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Objective To explore the predictive value of short term cognitive assessment in the acute phase of ischemic stroke for 3-6 months after stroke.Methods The demographic data,vascular risk factors,clinical and imaging data of 254 patients with acute ischemic stroke from August 2016 to December 2017 were prospectively registered.The cognitive function was assessed by Mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) 3 weeks after stroke onset.Comprehensive cognitive function assessment was performed after 3-6 months of stroke.Multiple factor Logistic regression was used to screen the independent risk factors of cognitive domain and overall cognitive function in 3-6 months.Results Totally 254 consecutive patients with acute ischemic stroke were enrolled.Combined with the inclusion and exclusion criteria,161 patients completed the baseline cognitive assessment,and 138 completed the comprehensive cognitive assessment in 3-6 months after stroke.Logistic regression analysis showed that 3 weeks baseline cognitive status was an independent factor affecting memory (P＜0.05,OR =62.47,95％CI=13.00-205.00),execution (P＜0.05,OR=38.29,95％CI=8.00-170.00),language (P＜0.05,OR=6.46,95％CI=2.31-18.04) and information processing speed (P＜0.05,OR=5.88,95％CI=2.24-15.41) in 3-6 months after stroke.According to the number of impaired cognitive domains,the overall cognitive function was defined.There were 61 cases of no or mild cognitive dysfunction group and 77 cases of moderate or severe cognitive impairment group.Multifactor logistic analysis showed that baseline cognitive status was independent of the overall cognitive function of 3-6 months after apoplexy adjusting for the age and education level (P＜0.05,OR=25.32,95％ CI =7.52-85.39).Conclusion Short cognitive assessment in early apoplexy can predict the short-term functional status of cognitive domains such as memory,execution,language and information processing speed after stroke,and can also predict the overall cognitive level.
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Objective To investigate the predictive role of cerebral white matter lesions (WML) and subcortical atrophy on cognitive function in patients with acute ischemic stroke (AIS) after 3 months.Methods 233 cases of AIS patients admitted to hospital continuously from September 2016 to March 2018 were enrolled and all of them underwent brain MRI.The degree of WML on FLAIR was evaluated according to the Fazekas grading standard.The linear measurement of subcortical atrophy on T1WI was carried out on the subcortical brain atrophy index,including EVANS ratio (ER),inverse cella media index (iCMI),caudate head index (CHI) and basal cistern index (BCI).Demographic,clinical and imaging data of all patients were also recorded.Mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) were conducted at 3 months after AIS.The patients were divided into normal cognitive function (NCI) group and post stroke cognitive impairment (PSCI) group according to evaluation results of MMSE and MoCA.Multivariate logistic regression analysis was used to screen the independent risk factors of cognitive impairment.Results Univariate analysis showed that age (t=-4.233,P=0.000),sex (x2 =7.501,P=0.006),education (H=21.188,P=0.000),NHISS score (H =5.791,P=0.016),history of atrial fibrillation (x2 =6.484,P=0.011),TIA (x2 =9.015,P=0.003),smoking history (x2 =6.943,P=0.008),Fazekas WML score (x2 =27.885,P=0.000),EVANS ratio (H =31.129,P =0.000),inverse cella media index (H =9.434,P =0.002),caudate head index (H=15.148,P=0.000),basal cistern index (t=-1.979,P=0.049) and baseline cognitive function (x2=136.994,P=0.000) were related to cognitive impairment in patients with AIS after 3 months (P＜0.05).Multivariate logistic regression analysis showed that WML score (OR=3.416,P=0.047,95％CI:1.017-11.482),EVANS ratio (OR=1.245,P=0.038,95％CI:1.012-1.531) and caudate head index (OR =1.187,P=0.040,95 ％ CI:1.008-1.397) were risk factors for cognitive impairment in AIS patients after 3 monfths adjusting for age,education,disease severity and baseline cognitive function.Conclusion WML,EVANS ratio and caudate head index can predict short-term cognitive function in patients with AIS.
