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Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate the rehabilitation effects of vestibular rehabilitation in acute brainstem infarction patients with subjective visual vertical (SVV) tilting, and the correlation between the SVV, balance confidence, dizziness/vertigo and walking function. Methods All 45 acute brainstem infarction patients with SVV tilting who were hospitalized in Tianjin Huanhu Hospital from July 2022 to July 2023 were collected. Patients were divided into vestibular rehabilitation group (n = 25) and general rehabilitation group (n = 20), Bucket Test was used to test SVV tilting angle, Activities-Specific Balance Confidence Scale (ABC) was used to evaluate balance confidence, Visual Analog Scales (VAS) was used to evaluate dizziness/vertigo and Functional Ambulation Category Scale (FAC) was used to evaluate walking function before and after 2 weeks of treatment. Results The SVV tilting angle (F = 4.356, P = 0.043), ABC score (F = 4.389, P = 0.042), dizziness/vertigo VAS score (F = 4.138, P = 0.048) were significantly different between vestibular rehabilitation group and general rehabilitation group. After treatment, the SVV tilting angle (t =-2.139, P = 0.038) and the dizziness/vertigo VAS score (t =-2.952, P = 0.005) in vestibular rehabilitation group were lower than those in general rehabilitation group, and the ABC score was higher than that in general rehabilitation group (t = 2.920, P = 0.006). SVV tilting angle (F = 196.923, P = 0.000), ABC score (F = 89.050, P = 0.000), dizziness/vertigo VAS score (F = 81.803, P = 0.000), FAC grade (F = 72.866, P = 0.000) were statistically significant. The SVV tilting angle (t = 0.763, P = 0.000; t = 0.972, P = 0.000) and dizziness/vertigo VAS score (t = 8.815, P = 0.000; t = 5.107, P = 0.000) after treatment were lower than those before treatment of 2 groups, and the ABC score (t = 0.689, P = 0.001; t = 0.703, P = 0.001) and FAC grade (t =-6.721, P = 0.000; t =-5.772, P = 0.000) were higher than those before treatment of 2 groups. Correlation analysis showed a positive correlation between SVV tilting angle and dizziness/vertigo VAS score in acute brainstem infarction patients with SVV tilting (r = 0.627, P = 0.000). Conclusions Vestibular rehabilitation can effectively improve the SVV tilting, balance confidence and dizziness/vertigo symptoms of acute brainstem infarction patients with SVV tilting, and the SVV tilting angle is closely related to the degree of dizziness/vertigo. [ABSTRACT FROM AUTHOR]

Anticoagulant treatment is an important strategy for secondary stroke prevention in non-valvular atrial fibrillation and acute ischemic stroke patients. However, the optimal timing for anticoagulation initiation after acute ischemic stroke has remained uncertain. In recent years, new clinical evidence has identified the benefit of early anticoagulation initiation rather than delayed anticoagulation initiation after acute ischemic stroke. This article reviews the literature on the topic of anticoagulation initiation in non-valvular atrial fibrillation with acute ischemic stroke patients. It helps physicians making decision to initiate anticoagulation at a more reasonable time point after balancing the risk of stroke recurrence and hemorrhagic transformation. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Norovirus (NoV) is one of the major pathogens causing acute gastroenteritis diseases worldwide and is highly susceptible to outbreak transmission, increasing medical and economic burden. Objective: To develop a novel detection method for NoV by recombinase aided amplification (RAA). Methods Based on the cDNA sequences corresponding to the GI and Gil NoV detection targets specified in ISO TS 15216-2-2013 and GB 4789.42, the optimal RAA primers and probes were designed and screened, and their specificity for other common food-borne diarrhea viruses was determined; the shortest detection time, reaction procedure, and reaction system were determined by optimization, and the analysis of this detection system was performed. The shortest detection time, reaction procedure and reaction system were optimized, and the sensitivity of the assay system for the detection of NoV reference plasmids and real samples was analyzed, thus establishing a rapid visualization method for the detection of GI and Gil NoV RAA. The optimized reaction procedure can shorten the detection time to about 10 min and reduce the reaction cost by two-thirds, and the sensitivity of the method can reach 10-2 ng/µL for the reference plasmid and 1 ng/µL for the real sample. The two NoV assays established are specific, sensitive, simple, rapid and visualized, and provide a good basis for future rapid NoV detection. [ABSTRACT FROM AUTHOR]

The triple-jiao is considered “the envoy of original qi,” but there is no documentation on what is “the ambassador” in ancient books. By combining prior literature and clinical thinking, we put forward the idea that “ governor conception and thoroughfare vessels are the ambassador of original qi”. The original qi is the root of ascending, descending, exiting, and entering of visceral meridians and collaterals. “ Governor conception and thoroughfare vessels ” is the main channel of the upward, downward, inward and outward movement of original qi. Meridian collaterals, zang-fu organs, four extremities and limbs are the branches of the ascending, descending, exiting, and entering of original qi. “Governor conception and thoroughfare vessels” and the triple-jiao constitute a complex network of original qi distribution and jointly maintain the basic activities of life. In accordance with “ governor conception and thoroughfare vessels is the ambassador of original qi” combined with clinical practice, in the treatment of spinal cord malignant tumors, it is necessary to regulate the governor vessel to release the exterior to regulate the exiting and entering of qi. In persistent disease, the exterior should be released to regulate the exiting and entering of qi, which is beneficial to ascending and descending of qi. For emergencies and severe diseases illness, it is necessary to tonify the original qi to facilitate the ascending, descending, exiting, and entering of qi. Therefore, we put forward the view that in the treatment of malignant tumors of the spinal cord, attention should be paid to the access of qi. In persistent disease, one should not forget the use of wind-dispelling Chinese medicinals to relieve the extenor. In emergencies and severe diseases, moxibustion should be applied to the Dantian district acupoints. The aim of the present study is to provide a reference for clinical workers in the treatment of persistent disease and acute critical illness. [ABSTRACT FROM AUTHOR]

