Influencing factors of early mortality after heart transplantation and constructing a prediction model / 中华器官移植杂志

Objective:To explore the risk factors for early mortality in heart transplant(HT)recipients and construct a nomogram prediction model.Methods:From 2018 to 2022, preoperative clinical data were retrospectively reviewed for 163 consecutive HT recipients.Risk factor variables were shortlisted by univariate correlation analysis based upon early(90-day)postoperative patient survival.Lasso regression was then employed for screening all variables and common variables were combined.A nomogram was constructed for predicting the probability of early mortality after considering actual circumstance.Receiver operating characteristic(ROC)curve, area under the ROC curve(AUC), Harrell's C-index and calibration curves were employed for evaluating and internally validate the performance of the model.Decision curve analysis was performed for assessing clinical utility of the model.Results:In survival and mortality groups, mechanical ventilation, nervous system lesions, use of extracorporeal membrane oxygenation, red blood cell count ≤3.52×10 12/L, mean pulmonary arterial pressure>27 mmHg, pulmonary vascular resistance>4.01 Wood Unit, albumin≤33 g/L, aspartate aminotransferase >50 U/L, hemoglobin ≤108 g/L, platelet count ≤109×10 9/L and total bilirubin>57 μmol/L demonstrated statistically significant differences( P<0.05). At the same time, according to actual situations and different variables, hemoglobin ≤108 g/L, albumin ≤33 g/L, platelet count ≤109×10 9/L, total bilirubin>57μmol/L, aspartate aminotransferase>50 U/L, nervous system lesions and average pulmonary arterial pressure >27 mmHg were seven variables.And a nomogram with relatively high reliability was constructed for predicting the probability of early mortality post-HT(nomogram model evaluation, AUC 0.917, C index 0.910 and good calibration curve). Decision curve analysis indicated that the nomogram could benefit HT recipients. Conclusions:Risk factors have been identified for early mortality in HT recipients.And the nomogram prediction model offers a simple and reliable tool for predicting early mortality post-HT.It has important implications for individualized treatment of HT candidates.

Chinese expert consensus on diagnosis, treatment and prevention of venous thrombus embolism associated with chest trauma (2022 version) / 中华创伤杂志

Chest trauma is one of the most common injuries. Venous thromboembolism (VTE) as a common complication of chest trauma seriously affects the quality of patients′ life and even leads to death. Although there are some consensus and guidelines on the prevention and treatment of VTE at home and abroad, the current literatures lack specificity considering the diagnosis, treatment and prevention of VTE in patients with chest trauma have their own characteristics, especially for those with blunt trauma. Accordingly, China Chest Injury Research Society and editorial board of Chinese Journal of Traumatology organized relevant domestic experts to jointly formulate the Chinese expert consensus on the diagnosis, treatment and prevention of chest trauma venous thromboembolism associated with chest trauma (2022 version). This consensus provides expert recommendations of different levels as academic guidance in terms of the characteristics, clinical manifestations, risk assessment, diagnosis, treatment, and prevention of chest trauma-related VTE, so as to offer a reference for clinical application.

The relationship between periprocedural thrombus migration and clinical outcomes in patients with acute large vessel occlusion after mechanical thrombectomy / 中华神经科杂志

Objective:To investigate the early predictive factors of periprocedural thrombus migration and the relationship between periprocedural thrombus migration and prognosis after mechanical thrombectomy (MT) in stroke patients.Methods:The patients with anterior circulation acute large vessel occlusion stroke (ALVOS) who underwent MT in the Stroke Center of Yijishan Hospital of Wannan Medical College from May 2015 to December 2019 were retrospectively analyzed. The baseline characteristics, procedural and clinical outcomes were collected. Univariate and multivariate regression analysis was used to explore the risk factors of thrombus migration and the relationship between thrombus migration and prognosis of patients.Results:There were 302 ALVOS patients [(68.8±11.0) years old and 166 males (55.0%)] included, of whom thrombus migration was identified in 80 patients (26.5%), including 60 cases (75.0%) of proximal migration. Cardiogenic stroke ( OR=2.722, 95% CI 1.367-5.418, P=0.004) and clot burden score (CBS; OR=0.849, 95% CI 0.745-0.968, P=0.015) were independent risk factors of thrombus migration. Proximal migration ( OR=2.822, 95% CI 1.220-6.528, P=0.015) was an independent risk factor of 90-day clinical outcome, while the effect of distal migration on 90-day clinical outcome was not statistically significant. Conclusions:Cardiogenic stroke and lower CBS score are independent predictors of periprocedural thrombus migration in ALVOS patients who underwent MT. Proximal migration is an independent risk factor for the prognosis of patients, which has important clinical intervention significance.

