Chinese Journal of Stroke

Win by Strategy WANG Yong-Jun

yongjunwang

2015, 10(09): 727-729.

Asbtract ( )

PDF (1732KB) ( )

References | Related Articles | Metrics

Cerebrovascular Disease and Mental Psychological Disorder

BI Xiao-Ying

2015, 10(09): 730-734.

Asbtract ( )

PDF (1583KB) ( )

References | Related Articles | Metrics

Study on the Relationship between Depression - executive Dysfunction Syndrome after Acute Ischemic Stroke and White Matter Lesions within Cholinergic Pathways

HU Rong, PAN Xiao-Ping, YANG Song-Ran, LI Guang-Sheng, MO Xiao-En, WANG Xiao- Juan, CHEN Shu-Da

2015, 10(09): 735-739.

Asbtract ( )

PDF (1963KB) ( )

References | Related Articles | Metrics

Objective To investigate the relationship between the depression-executive dysfunction syndrome(DES) after acute ischemic stroke and white matter lesions within cholinergic pathways cholinergic pathway using the cholinergic pathways hyperintensities scale(CHIPS) to rate the white matter lesions within cholinergic pathways. Methods One hundred and nineteen patients with acute ischemic stroke were recruited, which were divided into depression-executive dysfunction syndrome group and non-depressed-executive dysfunction syndrome group. All of them had a brain magnetic resonance imaging(MRI) scan, and white matter lesion on brain MRI was evaluated with the CHIPS. Results The total CHIPS scores in DES group increased significantly compared with non-DES group ( P =0.033), and the CHIPS scores in white matter lesion of high external capsule horizon in DES group increased significantly compared with non-DES group ( P =0.017). Conclusion DES after acute ischemic stroke had a strong relationship with white matter lesion within cholinergic pathways, and white matter lesion within cholinergic pathways may lead to DES.

Association between White Matter Changes and Cognitive Impairment in Patients with Subcortical Vascular Cognitive Impairment

ZHOU Kai-Ge, WU Xiong-Feng, ZHENG Hui-Wen, DING Su-Ju, LI Hai-Long, LI Jia-Si, BI Xiao-Ying.

2015, 10(09): 740-745.

Asbtract ( )

PDF (2031KB) ( )

References | Related Articles | Metrics

Objective To investigate the association between white matter changes of subcortical infarction vascular cognitive impairment and cognitive assess scores. Methods Ninety-one patients with subcortical infarction were consecutively recruited. According to Montreal cognitive assessment(MOCA), they were divided into two groups as subcortical vascular cognitive impairment group (SVCI, 49 cases) and subcortical infarction without cognitive impairment group (SI, 42 cases). The correlation between Cognitive impairment and white matter lesions by analysis the clinical, cognitive impairment and neuroimaging characteristics of patients were explored. Results The incidence of diabetes in SVCI patients is higher than SI patients (38.78% vs 16.67%, P =0.02). Cerebral white matter changes were found in 37 cases (75.51%) of SVCI patients. There is a negative correlation between the degree of white matter lesion and visuospatial executive( Rs = - 0.415, P =0.028), memory( Rs = - 0.577, P =0.001), attention( Rs = - 0.382, P =0.001), delay recall( Rs = - 0.389, P =0.041) according to MOCA assessment ( Rs = - 0.495, P =0.002). Conclusion Diabetes is an important risk factor in SVCI patients. White matter change is the most important imaging features, and reflects the degree of cognitive impairment.

Hemodynamics Monitor in Severe Cerebral Vascular Disease

YAN Jing, YANG Bo, WEN Miao, YANG Zhong-Hua, LIU Li-Ping, ZHAO Xing-Quan.

2015, 10(09): 746-750.

