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  • Ovid Technologies (Wolters Kluwer Health)  (10)
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  • Ovid Technologies (Wolters Kluwer Health)  (10)
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  • 1
    Online Resource
    Online Resource
    Endovascular Treatment Versus Best Medical Management in Acute Basilar Artery Occlusion Strokes: Results From the ATTENTION Multicenter Registry
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Circulation Vol. 146, No. 1 ( 2022-07-05), p. 6-17
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 146, No. 1 ( 2022-07-05), p. 6-17
    Abstract: The authors compare the effectiveness and safety of endovascular treatment (EVT) versus best medical management (BMM) in strokes attributable to acute basilar artery occlusion (BAO). Methods: The present analysis was based on the ongoing, prospective, multicenter ATTENTION (Endovascular Treatment for Acute Basilar Artery Occlusion) trial registry in China. Our analytic sample comprised 2134 patients recruited at 48 sites between 2017 and 2021 and included 462 patients who received BMM and 1672 patients who received EVT. We performed an inversed probability of treatment weighting analysis. Qualifying patients had to present within 24 hours of estimated BAO. The primary clinical outcome was favorable functional outcome (modified Rankin Scale score, 0–3) at 90 days. We also performed a sensitivity analysis with the propensity score matching–based and the instrumental variable–based analysis. Results: In our primary analysis using the inversed probability of treatment weighting–based analysis, there was a significantly higher rate of favorable outcome at 90 days among EVT patients compared with BMM-treated patients (adjusted relative risk, 1.42 [95% CI, 1.19–1.65]; absolute risk difference, 11.8% [95% CI, 6.9–16.7] ). The mortality was significantly lower (adjusted relative risk, 0.78 [95% CI, 0.69–0.88]; absolute risk difference, −10.3% [95% CI, −15.8 to −4.9] ) in patients undergoing EVT. Results were generally consistent across the secondary end points. Similar associations were seen in the propensity score matching–based and instrumental variable–based analysis. Conclusions: In this real-world study, EVT was associated with significantly better functional outcomes and survival at 90 days. Well-designed randomized studies comparing EVT with BMM in the acute BAO are needed. Registration: URL: www.chictr.org.cn ; Unique identifier: ChiCTR2000041117.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/CIRCULATIONAHA.121.058544
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 1466401-X
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  • 2
    Online Resource
    Online Resource
    The real world and thinking of thyroid cancer in China
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  International Journal of Surgery Oncology Vol. 4, No. 7 ( 2019-12-6), p. e81-e81
    Details
    In: International Journal of Surgery Oncology, Ovid Technologies (Wolters Kluwer Health), Vol. 4, No. 7 ( 2019-12-6), p. e81-e81
    Abstract: The incidence of thyroid cancer has increased year by year, which has a major impact on the physical and mental health of patients. At the same time, it has a heavy psychological and economic burden on society and individuals. Based on the actual data of the thyroid cancer in Liaocheng People’ Hospital in 2017, combine with the national and regional characteristics of China, this paper analyzes and discusses the controversy of initial thyroid operation modus. Materials and methods: The clinical and pathologic data of 552 patients of thyroid cancer were collected from the department of thyroid surgery, who were initially discovered and treated surgically. 40 patients underwent endoscopic surgery, the range of resection was lobectomy+central lymph node dissection of the affected lobe. There were 512 cases underwent open operation with total thyroidectomy+central lymph node dissection, 239 of which were treated with neck lateral lymph node dissection at the same time. Results: The overall metastasis rate of all patients was 59.42%. Even the lymph node metastasis of papillary thyroid microcarcinoma was as high as 46.92%. When the mass rose above 2 cm, the proportion of metastasis increased to 77.53%. When the tumor was complicated with bilateral and multiple high risk factor etc the proportion of metastasis were 63.54% and 71.19%, respectively. Meanwhile, the incidence of contralateral accidental malignancy was 7.25% after postoperative paraffin pathology. Conclusion: The malignant degree of thyroid cancer depends on the evolution of the tumor genome and there is a high rate of neck lymph node metastasis, especially when associated with high risk factors. It is recommended that at least total thyroidectomy+central lymph node dissection should be performed in initial treatment in China to avoid the risk of secondary operation and the burden of body and mind.
