Early endovascular interventional therapy can effectively improve the prognosis of patients with acute ischemic stroke. Dual-source CT dual-energy scanning, as a new CT imaging technology developed rapidly in recent years, with its unique technical characteristics and advantages, shows potential and application prospects in early endovascular interventional therapy of acute ischemic stroke. This article discusses the value of dual-source CT dual-energy scanning in the early screening and evaluation, the identification of postoperative iodine contrast agent extravasation and secondary cerebral hemorrhage, and the prediction of prognosis of patients with early endovascular interventional treatment of acute ischemic stroke. The purpose is to provide a theoretical basis for better application of dual-source CT dual-energy scanning in early endovascular interventional treatment of acute ischemic stroke.
ObjectiveTo investigate the operation and effect of pressure ulcers group (PUG) on the procedure of clinical management of pressure ulcers. MethodsThe in-hospital patients with high-risk pressure ulcers and patients with pressure ulcers from outside of the hospital (n=145) before the founding of PUG in 2011 were regarded as group A, and patients in this group were treated by traditional therapies. After PUG was founded in our hospital in January 2012, 192 patients with high-risk pressure ulcers and from outside of the hospital in 2012 were considered as group B. In addition, group C contained 380 patients treated in 2013. Group B and C were both treated by PUG that developed a management system of pressure ulcers and took active measures to control and prevent pressure ulcers. PUG trained 30 clinical nurse supervisors, who were recommended from relevant clinical departments. The incidence of inevitable pressure ulcer of hospitalized patients, the cure rate of patients with pressure ulcers from outside of the hospital, pressure ulcer knowledge level of clinical nurse supervisors were comparatively analyzed between group A and B, and between group A and C, respectively. ResultsAfter the establishment of PUG, the incidence of inevitable pressure ulcer of hospitalized patients in group A, B, and C was 76.20%, 17.02%, and 14.61%, respectively. The cure rate of patients from outside of the hospital was 54.84%, 86.84%, and 87.97%, respectively. Differences between group A and B, and between group A and C both were significant (P<0.01). The pressure ulcer knowledge level of all nurse supervisors improved significantly (P<0.001). ConclusionThe establishment of PUG makes the clinical pressure ulcer management more scientific and objective. Furthermore, it can effectively reduce the incidence of pressure ulcers, and also improve the quality of medical care and ensure the safety of patients.
Objective To investigate the effects of extracts of Pinellia ( EP) on a rat model of airway mucus hypersecretion induced by LPS. Methods Thirty Wisatr rats were randomly divided into 5 groups, ie. a blank group, a model group, and three EP groups treated with different doses of EP. There were 6 rats in each group. Airway mucus hypersecretion model was established by intratracheally instillation of LPS in the model group and three EP groups. The rats in three EP groups were orally administered with EP at dosages of 10 g/kg, 30 g/kg and 60 g/kg respectively for 4 days. The expression of Mucin 5AC ( MUC5AC) protein in airway was assayed by immunohistochemistry. The mRNA expressions of MUC5AC and Aquaporin-5( AQP-5) in lung tissue were detected by RT-PCR. ELISA technique was performed to detect TNF-αin bronchoalveolar lavage fluid( BALF) . Results LPS significantly stimulated the mRNA and protein expression of MUC5AC in lung and TNF-αlevel in BALF, and inhibited the expression of AQP-5 mRNA in lung. The EP at dosages of 10 g / kg and 30 g/ kg had little effect on mucus hypersecretion. While 60 g/kg of EP could significantly inhibited the expression of MUC5AC, and decreased the release of TNF-α in BALF. The AQP-5 mRNA was also up-regulated by 60 g /kg of EP. The expression of MUC5AC mRNA was positively correlated with level of TNF-α( r = 0. 948, P lt;0. 05) ; AQP-5 mRNA was negatively correlated with MUC5AC mRNA and TNF-α( r = - 0. 955, P lt; 0. 05; r = - 0. 909, P lt; 0. 05) . Conclusion EP ( 60 g/ kg) can significantly attenuated airway mucus hypersecretion in rats.
