Objective To investigate the influencing factors of hemorrhagic transformation in non-thrombolysis patients after acute cerebral infarction. Methods According to Chengdu Stroke Registry Project,2598 consecutive patients with acute cerebral infarction admitted to the Department of Neurology,West China Hospital within 1 week of attack from January 2010 to December 2013 were enrolled prospectively. The patients were divided into a hemorrhagic transformation group and a non-hemorrhagic transformation group according to whether they had hemorrhagic transformation or not. As for patients with hemorrhagic transformation,they were divided into a symptomatic hemorrhagic transformation (SHT)group and an asymptomatic hemorrhagic transformation (ASHT)group according to whether they had aggravation of symptom and sign. The baseline data of all patients were collected and compared between the groups. The P<0. 1 variables of the univariate analysis result were enrolled in multivariate logistic regression analysis in order to identify the independent influencing factor of hemorrhagic transformation. Results In 2598 patients,249 (9. 6%)had hemorrhagic transformation,28 of them (1. 1%)were SHT and 221 (8. 5%)were ASHT. There were significant differences in male,hypertension,dyslipidemia,atrial fibrillation,drinking and smoking ratio,blood glucose,cholesterol,low density lipoprotein cholesterol, National Institutes of Health Stroke Scale (NHISS)scores,and the trial of Org 1072 in acute stroke treatment (TOAST)classification between the HT group and the non-HT group (all P<0. 05). There were no significant difference in the related influencing factors between the SHT group and the ASHT group (all P>0. 05). The results of multivariate logistic regression analysis showed that dyslipidemia (OR,0. 588, 95%CI 0. 374-0. 924,P=0. 021)was negatively correlated with hemorrhagic transformation. Atrial fibrillation (OR,3. 188,95%CI 2. 159-4. 707,P<0. 001),blood glucose (OR,1. 081,95%CI 1. 044-1. 119,P<0.001),and NHISS score (OR,1. 305,95%CI 1. 170-1. 455,P<0. 001)were positively correlated with hemorrhagic transformation. In TOAST classification,relative to the large atherosclerotic stroke,the small artery occlusive cerebral infarction was negatively correlated with hemorrhagic transformation (OR,0. 315, 95%CI 0. 167-0. 596,P<0. 001). After removing the influencing factor of atrial fibrillation,compared with the large artery atherosclerotic stroke,cardioembolism stroke was positively correlated with hemorrhagic transformation (OR,2. 823,95%CI 1. 946-4. 095,P<0. 001). Conclusion Dyslipidemia,atrial fibrillation,blood glucose,NHISS score and TOAST classification were independently associated with hemorrhagic transformation in non-thrombolysis patients after acute cerebral infarction.

OBJECTIVE: To investigate the feasibility of the treatment of otosclerosis using laser stapedotomy with mini incision in the external auditory meatus. METHOD: Thirteen patients(15 ears) with otosclerosis evidence on clinic history. They were all operated using the laser assisted stapedotomy by mini incision in external auditory meatus because of the wide straight canal. Laser resection the tendo musculistapedius and anterior and postrior arch, breaking the articulatioincudostapedia, removing the stapes superstructure, making a hole of 6mm diameter in the rear of stapes footplate by laser drilling, implanting the corresponding length Piston artificial ossicle. RESULT: All the surgeries were successful and the operation time was about one hour. There was only one patient manifested vertigo and nausea after the operation. But the symptoms improved three days later after the expectant treatment. All the incisions were healed in the externals. There was significant difference between the preoperative and postoperative PTA. The air conduct improved in every frequent and the bone conduct improved in 1 kHz, 2 kHz and 4 kHz. CONCLUSION Laser assisted stapedotomy by mini incision in the external auditory meatus in patients having wide straight canal with otosclerosis can shorten the operation time, minimize the tissue damage, fasten the healing of the incision and reduce the complications postoperatively. In addition, the mini incision is beauty and easy to nurse.
Ear Canal ; surgery ; Humans ; Lasers ; Otosclerosis ; surgery ; Postoperative Complications ; Postoperative Period ; Prostheses and Implants ; Stapes ; Stapes Surgery ; Treatment Outcome

