Objective:To explore the incidenee of early hematoma growth in patients with intracerebral hemorrhage,and the correlation between early hematoma growth and early neurological deterioration.Methods:The evaluation of nervous system and CT scan in patients with intracerebral hemorrhage within 3 hours after the omet of symptoms were performed respectively at baseline,and 1,2,3,and 20 hours after the baseline.Results:In 106 patients,CT scan shelwed that the volume of intraparenehymal hemorrhage inereased significantly in 26% of patients at baseline and within 1 hour.CT scan showed that the bleeding volume increased in 12% of patients at 1,2,3,and 20 hours.By measuring baseline,1-hour Glasgow Coma Scale (GCS)score,and the changes of the National Institutes of Health Stroke Scale(NIHSS),it had found that the baseline status and the increased bleeding volume within 1 hour vdgre closely correlated with the clinical neurological deterioration.Conclusions:The early bleeding volume often inereases significantly in patiems with intracerebral hemorrhage,which is complicated with neurological deterioration.In order to determine whether these therapeutic measures improve the natural course of this early hematoma growth and decrease its occurrence,it is necessary to make a randomized clinical trial.

Anterior ischemic optic neuropathy (AION) is the ciliary artery-circulatory disorders for the supply of optic nerve head area before the sieve plate prozone and sieve plate district, result in the insufficient blood supply of the optic nerve head and ischemia hypoxia, edema. Clinical manifestations of the type with non-artery inflammatory neuropathy and artery inflammatory neuropathy, which would both eventually lead to the irreversible damage to the optic nerve. In the early phase of AION, the main method is giving a glucocorticoids intravenous drip and a periglomerular injection (or retrobulbar injection) in time, but using the glucocorticoids for a long time or in quantity can cause a series of complications. Therefore, the combination of traditional Chinese and western medicine treatment of AION has become more and more significant in clinic.

Objective:To investigate the correlations between perfused lung volumes, visual scores (using perfusion SPECT/CT) and right-heart catheter (RHC) hemodynamic parameters in patients with chronic thromboembolic pulmonary hypertension (CTEPH).Methods:A total of 51 consecutive CTEPH patients (17 males, 34 females, age (59±12) years) in the First Affiliated Hospital of Guangzhou Medical University between March 2015 and July 2019 were retrospectively analyzed. All patients underwent lung perfusion SPECT/CT imaging and RHC examinations. Perfused lung volumes were determined using threshold-based (15%-85%) segmentation. Visual semiquantitative scoring in each lung segment was performed using Begic method. RHC hemodynamic parameters including pulmonary artery systolic pressure (PASP), pulmonary arterial diastolic pressure (PADP), mean pulmonary artery pressure (mPAP), pulmonary arteriolar wedge pressure (PAWP), pulmonary vessel resistance (PVR), cardiac output (CO), cardiac index (CI) were recorded. Spearman correlation analysis was used to evaluate the correlations between perfused lung volumes, visual scores and hemodynamic parameters.Results:There were significant correlations between perfused lung volumes (30%-70% threshold) and mPAP ( rs values: from -0.414 to -0.302, all P<0.05). Among them, perfused lung volumes under the threshold of 40% and 45% were moderately correlated with mPAP ( rs values: -0.414, -0.412, both P<0.05). Perfused lung volume (40% threshold) was moderately negatively correlated with PASP, PADP ( rs values: -0.402, -0.440, both P<0.05), and slightly negatively correlated with PVR ( rs=-0.352, P<0.05). Visual scores were slightly positively correlated with the PADP ( rs=0.311, P<0.05), while there was no correlation between visual scores and other RHC hemodynamic parameters ( rs values: from -0.201 to 0.275, all P>0.05). Conclusion:Perfused lung volumes based on threshold-based segmentation in lung perfusion SPECT/CT imaging can accurately reflect hemodynamic status and may provide useful information for severity assessment of CTEPH.

