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Liu WS, Zhu SF, Guo YL, Huang R, Yang X. Effect of microbubbles on transcranial doppler ultrasound-assisted intracranial recombinant tissue-type plasminogen activator thrombolysis. Vascular 2023; 31:1194-1200. [PMID: 35799413 DOI: 10.1177/17085381221079109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the effect of microbubbles on the efficacy of transcranial doppler (TCD) ultrasound-assisted thrombolytic therapy of recombinant tissue-type plasminogen activator (rt-PA). METHODS Male New Zealand white rabbits (n = 36) were randomly divided into an rt-PA group (n = 18) and an rt-PA plus microbubble group (n = 18). After the cerebral infarction model was constructed with autologous blood clots, rt-PA and rt-PA plus microbubble intervention were performed, respectively. The hemodynamic changes and infarct size of the two groups were recorded. In addition, the ELISA method was used to detect the level of nitric oxide (NO), superoxide dismutase (SOD), and malondialdehyde (MDA) in the brain tissue of the two-group graph model and high-sensitivity C-reactive protein (hs-CRP) in the serum. RESULTS In the rt-PA group, the recanalization rate was 38.9% and the average infarct size was 11.8%. In the rt-PA plus microbubble group, the recanalization rate was 66.7% and the average infarct size was 8.2%. In addition, the average values for NO, SOD, MDA, and hs-CRP were 16.48 ± 5.39 μmol/L, 730.2 ± 9.86 U/mg, 0.92 ± 0.43 nmol/mg, and 8.56 ± 1.64 mg/L in the rt-PA group, respectively, and the average values were 9.18 ± 3.37 μmol/L, 426.2 ± 6.39 U/mg, 0.73 ± 0.44 nmol/mg, and 5.23 ± 0.94 mg/L in the rt-PA plus microbubble group, respectively. CONCLUSIONS The addition of microbubbles enhanced the effects of TCD-assisted rrt-PA thrombolysis.
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Affiliation(s)
- Wei-Song Liu
- Department of Internal Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Shao-Fen Zhu
- Department of Internal Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Yuan-Ling Guo
- Department of Internal Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Rong Huang
- Department of Internal Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Xue Yang
- Department of Internal Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
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Tong G, Wang X, Jiang H, Wu A, Cheng W, Cui X, Bao L, Cai R, Cai W. A Deep Learning Model for Automatic Segmentation of Intraparenchymal and Intraventricular Hemorrhage for Catheter Puncture Path Planning. IEEE J Biomed Health Inform 2023; 27:4454-4465. [PMID: 37310835 DOI: 10.1109/jbhi.2023.3285809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Intracerebral hemorrhage is the subtype of stroke with the highest mortality rate, especially when it also causes secondary intraventricular hemorrhage. The optimal surgical option for intracerebral hemorrhage remains one of the most controversial areas of neurosurgery. We aim to develop a deep learning model for the automatic segmentation of intraparenchymal and intraventricular hemorrhage for clinical catheter puncture path planning. First, we develop a 3D U-Net embedded with a multi-scale boundary aware module and a consistency loss for segmenting two types of hematoma in computed tomography images. The multi-scale boundary aware module can improve the model's ability to understand the two types of hematoma boundaries. The consistency loss can reduce the probability of classifying a pixel into two categories at the same time. Since different hematoma volumes and locations have different treatments. We also measure hematoma volume, estimate centroid deviation, and compare with clinical methods. Finally, we plan the puncture path and conduct clinical validation. We collected a total of 351 cases, and the test set contained 103 cases. For intraparenchymal hematomas, the accuracy can reach 96 % when the proposed method is applied for path planning. For intraventricular hematomas, the proposed model's segmentation efficiency and centroid prediction are superior to other comparable models. Experimental results and clinical practice show that the proposed model has potential for clinical application. In addition, our proposed method has no complicated modules and improves efficiency, with generalization ability.