Objective To study sex differences,in common risk factors,subtypes and outcomes in stroke.Methods 2912 patients hospitalized for stroke were evaluated for common risk factors,subtypes and outcomes data.Results Mean age was higher in women than in men(P

Objective To study the tumor targeting ability and application of farnesylthiosalicylic Acid (FTS) and heptamethine carbocyanine fluorescent dye-mediated near-infrared imagine in living animals, and confirm the inhibitory effect of this compound on growth of tumor cells.Methods Human breast cancer cell line MCF-7, glioma cell line U251 and prostate cancer cell line PC3 were cultured to logarithmic growth phase, and different concentrations of FTS and FTS-IR783 were added, respectively.We observed the inhibitory effect of those two compounds on the growth of tumor cells.Under fluorescence microscopy, specific accumulation of FTS-IR783 in these tumor cells was observed.The tumor cells (1×106) were transplanted subcutaneously into nude mice.These mice were subjected to intraperitoneal injection of FTS-IR783 (10 nmol/mouse) two weeks later.In the in vivo imaging, near infrared fluorescence signal and tumor volume were measured and their correlation was analyzed.Results Compared with FTS, FTS-IR783 significantly inhibited the growth of MCF-7, U251 and PC3 cells in vitro.FTS-IR783 was specifically uptaken by these three kinds of tumor cells, showing strong near infrared fluorescence in cell agglomerates.After subcutaneous injection of FTS-IR783, the correlation between fluorescence intensity and tumor volume was 0.987, 0.998 and 0.971, respectively.Conclusions The compound of FTS conjugated with near infrared fluorescent dye IR-783 can specifically recognize tumor cells, in both in vitro and in vivo imaging.At the same time, the compound can significantly inhibit the growth of tumor cells, and may be expected to become a new potential targeted drug.

Purpose: Plasma osmolality, a marker of dehydration, is associated with cardiovascular mortality. We aimed to investigate whether elevated plasma osmolality is associated with case fatality within 1 year after severe acute ischemic stroke. Materials and Methods: We included severe ischemic stroke patients (defined as National Institutes of Health Stroke Scale ≥15 score) within 24 hours from symptom onset admitted to the Department of Neurology, West China Hospital between January 2017 and June 2019. Admission plasma osmolality was calculated using the equation 1.86 * (sodium+potassium)+1.15 * glucose+urea+14. Elevated plasma osmolality was defined as plasma osmolality >296 mOsm/kg, indicating a state of dehydration. Study outcomes included 3-month and 1-year case fatalities. Multivariable logistic regression was performed to determine independent associations between plasma osmolality and case fatalities at different time points. Results: A total of 265 patients with severe acute ischemic stroke were included. The mean age was 71.2±13.1 years, with 51.3% being males. Among the included patients, case fatalities were recorded for 31.7% (84/265) at 3 months and 39.6% (105/265) at 1 year. Elevated plasma osmolality (dehydration) was associated with 3-month case fatality [odds ratio (OR) 1.98, 95% confidence interval (CI) 1.07–3.66, p=0.029], but not 1-year case fatality (OR 1.51, 95% CI 0.84–2.72, p=0.165), after full adjustment for confounding factors. Conclusion Elevated plasma osmolality was independently associated with 3-month case fatality, but not 1-year case fatality, for severe acute ischemic stroke.