Upper gastrointestinal tract cancers originating in the esophagus or esophagogastric junction constitute a major global health problem. On February 28, 2023, National Comprehensive Cancer Network (NCCN) released the clinical practice guidelines for esophageal and esophagogastric junction cancer (version 1.2023). This article will interpret the main updates related to the treatment and follow-up in this version compared to the version 5.2022, in order to provide the Chinese clinicians a better basis and reference for the diagnosis and treatment of the diseases.
Objective To investigate the medication adherence to antihypertensives, antidiabetics, and lipid-lowering agents and its influence on the prognosis of individuals at high risk of stroke. Methods A total of 16892 residents aged 40 years or above in eight communities in Sichuan participated in a face-to-face study from May to September 2015. A database of a high-risk population of stroke in Sichuan province was established, and data were collected via using a standardized structured questionnaire by experienced investigators, including the treatment status and medication compliance of participants with hypertension, diabetes, or dyslipidemia during the follow-up period. Multiple logistic regression analyses were performed to explore the influencing factors of medication adherence and its influence on the prognosis of individuals at high risk of stroke. Results A total of 2893 participants at high risk of stroke were enrolled. The treatment rates of hypertension, diabetes, and dyslipidemia were 50.1%, 49.2%, and 5.1%, respectively, when the high-risk individuals were identified. At the end of follow-up (with a median follow-up period of 4.8 years), the treatment rates of hypertension, diabetes, and dyslipidemia were 24.8%, 25.0%, and 7.9%, respectively. Medication adherence to antihypertensives, antidiabetics, and lipid-lowering agents were 27.8%, 25.5%, and 18.1%, respectively. Multiple logistic regression analyses showed that the education level of high school or above [odds ratio (OR)=2.134, 95% confidence interval (CI) (1.098, 4.147), P=0.025], medical insurance for urban residents [OR=1.556, 95%CI (1.086, 2.230), P=0.016] and urban employees [OR=2.325, 95%CI (1.362, 3.967), P=0.002], having fewer children [OR=0.819, 95%CI (0.719, 0.933), P=0.003], and family history of stroke [OR=1.559, 95%CI (1.066, 2.282), P=0.022] were associated with greater adherence to antihypertensives; medical insurance for urban employees was associated with greater adherence to antidiabetics [OR=2.494, 95%CI (1.173, 5.300), P=0.018]. After adjusting for confounding factors, failure to regular use of antihypertensives [OR=2.617, 95%CI (1.414, 4.842), P=0.002], antidiabetics [OR=3.909, 95%CI (2.394, 6.380), P<0.001], and lipid-lowering agents [OR=4.828, 95%CI (2.581, 9.033), P<0.001] in patients with hypertension, diabetes, and dyslipidemia, respectively were associated with increased risk of ischemic stroke during the follow-up period. Regular use of lipid-lowering agents in patients with dyslipidemia was associated with an increased risk of intracerebral hemorrhage during the follow-up [OR=4.371, 95%CI (1.156, 16.530), P=0.030]. Conclusions The prevalences of hypertension, diabetes, and dyslipidemia are high in high-risk individuals of stroke in Sichuan province. However, the treatment rates are unsatisfactory, and the medication adherence is poor. The medication adherence is affected by a variety of demographic and socioeconomic factors. Regular treatments of hypertension, diabetes, and dyslipidemia reduce the risk of ischemic stroke in individuals at high risk of stroke, but regular use of lipid-lowering agents in patients with dyslipidemia is associated with an increased risk of intracerebral hemorrhage during the follow-up.
Magnetic susceptibility is an intrinsic physical quantity which describes the relationship between material magnetization and applied external magnetic field. Quantitative susceptibility mapping (QSM) is an MRI technology which can quantify the buck magnetic susceptibility of tissue in vivo. It is particularly effective at elucidating anatomy with paramagnetic or diamagnetic components. QSM technology is a method for solving the ill-pose problem of un-conventional de-convolution of the measured tissue magnetic field with the unit magnetic dipole field to obtain the susceptibility source map. Many multi orientation scan based QSM and clinically acceptable single orientation QSM methods have been proposed to solve this ill-posed problem. In this paper, the QSM concept is introduced and the various QSM methods are systematically categorized and discussed. The aim of this paper is to summarize the current research progress of QSM, popularize the knowledge of QSM and promote the improvements and the rational application of QSM in clinical field.