Prognostic factors for acute posterior circulation cerebral infarction patients after endovascular mechanical thrombectomy: A retrospective study

This article was to analyze the factors influencing the prognosis of posterior circulation cerebral infarction (PCCI) patients, retrospectively.One hundred forty five patients diagnosed with PCCI in Nanyang Central Hospital between June 25, 2016 and October 14, 2019 were included and underwent cerebral vascular mechanical thrombectomy. The clinical data of those patients were collected. The patients were followed up for 3 months to observe the prognostic efficacy and explore the influencing factors for poor prognosis. The potential prognostic factors for PCCI patients after emergency endovascular mechanical thrombectomy were analyzed by univariate and multivariable logistic regression. The thermodynamic diagram was drawn to explore the associations between the prognostic factors.The risk of poor prognosis in PCCI patients receiving emergency endovascular mechanical thrombectomy was reduced by 0.552 time with every 1-point increase of the Alberta Stroke Program Early CT in posterior circulation score (odds ratio [OR] = 0.448, 95% confidence interval [CI]: 0.276–0.727). The risk of poor prognosis was increased by 0.827 time for each additional grade in the digital subtraction angiography-American Society of Intervention and Therapeutic Neuroradiology grading (OR = 1.827, 95% CI: 1.221–2.733, P = .003) and increased by 0.288 time for every 1-point increase in National Institutes of Health Stroke scale at 24 hours (OR = 1.288, 95% CI: 1.161–1.429). All P < .05.Alberta Stroke Program Early CT in posterior circulation score, digital subtraction angiography-American Society of Intervention and Therapeutic Neuroradiology grading, National Institutes of Health Stroke scale score at 24 hours were factors affecting the prognosis of PCCI patients undergoing emergency endovascular mechanical thrombectomy, which might provide evidence for endovascular treatment of PCCI.     

冻干重组葡激酶对正常人凝血、纤溶系统影响的研究

目的　探讨冻干重组葡激酶 (r Sak)对正常人出、凝血及纤溶系统的影响 ,为进一步临床应用提供翔实的依据。方法　健康志愿者 2 0例静脉注射不同剂量r Sak(1、2 5、5、10、15mg) ,观察临床出血情况以及动态监测用药前后BT、BPC、APTT、PT、TT、Fg、D D、PL∶A、α2 PI∶A。结果　 2 0例中 4例有轻微出血 ,以皮肤粘膜为主 ,可自行止血 ,无 1例伴内脏出血。其中 3例牙龈渗血 ,2例穿刺部位出血。 4例有D D轻微异常 ,其余以上指标皆无变化。实验显示本药为高度选择性溶栓药 ,对正常人出凝血相无改变。结论　在本试验剂量范围内 ,该药是相对安全的 ,可很好耐受 ,但用于临床的最佳剂量有待进一步临床验证     

肉桂醛多相催化选择性加氢制肉桂醇的研究进展

从催化剂活性组分、助剂、载体和还原方法等多方面综述了近年来肉桂醛多相选择性加氢制备肉桂醇的方法研究,探讨了肉桂醛加氢活性和肉桂醇选择性的影响因素,并展望了肉桂醛选择性加氢的发展前景。通过催化剂设计提高非贵金属催化剂的活性、选择性和稳定性,并进一步降低反应温度和压力是今后的研究方向。     

