1 patient (9.1%). Four patients (36.3%) had secondary col ateral circulation and 1 (9.1%) had tertiary col ateral circulation. Al patients w ere treated w ith medication on the basis of the management of risk factors. Three patients w ere treated w ith stenting and tw o were treated with carotid endarterectomy. No stroke occurred in al patients during folow -up til September 2014. Conclusions The vascular lesions of patients w ith CSS often occur in the extracranial segment of internal carotid artery. Usual y the compensatory blood is through the circle of Wil is. The presentation is ischemia in the stolen arteries. Its diagnosis needs to be examined by digital subtraction angiography. On the basis of medication therapy, some patients may be treated w ith surgery or endovascular intervention.
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BACKGROUND:In the deep caries treatment, the pulp capping agent used in indirect pulp can induce the formation of dentin bridge (the complex of dental pulp and dentin), to protect the pulp tissue from stimulus and save the pulp vitality, completely avoid the occurrence of complications, with a higher clinical success rate. OBJECTIVE:To evaluate the differences in clinical efficacy of five kinds of calcium hydroxide preparations. METHODS:Totaly 236 patients with deep caries were selected and randomized to undergo indirect pulp with the double-component calcium hydroxide powder (n=46), Metapex with one-component injection dosage form and the chemical curing calcium hydroxide preparation (n=47), Dycal with the chemical curing calcium hydroxide preparation (n=45), Ionosit-Baseliner (n=49) and Calcimol LC (n=49) with one-component and the light curing calcium hydroxide preparation. The status of the dental pulp, the restoration and the root tip were observed at 1, 6, 12 and 24 months after operation. RESULTS AND CONCLUSION: There was no significant difference between the five groups in the success rate of indirect pulp capping at 1, 6 and 12 months (P> 0.05). At 24 months, the success rate of indirect pulp capping in the double-component calcium hydroxide powder group was lower than that in the other four groups (P 0.05). Metapex, Dycal, Ionosit-Baseliner and Calcimol LC al have a good effect on indirect pulp capping to deep caries, which can be used as agents for long-term pulp protection.
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BACKGROUND:Studies have demonstrated that Fe-Cr-Mo soft magnetic aloy has desired magnetic properties and machining properties. Surface Cr6+ plating treatment can significantly enhance the corrosion resistance in oral environment, but its biosecurity needs further testing. OBJECTIVE: To evaluate the biocompatibility of Fe-Cr-Mo soft magnetic aloy with chromium plating. METHODS:Logarithmic growth phase L929 cel suspension was obtained and seeded in 96-wel plates at a cel concentration of 6×107/L. Pure titanium extract, Fe-Cr-Mo soft magnetic aloy original extract, Cr6+-plated Fe-Cr-Mo soft magnetic aloy and PVC extract were added respectively. After 5 days of culture, cel morphology and adherent circumstances were observed. The absorbance value was detected using cel counting kit-8 assay. The relative growth rate of cels in each group was calculated. The cytotoxicity grades of materials were evaluated. RESULTS AND CONCLUSION:In the pure titanium extracts group, the cels with normal morphology showed good adherent growth and no cytotoxicity. In the Fe-Cr-Mo soft magnetic aloy original extract group, the cel morphology and growth status were both good, with occasionaly individual cel lysis. Scattered reddish brown particles were visible in the culture solution, showing no or very mild cytotoxicity. In Cr6+-plated Fe-Cr-Mo soft magnetic aloy extract group, the cels grew wel and showed no or very mild cytotoxicity. In PVC extract group, more than 70% of cels were vacuole-shaped and presented with pyknosis or dissolution, there was a large number of cel debris, and cel growth was inhibited in over 50% cels, showing moderate cytotoxicity or above. The cytotoxicity of Cr6+-plated Fe-Cr-Mo soft magnetic aloy extract was grade 0-1. These results demonstrate that Fe-Cr-Mo soft magnetic aloywith chromium plating has good biocompatibility.
