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Objective:To investigate the predictors of early neurological deterioration (END) in patients with acute ischemic stroke (AIS) based on the Oxfordshire Community Stroke Project (OCSP) classification system.Methods:Patients with AIS admitted to the Department of Neurology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from February 2018 to November 2020 were enrolled retrospectively. According to the OCSP criteria, the patients were classified into total anterior circulation infarct (TACI), partial anterior circulation infarct (PACI), posterior circulation infarct (POCI), and lacunar infarct (LACI). END was defined as the National Institutes of Health Stroke Scale (NIHSS) total score within 72 h after onset increased by ≥2 or motor function score increased by ≥1 compared with the baseline. Multivariate logistic regression analysis was used to determine the independent risk factors for END in AIS patients with different OCSP types. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of each index for END in AIS patients with different OCSP types. Results:A total of 405 patients with AIS were enrolled. Their age was 68.84±12.27 years, and 250 were males (61.7%); 132 patients (32.6%) were in the TACI group, 108 (26.7%) were in the PACI group, 61 (15.1%) were in the POCI group, and 104 (25.7%) were in the LACI group. END occurred in 136 patients (33.6%). Multivariate logistic regression analysis showed that homocysteine (Hcy) (odds ratio [ OR] 1.065, 95% confidence interval [ CI] 1.012-1.212; P=0.015), baseline NIHSS score ( OR 1.209, 95% CI 1.095-1.335; P<0.001) and the time from onset to admission ( OR 1.663, 95% CI 1.282-2.082; P<0.001) were significantly and independently correlated with END in the TACI group. Hcy ( OR 1.137, 95% CI 1.040-1.244; P=0.005), fasting blood glucose ( OR 1.714, 95% CI 1.272-2.311; P<0.001), neutrophil to lymphocyte ratio (NLR) ( OR 1.370, 95% CI 1.016-1.848; P=0.039) and the time from onset to admission ( OR 1.266, 95% CI 1.056-1.519; P=0.011) were significantly and independently correlated with END in the PACI group. NLR ( OR 1.446, 95% CI 1.031-2.027; P=0.033) was significantly and independently correlated with END in the POCI group. Fasting blood glucose ( OR 1.301, 95% CI 1.006-1.683; P=0.045), NLR ( OR 1.393, 95% CI 1.025-1.894; P=0.034) and the time from onset to admission ( OR 1.171, 95% CI 1.008-1.361; P=0.039) were significantly and independently correlated with END in the LACI group. ROC curve analysis showed that the areas under the curve (AUC) of Hcy and baseline NIHSS score for predicting END in the TACI group were 0.617 (95% CI 0.521-0.713; P=0.021) and 0.784 (95% CI 0.706-0.862; P<0.001). The optimal cut-off values were 15.91 μmol/L and 19.5 points, respectively. The sensitivity and specificity were 63.7% and 85.2%, 62.0% and 86.9%, respectively. The AUC of Hcy, fasting blood glucose and NLR for predicting END in the PACI group were 0.672 (95% CI 0.548-0.797; P=0.005), 0.794 (95% CI 0.697-0.891; P<0.001) and 0.674 (95% CI 0.560-0.788; P=0.005), respectively. The optimal cut-off values were 15.2 μmol/L, 6.85 mmol/L, and 3.71, respectively. The sensitivity and specificity were 61.3% and 77.9%, 80.6% and 72.8%, 67.7% and 79.4%, respectively. The AUC of NLR for predicting END in the POCI group was 0.850 (95% CI 0.735-0.964; P<0.001). The optimal cut-off value was 5.2. The sensitivity and specificity were 84.2% and 81.4% respectively. The AUC of fasting blood glucose and NLR for predicting END in the LACI group were 0.728 (95% CI 0.614-0.842; P<0.001) and 0.731 (95% CI 0.614-0.842; P<0.001), respectively. The optimal cut-off values were 5.44 mmol/L and 2.71 respectively. The sensitivity and specificity were 80.0% and 62.7%, 76.0% and 79.2%, respectively. Conclusion:The predictors of END in AIS patients with different OCSP types are different.
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Objective To investigate the effect of aspirin on the endometrium of patients with severe intrauterine adhesions after electrical resection.Methods 130 patients with severe intrauterine adhesions after electrical resection from August 2013 to August 2015 in our hospital were selected and randomly divided into the observation group and the control group ( 65 cases in each group ); The control group were given progestogen sequential therapy, while the observation group were given aspirin for treatment on basis of the control group; All the two groups were treated for three menstrual cycles; Before and after treatment indexes including uterine endometrial thickness, ovulation of the uterine artery blood flow index artery pulsatility index in ultrasound (PI), resistance index (RI), endometrial blood flow parameters[vascular index (VI), flow index (FI) and vascular blood flow index (VFI)] were recorded and compared, as well as menstruation and uterine cavity shape 3 menstrual cycles after treatment;All the two groups were followed up for one year, and one year pregnancy rates in the two groups were recorded.Results After treatment, the total efficiency in the observation group was 92.3% significantly higher than 69.2% in the control group ( P <0.05 ) .After treatment, in the two groups endometrial thickness, PI, RI, VI, FI and VFI were significantly improved compared with before treatment (P<0.05), but the observation group improved more obviously (P<0.05).Within one years in the observation group the pregnancy rate was 57.1%higher than that in the control group 26.5%(P<0.05) .Conlcusions Application of aspirin can significantly improve the endometrial thickness on the basis of estrogen and progesterone sequential therapy , increase the endometrial blood flow and improve the pregnancy rate, which mechanism may be related to promoting endometrial repair and improving blood perfusion of the uterus.
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Objective To explore the horseshoe kidney of prenatal ultrasonography for detecting birth defects.Methods A total of 3260 women during 22～42 gestational weeks underwent real-time color Doppler ultrasongraphy to find out fetal mati kidney.All the cases were tracked within two month after delivery.Results In all 3260 pregnant women,104 cases were diagnosed on ultrasonography of 100%accordance with clinical diagnosis.Conclusions A systemic prenatal ultrasonographic examination in the second-trimester pregnancy is important for prenatal diagnosis of congenital malformations,which play a very significant role in decreasing fetal birth defects and improving new born population quality.
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P-glycoprotein is one of the members in the superfamily of ATP-binding cassette transporters. It is expressed in many sites in vivo, and is correlated with multidrug resistance. Under physiological conditions, as an efflux pump, P-glycoprotein in the blood-brain barrier can eliminate endogenous substrates and xenobiotics to maintain the balance of internal environment. But at the same time, it also limits the concentration of therapeutic drugs in brain, and thus reduces therapeutic efficacy. P-glycoprotein inhibitors can get drugs across the blood-brain barrier. It is of great importance to improve the blood concentration in brain and bioavailability of central nervous system drugs.
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Objective To investigate the therapeutical effect of Tetrandrine(Tet)combined with Glutathione(GSH)in rats with Parkinson's disease(PD).Methods The PD model rats were established through stereotactic microinjection of 6-hydroxydopamine,then they were randomly divided into PD group,GSH group,L-dopa group,GSH+Tet+L-dopa group and GSH+Tet group.The rats were peritoneal injected with corresponding medicines.The circling behavior of rats were observed induced by Apomorphine.The levels of GSH in substantia nigra and MAO-B in striatum were assayed after treatment,the numbers of dopaminergic neuron were observed by immunohistochemistry and the contents of TH mRNA were also be assayed in each group.Results(1)Compared with pretherapy,the rotation times of groups L-dopa,GSH +Tet+L-dopa,GSH+Tet had statistical significance(P