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Objective:To investigate the predictive value of systemic inflammatory response index (SIRI) for early neurological deterioration (END) and clinical outcome in patients with branch atherosclerotic disease (BAD).Methods:Consecutive patients with BAD admitted to the Department of Neurology, Jiangyin People’s Hospital Affiliated to Southeast University from September 2021 to September 2022 were retrospectively included. The clinical data were collected and SIRI was calculated. The calculation method of SIRI was neutrophil count × monocyte count/lymphocyte count. END was defined as an increase of ≥2 in the total score of the National Institutes of Health Stroke Scale (NIHSS) or an increase of ≥1 in the motor function score within 1 week of onset. The modified Rankin Scale was used for outcome evaluation at 3 months after onset, with a score >2 were defined as poor outcome. Multivariate logistic regression analysis was used to determine the independent correlation between SIRI and END, as well as poor outcome. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of SIRI for poor outcome. Results:A total of 125 patients with BAD were included, of which 62 (49.6%) had END and 32 (25.6%) had poor outcome. The multivariate logistic regression analysis showed that intravenous thrombolysis (odds ratio [ OR] 1.083, 95% confidence interval [ CI] 1.082-1.240; P=0.043) and high SIRI ( OR 1.465, 95% CI 1.150-3.676; P=0.028) were independent risk factors for END in patients with BAD; END ( OR 1.130, 95% CI 1.032-1.384; P=0.006), high baseline NIHSS score ( OR 1.571, 95% CI 1.184-2.101; P=0.003) and high SIRI ( OR 2.062, 95% CI 1.152-3.672; P=0.01) were independent risk factors for poor outcome in patients with BAD. ROC curve analysis showed that the area under the curves for SIRI, baseline NIHSS score, and the both combined prediction of poor outcome were 0.66 (95% CI 0.54-0.78), 0.70 (95% CI 0.58-0.81), and 0.83 (95% CI 0.74-0.93), respectively. Conclusions:High SIRI is an independent risk factor for END and poor outcome in patients with BAD. The SIRI and baseline NIHSS scores have certain predictive value for poor outcome in patients with BAD, and their combined diagnostic value is higher.
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Objective:To explore any effect of using extracorporeal shockwave therapy (ESWT) on the gastrocnemius muscle or the myotendinous junction on spasticity and the walking ability of stroke survivors.Methods:A total of 84 stroke survivors were randomly divided into a control group, a muscle belly group, and a myotendinous junction group, each of 28. In addition to conventional rehabilitation, the muscle belly and myotendinous junction groups received ESWT applied to the belly of the gastrocnemius muscle or the myotendinous junction. Before as well as one, two and three weeks after the treatment, all were evaluated using the Modified Ashworth Scale (MAS), passive range of motion (PROM), a visual analogue scale (VAS) for pain rating, and 10m maximum walking speed (10m MWS). Stride frequency and length were also measured and compared among the 3 groups.Results:After three weeks of ESWT treatment the average MAS, PROM and VAS scores of the belly and the junction group were significantly improved compared to before the treatment. The average MAS, PROM and VAS scores of the belly group and the average MAS score of the junction group were then significantly superior to the control group′s averages, and the average VAS score of the belly group was significantly better than that of the junction group. After one and two weeks of treatment, the average 10MWSs of the belly and junction groups were significantly better than the control group′s average, and after 3 weeks the belly group′s average speed was significantly better than the junction group′s. The stride frequency of the belly group had improved significantly compared with the control group after 2 weeks, and after 3 weeks both experimental groups had significantly better frequency than the control group. The average stride length of both the belly and junction groups was significantly better than the control group′s average throughout the testing.Conclusion:ESWT applied to the belly of the gastrocnemius muscle or the myotendinous junction can relieve muscle spasticity and pain and improve walking ability. Applying ESWT to the muscle belly is superior to on the myotendinous junction in terms of therapeutic efficacy.
