目的探索新的基底动脉影像学评分方法——基于MRA评估基底动脉闭塞预后评分(basilar artery occlusion prognosis score on magnetic resonance angiography,BAOPS-MRA)及其对非重症基底动脉闭塞患者预后的评估效果。方法提出基于MRA的...目的探索新的基底动脉影像学评分方法——基于MRA评估基底动脉闭塞预后评分(basilar artery occlusion prognosis score on magnetic resonance angiography,BAOPS-MRA)及其对非重症基底动脉闭塞患者预后的评估效果。方法提出基于MRA的新型基底动脉评分方法——BAOPS-MRA及其动脉节段评分标准。前瞻性连续入组2019年1月-2020年12月经头颅MRA诊断为基底动脉闭塞且NIHSS≤15分的后循环缺血性卒中患者,在该患者群体中评估BAOPS-MRA预测发病3个月功能预后的效能。根据发病3个月的随访结果,将患者分为预后良好(mRS≤2分)组和预后不良(mRS>2分)组,基于患者入院时的MRA结果,评定BAOPS-MRA,同时评定既往研究者提出的基于MRA的基底动脉和侧支循环的评分(basilar artery and collateration score on magnetic resonance angiography,BACS-MRA)。采用单因素和多因素方法分析两组的基线资料、血管狭窄部位和程度、BAOPS-MRA、BACS-MRA与3个月预后的关系。采用ROC曲线评估BAOPS-MRA预测患者预后的效能,并与BACS-MRA的预测效能进行比较。对BAOPS-MRA、BACS-MRA与发病3个月预后进行相关性分析。结果共纳入99例患者,其中预后良好组65例,预后不良组34例。预后良好组的BAOPS-MRA评分为7.0(2.0~16.0)分,预后不良组为2.5(0~12.0)分。多因素分析显示,BAOPS-MRA(OR 1.577,95%CI1.238~2.008,P=0.001)、BACS-MRA(OR 1.488,95%CI 1.193~1.857,P=0.001)、NIHSS(OR 0.786,95%CI 0.670~0.923,P=0.003)是患者3个月功能预后的独立影响因素。ROC曲线分析显示,BAOPSMRA评分预测3个月预后的截断值为5分,AUC为0.850(95%CI 0.765~0.936),敏感度为0.794,特异度为0.754;BACS-MRA预测3个月预后的截断值为4分,AUC为0.747(95%CI 0.641~0.852),敏感度为0.765,特异度为0.585,BAOPS-MRA较BACS-MRA的预测效能更佳。BAOPS-MRA(rs=0.580,P<0.001)、BACS-MRA(rs=0.409,P<0.001)与患者3个月预后良好呈正相关性。结论BAOPS-MRA评分可独立预测非重症基底动脉闭塞患者的3个月功能预后,具有一定的临床推广价值。展开更多
Transmission electron microscope (TEM) and high resolution transmission electron microscope (HRTEM) analyses have been performed on omphacite from ultra-high pressure (UHP) eclogites at the locality of Shima, Dabie Mo...Transmission electron microscope (TEM) and high resolution transmission electron microscope (HRTEM) analyses have been performed on omphacite from ultra-high pressure (UHP) eclogites at the locality of Shima, Dabie Mountains, China. TEM reveals that the microstructures consist dominantly of dislocation substructures, including free dislocations, loops, tiltwalls, dislocation tangles and subboundaries. They were produced by high-temperature ductile deformation, of which the main mechanism was dislocation creep. Antiphase domain (APD) boundaries are common planar defects; an age of 470 ± 6 Ma for UHP eclogite formation has been obtained from the equiaxial size of APDs in ordered omphacites from Shima, coincident with ages given by single-zircon U-Pb dating (471 ± 2 Ma). HRTEM reveals C2/c and P2/n space groups in different parts of one single omphacite crystal, and no exsolution is observed in the studied samples, which is attributed to rapid cooling. It is suggested that the UHP eclogites underwent a long period of annealing at high temperatures, followed by relatively rapid cooling. These data provide valuable information for the formation and exhumation mechanism of UHP eclogites in the Dabie high-pressure (HP) and UHP metamorphic belt.展开更多
