Objective To investigate the clinical effect and safety of compound glycyrrhizin combined with bozhi glycopeptide in treatment of erythema nodosum.Methods Sixty-four patients with erythema nodosum were divided into treatment group (36 cases) and control group (28 cases) by random digits table method.The patients in treatment group were given compound glycyrrhizin 120 mg,intravenous drip,once a day;and bozhi glycopeptide 4 ml,intravenous drip,once a day.The patients in control group were given compound glycyrrhizin 120 mg,intravenous drip,once a day.The clinical efficacy and recurrence were compared between 2 groups.Results The total effective rate in treatment group was significantly higher than that in control group [86.1％ (31/36) vs.57.1％ (16/28)],there was statistical difference (P ＜ 0.05).Follow-up for 3 months,the rate of recurrence in treatment group was significantly lower than that in control group [16.1％(5/31) vs.8/16],there was statistical difference (P＜ 0.05).Conclusion Compound glycyrrhizin combined with bozhi glycopeptide can effectively control the erythema nodosum,and has no significant adverse reactions,reduces the rate of recurrence,and it is worthy of promotion and application.

Objective:To investigate risk factors for decompressive craniectomy (DC) after endovascular therapy (EVT) in patients with acute anterior circulation ischemic stroke.Methods:Patients underwent EVT due to acute anterior circulation large vessel occlusion in Liaocheng Brain Hospital from January 2018 to January 2020 were retrospectively included. They were divided into DC group and non-DC group. Univariate and multivariate logistic regression analyses were used to determine risk factors for DC after EVT. Results:A total of 207 patients were enrolled, 126 were male (60.87%), and their age was 66.22±11.24 years old. The baseline National Institutes of Health Stroke Scale (NIHSS) score was 19.84±9.20, and the Alberta Stroke Program Early CT Score (ASPECTS) was 7.98±0.66. The immediate postoperative modified Treatment In Cerebral Ischemia (mTICI) blood flow grade in seven patients (5.80%) was ≤2a, 30 (14.49%) experienced hemorrhagic transformation (HT) after procedure, and 28 (13.5%) received DC. There were statistically significant differences between the DC group and the non-DC group in terms of past stroke history, preoperative NIHSS score and ASPECTS, vascular occlusion site, EVT time, immediate postoperative mTICI ≤2a, and HT (all P<0.05). Multivariate logistic regression analysis showed that atrial fibrillation (odds ratio [ OR] 3.202, 95% confidence interval [ CI] 1.335-9.796; P=0.011), previous stroke history ( OR 2.655, 95% CI 1.016-6.938; P=0.046), high preoperative NIHSS score ( OR 1.074, 95% CI 1.026-1.124; P=0.002), internal carotid artery occlusion ( OR 4.268, 95% CI 1.399-13.024; P=0.011), longer EVT time ( OR 1.010, 95% CI 1.003-1.016; P=0.003), mTICI grade ≤2a ( OR 5.342, 95% CI 1.565-18.227; P=0.007) and postoperative HT ( OR 3.036, 95% CI 1.024-9.004; P=0.045) were independent risk factors for DC. Conclusions:It is not uncommon for patients with acute anterior circulation ischemic stroke to need DC after EVT. Previous stroke history, atrial fibrillation, high baseline NIHSS score, internal carotid artery occlusion, prolonged blood EVT time, mTICI grade ≤2a and postoperative HT are independent predictors of needing DC after EVT.

