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目的 探讨急性缺血性脑卒中（AIS）患者血清血管内皮锌指蛋白 1（VEZF1）、干扰素调节因子 2 结合蛋白 2（IRF2BP2）表达变化及其与静脉溶栓预后的关系。方法 选取拟行 静 脉 溶 栓 的 AIS 患 者 266 例（AIS 组）, 根 据 NIHSS 评分评估病情, 分为轻度 94 例、中度 119 例、重度 53 例；另选择健康体检者 133 例作为对照组。AIS 组入院时、 对照组查体时采集静脉血, 采用实时荧光定量 PCR 法检测血清 VEZF1 mRNA, ELISA 法检测 IRF2BP2 蛋白, 比较两 组及不同程度 AIS 患者的血清 VEZF1 mRNA、IRF2BP2 蛋白水平。采用 Spearman 相关法分析 AIS 患者血清 VEZF1 mRNA、IRF2BP2 蛋白与 NIHSS 评分的相关性。AIS 患者接受重组组织型纤溶酶原激活剂静脉溶栓, 术后随访 3 个 月, 根据改良 Rankin 量表评价患者预后, 采用多因素非条件 Logistic 回归模型分析 AIS 静脉溶栓患者预后不良的影 响因素, 绘制受试者工作特征（ROC）曲线, 评价血清 VEZF1 mRNA、IRF2BP2 蛋白对预后不良的预测效能。结果 与 对照组比较, AIS 组血清 VEZF1 mRNA、IRF2BP2 蛋白表达降低, 其中重度患者低于轻度、中度患者, 中度患者低于重 度患者（P 均<0. 01). 血清 VEZF1 mRNA、IRF2BP2 蛋白与 NIHSS 评分呈负相关（rs 分别为-0. 770、-0. 798, P 均 <0. 01). AIS 患者术后 3 个月预后良好 194 例, 预后不良 72 例。梗死体积大、NIHSS 评分高是 AIS 患者预后不良的 独立危险因素, VEZF1 mRNA 高、IRF2BP2 蛋白高是独立保护因素（P 均<0. 01). 血清 VEZF1 mRNA 联合 IRF2BP2 蛋白预测 AIS 静脉溶栓患者不良预后的曲线下面积大于单一指标（P 均<0. 05). 结论 血清 VEZF1 mRNA、IRF2BP2 蛋白水平降低与 AIS 病情加重和预后不良有关, 血清 VEZF1 mRNA 联合 IRF2BP2 蛋白检测能够较好地预测 AIS 静脉 溶栓患者的不良预后。 [ABSTRACT FROM AUTHOR]

Objective To investigate the relationship between eosinophil-to-monocyte ratio (EMR) and the prognosis of patients with acute ischemic stroke (AIS) receiving intravenous thrombolysis . Methods The clinical data of 211 patients with AIS who received intravenous thrombolysis were collected from the First Affiliated Hospital of Bengbu Medical University from January 2021 to December 2022. The patients were divided into the good prognosis (mRS score≤2 points) group and the poor prognosis (mRS score>2 points) group according to the mRS score after 3 months. They were divided into the survival group and the death group according to their survival status. Univariate and multivariate logistic regression analysis were used to evaluate the relationship between EMR and the prognosis of patients with AIS receiving intravenous thrombolysis. ROC curve was used to compare the prediction accuracy of EMR, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR). According to the optimal cut-off value of the ROC curve, patients were divided into the high EMR group and the low EMR group to analyze the relationship between EMR level and the prognosis. Results Multivariate logistic regression analysis showed that EMR (OR 0.406, 95% CI 0.277- 0.597, P<0.001) was independently associated with poor prognosis in AIS patients receiving intravenous thrombolysis. The ROC curve showed that the AUC of EMR was 0.773 (95%CI 0.711-0.836, P<0.001), which was superior to NLR and PLR. Its optimal cut-off value was 0.435, the sensitivity was 90.2%, and the specificity was 55.8%. The poor prognosis (P<0.001) and mortality (P=0.009) of the high EMR group (81 cases) were reduced compared to the low EMR group (130 cases). Conclusions Lower EMR was independently associated with poor prognosis at 3 months in AIS patients receiving intravenous thrombolysis. [ABSTRACT FROM AUTHOR]

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

Objective: To investigate the effects of hyperbaric oxygen combined with alteplase intravenous thrombolysis on cerebral blood perfusion status and serum ischaemic modified albumin (IMA), neurofilament light chain protein (NFL) and Occludin levels in patients with acute ischemic stroke (AIS). Methods: 124 patients with AIS in our hospital from June 2022 to June 2023 were selected as the study objects, and were randomly divided into control group and observation group, 62 cases in each group. The control group was given alteplase intravenous thrombolysis therapy, and the observation group was given hyperbaric oxygen therapy on the basis of the control group. The clinical efficacy, National institute of Health Stroke Scale (NHISS) and modified Rankin scale (m RS) score, cerebral perfusion status [cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), time to peak (TMax], serum IMA,NFL, Occludin levels and incidence of adverse reactions were compared between the two groups. Results: Compared with control group,the total effective rate of observation group was higher, NHISS and m RS score were decreased after 2 weeks of treatment (P＜0.05). Compared with control group, CBF and CBV were increased and MTT and TMax were shortened in observation group after 2 weeks of treatment (P＜0.05). Compared with control group, serum IMA, Occludin and NFL levels in observation group decreased after 2 weeks of treatment (P＜0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P＞0.05). Conclusion: Hyperbaric oxygen combined with alteplase intravenous thrombolytic therapy for AIS patients can improve cerebral blood perfusion, reduce serum IMA, Occludin and NFL levels, and alleviate nerve function injury, with significant efficacy and high safety. [ABSTRACT FROM AUTHOR]

目的 探讨空腹血糖与接受静脉溶栓的缺血性卒中患者功能结局的关系。 方法 回顾性收集2018年10月—2020年11月首都医科大学附属北京天坛医院静脉溶栓患者的病历资料。纳入发病4.5 h内接受阿替普酶静脉溶栓的缺血性卒中患者为研究对象，采集相关研究数据（包括空腹血糖等）。研究结局设定为出院时功能结局良好，即mRS评分0～1分。采用多因素logistic回归分析探讨空腹血糖与功能结局的关联性。 结果 共入组205例患者，平均年龄为（63.21±11.67）岁，其中153例（74.63%）患者为男性，入院NIHSS评分为5（3～9）分。其中117例（57.07%）患者出院时功能结局不良，88例（42.93%）患者出院时功能结局良好。功能结局良好的患者空腹血糖水平低于功能结局不良的患者[5.10（4.46～7.06）mmol/L vs. 6.33（5.09～7.79）mmol/L，P=0.001]。多因素logistic回归分析结果显示，校正年龄、性别、NIHSS评分后，空腹血糖水平与接受静脉溶栓功能结局相关（OR 0.876，95%CI 0.774～0.991，P=0.035）；校正年龄、性别、NIHSS评分、桥接取栓后，关联性没有达到统计学意义（OR 0.891，95%CI 0.791～1.004，P=0.058）。 结论 对于接受静脉溶栓的缺血性卒中患者，高水平空腹血糖可能会增加静脉溶栓后出院功能结局不良风险。 Abstract: Objective To investigate the association between fasting blood glucose and functional outcomes in ischemic stroke patients treated with intravenous thrombolysis. Methods The study data of patients treated with intravenous thrombolysis in Beijing Tiantan Hospital, Capital Medical University from October 2018 to November 2020 were collected retrospectively. Ischemic stroke patients who received alteplase intravenous thrombolysis within 4.5 h of onset were included, and study data including fasting blood glucose were collected. The study outcome was set as a good functional outcome at discharge (mRS score 0-1). Multivariate logistic regression analysis was used to investigate the association between the fasting blood glucose and functional outcomes. Results A total of 205 patients were enrolled. The mean age was (63.21±11.67) years. The percentage of male was 153 (74.63%). The admission NIHSS score was 5 (3-9). There were 117 patients (57.07%) who did not have a good functional outcome at discharge and 88 patients (42.93%) who did. Fasting blood glucose levels in patients with good functional outcomes were lower than those in patients with poor functional outcomes [5.10 (4.46-7.06) mmol/L vs. 6.33 (5.09-7.79) mmol/L, P=0.001]. Multivariate logistic regression analysis showed that after adjusting for age, gender, and NIHSS score, there was a correlation between fasting blood glucose level and the outcome of receiving intravenous thrombolysis (OR 0.876, 95%CI 0.774-0.991, P=0.035). After adjusting for age, sex, NIHSS score and mechanical thrombectomy, the association was not statistically significant (OR 0.891, 95%CI 0.791-1.004, P=0.058). Conclusions In ischemic stroke patients undergoing intravenous thrombolysis, high level of fasting blood glucose may increase the risk of adverse discharge outcomes after intravenous thrombolysis.

