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Airborne pollen is a common allergen that causes allergic reactions. Researches have shown that airborne pollen may be an independent risk factor for ischemic stroke. The possible mechanisms of airborne pollen induced ischemic stroke include inflammation and oxidative stress response, atherosclerosis, blood hypercoagulability and thrombosis, and can increase the risk of ischemic stroke by promoting the occurrence of hypertension, respiratory and cardiovascular events.
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In addition to visual field defects, occipital lobe injury can also cause fundus changes, such as retinal nerve fiber layer atrophy, ganglion cell complex atrophy and even optic nerve atrophy, and these fundus changes have a good correlation with the visual field defect site. It is considered to be caused by transneuronal retrograde degeneration (TRD) of retinal ganglion cells secondary to occipital lobe injury. These changes can be detected by means of optical coherence tomography, fundus examination, magnetic resonance imaging, etc. Among them, optical coherence tomography is more sensitive than other examinations. Here, the anatomical basis of TRD, case reports, pathogenesis, auxiliary examination, treatment and prognosis of TRD secondary to occipital lobe injury are reviewd.
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AIMS: To investigate the efficacy and safety of minimally invasive bronchoscopic interventions for patients with tracheobronchial mucoepidermoid carcinoma (MEC). METHODS: Patients with tracheobronchial MEC were included in this retrospective study, and the clinical features, histologic grading, treatments, and cumulative survival rates were calculated. Patients were categorized into child (n = 16) and adult (n = 19) group according to their ages. Histologic grading, treatments, and survival status were compared between the two groups. RESULTS: In pathology, high-grade MEC counts for 6.77% and 42.10% in the child and adult group, respectively. As tumor growth pattern was concerned, 93.33% and 21.05% tumors in the child and adult group present intratracheal type. Multiple bronchoscopic interventions were conducted, including rigid bronchoscopy, argon plasma coagulation (APC), dioxide carbon cryotherapy, and electric loop. Tumors could be removed by multiple bronchoscopic interventions. Bronchoscopy-associated complications were rare, including an oral mucosa injury and a glottis edema. In the child group, one patient underwent left upper lung lobectomy. In the adult group, lobectomy and/or chemotherapy and/or radiotherapy were conducted in seven patients. The 5-year survival rate was 100% and 68.90% in the child and the adult group, respectively. CONCLUSIONS: Almost all children have low-grade and intratracheal MEC; 2/5 adults have invasive high-grade MEC. Multiple bronchoscopic interventions are effective in erasing low-grade intratracheal MEC without severe complications. For high-grade invasive MEC, aggressive and comprehensive therapy should be considered.
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Carcinoma, Mucoepidermoid , Adult , Argon Plasma Coagulation , Bronchoscopy , Carcinoma, Mucoepidermoid/pathology , Carcinoma, Mucoepidermoid/surgery , Child , Humans , Retrospective StudiesABSTRACT
Objective:To explore the feasibility of predicting axillary lymph node metastasis of breast cancer using radiomics analysis based on dynamic contrast-enhanced (DCE) MRI.Methods:The retrospective study enrolled 163 patients (163 lesions) with breast cancer diagnosed by core needle biopsy from January 2013 to December 2013 in Peking University First Hospital. The status of axillary lymph nodes in all patients was pathologically confirmed, and they had complete preoperative breast MRI images. Among the 163 patients, 94 patients were confirmed with axillary lymph node metastasis, and 69 patients without axillary lymph node metastasis. They were randomly divided into the training dataset ( n=115) and testing dataset ( n=48) in a 7∶3 ratio. The radiomics analysis was performed in the training dataset, including image preprocessing and labeling, radiomics feature extraction, radiomics model establishment and model predictive performance inspection. Model performance was tested in the testing dataset. Receiver operating characteristic curve and area under curve (AUC) was used to analyze the model prediction performance. Results:Of the 1 075 features extracted from the training dataset, principal component analyses (PCA) features 8, 41 and 67 were selected by random forest classifier. The radiomics model including 3 PCA features reached an AUC of 0.956 (95%CI 0.907-0.988), with sensitivity of 91.2%, specificity of 100% and accuracy of 94.8%. In the testing dataset, the radiomics model including 3 PCA features reached an AUC of 0.767 (95%CI 0.652-0.890), with sensitivity of 80.8%, specificity of 72.7% and accuracy of 77.1%.Conclusion:It is feasible to predict axillary lymph node metastasis using radiomics features based on DCE-MRI of breast cancer.
