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Objective To explore the prevention and treatment strategies for pancreatic fistula and pancreatic fistula combined with hemorrhage after pancreaticoduodenectomy. Methods We retrospectively reviewed 90 cases of pancreaticoduodenectomy at Guangdong Provincial People's Hospital from August 2019 to December 2022. According to whether postoperative pancreatic fistula occurred, the 90 patients were divided into a postoperative pancreatic fistula group (n = 35) and a postoperative non-pancreatic fistula group (n = 55). Among the 35 patients with postoperative pancreatic fistula, they were further categorized into two subgroups based on the presence of hemorrhage: the pancreatic fistula with hemorrhage group (n = 10) and the pancreatic fistula without hemorrhage group (n = 25). Chi-square test or Fisher's exact test was used for univariate analysis. Variables with statistical differences were selected for stepwise regression variable screening. Multivariate Logistic regression analysis was used to determine the independent risk factors for the occurrence of pancreatic fistula and postoperative pancreatic fistula with hemorrhage. Results All 90 patients successfully completed the pancreaticoduodenectomy. The incidence of postoperative pancreatic fistula was 38.9% (35/90). Significant differences were observed in pancreatic duct diameter (P = 0.013), intraoperative blood loss (P = 0.045), anastomosis type (P = 0.045), and residual pancreatic texture (P = 0.10) between the two groups (P < 0.05). Multivariate logistic regression analysis revealed that soft pancreas texture, pancreatic duct diameter < 3 mm, intraoperative blood loss ≥ 300 mL, and pancreatic-ojejunostomy were independent risk factors for postoperative pancreatic fistula. Among patients with postoperative pancreatic fistula, multivariate logistic regression analysis identified pancreatic fistula volume > 100 mL and duration of postoperative pancreatic fistula > 7 days as independent risk factors for hemorrhage. Conclusions The risk of pancreatic fistula after pancreatoduodenectomy is relatively high. Attention to preoperative pancreatic duct diameter and standardized evaluation of pancreatic texture can help identify postoperative pancreatic fistula. Careful hemostasis during operation and avoidance of early postoperative hemorrhage can reduce the incidence of grade B and C pancreatic fistulas. Patients with pancreatic fistula should be warned of the occurrence of combined hemorrhage when the fistula volume is greater than 100ml and the duration of postoperative pancreatic fistula is greater than 7 days. [ABSTRACT FROM AUTHOR]

Objective: To explore the effects of homologous recombination repair (HRR) gene mutations on the immunotherapy efficacy and the prognosis of advanced non-small cell lung cancer (NSCLC) patients. Methods: Clinical data of 124 patients with advanced NSCLC who received PD-1 inhibitor treatment between March 2018 and April 2023 at the First Affiliated Hospital of Zhengzhou University were collected. The patients were divided into the mutant group (n=57 cases) and the wild group (n=67 cases) according to the presence or absence of HRR gene mutations. The differences in clinical characteristics and immunotherapy efficacy between the two groups were analyzed by Chi-square test or Fisher's exact test. Kaplan-Meier method was used to compare the progression-free survival (PFS) of the two groups, and univariate and multivariate Cox regression were employed to analyze the factors affecting PFS. Results: The proportions of squamous cell carcinoma and tumor mutation burden (TMB) ≥10 mut/Mb were significantly higher in the HRR gene mutant group than in the wild group (54.4% vs 32.8%, 61.4% vs 29.9%, all P<0.05). The objective response rate (ORR) was 17.5% and 10.4% (P=0.252), and the disease control rate (DCR) was 86.0% and 73.1% (P=0.080) for patients in the HRR gene mutant group and the wild group, respectively. There was a significant difference in PFS of the HRR gene mutant group and the wild group (6.8 months vs 3.9 months, P<0.001). Multivariate analysis showed that HRR gene mutations (HR=0.550, 95%CI [0.352, 0.860], P=0.009) and the number of immunotherapy lines (HR=0.468, 95%CI[0.312, 0.702], P<0.001) were significantly correlated with PFS. Conclusion: The immunotherapy efficacy of the HRR gene mutant group is better than that of the wild group. HRR gene mutations are an independent protective factor for immunotherapy prognosis of patients with advanced NSCLC. [ABSTRACT FROM AUTHOR]

Objective To investigate and compare the efficacy of endoscopic-assisted hematoma evacuation and burr hole hematoma drainage combined with urokinase in the treatment of septated chronic subdural hematoma (CSDH). Methods A total of 38 patients with septated CSDH who were admitted in Peking Union Medical College Hospital and received endoscopic-assisted hematoma evacuation (endoscopy group, n = 19) or burr hole drainage combined with urokinase (burr hole group, n = 19) from January 2022 to December 2023. The change rate of the hematoma cavity was calculated, the modified Rankin Scale (mRS) and Barthel Index (BI) were used to evaluate neurological function prognosis and abilities of daily living. In addition, postoperative drainage time, postoperative hospitalization time, total hospitalization cost and incidence of cerebrospinal fluid leakage were recorded. Results The two treatment modalities did not show differences in the change rate of the hematoma cavity (t = 0.858, P = 0.396). Both endoscopy group (Z = -4.116, P = 0.000) and burr hole group (Z = -4.195, P = 0.000) had lower mRS scores on discharge than on admission, while the difference between the 2 groups on discharge was not significant (Z = -0.502, P = 0.616). The endoscopy group (Z = -1.557, P = 0.119) and burr hole group (Z = -0.091, P = 0.928) had no significant difference in BI scores on discharge versus on admission, and the difference in BI scores between the 2 groups on discharge was also not statistically significant (Z = -0.853, P = 0.394). Postoperative drainage time was longer in the endoscopy group (t = -2.488, P = 0.018), but postoperative hospitalization time was longer in the burr hole group (t = -3.894, P = 0.000). Total hospitalization cost in both 2 groups (t = 1.175, P = 0.248) and the incidence of cerebrospinal fluid leakage (Fisher's exact probability: P = 0.313) were not statistically significant. Conclusions Both neuroendoscopic surgery and burr hole drainage combined with urokinase treatment are safe and effective in treating septated CSDH. They can clear the hematoma and improve neurological function; neuroendoscopic surgery can faster improve the neurological function and shorter postoperative hospitalization time. [ABSTRACT FROM AUTHOR]

Objective To preliminarily summarize the epidemiological and clinical characteristics of functional movement disorder (FMD) based on movement disorders clinic in China. Methods and Results A total of 593 patients with movement disorders newly diagnosed in movement disorders clinic of 22 clinical medical centers from August to September in 2023 were included, including 37 patients (6.24%) with FMD and 556 patients (93.76%) with organic movement disorder. Comparison of the epidemiological characteristics of the 2 groups, the proportions of corona virus disease (COVID-19) infection (χ² = 4.217, P = 0.040) and psychopsychological symptoms (χ² = 18.694, P = 0.000) in the FMD group were higher than those in the organic movement disorder group, while age (t = 3.757, P = 0.000), age of onset (t = 3.720, P = 0.000) and proportion of hypertension (χ² = 4.736, P = 0.030) were lower than those in the organic movement disorder group. Comparison of the clinical characteristics of the 2 groups, the FMD group had higher proportions of tremor (χ² = 3.955, P = 0.047) and myoclonus (Fisher's exact probability: P = 0.011) than the organic movement disorder group, and the proportions of parkinsonism (χ² = 8.491, P = 0.004) and gait disorder (χ² = 5.028, P = 0.025) were lower than those in the organic movement disorder group. Conclusions The age and age of onset, as well as the proportions of COVID-19 infection, hypertension, psychopsychological symptoms, tremor, myoclonus, parkinsonism and gait disorder with FMD were different from those with organic movement disorder in China. [ABSTRACT FROM AUTHOR]

Objective To evaluate the diagnostic value of skeletal muscle biopsy in asymptomatic and pauci-symptomatic hyperCKemia. Methods and Results A total of 146 patients with asymptomatic or pauci - symptomatic hyperCKemia diagnosed in Peking University First Hospital from July 2020 to February 2023 were selected, and skeletal muscle biopsy was performed. About 72.60% (106/146) had histological changes, including muscular dystrophy (n = 73), inflammatory or necrotizing myopathy (n = 16), other myopathy (n = 15), and neurogenic skeletal muscle damage (n = 2). The positive rate of pathological diagnosis was 50.68% (74/146), including muscular dystrophy 82.43% (61/74), inflammatory myopathy 8.11% (6/74) and metabolic myopathy 9.46% (7/74). The positive rate of etiological diagnosis was 85.62% (125/146), including muscular dystrophy 67.20% (84/125), inflammatory myopathy 13.60% (17/125), metabolic myopathy 7.20% (9/125) and other causes 12% (15/125). Compared with different subgroups, the proportion of pathological changes ((χ² = 14.043, P = 0.000; (χ² = 12.740, P = 0.000), the positive rate of pathological diagnosis ((χ² = 10.641, P = 0.001; (χ² = 25.530, P = 0.000) and etiological diagnosis (Fisher's exact probability: P = 0.001; χ² = 10.811, P = 0.001) in the significantly elevated creatine kinase (CK) level group and the adolescent group was significantly higher than those in the mildly elevated CK level group and the adult group. The positive rate of pathological diagnosis in the asymptomatic group was higher than the pauci-symptomatic group (χ² = 4.792, P = 0.029). There were significant differences in the etiological ratio between the mildly elevated CK level group and the significantly elevated CK level group (Fisher's exact probability: P = 0.000), the adolescent group and the adult group (χ² = 86.149, P = 0.000), and the asymptomatic group and the pauci - symptomatic group (χ² = 20.608, P = 0.000). Conclusions Skeletal muscle biopsy was important in etiological diagnosis of asymptomatic and pauci-symptomatic hyperCKemia. Muscular dystrophy is a common cause of asymptomatic and pauci-symptomatic hyperCKemia. [ABSTRACT FROM AUTHOR]

