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Background and Purpose: Most patients cannot receive intravenous thrombolytic therapy in the early stage of stroke onset, and the application of mobile stroke unit (MSU) in prehospital intravenous thrombolytic therapy of acute stroke may change this situation. The first MSU in China was put into use in 2017. Herein, we aimed to explore the preliminary experience of MSU in prehospital thrombolysis of acute stroke. Methods: Patients who received prehospital intravenous thrombolytic therapy using MSU were classified to the MSU thrombolysis group, and the control group consisted of stroke patients admitted by regular ambulances, who were transferred to hospital for intravenous thrombolytic therapy. The feasibility, safety, and duration of procedures were compared. Results: There were 14 patients received prehospital intravenous thrombolysis on the MSU, and 24 patients underwent intravenous thrombolysis in the emergency center, who were transferred by the ordinary ambulance during the same period. The median call-to-needle time was 59.5 min in the MSU thrombolysis group, while it was 89 min in the control group; the difference between the 2 groups was statistically significant (p = 0.001). The median time from onset to thrombolysis was 70 and 102.5 min, respectively, in the 2 groups (p = 0.002). The percentages of good clinical outcome (modified Rankin Scale score ≤ 2) at 90-day follow-up were 79 and 67%, respectively (p = 0.488). The rate of symptomatic intracranial hemorrhage and mortality during the perioperative period did not differ significantly between 2 groups. Conclusion: Despite the small sample size, our preliminary experience of the application of MSU in the prehospital thrombosis therapy seems to indicate a significant reduction in time from call to needle, the efficacy of MSU in the treatment of acute stroke needs further experiment and larger sample size to confirm. [ABSTRACT FROM AUTHOR]

The efficacy and safety of intra-arterial (IA) chemotherapy versus intravenous (IV) chemotherapy for malignant gliomas were studied. We searched eight electronic databases to identify relevant randomized controlled trials that compared IA chemotherapy with IV chemotherapy in patients with malignant gliomas. This study was conducted in compliance with the Quality of Reporting of Meta-analysis (QUORUM) guidelines. The quality of data was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach. Four eligible randomized controlled trials including 460 patients were retrieved. Comparing IA chemotherapy and IV chemotherapy for malignant gliomas, disease control rate, efficacy rate, 1-year, 2-year, and 3-year overall survival as well as grade 3/4 leukocytopenia, thrombocytopenia, and anemia were not statistically different. In conclusion, IA chemotherapy is not superior to IV chemotherapy in terms of efficacy and overall survival as a treatment for malignant gliomas. Copyright © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]