This article describes the author's experience of providing nursing care for a middle-aged critically ill patient with acute myocardial infarction and cardiogenic shock who died after his life support was removed. The nursing care was provided from November 11th to 30th, 2019. Data was collected using physical assessments, chart reviews, discussions with the medical team, and interviews with the family. Three health problems were identified: low cardiac output, anticipatory grieving, and decision-making on withdrawing life-sustaining treatment. The nursing intervention included two parts: for the patient, maintaining hemodynamic stability was the main outcome of the treatment; and for the families, the nursing intervention included providing flexible visiting hours, encouraging the expression of emotions, listening to their worries and concerns, and consulting the palliative care team and arranging a family meeting to discuss the withdrawal of life-sustaining treatment. Finally, the decision of withdrawing life-support was made by the family. This nursing care experience can provide a reference for nurses' caring for patients and their families who are facing unexpected death and anticipatory grieving in the future. [ABSTRACT FROM AUTHOR]

Etiology of epilepsy is complex. Immune has been defined as one of the etiological groups of epilepsy. Autoimmune epilepsy attracts experts worldwide to investigate and new conceptual definitions has been proposed. Based on the pathophysiology, autoimmune epilepsy includes two entities, which are acute symptomatic seizures secondary to autoimmune encephalitis (AE) and autoimmune - associated epilepsy (AAE). We interpret the new concepts, the characteristics of extracellular and intracellular neuronal antibodies which contribute to the pathogenesis of epilepsy, and AE manifested by seizures in this review. We hope that the article helps researchers and clinicians have a better understanding of AAE and use standard terms in practical situations, thus improving diagnosis and treatment of epilepsy. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Acute graft-versus-host disease is one of the major complications of allogeneic hematopoietic stem cell transplantation, and it is also the key to the success of transplantation, which is particularly important to find specific biomarkers of acute graft-versus-host disease for the early diagnosis and treatment. The immune function of children is imperfect, and the changes of plasma biomarkers after acute graft-versus-host disease have their own characteristics. OBJECTIVE: To explore the correlation of plasma levels of soluble growth stimulation expressed gene 2 (sST2), regenerating islet-derived protein 3 alpha (REG3α), tumor necrosis factor receptor 1 (TNFR1), interleukin 6 (IL6), and interleukin 8 (IL8) with acute graft-versus-host disease in children after allogeneic hematopoietic stem cell transplantation. It is expected to provide reliable detection biomarkers for early diagnosis of acute graft-versus-host disease and prediction of therapy effect and prognosis. METHODS: Samples were collected from 127 pediatric patients who underwent allogeneic hematopoietic stem cell transplantation from March 2019 to December 2020 in the Department of Pediatrics, Nanfang Hospital. The plasma was collected at multiple time points, including 10 days before transplantation, 0, 7, 14, 28, and 90 days after transplantation, at the onset of acute graft-versus-host disease symptoms, 1, 2, and 4 weeks after acute graft-versus-host disease therapy. The plasma concentrations of sST2, REG3α, TNFR1, IL6 and IL8 were detected by the Luminex technology. RESULTS AND CONCLUSION: (1) Plasma samples were collected from 100 of 127 patients at the point of occurrence of acute graft-versus-host disease. Sixty cases never developed acute graft-versus-host disease symptoms; 40 cases presented acute graft-versus-host disease, among which 9 cases developed II-IV gastrointestinal acute graft-versus-host disease according to EBMT-NIH-CIBMTR classification standard. (2) The plasma concentrations of sST2 and REG3α at onset point in patients were significantly higher in the acute graft-versus-host disease group compared with the non-acute graft-versus-host disease group (P < 0.05). sST2 was significantly increased at 7 days after transplantation in the acute graft-versus-host disease group than that in the non-acute graft-versus-host disease group (P < 0.05). The sST2 and REG3α levels were significantly higher in the II-IV gastrointestinal acute graft-versus-host disease group than those in the non-gastrointestinal acute graft-versus-host disease group (P < 0.01; P < 0.05). There were no significant differences in TNFR1, IL6 and IL8 levels at onset point and 7 days after transplantation in patients between the acute graft-versus-host disease group and the non-acute graft-versus-host disease group (P > 0.05). (3) In all acute graft-versus-host disease patients, the plasma concentrations of sST2 and REG3α in the steroid-resistant acute graft-versus-host disease group showed increasing tendency compared with steroid-sensitive acute graft-versus-host disease group. (4) It is concluded that the increate of plasma sST2 and REG3α levels at onset point after transplantation suggests the incidence of acute graft-versus-host disease. sST2 and REG3α in plasma can be helpful for the early prediction of acute graft-versus-host disease. By analyzing the levels of biomarkers at 1, 2, and 4 weeks after treatment, no decrease in the sST2 and REG3α levels in patients with acute graft-versus-host disease after treatment may be related to poor prognosis. [ABSTRACT FROM AUTHOR]

BACKGROUND: The regimen of cyclosporin combined with four times of short-range methotrexate is still recognized as the classic prevention regimen for acute graft-versus-host disease. Previous studies have shown that whether day 11 methotrexate is used in sibling transplantation has no effect on the incidence of acute graft-versus-host disease. However, the effect of reducing day 11 methotrexate on the incidence of acute graft-versus-host disease in haploid hematopoietic stem cell transplantation patients remains unclear. OBJECTIVE: To investigate the efficacy of the omission of day 11 methotrexate in the regimen for the prophylaxis of graft-versus-host disease in haploid hematopoietic stem cell transplantation. METHODS: The clinical data of 63 patients with malignant hematologic diseases who received haploid hematopoietic stem cell transplantation from January 2017 to December 2019 were retrospectively analyzed. The graft-versus-host disease prevention regimen was cyclosporine combined with methotrexate 15 mg/m² on day 1, 10 mg/m² on day 3, day 6 and day 11. In the observation group (n=19), oral mucositis was grade III-IV at day 11, and day 11 methotrexate was cancelled. In the control group (n=44), oral mucositis was grade 0-II at day 11, and day 11 methotrexate was applied. The implantation situation, incidence of acute graft-versus-host disease, overall survival rate, and recurrence rate of the two groups were analyzed. RESULTS AND CONCLUSION: (1) The median follow-up time was 30(3-54) months and all neutrophils were successfully implanted in both groups. The median implantation time was 12(9-29) days and 12(8-25) days, respectively, showing no significant difference (P=0.682). There was one patient with poor platelet implantation in the observation group, and four patients with poor platelet implantation in the control group. The median time of platelet implantation was 12(9-18) days and 13(9-31) days in the two groups, respectively, (P=0.71), showing no statistical difference. (2) The overall incidence of acute graft-versus-host disease was 44.4%, and grade II-IV acute graft-versus-host disease was 28.6%. The incidence of II-IV acute graft-versus-host disease in the observation group and control group was 31.5% and 27.3%, respectively, (P=0.728), and there was no statistical difference between the two groups. (3) The results showed that for haploid hematopoietic stem cell transplantation, the omission of day 11 methotrexate did not increase the incidence of acute graft-versus-host disease compared with the standard methotrexate regimen. [ABSTRACT FROM AUTHOR]

