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Objective:To evaluate the predictive value of the National Institutes of Health Stroke Scale(NIHSS)score and the Glasgow Coma Scale(GCS)score for bleeding in patients with acute cerebral infarction after thrombolytic therapy.Methods:A total of 281 patients with acute cerebral infarction were enrolled at Henan Provincial People's Hospital and were treated with urokinase or recombinant human tissue plasminogen activator(rt-PA)for thrombolysis.The patients were followed up for up to 1 month after thrombolysis.Data on age, sex, time to thrombolysis, smoking, systolic blood pressure, platelets, prothrombin time, international normalized ratio, and NIHSS and GCS scores were collected.Logistic regression analysis was used to identify related factors for bleeding after thrombolysis in acute cerebral infarction and the receiver-operating characteristic curve(ROC)was used to assess the predictive values of these factors through calculating the area under the curve(AUC).Results:Logistic regression analysis showed that time to thrombolysis, prothrombin time before thrombolysis, NIHSS score before thrombolysis, NIHSS score 24 h after thrombolysis, GCS score before thrombolysis, and GCS score 24 h after thrombolysis were independent factors for hemorrhage after thrombolytic therapy( OR=23.318, 0.238, 17.099, 4.561, 0.004, and 0.258, P=0.038, 0.021, 0.038, 0.027, 0.006, and 0.040, respectively).ROC curve analysis showed that NIHSS score before thrombolysis, NIHSS score 24 h after thrombolysis, and time to thrombolysis were important factors for predicting bleeding after thrombolysis(AUC=0.833, 0.795, and 0.714, respectively, all P=0.000). Conclusions:For patients with acute cerebral infarction, the risk of bleeding after thrombolysis is significantly increased if the NIHSS score is unfavorable before thrombolysis or 24 h after thrombolysis, or the duration of acute cerebral infarction is long.Attention to risk factors and early intervention are warranted.
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Objective:This study aimed to investigate the changes of ventricular repolarization index on ECG and its relationship between prognosis in patients with acute cerebral trauma.Methods:From January 2014 to January 2018, data of 289 consecutive patients with emergency traumatic brain injuries were prospectively collected and ultimately 219 cases were selected into the study group. Meanwhile, 220 healthy persons matched by age and sex served as the control group. ECG indexes such as P wave dispersion (Pd), corrected QT(QTc), Tp-e and Tp-e/QT were all measured and calculated in the 1st and 72th hour. The independent sample t test and paired t test were used to compare the changes of the above indexes on the 1st day and the control group, the 1st day and the 3rd day, respectively, and the association between ECG indexes and the illness severity or adverse events (MACE) of the trauma group during hospitalization. Results:QTc, Tpec and Tp-e/QT of the acute cerebral trauma group increased on the 3rd day compared with the control group and on the first day, the differences were statistically significant ( P all <0.05). Tp-ec and Tp-e/QT in patients with moderate to severe brain injury in Glasgow Coma Scale (GCS) were increased, and the differences were statistically significant (150.48±16.58 vs 130.14±11.86, P=0.006). 0.29±0.04 vs 0.23±0.03, P=0.030). Tpec and Tp-e/QT were significantly increased in acute brain truma patients with MACE during hospitalization compared with those without MACE (149.76±12.52 vs 128.84±12.47, P <0.001). 0.30±0.04 vs 0.21±0.03,<0.001). Conclusion:Tp-e and Tp-e/QT in patients with acute cerebral trauma are correlated to the severity of the disease, which could be used as short-term prognostic indicators under certain conditions.
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Objective To investigate the current status about the application of alteplase (rt-PA) for intravenous thrombolysis in acute ischemic stroke patients,and clarify the relevant factors affecting patients'compliance of intravenous thrombolysis.Methods The acute ischemic stroke patients admitted in Department of Emergency,from January 2014 to December 2015 were recruited for study prospectively.After the patients with contraindications of thrombolysis were excluded,the eligible patients were divided into two groups,intravenous thrombolysis group (ITG) and non-intravenous thrombolysis group (NTG).Receiver operating characteristic curve (ROC) was used to determine the optimal cutoff point and the crucial NIHSS score of patients for decision on thrombolysis therapy.Results There were 230 patients with acute ischemic stroke occurred in the period of two years.Of 189 eligible patients,33 refused the intravenous thrombolysis treatment (NTG) whereas 156 willing to take the intravenous thrombolysis treatment (ITG).The intravenous thrombolysis rate of eligible ischemic stroke patients reached to Henan Provincial People's Hospital within the time window (4.5 hours) was 67.8％ without contraindications.The results of the single-factor analysis for the patients of the two groups displayed that the differences in factors including age,baseline NIHSS score,limb weakness,hemiplegic paralysis,dysphasia,as well as dizziness were significant between two groups (t =2.578,P =0.047;U =157.221,P =0.000;x2 =26.702,P =0.000;x2=9.069,P =0.003;x2 =7.381,P =0.007;x2 =28.636,P =0.000).The ROC analysis demonstrated the relationship between the baseline NIHSS score and the patients receiving intravenous thrombolysis.When NIHSS score ＜ 7,patients tended to refuse the treatment with intravenous thrombolysis (sensitivity 0.87,specificity 0.82).Among the patients receiving intravenous thrombolysis,the significant differences in intracranial hemorrhage rate,hospitalization mortality rate and 3-month mortality rate were not found between the patients with baseline NIHSS score≥7 and score ＜7 (1.9％ vs.3.9％,P =0.662;1.9％ vs.7.8％,P =0.168 and 3.8％ vs.11.7％,P =0.142,respectively).However a higher rate of favorable prognosis (3-month modified Rankin Scale score ≤ 1) was observed in thrombolysis patients (75.5％ vs.41.7％,P =0.000).Conclusions Factors such as age,baseline NIHSS score,limb weakness,hemiplegic paralysis,dysphasia,as well as dizziness are supposed to be associated with patients' compliance of intravenous thrombolysis.
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Abstract A novel luminol electrochemiluminescence strategy based on titanium dioxide/carbon nanotubes ( TiO2/CNTs) nanocomposites for detection of glucose was developed. First, the TiO2/CNTs nanocomposites were prepared by a sol-gel method and modified on the glassy carbon electrode. The electrochemiluminescence ( ECL) signal could be greatly enhanced when the electrode was established by the nanocomposites, which finally resulted in the increased sensitivity. Glucose oxidase calalyzed the oxidation of glucose to form H2 O2 , and the H2 O2 reacted with luminol to produce the ECL signal. Thus the above system was proved to be efficient for glucose detection. The modified electrode exhibited excellent ECL signals and a good linear range of 1. 0í10-7-5. 0í10-6 mol/L with a detection limit of 5. 2í10-8 mol/L towards glucose detection. This strategy was successfully demonstrated as a sensitive, rapid, simple and cost-effective method to detect glucose. Meanwhile, the TiO2/CNTs nanocomposites offered a novel material for the signal enhancement in electrochemiluminescence sensor.