Table of Content

05 September 2017, Volume 32 Issue 9

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Application value of prominent vessel sign on magnetic susceptibility weighted imaging in stroke

Jia Yanan， Liu Junyan

2017, 32(9):  737-741.  doi:10.3969/j.issn.1004-583X.2017.09.001

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In the patients with acute stroke， the oxygen extraction fraction(OEF) is increased in the hypoperfused parenchyma， resulting in an increase in the ratio of deoxygenated hemoglobin to oxygenated hemoglobin in the capillary and vein.  Because Susceptibility weighted imaging(SWI) is exquisitely sensitive to paramagnetic substances，   such as deoxyhemoglobin，prominent vessel sign(PVS) will appear on SWI when the concentration of deoxyhemoglobin in the veins increases. The presence of  PVS can be used to assess ischemic penumbra and cerebral reperfusion therapy， and also predict the establishment of collateral circulation and brain reserve capacity. Moreover， the presence of  PVS is also related to the prognosis of stroke.

Imaging evaluation of collateral circulation in acute ischemic stroke

Qi Yu， Xue Jing， Gao Peiyi

2017, 32(9):  742-746.  doi:10.3969/j.issn.1004-583X.2017.09.002

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The acute ischemic stroke is one of the diseases that endanger human health with its high mortality rate and disability rate.With the improvement of people's living standard， incidence rate of the disease is increasing year by year. Improving and recovering cerebral perfusion will contribute to the prognosis of the patients with ischemic cerebrovascular disease，therefore  the establishment of the collateral circulation is very important.The imaging evaluation of cerebral collateral circulation in clinic work is the key to choose the appropriate treatment. This article will review the anatomical structure of collateral circulation and the imaging evaluation of collateral circulation.

 

CT in evaluating cerebral collateral circulation of acute ischemic stroke patients

Wang Chunrao， Zhang Qiang， Chen Huijun

2017, 32(9):  747-751.  doi:10.3969/j.issn.1004-583X.2017.09.003

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Cerebral collateral circulation is important in the treatment of acute ischemic stroke. Collateral circulation is a major aspect that physicians would consider to decide the treatment of acute ischemic stroke and a good indicator of patient prognosis. Thus， it is important to accurately evaluate collateral circulation of acute ischemic stroke patients. This paper will review the techniques and clinical applications of CT in collateral circulation assessment， including singlephase CT angiography， multiphase CTA， and CT perfusion.

Complement C3 level and relationship with apolipoprotein B in essential hypertension patients

Liu Shasha1， Chen Dan2， Zhang Jing1， Huang Yuting1， Alimila·Saiyitijiang1， Nai Zhihui1， Gao Ying1

2017, 32(9):  752-754,758.  doi:10.3969/j.issn.1004-583X.2017.09.004

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Objective  To investigate complement C3 level  and relationship with apolipoprotein B in patients with essential hypertension. Methods  Observational group was composed of 58 patients with essential hypertension， and another 48 participants with nonessential hypertension were selected as control group. Relationship between complement C3 and apolipoprotein B was analyzed according to comparison of complement C3， triglyceride(TG)， total cholesterol(TC)， high density lipoprotein cholesterol(HDLC)， low density lipoprotein cholesterol(LDLC)， apolipoprotein A1， apolipoprotein B(ApoB)， body mass index， age， gender and other indicators. Results  The complement C3， TG， TC， LDLC and ApoB were significantly higher in observational group than those in control group (P<0.05). There was positive correlation between complement C3 with ApoB in observation group (P<0.05). There was positive correlation between ApoB and C3， TG， TC， LDLC in observation group (P<0.05). There was correlation between complement C3 and ApoB in multiple linear regression. Linear regression analysis showed that complement C3 was positively correlated with ApoB (P<0.05)， with ApoB as the dependent variable and complement C3 as the independent variable. Conclusion  In patients with essential hypertension， complement C3 and apolipoprotein B are correlated， and the interaction between two groups also affects mutually.