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As a new technology for screening carotid plaques, three-dimensional ultrasound plays an important role in clinical and scientific research. Recent studies have shown that three-dimensional ultrasound combined with various new algorithms can effectively evaluate carotid plaque load and vulnerability. However, due to the high cost of volumetric probes and the large volume affecting the detection angle, three-dimensional ultrasound has not been widely used in China. This article reviews the advantages of three-dimensional ultrasound in evaluating vulnerable plaques and plaque load, in order to provide reference for clinical work in the future.
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Cerebral developmental venous anomaly (DVA) is a kind of benign vascular malformation that mainly occurs supratentorially.Its diagnosis mainly depends on imaging examination.It is often misdiagnosed or missed because of low incidence and atypical clinical manifestations.This article reviews the etiology,pathogenesis,clinical manifestations,imaging features,and prognosis of DVA.
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Fornix infarction is a kind of cerebral infarction in special sites with memory disorder as its main manifestation, which is rare in clinical practice. Because the isolated fornix infarction is not often accompanied by obvious positive signs of nervous system, the patients complained fewer symptoms. The related manifestations were mostly provided by family members, which is prone to misdiagnosis and missed diagnosis. This article reviews fornix infarction from the aspect of anatomy, blood supply, infarction etiology, clinical manifestations, possible mechanisms, and imaging features by summarizing the available case reports.
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Many studies indicated that meteorological factors are associated with stroke risk,especially cold temperature.This article reviews the effect of cold temperature on the occurrence of stroke.
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Objective To investigate the correlation between 6 common triggers and ischemic stroke.Methods The demographic and clinical data of the consecutive inpatients with acute ischemic stroke were collected.A questionnaire survey of the triggers of the disease was conducted within 4 d after admission.A case cross-over study was used to compare the exposure of the 6 potential triggers (overeating,anger,negative emotion,heavy physical activity,sudden posture changes as response to a startling event,drinking coffee) at 2 h before onset (dangerous period) and at 1 d before onset during the same period (control period),and exposures to potential triggers in patients according to gender,age and etiological subtypes were further analyzed.Results A total of 369 patients were enrolled.They aged 24-93 years old (mean 61.75 ±13.57),220 patients were male (59.6％) and 149 were female (40.4％).A total of 91 patients (24.7％) exposed to at least one of the triggers at 2 h before onset (odds ratio [OR] 6.1,95％ confidence interval [CI] 3.7-9.9);OR for exposure to the sudden posture change in response to a startling event was 12.0 (95％ CI 2.4-59.3),for heavy physical activity 10.7 (95％ CI 4.2-27.6),for anger 8.0 (95％ CI 2.3-27.5),and for negative emotion 4.9 (95％ CI 2.3-10.3).There was no exposure to drinking coffee.There were no significant differences in the exposure to various triggers among the different gender,age,and etiological subtypes.Conclusions Sudden posture changes as response to a startling event,heavy physical activity,anger,and negative emotion are the triggers for ischemic stroke,attention should be paid to the influence of triggers in the prevention of ischemic stroke.
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Medulla oblongata is precise in structure and the blood supply is complicated. After its infarction, it is easy to be misdiagnosed or missed because of its various clinical manifestations and lack of specificity. This article reviews the pathogenesis, clinical manifestations, and prognosis of medullary infarction in different sites.
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The mortality and disability of ischemic stroke are high.A number of epidemiological studies have confirrned that air pollutants can increase the prevalence or admission rate of ischemic stroke.Air pollutants mainly include sulfur dioxide,nitrogen dioxide,fime particles,carbon monoxide,and ozone.This article reviews the main sources of various major air pollutants,the effect of major air pollutants on the risk of ischemic stroke onset,and the possible mechanisms.
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Cerebral small vessel disease is a group of heterogeneous diseases with stroke and cognitive impairment as the main clinical features.It can be divided into sporadic type and hereditary type.Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL) belongs to hereditary cerebral small vessel disease.It has been reported in China,Japan,Spain,Greece,and other countries.The diagnosis mainly depends on characteristic clinical symptoms,imaging features,and genetic testing.CARASIL manifests as diffuse white matter abnormal signal and subcortical multiple infarcts on MRI,and it caused by HTRA1 gene mutation.
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The clinical manifestation of vertebrobasilar dolichectasia (VBD) changes with the different degree of expansion and extension,including ischemic stroke,transient ischemic attack,hemorrhagic stroke,cerebral nerve and brainstem compression symptoms,and hydrocephalus.At present,the diagnosis of VBD mainly relies on CT,MRI multimodal imaging,and there are more complete diagnostic criteria.Because of the low incidence of VBD,the analysis of its clinical characteristics is helpful for early detection and early treatment in clinical practice,so as to improve the prognosis of patients.
