Objective To explore the application effect of time tracking platform in improving the reperfusion treatment of patients with acute ischemic stroke in primary hospitals. Methods and Results Patients with acute ischemi...Objective To explore the application effect of time tracking platform in improving the reperfusion treatment of patients with acute ischemic stroke in primary hospitals. Methods and Results Patients with acute ischemic stroke who carried out emergency intravenous thrombolysis and arterial thrombectomy in our hospital in 2021, 2022 and 2023 were selected. The time tracking mode was implemented, and the patients were recorded at each time node of the hospital and the whole-process digital management was conducted. Compared the mean DNT (Door to Needle Time) of intravenous thrombolysis in emergency stroke patients in 2021, 2022 and 2023, the total number of hospital cases within 4.5 h of onset, the total number of thrombolysis cases within 4.5 h of onset, the number of intravenous thrombolysis in 60 minutes of acute ischemic stroke, and the number of thrombolysis cases. The results show that from 2021 to 2023 our emergency stroke patients with intravenous thrombolysis average DNT shortened year by year, to the hospital within 4.5 h after the onset of the difference is statistically significant (all P < 0.05) conclusion through the application of stroke time tracking platform, is beneficial to shorten the treatment time of each link, can effectively reduce the hospital time delay, improve the rate of thrombolysis, improve the reperfusion of stroke centers in primary hospitals.展开更多
Objective：To explore the relationship between the needle-retaining time and the therapeutic effect of acupuncture in the treatment of ischemic stroke patients. Methods： Based on the level of the severity of the pati...Objective：To explore the relationship between the needle-retaining time and the therapeutic effect of acupuncture in the treatment of ischemic stroke patients. Methods： Based on the level of the severity of the patient＇s disease and the duration of acupuncture needle-retaining, 245 ischemic stroke inpatients were divided into 20 min, 40 min and 60 min groups according to the stratified random method. Acupoints used were Jianyu （肩髃LI 15）, Quchi （曲池LI 11）, Waiguan （外关TE 5）, Hegu （合谷LI 4）, etc. and stimulated electrically （2 Hz, sparse waves, an endurable strength） for 20 min, 40 min and 60 min respectively by using an electroacupuncture therapeutic apparatus. The treatment was given once daily, with 10 sessions being a therapeutic course. The severity of clinical neurological deficit was scored before and after the treatment Results： The results showed that acupuncture could improve the neurological deficit severity of ischemic stroke patients. The therapeutic effect of acupuncture in improving myodynamia of the upper limbs and hands, and the total score of 60 min group was the best, followed by 40 min group and 20 min group respectively,of acupuncture needle retention has a better therapeutic effect in the treatment indicating that longer duration of acupuncture needle retention has a better therapeutic effect in the treatment of stroke. Conclusion： There is a positive relationship between the needle-retaining time and the curative effect in improving ischemic stroke patients＇clinical symptoms and signs by acupuncture.展开更多