内囊预警综合征（capsule warning syndrome，CWS）是一组罕见的临床症状，具有反复发作刻板样神经功能缺损症状，易进展成完全性卒中的特点。本研究报道1例表现为发作性言语不清伴左侧肢体无力的CWS，该患者经阿替普酶静脉溶栓治疗后24 h内，仍反复发作刻板样言语不清、左侧肢体无力。经评估风险后，静脉溶栓后24 h内予以替罗非班抗血小板聚集治疗，3 d后桥接双重抗血小板聚集治疗，患者未再发作神经功能缺损症状。静脉溶栓治疗后启动抗血小板聚集时机以及抗血小板聚集的方案，仍需大规模数据进一步探讨。 Abstract: Capsule warning syndrome (CWS) is a group of rare clinical symptoms with frequent episodes of stereotyped neurological deficits, and easy progression to complete stroke. This study reported a case of CWS with paroxysmal speech inarticulateness and left limb weakness. Within 24 hours after intravenous thrombolysis with alteplase, the patient still had repeated episodes of stereotypical speech inarticulateness and left limb weakness. After assessing the risk, tirofiban was given within 24 hours after intravenous thrombolysis, and dual antiplatelet therapy was bridged 3 days later. The patient had no recurrence of neurological deficits. However, the timing of initiation of dual antiplatelet therapy after intravenous thrombolysis and the dual antiplatelet therapy program still need large-scale data to further explore.

急性缺血性脑卒中（AIS）是脑卒中最常见的类型, 具有高发病率、高致残率、高病死率、高复发率等特征。 抗血小板治疗一直是AIS急性期和二级预防的重要手段。传统的抗血小板药物, 如阿司匹林、氯吡格雷, 治疗AIS具 有较好的临床效果, 但由于可增加出血风险, 限制了其临床应用。血小板膜糖蛋白（GP）Ⅱb/Ⅲa受体拮抗剂是一类 新型的抗血小板药物, 可通过阻断血小板聚集的最终共同通路, 发挥强效抗血栓作用。目前, 阿昔单抗、替罗非班和 依替巴肽三种GPⅡb/Ⅲa受体拮抗剂已被批准用于临床。GPⅡb/Ⅲa受体拮抗剂单独治疗, 或联合静脉溶栓治疗, 或联合血管内治疗, 在预防AIS进展、抑制支架血栓形成、改善功能预后和降低病死率等方面均展现出了较好的临 床效果。但GPⅡb/Ⅲa受体拮抗剂可能会导致血小板减少症和出血等并发症, 治疗期间需密切监测血常规和凝血 功能, 以提高其用药安全性。 [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Stroke is the property of Chinese Journal of Stroke 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.)

Copyright of Chinese Journal of Stroke is the property of Chinese Journal of Stroke 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.)

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.)

在全球脑血管病医疗工作者的共同努力下，近年来脑血管病的诊疗取得了长足的进步。众多高质量的临床研究涵盖了脑血管病多个领域和热点，例如：缺血性卒中急性期取栓/溶栓，针对心房颤动的干预，血压管理等其他卒中急性期干预措施，为脑血管病的临床诊疗提供了扎实可靠的循证医学证据，并促进了脑血管病疾病负担的降低。本文对2023年脑血管病领域重要的临床研究进展进行回顾，帮助读者更好地了解这些临床研究的精华，并期待未来涌现出更多、更好的脑血管病临床研究。 Abstract: Cerebrovascular clinicians from different countries all over the world made great progress in the diagnosis and treatment of cerebral vascular diseases in recent years. Numerous high-quality clinical studies cover multiple fields and hotspots of cerebral vascular disease, such as thrombectomy/thrombolysis in the acute phase of ischemic stroke, intervention for atrial fibrillation, blood pressure management and other acute phase intervention measures, providing solid and reliable evidence-based medical evidence for clinical diagnosis and treatment in cerebral vascular disease, and promoting the reduction of cerebral vascular disease burden. This paper reviews the important clinical research progress in the field of cerebral vascular disease in 2023, helping readers better understand the advantages and great significance of these clinical studies, and looking forward to more and better cerebral vascular disease clinical studies in the future.

目的 系统评价急性缺血性卒中静脉溶栓后症状性颅内出血预测模型的特征，为静脉溶栓临床决策提供参考。 方法 检索中国知网、万方数据知识服务平台、维普资讯、PubMed、Embase、Web of Science和The Cochrane Library数据库，收集急性缺血性卒中静脉溶栓后症状性颅内出血预测模型相关研究信息，检索时限为建库至2022年12月18日。由2位研究员独立筛选文献、提取资料并评价偏倚风险后对纳入模型的基本特征和方法论进行系统评价。 结果 纳入20项研究，共30个预测模型。纳入模型ROC曲线的AUC值范围为0.42～0.94。24个（80%）预测模型的整体预测性能较好，模型对不同结局的定义和算法的区分度有明显差异。最常见的预测因子包括NIHSS评分、年龄、梗死的影像学征象或评分、血糖、收缩压和抗血小板药物。 结论 急性缺血性卒中静脉溶栓后症状性颅内出血预测模型呈现出建模算法多样化、模型性能更佳化、预测因素多元化等特点，但总体偏倚风险较高，未来研究还需要进一步校准模型。此外，应更加关注模型的更新与外部验证，提高其外推性及临床效用，从而发挥模型更大的临床价值。 Abstract: Objective To systematically evaluate the prediction models of symptomatic intracerebral hemorrhage after intravenous thrombolysis in acute ischemic stroke and to provide a reference for clinical decision-making of intravenous thrombolysis. Methods CNKI, WanFang Data, VIP, PubMed, Embase, Web of Science, and The Cochrane Library databases were searched to collect relevant studies, with a timeframe for searching the database from the establishment of the database to December 18, 2022. Two researchers independently screened the literature, extracted the data, assessed the risk of bias, and then systematically evaluated the basic characteristics and methodology of the included models. Results Twenty studies were included, with a total of 30 prediction models. The AUC of the included models ranged from 0.42 to 0.94. The overall predictive performance of the 24 (80%) prediction models was good, with significant differences in model differentiation across outcome definitions and algorithms. The most common predictors were NIHSS score, age, imaging signs or scores of infarction, blood glucose, systolic blood pressure, and antiplatelet drugs. Conclusions In recent years, the prediction models of symptomatic intracerebral hemorrhage after intravenous thrombolysis in acute ischemic stroke have shown the characteristics of diversified modeling algorithms, better model performance, and diversified predictors. However, the overall risk of bias was high, and future studies need to calibrate the models further. More attention should be paid to updating and externally validating the models to improve extrapolation and clinical utility and utilize the models’ clinical practice implications.