Background and purpose: Studies have shown that when high-grade histological patterns (micropapillary and solid patterns) are present, patients with lung adenocarcinoma have a significantly poorer prognosis and often require more aggressive treatment modalities, and preoperative determination of the presence of any high-grade patterns (HGP) in invasive lung adenocarcinoma can help predict patient prognosis and determine treatment strategies. The aim of the study was to establish a logistic regression model based on high-resolution CT signs to predict the HGP of stage ⅠA lung adenocarcinoma. Methods: The clinical, pathological and imaging data of 443 patients (445 lesions) with stage ⅠA lung adenocarcinoma confirmed by pathology diagnosis from First People's Hospital of Xiaoshan District (Oct. 2018 to Mar. 2021) and Zhongshan Hospital of Fudan University (Jan. 2018 to Dec. 2020) were retrospectively analyzed. The 445 lesions were divided into two groups according to the presence or absence of HGP in pathological findings: HGP (n=88) and non-HGP (n-HGP) (n=357). The clinical and pathological data of the patients included age, gender, smoking history, tumor location, stage and pathological growth pattern. On CT imaging, the size, density, shape, burr sign, lobulation sign, vacuole sign, air bronchus sign and pleural depression sign were observed. Mann-Whitney U test was used to compare quantitative parameters between the two groups, and χ2 test or Fisher's exact test was used for enumeration of data. The independent predictors were screened by univariate combined with multivariate logistic regression analysis, and the clinical model, CT model and clinical-CT model were constructed according to the results of multivariate logistic regression analysis. DeLong test was used to compare the diagnostic efficacy between models. Results: In the univariate analysis, there were significant differences in age, gender, smoking history, tumor size, density, shape, burr, lobulation sign and pleural traction between the HGP group and the n-HGP group (P＜0.05). Multivariate logistic regression analysis showed tumor size (P=0.04; OR=1.063, 95% CI: 1.003-1.126), density (P＜0.001; OR=8.249, 95% CI: 4.244-16.034), lobulation sign (P=0.001; OR=3.101, 95% CI: 1.598-6.021) were independent predictors of HGP, and the area under curve (AUC) values of clinical model, CT model and clinical-CT model for predicting HGP were 0.634, 0.838 and 0.834, respectively. Conclusion: Tumor size, density and lobulation sign are independent predictors of HGP in stage ⅠA lung adenocarcinoma. The logistic regression model based on high-resolution CT signs has good diagnostic performance and can provide a certain reference for clinical diagnosis and surgical treatment. [ABSTRACT FROM AUTHOR]

Background and purpose: It is not clear that the pattern of lymph node (group 12a) metastasis within the hepatoduodenal ligament (along the hepatic artery) in gastric cancer, its indications for dissection are still controversial, and there is a lack of relevant clinical study data from large samples. This study investigated the risk factors of lymph node group 12a metastasis in gastric cancer at different sites by observing the lymph node metastasis rate. Methods: The medical records of 1 112 gastric cancer patients admitted to the Department of Gastric Surgery in Henan Provincial People's Hospital from May 2016 to July 2021 were retrospectively analyzed. According to tumor location, they were divided into upper gastric cancer (561 cases), gastric body cancer (224 cases) and gastric antrum cancer (327 cases). The lymph node metastasis rate of group 12a in patients with different parts of gastric cancer was recorded. The c2 test and Fisher's exact probability test were used to compare the relationship between group 12a lymph node metastasis and clinicopathological features in patients with gastric cancer at different sites. Multivariate logistic regression analysis was used to analyze the risk factors of group 12a lymph node metastasis in patients with gastric cancer at different locations. Results: Group 12a lymph node metastasis occurred in 72 of 1 112 gastric cancer patients, and the overall metastatic rate was 6.5%. Among the 561 cases of upper gastric cancer, 25 cases developed group 12a lymph node metastasis, and the metastatic rate was 4.5%. Of the 224 patients with gastric body cancer, 17 cases were positive in group 12a lymph nodes, and the metastasis rate was 7.6%. Among the 327 cases of gastric antrum cancer, 30 cases were positive in group 12a lymph nodes, and the metastatic rate was 9.2%. Taking the lymph node metastasis in group 12a as the dependent variable, and taking the indicators with statistical significance in univariate analysis as independent variables, they were included in the model for multivariate logistic regression analysis. The results showed that tumor diameter (OR=3.122, 95% CI: 2.896-3.366, P<0.001), T stage (OR=2.406, 95% CI: 1.705-3.396, P<0.001), TNM stage (OR=7.910, 95% CI: 4.755-13.160, P<0.001) were risk factors for lymph node metastasis in group 12a of upper gastric cancer patients. Tumor diameter (OR=2.757, 95% CI: 2.495-3.047, P<0.001), T stage (OR=3.298, 95% CI: 2.346-4.638, P<0.001), vascular nerve invasion (OR=1.839, 95% CI: 1.368-2.473, P<0.001) were risk factors for lymph node metastasis in group 12a of patients with gastric body cancer. Body mass index (BMI) (OR=1.098, 95% CI: 1.023-1.178, P=0.010), tumor diameter (OR=2.865, 95% CI: 1.778-4.616, P<0.001), T stage (OR=13.497, 95% CI: 8.363-21.783, P<0.001), TNM stage (OR=3.806, 95% CI: 3.113-4.653, P<0.001) were risk factors for lymph node metastasis in group 12a of patients with gastric antrum cancer. Conclusion: The total lymph node metastasis rate in group 12a is low. Tumor size, invasion depth, N stage and tumor stage are independent risk factors for group 12a lymph node metastasis in gastric cancer. Besides, vascular nerve invasion is the independent risk factors for gastric body cancer. Gastric body cancer and gastric antrum cancer require routine dissection of group 12a lymph nodes. The metastatic rate of lymph nodes in group 12a of upper gastric cancer is low, and routine dissection is not required. However, when the diameter is ≥6 cm, the depth of tumor invasion is deep (T3-T4), and the tumor stage is late (Ⅲ-Ⅳ), group 12a lymph nodes need to be dissected. [ABSTRACT FROM AUTHOR]

Copyright of CT Theory & Applications is the property of Editorial Department of CT Theory & Applications 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 Wool Textile Journal is the property of National Wool Textile Science & Technology Information Center 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 explore the impact of liver metastasis on immunotherapy efficacy in patients with advanced gastric cancer. Methods: From February 2019 to January 2022, clinical data of patients with advanced gastric cancer who received immunotherapy in the Cancer Center of Changzhou No.2 People's Hospital affiliated to Nanjing Medical University were collected for this retrospective analysis. The baseline characteristics were compared by Chi-square test or Fisher exact probability method. Chi-square test and Kaplan-Meier survival analysis were used to compare the therapeutic efficacy and survival time between gastric cancer patients with and without liver metastasis. Results: A total of 48 patients with advanced gastric cancer were included in the analysis, and the patients were divided into a liver metastasis cohort (n=20) and a non-liver metastasis cohort (n=28). The physical condition of patients with liver metastasis was worse than those without liver metastasis. The objective response rates (ORR) in metastasis cohort and non-metastasis cohort were 15.0% and 35.7% (P>0.05), respectively; and the disease control rates (DCR) in these two cohorts were 65.0% and 82.1% (P>0.05), respectively. The median progression-free survival (PFS) was 5.0 and 11.2 months in the two groups (HR=0.40, P<0.05), and the median overall survival (OS) was 12.0 and 19.0 months (P>0.05), respectively. Conclusion: The efficacy of immunotherapy in gastric cancer patients with liver metastasis is worse than that in patients without liver metastasis. [ABSTRACT FROM AUTHOR]

Copyright of Journal of China Medical University is the property of Journal of China Medical University 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.)

Objective To explore the application of membranous concept in vestibular schwannoma surgery. Methods A total of 39 patients with vestibular schwannoma who received membranous surgical treatment in The First Affiliated Hospital of Anhui Medical University from May 2020 to June 2021 were enrolled. Through the retrosigmoid approach, the intraoperative electrophysiological monitoring was performed, and the membranous concept was used to separate the brain stem of the tumor and the interface between the tumor and the facial nerve and the cochlear nerve. Facial nerve function was evaluated by the House-Brackmann (H -B) grade and hearing was evaluated by the American Academy of Otolaryngology- Head and Neck Surgery (AAO-HNS) scale at one day, one week and one year after surgery. Results Total resection was performed in 31 cases (79.49%) and nearly total resection in 8 cases (20.51%). Facial nerve anatomical preservation was achieved in all patients, and facial nerve function returned to normal or nearly normal (H - B grade I - II) 84.62% (33/39), moderate facial paralysis (H - B grade III) 10.27% (4/39), moderate and severe facial paralysis (H-B grade IV) 5.13% (2/39) on the first day after surgery. One week after surgery, 71.79% (28/39) of patients with normal or nearly normal facial nerve function, 15.38% (6/39) of moderate facial paralysis, 10.27% (4/39) of moderate and severe facial paralysis, and 2.56% (1/39) of severe facial paralysis (H-B grade V). One year after surgery, 92.31% (36/39) of patients with facial nerve function returned to normal or nearly normal, 5.13% (2/39) of patients with moderate facial paralysis, and 2.56% (1/39) of patients with moderate and severe facial paralysis. Among the 10 patients (25.64%) who retained effective hearing before surgery (AAO-HNS grade ≥ C), there were 4, 3 and 6 cases at one day, one week and one year after surgery, respectively. Those who did not retain effective hearing before surgery did not recover effective hearing after surgery. According to the comparison of tumor volume and nature, the proportion of patients with normal facial nerve function (H-B grade I) in the tumor volume ≤ 3 cm group was higher than that in > 3 cm group [12/18 vs. 19.05% (4/21); Fisher's exact probability: P = 0.006], the proportion of patients with normal facial nerve function in the solid tumor group was higher than that in cystic group [71.43% (15/21) vs. 1/10; Fisher's exact probability: P = 0.010] at one year after surgery. Conclusions The membranous concept in vestibular schwannoma surgery can protect facial nerve function well, and has a positive effect on the protection of cochlear nerve and brain stem. [ABSTRACT FROM AUTHOR]

