Risk factors for intracerebral hemorrhage and coronary heart diseases over a 3-year period in patients admitted to some hospitals of Tongliao city of Nei Monggol Autonomous Region Retrospective analysis on case data

BACKGROUND： Intracerebral hemorrhage（ICH） and coronary heart disease （CHD） have the same pathological base, atherosclerosis, and the similar risk factors,such as smoking ,drinking, hypertension, hyperlipemia, diabetes mellitus, etc; but the distributions of two diseases are very different in the populations. This may be related to the exposure of risk factors and different effects of risk factors on two diseases. OBJECTIVE： To analyze the distribution difference of risk factors for ICH and CHD in the populations of Tongliao city of Nei Monggol Autonomous Region. DESIGN： Retrospective analysis. SETTING： School of Radiation Medicine and Public Health, Soochow University; Tongliao Hospital, Nei Monggol Autonomous Region. PARTICIPANTS： Random sampling was used to select 6 hospitals from 10 hospitals affiliated to Tongliao City of Nei Monggol Autonomous Region. Totally 1 672 medical records of patients with ICH and 2 195 medical records of patients with CHD admitted to Department of Neurology and Department of Cardiovascular Internal Medicine of above-mentioned 6 hospitals between January 2003 and December 2005 were collected according to the investigation need. METHODS： The subjects, whose medical records were involved, were performed retrospective analysis with pre-prepared questionnaire ＂Stroke and Coronary Heart Disease Epidemiologic Questionnaire＂. The main contents included： ①Social demography condition： The distributions of gender, age, nationality, etc. ②Previous history of disease： hypertension, diabetes mellitus, etc. ③Related risk factors： systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, smoking, drinking and glucose （GLU）. The database of Epidata was transformed to SPSS database. Single-and multiple-factor non-conditional Logistic regression analysis were performed on the data, and OR value and 95% CI were calculated. The distribution differences of risk factors for two diseases were compared. MAIN OUTCOME MEASURES： Single- and multi-factor non-conditional Logistic regression analysis results of each factor of patients. RESULTS： Single-factor non-conditional Logistic regression analysis showed that statistical significance existed in gender, age, nationality, smoking, drinking, history of hypertension, history of diabetes mellitus, hypertension, triglyceride （TG）, and GLU ten factors（OR =0.199, OR 95% CI 0.142-0.280 to OR =7.484, OR 95% CI 6.186-9.054, P 〈 0.01）. ②The results of multiple-factor non-conditional Logistic regression analysis showed 8 factors including age, gender, smoking, hypertension, history of hypertension, history of diabetes mellitus, GLU and TG（OR =0.203, OR 95% CI 0.114-0.361 to OR =8.262,OR 95% CI 5.466- 12.491, P 〈 0.01）. CONCLUSION： ICH and CHD are the diseases induced by various risk factors. Significant difference exists in gender, age, smoking, hypertension, history of hypertension, GLU, history of diabetes mellitus and TG.

Artificial intelligence-based comprehensive analysis of immune-stemness-tumor budding profile to predict survival of patients with pancreatic adenocarcinoma

Objective:Pancreatic ductal adenocarcinoma(PDAC)is an aggressive malignancy.CD8^(+)T cells,cancer stem cells(CSCs),and tumor budding(TB)have been significantly correlated with the outcome of patients with PDAC,but the correlations have been independently reported.In addition,no integrated immune-CSC-TB profile for predicting survival in patients with PDAC has been established.Methods:Multiplexed immunofluorescence and artificial intelligence(AI)-based comprehensive analyses were used for quantification and spatial distribution analysis of CD8^(+)T cells,CD133^(+)CSCs,and TB.In vivo humanized patient-derived xenograft(PDX)models were established.Nomogram analysis,calibration curve,time-dependent receiver operating characteristic curve,and decision curve analyses were performed using R software.Results:The established‘anti-/pro-tumor’models showed that the CD8^(+)T cell/TB,CD8^(+)T cell/CD133^(+)CSC,TB-adjacent CD8^(+)T cell,and CD133^(+)CSC-adjacent CD8^(+)T cell indices were positively associated with survival of patients with PDAC.These findings were validated using PDX-transplanted humanized mouse models.An integrated nomogram-based immune-CSC-TB profile that included the CD8^(+)T cell/TB and CD8^(+)T cell/CD133^(+)CSC indices was established and shown to be superior to the tumor-nodemetastasis stage model in predicting survival of patients with PDAC.Conclusions:‘Anti-/pro-tumor’models and the spatial relationship among CD8^(+)T cells,CSCs,and TB within the tumor microenvironment were investigated.Novel strategies to predict the prognosis of patients with PDAC were established using AI-based comprehensive analysis and machine learning workflow.The nomogram-based immune-CSC-TB profile can provide accurate prognosis prediction for patients with PDAC.