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Objective:To investigate the distribution and drug resistance of anaerobic bacteria in the patients with oral and maxillofacial infection.Methods:Aerobic and anaerobic bacteria cultures from 61 specimens of pus from the patients with oral and maxillofacial infection in the Department of Oral and Maxillofacial Surgery,Peking University School of Stomatology were identified.The culture type was evaluated by API 20A kit and drug resistance test was performed by Etest method.The clinical data and antibacterial agents for the treatment of the 61 cases were collected,and the final outcomes were recor-ded.Results:The bacteria cultures were isolated from all the specimens,with aerobic bacteria only in 6 cases (9 .8%),anaerobic bacteria only in 7 cases (1 1 .5%),and both aerobic and anaerobic bacteria in 48 cases (78.7%).There were 55 infected cases (90.2%)with anaerobic bacteria,and 81 anaero-bic bacteria stains were isolated.The highest bacteria isolation rate of Gram positive anaerobic bacteria could be found in Peptostreptococcus,Bifidobacterium and Pemphigus propionibacterium.No cefoxitin, amoxicillin/carat acid resistant strain was detected in the above three Gram positive anaerobic bacteria. The highest bacteria isolation rate of Gram negative anaerobic bacteria could be detected in Porphy-romonas and Prevotella.No metronidazole,cefoxitin,amoxicillin/carat acid resistant strain was found in the two Gram negative anaerobic bacteria.In the study,48 patients with oral and maxillofacial infection were treated according to the results of drug resistance testing,and the clinical cure rate was 81 .3%. Conclusion:Mixed aerobic and anaerobic bacteria cultures are very common in most oral and maxillofa-cial infection patients.Anaerobic bacteria culture and drug resistance testing play an important role in clinical treatment.
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Objective:To explore a rapid and cost-effective method for identification of Candida gla-brata through the comparison of two different methods , using molecular methods of sequencing as gold standard.Methods:From our clinic, 200 strains of suspected Candida glabrata were collected during the last 3 years and selected after incubation in CHROMagar Candida medium for 48 h.By comparing the results of the CHROMagar Candida medium, the identification of the rapid trehalose test for different kinds of strains were analyzed under incubation in the tubes for 3 h, 6 h, and 24 h at 37 ℃and 42 ℃, respectively .All the strains were identified to species level by methods of sequencing .The optimal time and temperature of the trehalose test for the identification of Candida glabrata were assessed .Two different methods, CHROMagar Candida medium and the rapid trehalose test , in identification of Candi-da glabrata were compared.Results:In all the 200 strains, Candida glabrata ferment trehalose with 3 h incubation under 42 ℃ were the optimal time and temperature for fermenting trehalose .The accuracy , sensitivity, and specificity of the rapid trehalose test were 99.00% (198/200), 98.66% (147/149) and 100.00%(51/51).The accuracy rate of CHROMagar Candida medium was 79.50%(159/200), the sensitivity and specificity were only 89.93%(134/149) and 49.02%(25/51), however, compared with the domestic current popular methods , the rapid trehalose test had better time efficiency ratio .Con-clusion:The evaluation results suggest that the rapid trehalose test has advantages in terms of operational convenience and low cost , and the results can be obtained in 3 h.Therefore, it has application value in clinical laboratory .
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Objective To explore the clinical efficacy of intranasal endoscopic turbinate fracture relocation press in treatment of chronic hypertrophic rhinitis.Methods According to digital table,66 patients with chronic hypertrophic rhinitis were randomly divided into two groups.33 cases in the observation group were treated with endoscopic sinus lateral fracture crush,33 patients in the control group received inferior turbinate submucosal injection of sclerosing treatment.The clinical effect was compared between the two groups.Results The total effective rate of the observation group was 93.9％,which was significantly higher than 72.7％ of the control group (x2 =6.23,P ＜0.05).The average nasal recovery time was (35 ± 12)d in the observation group,which was significantly shorter than (64 ± 21) d in the control group (t =1.74,P ＜ 0.05).The SCT test results had statistically significant differences between the two groups before treatment and 3 months after treatment (t =3.21,2.85,all P ＜0.05).After treatment,the difference was statistically significant between the two groups (t =2.13,P ＜ 0.05).Conclusion Endoscopic turbinate fracture relocation squeezing surgery in the treatment of chronic hypertrophic rhinitis was satisfied.