Publications by authors named "Haijing Sui"

9 Publications

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Clinical significance of evaluation of collateral circulation in short-term prognosis of wake-up stroke patients.

Adv Clin Exp Med 2021 Feb;30(2):183-188

Department of Neurology, Pudong New Area People's Hospital, Shanghai, China.

Background: In recent years, the clinical significance of collateral circulation in vascular embolism has been gradually found.

Objectives: To investigate the relationship between collateral circulation and short-term prognosis of wake-up stroke patients.

Material And Methods: The present observational study enrolled 269 cases of wake-up ischemic stroke patients. All patients presented with mismatched low perfusion volume/main infraction volume and received thrombolytic therapy after admission. The hemorrhagic transformation rate was recorded. The American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) grading was used for evaluation of collateral circulation. The stroke condition was determined using the National Institutes of Health Stroke Scale (NIHSS). The Barthel Index (BI) score was used for measurement of quality of life. The Modified Rankin Scale (mRS) was used for measurement of prognosis.

Results: The hypertension, diabetes and current smoker rates were significantly higher. The baseline NHISS scores and NIHSS scores after 24 h were remarkably lower. The NIHSS scores were markedly lower in ASITN/SIR grade 2-3 patients compared with ASITN/SIR grade 0-1 patients at 1 week, 2 weeks, 4 weeks, and 3 months after treatment. Patients with ASITN/SIR grade 2-3 had lower mRS score and higher BI scores. The ASITN/SIR grade was an independent risk factor for bad prognosis of wake-up ischemic stroke patients in 3 months.

Conclusions: Collateral circulation condition may be associated with short-term prognosis of wake-up stroke patients. Patients with worse collateral circulation may present higher risk for bad short-term prognosis.
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http://dx.doi.org/10.17219/acem/121927DOI Listing
February 2021

Clinical Characteristics and Eosinophils in Young SARS-CoV-2-Positive Chinese Travelers Returning to Shanghai.

Front Public Health 2020 10;8:368. Epub 2020 Jul 10.

Department of Image, Shanghai Pudong New Area People's Hospital Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai, China.

The COVID-19 outbreak, which was first reported in Wuhan, China, in December 2019, began to spread throughout the world, and now involves over 200 countries. A total of 37 overseas young and middle-aged people, who tested as SARS-CoV-2 positive upon their return to Shanghai, were enrolled for an analysis of their clinical symptoms, blood routine indexes, and lung CT images. The clinical symptoms were characterized by fever (51.4%), dry cough (13.5%), expectoration (27.0%), hypodynamia (21.6%), pharyngalia (10.8%), pharynoxerosis (8.1%), rhinobyon (13.5%), rhinorrhea (8.1%), muscular soreness (16.2%), and diarrhea (2.7%). In 16.2% of cases, no symptoms were reported. Fever was the most common symptom (51.40%). The pneumonic changes referred to the latticed ground glass imaging and similar white lung imaging accompanied by consolidated shadows. The rate of pneumonia was high (81.10%). We found that the exclusive percent of eosinophils was abnormally low. By analyzing the correlation of eosinophils, fever, and pneumonia, we found that the percentage of eosinophils was low in the COVID-19 patients afflicted with fever or pneumonia ( < 0.01). Additionally, pneumonia and fever were negatively correlated with the percentage of eosinophils and eosinophils/neutrophils ratio ( < 0.01, respectively), but not associated with pneumonia severity ( > 0.05). Fever was not correlated with pneumonia ( > 0.05). A low percentage of eosinophils may be considered as a biomarker of pneumonia of COVID-19, but not as a biomarker of pneumonia severity.
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http://dx.doi.org/10.3389/fpubh.2020.00368DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7365885PMC
July 2020

Ginsenoside Represses Symptomatic Intracerebral Hemorrhage after Recombinant Tissue Plasminogen Activator Therapy by Promoting Transforming Growth Factor-β1.

J Stroke Cerebrovasc Dis 2016 Mar 9;25(3):549-55. Epub 2015 Dec 9.

Department of Radiology, Pudong People's Hospital, Shanghai, China.

Background: Currently, the most effective treatment for brain ischemic stroke is recombinant tissue plasminogen activator (rt-PA); however, increased incidence of symptomatic intracerebral hemorrhage severely reduced its favorable treatment outcome.