Noncontrast Computed Tomography-Based Radiomics Analysis in Discriminating Early Hematoma Expansion after Spontaneous Intracerebral Hemorrhage

Objective@#To determine whether noncontrast computed tomography (NCCT) models based on multivariable, radiomics features, and machine learning (ML) algorithms could further improve the discrimination of early hematoma expansion (HE) in patients with spontaneous intracerebral hemorrhage (sICH). @*Materials and Methods@#We retrospectively reviewed 261 patients with sICH who underwent initial NCCT within 6 hours of ictus and follow-up CT within 24 hours after initial NCCT, between April 2011 and March 2019. The clinical characteristics, imaging signs and radiomics features extracted from the initial NCCT images were used to construct models to discriminate early HE. A clinical-radiologic model was constructed using a multivariate logistic regression (LR) analysis. Radiomics models, a radiomics-radiologic model, and a combined model were constructed in the training cohort (n = 182) and independently verified in the validation cohort (n = 79). Receiver operating characteristic analysis and the area under the curve (AUC) were used to evaluate the discriminative power. @*Results@#The AUC of the clinical-radiologic model for discriminating early HE was 0.766. The AUCs of the radiomics model for discriminating early HE built using the LR algorithm in the training and validation cohorts were 0.926 and 0.850, respectively.The AUCs of the radiomics-radiologic model in the training and validation cohorts were 0.946 and 0.867, respectively. The AUCs of the combined model in the training and validation cohorts were 0.960 and 0.867, respectively. @*Conclusion@#NCCT models based on multivariable, radiomics features and ML algorithm could improve the discrimination of early HE. The combined model was the best recommended model to identify sICH patients at risk of early HE.

Research progress of anterior circulation tandem lesions / 中华神经科杂志

Tandem lesions are relatively rare type of acute large vascular occlusion. At present, the clinical treatment strategy of tandem lesions is still unclear and lack of definite evidence-based medicine. This article reviews the characteristics, endovascular treatment strategy and clinical prognosis of anterior circulation tandem lesions, and looks forward to the treatment of tandem lesions.

Qualitative research of initial motivation of undergraduate nursing students participating in aged nursing voluntary service in aged care facility / 中国实用护理杂志

Objective:To explore the initial motivation of nursing students to engage in voluntary service for the aged, and to provide scientific basis for the formulation of strategies and measures of voluntary service for the aged.Methods:Totally 25 nursing students volunteers who regularly participated in the volunteer service for the aged in Changsha First Welfare Home were selected by objective sampling method for semi-structured in-depth interviews, and the data were analyzed by Colaizzi phenomenological 7-step analysis method.Results:Four themes of nursing students' initial motivation to participate in voluntary service for the aged were extracted: self-interest motivation, altruistic motivation, affinity motivation and achievement motivation. Among them, self-interest motivation included two sub-themes: enriching college life and life experience, improving one's own ability and gaining professional experience; altruistic motivation included two sub-themes: accompanying and helping the elderly and eliminating loneliness of the elderly; affinity motivation included two sub-themes: establishing emotional sustenance and making up for the lack of emotion; achievement motivation included two sub-themes: facing challenges bravely, acquiring a sense of achievement, serving society and others, and realizing one's own value.Conclusion:Nursing students have a clear initial motivation to participate in the voluntary service for the aged of the aged care facilities, and schools can strengthen the relevant education for students to participate in voluntary service in the training of nursing talents. The voluntary service for the aged can formulate corresponding development strategies and incentives according to the initial motivation of nursing students, so that promote the expansion and stability of the voluntary service for the aged team, and promote the development and improvement of voluntary service for the aged.