Asbtract ( )

PDF (1906KB) ( )

References | Related Articles | Metrics

Objective To analyze the effect of the new hemodynamics monitor technique Pulse Indicator Continous Cardiac Output(PiCCO) in the prognosis of severe cerebral vascular disease patients. Methods We consecutively enrolled the severe cerebral vascular disease patients after admission and applied PiCCO monitoring within 72 hours. We compared the baseline, clinical data and PiCCO monitoring result in the survival group and the death group. Results The patients who dead on the 7th day after admission had an abnormally elevating extravascular lung water index(EVLWI) compared with the survival group( P =0.007), and the difference of the first EVLWI and on the 7th day was significantly lower in the survival group ( P =0.043). Conclusion PiCCO monitoring detected the elevation of EVLWI may indicate the death after admission of the severe cerebral vascular disease patients.

Association between Blood Pressure and the Prognosis in Acute Cerebral Watershed Infarction

SHU Hao, NIE Zhi-Yu.

2015, 10(09): 751-756.

Asbtract ( )

PDF (2035KB) ( )

References | Related Articles | Metrics

Objective To evaluate the relationship between patients’ blood pressure in the acute phase of cerebral watershed infarction and their outcomes. Methods In this study, a consecutive series of patients hospitalized for cerebral watershed infarction within 48 hours of onset were enrolled. Blood pressures were measured for each patient from admission to the third day. All clinical datas included basic information, stroke risk factors and supporting test results were collected. At 3 months after stroke onset, the late outcomes were measured by the modified Rankin score (mRs). Results A total of 106 patients were brought into the research. After grouped by the systolic blood pressure (SBP), a u-shaped relationship was observed between blood pressure and late outcome. The optimal level of SBP was 150-160 mmHg. After adjusted for other prognostic factors, multiple logistic regression analysis showed that, SBP declined every 10 mmHg below 150 mmHg, the risk of late poor outcome increased by 73.3% ( OR =1.733, 95% CI 1.073-2.799, P =0.024); when SBP≥160 mmHg, SBP had no significant relationship with poor outcome. Conclusion Low blood pressure in acute cerebral infarction watershed indicated a poor outcome, The optimal level of systolic blood pressure might be 150-160 mmHg.

Contrast-enhanced Transcranial Color-coded Doppler in Intracranial Collateral Circulation in Patients with Cerebral Infarction with Limited Bone Windows

XU Bin*, XING Jin, ZHANG Wen-Jing, KANG Geng-Jie, ZHAI Lin, WU Chan, SUN Nan-Nan, MEN Yan, CUI Jian, ZHU Qian-Qian.

2015, 10(09): 757-760.

Asbtract ( )

PDF (2025KB) ( )

References | Related Articles | Metrics

Objective To observe the intracranial collateral circulation in patients with cerebral infarction and transient ischemic attack with limited bone windows by using of contrast-enhanced transcranial color-coded Doppler (CE-TCCD). Methods Seventy patients with ischemic stroke, and transient ischemic attack of whom transcranial color-coded Doppler could not detect the intracranial blood flow because of limited bone windows, were detected the intracranial blood flow and the anterior and posterior communicating arteries of Willis ring before magnetic resonance angiography(MRA) examination. And compared the diagnosis of both. Results Seventy patients consists of 51 males and 19 females, mean age was 66.4±11.9 years old. CE-TCCD were detected in 41 communicating arteries, 38 of which were consistent with the MRA diagnosis. Diagnostic consistency between the two was good (Kappa value 0.696, P <0.001). The sensitivity of CE-TCCD was 79.2% and the specificity of it was 91.9%. Conclusion Contrast-enhanced transcranial color-coded Doppler can be used to detect intracranial collateral circulation in patients with cerebral infarction and transient ischemic attack with limited bone windows.

Influence of Cognitive Function in Surgical and Drug Treatment for Adult Patients with Moyamoya Disease

DI Fei*, FAN Zhen-Hong, LI Jun-Jie.

2015, 10(09): 761-765.

