Objective To explore the impact of gender difference in 90-day outcomes after mechanical thrombectomy for acute cerebral infarction. Methods A prospective registration, observational, and retrospective analysis study was carried out. Patients with acute cerebral infarction who were admitted to the Department of Neurology of the First Affiliated Hospital of Chengdu Medical College and the Department of Neurology of Nanjing First Hospital between June 2015 and June 2019 were collected. Patients were divided into two groups based on gender. The detailed demographic, laboratory examination, imaging examination and clinical data were collected. Then, the data were analyzed using univariate and multivariate logistic regression analyses. Results A total of 298 patients were included. Among them, there were 185 males and 113 females. The differences in age, smoking, atrial fibrillation, using antiplatelet drugs before stroke, TOAST classification, and involved cerebrovascular sites between the two groups were statistically significant (P<0.05), and there was no statistically significant difference in other baseline data between the two groups (P>0.05). The results of univariate logistic regression analysis showed that the rate of 90-day favourable outcome of female patients was lower than that of male patients [odds ratio (OR)=0.462, 95% confidence interval (CI) (0.275, 0.775), P=0.030]. The results of multivariate logistic regression analysis showed that, after adjusting for confounding factors, there was no independent correlation between gender and the 90-day favourable outcome of patients with acute cerebral infarction who underwent mechanical thrombectomy [OR=1.511, 95% CI (0.745, 3.066), P=0.253]. Conclusion The gender has no significant effect on the 90-day favourable outcome of acute cerebral infarction patients treated with mechanical thrombectomy.
Migraine is the most common primary headache clinically, with high disability rate and heavy burden. Functional MRI (fMRI) plays a significant role in the study of migraine. This article reviews the main advances of migraine without aura (MwoA) based on resting-state fMRI in recent years, including the exploration of the mechanism of fMRI in the occurrence and development of MwoA in terms of regional functional activities and functional network connections, as well as the research progress of the potential clinical application of fMRI in aiding diagnosis and assessing treatment effect for MwoA. At last, this article summarizes the current distresses and prospects of fMRI research on MwoA.
New functional evaluation methods for coronary artery lesions have received widespread attention at home and abroad. As a new functional evaluation technique, the clinical value of quantitative flow ratio (QFR) in the accuracy and feasibility of diagnosing myocardial ischemia caused by coronary artery stenosis has been confirmed in many clinical trials. Compared with the traditional gold standard fractional flow reserve (FFR) for diagnosing coronary artery stenosis, QFR has the advantages of simple operation, time-saving and low cost. This article reviews the comparison of the diagnostic accuracy of FFR and QFR and the progress of clinical research, aiming to explore whether QFR may replace FFR as a functional evaluation method of coronary artery disease and guide clinical blood circulation reconstruction.
ObjectiveTo analyze the outcomes of complicated congenital heart diseases (CCHD) patients accepting multiple (>2) re-sternotomy operations.MethodsWe retrospectively analyzed the clinical data of 146 patients undergoing multiple cardiac re-sternotomy operations between 2015 and 2019 in our center. There were 95 males and 51 females with an age of 4.3 (3.1-6.8) years and a weight of 15.3 (13.4-19.0) kg at last operation.ResultsThe top three cardiac malformations were pulmonary atresia (n=51, 34.9%), double outflow of right ventricle (n=36, 24.7%) and functional single ventricle (n=36, 24.7%). A total of 457 sternotomy procedures were performed, with 129 (88.3%) patients undergoing three times of operations and 17 (11.7%) patients undergoing more than three times. Fifty-two (35.6%) patients received bi-ventricular repair, 63 (43.1%) patients received Fontan-type procedures, and 31 (21.2%) patients underwent palliative procedures. Ten (6.8%) patients experienced major accidents during sternotomy, including 7 (4.8%) patients of urgent femoral artery and venous bypass. Eleven (7.5%) patients died with 10 (6.8%) deaths before discharge. The follow-up time was 20.0 (5.8-40.1) months, and 1 patient died during the follow-up. The number of operations was an independent risk factor for the death after operation.ConclusionSeries operations of Fontan in functional single ventricle, repeated stenosis of pulmonary artery or conduit of right ventricular outflow tract post bi-ventricular repair are the major causes for the reoperation. Multiple operations are a huge challenge for CCHD treatment, which should be avoided.
Functional electronic stimulation (FES) may provide a means to restore motor function in patients with spinal cord injuries. The goal of this study is to determine the regions in the spinal cord controlling different hindlimb movements in the rats. Normalization was used for the regions dominating the corresponding movements. It has been verified that FES can be used in motor function recovery of the hindlimb. The spinal cord was stimulated by FES with a three-dimensional scan mode in experiments. The results show that stimulation through the electrodes implanted in the ventral locations of the lumbosacral enlargement can produce coordinated single- and multi-joint hindlimb movements. A variety of different hindlimb movements can be induced with the appropriate stimulation sites, and movement vectors of the hindlimb cover the full range of movement directions in the sagittal plane of the hindlimb. This article drew a map about spinal cord motor function of the rat. The regions in the spinal cord which control corresponding movements are normalized. The data in the study provide guidance about the location of electrode tips in the follow-up experiments.
