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Objective:To investigate the effectiveness and safety of early combined with tirofiban in the treatment of elderly patients with acute ischemic stroke after intravenous thrombolysis with alteplase.Methods:Elderly (60-75 years old) patients with acute ischemic stroke received intravenous alteplase thrombolysis in the Department of Neurology, Traditional Chinese Medicine Hospital of Huangdao District, Qingdao from January 2018 to May 2020 were enrolled prospectively. According to whether tirofiban is combined or not, they were divided into tirofiban group and non-tirofiban group. Tirofiban was pumped intravenously 2 h after intravenous thrombolysis, first 0.4 μg/(kg·min) for 30 min, then 0.1 μg/(kg·min) for 24 h. The efficacy endpoints included National Institutes of Health Stroke Scale (NIHSS) score at 7 d after treatment and modified Rankin Scale (mRS) score at 90 d after onset. 0-2 was defined as good outcome, and >2 was defined as poor outcome. The safety endpoints included the incidence of hemorrhagic transformation, symptomatic intracranial hemorrhage (sICH) and mortality within 90 days after onset.Results:A total of 124 patients with acute ischemic stroke were enrolled. The median age was 68 years (range, 60-75 years). There were 73 males (58.9%) and 51 females (41.1%). There were 62 patients (50%) in the tirofiban group and 62 (50%) in the non-tirofiban group. The median baseline NIHSS score was 14. Hemorrhagic transformation occurred in 7 patients (5.6%), of which 2 were sICH (1.6%). The follow-up at 90 d after onset showed that 68 patients (54.8%) had a good outcome, 56 (45.2%) had a poor outcome, of which 4 (3.2%) died. The NIHSS score at 7 d after treatment (5.52±4.79 vs. 7.35±3.80; t=2.357, P=0.020) and the rate of good outcome at 90 d after onset (64.5% vs. 45.2%; χ2=4.689, P=0.030) in the tirofiban group were significantly better than those of the non-tirofiban group, and there were no significant differences among the incidence of hemorrhagic transformation (4.8% vs. 6.5%; P=1.000), sICH (1.6% vs. 1.6%; P=1.000), and 90 d mortality (3.2% vs. 3.2%; P=1.000). Conclusion:After intravenous thrombolysis with alteplase, the early combined treatment with tirofiban in elderly patients with acute ischemic stroke can significantly improve the efficacy and outcome, and will not increase the risk of hemorrhagic transformation, sICH and death.
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Objective The study examined the influence on marginal bone levers at implants which implants were assigned to open healing and implant-abutment connection restored according to a platform-switching concept. Methods One implant were placed in the first molar of mandible of 48 patients , randomly assigned to open (OH) or submerge (SH) healing. Standardized radiographs were obtained after implant surgery, when implant transfer and crown mounting, and 6 ,12 and 24 months after implants restoration, then evaluated for implant-bone-lever alterations(ΔIBL). Results After 6 months after implants restoration,ΔIBL were (-0.25 ± 0.08)mm mm(OH)and (-0.26 ± 0.12)mm(SH). After 12 months follow-up, ΔIBL were (-0.29 ± 0.13)mm (OH)and (-0.31 ± 0.14) mm(SH), and after 24 months later, ΔIBLwere (-0.34 ± 0.15)mm(OH)and (-0.33 ± 0.11)mm (SH). Conclusions Platform-switched implants showed very limited peri-implant bone-lever alterations. The healing-mode neither affected the total amount nor the temporal patterns of ΔIBL.
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Objective:To investigate the relationship between surface hydrogen form and the bioactivity of titanium.Methods:Sandblast titanium was etched with the combination of sulfuric and hydrochloric acids(SLA group,n=3 ).Then etched titanium was heat at 450 ℃in air(SLA+HT group,n=3).Surface topography,roughness,hydrophility,surface chemical texture were observed. Finally,the titanium samples were soaked in body simulate fluid for 3 days,the mineral deposition properties were observed by X-ray diffraction.Results:Titanium hydride was formed on the titanium surface after etching.After heat treatment,surface texture and roughness were not changed,titanium hydride decomposed and hydrophility increased.More hydroxyapatite was found on the surface of the samples treated by SLA+HT and followed by SBF.Conclusion:Titanium hydride can not improve the bioactivity of titanium, heat treatment may increase the mineralization.