Clinical Effect Analysis of Small and Medium Doses of Betaloc Combined with Amiodarone in the Treatment of Ventricular Arrhythmia

Objective:To explore and analyze the clinical effect of small and medium doses of Betaloc combined with amiodarone in the treatment of ventricular arrhythmia.Methods:60 patients with ventricular arrhythmia that were treated in the Department of Cardiology of our hospital from May 2018-May 2023 were selected for this study,and they were divided into a research group(n=30)and a reference group(n=30).The study group was treated with small doses of Betaloc and amiodarone,while the reference group was treated with conventional treatment.The total efficacy of medication,QRS interval,standard deviation of normal-to-normal(NN)intervals(SDNN),root mean square of successive differences between normal heartbeats(RMSSD),standard deviation of the average NN intervals(SDANN),and incidence of adverse reactions were compared between the groups.Results:The effectiveness of medication in the study group was significantly higher than that in the reference group(P<0.05).Besides,there was no statistically significant difference(P>0.05)in the QRS interval and SDNN between the two groups before treatment.After treatment,the QRS interval and SDNN of the study group were significantly lower than those of the reference group(P<0.05).Before treatment,there was no significant difference in RMSSD and SDANN between groups(P>0.05).After treatment,RMSSD and SDANN in the study group were significantly better than those in the reference group(P<0.05),and the difference was statistically significant.The incidence of adverse reactions in the study group was significantly lower than that in the reference group(P<0.05),and the difference was statistically significant.Conclusion:Small doses of Betoprolol and amiodarone is more effective in the treatment of ventricular arrhythmia,which has the value of popularization and application.

Early intravenous administration of tirofiban is recommended in patients with acute ischemic stroke treated with alteplase:a meta-analysis

Background:The occurrence of early neurological deterioration following intravenous thrombolysis(IVT)is considered a particularly ominous clinical event and is strongly correlated with poor outcomes.Initiating tirofiban within 24 h after IVT has been suggested as a better treatment option to achieve long-term functional outcomes.However,the rationality of this remedy is a controversial.The purpose of the study was to evaluate the safety and efficacy of early intravenous tirofiban administration after IVT in patients with acute ischemic stroke(AIS).Methods:Databases including PubMed,EMBASE,Cochrane Library,and Web of Science were searched for clinical trials on early tirofiban implementation after IVT in patients with AIS from inception to September 2022.Odds ratios(ORs)were generated for dichotomous variants via meta-analysis using STATA 17.0 MP.Results:Five clinical trials with 725 patients were eligible.The study outcomes demonstrated that early tirofiban administration after IVT was not associated with symptomatic intracranial hemorrhage(OR,0.78;95%confidence interval(CI),0.22–2.74;P=0.70),asymptomatic intracranial hemorrhage(OR,1.11;95%CI,0.52–2.37;P=0.80),systemic bleeding(OR,0.97;95%CI,0.42–2.23;P=0.94),and death(OR,1.05;95%CI,0.47–2.31;P=0.91),but may reduce the incidence of early neurological deterioration(OR,0.09;95%CI,0.02–0.50;P=0.01),and was significantly associated with 90-day excellent(modified Rankin scale score 0–1)(OR,2.01;95%CI,1.35–3.02;P=0.00)and favorable(modified Rankin scale score 0–2)(OR,2.30;95%CI,1.63–3.23;P=0.00)functional outcomes.Conclusion:The early intravenous administration of tirofiban after IVT in patients with AIS may be a safe and effective treatment strategy that improves long-term neurological functional outcomes without increasing the risk of adverse events.

