1.Efficacy and risk factors of carotid artery stenting in patients with unilateral and bi-lateral carotid stenosis
Military Medical Sciences 2013;(11):856-860
Objective To investigate the efficacy and risk factors of carotid artery stenting ( CAS) in patients with uni-lateral and bilateral carotid stenosis .Methods We retrospectively studied 312 cases of patients with CAS diagnosed in xinqiao Hospital between January 2005 and January 2011 .According to the carotid artery lesions , patients were divided in-to the unilateral carotid stenosis group .Periprocedural data and those after one-month follow-up and one-year follow-up were collected in two groups and analysed by statistics .Results A total of 312 patients were enrolled in this study , including 136 patients with bilateral lesions and 176 patients with unilateral lesion .303 of these patients were followed up after one month, and 224 cases after one year.All the 312 patients were implanted with 391 stents.The two groups of patients with transient ischemic attack ( TIA) were different in the incidence of perioperative TIA (1.2%for bilateral lesions and 7.6%for unilateral lesions;P<0.01).Compared with bilateral carotid lesions group , the incidence of early postoperative adverse events (death, stroke, perioperative TIA,and perioperative myocardial infarction ) in unilateral carotid lesion group was lower (5.2%vs 11.4%), but of no statistical significance (P>0.05).The incidence of medium-term adverse events (death, stroke, perioperative TIA, perioperative myocardial infarction, and restenosis) in the bilateral carotid lesions group was significantly higher than in the unilateral group (21.8%vs 9.7%, P<0.01), mainly driven by a higher inci-dence of death, periprocedural TIA, and restenosis (P<0.05).Multivariate analysis showed that left ventricular dysfunc-tion, masculinity , bilateral carotid artery disease , renal insufficiency , and cerebral ischemic symptoms within the last 6 months before intervention , and low-density lipoprotein cholesterol ( LDL-C ) levels were the independent risk factors for medium-term adverse events .Conclusion Patients with bilateral carotid artery disease treated by CAS are more prone to adverse events than those with unilateral disease .
2.The evaluations of the effect of stent implantation using multimodal computed tomography in ischemic cerebrovascular patients
Wenjie ZI ; Yan YANG ; Dazhi DUAN ; Jie SHUAI
Chinese Journal of Nervous and Mental Diseases 2010;36(2):92-95
Objective To evaluate the effect of stent implantation using Multimodal CT in patients with MCA and ICA stenosis. Methods Twenty-six patients with ischemic cerebrovascular disease who received MCA or ICA stent implantation in ChongQing xinqiao Hospital were recruited. Multimodal Stroke Assessment Using CT Score (MOSAIC) was used to evaluate the Neuroimaging data before stent implantation and Alberta Stroke Program Early CT Score (ASPECTS) to evaluate the time to peak (TTP) of CTP before and after stent implantation. Results Patients were divided into 4 groups based on scores: 4 scores, 5 scores, 6 scores, and 7 scores groups. the improvement degree was increase by 31.7%±14.17%、38.6%±15.73%、43.3%±10.3%、358.6%±13.45% in 4 scores, 5 scores, 6 scores, and 7 scores groups, respectively. The paired t test demonstrated that there were a statistically significant difference among four groups(H=10.673, P <0.05). Preoperative MOSAIC score was positively correlated with the improvement of ASPECT score for TTP, with a correlation coefficient of 0.579 ( P <0.002). Conclusions Multimodal CT is a sensitive assessment for the evaluation of ischemic cerebrovascular disease and patients with a higher MOSAIC score may benefit more from stent implantation.
3.Correlation of serum albumin with short-term functional outcome of acute ischemic stroke
Minhui DAI ; Wenjie ZI ; Biyang CAI ; Lulu XIAO ; Keting LIU ; Yumeng ZHANG ; Shuyu ZHOU ; Ling TIAN ; Gelin XU
Journal of Medical Postgraduates 2015;(11):1152-1155
Objective No consensus has yet been achieved on the relationship of serum albumin with the functional out-come of acute ischemic stroke.The aim of our study was to determine whether the serum albumin level was associated with the short-term functional outcome of acute ischemic stroke in well-nourished patients. Methods Totally, 113 patients with first-ever acute ischemic stroke were recruited from Nanjing Stroke Registration Program between January and June 2015.Baseline data including de-mographic and body parameters, vascular risk factors, and laboratory results were collected.The NIH Stroke Scale ( NIHSS) was used to evaluate the severity of neurological deficits and the modified Rankin Scale ( mRS ) employed to assess the short-term functional outcome.According to the mRS at discharge, the patients were divided into a good outcome group ( mRS<3 ) and a poor out-come group ( mRS≥3 ) .The independent predictors of the short-term functional outcome were evaluated by multivariate logistic regression analysis. Results Of the 113 acute ischemic stroke patients included, 52 (46.0%) were in the good outcome group, and 61 (54.0%) in the poor outcome group.Those in the former group had a significantly higher BMI, lower serum LDL-C, lower WBC count, and lower NIHSS at admission than those in the latter .Multivariate logistic regression analysis showed that low serum albumin, NIHSS at admission, and arteriole occlusion were independent predictors of the poor short-term functional outcome ( OR=0.684, 95% CI:0.490-0.956, P=0.026). Conclusion Low serum albumin is an independent predictor of poor short-term functional outcome in acute ischemic stroke patients in well-nourished status.
