1.A case of ischemic stroke in a young adult caused by combined defects of protein C and protein S and noncompaction of the ventricular myocardium
Kaiwei CAI ; Yan DING ; Peijie DU ; Jiali GAO ; Pingping SONG ; Anding XU ; Heng MENG
Chinese Journal of Neurology 2023;56(3):329-333
Ischemic stroke in young adults has attracted more and more attention due to the diversity of its etiology. Although atherosclerosis is the most common cause of stroke in young adults, other or unknown causes are not uncommon . To improve clinicians′ understanding of the etiological diagnosis of stroke in young adults, this article reports a case of ischemic stroke in the First Affiliated Hospital of Jinan University. The patient was a 22-year-old male with acute onset who was diagnosed with acute ischemic stroke based on clinical presentation, physical examination, and magnetic resonance imaging of the brain. After actively searching for the cause, laboratory and genetic tests revealed that the patient had inherited thrombophilia (protein C and protein S deficiency), and cardiac magnetic resonance imaging examination found that the patient had noncompaction of the ventricular myocardium.
2.Simultaneous Determination of 7 Components in Qingkailing Oral Liquid by HPLC-MS/MS
Jinyun WU ; Kaiwei CAI ; Hongying CHEN ; Jiaqi WANG ; Biyan PAN ; Zhiyong XIE ; Qiongfeng LIAO
Traditional Chinese Drug Research & Clinical Pharmacology 2024;35(2):257-262
Objective An HPLC-MS/MS method was established for the simultaneous determination of 7 components in Qingkailing Oral Liquid.Methods The assay was performed on a Waters ACQUITY UPLC BEH C18 column(2.1 mm×10 mm,1.7 μm)and the sample was eluted with a gradient mobile phase containing 10 mmol·L-1 of ammonium acetate and 0.1%of formic acid in water(A)-methanol(B).The mass spectrometry was carried out by electrospray ionization(ESI)with positive/negative ions in multiple reaction monitoring(MRM)mode for quantitative analysis.Results The linear ranges of adenine,chlorogenic acid,caffeic acid,geniposide,baicalin,hyodeoxycholic acid and cholic acid were 0.100 4-3.213,0.784 5-8.982,0.998-3.194,0.622 5-19.92,25.05-300.6,2.513-30.15 and 7.775-93.30 μg·mL-1(r≥0.999 0).The average recoveries(n=6)were 100.9%,98.74%,101.2%,100.2%,100.8%,99.97%and 98.94%with RSD of 1.58%,0.59%,1.78%,1.25%,0.65%,1.69%and 1.07%.The contents of the above mentioned 7 components in 15 tested samples were in the ranges of 0.12-0.18,0.19-0.24,0.06-0.09,0.34-0.37,4.54-4.85,0.49-0.67 and 1.82-2.19 mg·mL-1.The contents of 7 components in tested sample from different manufacturers were closed.Conclusion The method has shown good sensitivity,accuracy,and repeatability.The study can provide reference and data support for the quality control and subsequent research of Qingkailing Oral Liquid.
3.Risk factors for early complications after anterior bone grafting and fusion surgery in patients with a-cute subaxial cervical spinal cord injury
Yi CAI ; Xiaozhong PENG ; Kaiwei CHEN
Chinese Journal of Spine and Spinal Cord 2024;34(10):1009-1015
Objectives:To investigate the risk factors of early postoperative complications in patients with a-cute subaxial cervical spinal cord injury after anterior bone grafting and fusion surgery.Methods:The clinical data of 168 cases of traumatic cervical spinal cord injury who underwent anterior surgery in our hospital from January 2017 to November 2021 were retrospectively analyzed.There were 133 males and 35 females.The age ranged from 23 to 82 years,with an average age of 53.8±11.2 years.There were 33 patients with preop-erative comorbidities(19.6%).ASIA classification of preoperative neurological impairment was as follows:34 patients of grade A,10 patients of grade B,62 patients of grade C,and 62 patients of grade D.50 patients were treated with high-dose methylprednisolone(29.8%).135 cases(80.4%)were treated with anterior cervical discectomy and fusion(ACDF),and 33 cases(19.6%)were treated with anterior cervical corpectomy and fusion(ACCF).Early postoperative complications and death of patients during hospitalization period were collected.Univariate logistic regression analysis was used to evaluate possible relationships between early postoperative complications and the factors including sex,age,preoperative comorbidities,cause of injury,neurological level of injury,preoperative ASIA grade,whether there was brain,thoracic and abdominal injury,whether high-dose methylprednisolone treatment was used,time from injury to surgery,preoperative hemoglobin(HGB),preopera-tive albumin(ALB),extent of surgery,surgical method,operative time,and intraoperative blood loss.A multi-variate logistic analysis was performed on the variables with P<0.2 in the univariate analysis to identify signif-icant independent risk factors.Results:The incidence of early postoperative complications was 29.1%(49/168).Univariate logistic regression analysis showed that the cause of injury(P=0.032),preoperative ASIA grade(P<0.001),whether combined with brain,thoracic and abdominal injury(P=0.043),whether high-dose methylpred-nisolone treatment was used(P=0.017),preoperative HGB(P=0.002),preoperative ALB(P=0.001)and surgical method(P=0.002)were correlated with early postoperative complications.Multivariate logistic regression analysis showed that preoperative ASIA grades A and B(P<0.001,OR=5.389,95%CI 2.243-12.950)and high-dose methylprednisolone treatment(P=0.044,OR=2.541,95%CI 1.024-6.303)were independent risk factors for early postoperative complications.Conclusions:Preoperative ASIA grades A and B and high-dose methylpred-nisolone treatment are the independent risk factors for early postoperative complications in patients with acute subaxial cervical spinal cord injury.