Objective To explore the relationships between CYP2C19 gene polymorphism, serum N-terminal Btype brain natriuretic peptide precursor (NT-proBNP) level, and poor prognosis of intravenous thrombolysis in patients with acute cerebral infarction (ACI). Methods A total of 210 patients with ACI were selected and treated with intrave‐ nous thrombolysis with alteplase. After 90 days of treatment, patients were divided into the poor prognosis group (mRS score ≥ 3 points) of 52 cases and good prognosis group (mRS score<3 points) of 158 cases based on the modified Rankin Scale (mRS) score. Before treatment, real-time fluorescence quantitative PCR was used to detect CYP2C19 gene polymor‐ phism, and time-resolved fluorescence immunoassay was used to detect serum NT-proBNP. The correlations between CYP2C19 gene polymorphism, serum NT-proBNP level and mRS Score were analyzed by Pearson or Spearman. Multivari‐ ate Logistic regression was used to analyze the influencing factors for prognosis of intravenous thrombolysis in ACI patients. The predictive value of CYP2C19 gene polymorphism and serum NT-proBNP level in predicting the prognosis of intrave‐ nous thrombolysis in ACI patients was analyzed by receiver operating characteristic curves. Results The age, hyperten‐ sion ratio, diabetes ratio, National Institutes of Health Stroke (NIHSS) score at admission and fasting blood glucose level in the poor prognosis group were higher than those in the good prognosis group (all P<0. 05). There was a statistically sig‐ nificant difference in CYP2C19 gene polymorphism between the poor prognosis group and the good prognosis group (P< 0. 05), and the serum NT-proBNP level in the poor prognosis group was higher than that in the good prognosis group (P< 0. 05). The CYP2C19 gene polymorphism (rs =0. 362) and serum NT-proBNP level (r=0. 426) were positively correlated with mRS score in ACI patients (both P<0. 05). High NIHSS score, CYP2C19 gene slow metabolism type, and high se‐ rum NT-proBNP levels were risk factors for poor prognosis in ACI patients (all P<0. 05). The area under the curve of CYP2C19 gene polymorphism and serum NT-proBNP levels alone and in combination for the prognosis of intravenous thrombolysis in ACI patients was 0. 752, 0. 786, and 0. 861, respectively, and the area under the curve of the combina‐ tion of the two was higher than that of either alone (all P<0. 05). Conclusion CYP2C19 gene polymorphism and high level of NT-proBNP are risk factors for poor prognosis in ACI patients undergoing intravenous thrombolysis, and the combination of the two has higher predictive value for poor prognosis. [ABSTRACT FROM AUTHOR]

Objective To investigate the timing of edaravone dexborneol in intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) for elderly patients with moderate to severe acute ischemic stroke (AIS). Methods A total of 221 patients older than 80 years with moderate to severe AIS receiving intravenous thrombolysis with rt-PA were divided into the control group (70 cases received intravenous thrombolytic therapy with rt-PA), the early group (n=75, edaravone dexborneol began immediately after intravenous thrombolysis with rt-PA) and the late group (n=76, edaravone dexborneol started at 24 h after intravenous thrombolysis with rt-PA). The neurologic improvement rate at 7 days and good prognosis rate at 90 days were used to evaluate the efficacy. The short-term efficacy and long-term efficacy of the three groups were compared. The incidences of symptomatic intracranial hemorrhage within 24 h, extracranial complications within 14 days and mortality within 90 days were observed, and the safety of the three groups was compared. Results The neurologic improvement rate at 7 days and the good prognosis rate at 90 days of the early group and the late group were higher than those of the control group, and those were higher in the early group than in the late group (all P<0. 05). The incidences of symptomatic intracranial hemorrhage within 24 h and extracranial complications within 14 days in the early group were lower than those in the late group and control group (all P<0. 05), while there were no statistically significant differences between the late group and the control group (all P>0. 05). The mortality rates within 90 days of the early and late groups were lower than that of the control group, and that was lower in the early group than in the late group (P<0. 05). Conclusion Immediate application of edaravone dexborneol after intravenous thrombolysis with rt-PA is the optimal intervention time for elderly patients with moderate to severe AIS, which can promote the efficacy and safety, reduce complication rate and improve the prognosis of patients. [ABSTRACT FROM AUTHOR]

Cerebrovascular clinicians from different countries all over the world made great progress in the diagnosis and treatment of cerebral vascular diseases in recent years. Numerous high-quality clinical studies cover multiple fields and hotspots of cerebral vascular disease, such as thrombectomy/thrombolysis in the acute phase of ischemic stroke, intervention for atrial fibrillation, blood pressure management and other acute phase intervention measures, providing solid and reliable evidence-based medical evidence for clinical diagnosis and treatment in cerebral vascular disease, and promoting the reduction of cerebral vascular disease burden. This paper reviews the important clinical research progress in the field of cerebral vascular disease in 2023, helping readers better understand the advantages and great significance of these clinical studies, and looking forward to more and better cerebral vascular disease clinical studies in the future. [ABSTRACT FROM AUTHOR]

Objective To systematically evaluate the prediction models of symptomatic intracerebral hemorrhage after intravenous thrombolysis in acute ischemic stroke and to provide a reference for clinical decision-making of intravenous thrombolysis. Methods CNKI, WanFang Data, VIP, PubMed, Embase, Web of Science, and The Cochrane Library databases were searched to collect relevant studies, with a timeframe for searching the database from the establishment of the database to December 18, 2022. Two researchers independently screened the literature, extracted the data, assessed the risk of bias, and then systematically evaluated the basic characteristics and methodology of the included models. Results Twenty studies were included, with a total of 30 prediction models. The AUC of the included models ranged from 0.42 to 0.94. The overall predictive performance of the 24 (80%) prediction models was good, with significant differences in model differentiation across outcome definitions and algorithms. The most common predictors were NIHSS score, age, imaging signs or scores of infarction, blood glucose, systolic blood pressure, and antiplatelet drugs. Conclusions In recent years, the prediction models of symptomatic intracerebral hemorrhage after intravenous thrombolysis in acute ischemic stroke have shown the characteristics of diversified modeling algorithms, better model performance, and diversified predictors. However, the overall risk of bias was high, and future studies need to calibrate the models further. More attention should be paid to updating and externally validating the models to improve extrapolation and clinical utility and utilize the models’ clinical practice implications. [ABSTRACT FROM AUTHOR]

Objective To explore the clinical effect of acupuncture combined with medicine combined with intravenous thrombolysis in the treatment of acute cerebral infarction(ACI). Methods A total of 224 ACI patients who met the standards were included in the combination group, the traditional Chinese medicine (TCM) group, the acupuncture group, and the control group in the order of treatment, with 56 cases in each group. The control group received intravenous thrombolysis, while the TCM group received Jieyu Dan Jiajian Fang on the basis of the control group. The acupuncture group received Xingnao Kaiqiao Acupuncture on the basis of the control group. The combination group received Jieyu Dan Jiajian Fang and Xingnao Kaiqiao Acupuncture on the basis of the control group. All four groups were treated for five days as one course of treatment, with a total of three courses of treatment. Results In the comparison of TCM syndrome score, inflammatory factors and blood rheology indicators, the four groups had different degrees of reduction compared with those before treatment(P <0. 05), and the reduction was more obvious in the combination group and the TCM group(P <0. 05). In terms of basic recovery, the combination group, the TCM group, and the acupuncture group were all better than the control group(P <0. 05). Conclusion The clinical application of acupuncture and medicine combined with intravenous thrombolysis in the treatment of ACI has significant curative effect. [ABSTRACT FROM AUTHOR]

