Risk factors for cryptogenic stroke in patients with patent foramen ovale / 国际脑血管病杂志

Objective:To investigate the potential risk factors for cryptogenic stroke (CS) in patients with patent foramen ovale (PFO).Methods:Patients underwent PFO closure in the Department of Cardiovascular Surgery, the Second Hospital of Hebei Medical University from June 2018 to December 2021 were enrolled retrospectively. Transesophageal echocardiography was used to evaluate the morphological characteristics of foramen ovale and right-to-left shunt (RLS). Multivariate logistic regression analysis was used to determine the independent risk factors for CS in patients with PFO. Results:A total of 203 patients with PFO were enrolled. Their age was 41.9±14.3, and 116 patients (57.1%) were male. There were 102 patients in CS group and 101 patients in non-stroke group. The age, body mass index, systolic blood pressure and diastolic blood pressure, and the constituent ratios of male, hypertension, diabetes, hyperlipidemia and smoking of the CS group were significant higher than those of the non-stroke group (all P<0.05). The PFO channel of the CS group was longer, wider and more combined with resting RLS (all P<0.05). Multivariate logistic regression analysis showed that systolic blood pressure (odds ratio [ OR] 1.065, 95% confidence interval [ CI] 1.022-1.111; P=0.003), PFO length ( OR 1.124, 95% CI 1.004-1.258; P=0.043) and resting RLS ( OR 5.449, 95% CI 2.283-13.004; P<0.001) were the independent risk factors for CS in patients with PFO. Conclusion:Systolic blood pressure, PFO length and the presence of resting RLS are the independent risk factors for CS in patients with PFO.

THE CURRENT SITUATION OF ALLOCATIONS OF HUMAN RESOURCES IN OUR HOSPI-TAL / 现代医院

Objective To provide references foroptimizing the structure of human resourcesby investigating human resource development and the current situation of allocation in the hospital .Methods Descriptive statistical a-nalysis and Spearman rank correlation analysis were conducted on the data of human resource in the hospital from 2004 to 2013 and the situation of personnel allocation in the hospital at the end of 2013 was emphatically analyzed by the statistical description.Results The development of the total human resource from 2004 to 2013was adapted to the hospital development , but the development of staff at each positionwas at unbalance .The nursingstaff wasin short . The educational background structure of all kinds of positions was reasonable , but thestructure of professional titleswas unreasonable , without developing into talents team .Moreover ,the non-permanently-contracted staff took up a lar-ger proportion .Conclusion Hospitals need to achieve comprehensive development of human resource by setting up scientific conception of talents ,to improve the quantity and quality of nursing staff by enhancing nursing staff construc -tion, to forming an reasonable talent team by balancing the structure of personnel quality , and to stabilize the hospital staff structure by attaching importance to the management of non -permanently contracted staff .

Application of superslim endoscope in treatment of colonic obstruction in left colorectal cancer / 中国医师进修杂志

Objective To discuss the application of transanal placement of ileus tube in treatment of colonic obstruction in left colorectal cancer.Methods Thirty-two patients with left malignant colorectal obstruction were divided into ordinary colonoscope group (16 cases) and superslim endoscope group (16 cases) by random digits table.The catheter success rate,catheter operating time and exposure to X-ray time was compared between two groups.Results Fifteen cases were successful and 1 case was failed in ordinary colonoscope group.Thirteen cases were successful and 3 cases were failed in superslim endoscope group.There was no significant difference in the catheter success rate between two groups (x2 =1.143,P =0.285).The catheter operating time was (42 + 15),(20 +6) min in ordinary colonoscope group and superslim endoscope group,and there was significant difference between two groups (t =3.895,P =0.005).The exposure to X-ray time was (20 + 12),(5 + 2) min,and there was significant difference between two groups (t =-3.596,P =0.007).Conclusion Transanal placement of ileus tube is more successful and convenient by superslim endoscope combined with anesthesia than by ordinary colonoscope.

T-lymphocyte subsets in patients with Guillain-Barré syndrome change after intravenous immunoglobulin treatment and its significance / 中华神经科杂志

Objective To study the changes of the T-lymphocyte subsets in patients with Guillain-Barré syndrome(GBS)before and after intravenous immunoglobulin treatment(IVIG),and to explore the possible mechanism of the IVIG curing GBS further.Methods Chose 31 cases of clinically confirmed GBS were enrolled and compared before and after the treatment.According to the effect of the therapy,31 cases of the total were sub-divided into effective and ineffective groups.Relative counting of peripheral blood T-lymphocyte subsets was preformed with flow cytometry.Results ①The percentage of CD8+ T and CD4+CD29+ T cell was significantly lower(CD8+T:28.77%±11.02% vs 31.84%±12.35%,CD4+CD29+T:56.71%±12.44% vs 62.40%±12.72%,t=2.995,3.919,P＜0.05)after therapy,while the rate of CD4+/CD8+T and the percentage of CD4+CD45RA+T cell increased notably(t=2.368,3.860,P＜0.05);but there was no notable difference in the percentage of CD3+T and CD4+T cell.②The percentage of CD8+T and CD4+CD29+ T cell was significantly lower(t=2.144,3.343,P＜0.05)after the treatment,while the rate of CD4+/CD8+T and the percentage of CD4+CD45RA+T cell increased notably(t=2.159,3.277,P＜0.05)in the good curative effect group,but there was no change in the bad curative effect group.③61.29%(19/31)of the patients significantly improved by IVIG,and there was no death case.Conclusions T-lymphocyte subsets change in a varing degree after IVIG treatment in acute GBS patients,which lays an immunological foundation for the further study of pathogenesis and mechanism of IVIG curing GBS;effective on GBS,IVIG can actively suppress pathogenetic condition and promote the recovery of nrevous function.

Association between the level of tumor necrosis factor ? and the clinical features of multiple sclerosis / 临床神经病学杂志

Objective To investigate the relationship between the level of tumor necrosis factor (TNF)? and the clinical features of multiple sclerosis(MS). Methods The TNF? level of 58 MS patients (MS group) was determined by means of sandwich enzyme-linked immunosorbent assay (ELISA). The correlative analysis between level of TNF? and the Expanded Disability Status Scale (EDSS), the clinical data (including the duration of disease,the number of relapses and the age of onset) were take in MS patients. Results (1)TNF? level was significantly increased in MS acute stage compared with those in MS remission stage and healthy controls (P