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Hypertensive intracerebral hemorrhage (ICH) is mostly single in basal ganglia, thalamus and pons. Simultaneous hemorrhage in other brain regions is relatively rare, accounting for only 5.6% of all hemorrhagic strokes, while bilateral symmetrical hemorrhage is extremely rare. A case of bilateral basal ganglia symmetrical hemorrhage is reported for clinical reference.
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Objective:To explore the efficacy and safety of intraarterial microguidewire electrocoagulation in arterial aneurysms.Methods:(1) SilverSpeed, a kind of microguidewire used in clinical intravascular treatment for intracranial aneurysms, was used to conduct in vitro electrolysis gas generation experiment with isolated arterial blood of anticoagulant New Zealand white rabbits as medium, and thrombus attachment on the surface of microguidewire was observed under scanning electron microscope. (2) Rabbit common carotid artery aneurysm models were established by using vein bag transplantation method, and divided into microguidewire electrocoagulation treatment groups ( n=40) and blank control group ( n=10). The number of closured tumor cavity and the quality of formed thrombus were observed after electrocoagulation simulation treatment with SilverSpeed microguidewire (charging at 6, 9, 12, 15, and 18 V voltage, respectively for 1, 3, 6, 9, 12, and 15 min). DSA was used to observe whether there was ruptured aneurysms or thrombosis of parent artery. Twelve h later, head MRI diffusion weighted sequence scan was performed to detect whether there were new cerebral ischemia foci in the distal cerebral blood supply area of the parent artery. DSA was performed again 6 months after surgery to observe whether the aneurysms recurred. Results:(1) Electrolytic gas generation experiment results showed that bubbles were generated after electrification of SilverSpeed microguidewire; the higher the voltage, the more severe the reaction. Scanning electron microscope showed that thrombus attached to the surface of the microguidewire after electrification in isolated blood; and the higher the voltage, the denser the thrombus. (2) Under the same charging time, the higher the voltage, the larger the number of closured tumor cavity in rabbits of the microguidewire electrocoagulation treatment groups. Under the same voltage, the longer the charging time, the better the quality of thrombosis. Ischemic events occurred only in the microguidewire electrocoagulation treatment group with voltage>9 V, and the charging duration was not associated with the incidence of embolic events. When the voltage was 15 V, 2 experimental rabbits died due to aneurysm rupture 3 min after electrification. When the voltage was 18 V, 4 experimental rabbits died of cardiac arrest 9 min after electrification, and another 2 rabbits died of aneurysm rupture 6 min after electrification.Conclusions:High voltage is the main cause of adverse events in the microguidewire electrocoagulation treatment of aneurysms. After setting the appropriate voltage, prolonging the electrification time can improve the electrocoagulation effect without increasing the safety risk.
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Objective To observe the effect of diabetes base education combined with peer education on blood glucose control,metabolic index and self management level in type 2 diabetes patients.Methods 150 patients with type 2 diabetes were randomly divided into 3 groups.Group A received diabetes base education,Group B received peer education group,and group C received peer education joint base education group.Before treatment and 6 months after treatment,fasting blood glucose (FPG),postprandial blood glucose (2 h PG),glycosylated hemoglobin (HbA1 c),triglyceride (TG),cholesterol (TC),low density lipoprotein (LDL-C),high density lipoprotein (HDL-C),systolic blood pressure,diastolic blood pressure change,body mass index (BMI) were observed,so as to evalute the diabetes self-management behavior at the same time before and after treatment.Results After 6 months of intervention,FPG,2 h PG,HbAlc,TG,TC,LDL-C,HDL-C,blood pressure,body weight and other metabolic indicators in the three groups were significantly improved (P ＜ 0.05).There was no significant difference between the group A and group B on the improvement of blood glucose control and metabolic indexes (P ＞ 0.05).In group C,the blood glucose control index (FPG,2 h PG,HbAlc) and the improvement of blood lipid were obviously superior to those in the group A and B (P ＜ 0.05).Conclusions The combination of base education and peer education can improve blood glucose control and blood lipid level in patients with type 2 diabetes,and can also promote self-management behavior in patients with type 2 diabetes.
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Objective To compare efficacy of different insulin intensive treatment in the treatment of type 2 diabetes,to provide a reference for the programming of intensive treatment of diabetes.Methods 60 type 2 diabetes patients met inclusion criteria were divided into insulin aspart 30 intensive treatment group (I group) and insulin glargine intensive treatment group(Ⅱ group) by random number table,30 cases of each group,I group was given subcutaneous injection of insulin aspart 30,tid,Ⅱ group was given subcutaneous injection of insulin glargine at bedtime,qd.Both groups were treated for 14d,record the time of blood glucose control,observed the occurrence of low blood sugar,detected the HOMA-IR,HOMA-β and clinical efficacy.Results After treatment,the fasting glucose,2h postprandial blood glucose,glycosylated hemoglobin,HOMA-IR,HOMA-β of Ⅰ group and Ⅱ group were (6.0 ± 0.9)mmol/L vs (5.4 ±1.1)mmol/L,(7.4 ± 1.9)mmol/L vs (6.6±2.3)mmol/L,(6.2 ± 1.7)％ vs (6.0 ± 1.9)％,(1.11 ±0.32) vs (1.01 ±0.35),(5.23 ± 1.63) vs (5.46 ±1.41),the fasting glucose,2h postprandial blood glucose,glycosylated hemoglobin,HOMA-IR of Ⅰ and Ⅱ group after treatment compared with those before treatment,the differences were statistically significant.The HOMA-β of Ⅰ and Ⅱ group was significantly higher than that before treatment,the difference was statistically significant.The fasting blood glucose,2h postprandial blood glucose,glycosylated hemoglobin,HOMA-IR,HOMA-β before and after treatment between two groups was not significantly different,the time of blood glucose control between Ⅰ and Ⅱ group were (6.5 ± 2.8) d vs (6.2 ± 2.5) d,the difference was not statistically significant,the low blood sugar of Ⅰ and group Ⅱ was 20％ (6/30) vs 3％ (1/30),there was statistically significant difference.Conclusion The insulin aspart 30 and insulin glargine intensive treatment all can control blood sugar,increase insulin β-cell function,reduce insulin resistance in the treatment of type 2 diabetes,but insulin glargine significantly reduced the incidence of hypoglycemia and insulin glargine is the ideal insulin for blood glucose security control.
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Objective To investigate the relationship between plasma visfatin levels and type 2 diabetes mellitus patients with carotid atherosclerosis.Methods 60 subjects were divided into 3 groups,T2DM no carotid atherosclerosis group (20 cases),T2DM with carotid atherosclerosis group (20 cases)and normal control group (20cases).Carotid IMT,plasma visfatin,waist circumference (WC),fasting plasma glucose (FPG),HbA1C,blood lipids,fasting serum insulin (FINS) were assayed or measured in all subjects.Results Plasma visfatin levels in T2DM with carotid atherosclerosis were significantly higher than those in normal control group and T2DM group [ (50.85 ± 20.14) ng/ml vs (18.50 ± 4.60) ng/ml,(50.85 ±20.14) ng/ml vs (35.52 ± 10.18) ng/ml,F = 105.983,P ＜0.01].Correlation analysis showed that plasma levels of visfatin were positively correlated with carotid IMT(r =0.476,P ＜0.01),TG (r =0.328,P ＜0.01),WC (r =0.206,P ＜0.05) and it was negatively correlated with HDL-C(r=-0.298,P ＜0.01).Conclusion Plasma visfatin was correlated with the development of macrovascular complications in T2DM patients,and it might be involved in the atherosclerotic pathological and physiological basis.