Effect of nicorandil on cardiac function and exercise tolerance in patients with non-ST-elevation myocardial infarction after elective percutaneous coronary intervention

Wei Liye， Xia Yue， Qi Guoqing， Zhao Hongliang

2017, 32(9):  755-758.  doi:10.3969/j.issn.1004-583X.2017.09.005

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Objective  To  investigate the effect of nicorandil on cardiac function and exercise tolerance in patients with nonSTelevation myocardial infarction(NSTEMI) after elective percutaneous coronary intervention(PCI).Methods  Totally  80 patients with NSTEMI were randomly assigned to two groups: control group and nicorandil group， 40 cases in each group.The left ventricular ejection fraction(LVEF)，left ventricular enddiastolic diameter (LVEDD)，6 min walking distance(6MWD)，New York Heart Association classification (NYHA classification)  of heart function  and major adversecardiac events (MACEs)  were calculated. Patients were followed up for six months.Results  There were no significant difference in baseline evaluation indexes of heart function characteristics between two groups(P>0.05). After six months， LVEF was significantly increased， LVEDD decreased significantly， NYHA classification was significantly improved in nicorandil group (P<0.05). In control group， LVEF and NYHA classification were significantly improved(P<0.05)，  but LVEDD was significantly increased  as  compared with baseline (P<0.05).Patients were followed up for six months. The LVEF， LVEDD， 6MWD  and  NYHA classification of two groups were statistically significant (P<0.05)， and the  occurrence of  MACEs in nicorandil  group  was significantly  lower  than that in control  group (10.0% vs 26.7%，P<0.05).Conclusion  Nicorandil  can improve heart function，  increase exercise capacity  and reduce the incidence of MACE in patients with NSTEMI after elective PCI.

Pseudohypoparathyroidism and hypokalemia: clinical manifestation analysis

Zhang Wei1，2， Zhang Mei1， Wang Yucheng1， Cui Dai1， Zhou Hongwen1，

2017, 32(9):  759-762.  doi:10.3969/j.issn.1004-583X.2017.09.006

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Objective  To investigate the clinical characteristics of patients with pseudohypoparathyroidism(PHP) and hypokalemia. Methods  The clinical data of 13 patients with PHP in our hospital from July 2006 to April 2016 were analyzed retrospectively. Results  None of which had Albright's hereditary osteodystrophy(AHD). Convulsion  was observed in  86.4％  patients. Myasthenia and numbness of limbs were 38.5%. Hypocalcemia， hyperphospheremia and high level of parathyroid hormone was the main characteristics of laboratory examination. In all 13 cases， hypokalemia rate was 46.2%，10 with abnormal thyroid function. The course of the disease was longer in patients with hypokalemia than controls. There was no significant difference in other clinical manifestation and laboratory examination in patients with or without hypokalemia. There were no typical  AHO  body deformity. The clinical manifestations of 84.6% patients were tetany symptoms and 38.5% patients had limb weakness and numbness. 6 patients were with hypokalemia. 10 patients with abnormal thyroid function. The patients with hypokalemia had longer course of disease. The serum potassium was between 33.5  mmol/L and other clinical and biochemical indicators and non hypokalemia group had no significant difference. Conclusion  PHP patients were susceptible to hypokalemia and subclinical hypothyroidism.