    Type of Medium: Online Resource
    ISSN: 2471-3864
    URL: Article
    DOI: 10.1097/IJ9.0000000000000081
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2898335-X
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  • 3
    Online Resource
    Online Resource
    N-terminal probrain natriuretic peptide levels as a predictor of functional outcomes in patients with ischemic stroke
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  NeuroReport Vol. 25, No. 13 ( 2014-09-10), p. 985-990
    Details
    In: NeuroReport, Ovid Technologies (Wolters Kluwer Health), Vol. 25, No. 13 ( 2014-09-10), p. 985-990
    Type of Medium: Online Resource
    ISSN: 0959-4965
    URL: Article
    DOI: 10.1097/WNR.0000000000000195
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 2031485-1
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  • 4
    Online Resource
    Online Resource
    Prognostic factors for acute vertebrobasilar artery occlusion-reperfusion: a multicenter retrospective cohort study
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  International Journal of Surgery Vol. 109, No. 8 ( 2023-05-18), p. 2303-2311
    Details
    In: International Journal of Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 109, No. 8 ( 2023-05-18), p. 2303-2311
    Abstract: This study aimed to analyze the long-term prognostic factors in acute vertebrobasilar artery occlusion (VBAO) patients treated with endovascular treatment (EVT). Methods: This study was performed using the acute posterior circulation ischemic stroke registry database from 21 stroke centers in 18 cities in China and retrospectively included consecutive patients aged 18 years or older with an acute, symptomatic, radiologically confirmed VBAO who were treated with EVT between December 2015 and December 2018. Favorable clinical outcomes were evaluated by machine-learning methods. A clinical signature was constructed in the training cohort using the least absolute shrinkage and selection operator regression and was validated in the validation cohort. Results: From 28 potential factors, 7 variables were independent prognostic factors and were included in the model: Modified Thrombolysis in Cerebral Infarction (M) [odds ratio (OR): 2.900; 95% confidence interval [CI]: 1.566–5.370] , age (A) (OR, 0.977; 95% CI: 0.961–0.993), National Institutes of Health Stroke Scale (N) (13–27 vs. ≤12: OR, 0.491; 95% CI: 0.275–0.876; ≥28 vs. ≤12: OR, 0.148; 95% CI: 0.076–0.289), atrial fibrillation (A) (OR, 2.383; 95% CI: 1.444–3.933), Glasgow Coma Scale (G) (OR, 2.339; 95% CI: 1.383–3.957), endovascular stent-retriever thrombectomy (E) (stent-retriever vs. aspiration: OR, 0.375; 95% CI: 0.156–0.902), and estimated time of onset of the occlusion to groin puncture (Time) (OR, 0.950; 95% CI: 0.909–0.993) (abbreviated as MANAGE Time). In the internal validation set, this model was well calibrated with good discrimination [C-index (95% CI)=0.790 (0.755–0.826)]. A calculator based on the model can be found online (http://ody-wong.shinyapps.io/1yearFCO/). Conclusion: Our results indicate that optimizing for EVT, along with specific risk stratification, may improve long-term prognosis. However, a larger prospective study is needed to confirm the findings.