背景急性缺血性卒中(AIS)高发,及时恢复脑血流是治疗的关键,超时间窗就诊患者无更多促进脑血流恢复的治疗手段。研究远隔缺血后适应(RIPostC)治疗对AIS超时间窗就诊患者的临床疗效、并发症和预后,具有重要的临床意义。目的探究RIPostC...背景急性缺血性卒中(AIS)高发,及时恢复脑血流是治疗的关键,超时间窗就诊患者无更多促进脑血流恢复的治疗手段。研究远隔缺血后适应(RIPostC)治疗对AIS超时间窗就诊患者的临床疗效、并发症和预后,具有重要的临床意义。目的探究RIPostC治疗对AIS超时间窗患者干预的影响,为超时间窗就诊的AIS患者寻求安全、有效的脑血流恢复治疗方式。方法本研究采用随机、分组、安慰剂对照法进行试验。选取2021-09-02—2022-08-31于北京航天总医院神经内科病房住院治疗的超溶栓时间窗(发病时间>6 h)的AIS患者为研究对象。依据随机数字表法将患者分为对照组和试验组。试验期+随访期共90 d,均使用同等的一般治疗、脑血管病常规治疗,试验组在此基础上给予RIPostC治疗14 d(28次),对照组给予模拟的RIPostC治疗14 d(28次)。在干预前和干预后30 d、干预后90 d,采用改良Rankin量表(mRS)、美国国立卫生研究院卒中量表(NIHSS)评估两组患者神经功能,简易精神状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)评估患者认知功能,工具性日常生活能力量表(IADL)评估日常生活能力,焦虑自评量表(SAS)、抑郁自评量表(SDS)评估精神状态,经颅多普勒超声(TCD)评估脑血流速度,以白介素(IL)-6反映炎症情况。结果122例患者中,最终完成试验及随访99例,其中试验组49例,对照组50例。两组患者性别、年龄、基础疾病(高血压、糖尿病、冠心病)及基线NIHSS评分比较,差异无统计学意义(P>0.05)。重复测量方差分析结果示,时间与组别对MMSE、MoCA、mRS、NIHSS、脑血流速度、IL-6存在交互作用(P<0.05),时间和组别对MMSE、MoCA、NIHSS、脑血流速度、IL-6主效应显著(P<0.05),时间对mRS、SAS、SDS、IADL主效应显著(P<0.05)。试验组干预后30、90 d MMSE、MoCA评分及脑血流速度均高于对照组,mRS、NIHSS评分均低于对照组(P<0.05);试验组干预后30、90 d SDS、IADL评分低于对照组(P<0.05);试验组干预后30 d SAS评分高于对照组,IL-6低于对照组(P<0.05)。99例患者中共有23例患者发生不良反应,其中试验组17例,对照组6例,两组皮肤瘀点、头晕、心慌、胸闷发生率比较,差异无统计学意义(P>0.05);对照组患者皮肤瘀斑发生率[4.00%(2/50)与12.24%(6/49)]、总不良反应发生率[12.00%(6/50)与34.69%(17/49)]低于试验组(P<0.05)。结论RIPostC治疗可降低AIS患者的炎症反应,对神经功能、认知功能抑郁情绪及颅内血流速度可起到积极的改善效果。展开更多
In year 2001 a paper in the ANAS considered links between month of birth and longevity. In the following years we published four papers related to “big killers” (cardiac and oncology) that showed some differences in...In year 2001 a paper in the ANAS considered links between month of birth and longevity. In the following years we published four papers related to “big killers” (cardiac and oncology) that showed some differences in birth months distribution of this group and studied by LA, NS Gavrilov’s centenarians. The aim of this study was to study conception and birth months of another modern “big killer”—cerebral stroke (CVA) that is taking a leading role among cardiovascular causes of death in the last decades. Methods: 130,120 deaths of both gender CVA victims in Lithuania at 1989-2013 were studied. In addition to birth month, the months of conception (9 months before birth) were studied. Our data were compared with results of centenarians (birth of LA, NS Gavrilov’s study and transformed by authors also their conception month). Results: The maximum of births were January, March and May for CVA victims, while the analogical conception maximum were in April, June, May and July. The similar data for centenarians were that maximal births were in November, September, October (LA, NS Gavrilov) and conception in December, January, February. These results are similar to data related to cardiac and oncology deaths published in our previous publications. Conclusion: The conception and birth month of victims of CVA is different of similar data obtained by centenarians study. Different environmental conditions at different parts of the year and solar cycle can play a role affecting the embryo at early stages of development, predisposing to some pathologies in coming years of life.展开更多
Stroke is a very common neurological condition that causes permanent disability in half of the cases, at least in sub-Saharan Africa. They represent the second most common cause of death in Africa. Objective of this s...Stroke is a very common neurological condition that causes permanent disability in half of the cases, at least in sub-Saharan Africa. They represent the second most common cause of death in Africa. Objective of this study was to evaluate the prognostic value of the intake period of patients suffering from these conditions on the survival time of one month of hospitalization in hospitals in Bangui. We conducted a prospective study cross prognostic kind in the neurology departments, internal medicine and intensive care units of two large central hospitals from February to August 2017. Subject recruitment was complete with a made questionnaire based on the modified one of the World Health Organization on neurological disorders. A total of 154 patients were included, with a mean