Clinical characteristics and risk factors in type 2 diabetic nephropathy

Luo Jiakai， Li Zhihong， Yin Fei， Yuan Xiaochao， Wang Xin

2017, 32(9):  763-766.  doi:10.3969/j.issn.1004-583X.2017.09.007

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Objective  To investigate the clinical characteristics and risk factors in type 2 diabetic nephropathy. Methods  A total of 3 251 type 2 diabetes mellitus patients were chosen to carry on a retrospective casecontrol study.According to nephropathy or not，the patients were divided into DN group and nonDN group，general information and laboratory examination were compared between. The related risk factors of type 2 diabetic nephropathy were analyzed by logistic regression.Results  Disease course，body mass index(BMI)，systolic blood pressure(SBP)，diasstolic blood pressure(DBP)，total cholesterol(TC)， triglyceride(TG)，low density lipoprotein cholesterol(LDLC)，creatinine(Cr)，serum uric acid(SUA)，fasting blood glucose(FPG)，hemoglobin A1c(HbA1c)， fibrinogen  in DN group were significantly higher than those of nonDN group (P<0.05).Logistic regression analysis showed that disease course two groups， smoking， BMI，SBP， SUA， HbAlc and TG were risk factors of type 2 diabetic nephropathy.Conclusion  The risk factors of type 2 diabetic nephropathy are disease  course， smoking， BMI，SBP， SUA， HbAlc and TG， early screening for highrisk factors are recommended to reduce the occurrence of type 2 diabetic nephropathy.

Relationship between serum bilirubin and type 2 diabetic nephropathy

Zhou Yuanyuan1， Wang Zhanjian2， Qiu Hongmei1， Li Wei1

2017, 32(9):  767-769,773.  doi:10.3969/j.issn.1004-583X.2017.09.008

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Objective  To explore the relationship between bilirubin level and diabetic neohropathy（DN）.Methods  A total of 525 patients with type 2 diabetes mellitus(T2DM) were selected and divided into three groups according to  urinary albumintocreatinine ratio （ACR）:  normal group（ACR in men＜2.5 mg/mmol，ACR in women＜3.5 mg/mmol）  in 299 cases；early diabetic nephropathy group （ACR in men 2.530.0 mg/mmol，ACR in women 3.530.0 mg/mmol）  in 116 cases；clinical diabetic nephropathy group （ACR＞30 mg/mmol.  Exclusions were patients with renal failure）  in 110 cases. General data and serum bilirubin level were compared and analyzed among three groups.Results  The serum total bilirubin(TBIL)，direct bilirubin and indirect bilirubin in normal group were all lower than those in early diabetic nephropathy group and normal group（P<0.05）.Logistic regression analysis showed that TBIL was a protective factor for DN.Conclusion  Serum TBIL level is negatively correlated with the progression of  DN  in T2DM patients.

Brain function in  patients with functional dyspepsia associated with depression and anxiety state

Liu Yu1， Wang Liangzhi2

2017, 32(9):  770-773.  doi:10.3969/j.issn.1004-583X.2017.09.009

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Objective  To investigate  the relationship between functional dyspepsia（FD）  and mental psychological factors and explore the clinical significance of brain function check diagnosis on FD patients associated with anxiety and depression state. Methods  Psychological assessments， SelfRating Anxiety Scale(SAS) and SelfRating Depression Scale(SDS) were performed on 100 FD patients and 30 healthy volunteers. Electroencephalogram(EEG) and encephalofluctuo gram technology(ET) were also performed to compare  the abnormal rates and the differences of neurotransmitter between FD and control group. Results  Of 100 FD patients， the incidence rates of anxiety， depression and both anxiety and depression states were  30%， 33% and 11%， respectively.Of 30 healthy volunteers， the incidence rates of anxiety and depression were  6.7% and 10%， respectively. The scores of  SDS  and SAS  in  FD group were obviously higher than those of control group（P＜0.05）.EEG abnormal rate in  FD patient group was significantly  higher than that of control group， respectively  35% and 10%（P＜0.05).Neurotransmitters γaminobutyric acid(GABA) activity was decreased much more in FD with anxiety state than that of control group，while norepinephrine(NE)， acetylcholine(Ach) and glutamic acid(Glu)  activities were significantly  higher than those of control group (P<0.05). Neurotransmitters 5hydroxytryptamine(5HT) and dopamine(DA) were  much lower in FD patients with depression state than those of the control group (P<0.05). 5HT and DA were  lower in FD with anxiety and depression state than those of control group， but NE was significantly  higher than that of control group (P<0.05). There  was  no statistical significance in the difference of neurotransmitter activity between FD patients without anxiety and depression state and control group (P>0.05).Conclusion  The incidence rate of anxiety and depression state and the abnormity of EEG in FD patients are much higher than common people， the reason is due to the inordinate changes of neurotransmitter in the brain.