Asbtract ( )

PDF (1925KB) ( )

References | Related Articles | Metrics

Objective To investigate the influence of surgical and pharmacological therapies on the cognitive function of patients with adult moyamoya disease. Methods A total of 52 patients with adult moyamoya disease were included, and were divided into a surgical group and a control group according to their treatment plans. Patients in the control group were treated with conservative therapy using aspirin enteric-coated sustained release tablets, dextran 40, oxiracetam, and dexamethasone. Patients in the surgical group received surgical therapies (direct bypass operations and indirect bypass operations). The cognitive functions of patients in the two groups were assessed before treatments and 6 months after treatments to evaluate the improvement in patients’ cognitive functions. Results There was no significant difference in patients’ cognitive functions between the two groups before treatments. At 6-month follow-up, Montreal cognitive assessment(MoCA) of the patients showed that patients’ cognitive functions of the surgical group ( t =2.092, P =0.009) and the control group ( t =2.814, P =0.007) had improved significantly compared to those before treatments, respectively. Assessments using mini-mental state examination(MMSE) showed significant improvement in the surgical group ( t =2.706, P =0.005) while the control group had no significant improvement. Comparison of the curative effects between the two groups showed that the rate of therapeutic effectiveness was higher in the surgical group than in the control group, which is statistically significant (96.15% vs 84.62%, χ 2 =10.15, P <0.05). Conclusion Surgical therapy for moyamoya disease can better improve patients’ cognitive functions and clinical curative effects than pharmacological therapy.

Study on Improving Medical Process to Shorten the Door-to-needle Time of the Acute Ischemic Stroke Patients

LIANG Jian-Shu*, ZHANG Wei-Yi, WANG Zi-Xuan.

2015, 10(09): 766-769.

Asbtract ( )

PDF (1763KB) ( )

References | Related Articles | Metrics

Objective To evaluate whether improving emergency medical procedures can impact the door-to- needle time(DNT), the time required when acute ischemic stroke patients have been hospitalised to be treated by intravenous thrombolysis. Methods During January to April in 2015, the experimental group consists of the acute ischemic stroke patients treated by intravenous thrombolysis with recombinant tissue plasminogen activator(rt-PA). After starting the green channel, nurses have to immediately mark the patients clearly, write the triage nurse’s screen into the management process and move the rt-PA thrombolytic place from ward to the emergency room simultaneously. The acute ischemic stroke patients treated by intravenous thrombolysis with rt-PA before the process improvement during January to April in 2015 are considered as the control group. Then we evaluate the DNT between the two groups. Results In control group, the median duration of DNT is 133(80-174) min, while the experimental group’s DNT median duration is 102(56-168) min, the two groups have significantly difference( P =0.011). Conclusion Adopt the integrated implementation carried out by multi-disciplinary cooperation and optimize the emergency medical treatment process can reduce the in-hospital delays of rt-PA intravenous thrombolysis.

Progress of Researches on the Mechanism of the Role of Nonspecific Inflammation Mediatedby Microglia Activation in the White Matter Demyelination of Vascular Cognitive Impairment

LI Hai-Long, BI Xiao-Ying.

2015, 10(09): 771-777.

Asbtract ( )

PDF (1855KB) ( )

References | Related Articles | Metrics

Microglia as the main immune surveillance cell in central nervous system can cause acute or chronic cerebral ischemic injury via mediating inflammation and oxidative stress and releasing varieties of products with neurotoxicity, which could even cause the death of neurons and other glial cells. White matter demyelinatingis the feature of vascular cognitive impairment, marked by magnetic resonance imaging of brain, which is a disease caused by chronic cerebral ischemic damage. We reviewed researches on the mechanism of the role of ischemic nonspecific inflammation in the white matter damage mediated by microglia activation, in order to provide reference and help for further mechanism studies.

Cerebral Microbleeds and the Relationship with Vascular Cognitive Impairment

TAO Zhen, CAO Bing-Zhen.

2015, 10(09): 778-781.

