Objective To explore the changes of the levels of Interleukin-6 (IL-6), tumor necrosis factor a (TNF-α) and c-reactive protein (CRP) after carotid artery stenting (CAS) and their relation to restenosis in patients with transient ischemic attack. Methods The patients were divided into group A (with 1 stenting and 1 lesion, n=38) and group B (with 2 stenting and 2 lesions, n=29) according to the pathologic changes and complicated degrees of CAS, and all the patients were divided into restenosis group (n=14) and non-restenosis group (n=48) according to the examination results of cervical CTA 1 y after CAS. The levels of EL-6, TNF-α and CRP were measured before CAS and 1 h, 2 w, 1 and 6 mon, and 1 y after stents. The level of CRP was measured by enhanced immunoturbidirnetic assay, and the levels of IL-6 and TNF-a were measured by radioimmunoassay. Results to the follow-up survey, 1 died and 4 were lost. Fourteen had restenosis of different degrees. The restenosis rate more than 50 percent was noted in 3 patients. Compared to those before CAS, the levels of CRP, IL-6 and TNF-α were increased rapidly after CAS (P<0.05). Compared to those in the group A, the levels of CRP, IL-6 and TNF-α in the group B 1 h, 2 w and 6 mon after CAS were obviously increased (P<0.05). Compared to those in the non-restenosis group, the levels of CRP, IL-6 and TNF-α in the restenosis group 1 h, 2 w and 6 mon after CAS were obviously increased (P<0.05). Conclusion The levels of IL-6, TNF-α and CRP increased rapidly after CAS, then reduced gradually and increased once again 6 months after CAS, which was notable in restenosis group. They can be the reference indexes of the forecast for early restenosis.

Objective To explore the changes of levels of von willebrand (vWF) and endothelin-1 (ET-1) and their relations with restenosis in patients performed carotid artery stenting (CAS).Methods The levels of vWF and ET-1 in 67 patients were measured before CAS and 1 h, 2 w, 1 and 6months, and 1 y after the stenting. All the patients were divided into restenosis group and non-restenosis group according to the examining results of cervical CTA 1 y after CAS. Results In the follow-up survey, 1 patient was died and 4 were out of touch. Fourteen patients had restenosis of different degrees;the restenosis rates of 3 patients was more than 50 percent. The level of vWF 1 h and 6 months after CAS and the level of ET-1 1 h, 2 w and 6 months after CAS were increased rapidly as compared with those before CAS (P<0.05). As compared with those in the on-restenosis group, the level of vWF 1 h, 2 w and 6 months after CAS and the level of ET-1 1 h, 2 w, 1 and 6 months after CAS in the restenosis group were obviously increased (P<0.05). Conclusion The levels of vWF and ET-1 increase continually in a short term (within 2 weeks) after CAS, and increase once again 6 months after CAS which increases the risk of restenosis.Monitoring the levels of vWF and ET-1 may be of great value in judging long-term prognosis.

Objective To evaluate the effects of artery-interventional therapy and drug treatment on patients with symptomatic carotid artery total occlusion,and observe the follow-up results of cerebrovascular events after clinical interference.Methods According to patient′s intention,62patients with symptomatic carotid artery total occlusion,admitted to our hospitals from February 2004 to January 2009,were divided into artery-interventional therapy group(n=21)and drug treatment group (n=41).In the artery-interventional therapy group,patients were given revascularization of internal carotid by endovascular intervention.In the drug treatment group,patients were given aspirin,clopidogrel and statins.The major end-point outcome of follow-up survey was the 2-year functional prognosis evaluated by modified Rankin Scale(mRS),and Rank sum test was employed to compare the differences of mean rank of the 2 groups; the minor end-point outcome was the cardiovascular events,and Kaplan-Meier method and multivariate Cox regression were employed to analyze the median time and independent risk factors.Results During the 3,6 and 9 months,1 and 2 years of follow-up,mRS average ranks in the artery-interventional therapy group were statistically lower than those in the drug treatment group(P＜0.05).The median times of recurrence of cardio-cerebrovascular events in the artery-interventional therapy group and drug treatment group were(17.42±1.20)months(95％CI:15.07-19.76)and(19.43±1.51)months(95％CI:16.48-22.38),respectively,and Kaplan-Meier analysis showed no significant difference(P＞0.05).Survival Cox regression analysis showed that independent factors of cardio-cerebrovascular events were smoking(RR=3.189,95％CI:1.020-9.968,P=0.046),diabetes(RR=2.717,95％CI:1.113-6.631,P=0.028),and baseline NIHSS scores(RR=2.984,95％CI:1.049-8.485,P=0.040),but treatment methods(artery-interventional therapy and drug treatment)were not independent factors(RR=1.191,95％CI:0.430-3.296,P=0.737).Conclusion Artery-interventional therapy is superior to drug therapy in achieving better functional prognosis; however,the 2-year-follow-up shows that the artery-interventional therapy can not reduce the occurrence of cardio-eerebrovascular events.Smoking,diabetes and baseline NIHSS scores are independent factors of recurrence of cardio-cerebrovascular events.

