ABSTRACT
@#Background & Objective: Endovascular treatment is the widely accepted treatment for patients with anterior circulation stroke within 6 hours of onset of stroke. We aimed to evaluate the advantages of endovascular treatment compared to standard medical treatment in treating patients with anterior circulation stroke beyond the 6-hour therapeutic window. Methods: We reviewed the literature concerning endovascular treatment versus medical treatment beyond the 6-hour therapeutic window. Using random-effects meta-analysis, we evaluated the following outcomes: modified Rankin scale in the three-month follow-up [excellent outcome (mRS≤1), functional independence (mRS≤2), moderate outcome(mRS≤3)], recanalization rate at 24 hours, mortality at 90 days or in-hospital, symptomatic intracranial hemorrhage, parenchymal hematoma type 2 and hemorrhagic infarction 1. Results: Four studies including 642 patients were evaluated. Endovascular treatment was associated with higher odds of excellent outcome (OR 2.55; 95% CI 1.48 to 4.41,), functional independence (OR 3.64; 95% CI 2.43 to 5.45), moderate outcome (OR 2.70; 95% CI 1.95-3.74) and recanalization rate at 24 hours (OR 8.81; 95%CI 2.81 to 27.69) compared to MT. No difference in the rates of mortality, symptomatic intracranial hemorrhage, parenchymal hematoma type 2 or hemorrhagic infarction 1 was found between the 2 groups. Studies using strict perfusion imaging inclusion selection showed better moderate outcome in comparison to the studies without perfusion imaging inclusion selection (P <0.012). Conclusion: Our study highlights the superiority of endovascular treatment over standard medical treatment alone for treating patients with anterior circulation stroke beyond 6 hours since stroke onset, although more studies are required for further investigation. Standard of strict selection for eligible patients before endovascular treatment should be based on DAWN or DEFFUSE 3 inclusion criteria.
ABSTRACT
Objective@#To provide empirical evidence on the effectiveness of comprehensive sexuality education (CSE) on sexual knowledge and sexual attitudes improvement among college students.@*Methods@#Sexual knowledge and attitudes questionnaire survey was implemented among college students in Beijing, who later received the CSE for a full semester. Sexual knowledge and attitude were evaluated after intervention and were compared with control students.@*Results@#The average score of sexual knowledge was low among college students in Beijing. Most students held neutral attitudes towards "AIDS community" and "masturbation behavior" and positive attitudes towards "LGBT"(58.85%, 68.75%, 61.98%). Compared with the control group, after one semester of CSE curriculum intervention, the average scores of the five dimensions on sexual knowledge in the intervention group was significantly improved(11.79±1.16, 9.36±1.23, 4.84±0.88, 4.91±1.00, 5.35±1.03)(t=11.25, 15.74, 10.37, 5.59, 8.17, P<0.01), and the attitudes towards "sexual minorities", "AIDS communities" and "masturbation behavior" were also significantly improved(30.59±3.91, 17.70±3.41, 10.12±2.17)(t=5.16, 5.83, 2.97, P<0.01).@*Conclusion@#College students’ knowledge of sexuality is not optimistic. The attention to proper sexual attitudes is in great need. Systematic and comprehensive sexuality education curriculum could improve college students’ sexual knowledge and attitudes.
ABSTRACT
Objective To evaluate the clinical effect of endovascular embolization for the treatment of cerebellar arteriouvenous malformations (AVMs) associated with aneurysm, and to discuss its technical points. Methods The clinical data of 142 patients with cerebellar AVMs were retrospectively analyzed. Of the 142 patients, 42 had concomitant aneurysms. The patients were divided into concomitant aneurysm group and without aneurysm group. Using univariate and multivariate statistical models, the patient’s gender and age, the presence or absence of hemorrhage, the lesion’s location and size, and the presence or absence of deep venous drainage were analyzed. Results A total of 61 concomitant aneurysms were detected in the 42 patients, which were located within the malformation mass (n=14) or on the feeding artery (n=47). The concomitant aneurysms located in the malformation were closely related to AVM hemorrhage and the deep venous drainage. During the follow-up period after endovascular embolization, no recurrence of bleeding was observed in all the 42 patients. Conclusion In order to reduce the relapse rate of hemorrhage, the formulation of therapeutic measures should be based on the management of the concomitant aneurysm when endovascular embolization treatment is employed for AVM associated with aneurysm.