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MRI和CT检出急性脑出血的比较研究

世界核心医学期刊文摘（神经病学分册） 2005年第6期1卷 1-2页

作者： Kidwell C.S. Chalela j.A. saver j.l. 黄卫东 Washington Hosp. Ctr. Stroke Center East Bldg. 100 Irving St NW Washington DC 20010 United States Dr.

Context: Noncontrast computed tomography (CT) is the standard brain imaging study for the initial evaluation of patients with acute stroke symptoms. Multimodal magnetic resonance imaging (MRI) has been proposed as an alternative to CT in the emergency stroke setting. However, the accuracy of MRI relative to CT for the detection of hyperacute intracerebral hemorrhage has not been demonstrated. Objective: To compare the accuracy of MRI and CT for detection of acute intracerebral hemorrhage in patients presenting with acute focal stroke symptoms. Design, Setting, and Patients: A prospective, multicenter study was performed at 2 stroke centers (U- ClA Medical Center and Suburban Hospital, Bethesda, Md), between October 2000 and February 2003. Patients presenting with focal stroke symptoms within 6 hours of onset underwent brain MRI followed by non- contrast CT. Main Outcome Measures: Acute intracerebral hemorrhage and any intracerebral hemorrhage diagnosed on gradient recalled echo (GRE) MRI and CT scans by a consensus of 4 blinded readers. Results: The study was stopped early, after 200 patients were enrolled, when it became apparent at the time of an unplanned interim analysis that MRI was detecting cases of hemorrhagic transformation not detected by CT. For the diagnosis of any hemorrhage, MRI was positive in 71 patients with CT positivein 29 (P lent (96% concordance). Acute hemorrhage was diagnosed in 25 patients on both MRI and CT. In 4 other patients, acute hemorrhage was present on MRI but not on the corresponding CT - each of these 4 cases was interpreted as hemorrhagic transformation of an ischemic infarct. In 3 patients, regions interpreted as acute hemorrhage on CT were interpreted as chronic hemorrhage on MRI. In 1 patient, subarachnoid hemorrhage was diagnosed on CT but not on MRI. In 49 patients, chronic hemorrhage, most often microbleeds, was visualized on MRI but not on CT. Conclusion:

关键词： CT MRI 急性脑卒中卒中治疗超急性缺血性脑梗死局灶性脑卒中早期评估梯度回波蛛网膜下腔出血

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发病前使用抗血小板治疗和缺血性卒中的预后

世界核心医学期刊文摘(神经病学分册) 2006年第10期 29-30页

作者： Sanossian N. saver j.l. Rajajee V. 赵天智 Stroke Center Department of Neurology University of California at Los Angeles 710 Westwood Plaza Los Angeles CA 90095 United States Dr.

Objective: To evaluate the independent effect of premorbid antiplatelet use on incident ischemic stroke severity and outcome at discharge. Methods: The authors studied consecutive patients presenting within 24 hours of ischemic stroke over a 1- year period. National Institutes of Health Stroke Scale (NIHSS) score at presentation was used as index of stroke severity and a modified Rankin scale of 0 to 1 at discharge as index of good functional outcome. Patients were categorized according to their premorbid antiplatelet use as antiplateletinclusive (AI) and no antiplatelet (NA). Demographic data, risk factors, pertinent laboratory tests, other medications, and stroke mechanisms were controlled for across the two groups using multivariate logistic regression. Results: A total of 260 individuals met study criteria: 92 patients were on antiplatelet agents prior to admission, 168 were on no antiplatelets. Pretreatment with antiplatelet was associated with lower presenting median NIHSS (4.5 vs 7, p = 0.005). Antiplatelet use was associated with less severe stroke at presentation in those having no history of stroke or TIA (4.8 vs 8.0, p = 0.03) but not in those with a prior history of stroke or TIA (4.9 vs 4.9, p = 0.987). The likelihood of a good outcome was increased in those on antiplatelets after adjusting for other variables (OR 2.105, p = 0.0073). Conclusions: Prestroke use of antiplatelet may be associated with reduced severity of incident ischemic strokes in those with no prior history of stroke or TIA, and with an increased likelihood of a good discharge outcome regardless of prior cerebrovascular event history.

关键词：缺血性卒中抗血小板治疗 TIA 预后

一个急性中风队列中单侧感觉缺失的发生率、危险因素、解剖部位和病程

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世界核心医学期刊文摘（神经病学分册） 2005年第1期1卷 48-49页

作者： Ringman j.M. saver j.l. Woolson R.F. 邓剑平 Department of Neurology Univ. of California Los Angeles 710 Westwood Plaza Los Angeles CA 90095- 1769 United States Dr.