Objective Based on structure of animal trabecular bone, implants with porous structure were designed to describe mechanical properties of trabecular structure and explain significance of bionic trabecular porous implants in clinical treatment. Methods Based on anisotropic mechanical properties of animal trabecular bone, a porous structure was designed using the topology optimization method. The principles of partition and block reconstruction were first proposed according to bone function theory. The trabecular structure was then reconstructed based on micro-CT images. The boundary constraint and external load were applied on this model according to the respective-volume-element (RVE) method. Taking the solved mechanical properties as objective functions of optimization, the porous structure design and optimization were conducted using the variable density method and the homogenization method. Results The trabecular bone possessed the anisotropic mechanical properties. It was found that the volume fraction showed an increasing trend from the edge to the middle across the same section of trabecular bone. But there was no obvious regular pattern in Poisson’s ratio, which was evenly distributed in the range between 0.17 and 0.30. As to the values of elastic modulus and shear modulus, they were both significantly higher in the main pressure position compared with those in the other positions. After topography optimization based on these mechanical properties, the Poisson’s ratio of the optimized model was in the same range as the animal trabecular bone. The elastic modulus error was less than 14%， with the minimum being only 3%. In addition, the shear modulus error was below 8%， which ultimately complied with criteria of the original goal. Conclusions The designed porous structure based on topology optimization had the same anisotropic characteristics as animal trabecular bone, while reducing the stress concentration phenomenon, which could achieve the specific design for porous structure, thus providing a reasonable and effective method for clinical porous implants.

OBJECTIVETo explore the mechanism of lumen loss of the left circumflex ostium after main vessel stent implantation.

METHODSTwenty-eight patients undergoing provisional T technique were enrolled in this study. Intravascular ultrasound (IVUS) examination was performed before and after main vessel stenting and kissing balloon post-dilatation to evaluate the geometrical changes of the vessels.

RESULTSThe CSA of LCX ostium lumen decreased significantly from 5.9∓2 mm(2) to 4.9∓1.9 mm(2) (P<0.01) after the procedure, and the CSA of LCX ostium P and M increased from 5.4∓2.9 mmmm(2) to 5.7∓2.9 mm(2) (P=0.21) after the main vessel stenting. The changes in LCX ostium lumen CSA was correlated with the changes of LCX ostium EEM CSA but not the LCX ostium P and M CSA. After kissing balloon post-dilatation, the CSA of LCX ostium lumen increased from 4.9∓1.9 mm(2) to 5.5∓1.9 mm(2) (P<0.01) , and the CSA of LCX ostium P and M showed no obvious changes (5.7∓2.9 mmmm(2) vs 5.7∓2.6 mmmm(2), P=0.89). The changes of LCX ostium lumen CSA were correlated with the those of the LCX ostium EEM CSA (R=0.432, P=0.02).

CONCLUSIONAfter stent implantation from the LMCA to the LAD, most of lumen losses of the LCX are due to carina shift, and in occasional cases, plaque shift occurs from the distal LMCA to the ostium of the LCX. Kissing balloon technique can adjust carina shift but can not improve plaque shift.

Aged ; Angioplasty, Balloon, Coronary ; Coronary Artery Disease ; diagnostic imaging ; therapy ; Coronary Stenosis ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Stents ; Treatment Outcome ; Ultrasonography, Interventional

Objective:To investigate the efficacy of 99Tc m-pyrophosphate (PYP) SPECT imaging for the differential diagnosis of transthyretin-related cardiac amyloidosis (ATTR-CA) and hypertrophic cardiomyopathy (HCM). Methods:Data of patients who were definitively diagnosed with ATTR-CA (35 patients (28 males, 7 females); age 62.5(58.6, 64.3) years) or HCM (14 patients (13 males, 1 female); age 60.5(57.3, 68.7) years) by extracardiac biopsy and echocardiography in the Second Xiangya Hospital of Central South University between June 2020 and March 2023 were retrospectively analyzed. All patients underwent planar and SPECT imaging 1 h after injection of 370-720 MBq 99Tc m-PYP. Visual scoring was performed (0-1 was negative, 2-3 was positive), and heart-to-contralateral lung uptake ratio (H/CL) was calculated based on planar images. The χ2 test was used to compare the difference in visual scores between ATTR-CA and HCM groups, and the diagnostic efficacy of the visual score was calculated. The H/CL differences between ATTR and HCM groups were compared with Mann-Whitney U test, and the ROC curve was used to analyze the efficacy of H/CL for the differential diagnosis of ATTR-CA and HCM. Results:There were 34 patients with visual scores≥2 and 1 patient with visual score<2 in the ATTR-CA group, 6 patients with visual scores =2 and 8 patients with visual scores <2 in HCM group, and there were significant differences between the 2 groups ( χ2=16.20, P<0.001). The diagnostic sensitivity of the visual score was 97.1%(34/35), and the specificity was 8/14. The H/CL in the ATTR-CA group was significantly higher than that in the HCM group (2.08(1.97, 2.20) vs 1.26 (1.17, 1.35), z=-5.09, P<0.001). The ROC curve analysis suggested that the optimal cut-off value was 1.45 (AUC: 0.980, 95% CI: 0.946-1.000; P<0.001); the sensitivity of H/CL differential diagnosis between HCM and ATTR-CA was 97.1%(34/35), and the specificity was 14/14. Conclusion:99Tc m-PYP SPECT imaging is useful in differentiation of ATTR-CA and HCM, and the optimal cut-off value of H/CL for differential diagnosis of these 2 diseases is 1.45.