Objective To analyze the imaging data of patients with hyperacute hypertensive cerebral hemorrhage with leukoaraiosis (LA), and to evaluate the possibility of unstable CT signs of hematoma as a predictor of hematoma enlargement risk. Methods The imaging data of 95 patients who were admitted to the Department of Emergency of The Affiliated Hospital of Xuzhou Medical University from March to April, 2021 and underwent head CT scan within 6 h of onset were collected, and hematoma volume was obtained by ITK-SNAP software. Unstable CT signs of hematoma including irregular shape sign, mixed density sign, black hole sign, swirl sign, satellite sign, island sign and liquid-liquid level sign were recorded. The severity of LA was assessed by the Blennow scale. Univariate and multivariate stepwise Logistic regression analysis were used to screen the risk factors of large volume cerebral hemorrhage (≥ 30 ml). Results According to the hematoma volume of cerebral hemorrhage, 95 cases were divided into < 30 ml group (n = 53) and ≥ 30 ml group (n = 42). Logistic regression analysis showed that severe LA was a risk factor for large volume hematoma in cerebral hemorrhage (OR = 6.222, 95%CI: 2.506-15.452; P = 0.000). CT showed that the proportions of irregular shape sign (χ² = 17.599, P = 0.000), mixed density sign (χ² = 5.644, P = 0.018), black hole sign (χ² = 23.161, P = 0.000), swirl sign (χ² = 26.128, P = 0.000), satellite sign (χ² = 25.148, P = 0.000), island sign (χ² = 20.575, P = 0.000), ≥ 2 combined signs (χ² = 23.245, P = 0.000) and ≥ 3 combined signs (χ² = 58.902, P = 0.000) were higher in the hematoma volume ≥ 30 ml group than those in < 30 ml group. Severe LA (grade II and III) group (n = 50) showed irregular shape sign (χ² = 5.502, P = 0.019), black hole sign (χ² = 10.715, P = 0.001), swirl sign (χ² = 7.336, P = 0.007), satellite sign (χ² = 4.467, P = 0.035), island sign (χ² = 19.961, P = 0.000), ≥ 2 combined signs (χ² = 12.684, P = 0.000) and ≥ 3 combined signs (χ² = 17.593, P = 0.000) were higher than those in non-severe (non and grade I) group (n = 45). Conclusions Severe LA is an important risk factor for hematoma volume expansion (≥ 30 ml) in hyperacute hypertensive cerebral hemorrhage. The positive rates of unstable CT signs of hematoma in acute stage are higher, suggesting that this indicator can be used as a risk predictor for hematoma expansion after cerebral hemorrhage. [ABSTRACT FROM AUTHOR]