Different strategies for ultra-early reperfusion therapy in anterior circulation acute ischemic stroke safety and effectiveness of the comparative observation

Background:To compare the safety and effectiveness of direct mechanical thrombectomy and bridging therapy for stroke with acute anterior circulation large vessel occlusion within 4.5 hours of onset.Methods:Retrospectively collected from 66 patients with acute ischemic stroke admitted to the Department of Neurology of Tongliao Hospital and Xuanwu Hospital from August 2019 to November 2021 within 4.5 hours.According to the different recanalization methods,30 patients were assigned to the direct thrombectomy treatment group,and 36 patients in the bridging treatment group(i.e.,the intravenous thrombolysis bridging mechanical thrombectomy treatment group).The primary outcome measure was the neurological outcome at the onset of 90d.Secondary outcome measures were intraoperative vascular recanalization and reperfusion,and the US National Institute of Health Stroke Scale score at 24 hours after surgery.The primary safety indicators are intracranial hemorrhage,including symptomatic intracranial hemorrhage and non-symptomatic intracranial hemorrhage,and 90d mortality.Results:The direct thrombectomy group had lower body mass index,hypertension and baseline Alberta early computed tomography score than the bridging treatment group,and longer time from onset to visit than the bridging group(206.5(119.5,256.25)min vs.150.5(25.205,212.75)min),the above difference were statistically significant(P<0.05).There were no significant differences in successful vascular reperfusion(93%vs.89%),24 hours postoperative National Institute of Health Stroke Scale score(11(5,18)vs.11(5,20)),intracranial hemorrhage(11%vs.14%),symptomatic intracranial hemorrhage(7%vs.17%),90d mRS0 to 2 points(43%vs.36%)and 90d mortality(23%vs.22%)(P>0.05).Conclusion:Similar clinical efficacy and safety of direct mechanical thrombectomy and bridging therapy for acute anterior circulation large vessel occlusive stroke within 4.5 hours of onset,direct thrombectomy can be used as an alternative scheme for acute anterior circulation intracranial large artery occlusive stroke.

Risk factors for myopia in Inner Mongolia medical students in China

Objective: The aim of the study was to investigate myopia and related factors in Inner Mongolia Medical Students, China. Methods: The survey employed a self-administered questionnaire. All medical students from the Inner Mongolia Medical University campus and those living and learning on campus were eligible. The questionnaire consisted of three sections: students’ basic information, attitude on myopia behavior, and myopia status of students. 6047 medical students completed the questionnaire. Results: A total of 6040 (90.5%) students aged 16 to 28 years (mean 21 ± 1.5 years) completed the questionnaire, of which 1772 (29.3%) were male and 4268 (70.6%) were female. The Mongolia of medical students had the lowest rate (64.3%) of myopia. The prevalence of myopia in Han nationality was highest (72.8%). Myopia occurred more frequently among students living in the city than in the rural. 76.4% urban and 66.6% rural students had myopia (p < 0.001). For myopia students it was established that 85.5% had begun to wear spectacles in middle school. Conclusion: A high myopia prevalence was demonstrated among medical students in the Inner Mongolia area of China. Our study’s findings could help health care professionals develop targeted myopia control policies for the population of students in Inner Mongolia of China and ensure the policies are more rational, useful, and effective.

Protective effects of a composition of Chinese herbs- Gurigumu-13 on retinal ganglion cell apoptosis in DBA/2J glaucoma mouse model

AIM： To explore the concrete mechanism of a Mongolian compound medicine-Gurigumu-13 （GRGM） for glaucoma treatment. METHODS： DBA/2J mice, as glaucoma models, were intragastric administrated with GRGM to study the effect of GRGM on retinal ganglion cells （RGCs）. The loss of RGCs was evaluated with the number of RGCs and axons. The expression of the target protein of RGCs or mouse retinas was determined by Western blot. The relative content of malondialdehyde （MDA） was examined by ELISA assay. RESULTS： GRGM distinctly improved retina damage via increasing the number of neurons, RGCs and axons in a concentration dependent manner. Meanwhile, GRGM obviously decreased the high level of MDA and the expression of oxidative stress-related proteins in retinas of DBAJ2J mice, but promoted the expression of antioxidant proteins. Additionally, GRGM also significantly inhibited the protein expression of Bip and Chop, which were markers of endoplasmic reticulum stress-induced apoptosis. CONCLUSION： GRGM have obvious protective effects on RGCs in DBA/2J mice, and increase the number of RGCs and axons via inhibiting oxidative stress and endoplasmic reticulum stress.

