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Objective:To explore the clinical application value of limb remote ischemic postconditioning (LRIPC) in patients with acute cerebral infarction after recanalization.Methods:A total of 78 patients with acute cerebral infarction admitted to the First Affiliated Hospital of Shantou University Medical College from June 2017 to March 2019 were selected. According to the random number table method, they were divided into the observation group with 39 cases (LRIPC + conventional medical treatment) and the control group with 39 cases (conventional medical treatment). The National Institutes of Health Stroke Scale (NIHSS) and Montreal Cognitive Assessment scale (MoCA) scores, the changes of cerebral blood perfusion, cerebral infarction volume and the levels of nerve function indexes before and after the treatment were compared and analyzed.Results:After the treatment, the NIHSS scores in the observation group were lower than thosein the control group, and the MoCA scores were higher than those in the control group, the differences were statistically significant ( P<0.05). After the treatment, the mean transit time of cerebral blood flow in the observation group was shorter than that in the control group, while the regional cerebral blood flow and regional cerebral blood volume were higher than those in the control group, the differences were statistically significant ( P<0.05). After the treatment, the volume of cerebral infarction in the observation group was lower than that in the control group ( P<0.05). After the treatment, the levels of matrix metalloproteinase 9 and S-100B protein in the observation group were lower than those in the control group: (142.45 ± 36.23) mg/L vs. (176.89 ± 42.63) mg/L, (2.52 ± 0.46) μg/L vs. (3.61 ± 0.75) μg/L; and the level of nerve growth factor was higher than that in the control group: (143.49 ± 10.58) μg/L vs. (124.96 ± 13.62) μg/L, the differences were statistically significant ( P<0.05). Conclusions:LRIPC can improve the nerve functions, cognitive functions andreduce the volume of cerebral infarction by improving cerebral blood flow. It also has a good effect on alleviating the neurological functional impairment after vascular recanalization.
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Objective: To analyze the clinical pathological characteristics and prognosis of breast cancer patients with uncommon metastases. Methods: Clinical data of 68 cases of breast cancer with uncommon metastases from 2012 to 2015 was retrospectively analyzed. The definition of uncommon sites of metastases is the metastatic sites except for lymph node, chest wall, breast, bone, liver, lung, brain and peritoneal and pleural metastases. Results: Among the 68 patients, the uncommon metastatic sites included adrenal gland, ovary, pancreas, eyes, uterus, spleen, rectum, bladder, kidney, thyroid gland and parotid gland. The top three common metastatic sites were adrenal gland (44.1%, 30/68), ovary (41.2%, 28/68) and pancreas (11.8%, 8/68); 75.0% (51/68) of the patients had other common metastases. The median survival time after uncommon metastases was 23.5 months (range: 1.4-116.0 months). The univariate analysis showed that the patients without metastases outside the special sites had a better survival than those with common metastases (median survival time were 36.0 and 18.0 months, respectively; P = 0.007). Conclusion: Breast cancer metastasis is widespread, in addition to the common sites, the cancer can be transferred to many other sites. Patients with uncommon metastases from breast cancer may have a favorable prognosis if they do not accompany with other common metastases, and local treatment may improve the survival of some selected patients. Many ovarian metastases are found after the operation, and the possibility of ovarian metastasis should be considered in the selection of the method of ovarian ablation.
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Objective To explore the incidence and risk factors of depression in coronary heart disease patients who underwent revascularization therapy. Methods A total of 493 patients who were admitted in Tianjin chest hospital from April 2012 to February 2013 were enrolled, among whom 258 patients acceptted coronary artery bypass grafting (CABG) and the rest 235 patients underwent percutaneous coronary intervention (PCI). Self-rating depression scale (SDS) was employed to assess the state of patients at both1 day before and 7 days after the operations. According to the postopera?tive scores, CABG group was divided into the depression group (n=90) and non-depression group (n=168) while PCI group was also divided into depression group (n=54) and non-depression group (n=181). Basic clinical datum of patients were col?lected and analyzed and independent risk factors of depression was analyzed though logistic multi-variant regression. Results The incidence of postoperative depression among CABG patients was significantly higher than that in PCI patients (P<0.05).(1)In the CABG group, age, ratio of female gender, alcohol intake, rate of past depression, length of anaesthesia, length of staying in ICU and incidence of postoperative cognitive dysfunction(POCD)were all higher in depression subgroup than those in non-depression subgroup. Female and preoperative depression were both independent risk factors for postoper?ative depression in patients underwent CABG.(2)In PCI group, ratio of female gender, blood pressure, incidence of Diabe?tes Mellitus, the rate of past Myocardiac infaction (MI), length of intervention therapy and the number of planted stents were all higher in depression subgroup than non-depression subgroup. Female, past MI and length of intervention therapy are all independent factors of post-operative depression in patients underwent PCI. Conclusion Incidence of depression in pa?tients underwent revascularization is high. Female is the dependent risk factor in both CABG group and PCI group. Com?pared with PCI, CABG had greater influence on development of depression in postoperative patients.
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Objective To explore the reasonable experimental parameters on establishment of rabbit model of infusion phlebitis induced by mannitol.Methods New Zealand rabbits were injected with 20％ mannitol,then pathological lesion of rabbit auricular vein induced by different infusion velocity,different sampling time and sites were observed under microscope with vascular injury,inflammatory cell infiltration,frequency of thrombokinesis as indexes.Results The three indexes were the highest and the most obvious characteristics of infusion phlebitis were noted at the following experimental conditions:5.0 ml/min (infusion velocity),sampling time at 24h after administration and sampling site at 1cm region in front of the catheter tip.Conclusions Rabbit model of infusion phlebitis induced by mannitol can be set up more stable by using these parameters.