Differential expression of miR-30a-5p in post stroke depression and bioinformatics analysis of the possible mechanism / 南方医科大学学报

OBJECTIVE@#To investigate the differential expression of miR-30a-5p in patients with poststroke depression and explore the possible mechanism.@*METHODS@#We obtained the target microRNAs through searching PubMed using the online software VENNY2.1. We collected the baseline demographic, clinical and radiographic data from consecutive patients with first-ever acute ischemic stroke on admission in our department from October, 2018 to March, 2019. From each patient, 5 mL peripheral venous blood was collected upon admission. Hamilton Depression Scale (HAMD-17) was used to evaluate the degree of depression at the end of the 3-month follow-up. The patients with a HAMD-17 score≥7 were diagnosed to have depression according to the diagnostic criteria of the Fourth Edition of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association (DSM-IV). The patients were divided into post-stroke depression group (PSD group, =11) and non-post-stroke depression group (non-PSD group, =25), and their plasma levels of miR-30a-5p were detected using qPCR. The STARBASE Database ENCORI miRNA-mRNA module and Comparative Toxicogenomics Database were used to predict and screen the possible target genes related to miR-30a-5p, and the possible mechanism of the target genes was further analyzed through bioinformatics.@*RESULTS@#miR-30a-5p was identified by cross-screening as the target miRNA associated with stroke and depression and showed obvious differential expression between PSD and non-PSD patients (2.462±0.326 1±0.126, < 0.0001). ROC curve analysis showed that the AUC of miR-30a-5p for predicting PSD was 0.869 (95%: 0.745-0.993, =0.0005) at the cutoff value of 1.597, with a sensitivity and specificity of 0.727 and 0.840, respectively. The target proteins of miR-30a-5p involved a wide range of biological processes, including signal transduction, intercellular communication, regulation of nucleobase, nucleoside, nucleotide and nucleic acid metabolism. KEGG pathway enrichment analysis showed that the target proteins affected mainly the neural nutrient signaling pathway, axon guidance signaling pathway and insulin signaling system. We also identified the top 20 HUB genes that might be associated with post-stroke depression.@*CONCLUSIONS@#Plasma miR-30a-5p is differentially expressed in PSD and can serve as a new blood marker for diagnosis and also a therapeutic target of PSD.

Differential expression of miR-30a-5p in post stroke depression and bioinformatics analysis of the possible mechanism / 浙江大学学报·医学版

OBJECTIVE@#To investigate the differential expression of miR-30a-5p in patients with poststroke depression and explore the possible mechanism.@*METHODS@#We obtained the target microRNAs through searching PubMed using the online software VENNY2.1. We collected the baseline demographic, clinical and radiographic data from consecutive patients with first-ever acute ischemic stroke on admission in our department from October, 2018 to March, 2019. From each patient, 5 mL peripheral venous blood was collected upon admission. Hamilton Depression Scale (HAMD-17) was used to evaluate the degree of depression at the end of the 3-month follow-up. The patients with a HAMD-17 score≥7 were diagnosed to have depression according to the diagnostic criteria of the Fourth Edition of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association (DSM-IV). The patients were divided into post-stroke depression group (PSD group, =11) and non-post-stroke depression group (non-PSD group, =25), and their plasma levels of miR-30a-5p were detected using qPCR. The STARBASE Database ENCORI miRNA-mRNA module and Comparative Toxicogenomics Database were used to predict and screen the possible target genes related to miR-30a-5p, and the possible mechanism of the target genes was further analyzed through bioinformatics.@*RESULTS@#miR-30a-5p was identified by cross-screening as the target miRNA associated with stroke and depression and showed obvious differential expression between PSD and non-PSD patients (2.462±0.326 1±0.126, < 0.0001). ROC curve analysis showed that the AUC of miR-30a-5p for predicting PSD was 0.869 (95%: 0.745-0.993, =0.0005) at the cutoff value of 1.597, with a sensitivity and specificity of 0.727 and 0.840, respectively. The target proteins of miR-30a-5p involved a wide range of biological processes, including signal transduction, intercellular communication, regulation of nucleobase, nucleoside, nucleotide and nucleic acid metabolism. KEGG pathway enrichment analysis showed that the target proteins affected mainly the neural nutrient signaling pathway, axon guidance signaling pathway and insulin signaling system. We also identified the top 20 HUB genes that might be associated with post-stroke depression.@*CONCLUSIONS@#Plasma miR-30a-5p is differentially expressed in PSD and can serve as a new blood marker for diagnosis and also a therapeutic target of PSD.

