Value of magnetic resonance angiography-diffusion weighted imaging mismatch in predicting ischemic penumbra in acute posterior cerebral infarction with basilar artery occlusion / 中国脑血管病杂志

Objective To explore the value of MRA-DWI mismatch (MDM) in predicting ischemic penumbra in acute posterior cerebral infarction with basilar artery occlusion. Methods From September 2015 to July 2018, 58 acute posterior cerebral infarction patients with basilar artery occlusion within 24 hours from symptom onset in the Department of Neurology, the Fourth Affiliated Hospital of China Medical University were retrospectively recruited. The thirty-eight patients with DWI- ASPECTS ≥7 were divided into the MDM-P group and twenty patients with DWI- ASPECTS 0. 05); the differences in NIHSS (3 [2, 12] vs. 11[4, 26], Z=2.434) and DWI-ASPECTS (8[7, 8]vs. 4[3, 5] , Z = 12.950)were statistically significant (all P 0. 05), but significant difference in reperfusion therapy (42.9% [9/21] vs. 67. 6% [25/37], χ2 =3.372) and MDM-P (85.7% [18/21] vs. 54. 1% [20/37], χ2 =5.944) (all P<0.05). Logistic regression analysis showed MRA-DWI mismatch (OR, 4. 914, 95% CI 1. 158 -20. 860, P = 0. 031) was an independent predictor of early neurological deterioration in acute posterior cerebral infarction. Conclusions MRA-DWI mismatch may be a predictor of END in acute posterior cerebral infarction with basilar artery occlusion, indicating that ischemic penumbra may be present in these patients, and it provides evidence for guiding reperfusion therapy.

Fatigue among Clinicians and the Safety of Patients / 中国医学伦理学

Sleep deprivation due to extended work hours and circadian disruptionhas long been a concern in medicine.Clinicians who have been deprived of sleepfailed to ensure that patients are safe or that the quality of care they receive is high.So it can not be ignored to solve the tense relationship between the clinicians and the patients in China.As a result,to pay attention to the fatigue among clinicians and the safety of patients in our country has its practical significance.Take an active strategy to properly resolve the problem of fatigue among clinicians to ensure medical security,the establishment of safe,high-quality health care system,not only directly related to the treatment of patients,but also to the harmonious relations between clinicians and patients to ensure the safety of health care are very important.