Background: There is scant information on characteristics, treatment, functional outcome and case fatality of ischemic stroke with atrial fibrillation (AF) in China. Methods: For this study, first-ever ischemic stroke patients who were admitted within 1 month of stroke onset during the period of March 2002 through December 2008 were included. Data on ischemic stroke patients were collected which included: demographics, risk factors, treatment administered, stroke-related complications and 3-month, 6-month and 1-year death and disability. Multivariate regression models were used to analyze predictors for death and disability. Results: Of the 2,683 patients included in this study, 366 (13.6%) had AF. In this group, valvular AF was observed in 153 (41.8%) patients. Compared to patients without AF, patients with AF were older (66.1 vs. 63.6, p = 0.001) and had a higher NIHSS score on admission (median 10 vs. 4, p < 0.001) and more frequently suffered from hemorrhagic transformation (7.3 vs. 2.8%, p < 0.001), pulmonary infection (27 vs. 10.6%, p < 0.001), urinary tract infection (8.5 vs. 3.0%, p < 0.001), acute gastrointestinal tract hemorrhage (4.1 vs. 1.9%, p = 0.008), electrolyte disturbance (5.2 vs. 1.8%, p < 0.001), acute renal failure (1.1 vs. 0.5%, p = 0.005) and urinary incontinence (3.8 vs. 0.6%, p < 0.001) during hospitalization. The percentages of patients with AF who received oral anticoagulants were 3.3% before stroke onset and 14.2% at discharge. Moreover, patients with AF had a higher proportion of disability (determined as modified Rankin Scale score 3–5) in 3-month, 6-month and 1-year follow-ups (46.6, 41.9 and 37.6 vs. 29.1, 24.0 and 19.3%, respectively, p < 0.001) and higher case fatality in hospitalization, 3-month, 6-month and 1-year follow-ups (10.1, 25.5, 29.1 and 34.0 vs. 2.0, 7.4, 8.8 and 11.6%, respectively, p < 0.001). Multivariate logistic regression determined that AF, age and NIHSS score were the independent predictors for the 3-month, 6-month and 1-year death. Conclusions: Ischemic stroke patients with AF have a poorer outcome, a higher frequency of stroke-related complications and a higher case fatality than patients without AF. Oral anticoagulants were underused in AF patients.

A novel and flexible strategy involving hydrothermal transformation of guest‐incorporated zeolite‐seeded mesoporous silica spheres was proposed to prepare guest‐encapsulated hollow zeolite spheres and three‐dimensionally (3D) ordered macroporous zeolite monoliths. The guest species that were pre‐incorporated into the mesopores of silica spheres could be spontaneously encapsulated inside the formed hollow zeolite shells by consuming silica nutrition of the original mesoporous silica cores during the hydrothermal process. A wide range of guest materials with a size ranging from nanometers to micrometers, e.g., Ag and PdO nanoparticles, and mesoporous spheres of carbon and polymer of micrometer size were successfully encapsulated into both discrete hollow zeolite spheres and 3D ordered macroporous zeolite monoliths. Such materials are expected to find a variety of applications such as catalysis, adsorption, and novel microreactors for their special structures with active species inside and zeolitic porous shell outside.

Few prospective studies have examined the frequency, predictors and long-term outcomes of spontaneous hemorrhagic transformation (HT) in patients with ischemic stroke not receiving thrombolytic treatment. We prospectively enrolled a consecutive cohort of 407 patients with ischemic stroke who were admitted within one month of stroke onset. In patients who developed spontaneous HT, the area of the infarct and HT were examined by computed tomography (CT) or magnetic resonance imaging (MRI). Univariate analysis was used to correlate clinical characteristics with appearance of HT, then multivariate logistical regression was used to identify independent predictors of spontaneous HT and factors that predict 3-month prognosis of ischemic stroke. Spontaneous HT was observed in 50 patients (12.3 %), comprising 33 cases (66 %) of hemorrhagic infarction, 17 (34 %) of parenchymal hematoma, 32 (64 %) of non-symptomatic HT, and 18 (36 %) of symptomatic HT. In 40 % of HT cases, the condition was detected by CT or MRI within 4-7 days of symptom onset. Multivariate logistic regression identified atrial fibrillation (OR 4.88, 95 % CI 1.83-13.00, P = 0.002) and infarct area (OR 4.48, 95 % CI 1.85-10.85, P = 0.001) as independent predictors of HT in ischemic stroke. Multivariate analysis also found that spontaneous HT was not independently associated with a worse 3-month prognosis for ischemic stroke (OR 1.59, 95 % CI 0.38-6.69, P = 0.527). Spontaneous HT occurred in 12.3 % of our patients with ischemic stroke, and atrial fibrillation and large infarct area were independent predictors. Spontaneous HT was not an independent predictor of a worse 3-month prognosis for ischemic stroke.

The antifibrinolytic and anti-inflammatory effects of multiple doses of oral tranexamic acid in total knee arthroplasty patients: a randomized controlled trial. J Thromb Haemost 2018; 16: 2442-53. maximum reductions in blood loss and inflammatory response, improved analgesia, and promoted early rehabilitation. Further studies are required to ensure that these findings are reproducible. A B C D Fig. 4. Postoperative clinical outcomes.Patient-rated pain with 45°knee flexion (A) and at rest (B), knee circumference (local inflammation) (C) and range of motion (ROM) (D) after total knee arthroplasty. *Significantly different (P < 0.05) between groups A and B. †Significantly different (P < 0.05) between groups A and C. ‡Significantly different (P < 0.05) between groups A and D. §Significantly different (P < 0.05) between groups A and E. ¶Significantly different (P < 0.05) between groups B and C. **Significantly different (P < 0.05) between groups B and D. † †Significantly different (P < 0.05) between groups B and E. ‡ ‡Significantly different (P < 0.05) between groups C and D. § §Significantly different (P < 0.05) between groups C and E. ¶ ¶Significantly different (P < 0.05) between groups D and E. POD, postoperative day. [Color figure can be viewed at wileyonlinelibrary.com]

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