Risk factors of malignant brain edema after successful recanalization of acute large vascular occlusion stroke / 中华神经科杂志

Objective:To observe the incidence, risk factors of malignant brain edema (MBE) and the influence of MBE on outcomes after early successful recanalization of acute large vascular occlusion stroke (ALVOS).Methods:A total of 149 patients (age (68±11) years, male 85 (57.0%)) with ALVOS who underwent early endovascular treatment and achieved successful recanalization at the First Affiliated Hospital of Wannan Medical College from July 2014 to February 2019 were retrospectively analyzed. Baseline data, perioperative data, and 90-day prognostic information were collected from patients enrolled in the study. Univariate and multivariate analyses were used to explore the relationship between MBE and outcomes, and the risk factors of MBE.Results:Among the 149 patients, baseline National Institutes of Health Stroke Scale score was 16 (13, 20), baseline Alberta Stroke Project early CT score was 9 (8, 10), the time of onset-to-puncture was (248.3±61.3) minutes, and the onset-to-recanalization time was (312.4±69.7) minutes. MBE occurred in 23 patients (15.4%, 23/149). The 90-day favorable outcome (90-day modified Rankin Scale score≤ 2) in patients with MBE was significantly lower than those without MBE (17.4% (4/23) vs 61.1% (77/126), χ 2=14.985, P<0.001), and the 90-day mortality in patients with MBE was significantly higher than those without MBE (43.5% (10/23) vs14.3% (18/126), χ 2=10.861, P=0.003). MBE was shown to be an independent predictor of 90-day poor outcome (adjusted OR=12.078, 95 %CI 1.934-75.443, P=0.008) and death (adjusted OR=4.146, 95 %CI 1.060-16.216, P=0.041). Multivariate Logistic regression analysis showed that the collateral circulation status was related to the incidence of MBE in patients with ALVOS after successful recanalization (level 2 vs level 0, adjusted OR=0.109, 95 %CI 0.021-0.563, P=0.008). Conclusions:MBE is an independent risk factor of ALVOS patients with poor outcome or death in 90 days. For patients with ALVOS, even if the occlusive vessels have been successfully recanalized after early endovascular treatment, MBE is still not uncommon. The collateral circulation state is an independent predictive factor of the development of MBE after recanalization by early endovascular treatment in patients with ALVOS.

Protective effect and mechanism of Jinshuibao tablet on acute kidney injury induced by cisplatin in rats / 中国药科大学学报

@#This study aimed to observe the therapeutic effect and mechanism of Jinshuibao tablet on acute renal injury induced by cisplatin. Acute renal injury models in SD rats were induced separately by single intraperitoneal injection of cisplatin(5 mg/kg)and intravenous injection for 5 consecutive days at a dosage of 2 mg/kg per day. The renal function and renal histopathological changes were observed in rat acute renal injury models after prevention and treatment with Jinshuibao tablet, respectively. The content of tumor necrosis factor(TNF-α)and reactive oxygen species(ROS), the activity of Caspase 3 and the expression of t-p38, p-p38, Bax and Bcl-2 in the kidneys were detected. The results showed that preventive and therapeutic administration of Jinshuibao tablets could both significantly inhibit the increase of the blood urea nitrogen(BUN)and creatinine(CRE), increase the creatinine clearance rate, reduce the contents of TNF-α and ROS, and decrease the activity of Caspase 3 in acute renal injury models induced by cisplatin. The renal histopathological results showed that Jinshuibao tablets could significantly reduce renal histopathology scores, ameliorate renal tubule degeneration and inflammatory infiltration. Western blot results showed that Jinshuibao tablets could significantly decrease the expression of t-p38 and p-p38, while increasing the Bcl-2/Bax ratio in the kidneys. These results suggested that preventive and therapeutic administration of Jinshuibao tablets could both improve renal function and pathological changes of renal tissue, which might be related to the inhibition of TNF-α and the ROS-p38 MAPK-Caspase3 pathway and thus inhibition of apoptosis.

