检索结果-南通市图书馆

Study of Simplified Coma Scales： Acute Stroke Patients with Tracheal Intubation

Chinese Medical Journal 2018年第18期131卷 2152-2157页

作者： Jun-Ping Wang Ying-Ying Su Yi-Fei Liu Gang Liu Lin-Lin Fan Dai-Quan Gao department of neurocritical care unit Xuanwu Hospital Capital Medical University Beijing 100053 China

Background： Whether the Glasgow Coma Scale （GCS） can assess intubated patients is still a topic of controversy. We compared the test performance of the GCS motor component （GCS-M）/Simplified Motor Score （SMS） to the total of the GCS in predicting the outcomes of intubated acute severe cerebral vascular disease patients. Methods： A retrospective analysis of prospectively collected observational data was performed. Between January 2012 and October 2015, 106 consecutive acute severe cerebral vascular disease patients with intubation were included in the study. GCS, GCS-M, GCS eye-opening component, and SMS were documented on admission and at 24, 48, and 72 h after admission to Neurointensive care unit （NCU）. Outcomes were death and unfavorable prognosis （modified Rankin Scale： 5-6） at NCU discharge. The receiver operating characteristic （ROC） curve was obtained to determine the prognostic performance and best cutoff value for each scoring system. Comparison of the area under the ROC curves （AUCs） was performed using the ***： Of 106 patients included in the study, 41 （38.7%） patients died, and 69 （65.1%） patients had poor prognosis when discharged from NCU. The four time points within 72 h of admission to the NCU were equivalent for each scale＇s predictive power, except that 0 h was the best for each scale in predicting outcomes of patients with right-hemisphere lesions. Nonsignificant difference was found between GCS-M AUCs and GCS AUCs in predicting death at 0 h （0.721 vs. 0.717, Z = 0.135, P = 0.893） and 72 h （0.730 vs. 0.765, Z = 1.887, P = 0.060）, in predicting poor prognosis at 0 h （0.827 vs. 0.819, Z = 0.395, P = 0.693）, 24 h （0.771 vs. 0.760, Z = 0.944, P = 0.345）, 48 h （0.732 vs. 0.741, Z= 0.593, P= 0.590）, and 72 h （0.775 vs. 0.780, Z= 0.302, P= 0.763）. AUCs in predicting death for patients with left-hemisphere lesions ranged from 0.700 to 0.804 for GCS-M and from 0.700 to 0.824 for GCS, in predicting poor prognosis ranged from 0.841 to 0.969 for GC

关键词： Coma Scale Consciousness Disorders Intubation Prognosis

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Diagnosis of brain death： confirmatory tests after clinical test

引用

Chinese Medical Journal 2014年第7期127卷 1272-1277页

作者： Su Yingying Yang Qinglin Liu Gang Zhang Yan Ye Hong Gao Daiquan Zhang Yunzhou Chen Weibi department of neurocritical care unit Xuanwu Hospital Capital Medical University Beijing 100053 China

Background The brain death confirmation tests occupy a different position in each country＇s diagnostic criteria （or guideline）; the choices of tests are also *** brain death criteria include clinical judgment and confirmation *** study aimed to confirm the preferred confirmatory test and complementary confirmatory *** We did a clinical brain death determination on deep coma patients,and then divided them into brain death group and non-brain death *** to the Chinese standards for determining brain death,both the groups accepted confirmatory tests including electroencephalograph （EEG）,somatosensory evoked potentials （SEP）,and transcranial Doppler （TCD）.The sensitivity,specificity,false positive rate,and false negative rate were calculated to evaluate the accuracy of the confirmatory *** Among the 131 cases of patients,103 patients met the clinical criteria of brain *** arrest provocation test was performed on 44 cases and 32 cases （73％） successfully completed and confirmed that they have no spontaneous *** the three confirmation tests,EEG had the highest completion rate （98％） and good sensitivity （83％） and specificity （97％）; TCD had followed completion rate （54％） and not good sensitivity （73％） and specificity （75％）; SEP had the lowest completion rate （49％）,good sensitivity （100％）,and not good specificity （78％）.After the combination of SEP or TCD with EEG,the specificity can increase to 100％.Conclusions The completion rate of respiratory arrest provocation test remains a problem in the clinical diagnosis of brain *** the test cannot be completed,whether to increase a confirmatory test is *** had an ideal sensitivity,and the specificity will reach 100％ after combining with TCD or *** a confirmed test was uncertain,we suggest increasing another confirmatory test.

