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Objective:To compare the effects of intensive and standard blood pressure control on the outcomes of patients with acute ischemic stroke in the anterior circulation who have successfully recanalized after endovascular therapy (EVT).Methods:A multicenter, open-label, blinded-endpoint, randomized controlled design was used. Patients with anterior circulation stroke received EVT and successfully recanalized in Nanjing First Hospital, Nanjing Medical University and several branch hospitals from July 2020 to October 2022 were prospectively included. They were randomly divided into the intensive blood pressure control group (target systolic blood pressure [SBP] 100-120 mmHg) or the standard blood pressure control group (target SBP 121-140 mmHg). The blood pressure of both groups needs to achieve the target within 1 h and maintain for 72 h. The primary outcome endpoint was outcome at 90 d, and the good outcome was defined as a score of 0-2 on the modified Rankin Scale. Secondary outcome endpoints included early neurological improvement, symptomatic intracranial hemorrhage (sICH) within 24 h, and death and serious adverse events within 90 d.Results:A total of 120 patients were included, including 63 in the intensive blood pressure control group and 57 in the standard blood pressure control group. There was no statistically significant difference in baseline characteristics between the two groups. The SBP at 72 h after procedure was 122.7±8.1 mmHg in the intensive blood pressure control group and 130.2±7.4 mmHg in the standard blood pressure control group, respectively. There were no significantly differences in the good outcome rate (54.0% vs. 54.4%; χ2=0.002, P=0.963), the early neurological improvement rate (45.2% vs. 34.5%; χ2=1.367, P=0.242), the incidence of sICH (6.3% vs. 3.5%; P=0.682), mortality (7.9% vs. 14.0%; χ2=1.152, P=0.283) and the incidence of serious adverse events (12.7% vs. 15.8%; χ2=0.235, P=0.628) at 90 d between the intensive blood pressure control group and the standard blood pressure control group. Conclusion:In patients with anterior circulation stroke and successful revascularization of EVT, early intensive blood pressure control don’t improve clinical outcomes and reduce the incidence of sICH.
ABSTRACT
Hypertension plays a unique role in the pathogenesis and outcomes of acute ischemic stroke. Therefore, blood pressure management, especially blood pressure regulation in acute stage, is of great significance for the treatment of acute ischemic stroke. However, there is no unified antihypertensive scheme for acute stroke. This article reviews the related research progress of blood pressure management in acute ischemic stroke.
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Objective:To investigate the analysis of features and differential diagnosis of ultrasonic image for patient with endometrial lesions.Methods: The imaging data of 80 patients with endometrial lesions were selected as random number table. The relevant ultrasound manifestations and sonographic features of patients were further analyzed, and then these data were compared with the pathological diagnosis by using operation.Results: In the 80 patients with endometrial lesions, 43 cases were endometrial polyps, and in the 43 cases, there were 41 cases were consistent with the pathological diagnosis and the diagnostic accordance rate was 95.35%, while there were 2 cases were not consistent between the two methods. 33 cases of the 80 patients were submucous myoma of uterus, and there were 29 cases of them were consistent with the pathological diagnosis and the diagnostic accordance rate was 87.88%, while there were 4 cases were not inconformity. And 4 cases of the 80 patients were endometrial carcinoma, the result was completely consistent with the pathological diagnosis and the diagnostic accordance rate was 100%. In the 6 misdiagnose cases, the ratios of atypical cases and (or) typical cases were 1:16, 5:36 and 1:8, respectively. All of these endometrial lesions has the distinctive manifestations on the ultrasonoscopy of color Doppler.Conclusion: For the detection of endometrial lesions, transvaginal colar Doppler ultrasonic detection has unique feature of ultrasonogram compared with other detection methods. In the contrast, there is a regular congruent relationship between the ultrasonogram of typical disease and section of pathological specimen by using operation in a certain degree, and the ultrasonogram of typical disease has definite diagnosis value.
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Objective:To identify the vision care access in rural primary health institutions and the utilization of vision inspections among rural residents. Methods:Survey data was collected from primary health institutions ( town-ship health centers and village clinics) and households. The descriptive statistics and multivariate regression analysis were applied to analyze data. Results:The household survey data shows that 33. 2% of rural residents self-reported having poor vision, and 22. 1% of rural residents stated that they had ever used vision care (vision screening or vison examinations) . The health facilities survey data shows that 84% of township health centers and 44% of village clinics can provide vision care. The multivariate analysis shows that the vision care access in township health centers is sig-nificantly correlated with the probability of residents’ utilization of vision care, but there is no significant correlation between the provision of vision care in village clinics and its utilization. Conclusions:The vision care access is low in rural China though there is a huge demand therefore. Inadequate supply of primary vision care services in primary health institutions may result in low utilization among rural residents. It is suggested that the government further pro-mote the National Public Health Service Program and strengthen the capacity of primary health facilities to provide primary vision care. To do so, an increase in the utilization of vision care among rural residents can be expected, which would thereby reduce potential losses caused by further vision impairment.
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Objective: To investigate the effect with its possible mechanisms of zacopride on vasodilatation of isolated coronary arterial rings in experimental rats. Methods: The tension of vasodilatation of isolated coronary arterial rings of male SD rats was recorded by Powerlab and DMT system. The rats were divided into 4 groups: +Endo (vehicle) group, +Endo (zacopride) group and -Endo (vehicle) group, –Endo (zacopride) group.n=6 in each group. The vasodilatation effects of zacopride on KCl (60 mmol/L) and U46619 (10-6 mol/L) pre-constricted arterial ring were recorded; the effects of different agents on zacopride caused vasodilatation were studied. Results: In both +Endo (zacopride) and –Endo (zacopride) groups, zacopride showed a dose dependent vasodilatation effect on coronary ring pre-constricted by KCl and U46619. The maximum vasodilatation effect of zacopride in KCl treated+Endo (zacopride) group was (90.15 ± 6.38) %, in U46619 treated-Endo (zacopride) group was (81.67 ± 4.97 ) %; the maximum vasodilatation effect of zacopride in KCl treated-Endo (zacopride) group was (85.48±5.04) %, in U46619 treated–Endo (zacopride) group was (79.65 ± 3.51) %, compared to each corresponding vehicle group, allP0.05. Conclusion: Zacopride had vasodilatation effect on coronary arterial ring which was pre-constricted by KCl and U46619, which might be related to the channel of IK1.