ObjectiveTo evaluate the impact of different surgical strategies for moderate functional mitral regurgitation (FMR) at the time of aortic valve replacement (AVR) on patients' prognosis.MethodsA total of 118 AVR patients, including 84 males and 34 females, aged 58.1±12.4 years, who were complicated with moderate FMR were retrospectively recruited. Patients were divided into three groups according to the treatment strategy of mitral valve: a group A (no intervention, n=11), a group B (mitral valve repair, n=51) and a group C (mitral valve replacement, n=56). The primary endpoint was the early and mid-term survival of the patients, and the secondary endpoint was the improvement of FMR.ResultsThe median follow-up time was 29.5 months. Five patients died perioperatively, all of whom were from the group C. Early postoperative FMR improvement rates in the group A and group B were 90.9% and 94.1% (P=0.694). The mid-term mortality in the three groups were 0.0%, 5.9% and 3.9%, respectively (P=0.264), while the incidences of major cardiovascular and cerebrovascular events were 0.0%, 9.8% and 17.7%, respectively (P=0.230). Improvements of FMR in the group A and group B were 100.0% and 94.3% at the mid-term follow-up (P>0.05).ConclusionFor patients receiving AVR with moderate FMR, conservative treatment or concurrent repair of mitral valve may be more reasonable, while mitral valve replacement may increase the incidence of early and mid-term adverse events.
Objective To obtain the full-length gene and functional domains of FXYD6 gene which is a cholangiocarcinoma related gene. Methods A new strategy with the integration of bioinformatics and molecular biology was used. Bioinformatical methods were used to analyze the full-length sequence, and to predict the functional domains of its protein. And the full-length sequence of FXYD6 was isolated by polymerase chain reaction from fetal hepatic, brain and spleen cDNA libraries, and then cloned in pGEM-T vector for sequence analyzing. Goldkey Sequence Analyzing Software was used to analyze the sequence of candidate domain without signal peptide.Results The full-length sequence of FXYD6 was isolated by Touch-down PCR from fetal hepatic and brain cDNA library, but was not from spleen cDNA library. The open reading frame Finder software was used in the National Center for Biotechnology Information website to find the most probable encoding regions of FXYD6 gene. And the +1 phase was selected as the template sequence, from 67 bp to 354 bp, to predict the functional domains by Goldkey Sequence Analyzing Software. The signal peptide was located from 1 amino acid (aa) to 17 aa， and the main domain was composed from 18 aa to 34 aa. The region between 35 aa and 57 aa was the transmembrane region. The FHYD peptide chain was highly conserved amino acids. Conclusion The study of full-length cDNA cloning of FXYD6 gene and its functional domains provides the basis for understanding the relationship between the structure and function of FXYD6. More work shall be performed on FXYD6 protein and its influence on the mechanism of cholangiocarcinoma.
Although attention plays an important role in cognitive and perception, there is no simple way to measure one's attention abilities. We identified that the strength of brain functional network in sustained attention task can be used as the physiological indicator to predict behavioral performance. Behavioral and electroencephalogram (EEG) data from 14 subjects during three force control tasks were collected in this paper. The reciprocal of the product of force tolerance and variance were used to calculate the score of behavioral performance. EEG data were used to construct brain network connectivity by wavelet coherence method and then correlation analysis between each edge in connectivity matrices and behavioral score was performed. The linear regression model combined those with significantly correlated network connections into physiological indicator to predict participant's performance on three force control tasks, all of which had correlation coefficients greater than 0.7. These results indicate that brain functional network strength can provide a widely applicable biomarker for sustained attention tasks.
ObjectiveTo review the current research and application progress of three-dimentional (3D) printed porous titanium alloy after tumor resection, and provide direction and reference for the follow-up clinical application and basic research of 3D printed porous titanium alloy. MethodsThe related literature on research and application of 3D printed porous titanium alloy after tumor resection in recent years was reviewed from three aspects: performance of simple 3D printed porous titanium alloy, application analysis of simple 3D printed porous titanium alloy after tumor resection, and research progress of anti-tumor 3D printed porous titanium alloy. Results3D printing technology can adjust the pore parameters of porous titanium alloy, so that it has the same biomechanical properties as bone. Appropriate pore parameters are conducive to inducing bone growth, promoting the recovery of skeletal system and related functions, and improving the quality of life of patients after operation. Simple 3D printed porous titanium alloy can more accurately match the bone defect after tumor resection through preoperative personalized design, so that it can closely fit the surgical margin after tumor resection, and improve the accuracy and efficiency of the operation. The early and mid-term follow-up results show that its application reduces the postoperative complications such as implant loosening, subsidence, fracture and so on, and enhances the bone stability. The anti-tumor performance of 3D printed porous titanium alloy mainly includes coating and drug-loading treatment of pure 3D printed porous titanium alloy, and some progress has been made in the basic research stage. ConclusionSimple 3D printed porous titanium alloy is suitable for patients with large and complex bone defects after tumor resection, and the anti-tumor effect of 3D printed porous titanium alloy can be achieved through coating and drug delivery.
Objective To review the current status of magnetic resonance imaging (MRI) techniques in the evaluation of hepatic fibrosis. Methods The application and recent advances of various kinds of MRI techniques in evaluating hepatic fibrosis were summarized by literature review. Results The state-of-the-art of MRI evaluating of hepatic fibrosis included common contrast-enhanced MRI, double contrast-enhanced MRI, and various functional MRI techniques. Common contrast-enhanced MRI could detect morphological changes of the liver, but little value in phasing. Double contrast-enhanced MRI markedly increased the contrast to noise ratio. Except diagnosis liver fibrosis, functional MRI also could phase it by its serverity. Conclusion MRI techniques, especially those functional MRI techniques, are advancing very fast and have very great potentiality in both the diagnosis and severity assessment of hepatic fibrosis.