4.Impact of distillage recycling on the glycolysis key enzymes, stress response metabolites and intracelluler components of the self-flocculating yeast.
Lihan ZI ; Chunming ZHANG ; Jiangang REN ; Wenjie YUAN ; Lijie CHEN
Chinese Journal of Biotechnology 2010;26(7):1019-1024
This research aimed to study the effect of distillage recycling on ethanol fermentation, the key glycolytic enzymes and cell composition of the self-flocculating yeast. With the self-flocculating yeast SPSC01 and medium composed of 220 g/L glucose, 8 g/L yeast extract and 6 g/L peptone, continuous ethanol fermentation was carried out at the dilution rate of 0.04 h(-1) with a 1.5 L tank bioreactor. Fermentation broth was collected every 3 days, and ethanol and other volatile byproducts were removed by distillation, but the stillage with high boiling byproducts was recycled to prepare the medium instead of fresh water. The system was run for 20 days, during which ethanol and biomass concentrations in the effluent decreased continuously, indicating the significant inhibition of the high boiling byproducts accumulated within the system. Thus, the activities of the key enzymes of the glycolytic pathway: hexokinase, 6-phosphofructose kinase, and pyruvate kinase were analyzed, and it was observed that all of them were inhibited. Furthermore, the biosynthesis of the stress response metabolites glycerol and trehalose was investigated, and it was found that glycerol production that can protect yeast cells against osmotic pressure stress was enhanced, but trehalose biosynthesis that can protect yeast cells against ethanol inhibition was not improved, correspondingly. And in the meantime, the biosynthesis of the major intracellular components proteins and hydrocarbons was adjusted, correspondingly.
Bioreactors
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microbiology
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Ethanol
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metabolism
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Fermentation
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Flocculation
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Glycerol
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metabolism
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Glycolysis
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Hexokinase
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metabolism
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Industrial Microbiology
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methods
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Phosphofructokinase-1
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metabolism
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Saccharomyces cerevisiae
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enzymology
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genetics
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metabolism
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Schizosaccharomyces
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enzymology
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genetics
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metabolism
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Trehalose
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metabolism
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Triticum
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metabolism
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Zea mays
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metabolism
5.Symptomatic intracranial hemorrhage after mechanical thrombectomy in patients with acute ischemic stroke caused by anterior circulation tandem occlusion: predictive factors and impact on outcomes
Yongjie BAI ; Shuai ZHANG ; Shun LI ; Xianjin SHANG ; Wenjie ZI ; Peiyang DUAN ; Jisheng QI
International Journal of Cerebrovascular Diseases 2019;27(6):401-407
Objective To investigate the predictive factors of symptomatic intracranial hemorrhage(SICH) and the effect on outcomes after mechanical thrombectomy in patients with acute ischemic strokecaused by anterior circulation tandem occlusion. Methods From January 2014 to September 2018, patients with acute ischemic stroke caused by anterior circulation tandem occlusion and treated by endovascular mechanical thrombectomy from the Departments of Neurology in 5 general hospitals (the First Affiliated Hospital of Henan University of Science and Technology, the Affiliated Hospital of Yangzhou University,General Hospital of Eastern Theatre Command of PLA, Yijishan Hospital of Wannan Medical College,Xinqiao Hospital of Army Medical University of PLA) were enrolled retrospectively. SICH was evaluated according to the criteria of Heidelberg Bleeding Classification. The functional outcome was assessed by the modified Rankin Scale score at 90 d after onset, and 0-2 was defined as good outcome. Multivariate logistic regression analysis was used to determine the effect of SICH on the outcome at 90 d and the independent risk factors for SICH. Results A total of 124 patients with acute ischemic stroke caused by anterior circulation tandem occlusion and treated by endovascular mechanical thrombectomy were enrolled in this study. Among them, 19 (15. 3%) had SICH, 60 (48. 4%) had good outcomes, and 28 (22. 6%) died. The incidence of poor outcomes (94. 7% vs. 43. 8%; χ2 = 16. 708, P < 0. 001 ) and mortality (57. 9% vs.16. 2%; P < 0. 001 ) in the SICH group were significantly higher than those in the non-SICH group.Multivariate logistic regression analysis showed that SICH was an independent risk factor for poor outcome(odds ratio [OR] 27. 78, 95% confidence interval [CI] 2. 60-96. 70; P = 0. 006), while larger infarct core(low ASPECT score) was the only independent predictor of SICH (OR 2. 63, 95% CI 1. 18-5. 88; P =0. 018). Conclusion In patients with acute ischemic stroke caused by anterior circulation tandem occlusion and treated by endovascular mechanical thrombectomy, SICH is associated with poor outcome and higher mortality at 3 months, and larger preoperative infarction core is an independent predictor of SICH.