Objective To investigate the efficacy and safety of emergent carotid artery stenting (CAS) after intracranial artery mechanical thrombectomy for acute internal carotid artery (ICA) stenosis related tandem lesions. Methods A total of 79 patients with acute ICA stenosis related tandem lesions admitted to the Advanced Stroke Center of Zhangzhou Hospital affiliated to Fujian Medical University from January 2015 to December 2019 were selected. All patients underwent urgent endovascular therapy with "half" anterograde approach with or without usage of embolic prevention device (EPD) technology, and divided into CAS group (n = 47) and non-CAS group (n = 32) according to whether CAS was performed in emergency. Compared and analysed the 2 groups of surgical related indexes [including the preoperative Alberta Stroke Program Early CT Score (ASPECTS), the occlusion site of tandem lesions, the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology Collateral Flow Grading System (ASITN/SIR ACG), puncture-to-reperfusion time, leakage on C-arm CT, incidence of distal embolism], and the clinical prognostic indicators [including the incidence of symptomatic intracranial hemorrhage (sICH), culprit artery reocclusion rate, postoperative 90-d favorable outcome rate and mortality]. Univariate and multivariate forward Logistic regression were used to analysis the influencing factors of postoperative 90-d poor prognosis in acute ICA stenosis related tanchem lesions. Results All 79 patients had immediate postoperative mTICI grading ≥ 2b, the vascular recanalization rate was 100%. There was no statistically significant differences in the preoperative ASPECTS (t = -0.170, P = 0.865), the occlusion site of tandem lesions (Z = 5.907, P = 0.091), the ASITN/SIR ACG (t = -0.900, P = 0.368), puncture-to-reperfusion time (t = 0.182, P = 0.856), leakage on C-arm CT (Z = -0.171, P = 0.864), incidence of distal embolism (χ² = 0.872, P = 0.350), the incidence of sICH (χ² = 1.670, P = 0.434), the culprit artery re-occlusion rate (χ² = 0.000, P = 1.000), postoperative 90-d favorable outcome rate (χ² = 2.149, P =0.143) and the mortality (χ² = 0.150, P = 0.699) between CAS group and non-CAS group. Logistic regression analysis showed that increasing age (OR = 1.078, 95%CI: 1.011-1.148; P = 0.021), leakage on C-arm CT (OR = 5.163, 95%CI: 1.633-16.326; P = 0.005) were risk factors for postoperaive 90-d poor outcomes of the patients with acute carotid atherosclerotic stenosis related tandem lesions. Conclusions For patients with acute ICA stenosis related tandem lesions used "half" anterograde approach with or without usage of EPD technology, the decision of emergent CAS after mechanical thrombectomy was made according to the stenosis degree of ICA and leakage on C-arm CT. This strategy is safe and feasible, and has the potential of clinical promotion. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Central China Normal University is the property of Huazhong Normal University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate the effectiveness and safety of hybrid surgery (microsurgery combined with intraoperative DSA) in the treatment of acute hemorrhagic cerebral vascular disease. Methods The clinical data, imaging data, treatment and prognosis of 11 patients with acute hemorrhagic cerebral vascular disease treated by hybrid operation from April 2020 to February 2021 in the Anqing First People's Hospital of Anhui Medical University were analyzed. The results showed 3 cases of cerebral arteriovenous malformation (CAVM), including 2 cases located in temporoparietal lobe and one case in right lateral fissure; 2 cases of dural arteriovenous fistula (DAVF) at the base of anterior cranial fossa while fistulaes located in sieve plate; 6 cases of intracranial aneurysms, including 3 cases in the middle cerebral artery (MCA) bifurcation, one case in the pericallosal artery, and 2 cases in the communicating segment of internal carotid artery (ICA). Results All 11 patients completed the surgery successfully, and the success rate was 100%. CAVM resection combined with hematoma removal were performed in 3 cases of CAVM, including one case that intraoperative DSA suggested a little residual malformed mass after initial resection, while DSA reexamination suggested total resection after supplementary resection. Dural arteriovenous fistula resection combined with hematoma removal were performed in 2 cases of anterior fossa, after the fistula was closed, DSA reexamination suggested the arteriovenous fistula disappeared completely. Intracranial aneurysm clipping was performed in 6 cases, DSA showed complete clipping in 4 cases, and complete clipping in 2 cases of aneurysm neck residual after adjustment or aneurysm clip supplement. DynaCT indicated satisfactory final removal of intracranial hematoma in all patients with intracranial hematoma. No patient had serious complications such as rebleeding and cerebral infarction. After a mean follow-up of 8.45 months, modified Rankin Scale (mRS) was 1 in 4 cases and 1 in 2 cases, and 0 in the other 9 cases. All patients underwent at least one CTA or DSA reexamination, and no residual or recurrent vascular lesions were found. Conclusions Hybrid operation as a new treatment mode for acute hemorrhagic cerebral vascular disease is safe and effective, and further accumulation of cases and experience are needed. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Idiopathic Pulmonary fibrosis (IPF) is a chronic, progressive, fibrotic interstitial lung disease with unknown cause, which is closely related to lung cancer. A serious complication called Acute exacerbation of IPF (AE-IPF) is prone to occur after lung resection. It progresses rapidly without effective treatment and has a poor prognosis. A typical case of AE-IPF after lung cancer surgery was reported, and its clinical characteristics, imaging features, diagnosis and treatment were summarized. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A ketogenic diet leads to hidden health concerns such as inducing hyperlipidemia and ketoacidosis when there is improper and careless risk evaluation. The objective of this article was to describe the nursing experience of a 42-year-old male patient with diabetes on ketogenic diet, which was further complicated with hyperlipidemia-related acute pancreatitis. The nursing period was from April 3, 2018 to April 16, 2018. We collected the data from different methods such as direct care, physical assessment, observations during nursing care and so on. We applied Gordon's 11-itemed functional health patterns to assess, analyze, and summarize the main health problems, namely tissue perfusion changes, pain, and anxiety, faced by the subject. The active care and companionship during the nursing process with attentive listening and non-criticizing communication techniques was crucial to build a favorable relationship. We used simple human body organ and blood circulation charts to explain the physiological relationship between acute pancreatitis and ketogenic diet. We established the treatment goals with the patient and family members, and also helped in building trust, relieving anxiety, and increasing self-control. We hope this experience will be useful for the nursing staff while serving as a reference for similar cases in the future. [ABSTRACT FROM AUTHOR]

Objective To investigate the extracrainal-intracranial (EC-IC) bypass for large and giant intracranial thrombotic aneurysms. Methods Fifteen patients of large or giant intracranial thrombotic aneurysms were treated with EC-IC bypass from March 2013 to July 2020 in The First Affiliated Hospital of Soochow University. Among them, there were 9 patients with large aneurysms (maximum diameter of aneurysm 1.50-2.50 cm) and 6 patients with giant aneurysms (maximum diameter of aneurysm > 2.50 cm). According to locations, there were 7 paraclinoid internal carotid artery (ICA) aneurysms, 3 supraclinoid ICA aneurysms, 3 middle cerebral artery (MCA) aneurysms and 2 ICA bifurcation aneurysms. Six cases were treated with low-flow superficial temporal artery (STA)-MCA bypass and aneurysmal clipping, 2 cases with STA-MCA bypass and aneurysmectomy, one with STA-MCA bypass and ligation of extracranial ICA, 4 patients with high-flow external carotid artery (ECA)-radial artery (RA)-MCA bypass and trapping of aneurysms, 2 patients with high-flow ECA-RA-MCA bypass and aneurysmectomy. Results Aneurysm occlusion was confirmed in postoperative DSA or CTA in 15 patients and intraoperative TCD and indocyanine green angiography (ICGA) verified the patency of grafts. Thirteen patients achieved better outcome postoperatively. The muscle strength of contralateral limb in another one decrease following bypass. Emergency CT indicated ipsilateral basal ganglia infarction, and the muscle strength recovered to grade 5 after rehabilitation treatment. A mean 12.70 months follow-up was carried out. One patient suffered acute subdural hematoma 7 d following bypass and presented coma after a second craniotomy. Fourteen patients achieved good outcomes (GOS score 4-5) at last 6 months follow-up. One patient had a poor outcome (GOS score ≤ 3) at last 6 months follow-up. Conclusions EC-IC bypass can be individually carried out for large or giant intracranial thrombotic aneurysm. Preoperative assessment of cerebral hemodynamic and classification of aneurysms can provide favorable support for treatment. [ABSTRACT FROM AUTHOR]

Background: Prior to acute myocardial infarction (AMI), patients may experience different prodromal symptoms (PSs) that may delay their seeking medical treatment prior to hospitalization. Purpose: This study was designed to identify the relationship between PSs and demographics, including gender and age, acute symptoms, and pre-hospital delay time, in patients with AMI. Methods: A cross-sectional study design was applied, and a convenience sampling approach was used to recruit 121 patients in the emergency room of a medical center located in southern Taiwan. Instruments, including a demographic and disease variables datasheet, acute symptoms of AMI, McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey (MAPMISS), and pre-hospital delay time, were used. Chi-square, Fisher exact, and Spearman correlation coefficients tests were used to examine the respective relationships between the targeted variables and PSs. Binary logistic regression analysis was used to determine the important determinants of PSs. Results: Most (83.5%) of the participants had experienced PSs. The MAPMISS score was significantly associated with age (ρ= -.20, p < .05) and marital status (Z = 2.23, p < .05). Three prodromal symptoms, including pain or discomfort in left breast, pain or discomfort in the legs, and change in headache intensity, were significantly different between male and female participants. Only one symptom, pain or discomfort in the central high chest area, differed significantly among age groups. Binary logistic regression analysis found that participants in the 40-60 years old age group were 3.19 times more likely to develop PSs than their peers in the 65 years old and older group. Conclusions / Implications for Practice: The results of this study suggest that PSs should be incorporated into medical education to increase the cognition and awareness of healthcare professionals toward PSs and to improve patient education overall in order to strengthen public awareness regarding the relationship between PSs and AMI and subsequently increase the timeliness of their seeking appropriate medical help. [ABSTRACT FROM AUTHOR]