Objective To construct lipid nanoparticles DLin-LNP for mRNA delivery. Methods DLin-LNP was prepared by thin film hydration method, and DLin-LNP/mRNA was further constructed by using EGFP-mRNA as model drug. The particle size, zeta potential, and appearance morphology were measured. Furthermore, the intracellular distribution and transfection of DLin-LNP/mRNA in RM-1 cells was investigated by laser scanning confocal microscope. Results DLin-LNP was successfully prepared. The average particle size was about (151.1±2.1) nm, the no-load potential was (23.7±0.5) mV. The cytotoxicity of DLin-LNP was far lower than that of the commercially available liposomal Lipo8000. The results of transfection experiment indicated that DLin-LNP has high transfection efficiency for mRNA delivery with low cytotoxicity and good stability. Conclusion DLin-LNP could become a potential mRNA vector for gene therapy.

Objective:To explore the effectiveness of 18F-deuterated-Florbetapir (D3FSP) PET/CT imaging in detecting β-amyloid (Aβ) deposition in the brain and its correlation with plasma biomarkers. Methods:A retrospective analysis was conducted on 79 patients (32 males, 47 females; age(66±7)years) who underwent 18F-D3FSP PET/CT imaging from June 2022 to November 2023 at the First Affiliated Hospital, Guangzhou Medical University, as a part of the Greater Bay Area Healthy Aging Brain Longitudinal Cohort Study (GHABS). Based on the Alzheimer′s Disease Neuroimaging Initiative cohort standard protocol, patients were categorized into cognitively unimpaired (CU) group, mild cognitive impairment (MCI) group, and Alzheimer′s disease (AD) group. Brain regions were segmented using the AW workstation and the SUV ratio (SUVR) was calculated with the cerebellum as the reference region. One-way analysis of variance, Bonferroni correction and Pearson correlation analysis were used to analyze data. The ROC curve analysis was used to analyze the cut-off value and the diagnostic efficacy of SUVR. Results:There were 48, 15 and 16 cases in CU, MCI and AD groups respectively. During the transition from CU to MCI and then to AD, there was a rising trend in SUVR ( F values: 11.15-22.38, all P<0.001) across the whole brain and various brain regions (bilateral frontal lobes, bilateral anterior cingulate gyrus, bilateral precuneus, bilateral parietal lobes, bilateral lateral temporal lobes, and bilateral occipital lobes). SUVRs of the right anterior cingulate gyrus and bilateral precuneus were different between the CU and MCI groups (all P<0.017), and those of bilateral frontal lobes, right precuneus, bilateral parietal lobes, bilateral lateral temporal lobes, and bilateral occipital lobes were different between the MCI and AD groups (all P<0.017). SUVRs of brain regions were negatively correlated with cognitive scale scores ( r values: from -0.57 to -0.37, all P<0.001), and were positively correlated with plasma phosphorylated tau181 (p-tau181, r values: 0.50-0.61, all P<0.001). The ROC curve analysis suggested that the cut-off value of SUVR in the precuneus for distinguishing CU from AD was 1.20, with the AUC, sensitivity, specificity and accuracy of 0.85, 12/16, 91.7%(44/48)and 87.5%(56/64), respectively. Conclusion:18F-D3FSP PET/CT imaging has good clinical application value in assessing the deposition sites and the extent of Aβ in the brain, which is related to clinical cognition and plasma p-tau181 level.