Bladder malacoplakia: A case report

BACKGROUND Bladder malacoplakia is a rare chronic granulomatous disease.The most common site of the malacoplakia is the urinary system.The etiology of bladder malacoplakia is complex,with its clinical misdiagnosis rate is high.Therefore,exposure to more clinical cases is necessary to improve the diagnosis and treatment of this condition.CASE SUMMARY A 65-year-old woman was admitted to our hospital because of dysuria.She presented with dysuria,frequent urination,urgency,pain,and absence of hematuria and pyuria.After the examination,bladder tumor electrocision was performed under combined intravenous and inhalation anesthesia on September 6,2021.During the operation,electrotomy and electrocoagulation were performed.The operation was then followed by anti-infection treatment,and the patient recovered well.The postoperative pathology was diagnosed as bladder malacoplakia by light and electron microscopic analyses.On a follow-up after 4 mo,no significant difference between electrotomy and electrocoagulation was found,with both achieving a curative effect.CONCLUSION Diagnosing bladder malacoplakia depends on histopathological examination.Antibiotic treatment with bladder tumor resection or electrocoagulation provides better therapeutic effect.

The impact of academic stress on medical students attending college in the Inner Mongolia Area of China

The aim of this study was to examine whether student characteristics affect the risk of health conditions, and explore whether the degree of academic stress affects the level of distress. We surveyed medical students in the Inner Mongolia Medical College China using a questionnaire. A logistic regression analysis was used to ascertain factors associated with distress. The Wilcoxon Mann-Whitney test was used to determine the relationship between distress and different academic stress levels. Of the 6044 students completing questionnaires, 47.5% self-reported distressing body symptoms induced by academic stress. Chi square tests showed statistically significant associations between distress and gender, academic stress, and residence;feeling academic stress caused a more than 1.5 times risk of distress. Gender and academic stress were significantly associated with distress in non-conditional binary logistic regression models. Compared with male students, female students was more likely to feel distress. The Wilcoxon Mann-Whitney test also showed that the distress rate increased with academic stress and a dose-response relationship between the distress rate and stress level was found. The present study indicates that it is important to reduce academic stress and manage it in order that better outcomes be achieved in regard to distress, especially in females.

Serum cystatin C levels are negatively correlated with post-stroke cognitive dysfunction

Stroke is the leading cause of death and long-term disability worldwide,and cognitive impairment and dementia are major complications of ischemic stroke.Cystatin C (CysC) has been found to be a neuroprotective factor in animal studies.However,the relationship between CysC levels and cognitive dysfunction in previous studies has revealed different results.This prospective observational study investigated the correlation between serum CysC levels and post-stroke cognitive dysfunction at 3 months.Data from 638 patients were obtained from the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS).Cognitive dysfunction was assessed using the Mini-Mental State Examination (MMSE) at 3 months after stroke.According to the MMSE score,308 patients (52.9%) had post-stroke cognitive dysfunction.After adjusting for potential confounding factors,the odds ratio (95% CI) of post-stroke cognitive dysfunction for the highest quartile of serum CysC levels was 0.54 (0.30–0.98),compared with the lowest quartile.The correlation between serum CysC and cognitive dysfunction was modified by renal function status.We observed a negative linear dose-response correlation between CysC and cognitive dysfunction in patients with normal renal function (Plinearity = 0.044),but not in those with abnormal renal function.Elevated serum CysC levels were correlated with a low risk of 3-month cognitive dysfunction in patients with acute ischemic stroke,especially in those with normal renal function.The current results suggest that CysC is a protective factor for post-stroke cognitive dysfunction,and could be used to treat post-stroke cognitive dysfunction.The CATIS study was approved by the Institutional Review Boards at Soochow University from China (approval No.2012-02) on December 30,2012,and was registered at ClinicalTrials.gov (identifier No.NCT01840072) on April 25,2013.

