1.Predictive factors of short-term poor outcome in patients with cerebral venous sinus thrombosis: a retrospective case series study
Qingyan ZHANG ; Lixin YIN ; Tuerxun TUERHONG ; Aisha MAIMAITILI ; Shaoshan LI ; Weimin LI ; Shabier TUERXUN
International Journal of Cerebrovascular Diseases 2014;22(1):44-48
Objective To investigate the predictive factors of short-term poor outcome in patients with cerebral venous sinus thrombosis (CVST).Methods The clinical data of 42 consecutive inpatients with CVST were analyzed retrospectively.The clinical outcomes were assessed with the modified Rankin scale (mRS) at discharge.The patients were divided into either a good outcome group (mRS 0 to 2) or a poor outcome group (mRS 3 to 6).The related factors,such as demographic,etiology,and clinical features were compared between the two groups,Multivariate logistic regression analysis was used to determine the independent predictive factors for short-term poor outcome in patients with CVST.Results A total of 42 patients with CVST were enrolled,29 of them (69.05%) had good outcome and 13 (30.95%) had poor outcome.The proportions of central nervous system infections (20.69% vs.61.54% ; x2 =6.740,P =0.009),cancer (6.90% vs.38.46% ;x2 =6.439,P =0.011),pregnancy,postpartum,oral contraceptives or hormone replacement therapy (6.90% vs.38.46% ; x2 =6.439,P =0.011),and high homocysteine hyperlipidemia (27.59% vs.76.92% ;x2 =8.922,P =0.003),as well as the baseline D-dimer levels (730 ± 240 ng/ml vs.1 060 ± 250 ng/ml; t =4.485,P =0.000) in patients of the good outcome group were significantly lower than those of the poor outcome group.There was significant difference in treatment modalities (x2 =11.274,P =0.004) with the poor outcome group.The proportions of patients in anticoagulants,thrombolysis and anticoagulants + thrombolysis were 13.79%,24.14%,and 62.07%,respectively,in the good outcome group,while those were 61.54%,23.08%,and 15.39%,respectively,in the poor outcome group.Multivariate logistic regression analysis showed that the baseline D-dimer level >990 ng/mL was an independent predictive factor for short-term poor outcome in patients with CVST (odds ratio [OR] 1.006,95% confidence interval [CI] 1.002-1.011; P=0.005).Anticoagulants + thrombolytic therapy was an independent protective factor for short-term poor outcome in patients with CVST (OR 0.027,95% CI 0.002-0.447; P=0.033).The ROC curve analysis showed that when the cutoff value of the baseline D-dimer was 990 ng/ml,the sensitivity and specificity of predicting short-term poor outcome of CVST were 76.9% and 86.2% respectively.Conclusions The level of baseline D-dimer >990 ng/ml is an independent predictive factor for short-term poor outcomes in patients with CVST.The effect of anticoagulants in combination with thrombolytic therapy is best in patients with CVST.
2.Association between MMP-9 gene rs20544 polymorphism and hemorrhagic transformation in patients with acute ischemic stroke
Yanwei HOU ; Zaiyu GUO ; Tuerxun TUERHONG ; Heliang ZHANG ; Wei ZHAO
International Journal of Cerebrovascular Diseases 2019;27(7):497-502
Objective To investigate the association between matrix metalloproteinase (MMP)-9 gene rs20544 polymorphism and hemorrhagic transformation (HT) in patients with acute ischemic stroke (AIS). Methods Patients with AIS admitted to the Department of Neurology, TEDA Hospital from March 2016 to September 2018 were enrolled. They were divided into HT group and non-HT group depending on whether HT occurred. HT was defined as no bleeding found in the first imaging examination, and the head CT rescaning indicated a high-density lesion in the low-density area. MMP-9 gene rs20544 single nucleotide polymorphism was determined by TaqMan ? SNP genotype analysis kit. Multivariate logistic regression analysis was used to determine the independent association between rs20544 polymorphism and HT. Results A total of 204 patients with AIS were enrolled, aged 66.91 ± 9.07 years, 89 males (43.63% ), and 45 (22.06% ) developed HT. There were significant differences in atrial fibrillation, diabetes, fasting blood glucose, and triglyceride between the HT group and the non-HT group (all P<0.05). There was also a significant difference in rs2054 genotype distribution between the HT group and the non-HT group (χ2 =7.067; P=0.029 ). Multivariate logistic regression analysis showed that after adjusting atrial fibrillation, diabetes, fasting blood glucose, triglyceride, and hyperlipidemia, rs20544 CC genotype (odds ratio 2.074, 95% confidence interval 1.368-4.041) and CT genotype (odds ratio 1.571, 95% confidence interval 1.109-2.544) were the independent risk factors for HT. Conclusion MRP-9 gene rs20544 single nucleotide polymorphism is associated with increased susceptibility to HT in patients with AIS.