Objective To investigate the efficacy and safety of low dose rt-PA combined with transcranial Doppler ultrasonography (TCD) in the intravenous thrombolysis treatment of acute ischemic stroke. Methods A total of 139 patients with acute ischemic stroke admitted to Anhui No. 2 Provincial People's Hospital from July 2016 to May 2019 were randomly divided into the rt-PA standard dose group (0.90 mg/kg, total dose ≤ 90 mg), low dose group (0.60 mg/kg, total dose ≤ 60 mg) and low dose combined with TCD group (combined treatment group). TCD was used to continuously monitor the blood flow of middle cerebral artery for 2 h at the beginning of thrombolysis in the combined treatment group. TCD was only performed before and 2 h after thrombolysis in the standard dose group and low dose group. Two hours after thrombolysis, the recanalization rates of intracranial vessels in different treatment groups were compared. National Institutes of Health Stroke Scale (NIHSS) score was used to evaluate the severity of clinical symptoms in each group, and the incidence of symptomatic intracranial hemorrhage 24-48 h after thrombolysis was recorded. The self-care ability of 90 d after thrombolytic therapy was evaluated by modified Rankin Scale (mRS), and the mortality rate was calculated. Results The recanalization rate in the combined treatment group were higher than those in the standard dose group (P = 0.037) and low dose group (P = 0.030), and the NIHSS score 2 h after thrombolysis was lower than that in the standard dose group (P = 0.046) and low dose group (P = 0.026); the incidence of symptomatic intracranial hemorrhage (P = 0.017, 0.024) and 90 d mortality (P = 0.005, 0.016) in the low dose group and combined treatment group were lower than those in the standard dose group. Conclusions Low dose rt-PA combined with TCD assisted intravenous thrombolysis can improve the recanalization rate without increasing the risk of symptomatic intracranial hemorrhage and death. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background & Problems: Early rehabilitation exercise has been shown to reduce the onset of disability in patients following acute stroke. However, the clinical execution rate of early rehabilitation exercise for those patients remains low. Our medical team developed an early rehabilitation care plan for patients with acute stroke in 2013, at which time the execution rate of early rehabilitation exercise for these patients in our hospital was only 37.1%. The survey found that patients and caregivers had insufficient awareness of early rehabilitation exercise; hospital staffs lacked appropriate assistive devices, rehabilitation equipment, nursing guidance tools, and handover records; and new nursing staffs were insufficiently aware of the importance of early rehabilitation exercise. This care plan was developed to improve the execution rate of early rehabilitation exercise in patients with acute stroke to slow the progression of their disability. Purpose: The project was designed to improve the knowledge of new nursing staffs regarding early rehabilitation care and the early rehabilitation exercise completion rate of nursing staffs to raise the execution rate of early rehabilitation exercise in patients with acute stroke. Resolution: After completing the cause analysis, multiple strategies were pursued: (1) nursing education sheets with texts, illustrations, video, and posters were used; (2) group in-service educational training was organized; (3) an innovative transfer belt was designed; (4) facilities were set up to deliver virtual-reality (VR) training; (5) standard procedures on early rehabilitation exercise in patients with acute stroke were revised and implemented; (6) nursing handover procedures were revised; and (7) education courses on early rehabilitation exercise for post-stroke patients were developed. Results: The accuracy of knowledge related to early rehabilitation exercise among new nursing staff improved from 31.3% to 80%; the completion rate for nursing education increased from 53.6% to 98%; and the early rehabilitation exercise execution rate increased from 37.1% to 82.8%. Conclusions: This project successfully increased the motivation and confidence of patients in rehabilitation and the rate of exercise program execution, which may be expected to impact positively on patients' quality of life. [ABSTRACT FROM AUTHOR]

Objective To explore the value of continued nursing after hospital discharge to improve the effect of thrombolytic therapy in patients with acute ischemic stroke (AIS). Methods A total of 110 patients with AIS who were diagnosed and underwent intravenous thrombolytic therapy in Changshu Second People's Hospital from January 2018 to January 2020 were selected. They were randomly divided into an observation group (n = 55) and a control group (n = 55) by using a random number table. The control group was given AIS routine post-discharge care. The observation group patients were given continuing care after discharge on the basis of the control group. The rehabilitation effect, rehabilitation compliance and nursing satisfaction were compared. Results 3 months after discharge, the NIH Stroke Scale (NIHSS) scores of the two groups were lower than those of the three days before discharge, and the NIHSS scores of the observation group were lower than those of the control group (both P <0. 05). The Modified Bathel Index (MBI) score of 3 months after discharge was significantly higher than that of the 3 days before discharge, and the MBI scores of the observation group were higher than those of the control group (both P < 0. 05). Rehabilitation compliance of patients in the observation group at 3 months after discharge was significantly higher than that in the control group (P < 0. 05). The total satisfaction of patients in the observation group was significantly higher than that in the control group (P < 0. 05). Conclusion Continuing care after discharge is helpful to improve the treatment effect of AIS patients, so as to accelerate the recovery of patients. [ABSTRACT FROM AUTHOR]