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Ischemic stroke is often triggered under the effect of the basic lesions combined with a variety of incentives in daily life. Its generative mechanism is complicated, and there are more risk factors. Only according to the long-term existence of chronic risk factors, it cannot make appropriate explanation for the acute onset of this disease. At present, there are a few studies on the predisposing factors of stroke, and its related mechanism needs to be further discussed. This article aims to introduce the relationship between the common predisposing factors and ischemic stroke, discusses its possible mechanism, and provides reference for the clinical prevention work of ischemic stroke.
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With a low incidence and a non-specific clinical manifestation, medial medulary infarction (MMI) can often be misdiagnosed or missed diagnosis. Magnetic resonance imaging(MRI) played a major role in diagnosing the MMI. This article reviews the epidemiology, etiology, pathogenesis, clinical and imaging manifestations, diagnosis and differential diagnosis, and prognosis of MMI.
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Objective To establish the pyrogen removing effect of activated carbon in the technics of traditional Chinese medicine (TCM) injections. Methods The content of bacterial endotoxin concentration was detected by kinetic turdimetric assay to evaluate the effect of removing pyrogen before and after using activated carbon in concentrated solution of TCM injection. Results The activated carbon adsorption rate of Shuanghuanglian concentrated solution≥70%and the activated carbon adsorption rate of Danshen concentrated solution>95%. Conclusion Pyrogen manufacturing process is scientific and rational by adding activated carbon adsorption in powder injection of TCM. The bacterial endotoxin of large doses can't be removed fully by activated carbon adsorption.
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Objective To investigate the effects of endogenous estrogen on blood glucose level,serum insulin level,and plasma total antioxidant capacity in streptozotocin-induced diabetic female mice,and to explore possible protective effects of estrogen on pancreatic islet cells.Methods Female mice were randomly according to body weight divided into four groups:( 1 ) Sham( Sham operation and vehicle administration) ; ( 2 ) Ovx( ovariectomy and vebicle administration ) ; ( 3 ) Sham + STZ ( Sham operation and STZ administration ) ; and ( 4 ) Ovx + STZ ( ovariectomy and STZ administration).The diabetic mice were induced by intraperitoneal injection of streptozotocin (STZ,50 mg/kg ).Blood glucose levels were measured once a week.Results The blood glucose level and malondialdehyde of Ovx group were higher than that in Sham group,while total anti-oxidant capacity ( T-AOC ) was lower than those in Sham group.the blood glucose level and MDA of Ovx+ STZ group were higher than those in Sham +STZ group,while T-AOC and serum insulin level were lower than those in Sham + STZ group.Conclusions Endogenous estrogen may have some protective effects on pancreatic islet function from streptozotocin-induced diabetes mellitus in female mice.
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Objective To investigate the relationship between carotid atherosclerotic plaque and multiple risk factors of angiocardiopathy,and to evaluate the injuries caused by different risk factors to subclinical target organ to control the general risk factors of angiocardiopathy.Methods Four hundred and twenty six outpatients and impatients,treated in our hospital from May 2007 to May 2009 with the results of color ultrasonic examination,were divided into carotid atherosclerotic plaque group(284 cases) and no carotid atherosclerotic plaque group( 142 cases).The clinical information including their age,body mass index,smoking condition,past medical history such as hypertension,diabetes mellitus and hyperlipoidemia were recorded,and the levels of total cholesterol(T C),high density lipoprotein cholesterol( HDL-C),low density lipoprotein cholesterol(LDL-C),triglyceride (TG),lipoprotein ( a ) ( LP (a) ),apolipoprotein A - 1 ( Apo A 1 ),apolipoprotein B ( Apo B ),highsensitivity C-reactive protein( hs-CRP),homocysteine ( HCY),microalbuminuria( MAU ) and uricacid(UA) were determined by lab tests.The independent variable and univariable data were processed and analyzed statistically to find out the risk factors of carotid atherosclerotic plaque.Results Age and drinking were significantly correlated with the carotid intima-media wall thickening(IMT) (P ＜ 0.001 ).Overweight,diabetes mellitus,increased LP (a),hyperlipoidemia,age,increased MAU and HCY could independently predict carotid atherosclerosis and plaque formation ( x2 =71.35,38.45,t =3.26,x2 =37.23,t =118.51,6.723 and 3.17respectively,Ps ＜ 0.05 ).The aggregated number of the risk factors was correlated to IMT and carotid atherosclerotic plaque ( P =0.0001 ).Conclusion Age,drinking,overweight,diabetes mellitus,increased LP (a),hyperlipoidemia,MAU and HCY are risk factors of carotid atherosclerosis and plaque formation,and the contribution of each factor can multiply and overlap,more risk factors means greater risk.