Methods: We aimed to investigate the effect of ginsenoside (Gs) on symptomatic intracerebral hemorrhage after rt-PA treatment. Stroke patients were randomly divided into 2 treatment groups, one receiving rt-PA + placebo (Pc) and the other rt-PA + Gs. Twenty-four hours after the treatment, outcomes were assessed with transcranial Doppler (TCD) ultrasonography and National Institutes of Health Stroke Scale (NIHSS), and plasma levels of transforming growth factor-β1 (TGF-β1), matrix metalloproteinase (MMP)-2, and MMP-9 were also measured. After initial cotreatment, the patients were continuously administered with either Pc or Gs, and the treatment outcomes at 7 days were assessed with TCD, NIHSS, modified Rankin scale (MRS), and Glasgow outcome scale (GOS).

Results: Cotreatment of rt-PA with Gs significantly improved outcomes in patients compared to the Pc group, as indicated by improved TCD and NIHSS scores and reduced incidence of symptomatic intracerebral hemorrhage, which could be attributed to a Gs-induced increase in TGF-β1 and a decrease in both MMP-2 and MMP-9 serum levels. Seven days of Gs treatment also significantly improved outcomes in patients compared to the Pc group, assessed by TCD, NIHSS, MRS, and GOS.

Conclusion: Our study supports the clinical use of Gs as a potential supplement with rt-PA treatment, which reduces symptomatic intracerebral hemorrhage, therefore improving the treatment outcome of stroke patients.
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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2015.11.004DOI Listing
March 2016

Comparison of fast MRI-based individual thrombolysis therapy for patients with superacute infarction.

J Stroke Cerebrovasc Dis 2014 Apr 25;23(4):e263-9. Epub 2014 Jan 25.

Department of Neurology, Pudong People's Hospital, Shanghai, China.

Background: The aim of this study is to investigate the outcomes of magnetic resonance imaging (MRI)-based individual thrombolysis therapy using recombinant tissue plasminogen activator (rt-PA) in patients with superacute infarction, comparing the outcome in 1 group of patients treated within 4.5 hours compared with 4.5- to 12-hour window treatment group.

Methods: We studied 135 patients stratified to 2 different groups based on whether they presented with stroke symptoms within 4.5 hours (4.5-hour group, 72 patients) or between 4.5 and 12 hours (4.5- to 12-h group, 63 patients). All patients were treated with rt-PA after MRI confirmed superacute ischemic stroke (hyperintense in diffusion-weighted imaging but no hypointense change in T2-weighted image (T2WI) or fluid-attenuated inversion recovery). Clinical neurologic deficit was evaluated using the National Institutes of Health Stroke Scale on admission, at 24 hours, and 7 days later. A 90-day clinical outcome was assessed using the modified Rankin Scale (mRS).

Results: There was no significant difference in the clinical outcome between the patients treated with thrombolysis within the first 4.5 hours and those treated between 4.5 and 12 hours. The 2 groups both had recanalization, mRS, and favorable outcome at 90 days (P > .05).

Conclusions: Our study suggested that fast MR-based thrombolysis using rt-PA was safe and reliable in superacute infarction within 4.5 hours and 4.5-12 hours poststroke.
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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2013.11.014DOI Listing
April 2014

Effect and mechanism of propofol on myocardial ischemia reperfusion injury in type 2 diabetic rats.

Microvasc Res 2013 Nov 26;90:162-8. Epub 2013 Aug 26.

Department of Anesthesiology, Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China.

Background: Propofol has been reported to have an inhibitory effect on ischemia/reperfusion (I/R) injury in various experimental models by reducing oxidative stress, protecting mitochondrial function and suppressing apoptosis. The aim of this study was to investigate the effect and mechanism of propofol on myocardial I/R injury in type 2 diabetic rats.

Methods: A total of 24 streptozotocin (STZ)-induced diabetic rats were randomly divided into three equal groups as follows: the DI group with myocardial I/R, which was induced by occluding the left anterior descending coronary artery for 30min, followed by 2h of reperfusion; the DP group, which underwent I/R and propofol infusion at 6mg·kg(-1)·h(-1); and the DC group, which underwent sham operations without tightening of the coronary sutures. As a control, 24 healthy, age-matched, male Wistar rats were randomly divided into three equal groups: the CI, CP and CC groups. The injured cardiac tissues were removed for microscopic examination after reperfusion. The serum concentrations of nitric oxide (NO) and endothelin (ET-1); the expression of Bax, Bcl-2 and Caspase-3 within the cardiac structures; and the number of apoptotic myocardial cells were measured.