Analysis of plasma colony stimulating factors and inflammatory factors in patients with cognitive impairment

Zhang Ximeng1， Cai Xiaoying2， Fang Yannan2

2017, 32(9):  774-777.  doi:10.3969/j.issn.1004-583X.2017.09.010

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Objective  Detect the concentration of granulocyte colony stimulating factor (GCSF)， macrophage colony stimulating factor (MCSF) 、some inflammatory factors and βamyloid (Aβ) in plasma of patients with Alzheimer's Disease (AD) and vascular dementia (VaD). Analyze their relationship， explore the role of these factors in the pathogenesis of AD and VaD， and provide a new target for the diagnosis and treatment of both.Methods  24 AD patients， 17 VaD patients and 32 healthy controls were included. Basic information of them were collected. The concentration of plasma GCSF， MCSF， IL4， IL5， IL6， IL12p40， IL12p70， IL15， IL16， IL17， Aβ40， Aβ42 were measured by array. Results  The concentrations of plasma GCSF， MCSF， IL4， IL5， IL6， IL12p40， IL12p70， IL15 and IL16 in AD group were significantly lower than those in the control group. The concentrations of MCSF and IL4 in VaD group were significantly lower than those in control group. The levels of plasma Aβ42 in AD group and VaD group were significantly higher than those in control group. Each factor showed no significant difference between AD and VaD groups.Conclusion  Immunosenescence may be the pathogenesis of AD. Vascular factors are important in the pathogenesis of VaD. GCSF can be used in identification of AD and VaD， and also as a potential target for the treatment of AD.

Retrospectively analysis of different degree of sedation in  patients with  mechanical ventilation in adult ICU

Bu Ke， Liu Lingang， Zhang Raorao

2017, 32(9):  778-781.  doi:10.3969/j.issn.1004-583X.2017.09.011

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Objective  To evaluate the efficacy and safety of different degree of sedation in the treatment of patients with mechanical ventilation.  Methods  405 patients who received  mechanical ventilation over 48 hour from January 2014 to December 2016 in ICU of  the hospital  were enrolled. According to different methods of sedation， the patients were divided into intermittent sedation group (192 patients) and continuous sedation group (213 patients). The patients with continuous sedation were divided into light sedation group (SAS score 23) and deep sedation group (SAS score 45) according to the SAS scores. Each group was given fentanyl for analgesia and propofol or midazolam for sedation. Duration of mechanical ventilation， ICU hospitalization time， total hospitalization time， hospitalization fatality rate and incidence of complications and adverse events were recorded.Results  Compared with the continuous sedation group，the duration of mechanical ventilation  were significantly shorter than the intermittent sedation group(P<0.05). ICU hospitalization time， total hospitalization time， hospitalization fatality rate showed no significant differences between two groups(P>0.05). In the continuous sedation group， with continuous light sedation group compared to continuous deep sedation group， mechanical ventilation time， ICU hospitalization time  and total hospitalization time  were significantly longer and the incidence of VAP  was significantly higher in continuous deep sedation group (all P<0.05).Compared with the last light sedation group for deep sedation group，the mechanical ventilation time and ICU length of hospital stay， the total length of hospital stay and the incidence of VAP were significantly longer in the continuous light sedation group (all P<0.05).Hospital mortality， the incidence of delirium and accidental extubation of two groups had no statistical significance (P>0.05). Conclusion  Intermittent sedation and continuous sedation were feasible during mechanical ventilation， but the incidence of VAP was significantly reduced by continued shallow sedation， shortened mechanical ventilation and ICU hospitalization time.

