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Objective To investigate the efficacy and safety of endovascular recanalization 6-24 h after onset in patients with acute basilar artery occlusion,and explore the related factors for their prognoses.Methods Clinical data of 37 patients with acute basilar artery occlusion,received endovascular recanalization in our hospital from January 2016 to July 2019,were retrospectively collected;23 patients were into group of onset-to-puncture time (OPT)＞6 h (6-24 h),and 14 patients were into group of OPT ≤ 6 h (0-6 h).Statistical methods were used to compare the postoperative symptomatic intracranial hemorrhage rate,good prognosis rate (modified Rankin scale [mRS] scores ≤ 3) and mortality 3 months after onset between the two groups;clinical data between the subgroups with good and poor prognoses in patients of group of OPT＞6 h were compared.Results The postoperative symptomatic intracranial hemorrhage rate,and good prognosis rate and mortality of patients from group of OPT＞6 h were 30.4％,47.8％ and 43.5％,respectively;and there were no statistically significant differences as compared with those in patients from group of OPT≤6 h (35.7％,35.7％,and 42.9％,P＞0.05).Scores of scales based on preoperative CTA images (posterior circulation-Alberta stroke program early CT scale [pc-ASPECTS],scale of posterior circulation on CTA [pc-CTA],and scale of basilar artery on CTA [BATMAN]) showed significant differences between the good prognosis subgroup and poor prognosis subgroup in patients fiom group of OPT＞6 h (P＜0.05).Conclusion Endovascular recanalization 6-24 h after onset is effective in patients with acute basilar artery occlusion,and the safety does not obviously decrease;scores of pc-ASPECTS,pc-CTA and BATMAN may be related to the clinical prognoses.
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Acute basilar artery occlusion (ABAO) has a high rate of disability and mortality, and the key to its treatment is to start reperfusion therapy as early as possible. A number of retrospective studies have found that the good prognosis rate of endovascular treatment of ABAO is related to number of infarction locus, extent of ABAO, vascular occlusion and collateral circulation. Screening patients through imaging evaluation before endovascular treatment may further improve the rate of favorable outcome. This article reviews research progress on the correlation between imaging evaluation before endovascular treatment of ABAO and clinical prognoses.
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Objective To assess the effect of ultrasound-guided multiple-spot sector stereotaxis in unipolar cooling cycle radiofrequency ablation of hepatic carcinomas. Methods Ninety-six patients with 112 liver malignancies were treated with ultrasound-guided percutaneous radiofrequency ablation using multiple-spot sector stereotaxis method. Conventional multi-section ultrasound scanning was performed to determine the exact location of tumors. Contrast enhanced ultrasound (CEUS) was performed 15 minutes after treatment to determine whether the tumors were completely inactivated. Contrast enhanced CT (CECT) and CEUS were performed 1 month after treatment to evaluate the therapeutic effect. Results A total of 293 punctures were performed for 112 tumors, technical successful rate with a successful rate of puncture was 91.81% (269/293). CEUS showed no blood flow signals in the tumors 15 minutes after therapy. One month after therapy, CT showed the volume of tumors shrunk, no enhancement was found in 100 tumors (100/112, 89.29%), while partial reinforcement was noticed in 12 tumors (10.71%). Meanwhile, CEUS showed no enhancement in 90 tumors (90/103, 87.38%), when partial reinforcement was noticed in 13 tumors (13/103, 12.62%). Conclusion Ultrasound-guided multiple-spot sector stereotaxis unipolar cooling cycle radiofrequency ablation is an effective and reliable method to treat hepatic carcinomas.
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Objective To investigate the risk factors in children with hand-foot-mouth disease(HFMD)hospitalized after the second visit to outpatient department(OPD),and to evaluate their predictive value.Method In May 2008,180 of 343 pediatric patients with HFMD were repatriated to family or community after preliminary diagnosis in Bering Ditan Hospital.The ill children hospitalized after revisit(RVH)were compared with the remaining children(control group)for seeking the differences in age,HFMD contagion,temperattLre,interval between onset and visit,WBC count,skin lesion and comphcating risk symptoms by respective analysis.Logistic regression analysis was performed to find the risk factors involved in patients with RVH and diagnostic evaluation was introducted to predict the probability of RVH.Results Of 180 ill children,17(9.44%)ones returned to family or community requested admission into hospital for further consultation because who symptoms urtremitted or complications developed.The average duration between the preliminary visit and second visit was 3.26 days(0.5～14 days).No significant differences were found between RVH group and control group in age(P=0.669),ratio of gender(P=0.101),conttagion with HFMD(P=0.104),and typing of vires(P=0.475).Compared with control groups,the significant prolongation of interval between onset and visist(3.71±1.10)d,significant eleva-tion of temperature(38.74±0.57)℃ and WBC counls(10.99±3.67)×109 were noticed in ill children of RVH(P<0.05).According to logistic regression,interval between onset and visit nlore than 3 days,body tem-perature at the first visit higher than 38.5℃,WBC count over 10.0×109,and the accompaniment of serious symptoms were confirmed to be independent risk factors involved in RVH.Of them,67.85%(11/16)ill children with three or more risk factors of RVH showed diagnosis sensitivity and specificity reach to 64.53%and 97.14%,respectively.Conclusions Risk factors confirmed are the interval between onset and the visist more than 3 days,bodv temperature higher than 38.5℃ at the first visit,WBC count more than 10.0×109,and the accompaniment of severe symptoms.The ill children with three or more risk factors are in great request of more closely monitoring and should not be the candidates for repatriation to family or community after preliminary diagnosis.