RÉSUMÉ
Objective@#To understand the incidence of stroke in the population of Jinchang Cohort and the relationship between metabolic diseases and stroke, and provide scientific evidence for the prevention and treatment of stroke in the population.@*Methods@#The epidemiological investigation data and physical examination data of the 33 042 follow-up participants in Jinchang Cohort were collected for a prospective cohort study. Restricted cubic splines functions was used to analyze the dose-response relationship between metabolic indexes and the risk of stroke incidence.@*Results@#1) The incidence rate of stroke in Jinchang Cohort was 1.59%, and the standardized incidence rate was 3.99%. 2) Hypertension (male HR=2.20, female HR=4.45) and dyslipidemia (male HR=1.49, female HR=1.79) were the risk factors of stroke incidence in the population and diabetes had influence on the incidence of stroke only in the males (HR=1.79), while obesity had influence only in the females (HR=1.64). The more kinds of metabolic diseases, the higher risk of stroke incidence was. 3) Systolic blood pressure had a non-linear dose-response correlation with the risk of stroke incidence, while diastolic blood pressure had a positive linear correlation with the risk of stroke incidence.@*Conclusions@#The incidence of stroke in Jinchang Cohort population was high compared with both domestic level and oversea level. The patients with metabolic diseases were the population at high-risk for stroke, and more attention should be paid to them in the prevention and treatment of stroke. Diastolic blood pressure might be more closely related to stroke.
RÉSUMÉ
Objective: To evaluate new ischemic brain damage after using protective filter device during carotid artery stenting with diffusion-weighted magnetic resonance imaging (DWI). Methods: A total of 60 patients with carotid stenosis (stenotic rate 50%-95%) were included in this study. They underwent carotid artery stenting and were divided into protective filter device group (n = 30) and none protective filter device group (n = 30). DWI was performed within 24 hours before and after the procedure. The number, size, and location of new cerebral ischemic lesions after the procedure were counted. Results: Circled digit oneDWI was performed within 24 hours after the procedure. A total of 18 patients occurred high-density ischemic cerebral lesions, six of them (20%) were in the protective filter device group and 12 (40%) were in the none protective filter device group. There was no significant difference (P >0.05). Circled digit two A total of 41 new ischemic cerebral lesions were detected, 14 of them were in the protective filter device group and 27 were in the none protective filter device group. The lesions mainly located in the same sides of stents. There was no significant difference in the constituent ratio of the lesion sites between two groups (P > 0.05). Circled digit threeThere were 33 lesions of ≤3 mm diameter, 13 of them were in the protective filter device group and 20 were in the none protective filter device group. There were 8 lesions >3 mm in diameter, one of them was in the protective filter device group and 7 were in the none protective filter device group. There was no significant difference in the constituent ratio of the lesion size between the two groups (P >0.05). Conclusion: Using protective filter device during carotid artery stenting may decrease the occurrence of new ischemic cerebral lesions, especially large large sized lesions. However, new ischemic cerebral lesions may occur during the procedure.
RÉSUMÉ
Objective To assess the efficacy and safety of microvascular decompression for treatment of trigeminal neuralgia in elderly patients. Methods The clinical data of29 elderly patients (above 65 years old) with trigeminal neuralgia treated with microvascular decompression were retrospectively reviewed to analyze the outcomes of the surgery and complications in comparison with those of younger patients below 65 years of age. Results Good therapeutic effects were achieved in both groups without obvious difference between them,the rate ofpostoperative pain relieffor the elderly group is 93.10%,96.36%for the control group.The elderly patients showed some special anatomical and systemic features in relation to aging,including the presence of brain atrophy,obvious arteriosclerosis in the culprit arteries(the elderlygroupis about 1/4,the control group is about 1/10),multiple systemic diseases(the elderly group accounted for 71.69%,41.81%for control group),and increased risk of surgical complications(one of the elderly group appears brainstem infarction,2 cases of lower extremity deep VenOUS thromboembolism disease). Conclusion Microvascular decompression provides an effective cure or pain relief for most elderly patients with trigeminal neuralgia with the application of effective perioperative treatment.