Effect of emodin loaded solid lipid nanoparticles on Parkinson model in rats

Wang Xia1， Meng Min1， Wu Yuqiong2， Li Jincheng3， Shi Yanbin3

2017, 32(9):  782-786.  doi:10.3969/j.issn.1004-583X.2017.09.012

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Objective  To evaluate therapeutic effect of emodin loaded solid lipid nanoparticles (EMOSLN) on  Parkinson model of  rats. Methods  EMOSLN were prepared by applying emulsion evaporationsolidification at low temperature method with glyceryl monostearate and cremophor RH40 as well as polysorbate 80(tween 80) (3:1，w/w). To observe the influence of EMOSLN in 6OHDA induced  the behavior  of  Parkinson model rats′， concentration of MAOB and COMT in middle brain following oral administration， therapeutic effect of EMOSLN on rats model of Parkinson disease.Results  EMOSLN was spherical in morphology and the diameter was in the range of 40100 nm. Compared with Parkinson disease model rats divided into normal saline group， rotating behavior of rats in EMOSLN group and emodin suspension group was improved. Concentrations of MAOB and COMT in middle brain of Parkinson disease model rats for EMOSLN group were significantly reduced，while MAOB concentration in middle brain of emodin suspension group reduced significantly but COMT concentration showed no significant difference compared to normal saline control group. Conclusion  EMOSLN showed effect on 6OHDA rat model of Parkinson disease by lowering concnentation of COMT and MAOB， and its therapeutic efficiency is better than that of emodin suspension.

Effect of probiotics products on glucolipid metabolism and inflammation reaction of type 2 diabetes mellitus: a metaanalysis

Liu Yongjin， Du Bo， Shao Jiangjian， Chen Chaoyun， Huang Suping

2017, 32(9):  787-792.  doi:10.3969/j.issn.1004-583X.2017.09.013

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Objective  To investigate the effect of probiotics products on glucolipid metabolism and inflammation reaction of type 2 diabetes mellitus (T2DM). Methods  Databases were electronically searched to collect randomized controlled trials (RCTs) about probiotics products on glucolipid metabolism and inflammation reaction of T2DM which were published before December 2016. Two reviewers independently screened literatures， extracted data and assessed the risk of bias of included studies， and the metaanalysis was performed by using RevMan 5.3 software. Results  A  total of 11 RCTs involving 567 patients were included. The results of metaanalysis demonstrated that probiotics products had positive effect on the levels of FPG， HbA1c compared with the control group; While there was no statistic significance on the levels of TG， TC， HDLC， LDLC and hsCRP. Conclusion  Probiotics products are effective in lowing the levels of blood glucose， and probiotics products is a form of recommendable adjuvant therapy for T2DM.

Lowdensity lipoprotein cholesterol and mortality in the elderly--a meta analysis

Liu Jianping1， Liu Yan1， Wu Yuhuai1， Liu Jianwei2

2017, 32(9):  793-797.  doi:10.3969/j.issn.1004-583X.2017.09.014

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Objective  To systematically evaluate the association between lowdensity lipoprotein cholesterol (LDLC) and mortality.Methods  The Pubmed， Cochrane Library， CNKI， CBM and Wangfang databases were searched from building databases to December 2016. The enrollment involved screening cohort studies with OR values and 95% CI or the relevant data which can be calculated.Results  Five studies with 50 361 participants were finally included. High LDLC as reference: the pooled RR was  1.405（95%CI=1.2061.635，P<0.01）. Low LDLC as reference:　the pooled RR was 0.552 （95%CI=0.5060.602，P<0.01）. With the change of LDLC， the risk of mortality became inverse. Conclusion  High LDLC is inversely  associated with the allcause mortality in the elderly.