Objective To evaluate the Bian Que Flying Rescue system in rescue and emergency care of acute stroke patients. Methods Totally 160 acute stroke patients were divided into the control group (n=80) and observation group (n=80) according to hospital admission sequence. Routine pre-hospital and in-hospital rescue plan was adopted for patients in the control group, and a modified rescue plan based on the Bian Que Flying Rescue system was used for patients in the observation group. The Call to Needle Time, Reception to CT Diagnosis time, Door-to-Needle Time(DNT), Onset-to-Treatment time(OTT) and time to the clinical ward were recorded and compared between two groups. The rate of thrombolytic therapy within 60 min and Spontaneous Intracerebral Hemorrhage(sICH) in 24 h were observed . Results The Call to Needle Time, Reception to CT Diagnosis time, Door-to-Needle Time(DNT), Onset-to-Treatment time(OTT) and time to the clinical ward in the observation group were shorter than those in the control group respectively (P＜0. 01). The rate of thrombolytic therapy within 60 min in the observation group was higher than that in the control group (P＜0. 05). No sICH was happened in either group. Conclusion TheBian Que Flying Rescue system is effective to shorten the emergency response duration and DNT in the rescue and emergency care of acute stroke patients (目的 探讨“扁鹊飞救”系统在脑卒中患者急诊救治中的应用效果。方法 选取2018年11月—2022年12月医院急诊科收治的160例脑卒中患者为研究对象。按照入院先后顺序分为对照组和观察组, 各80例, 对照组采用常规院前及院内急救方案, 观察组实施基于“扁鹊飞救”系统的急性脑卒中救治方案。收集两组患者一般资料, 统计患者救治过程中呼叫“120”至静脉溶栓时间、接诊到CT确诊时间、入院到开始静脉溶栓时间(DNT)、发病至治疗时间(OTT)、入住专科治疗时间等多个关键时间段, 统计患者入院后60 min溶栓率和24 h内症状性颅内出血(sICH)发生情况。结果 观察组患者呼叫“120”至静脉溶栓时间、接诊到CT确诊时间、入院到开始静脉溶栓时间(DNT)、发病到专科治疗时间(OTT)、入住专科治疗时间均较对照组缩短, 差异有统计学意义(P＜0. 01)。观察组60 min溶栓率高于对照组(P＜0. 05), 两组均无24 h内sICH发生。结论 在急诊卒中中心应用“扁鹊飞救”系统, 能有效缩短急救反应时间及患者静脉溶栓时间, 使急诊脑卒中患者急救流程更完善、更快捷。)

目的 评估我国2016—2022年发病6 h内急性缺血性卒中患者静脉溶栓的变化趋势，并比较rt-PA与尿激酶静脉溶栓的院内临床结局差异。 方法 纳入中国卒中中心联盟（Chinese Stroke Center Alliance，CSCA）2016年1月—2022年12月登记的发病6 h内到院的急性缺血性卒中患者555 991例，计算各年份rt-PA静脉溶栓和尿激酶静脉溶栓的比例变化。采用多因素logistic回归法，以rt-PA溶栓为对照，分析尿激酶溶栓对院内脑梗死出血转化、院内死亡及出院时良好神经功能结局（mRS评分0～1分）的影响。 结果 分别有113 521例和30 950例患者进行了rt-PA和尿激酶静脉溶栓，溶栓率分别为20.42%和5.57%。从2016年至2022年，rt-PA静脉溶栓率从11.26%逐年递增至30.19%，而尿激酶静脉溶栓率则始终波动在较低水平。多因素logistic回归分析显示，与rt-PA静脉溶栓相比，尿激酶静脉溶栓患者发生脑梗死后出血转化（OR 0.740，95%CI 0.662～0.827，P＜0.01）和院内死亡的风险较低（OR 0.820，95%CI 0.764～0.881，P＜0.01），但两组患者出院时良好功能结局率无显著差异（OR 0.989，95%CI 0.951～1.028，P=0.57）。 结论 2016—2022年期间，我国发病6 h内到院的急性缺血性卒中患者rt-PA静脉溶栓率呈逐年增长趋势；尿激酶溶栓后发生脑梗死出血转化风险及院内死亡风险可能低于rt-PA静脉溶栓。 Abstract: Objective To investigate the temporal trend of intravenous thrombolysis in patients with acute ischemic stroke (AIS) who arrived within 6 hours after onset from 2016 to 2022 in China, and compare the risks of in-hospital outcomes between rt-PA and urokinase thrombolysis. Methods A total of 555 991 AIS patients who arrived within 6 hours after onset were enrolled in the Chinese Stroke Center Alliance (CSCA) from January 2016 to December 2022. The rates of rt-PA and urokinase intravenous thrombolysis in AIS patients within 6 hours after onset were calculated respectively of each year. Multivariate logistic regression was used to analyze the risks of hemorrhagic transformation, in-hospital death and good functional outcome at discharge (mRS score 0-1) of urokinase thrombolysis group compared with rt-PA group. Results 113 521 and 30 950 patients were treated with rt-PA and urokinase intravenous thrombolytic therapy respectively. The thrombolysis rates of rt-PA and urokinase were 20.42% and 5.57% respectively. From 2016 to 2022, the rt-PA intravenous thrombolysis rate increased from 11.26% to 30.19%, while the urokinase thrombolysis rate fluctuated at a low level. Multivariate logistic regression analysis showed that compared with rt-PA intravenous thrombolytic therapy, patients with urokinase intravenous thrombolytic therapy had a lower risk of hemorrhagic transformation (OR 0.740, 95%CI 0.662-0.827, P

目的　探讨蒙药额尔敦—乌日勒口服辅助阿替普酶 (rt-PA) 静脉溶栓对急性脑梗死 (ACI) 患者的治疗效 果。方法　选择ACI患者116例，按照治疗方案分为rt-PA组55例 (给予rt-PA 0. 9 mg/kg静脉溶栓) 、蒙药联合rt-PA 组61例 (在rt-PA组基础上给予额尔敦—乌日勒口服，15粒/次，1次/天，共90 d) 。比较两组入院时、溶栓即刻、溶栓 后 14 d以及溶栓后 90 d的 NIHSS评分、Barthel指数及 mRS评分；两组溶栓后 90 d评价临床疗效，计算总有效率；比 较两组出血及死亡情况。结果　与同组入院时和溶栓即刻比较，两组溶栓后14、90 d NIHSS评分、mRS评分均降低 而 Barthel 指数均升高，且蒙药联合 rt-PA 组变化更明显 (P 均<0. 05) 。蒙药联合 rt-PA 组显效 22 例、好转 35 例、无 效 4例，总有效率为93. 44%，rt-PA组分别为6、35、14例及85. 46%；两组比较P<0. 05。蒙药联合rt-PA组溶栓后90 d 梗死区域继发性出血 1例 (1. 6%) 、症状性出血 1例 (1. 6%) 、全因死亡 1例 (1. 6%) ，rt-PA组分别为 1例 (1. 8%) 、2例 (3. 6%) 、1例 (1. 8%) ；两组比较P均>0. 05。结论 ACI患者rt-PA静脉溶栓后辅助口服额尔敦—乌日勒有助于修复 损伤神经并提高神经功能，且安全性较高。 [ABSTRACT FROM AUTHOR]

Anti-platelet therapy is the basic strategy for the prevention and treatment of ischemic stroke. Aspirin plays an anti-platelet aggregation role by inhibiting TXA2 pathway, while thiopyridine drugs such as clopidogrel and ticagrelor play an anti-platelet aggregation role by inhibiting ADP pathway. Both of these pathways play a role in the upstream pathway of platelet aggregation, while platelet glycoprotein (GP) IIb/II a receptor is the final pathway of platelet aggregation and thrombosis, and the antagonists can quickly exert their anti-platelet aggregation effects by directly binding to GP II b/ II a receptors.. Tirofiban is the main GP IIb/Il a receptor antagonist used in clinic in China at present, and its application in cardiovascular field and coronary intervention therapy has also been recommended by authoritative guidelines for coronary atherosclerotic heart disease at home and abroad. However, the application of tirofiban in cerebrovascular diseases is still in the exploratory stage, lacking the support of large-scale clinical trial data, and it belongs to off-label drug use. This paper reviewed the application status and research progress of tirofiban in acute ischemic stroke based on the relevant literature at home and abroad in recent five years. [ABSTRACT FROM AUTHOR]

