Study on the evaluation of glenoid bone defects by MRI three-dimensional reconstruction / 中国修复重建外科杂志

OBJECTIVE@#To investigate the feasibility of MRI three-dimensional (3D) reconstruction model in quantifying glenoid bone defect by comparing with CT 3D reconstruction model measurement.@*METHODS@#Forty patients with shoulder anterior dislocation who met the selection criteria between December 2021 and December 2022 were admitted as study participants. There were 34 males and 6 females with an average age of 24.8 years (range, 19-32 years). The injury caused by sports injury in 29 cases and collision injury in 6 cases, and 5 cases had no obvious inducement. The time from injury to admission ranged from 4 to 72 months (mean, 28.5 months). CT and MRI were performed on the patients' shoulder joints, and a semi-automatic segmentation of the images was done with 3D slicer software to construct a glenoid model. The length of the glenoid bone defect was measured on the models by 2 physicians. The intra-group correlation coefficient ( ICC) was used to evaluate the consistency between the 2 physicians, and Bland-Altman plots were constructed to evaluate the consistency between the 2 methods.@*RESULTS@#The length of the glenoid bone defects measured on MRI 3D reconstruction model was (3.83±1.36) mm/4.00 (0.58, 6.13) mm for physician 1 and (3.91±1.20) mm/3.86 (1.39, 5.96) mm for physician 2. The length of the glenoid bone defects measured on CT 3D reconstruction model was (3.81±1.38) mm/3.80 (0.60, 6.02) mm for physician 1 and (3.99±1.19) mm/4.00 (1.68, 6.38) mm for physician 2. ICC and Bland-Altman plot analysis showed good consistency. The ICC between the 2 physicians based on MRI and CT 3D reconstruction model measurements were 0.73 [95% CI (0.54, 0.85)] and 0.80 [95% CI (0.65, 0.89)], respectively. The 95% CI of the difference between the two measurements of physicians 1 and 2 were (-0.46, 0.49) and (-0.68, 0.53), respectively.@*CONCLUSION@#The measurement of glenoid bone defect based on MRI 3D reconstruction model is consistent with that based on CT 3D reconstruction model. MRI can be used instead of CT to measure glenoid bone defects in clinic, and the soft tissue of shoulder joint can be observed comprehensively while reducing radiation.

Establishment and validation of reference interval of D-dimer in plasma of healthy pregnant women in Xi ′an / 中华检验医学杂志

Objective:To provide normal reference thresholds for clinical dynamic monitoring of the risk of microthrombus during pregnancy, we aimed to establish reference intervals of D-dimer in healthy pregnant women during different periods of gestation in Xi′an.Method:From December 2020 to March 2022, a total of 1502 healthy pregnant women and healthy non-pregnant women (healthy non-pregnant control group) who received routine prenatal examination in Northwest Women and Children′s Hospital were recruited in the study by questionnaire, including 1236 healthy pregnant women and 266 healthy non-pregnant control group. Plasma D-dimer concentration was detected by STA-R Evolution automatic blood coagulation analyzer and the concentration levels of D-dimer in different pregnancies and age groups were calculated using Graph Prism 9.0 software. In addition, 20 samples were collected in each pregnancy to verify the established reference interval.Results:There was no significant difference in plasma D-dimer levels between<30 years old and ≥30 years old at different gestational weeks. Plasma D-dimer level in healthy pregnant women group was significantly higher than that in healthy non-pregnant women group of the same age (P<0.05). With the increase of gestational week, plasma D-dimer level in pregnant women increased significantly, and plasma D-dimer level at different gestational weeks ≤13 weeks, 13+ 1-20 weeks, 20+ 1-27 weeks, 27+ 1-35 weeks, ≥35 +1 week were 0.33 (0.26, 0.47) μg/ml, 0.41 (0.30, 0.51) μg/ml, 0.71 (0.48, 0.94) μg/ml, 0.91 (0.70, 1.27) μg/ml, 1.30 (0.96, 1.72) μg/mlrespectively. Unilateral reference interval acuities were≤0.89 μg/ml, ≤1.53 μg/ml, ≤2.44 μg/ml, ≤2.74 μg/ml, ≤3.82 μg/ml respectively. The reference range established in this study was verified by 20 independent samples from each of the 5 gestational age groups, and the results were acceptable. Conclusion:This study preliminarily established the reference interval of plasma D-dimer in healthy pregnant women at different gestational weeks in Xi ′an area, which is helpful for the auxiliary diagnosis of thrombotic diseases during pregnancy.