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Objective:To detect the changes in mental arithmetic competence and the related influencing factors in patients with early Parkinson's disease(PD)by using mental arithmetic task behavioral experiment.Methods:Thirty-one patients with early PD and 40 healthy controls were enrolled in this study.The cognitive functions were tested by mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA). The differences of mental arithmetic competence between the two groups were measured by behavioral experiment.Results:There was no significant difference in correct rate, reaction time and post-corrected reaction time while performing baseline tasks and easy mental arithmetic tasks between the two groups( P>0.05). The reaction time had no significant difference between the two groups after adjusting some confounding factors( P>0.05). However, the correct rate while performing difficult mental arithmetic tasks was significantly lower( t=-2.232, P=0.029)and the reaction time was significantly longer( t=2.149, P=0.035)in PD group than in the controls, and the significant difference in reaction time persisted even after adjusting some confounding factors( t=3.139, P=0.003). In PD group, the correct rate of difficult mental arithmetic tasks was positively associated with MoCA scores( r=0.561, P=0.004), and negatively associated with age( r=-0.532, P=0.008). The reaction time and post-corrected reaction time while performing difficult metal arithmetic task were negatively associated with MoCA scores( r=-0.525, P=0.01; r=-0.554, P=0.005)and positively associated with age( r=0.485, P=0.037; r=0.514, P=0.012)in PD group. Conclusions:The difficult mental arithmetic competence is impaired in early PD patients, which is statistically significantly correlated with cognitive function and age.
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Objective To investigate the relationship between two single nucleotide polymorphisms (rs356219,rs356165 sites) and cognitive dysfunction in Parkinson disease.Methods 236 patients with Parkinson's disease were randomly selected from November 2014 to November 2017.According to the results of MoCA cognitive function evaluation,the patients were divided into group A (cognitive dysfunction group)and group B (normal cognition group).At the same time,65 patients were randomly selected as group C (Health control group).The allele frequency and genotype distribution of rs356219 and rs356165 were compared,and the differences among the three group were compared.Results In the rs356165 allele frequency,group A (G:57.14％,A:42.86％),group B (G:56.45％,A:43.55％) and group C (G:52.31％,A:47.69％) had no statistical significance (P＞ 0.05).In the rs356165 genotype,G/G (21.43％) and A/A (14.29％) in group A were higher than group C (G/G:4.62％,A/A:1.54％),G/G (22.58％) in group B and A/A (14.52％) were higher than group C G/G (4.62％) and A/A (1.54％) (P＜ 0.05).In the rs356219 allele frequency,group A (G:64.29％,A:64.29％) and group B (G:64.52％,A:35.486％) and group C (G:46.15％,A:53.85％) was statistically significant (P＜0.05),but no statistical significance between group A and group B (P＞0.05);In the rs356219 genotype,group A (G/G:35.71％,A/A:21.43％,A/G:42.86％),group B (G/G:35.48％,A/A:22.58％,A/G:41.94％) and group C (G/G:30.77％,A/A:26.15％,A/G:43.08％) had no statistical significance (P＞ 0.05),and there was no statistical significance between group A and group B (P＞0.05).Conclusions The polymorphism of rs356219 and rs356165 sites in rho-synaptic nucleoprotein plays an important role in the pathogenesis of Parkinson disease.However,there was no correlation with cognitive dysfunction in patients with Parkinson disease.
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BACKGROUND: Mesh plug tension-free hernioplasty is commonly used for inguinal hernia. In the operation, different mesh materials can be selected, among which the modified Kugel mesh is extensively applied. OBJECTIVE: To observe the biocompatibility of modified Kugel mesh in mesh plug tension-free hernioplasty for inguinal hernia. METHODS: Total y 79 cases of inguinal hernia were treated by mesh plug tension-free hernioplasty. The patients were randomly divided into observation group repaired with Bard mesh (modified Kuge) (n=38) and control group repaired with Prolene mesh (n=41). After 12-month fol ow-up, levels of interleukin 6, C-reactive protein and tumor necrosis factor α were detected and compared before and after treatment;adverse events, including wound infection or infection caused by the mesh in the two groups were recorded. RESULTS AND CONCLUSION: Levels of interleukin 6, C-reactive protein and tumor necrosis factor α in the two groups were significantly decreased after treatment than before treatment (P < 0.05). No wound infection or infection caused by the mesh appeared in both two groups. Although scrotum effusion occurred in two cases of each group, their outcomes al improved significantly after active puncture and suction treatment without other serious problems. No recurrence was found during the 12-month fol ow-up. These results show that the modified Kugel mesh has good biocompatibility in mesh plug tension-free hernioplasty for inguinal hernia.
