Safety and efficacy of magnetic resonance imaging-guided focused ultrasound neurosurgery for Parkinson’s disease: a systematic review

Neurosurgical Review - Magnetic resonance imaging-guided focused ultrasound (MRgFUS) neurosurgery is a new option for medication-resistant Parkinson’s disease (PD), but its safety and...     

Incidence and risk factors of suicide among patients diagnosed with bladder cancer: A systematic review and meta-analysis

Background: Patients with bladder cancer have a high risk of suicide. This study aimed to assess how bladder cancer increases suicide risk and to identify the demographic and clinical factors associated with suicidal death among patients with bladder cancer. Methods: Literature search of MEDLINE, PsycINFO, Embase, Web of Sciences and Cochrane Library databases was conducted up to April 2020 to identify eligible studies related to the incidence and risk factors of suicide after bladder cancer diagnosis. Summary multivariate-adjusted risk estimates and their associated 95% confidence intervals (CIs) were calculated using inverse variance method with random or fixed-effect modeling. Results: Five retrospective cohorts comprising 563,680 patients with bladder cancer were included. Higher risk of suicide by 1.90-fold was observed among patients with bladder cancer (hazard ratio, HR = 1.90, 95% CI: 1.29–2.81; P = 0.001; I² = 81.2%), especially in those aged 70 years or older (HR = 1.36, 95% CI: 1.29–1.43; P < 0.001; I² = 0%), unmarried (HR = 1.72, 95% CI: 1.61–1.83; P < 0.001; I² = 0%), and those with regional bladder cancer (HR = 1.88, 95% CI: 1.10–3.21; P = 0.021; I² = 96.3%), compared with those without bladder cancer. Furthermore, gender and race were not associated with increased suicide risk among patients with bladder cancer. Conclusions: Suicide risk is increased among patients with bladder cancer, particularly those aged 70 years or older, unmarried and those with regional bladder cancer. Hence, early psychological support must be provided during the follow-up period of these special populations with a high suicide risk.     

高压氧中毒小鼠脑微血管图像分析定量研究

本文采用计算机图像定量测量方法，对高压氧中毒后小鼠软脑膜微血管和大脑皮质毛细胞血管内皮细胞碱性磷酶活性进行了定量检测。结果表明，ＨＢＯＩ后小鼠软脑膜毛细血管开放数目减少，毛细血管密度降低。     

不同机制大动脉粥样硬化型脑卒中基线特征和血管内治疗后结局比较

目的 本研究旨在比较颅内大血管伴/不伴同侧颈内动脉闭塞的大动脉粥样硬化型脑卒中患者基线特征以及行血管内治疗后结局的差异。方法 对DIRECT-MT亚组进行回顾性分析,以比较前循环大动脉粥样硬化（large-artery atherosclerosis,LAA）型卒中串联闭塞和颅内闭塞接受血管内治疗（endovascular treatment,EVT）的患者的基线特征和预后,分析不同机制学特征（动脉粥样硬化或动脉-动脉栓塞）对临床结局的影响。结果 LAA型卒中患者共108例,其中串联闭塞63例,颅内闭塞45例。颅内闭塞组患者高血压史率高于串联闭塞组（77.8% vs. 52.4%, P=0.007）。颅内闭塞组闭塞部位最常见于大脑中动脉M1段（88.6%）,而串联闭塞组颅内闭塞主要位于颈内动脉颅内段（49.2%）和大脑中动脉M1段（49.2%）（P＜0.001）。两组患者在年龄、性别、术前抗栓、他汀类药物的使用,卒中、房颤、吸烟史,基线mRS、NIHSS评分,是否静脉溶栓,侧枝循环,以及救治流程时间差异均无统计学意义（P均＞0.05）。90天mRS 0-2分的患者比例两组差异无统计学意义（53.3% vs. 41.9%, P=0.243）。颅内闭塞组术后成功再灌注率高于串联闭塞组（93.3% vs. 77.4%, P=0.026）,但术后24-72小时血管再通的比例前组低于后组（57.1% vs. 77.2%, P=0.034）。最终梗死体积,颅内闭塞组小于串联闭塞组（20.1 vs. 34.5, P=0.025）。术后NIHSS评分,90天EQ-5D-5L评分和BI指数等其他次要结局,两组间差异无统计学意义（P均＞0.05）。两组在90天内的死亡率,发生的无症状性和症状性颅内出血率,5-7天时在另外的血管区域新发脑梗死,以及新流域栓塞的患者百分比相似,差异无统计学意义（P均＞0.05）。结论 动脉粥样硬化导致的串联闭塞相较于孤立颅内闭塞,末次造影成功再灌注率较低,梗死体积更大,但术后24-72小时再通率更高,且神经功能良好预后率以及不良事件发生率均与颅内闭塞相仿。     

咪唑安定、异丙酚对体外循环期酸碱平衡的影响

目的 观察异丙酚和咪唑安定在体外循环麻醉中对术前和术中的酸碱度的影响.方法 40例先天性心脏病患者随机分为两组(异丙酚组、咪唑安定组),监测手术前、主动脉阻断10 min和复温至31℃时血气指标等的动态变化.结果与手术前比,主动脉阻断10 min和复温后,血液pH、PaCO2、HCO3-、BEB两组均有明显变化(P＜0.05),但两组间差异无显著性(P＞0.05).结论异丙酚和咪唑安定在体外循环麻醉中其对酸碱度无明显的影响.     

海水淹溺肺水肿兔血浆MDA和SOD的变化

目的 :观察海水淹溺肺水肿 (PE SWD)兔血浆中丙二醛 (MDA)和超氧化物歧化酶 (SOD)变化规律 ,探讨上述两项指标发生变化的原因和机制。方法 :用核黄素光照法和硫代巴比妥酸法 ,对PE SWD兔动脉血浆MDA和SOD进行定量检测和动态观察。结果 :灌海水后 30min ,MDA和SOD较灌海水前均显著升高 ,尔后两者均逐渐下降 ,但仍远远高于灌海水前。结论 :PE SWD发生发展过程中 ,MDA的损害性作用使肺泡表面活性物质表面特性发生改变 ,影响了正常的呼吸功能 ,并掩盖了SOD的保护性作用。