Intravenous thrombolytic therapy for cardiogenic and large-artery atherosclerosis stroke: an observational study / 中华神经医学杂志

Objective To compare the safety and effectiveness of intravenous thrombolysis treatment in large artery atherosclerosis (LAA) and cardioembolic (CE) strokes in patients with acute anterior circulation ischemic stroke.Methods Two hundred and thirty-eight patients with acute anterior circulation ischemic stroke, admitted to and treated with intravenous thrombolysis in our hospital from January 2017 to June 2018 were chosen in our study. These patients were divided into either a LAA group (n=158) or a CE group (n=80) according to etiological subtypes. The differences in baseline data and outcomes 90 d after the onset between the two groups were compared. Baseline data of patients in the good outcome group and the poor outcome group were compared and independent risk factors for poor outcome were determined by multivariate Logistic regression analysis.Results As compared with the patients from the LAA group, patients from the CE group had older age and higher proportion of patients combined with atrial fibrillation, with significant differences (P<0.05); there were no statistically significant differences in the good outcome rate, mortality rate and incidence of symptomatic intracranial hemorrhage between the two groups (P>0.05). Among the 238 patients, 112 were into the good outcome group and 126 were into the poor outcome group; as compared with patients from the poor outcome group, patients from the good outcome group had younger age, and lower National Institute of Health Stroke Scale (NIHSS) scores and lower levels of fasting blood glucose before and after thrombolysis, with statistically significant differences (P<0.05); multivariate Logistic regression analysis showed that older age (odds ratio [OR]=1.040, 95％ confidence interval [CI]: 1.010-1.071,P=0.008) and higher NIHSS scores 24 h after thrombolysis (OR=1.259, 95％CI: 1.175-1.350,P=0.000) were independently associated with poor outcome.Conclusion The outcomes of intravenous thrombolysis in patients with acute anterior ischemic stroke are only associated with age and severity of stroke, and not associated with TOAST etiological subtypes; intravenous thrombolysis for cardiogenic stroke is safe and effective.

Low-dose versus standard-dose intravenous alteplase for acute ischemic stroke:comparison of efficacy and safety / 国际脑血管病杂志

Objective To investigate the efficacy and safety of low-dose and standard-dose intravenous alteplase for acute ischemic stroke. Methods The patients with acute ischemic stroke treated with intravenous alteplase from August 2012 to January 2016 were analyzed retrospectively. According to the dosage of the drug, the patients were divided into either a low-dose group (0. 6-0. 8 mg/kg) or a standard-dose group (0. 9 mg/kg). The efficacy was evaluated with the modified Rankin Scale (mRS) at 90 days, and a favorable functional outcome was defined as mRS 0-1. The safety was evaluated by the mortality at 90 days and the incidence of symptomatic intracerebral hemorrhage (SICH) within 7 d after onset. Results A total of 790 patients were enrolled, including 612 in the low-dose group and 178 in the standard-dose group. There was no significant difference in each baseline clinical data between the 2 groups. Compared with the standard-dose group, there was no significant difference in the good outcome rate of the small-dose group at day 90 (35. 6% vs. 37. 6% ; χ2 = 0. 872, P = 0. 35) and mortality (5. 1% vs. 6. 2% ;χ2 = 2. 173, P = 0. 14), but the incidence of SICH was significantly lower (1. 8% vs. 5. 1% ; χ2 = 5. 875, P =0. 015). Conclusion The efficacy of low-dose intravenous alteplase for acute ischemic stroke is equivalent to the standard-dose and the safety is better.

Research progress on preparative parameters that influnce the characteristics of PLA/PLGA/PELA microspheres prepared by double emulsion method / 国际生物医学工程杂志

At present PLA and its copolymer is a kind of most widely used biodegradable polymers to prepare microspheres because of its good biocompatibility. The double emulsion method is the most used technique for microspheres loade with water-soluble drugs, proteins and peptides. Microspheres with different particle size or release character could be used in different applications such as targeted drug delivery or long-acting drug delivery. The characters of microspheres are influenced by the preparative parameter. This article reviewed the preparative parameters that influence the character of microspheres.