The effect of ovariectomy on bone mineral density and bone microstructure of SOST gene knockout mice / 中国医师杂志

Objective:To observe the changes in bone mineral density and microstructure parameters in sclerostin (SOST) gene knockout (SOST -/-) mice after ovariectomy. Methods:Twelve 4-week-old SOST knockout mice were randomly divided into two groups ( n=6): ovariectomized group (SOV), sham operated group (SSO). Twelve wild-type mice were randomly divided into two groups ( n=6): wild-type ovariectomized group (WTO), wild-type sham operated group (WTS). Twelve weeks later, mice were sacrificed and one lumbar vertebra of each mouse was selected for micro-CT analysis. The bone mineral density, trabecular volume fraction, trabecular number and trabecular thickness were observed and compared in the 4 groups. Results:There was no difference in bone mineral density, trabecular volume fraction, trabecular number and trabecular thickness between SOV and SSO groups. Bone mineral density, trabecular volume fraction, trabecular number and trabecular thickness in SOV and SSO groups were significantly higher than those in WTO and WTS groups ( P<0.001). Bone mineral density, trabecular volume fraction and trabecular number in WTO group were significantly lower than those in WTS group ( P=0.017, 0.039, 0.021, respectively). There was no difference in trabecular thickness between WTO and WTS groups. Conclusions:Sclerostin knockout mice showed high bone mass, and ovariectomy did not lead to bone loss and bone microstructure degeneration, which indicates that slerostin is a potential therapeutic target for postmenopausal osteoporosis.

Predictive value of inflammatory indicators for post-stroke depression in patients with ischemic stroke / 南方医科大学学报

OBJECTIVE@#To investigate the association of venous blood neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) and levels of interleukin-17 (IL-17) and IL-6 at 2 weeks after admission with the occurrence of post-stroke depression (PSD) in patients with first-ever acute ischemic stroke.@*METHODS@#The hospitalized patients with first-ever acute ischemic stroke were recruited consecutively from the Department of Neurology of Yijishan Hospital from March, 2015 to September, 2017. The demographic and baseline clinical data on admission and the imaging data were collected. The diagnosis of PSD was established in line with DSM-IV (SCID-I-R) at 3 months during the follow-up. The severity of PSD was assessed using the Hamilton Depression Scale (HAMD-17). Multivariate logistic regression analysis was used to investigate the correlation of NLR, PLR, IL-17, and IL-6 with PSD in these patients.@*RESULTS@#A total of 376 patients with acute ischemic stroke were enrolled, including 224 male patients (59.57%) and 152 female patients (40.43%), whose mean age was 61.37±10.34 years. Of these patients 104 (27.66%) were found to have PSD. Univariate analysis showed that gender, years of education, BMI, widowhood, NIHSS score, MMSE score, mRS score, and laboratory indexes (NLR, PLR, IL-17, and IL-6) were all significantly correlated with PSD (all < 0.05). Multivariate logistic regression analysis showed that, after adjusting for the compounding factors, the third quartile of NLR ( < 0.001), the third quartile of PLR (=0.002), IL-17 (=0.025) and IL-6 (=0.016) were independent factors that predicted the occurrence of PSD.@*CONCLUSIONS@#Elevated NLR and PLR at admission and levels of IL-17 and IL-6 at 2 weeks after admission are all independent predictors of the occurrence of PSD at 3 months after stroke.

Correlation between white matter hyperintensities and post-stroke depression / 国际脑血管病杂志

Objective To investigate the correlation between white matter hyperintensities (WMHs) and post-stroke depression (PSD) in patients with acute ischemic stroke. Methods From December 2015 to December 2016, patients with acute ischemic stroke admitted to the Department of Neurology, Yijishan Hospital, Wannan Medical College were enrolled retrospectively. The demographic and baseline clinical data were documented. The patients underwent a 3. 0 T-MRI examination within 3 d of admission, and the severity of periventricular and deep WMHs was graded using the Fazekas 4-point scale. Depression was diagnosed at 3 months after onset according to Chinese classification of mental disorders (3rd edition). The patients were divided into PSD group and non-PSD group. Multivariate logistic regression analysis was used to determine the independent correlation between WMHs and PSD. Results A total of 203 patients were enrolled and followed up, including 117 males ( 57. 64％) and 86 females ( 42. 36％), aged 66. 6 ± 10. 2 years. The baseline National Institutes of Health Stroke Scale (NIHSS ) score was 4. 7 ± 2. 8; 67 patients in the PSD group (33. 00％) and 136 patients in the non-PSD group (67. 00％). Univariate analysis showed that there were significant differences in years of education, baseline NIHSS score, Mini-Mental State Examination (MMSE) score at 3 months, severe deep WMHs (Fazekas 3), and prefrontal infarction between the PSD group and the non-PSD group (all P < 0. 05). Multivariate logistic regression analysis showed that after adjusting for years of education, baseline NIHSS score, 3-month MMSE score, and prefrontal infarction, severe deep WMHs (odds ratio [OR] 2. 192, 95％ confidence interval [CI] 1. 212-4. 946; P = 0. 019) was independently correlated with PSD. In addition, baseline NHISS score (OR 1. 071, 95％ CI 1. 009-1. 137; P = 0. 034 ) and acute prefrontal infarction (OR 4. 326, 95％ CI 1. 074- 14. 371; P = 0. 045) were also independently correlated with PSD. Conclusion Severe deep WMHs is the independent risk factor for PSD at 3 months after the onset of ischemic stroke.