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Sui HJ, Yan CG, Zhao ZG, Bai QK. Prognostic Value of Diffusion-Weighted Imaging (DWI) Apparent Diffusion Coefficient (ADC) in Patients with Hyperacute Cerebral Infarction Receiving rt-PA Intravenous Thrombolytic Therapy. Med Sci Monit 2016; 22:4438-4445. [PMID: 27864581 PMCID: PMC5119690 DOI: 10.12659/msm.897149] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 03/21/2016] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the potential value of apparent diffusion coefficient (ADC) of diffusion-weighted imaging (DWI) in the prognosis of patients with hyperacute cerebral infarction (HCI) receiving intravenous thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA). MATERIAL AND METHODS From June 2012 to June 2015, 58 cases of HCI (<6 h) undergoing rt-PA intravenous thrombolytic therapy (thrombolysis group) and 70 cases of HCI (<6 h) undergoing conventional antiplatelet and anticoagulant therapy (control group) in the same period were collected. DWI was conducted on all the subjects, and ADC maps were generated with Functool software to quantify ADC value. The clinical outcomes of HCI patients were observed for 3 months, and prognostic factors were analyzed. RESULTS Before thrombolysis treatment, the lesion area presented high signal intensity on DWI map and low signal intensity on ADC map, and gradually weakened signal intensity on DWI map and gradually enhanced signal intensity on ADC map were observed after thrombolysis. The ADC values of the thrombolysis group were significantly higher than those of the control group after treatment (24 h, 7 d, 30 d, and 90 d) (all P<0.05), and the ADC and rADC values in the thrombolysis group gradually increased over time (all P<0.05). Multiple logistic regression analysis showed that baseline National Institutes of Health Stroke Scale (NIHSS) score, baseline rADC value, and stroke history were the independent factors for the prognosis of HIC patients with thrombolysis (all P<0.05). CONCLUSIONS The values of ADC and rADC may provide guidance in the prognosis of HCI patients receiving rt-PA, and the baseline rADC value is the protective factor for the prognosis of HCI patients receiving rt-PA.
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Affiliation(s)
- Hai-Jing Sui
- Department of Imaging Radiology, People’s Hospital of Pudong New Area, Shanghai, P.R. China
| | - Cheng-Gong Yan
- Department of Radiology, Pudong New Area Hospital of Traditional Chinese Medicine, Shanghai, P.R. China
| | - Zhen-Guo Zhao
- Department of Imaging Radiology, People’s Hospital of Pudong New Area, Shanghai, P.R. China
| | - Qing-Ke Bai
- Department of Neurology, People’s Hospital of Pudong New Area, Shanghai, P.R. China
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Gao Z, Qian L, Niu C, Chen B, Guo H, Sun P, Wang Y, Ning L, Li Q, Fu X. Evacuating Hypertensive Intracerebral Hematoma with a Cortical Sulcus Approach. World Neurosurg 2016; 95:341-347. [DOI: 10.1016/j.wneu.2016.08.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 08/06/2016] [Accepted: 08/08/2016] [Indexed: 10/21/2022]
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Li K, Jia J, Wang Z, Zhang S. Elevated Serum Levels of NSE and S-100β Correlate with Increased Risk of Acute Cerebral Infarction in Asian Populations. Med Sci Monit 2015; 21:1879-88. [PMID: 26124190 PMCID: PMC4492484 DOI: 10.12659/msm.893615] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND We investigated the clinical value of serum levels of neuron-specific enolase (NSE) and human soluble protein-100β (S-100β) in acute cerebral infarction (ACI) patients. MATERIAL AND METHODS A literature search of electronic databases identified relevant case-control studies that examined the correlations between NSE and S-100β serum levels, and ACI. The retrieved studies were screened based on our strict inclusion and exclusion criteria, and high-quality studies were subsequently selected for meta-analysis. STATA software (Version 12.0, Stata Corporation, College Station, TX, USA) was utilized for statistical analysis. RESULTS A total of 13 case-control studies, containing 911 ACI patients and 686 healthy controls, were enrolled in this meta-analysis. The results of the meta-analysis showed that serum levels of NSE and S-100β in ACI patients were significantly higher than the control group. Subgroup analysis based on ethnicity revealed that the serum levels of NSE and S-100β in ACI patients were significantly higher than the control group in Asian population. In Caucasian population, the serum levels of NSE in case group was significantly higher than the control group, but no significant differences in serum levels of S-100β were observed between ACI patients and the control group. CONCLUSIONS Based on our results, we conclude that serum levels of NSE and S-100β strongly correlate with ACI in Asian population, and may be important clinical markers for diagnosis and treatment of ACI.