3.Predictors of hemorrhagic transformations after endovascular mechanical thrombectomy in patients with acute ischemic stroke
Yanwei HOU ; Zaiyu GUO ; Tuerxun TUERHONG ; Heliang ZHANG ; Wei ZHAO
International Journal of Cerebrovascular Diseases 2019;27(1):1-5
Objective To analyze the independent risk factors for hemorrhagic transformation (HT)after endovascular mechanical thrombectomy in patients with acute ischemic stroke (AIS).Methods From March 2015 to February 2018,patients with AIS treated with mechanical thrombectomy at the Department of Neurology,TEDA Hospital were selected.The patients with hemorrhagic infarction (HI) or parenchymal hematoma (PH) were used as the case group,and those without HT were used as the control group.The independent risk factors for HI or PH after mechanical thrombectomy in patients with AIS were determined by multivariate logistic regression analysis.Results A total of 132 patients with AIS were enrolled in the study,and 60 (45.4%) developed HT,of which 37 were HI (28.03%) and 23 were PH (17.42%).Multivariate logistic regression analysis showed that after adjusting for gender,alcohol consumption,fasting blood glucose and glycated hemoglobin,diabetes (odds ratio [OR] 3.485,95% confidence interval[CI]l.121-6.928;P=0.019),atrial fibrillation (OR 3.962,95% CI 1.143-7.514;P =0.007) and high fasting blood glucose (OR 3.254,95% CI 1.107-6.549;P =0.036) were the independent risk factors for HI after mechanical thrombectomy in patients with AIS;after adjusting for gender,hyperlipidemia and glycosylated hemoglobin,diabetes (OR 3.348,95% CI 1.120-6.709;P =0.025) and high fasting blood glucose (OR 3.172,95% CI 1.129-7.023;P =0.014) were the independent risk factors for PH after mechanical thrombectomy in patients with AIS.Conclusion Diabetes,atrial fibrillation and high fasting blood glucose were the independent risk factors for HT after mechanical thrombectomy in patients with AIS.
4. Progress in the treatment of lower extremity arteriosclerosis obliterans with intracavitary volume reduction
International Journal of Surgery 2019;46(11):784-787
Arteriosclerosis obliterans(ASO) of lower limbs is a common vascular disease in clinic. The main treatment methods of ASO include medical treatment, surgical treatment and endovascular treatment. Endovascular therapy has been widely used in clinical treatment because of its small trauma and rapid recovery. Endovascular therapy includes percutaneous transluminal angioplasty and intraluminal volume reduction. Intravascular volume reduction has become the focus of the development of endovascular therapy. It is a prerequisite for the treatment of ASO to master various intraluminal therapy methods. This article focuses on the progress of intracavitary volume reduction therapy in ASO.
5.Clinical Research Guidelines for Treatment of Shingles with New Uyghur Medicine (Draft)
Abudukelimu ABUDUWAILI ; Aibai SILAFU ; Pingshan WANG ; Wufuer TUERXUN ; Maitinuer YUSUFU ; Wusiman MUHAMAITI ; Hong ZHANG ; Aximu TUERHONG ; Saimaiti REFUHATI ; Liansheng BAI ; Jinfeng LI ; Abuduaini ABUDUJILILI ; Zhijian LI ; Gongshu LI ; Binglin LIU ; Xiaojing PEI ; Bei ZHOU
Chinese Journal of Information on Traditional Chinese Medicine 2017;24(1):1-4
This research conducted retrospective multi-center study on medical records of Uyghur Medicine diagnosis and treatment program of shingles, and collected information about demography, diagnostics, and therapeutics, efficacy evaluation and nursing to conclude and analyze the main syndromes and sub-disease performance. Shingles was divided into 3 types in Uyghur Medicine field: abnormal blood type shingles, abnormal bile liquid type shingles, and abnormal black choledochal typeshingles. Uighur Medicine syndrome type standards of shingles were established. Rash suspended time, rash dry scab time, the pain start to ease time interval, time completely pain, pain bounce rate, the incidence of postherpetic neuralgia, and PHN recovery time were evaluated. Disease and syndrome clinical criteria of shingles were established by evaluating Uygur Medical symptoms improvement, improvement of patients’ life quality and the changes in patients’ internal environment. On this basis, in accordance with the technical requirements of the national medicine review, the research developed clinical research guidelines for the treatment of shingles with new Uyghur Medicine (draft).