Purpose: Plasma osmolality, a marker of dehydration, is associated with cardiovascular mortality. We aimed to investigate whether elevated plasma osmolality is associated with case fatality within 1 year after severe acute ischemic stroke. Materials and Methods: We included severe ischemic stroke patients (defined as National Institutes of Health Stroke Scale ≥15 score) within 24 hours from symptom onset admitted to the Department of Neurology, West China Hospital between January 2017 and June 2019. Admission plasma osmolality was calculated using the equation 1.86 * (sodium+potassium)+1.15 * glucose+urea+14. Elevated plasma osmolality was defined as plasma osmolality >296 mOsm/kg, indicating a state of dehydration. Study outcomes included 3-month and 1-year case fatalities. Multivariable logistic regression was performed to determine independent associations between plasma osmolality and case fatalities at different time points. Results: A total of 265 patients with severe acute ischemic stroke were included. The mean age was 71.2±13.1 years, with 51.3% being males. Among the included patients, case fatalities were recorded for 31.7% (84/265) at 3 months and 39.6% (105/265) at 1 year. Elevated plasma osmolality (dehydration) was associated with 3-month case fatality [odds ratio (OR) 1.98, 95% confidence interval (CI) 1.07–3.66, p=0.029], but not 1-year case fatality (OR 1.51, 95% CI 0.84–2.72, p=0.165), after full adjustment for confounding factors. Conclusion Elevated plasma osmolality was independently associated with 3-month case fatality, but not 1-year case fatality, for severe acute ischemic stroke.

Objective To analyze basic data and outcomes in Chengdu Stroke Registry.Methods The stroke patients consecutively admitted to Department of Neurology,West China Hospital,Sichuan University since March 1,2002 were prospectively registered.The baseline demographic,risk factors,treatment,and outcome data was recorded with standardized stroke register form by trained specialists.The patients were followed up at seven days,one,three,six months and one year after onset of the stroke for death and disability.Results A total of 3123 consecutive patients were registered between March 1,2002 and August 31,2006,of which 65.5％ came from urban areas and 34.5％ from rural areas.The age was (63.05 ± 17.98) years old and male accounted for 60.3％.Ninety-seven percent (3028/3123) of patients completed CT or MRI scanning during hospitalization.A total of 1804 patients were included between March 2002 and September 2004,of which ischemic stroke accounted for 62.1％ (1120/1804),intracranial hemorrhage 28.4％ (513/1804),subarachnoid hemorrhage 4.0％ (72/1804) and TIA 5.5％ (99/1804).The median NIHSS score on admission was 8(3-15) points in patients with cerebral hemorrhage,and 5(2-10) points in patients with ischemic stroke.Compared with the patients with intracranial hemorrhage,patients with ischemic stroke more frequently had a history of diabetes (OR =2.427,95％ CI 1.811- 3.253,P=0.000),atrial fibrillation (OR=6.121,95％ CI3.535-10.60,P=0.000),coronary heart disease (OR=4.144,95％ CI 2.944-5.832,P =0.000) and TIA (OR=4.342,95％ CI 1.726-10.92,P =0.001 ),and less alcohol consumption ( OR =0.740,95％ CI 0.611-0.896,P =0.002 ).The proportion of in-hospital treatments were thrombolysis 0.9％,anti-platelet therapy 83.0％,mannitol 23.5％,neuroprotective agents (citicoline) 68.1％,and Chinese herbal medicine 89.7％.Case fatality rate was 10.7％ and 13.9％ respectively at 7 days and one month for patients with intracranial hemorrhage,3.0％ and 5.2％ respectively for ischemic stroke.Death or disability was 40.4％,40.3％ and 38.9％ in patients with intracranial hemorrhage and 37.1％,35.0％ and 33.4％ for ischemic stroke at the end of 3,6,12 months respectively.Conclusions Our stroke registry is featured with the largest sample,and the longest period of consecutively registration.It provides an important platform for clinical investigation of stroke.Our study suggested case fatality and disability is lower in this group than in other ethics.Above features should be considered in design of future clinical trials in China.

