Objective To study the clinical curative effect and complication of methylprednisolone in the treatment of patients with acute myelitis.Methods 42 patients with acute myelitis were selected and randomly divid-ed into two groups,21 cases in each group.The control group was treated with dexamethasone,the observation group was treated with methylprednisolone.After treatment,the clinical parameters and effect of the two groups were com-pared.Results The total effective rate of the observation group was 85.7%,which was higher than 42.9% of the control group (χ2 =2.41,P <0.05).The improvement of muscle strength,restore micturition,walk on their own time in the observation group were (10.1 ±4.1)d,(7.1 ±3.4)d,(16.1 ±4.2)d,respectively,which were better than (23.4 ±7.3)d,(10.2 ±3.1)d,(22.6 ±7.3)d in the control group(t =3.15,1.69,1.97,all P <0.05).The total incidence of gastrointestinal reaction and complication rates of the observation group was 4.8%,which was lower than 19.0% of the control group (χ2 =6.37,P <0.05).Conclusion In treatment of patients with acute myelitis,methyl-prednisolone has good effect,which should be used in clinical practice.

A novel polymer- overoxidized polypyrrole film chemically modified electrode (CME) as the liquid chromatography-electrochemical detector (LC-ECD) was fabricated and applicated, which could be used to determine the monoamine neurotransmitters. The experimental model of parkinsonian animal was established by using medicine. Microdialysis sampling coupled with LC-ECD was used to monitor the monoamine neurotransmitters and their metabolites in experimental animal brain in vivo under different situations. The mechanism of experimental animal's Parkinsonian disease was studied elementarily. An accurate and reliable analysis method was supplied for filting the new and the more effective medicine to cure parkinsonian disease.

Objectives: To observe the effect of total enteral nutrition (TEN)and total parenteral nutrition (TPN)in aged patients with mechanical ventil ation. Methods: 60 cases of aged patients with mechanical ventilation were randomly divided to TEN group and TPN group.All patients accepted the same amount of calorie and nitrogen. Results: with regard to albumin and hemoglobin levels and nitrogen equilibrium TEN group was superior to parenteral nutrition group ( P 0.05). Conclusions: Enteral nutrition can reduce mechanical ventilation time and lower treatment cost in aged patients.

Objective To investigate the characteristics of cerebral vascular imaging and risk factors of stroke in popu?lation with family history of stroke in rural areas of Ji County, Tianjin. Methods The volunteers with family history of stroke were recruited in the study to undergo computed tomography and computed tomography angiography (CTA) of head as well as physical and laboratory examinations. A total of 281 subjects, including 153 male and 128 female, underwent exami?nation, and were divided into stroke group and non-stroke group. Results The detection rates were significantly higher in male subjects than those of female subjects, including smoking rate, drinking rate, educational level, and decreased level of high density lipoprotein cholesterol (HDL-C), whereas the detection rate of high level of triacylglycerol (TG) was significant?ly higher in female than that of male subjects (P<0.05). There were 38 subjects in stroke group. The age, internal carotid ar?tery calcification rate (ICAC) and internal carotid artery tortuosity (ICAT) rate were significantly higher in stroke group than those of non-stroke group (P<0.05) . The results of multivariate Logistic regression analysis indicated that age, hyperten?sion, ICAC, and ICAT were independent risk factors for stroke. Conclusion For population with family history of stroke, age, hypertension, ICAC and ICAT were risk factors of stroke.