The clinical and urodynamic data of 37 patients with benign prostate hyperplasia (BPH) and 30 diabetic patients complicated with BPH (BPH+DM) admitted between Jan 2014 and July 2017 were analyzed retrospectively. The International Prostate Symptom Score (IPSS), maximal flow rate (Qmax), post-voiding residual urine volume (PVR), maximum cystometric capacity (MCC), first desire to void (FDV), pressure of detrusor maximum (Pdet, max), bladder outlet obstruction index (BOOI), bladder contraction index (BCI) were compared between BPH group and BPH+DM group. According to BOOI-BCI linear regression, 22 cases (group A) and 15 cases (group B) of BPH patients were above and below the linear curve; while there were 14 cases (group C) and 16 cases(group D)of BPH+DM patients above and below the curve, respectively. The mean±SD FDV, MCC, Pdet, max, PVR, BOOI, BCI were (172.7±93.0)ml vs. (300.5±118.4)ml (P<0.05), (311.9±147.1)ml vs. (509.3±98.6)ml (P<0.05), (84.7±51.5)cmH2O(1 cm H2O=0.098 kPa) vs. (49.7± 32.9)cmH2O vs (P<0.05), 10.0 ml(0—200 ml) vs. 41.5 ml(0—450 ml), 69.7 ± 53.7 vs. 35.9 ± 32.3 (P<0.05), 122.3±50.2 vs 84.2±43.3 (P<0.05) in BPH and BPH+DM groups, respectively. In BPH group and BPH+DM group, the regression coefficients of BOOI-BCI were 0.889 and 0.724, respectively. In group A and group B, the difference value of IPSS and Qmax pre and post operation were 7.6±3.5 and 7.3±4.1 (P>0.05), (2.6±1.1)ml/s and (3.7±1.3) ml/s (P<0.05), respectively. In group C and group D, the difference value of IPSS and Qmax pre and post operation were 5.3 ± 2.4 and 6.0 ± 3.3 (P>0.05), (2.4 ± 1.0)ml/s and (3.8 ± 1.4)ml/s (P<0.05), respectively. The study indicates that the therapeutic effect is better for the patients blow BOOI-BCI regression linear curve compared to the patients above the linear curve.

OBJECTIVETo review the influencing factors of the early complication after carotid endarterectomy (CEA).

METHODSRetrospective analysis of clinical data of 509 cases received CEA in Xuan Wu Hospital of Capital Medical University, Liaocheng People's Hospital and Dalian Central Hospital from January 2001 to December 2011. There are 422 male patients and 72 female patients among the 494 patients, 15 patients underwent CEA by stages. The patients were between 35-84 years old,and the mean age was (64 ± 9) years. The complications within 30 days after CEA were analyzed, and find the risk factors for the major adverse events. Chi-square analysis was performed to analyze the correlation between the each variable of the basic characteristics of population, clinical features and intraoperative data and early adverse events after CEA. Logistic regression analysis was used to assess the relationship between a variety of factors and the postoperative complications within 30 days.

RESULTSTechnical complete rate of 98.6%, 7 cases of near-total occlusion patients could not been recanalized. Major complications in 30 days after CEA occurred in 20 cases (3.9%), including 6 cases of deaths (1.2%), 9 cases of cerebral infarction (1.8%) and 5 cases of cerebral hemorrhage (1.0%). Secondary complications occurred in 120 cases (23.6%). Univariate analysis showed modified Rankin scale (mRS) ≥ 3 on the incidence of early postoperative complication had significantly difference (χ² =20.517, P < 0.01), multivariate logistic regression analysis revealed that smoking (OR=2.667, 95% CI: 1.048-6.791, P=0.040) and mRS ≥ 3 (OR=8.690, 95% CI: 3.279-23.031, P=0.000) were the significant predictors of 30 days of the end event.

CONCLUSIONThe complications after CEA are uncommon, the security is proved. Smoking and mRS ≥ 3 can increase the risk of CEA.

Adult ; Aged ; Aged, 80 and over ; Cerebral Hemorrhage ; complications ; Cerebral Infarction ; complications ; Endarterectomy, Carotid ; adverse effects ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Postoperative Complications ; Retrospective Studies ; Risk Factors ; Smoking ; Time Factors ; Treatment Outcome

Objective:To analyze the clinical characteristics and diagnosis and treatment experiences of Langerhans cell histocytosis (LCH) in skull.Methods:Sixteen patients with cranial LCH admitted to our hospital from January 2015 to December 2019 were chosen in our study. Their clinical data, diagnosis and treatment procedures and prognoses were retrospectively analyzed.Results:Among the 16 patients, there were 13 males and 3 females, aged from 1 to 31 years. The clinical manifestations included space-occupying lesions of the skull; and imaging showed bone destruction of the skull, with or without involvement of other bones or organs. All patients were pathologically confirmed to have LCH after surgical total resection of the lesions. Routine whole-body bone scanning was performed after surgery: one was found to have local abnormal metabolic activity and received local radiotherapy; 8 were combined with other bone or organ involvement, and received chemotherapy. All the patients were followed up for 1-5 years, and no recurrence was found, and no one died.Conclusion:Good prognosis can be achieved in cranial LCH patients accepted resection by giving additional treatment according to the results of postoperative reexamination and combination use of standardized radiotherapy and chemotherapy.