Anti-Arrhythmia Agents ; Brugada Syndrome/complications* ; Bundle-Branch Block/complications* ; Electrocardiography ; Humans ; Quinidine ; Ventricular Fibrillation

Objective:To compare the differences in the prevalence of mild micro-hepatic encephalopathy (MHE) among patients with cirrhosis by using the psychometric hepatic encephalopathy score (PHES) and the Stroop smartphone application (Encephal App) test.Methods:This prospective, multi-center, real-world study was initiated by the National Clinical Medical Research Center for Infectious Diseases and the Portal Hypertension Alliance and registered with International ClinicalTrials.gov (NCT05140837). 354 cases of cirrhosis were enrolled in 19 hospitals across the country. PHES (including digital connection tests A and B, digital symbol tests, trajectory drawing tests, and serial management tests) and the Stroop test were conducted in all of them. PHES was differentiated using standard diagnostic criteria established by the two studies in China and South Korea. The Stroop test was evaluated based on the criteria of the research and development team. The impact of different diagnostic standards or methods on the incidence of MHE in patients with cirrhosis was analyzed. Data between groups were differentiated using the t-test, Mann-Whitney U test, and χ2 test. A kappa test was used to compare the consistency between groups. Results:After PHES, the prevalence of MHE among 354 cases of cirrhosis was 78.53% and 15.25%, respectively, based on Chinese research standards and Korean research normal value standards. However, the prevalence of MHE was 56.78% based on the Stroop test, and the differences in pairwise comparisons among the three groups were statistically significant (kappa = -0.064, P < 0.001). Stratified analysis revealed that the MHE prevalence in three groups of patients with Child-Pugh classes A, B, and C was 74.14%, 83.33%, and 88.24%, respectively, according to the normal value standards of Chinese researchers, while the MHE prevalence rates in three groups of patients with Child-Pugh classes A, B, and C were 8.29%, 23.53%, and 38.24%, respectively, according to the normal value standards of Korean researchers. Furthermore, the prevalence rates of MHE in the three groups of patients with Child-Pugh grades A, B, and C were 52.68%, 58.82%, and 73.53%, respectively, according to the Stroop test standard. However, among the results of each diagnostic standard, the prevalence of MHE showed an increasing trend with an increasing Child-Pugh grade. Further comparison demonstrated that the scores obtained by the number connection test A and the number symbol test were consistent according to the normal value standards of the two studies in China and South Korea ( Z = -0.982, -1.702; P = 0.326, 0.089), while the other three sub-tests had significant differences ( P < 0.001). Conclusion:The prevalence rate of MHE in the cirrhotic population is high, but the prevalence of MHE obtained by using different diagnostic criteria or methods varies greatly. Therefore, in line with the current changes in demographics and disease spectrum, it is necessary to enroll a larger sample size of a healthy population as a control. Moreover, the establishment of more reliable diagnostic scoring criteria will serve as a basis for obtaining accurate MHE incidence and formulating diagnosis and treatment strategies in cirrhotic populations.