Effect of revascularization on clinical outcome in elderly CHD patients with DM undergoing PCI / 中华老年心脑血管病杂志

Objective To assess the effect of revascularization on clinical outcome in elderly CHD patients with DM undergoing PCI.Methods 1055 CHD patients with DM undergoing PCI were divided into complete revascularization (CR) group (n=261),non-CR group 1 (n=385) and non-CR group 2 (n=409).The patients were followed up for 2 years during which the cardiovascular events were recorded.The SYNTAX revascularization index (SRI) was calculated according to the ROC curve and the best prognostic accuracy of revascularization was assayed.Results A significant difference was found in the incidence of MACE,angina pectoris,motality,cardiogenic death,myocardial infarction,unplanned revascularization during the 2-year follow-up period (P＜ 0.05,P＜0.01).Logistic regression analysis showed that SRI was a protective factor for MACE,reduced 64％ of MACE,and thus played a great role in predicting the incidence of MACE in elderly CHD patients with DM after 2 years of PCI (P=0.010).The area under the ROC curve showed the best prognostic accuracy of revascularization was 65％.Conclusion The incidence of cardiovascular events is low in elderly CHD patients with DM after 2 years of CR.The revascularization rate should be higher than 65％ for those who cannot undergo CR in order to reduce their mortality during the long-term follow-up period.

Correlation between lesion sites and post-stroke depression in patients with ischemic stroke / 国际脑血管病杂志

Objeetive To investigate the relationship between the lesion sites and post-stroke depression (PSD) in patients with acute ischemic stroke.Methods From January 2015 to June 2016,patients with first-ever acute ischemic stroke admitted to the Department of Neurology,Wuhu Yijishan Hospital were enrolled prospectively.The demographic and baseline clinical data were recorded.The stroke lesions were localized by imaging and clinical symptoms within 24 h after admission.The patients were divided into PSD group (≥8) and non-PSD group (＜8) according to the Hamilton Depression Rating Scale score at l-month follow-up.Multivariate logistic regression analysis was used to investigate the independent correlation between PSD and lesion sites.Results A total of 376 patients with acute ischemie stroke were enrolled,including 177 females (47.07％) and 199 males (52.93％).Univariate analysis showed that there were significant differences in sex,years of education,hypertension,etiological classification of stroke (small vessel occlusion,cardiogenic embolism),baseline National Institutes of Health Stroke Scale (NIHSS) score,baseline Mini-Mental State Examination (MMSE) and left frontal lobe,left temporal lobe,and left basal ganglia lesions between the PSD group and the non-PSD group (all P ＜0.05).Multivariate logistic regression analysis showed that after adjusting for age,sex,years of education,hypertension,etiological classification of stroke,NIHSS score,and MMSE score,there was an independent correlation between the lesions in the left frontal lobe (odds ratio [OR] 1.838,95％ confidence interval [CI] 1.028-3.947;P =0.034),the left basal ganglia (OR 1.672,95％ CI 1.103-2.883;P=0.023),hypertension (OR 1.764,95％ CI 1.179-3.365;P =0.016) and PSD.Conclusions One month after the onset of ischemic stroke,there was a significant correlation between PSD and the lesion sites.Left frontal lobe lesion and left basal ganglia lesion were the independent predictors.