Objective:To explores the clinical efficacy and safety of carotid endarterectomy in patients with high bifurcation carotid artery stenosis.Methods:A total of 169 patients with carotid artery stenosis (147 patients with non-high bifurcation carotid artery stenosis and 22 patients with high bifurcation carotid artery stenosis), underwent carotid endarterectomy under surgical microscope in our hospital from January 2017 to January 2020, were included in the study. Patients with high bifurcation carotid artery stenosis were operated by cutting off the posterior abdomen of the digastric muscle to assist in exposing the distal end of the internal carotid artery plaque. Cervical CTA/DSA examination was performed within one week of surgery to confirm whether carotid artery stenosis was relieved; ultrasound examination of cervical vessels was performed 6 months and 1 year after surgery to determine whether restenosis was appeared in the carotid artery. The surgical efficacy, perioperative complications and re-examination results were compared between the two groups.Results:Postoperative carotid artery stenosis was relieved in both groups. The proportions of new cerebral infarction and temporary neurological impairment between the two groups (4.5% vs. 2.0%; 9.1% vs. 3.4%) showed no significant differences ( P>0.05). Carotid artery restenosis was not found in both groups. There was no obvious functional abnormality in the digastric muscles of patients with high bifurcation carotid stenosis. Conclusion:Cutting off the posterior abdomen of the digastric muscle during carotid endarterectomy can better expose the distal end of the internal carotid plaque in patients with high bifurcation carotid stenosis, and provide convenience for effective relief of carotid artery stenosis with high safety.

Endogenously eliminating the hematoma is a favorable strategy in addressing intracerebral hemorrhage (ICH). This study sought to determine the role of retinoid X receptor-α (RXR-α) in the context of hematoma absorption after ICH. Our results showed that pharmacologically activating RXR-α with bexarotene significantly accelerated hematoma clearance and alleviated neurological dysfunction after ICH. RXR-α was expressed in microglia/macrophages, neurons, and astrocytes. Mechanistically, bexarotene promoted the nuclear translocation of RXR-α and PPAR-γ, as well as reducing neuroinflammation by modulating microglia/macrophage reprograming from the M1 into the M2 phenotype. Furthermore, all the beneficial effects of RXR-α in ICH were reversed by the PPAR-γ inhibitor GW9662. In conclusion, the pharmacological activation of RXR-α confers robust neuroprotection against ICH by accelerating hematoma clearance and repolarizing microglia/macrophages towards the M2 phenotype through PPAR-γ-related mechanisms. Our data support the notion that RXR-α might be a promising therapeutic target for ICH.

Endogenously eliminating the hematoma is a favorable strategy in addressing intracerebral hemorrhage (ICH). This study sought to determine the role of retinoid X receptor-α (RXR-α) in the context of hematoma absorption after ICH. Our results showed that pharmacologically activating RXR-α with bexarotene significantly accelerated hematoma clearance and alleviated neurological dysfunction after ICH. RXR-α was expressed in microglia/macrophages, neurons, and astrocytes. Mechanistically, bexarotene promoted the nuclear translocation of RXR-α and PPAR-γ, as well as reducing neuroinflammation by modulating microglia/macrophage reprograming from the M1 into the M2 phenotype. Furthermore, all the beneficial effects of RXR-α in ICH were reversed by the PPAR-γ inhibitor GW9662. In conclusion, the pharmacological activation of RXR-α confers robust neuroprotection against ICH by accelerating hematoma clearance and repolarizing microglia/macrophages towards the M2 phenotype through PPAR-γ-related mechanisms. Our data support the notion that RXR-α might be a promising therapeutic target for ICH.
Anilides/pharmacology* ; Cerebral Hemorrhage/drug therapy* ; Hematoma/drug therapy* ; Humans ; Macrophages ; Microglia ; Neuroprotection ; PPAR gamma ; Retinoid X Receptor alpha