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51.

Background

The intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator (rt-PA) therapy is safe and efficient during the treatment of acute ischemic stroke. Nonetheless, the different outcomes among various stroke subgroups have limited data with regard to the safety and efficacy of cryptogenic stroke (CS). The present study compared the safety and efficacy when IVT with rt-PA was used for the treatment of CS and the other stroke subtypes.

Methods

This study classified the IVT with rt-PA patients within 4.5 hours after stroke onset, based on the trial of ORG 10172 in acute stroke treatment criteria in terms of diagnostic evaluation. The data were obtained from the Thrombolysis Implementation and Monitor of Acute Ischemic Stroke in China database, a large multicenter prospective registry. A multivariable logistic regression model was employed to compare the differences between the subtypes in symptomatic intracerebral hemorrhage (sICH) within 7 days and studied the mortality and the outcome during 90 days.

Results

In total, 1118 patients were recruited; of these, 131 (11.7%) suffered from CS and 987 (88.3%) with the other etiology. In the CS group, patients were younger than those in the other etiology groups (P < .001). Moreover, it had a lower prevalence of previous stroke (P?=?.0117), receiving antiplatelet drug in 24 hours prior to thrombolysis (P?=?.0017), and functional independence (mRS > 1 before stroke, P?=?.003). The CS group had lower blood pressure (systolic blood pressure P?=?.0001; diastolic blood pressure; P?=?.0212) before thrombolysis, atrial fibrillation (P < .001), and diabetes mellitus (P?=?.0005). Transient ischemic attack, hypertension, hyperlipidemia, blood glucose, receiving anticoagulants in 24 hours prior to thrombolysis, and standard dosage of rt-PA were equally distributed in both groups. After the adjustment of confounders between the CS and the other subgroups, no obvious differences were observed in sICH rate and mortality (P > .05) The CS patients exhibited excellent recovery (mRS, 0-1; 63.78%) and functional independence (mRS, 0-2; 74.8%) than the large artery atherosclerosis patients.

Conclusions

IVT with rt-PA is a safe and effective method for the treatment of CS patients.  相似文献   
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新型冠状病毒肺炎(corona virus disease 2019,COVID-19)自2019年12月爆发以来,由于具有高传染性,迅速在世界各地蔓延,国内外疫情防治形势空前严峻。COVID-19不仅造成肺部、肠道、肾脏等多脏器损害,且部分患者以眼表损害为首发或伴发症状出现,临床上很容易被忽视。COVID-19的眼表损害归属于祖国医学“天行赤眼”范畴,本文结合国内外最新的文献报道,探讨新型冠状病毒(2019 novel corona virus,2019-nCoV)对眼表的损害,阐明其可能机制,并从中西医角度提出可行的治疗措施。  相似文献   
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Objective: This study investigated the effect of regular swimming exercise according to the duration-intensity on neurocognitive function in a cerebral infarction rat model.

Methods: Forty male Sprague–Dawley 10-week-old rats, weighing 300 ± 50 g, were subjected to photothrombotic cerebral infarction. The remaining 36 rats were randomly divided into four groups (n = 9 per group: non-exercise (group A); swimming exercise of short duration-intensity (5 min/day, group B); swimming exercise of moderate duration-intensity (10 min/day, group C); and swimming exercise of long duration-intensity (20 min/day, group D). Exercise was performed five times a week for 4 weeks, beginning the day after cerebral infarction. Neurocognitive function was evaluated with the Morris water maze test. Immunohistochemistry and western blot analysis examined brain-derived neurotrophic factor (BDNF) and vascular endothelial growth factor (VEGF) at 4 weeks postinfarction.

Results: At 4 weeks postinfarction, escape latency was found to be shorter in group C than in any of groups A, B, or D. Immunohistochemistry revealed the most significant immunoreactivity for BDNF and VEGF in group C. Western blot analysis demonstrated that BDNF and VEGF proteins were markedly expressed in group C.

Conclusions: Regular swimming exercise of moderate duration-intensity may be the most effective exercise protocol for the recovery of neurocognitive function in cerebral infarction rat model.  相似文献   

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目的:探讨醛-酮还原酶家族7成员A3(AKR7A3)在肺腺癌中的异常表达及与临床病理特征的关系,并探究其临床意义。方法:采用生物信息学数据库分析、免疫组化、Western Blot、Real-time PCR等方法对肺腺癌组织及不同细胞中AKR7A3的表达进行检测与分析。结果:Oncomine数据库分析结果显示,在肺腺癌中,AKR7A3的表达普遍高于正常肺组织,分别为正常肺组织的1.811倍(P=0.022)、1.356倍(P<0.01)、1.413倍(P=0.002)。Kaplan-Meier Plotter数据库分析结果显示,AKR7A3高表达的患者较低表达的患者生存时间缩短,差异具有统计学意义(P=0.003 7)。免疫组化染色显示肺腺癌组织中AKR7A3的表达较癌旁增高,在与临床病理特征的相关性分析中,发现其与肿瘤分化程度(P<0.01)、淋巴结转移情况(P=0.029)以及TNM分期(P<0.01)相关,且会造成患者生存时间缩短(P=0.031)。Cox多因素分析表明AKR7A3可能是影响肺腺癌患者预后的独立危险因素(P=0.012)。Western Blot及Real-time PCR实验提示不同肺腺癌细胞中AKR7A3蛋白及mRNA表达普遍增高。结论:AKR7A3在肺腺癌中表达增高,对预后有不良影响,有促进肿瘤发生发展的作用。  相似文献   
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