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BACKGROUND:Preparation of calcium hydroxide paste for apexification of immature permanent teeth has recently achieved satisfactory clinical efficacy because of its advantages including simple-to-use, being wel proportioned and ful contact with dentin and root apical periodontal tissues after being guided into root canal. OBJECTIVE: To validate the clinical efficacy of apexification of immature permanent teeth with calcium hydroxide paste. METHODS:Thirty-four patients with periapical periodontitis caused by fracture of abnormal central cusp, consisting of 18 males and 16 females, aged 8-12 years, were included and they received apexification with calcium hydroxide paste. X-ray observation of the tooth apex was performed at 1, 3, 6, 12 and 24 months after operation. RESULTS AND CONCLUSION:Among the 34 cases, 32 cases were successful and 2 cases failed in apexification of immature permanent teeth with calcium hydroxide paste, the success rate was 94%. 16 cases had apical closure at 9-12 months, 15 cases finished apexification at 12-15 months, 1 case with severe infection finished induction at 18-21 months, and two cases could not finish induction at 24 months. During 2 years of folow-up period, there were no recurrence of periapical periodontitis, tooth loose and shedding, tooth fracture, root progressive absorption and other complications. Al the teeth had type II apical closure, and there were no type I and IV apical closure, and the rare cases had the type between II and III which was difficult to distinguish. Apexification with calcium hydroxide paste for immature permanent teeth with incomplete developed root can preserve the affected teeth, aleviate inflammation, and show good induction effects.
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BACKGROUND:Chroming can improve the corrosion resistance of soft magnetic aloys. OBJECTIVE:To identify the optimal chroming conditions of two soft magnetic aloys, Fe-Cr-Mo and Fe-Ni, so as to improve their corrosion resistance. METHODS:Twelve pieces of square-shaped Fe-Cr-Mo and Fe-Ni soft magnetic aloys were casted in the size of 20 mm×20 mm×2 mm. After sanding and polishing, chrome plating was performed on these specimens and the coating thickness and hardness were measured. The selection factors included electroplate type (hexavalent chromium and trivalent chromium), current density (15, 20, 25, 35, 40, 45 A/dm2) and electroplating time (30, 40, 60 minutes). The optimal chroming conditions were determined by one-factor experimental method and the chrome plating was observed under a scanning electron microscope. RESULTS AND CONCLUSION:Cr6+ coating was significantly better than Cr3+ coating in the aspects of hardness, thickness and uniformity, indicating Cr6+ coating can significantly improve the corrosion resistance of Fe-Cr-Mo and Fe-Ni aloys. For Fe-Cr-Mo soft magnetic aloy, the optimal conditions of Cr6+ coating were as folows: current density of 45 A/dm2 and electroplating time of 60 minutes; the optimal conditions of Cr3+ coating were as folows: current density of 20 A/dm2 and electroplating time of 30 minutes. For Fe-Ni soft magnetic aloys, the optimal conditions of Cr6+ coating were as folows: current density of 35 A/dm2 and electroplating time of 60 minutes; the optimal conditions of Cr3+ coating were as folows: current density of 20 A/dm2 and electroplating time of 40 minutes.
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BACKGROUND:Studies have demonstrated that implantation of pile and different amount of residual tooth can change the stress distribution patterns of the tooth dentin within the residual root, and have an effect on the fracture mode of post-core restoration. OBJECTIVE:To evaluate the effects of the different amount of residual tooth on the fracture mode under oblique loading conditions in fiber pile composite resin core ful crown restoration. METHODS:Forty single rooted premolars extracted from orthodontic patients were divided into four groups after root canal preparation and filing. The plane going through buccal and lingual enamel cementum border midpoint and perpendicular to the long axis of the tooth was taken as the reference plane, so that the remaining amount of the tooth were 0, 1, 2, 3 mm. Fiber pile composite resin core metal ful restoration was conducted. After the repair, the oblique loading at 45° and at the rate of 1 mm/min was conducted. Fracture mode and load-displacement curve when root fracture occurred were recorded. RESULTS AND CONCLUSION:The tooth neck fracture usualy occurred in the 0 mm group, and central root fracture usualy occurred in the remaining three groups. There was a significant difference in the total fracture mode between 0 mm group and the remaining three groups (P 0.05). In oblique loading conditions, when the remaining tooth structure was smal, the prosthesis was prone to have dental neck fracture. Fiber posts played a protective role in the tooth root, but the clinical probability of failure increased. The fracture mode was changed with the increase of residual tooth amount, transferring from the neck edge to the root. These results demonstrate that we must retain more tooth tissue from the crown in the restoration of residual root with fiber post-core crown.