Objective To analyze the surgical strategy, efficacy and long-term safety of chronic neuropathic pain (NP) after simple cauda equina injury. Methods The clinical data of patients with chronic NP after cauda equina injury treated by dorsal root entry zone (DREZ) derogation and spinal cord stimulation (SCS) in Xuanwu Hospital, Capital Medical University from September 2011 to December 2020 were analyzed. The DREZ derogation or SCS was selected according to the lesion location, injury degree and pain distribution. The long-term effect was evaluated according to the preoperative and postoperative Visual Analog Scales (VAS) scores, pain relief rate ≥ 50% was considered as effective, and the complications related to the surgery were followed up. Results Among 24 cases, 14 cases were treated with SCS, 9 cases had pain relief rate 60%-80%, and permanent pulse generator (IPG) was implanted; the pain relief rate was more than 60% in 2 cases, but it did not meet expectation so that the IPG was not implanted; no pain relief in 3 cases, DREZ derogation was performed later, the pain was relieved in 2 cases, and one case was still ineffective. DREZ derogation was firstly performed in 10 cases, and the pain disappeared in 7 cases; 2 cases had residual pain in some areas; one case was ineffective, and the pain was still unrelieved after SCS. After long-term implantation of IPG, 2 cases had been taken out of the stimulator due to fluid accumulation at the implantation site. After DREZ derogation, 3 cases had pain at the upper boundary of the preoperative pain area, which gradually disappeared within 2 weeks to one month. In one patient, the pain disappeared in early stage, which recurred after 2 years, and disappeared after the second DREZ derogation. There was no significant difference in the effective rate between 2 groups (9/13 vs. 11/15, Fisher's exact probability: P = 1.000). However, DREZ derogation had high pain improvement rate than SCS [100% (0, 100%) vs. 25% (0, 75%); Z = 0.441, P = 0.030]. Conclusions For chronic neuropathic pain after simple cauda equina injury with clear etiology, both SCS and DREZ derogation may receive satisfactory long-term effect. SCS is the first choice for patients with lower limb movement, urinary and bowel function in pain area. DREZ derogation is the first choize for patients without lower limb movement, urinary and bowel. The pain improvement rate of DREZ derogation was better than that of SCS. [ABSTRACT FROM AUTHOR]

Copyright of West China Journal of Stomatology is the property of Sichuan University, West China College of Stomatology 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 explore the anatomic course of inferior alveolar nerve canal in patients with hemifacial microsomia. Methods In this retrospective study, 153 patients with hemifacial microsomia from November 2014 to October 2021 were included. All patients were divided into 4 types according to the Pruzansky-Kaban classification. The data of cranial CT scans were imported into Mimics 19.0 software for three-dimensional reconstruction. The anatomic location of entrance, course and exit of bilateral inferior alveolar nerve canal were delineated. The differences between affected and unaffected side were compared by two-sided Fisher's exact test. The relationship between the variation of inferior alveolar nerve canal and the severity of mandibular deformities was analyzed by Cochran-Armitage trend test. Results In all patients, there were 14 cases of type Ⅰ (9.2%), 84 cases of type Ⅱa (54.9%), 36 cases of type Ⅱb (23.5%) and 19 cases of type Ⅲ (12.4%). There was no significant difference in the anatomic location of inferior alveolar nerve canal between the affected and unaffected side in type I and Ⅱa hemifacial microsomia. There was significant difference in the entrance, anatomic course and exit of inferior alveolar nerve canal in type Ⅱb and type Ⅲ hemifacial microsomia (P<0.05) . The higher the degree of the mandibular deformity was, the higher the incidence of inferior alveolar nerve canal variation was (P<0.05). Conclusion Variations of the anatomic course of the inferior alveolar nerve canal existed in type 域b and type Ⅲ hemifacial microsomia, and the imaging evaluation is recommended before surgical intervention. [ABSTRACT FROM AUTHOR]

Objective To summarize the clinical features of optic neuritis (ON) complicated with chronic hepatitis B virus (HBV) infection, and evaluate the effectiveness of different treatment regimens, recurrence of ON, visual prognosis, HBV reactivation, liver function and liver structure changes. Methods and Results Total 19 patients (23 eyes) with acute ON complicated with chronic HBV infection admitted to Beijing Tongren Hospital, Capital Medical University from January 2015 to June 2021 were included. There were 13 females and 6 males, 15 cases with monocular onset, 17 cases with unidirectional course of disease, and 6 cases with optic disc edema. The time to the worst visual acuity (peak time) was 3 (2, 7) d after onset, and 16/23 eyes had severe visual impairment. Enhanced MRI showed abnormal intensity in orbital, intraductal or intracranial segments of optic nerve, even involving optic nerve sheath and optic chiasm. Anti-nuclear antibody (ANA) was positive in 5 cases and A type Sjögren's syndrome antibody (SSA) was weakly positive in one case. Cerebrospinal fluid (CBF) pressure decreased in 1/7 cases and white blood cell count increased in 2/7 cases. HBV DNA positive group (HBV DNA ≥ 100 IU/ml, 10 cases and 11 eyes) had more severe visual impairment than negative group (HBV DNA < 100 IU/ml, 9 cases and 12 eyes), the difference was statistically significant (Fisher's exact probability: P = 0.005, 0.003). HBV DNA positive group was treated with entecavir, and the recurrence of ON was ignored during follow-up. HBV DNA negative group didn't receive antiviral therapy, one case progressed to cirrhosis, 3 cases had abnormal liver function, and 2 cases had HBV reactivation. Conclusions The visual function of patients with ON complicated with chronic HBV infection was seriously impaired, and the response to glucocorticoid therapy was not good. The visual impairment of patients with positive HBV DNA was more serious than patients with negative HBV DNA. Patients with ON complicated with chronic HBV infection should be treated with antiviral drugs in combination with glucocorticoid therapy. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Cancer Biotherapy is the property of Editorial Office of Chinese Journal of Cancer Biotherapy 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 Hydrographic Surveying & Charting / Haiyang Cehui is the property of Hydrographic Surveying & Charting Editorial Board 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 analyze compensatory ability of the cerebral collateral circulation and relevant factors affecting cerebral ischemic tolerance for internal carotid artery (ICA) occlusion by Balloon Test Occlusion (BTO), providing reference basis for the selection of treatment methods in tumors or complicated aneurysms with ICA involved. Methods The clinical data of 87 cases BTO (85 patients, two of whom underwent bilateral BTO) of ICA in Tianjin Huanhu Hospital from June 2016 to September 2021 were analyzed retrospectively. The integrity of anterior or posterior of circulation structure, collateral compensatory capacity, tolerance to ICA occlusion and its influencing factors were analyzed. Results There were 8 [9.20% (8/87)] BTO positive cases. The positive rate was of cases with incomplete anterior communicating artery was higher than those with complete anterior communicating artery [3/5 vs. 6.10% (5/82); Fisher's exact probability: P = 0.005]. The positive rate of cases with complete fetal posterior cerebral artery (fPCA) which was higher than those without complete fPCA [3/7 vs. 6.25% (5/80); Fisher's exact probability: P = 0.015]. The positive rate of cases with non-open anterior circulation which was higher than those cases with open anterior circulation [3/6 vs. 6.17% (5/81); Fisher's exact probability: P = 0.009]. The positive rate of cases with non - open posterior circulation which was higher than those cases with open posterior circulation [20% (5/25) vs. 0 (0/59); Fisher's exact probability: P = 0.002]. Only the positive rate of patients with anterior circulation opening was higher than that of patients with open anterior circulation and open posterior circulation [13.04% (3/23) vs. 0 (0/3); Fisher's exact probability: P = 0.022], neither anterior nor posterior circulation opening were significantly higher than those with only anterior circulation opening [2/2 vs. 13.04% (3/23); Fisher's exact probability: P = 0.033] and both anterior and posterior circulation opening [2/2 vs. 0 (0/56); Fisher's exact probability: P = 0.001]. Once the ICA occluded, the anterior circulation, the posterior circulation, both of anterior and posterior circulation could provide anterior cerebral artery (ACA) supplied area with compensatory blood flow for 88.10% (74/84), 3.57% (3/84), 5.95% (5/84) cases, respectively. The anterior circulation, the posterior circulation, both anterior and posterior circulation could provide middle cerebral artery (MCA) supplied area with compensatory blood flow for 27.38% (23/84), 16.67% (14/84), 53.57% (45/84) cases, respectively. There were statistically significant differences in the compensatory capacity between ACA (χ² = 53.000, P = 0.000) and MCA (χ² = 54.244, P = 0.000). The combined compensatory capacity of both anterior and posterior circulation was higher than that of single anterior circulation (Z = 6.754, P = 0.000; Z = 6.180, P = 0.000), single posterior circulation (Z = 2.277, P = 0.023; Z = 5.065, P = 0.000) and neither anterior nor posterior circulation (Z = 1.991, P = 0.047; Z = 2.478, P = 0.013). Conclusions The anterior circle is functionally much more important than the posterior circle. Non-open anterior circulation, especial absence of anterior communicating artery, complete fPCA, neither anterior nor posterior circulation were highly predictive for intolerance to ICA occlusion. For these cases, attention should be paid to the protection of ICA or active blood flow reconstruction technology to reduce the occurrence of cerebral ischemia. Those cases with both opened anterior circulation and opened posterior circulation provided higher compensatory ability than those with single circulation. For those cases, the ICA of could be sacrificed. [ABSTRACT FROM AUTHOR]