Results: Compared with the baseline levels before ischemia, the serum concentration of ET-1 after 2h of reperfusion was increased in the CI and DI groups, while the concentration of NO in these groups decreased after reperfusion. Compared with the I/R groups, propofol increased the content of NO and decreased the content of ET-1. Compared with the sham operation groups, I/R decreased the ratio of the anti-apoptotic protein Bcl-2 to the pro-apoptotic protein Bax, which resulted in an elevation of the index of apoptosis (AI). In contrast, compared with the I/R group, propofol increased the Bcl-2-to-Bax ratio and decreased the AI. I/R increased the expression of caspase-3 compared with the sham treatment groups, while treatment with propofol reduced caspase-3 expression relative to the I/R groups.

Conclusions: These data suggest that propofol can protect against myocardial ischemia-reperfusion injury in both normal and type 2 diabetic rats, possibly by attenuating endothelial cell injury and inhibiting the apoptosis of cardiomyocytes.
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http://dx.doi.org/10.1016/j.mvr.2013.08.002DOI Listing
November 2013

Clinical outcomes of fast MRI-based trombolysis in wake-up strokes compared to superacute ischemic strokes within 12 hours.

Neurol Res 2013 Jun 19;35(5):492-7. Epub 2013 Apr 19.

Department of Neurology, Pudong People's Hospital, Shanghai, China.

Background: It is unknown whether thrombolysis is beneficial in patients with Wake-Up Ischemic Strokes (WUIS). This study compares the clinical outcomes of MRI-based intravenous thrombolysis in patients with hyperacute ischemic stroke presenting within 12 hours of symptom onset against WUIS patients receiving the same therapy.

Methods: Patients presenting within 12 hours of acute stroke symptom onset and those with WUIS confirmed by CT, and without intracranial hemorrhage, were encouraged to perform an emergent brain MRI scan to confirm the diagnosis of hyperacute ischemic stroke [hyper-intense in diffusion-weighted imaging (DWI) and no hypo-intense change in T2-weighted imaging (T2WI) or FLAIR]. These patients then received intravenous thrombolytic therapy with tissue-type plasminogen activator (rt-PA). All patients were divided into either stroke presenting within 12 hours or WUIS. The clinical outcomes were assessed by the modified Rankin Scale (mRS) and the Barthal Index (BI) at baseline and at 90 days after the thrombolysis therapy.

Results: A total of 427 patients presenting with stroke like symptoms were given a MRI scan. Of these, 240 patients had confirmed diagnosis of hyperacute ischemic stroke (WUIS, n = 68, 68/116 = 58·62% versus within 12 hour, n = 172, 172/311 = 55·3%). Altogether, 186 patients (138 in within 12 hours group, and 48 in WUIS group) received intravenous thrombolytic therapy with rt-PA. No significant differences were found in clinical outcomes between the two groups at the baseline and at 90 days after the thrombolysis therapy. Also, no difference was found in the incidence rate of secondary hemorrhage (including both of asymptomatic and symptomatic) and mortality rate between the two groups.

Conclusion: Our study suggested that MRI-based intravenous thrombolysis is safe and effective in both of patients' hyperacute stroke within 12 hours of symptom onset and WUIS.
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http://dx.doi.org/10.1179/1743132813Y.0000000208DOI Listing
June 2013

Susceptibility-weighted imaging for cerebral microbleed detection in super-acute ischemic stroke patients treated with intravenous thrombolysis.

Neurol Res 2013 Jul 22;35(6):586-93. Epub 2013 Feb 22.

Department of Neurology, Pudong People's Hospital, Shanghai, China.

Objective: Fast magnetic resonance imaging (MRI) and susceptibility-weighted imaging (SWI) methods may provide more accurate detection of the highly variant time window for successful intravenous (IV) thrombolytic drug treatment (averaging 3 hours) for cerebral microbleeds (CMBs) in acute stroke patients.

