1.Cognitive function change characteristics and diagnostic efficiency analysis of related indexes after white matter lesions in patients with asymptomatic middle cerebral artery stenosis
Shiyi ZUO ; Yong LIU ; Yuting FENG
Chongqing Medicine 2024;53(12):1778-1783
Objective To explore the characteristics of white matter lesions(WMLs)causing cognitive function change in the patients with asymptomatic middle cerebral artery(MCA)stenosis,and to analyze the diagnostic efficiency of related indexes.Methods Thirty-nine patients diagnosed with asymptomatic MCA ste-nosis and presenting with WMLs in the department of neurology of the hospital from 2021 to 2022 were in-cluded as the observation group,and 34 healthy people were included as the control group.The two groups conducted the behavioral assessment of cognitive function,such as the Mini-Mental State Examination(MMSE),Montreal Cognitive Assessment(MoCA),Test of Connectivity Type A(TMT),Digit Symbol Test(SDMT),Digit Breadth Test(DST),Drawing the Clock Test(CDT),and Verbal Fluency Test(VFT).The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficiency of related indica-tors.Results In the single cognitive function assessment scales,the scores of TMT in the observation group were significantly higher than those in the control group(P<0.01),the scores of SDMT,DST,CDT and VFT in the observation group were significantly lower than those in the control group and the differences were sta-tistically significant(P<0.01).In the comprehensive cognitive function assessment scales,the total scores of MMSE and MoCA in the observation group were significantly lower than those in the control group(P<0.01).In the scores of each factor of the MMSE scale,the verbal ability in the observation group was signifi-cantly lower than that in the control group(P<0.01),but the scores of orientation,memory,attention,calcu-lation and recall were had no statistically significant differences between the two groups(P>0.05).In the scores of each factor of MoCA,the visuospatial and executive ability,delayed memory,attention and abstrac-tion ability in the observation group were significantly lower than those in the control group(P<0.01),but the scores of naming ability,attention ability and orientation ability had no statistically difference(P>0.05).The area under the ROC curve(AUC),sensitivity and specificity of MoCA and MMSE were 0.80,0.73,0.52,0.71,0.92 and 0.74 respectively.The efficiency of MoCA for diagnosing cognitive function disorders caused by asymptomatic MCA stenosis was higher.Conclusion Compared with single cognitive function assessment scale,the comprehensive cognitive function assessment scales could more comprehensively and accurately screen the cognitive function disorders caused by WMLs in the patients with asymptomatic MCA stenosis,in which the diagnostic efficiency of MoCA is the highest.
2.Evaluation of a stent system based on "PETTICOAT" technique in distal aortic remodeling for type B aortic dissection: a multi-center "Matching" comparative study
Chengkai HU ; Jue YANG ; Wei WANG ; Xiangchen DAI ; Xinwu LU ; Youfei QI ; Hongpeng ZHANG ; Yuchong ZHANG ; Shouji QIU ; Genmao CAO ; Enci WANG ; Peng LIN ; Fandi MO ; Shiyi LI ; Zheyun LI ; Ziang ZUO ; Yi SI ; Weiguo FU ; Lixin WANG
Chinese Journal of General Surgery 2024;39(5):350-356
Objective:To compare the aortic remodeling of the Fabulous stent system and standard thoracic aortic endovascular repair (TEVAR) on distal aorta type B aortic dissection (TBAD). Methods:The prospective data collected between Dec 2017 and Oct 2019 from 134 patients with type B aortic dissection (TBAD) who underwent treatment with the "Fabulous" stent system, and retrospective data from 159 TBAD patients receiving standard TEVAR from corresponding multicenter. By using propensity score matching analysis, we compared the prognosis and aortic remodeling outcomes in patients undergoing Fabulous and standard TEVAR treatments during a 1-year postoperative follow-up.Results:In this study, 62 patients in Fabulous group and 62 patients in standard TEVAR were included.There were no significant statistical differences in baseline characteristics between the two groups. In terms of aortic remodeling in bare stent region, Fabulous group had better change trends of diameter of true lumen [10.6 (4.4, 14.5) mm vs. 4.7 (0.9, 10.7) mm, P=0.001] and false lumen [-24.2 (-30.5, -4.9) mm vs. 0.7 (-11.8, 2.3) mm, P<0.001] than those in the standard TEVAR group. The rate of complete false lumen thrombosis was also higher in the Fabulous group (62.9% vs. 37.1%, P=0.042). Conclusion:The Fabulous stent system, when compared to standard TEVAR surgery, demonstrates good aortic remodeling outcomes in the distal aorta.