age of 63.15 years ± 10.98 and extremes ranging from 38 to 91 years. A male predominance was noted (60%) with a sex ratio (M/F) of 1.5. For 76 subjects (49.35%), care was taken with a hospital admission period of less than or equal to one day, while for 78 other 78 (50.65%) the admission period was higher to one day. Average admission time patients caught early was 1.00 day and the upper limit intake to one day was 4.59 ± 2.33 days with a statistically significant difference (p < 0.0001). Median admission delay for patients treated late was 4 days. Pre-hospital and hospital determinants by admission delay are presented in Table 1. The survival time was better in the group of patients who were treated early (p = 0.0039). This study shows the negative impact of late management on the survival time of patients.展开更多
文摘Objective To explore the application effect of time tracking platform in improving the reperfusion treatment of patients with acute ischemic stroke in primary hospitals. Methods and Results Patients with acute ischemic stroke who carried out emergency intravenous thrombolysis and arterial thrombectomy in our hospital in 2021, 2022 and 2023 were selected. The time tracking mode was implemented, and the patients were recorded at each time node of the hospital and the whole-process digital management was conducted. Compared the mean DNT (Door to Needle Time) of intravenous thrombolysis in emergency stroke patients in 2021, 2022 and 2023, the total number of hospital cases within 4.5 h of onset, the total number of thrombolysis cases within 4.5 h of onset, the number of intravenous thrombolysis in 60 minutes of acute ischemic stroke, and the number of thrombolysis cases. The results show that from 2021 to 2023 our emergency stroke patients with intravenous thrombolysis average DNT shortened year by year, to the hospital within 4.5 h after the onset of the difference is statistically significant (all P < 0.05) conclusion through the application of stroke time tracking platform, is beneficial to shorten the treatment time of each link, can effectively reduce the hospital time delay, improve the rate of thrombolysis, improve the reperfusion of stroke centers in primary hospitals.
文摘Objective：To explore the relationship between the needle-retaining time and the therapeutic effect of acupuncture in the treatment of ischemic stroke patients. Methods： Based on the level of the severity of the patient＇s disease and the duration of acupuncture needle-retaining, 245 ischemic stroke inpatients were divided into 20 min, 40 min and 60 min groups according to the stratified random method. Acupoints used were Jianyu （肩髃LI 15）, Quchi （曲池LI 11）, Waiguan （外关TE 5）, Hegu （合谷LI 4）, etc. and stimulated electrically （2 Hz, sparse waves, an endurable strength） for 20 min, 40 min and 60 min respectively by using an electroacupuncture therapeutic apparatus. The treatment was given once daily, with 10 sessions being a therapeutic course. The severity of clinical neurological deficit was scored before and after the treatment Results： The results showed that acupuncture could improve the neurological deficit severity of ischemic stroke patients. The therapeutic effect of acupuncture in improving myodynamia of the upper limbs and hands, and the total score of 60 min group was the best, followed by 40 min group and 20 min group respectively,of acupuncture needle retention has a better therapeutic effect in the treatment indicating that longer duration of acupuncture needle retention has a better therapeutic effect in the treatment of stroke. Conclusion： There is a positive relationship between the needle-retaining time and the curative effect in improving ischemic stroke patients＇clinical symptoms and signs by acupuncture.