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<p><b>OBJECTIVE</b>To investigate the effect of ligation level of inferior mesenteric artery (IMA) on postoperative defecation function in patients with rectal cancer.</p><p><b>METHODS</b>A total of 128 rectal cancer patients who were planned to undergo low anterior resection in the First Hospital of Zibo City between January 1, 2012 and December 31, 2013 were prospectively enrolled and randomly divided into IMA high ligation group(63 cases, cutting distance of 1.0 to 1.5 cm to the root of IMA) and low ligation group(65 cases, cutting distance of 0.5 to 1.0 cm to the root of left colic artery originated from IMA). The efficacy, especially the defecation function, was observed and compared 3 months and 1 year after surgery between the two groups.</p><p><b>RESULTS</b>No significant difference was found in the number of harvested lymph nodes between two groups[8(1-30) vs. 7(2-28), P=0.125], but high ligation group had greater number of metastatic lymph nodes[1(0-9) vs. 0(0-8), P=0.041]. Frequency of defecation in high ligation group was significantly higher than that in low ligation group during postoperative 3-month follow-up[5(2-10)/d vs. 3(1-8)/d, P=0.035], whereas other indexes of defecation function were not significantly different(all P>0.05). The proportion of patients needing laxatives in high ligation group was higher than that in low ligation group during postoperative 1-year follow-up [11.3%(6/53) vs. 1.7%(1/58), P=0.038], whereas other indexes of defecation function were not significantly different as well (all P>0.05). Three cases and 2 cases showed recurrence in high ligation group and low ligation group respectively during postoperative 1-year follow-up without significant difference(P=0.623).</p><p><b>CONCLUSION</b>Low ligation of IMA in low anterior resection for rectal cancer is beneficial to the protection against defecation function.</p>
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Objective To detect the impairment of response inhibition and working memory in patients with alcohol dependence.Methods A total of forty-eight alcohol dependent patients and fifty age,gender,IQ,education matched controls were recruited.Neuropsychological tests were applied to measure the differences of response inhibition and working memory between the two groups.Results In the response inhibition task,the patient group had more commission errors ((7.02± 3.48) vs (3.45± 1.52)) and longer reaction time ((605.45 ± 142.56)ms vs (435.72±51.18)ms) compared to the control group (t=6.534,P=0.000; t=7.781,P=0.000).In the spacial working memory task,the patient group also had more commission errors ((4.58± 3.45) vs (0.43± 0.88)) and longer reaction time((10566.16±2455.61) ms vs (9185.44±2677.52) ms) than control (t=8.085,P =0.000; t=2.657,P=0.009).Conclusion There are significant deficiencies in response inhibition and working memory in patients with alcohol dependence.
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ObjectiveTo detect the fiber structure and volume differences in frontal lobe between patients with amnestic mild cognitive impairment (aMCI) and normal control.MethodsT1 -weighted magnetic resonance imaging and diffusion tensor imaging were obtained in 28 aMCI patients and 25 normal controls.Volumes,fiber fractional anisotropy (FA),fiber apparent diffusion coefficient (ADC),fiber number,and average fiber length of frontal lobe in the two groups were measured.ResultsVolumes of left frontal lobe ( ( 337.35 ± 20.45 ) cm3 ) in aMCI group were smaller than control ( (358.54 ± 27.26) cm3 ) ( t =- 3.223,P =0.002 ).Numbers of short range fiber in left frontal lobe ( 16985 ± 892) were significantly increased relative to control ( 16387 ±752) ; while numbers of long range fiber (3214 ± 185 ) were reduced compared with control (3425 ± 277 ),and ADC values increased ( t =2.621,P =0.012; t =-3.714,P =0.001 ; t =17.595,P=0.000).In aM CI group,numbers of long range fiber in right frontal lobe were reduced (2895 ± 343 vs.3451 -± 230,t =- 7.011,P =0.000),and ADC values were increased ( t =4.443,P =0.000).In aMCI group,numbers of long range fiber in left frontal lobe were positively correlated with scores of mini-mental state examination ( MMSE ) ( r =0.457,P =0.015 ),while ADC values of long range fiber in left frontal lobe were negatively correlated with scores of MMSE ( r=-0.415,P=0.028).ConclusionThe structure and fiber connectivity are affected in aMCI patients and the lesion of connectivity in left frontal lobe are related to the severity of symptom.