关键词： brain death clinical diagnosis confirmatory tests electroencephalograph somatosensory evoked potentials transcranial Doppler

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Evaluation of neuro-intensive care unit performance in China： predicting outcomes of Simplified Acute Physiology Score II or Glasgow Coma Scale

引用

Chinese Medical Journal 2013年第6期126卷 1132-1137页

作者： ZHAO Xiao-xia SU Ying-ying WANG Miao ZHANG Yan YE Hong FENG Huan-huan ZHANG Yun-zhou GAO Dai-quan CHEN Wei-bi department of neurocritical care unit Xuanwu Hospital Capital Medical University Beijing 100053 China

Background Severity scoring systems are useful tools for measuring the severity of the disease and its outcome. This pilot study was to verify and compare the prognostic performance of the Simplified Acute Physiology Score II （SAPS II） and Glasgow Coma Scale （GCS） in neuro-intensive care unit （N-ICU） patients. Methods A total of 1684 patients consecutively admitted to the N-ICU at Xuanwu Hospital between January 1, 2005 and December 31, 2011 were enrolled in this study. The data-base included admission data, at 24-, 48-, and 72-hour SAPS II and GCS. Repeated measure data analysis of variance, Logistic regression analysis, the Hosmer-Lemeshow goodness-of-fit statistic, and the area under the receiver operating characteristic were used to evaluate the performance. Results There was a significant difference between the SAPS II or GCS score at four time points （F=16.110, P=0.000 or F=8.108, P=0.000）. The SAPS II scores or GCS score at four time points interacted with the outcomes with significant difference （F=116.771, P=0.000 or F=65.316, P=0.000）. Calibration of the SAPS II or GCS score at each time point on all patients was good. The percentage of a risk estimate prediction corresponding to observed mortality was also good. The 72-hour score have the greatest consistency. Discriminations of the SAPS II or GCS score at each time were all satisfactory. The 72-hour score had the greatest discriminative power. The cut-off value was 33 （sensitivity of 85.2% and specificity of 74.3%） and 6 （sensitivity of 70.6% and specificity of 65.0%）. The SAPS II at each time point on all patients showed better calibration, consistency and discrimination than GCS. The binary Logistic regression analysis identified physiological variables, GCS, age, and disease category as significant independent risk factors of death. After the two variables including underlying disease and type of admission were excluded, we built the simplified SAPS II model. A correlation was suggested between the si

关键词： Simplified Acute Physiology Score II Glasgow Coma Scale neuro-intensive care unit repeated measure data analysis calibration discriminations

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Early Hypothermia for Refractory Status Epilepticus

引用

Chinese Medical Journal 2015年第12期128卷 1679-1682页

作者： Guo-Ping Ren Ying-Ying Su Fei Tian Yun-Zhou Zhang Dai-Quan Gao Gang Liu Wei-Bi Chen department of neurocritical care unit Xuanwu Hospital Capital Medical University Beijing 100053 China

INTRODUCTION Currently, the recommended therapy to control refractory status epilepticus （RSE） is intravenous （IV） anesthetics, such as midazolam, propofol, barbiturates, and so on. However, 15%-26% of RSE cases s... 详细信息

关键词： Anesthetic Effect Hypothermia Prognosis Refractory Status Epilepticus

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Phenotypic ASCOD characterisations of ischaemic stroke in the young at an urban tertiary care centre

引用

Stroke & Vascular Neurology 2018年第4期3卷 209-214页

作者： Angela Liu Mohsen Pirastehfar Daohai Yu Guillermo Linares department of Neurology Washington University in St LouisSaint LouisMissouriUSA department of Vascular Neurology UC San DiegoLa JollaCaliforniaUSA department of Clinical Sciences Lewis Katz School of Medicine at Temple UniversityPhiladelphiaPennsylvaniaUSA department of Stroke and neurocritical care University of Vermont College of MedicineBurlingtonVermontUSA