Objective To explore the epidemiological characteristics of the proportion of hospitalized patients with congenital microtia. Methods From August 2020 to July 2021, the gender, age, location, left or right side, grade and whether accompanied by external auditory canal atresia, tragus loss, preauricular fistula, accessory auricle anomaly, hemifacial dysplasia, facial nerve dysplasia and macrostomia of 710 patients with microtia were statistically analyzed. The correlation between microtia of different grades and accompanying symptoms was analyzed by Pearson χ² test and Fisher's exact test. Results In 710 patients, there were 502 males (70.7%) and 208 females (29.3%). The age ranged from 6 to 56 years old. The residence of patients distribute multiple provinces in China, with Shanxi had the most cases of 101 (14.23%). There were 213 cases (30.00%) on the left side, 441 cases (62.11%) on the right side and 56 cases (7.89%) on both sides. There were 57 ears (7.44%) with microtia of degreeⅠ, 544 ears of degree Ⅱ(71.02%) and 165 ears of degree Ⅲ (21.54%). There was significant difference in the incidence of external auditory canal atresia, accessory auricle anomaly and tragus loss among different degrees of microtia (χ²=158.783, 8.782, 178.674, P<0.05). There was no significant difference in the incidence of preauricular fistula (χ²=4.998, P=0.082). There was significant difference in the incidence of hemifacial dysplasia or facial nerve dysplasia among different degrees of microtia (χ²=237.148, 143.781, P<0.05). There was no significant difference in the incidence of macrostomia (χ²=4.611, P=0.082). Conclusion Statistical analysis of the epidemiological characteristics of 710 patients with microtia showed the following characteristics: more males than females, more unilateral side than bilateral sides, more right side than left side, scattered distribution throughout the country, and different severity is related to some other facial deformities. These characteristics provided reference for the study of prevention and treatment strategies of microtia. [ABSTRACT FROM AUTHOR]

Background and objective Malignant pleural effusion is one of the common clinical manifestations of patients with lung adenocarcinoma. Patients with pleural effusion at the initial diagnosis of lung adenocarcinoma usually indicate poor prognosis. Epidermal growth factor receptor (EGFR) mutations mainly occur in patients with lung adenocarcinoma. Patients with different mutant subtypes have different prognosis. The clinical characteristics and prognostic factors of patients with EGFR mutated lung adenocarcinoma of different molecular subtypes combined with pleural effusion at initial diagnosis are still unclear. This study was designed to explore the clinical characteristics and prognostic factors of these patients in order to provide management recommendations for them. Methods A retrospective analysis of the clinical characteristics, treatment, outcomes and progression-free survival (PFS) of first-line treatment in patients with EGFR mutated lung adenocarcinoma combined with pleural effusion at initial diagnosis admitted to Department of Medical Oncology and Radiation Sickness, Peking University Third Hospital from January 2012 to June 2021 was performed. Pearsons chi-square test or Fisher's exact test were performed for comparison between groups. Kaplan-Meier method was performed for survival analysis and Cox proportional risk regression model was performed for multivariate analysis. Results 76 patients met the inclusion criteria in this study. The incidences of EGFR classical mutations 19del, 21L858R and non-classical mutations were 46.0%, 38.2% and 15.8%, respectively among these patients. There was no significant difference between the three mutations in terms of gender, age, presence of dyspnea at presentation, whether other distant metastases were combined, site of pleural effusion, volume of pleural effusion, presence of other combined effusions, tumor-node-metastasis (TNM) stage, presence of other gene mutations, and treatment of pleural effusion (P>0.05). In patients with EGFR classical mutations 19del or 21L858R or non-classical mutations subtype, the proportion of chemotherapy in first-line regimens were 17.1%, 20.7% and 58.3%, respectively (P=0.001); and first-line disease control rates were 94.3%, 75.9% and 50%, respectively (P=0.003); pleural effusion control rates were 94.3%, 79.3% and 66.7%, respectively (P=0.04); PFS were 287 d, 327 d and 55 d, respectively (P=0.001). Univariate analysis showed that EGFR mutation subtype, control of pleural effusion, first-line treatment agents, and first-line treatment efficacy were significantly associated with PFS (P<0.05). Cox multifactorial analysis showed that only EGFR mutation subtype and first-line treatment efficacy were independent prognostic factors for PFS (P<0.05). Conclusion PFS was significantly better for classical mutations than for non-classical mutations in patients with EGFR mutated lung adenocarcinoma combined with pleural effusion at initial diagnosis. Improving the efficacy of first-line therapy is the key to improve the prognosis of these patients. [ABSTRACT FROM AUTHOR]

To investigate the expression of Long non-coding RNA (LncRNA) SNHG4 in colorectal cancer (CRC) and its effects on cell oxaliplatin(L-OHP) resistance. LncRNA SNHG4 expression levels in CRC tissues and its corresponding adjacent tissues of 24 cases were analyzed by quantitative real-time PCR (qRT-PCR). The correlation between LncRNA SNHG4 expression and clinicopathologic features of CRC patients was analyzed by Fisher's exact test. Cultured in vitro, HCT116 cells were divided into sh-SNHG4 group (knockdown group) and sh-NC group (negative control group). qRT-PCR assays were used to detect the expression of LncRNA SNHG4 in sh-SNHG4 group and sh-NC group. CCK-8 assays indicated that relative cell viability in HCT116 treated with oxaliplatin at concentrations of 1.0, 2.5, 5.0, 10.0 and 20.0 滋mol/L. Cell proliferation and nuclear DNA damage in HCT116 treated with 10 滋mol/L oxaliplatin were analyzed by EdU and IF assays, respectively. Relative expression level of LncRNA SNHG4 was elevated in CRC tumor tissues compared with adjacent normal tissues(P<0.05). High LncRNA SNHG4 expression level was significantly correlated with lymph node metastasis, TNM stage and vascular invasion of CRC patients(P<0.05). Decreased relative cell viability was observed in sh-SNHG4 group compared with sh-NC group under the treatment of L-OHP with gradient concentration(P<0.05). Compared with sh-NC group, decreased proliferation and enhanced nuclear DNA damage were detected in sh-SNHG4 group treated with 10 滋mol/L L-OHP (P<0.05). LncRNA SNHG4 is upregulated in CRC tissues and correlated with lymph node metastasis, TNM stage and vessel invasion. LncRNA SNHG4 Knockdown could reduce the resistance to L-OHP in HCT116 cells. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Cancer Biotherapy is the property of Editorial Office of Chinese Journal of Cancer Biotherapy 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 study the characteristics of cognitive and neuropsychiatric behavioral features of Alzheimer's disease (AD) with white matter lesion (WML). Methods A total of 58 cases of AD patients were reruited from January 2010 to December 2020. The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to evaluate the degree of cognitive impairments. Activities of Daily Living Scale (ADL) was used to evaluate the abilities of daily living. Neuropsychiatric Inventory (NPI) was used to evaluate behavioral and psychological symptoms. The Hamilton Depression Rating Scale 21 - Items (HAMD-21) was used to evaluate the mental or emotional state. Clinical Dementia Rating Scale (CDR) was used to evaluate the dementia severity. The Fazekas scale was utilized to assess the severity of periventricular white matter hyperintensities (PWMH) and deep white matter hyperintensities (DWMH). Results 1) The distribution frequency of hypertension (χ2 = 4.665, P = 0.031), NPI score (Z = 1.987, P = 0.047), CDR score (Z = 2.069, P = 0.039), MMSE score (t = 2.927, P = 0.005) and MoCA score (t = 3.394, P = 0.001) in WML group were significantly different than those in non-WML group. Among which, attention and calculation ability (Z = 2.234, P = 0.025), recall ability (Z = 2.792, P = 0.005), naming ability (Z = 2.382, P = 0.017), retelling ability (Z = 2.685, P = 0.007) were lower than those in non-WML group. The incidence of delusion (Fisher's exact probability: P = 0.046), depression/dysthymia (χ2 = 4.376, P = 0.036), apathy/indifference (χ² = 4.063, P = 0.044) in WML group were significantly higher than those in non-WML group. 2) The distribution frequency of hypertension (χ2 = 11.195, P = 0.001), low-density lipoprotein cholesterol (LDL-C; t = 2.573, P = 0.013), ADL score (Z = 3.269, P = 0.001), NPI score (Z = 3.439, P = 0.001) and CDR score (t = 2.740, P = 0.006) in moderate to severe WML group were higher than those in mild WML group. MMSE score (t = 3.686, P = 0.001) and MoCA score (t = 5.225, P = 0.000) were lower than those in without or mild WML group. 3) Homocysteine (Hcy; F = 6.291, P = 0.003), distribution frequency of hypertension (χ² = 10.716, P = 0.005), distribution frequency of WML (χ² = 8.100, P = 0.017), total Fazekas scores (H = 13.658, P = 0.001), Fazekas score of PWMH (H = 6.540, P = 0.038) and Fazekas score of DWMH (H = 21.550, P = 0.000) were statistically significant. While distribution frequency of hypertension (χ² = 6.702, P = 0.010; Fisher's exact probability: P = 0.006), Hcy (P = 0.039, 0.001), Fazekas total scores (Z = 2.898, P = 0.004; Z = 3.223, P = 0.001) and Fazekas score of DWMH (Z = 2.807, P = 0.005; Z = 4.144, P = 0.000) in severe dementia group were higher than those in moderate and mild dementia group, and only the distribution frequency of WML was higher than that in mild dementia group (Fisher's exact probability: P = 0.008), Fazekas score of PWMH was higher than that in moderate dementia group (Z = 2.567, P = 0.010), and Fazekas score of DWMH in moderate dementia group was higher than that in mild dementia group (Z = 2.950, P = 0.003). 4) The total Fazekas scores (Z = 3.284, P = 0.001) and DWMH scores (Z = 4.083, P = 0.000) in AD patients with hypertension were significantly higher than those in AD patients without hypertension. Conclusions The degree of WML was closely related to cognitive function and neuropsychiatric behavioral symptoms of AD patients, which can be used as an observation index for the development of AD. Therefore, we should pay attention to early screening and prevention of WML related risk factors. [ABSTRACT FROM AUTHOR]