Objective: To delineate the frequency, course, risk factors, and neuroanatomy of hemispatial neglect in a large stroke cohort. Methods: One thousand two hundred eighty one patients with acute stroke were enrolled in a multicenter trial of an anticoagulant. Presence and severity of neglect were assessed with the NIH Stroke Scale (NIHSS) neglect item, assessing tactile extinction and visuospatial neglect at entry, daily for 1 week, and at 3 months. Head CT scans were obtained on day 7, and infarct location and size were characterized. Results: Neglect was common at presentation, occurring in 43% of right brain lesioned (RBl) patients and 20% of left brain lesioned (lBl) patients (p lect was present in 17% of RBl patients and in 5% of lBl patients (p l patients, neglect was most frequently associated with lesions involving the (in descending order) temporal, parietal, frontal, occipital lobes, basal ganglia, and thalamus. Neglect was more common and persistent with cortical than with subcortical lesions. Increasing age was associated with increased risk of neglect in RBl patients, whereas gender and handedness did not significantly affect neglect frequency. Conclusions: This series confirms that hemispatial neglect may occur with damage to several supratentorial structures but is most common and persistent with lesions of the right temporoparietal cortex. Increasing age is associated with neglect, parti cularly after right brain lesions. Gender and handedness do not exert a marked effect on the likelihood of the occurrence of neglect.

关键词：急性中风感觉缺失病变位置中风患者脑损伤多中心临床试验神经解剖优势手抗凝剂损伤后

PROTECT:一项预防血栓复发的协调性卒中治疗计划

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世界核心医学期刊文摘（神经病学分册） 2005年第3期1卷 50-51页

作者： Ovbiagele B. saver j.l. Fredieu A. 李一明 Stroke Center Department of Neurology Univ. of California at Los Angeles 710 Westwood Plaza Los Angeles CA 90095 United States Dr.

Objective: To assess the impact of the Preventing Recurrence of Thromboembolic Events through Coordinated Treatment (PROTECT) Program on achievement of its ei ght secondary prevention goals at the time of discharge. Methods: Achievement ra tes for the eight program goals at time of discharge were compared in all patien ts discharged from a university hospitalbased stroke service with a diagnosis of ischemic st roke or TIA during a 1 year period after implementation of the PROTECT Program vs rates obtained from a comparable group of patients admitted to the same servi ce during the preceding year. Results: Demographic and medical features were com parable in the baseline and intervention cohorts for all patients with cerebral ischemia presumed due to large vessel atherosclerosis or small vessel disease (baseline year n = 117, intervention n = 130). Implementation rates in patients without specific contraindications increased for all four medication goals: 97 t o 100%for antithrombotic agents, 68 to 97%for statins, 42 to 90%for angiotens in converting enzyme inhibitors/angiotensin receptor blockers, and 14 to 70%fo r diuretics. Although data were not collected on baseline lifestyle instruction rates, instruction in the programs four lifestyle interventions was achieved b y discharge in 100%of the intervention cohort. Conclusion: Implementation of th is single center, systems based, inhospital program to initiate secondary stro ke prevention therapies was associated with a substantial increase in treatment utilization at the time of hospital discharge.

关键词：卒中治疗 PROTECT 生活方式指导脑缺血干预组他汀类药物血管紧张素抗凝血药物大学医院受体阻断剂

超老龄缺血性卒中或TIA患者的次级预防药物处方

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世界核心医学期刊文摘(神经病学分册) 2006年第10期 28-29页

作者： Ovbiagele B. Hills N.K. saver j.l. johnston S.C. 赵天智 Stroke Center Department of Neurology University of California at Los Angeles 710 Westwood Plaza Los Angeles CA 90095 United States Dr.

Background: An age bias may exist in the prescription of important secondary- preventive therapies in the elderly. Objective: To evaluate patterns of drug prescription for cardiovascular prevention in the very elderly following hospitalization for an acute ischemic stroke or TIA. Methods: The authors compared subjects ages ≥ 80 with those lifornia Acute Stroke Prototype Registry to evaluate the impact of age on receipt of secondary- prevention medications at the time of hospital discharge. Prespecified secondary- prevention drug classes studied were antithrombotics, lipid- lowering agents, and antihypertensives. Results: Overall, there were 260 patients age ≥ 80 and 534 age less likely to receive actual treatment with antithrombotic medications (p = 0.002) and lipid- lowering medications (p = 0.005) but were more likely to receive antihypertensive medications (p = 0.0007) than their younger counterparts. With regard to optimal treatment (defined as receipt of, or a valid contraindication to, treatment in each category), those ≥ 80 were equally likely to receive antithrombotic medications and lipid therapy but remained more likely to receive antihypertensive treatment (77.7 vs 67.0% ; p = 0.0007). There were no differences in receipt of optimal combination therapy (defined as optimal treatment in all three therapeutic classes) between patient age groups, even when adjusted for medical history. Conclusion: After hospitalization for stroke or TIA, no differences in overall optimal treatment prescription of secondary- prevention medications between patients ages ≥ 80 and their younger counterparts were observed.