Background and purpose Stroke in young individuals is a serious public health *** study aimed to characterise the various phenotypes of ischaemic stroke in a young urban population(≤50 years old)using the ASCOD classification system,which assigns a score to five stroke categories:atherosclerosis,small vessel disease(SVD),cardioembolism,other and *** each category,a numerical score represents the degree of causality attributed to the *** This retrospective study cohort was composed of patients from an urban tertiary care academic *** were selected by searching Get With the Guidelines database for adults≤50 years old with ischaemic *** study sample included 175 ischaemic strokes in 157 patients,with 16 subjects *** retrospective chart review,each stroke was scored according to the ASCOD classification *** logistic regression analyses were performed to explore each ASCOD category’s association with causal risk *** Of possible causal mechanisms,defined as receiving a grade 1 or 2,a cardiovascular aetiology was most prevalent(25.7%),followed by SVD(22.3%),and closely by atherosclerosis(21.1%).Of general phenotypes,defined as receiving a grade 1 or 2 or 3,atherosclerosis was the most prevalent(51.4%),followed by SVD(47.4%),cardioembolism(42.3%)and other(35.4%).31.6%of all strokes were of unclear *** between 45 and 50 years old were more likely to develop a cardioembolic or SVD stroke when compared with subjects<45 years *** This study took a novel approach to ASCOD phenotyping,allowing several observations:(1)In patients with advanced atherosclerosis receiving the score A1,the vast majority had systemic atherosclerosis in multiple vascular territories;(2)the cardiac score C2(6),defined as a radiographic pattern highly suggestive of a central embolic source,may overestimate the prevalence of true cardiac disease;(3)incidental laboratory findings may detec

关键词： ASCO character category

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Brain-targeting,acid-responsive antioxidant nanoparticles for stroke treatment and drug delivery

引用

Bioactive Materials 2022年第10期7卷 57-65页

作者： Shenqi Zhang Bin Peng Zeming Chen Jiang Yu Gang Deng Youmei Bao Chao Ma Fengyi Du Wendy C.Sheu W.Taylor Kimberly J.Marc Simard Daniel Coman Qianxue Chen Fahmeed Hyder Jiangbing Zhou Kevin N.Sheth department of Neurosurgery USA department of Biomedical Engineering USA department of Radiology and Biomedical Imaging USA department of Neurology Yale UniversityNew HavenCT06510USA department of Neurosurgery Renmin Hospital of Wuhan UniversityWuhanHubei430060China department of Neurology Division of Neurocritical CareMassachusetts General HospitalBostonMAUSA department of Neurosurgery University of Maryland School of MedicineBaltimoreMD21201USA

Stroke is the leading cause of death and ***,there is no effective pharmacological treatment for this disease,which can be partially attributed to the inability to efficiently deliver therapeutics to the *** we report the development of natural compound-derived nanoparticles(NPs),which function both as a potent therapeutic agent for stroke treatment and as an efficient carrier for drug delivery to the ischemic ***,we screened a collection of natural nanomaterials and identified betulinic acid(BA)as one of the most potent antioxidants for stroke ***,we engineered BA NPs for preferential drug release in acidic ischemic tissue through chemically converting BA to betulinic amine(BAM)and for targeted drug delivery through surface conjugation of AMD3100,a CXCR4 *** resulting AMD3100-conjugated BAM NPs,or A-BAM NPs,were then assessed as a therapeutic agent for stroke treatment and as a carrier for delivery of NA1,a neuroprotective *** show that intravenous administration of A-BAM NPs effectively improved recovery from stroke and its efficacy was further enhanced when NA1 was *** to their multifunctionality and significant efficacy,we anticipate that A-BAM NPs have the potential to be translated both as a therapeutic agent and as a drug carrier to improve the treatment of stroke.