6.Clinical Research Guidelines for Treatment of Acne Vulgaris with New Uyghur Medicine ;(Draft)
Abudukelimu ABUDUWAILI ; Aibai SILAFU ; Pingshan WANG ; Wufuer TUERXUN ; Maitinuer YUSUFU ; Wusiman MUHAMAITI ; Hong ZHANG ; Aximu TUERHONG ; Liansheng BAI ; Jinfeng LI ; Maihemute GUHAER ; Abuduaini ABUDUJILILI ; Zhijian LI ; Gongshu LI ; Binglin LIU ; Xiaojing PEI ; Bei ZHOU
Chinese Journal of Information on Traditional Chinese Medicine 2017;24(2):1-4
In this article, retrospective multi-center study on medical records of Uyghur Medicine diagnosis and treatment program of acne vulgaris was done and demographic, diagnostic, therapeutic, efficacy evaluation and nursing data and other information were collated and analyzed. The main and secondary disease manifestations of acne vulgaris were analyzed inductively and acne vulgaris was divided into 3 types in Uyghur Medicine field, which are blood-type acne vulgaris, yellow bile-type acne vulgaris, and astringent mucus-type acne vulgaris. Uyghur Medicine syndrome type standards of acne vulgaris were established. At the same time, through evaluating skin integrity and morphology of lesions as well as changes in patients’ symptoms and quality of life and observing changes in patients’ internal environment respectively before and after treatment, disease and syndrome clinical criteria of acne vulgaris were established. On this basis, in accordance with the technical requirements of the national medicine review, this study developed clinical research guidelines for the treatment of acne vulgaris with new Uyghur Medicine.
7.Correlation between four limbs perfusion index and lactic acid in patients with severe neurological diseases.
Wen GUO ; Long MA ; Tuerxun TUERHONG ; Xiaopeng LI ; Bo LIU ; Zhiyi XIE ; Xiangyou YU
Chinese Critical Care Medicine 2023;35(5):509-512
OBJECTIVE:
To observe the correlation between the four limbs perfusion index (PI) and blood lactic acid in patients with neurosis, and evaluate the predictive value of PI on microcirculation perfusion metabolic disorder in patients with neurosis.
METHODS:
A prospective observational study was conducted. Adult patients admitted to the department of neurological intensive care unit (NICU) of the First Affiliated Hospital of Xinjiang Medical University from July 1 to August 20 in 2020 were enrolled. Under the condition of indoor temperature controlled at 25 centigrade, all patients were placed in the supine position, and the blood pressure, heart rate, PI of both fingers and thumb toes and arterial blood lactic acid were measured within 24 hours and 24-48 hours after NICU. The difference of four limbs PI at different time periods and its correlation with lactic acid were compared. Receiver operator characteristic curve (ROC curve) was used to evaluate the predictive value of four limbs PI on patients with microcirculatory perfusion metabolic disorder.
RESULTS:
A total of 44 patients with neurosis were enrolled, including 28 males and 16 females; average age (61.2±16.5) years old. There were no significant differences in PI of the left index finger and the right index finger [2.57 (1.44, 4.79) vs. 2.70 (1.25, 5.33)], PI of the left toe and the right toe [2.09 (0.85, 4.76) vs. 1.88 (0.74, 4.32)] within 24 hours after entering the NICU, and the PI of the left index finger and the right index finger [3.17 (1.49, 5.07) vs. 3.14 (1.33, 5.36)], PI of the left toe and the right toe [2.07 (0.75, 5.20) vs. 2.07 (0.68, 4.67)] at 24-48 hours after NICU admission (all P > 0.05). However, compared to the PI of the upper and lower limbs on the same side, except for the 24-48 hours after ICU of the PI difference between the left index finger and the left toe (P > 0.05), the PI of the toe was lower than that of the index finger at the other time periods (all P < 0.05). The correlation analysis showed that the PI value of four limbs of patients in both time periods were significantly negatively correlated with arterial blood lactic acid (the r values of the left index finger, the right index finger, the left toe and the right toe were -0.549, -0.482, -0.392 and -0.343 respectively within 24 hours after entering the NICU; the r values of the left index finger, the right index finger, the left toe and the right toe were -0.331, -0.292, -0.402 and -0.442 respectively after entering the NICU 24-48 hours, all P < 0.05). Taking lactic acid ≥ 2 mmol/L as the diagnostic standard for metabolic disorder of microcirculation perfusion (total 27 times, accounting for 30.7%). The efficacy of four limbs PI in predicting microcirculation perfusion metabolic disorder were compared. ROC curve analysis showed that the area under the curve (AUC) and 95% confidence interval (95%CI) of left index finger, right index finger, left toe and right toe predicting microcirculation perfusion metabolic disorder were 0.729 (0.609-0.850), 0.767 (0.662-0.871), 0.722 (0.609-0.835), 0.718 (0.593-0.842), respectively. There was no significant difference in AUC compare with each other (all P > 0.05). The cut-off value of PI of right index finger for predicting microcirculation perfusion metabolic disorder was 2.46, the sensitivity was 70.4%, the specificity was 75.4%, the positive likelihood ratio was 2.86, and the negative likelihood ratio was 0.30.
CONCLUSIONS
There are no significant differences in PI of bilateral index fingers, bilateral toes in patients with neurosis. However, unilateral upper and lower limbs showed lower PI in the toe than in the index finger. There is a significantly negatively correlation between PI and arterial blood lactic acid in all four limbs. PI can predict the metabolic disorder of microcirculation perfusion, and its cut-off value is 2.46.
Adult
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Female
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Male
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Humans
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Middle Aged
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Aged
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Lactic Acid
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Microcirculation
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Perfusion Index
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Lower Extremity
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Area Under Curve
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Nervous System Diseases