Objective To analyze the effect of emergency nursing team model combined with chain management on the emergency efficiency and treatment effect of acute stroke. Methods A total of 98 patients with acute stroke admitted to Dongfeng People's Hospital of Zhongshan City from December 2018 to May 2020 were selected and divided into an observation group (n =49) and a control group (n =49) according to the random number table. The control group received routine nursing, and the observation group received the emergency nursing team model combined with chain management on the basis of routine nursing. The treatment effect, first aid efficiency, occurrence of adverse events, and the National Institutes of Health Stroke Scale (NIHSS) scores and Barthel Index (BI) scores before and after thrombolysis were compared between the two groups. Results The total effective rate of treatment in the observation group was 97. 96%, which was significantly higher than 81. 63% in the control group (P <0. 05). The triage time, waiting time and emergency treatment time of the observation group were significantly shorter than those of the control group (all P < 0. 05). After thrombolysis, the NIHSS scores of the two groups were lower than those before thrombolysis, and the BI scores were higher than those before thrombolysis. The NIHSS scores of the observation group were lower than those of the control group, and the BI scores were higher than those of the control group. The differences were statistically significant (all P < 0. 05). The incidence of adverse events in the observation group was 2.04%, and 8.16% in the control group. The difference was not statistically significant (P > 0. 05). Conclusion The application of emergency nursing team model combined with chain management in acute stroke can improve the effect and efficiency of emergency treatment, improve neurological function, improve the ability of daily life, and reduce the incidence of adverse events. [ABSTRACT FROM AUTHOR]

BACKGROUND: Chronic soft tissue injury is easy to occur during daily living, sports training, treatment and rehabilitation of various acute and chronic diseases. Chronic soft tissue injury can cause pain. If there is no good treatment for the injured soft tissue, it is easy to develop limb dysfunctions (such as limited joint movements) due to have cicatricial contraction and adhesion, limited human activity and participation ability, affecting the quality of daily life activities. It can also reduce the effect of sports training or rehabilitation treatment for athletes and patients with various acute and chronic diseases. In recent years, the treatment of chronic soft tissue injury by instrument-assisted soft tissue mobilization has been widely concerned, which has a positive effect on pain relief after chronic soft tissue injury. This technology has been widely studied abroad, but less in China. OBJECTIVE: To summarize the progress of instrument-assisted soft tissue mobilization in the treatment of chronic soft tissue injury. METHODS: PubMed, WanFang, and CNKI were searched. Relevant literature concerning instrument-assisted soft tissue mobilization, chronic soft tissue injury and pain was retrieved and summarized. RESULTS AND CONCLUSION: Instrument-assisted soft tissue mobilization has a positive effect on the improvement of pain and joint limitation caused by chronic soft tissue injury. It has been proved that instrument-assisted soft tissue mobilization can also improve the soft tissue function of healthy people. Instrument-assisted soft tissue mobilization is suggested to be used in clinical treatment and sports training as a means of treatment and prevention. Current basic research on this technology is still insufficient. In the future, in addition to a large number of clinical randomized controlled studies, we should deeply explore its action mechanism to provide theoretical support for clinical application. [ABSTRACT FROM AUTHOR]

Background Autoimmune autonomic neuropathy with onset of acute autonomic nerve dysfunction is often misdiagnosed because its main symptoms are syncope and gastrointestinal motility disorder. This study summarized the clinical, electrophysiological and pathological changes of peripheral nerve biopsy of patients of autoimmune autonomic neuropathy with onset of acute autonomic nerve dysfunction, which could provide reference for diagnosis, differential diagnosis and treatment. Methods and Results The clinical data of 3 patients diagnosied with autoimmune autonomic neuropathy with onset of acute autonomic nerve dysfunction who were hospitalized in Department of Neurology, Peking University First Hospital from February 2016 to February 2019 were collected. All of the 3 patients were young women, presented with onset symptoms as acute orthostatic hypotension and gastrointestinal motility disorder. Two patients had dysuria and dyshidrosis, and 2 patients had pupil changes. Electrophysiology revealed decreased sensory and motor nerve conduction velocity in 2 patients. Abnormal F wave and H reflex were found in 2 patients. The conduction velocity of large myelinated fibers was normal in one patient. In the autonomic function test, 2 patients had decreased Valsalva ratio, decreased heart rate variability of deep breathing. The blood pressure changes during tilt test between lying and upright position of 2 patients in acute stage was more than 30/15 mm Hg. Two patients underwent lumbar puncture, and one patient showed albuminocytologic dissociation. Sural nerve biopsies showed moderate to marked loss of small myelinated fibers and unmyelinated fibers. Two patients in acute stage were treated with immunomodulatory therapy (glucocorticoid combined with intravenous immunoglobulin), and their symptoms improved in varying degrees. Conclusions Autoimmune autonomic neuropathy with acute autonomic nerve dysfunction has unique clinical manifestations. Early consideration of autoimmune autonomic neuropathy followed by diagnostic work-up and prompt immune treatment will help to improve the prognosis. [ABSTRACT FROM AUTHOR]

Objective To explore the efficacy and safety of endovascular treatment (EVT) for acute ischemic stroke with large vessel occlusion (AIS-LVO) caused by carotid artery dissection (CAD). Methods From July 2018 to July 2019, 19 patients with AIS-LVO caused by CAD, including 11 cases of internal carotid artery (ICA) dissection and 8 cases of vertebral artery (VA) dissection, were treated with EVT (including thrombus aspiration, stent thrombectomy, balloon dilatation and stent implantation). Modified Thrombdy in Cerebral Infarction (mTICI) was to evaluate vascular recanalization, modified Rankin Scale (mRS) was to evaluate the prognosis. Results The forward blood flow of 15 patients recovered to mTICI grade 3 (complete recanalization), and 4 patients recovered to mTICI grade 2b (partial recanalization). Patients with postoperative complications were: one case of death caused by cerebral hernia, one case of cerebral edema due to a large cerebral infarction, one case had a small amount of cerebral hemorrhage, one case of subarachnoid hemorrhage. Seventeen patients had good prognosis at discharge (mRS score ≤ 2), one case had a poor prognosis (mRS score 4), and one case died. Conclusions Patients with AIS-LVO caused by CAD were assessed and treated with EVT, and the effect of recanalization of occlusive vessels is obvious, and the clinical prognosis is good. [ABSTRACT FROM AUTHOR]