Objective To observe distribution and morphological characteristics of symptomatic atherosclerotic plaques in the middle cerebral artery (MCA) using high?resolution magnetic resonance imaging (HR?MRI), and to investigate HR?MRI characteristics of atherosclerotic plaques in the MCA in patients with acute cerebral infarction. Methods A total of 57 symptomatic patients with MCA atherosclerotic plaques recruited in the Affiliated Hospital of Yangzhou University from January 2014 to January 2016 were imaged with diffusion weighted imaging (DWI), three dimensional time of flight magnetic resonance angiography (3D TOF?MRA) and HR?MRI scanning for plaque on a 3.0 T MRI scanner. According to the results of DWI examination, the 57 patients were divided into transient ischemic attack (TIA) group (27 cases) and acute cerebral infarction group (30 cases). The distribution of the narrowest lumen plaque was evaluated by cross?section division into four equal arcs (superior, inferior, ventral, dorsal arcs). For quantitative analysis, lumen area (LAMLN), vessel area (VAMLN) at maximal lumen narrow (MLN) and LAreference, VAreference were measured, then wall area (WA), plaque area (PA), percentage of plaque burden, rate of lumen stenosis and remodeling index (RI) were calculated. The data of each group were compared and analyzed. Results The location and morphological analysis of the 57 patients with symptomatic MCA atherosclerotic plaques revealed that plaques were located in the ventral wall in 19 cases (33.3%), the upper wall in 15 cases (26.3%), the dorsal wall in 10 cases (17.5%), and the lower wall in 13 cases (22.8%). For the location variations in ventral wall, upper wall, dorsal wall and lower wall, the TIA group was shown as six cases (22.2%), five cases (18.5%), seven cases (25.9%) and nine cases (33.3%), and the acute cerebral infarction group was shown as 13 cases (43.3%), 10 cases (33.3%), three cases (10.0%) and four cases (13.3%), respectively. There was no statistically significant difference in the distribution of each side wall between the two groups (P>0.05). VAreference, LAreference, VAMLN and RI of the TIA group and the acute cerebral infarction group were (19.89 ± 1.34) mm2, (15.19 ± 2.04) mm2, (20.78 ± 1.78) mm2, 1.09 ± 0.11 and (19.70 ± 1.34) mm2, (14.60 ± 2.33) mm2, (21.53 ± 2.34) mm2, 1.10 ± 0.11, respectively. There was no statistically significant difference between the two groups (P>0.05). The remodeling patterns of both groups were mainly positive remodeling, with a total of 44 cases (77.2%). In the TIA group and the acute cerebral infarction group, the WAMLN, PA, stenosis rate and plaque load percentages were (8.85±1.92) mm2, (4.00±3.00) mm2, 20.92%± 9.18%, 19.05% ± 14.93% and (11.10 ± 1.88) mm2, (6.00 ± 2.25) mm2, 28.56% ± 8.67%, 27.30% ± 7.69%, respectively. The differences between the two groups were statistically significant (t=-4.466, t=-2.865, t=-3.231, t=-2.580, P<0.01). There were eight patients (29.6%) with unsmooth plaque surface in the TIA group and 19 patients (63.3%) in the acute cerebral infarction group. The differences between the two groups were statistically significant (χ2=6.475, P<0.05). LAMLN in the TIA group and the acute cerebral infarction group was (11.93±1.59) mm2 and (10.43±2.08) mm2 respectively, and the difference between the two groups was statistically significant (t=3.033, P<0.01). Conclusions Symptomatic atherosclerotic plaques in MCA in the acute cerebral infarction group have higher plaque load, thicker vascular wall at the maximum stenosis and more unsmooth plaque surface. This indicates the characteristics of high?risk plaques to a certain extent.

