Objective To differentiate cerebral parenchymal hemorrhage from contrast extravasation based on the imaging characteristics of a high-density shadow within the brain parenchyma,which is demonstrated on early(within 24 hours)plain CT scan in patients with acute ischemic stroke after receiving mechanical thrombectomy(MT).Methods The clinical data of 77 patients with ischemic stroke caused by acute large-vessel occlusion,who received MT and whose early plain CT scan(performed within 24 hours after MT)showed a high-density shadow within the brain parenchyma,were retrospectively analyzed.According to the results of CT reexamination performed at 24-48 hours after treatment,the patients were divided into parenchymal hemorrhage group(n=38,43 sites)and pure contrast extravasation group(n=39,47 sites).The direct signs(including location distribution,maximum CT value,volume,mixed density sign)and the indirect signs(including local space-occupying effect,intraventricular high density,subarachnoid high density)of the post-thrombectomy intraparenchymal high-density(PTIH)shadow displayed on early CT images after MT were analyzed.The differences in imaging characteristics between the two groups were analyzed by using t-test,Mann-Whitney rank sum test,chi-square test,Fisher exact test and multivariate logistic regression analysis.Results The space-occupying effect(28/38 versus 9/39,P=0.003)and intraventricular high density lesion(5/38 versus 0/39,P=0.025)were more likely to occur in the parenchymal hemorrhage group than in the pure contrast extravasation group.The newly-developed 90 PTIH lesions included 43 parenchymal hemorrhage foci and 47 contrast extravasation foci.Multivariate logistic regression analysis showed that the differences in the PTIH volume and mixed density sign between the two groups were statistically significant(both P＜0.05,OR=2.93 and OR=9.24 respectively).The optimal critical value of PTIH volume for diagnosing cerebral parenchymal hemorrhage was 9.3 cm3.Conclusion The space-occupying effect and intraventricular high density are the indirect signs for judging a newly-developed PTIH to be a cerebral parenchymal hemorrhage.PTIH volume ≥9.3 cm3 and mixed density sign are the direct signs for judging a newly-developed PTIH to be a cerebral parenchymal hemorrhage.

Objective To evaluate the impact of the growth speed of cerebral infarction on the occurrence of symptomatic intracranial hemorrhage(sICH)in patients with acute anterior circulation ischemic stroke after mechanical thrombectomy.Methods The clinical data of patients with acute ischemic stroke(AIS),who received mechanical thrombectomy at the First Affiliated Hospital of Soochow University of China from June 2016 to December 2022,were retrospectively analyzed.After thrombectomy,the patients were divided into sICH group and non-sICH group according to Heidelberg criteria.The clinical data and imaging findings were compared between the two groups.Multivariate logistic regression analysis was used to identify the independent risk factors for sICH after thrombectomy,and the area under the receiver operating characteristic curve(AUC)was used to evaluate the efficacy of the growth speed of cerebral infarction in predicting sICH.Results A total of 218 patients were enrolled in this study,sICH group had 23 patients and non-sICH group had 195 patients.The differences in NIHSS score,collateral circulation status,core infarction volume,and growth speed of cerebral infarction between the two groups were statistically significant(all P＜0.05).Multivariate logistic regression analysis showed that rapid growth speed of cerebral infarction was an independent risk factor for sICH occurring after mechanical thrombectomy.For predicting sICH,the sensitivity and specificity of the growth speed of cerebral infarction were 78.3％and 69.7％respectively,with an AUC of 0.751 and a predicted value of 7.6 mL/h.Conclusion The rapid growth speed of cerebral infarction is a predictive factor for sICH occurring after mechanical thrombectomy in patients with acute anterior circulation ischemic stroke.The risk of sICH becomes higher after mechanical thrombectomy when the growth speed of cerebral infarction is faster than 7.6 mL/h.