Objective To screen the related factors of prognosis after mechanical thrombectomy in patients with acute ischemic stroke with large vessel occlusion (AIS-LVO). Methods From January 2018 to July 2019, a total of 117 patients with AIS-LVO underwent intravascular mechanical thrombectomy (including stent thrombectomy, catheter aspiration, stent thrombectomy combined with catheter aspiration). Univariate and multivariate Logistic regression analysis were used to screen the risk factors for poor prognosis. Results Logistic regression analysis showed that the elderly (OR = 1.062, 95%CI: 1.013-1.113; P = 0.012), the previous diabetes (OR = 3.074, 95%CI: 1.023-9.240; P = 0.045), the high NIHSS score at admission (OR = 1.143, 95%CI: 1.043-1.252; P = 0.004), the responsible blood vessel was vertebrobasilar artery (OR = 11.151, 95% CI: 2.877-43.079; P = 0.000) were the risk factors of poor prognosis after mechanical thrombectomy for AIS-LVO. Conclusions Elderly, the previous diabetes, high NIHSS score and posterior circulation infarction are associated with poor prognosis in patients with AIS-LVO after intravascular mechanical thrombectomy. [ABSTRACT FROM AUTHOR]

Stress cardiomyopathy(SCM) is a common clinical acute cardiovascular disease event, which can be induced by psychological factors, disease factors, drug factors and physical stress factors. The main manifestations of SCM patients are chest pain,reversible left ventricular dysfunction, abnormal levels of myocardial injury markers and abnormal electrocardiogram, which are highly similar to acute myocardial infarction. Ventricular angiography in SCM patients show that left ventricular apical systolic force decreased significantly and compensatory contraction increased at the bottom of the heart, which led to narrow neck at the end of the left ventricular systolic phase, which led to the main shape of the left ventricle at the end of contractile is round-bottomed and narrow-necked. Because shape of systolic left Ventricular Angiography in patients with SCM is similar to the fish basket used by Japanese fishermen to catch octopus, so it is called octopus basket cardiomyopathy. This study mainly reviews the research progress of SCM from three aspects:clinical manifestations, diagnosis and pathogenesis, so in order to provide reference for the prevention and treatment of clinical SCM. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

According to the research progress in recent years, "Chinese guidelines for diagnosis and treatment of acute ischemic stroke 2018" has greatly revised and supplemented the criteria for the diagnosis and treatment of acute ischemic stroke. Based on the new clinical research evidence published in the past four years, this paper interprets the revisions and supplements of the guidelines 2018. [ABSTRACT FROM AUTHOR]

Copyright of Imaging Science & Photochemistry is the property of Imaging Science & Photochemistry Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Blood pressure management in acute phase of intracerebral hemorrhage (ICH) is always concerned and controversial, until Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT) and INTERACT2 provides reliable evidence for blood pressure management of ICH. This article focuses on the high-quality clinical studies of INTERACT and INTERACT2 published by Chinese scholars in foreign journals in the past three years. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Lung Cancer is the property of Chinese Journal of Lung Cancer and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Acute symptomatic seizure is defined in a recent recommendation from the International League Against Epilepsy (ILAE) as a clinical seizure occurring in close relationship with acute central nervous system (CNS) damage. Acute stroke, CNS infection, traumatic brain injury (TBI), serum electrolytic and metabolic disorders, hypoxic - ischemic encephalopathy (HIE), alcohol withdrawal or acute intoxication and illicit drugs, etc. would result in acute symptomatic seizures. When the etiology is solved or the acute stage passes, the possibility of seizure recurrence is low. Depending on different causes, the incidence, seizure type, risk factors, recurrence rate and prognosis are different. After occurrence of the first seizure, the etiology and diagnosis could be confirmed by systematic examination and test. It is necessary to treat the primary disease systematically and apply anti-epileptic therapy according to individual condition. [ABSTRACT FROM AUTHOR]

The aim of this article is to describe a nursing process of an infertile woman eight weeks into pregnancy after multiple artificial inseminations facing decision to terminate pregnancy due to acute appendicitis and grief and loss as result of the decision. The Nursing period was from April 18 to 27, 2015. The author conducted systematic evaluation with Roy's adaptation model via direct care, meetings, and phone interviews, and confirmed that the patient had hyperthermia, acute pain, grief, and decisional conflict. During the nursing period, the author provided individual physiological care, and coordinated with the medical team to hold a family meeting to provide medical information and instructions to assist the patient in facing the decision of pregnancy termination. The author also assisted the patient to accept the fact of her loss and overcome the grief reaction from pregnancy termination through listening, companionship, psychological support, and religion and spiritual solace. This article can serve as a reference for clinical nurses to improve the quality of professional care. [ABSTRACT FROM AUTHOR]

Objective To explore the clinical changes of peripheral inflammatory markers and oxidative stress during post-acute and chronic phase after severe traumatic brain injury (sTBI). Methods A total of 24 sTBI patients were included in this study. The changes of peripheral inflammatory markers [interleukin (IL)-1β, IL-6, interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α)] and oxidative parameters [glutathione peroxidase (GSH - Px), superoxide dismutase (SOD), catalase (CAT), glutathione reductase (GR) and total plasma antioxidant activity (TEAA)] were monitored. Functional Independence Measure (FIM) and Dyskinesia Rating Scale (DRS) were used to evaluate cognitive function and motor function. Results There were significant differences on IL-6 (F = 105.982, P = 0.000), IFN (F = 19.873, P = 0.000), GSH-Px (F = 162.090, P = 0.000), SOD (F = 28.254, P = 0.000) and CAT (F = 4.782, P = 0.011) during different periods of sTBI (post-acute phase, chronic early phase, chronic phase). IL-6 and GSH-Px in chronic early phase (IL-6: t = 11.753, P = 0.000; GSH-Px: t = 16.901, P = 0.000) and chronic phase (IL-6: t = 14.533, P = 0.000; GSH-Px: t = 13.828, P = 0.000) were significantly lower than post-acute phase. IL-6 and GSH-Px in chronic phase (IL-6: t = 2.341, P = 0.012; GSH-Px: t = 3.073, P = 0.003) were significantly lower than chronic early phase. SOD in chronic early phase and chronic phase was significantly higher than post - acute phase (t = 7.264, P = 0.000; t = 5.303, P = 0.000). CAT in chronic early phase was significantly higher than post-acute phase (t = 3.060, P = 0.003). After 12 months, 24 patients completed the follow-up, and their FIM scores were significantly increased (t = 36.260, P = 0.000), while DRS scores were significantly decreased (t = 49.010, P = 0.000). Pearson correlation analysis showed that IL-6 (r = 0.446, P = 0.020) and GSH-Px (r = 0.142, P = 0.000) were positively correlated with overall cognitive performance index (CPI). IL-6 was positively correlated with attention (r = 0.431, P = 0.026) and executive function (r = 0.522, P = 0.005) of synthetic index (SI). IFN-γ (r = 0.497, P = 0.009) and TNF-α (r = 0.479, P = 0.009) were positively correlated with executive function of SI. GSH-Px was positively correlated with all SI (r = 0.220, P = 0.000; r = 0.344, P = 0.000; r = 0.011, P = 0.000). Conclusions Imbalance of oxidative stress response and over-production of inflammatory markers in acute phase of patients with severe traumatic brain injury might adversely affect the neurological functional recovery. Inflammatory markers and oxidative stress response might offer a feasible way to monitor recovery and predict the prognosis after severe traumatic brain injury. [ABSTRACT FROM AUTHOR]

