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Objective:To investigate the efficacy and adverse reactions of ticagrelor combined with atorvastatin in the treatment of acute cerebral infarction (ACI).Methods:A total of 80 patients with ACI who were diagnosed and treated in Anhui Suixi County Hospital from October 2021 to October 2022 were selected retrospectively and randomly divided into the control group and observation group, each group with 40 cases. The patients in the control group were treated with routine basic treatment and atorvastatin for ACI. The patients in the observation group was treated with ticagrelor on the basis of the control group. The clinical efficacy, neurological function, daily living ability, platelet function (platelet count, platelet inhibition rate), inflammatory factors including high sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6) and adverse reactions of the two groups were compared.Results:The total effective rate of the observation group was higher than that of the control group: 92.50%(37/40) vs. 72.50% (29/40), there was statistical differences ( P<0.05). After treatment, the score of National Institute of Health Stroke Scale of the observation group was lower than that of the control group: (9.37 ± 2.91) points vs. (14.20 ± 3.39) points, and the score of Barthel index scale (BI) was higher than that of the control group: (72.26 ± 13.27) points vs. (58.93 ± 9.43) points, there were statistical differences ( P<0.05). After treatment, the platelet count and platelet adenosine diphosphate (ADP) inhibition rate of the observation group were higher than those of the control group: (284.65 ± 41.58) × 10 9/L vs. (210.46 ± 36.12) × 10 9/L, (79.43 ± 16.42)% vs. (62.40 ± 13.95)%, there were statistical differences ( P<0.05). After treatment, the serum hs-CRP and IL-6 levels of the observation group were lower than those of the control group: (11.64 ± 2.96) mg/L vs. (19.75 ± 4.57) mg/L, (4.26 ± 0.93) ng/L vs. (8.95 ± 1.83) ng/L, there were statistical differences ( P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups after treatment ( P>0.05). Conclusions:Ticagrelor combined with atorvastatin has a better therapeutic effect on ACI, which can effectively improve the neurological deficit and the ability of self-care.
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Objective:To analyze the factors influencing prognosis of intrahepatic cholangiocarcinoma (ICC) after surgical resection.Methods:The clinical data of patients diagnosed with ICC and who underwent surgical resection from December 2015 to December 2019 at the Fifth Medical Center of PLA General Hospital were retrospectively analyzed. Of 39 patients who were included in this study, there were 23 males and 16 females, with age of (54.1±7.2) years old. The body mass index, hepatitis B virus infection status, tumor diameter, degree of differentiation, microvascular tumor thrombus, lymph node metastasis, and serum levels of carbohydrate antigen 19-9 (CA19-9) were analyzed as risk factors affecting postoperative recurrence and survival.Results:The median times to recurrence were significantly better in patients with a tumour length <5 cm (11 vs. 5 months), patients without microvascular tumor thrombus (54 vs. 6 months) and patients without lymph node metastasis (8 vs. 5 months) (all P<0.05). The median survival of patients with CA19-9≥100 U/ml was significantly shorter than that of patients with CA19-9<100 U/ml, (9 vs. 27 months, P<0.05). Tumor diameter>5 cm, microvascular tumor thrombus, lymph node metastasis, and CA19-9 ≥100 U/ml are risk factors affecting the recurrence time after ICC resection, CA19-9 ≥100 U/ml is a risk factor affecting survival time after ICC resection. Conclusion:Tumor diameter, microvascular tumor thrombus, lymph node metastasis and CA19-9 can be used to estimate the risk of ICC recurrence, and CA19-9 level can be used to estimate postoperative survival of ICC patients after resection.
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BackgroundSARS-CoV-2-caused coronavirus disease (COVID-19) is posing a large casualty. The features of COVID-19 patients with and without pneumonia, SARS-CoV-2 transmissibility in asymptomatic carriers, and factors predicting disease progression remain unknown. MethodsWe collected information on clinical characteristics, exposure history, and laboratory examinations of all laboratory-confirmed COVID-19 patients admitted to PLA General Hospital. Cox regression analysis was applied to identify prognostic factors. The last follow-up was February 18, 2020. ResultsWe characterized 55 consecutive COVID-19 patients. The mean incubation was 8.42 (95% confidence interval [CI], 6.55-10.29) days. The mean SARS-CoV-2-positive duration from first positive test to conversion was 9.71 (95%CI, 8.21-11.22) days. COVID-19 course was approximately 2 weeks. Asymptomatic carriers might transmit SARS-CoV-2. Compared to patients without pneumonia, those with pneumonia were 15 years older and had a higher rate of hypertension, higher frequencies of having a fever and cough, and higher levels of interleukin-6 (14.61 vs. 8.06pg/mL, P=0.040), B lymphocyte proportion (13.0% vs.10.0%, P=0.024), low account (<190/{micro}L) of CD8+ T cells (33.3% vs. 0, P=0.019). Multivariate Cox regression analysis indicated that circulating interleukin-6 and lactate independently predicted COVID-19 progression, with a hazard ratio (95%CI) of 1.052 (1.000-1.107) and 1.082 (1.013-1.155), respectively. During disease course, T lymphocytes were generally lower, neutrophils higher, in pneumonia patients than in pneumonia-free patients. CD8+ lymphocytes did not increase at the 20th days after illness onset. ConclusionThe epidemiological features are important for COVID-19 prophylaxis. Circulating interleukin-6 and lactate are independent prognostic factors. CD8+ T cell exhaustion might be critical in the development of COVID-19.