Objective:To investigate the effects of noninvasive positive pressure ventilation combined with positive expiratory pressure device on pulmonary function, inflammatory factors and short-term prognosis in older adult patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD), which provide objective evidence for clinical treatment and prognosis evaluation of this disease.Methods:Eighty-three older adult patients with AECOPD who received treatment in Taizhou Central Hospital, China between January 2016 and December 2018 were included in this study. They were randomly assigned to undergo either noninvasive positive pressure ventilation (control group, n = 38) or noninvasive positive pressure ventilation combined with positive expiratory pressure device (study group, n = 45) for 7 days. Pulmonary function, blood gas indexes, inflammatory factor levels and curative effect were compared between the two groups. Results:After treatment, partial pressure of oxygen (PaO 2) and oxygenation index (PaO 2/FiO 2) in each group were significantly increased, and partial pressure of carbon dioxide (PaCO 2) was significantly decreased, compared with before treatment (all P < 0.05). The degree of improvement in PaO 2, PaCO 2 and PaO 2/FiO 2 in the study group was greater than that in the control group ( t = 2.261, 6.854, 2.040, all P < 0.05). The ratio of forced expiratory volume in the first second (FEV 1) to forced vital capacity (FEV 1/FVC), the ratio of FEV1 to predicted value (FEV 1/Pre), and the maximum voluntary ventilation (MVV) per minute in each group were significantly increased compared with before treatment. After treatment, the degree of increase in FEV 1/FVC, FEV 1/Pre, and MVV in the study group was greater than that in the control group ( t = 2.442, 2.120, 2.944, all P < 0.05). After treatment, serum levels of inerleukin-8, tumor necrosis factor-α, and high-sensitivity C-reactive protein in each group were significantly decreased compared with before treatment (all P < 0.05). After treatment, the degree of decrease in serum levels of inerleukin-8, tumor necrosis factor-α, and high-sensitivity C-reactive protein in the study group was significantly greater than that in the control group ( t =7.978, 10.857, 8.543, all P < 0.05). Length of hospital stay, duration of antibiotic use, chronic obstructive pulmonary disease assessment test score and St. George's Respiratory Questionnaire score in the study group were (7.52 ± 1.38) days, (7.14 ± 1.38) days, (18.95 ± 4.76) points, (1.73 ± 4.21) points, respectively, which were significantly shorter/lower than those in the control group [(8.55 ± 1.47) days, (8.25 ± 1.45) days, (8.07 ± 5.81) points, (55.97 ± 5.28) points, t = -2.510, -2.722, -7.943, -10.351, all P < 0.05]. Conclusion:Noninvasive positive pressure ventilation combined with positive expiratory pressure device can effectively improve the pulmonary function of older adult patients with AECOPD, decrease the level of inflammatory factors, and improve short-term prognosis. This study is highly innovative and scientific and is of significance for clinical promotion.

OBJECTIVETo compare the efficacy and safety of 5 mg perindopril arginine salt and 4 mg perindopril tert-butylamine salt for patients with mild to moderate essential hypertension.

METHODSThe study was designed as multicenter, randomized, double-blind, active controlled trial with two parallel groups enrolling 524 participants with mild to moderate essential hypertension. After 2-week run-in period, 186 patients were enrolled and randomly treated with 5 mg perindopril arginine salt and 183 patients were enrolled and randomly treated with 4 mg perindopril tert-butylamine salt. The random sequence was generated by the I.R.I.S., and a balance was made in each center. After double-blind treatment for 8 weeks, the dose could be doubled for patients with uncontrolled BP ((SBP) ≥ 140 mmHg (1 mmHg = 0.133 kPa) or diastolic blood pressure (DBP) ≥ 90 mmHg) and patients were treated for another 4 weeks.

RESULTSThe sitting SBP was similarly decreased by (19.9 ± 17.2) mmHg in perindopril arginine group and (18.5 ± 14.7) mmHg (P = 0.000 5) in perindopril tert-butylamine group post 8 weeks treatment. Dose was doubled in 109 patients (59.9%) in perindopril arginine group and 116 patients (63.7%) in perindopril tert-butylamine group. At 12 weeks post therapy, the sitting SBP decreased by (19.8 ± 16.2) and (19.6 ± 16.3) mmHg respectively in the 2 groups. The decrease of sitting DBP was also similar in both groups (-12.0 ± 10.0) mmHg and (-11.0 ± 8.9) mmHg (P < 0.000 1), respectively. The control rate or response rate was also similar between the two groups (control rate over 8 weeks was 38.5% vs. 31.3%, 95% CI (-2.6-16.9), control rate over 12 weeks was 36.3% vs. 35.7%, 95% CI (-9.3-10.4), response rate over 8 weeks was 64.3% vs. 63.2%, 95% CI (-8.8-11.0), response rate over 12 weeks was 65.9% vs. 64.8%, 95% CI (-8.7-10.9)). Incidence of adverse events was low and similar in both therapy groups.

