Objective To explore the correlation of cognitive impairment and areas of middle cerebral artery (MCA) territory infarction.Methods The Montreal Cognitive Assessment (MoCA) was used to evaluate neuropsychological statuses in the patients who developed first-time acute cerebral infarction for 2 weeks. MoCA scores and sub-scores were recorded. 132 patients were selected with MCA occlusion,scores of MoCA were more than 15, and cognitive impairment in at least one domain, and then subgrouped by infarction site. The correlation between the results of neuropsychological cognitive assessment and the sites of infarction was analyzed. Results MCA occlusion was correlated with the impairments of visual spatial/executive, attention, language and memory (B=-1.875~-1.094, P<0.05). Infarction in frontal lobe was correlated with the impairments of visual spatial/executive, attention, abstract and memory (B=-1.760~-1.329, P<0.05),temporal lobe with visual spatial/executive and memory impairment (B=-1.849~-1.735, P<0.05), parietal lobe with visual spatial/executive, attention and memory impairment (B=-1.695~-1.482, P<0.05), basal ganglia with visual spatial/executive, attention, language and memory impairment (B=-1.932~-1.041, P<0.01). Conclusion The characteristics of impairment in cognitive function is different with infarction sites in MCA territory.

Objective To analyze the dynamic evolution of brain MRI in patients with mitochondrial myopathy,encephalopathy,lactic acidosis,and stroke-like episodes (MELAS) syndrome.Methods A retrospective study was performed on 58 MELAS cases with pathologically and (or) molecularly confirmed diagnosis.MRI were repeated within 60 days after the onset of stroke-like episodes (SLE) and the evolution changes of cerebral lesions were accessed.Brain atrophy index (BAI) was calculated in the remission stage from 31 patients with MELAS,and the correlation between BAI,age and disease duration was analyzed.Results The proportion of lesions expansion,migration and shrink within 30 days after the onset of SLE was 64.1％ (25/39),10.2％ (4/39),17.9％ (7/39),respectively,and 13％ (3/23),21.7％ (5/23),56.5％ (13/23),between 30-60 days after the onset of SLE respectively.In the recovery stage of SLE,the BAI in 31 patients with MELAS was 15.2％ ±2.8％.The correlation coefficient between BAI and the age,total disease course and duration of encephalopathy was 0.329 (P =0.043),0.405 (P =0.012) and 0.649 (P =0.000).Conclusions Brain atrophy in the studied MELAS patients gradually develops and strokelike lesions shrink with progression of the disease.However,the migration of lesions is persistent.

Objective To observe the time characteristics of acute aortic dissection (AAD) in Urumqi and its peripheral areas in Xinjiang Uygur autonomous region, and to explore the effect of meteorological conditions on the onset of AAD.Methods Retrospective analysis of the related data of the adult AAD patients diagnosed by imaging examination, and admitted to the First Affiliated Hospital of Xinjiang Medical University from March 2010 to July 2016 was performed. The onset time, the contemporaneous meteorological data, including daily minimum, average, and the highest temperature, daily average air pressure, daily average relative humidity, daily precipitation, daily average wind speed, daily maximum wind speed, and sunshine duration per day were collected. Analysis of concentrated distribution trend of the AAD onset was done by circular distribution statistics. Meteorological conditions were compared between the AAD day and no AAD day. The changes of air temperature 5 days before onset were observed.Results A total of 379 patients were enrolled, with 307 male and 72 female. The ratio of male to female was 4.19:1, the average age was 52.27±12.18; and the underlying diseases was hypertension (about 58.05%); the incidence sites were Urumqi and Changji city. ① The incidence of AAD in Urumqi and its peripheral areas had clear concentrated trend, and the peak period of AAD corresponded to January 1st to 2nd (homogeneity testr = 0.104,r0.05 = 0.009,P < 0.05). ② The minimum, mean and maximal atmospheric temperatures on the AAD day were lower than no AAD day [℃: 4.10 (-9.55, 14.60) vs. 7.75 (-6.70, 16.20), 14.10 (-1.50, 25.00) vs. 17.50 (0.60, 26.78), 8.50 (-6.22, 19.45) vs. 12.10 (-3.60, 20.90), allP < 0.05], sunshine duration was significantly shorter than no AAD day [hours: 8.50 (4.60, 10.70) vs. 8.90 (5.50, 11.50), P< 0.01], and atmospheric pressure were higher than no AAD day [kPa: 91.24 (90.66, 91.75) vs. 91.12 (90.62, 91.61), 19.11 (18.99, 19.22) vs. 19.09 (18.98, 19.19), bothP < 0.05]; there were no significant differences in the incidence of daytime temperature difference, average relative humidity, precipitation, average wind speed, and maximum wind speed between the two groups. ③ the peak period of AAD occurrence was December (38 cases), which was followed by January (36 cases); and there were 26 cases of each month in May, June, July, and September, which were lower than the rest of months. It was shown by the temperature distribution that the minimum average temperature was in January (-12.46 ℃), followed by December (-9.03 ℃); the maximum average temperature was in July [(24.59±3.21)℃], followed by August [(23.14±3.64)℃]. ④ The patients was sorted according to the quartile of daily mean temperature, into < -5.2 ℃, -5.2-10.7 ℃, 10.7-20.4 ℃, and > 20.4 ℃ groups, and each group had 104, 99, 98, 78 cases of AAD, respectively. The number of AAD in lowest temperature group was 1.33 times of the highest temperature group. In the 45-59 and 60-74 years, the number of AAD in lowest temperature group was higher than that in the highest temperature group (50 vs. 36, 26 vs. 13). In patients with hypertension, the number of AAD in lowest temperature group was higher than that in the highest temperature group (60 vs. 44). ⑤ The maximum air temperature, mean air temperature of the day from 5 days before to the onset day of AAD, and the lowest temperature from 3 days before to the onset day of AAD display slowly decrease trends, but there was no significant difference in daily temperature.Conclusions The incidence of AAD in Urumqi and its peripheral areas was concentrated from January 1st to 2nd of each year. When the temperature was lower than -5.2 ℃, AAD were more likely to attack. The 5 days changes of temperature and daily temperature before the attack were relevant with onset of AAD. It was speculated that the weather conditions such as air temperature may affect patient who has a past history of cardiovascular disease to attack AAD.