Methods: This prospective study applies fast MRI and SWI for examination of 279 prescreened ischemic stroke patients within 12 hours of stroke onset. One hundred and sixty-two (58.1%) of 279 patients were diagnosed with super-acute ischemic stroke with restricted diffusion, hyperintense diffusion-weighted imaging signals, and no ischemic change in T2-weighted imaging, fluid-attenuated inversion recovery, or T1-weighted imaging signals. Recombinant tissue plasminogen activator IV thrombolysis was administered to 113 (69.75%) patients (thrombolysis group). All patients underwent regular sequence MRI and SWI follow-up.

Results: Computed tomography and MRI sequence scans revealed hemorrhagic transformations in 13 (11.50%) thrombolysis and four (8.16%) non-thrombolysis group patients. MRI-guided thrombolysis treatment produced no significant differences between the two groups. SWI revealed new CMBs in 46 (40.70%) and nine (18.37%) thrombolysis and non-thrombolysis group patients, respectively. Significantly better National Institutes of Health stroke scale (24 hours) (P<0.05), modified Rankin scale (90 days) (P<0.01), and life quality Barthal index scores were observed in CMB patients (P<0.01).

Conclusions: SWI revealed higher CMB incidence and clinical improvement in recombinant tissue plasminogen activator IV thrombolysis-treated super-acute ischemic stroke patients, suggesting that CMBs may indicate vascular re-canalization/reperfusion. Thus, SWI can be applied to extend individual patient windows for thrombolytic treatment beyond general recommendations of treatment within 3 hours, allowing treatment up to 12 hours from stroke onset.
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http://dx.doi.org/10.1179/1743132813Y.0000000179DOI Listing
July 2013

Fast multimode MRI based emergency assessment of hyperacute stroke thrombolysis.

Neurol Res 2009 May;31(4):346-50

Department of Radiology, People's Hospital of Pudong New Area, Shanghai, China.

Objective: To investigate the value of fast multimode magnetic resonance imaging (MRI) based emergency assessment hyperacute stroke thrombolysis.

Methods: One hundred and twenty four patients with 12 hour window acute ischemic strokes were examined by fast multimode MRI, and among them, 46 patients with hyperacute cerebral infarction confirmed by fast multimode MRI were treated by recombinant tissue plasminogen activator and followed up periodically by MRI.

Results: The 46 patients selected by fast multimode MRI to receive thrombolytics demonstrated clinical improvement with 90 days modified Rankin scale scores < or =2 and life quality Barthal index of 80-100. Six patients developed asymptomatic intracranial hemorrhage (13.0%) 1-7 days after receiving thrombolytics.

Conclusions: Patients suffering from hyperacute ischemic cerebral infarction that are strong candidates for intravenous thrombolytic therapy can be identified by multimode MRI, especially for those whose time windows were undefined or beyond 3 hours after symptom onset. Fast multimodal MRI based selection of the hyperacute stroke model is more feasible compared with the traditional diffusion weighted imaging/perfusion weighted imaging mismatch model for the emergency assessment of hyperacute stroke thrombolysis.
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http://dx.doi.org/10.1179/174313209X444053DOI Listing
May 2009

The application of fast multiparametric protocol MRI-based thrombolysis with rt-PA hyperacute cerebral infarction.

Neurol Res 2008 May;30(4):344-7

Department of Neurology, People's Hospital of Pudong New Area, Shanghai, China.

Objective: To investigate the value of fast multiparametric protocol magnetic resonance imaging (MRI)-based thrombolysis in hyperacute cerebral infarction.

Methods: Seventy-seven patients with acute ischemic stroke were examined by multiparametric protocol MRI and among them, 12 patients with hyperacute cerebral infarction were treated by recombinant tissue plasminogen activator (rt-PA) and followed up periodically by MRI.

Results: The 12 patients selected by FMPMRI to receive thrombolysis demonstrated clinical improvement, with 90 day modified Rankin scale scores (mRs) < or = 2 and life quality Barthel index (BI) of 80-100. The only complication involved one patient (8.3%) who developed an asymptomatic intracranial hemorrhage 3 weeks after receiving thrombolytics.

Conclusion: Multiparametric protocols have significant clinical potential for the treatment of hyperacute stroke patients who are candidates for receiving intravenous thrombolytic therapy. Our data suggest that patients suffering from hyperacute ischemic cerebral infarction that are strong candidates for intravenous thrombolytic therapy can be identified by multiparametric protocol MRI, especially to those whose time windows were undefined or beyond 3 hours after symptom onset.
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http://dx.doi.org/10.1179/174313208X300314DOI Listing
May 2008