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Objective: To explore the clinical application value of quantitative electroencephalogram combined with platelet/lymphocyte ratio (PLR), neutrophil/lymphocyte ratio (NLR), and mean platelet volume (MPV)/platelet count (PLT) ratio in the evaluation of efficacy and short-term prognosis of intravenous thrombolytic therapy for acute cerebral infarction (ACI). Methods: 119 patients with ACI who were admitted to Changsha First Hospital from October 2019 to October 2022 were selected as the study objects. According to the efficacy of intravenous thrombolytic therapy, they were divided into effective thrombolytic therapy group and ineffective thrombolytic therapy group.Compare the changes of power ratio index(DTABR), PLR, NLR, MPV/PLT ratio between the two groups. According to the prognosis of patients with ACI, they were divided into good prognosis group and poor prognosis group. Univariate analysis was performed to compare the baseline clinical data in the two groups. Multivariate Logistic regression model was used to analyze the influencing factors of prognosis of ACI intravenous thrombolysis. Receiver operating characteristic curve (ROC) was used to analyze the prognostic efficacy of each index for ACI intravenous thrombolysis. Results: After treatment, DTABR, neutrophilic granulocyte count, PLT, MPV, PLR, NLR and MPV/PLT ratio in the ineffective thrombolytic therapy group were significantly higher than those in the effective thrombolytic therapy group (P＜0.05), while the lymphocyte count was significantly lower than that in the effective thrombolytic therapy group (P＜0.05). Compared with the good prognosis group, the poor prognosis group was significantly increased in age, National Institutes of Health neurological deficit score (NIHSS) at admission, NIHSS score 24 h after thrombolysis, hypertension history ratio, DTABR, neutrophil count, PLT, MPV, PLR, NLR, and MPV/PLT ratio (P＜0.05), the lymphocyte count was significantly decreased (P＜0.05). Logistic regression model showed that increased NIHSS score at admission and 24 h after thrombolysis, increased DTABR, increased PLR, increased NLR and increased MPV/PLT ratio were risk factors for poor prognosis of ACI intravenous thrombolysis(P＜0.05). ROC curve showed that DTABR, PLR, NLR, MPV/PLT ratio combined to predict the prognosis of ACI intravenous thrombolysis was more effective. Conclusion: Quantitative electroencephalogram DTABR, PLR, NLR, MPV/PLT ratio are closely related to the efficacy and short-term prognosis of intravenous thrombolytic therapy for ACI, and which have high predictive value for short-term prognosis. [ABSTRACT FROM AUTHOR]

目的 探索在中国县级医院条件下，急性缺血性卒中患者经急诊MRI筛选后进行超时间窗溶栓的安全性和有效性以及在中国基层卒中中心进行影像学指导超时间窗溶栓的可行性。 方法 前瞻性连续纳入2021年7月-2022年1月江西省兴国县人民医院经头颅MRI筛选后符合影像错配（DWI序列高信号-FLAIR序列等信号）标准并进行超时间窗静脉溶栓的首次急性缺血性卒中患者为超时间窗溶栓组。以同时间段标准溶栓时间窗内（发病4.5 h内）静脉溶栓的急性缺血性卒中患者为对照组（标准时间窗溶栓组）。主要有效性结局为3个月时功能结局良好（mRS 0～1分）。主要安全性结局为36 h内症状性出血转化（NIHSS较基线增加≥4分且影像学证实颅内出血）。比较两组溶栓治疗的有效性和安全性，同时对两组的过程结局（基线、溶栓24 h和出院时NIHSS）进行组内比较。 结果 研究共纳入超时间窗溶栓组39例，其中男性23例，女性16例，平均年龄为69.6±10.4岁；标准时间窗溶栓组60例，其中男性39例，女性21例，平均年龄66.1±11.0岁。在有效性结局方面，两组发病3个月功能结局良好率差异无统计学意义（超时间窗溶栓组64.1% vs. 标准时间窗溶栓组76.7%，P=0.175）。在安全性结局方面，两组的症状性出血转化率差异无统计学意义（超时间窗溶栓组0 vs. 标准时间窗溶栓组1.7%，P=0.418）。在过程结局方面，超时间窗溶栓组溶栓24 h[3.0（2.0～5.0）分]和出院时NIHSS[1.0（0～5.0）分]较基线NIHSS[4.0（3.0～8.5）分]均改善，差异有统计学意义；标准时间窗溶栓组出院时NIHSS[0（0～2.0）分]较基线NIHSS[4.0（2.0～8.3）分]改善，差异有统计学意义。 结论 在中国县级医院对超时间窗缺血性卒中患者进行MRI筛选下的标准剂量阿替普酶静脉溶栓治疗是可行且安全的，有进一步在国内基层卒中中心推广的价值。 Abstract: Objective To explore the safety and efficacy of MRI-guided thrombolysis beyond time window in patients with acute ischemic stroke in a county-level hospital in China. Methods The consecutive patients with first acute ischemic stroke who underwent intravenous thrombolysis guided by MRI (mismatch of high signal on DWI-equal signal on FLAIR) in Xingguo People’s Hospital, Jiangxi Province from July 2021 to January 2022 were enrolled in this prospective study. The patients who underwent intravenous thrombolysis beyond time window (>4.5 hours) were selected as the observation group, and the patients who underwent intravenous thrombolysis within 4.5 hours of onset were selected as the control group. The primary efficacy outcome was a good functional outcome (defined as a mRS score of 0 to 1) at 3 months. The primary safety outcome was symptomatic hemorrhagic transformation within 36 hours (defined as an increase of 4 score in NIHSS from baseline and MRI-based intracranial hemorrhage). The efficacy and safety of thrombolysis were compared between the two groups. The NIHSS scores at different time points (baseline, at 24 hours after thrombolysis and at discharge) were compared in each group. Results A total of 39 cases were included in the observation group, with a mean age of 69.6±10.4 years and 23 males; and 60 cases in the control group, with a mean age of 66.1±11.0 years and 39 males. There was no statistical difference in the percentage of 90-day good functional outcome between the two groups (observation vs. control: 64.1% vs. 76.7%, P=0.175); and there was also no statistical difference in the percentage of symptomatic hemorrhagic transformation between the two groups (observation vs. control: 0 vs. 1.7%, P=0.418). The NIHSS scores at 24 hours [3.0 (2.0-5.0)] and at discharge [1.0 (0-5.0)] improved compared to the baseline NIHSS [4.0 (3.0-8.5)] in the observation group, and the NIHSS score at discharge [0 (0-2.0)] improved compared to the baseline NIHSS [4.0 (2.0-8.3)] in the control group, with all the above differences having statistical significance. Conclusions The MRI-guided intravenous thrombolysis beyond time window in patients with ischemic stroke is feasible and safe in county-level hospitals in China.

