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Objective:To investigate the risk factors for ruptured saccular intracranial aneurysms in young adults.Methods:Young patients with saccular intracranial aneurysm admitted to the First People's Hospital of Kashgar Region from February 2017 to November 2022 were retrospectively included. The demographic and clinical data from patients were collected. Risk factors of ruptured intracranial aneurysm were determined by univariate and multivariate regression analysis.Results:A total of 151 young patients with saccular intracranial aneurysm were enrolled, including 94 in the ruptured group (62.2%) and 57 in the unruptured group (37.8%). There were 70 males (46.4%) and 81 females (53.6%), with a median age of 41 years (interquartile range, 36-42 years). Univariate analysis showed that there were statistically significant differences in the proportion of male and triglycerides level between the ruptured group and the unruptured group (all P<0.05). Multivariate logistic regression analysis showed that males (odds ratio [ OR] 5.546, 95% confidence interval [ CI] 1.946-15.807; P=0.001), lower triglycerides ( OR 0.244, 95% CI 0.219-0.511; P<0.001), and aneurysms located in the anterior cerebral artery/anterior communicating artery ( OR 4.207, 95% CI 1.361-13.004; P=0.013) and middle cerebral artery ( OR 3.277, 95% CI 1.091-9.848; P=0.034) were the independent risk factors for intracranial aneurysm rupture. Conclusions:Male and lower triglycerides are the risk factors for ruptured saccular intracranial aneurysms in young adults. In addition, intracranial aneurysms located in the anterior cerebral artery/anterior communicating artery and middle cerebral artery are more prone to rupture.
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Objective:To investigate the correlation between serum cystatin C and formation of intracranial aneurysms.Methods:Patients with unruptured intracranial aneurysms hospitalized in the First People's Hospital of Kashgar from January 2016 to September 2021 were retrospectively enrolled as the case group and patients with trigeminal neuralgia in the same period as the control group. The demographic and clinical data of patients were collected, and the correlation between serum cystatin C and the occurrence of intracranial aneurysms was determined by univariate and multivariate logistic regression analysis. Results:A total of 114 patients with unruptured intracranial aneurysms and 142 patients with trigeminal neuralgia were enrolled. Univariate analysis showed that there were significant differences in triglyceride and cystatin C, as well as the proportions of male and hypertensive patients between the case group and the control group (all P<0.05). Multivariate logistic regression analysis showed that there was a significant independent negative correlation between the serum cystatin C and the risk of intracranial aneurysms (odds ratio 0.045, 95% confidence interval 0.011-0.184; P<0.001). Conclusion:Serum cystatin C may be an independent protective factor for the formation of intracranial aneurysms.
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Objective:To investigate the clinical value of digital three-dimensional reconstruction model of pituitary adenoma in transsphenoidal endoscopic pituitary adenoma resection.Methods:Fifty-eight patients with endoscopic pituitary, admitted to our hospital from July 2020 to March 2022, were chosen. All patients accepted transsphenoidal surgery under microscope and were randomly assigned to a control group (without digital 3D reconstruction technology before surgery) and a model group (with digital 3D reconstruction technology before surgery). The tumor size, preoperative and postoperative hormone levels, surgical duration, intraoperative blood loss, extent of surgical resection, and complications 3 months after follow up were compared.Results:There was no significant difference in age, gender, tumor types, tumor sizes and Knosp grading between the two groups ( P>0.05), indicating comparability. The resection degree of pituitary tumor in model group was better than that that in control group; the proportion of patients with total and subtotal resection in the model group was significantly higher than that in the control group (24/29 vs. 16/29, P=0.045). Intraoperative blood loss, surgical duration and average hospital stay in the model group were significantly decreased as compared those in the control group ( P<0.05); the duration of tumor resection in the model group ([46.93±10.77] min) was significantly shorter than that in the control group ([56.00±12.47] min, P<0.05). The levels of prolactin and human growth hormone in the model group 1 and 7 d after surgery were decreased as compared with those in the control group, without significant differences ( P>0.05). Three months after follow-up, the incidences of diabetes insipidus, hyponatremia and hypopituitarism in model group were significantly lower than those in control group ( P<0.05). The satisfaction rate in the model group was significantly higher than that in the control group ( P<0.05). Conclusion:The construction of digital three-dimensional reconstruction model of pituitary adenoma is helpful in understanding the adjacent relationship between tumors, nerves, and blood vessels before surgery, develop personalized surgical plan and improve surgical efficiency.
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Objective To observe the therapeutic effect of phloroglucinol combined with diazepam in prolonged or protracted active phase of first stage of labor,and the outcome of perinatal phase.Methods Two hundred vaginal delivery primipara with prolonged or protracted active phase after dilatation of cervix 2-3 cm were selected.The patients were divided into 2 groups by random digits table method with 100 cases each,the patients in observation group were given phloroglucinol 80 mg and diazepam 10 mg,and the patients in control group were given diazepam 10 mg.The cervical dilatation,the degree soft hardness and edema of cervix,time of active phase,time of second stage of labor,mode of delivery,vaginal bleeding in 2 h postpartum and outcome of perinatal phase in the 2 groups were observed.Results In observation group,the cervical dilatation rate was (2.31 ± 0.27) cm/h,the time of active phase was (187.27 ± 33.22) min.In control group,the cervical dilatation rate was (1.82 ±0.48) cm/h,the time of active phase was (251.32 ± 45.33) min,there were statistical differences between 2 groups (P ＜ 0.05).The rate of uterineincision delivery in observation group was significantly lower than that in control group [18.0％(18/100) vs.32.0％ (32/100)],there was statistical difference (P ＜ 0.05).There were no statistical differences in time of second stage of labor,vaginal bleeding in 2 h postpartum,rate of neonatal asphyxia between 2 groups (P ＞0.05).Conclusion The effect of phloroglucinol combined with diazepam in prolonged or protracted active phase is remarkable,it can promote the progress of labor,speed up delivery progress,improve the rate of vaginal delivery and decrease the rate of uterine-incision delivery,and no adverse effects on the outcome of perinatal phase,it is worth popularizing.
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Drug-induced immune hemolytic anemia has complicated manifestations and pathogenesis, and therefore clinicians should know its etiology and pathogenesis for safe medication. In this paper, we made a discuss on the etiology and pathogenesis of drug-induced immune hemolytic anemia from both traditional Chinese and western medicine viewpoint hoping to provide references for clinical physicians.
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Objectives To detect the expression and distribution of ubiquitin in neurofibrillary tangles(NFT) and senile plaque neurites in the hippocampal formation of Alzheimer's disease brain and explore the significance of ubiquitin in pathological mechanism of Alzheimer's disease.Methods The expression of ubiquitin in the hippocampal formation of 7 patients with Alzheimer's disease and 5 non-dementia elderly was detected using immunohistochemical technique.Results Neurofibrillary tangles and senile plaque neuritis were labeled by the antibody of ubiquitin in hippocampal formation of Alzheimer's disease brain, but pretangle neurons were not stained. Containing NFT neurons stained by ubiqutin antibody immunoreactive products were distributed more in the CA1 and CA2 (42.13?0.65, 30.57?0.78 respectively)than those in CA3 and CA4 (12.43?0.24?18.34?0.81 respectively)of the hippocampal formation (P