CONCLUSIONSThe results show that perindopril arginine salt 5 mg is as efficient as perindopril tert-butylamine 4 mg on lowering BP for patients with mild to moderate essential hypertension. Both drugs have good safety profile and are well tolerated by patients in this cohort.

Antihypertensive Agents ; Arginine ; Blood Pressure ; Butylamines ; Double-Blind Method ; Essential Hypertension ; Humans ; Hypertension ; Perindopril ; Sodium Chloride

Objective: To assess the enhancement characteristics of plaques in patients with intracranial atherosclerotic stenosis using three-dimensional high-resolution magnetic resonance imaging (3D HR MRI), and to analyze the correlation between the enhancement characteristics of plaques and the time from onset of stroke symptoms to MRI examination. Methods: The enhancement characteristics of plaques were retrospectively analyzed in 61 patients with cerebral infarction who were scanned in MRI room of the Affiliated Hospital of Yangzhou University from January 2014 to January 2016. According to the elapsed time between symptom onset and MR examination, 61 patients were classified into early stage group (<4 weeks, n=26), middle stage group (4-12 weeks, n=20) and late stage group (>12 weeks, n=15). All cases underwent three-dimensional sampling perfection with application optimized contrast using different angle evolutions (3D-SPACE) T₁WI and enhanced 3D-SPACE T₁WI sequence scans, as well as routine head MRI examinations. The signal intensities of plaques before and after enhancement scanning were compared on the 3D-SPACE T₁WI sequence. The degrees of plaque enhancement were qualitatively analyzed, and the enhancement rates of plaques were quantitatively calculated. The correlation between the enhancement characteristics of plaques and time of symptom onset of stroke was analyzed. Results: Sixty-one intracranial atherosclerotic plaques on the 3D HR MRI showed eccentric thickening or annular thickening of the vessel wall, and slightly higher signals on the T₁WI. They showed different degrees of enhancement or no enhancement after enhancement scans. The characteristics of plaque enhancement in 61 patients with cerebral infarction were analyzed. The results showed that 26 plaques in the early stage group were obviously enhanced for 21 cases (80.8%), mildly enhanced for 4 cases (15.4%), no enhancement for 1 case (3.8%), and the enhancement rate was 80.49%±18.64%. Twenty plaques in the middle stage group were obviously enhanced for 2 cases (10.0%), mildly enhanced for 14 cases (70.0%), no enhancement for 4 cases (20.0%), and the enhancement rate was 52.09%±18.17%. Fifteen plaques in the late stage group were mildly enhanced for 2 cases (2/15), no enhancement for 13 cases (13/15), and the enhancement rate was 12.16%±10.44%. There were statistically significant differences in the degrees of plaque enhancement and plaque enhancement rates among the three groups (χ²=22.834, P<0.01; F=78.403, P<0.01). Further analysis showed that there was a statistically significant difference in the degree of enhancement and enhancement rate of plaques between the early stage group and the middle stage group (χ²=-4.177, P<0.01; t=5.179, P<0.01), and there was a statistically significant difference between the middle stage group and the late stage group (χ²=-2.484, P<0.05; t′=8.189, P<0.01), and the difference between the early stage group and the late stage group was also statistically significant (χ²=-3.796, P<0.01; t′=15.044, P<0.01). There was a significant negative correlation between the time from onset of stroke symptoms to MRI examination and the enhancement rate of plaques (r=-0.903, P<0.01). Conclusions Enhanced HR MRI scanning can clearly show the enhancement of intracranial atherosclerotic plaques. With the prolongation of the onset time interval, the enhancement of intracranial atherosclerotic plaques gradually weakens, which can assess the vulnerability of plaques and has important guiding significance for secondary prevention of ischemic stroke.