Research Progress on the Relationship Between White Matter Lesions and Vascular Cognitive Impairment

As the incidence of cerebrovascular disease increases,the incidence of white matter lesions (WMLs) and vascular cognitive impairment (VCI) also increases.Ischemic WMLs is directly related to VCI,especially non-dementia VCI.Early symptoms of non-dementia VCI are hidden and difficult to identify.About 50% of patients develop dementia.This article reviews the correlation between WMLs and VCI in terms of etiology,risk factors,pathogenesis and imaging manifestations.It provides scientific basis or ideas for clinical diagnosis and treatment for WMLs and VCI.

Effect of Data Augmentation of Renal Lesion Image by Nine-layer Convolutional Neural Network in Kidney CT

Artificial Intelligence(AI)becomes one hotspot in the field of the medical images analysis and provides rather promising solution.Although some research has been explored in smart diagnosis for the common diseases of urinary system,some problems remain unsolved completely A nine-layer Convolutional Neural Network(CNN)is proposed in this paper to classify the renal Computed Tomography(CT)images.Four group of comparative experiments prove the structure of this CNN is optimal and can achieve good performance with average accuracy about 92.07±1.67%.Although our renal CT data is not very large,we do augment the training data by affine,translating,rotating and scaling geometric transformation and gamma,noise transformation in color space.Experimental results validate the Data Augmentation(DA)on training data can improve the performance of our proposed CNN compared to without DA with the average accuracy about 0.85%.This proposed algorithm gives a promising solution to help clinical doctors automatically recognize the abnormal images faster than manual judgment and more accurately than previous methods.

Contrast-induced Encephalopathy after Endovascular Embolization of an Anterior Communicating Artery Aneurysm:Case Report and Literature Review

We report a case of contrast-induced encephalopathy after endovascular embolization of an anterior communicating artery aneurysm.A 59-year-old woman was admitted to Tongliao Hospital for neurointerventional treatment due to a left anterior communicating artery aneurysm.She had a history of hypertension,which was controlled by regular medication.The contraindications were eliminated following a preoperative examination,and head computed tomography(CT)showed no abnormalities.After evaluation,interventional embolization was performed.Three hours postoperatively,the patient complained of a headache on the right side,which was accompanied by frequent nausea.Emergency head CT showed no intracranial hemorrhage,obvious brain tissue edema in the right cerebral hemisphere,blurred sulcus/gyrus,or metal artifacts(spring coils)in the left frontal lobe.The patient was diagnosed with contrast-induced encephalopathy(CIE).This patient achieved good prognosis through timely and reasonable treatment.CIE is very rare clinically,improper treatment may lead to irreversible clinical outcomes;it should cause alarm to doctors.

Research progress of male sexual dysfunction following stroke

Stroke is a major disabling and fatal disease worldwide.There are many studies on neurological deficits and cognitive impairment after stroke,but there are few studies on sexual dysfunction,which is an important part of patients'quality of life.Studies have shown that male sexual dysfunction following stroke is very common,such as loss of libido,erectile dysfunction and ejaculatory weakness.Among them,young male stroke patients have particularly high requirements for quality of life and are ashamed to speak when they have secondary dysfunction.Related knowledge and degree of attention of medical staff are also relatively less.The location and area of stroke and the occurrence and development process of the disease may affect the sexual function of patients.Its etiology roughly includes both organic and functional aspects.Further study of post-stroke sexual dysfunction and strengthening the diagnosis and treatment of sexual dysfunction in stroke patients should be included in the category of stroke rehabilitation.

