This work is supported by Medical Science Technique Foundation of Guangdong Province.Abstract Objective To evaluate the newly developed perfluoropropene filled echo contrast agent (FCT 188) in non invasive assess...This work is supported by Medical Science Technique Foundation of Guangdong Province.Abstract Objective To evaluate the newly developed perfluoropropene filled echo contrast agent (FCT 188) in non invasive assessment of risk areas (RA) and infarct areas (IA) with intravenous myocardial contrast echocardiography (MCE) in canine model of ischemia followed by reperfusion. Methods Eight chest opened Beagle dogs with a 90 minute ischemia followed by a 240 minute reperfusion were studied. MCE was performed after a bolus injection of FCT 188 (0.025 ml/kg, Ⅳ) into a superficial vein of the forelimb at baseline, 20 minutes after occlusion, and 4 h after reperfusion to non invasively assess the left ventricular myocardium area (LVMA), myocardial ischemic risk area (RA), and infarct area (IA) in a short axis view of left ventricle. The accuracy of detecting myocardial perfusion with intravenous MCE was further assessed by in vitro myocardial staining of the matched cross sections. Both RA and IA were expressed as percent of LVMA. Results LVMA, RA, IA, and IA/RA ratio were accurately assessed by MCE (LVMA: 6.60 cm 2±0.76 cm 2; RA: 35.7%±6.68%; IA: 21.0%±13.2%; IA/RA: 60.3%±31.4%; n=7) as compared with those of the matched cross section (LVMA: 6.81 cm 2±0.73 cm 2, P=0.062; RA: 35.3%±9.9%, P= 0.84; IA: 25.10%±14.5%, P=0.07; IA/RA: 68.0%±22.2%, P=0.28, respectively). There was a significant correlation of MCE assessed IA/RA ratio and its corresponding pathologiclly determined finding in vitro (Y=1.21X-21.6, r=0.73, P=0.015). No significant changes of electrocardiogram (ECG), mean artery pressures (MAP), pulmonary artery pressures (PAP), and pulmonary artery wedge pressures (PAWP) were found between pre and post intravenous injection of FCT 188 at each time point. Conclusion These indicate that FCT 188 can be used to assess risk areas and infarct areas accurately and non invasively with intravenous MCE in the canine model of a 90 minute ischemia followed by a 240 minute reperfusion and might have potential significance for non invasive assessment of myocardial reperfusion clinically.展开更多
We reported a 50-year-old female patient with left supplementary motor area infarction who presented right lower limb apraxia and investigated the possible causes using transcranial magnetic stimulation. The patient w...We reported a 50-year-old female patient with left supplementary motor area infarction who presented right lower limb apraxia and investigated the possible causes using transcranial magnetic stimulation. The patient was able to walk and climb stairs spontaneously without any assistance at 3 weeks after onset. However, she was unable to intentionally move her right lower limb although she understood what she supposed to do. The motor evoked potential evoked by transcranial magnetic stimulation from the right lower limb was within the normal range, indicating that the corticospinal tract innervating the right lower limb was uninjured. Thus, we thought that her motor dysfunction was not induced by motor weakness, and confirmed her symptoms as aprax- ia. In addition, these results also suggest that transcranial magnetic stimulation is helpful for diagnosing apraxia.展开更多