Diabetes mellitus(DM)is a disease syndrome characterized by chronic hyperglycaemia.A long-term high-glucose environment leads to reactive oxygen species(ROS)production and nuclear DNA damage.Human umbilical cord mesenchymal stem cell(HUcMSC)infusion induces significant antidiabetic effects in type 2 diabetes mellitus(T2DM)rats.Insulin-like growth factor 1(IGF1)receptor(IGF1R)is important in promoting glucose metabolism in diabetes;however,the mechanism by which HUcMSC can treat diabetes through IGF1R and DNA damage repair remains unclear.In this study,a DM rat model was induced with high-fat diet feeding and streptozotocin(STZ)administration and rats were infused four times with HUcMSC.Blood glucose,interleukin-6(IL-6),IL-10,glomerular basement membrane,and renal function were examined.Proteins that interacted with IGF1R were determined through coimmunoprecipitation assays.The expression of IGF1R,phosphorylated checkpoint kinase 2(p-CHK2),and phosphorylated protein 53(p-p53)was examined using immunohistochemistry(IHC)and western blot analysis.Enzyme-linked immunosorbent assay(ELISA)was used to determine the serum levels of 8-hydroxydeoxyguanosine(8-OHdG).Flow cytometry experiments were used to detect the surface markers of HUcMSC.The identification of the morphology and phenotype of HUcMSC was performed by way of oil red"O"staining and Alizarin red staining.DM rats exhibited abnormal blood glucose and IL-6/10 levels and renal function changes in the glomerular basement membrane,increased the expression of IGF1 and IGF1R.IGF1R interacted with CHK2,and the expression of p-CHK2 was significantly decreased in IGF1R-knockdown cells.When cisplatin was used to induce DNA damage,the expression of p-CHK2 was higher than that in the IGF1R-knockdown group without cisplatin treatment.HUcMSC infusion ameliorated abnormalities and preserved kidney structure and function in DM rats.The expression of IGF1,IGF1R,p-CHK2,and p-p53,and the level of 8-OHdG in the DM group increased significantly compared with those in the control group,and decreased after HUcMSC treatment.Our results suggested that IGF1R could interact with CHK2 and mediate DNA damage.HUcMSC infusion protected against kidney injury in DM rats.The underlying mechanisms may include HUcMSC-mediated enhancement of diabetes treatment via the IGF1R-CHK2-p53 signalling pathway.

Objective:To investigate the safety of tirofiban in patients with anterior circulation acute large vessel occlusion cerebral infarction during bridging endovascular treatment (EVT) after intravenous thrombolysis (IVT).Methods:Two hundred and three patients received bridging EVT after IVT in Department of Intervention, First Affiliated Hospital of Soochow University from January 2017 to January 2022 were chosen. Patients were divided into tirofiban group ( n=80) and non-tirofiban group ( n=123) according to whether or not tirofiban was used during EVT, and then patients from tirofiban group were subdivided into stent implantation group ( n=52) and non-stent implantation group ( n=28) according to whether or not emergency stent implantation was performed. The clinical data, safety indexes (intracranial hemorrhage [ICH] rate 24 h, 2-3 d, and 90 d after EVT, new ICH incidence 3-90 d after EVT, fatal ICH rate, and mortality 90 d after EVT), and prognoses 90 d after EVT were compared. Results:(1) Compared with the non-tirofiban group, the tirofiban group had significantly higher proportions of males, and patients with tandem occlusion, balloon dilation or stent implantation, and statistically lower proportion of patients with atrial fibrillation, significantly longer surgical time, and significantly different distribution of stroke types ( P<0.05). No significant differences were noted in ICH incidences 24 h after EVT, 2-3 d after EVT and 90 d after EVT, fatal ICH incidence, mortality incidence 90 d after EVT, or good prognosis rate 90 d after surgery between tirofiban group and non-tirofiban group ( P>0.05). (2) Patients in the stent implantation group had significantly higher percentages of tandem occlusion and balloon dilation compared with those in the non-stent implantation group ( P<0.05). No significant difference was noted in good prognosis rate 90 d after EVT or new ICH incidence 3-90 d after EVT between the stent implantation group and the non-stent implantation group ( P>0.05). Compared with the non-stent implantation group, the stent implantation group had statistically higher ICH incidences 24 h after EVT, 2-3 d after EVT, and 90 d after EVT, significantly higher fatal ICH incidence and mortality 90 d after EVT ( P<0.05). Conclusion:Tirofiban is safe in patients with anterior circulation acute large vessel occlusion cerebral infarction during EVT after IVT; however, if emergency stent implantation is performed, it will lead to increased intracranial hemorrhage and mortality.

Scalp arteriovenous fistula (SAVF) is a rare complication of thread-lift sutures for facial rejuvenation.This article reports a 23-year-old female patient who suffered from entotic sounds in left ear after thread lifting. Then, the entotic sounds was gradually aggravated with palpitations. The cerebral angiography showed a high flow scalp arteriovenous fistula in the left temporal region, which got satisfactory result by endovascular embolization with coil and medical glue. There was no recurrence of the fistulas after one year of follow-up.

Scalp arteriovenous fistula (SAVF) is a rare complication of thread-lift sutures for facial rejuvenation.This article reports a 23-year-old female patient who suffered from entotic sounds in left ear after thread lifting. Then, the entotic sounds was gradually aggravated with palpitations. The cerebral angiography showed a high flow scalp arteriovenous fistula in the left temporal region, which got satisfactory result by endovascular embolization with coil and medical glue. There was no recurrence of the fistulas after one year of follow-up.