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BACKGROUND:Temporary crown has been used widely in clinic. The physical properties and biological safety of temporary crown and cement materials are more superior along with the development of material science. OBJECTIVE:To summarize clinical application, physical properties and biological safety of the temporary crown and cement materials. METHODS:PubMed database was searched by the key words of temporary crown, provisional crown, temporary restoration, provisional restoration, interim restoration in English to retrieve relevant articles published from January 2004 to December 2014. Literatures addressing the temporary crown and cement materials were included, and the repetitive researches were excluded. RESULTS AND CONCLUSION:Through the clinical evaluation and experimental study, the physical properties (polymerization shrinkage, polymerization heat production, polymerization monomer release) and biological safety (cytotoxicity, irritation to the soft tissue) of the temporary crown and cement materials are the key problems needed to overcome. With the appearance of new materials and new fabrication methods, the temporary crown and adhesive materials have great application prospect and higher clinical value, but in the exploration process of the laboratory research and clinical application, there are many problems to be solved.
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BACKGROUND:In the comprehensive treatment of cracked teeth, the temporary protection using the orthodontic band and resin temporary crown can effectively prevent tooth fracture and protect the cracked teeth with a higher clinical success rate. OBJECTIVE:To evaluate the differences in clinical efficacy of orthodontic band and resin temporary crown on the temporary protection of cracked teeth. METHODS: Totaly 189 patients (97 males and 92 females, aged 19-65 years) with cracked teeth were selected, randomly divided into two groups and respectively underwent the temporary protection to cracked teeth with the orthodontic band (n=93) and resin temporary crown (n=96) in the comprehensive treatment. Retention effect, periodontal status and patient satisfaction were observed. RESULTS AND CONCLUSION:There were three cases with loose band and one case with faling band in the group of orthodontic band; there were two cases with faling band in the group of resin temporary crown. No significant difference between two groups in the retention effect was found. There were 11 cases of gingivitis or exploring hemorrhage in the group of orthodontic band and 2 cases in the group of resin temporary crown, indicating the periodontal status in the group of resin temporary crown was better than that in the group of orthodontic band (P< 0.05). There were 18 cases of lower satisfaction for poor color, expand feeling caused by the rubber band and discomfort caused by the band protruding from tooth surface in the group of orthodontic band; there were 3 cases of lower satisfaction in the group of resin temporary crown, and the patient satisfaction in the group of resin temporary crown were higher than that in the group of orthodontic band (P < 0.05). There is a better clinical effect in the temporary protection to cracked teeth by using the resin temporary crown, especialy in the terms of retention effect, periodontal status and patient satisfaction.
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Objective To evaluate the reliability of the panoramic radiographs for diagnosing mandibular asymmetry.Methods A total of 25 cases with no asymmetry in chief complaint or in appearance were selected for symmetry group.Pa and PAC from 16 cases of facial asymmetry were selected for asymmetric group.Marker points were fixed,a reference line and the reference plane drawn,and then relevant measurement items determined.The repeatability of the fixed position was observed.The difference of all measurement items between the left and right on Pa in symmetry group and asymmetric group were compared respectively and the asymmetric rate of corresponding measuredvalues on two sides between two groups were observed too.Correlation test was used to evaluate the measured-values on Pa and PAC in asymmetric group.Results Dispersion became smaller with the help of reference line and reference plane.And the dispersion was larger when Me was used as a marker other than MF.Most measured-values in symmetry group on Pa and all measured-values in asymmetric group on Pa showed statistically significant difference (P＜ 0.05).The mean difference of CP-GoP distance representing the vertical measured-value was 4.73 mm (P＜0.01); and the mean difference of GoP-MF distance representing the horizontal measured-value was 5.77 mm (P＜0.01).The horizontal measurements on PA and PAC showed closer correlation (r=0.78～0.85,P＜0.01) while the vertical was poorer (r=0.64,P＜0.01).Conclusions This study suggests that marking assisted with reference line and reference plane could get a more repeatable fixed-point on Pa.MF point could be used as a fixed-point for measuring mandibular asymmetry on Pa and the Pa measurement can be used to evaluate mandibular asymmetry.