关键词： Drug delivery Acid-triggered release Antioxidant nanoparticles NA1 Ischemic stroke

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

The Roles and Mechanisms of TRAT1 in the Progression of Non-Small Cell Lung Cancer

引用

Current Medical Science 2022年第6期42卷 1186-1200页

作者： Qiang GUO Si-hua WANG Yan-mei JI Song TONG Dan LI Xiang-chao DING Chuang-yan WU department of Thoracic Surgery Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China department of neurocritical care Medicine Taihe HospitalHubei University of MedicineShiyan442000China department of Oncology Huanggang Central Hospital Affiliated to Yangtze UniversityHuanggang438000China department of Thoracic Surgery Renmin Hospital of Wuhan UniversityWuhan430060China

Objective T cell receptor-associated transmembrane adaptor 1(TRAT1)is one of the hub genes regulating T cell receptors(TCRs).Herein,the roles of TRAT1 in the prognosis and immune microenvironment of non-small cell lung cancer(NSCLC)were *** The expression and prognosis values of TRAT1 in NSCLC,and the relationship between TRAT1 expression levels and cancer immune cell infiltration was identified via the TIMER,UALCAN,TISIDB,and other *** mechanism of TRAT1 in NSCLC was analyzed using gene set enrichment analysis(GSEA).Results The expression level of TRAT1 was decreased in NSCLC *** TRAT1 expression was associated with shorter overall survival of patients with NSCLC and was related to gender,smoking,and tumor ***1 was involved in regulating immune response,TCR signaling pathway,PI3K/AKT,and other ***1 expression levels were positively correlated with immune cell infiltration in *** Down-regulation of TRAT1 expression was associated with an unfavorable prognosis and immune infiltration of NSCLC.

关键词： T cell receptor-associated transmembrane adaptor 1 non-small cell lung cancer immune infiltration prognosis T cell receptors

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Signal Alteration of Substantia Nigra on 3.0T Susceptibility-weighted Imaging in Parkinson's Disease and Vascular Parkinsonism

引用

Current Medical Science 2019年第5期39卷 831-835页

作者： Xue-jun ZHAO Xi-yuan NIU He-yang YOU Min ZHOU Xue-bing JI Ying LIU Lei WU Xiao-ling DING neurocritical care unit The First Affiliated Hospital of USTCDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefei 230001China department of Neurology The First Affiliated Hospital of USTCDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefei 230001China department of Radiology The First Affiliated Hospital of USTCDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefei 230001China

Recent researches have found that 7 Tesla SWI can detect the alteration of substantia nigra hyperintensity in Parkinson's disease(PD),multiple system atrophy(MSA),and progressive supranuclear palsy(PSP).The aim of this study was to investigate whether 3 Tesla SWI(3T SWI)can visualize anatomical alterations occurring in a hyperintense structure of the substantia nigra in PD and vascular parkinsonism(VP),and whether the evaluation of abnormal signal can be used as a factor in the differential diagnosis of PD and *** 3 Tesla MRI,we evaluated 38 healthy subjects,33 patients with PD and 34 patients with *** blinded readers independently assessed the *** found that the dorsolateral nigral hyperintensity was absent in 31 of 33 patients with PD and 15 of 34 patients with *** dorsolateral nigral hyperintensity was present in 19 of 34 patients with VP and 35 of 38 healthy *** comparisons of absence of dorsolateral nigral hyperintensity revealed significant differences between the patients with PD and those with VP(P<0.001).The sensitivity of SWI for PD was 93.9%and the specificity was 92.1%.Visual assessment of dorsolateral nigral hyperintensity on high-field SWI scans may serve as a new simple diagnostic imaging marker for *** our study results indicate that 3T SWI can be used as a tool to identify PD and VP.