OBJECTIVETo prepare freeze-dried long-circulation oridonin liposomes with optimized parameters.

METHODSEthanol injection method followed by freeze-drying was used to prepare the liposomes. Sephadex column was used to purify liposomes. Effects of formulation factors on entrapment efficiency of long-circulation oridonin liposomes were studied. The particle size, distribution and in vitro release were determined. Pharmacokinetics of oridonin liposomes in rats was determined by HPLC and the pharmacokinetic parameters calculated by Kinetica(TM) software were compared with conventional oridonin liposomes and solution.

RESULTSThe optimized lipid formulation for long-circulation liposomes was composed of soy lecithin, cholesterol and DSPE-PEG 2000 with a ratio of 1:0.5:1.8(w/w). The ratio of drug to lipid was 1:6. Freeze-drying protectant was a mixture of glucose and mannitol (3:1). The entrapment efficiency (EE) of long-circulation oridonin liposomes was about 65%. The particle size of liposomes after hydrolyzation was 164 nm with good DPI. The liposomes showed a sustained drug release in vitro. Intravenous injected oridonin fitted with two-compartment pharmacokinetic model. The MRT of long-circulation liposomes was 2 times and 6 times and AUC was about 2 times and 3 times of conventional liposomes and oridonin solution, respectively.

CONCLUSIONFreeze-dried liposomes with high EE have been obtained by the proposed approach. This long-circulation liposomes extend oridonin half time and significantly increase AUC in rats.

Animals ; Delayed-Action Preparations ; Diterpenes, Kaurane ; administration & dosage ; pharmacokinetics ; Drug Stability ; Freeze Drying ; Liposomes ; administration & dosage ; pharmacokinetics ; Male ; Rats ; Rats, Sprague-Dawley ; Tissue Distribution

Objecflve To determine the prevalences of nutritional risk,undemutrition,overweight,and obesity as well as nutritional support and the changes of nutritional risks from admission to discharge or over a two-week period.Methods A consecutive sampling was performed.Dam were collected from general surgical depart-ments in three Beijing teaching hospitals from March to July in 2007.Patients were screened using Nutritional Risk Screening 2002(NRS2002)on admission and two weeks after admission(or discharge).The nutritional supper apphcation during hospital stay was recorded.NRS2002 score≥3 was classified as nutritional risk.BMI<1 8.5kg/m2 with impaired genend condition was defined as undemutrition.Results Among 300 enrolled patients,the NRS2002 WaS completed by 99.0%(297/300)of all patients.The nutritional risk and the prevalence of under_nutrition,overweight,and obesity was 30.0%,8.1%,38.3%,and 9.4%,respectively at admission.Fifty of 90(62.2%)patients who were at nutritional risk received nutritional support while 40 of 210(19.O%)non-risk patients received nutritional support.Especially among major abdominal surgery patients,56 of 90(71.6%)pa-tients who were at nutritional risk received nutritional supper while 35 of 81(43.2%)non-risk pafients received nutritional support.The prevalence of nutritional risk changed from 30.0%to 35.8%(X2=2.271,P=0.132).Conclusions NRS2002 is a feasible nutritional risk screening tool among general surgical pafienm in selected Bei-jing teaching hospitals.Nutritional support is somehow inappropriately apphed in general surgical hospitalized pa-tients.The prevalence of nutritional risk remains unchanged in general surgical patients during hospitalization.