Objective To investigate the efficacy and safety of intraoperative high-field MRI combined with fluorescence-guided glioma resection. Methods A total of 53 patients with glioma admitted to The Fisrt Bethune Hospital of Jilin University from June 2017 to June 2018 were enrolled, including 33 patients (62.26%) whose tumors were located in important brain functional areas (17 cases in motor area, 11 cases in language area, 5 cases in thalamus). Glioma resection was performed under fluorescence-guided (fluorescence guidance group, n = 28) and intraoperative high-field MRI combined with fluorescence-guided glioma resection (combined group, n = 25). Results Total tumor resection was performed in 42 cases (79.25%) and subtotal tumor resection in 11 cases (20.75%). Of the 33 patients whose tumors were located in important brain functional areas, total resection was performed in 25 cases (75.76%) and subtotal resection in 8 cases (24.24%). There were 12 cases (22.64%) of astrocytoma (WHO grade II), 17 cases (32.08%) of anaplastic astrocytoma (WHO grade III) and 24 cases (45.28%) of glioblastoma (WHO grade IV) were confirmed by postoperative pathology. There were 16 cases of speech disorder (30.19%), 21 cases of transient limb movement disorder (39.62%), 6 cases of mental disorder (11.32%), 8 cases of intracranial infection (15.09%), 2 cases of small epidural hemorrhage (3.77%), and no death after the operation. The operation time of combined group was longer than that of fluorescence guidance group [(3.79 ± 1.14) h vs. (2.53 ± 1.04) h; t = - 4.718, P = 0.000]. The tumor total resection rate in the combined group was higher than that in fluorescent guidance group [92% (23/25) vs. 67.86% (19/28); χ² = 4.681, P = 0.031], the WHO grade had significant difference between 2 groups (χ2 = 2.041, P = 0.036), but the tumor total resection rate in important brain functional areas [88.89% (16/18) vs. 60% (9/15); Fisher's exact probability: P = 0.101] and the incidence of postoperative complications [37.73% (20/53) vs. 62.26% (33/53); χ² = 0.179, P = 1.000] were no significant difference between 2 groups. In the mean follow-up of 9 months, 11 patients (20.75%) had tumor recurrence. There was no significant difference in the recurrence rate between combined group and fluorescence guidance group [12% (3/25) vs. 28.57% (8/28); χ² = 2.205, P = 0.138]. Conclusions Intraoperative high-field MRI combined with fluorescence guidance can significantly improve the total resection rate of glioma, while preserving important brain functional areas and neural structures as much as possible, improving the quality of life and prolonging the progression-free survival of patients. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to investigate and compare facility workers’ and family caregivers’ perceptions toward closed-circuit television (CCTV) in long-term care facilities. Methods: The participants included 70 family caregivers and 66 facility workers in nine long-term care facilities. A structured questionnaire gathered participants’ perceptions of CCTV in long-term care facilities. Data were analyzed using descriptive statistics, t-test, chi-squared test, and Fisher’s exact test with SPSS 26.0. Results: Family caregivers positively perceived both the function (p<.001) and compulsory installation (p<.001) of CCTV in long-term care facilities compared to facility workers. Also, family caregivers highly perceived the necessity of two improvement plans for CCTV application: “the agreement on a video-data-application plan” (p=.032), and “the necessity of a video-analytics expert” (p=.001) compared to facility workers. Conclusion: Family caregivers were more likely to recognize the importance of CCTV in long-term care facilities than facility workers. Further education on the necessity of CCTV, its positive functions, and various usage methods is required considering that the discussion on CCTV installation in long-term care facilities will become more prevalent. In addition, the legal regulations related to CCTV installation should be prepared in detail. Furthermore, it is necessary to understand that CCTV is not a solution to elder abuse, and long-term care facilities should consider future uses of AI-CCTV. [ABSTRACT FROM AUTHOR]

Background Bypass surgery for moyamoya disease (MMD) mainly used the middle cerebral artery (MCA) as the recipient artery. There is a high risk of ischemia in the blood supply area of the anterior cerebral artery (ACA) during the perioperative period and follow-up period. This study compared and analyzed the efficacy of superficial temporal artery (STA)-ACA and STA-MCA double barrel bypass and STA-MCA double barrel bypass in the treatment of MMD. Methods In total 41 hemispheres of 32 ACA territory ischemic MMD patients were treated from January 2017 to December 2020 in The First Hospital of China Medical University. Separately performed STA-ACA and STA-MCA double barrel bypass and encephalo-myosynangiosis (EMS; ACA group, 10 hemispheres of 10 patients) and STA-MCA double barrel bypass and EMS (MCA group, 31 hemispheres of 25 patients). Compared and analyzed STA blood flow [including cut flow (CF), blood flow and cut flow index (CFI)], bypass vascular patency, cerebral perfusion [including the relative value of mean transit time (MTT), time to peak (TTP), cerebral blood flow (CBF) and cerebral blood volume (CBV)], neurological prognosis [modified Rankin Scale (mRS)], and the cerebral ischemia and intracranial hemorrhage morbidity and mortality in perioperative period and follow-up period. Results Thirty-two patients successfully completed 41 hemisphere operations. Intraoperative STA CF value of ACA group was significantly lower than MCA group [24.00 (15.38, 53.00) ml/min vs. 47 (36, 70) ml/min; Z = -2.547, P = 0.011]. CFI of STA one week after operation of ACA group was significantly greater than MCA group [3.57 (1.66, 4.66) vs. 1.30 (0.75, 1.70); Z = -2.357, P = 0.018]. No statistical significance between 2 groups in STA blood flow one week after operation [82.00 (62.50, 103.00) ml/min vs. 75.00 (27.90, 104.50) ml/min; Z = -0.221, P = 0.825]. The ACA group anastomotic patency rate was 12/12 and the MCA group was 81.58% (31/38), the difference was not statistically significant (χ2 = 1.268, P = 0.260). Bilateral frontal ischemia was observed in one hemisphere operation (1/10) in ACA group at perioperative period. Frontal ischemia was observed in 4 hemisphere operations (12.90%) and hemorrhagic temporal occipital infarction was observed in one hemisphere operation (3.23%) in MCA group at perioperative period. There was no statistically significant difference in the morbidity between 2 groups (Fisher exact probability: P = 1.000). No cerebral ischemia, intracranial hemorrhage and death occurred in ACA group, and surgical side frontal ischemia was observed in one hemisphere operation one year after operation in MCA group. There was no statistically significant difference in the morbidity between 2 groups (Fisher exact probability: P = 1.000). ACA group improved in 6 hemisphere operations (6/10), no changed in 3 hemisphere operations (3/10), deteriorated in one hemisphere operation (1/10). MCA group improved in 10 hemisphere operations (32.26%), no changed in 17 hemisphere operations (54.84%), deteriorated in 4 hemisphere operations (12.90%). There was no statistically significant difference between 2 groups (Z = -1.355, P = 0.223). Conclusions The STA-ACA and STA-MCA double barrel bypass in the treatment of ACA territory ischemic MMD patients can obtain good anastomotic patency rate and satisfactory long-term efficacy. Compared with the STA-MCA double barrel bypass, this surgery can obtain higher STA CFI, while long-term outcomes of patients were the same. [ABSTRACT FROM AUTHOR]