关键词： magnetic resonance imaging susceptibility-weighted imaging Parkinson's disease vascular parkinsonism substantia nigra

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

A Lazarus effect： A case report of Bupropion overdose mimicking brain death

引用

World Journal of Emergency Medicine 2018年第1期9卷 67-69页

作者： Douglas Stranges Alan Lucerna James Espinosa Neveen Malik Marc Mongeau Kelly Schiers Syed Omar Shah Joan Wiley Philip Willsie department of Emergency Medicine Department of Internal Medicine Rowan University SOM Kennedy University Hospital Washington Twp N J USA department of Emergency Medicine Rowan University SOM Kennedy University Hospital Stratford NJ USA department of Pulmonaryy/Critical care/Sleep Medicine Kennedy Health Alliance Kennedy University Hospital Washington Twp N J USA department of Pulmonary and Critical care Medicine Rowan University SOM Kennedy University Hospital Washington Twp N J USA department of neurocritical care Thomas Jefferson University Hospital Philadelphia PA USA

Dear editor, We report a case of a 47-year-old female who presented with a toxic bupropion ingestion leading to cardiac arrest. She initially exhibited a loss of brainstem reflexes in conjunction with burst-suppression pattern on EEG. Burst suppression is an EEG waveform pattern of alternating isoelectric suppressions and high voltage bursts, Our patient ultimately made a full neurologic recovery a few days later. While there are two other cases in the literature of bupropion overdose resulting in EEG burst-suppression and loss of brainstem reflexes, we believe this is the only reported adult case complicated by cardiac arrest.

关键词： A Lazarus effect A case report of Bupropion overdose mimicking brain death

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Cerebral small vessel disease modifies outcomes after minimally invasive surgery for intracerebral haemorrhage

引用

Stroke & Vascular Neurology 2024年第4期9卷 446-456,I0147页

作者： Yunke Li Sung-Min Cho Radhika Avadhani Hassan Ali Yi Hao Santosh B Murthy Joshua N Goldstein Fan Xia Xin Hu Natalie L Ullman Issam Awad Daniel Hanley Wendy C Ziai The George Institute for Global Health BeijingChina department of Neurology Division of Neurocritical CareJohns Hopkins Medical InstitutionsBaltimoreMarylandUSA department of Neurology Division of Brain Injury OutcomesJohns Hopkins Medical Institutions CampusBaltimoreMarylandUSA department of Neurology Weill Cornell Medical CollegeNew YorkNew YorkUSA department of Emergency Medicine Massachusetts General HospitalBostonMassachusettsUSA department of Neurosurgery West China Hospital of MedicineChengduSichuanChina department of Neurosurgery University of Chicago Pritzker School of MedicineChicagoIllinoisUSA

Background Minimally invasive surgery(MIS)for spontaneous supratentorial intracerebral haemorrhage(ICH)is controversial but may be beneficial if end-of-treatment(EOT)haematoma volume is reduced to≤15 *** explored whether MRI findings of cerebral small vessel disease(CSVD)modify the effect of MIS on long-term *** Prespecified blinded subgroup analysis of 288 subjects with qualified imaging sequences from the phase 3 Minimally Invasive Surgery Plus Alteplase for Intracerebral Haemorrhage Evacuation(MISTIE)*** tested for heterogeneity in the effects of MIS and MIS+EOT volume≤15 mL on the trial’s primary outcome of good versus poor function at 1 year by the presence of single CSVD features and CSVD scores using multivariable *** Of 499 patients enrolled in MISTIE III,288 patients had MRI,149(51.7%)randomised to MIS and 139(48.3%)to standard medical care(SMC).Median(IQR)ICH volume was 42(30–53)*** the full MRI cohort,there was no statistically significant heterogeneity in the effects of MIS versus SMC on 1-year outcomes by any specific CSVD feature or by CSVD scores(all P_(interaction)>0.05).In 94 MIS patients with EOT ICH volume≤15 mL,significant reduction in odds of poor outcome was found with cerebral amyloid angiopathy score<2(OR,0.14(0.05–0.42);P_(interaction)=0.006),absence of lacunes(OR,0.37(0.18–0.80);P_(interaction)=0.02)and absence of severe white matter hyperintensities(WMHs)(OR,0.22(0.08–0.58);P_(interaction)=0.03).Conclusions Following successful haematoma reduction by MIS,we found significantly lower odds of poor functional outcome with lower total burden of CSVD in addition to absence of lacunes and severe *** features may have utility for prognostication and patient selection in clinical trials of MIS.

关键词： Surgery surgery absence

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：