Objective: To observe distribution and morphological characteristics of symptomatic atherosclerotic plaques in the middle cerebral artery (MCA) using high-resolution magnetic resonance imaging (HR-MRI), and to investigate HR-MRI characteristics of atherosclerotic plaques in the MCA in patients with acute cerebral infarction. Methods: A total of 57 symptomatic patients with MCA atherosclerotic plaques recruited in the Affiliated Hospital of Yangzhou University from January 2014 to January 2016 were imaged with diffusion weighted imaging (DWI), three dimensional time of flight magnetic resonance angiography (3D TOF-MRA) and HR-MRI scanning for plaque on a 3.0 T MRI scanner. According to the results of DWI examination, the 57 patients were divided into transient ischemic attack (TIA) group (27 cases) and acute cerebral infarction group (30 cases). The distribution of the narrowest lumen plaque was evaluated by cross-section division into four equal arcs (superior, inferior, ventral, dorsal arcs). For quantitative analysis, lumen area (LA_MLN), vessel area (VA_MLN) at maximal lumen narrow (MLN) and LA_reference, VA_reference were measured, then wall area (WA), plaque area (PA), percentage of plaque burden, rate of lumen stenosis and remodeling index (RI) were calculated. The data of each group were compared and analyzed. Results: The location and morphological analysis of the 57 patients with symptomatic MCA atherosclerotic plaques revealed that plaques were located in the ventral wall in 19 cases (33.3%), the upper wall in 15 cases (26.3%), the dorsal wall in 10 cases (17.5%), and the lower wall in 13 cases (22.8%). For the location variations in ventral wall, upper wall, dorsal wall and lower wall, the TIA group was shown as six cases (22.2%), five cases (18.5%), seven cases (25.9%) and nine cases (33.3%), and the acute cerebral infarction group was shown as 13 cases (43.3%), 10 cases (33.3%), three cases (10.0%) and four cases (13.3%), respectively. There was no statistically significant difference in the distribution of each side wall between the two groups (P>0.05). VA_reference, LA_reference, VA_MLN and RI of the TIA group and the acute cerebral infarction group were (19.89±1.34) mm², (15.19±2.04) mm², (20.78±1.78) mm², 1.09±0.11 and (19.70±1.34) mm², (14.60±2.33) mm², (21.53±2.34) mm², 1.10±0.11, respectively. There was no statistically significant difference between the two groups (P>0.05). The remodeling patterns of both groups were mainly positive remodeling, with a total of 44 cases (77.2%). In the TIA group and the acute cerebral infarction group, the WA_MLN, PA, stenosis rate and plaque load percentages were (8.85±1.92) mm², (4.00±3.00) mm², 20.92%±9.18%, 19.05%±14.93% and (11.10±1.88) mm², (6.00±2.25) mm², 28.56%±8.67%, 27.30%±7.69%, respectively. The differences between the two groups were statistically significant (t=-4.466, t=-2.865, t=-3.231, t=-2.580, P<0.01). There were eight patients (29.6%) with unsmooth plaque surface in the TIA group and 19 patients (63.3%) in the acute cerebral infarction group. The differences between the two groups were statistically significant (χ²=6.475, P<0.05). LA_MLN in the TIA group and the acute cerebral infarction group was (11.93±1.59) mm² and (10.43±2.08) mm² respectively, and the difference between the two groups was statistically significant (t=3.033, P<0.01). Conclusions Symptomatic atherosclerotic plaques in MCA in the acute cerebral infarction group have higher plaque load, thicker vascular wall at the maximum stenosis and more unsmooth plaque surface. This indicates the characteristics of high-risk plaques to a certain extent.

The formation mechanisms of rare intracranial aneurysms are various, which lead to various kinds of treatment methods. The present article summarized the pathogenesis, pathologic changes in vascular walls and imaging features of rare intracranial aneurysms including segmental ectasia, aneurysms with dissection, aneurysms with intramural hemorrhage, mycotic aneurysms, aneurysms related to HIV, neoplastic aneurysms and traumatic aneurysms through literature review.
Diagnostic Imaging ; Dilatation, Pathologic ; Humans ; Intracranial Aneurysm ; diagnosis ; pathology ; therapy