文摘目的探索新的基底动脉影像学评分方法——基于MRA评估基底动脉闭塞预后评分(basilar artery occlusion prognosis score on magnetic resonance angiography,BAOPS-MRA)及其对非重症基底动脉闭塞患者预后的评估效果。方法提出基于MRA的新型基底动脉评分方法——BAOPS-MRA及其动脉节段评分标准。前瞻性连续入组2019年1月-2020年12月经头颅MRA诊断为基底动脉闭塞且NIHSS≤15分的后循环缺血性卒中患者,在该患者群体中评估BAOPS-MRA预测发病3个月功能预后的效能。根据发病3个月的随访结果,将患者分为预后良好(mRS≤2分)组和预后不良(mRS>2分)组,基于患者入院时的MRA结果,评定BAOPS-MRA,同时评定既往研究者提出的基于MRA的基底动脉和侧支循环的评分(basilar artery and collateration score on magnetic resonance angiography,BACS-MRA)。采用单因素和多因素方法分析两组的基线资料、血管狭窄部位和程度、BAOPS-MRA、BACS-MRA与3个月预后的关系。采用ROC曲线评估BAOPS-MRA预测患者预后的效能,并与BACS-MRA的预测效能进行比较。对BAOPS-MRA、BACS-MRA与发病3个月预后进行相关性分析。结果共纳入99例患者,其中预后良好组65例,预后不良组34例。预后良好组的BAOPS-MRA评分为7.0(2.0~16.0)分,预后不良组为2.5(0~12.0)分。多因素分析显示,BAOPS-MRA(OR 1.577,95%CI1.238~2.008,P=0.001)、BACS-MRA(OR 1.488,95%CI 1.193~1.857,P=0.001)、NIHSS(OR 0.786,95%CI 0.670~0.923,P=0.003)是患者3个月功能预后的独立影响因素。ROC曲线分析显示,BAOPSMRA评分预测3个月预后的截断值为5分,AUC为0.850(95%CI 0.765~0.936),敏感度为0.794,特异度为0.754;BACS-MRA预测3个月预后的截断值为4分,AUC为0.747(95%CI 0.641~0.852),敏感度为0.765,特异度为0.585,BAOPS-MRA较BACS-MRA的预测效能更佳。BAOPS-MRA(rs=0.580,P<0.001)、BACS-MRA(rs=0.409,P<0.001)与患者3个月预后良好呈正相关性。结论BAOPS-MRA评分可独立预测非重症基底动脉闭塞患者的3个月功能预后,具有一定的临床推广价值。
基金This work was supported by the Research Fund for the Doctoral Program of Higher Education of China(Project No.9349101)National Natural Science Foundation of China grants 49572146 and 49872069.
文摘Transmission electron microscope (TEM) and high resolution transmission electron microscope (HRTEM) analyses have been performed on omphacite from ultra-high pressure (UHP) eclogites at the locality of Shima, Dabie Mountains, China. TEM reveals that the microstructures consist dominantly of dislocation substructures, including free dislocations, loops, tiltwalls, dislocation tangles and subboundaries. They were produced by high-temperature ductile deformation, of which the main mechanism was dislocation creep. Antiphase domain (APD) boundaries are common planar defects; an age of 470 ± 6 Ma for UHP eclogite formation has been obtained from the equiaxial size of APDs in ordered omphacites from Shima, coincident with ages given by single-zircon U-Pb dating (471 ± 2 Ma). HRTEM reveals C2/c and P2/n space groups in different parts of one single omphacite crystal, and no exsolution is observed in the studied samples, which is attributed to rapid cooling. It is suggested that the UHP eclogites underwent a long period of annealing at high temperatures, followed by relatively rapid cooling. These data provide valuable information for the formation and exhumation mechanism of UHP eclogites in the Dabie high-pressure (HP) and UHP metamorphic belt.
