1.Efficacy and safety of dual antiplatelet therapy with clopidogrel and aspirin for minor ischemic stroke with tiny unruptured intracranial aneurysm: comparison with aspirin alone
Chenxi LI ; Huiliang WANG ; Xiaofeng ZHANG ; Jilan HAN ; Lingyan FAN ; Yeliang DU ; Guoping XING
International Journal of Cerebrovascular Diseases 2024;32(9):661-667
Objective:To investigate the efficacy and safety of dual antiplatelet therapy (DAPT) in patients with minor ischemic stroke (MIS) and tiny unruptured intracranial aneurysm (UIA).Methods:Patients with MIS and tiny UIA admitted to the Department of Neurology, Weifang People's Hospital from October 1, 2022 to February 29, 2024 were included retrospectively. MIS was defined as baseline National Institutes of Health Stroke Scale (NIHSS) score ≤3. Tiny UIA was defined as UIA with a diameter of ≤3 mm. According to the antiplatelet therapy regimen, the patients were divided into an aspirin alone group and an aspirin+clopidogrel DAPT group. The main outcome measure was the clinical outcome at 90 days after onset. The modified Rankin Scale (mRS) score 0-1 was defined as a good outcome and >1 was defined as a poor outcome. Secondary outcome measures included aneurysm rupture, cerebral hemorrhage, and recurrence of cerebral ischemic events. Multivariate logistic regression analysis was used to identify the independent influencing factors for poor outcome. Results:A total of 183 patients with MIS and tiny UIA were included, including 108 males (59.0%), median aged 68 years (interquartile range, 61-73 years). All the UIAs were solitary. The mRS score of all patients before onset was 0; 152 patients (83.1%) had good outcome at 90 days after onset, 31 (16.9%) had poor outcome, and no UIA occurred rupture bleeding. Of the 94 patients (51.4%) who received aspirin monotherapy, 14 patients (14.9%) experienced recurrent cerebral ischemic events during follow-up, and 73 (77.7%) had good outcome. Of the 89 patients (48.6%) who received DAPT, 5 (5.6%) experienced recurrent ischemic events during follow-up, and 79 (88.8%) had good outcome. The recurrence rate of cerebral ischemic events in the aspirin group was significantly higher than that in the DAPT group ( χ2=4.227, P=0.040), while the good outcome rate was significantly lower than that in the DAPT group ( χ2=4.006, P=0.045). Multivariate logistic regression analysis showed that baseline NIHSS score was an independent risk factor for poor outcome (odds ratio 4.597, 95% confidence interval 1.864-11.339; P=0.001), while DAPT was an independent protective factor for good outcome (odds ratio 0.265, 95% confidence interval 0.079-0.892; P=0.032). Conclusion:Compared with aspirin monotherapy, the short-term combination of aspirin and clopidogrel in patients with MIS and tiny UIA may improve the outcome, reduces the recurrence of cerebral ischemic events, and has good safety.
2.Change of the level of copeptin in plasma and its sigificance in patients with intracerebral hemorrhage combined with stress ulcer
Chuanchuan SUN ; Yeliang DU ; Junyan ZHOU ; Xueliang QIU ; Yanfang ZHU
Chinese Journal of Postgraduates of Medicine 2015;38(5):330-332
Objective To explore the change of copeptin in plasma and its significance in patients with intracerebral hemorrhage combined with stress ulcer.Methods Eighty patients with intracerebral hemorrhage were collected.Forty-nine patients of pure intracerebral hemorrhage and 31 patients of intracerebral hemorrhage combined with stress ulcer were included.Thirty healthy people were taken as controls.The level of copeptin in plasma was measured and compared in all subjects.Results The level of copeptin in plasma in patients with pure intracerebral hemorrhage and intracerebral hemorrhage combined with stress ulcer was significantly higher than that in controls:(303.684 ± 68.691),(527.034 ± 74.111) ng/L vs.(121.460 ± 53.364) ng/L,and the level of copeptin in plasma in patients with intracerebral hemorrhage combined with stress ulcer was significantly higher than that in patients with pure intracerebral hemorrhage.The differences were statistically significant (P < 0.05).Conclusion The level of copeptin in plasma in patients with pure intracerebral hemorrhage increases significantly,and it is much higher in patients with intracerebral hemorrhage combined with stress ulcer.
3.Electron microscopic observations on changes of cytoplasmic organelles in the oocytes of Cervus nippon hortulorun
Yingmei LI ; Chao TANG ; Changyong TIAN ; Bo KANG ; Yeliang DU ; Zefang MA
Acta Anatomica Sinica 2010;41(1):119-123
Objective Revealing the developmental regulation of Cervus nippon's oocyte and organelles. Methods In the experiment,follicle systems during both estrum and non- estrum were divided into the primordial follicle,growing follicle and mature follicle according to the Cervus nippon's follicle diameter size,formation of zonapellucida,appearance time of follicular cavity.At the same time,observations on cytoplasmic organelles in development of oocytes were conducted with electron microscopic,eyepiece micrometer and photomicrographic technique(The number of every oocyte observed is 6-8). Results In the primordial follicle and early growing follicle phase,the quantity of mitochondria,golgi apparatus,smooth endoplasmic reticulum and cortical granules increased gradually and all organelles moved to the cortical area.However,in the late growing follicle and mature follicle phase,Golgi apparatus and rough endoplasmic reticulum disappeared,cortical granules began to arrange themselves in line beneath the plasma membrane of the oocyte,mitochondrias dispersed toward the central region of cytoplasm,and almost all the round mitochondria with rare cristae turned into hooded ones, and nucleus compaction occurred.In addition,the short and thick microvilli began to appear from the primary follicle ovocyte,become intensive and slender when secondary follicle's ovocyte;It's until tertiary follicle's ovocyte,microvilli started to shorten and become coarse,and even parts of them contract from the zona pellucida gradually.Conclusion In the development of oocytes, the changes of type,quantity and distribution on mitochondria has a close relation with cells at proliferation,differentiation and metabolism level.Cortical granule has no association with golgi apparatus basically,but smooth endoplasmic reticulum(SER).The nuclei are the sites of RNA synthesis and warehouses,and its densification is the premise of meiosis recovery.

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