目的 探讨以护士为主导的护理干预对急性缺血性脑卒中(AIS) 患者静脉溶栓用药时间, 依从 率及预后的影响。方法 选择该院2021年1月至2022年1月收治的 AIS 患者 62 例作为研究对象, 采用随机 数表法将其分为观察组和对照组, 各31例。2组患者均在入院后给予静脉溶栓, 对照组行常规护理干预, 观察 组行以护士为主导的护理干预, 比较2组入院至静脉溶栓用药时间及 1h 内溶栓率, 比较2组治疗前后的改良 RANKIN 量表评分及美国国立卫生研究院卒中量表(NIHSS) 评分, 比较2组患者的依从率, 同时比较2组患 者的症状性脑出血率, 病死率。结果 观察组入院至静脉溶栓用药时间短于对照组, 1h 内溶栓率高于对照组, 差异有统计学意义 (P<0.05)。护理后2周观察组的 mRS 及 NIHSS 评分均低于对照组, 差异有统计学意义 (P<0.05)。观察组依从率高于对照组, 差异有统计学意义 (P<0.05)。观察组脑介入溶栓率高于对照组, 差 异有统计学意义(P<0.05)。结论 以护士为主导的护理干预能够缩短 AIS 患者的溶栓时间, 提高患者依从 率, 改善患者预后. [ABSTRACT FROM AUTHOR]

Objective To investigate the effect of optimizing the nursing process of green channel on time course of intravenous thrombolysis for acute ischemic stroke (AIS). Methods Totally 99 AIS patients who received intravenous thrombolysis were divided into two groups according to the according to date of hospital admission: 41 cases who received intravenous thrombolysis before implementation of optimized nursing process of green channel (between November 2020 and March 2021) were included as the control group, 48 cases who received intravenous thrombolysis after implementation of optimized nursing process of green channel (between April 2021 and October 2021) were included as the observation group. The time between admission to CT scanning, time between admission to signing the informed consent, door-to-needle time (DNT) and proportion of patients with DNT≤35 min were measured and compared between groups. Results Shorter time between admission to CT scanning, time between admission to signing the informed consent and door-to-needle time were reported in the observation group than those in the control group(P＜0. 0). There were more patients with DNT≤35 min in the observation group than those in the control group(89. 58% vs. 46. 34%, P

Objective To investigate the safety and efficacy of urokinase intravenous thrombolysis in patients with acute cerebral infarction (ACI) whose onset time is 4.5 to 6.0 hours beyond the time window of alteplase.Methods A total of 168 ACI patients whose onset time was 4.5 to 6.0 hours admitted to this hospital from June 2017 to October 2020 were selected and divided into treatment group (urokinase thrombolysis therapy) and control group (antiplatelet aggregation therapy) according to different treatment methods, with 84 cases in each group.The scores of National Institutes of Health Stroke Scale (NIHSS),modified Rankin Scale (mRs) and Barthel Index (BI) were compared between the two groups at admission, 24 hours and (7±2) days after treatment, and the day of discharge.The logistic regression model was used to analyze the risk factors of urokinase intravenous thrombolysis in patients with ACI.Results The total effective rate of the patients in the treatment group, as well as the scores of NIHSS at admission, 24 hours and (7±2) days after treatment, and the day of discharge, and the scores of mRs and BI at discharge were significantly better than those in the control group, with statistically significant differences (P<0.05) .Gender, age, smoking, fasting blood glucose, total cholesterol, low-density lipoprotein, hypertension, and coronary heart disease were the risk factors that directly affected the efficacy of urokinase intravenous thrombolysis in the patients with ACI (P<0.05) .There was no statistically significant difference in the incidence of complications between the two groups (P>0.05) .Conclusion Urokinase intravenous thrombolysis is safe and effective in the treatment of ACI patients whose onset time is 4.5 to 6.0 hours beyond the time window of intravenous thrombolysis with alteplase, which can effectively reduce the disability rate and improve the prognosis of ACI patients.Although urokinase may increase the risk of bleeding after intravenous thrombolysis, the bleeding rate is extremely low.Therefore, it is worthy of clinical application. [ABSTRACT FROM AUTHOR]

Objective To investigate the evaluation value of Tan score on thrombolysis in patients with acute middle cerebral artery（AMCA）M1 segment occlusion. Methods We selected 156 cases of AMCA M1 segment occlusion pa⁃ tients treated with intravenous thrombolysis，and the patients were divided into the unpassed（n=94）and recanalized（n= 62）groups according to the thrombolysis in cerebral infarction（TICI）vascular perfusion classification. We compared the base information and Tan scores between the two groups. Multifactorial Logistic regression analysis was used to analyze the factors influencing the failure of thrombolysis in patients with AMCA M1 segment occlusion. The receiver operating charac⁃ teristic（ROC）curve of subjects was used to analyze the value of Tan score to predict thrombolysis failure in patients with AMCA M1 occlusion. We compared the modified Rankin Scale（mRS）grading among patients with different Tan scores. Results Tan score<2，history of hypertension，proportion of history of atrial fibrillation and National Institutes of Health Stroke Scale（NIHSS）score on admission，fasting blood glucose（FPG），low-density lipoprotein cholesterol（LDL-C）， uric acid（UA），and C-reactive protein（CRP）levels were significantly higher in the unpassed group than in the recana⁃ lised group，and the time from onset to admission was significantly longer in the unpassed group than in the recanalised group（all P<0. 05）. Multifactorial Logistic regression analysis showed that history of hypertension（OR=4. 318，95%CI： 2. 405-8. 276），time from onset to admission（OR=1. 076，95%CI：1. 025-1. 128），and NIHSS score at admission（OR= 1. 170，95%CI：1. 081-1. 395）were independent risk factor for thrombolysis failure in patients with AMCA M1 segment occlusion，and Tan score ≥2（OR=0. 316，95%CI：0. 160-0. 627）was a protective factor（P<0. 05）. The ROC curve showed that the area under the curve（AUC），sensitivity and specificity of the Tan score in predicting thrombolysis failure in patients with AMCA M1 segment occlusion were 0. 849（95%CI：0. 783-0. 901），77. 17%，and 85. 94%，respective⁃ ly. Conclusion Tan score is related to thrombolytic outcome in patients with AMCA M1 segment occlusion and can be used as a predictor of thrombolysis failure. [ABSTRACT FROM AUTHOR]

Recanalization therapy has become an effective treatment for acute ischemic stroke (AIS), but due to the influence of various factors such as bleeding transformation, poor reperfusion and vascular reocclusion, some AIS patients will experience early neurological deterioration (END) after recanalization therapy, which is mainly manifested as disease progression and aggravated neurological impairment, seriously affecting the prognosis of patients. At present, there is no uniform name and diagnostic criteria for END, and results of studies on END after recanalization therapy are also different. This article reviews the pathogenesis, risk factors and predictors of END after recanalization therapy. [ABSTRACT FROM AUTHOR]

Objective To investigate the application effect of analysis of Healthcare Failure Mode and Effect Analysis（HFMEA) in the risk management of emergency intravenous thrombolysis in acute ischemic stroke (AIS) patients. Methods A total of 100 AIS patients admitted in this hospital from June to December2018 were selected as the control group. The HFMEA was used to review,discuss,and evaluate the whole process of emergency intravenous thrombolysis in AIS patients,and to select failure modes with RPN>125 or S>9 in emergency intravenous thrombolysis in this hospital, and to develop targeted improvement measures to intervene. From January to June 2019, 100 patients with AIS treated in the emergency department of this hospital after the implementation of HFMEA were selected as the observation group. The RPN value of emergency intravenous thrombolysis, the time of completing various examinations and intravenous thrombolysis after arriving at the emergency department of the two groups were observed to compare the effect before and after the implementation of HFMEA. Results After the implementation of HEMEA, the RPN scores of all aspects of emergency intravenous thrombolysis in AIS patients in the observation group were lower than those in the control group (before the implementation). And after the implementation of HEME A, the time of completing various examinations and intravenous thrombolysis after arriving at the emergency department decreased. The differences were statistically significant (P <0.05). Conclusion Applying HFMEA to the risk management of emergency intravenous thrombolysis in AIS patients can optimize the process related to the operation of emergency intravenous thrombolysis according to the actual situation of the hospital, reduce the risk of emergency thrombolysis in AIS patients, increase patient safety, and reflect patient-centeredness throughout the process, which can effectively improve the patient’s medical experience and establish a good image of the hospital and medical staff. [ABSTRACT FROM AUTHOR]