Evaluation of stroke prognostication using age and National Institute of Health Stroke Scale index for outcome after early endovascular treatment for anterior circulation large vessel occlusion / 中华神经科杂志

Objective To evaluate the value of stroke prognostication using age and National Institute of Health Stroke Scale index (SPAN) for outcome after early endovascular treatment for anterior circulation large vessel occlusion.Methods The patients who underwent early endovascular treatment were prospectively,sequentially collected in Yijishan Hospital of Wannan Medical College from December 2014 to September 2017 and Jinling Hospital from March 2014 to March 2017.Individuals whose age in years plus NIHSS score was greater than or equal to 100 were designated as SPAN-100-positive patients,while those with a score less than 100 were designated as SPAN-100-negative patients.We compared the baseline data and perioperative data between the two groups.The 90 days modified Rankin Scale score≤2 was regarded as favorable outcome.Single factor and multivariable Logistic regression analyses were used to determine the association between SPAN-100 and outcomes.Results One hundred and ninety patients were enrolled,20 (10.5％) of which were SPAN-100 positive,and 170(89.5％) were SPAN-100 negative.There were no significant differences between the two groups on postoperative intracerebral hemorrhage and 90 days mortality.Ninety days independence rates were higher in SPAN-100-negative patients (77/170,45.3％) than in SPAN-100 positive patients (4/20,20.0％;x2 =4.681,P =0.030).Multi-factor Logistic regression analysis showed that the higher preoperation systolic pressure (OR =1.030,95％ CI 1.008-1.052,P =0.007),the lower Alberta Stroke Program Early CT Score (OR =1.609,95％ CI 1.056-2.453,P =0.027) and poor collateral circulation(OR =5.714,95％ CI 1.668-19.570,P =0.006) were the independent risk factors of outcomes.Conclusion SPAN-100 is not an independent predictor of favorable outcome after adjusting for factors of outcomes in patients with anterior circulation large vessel occlusion.

Outcomes of endovascular treatment for acute anterior circulation ischemic stroke: Intracranial atherosclerotic versus cardioembolic stroke / 国际脑血管病杂志

Objective To compare the outcomes of endovascular treatment between intracranial large artery atherosclerosis stroke (LAA) and cardioembolic stroke (CE) in Chinese patients with acute anterior circulation ischemic stroke.Methods Patients with acute anterior circulation ischemic stroke treated with the Solitaire stent retriever were enrolled.The patients were divided into either a LAA group or a CE group according to etiological subtype.The outcomes were compared between 2 groups.Multivariable logistic regression analysis was used to determine the independent risk factors for poor outcome (defined as the modified Rankin Scale score ＞2 at 90 d after onset).Results A total of 126 patients were enrolled in the study,including 62 (49.2％) in the LAA group and 64 (50.8％) in the CE group.The proportions of poor outcome at 90 d (59.0％ vs.41.0％;x2 =5.482,P =0.019) and symptomatic intracerebral hemorrhage at 72 h (12.5％ vs.1.6％;Fisher exact test P =0.033) in the CE group were significantly higher than those in the LAA group.Multivariate logistic regression analysis showed that high baseline National Institutes of Health Stroke Scale scores was independently associated with poor outcome (odds ratio [OR] 1.119,95％ confidence interval [CI] 1.026-1.221;P =0.011),good collateral circulation was was independently associated with good outcome (OR 0.227,95％ CI 0.097-0.788;P =0.016),and etiological subtype was not independently associated with outcome (OR 1.280,95％ CI O.454-3.633;P =0.630).Conclusion Etiological subtype is not associated with outcome in patients with acute anterior circulation ischemic stroke treated with the Sofitaire stent retriever.