Objective: To study the predictive value of combination scores of leukocyte and platelet counts (COL-P) for in-hospital mortality in patients with acute ST segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI) treatment. Methods: A total of 660 STEMI patients with emergent PCI in our hospital from 2009-11 to 2013-08 were retrospectively studied. The patients were divided into 3 groups according to COL-P scores: COL-P0 group,n=283, COL-P1 group,n=319 and COL-P3 group,n=58. The relationship between the in-hospital mortality and COL-P scores was analyzed among different groups. Results: There were 88/660 in-hospital death. The patients in death group had the higher white blood cell count and lower platelet count than those in survival group, bothP<0.01. Logistic regression analysis indicated that compared with COL-P0 group, the COL-P scores at COL-P1 level (OR 4.346, 95% CI 2.134-8.850,P<0.001) and COL-P2 level (OR 10.126, 95% CI 4.061-25.250,P<0.001) were the independent risk factors for in-hospital death in STEMI patients after emergent PCI. The in-hospital mortality in COL-P0, COL-P1 and COL-P2 groups were at 4.9%, 15.4% and 43.1% respectively, allP<0.001. Conclusion: COL-P score was useful for predicting the in-hospital mortality in STEMI patients after emergent PCI, while the long term mortality estimation should be further studied.

Objective To determine whether recombinant adeno-associated virus serotyoe 9 with CaMEK gene transfected on myocardial cells leads to reduce I/R-induced apoptosis.Methods Establish an ischemic/reperfusion(I/R) model of myocardial cells in vitro and the cells were divided into four experimental groups:(1) control group;(2) I/R group;(3) I/R+rAAV9-CBA-CaMEK group;(4) I/R+rAAV9-CBACaMEK+PD98059 group,respectively.The P-ERK1/2 and the Caspase-3,Bax were quqntitated by Western blot.Results These data clearly demonstrate that AAV9-mediated CaMEK gene transfected lead to active ERK1/2 and reduce I/R-induced apoptosis notablely.Conclusion rAAV9-mediated CaMEK gene transfected on myocardial cells can reduce I/R-induced apoptosis.

Objective:To identify the risk factors for postoperative acute kidney injury (AKI) in patients undergoing radical resection of malignant colorectal cancer.Methods:Patients undergoing radical resection of malignant colorectal cancer from November 1, 2019 to December 1, 2020, were selected, and the medical records including gender, age, height, weight, American Society of Anesthesiologists (ASA) physical status, complications (hypertension, diabetes mellitus, coronary heart disease, chronic kidney disease and renal insufficiency), neoadjuvant therapy before surgery, preoperative serum creatinine level (within 1-3 days before surgery), preoperative prophylactic ureteral intubation, operation methods, intraoperative blood loss and blood transfusion, intraoperative fluid infusion and urine output, intraoperative hypotension occurrence and duration, intraoperative prophylactic ileostomy, operation time, postoperative length of stay, postoperative complications (ileus, anastomotic leak/abdominal infection), postoperative antibiotics and nonsteroidal anti-inflammatory drugs use were retrospectively collected.Postoperative AKI was diagnosed based on Kidney Disease Improving Global Outcomes criteria.The patients were divided into AKI group and non-AKI group according to whether postoperative AKI occurred within 7 days after surgery, and the risk factors for postoperative AKI were screened by multivariate Poisson regression analysis.Results:A total of 543 patients were included in this study.There were 14 cases of postoperative AKI and the incidence was 2.6%.Poisson regression analysis showed that preoperative hypertension ( OR=5.04, 95% confidence interval 1.57-22.18, P=0.041) and postoperative use of vancomycin ( OR=8.87, 95% confidence interval 2.27-28.99, P=0.004) were the independent risk factors for postoperative AKI. Conclusion:Preoperative hypertension and postoperative use of vancomycin are the independent risk factors for postoperative AKI in patients undergoing radical resection of malignant colorectal cancer.