Objective By comparing consistency of cerebrospinal fluid (CSF) pathogen metagenomic next-generation sequencing (mNGS) results and final clinical diagnoses of central nervous system infection, we discuss the objective inclusion criteria for suspected central nervous system infection patients sending CSF pathogen mNGS. Methods From March 2017 to April 2020, Department of Neurology, Beijing Tongren Hospital, Capital Medical University sent CSF of 35 patients for pathogen mNGS and conventional pathogen testing to exclude central nervous system infection. Sensitivities, specificities and Youden's index of mNGS as well as conventional pathogen testing were calculated and compared. We also drew receiver operating characteristic (ROC) curves and calculated areas under the curve (AUC) to compared diagnostic efficacies of two methods. All patients were then scored according to objective inclusion criteria for sending samples (one score for one item). Positive coincidence rates of CSF pathogen mNGS and final clinical diagnoses of central nervous system infection of each score were also calculated. Results Nineteen of 35 patients enrolled were finally clinical diagnosed as central nervous system infection. Eighteen cases were positive by CSF pathogen mNGS, with positive rate 51.43% (18/35). Seventeen cases were positive by conventional pathogen testing with positive rate 48.57% (17/35). Seventeen cases of clinical diagnosed central nervous system infection were CSF pathogen mNGS positive, with diagnostic sensitivity 17/19, specificity 15/16 and Youden index 0.832. Fourteen cases of clinical diagnosed central nervous system infection were conventional pathogen testing positive, with diagnostic sensitivity 14/19, specificity 13/16 and Youden index 0.612. ROC curve showed the AUC of CSF pathogen mNGS was 0.916 (95%CI: 0.822-1.000, P = 0.000), and AUC of conventional pathogen testing was 0.806 (95%CI: 0.674-0.938, P = 0.000). There was no difference in diagnostic efficacies between CSF pathogen mNGS and conventional pathogen testing (Z = 1.245, P = 0.213). According to objective inclusion criteria for sending pathogen mNGS of CBF, the positive coincidence rates of mNGS were 0 score (0/4), 1 score (0/ 2), 2 scores (1/8), 3 scores (3/4), 4 scores (4/6), 5 scores (3/4), 6 scores (6/7). The positive coincidence rates of mNGS showed an overall trend of increase with scores, and notably cases ≥ 3 scores had higher positive coincidence rates than cases < 3 scores (Fisher exact probability: P = 0.000). Conclusions CSF pathogen mNGS can assist in accurate diagnosis of central nervous system infection. Sending CSF according to objective inclusion criteria based on clinical and routine auxiliary examination results can improve positive coincidence rate of pathogen mNGS. [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 Abnormal muscle response (AMR) is widely used as an indicator of the degree and effect of surgery during microvascular decompression (MVD) for hemifacial spasm (HFS). However, the positive rate of AMR during operation is quite different because of individual differences and single recording of muscle, which can not predict surgical outcomes. We present an improved method to record from multiple muscles innervated by multiple branches of the facial nerve to enlarge the AMR positive rate. Methods A total of 96 HFS patients in our hospital from January 2017 to June 2019, underwent MVD with intraoperative AMR monitoring. Ipsilateral frontalis, orbicularis oculi, orbicularis oris and mentalis were simultaneously monitored for AMR in stimulating the affected zygomatic branch of facial nerve in all cases. The effect of MVD for facial nerve was analyzed based on the disappearance of intraoperative AMR and the postoperative result. Results The AMR positive rate of frontalis was 43.75% (42/96), of orbicularis oculi was 38.54% (37/96), of orbicularis oris was 64.58% (62/96) and of mentalis was 78.13% (75/96). Total AMR positive rate was further improved to 97.92% (94/96) when the 4 muscles were monitored simultaneously. The AMR positive rates between multiple muscles monitoring group and any single muscle monitoring groups were significantly different (P = 0.000, for all). The AMR positive rates of orbicularis oris and mentalis were higher than that of frontalis (P = 0.000, 0.006) and orbicularis oculi (P = 0.000, 0.000). The postoperative results were statistically different between AMR complete disappearance group and AMR persistence group (Fisher exact probability: P = 0.043). Conclusions The method of multibranch facial muscles monitoring can effectively increase the AMR positive rate. AMR disappearance after the operation can evaluate the effect of facial nerve decompression and judge the prognosis. [ABSTRACT FROM AUTHOR]

Six kinds of cosmetics, including cleanser, care cosmetics and makeup categories, and seven representative microorganisms were selected to conduct the partial equivalence study between amplified ATP bioluminescence assay and the detection method of aerobic bacterial count and molds and yeast count in Safety and Technical Standard for Cosmetics (2015th Edition). The seven representative microorganisms were inoculated into the six kinds of cosmetics at target concentrations of 10, 5, 1 and 0.1 CFU/g, respectively. Tests on each concentration were repeated five times. Fisher exact test statistical analysis show that the detection limit of amplified ATP bioluminescence assay is significantly better than that of the standard method (p=0.000 1). Seven representative strains grew well in the MTAT medium, and the results of artificially contaminated samples detected by the amplified ATP bioluminescence assay were all positive, indicating that the method has good specificity. Three different laboratories were selected to compare the two methods using the same samples, and no statistical difference was found in the results, indicating the method is reproducible (p>0.05). The enrichment media MTAT, prepared with selected brands of TAT base medium, were assessed using growth promotion, and their ATP test results were all positive, indicating that the method is has good durability. Therefore, the amplified ATP bioluminescence assay is partially equivalent to the standard method. [ABSTRACT FROM AUTHOR]

Objective To analyze the clinical characteristics of patients with neuromyelitis optica spectrum disorders (NMOSDs) with or without autoantibodies other than aquaporin 4 (AQP4) - IgG. Methods A total of 90 NMOSDs patients were included from September 2014 to June 2017. First symptoms, first diagnosis, monophasic or polyphasic course of disease, comorbidities, Expanded Disability Status Scale (EDSS) score, treatment regimen and annualized relapse rate (ARR) were recorded. Laboratory tests for cerebrospinal fluid (CSF) white blood cell count and protein quantification, as well as serum autoimmune - related antibodies, including anti - nuclear antibody (ANA), A type and B type Sjögren's syndrome antibody (SSA and SSB), thyroid peroxidase (TPO) and thyroglobulin (TG) antibodies, anti-double stranded DNA antibody (dsDNA), perinuclear antineutrophil cytoplasmic antibody (pANCA), anti-endothelial cell antibody (AECA), Ro-52 antibody, Jo-1 antibody, anti-cardiolipin antibody (ACA), anti-mitochondria antibody M2 subtype (AMA-M2), human leukocyte antigen-B27 (HLA-B27), and myelin oligodendrocyte glycoprotein (MOG) antibody were examined. Brain and whole spine MRI were performed to observe the lesion site, distribution and length of spinal cord lesions. Results Among the 90 patients, 34 (37.78%) were accompanied by autoimmune-related antibodies (positive group), including 19 (55.88%) ANA positive cases, 13 (38.24%) SSA positive cases, 12 (35.29%) TPO antibody positive cases, and 10 (29.41%) TG antibody positive cases. The remaining 56 patients (62.22%) were not accompanied by autoimmune-related antibodies (negative group). In both groups, optic neuritis [52.94% (18/34) vs. 58.93% (33/56)], brain symptoms [26.47% (9/34) vs. 17.86% (10/56)] and myelitis [14.71% (5/34) vs. 21.43% (12/56)] were the main initial symptoms (Fisher exact probability: P = 0.504). There were no significant differences in the first diagnosis (χ² = 1.634, P = 0.201), monophasic or polyphasic course (Fisher exact probability: P = 1.000), comorbidities (χ² = 1.275, P = 0.302), EDSS score at the peak of the first onset (Z = - 0.747, P = 0.455) and at the inclusion (Z = - 0.379, P = 0.705), treatment plan (χ² = 0.662, P = 0.416) and ARR (Z = - 0.370, P = 0.711). There was no statistically significant difference in CSF white blood cell count (Z = - 1.163, P = 0.245) and protein quantification (Z = - 0.340, P = 0.734). MRI showed that 68 cases (75.56% ) had intracranial lesions [28 cases (82.35%) in the positive group and 40 cases (71.43%) in the negative group], mainly located in the parietal lobe, frontal lobe and lateral ventricle. There were 62 cases (68.89%) with spinal lesions [21 cases (61.76%) in the positive group and 41 cases (73.21%) in the negative group], which were mainly cervical and thoracic myeloid lesions and medium - length segment lesion. There were no statistically significant differences in intracranial lesions (χ² = 1.367, P = 0.242), spinal cord lesions (χ² = 1.294, P = 0.255) or lesion length (Z = - 0.647, P = 0.517) between 2 groups. Conclusions There were no significant differences between NMOSDs patients with and without other autoimmune-related antibodies in terms of initial symptoms, CSF white blood cell count and protein quantification, MRI lesion distribution characteristics, etc. The value of autoimmune - related antibodies in clinical characteristics of NMOSDs patients remains to be further explored. [ABSTRACT FROM AUTHOR]

BACKGROUND: During the orthodontic treatment, the results of related reports on potential risk factors affecting the clinical success rate of miniscrew implants are inconsistent. The influential factors that clinicians concern are not all included in this study, and the conclusions from animal experiments are difficult to apply to clinical practice directly. Therefore, what factors affect the clinical success rate of miniscrew implants need further thorough and systematic research. OBJECTIVE: To investigate the factors that influence the clinical success rate of miniscrew implants used as orthodontic anchorage. METHODS: A total of 114 patients with oral implants, including 42 males and 72 females, aged (19.26±9.19) years were included in this study. A total of 253 miniscrew implants were implanted as orthodontic anchorage. The following influential factors were included: gender, age, vertical skeletal facial pattern, implant site, implant arch, soft tissue type at the implant site, oral hygiene status, diameter and length of the miniscrew implants, implantation method, implantation angle, stress loading timing and intensity, and clinical use. Logistic regression analysis was used to study the correlation between success rate and all variables. Analysis of variance was used to test the effect of each variable on clinical success rate. This trial protocol was approved by the Medical Ethics Committee of Sichuan University. RESULTS AND CONCLUSION: Among 253 successful miniscrew implants, the overall success rate was 88.54% with an average loading period of 9.5 months. The average loading period of the 29 failed miniscrew implants was 2.3 months. The chi-square test, Fisher exact test and logistic regression revealed that age, oral hygiene, vertical skeletal facial pattern, and implant site were significantly correlated with clinical success rate (P < 0.05). However, gender, sagittal bone facial patter, implant arch, soft tissue type at implant site, diameter and length of miniscrew implant, implantation method, implantation angle, stress loading timing and strength, and clinical use were not significantly correlated to clinical use (P > 0.05). These results suggest that to minimize the failure of miniscrew implants, proper oral hygiene instruction and effective supervision should be given to patients, in particular to those young ( < 12 years) high mandibular plane patients. [ABSTRACT FROM AUTHOR]