Primary coronary revascularization by means of percutaneous coronary intervention(PCI)is a highly effective treatment of acute myocardial infarction re-establishing coronary perfusion and stopping the ongoing necrosis...Primary coronary revascularization by means of percutaneous coronary intervention(PCI)is a highly effective treatment of acute myocardial infarction re-establishing coronary perfusion and stopping the ongoing necrosis in the dependent myocardium.Single-photon emission computed tomography(SPECT)is the most widely used modality assessing myocardial salvage as the difference between the acute perfusion defect before intervention and the remaining scar size measured in a second scan several days after the event.SPECT allows quantification of area at risk(AAR)and final infarct size(FIS)by tracer injection prior to revascularization and after 1 month,respectively.SPECT provides the most validated measure of myocardial salvage and has been utilized in multiple randomizedclinical trials.However,SPECT is logistically challenging,expensive,and includes radiation exposure.More recently,a large number of studies have suggested that cardiac magnetic resonance(CMR)can determine salvage in a single examination by combining measures of myocardial oedema in the AAR exposed to ischaemia reperfusion with FIS quantification by late gadolinium enhancement.展开更多
目的探究D-二聚体水平预测依达拉奉右莰醇治疗进展性脑梗死后病灶面积改善的价值。方法选取2023年1月至2024年4月郑州大学附属郑州中心医院收治的102例进展性脑梗死患者为研究对象。根据预后情况将患者分为预后良好组(74例)与预后不良组...目的探究D-二聚体水平预测依达拉奉右莰醇治疗进展性脑梗死后病灶面积改善的价值。方法选取2023年1月至2024年4月郑州大学附属郑州中心医院收治的102例进展性脑梗死患者为研究对象。根据预后情况将患者分为预后良好组(74例)与预后不良组(28例)。比较两组患者一般资料、血清指标。采用EmpowerStats软件中的分层交互作用检验分析时间对D-二聚体水平与病灶面积变化之间关系的影响。采用多元Cox回归分析对D-二聚体水平与预后不良风险的关系进行分析。结果预后良好组、预后不良组收缩压、糖尿病、高血压、心房颤动、高脂血症、D-二聚体、尿酸(UA)、治疗前美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分差异均有统计学意义(均P<0.05)。治疗后当天、1、2、4周,预后不良组D-二聚体水平[(219.43±21.67)g/L比(172.88±22.11)g/L、(207.67±22.43)g/L比(153.79±22.12)g/L、(184.49±22.08)g/L比(122.95±22.11)g/L、(163.59±22.45)g/L比(101.69±22.47)g/L]、Alberta卒中项目早期CT评分(Alberta Stroke Program Early CT Score,ASPECTS)[(1.45±0.46)分比(2.22±0.45)分、(2.84±0.44)分比(4.62±0.43)分、(3.72±0.47)分比(5.95±0.51)分、(5.02±0.58)分比(7.52±0.45)分]均差于预后良好组,差异均有统计学意义(均P<0.05)。各时间点D-二聚体水平与病灶面积变化存在相关性(均P<0.05)。根据D-二聚体水平三分位数将患者分为低水平组(D-二聚体<188.27 g/L,25例)、中水平组(D-二聚体188.27~241.21 g/L,54例)和高水平组(D-二聚体>241.21 g/L,23例),高水平组患者预后不良风险均高于其他两组(P<0.05)。结论D-二聚体水平对依达拉奉右莰醇治疗进展性脑梗死后病灶面积改善具有一定的预测价值,可作为临床监测依达拉奉右莰醇治疗进展性脑梗死患者效果的指标。展开更多
文摘This work is supported by Medical Science Technique Foundation of Guangdong Province.Abstract Objective To evaluate the newly developed perfluoropropene filled echo contrast agent (FCT 188) in non invasive assessment of risk areas (RA) and infarct areas (IA) with intravenous myocardial contrast echocardiography (MCE) in canine model of ischemia followed by reperfusion. Methods Eight chest opened Beagle dogs with a 90 minute ischemia followed by a 240 minute reperfusion were studied. MCE was performed after a bolus injection of FCT 188 (0.025 ml/kg, Ⅳ) into a superficial vein of the forelimb at baseline, 20 minutes after occlusion, and 4 h after reperfusion to non invasively assess the left ventricular myocardium area (LVMA), myocardial ischemic risk area (RA), and infarct area (IA) in a short axis view of left ventricle. The accuracy of detecting myocardial perfusion with intravenous MCE was further assessed by in vitro myocardial staining of the matched cross sections. Both RA and IA were expressed as percent of LVMA. Results LVMA, RA, IA, and IA/RA ratio were accurately assessed by MCE (LVMA: 6.60 cm 2±0.76 cm 2; RA: 35.7%±6.68%; IA: 21.0%±13.2%; IA/RA: 60.3%±31.4%; n=7) as compared with those of the matched cross section (LVMA: 6.81 cm 2±0.73 cm 2, P=0.062; RA: 35.3%±9.9%, P= 0.84; IA: 25.10%±14.5%, P=0.07; IA/RA: 68.0%±22.2%, P=0.28, respectively). There was a significant correlation of MCE assessed IA/RA ratio and its corresponding pathologiclly determined finding in vitro (Y=1.21X-21.6, r=0.73, P=0.015). No significant changes of electrocardiogram (ECG), mean artery pressures (MAP), pulmonary artery pressures (PAP), and pulmonary artery wedge pressures (PAWP) were found between pre and post intravenous injection of FCT 188 at each time point. Conclusion These indicate that FCT 188 can be used to assess risk areas and infarct areas accurately and non invasively with intravenous MCE in the canine model of a 90 minute ischemia followed by a 240 minute reperfusion and might have potential significance for non invasive assessment of myocardial reperfusion clinically.