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Objective To investigate the change of serum osteoprotegerin level and relationships between serum osteoprotegerin level and coronary heart disease (CHD) in patients with type2 diabetes mellitus (DM) complicated with CHD.Methods One hundred and eight patients with type 2 DM complicated with CHD were selected as DM with CHD group,including 68 cases with acute coronary syndrome and 40 cases with stable angina pectoris.In addition,60 type 2 DM patients without CHD (DM without CHD group) and 40 healthy people (control group) were selected.Serum osteoprotegerin level was measured by enzyme linked immunosorbent assay.Results The serum osteoprotegerin level in DM with CHD group was significantly higher than that in DM without CHD group and control group [(4.12 ± 0.71)ng/L vs.(2.69 ± 0.52) and (2.14 ± 0.37) ng/L],and there were statistical differences (P＜ 0.05 or ＜ 0.01).In DM with CHD group,the serum osteoprotegerin level in acute coronary syndrome was significantly higher than that in stable angina pectoris [(4.56 ±0.92) ng/L vs.(3.61 ±0.76) ng/L],and there was statistical difference (P ＜ 0.05).The serum osteoprotegerin level in patients with Gensini score ＞ 40 scores (41 cases)was significantly higher than that in patients with Gensini score 20-40 scores (53 cases) and patients with Gensini score ＜ 20 scores (14 cases) [(4.92 ± 0.89) ng/L vs.(4.08 ± 0.75) and (3.39 ± 0.85) ng/L],and there were statistical differences (P ＜ 0.01 or ＜ 0.05).The serum osteoprotegerin level in patients with Gensini score 20-40 scores was significantly higher than that in patients with Gensini score ＜ 20 scores,and there was statistical difference (P ＜0.05).The serum osteoprotegerin level in single-vessel lesion (16 cases),double-vessel lesion (57 cases) and three-vessel lesion (35 cases) [(3.52 ± 0.82),(4.54 ± 0.68),(4.75 ±0.93) ng/L] were significantly higher than those in control group,and there were statistical differences (P ＜ 0.05); and the serum osteoprotegerin level in double-vessel lesion and three-vessel lesion were significantly higher than those in single-vessel lesion,and there were statistical differences (P ＜ 0.05) ;there was no statistical difference between three-vessel lesion and double-vessel lesion(P＞ 0.05).The results of Logistic regression analysis showed that glycosylated hemoglobin,total cholesterol,high sensitivity C reactive protein and osteoprotegerin were independent risk factors of type 2 DM complicated with CHD.Conclusions Serum osteoprotegerin level in patients with type 2 DM complicated with CHD is significantly increased.There is a significant association between serum osteoprotegerin level and the presence and severity of CHD,and the serum osteoprotegerin level is independent risk factors of type 2 DM complicated with CHD.
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In-stent restenosis after stenting is a major problem to perplex the minimally invasive interventional treatment and development in atherosclerotic cardio-cerebrovascular diseases.Intravascular inflammatory response is one of the important causes for restenosis after stenting in which as represented by interleukins,the cytokines play complex and variable roles.This article reviews the effects of the expression levels of interleukins on vascular endothelial hyperplasia and the incidence of in-stent restenosis.
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Serum bone alkaline phosphatase (BAP) , osteocalcin (OC) , C-telopeptides of type-1 collagen (CTx) , osteoprotegerin (OPG) levels, and bone mineral density (BMD) were evaluated in 62 hyperthyroid patients and 60 healthy subjects matched for sex and age. In hyperthyroid patients, the biochemical evaluations and bone density were performed before and after 6 months of methimazole ( MMI) treatment. Results showed that the BMD in lumbar spine L2 - L4, neck of femur, Ward's triangle and greater trochanter of patients before treatment were all significantly lower than those in healthy controls, and improved markedly after MMI treatment. The serum bone turnover parameters BAP, OC and CTx in patients before treatment were all significantly higher than those in control group, and were decreased markedly after treatment. The serum OPG level in patients with hyperthyroidism was significantly higher than that in healthy controls, and decreased markedly after treatment. The serum OPG levels were significantly correlated with bone turnover parameters ( BAP, OC, CTx) and BMD, which indicates that serum OPG level can reflect the abnormality of bone metabolism in patients with hyperthyroidism.