Objective:To investigate influencing factors of dental caries among 3 to 5-year-old children in the Yuhua District of Changsha by Cariostat detection and provide evidence to prevent caries.Methods:1 032 children aged 3-5 years old from 6 kindergartens in Yuhua District of Changsha were randomly selected for oral health examination. 565 children in 6 large classes, 6 middle classes and 6 small classes were randomly selected from 6 kindergartens were perfected caries activity test (CAT) by Cariostat detection.Results:Among 1 032 children, 626 had caries, the caries rate was 60.66%, the caries was 2.87±3.67, and the caries filling rate was 8.53%. The caries rate of maxillary central incisors was the highest (37.89%), followed by mandibular second primary molars (32.56%) and mandibular first primary molars (32.36%). There was significant difference in caries rate among different age groups (χ 2=9.231, P<0.05). The caries rate of 5-year-old children was the highest (66.50%). 1 032 children were divided into 4 groups according to dmft (decayed, missing, filled teeth) value, and the number of caries free group was the largest; the number of caries in the middle caries group was the least. The number of missing teeth in 1 032 children with caries was 2 959. The number of missing teeth in the high caries group was the most, up to 1 861, accounting for 61.89% of the total number of missing teeth. The analysis of 565 children by CAT showed that the caries rate was different in different CAT grades (χ 2=27.390, P<0.05). The caries rate in the high-risk group was the highest, 90.48%. The CAT value was positively correlated with caries ( r=0.261, P<0.05). Conclusions:The incidence of dental caries in children aged 3-5 years in Yuhua District of Changsha was 60.66%. Cariostat method can truly reflect the situation of caries in children and is helpful to screen the population susceptible to caries in children.

OBJECTIVE:To establish a method for the separation and detection of related substances in baicalein,identify its structure and preliminarily explore the degradation mechanism. METHODS:HPLC was adopted to detect the baicalein,related impurities and forced destruction of degradation products in synthesis process:the column was ES Industries? FluoroSep-RP Phenyl with mobile phase of 0.3%formic acid-methanol-acetonitrile(gradient elution)at a flow rate of 1.0 mL/min,the detection wavelength was 275 nm,the column temperature was 10℃,and the injection volume was 10μL. LC-MS/MS was conducted to identify the related substances and conjecture degradation mechanism:the column was ES Industries? FluoroSep-RP Phenyl with mobile phase of 0.3%formic acid- methanol (gradient elution)at a flow rate of 1.0 mL/min,the detection wavelength was 275 nm,column temperature was 10℃,and the injection volume was 10μL;ion source was electrospray ion source,positive and negative ions,nebulizer pressure was 55 psi and the drying gas flow was 11 L/min,drying gas temperature was 350℃,capillary voltage was 4.0 kV,detection modes were full-scan first-order MS and selective ion full-scan second-order MS,scan ranges were m/z 100-1000 (first-order MS) and 50-500(second-order MS),ionization voltage was 80-135 eV,and the collision energy was 10-30 eV. RESULTS:The linear range of baicalein was 2.4-480μg/mL(r=0.9999);RSDs of precision,stability and reproducibility tests were lower than 2.0%;the limit of quantitation was 7.2 ng,the limit of detection was 2.4 ng. Baicalein was well separated with related substance and 3 major degradation products,the related substance was chemical synthesis precursor wood butterfly;the degradation products were 6,7-quinone derivatives and 7,8-quinone derivatives,which were isomers;oxidative degradation products were benzoic acid phenyl ester derivatives. CONCLUSIONS:The main mechanisms of alkali degradation and oxidative degradation of baicalein include pyran, reciprocal rearrangement and oxidation reaction;the established method is specific and sensitive,and can be used for the detection of related substances in baicalein.

Diagnostic Errors ; Humans ; Pneumoconiosis ; diagnosis

OBJECTIVETo investigate the pathological characteristics of draining pulmonary lymph nodes in coal workers' pneumoconiosis (CWP) and study their significance for the early diagnosis of CWP.

METHODSThe autopsy materials of 12 coal workers were subjected to HE staining and observed under a light microscope, and a retrospective analysis was performed considering the occupational history.

RESULTSThe age range of 12 cases was 46∼71 years (mean, 58 years), and the exposure time range was 3∼32 years (mean, 22.8 years). The draining pulmonary lymph nodes of 1 case with dust reaction mostly had coal dust deposition, mild pulmonary fibrosis, and local dust fibrosis in the medullary sinus; 1 case of stage I anthracosilicosis mainly showed extensive dust fibrosis and coal dust deposition; 8 cases of stage II anthracosilicosis mainly showed dust fibrosis and silicotic nodules; 1 case of stage III anthracosilicosis and 1 case of stage III silicosis mainly showed silicotic nodules' fusion with each other, and lymph nodes' adhesion and formation of massive fibrosis, and the formation of silicotic nodules was especially obvious in cases of stage III silicosis.

CONCLUSIONThe dust lesions of draining pulmonary lymph nodes become severer with higher severity of pulmonary lesions in cases of CWP. The cases of simple silicosis have earlier and severer lesions in draining pulmonary lymph nodes than in lung tissue.

Aged ; Anthracosis ; pathology ; Autopsy ; Coal Mining ; Humans ; Lymph Nodes ; pathology ; Male ; Middle Aged ; Retrospective Studies