Rho/Rock信号转导通路中的关键因子RhoA、Rock Ⅰ、p-LMC在后发性白内障动物模型中的表达

目的 建立SD大鼠后囊膜混浊(posterior capsular opacification,PCO)动物模型,检测Rho/Rock通路中的关键因子RhoA、Rho激酶Ⅰ(Rho associated coiledcoil forming protein kinase-Ⅰ,Rock Ⅰ)和肌球蛋白轻链(phosphorylated myosin light chain,p-MLC)在PCO中的表达.探讨Rho/Rock通路在PCO形成过程中的作用.方法 选用健康SD大鼠30只,随机分为对照组(0d)和实验组(3d、7d、14 d、28 d),每个时间点各6只.所有大鼠(右眼)均行晶状体囊外摘出术,显微镜下观察不同时间点术眼前节的炎症反应及PCO发生情况.ELISA法检测不同时间点房水中TGF-β的表达.处死大鼠后摘除眼球行组织病理学检查,免疫组织化学和Western Blot法检测RhoA、Rock Ⅰ、p-MLC在晶状体后囊上的表达.结果 随着术后观察时间的推移,PCO混浊程度逐渐增加,HE染色显示晶状体上皮细胞不同程度的增生、移行.对照组术后0d、3d、7d、14 d、28 d房水中TGF-β的表达量分别为(37.28±1.31)μg·L-1、(40.29±3.17) μg·L-1、(42.12±3.45) μg·L-1、(60.42±4.75) μg·L-1、(68.69±8.06)μg·L-1,实验组各时间点与对照组相比,差异有统计学意义(F=137.158,P＜0.05);不同时间点两两相比,差异均有统计学意义(均为P＜0.05).术后0d、3d、7d、14 d和28 d晶状体后囊膜上RhoA蛋白相对表达量(RhoA/GAPDH)分别为1.00±0.00、1.49±0.01、1.57±0.03、1.77±0.02和1.97±0.02,实验组各时间点与对照组相比,差异有统计学意义(F=94.546,P＜0.05);不同时间点两两相比,差异均有统计学意义(均为P＜0.05).Rock Ⅰ蛋白的表达量(Rock Ⅰ/GAPDH)分别为1.00±0.00、0.35±0.12、1.42 ±0.14、1.78±0.09和1.95±0.14,实验组各时间点与对照组相比,差异有统计学意义(F=30.942,P＜0.05);不同时间点两两相比,差异均有统计学意义(均为P＜0.05).p-MLC蛋白的相对表达量(p-MLC/GAPDH)分别为1.00±0.00、1.44±0.08、1.47±0.13、1.63±0.10和2.12±0.20,实验组各时间点与对照组相比,差异有统计学意义(F =34.313,P＜0.05);不同时间点两两相比,差异均有统计学意义(均为P＜0.05).结论 RhoA、Rock Ⅰ、p-MLC在PCO形成过程中表达逐渐增多,Rho/Rock信号转导通路可能与PCO的发生、发展有关.     

Blindness after confinement

Four days after an elective caesarean section, a patient went blind within a few hours, associated with a sudden rise in blood pressure. The blindness, initially thought to be caused by a cerebral infarct, was ultimately diagnosed as a result of posterior reversible leuco-encephalopathy syndrome. This rare syndrome is reviewed.     

Posterior leukoencephalopathy syndrome as a cause of reversible blindness during pregnancy

Cortical blindness is a rare and dramatic complication of pre-eclampsia. The precise nature of the pathogenesis of this condition has not previously been understood. Three preeclamptic patients with unremarkable previous medical history presented with acute blindness between the 28th and 33rd weeks of pregnancy. They were all diagnosed as posterior leukoencephalopathy syndrome (PLES). In all these patients, MRI study revealed the typical feature of gray-white matter edema localized to the temporo-parieto-occipital areas. Vision and MRI findings were restored in all patients after delivery. Although PLES has been described as a puerperal clinicoradiologic entity, it may be seen in preeclamptic-eclamptic patients during the pregnancy. Therefore neuro-imaging studies should be carried out in pregnant patients with visual disturbances in order to exclude PLES. Prompt diagnosis, immediate control of blood pressure, and elimination of possible causes resolves clinical and imaging findings.     

后路椎间融合器结合新型椎弓根钉系统治疗腰椎滑脱症

目的 探讨纯钛多孔涂层后路椎间融合器结合新型椎弓根钉系统对腰椎滑脱症的治疗效果。方法 33例腰椎滑脱症病人,采用后路全椎板切除减压、纯钛多孔涂层后路椎间融合器行椎间融合、新型椎弓根钉系统内固定治疗。结果 33例术后均随访,时间6~36个月,平均18.6个月。本组患者术后无神经损伤和切口感染,动态摄片观察无融合器移位、椎弓根螺钉松脱、断裂等并发症。按Brantigan评价标准评定结果:优21例、良10例、可2例、差0例。结论 纯钛多孔涂层后路椎间融合器结合新型椎弓根钉系统治疗腰椎滑脱症,具有椎管减压充分、椎体复位好、术后能立即改善疼痛症状、立即稳定椎体、病人可早期下床等优点,是一种治疗腰椎滑脱症较理想的方法。