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Objective To provide basis of preventing and treating complications by monitoring plasma colloid osmotic pressure and blood clotting function during anesthesia of percutaneous nephrolithotomy (PCNL).Methods 30 patients with upper urinary calculus were equally and randomly divided into two groups according to the different anesthesia method. In General anesthesia group, Midazolam 0. 1 mg/kg、diprivan 1.5mg/kg、Vecuronium bromide 0. 15mg/kg、fentanyl 4μg/kg were used to guide and forane 1 ～ 1.3MAC were used to keep inhalation anesthesia. In lumbar-epidural anesthesia group T12～12 or T12 ～ L1 epidural anesthesia with 0.75% ropivacaine 8 ～ 10 ml and L2～4 lumbar anesthesia with bupivacaine 10mg were used. Plasma colloid osnotic pressure, central venous pressure and TEG were detected at the beginning and at the end of operation and fluid consumption were compared between the two groups. Results There was no obvious difference between the two groups. In both groups ,COP was obviously reduced and CVP was improved after the operation which significantly different with those pre-operation ( all P <0. 01 ). R value reduced significantly(P <0. 05). There were 10 patients complicated with chilling, unconffortability,or anxiety. Conclusion During anesthesia of percutaneous nephrolithotomy, with operation time going on, COP reduced obviously, which increased the risk of heart failure, pulmonary edema, etc. but had no effect on blood clotting.
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Objective To analyze imaging infarct patterns and features in patients with severe stenosis or occlusion of internal carotid artery (ICA) and middle cerebral artery (MCA)from the point of view of diffusion-weighted imaging (DWI) and to investigate the infarction related mechanism. Methods Eighty-eight patients with acute ischemic stroke who had moderate to severe ICA or MCA stenosis or occlusion confirmed by cerebral angiography were analyzed retrospectively. They were divided into ICA lesion and MCA lesion groups. The infarct patterns were classified as single and multiple according to DWI. The former were reclassified as perforating artery infarct (PAI), pial infarct (PI), watershed infarct, and large infarct. Results There were 11 types of infarct patterns in MCA territories. The DWI multi-infarct pattern accounted for 62.5% of all patients (55/88). PI with watershed infarction appeared more often in the ICA lesion group (11/45, P=0. 040), and PI with PAI appeared more often in the MCA lesion group (10/43, P = 0. 037). Conclusions In patients with cerebral infarction associated with ICA or MCA severe stenosis or occlusion, most of them showed multi-infarct pattern,which suggested the mixed mechanisms such as embolization, hypoperfusion/impaired clearance of emboli, and local perforating branch occlusion were the main mechanisms of the occurrence of cerebral infarction. The main mechanism of cerebral infarction in the ICA lesion group was embolization combined with hypoperfusion/impaired clearance of emboli, while in the MCA lesion group was embolization combined with local perforating branch occlusion.
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Transient ischemic attack is an unstable cerehrovascular sign and a neurological emergency. The development of neuroimaging not only provides an important approach for insight into the understanding of transient ischemic attack, but also becomes one of the hotspots in the research of transient ischemic attack.
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In recent years, here are many new understandings in the definition, etiology, diagnosis and treatment of transient ischemic attack (TLA).The latest viewpoint considers that TIA is a transient episode of neurological dysfunction caused by brain, spinal cord or focal retinal ischemia, without the evidence of acute infarction. The duration of TIA is no longer the key factor, whether the existence of infarction or not is the key factor in the differentiation of TIA and ischemic stroke. Therefore ,it should emphasize the importance of neuroimaging in the diagnosis of TIA. As a neurological emergency, the risk level of TIA should be stratified and evaluated, and the active interventions should be performed.