Objective:To construct a risk prediction model for hemorrhagic transformation (HT) in elderly patients with acute cerebral infarction (ACI) complicated by cerebral small vessel disease (CSVD) based on thromboelastography (TEG) and coagulation function indicators.Methods:Clinical data of 120 elderly ACI patients with CSVD admitted to the First Affiliated Hospital of Xi′an Jiaotong University from June 2021 to June 2024 were retrospectively analyzed. Patients were divided into HT group (42 cases) and non-HT group (78 cases) according to the occurrence of HT within 7 days of admission. TEG parameters, coagulation function indicators, and general data were compared between the two groups. Multivariate logistic regression analysis was used to screen the influencing factors of HT, and a nomogram model was constructed accordingly. The receiver operating characteristic (ROC) curve was used to evaluate its predictive efficacy.Results:Compared with the non-HT group, the HT group had significantly longer coagulation reaction time (R), higher 30-minute clot lysis rate (LY30), longer activated partial thromboplastin time (APTT), older age, higher prevalence of diabetes mellitus, higher National Institutes of Health Stroke Scale (NIHSS) score, and larger infarct size, while the fibrinogen (FIB) level was lower (all P<0.05). Multivariate stepwise logistic regression showed that R ( OR=3.295, 95% CI: 1.226-8.848), LY30 ( OR=6.118, 95% CI: 3.111-12.030), FIB ( OR=0.213, 95% CI: 0.085-0.527), NIHSS score ( OR=4.061, 95% CI: 1.431-11.520), and infarct size ( OR=5.314, 95% CI: 2.588-10.909) were independent influencing factors for HT in elderly ACI patients with CSVD (all P<0.05). The C-index of the nomogram model constructed based on the above factors was 0.836, and the calibration curve for predicting HT was close to the ideal curve ( P>0.05). ROC curve analysis showed that the model had a sensitivity of 85.70%, specificity of 83.30%, and area under the curve (AUC) of 0.879 (95% CI: 0.810-0.949, P<0.05) for predicting HT. Conclusions:R, LY30, and FIB levels are influencing factors for HT in elderly ACI patients with CSVD. The nomogram model constructed based on these factors can effectively predict the risk of HT.

Objective:To construct a risk prediction model for hemorrhagic transformation (HT) in elderly patients with acute cerebral infarction (ACI) complicated by cerebral small vessel disease (CSVD) based on thromboelastography (TEG) and coagulation function indicators.Methods:Clinical data of 120 elderly ACI patients with CSVD admitted to the First Affiliated Hospital of Xi′an Jiaotong University from June 2021 to June 2024 were retrospectively analyzed. Patients were divided into HT group (42 cases) and non-HT group (78 cases) according to the occurrence of HT within 7 days of admission. TEG parameters, coagulation function indicators, and general data were compared between the two groups. Multivariate logistic regression analysis was used to screen the influencing factors of HT, and a nomogram model was constructed accordingly. The receiver operating characteristic (ROC) curve was used to evaluate its predictive efficacy.Results:Compared with the non-HT group, the HT group had significantly longer coagulation reaction time (R), higher 30-minute clot lysis rate (LY30), longer activated partial thromboplastin time (APTT), older age, higher prevalence of diabetes mellitus, higher National Institutes of Health Stroke Scale (NIHSS) score, and larger infarct size, while the fibrinogen (FIB) level was lower (all P<0.05). Multivariate stepwise logistic regression showed that R ( OR=3.295, 95% CI: 1.226-8.848), LY30 ( OR=6.118, 95% CI: 3.111-12.030), FIB ( OR=0.213, 95% CI: 0.085-0.527), NIHSS score ( OR=4.061, 95% CI: 1.431-11.520), and infarct size ( OR=5.314, 95% CI: 2.588-10.909) were independent influencing factors for HT in elderly ACI patients with CSVD (all P<0.05). The C-index of the nomogram model constructed based on the above factors was 0.836, and the calibration curve for predicting HT was close to the ideal curve ( P>0.05). ROC curve analysis showed that the model had a sensitivity of 85.70%, specificity of 83.30%, and area under the curve (AUC) of 0.879 (95% CI: 0.810-0.949, P<0.05) for predicting HT. Conclusions:R, LY30, and FIB levels are influencing factors for HT in elderly ACI patients with CSVD. The nomogram model constructed based on these factors can effectively predict the risk of HT.

Objective:To evaluate the efficacy of combined fascia sheath suspension (CFS) and frontalis muscle flap suspension in the treatment of severe congenital blepharoptosis.Methods:We searched PubMed, EMbase, Cochrane Library, web of science and Chinese Hownet, Wanfang, VIP, CBM and other databases to collect randomized and non-randomized controlled trials comparing the efficacy of CFS and frontalis muscle flap suspension in the treatment of severe congenital ptosis, from the establishment of literature retrieval database to March 2020; two researchers used RevMan 5.3 software to select and exclude the literature, extract the data and evaluate the quality, set up appropriate effect index and conduct Meta-analysis.Results:Eleven studies included 661 patients, There were 312 cases in study group and 349 cases in control group. The results of Meta analysis showed that the OR of the two groups was 4.88 with 95% CI (2.69, 8.85); the OR of failure rate was 0.20, with 95% CI (0.11, 0.37); the OR of complications was 0.22, with 95% CI (0.14, 0.34). All three groups of data were statistically significant ( P<0.05). Conclusions:The available evidence shows that the combined fascia sheath suspension (CFS) is effective in the treatment of severe congenital blepharoptosis compared with frontalis muscle flap suspension, but the complications of CFS are lower and the satisfaction is higher; these findings have yet to be validated by more high-quality studies due to limitations in the quality and quantity of studies included.

Objective To observe the effect of hemoperfusion on micro-inflammation in patients with maintenance hemodialysis (MHD).Methods Fifty MHD patients (MHD group) and 25 healthy volunteers (control group) were involved in this study.The MHD patients were divided into two groups by random digits table:hemoperfusion combined with hemodialysis group (HP + HD group,25 cases) and hemodialyais group (HD group,25 cases).The plasma levels of micro-inflammatory cytokines including high-sensitive C-reactive protein (hs-CRP),interleukin-6 (IL-6) and tumor necrosis faetor-α (TNF-α ) were measured before and after treatment.Results The plasma levels of hs-CRP,IL-6 and TNF-α in MHD group were significantly higher than those in control group [(6.72 ± 2.63) mg/L vs.(1.35 ± 0.92) mg/L,(348.83 ± 64.41) ng/L vs.(54.49 ±22.47) ng/L,(7.52 ± 3.17) ng/L vs.(2.53 ±0.88) ng/L](P＜0.05).There was no significant difference in the plasma levels of hs-CRP,IL-6,TNF-α before treatment between HD group and HP+HD group (P＞0.05),Compared with those in HD group,the plasma levels of hs-CRP,IL-6 and TNF-α after treatment in HP+HD group were significantly decreased [(4.78 ±2.49) mg/L vs.(6.89 ±2.69) mg/L,(260.54 ±56.72) ng/L vs.(357.14 ±56.37) ng/L,(5.36 ±2.41) ng/L vs.(7.49 ±2.87) ng/L] (P <0.05).Conclusion Hemoperfusion improves micro-inflammation in patients with MHD.