Objective To investigate the effect of scan table on size-specific dose estimate ( size-specific dose estimate, SSDE) in children's CT scan. Methods CT imaging data and CTDIvol of 44 children ( 15 heads, 13 chests, 16 abdomen-pelvis) who underwent Siemens SOMATOM Definition AS+ 64 row 128-slice CT scan were retrospectively collected. CTDIvol of each patient was recored, WED ( water equivalent diameter) was calculated by two different methods ( with or without table) , donated as WED-T and WED-NT, then the corresponding SSDEWED ( SSDEWED-T and SSDEWED-NT ) was calculated. And the SSDEWED-NT was used as reference to evaluate the difference between WED and SSDEWED obtained by two different methods. Results Including part of table will lead to the overestimate for WED, with mean differences of 0. 10％, 2. 82％ and 2. 54％ for head, chest and abdomen-pelvis, respectively, while SSDEWED will be underestimated by 0. 06％ ( head ) , 2. 70％ ( chest ) and 1. 59％ ( abdomen-pelvis ) . Conclusions Including par of the patient table has a certain effect on SSDEWED for children, more attention should be paid for the application of SSDEWED.

Objective:To investigate the efficacy and safety of anlotinib in distant metastatic radioactive iodine-refractory differentiated thyroid cancer (RAIR-DTC).Methods:Retrospective analysis was performed on 17 patients with distant metastatic RAIR-DTC (6 males, 11 females, age: 57.0(45.5, 63.0) years) from Affiliated Hospital of Qingdao University between October 2018 and February 2023, including 13 patients receiving first-line treatment and 4 patients receiving second-line treatment with anlotinib. The changes of serum thyroglobulin (Tg) during the treatment of anlotinib, the changes of maximum diameter of the target lesion at the last follow-up compared with the diameter at baseline, the imaging efficacy, and treatment-related adverse events were analyzed. The serological and imaging effects of the first-line treatment group and the second-line treatment group were compared. The Fisher exact test was used to analyze the differences between groups.Results:The follow-up time of 17 patients was 17.3(9.5, 21.4) months, and the objective response rate (ORR) and disease control rate (DCR) were 7/17 and 16/17, respectively. There were no significant differences of ORR (6/13 vs 1/4; P=0.603) and DCR (13/13 vs 3/4; P=0.235) between the first-line and second-line treatment groups. The change rates of serum Tg at 3, 6 weeks and the last follow-up were -30.2%(-61.2%, -15.5%), -64.8%(-90.6%, -32.3%), and -85.8%(-96.1%, -50.7%), respectively. At the last follow-up, the change rate of maximum diameter of target lesions was -20.0%(-45.0%, -5.2%). The incidence of treatment-related adverse reactions was 14/17, and 2 patients (2/17) had grade 3 or above adverse reactions. Conclusion:Anlotinib shows superior efficacy with tolerable toxicity in the first-line treatment of distant metastatic RAIR-DTC, and hopefully plays an important role in second-line treatment for RAIR-DTC resistant to sorafenib.

OBJECTIVE To explore the CT and MRI appearances of otogenic sigmoid sinus thrombophlebitis(SST) and abscess. METHODS The HRCT, plain MRI, magnetic resonance venography(MRV), enhanced MRI findings in 11 patients with otogenic SST were retrospectively analyzed. RESULTS On CT, the bony wall of sigmoid sinus was eroded in 10 cases (10/11), and air bubbles were found in or around sigmoid sinus in 4 cases. On plain MRI, sigmoid sinus flow void effect disappeared in all 11 cases. SST manifested as high signal on T2W1 in all 11 cases, and as low signal on T1WI in 2 cases, isointense signal on T1WI in 6 cases, high signal on T1WI in 3 cases. Contrast enhancement MRI showed enhancement in wall of venous sinus, but venous sinus thrombosis did not enhanced, but showed as irregular filling defect or empty triangle. MRV showed that involved venous sinus was not visualized. CONCLUSION CT can show the erosion of the bony wall of sigmoid sinus which may indicate the SST; and if air bubbles are found around or in the sigmoid sinus, the abscess around or in the sigmoid sinus should be doubted. Conventional MRI combined with MRV are effective and noninvasive methods in the diagnosis of SST.