Objective To investigate the imaging signs of perineural spread in head and neck tumors, and to explore its value in the differential diagnosis of adenoid cystic carcinoma (ACC) and squamous cell carcinoma (SCC) of nasal cavity, paranasal sinus, and palate. Methods The clinical and imaging data of pathologically confirmed primary ACC and primary SCC of nasal cavity, paranasal sinus, and palate from 2012 through 2018 were analyzed retrospectively. The MRI signs of perineural spread and erosion of cranial nerve canals were analyzed. Kappa lest was used to evaluate the consistency of the two reviewers. Two independent samples chi-square test or fisher exact probability method was used to analyze the difference in the incidence of perineural spread between the two groups. Multivariate logistic; regression analysis was performed for statistically significant signs. HOC curve was drawn to evaluate the effectiveness of MRI signs of perineural spread in the differential diagnosis of tumors in the two groups. Results The two reviewers were consistent in evaluating the signs of perineural spread (k>0.75. P<0.001). In ACC, the signs included asymmetrical neural thickening and enhancement, obliteration of the fat of pterygopalatine fossa, soft tissue surrounding the cavernous sinus, loss of long T2 signal of Meckel cavity, with significantly higher incidence of muscle edema and enhancement of infratemporal fossa than that in SCC (P<0.05). The incidence of erosion of vidian canal, greater palatine foramen, round foramen and foramen ovale in ACC was also significantly higher than that in SCC (P<0.05). There was no significant difference in the incidence of erosion of supraorbital fissure, optic canal, infraorbital fissure, and sphenopalatine foramen between the two groups (P>0.05). Multivariate logistic; regression analysis showed that asymmetric; neural thickening and erosion of greater palatine foramen were significant predictors of ACC in nasal cavity, paranasal sinus and palate with odds ratios of 14.5 (95% Cl: 2.981-70.384) and 7.1 (95% Cl: 1.406-35.891), respectively. The incidence of MRI signs of perineural spread in ACC (0.50±0.28) was significantly higher (P<0.05) than that in SCC (0.13 ±0.14). Using 3 perineural spread signs as diagnostic indicators, 78.3% sensitivity, 88.0% specificity, and 0.88 area under receiver operating characteristic curve were obtained. Conclusion There is a significant difference in the incidence of perineural spread in ACC and SCC of nasal cavity, paranasal sinus, and palate, which can aid the differential diagnosis. [ABSTRACT FROM AUTHOR]

Objective To summarize clinical and imaging features of posterior reversible leukoencephalopathy syndrome (PRES) caused by systemic lupus erythematosus (SLE) and nephrotic syndrome (NS). Methods A total of 53 patients clinically diagnosed with PRES from January 2013 to December 2017 were selected. The patients were divided into SLE group (31 patients) and NS group (22 patients) according to their primary diseases. Differences between the 2 groups in imaging features, affected sites and severity of lesions were compared. Results Incidence rates of epileptiform seizure (χ² = 9.255, P = 0.002) and visual impairment (χ² = 7.005, P = 0.008) of the NS group were higher than those in the SLE group. In the SLE group, bilateral periventricular areas (adjusted χ² = 5.377, P = 0.020), basal ganglia (adjusted χ² = 4.825, P = 0.028) and centrum semiovale (χ² = 8.113, P = 0.004) were mainly involved. The differences of imaging type between the 2 groups were statistically significant (Fisher's exact probability: P = 0.029). The proportion of parietal occipital lobe distribution in NS group was significantly higher than that in SLE group (Fisher's exact probability: P = 0.016). After treatment, PRES recovery in the SLE group was better and faster than that in NS group (t = 2.612, P = 0.013). Conclusions Common pathogens of PRES namely SLE and NS are different in certain degree of imaging features, and this will be significant to understand pathophysiological mechanism and clinical diagnosis of this disease. [ABSTRACT FROM AUTHOR]

Objective To explore the influencing factors, biomarkers, etiology and imaging features of cancer - associated ischemic stroke. Methods The clinical data of 693 patients with ischemic stroke from April 2018 to January 2019 were retrospectively collected. The patients were divided into ischemic stroke with active cancer (cancer group, N = 31) and traditional ischemic stroke (control group, N = 662). The sociodemographic data, risk factors for stroke, National Institutes of Health Stroke Scale (NIHSS) scores on admission, platelet count, D - dimer, fibrinogen and C - reactive protein (CRP) level, features of infarcts on diffusion - weighted imaging [DWI, which was acute multiple ischemic lesions located in more than one vascular territories (AMIMCT)J, and the tumor type and histological classification in cancer group were recorded. Univariate and multivariate backward Logistic regression analysis were used to analyze the influencing factors of cancer-associated ischemic stroke. Results Compared with control group, patients in cancer group had older age (x =2.148, P = 0.032), lower proportion of hypertension (x =5.425, P = 0.020) and hyperlipidemia (Fisher exact probability: P = 0.000), and elevated levels of serum D - dimer (Z = 2687.500, P = 0.001), fibrinogen (t = 2.402, P = 0.022) and CRP (Z = 3669.000, P = 0.001). There was significant difference between 2 groups on TOAST (Fisher exact probability: P = 0.000). Patients in cancer group had lower proportion of large artery atherosclerosis (LAA; Fisher exact probability: P = 0.000), but higher proportion of stroke of undetermined etiology (SUE; x2 = 175.418, P = 0.000) and AMIMCT (x2 = 22.560, P = 0.000). Multivariate backward Logistic regression analysis showed having no history of hyperlipidemia (OR = 0.188, 95%CI: 0.048-0.730; P = 0.016), SUE (OR = 29.854, 95%CI: 10.310-86.449; P = 0.000), elevated levels of D - dimer (OR = 1.663, 95%CI: 1.294-2.137; P = 0.000) and fibrinogen (OR = 1.785, 95% CI: 1.294-2.137; P = 0.000) were risk factors for cancer - associated ischemic stroke. Conclusions It is usually lack of evidence of LAA for cancer - associated ischemic stroke. Elevated D - dimer and fibrinogen, and SUE demonstrated that hypercoagulability and microembolus embolism may be the possible mechanism of cancer-associated ischemic stroke. [ABSTRACT FROM AUTHOR]

Objective To evaluate the value of Knosp classification and cavernous sinus zoning in the diagnosis of pituitary adenoma invasiveness and the significance of endoscopic transnasal surgery for pituitary adenomas. Methods There were 75 cases with pituitary adenomas of Knosp grade 3-4 (44 cases of Knosp grade 3 and 31 cases of Knosp grade 4) who were performed endoscopic transnasal surgery from July 2015 to June 2017 in our hospital. Based on coronal MRI of sellar region in patients with Knosp 3 pituitary adenomas, the ratio R of distance from the middle point of internal carotid artery (ICA) cavernous sinus segment to the upper part of anterior clinoid process segment and vertical distance from the furthest point of tumor invasion to the line was calculated and analyzed statistically. According to cavernous sinus zoning under endoscope and involvement of medial wall of cavernous sinus, patients with Knosp grade 3 pituitary adenomas were further divided into Knosp grade 3A (invasive and non-invasive) and 3B by invading different cavernous spaces. The total removal rate of tumor was reviewed by MRI in sellar region after operation. Results Among 75 cases, 36 were classified as Knosp grade 3A in 44 cases of Knosp grade 3 pituitary adenomas, including 12 cases of invasive pituitary adenomas (mainly involving posterior superior space of cavernous sinus and affecting oculomotor nerve) and 24 cases of non-invasive pituitary adenomas (the tumor pushed against the medial wall of cavernous sinus, presenting "pseudoinvasion"). The ratio R of invasive pituitary adenomas was significantly smaller than non-invasive pituitary adenomas (1.28 ± 0.18 vs. 1.74 ± 0.27; t = 5.275, P = 0.000). The Knosp grade 3A was divided into 2 groups according to the median value of ratio R: ≤ 1.59 group (17 cases) and > 1.59 group (19 cases). The invasion rate of ratio R ≤ 1.59 group was higher than that of > 1.59 group (12/17 vs. 0/19; Fisher's exact probability, P = 0.000). The total resection rate of 75 cases was 72% (54/75), among which the total resection rate of Knosp grade 3 was 84.09% (37/44), and rate of Knosp grade 4 was 54.84% (17/31). The average follow-up period was (14.84 ± 5.66) months, and no one case relapsed. Conclusions The calculation of ratio R in preoperative coronal MRI helps to evaluate the invasion degree of Knosp grade 3A pituitary adenomas. Combined with artificial division of cavernous sinus, it has guiding significance in endoscopic transnasal surgery for pituitary adenoma removal. [ABSTRACT FROM AUTHOR]