关键词： TIA 药物处方次级预防患者

Prehospital transdermal glyceryl trinitrate for ultra- acute ischaemic stroke: data from the RIGHT- 2 randomised sham- controlled ambulance trial

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Stroke & Vascular Neurology 2024年第1期9卷 38-49,I0035-I0046页

作者： jason Philip Appleton lisa j Woodhouse Craig S Anderson Sandeep Ankolekar lesley Cala Mark Dixon Timothy j England Kailash Krishnan Grant Mair Keith W Muir john Potter Christopher I Price Marc Randall Thompson G Robinson Christine Roffe Else C Sandset jeffrey l saver Angela Shone Aloysius Niroshan Siriwardena joanna M Wardlaw Nikola Sprigg Philip M Bath Stroke University Hospitals Birmingham NHS Foundation TrustBirminghamUK Institute of Applied HealthResearch University of Birmingham College of Medical and Dental SciencesBirminghamUK Stroke Trials Unit Mental Health and Clinical NeurosciencesUniversity of NottinghamNottinghamUK Faculty of Medicine The George Institute for Global HealthSydneyNew South WalesAustralia The George Institute China at Peking University Health Science Center BeijingChina Neurology Royal Prince Alfred HospitalSydney Health PartnersSydneyNew South WalesAustralia Department of Neurology King's College Hospital NHS Foundation TrustLondonUK Faculty of Health and Medical Sciences University of Western AustraliaCrawleyWestern AustraliaAustralia East Midlands Ambulance Service NHS Trust NottinghamUK Stroke Queen's Medical CentreNottingham University Hospitals NHS TrustNottinghamUK Centre for Clinical Brain Sciences Dementia Research InstituteUniveristy of EdinburghEdinburghUK Institute of Neurology and Psychology University of GlasgowGlasgowUK Bob Champion Research and Education Building University of East AngliaNorwichUK Institute of Neuroscience Newcastle UniversityNewcastle upon TyneUK Department of Neurology Leeds Teaching Hospitals NHS TrustLeedsUK Department of Cardiovascular Sciences and NIHR leicester Biomedical Research Centre University of LeicesterLeicesterUK Stroke Research in Stoke Institute for Science and Technology in MedicineKeele UniversityStoke-on TrentUK Department of Neurology Oslo University HospitalOsloNorway Research and Development Norwegian Air Ambulance FoundationOsloNorway Department of Neurology and Comprehensive Stroke Center David Geffen School of MedicineUCLALos AngelesCaliforniaUSA Research and Graduate Services University of NottinghamNottinghamUK Community and Health Research Unit University of LincolnLincolnUK

Background The effect of transdermal glyceryl trinitrate(GTN,a nitrovasodilator)on clinical outcome when administered before hospital admission in suspected stroke patients is ***,we assess the safety and efficacy of GTN in the prespecified subgroup of patients who had an ischaemic stroke within the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2(RIGHT-2).Methods RIGHT-2 was an ambulance-based multicentre sham-controlled blinded-endpoint study with patients randomised within 4hours of *** primary outcome was a shift in scores on the modified Rankin scale(mRS)at day *** outcomes included death;a global analysis(Wei-lachin test)containing Barthel Index,EuroQol-5D,mRS,telephone interview for cognitive status-modified and Zung depression scale;and neuroimaging-determined‘brain frailty’*** were reported as n(%),mean(SD),median[IQR],adjusted common OR(acOR),mean difference or Mann-Whitney difference(MWD)with 95%*** 597 of 1149(52%)patients had a final diagnosis of ischaemic stroke;age 75(12)years,premorbid mRS>2107(18%),Glasgow Coma Scale 14(2)and time from onset to randomisation 67[45,108]***‘brain frailty’was common:median score 2[2,3](range 0–3).At day 90,GTN did not influence the primary outcome(acOR for increased disability 1.15,95%CI 0.85 to 1.54),death or global analysis(MWD 0.00,95%CI-0.10 to 0.09).In subgroup analyses,there were non-significant interactions suggesting GTN may be associated with more death and dependency in participants randomised within 1hour of symptom onset and in those with more severe *** In patients who had an ischaemic stroke,ultra-acute administration of transdermal GTN in the ambulance did not improve clinical outcomes in a population with more clinical and radiological frailty than seen in previous in-hospital *** IS AlREADY KNOWN ON THIS TOPIC⇒Transdermal glyceryl trinitrate(GTN)was associat-ed with less death and dependency in those w