The risk factors of gestational diabetes mellitus and its influence on pregnancy outcome / 中国医师杂志

Objective To explore the risk factors of gestational diabetes mellitus and its influence on pregnancy outcome,and to provide guidance for early intervention of gestational diabetes to improve pregnancy outcome in clinic.Methods Totally 159 patients with gestational diabetes mellitus in our hospital from January 2014 to January 2016 as observation group were collected,and at the same time,634 healthy pregnancy women as control group were collected.The risk factors of gestational diabetes mellitus were analyzed by the Logistic regression analysis and comparison of pregnancy outcome between two groups was conducted.Results The patients in the observation group with age ≥ 35 years,overweight or obesity before pregnancy,adverse pregnancy history,family history of diabetes,hypertension and vaginal candida and thyroid peroxidase antibody (TPOAb) compared with the control group,the difference was statistically significant (P ＜ 0.05).Multivariate logistic regression analysis showed that age ≥ 35 years,overweight or obesity before pregnancy,adverse pregnancy history,family history of diabetes,and positive TPOAb were the independent risk factors of gestational diabetes mellitus,OR was 2.441,2.889,1.486,4.879,and 1.323,respectively;the difference was statistically significant (P ＜ 0.05).The incidence of premature rupture of membrane,pregnancy hypertensive disorder,premature birth,polyhydramnios,uterine-incision and postpartum hemorrhage in observation group were higher than those in control group,the difference was statistically significant (P ＜ 0.05).The incidence of giant baby,fetal distress and mild neonatal asphyxia were higher than those in control group,and the difference was statistically significant (P ＜ 0.05).No statistical significance in fetal growth restriction,neonatal malformations between two groups was found (P ＞ 0.05).Conclusions Age ≥35 years,overweight or obesity before pregnancy,adverse pregnancy history,family history of diabetes,and thyroid dysfunction were the independent risk factors of gestational diabetes mellitus,and it has serious effect on pregnancy outcome,so that it should take measures to prevent the independent risk factors.

Influence of Climatic Factors on the Incidence of Spontaneous Pneumothorax / 中国医科大学学报

Objective To analyze the onset time rule of spontaneous pneumothorax ,and investigate the influence of climatic factors such as atmo-spheric pressure,wind speed,etc. on the onset of spontaneous pneumothorax. Methods Five hundred and ninety-three patients of spontaneous pneumothorax in Cenral Hospital Affiliated to Shenyang Medical College were enrolled for this study between January 1,2011 and December 31, 2015. The data of the average daily atmosphere pressure and wind speed in five years were recorded. The relationship between the onset of sponta-neous pneumothorax and the change of the atmosphere pressure and wind speed was analyzed. Results The incidence of spontaneous pneumotho-rax in Shenyang area was obvious seasonal. Primary spontaneous pneumothorax episodes were observed mostly in spring and in March and April;Second spontaneous pneumothorax episodes were observed mostly in winter and in November and December. The difference in mean atmospheric pressure was 0.6 hPa lower than on days in which no spontaneous pneumothorax occurred. This difference was statistically significant(P=0.015). We observed significantly higher average wind speed on days with SP versus days without(9.46±6.33 m/s vs 7.11±5.47 m/s,P<0.001). Conclu-sion Spontaneous pneumothorax has obvious aggregation of onset time. A sharp drop in atmospheric pressure and increases in wind speed has im-portant influence on the incidence of spontaneous pneumothorax.

Comparative study of two prediction scoring systems on patients with suspected coronary heart disease / 中国介入心脏病学杂志

Objective To investigate and compare the predictive value of 2 prediction scoring systems for diagnosis of coronary heart disease (CHD) in patients with suspected symptom, and provide information for diagnosis and therapy. Methods By prospectively studying a database of 272 patients with suspected CHD,the total score was calculated by prediction scoring system including PROCAM (The Prospective Cardiovascular Munster Study) and SCP(Suspected CHD Prediction Scoring System) with the data of clinic parameters and risk factors. All patients received coronary angiography and they were categorized into the CHD group (n =94) and non CHD group ( =178) according to the angiography result. The relationship between total scores and the SYNTAX score was evaluated by Spearman analysis and the value of the prediction scoring system was evaluated by the ROC (receiver operating characteristic) system. Results The score of PROCAM was from 6. 00 -77. 00(41. 76 ± 19. 91), and the score was significantly correlated with the extent and severity of coronary artery atherosclerosis (rs = 0. 420,P = 0. 023). The score of SCP was from 1. 00 - 13. 00(8. 64 ± 3. 42), and it was significantly correlated with the SYNTAX score (rs = 0. 482,P = 0. 016). The areas under ROC was 0. 770 (P = 0. 007) in PROCAM and that was 0. 733 (P = 0. 012) in SCP. Conclusions The nature and extent of coronary artery atherosclerosis could be evaluated by the scoring system effectively,which had a good correlation with CAG result.