目的:探讨卒中患者预后指数(SPAN-100)对于行早期血管内治疗(EVT)的前循环急性大血管闭塞性卒中(ALVOS)患者的临床预后评估价值。方法:行EVT的ALVOS患者,根据SPAN-100评分分为<100组和≥100组,统计2组的性别、年龄、血压、基础疾病...目的:探讨卒中患者预后指数(SPAN-100)对于行早期血管内治疗(EVT)的前循环急性大血管闭塞性卒中(ALVOS)患者的临床预后评估价值。方法:行EVT的ALVOS患者,根据SPAN-100评分分为<100组和≥100组,统计2组的性别、年龄、血压、基础疾病等基线资料,对比2组围手术期相关参数,分析影响ALVOS患者EVT预后的影响因素。结果:共入组128例ALVOS患者,其中<100组107例(83.59%),≥100组21例(16.41%)。≥100组女性比例、年龄、入院时NIHSS评分、房颤病史比例、高血压病史比例均高于<100组(P<0.05),≥100组术前Alberta卒中项目早期CT评分(ASPECTS)显著低于<100组(P<0.05);2组术前血压、糖尿病比例、TOAST分型、病变血管情况比较差异无统计学意义(P>0.05)。≥100组发病到置鞘时间明显短于<100组(P<0.05),2组桥接治疗比例相当(P>0.05);在血管再通上,2组血管再通时间、术前侧支循环状态、取栓次数比较差异无统计学意义(P>0.05),≥100组TICI≥2b级的比例显著低于<100组(P<0.05);≥100组的90 d mRS评分显著差于<100组(P<0.05),≥100组的90 d功能独立比例显著低于<100组(P<0.05),2组90 d死亡率、出血转化情况比较差异无统计学意义(P>0.05)。Logistic回归分析显示,术前高收缩压、不良侧支循环、ASPECTS评分是影响ALVOS患者预后的独立危险因素(OR=1.035、1.726、1.538,P<0.05)。结论:SPAN-100并不能作为ALVOS患者早期血管内治疗的风险预测评估工具,但术前高收缩压、不良侧支循环、ASPECTS评分是影响ALVOS患者预后的独立危险因素。展开更多
AIM: To evaluate the association between serum concentrations of S100β in patients with cirrhosis and the presence of low grade hepatic encephalopathy (HE).METHODS: This was a cross-sectional study. The po...AIM: To evaluate the association between serum concentrations of S100β in patients with cirrhosis and the presence of low grade hepatic encephalopathy (HE).METHODS: This was a cross-sectional study. The population was categorized into four groups healthy subjects, cirrhosis without HE, cirrhosis with covert hepatic encephalopathy (CHE) and cirrhosis with overt HE. Kruskal-Wallis, Mann Whitney’s U with Bonferroni adjustment Spearman correlations and area under the ROC were used as appropriate.RESULTS: A total of 61 subjects were included, 46 cirrhotic patients and 15 healthy volunteers. S100β values were different among all groups, and differences remained significant between groups 1 and 2 (P < 0.001), and also between groups 2 and 3 (P = 0.016), but not between groups 3 and 4. In cirrhotic patients with HE S100β was higher than in patients without HE [0.18 (0.14-0.28) ng/mL vs 0.11 (0.06-0.14) ng/mL, P < 0.001]. There was a close correlation between serum concentrations of S100β and psychometric hepatic encephalopathy score in patients with cirrhosis without HE compared to the patients with cirrhosis with CHE (r = -0.413, P = 0.019). ROC curve analysis yielded > 0.13 ng/mL as the best cutoff value of S100β for the diagnosis of HE (sensitivity 83.3%, specificity 63.6%).CONCLUSION: Serum concentrations of S100β are higher in patients with cirrhosis than in healthy volunteers, and are further increased in the presence of hepatic encephalopathy. The results suggest that serum biomarkers such as S100β could help in the correct characterization of incipient stages of HE.展开更多
Emerging evidence suggests that bone marrow-derived mesenchymal stem cell transplantation improves neurological function after cardiac arrest and cardiopulmonary resuscitation;however, the precise mechanisms remain un...Emerging evidence suggests that bone marrow-derived mesenchymal stem cell transplantation improves neurological function after cardiac arrest and cardiopulmonary resuscitation;however, the precise mechanisms remain unclear. This study aimed to investigate the effect of bone marrow-derived mesenchymal stem cell treatment on expression profiles of multiple cytokines in the brain after cardiac arrest and cardiopulmonary resuscitation. Cardiac arrest was induced in rats by asphyxia and cardiopulmonary resuscitation was initiated 6 minutes after cardiac arrest. One hour after successful cardiopulmonary resuscitation, rats were injected with either phosphate-buffered saline(control) or 1 × 10~6 bone marrow-derived mesenchymal stem cells via the tail vein. Serum S100 B levels were measured by enzyme-linked immunosorbent assay