关键词： Glasgow nitrate random

Decorating crystalline YFe_(2-x)Al_(x) on the Mg_(60)la_(10)Ni_(20)Cu_(10) amorphous alloy as “hydrogen pump” to realize fast de/hydrogenation

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journal of Materials Science & Technology 2024年第6期173卷 72-79页

作者： l.j.Huang H.Wang l.Z.Ouyang M.Zhu H.j.l.n School of Materials Science and Engineering Key Laboratory of Advanced Energy Storage Materials of Guangdong ProvinceSouth China University of TechnologyGuangzhou 510641China Institute of Advanced Wear&Corrosion Resistance and Functional Materials Jinan UniversityGuangzhou 510632China

Mg-based amorphous alloys are one of the potential hydrogen storage materials but suffer from sluggish dehydrogenation/hydrogenation(de/hydrogenation)*** this work,as a new strategy,a hydrogen pump is built on the surface of amorphous alloys to solve this *** milling crystalline YFe_(2-x)Al_(x) hydrogen storage alloy with Mg_(60)la_(10)Ni_(20)Cu_(10) amorphous alloy,fine crystalline particles were seeded on amorphous alloy powder to form a“strawberry”*** to the TEM observation,a metallurgical bonding boundary formed between the Mg-based amorphous matrix and the Y-Fe-Al crystalline *** microstructure and de/hydrogenation kinetics investigation,the“hydrogen pump”effect of the seeded crystalline alloy was confirmed,which makes it much easier for the hydrogen to dissociate on and diffuse through the surface of the Mg-based amorphous *** such effect,the H absorption rate of Mg_(60)la_(10)Ni_(20)Cu_(10) amorphous alloy became almost eight times faster and it absorbs ~2.8 wt.% in 1 h at 130℃ under 4.5 MPa-H_(2).Further,fast hydrogenation can even achieve at 70℃ and the low-temperature dehydrogenation kinetics of the amorphous hydride can be also greatly *** present work proves that surface modification is of great importance for obtaining Mg-based amorphous alloy with ideal hydrogen storage performance.

关键词： Hydrogen storage Mg-based amorphous alloy Hydrogen pump Composite structure

Reply to the note by li Piani et al.

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Defence Technology（防务技术） 2024年第1期31卷 603-606页

作者： T.li Piani j.Weerheijm l.j.Sluys TU Delft Stevinweg 12628 CNDelftthe Netherlands TNO PO Box 452280 AARijswijkthe Netherlands NlDA Faculty of Military Sciences1781 CADen Helderthe Netherlands

In 2017,a ballistic phenomenological model was proposed by the authors of Ref.[1] to numerically simulate the experimental depths of small caliber projectiles impacting walls made of *** opportunity for a new model in the field revealed from the observation that two older models recently used by the authors of Ref.[2] shared a linear relationship between the penetration depth P and the impacting velocity v_(O).

关键词： Penetration Adobe Modeling

Biomaterials and emerging technologies for tissue engineering and in vitro models

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Bio-Design and Manufacturing 2024年第3期7卷 237-239页

作者： j.Miguel Oliveira Rui l.Reis 3B’s Research Group I3Bs-Research Institute on BiomaterialsBiodegradables and BiomimeticsHeadquarters of the European Institute of Excellence on Tissue Engineering and Regenerative MedicineUniversity of MinhoAveParkZona Industrial da Gandra4805-017 BarcoGuimarãesPortugal ICVS/3B’s-PT Government Associate laboratory 4806-909 Braga/GuimarãesPortugal

The latest advances in the field of biomaterials have opened new avenues for scientific breakthroughs in tissue engineer-ing which greatly contributed for the successful translation of tissue engineering products into the market/***-materials are easily processed to become similar to natural extracellular matrix,making them ideal temporary supports for mimicking the three-dimensional(3D)microenvironment required for maintaining the adequate cell/tissue functions both in vitro and in vivo^([1]).

关键词： breakthrough biomaterials engineer