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Objective To investigate the sensitivity difference between CT angiography (CTA)and MR angiography (MRA)in detecting portal hypertension,and explore the diagnostic value of the two methods for portal hypertension.Methods The imaging data of portal hypertension patients who were diagnosed by surgical exploration or vascular intervention in our hospital were collected,the accuracy and sensitivity of CTA and MRA in portal hypertension diagnosis were analyzed.Results A total of 351 portal hypertension patients were included in our study,prehepatic portal hypertension were 89 cases,intrahepatic portal hypertension were 121 cases,posterior portal hypertension were 131 cases.The detective cases about prehepatic portal hypertension,intrahepatic portal hypertension and posterior portal hypertension in MRA group were 85 cases,101 cases and 97 cases,in CTA were 79 cases,120 cases and 128 cases. The portal hypertension detection rate of CTA was 93.16%,there was significant difference with surgical exploration or interventional angiography (P1,3＜0.000 1＜0.05).The portal hypertension detection rate of MRA was 80.63%,there was significant difference with surgical exploration or interventional angiography (P1,2＜0.000 1＜0.05),the differences between MRA and CTA was significant (P2,3＜0.000 1＜0.05). Conclusion The sensitivity of CTA is much higher than MRA,which is a non-invasive examination,and worthy of clinical promotion.
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Objective: To evaluate the therapeutic effect and security of Buyang Huanwu decoction in treatment of the ischemic stroke recovery. Methods: We retrieved the relevant articles of random and semi- random control trials in treating ischemic stroke recovery using Buyang Huanwu decoction, published in China National Knowledge Infrastructure (CNKI), the Wanfang Data, the Weipu Information Resources System, the Chinese Biomedical Literature Database (CBM), Cochrane Library, PUBMED and MEDLINE from the date of establishment until to March 2018. The quality of studies was evaluated according to the Cochrane Reviewers?? handbook 5.1, and the study was carried out using Cochrane system assessment methods. Statistical analysis was performed with Rev Man 5.3. Results: Altogether 39 studies and 3539 cases of ischemic stroke recovery were enrolled. In terms of clinical efficacy, the difference between Buyang Huanwu Decoction and Western Medicine conventional therapy in the treatment of ischemic stroke was significantly different from that of conventional western medicine therapy [RR =1.26, 95％CI (1.20, 1.31), Z =10.05, P ＜ 0.00001], and the difference between Buyang Huanwu Decoction and other Chinese patent medicines was statistically significant [RR =1.12, 95％CI(1.06, 1.19), Z =3.82, P =0.0001]; neurological deficit NIHSS score [MD =-2.55, 95％CI (-3.10, -2.01), Z =9.20, P ＜ 0.00001]; clinical neurological deficit score (CSS) [MD =-3.85, 95％CI (-5.21, -2.50), Z =5.56, P ＜ 0.00001]; limb motor function score (FMA) [MD =6.10, 95％CI (1.19, 11.01), Z =2.43, P =0.01]; Barthel Index of Daily Living Activity Scale [MD =9.09, 95％CI (6.95, 11.23), Z =8.33, P ＜ 0.00001]; In terms of improving blood rheology index, serum peroxide lipid (LPO), serum superoxide dismutase (SOD) and other biochemical indicators, due to the small number of studies, it may have a certain effect. Most studies did not report adverse reactions. Conclusion: Based on the existing clinical evidence, combination of Buyang Huanwu decoction and western medicine has higher clinical efficacy than western medicine alone for the ischemic stroke recovery. Due to the limited methodological quality of the included studies, more high- quality RCTs with large scale are needed to increase the strength of the above evidence.
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This article was aimed to review and make a commentary on modern medicine and traditional Chinese medicine (TCM) treatment for intracerebral hemorrhage. This article introduced applications and evaluations on medi-cations to reduce intracranial pressure, blood pressure control medications, ultra-early hemostatic medications, hy-pothermia and neuroprotective agents from modern medicine treatment on acute intracerebral hemorrhage. The article also introduced the current large-scale TCM clinical trials for acute intracerebral hemorrhage treatment and some systematic reviews on medications in order to provide theoretical evidences for the clinical treatment of acute intrac-erebral hemorrhage.