and neurological deficit scores were evaluated to assess brain damage at 3 days after cardiopulmonary resuscitation. Serum S100 B levels were remarkably decreased and neurological deficit scores were obviously improved in the mesenchymal stem cell group compared with the phosphate-buffered saline group. Brains were isolated from the rats and expression levels of 90 proteins were determined using a RayBio Rat Antibody Array, to investigate the cytokine profiles. Brain levels of the inflammatory mediators tumor necrosis factor-α, interferon-γ, macrophage inflammatory protein-1α, macrophage inflammatory protein-2, macrophage inflammatory protein-3α, macrophage-derived chemokine, and matrix metalloproteinase-2 were decreased ≥ 1.5-fold, while levels of the anti-inflammatory factor interleukin-10 were increased ≥ 1.5-fold in the mesenchymal stem cell group compared with the control group. Donor mesenchymal stem cells were detected by immunofluorescence to determine their distribution in the damaged brain, and were primarily observed in the cerebral cortex. These results indicate that bone marrow-derived mesenchymal stem cell transplantation attenuates brain damage induced by cardiac arrest and cardiopulmonary resuscitation, possibly via regulation of inflammatory mediators. This experimental protocol was approved by the Institutional Animal Care and Use Committee of Fujian Medical University, China in January 2016(approval No. 2016079).展开更多
目的:探讨天麻钩藤汤联合温胆汤治疗原发性高血压病(Essential Hypertension,EH)合并头痛患者的效果。方法:选择2017年1月-2018年12月我院接收治疗的EH患者总共100例作为本次的研究对象,并按照随机的方法分为两组,即研究组(50例)及对照...目的:探讨天麻钩藤汤联合温胆汤治疗原发性高血压病(Essential Hypertension,EH)合并头痛患者的效果。方法:选择2017年1月-2018年12月我院接收治疗的EH患者总共100例作为本次的研究对象,并按照随机的方法分为两组,即研究组(50例)及对照组(50例)。其中对照组的患者服用天麻钩藤汤,研究组的患者服用温胆汤合天麻钩藤汤;观察并记录两组的降压效果、中医证候积分以及生活质量测评表(Quality Of Life,QOL)-100评分。结果:给予治疗后,研究组及对照组的收缩压与舒张压均出现一定程度的下降,并且前组显著低于后组(P<0.05);研究组的QOL-100评分总分为(14.67±3.71)分,对照组的QOL-100评分总分为(11.75±3.16)分,前组的QOL-100评分显著高于后组(P<0.05);给予治疗后,研究组的中医证候积分显著低于对照组(P<0.05)。结论:在治疗EH患者的过程中,天麻钩藤汤联合温胆汤服用的降压效果非常理想,明显改善临床症状,可以广泛使用。展开更多
文摘目的:探讨卒中患者预后指数(SPAN-100)对于行早期血管内治疗(EVT)的前循环急性大血管闭塞性卒中(ALVOS)患者的临床预后评估价值。方法:行EVT的ALVOS患者,根据SPAN-100评分分为<100组和≥100组,统计2组的性别、年龄、血压、基础疾病等基线资料,对比2组围手术期相关参数,分析影响ALVOS患者EVT预后的影响因素。结果:共入组128例ALVOS患者,其中<100组107例(83.59%),≥100组21例(16.41%)。≥100组女性比例、年龄、入院时NIHSS评分、房颤病史比例、高血压病史比例均高于<100组(P<0.05),≥100组术前Alberta卒中项目早期CT评分(ASPECTS)显著低于<100组(P<0.05);2组术前血压、糖尿病比例、TOAST分型、病变血管情况比较差异无统计学意义(P>0.05)。≥100组发病到置鞘时间明显短于<100组(P<0.05),2组桥接治疗比例相当(P>0.05);在血管再通上,2组血管再通时间、术前侧支循环状态、取栓次数比较差异无统计学意义(P>0.05),≥100组TICI≥2b级的比例显著低于<100组(P<0.05);≥100组的90 d mRS评分显著差于<100组(P<0.05),≥100组的90 d功能独立比例显著低于<100组(P<0.05),2组90 d死亡率、出血转化情况比较差异无统计学意义(P>0.05)。Logistic回归分析显示,术前高收缩压、不良侧支循环、ASPECTS评分是影响ALVOS患者预后的独立危险因素(OR=1.035、1.726、1.538,P<0.05)。结论:SPAN-100并不能作为ALVOS患者早期血管内治疗的风险预测评估工具,但术前高收缩压、不良侧支循环、ASPECTS评分是影响ALVOS患者预后的独立危险因素。
基金Supported by CONACYT/UNAM and FUNDACIóN PARA LA SALUD Y LA EDUCACIóN DR. SALVADOR ZUBIRáN A.C (To Macias-Rodriguez RU)CONACYT/UNAM (To Ruiz-Margáin A) Ramón y Cajal Researcher, No. RYC-2014-15242 (To Cubero FJ)
文摘AIM: To evaluate the association between serum concentrations of S100β in patients with cirrhosis and the presence of low grade hepatic encephalopathy (HE).METHODS: This was a cross-sectional study. The population was categorized into four groups healthy subjects, cirrhosis without HE, cirrhosis with covert hepatic encephalopathy (CHE) and cirrhosis with overt HE. Kruskal-Wallis, Mann Whitney’s U with Bonferroni adjustment Spearman correlations and area under the ROC were used as appropriate.RESULTS: A total of 61 subjects were included, 46 cirrhotic patients and 15 healthy volunteers. S100β values were different among all groups, and differences remained significant between groups 1 and 2 (P < 0.001), and also