ABSTRACT
OBJECTIVE: This study aims to compare clinical efficiency of mechanical thrombectomy combined with rhPro-UK thrombolysis on moderate or severe acute brain infarction. PATIENTS AND METHODS: A total of 90 acute cerebral infarction patients due to artery stenosis or blockade from May 2016 to May 2017 were recruited and randomly assigned into thrombolysis group (N = 30), mechanical thrombectomy (N = 30), and combined treatment group (N = 30). Clinical information was collected. Thrombolysis group received rhPro-UK, mechanical thrombectomy group received Solitaire scaffold, and combined group received rhPro-UK after Solitaire scaffold. Barthel scale and NIHSS scale were used to evaluate the quality of life and mental deficit of patients. Modified thrombolysis in cerebral infarction (mTICI) was compared among three groups, along with the observation of hemorrhage, neurological recovery within 90 days, and adverse effects. RESULTS: No significant difference was found in NIHSS within 24 h of treatment among three groups (p > 0.05), but the decreasing levels were shown at 24 h, 7 days, and 90 days comparing to those before treatment (p < 0.05). In combined treatment group, lower NIHSS at 7 d and 90 d were detected comparing to other two groups (p < 0.05). Recanalization rates were 53.33% and 60.00% in thrombolysis and mechanical groups (p > 0.05), respectively, which were significantly lower than that in combined group (83.33%) (p < 0.05). Curative rate in combined group was 70%, significantly higher than thrombolysis (46.67%) and mechanical group (53.33%) (p < 0.05). No statistical difference of curative rate was observed between thrombolysis and mechanical groups (p > 0.05). Moreover, neither significant difference of coagulation function nor platelet count was found among three groups (p > 0.05). CONCLUSIONS: Mechanical thrombectomy combined with thrombolysis presented favorable efficiency in the treatment of moderate to severe acute cerebral infarction than single treatment, among which the occurrence of adverse effects were similar.
Subject(s)
Cerebral Infarction/therapy , Fibrinolytic Agents/administration & dosage , Thrombectomy , Thrombolytic Therapy , Urokinase-Type Plasminogen Activator/administration & dosage , Aged , Cerebral Infarction/diagnosis , Cerebral Infarction/physiopathology , China , Combined Modality Therapy , Female , Fibrinolytic Agents/adverse effects , Humans , Male , Middle Aged , Recovery of Function , Risk Factors , Severity of Illness Index , Thrombectomy/adverse effects , Thrombectomy/instrumentation , Thrombolytic Therapy/adverse effects , Time Factors , Treatment Outcome , Urokinase-Type Plasminogen Activator/adverse effectsABSTRACT
Lung cancer is the leading cause of cancer morbidity and mortality around world. Heat shock protein beta-1 (HSPB1) expression is aberrantly increased in non-small cell lung cancer (NSCLC) patients. However, the roles of HSPB1 expression in the prognosis of NSCLC are still elusive. In this study, we investigated the prognostic roles of HSPB1 in NSCLC by using "The Kaplan-Meier plotter" (KM plotter) database. Our data indicated that HSPB1 mRNA low expression was correlated to better overall survival (OS) for all NSCLC patients, hazard ratio (HR) 1.41 (1.24-1.61), p=1.1e-7, and better OS in lung adenocarcinoma (LUAD) patients, HR 1.81 (1.42-2.32), p=1.5e-06, but not in lung squamous cell carcinoma (LUSC) patients, HR 1.21 (0.94-1.55), p=0.14. In addition, mRNA low expression of HSPB1 is also significantly associated with better OS of NSCLC patients in different smoking status, in different chemotherapy status, in clinical stage I et II, as well as patients with successful surgery treatment. Our results indicated that HSPB1 expression may have distinct prognostic values in NSCLC patients, and may provide an effective clinical strategy to accurately predict the prognosis of NSCLC patients.