Document Analysis of Correlation between Climate and Stroke

Aim: The aim of the research is to determine characteristic of the correlation between climate and stroke through the analysis of relevant documents. Methods: We found 115 researches of temperature and season on stroke mortality/incidence and these were categorized according to location, meteorology, date span, data source and research sites’ latitudes. We divided the globe into 5 temperature zones based on latitude ranges: 0 - 10, 10 - 23.5, 23.5 - 40, 40 - 50, and >50 degrees, and allotted a zone to each country. Stroke mortality by five temperature zones was calculated per 100,000 people. Results: 70% of the researches came from latitudes greater than 40 degrees with 92% of researches located in Europe, USA, and Asia. The mortality range was 42 - 63 per 105 individuals within latitudes 0 - 40 degrees. In latitudes 40 - 66.5 degrees, a linear upward trend (y = 69.82x &#8722;22.823, R2 = 0.99) was noticed. More than 75% of the research reports indicated a negative correlation between climate and stroke, and the proportion was almost 6 and 7 times greater than that of the fluctuation and non-correlation, respectively. The most frequently used research methods were regression analysis and time series analysis. Conclusion: All of the research results confirmed that lower temperature is associated with higher mortality and incidence of stroke, while higher latitude is correlated with higher stroke mortality, consistent with the temperature zones.

Clinical analysis of DC-CIK combined surgery for advanced renal cell carcinoma

Objective:This the aim of article to investigate the clinical efficacy of DC-CIK Immunotherapy for advanced renal cell carcinoma.Method:36 patients with advanced renal carcinoma were randomly divided into two groups:DC-CIK in treatment group and IFN-αin control group.Results:after treatment with DC-CIK in the treatment group,compared with the control group after treatment with IFN-α,CT was reexamined 1 year after treatment in both groups.There were significant differences in Alt,AST,SCR and BUN(P<0.05),CD3(+),CD4(+)and CD8(+)in the treatment group were significantly higher than those in the control group(P<0.05),The percentage of CD3(-)CD56(+),the Count of CD3(-)CD56(+)and the percentage of Tc were significantly different(P<0.05),and the KPS score was significantly different between the treatment group treated with DC-CIK and the control group treated with IFN-α(P<0.05).Conclusion:DC-CIK can inhibit and kill the tumor cells,and change the activity of T cell subsets,improve the immune function and quality of life of patients with advanced renal cell carcinoma.It is an immunotherapy program worthy of wide application in clinic practice.

Research progress of perioperative stroke

Perioperative stroke is one of the serious complications in perioperative patients,and its incidence is related to the risk factors of stroke,surgical methods,anesthesia,and surgical complexity.This article reviews the definition,incidence,risk factors,preventive measures,and management of perioperative patients of perioperative stroke,to provide a theoretical basis for clinical work,to reduce the incidence of perioperative stroke.

Advances in the Pathogenesis of Vascular Cognitive Impairment

As the population ages,the number of patients with vascular cognitive impairment(VCI)increases,which increases the burden on patient's family and social.At present,the treatment and pathogenesis of VCI is still unclear.This paper reviews the literature on VCI pathogenesis,especially the molecular mechanism(oxidative stress,endoplasmic reticulum stress,inflammation,autophagy.),aiming to provide direction and reference for VCI pathogenesis research and target therapy.

Fibrous histiocytoma of the spermatic cord 1 case and review of the literature

Objective:The diagnosis and treatment of this disease were discussed based on the relevant literature and the clinical data of spermatic fibrous histiocytoma in our hospital.Methods:The clinical data of 1 case of spermatic cord fibrous histiocytoma admitted to urology department were retrospectively analyzed,combined with relevant literature review and discussion.Results:After surgical radical treatment,the pathological result was fibrous histiocytoma.Conclusion:Spermatic cord fibrous histiocytoma is a rare tumor of genitourinary system.The diagnosis is mainly based on pathological results.Surgery is the first choice for treatment.Adjuvant radiotherapy and chemotherapy are not effective and the prognosis is poor.Regular postoperative review is required.

Association of systolic blood pressure after discharge and the risk of clinical outcomes in ischemic stroke patients with diabetes:a cohort study

To the Editor:Hypertension is an important risk factor for the incidence and prognosis of diabetes and ischemic stroke.Both diabetes and ischemic stroke are common disorders that often occur together,and up to approximately 34%of acute ischemic stroke patients also experience diabetes.[1]Previous studies have shown that stroke patients with hyperglycemia or diabetes exhibited increased risks of recurrent stroke,poor neurological outcomes,and mortality.However,few studies have explored the relationship between systolic blood pressure(SBP)levels or SBP trajectories and clinical outcomes in patients with both ischemic stroke and diabetes.