Objective To evaluate the efficiency and safety of endovascular thrombectomy for acute ischemic stroke caused by acute large vessel occulsion. Methods A total of 41 patients with acute ischemic stroke caused by acute large vessel occulsion were treated with endovascular thrombectomy. Time from onset to admission, from admission to femoral artery puncture, from onset to recanalization were recorded. Modified Thrombolysis in Cerebral Infarction (mTICI) was used to assess the recanalization immediately after operation. National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the neurological function at 24 h after operation. Modified Rankin Scale (mRS) was used to evaluate clinical prognosis at 90 d after operation. Perioperative procedure-related complications and occurrence rate of symptomatic intracranial hemorrhage within at 90 d after operation were recorded. American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) Collateral Flow Grading System (ACG) was used to assess collateral compensation of anterior circulation. BATMAN score was used to assess collateral compensation of posterior circulation. Results Among 41 patients, 12 (29.27%) were treated with recombinant tissue-type plasminogen activator (rt-PA) intravenous thrombolysis. There were 32 patients (78.05%) achieved successful recanalization, including 20 patients (80%, 20/25) in anterior circulation and 12 (12/16) in posterior circulation, and no significant difference was seen between them (adjusted χ2 = 1.424, P = 0.706). At 24 h after operation, 28 patients (68.29%) had better neurological function than preoperation (NIHSS decreasing ≥ 4 score), including 18 patients (72%, 18/25) with anterior circulation occlusion and 10 (10/16) with posterior circulation occlusion, and there was no significant difference between them (χ2 = 0.407, P = 0.524). Eleven patients (26.83%) died within 90 d after operation, including 4 patients (16%, 4/25) with anterior circulation occlusion and 7 (7/16) with posterior circulation occlusion, and there was no significant difference between them (adjusted χ2 = 2.130, P = 0.144). Among the 11 dead, 3 died of complicated pulmonary infection and respiratory failure, and 8 died of ischemic stroke. The other 30 patients were followed up for 3 months to one year, average (231.92 ± 95.36) d. At 90 d after operation, 14 patients (34.15%) had good outcome (mRS ≤ 2 score), including 10 patients (47.62%, 10/21) with anterior circulation occlusion and 4 (4/9) with posterior circulation occlusion, and there was no significant difference between them (adjusted χ² = 0.493, P = 0.483). Among 41 patients, 6 patients (14.63% ) had symptomatic intracranial hemorrhage, including 4 patients (16%, 4/25) with anterior circulation occlusion and 2 (2/16) with posterior circulation occlusion, and no significant difference was seen between them (adjusted χ² = 3.303, P = 0.856). Collateral compensation was evaluated in 33 patients (20 with anterior circulation occlusion and 13 with posterior patients circulation occlusion). In 20 patients with anterior circulation occlusion, 14 patients (70%) had good collateral compensation, in whom 9 (9/14) had good outcome 90 d after operation, while the other 6 patients (30%) had poor collateral compensation and then had good outcome 90 d after operation, and significant difference was seen between them (Fisher exact probability: P = 0.014). Among 13 patients with posterior circulation occlusion, 3 patients (3/13) had good collateral compensation and had good outcome 90 d after operation, while the other 10 (10/13) had poor collateral compensation, in whom one (1/10) had good outcome 90 d after operation, and significant difference was seen between them (Fisher exact probability: P = 0.014). Conclusions Endovascular thrombectomy is an efficient and safe method for acute ischemic stroke caused by acute large vessel occlusion. Rigorously master the indication and preoperative evaluation, and perfect acute rescue procedure and treatment for stroke may increase the efficacy of endovascular thrombectomy. [ABSTRACT FROM AUTHOR]

Objective The incidence of stroke in China has been growing year by year and has become the first cause of death exceeding cancer and heart disease. However, non-standard thrombolytic drug dose and therapeutic time window have seriously affected the treating effect of acute ischemic stroke. This study aims to explore the effect of intravenous alteplase with standard dose and reperfusion injury of ischemic brain tissue and prognosis of patients receiving thrombolytic therapy within therapeutic time window. Methods Clinical data of 86 patients with acute ischemic stroke receiving thrombolytic therapy with alteplase were retrospectively analyzed. Efficacy at 24 h and 3 months after thrombolysis was evaluated according to the multi-modal MRI, and the U.S. National Institutes of Health Stroke Scale (NHISS) and modified Rankin Scale (mRS) were used to identify the extent of neurological function improvement and prognosis of patients. Results Among 86 patients, 56 cases were anterior circulation ischemia, and 30 cases were posterior circulation ischemia. At 24 h after thrombolysis, 62 cases with favorable neurological function outcome accounted for 72.09%, and 24 cases with poor outcome accounted for 27.91%. The NHISS scores before and after thrombolysis were statistically different (P = 0.023). Based on multi⁃modal MRI of 42 cases at 24 h after thrombolysis, there were 18 cases with complete vascular recanalization (42.86%), 6 cases with partial recanalization (14.28%) and 18 cases with occlusion (42.86%). The difference before and after thrombolytic thearpy was statistically significant (P = 0.073). In the follow-up of 3 months, 78 patients with favorable function outcome accounted for 90.70%, and 8 cases with poor outcome accounted for 9.30%, which were significantly different from that before thrombolysis (P = 0.008). Conclusion Cerebral vascular recanalization and reperfusion of brain tissue are reliable indicators of clinical efficacy for intravenous thrombolysis with alteplase.

Copyright of Chinese Journal of Contemporary Neurology & Neurosurgery is the property of Chinese Journal of Contemporary Neurology & Neurosurgery and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)