OBJECTIVE: To investigate the association of myocardial blood flow (MBF) quantified by dynamic computed tomography (CT) myocardial perfusion imaging (MPI) with troponin level and left ventricle (LV) function in patients with ST-segment elevated myocardial infarction (STEMI). MATERIALS AND METHODS: Thirty-five STEMI patients who successfully had undergone reperfusion treatment within 1 week of their infarction were consecutively enrolled. All patients were referred for dynamic CT-MPI. Serial high-sensitivity troponin T (hs-TnT) levels and left ventricular ejection fraction (LVEF) measured by echocardiography were recorded. Twenty-six patients with 427 segments were included for analysis. Various quantitative parameters derived from dynamic CT-MPI were analyzed to determine if there was a correlation between hs-TnT levels and LVEF on admission and again at the 6-month mark. RESULTS: The mean radiation dose for dynamic CT-MPI was 3.2 ± 1.1 mSv. Infarcted territories had significantly lower MBF (30.5 ± 7.4 mL/min/100 mL versus 73.4 ± 8.1 mL/min/100 mL, p < 0.001) and myocardial blood volume (MBV) (2.8 ± 0.9 mL/100 mL versus 4.2 ± 1.1 mL/100 mL, p = 0.044) compared with those of reference territories. MBF showed the best correlation with the level of peak hs-TnT (r = −0.682, p < 0.001), and MBV showed a moderate correlation with the level of peak hs-TnT (r = −0.437, p = 0.026); however, the other parameters did not show any significant correlation with hs-TnT levels. As for the association with LV function, only MBF was significantly correlated with LVEF at the time of admission (r = 0.469, p = 0.016) and at 6 months (r = 0.585, p = 0.001). CONCLUSION: MBF quantified by dynamic CT-MPI is significantly inversely correlated with the level of peak hs-TnT. In addition, patients with lower MBF tended to have impaired LV function at the time of their admission and at 6 months.
Blood Volume ; Echocardiography ; Heart Ventricles ; Humans ; Infarction ; Myocardial Infarction ; Myocardial Perfusion Imaging ; Reperfusion ; Stroke Volume ; Troponin T ; Troponin

Objective:To analyze the value of three-dimensional speckle tracking echocardiography (3D-STE) in evaluation of left ventricular diastolic function in elderly patients with heart failure (HF).Methods:130 elderly patients with heart failure (HF pEF) with preserved left ventricular ejection fraction in Gulou Hospital Affiliated to Medical College of Nanjing University from January 2018 to October 2019 were studied. All of them were examined by conventional ultrasound, 3D-STE and left-heart catheterization. Their cardiac three-dimensional full-volume dynamic images were collected and then analyzed with three-dimensional speckle tracking technique. The global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS), and global area strain (GAS) were measured. According to the detected left ventricular end diastolic pressure (LVEDP), the patients were divided into the normal left ventricular diastolic function group (LVEDP≤15 mmHg) and the left ventricular diastolic dysfunction group (LVEDP>15 mmHg). The GLS, GRS, GCS and GAS of the two groups were compared. Pearson correlation analysis was performed to analyze the correlation between GLS, GRS, GCS, GAS and LVEDP, and ROC curves were used to analyze efficiencies of GLS, GRS, GCS and GAS in prediction of left ventricular diastolic dysfunction.Results:The absolute values of GLS, GRS, GCS and GAS of the left ventricular diastolic dysfunction group were lower than those of the normal left ventricular diastolic function group ( P<0.05). The GLS, GCS and GAS were positively correlated with LVEDP ( P<0.05), while GRS was negatively correlated with LVEDP ( P<0.05). The AUC values of GLS, GRS, GCS and GAS for predicting left ventricular diastolic dysfunction were 0.667, 0.775, 0.762 and 0.840, respectively. The sensitivities were 79.17%, 72.22%, 69.44% and 80.56%, specificities were 48.28%, 70.69%, 82.76% and 77.59%, accuracy rates were 65.38%, 71.54%, 75.38% and 79.23%, respectively. Conclusions:The 3D-STE-related strain parameters GLS, GRS, GCS and GAS can be used as ultrasound indexes for assessment of left ventricular diastolic function in elderly patients with HF pEF, which is helpful for early detection of changes in left ventricular diastolic function in elderly patients with HF.