between groups 2 and 3 (P = 0.016), but not between groups 3 and 4. In cirrhotic patients with HE S100β was higher than in patients without HE [0.18 (0.14-0.28) ng/mL vs 0.11 (0.06-0.14) ng/mL, P < 0.001]. There was a close correlation between serum concentrations of S100β and psychometric hepatic encephalopathy score in patients with cirrhosis without HE compared to the patients with cirrhosis with CHE (r = -0.413, P = 0.019). ROC curve analysis yielded > 0.13 ng/mL as the best cutoff value of S100β for the diagnosis of HE (sensitivity 83.3%, specificity 63.6%).CONCLUSION: Serum concentrations of S100β are higher in patients with cirrhosis than in healthy volunteers, and are further increased in the presence of hepatic encephalopathy. The results suggest that serum biomarkers such as S100β could help in the correct characterization of incipient stages of HE.
基金supported by the Natural Science Foundation of Fujian Province of China,No.2015J01375(to QML)Fujian Provincial Hospital Foundation of China,No.2014070(to QML)
文摘Emerging evidence suggests that bone marrow-derived mesenchymal stem cell transplantation improves neurological function after cardiac arrest and cardiopulmonary resuscitation;however, the precise mechanisms remain unclear. This study aimed to investigate the effect of bone marrow-derived mesenchymal stem cell treatment on expression profiles of multiple cytokines in the brain after cardiac arrest and cardiopulmonary resuscitation. Cardiac arrest was induced in rats by asphyxia and cardiopulmonary resuscitation was initiated 6 minutes after cardiac arrest. One hour after successful cardiopulmonary resuscitation, rats were injected with either phosphate-buffered saline(control) or 1 × 10~6 bone marrow-derived mesenchymal stem cells via the tail vein. Serum S100 B levels were measured by enzyme-linked immunosorbent assay and neurological deficit scores were evaluated to assess brain damage at 3 days after cardiopulmonary resuscitation. Serum S100 B levels were remarkably decreased and neurological deficit scores were obviously improved in the mesenchymal stem cell group compared with the phosphate-buffered saline group. Brains were isolated from the rats and expression levels of 90 proteins were determined using a RayBio Rat Antibody Array, to investigate the cytokine profiles. Brain levels of the inflammatory mediators tumor necrosis factor-α, interferon-γ, macrophage inflammatory protein-1α, macrophage inflammatory protein-2, macrophage inflammatory protein-3α, macrophage-derived chemokine, and matrix metalloproteinase-2 were decreased ≥ 1.5-fold, while levels of the anti-inflammatory factor interleukin-10 were increased ≥ 1.5-fold in the mesenchymal stem cell group compared with the control group. Donor mesenchymal stem cells were detected by immunofluorescence to determine their distribution in the damaged brain, and were primarily observed in the cerebral cortex. These results indicate that bone marrow-derived mesenchymal stem cell transplantation attenuates brain damage induced by cardiac arrest and cardiopulmonary resuscitation, possibly via regulation of inflammatory mediators. This experimental protocol was approved by the Institutional Animal Care and Use Committee of Fujian Medical University, China in January 2016(approval No. 2016079).
文摘目的:探讨天麻钩藤汤联合温胆汤治疗原发性高血压病(Essential Hypertension,EH)合并头痛患者的效果。方法:选择2017年1月-2018年12月我院接收治疗的EH患者总共100例作为本次的研究对象,并按照随机的方法分为两组,即研究组(50例)及对照组(50例)。其中对照组的患者服用天麻钩藤汤,研究组的患者服用温胆汤合天麻钩藤汤;观察并记录两组的降压效果、中医证候积分以及生活质量测评表(Quality Of Life,QOL)-100评分。结果:给予治疗后,研究组及对照组的收缩压与舒张压均出现一定程度的下降,并且前组显著低于后组(P<0.05);研究组的QOL-100评分总分为(14.67±3.71)分,对照组的QOL-100评分总分为(11.75±3.16)分,前组的QOL-100评分显著高于后组(P<0.05);给予治疗后,研究组的中医证候积分显著低于对照组(P<0.05)。结论:在治疗EH患者的过程中,天麻钩藤汤联合温胆汤服用的降压效果非常理想,明显改善临床症状,可以广泛使用。