    Type of Medium: Online Resource
    ISSN: 1743-9159
    URL: Article
    DOI: 10.1097/JS9.0000000000000476
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2201966-2
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  • 5
    Online Resource
    Online Resource
    Bone defect reconstruction with autologous bone inactivated with liquid nitrogen after resection of primary limb malignant tumors : An observational study
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Medicine Vol. 99, No. 24 ( 2020-06-12), p. e20442-
    Details
    In: Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 99, No. 24 ( 2020-06-12), p. e20442-
    Abstract: Surgical treatment of malignant bone tumors comprises tumor resection and reconstruction. The most commonly used reconstruction method is prosthesis replacement, which achieves good early function, but has a high long-term incidence of complications. Another reconstruction option is autologous bone replantation, which has the advantages of anatomical matching and no need for large bone bank support. Few studies have evaluated reconstruction with liquid nitrogen-inactivated autogenous bone. The present study aimed to evaluate the oncological results, bone healing results, complications, and indications of reconstruction with liquid nitrogen-inactivated autogenous bone grafts. The study population comprised 21 consecutive patients. The tumor site was the tibia in 9 cases, femur in 8, and humerus in 4. There were 37 osteotomy ends in total. After freezing and rewarming, the medullary cavity of the autogenous bone was filled with antibiotic bone cement. Seventeen patients received bilateral plate fixation, 2 received intramedullary nail and distal plate fixation, and 2 received single plate fixation. The average follow-up was 31 ± 6 months. Eighteen patients survived without tumors, and the 3-year survival rate was 80.4%. All cases had adequate surgical margins, but recurrence developed in 1 patient. Metastasis occurred in 3 patients, who all died of metastasis. Intraoperative inactivated bone fracture occurred in 1 patient, and screw breakage was found in 1 patient. Nonunion occurred at 1 humeral diaphysis osteotomy site, and 1 patient was lost to follow-up; the average healing time of the other 35 ends was 13 ± 6 months, and the bone healing rate was 97.2%. The average bone healing times in the metaphysis and diaphysis were 9 ± 3 months and 15 ± 6 months ( P  = .003). The average bone healing times in the upper and lower limbs were 16.6 ± 7.4 months and 12.3 ± 5.8 months ( P  = .020). The average Muscle and Skeletal Tumor Society score was 28 ± 3 (21–30) in the 18 survivors. Liquid nitrogen-inactivated autologous bone replantation for primary malignant limb tumor was safe and effective, as shown by the relatively low complication rate, high bone healing rate, and satisfactory postoperative function. This is a reliable biological reconstruction method for malignant bone tumors with specific site and bone destruction characteristics.
    Type of Medium: Online Resource
    ISSN: 0025-7974 , 1536-5964
    URL: Article
    DOI: 10.1097/MD.0000000000020442
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 2049818-4
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  • 6
    Online Resource
    Online Resource
    A nonrandomized controlled study of sacral giant cell tumors with preoperative treatment of denosumab
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Medicine Vol. 97, No. 46 ( 2018-11), p. e13139-
    Details
    In: Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 97, No. 46 ( 2018-11), p. e13139-
    Abstract: The aim of this nonrandomized controlled study (level 3)was to evaluate whether preoperative denosumab treatment can reduce intraoperative blood loss, facilitate surgical treatment, and improve local control of sacral giant-cell tumor (GCT). Surgical treatment of sacral GCT is very difficult due to extensive bone destruction and complex anatomical structures. The huge intraoperative blood loss may interrupt surgical management and judgment of tumor range. Denosumab can inhibit the differentiation of osteoclast-like giant cells and bone destruction by blocking RANKL-RANK pathway. Study group (preoperative denosumab treatment) and control group (no denosumab treatment) were matched for age, gender, tumor site, staging, and tumor size. In study group, enhanced computed tomography (CT) was performed before and after denosumab treatment. The comparison parameters between 2 groups: CT enhancement rate, intraoperative blood loss, and oncologic outcome. The mean preoperative time of denosumab treatment was 5.2 months in study group. The mean CT enhancement rate of study group was 2.60 before treatment and 1.37 after treatment ( P  = .012). The posttreatment CT enhancement rate of study group was significantly lower than that of control group ( P  = .007). The mean intraoperative bleeding of study group and control group was 2166.7 and 5240 mL, respectively ( P  = .040). The mean operative time of study group and control group was 268.3 and 268.5 minutes, respectively ( P  = .997). The recurrence rate of study group (66.7%) was significantly higher than that of control group (0%) ( P  = .046). Preoperative denosumab treatment has the tendency to reduce blood supply and intraoperative bleeding of sacral GCT. But the sclerosis and bony separation can increase the difficulty of tumor curettage and lead to high recurrence rate after denosumab treatment. It is necessary to study the best surgical opportunity after denosumab treatment and precise method to judge tumor range.