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

Objective: To investigate the predictive value of combined monitoring of serum uric acid（UA）, homocysteine（Hcy）and low density lipoprotein cholesterol（LDL-C） on intracerebral hemorrhagic transformation（HT） after intravenous thrombolytic therapy with alteplase in patients with acute cerebral infarction（ACI）. Methods: 173 patients with ACI who received intravenous thrombolysis with alteplase treated in Chengdu 363 Hospital Affiliated to Southwest Medical University from January 2018 to December 2020 were selected. They were divided into HT group and non HT group according to whether HT occurred after intravenous thrombolysis. The clinical data and serum UA, Hcy and LDL-C levels of the two groups were compared. The influencing factors of HT after intravenous thrombolytic therapy with alteplase in patients with ACI were analyzed by multivariate logistic regression. The predictive value of combined monitoring of serum UA, Hcy and LDL-C for HT after intravenous thrombolytic therapy with alteplase in patients with ACI was analyzed by receiver operating characteristic（ROC） curve. Results: 47 of 173 patients developed HT, with an incidence of 27.17%.Compared with non HT group, HT group was older, systolic blood pressure, diastolic blood pressure, national Institutes of Health Stroke Scale（NIHSS） score, random blood glucose before thrombolysis and Hcy level were higher, while LDL-C and UA levels were lower（P< 0.05）. Multivariate logistic regression analysis showed that systolic blood pressure, NIHSS score, random blood glucose before thrombolysis and Hcy level were the risk factors of HT after intravenous thrombolysis with alteplase in patients with ACI, while UA and LDL-C levels were protective factors. The results of ROC curve analysis showed that the area under the curve（AUC） of serum UA, Hcy and LDL-C after intravenous thrombolytic therapy with alteplase in patients with ACI were 0.764, 0.794, 0.674 and 0.888 respectively, and the AUC was significantly higher in combination monitoring. Conclusion: Low levels of serum UA, LDL-C and high levels of Hcy are the influencing factors of HT after intravenous thrombolytic therapy with alteplase in patients with ACI. Combined monitoring can improve the predictive value of HT. [ABSTRACT FROM AUTHOR]

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

To study the clinical effect of intravenous thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) in the early stage of acute cerebral infarction within 4.5 hours after onset. The clinical dataes of 652 patients with acute cerebral infarction who were admitted to the Department of Neurology of our hospital within 4.5 hours after onset from July 1, 2018 to October 31, 2020 were retrospectively analyzed. Among them, 285 patients receiving intravenous thrombolytic therapy with rt-PA were included in the thrombolytic group, while 367 patients without thrombolytic therapy were included in the control group who only received conventional treatment such as antiplatelet aggregation, statin lipid-lowering, and brain protection. The National Institutes of Health Stroke Scale (NIHSS) scores of two groups before treatment and 24 hours, 7 days and 14 days after treatment, and the modified Rankin Scale (MRS) scores at 3 months after treatment were recorded. For patients with dysphagia, the results of drinking water test were collected. The bleeding and mortality of the two groups were statistically analyzed. The NIHSS score of 24 hours, 7 days and 14 days after treatment and mRS score at 3 months after treatment in thrombolytic group were significantly improved, compared with the control group, the difference was statistically significant (P<0.05). For patients with dysphagia, the effective rate of thrombolytic group was higher than that of the control group (P<0.05). The probability of mild hemorrhage in thrombolytic group was higher than that of the control group(P<0.05). There was no significant difference in symptomatic and fatal cerebral hemorrhage between the two groups (P>0.05). After thrombolysis, the site of massive and fatal intracerebral hemorrhage was mostly in the central area of infarction, the amount of bleeding was more than 10 mL, and the clinical NIHSS score of patients ≥ 24 scores. The mortality of thrombolytic group was lower than that of control group (P<0.05). Patients with acute cerebral infarction within 4.5 hours after onset who received intravenous rt-PA thrombolysis has a good short-term treatment effect, the risk of slight bleeding is higher, but the mortality is reduced. Patients with severe clinical neurological impairment, NIHSS score ≥ 24 scores, high risk of bleeding have poor prognosis, thrombolytic therapy is not recommended. [ABSTRACT FROM AUTHOR]

Objective To explore the value of risk score of hemorrhagic transformation after intravenous thrombolysis(SEDAN) of predicting hemorrhagic transformation (HT) risk in patients with acute ischemic stroke (AIS) who received intravenous thrombolytic therapy with recombinant tissue plasminogen activator(rt-PA). Methods The clinical data of MS patients who received rt-PA intravenous thrombolytic therapy from January 2019 to December 2020 were collected retrospectively. The SEDAN scores were used to group the patients, and the incidence of HT in each group was recorded and compared. Results A total of 191 patients were enrolled. There were 40 patients with HT, of which 18 were asymptomatic intracranial hemorrhage,16 were symptomatic intracranial hemorrhage, and 6 were fatal intracranial hemorrhage. There was significant difference of HT incidence among each groups (X²=63. 174,P<0. 001). Spearman correlation analysis showed that SEDAN score was positively correlated with the incidence of HT (correlation coefficient was 0. 399,P<0.001). Conclusion For AIS patients who treated with rt-PA, as the SEDAN score increased, the incidence and severity of HT increased. The SEDAN score is a simple and practical tool to predict the incidence of HT in AIS patients treated with rt-PA. [ABSTRACT FROM AUTHOR]

目的 观察静脉溶栓联合血管内治疗在前循环大血管狭窄导致的低灌注性脑梗死患者中的疗效和 安全性。 方法 回顾性纳入2017年3月-2019年3月在聊城市第三人民医院因单侧颈内动脉或大脑中动脉严重 狭窄导致急性低灌注脑梗死患者，所有患者均给予标准剂量阿替普酶静脉溶栓联合多途径血管内 治疗，随访术后2周、1个月和3个月的NIHSS及mRS评分。 结果 共纳入40例行静脉溶栓联合血管内治疗的急性低灌注脑梗死患者，其中男性24例（60%）， 平均年龄70±4岁（60～80岁）。治疗后患者血管狭窄程度较治疗前明显改善（中位数：18% vs 86%， P

目的 观察rt-PA静脉溶栓桥接血管内治疗急性缺血性卒中的临床疗效和安全性。 方法 回顾性纳入2017年1-12月郑州市第一人民医院神经重症科收治的前循环急性缺血性卒中患 者，按rt-PA静脉溶栓后是否桥接血管内治疗分为单纯静脉溶栓组和桥接治疗组。主要疗效结局为治 疗后3个月mRS评分，次要疗效结局为24 h、3 d和30 d的NI HSS评分。安全性结局为2 d症状性颅内出血及 其他部位出血、10 d全因死亡。 结果 共入组56例患者，平均年龄60.77±12.72岁，男性35例（62.5%）。单纯静脉溶栓组39例，桥接 治疗组17例。桥接治疗组3个月mRS评分≤2分比例高于单纯静脉溶栓组（88.2% vs 56.4%，P =0.021）。 两组治疗后24 h、3 d和30 d NIHSS评分差异无统计学意义。两组2 d症状性颅内出血率及其他部位出血 率、10 d全因死亡率差异无统计学意义。 结论 rt-PA静脉溶栓桥接血管内治疗可改善急性缺血性卒中患者3个月预后。 Abstract: Objective To observe the clinical efficacy and safety of rt-PA intravenous thrombolysis bridging endovascular therapy in patients with acute ischemic stroke (AIS). Methods Data of AIS patients who receiving intravenous thrombolysis and endovascular treatment in the Department of Critical Care of the First Hospital of Zhengzhou from January 2017 to December 2017 were selected. According to the treatment method, the patients were divided into intravenous thrombolysis group and the bridging group. The intravenous thrombolysis group only received rt-PA intravenous thrombolysis, while the bridging group received rt-PA intravenous thrombolysis followed by endovascular treatment. The primary outcome was mRS score at 3 months, secondary outcome were the NIHSS score at 24 hours, 3 days and 30 days after the procedure. Safety outcome was the symptomatic intracranial hemorrhage and other bleeding from other sites within 2 days and all-cause death within 10 days. Results A total of 56 patients were included in this study, with a mean age of 60.77±12.72 years old and 35 (62.5%) males, 39 patients in intravenous thrombolysis group and 17 patients in the bridging treatment group. The rate of mRS ≤2 at 3 months in the bridging treatment group was higher than that in intravenous thrombolysis group (88.2% vs 56.4%, P =0.021). There was no statistical difference in NIHSS score at 24 hours, 3 days and 30 days after treatment. There were no statistical differences in the safety outcome between the two groups. Conclusions rt-PA intravenous thrombolysis bridging endovascular treatment can improve the prognosis of AIS patients at 3 months.