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Affiliation(s)
- Ke Li
- Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, China (mainland)
| | - Jianjun Jia
- Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, China (mainland)
| | - ZhenFu Wang
- Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, China (mainland)
| | - ShanChun Zhang
- Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, China (mainland)
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Chi FL, Lang TC, Sun SJ, Tang XJ, Xu SY, Zheng HB, Zhao HS. Relationship between different surgical methods, hemorrhage position, hemorrhage volume, surgical timing, and treatment outcome of hypertensive intracerebral hemorrhage. World J Emerg Med 2014; 5:203-8. [PMID: 25225585 DOI: 10.5847/wjem.j.issn.1920-8642.2014.03.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 07/19/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The present study aimed to explore the relationship between surgical methods, hemorrhage position, hemorrhage volume, surgical timing and treatment outcome of hypertensive intracerebral hemorrhage (HICH). METHODS A total of 1 310 patients, who had been admitted to six hospitals from January 2004 to January 2008, were divided into six groups according to different surgical methods: craniotomy through bone flap (group A), craniotomy through a small bone window (group B), stereotactic drilling drainage (group C1 and group C2), neuron-endoscopy operation (group D) and external ventricular drainage (group E) in consideration of hemorrhage position, hemorrhage volume and clinical practice. A retrospective analysis was made of surgical timing and curative effect of the surgical methods. RESULTS The effectiveness rate of the methods was 74.12% for 1 310 patients after one-month follow-up. In this series, the disability rate was 44.82% 3-6 months after the operation. Among the 1 310 patients, 241 (18.40%) patients died after the operation. If hematoma volume was >80 mL and the operation was performed within 3 hours, the mortality rate of group A was significantly lower than that of groups B, C, D, and E (P<0.05). If hematoma volume was 50-80 mL and the operation was performed within 6-12 hours, the mortality rate of groups B and D was lower than that of groups A, C and E (P<0.05). If hematoma volume was 20-50 mL and the operation was performed within 6-24 hours, the mortality rate of group C was lower than that of groups A, B and D (P<0.05). CONCLUSIONS Craniotomy through a bone flap is suitable for patients with a large hematoma and hernia of the brain. Stereotactic drilling drainage is suggested for patients with hematoma volume less than 80 mL. The curative effect of HICH individualized treatment would be improved via the suitable selection of operation time and surgical method according to the position and volume of hemorrhage.
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Affiliation(s)
- Feng-Ling Chi
- Department of Neurosurgery, Shanghai 7th Hospital, Shanghai 200137, China
| | - Tie-Cheng Lang
- Yueyang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Shu-Jie Sun
- Emergency Medicine Department, Dongfang Hospital of Shanghai, Shanghai, China
| | - Xue-Jie Tang
- Second Hospltal of Dalian Medical University, Dlian, China
| | - Shu-Yuan Xu
- Shanghai Pudong New Area Gongli Hospital, Shanghai, China
| | - Hong-Bo Zheng
- First People's Hospital of Qiqihaer City, Heilongjiang Province, China
| | - Hui-Song Zhao
- Third Affiliated Hospital, Qiqihar Medical College, Heilongjiang Province, China
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Li LM, Cai WB, Ye Q, Liu JM, Li X, Liao XX. Comparison of plasma microRNA-1 and cardiac troponin T in early diagnosis of patients with acute myocardial infarction. World J Emerg Med 2014; 5:182-6. [PMID: 25225581 DOI: 10.5847/wjem.j.issn.1920-8642.2014.03.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 06/19/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Early reperfusion can effectively treat acute myocardial infarction (AMI) and reduce the mortality significantly. This study aimed to compare the role of plasma microRNA-1 (miR-1) and cardiac troponin T (cTnT) in early diagnosis of AMI patients. METHODS From May 2011 to May 2012, plasma samples were collected from 56 AMI patients and 28 non-AMI controls. The expression of plasma miR-1 was measured by quantitative reverse transcription-polymerase chain reaction (qRT-PCR), and the level of plasma cTnT was measured using electrochemiluminescence-based methods on an Elecsys 2010 Immunoassay Analyzer. SPSS 16.0 was used for the statistical analysis of the results. Data were expressed as mean±standard deviation unless otherwise described. The differences about clinical characteristics between the AMI patients and controls were tested using Student's t test or Fisher's exact test. The Mann-Whitney U test was conducted to compare the expression of microRNAs between the AMI patients and controls. MicroRNAs expression between different intervals of the AMI patients was compared using Wilcoxon's signed-rank test. The receiver operating characteristic (ROC) curve was established to discriminate the AMI patients from the controls. RESULTS In the present study, the expression of plasma miR-1 was significantly increased in the AMI patients compared with the healthy controls (P<0.01). The plasma miR-1 in the AMI patients decreased to the normal level at 14 days (P>0.05). The expression of plasma miR-1 was not related to the clinical characteristics of the study population (P>0.05). ROC curve analyses demonstrated that miR-1 was specific and sensitive for the early diagnosis of AMI, but not superior to cTnT. CONCLUSION Plasma miR-1 could be used in the early diagnosis of AMI, but it is similar to cTnT.
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Affiliation(s)
- Li-Ming Li
- Department of Emergency Medicine, Pengpai Memorial Hospital of Haifeng, Haifeng, China
| | - Wen-Bo Cai
- Department of Emergency Medicine, Pengpai Memorial Hospital of Haifeng, Haifeng, China
| | - Qin Ye
- Department of Emergency Medicine, Pengpai Memorial Hospital of Haifeng, Haifeng, China
| | - Jian-Min Liu
- Department of Emergency Medicine, Pengpai Memorial Hospital of Haifeng, Haifeng, China
| | - Xin Li
- Department of Emergency Medicine, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xiao-Xing Liao
- Department of Emergency Medicine, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
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