    Type of Medium: Online Resource
    ISSN: 0025-7974 , 1536-5964
    URL: Article
    DOI: 10.1097/MD.0000000000013139
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 2049818-4
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  • 7
    Online Resource
    Online Resource
    Long-lasting repetitive transcranial magnetic stimulation modulates electroencephalography oscillation in patients with disorders of consciousness
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  NeuroReport Vol. 28, No. 15 ( 2017-10-18), p. 1022-1029
    Details
    In: NeuroReport, Ovid Technologies (Wolters Kluwer Health), Vol. 28, No. 15 ( 2017-10-18), p. 1022-1029
    Type of Medium: Online Resource
    ISSN: 0959-4965
    URL: Article
    DOI: 10.1097/WNR.0000000000000886
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 2031485-1
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  • 8
    Online Resource
    Online Resource
    Abstract WP133: A Novel Collateral Metric of MCA Hemodynamics in SAMMPRIS
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Stroke Vol. 48, No. suppl_1 ( 2017-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 48, No. suppl_1 ( 2017-02)
    Abstract: Background: Collateral status has been shown to be a potent determinant of long-term clinical outcomes in subjects with intracranial atherosclerosis, yet the grading of collaterals can be challenging. We developed a simple collateral metric of spatial and temporal hemodynamic changes at the anterior borderzone in MCA stenoses. Methods: Conventional angiography acquired at baseline in SAMMPRIS was analyzed in the subset of MCA stenoses. Two readers independently measured the anterior watershed angle (AWSA) or borderzone shift on AP views. The angle and the relative timing of arterial flow of the MCA and ACA were compared with the previously recorded collateral composite of TICI antegrade flow combined with compensatory ASITN grade. Results: 176/195 (90%) subjects with MCA stenoses in SAMMPRIS had baseline angiography with AP projections adequate for both the spatial and temporal characterization of the anterior borderzone, with previously defined collateral status in 165/195 (85%). AWSA ranged from 16-65° (mean RR°, SD TT). Arterial opacification at this borderzone revealed synchronous ACA and MCA filling in 116 or 59% of cases, delayed ACA collaterals in 54/176 (31%) and early collaterals in 6/176 (3%). Inter-rater reliability was excellent (IRR=0.87). AWSA 〉 30° was associated with impaired MCA TICI flow, yet the relative arrival of arterial collaterals varies extensively. AWSA was closely related (r=-.72, p 〈 0.001) to the previously established TICI score of antegrade flow reduction in the MCA. The combined spatial and temporal data of AWSA and associated arterial filling exhibited strong association (AUC of 96% for nonlinear regression) with SAMMPRIS collateral status (impaired, normal, robust collaterals). Conclusions: A novel metric incorporating both the degree of borderzone shift and arterial collateral filling may be easily and reliably quantified to determine collateral status, a strong predictor of outcome in intracranial atherosclerosis. Validation of this simple marker and correlation with noninvasive imaging features are proceeding.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.48.suppl_1.wp133
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 1467823-8
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  • 9
    Online Resource
    Online Resource
    Abstract TP113: Intracranial Atherosclerotic Stenosis Prevalence in a North American Stroke Population
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Stroke Vol. 48, No. suppl_1 ( 2017-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 48, No. suppl_1 ( 2017-02)