文摘背景急性缺血性卒中(AIS)高发,及时恢复脑血流是治疗的关键,超时间窗就诊患者无更多促进脑血流恢复的治疗手段。研究远隔缺血后适应(RIPostC)治疗对AIS超时间窗就诊患者的临床疗效、并发症和预后,具有重要的临床意义。目的探究RIPostC治疗对AIS超时间窗患者干预的影响,为超时间窗就诊的AIS患者寻求安全、有效的脑血流恢复治疗方式。方法本研究采用随机、分组、安慰剂对照法进行试验。选取2021-09-02—2022-08-31于北京航天总医院神经内科病房住院治疗的超溶栓时间窗(发病时间>6 h)的AIS患者为研究对象。依据随机数字表法将患者分为对照组和试验组。试验期+随访期共90 d,均使用同等的一般治疗、脑血管病常规治疗,试验组在此基础上给予RIPostC治疗14 d(28次),对照组给予模拟的RIPostC治疗14 d(28次)。在干预前和干预后30 d、干预后90 d,采用改良Rankin量表(mRS)、美国国立卫生研究院卒中量表(NIHSS)评估两组患者神经功能,简易精神状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)评估患者认知功能,工具性日常生活能力量表(IADL)评估日常生活能力,焦虑自评量表(SAS)、抑郁自评量表(SDS)评估精神状态,经颅多普勒超声(TCD)评估脑血流速度,以白介素(IL)-6反映炎症情况。结果122例患者中,最终完成试验及随访99例,其中试验组49例,对照组50例。两组患者性别、年龄、基础疾病(高血压、糖尿病、冠心病)及基线NIHSS评分比较,差异无统计学意义(P>0.05)。重复测量方差分析结果示,时间与组别对MMSE、MoCA、mRS、NIHSS、脑血流速度、IL-6存在交互作用(P<0.05),时间和组别对MMSE、MoCA、NIHSS、脑血流速度、IL-6主效应显著(P<0.05),时间对mRS、SAS、SDS、IADL主效应显著(P<0.05)。试验组干预后30、90 d MMSE、MoCA评分及脑血流速度均高于对照组,mRS、NIHSS评分均低于对照组(P<0.05);试验组干预后30、90 d SDS、IADL评分低于对照组(P<0.05);试验组干预后30 d SAS评分高于对照组,IL-6低于对照组(P<0.05)。99例患者中共有23例患者发生不良反应,其中试验组17例,对照组6例,两组皮肤瘀点、头晕、心慌、胸闷发生率比较,差异无统计学意义(P>0.05);对照组患者皮肤瘀斑发生率[4.00%(2/50)与12.24%(6/49)]、总不良反应发生率[12.00%(6/50)与34.69%(17/49)]低于试验组(P<0.05)。结论RIPostC治疗可降低AIS患者的炎症反应,对神经功能、认知功能抑郁情绪及颅内血流速度可起到积极的改善效果。
文摘In year 2001 a paper in the ANAS considered links between month of birth and longevity. In the following years we published four papers related to “big killers” (cardiac and oncology) that showed some differences in birth months distribution of this group and studied by LA, NS Gavrilov’s centenarians. The aim of this study was to study conception and birth months of another modern “big killer”—cerebral stroke (CVA) that is taking a leading role among cardiovascular causes of death in the last decades. Methods: 130,120 deaths of both gender CVA victims in Lithuania at 1989-2013 were studied. In addition to birth month, the months of conception (9 months before birth) were studied. Our data were compared with results of centenarians (birth of LA, NS Gavrilov’s study and transformed by authors also their conception month). Results: The maximum of births were January, March and May for CVA victims, while the analogical conception maximum were in April, June, May and July. The similar data for centenarians were that maximal births were in November, September, October (LA, NS Gavrilov) and conception in December, January, February. These results are similar to data related to cardiac and oncology deaths published in our previous publications. Conclusion: The conception and birth month of victims of CVA is different of similar data obtained by centenarians study. Different environmental conditions at different parts of the year and solar cycle can play a role affecting the embryo at early stages of development, predisposing to some pathologies in coming years of life.
文摘Stroke is a very common neurological condition that causes permanent disability in half of the cases, at least in sub-Saharan Africa. They represent the second most common cause of death in Africa. Objective of this study was to evaluate the prognostic value of the intake period of patients suffering from these conditions on the survival time of one month of hospitalization in hospitals in Bangui. We conducted a prospective study cross prognostic kind in the neurology departments, internal medicine and intensive care units of two large central hospitals from February to August 2017. Subject recruitment was complete with a made questionnaire based on the modified one of the World Health Organization on neurological disorders. A total of 154 patients were included, with a mean age of 63.15 years ± 10.98 and extremes ranging from 38 to 91 years. A male predominance was noted (60%) with a sex ratio (M/F) of 1.5. For 76 subjects (49.35%), care was taken with a hospital admission period of less than or equal to one day, while for 78 other 78 (50.65%) the admission period was higher to one day. Average admission time patients caught early was 1.00 day and the upper limit intake to one day was 4.59 ± 2.33 days with a statistically significant difference (p < 0.0001). Median admission delay for patients treated late was 4 days. Pre-hospital and hospital determinants by admission delay are presented in Table 1. The survival time was better in the group of patients who were treated early (p = 0.0039). This study shows the negative impact of late management on the survival time of patients.
