Endovascular treatment vs drug therapy alone in patients with mild ischemic stroke and large infarct cores.

BACKGROUND: Treatment decision making is strictly associated with the outcomes in patients with ischemic stroke who show a large core infarct. Medical care alone may result in suboptimal treatment efficacy, and endovascular treatment may be accompanied by safety issues. Whether endovascular treatment is superior to medical care is not well investigated in the clinical studies. AIM: To investigate the efficacy of endovascular treatment and drug therapy alone in mild ischemic stroke patients with large infarct cores. METHODS: Fifty patients with mild ischemic stroke and 50 patients with acute ischemic stroke caused by anterior large vessel occlusion were selected at the First Affiliated Hospital of Hebei North University between January 2021 and December 2021. Patients were divided into an endovascular therapy group and a drug therapy group according to different treatment methods. In the endovascular therapy group, there were 28 patients with minor stroke and 22 patients with large infarct cores. The drug therapy group had 22 patients with minor stroke and 28 patients with large infarct cores. The National Institutes of Health Stroke Scale (NIHSS) scores were collected and compared between the two groups immediately after the operation and 24 h and 7 d after the operation. The modified Rankin scale (mRS) and/or activity of daily living were assessed at hospital discharge. RESULTS: There was no significant difference in NIHSS scores between the two groups before the operation (P > 0.05). NIHSS scores were lower in the endovascular therapy group than in the drug therapy group at 24 h and 7 d after the operation and at hospital discharge (all P < 0.05). The incidence of early neurologic deterioration was significantly lower in the endovascular therapy group than in the drug therapy group (P < 0.05). At hospital discharge, the mRS score was lower in the endovascular treatment group than in the drug therapy group, and the activity of daily living score was better in the endovascular treatment group than in the drug therapy group (all P < 0.05). During a follow-up of 3 mo, 17 patients (34.0%) had good prognosis (mRS ≤ 2), 33 patients (66.0%) had poor prognosis (mRS > 2), and 11 patients (22.0%) died. In the medical treatment group, 16 patients (mRS ≤ 2) had good prognosis (32.0%), 34 patients (mRS > 2) had poor prognosis (68.0%), and 14 patients (28.0%) died. There was no significant difference in prognosis and mortality between the two groups (P > 0.05). CONCLUSION: Endovascular therapy can improve NIHSS score and mRS score in patients with mild ischemic stroke and large infarct cores. It is suitable for clinical application.

Higher serum zinc levels may reduce the risk of cervical cancer in Asian women: A meta-analysis.

OBJECTIVE: This meta-analysis was conducted to examine the possible association between serum zinc concentration and cervical cancer risk. METHODS: PubMed, WanFang, China National Knowledge Infrastructure, and SinoMed databases were searched for relevant articles published between January 1980 and September 2017. Results were combined using a random-effects model, and pooled standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated to compare serum zinc levels in patients with cervical cancer versus controls. Publication bias was evaluated using Begg's funnel plot and Egger's regression asymmetry test. RESULTS: Twelve articles regarding serum zinc levels and cervical cancer were included in this meta-analysis. Combined results showed that serum zinc levels in cervical cancer cases were significantly lower than in controls without cervical cancer (summary SMD -1.379, 95% CI -1.527, -1.231), with high heterogeneity ( I2 = 98.8%). Analysis of data stratified by geographic location showed a significant association between serum zinc levels and cervical cancer risk in Asian populations (summary SMD -1.391, 95% CI -1.543, -1.239). CONCLUSIONS: Higher serum zinc levels may be a protective factor for cervical cancer in Asian women.

The comparison of lesion outline and temperature field determined by different ways in atrial radiofrequency ablation.

BACKGROUND: The aim of this study is to research the lesion outline and temperature field in different ways in atrial radiofrequency ablation by using finite element method. METHODS: This study used the method which considered the thermal dosage to determine the boundary between viable and dead tissue, and compared to the 50 °C isotherm results in analyzing lesion outline. Besides, we used Hyperbolic equation which considered the relaxation time to calculate the temperature field and contrasted it with Pennes' bioheat transfer equation. RESULTS: As the result of the comparison of the lesion outline, when the ablation time was 120 s, the isotherm of the thermal dosage was larger than the 50 °C isotherm and with the increasing of the voltage the gap increased. When the ablation voltage was 30 V, the 50 °C isotherm was larger than the thermal dosage isotherm when the ablation time was less than 160 s. The isotherms overlapped when the time was 160 s. And when the ablation time was more than 160 s, the 50 °C isotherm was less than the thermal dosage isotherm. As to the temperature field, when the ablation voltage was 30 V with the ablation time 120 s the highest temperature decided by Hyperbolic was 0.761 °C higher. The highest temperature changed with relaxation time. In most cases, the highest temperature of the Hyperbolic was higher otherwise the relaxation time was 30-40 s. CONCLUSIONS: It is better to use CEM43 °C to estimate the lesion outline when the ablative time within 160 s. For temperature distribution, the Hyperbolic reflects the influence of heat transmission speed, so the result is more close to the actual situation.

Numerical study of the effect of blood vessel on the microwave ablation shape.

The existence of large blood vessels seriously impacts the results of microwave ablation on heat transfer of surrounding tissue, and the research of influences about large blood vessels could be essential and significant. The temperature distribution in the tissue was analyzed with a microwave heating source by finite element method. The model, where the blood vessel is parallel to antenna, has different distances from antenna to blood vessel. As distance was greater than 20mm, the effect of blood vessel that was parallel to antenna was ignored and the ablation area was elliptical-like. When distance was less than 10mm, the part of asymmetrical coagulated area was on the right side of blood vessel. Therefore, the temperature contour by different conditions could provide numerical references, which is whether to block blood vessel or not, to achieve the aim of guiding the clinical practice, according to the locations of tumor and blood vessel.