Our results suggest that, in Chinese patients with anterior circulation LVO stroke, direct endovascular mechanical thrombectomy initiated within an intravenous thrombolysis time window carries similar effectiveness to that of bridging therapy and a decreased asymptomatic intracranial hemorrhage risk. DEVT may be an alternative for bridging therapy. Future randomized controlled trials are warranted.
Background and purpose
Acute ischaemic stroke (AIS) is a vital cause of mortality and morbidity in China. Many AIS patients develop early neurological deterioration (END). This study aimed to construct a nomogram to predict END in AIS patients.
Methods
Acute ischaemic stroke patients in Nanjing First Hospital were recruited as the training cohort. Additional patients in Nantong Third People’s Hospital were enrolled as the validation cohort. Multivariate logistic regression was utilized to establish the nomogram. Discrimination and calibration performance of the nomogram were tested by concordance index and calibration plots. Decision curve analysis was employed to assess the utility of the nomogram.
Results
In all, 1889 and 818 patients were recruited in the training and validation cohorts, respectively. Age [odds ratio (OR) 1.075; 95% confidence interval (CI) 1.059–1.091], diabetes mellitus (OR 1.673; 95% CI 1.181–2.370), atrial fibrillation (OR 3.297; 95% CI 2.005–5.421), previous antiplatelet medication (OR 0.473; 95% CI 0.301–0.744), hyper‐sensitive C‐reactive protein (OR 1.049; 95% CI 1.036–1.063) and baseline National Institutes of Health Stroke Scale (OR 1.071; 95% CI 1.045–1.098) were associated with END and incorporated in the nomogram. The concordance index was 0.826 (95% CI 0.785–0.885) and 0.798 (95% CI 0.749–0.847) in the training and validation cohorts. By decision curve analysis, the model was relevant between thresholds of 0.06 and 0.90 in the training cohort and 0.08 and 0.77 in the validation cohort.
Conclusions
The nomogram composed of hyper‐sensitive C‐reactive protein, age, diabetes mellitus, atrial fibrillation, previous antiplatelet medication and baseline National Institutes of Health Stroke Scale may predict the risk of END in AIS patients.
A single layer of dense Si quantum dots with average size of 4 nm sandwiched in amorphous SiN layers was prepared by laser crystallization of ultrathin amorphous Si film followed by subsequently thermal annealing. The electroluminescent diodes were fabricated by evaporating Al electrodes on back sides of p-Si substrates and the top surface of samples. Room temperature electroluminescence can be detected with applying the negative voltage around 10V on the top gate electrode and the luminescent intensity is increased with increasing the applied voltage. It was found that the integrated luminescent intensity is linearly proportional to the injection current which suggested the intensity depends on the concentrations of injected carriers after Fowler-Nordheim tunneling through amorphous SiN barriers. The influence of the amorphous SiN with different band gap on the device performance was also discussed briefly.
Background: The effect of immunonutrition is controversial compared to standard supplementation with respect to the management of patients with acute pancreatitis. Methods: An online literature search on four databases (PubMed, Cochrane, Embase and Web of Science) was performed to identify all of the randomised controlled trials assessing the effects of enteral or parenteral immunonutrition in acute pancreatitis. A fixed or random effects model was chosen using REV-MAN, version 5.3 (https://revman.cochrane.org). The count data were analysed using the risk ratio (RR) and 95% confidence interval (CI). Results: Five hundred and sixty-eight patients were included via our search in which 14 articles matched our criteria for enrolling the meta-analysis. Immunonutrition significantly reduced the risk of organ failure (RR = 0.42; 95% CI = 0.26-0.70, P = 0.0008), infectious complications (RR = 0.78; 95% CI = 0.62-0.99; P = 0.04) and mortality (RR = 0.37; 95% CI = 0.21-0.66; P = 0.006). Length of hospital stay was also shorter in patients who received immunonutrition (mean difference = À1.73 days; 95% CI = À2.36 to À1.10; P < 0.00001). Total interventions of patients were decreased (RR = 0.73; 95% CI = 0.55-0.97; P = 0.03). Body mass index in patients with immunonutrition was reduced more than standard nutrition (mean difference = À2.00; 95% CI = À3.96 to À0.04; P = 0.05). Conclusions: Immunonutrition support such as glutamine and x-3 fatty acids is potentially beneficial with respect to improving clinical outcomes in patients with acute pancreatitis.
OBJECTIVE:
The objective of this study was to examine whether the National Institute of Health Stroke Scale was associated with the short- and long-term prognosis of patients with acute ischemic stroke treated with intravenous thrombolysis.
METHODS:
A total of 247 patients with acute ischemic stroke admitted to the hospital from April 2019 to October 2020 were retrospectively selected as study subjects, and the immediate and long-term prognosis after thrombolysis was assessed using the modified Rankin Scale and divided into good prognosis group (119 cases) and poor prognosis group (128 cases) based on the effect of thrombolysis. Both groups were treated with alteplase, the National Institute of Health Stroke Scale of the two groups was compared, and the factors affecting the prognosis of acute ischemic stroke were analyzed.
RESULTS:
After intravenous thrombolysis, 24 h, and 7 days of treatment, the National Institute of Health Stroke Scale in the poor prognosis group was higher than those of patients in the good prognosis group, and the differences were statistically significant (p<0.05). The results of the multivariate analysis suggested that National Institute of Health Stroke Scale before treatment was an independent factor associated with the 3-month (OR: 1.068, 95%CI 1.015–1.123, p=0.011) and long-term poor prognosis (OR: 1.064, 95%CI 1.012–1.119, p=0.015) in patients with acute ischemic stroke receiving intravenous thrombolysis after adjustment of age, gender, body mass index, smoking, alcohol consumer, onset-to-door time, door-to-needle time, and imaging score.
CONCLUSION:
The National Institute of Health Stroke Scale could be a promising indicator for the prognosis, and active intervention is needed to improve the quality of life in patients with acute ischemic stroke.
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