文摘We reported a 50-year-old female patient with left supplementary motor area infarction who presented right lower limb apraxia and investigated the possible causes using transcranial magnetic stimulation. The patient was able to walk and climb stairs spontaneously without any assistance at 3 weeks after onset. However, she was unable to intentionally move her right lower limb although she understood what she supposed to do. The motor evoked potential evoked by transcranial magnetic stimulation from the right lower limb was within the normal range, indicating that the corticospinal tract innervating the right lower limb was uninjured. Thus, we thought that her motor dysfunction was not induced by motor weakness, and confirmed her symptoms as aprax- ia. In addition, these results also suggest that transcranial magnetic stimulation is helpful for diagnosing apraxia.
文摘Primary coronary revascularization by means of percutaneous coronary intervention(PCI)is a highly effective treatment of acute myocardial infarction re-establishing coronary perfusion and stopping the ongoing necrosis in the dependent myocardium.Single-photon emission computed tomography(SPECT)is the most widely used modality assessing myocardial salvage as the difference between the acute perfusion defect before intervention and the remaining scar size measured in a second scan several days after the event.SPECT allows quantification of area at risk(AAR)and final infarct size(FIS)by tracer injection prior to revascularization and after 1 month,respectively.SPECT provides the most validated measure of myocardial salvage and has been utilized in multiple randomizedclinical trials.However,SPECT is logistically challenging,expensive,and includes radiation exposure.More recently,a large number of studies have suggested that cardiac magnetic resonance(CMR)can determine salvage in a single examination by combining measures of myocardial oedema in the AAR exposed to ischaemia reperfusion with FIS quantification by late gadolinium enhancement.
文摘目的探究D-二聚体水平预测依达拉奉右莰醇治疗进展性脑梗死后病灶面积改善的价值。方法选取2023年1月至2024年4月郑州大学附属郑州中心医院收治的102例进展性脑梗死患者为研究对象。根据预后情况将患者分为预后良好组(74例)与预后不良组(28例)。比较两组患者一般资料、血清指标。采用EmpowerStats软件中的分层交互作用检验分析时间对D-二聚体水平与病灶面积变化之间关系的影响。采用多元Cox回归分析对D-二聚体水平与预后不良风险的关系进行分析。结果预后良好组、预后不良组收缩压、糖尿病、高血压、心房颤动、高脂血症、D-二聚体、尿酸(UA)、治疗前美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分差异均有统计学意义(均P<0.05)。治疗后当天、1、2、4周,预后不良组D-二聚体水平[(219.43±21.67)g/L比(172.88±22.11)g/L、(207.67±22.43)g/L比(153.79±22.12)g/L、(184.49±22.08)g/L比(122.95±22.11)g/L、(163.59±22.45)g/L比(101.69±22.47)g/L]、Alberta卒中项目早期CT评分(Alberta Stroke Program Early CT Score,ASPECTS)[(1.45±0.46)分比(2.22±0.45)分、(2.84±0.44)分比(4.62±0.43)分、(3.72±0.47)分比(5.95±0.51)分、(5.02±0.58)分比(7.52±0.45)分]均差于预后良好组,差异均有统计学意义(均P<0.05)。各时间点D-二聚体水平与病灶面积变化存在相关性(均P<0.05)。根据D-二聚体水平三分位数将患者分为低水平组(D-二聚体<188.27 g/L,25例)、中水平组(D-二聚体188.27~241.21 g/L,54例)和高水平组(D-二聚体>241.21 g/L,23例),高水平组患者预后不良风险均高于其他两组(P<0.05)。结论D-二聚体水平对依达拉奉右莰醇治疗进展性脑梗死后病灶面积改善具有一定的预测价值,可作为临床监测依达拉奉右莰醇治疗进展性脑梗死患者效果的指标。