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

目的研究分析单纯静脉溶栓与桥接治疗颅内大动脉闭塞急性轻型缺血性脑卒中(MIS)的效果。方法选取2019年5月至2020年5月于该院治疗的69例脑卒中患者作为研究对象,采用随机数字表法将其分为对照组(n=34例)和试验组(n=35例)。对照组给予单纯静脉溶栓治疗,试验组在对照组的基础上给予桥接血管内治疗,比较两组患者血管再通率、转归良好率、血管再通时间、住院费用、取栓次数、治疗前后脑利钠肽(BNP)、神经元特异性烯醇化酶(NSE)及神经功能评分。结果试验组血管再通率及转归良好率均高于对照组,差异均有统计学意义(P<0.05)。试验组血管再通时间短于对照组,试验组住院费用低于对照组,试验组取栓次数少于对照组,差异均有统计学意义(P<0.05)。治疗后试验组BNP、NSE及神经功能评分均低于对照组,差异有统计学意义(P<0.05)。结论静脉溶栓联合桥接治疗可明显提高MIS患者血管再通率并改善其神经功能,减少取栓次数且促进患者康复,改善患者血清中BNP、NSE水平。 [ABSTRACT FROM AUTHOR]

颅内静脉窦血栓形成是一种少见的脑血管疾病,其临床表现缺乏特征性,较易漏诊、误诊及延误治疗,且预后较 差。抗凝治疗为颅内静脉窦血栓形成的一线治疗方法,血管内治疗是其有益补充或替代治疗手段。该文从静脉药物溶栓、静脉抗 血小板治疗、机械取栓、支架置入术几个方面对血管内治疗技术的研究进展进行综述。 [ABSTRACT FROM AUTHOR]

Objective To investigate the clinical efficacy and safety of direct mechanical thrombectomy in the treatment of acute anterior circulation large vessel occlusion ( aLVO) stroke. Methods 59 patients with acute occlusion of anterior circulation within 4. 5 hours were randomly divided into direct thrombolysis group ( n = 29 ) and intravenous thrombolysis combined with mechanical thrombolysis group ( n = 30) . The rates of vascular patency, good neurological prognosis 90 days after operation ( modified Rankin Scale score 0 - 2), symptomatic intracranial hemorrhage and death were analyzed and compared. Results There was no significant difference in the vascular patency rate( 89. 7% vs 90. 0%) and 90 day prognosis rate ( 41. 4% vs 43. 3%) between the two groups( all P > 0. 05 ) . There was no significant difference in the incidence of symptomatic intracranial hemorrhage ( 6. 90% vs 10. 0% ) and mortality ( 13. 8 % vs l 6. 7 % ) between the two groups( all P > 0. 05). Conclusions For patients with acute anterior circulation occlusion within 4. 5 hours, direct mechanical thrombectomy and bridging therapy have good efficacy and safety, and there is no significant difference between them. Direct mechanical thrombectomy can be used as an effective treatment for patients with acute anterior circulation occlusion. [ABSTRACT FROM AUTHOR]

Objective ：To investigate the efficacy and safety of intravenous thrombolysis with alteplase in advanced-age patients (80 years old) with acute cerebral infarction. Methods: The patients with acute cerebral infarction who were treated with alteplase in Xi'an No. 1 Hospital were selected as research subjects in a retrospective analysis, and were divided by age into the advanced-age group (80 years old), the elderly group (65-79 years old), and the young and medium-age group (18-64 years old). The general conditions and adverse drug reactions (ADRs) were recorded for the patients of the 3 groups. The National Institute of Health Stroke Scale (NIHSS) was used to evaluate neurological deficits before and after thrombolysis at 1 h, 24 h and the 7th day. The total effective rates on the 7th day after thrombolysis were compared among the 3 groups. The short--term efficacy was evaluated by modified Rankin s (mRS) scores. Results: There were no significant differences in bleeding complications, to tai effective rates and the proportions of the patients with poor prognosis in the 3 groups (0.05). The NIHSS scores of the patients in the advanced-age group and the young and medium-age group significantly decreased at 24 h and the 7th day after thrombolysis. 05), but the proportion of the patients with good prognosis in the advanced-age group was lower than that in the young and medium-age group (P<0.05). Conclusion ： Intravenous thrombolysis with alteplase is safe and effective for the treatment of advanced-age patients with acute cerebral infarction. [ABSTRACT FROM AUTHOR]

目的 比较不同严重程度急性缺血性卒中（acute ischemic stroke，AIS）患者rt-PA静脉溶栓后失语改 善的比例及程度。 方法 回顾性分析2015年4月-2017年3月在郑州人民医院神经内科卒中中心连续入院接受rt-PA静 脉溶栓治疗的AIS患者360例，根据NIHSS评分分为NIHSS评分≤8分组和NIHSS评分＞8分组。收集两组 患者的年龄、性别、高血压病史、糖尿病病史、心脏病病史、吸烟饮酒史、LDL-C、发病至溶栓时间等 基线资料。比较两组患者溶栓24 h后神经功能显著好转、失语改善的比例差异，并比较两组失语改 善程度的差异。 结果 共计纳入伴有失语的AIS患者158例，其中NIHSS评分≤8分患者49例，NIHSS评分＞8分患者109 例，两组基线资料及溶栓24 h后神经功能显著好转等指标差异无统计学意义；NIHSS评分≤8分组溶 栓24 h后失语改善比例高于NIHSS评分＞8分组（67.3% vs 45.9%，P =0.021），NIHSS评分≤8分组失语 完全改善比例高于NIHSS评分＞8分组（69.7% vs 44.0%，P =0.021）。 结论 伴有失语的AIS患者rt-PA静脉溶栓24 h后，NIHSS评分≤8分患者失语改善比例高于NIHSS评分 ＞8分患者。 Abstract: Objective To investigate aphasia improvement after intravenous thrombosis in acute ischemic stroke patients with different severity. Methods Data of 360 acute ischemic stroke patients treated with rt-PA intravenous thrombolysis in Department of Neurology, Zhengzhou People’s Hospital from April 2015 to March 2017 were collected. Based on the NIHSS score on admission, all patients were divided into two groups: NIHSS≤8 group and NIHSS>8 group. The baseline data included age, sex, hypertension, diabetes, heart disease, smoking and drinking, low density lipoprotein cholesterol, onset-to-needle time and etc. Improvement of aphasia and neurological function between the two groups were compared. Results Finally, 158 patients with aphasia were included in this study, with 49 patients with NIHSS ≤8 and 109 patients with NIHSS >8. Baseline data and neurological function improvement at 24 h after thrombolysis between the two groups had no statistical difference. The improvement percentage of aphasia at 24 h after thrombolysis in NIHSS ≤8 group was higher than that in NIHSS >8 group (67.3% vs 45.9%, P =0.021). The complete improvement percentage of aphasia at 24 h after thrombolysis in NIHSS ≤8 group was higher than that in NIHSS >8 group (69.7% vs 44.0%, P =0.021). Conclusions For acute ischemic stroke patients with aphasia, the improvement percentage of aphasia in patients with NIHSS ≤8 was higher than that in patients with NIHSS >8 at 24 h after intravenous thrombolysis.