    Abstract: Background and Purpose: Intracranial atherosclerotic stenosis (ICAS) is a common cause of stroke especially in Asia, but little is known about its prevalence in ischemic stroke patients in North America. We studied the prevalence of ICAS in a single comprehensive stroke center leveraging the routine acquisition of MRI and MR angiography (MRA). Methods: We retrospectively reviewed patients with ischemic stroke and transient ischemic attack who were admitted within seven days of onset from Jan 2014 to July 2016. Patients we excluded: 1) Age 〈 18 years; 2) without intracranial angiography; 3) overt cardiogenic occlusion or risk factors. Data were retrieved including demographics, vascular risk factors, brain imaging including MRA, CTA, and /or DSA, and prior medical prevention of stroke. ICAS was defined as the proximal atherosclerotic stenosis or occlusion ≥50% in diameter. We estimated the prevalence of ICAS at this single stroke center. Results: 685 included patients were aged 20 to 101 years, 384(56.1%) were men, 520 (75.9%) were white, and 74(10.8%) were black. ICAS was prevalent in 41.6% of all included patients. Univariate analysis indicated that the prevalence of ICAS was significantly increased along with age, it was 39.3% for 41-60 years, and 43.8% for 61-80 years (P=0.034). But no significant difference was found between different races, it was 40.8% in Whites, and 40.5% in Blacks, and other races were 47.3%. Patients with ICAS had more severe stroke (NIHSS 〉 3 vs NIHSS≤3: OR 2.729; 95%CI: 1.748-4.260; P 〈 0.001). Higher levels of high-density lipoprotein cholesterol were associated with decreased odds of ICAS (OR 0.981; 95% CI: 0.968-0.995; P 〈 0.006). Our data did not show hypertension, dyslipidemia and body mass index and smoking were associated with ICAS. Conclusions: The prevalence of ICAS in North America may be much higher than previous estimates. The impact of this common cause of recurrent stroke warrants further study, even in populations were cardiogenic embolic risk is common.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.48.suppl_1.tp113
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 1467823-8
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  • 10
    Online Resource
    Online Resource
    The clinical outcome of recurrent sacral chordoma with further surgical treatment
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Medicine Vol. 97, No. 52 ( 2018-12), p. e13730-
    Details
    In: Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 97, No. 52 ( 2018-12), p. e13730-
    Abstract: Case series. To analyze the clinical results and related factors of further surgical treatment for recurrent sacral chordomas. Chordomas are rare primary malignant tumors with a high recurrence rate. The treatment of recurrent tumors is difficult and controversial. Contamination by previous operations and disturbed local anatomical structures may increase the risk of reoperation. Most previous studies have focused on the primary tumor; there are very few reports on the clinical diagnosis, treatment, and prognosis of recurrent sacral chordomas. Thirty-four patients with recurrent sacral chordomas from 1979 to 2014 were included in this study. The patients comprised 25 men and 9 women with an average age of 50.7 (24–75) years. The average time until recurrence was 19.4 (4–51) months postoperatively, and 85.3% of the recurrent tumors were located in bone. The patients had an average of 1.2 (1–3) recurrences before further operations were performed in our hospital. The mean maximum tumor diameter was 8.1 (4.6–12.0) cm. Thirty-one patients underwent further tumor resection in our hospital. The postoperative recurrence, metastasis, and survival results were followed and analyzed. The mean follow-up after surgical treatment of recurrence was 49.6 (12–144) months. Nine patients (37.5%) developed recurrence again after an average of 26.7 months. The 3-year and 5-year recurrence-free survival rate was 69.4% and 63.1%, respectively. Multivariate analysis showed that the tumor level within the sacrum ( P  = .001) and the surgical margin ( P  = .001) were significant recurrence-related factors. Four patients (16.7%) developed lung metastasis. Eighteen patients were alive at last follow-up. The 5-year and 10-year survival rate after surgical treatment of recurrence was 67.3% and 53.9%, respectively. Most recurrent tumors are located in bone, and a safe osteotomy margin is important. The surgical margin is the only controllable factor of further tumor recurrence. Some patients with recurrence achieve long survival and obtain a clinical benefit from repeated operations if complete resection is achieved.
    Type of Medium: Online Resource
    ISSN: 0025-7974 , 1536-5964
    URL: Article
    DOI: 10.1097/MD.0000000000013730
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 2049818-4
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