OBJECTIVE To establish an UPLC-MS/MS method for the determination of the concentrations of cyperenone and α-cyperone in rat plasma and to study the pharmacokinetics. METHODS Gradient elution was carried out on a Phenomennex C18(150 mm×2.0 mm, 3 μm) column with acetonitrile-water as mobile phase. The column temperature was 30 ℃, injection volume was 1 μL, osthenite was used as the internal standard, electrospray ion source and positive ion mode were used. The m/z values of cyperenone, α-cyperone and osthenite were 219.1/135.1, 219.1/111.0 and 245.0/123.0, respectively. The plasma concentrations of cyperenone and α-cyperone were measured, and the main pharmacokinetic parameters were calculated using DAS 2.0 software. RESULTS The linear relationship of cyperenone was good in the range of 10-500 ng·mL-1(r=0.991 0), and the linear relationship of α-cyperone was good in the range of 2.5-300 ng·mL-1(r=0.994 1), RSDs of intra-day precision were less than 9.45%. RSDs of daytime precision were less than 9.09%. The recoveries were greater than 86.79%. After intragastric administration of essential oil extract(20 mg·kg-1) from Cyperus rotundus L. in SD rats. The pharmacokinetic parameters of Cmax, AUC0-∞ and MRT(0-∞) of cyperenone and α-cyperone were (8 862.59±1 106.81)ng·L-1, (7 060.94±774.25)ng·L-1·h, (3.21±0.72)h and (934.69±106.81)ng·L-1, (792.26±74.52)ng·L-1·h, (4.94± 0.82)h, respectively. CONCLUSION The established method can be used for the rapid and accurate determination of the concentration of cyperenone and α-cyperone in plasma, and can be used for the pharmacokinetic study of cyperenone and α-cyperone in rats in vivo.

ObjectiveTo investigate the current status of secondary prevention of stable angina in patients with coronary heart disease in three regions of China， namely Henan Province， Xinjiang Uygur Autonomous Region， and Tianjin City， and analyze the the influencing factors. MethodsA cross-sectional study was conducted to include patients with stable angina with coronary heart disease in Henan， Tianjin and Xinjiang from August 10， 2020 to March 14， 2021. General information， traditional Chinese medicine （TCM） syndrome elements， prescriptions and other data of patients were collected， and clinical characteristics， blood pressure， blood lipid and blood glucose of patients were analyzed； the patients were divided into groups according to whether their blood pressure， blood lipid and blood glucose were up to standard. With the most common syndrome element as the main variable， region， age and gender as covariables， Logistic regression equation was incorporated to analyze the influencing factors for the patients' blood pressure， blood lipid and blood glucose being up to standard. ResultsA total of 1061 coronary heart disease patients with stable angina were included， including 658 in Henan， 210 in Xinjiang， and 193 in Tianjin. The clinical characteristics of patients in the three regions showed statistical different in age， sex， disease course， complication， blood pressure， blood lipid， blood glucose， smoking， drinking， living habits， and medication treatment （P＜0.05 or P＜0.01）. For the included patients， qi deficiency （79.55%， 844/1061） and blood stasis （39.96%， 424/1061） were the main syndrome elements. The overall compliance rate of blood pressure was 48.89% （506/1035）， blood lipids 12.68% （133/1049） and blood glucose 48.18% （504/1046）. Qi deficiency was the independent factor affecting the blood pressure of coronary heart disease patients with stable angina combined with hypertension （P = 0.029，95%CI ［1.048， 2.369］）， and the independent factors influencing the blood lipid standard of coronary heart disease patients with stable angina （P = 0.011， 95%CI ［1.133， 2.646］）， but not the independent factors affecting blood glucose standard in coronary heart disease patients with diabetes （P＞0.05）. ConclusionCoronary artery disease patients with stable angina have geographical variability in clinical characteristics and distribution of TCM syndrome elements， and the overall control of blood pressure， blood lipids， and blood glucose is poor， and qi deficiency syndrome is an independent risk factor affecting the control of blood pressure and blood lipids.