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Objective To evaluate the effect of fast track surgery on immunologic functions and clinical outcome in patients with gastric cancer during perioperative period. Methods Thirty-six gastric cancer patients receving radical operation were randomly divided into two groups: fast track group (18, fast track surgery) and conventional management group (18, non-fast track surgery). Serum levels of IgA、IgM、 IgG and C reaction protein (CRP) in 36 patients were assayed preoperatively and postoperatively on 1st, 3rd, 7th day. The postoperative hospital stay, duration of fever, inhospital expense, postoperative time of flatus and postoperative complications were recorded respectively. Results On the postoperative 3rd day, serum levels of IgA [(1.57 ± 0. 40) g/L vs. (1.27±0.49) g/L, P <0. 05],IgG[(9.99 ± 2. 12) g/L vs.(8.53±2. 15)g/L, P<0.05]and IgM [(0.92 ± 0.18) g/Lvs. (0.78 ± 0.20) g/L, P<0.05]in patients of fast track group were significantly higher than those in patients in non-fast track group. On the postoperative 1 st, 3rd , 7th day, serum levels of CRP [d1 (56 ± 10) g/L vs. (79 ± 9) g/L,P < 0. 05];d3[(140±15) g/L vs. (170±15) g/L, P<0.05)];d7 [(52±11) g/L vs. (78±12) g/L,P<0.05]in patients of fast track group were significantly lower than those in patients in non-fast track group. The duration of fever [(2. 4 ± 0.9) d vs. (3.8 ± 0. 8) d, P < 0.05], passage of gas by anus [(3. 1 ± 0. 8) d vs. (4.4±0.7) d,P<0.05], time of hospitai stay [(6.3 ± 1.2) d vs. (8.2 ± 0.9) d,P<0.05]and treatment expense in patients of fast track group[(25 260 ± 2910) $ vs. (30 651 ± 3578) $ ,P <0. 05]were also significantly lower than those in non-fast track group (P < 0. 05). Patients in fast track group had no more complications than those in non-fast track group (P > 0. 05). While discharged from hospital, the quality of life score [(14. 8 ± 1.9) vs. (16. 1 ± 1.6), P < 0. 05]in patients of fast track group was significantly higher than that in patients in non-fast track group (P < 0. 05). Conclusions Fast track surgery mitigates the immunologic impairment of gastric cancer patients during perioperative period, and accelerates postoperative rehabilitation.
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Objective: To investigate the influence of fast tract surgery on the humoral immunity and the chief clinical index of gastric cancer patients.Methods: 56 patients with gastric cancer from December 2007 to June 2008 were randomly divided into two groups: experiment group(fast tract surgery group, n=28)and control group(conventional treatment group, n=28 ). The changes of serum levels of humoral immunity and the chief clinical index were analysed and compared.Results: The serum levels of humoral immunity in both group were decreased. The serum levels of C3 and C4 on the postoperative 1st day were(0.845±0.126)g/L and(0.212±0.070)g/L respectively(P<0.05) in FTS group.The serum levels of IgA, IgM and IgG on the postoperative 3rd day were(1.603±0.468)g/L,(0.845±0.187)g/L,(9.548±1.920)g/L respectively(P<0.05) in FTS group. The duration of antibiotic use, first passage of flatus, the lengh of hospital stay, the occurance of postoperative complications in FTS group were also significiantly lower than those in control group (P<0.01, P<0.05).Conclusion: Fast tract surgery affectes on the humoral immunity of gasrtic cancer patients, and it might contribute to the improved outcomes of postoperative patients.
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Objective: To investigate the characters of body composition of gastric cancer patients.Methods: Body composition was measured by dual-energy X-ray absorptiometry(DEXA)in 50 gastric cancer patients and 31 healthy subjects,and nutritional state was evaluated by mini nutritional assessment(MNA).Results: Compared with control group,male gastric cancer patients showed a reduction in lean body mass and fat mass(15 658?6 481)g vs(19 527?6 150)g,t=2.079,P
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Objective To investigate the expression of TIMP-1 in brain tissue of perihematoma and the relationship between TIMP-1 and brain edema in experimental intracerebral hemorrhage(ICH). Methods ICH models of rats were established by autologous blood injection. Then the brain water content was measured by comparion of wet and dry weight,the permeability of blood-brain barrier (BBB) was evaluated by evans blue contents,and the expression of TIMP-1 in brain tissue of perihematoma was detected by Western Blot at 1 h,3 h,6 h,12 h,24 h,36 h,48 h,72 h and 7 d total 9 time points after ICH. The relationship among the results were analysed,and compared with the sham operation group. Results Compared with the sham operation group,the brain water contents and evans blue contents were significantly increased at all the time points in ICH group (P