The purpose of this study is to investigate the risk factors for postoperative deep vein thrombosis (DVT) in patients with traumatic spinal fractures complicated with Spinal Cord Injury(SCI). We conducted a retrospective analysis of 110 patients with traumatic spinal fractures and SCI admitted to our hospital from March 2021 to April 2024. DVT was diagnosed using ultrasound. Patient history, general data, surgical data, laboratory tests, and thromboelastogram (TEG) results were collected. The patients were divided into a DVT group and a non-DVT group according to the results of ultrasound one week after surgery. The risk factors and diagnostic value were analyzed using binary logistic regression and receiver operating characteristic (ROC) curves in both univariate and multivariate analyses. Multivariate and ROC analysis results showed that D-dimer, lower extremity, duration of bedrest, and MA values of TEG were independent risk factors for DVT in SCI, with D-dimer having the highest diagnostic value (AUC = 0.883). The AUC values for lower extremity, duration of bedrest, and MA were 0.731, 0.750, and 0.625. In conclusion, Postoperative D-dimer > 5.065 mg/l, lower extremity < 3, duration of bedrest, and MA value of TEG are independent risk factors for postoperative DVT in SCI patients, D-dimer having the highest diagnostic value. When the above risk factors occur, clinicians need to be vigilant and take appropriate prevention and treatment measures.
Objective: To establish a clinical practical prediction model for hematoma expansion（HE） in spontaneous intracerebral hemorrhage. Methods: The clinical and imaging data of 283 patients with spontaneous intracerebral hemorrhage from May 1, 2018 to May 31, 2021 in the Second Affiliated Hospital of Soochow University were retrospectively analyzed. Significant variables in univariate analysis（P＜0.05） were included in multivariate logistic analysis, and stepwise regression was used to screen independent risk factors for prediction model of HE. R language was applied to draw Nomogram. Bootstrap method was used to repeat the sampling of the data in this study 1 000 times for internal verification. Receiver operating characteristic curve, clinical decision curve, and calibration curve were used to evaluate the discriminating ability, clinical practicability and reliability of the model. Results: HE model incorporated standard deviation of red blood distribution width（RDW-SD）, initial hematoma volume, vortex sign, island sign, and mixed sign. The area under receiver operating characteristic curve（AUC） value of the HE model was 0.867. The sensitivity and specificity were 0.728 and 0.876, respectively, with Youden index of 0.605. The internal verification showed that the C-index of the model was 0.859, and the standard error was 0.014. The preliminary external verification indicate that HE model had a good predictive ability. Conclusion: The HE model constructed based on clinical-imaging data, including RDW-SD, initial hematoma volume, vortex sign, island sign, and mixed sign, had a good predictive efficacy.
人参是一种化学成分复杂、生物活性广泛且药理作用独特的传统药物.人参皂苷是人参的主要活性成分,随着现代分离技术的发展,已分离出包括Rb1、Rb2、Rc、Rg1、Re、Rd、Rg3和Rh2在内的超过150种人参皂苷单体.近年来,人参皂苷被证实可通过清除氧 自由基,减少钙超载,减轻炎症反应和细胞凋亡而抑制心肌缺血再灌注损伤(MIRI).本文查阅近年来国内外相关文献,就人参皂昔抗MIRI的作用及机制进行综述.
目的:卵圆孔未闭(PFO)与隐源性卒中(CS)有关.本研究的 目的是阐明与CS相关的危险因素并构建识别高风险PFO的评分系统.方法:回顾性分析2016年12月-2022年1月PFO患者的卵圆孔形态和功能特征.采用单因素和多因素分析确定与CS相关的危险因素并建立预测模型和评分系统.采用受试者工作特征曲线(ROC)评价模型和评分系统的性能,并确定高风险和低风险PFO的最佳截断值.结果:共纳入116例PFO患者,包括47例CS患者和69例非卒中患者.多因素Logistic回归分析显示,高血脂、大尺寸PFO、高移动性房间隔、房间隔瘤和静息状态中-大量右向左分流与CS相关(均P＜0.05).构建的评分系统分值范围为0～7分.ROC曲线下面积为0.776(95％CI:0.687,0.865),得分≥2分的PFO被识别为高风险.结论:由高血脂、大尺寸PFO、高移动性房间隔、房间隔瘤和静息状态中-大量右向左分流构建的评分系统有助于识别可能发生缺血性卒中的高风险PFO患者.
酪氨酸激酶抑制剂(TKIs)为 目前治疗非小细胞肺癌患者(NSCLC)表皮生长因子受体(EGFR)基因突变的一线用药,非典型EGFR突变病例数较少,且患者个体异质性较高,相关前瞻性临床治疗数据少.本文以德国国家基因组医学网络研究分类为基础,对目前NSCLC中罕见EGFR突变(G719X、S768I、L861Q及其复合突变)的研究现状和TKIs(吉非替尼、阿法替尼和奥希替尼)治疗NSCLC罕见EGFR突变的相关研究进展进行讨论.