Objective: To explore the independent risk factors of axillary lymph node metastasis in early breast cancer and establishing an effective risk prediction model. Methods: The clinical data of 404 early breast cancer patients from June 2016 to December 2017 in Liaoning Cancer Hospital were enrolled in this study. The chi-square test or Fisher's exact test were used to analyze the clinical pathological characteristics and axillary lymph node metastasis. Multivariate stepwise logistic regression analysis was used to explore the independent risk factors of axillary lymph node metastasis. Risk prediction model was established according to the regression coefficients of each risk factor. ROC curve was used to verify the effectiveness of the test and calibration curve was drawn to evaluate its consistency with the real situation. Results: Axillary lymph node metastasis in early breast cancer was significantly different(P＜0.05) between tumor size, pathological grade, vascular invasion, ER expression, size of KI67, molecular subtype and total number of lymph nodes≥ 14 (14 were the average number of lymph nodes), but not related to age, menopause, tumor location, pathological type, PR and other factors (P>0.05). Univariate and multivariate analysis showed that tumor > 2 cm, pathological grade III, vascular invasion and ER expression≧ 50%were independent risk factors for axillary lymph node metastasis in early breast cancer(P＜0.05). The area under the ROC curve was 0.852 (95%CI was (0.812, 0.892), P<0.01). The calibration curve R2=0.9086 (P<0.05).Conclusion: Tumor>2 cm, pathological grade III, vascular invasion, and ER≧50%are independent risk factors for axillary lymph node metastasis in early breast cancer. [ABSTRACT FROM AUTHOR]

Background: Patients with type 2 diabetes mellitus (T2DM) face a higher risk of diabetic foot neuropathy, which increases the risk of death. The early detection of factors that influence diabetic neuropathy reduces the risk of foot lesions, including foot ulcerations, lower extremity amputation, and mortality. Purpose: To explore the demographic, disease-characteristic, health-literacy, and foot-self-care-behavior factors that affect diabetic foot neuropathy in patients with T2DM. Methods: A case-control study design was employed in which cases (Michigan Neuropathy Screening Instrument, MNSI) ≥ 2 were matched to controls based on age and gender in a medical center. A total of 114 patients diagnosed with T2DM in a medical center were recruited as participants. Data were collected using a structured questionnaire. The collected data were analyzed using Fisher's exact test, Mann-Whitney U test, and logistic regression. Results: The results of multiple logistic regression showed that glycated hemoglobin (B = 1.696, p = .041) and communication and critical health literacy (B = -0.082, p = .034) were significant factors of diabetic foot neuropathy. Conclusions/Implications for Practice: The findings of this study suggest that nurses should assess the health literacy of patients with T2DM before providing health education and should develop a specific foot-care intervention for individuals with poor glycemic control. [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]

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.)

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.)

Background and purpose Higher reperfusion rates have been established with endovascular treatment of acute ischemic stroke (AIS). There are limited data on the comparative performance of mechanical thrombectomy devices. Methods A retrospective single-center analysis was undertaken of all consecutive patients who underwent thrombectomy using Merci, Penumbra or stent retrievers (SR) from September 2010 to November 2012. Baseline characteristics, rates of successful recanalization (modified Thrombolysis in Cerebral Infarction (mTICI) score 2b - 3), symptomatic intracerebral hemorrhage (sICH), final infarct volume, 90-day mortality and independent functional outcomes at 90 days were compared across the three devices. Results Our cohort included 287 patients. There were mild imbalances in baseline characteristics with trends towards higher National Institutes of Health Stroke Scale (NIHSS) score in patients in the Merci group (SR=18 vs Merci=21 vs Penumbra=19, p=0.06) and lower Alberta Stroke Program Early CT Score (ASPECTS) in patients in the SR group (>7: SR=51% vs Merci=61% vs Penumbra=62%, p=0.12). On univariate analysis there were no differences in the rate of sICH (SR=7% vs Merci=7% vs Penumbra=6%, p=0.921) and infarct volume (SR=61.5 mL vs Merci=69.5 mL vs Penumbra=59.2 mL, p=0.621). Trends towards better functional outcomes were found with Penumbra and SR vs Merci (41% vs 36% vs 25%, respectively, p=0.079). Complete or near complete reperfusion (mTICI 2b - 3) was higher in the SR and Penumbra groups than in the Merci group (86% vs 78% vs 70%, respectively, p=0.027). Binary logistic regression showed that SR was an independent predictor of good functional outcome (OR 2.27, 95% CI 1.018 to 5.048; p=0.045). Conclusions Although our initial data confirm the superiority of SR technology over the Merci device, there was no significant difference in near complete/complete reperfusion, final infarct volumes or clinical outcomes between SR and Penumbra thromboaspiration. [ABSTRACT FROM AUTHOR]

Background: Uncontrolled blood pressure (BP) attributed to medication non-adherence may increase the risks of complications and of death. Purpose: This study aimed to identify factors that influence poor medication adherence in hypertensive patients and to establish the relationship between BP and medication adherence. Methods: This cross-sectional study enrolled 546 outpatients with hypertension from a regional hospital in eastern Taiwan. Data collected from participants included BP measurements and answers to a structured questionnaire. Descriptive statistics were performed for all measures as appropriate. Assessments of differences in adherence were based on demographic, medical history, and BP. Chi-Square test and Fisher's exact test for categorical variables or independent i-test for continuous variables were performed. The relationship between adherence and BP was analyzed using multiple regression analysis. All data were analyzed using SPSS 20.0 statistical analysis software. Results: A total of 30% of patients were classified in the poor adherence category. A significant difference was found between adherence and poor adherence groups in terms of: type of medication, side effects, and sources of medications. No significant difference, however, was found across the two adherence groups in terms of: number of pills, medication schedule, duration of hypertension and its related complications, and use of complementary-and-alternative medicine (CAM). The diastolic blood pressure (DBP) and mean arterial pressure (MAP) differed significantly between the two groups. However, no significant difference in systolic blood pressure (SBP) was identified between the two groups. When SBP and DBP were considered separately, the number of patients who had good and poor control of SBP and DBP differed significantly between the two groups. Side effects and sources of medications were significant predictors of adherence (p < .05). Adherence was a significant predictor of SBP and DBP (p < .05). Conclusions: Side effects and sources of medications were identified as factors that influence the medication adherence of Taiwanese patients, which was identified as a reliable predictor of BP outcome. [ABSTRACT FROM AUTHOR]

Background: Clear directions and explanations from nurses related to health behaviors and discharge procedures have been shown to effectively reduce the risk of patient readmission. Nurses thus need to develop good communication skills in order to ensure that their communications help patients become better-informed and less anxious about discharge procedures. Purpose: This research evaluates the communication skills of nurses following two different education interventions. Methods: Experimental design principles for education interventions were followed in this research. Medical nurses certified at the N to N2 level in a municipal hospital in Taipei City were enrolled as participants (N = 78) and divided into an experimental group and control group using stratified purposive randomization. The experimental group received clinical scenario-based simulation education for communication. The control group received standard class-based education for communication. Both groups received a pre-test evaluation and an OSCE post-test evaluation. Results were analyzed using SPSS 17.0 software. Results: Independent t-test results revealed significant increases in communication skills (t = 3.406, p < .05) in both groups, with the increase in the experimental group (M = 5.00, SD = 0.82) significantly greater than the increase in the control group (M = 4.11, SD = 1.41). However, the mean scores from the post-test standardized patient survey found no significant differences between the two groups in terms of communication skills. Conclusion: The results indicate that the clinical scenario-based simulation education intervention is more effective than traditional class-based education in enhancing the communication skills of nurses. [ABSTRACT FROM AUTHOR]

The procedure included chart review, the repetitive saliva swallowing test (RSST), and the modified water swallowing test (MWST). Dysphagia was defined as either RSST or MWST abnormal. JMP 9.0 was used to perform descriptive statistics, t-test, chi-square test and logistic regression analysis Results: At clinical examination, 53.61% of the study subjects demonstrated dysphagia. Chi-square analysis showed that five abnormal signs (could not close mouth with water, without mastication, food stuck in the throat, obvious sputum sound, and choking after swallowing) are all associated with dysphagia. Multiple logistic regression analysis revealed choking is a significant predictor variable of dysphagia. Conclusion: Over half of the rehabilitation unit stroke patients in this study had dysphagia. Nurses are the primary care providers for dysphagia patients. Therefore, there is a need for ward nurses to have skills to assess, recognize, and manage dysphagia and to enhance patient safety. [ABSTRACT FROM AUTHOR]

Background: Limited disease knowledge is frequently the cause of disease-related anxiety in myocardial infarction patients. The ability to communicate effectively serves multiple purposes in the professional nursing practice. By communicating effectively with myocardial infarction patients, nurses may help reduce their anxiety by keeping them well informed about their disease and teaching them self-care strategies. Purpose: This research evaluates the communication skills of nurses following scenario-based simulation education in the context of communication with myocardial infarction patients. Methods: This study used an experimental design and an educational intervention. The target population comprised nurses of medicine (clinical qualified level N to N2 for nursing) working at a municipal hospital in Taipei City, Taiwan. A total 122 participants were enrolled. Stratified block randomization divided participants into an experimental group and a control group. The experimental group received clinical scenario-based simulation education for communication. The control group received traditional class-based education for communication. Both groups received a pre-test and a Communication Skills Checklist post-test assessment. Results were analyzed using SPSS 17.0 for Windows software. Results: A t-test showed significant increases in communication skills (p < .001) in the experimental group and ANCOVA results identified significant between-group differences (p < .001) in communication skills following the education intervention. Conclusions: The results indicate that clinical scenario-based simulation education for communication is significantly more effective than traditional class-based education in enhancing the ability of nurses to communicate effectively with myocardial infarction patients. [ABSTRACT FROM AUTHOR]