Asbtract ( )

PDF (1766KB) ( )

Related Articles | Metrics

Research Progress on Non-High-Density Lipoprotein Cholesteral and Cardiovascular and Cerebrovascular Diseases

LIU Yang, GUO Yang.

2015, 10(09): 799-803.

Asbtract ( )

PDF (1777KB) ( )

References | Related Articles | Metrics

Non-high-density lipoprotein cholesterol (non-HDL-C) reflects the total amount of atherogenic cholesterol. The concept of non-HDL-C was first proposed on the National Cholesteral Education Program Adult Treatment Panel III and was assigned to be the second target for lipid- lowering therapy. More and more recent studies at home and abroad have shown that the non- HDL-C could be a more accurate predictor of morbidity and morality of coronary atherosclerotic heart disease than traditional markers such as low density lipoprotein cholesterol. Currently, there are less and scattered research on the association between non-HDL-C and cerebrovascular diseases. This review aims to summarize and analyze the research progress of non-HDL-C.

Role of the Nurse on Early Interventions in Acute Ischemic Stroke Care

YAO Ning*, SHEN Yan.

2015, 10(09): 804-807.

Asbtract ( )

PDF (1892KB) ( )

References | Related Articles | Metrics

In the acute phase of ischemic stroke treatment, a trained nurse practitioner can serve as coordinator and leader of intravenous thrombolysis team with recombinant tissue plasminogen activator(rt-PA). This model enables significantly reduce door-to-needle times and waiting-time in emergency department for ischemic stroke patients. The high ratio of practicing nurses can reduce mortality and play an important role to the patients' prognosis in a stroke unit for the acute treatment of patients with ischemic stroke.

Establishment and Management of a Training System for Clinical Rehabilitation Personnel in Tertiary General Hospitals

YANG Hong-Bin, WANG Zhong.

2015, 10(09): 808-810.

Asbtract ( )

PDF (1563KB) ( )

References | Related Articles | Metrics

As a significant part of modern medicine, rehabilitation medicine plays an important role in helping the patients gain full recovery and regain their social function. Beijing Tiantan Hospital, Capital Medical University uses effective strategies to improve the development of rehabilitation and stability of rehabilitation personnel in cerebrovascular disease, which is one of the primary research interests of Beijing Tiantan Hospital, such as utilizing academic leaders, reinforcing personnel training, assessment and other measures. This article prepares to introduce the construction experience in rehabilitation discipline in Beijing Tiantan Hospital.

Application of Problem-based Learning Method with the Lesson-based Learning Method in Vascular Neurology Teaching

ZHANG Yu-Mei, WANG Chun-Xue, ZHANG Ning, et al.

2015, 10(09): 811-813.

Asbtract ( )

PDF (1842KB) ( )

References | Related Articles | Metrics

Objective To summarize the effect of problem-based learning(PBL) method combine with lesson- based learning(LBL) teaching method in medical students' clinical practice. Methods The object is our seven-year program medical student major in clinical medical in Beijing Tiantan hospital affiliated to the Capital University of Medical Sciences, Neurology. We taught them by a PBL combine with LBL teaching method, then we asked them to do a questionnaire survey to collect their opinions of this teaching method. Results The qualified questionnaires are 200, the statistical analysis showed that this teaching method have inspired their learning interest, deepened their understanding of theoretical knowledge, expanded their clinical logic thinking ability, improved their ability of solving problems. Their ability to integrate theory with practice, capacity for independent thinking, communication collaborative capacity have been improved (84.3%-92.3% respondents). 85.3% of the respondents believe that this teaching method had the necessity to continue to be adopted. Conclusion Medical students gave a high acceptivity to PBL combine with LBL teaching method. This teaching method can help to improve students’ learning initiative.

Application of Problem Base-Learning Teaching Method in Teaching Vascular Dementia

PIAO Ying-Shan, ZHANG Wei

2015, 10(09): 814-816.

Asbtract ( )

PDF (1842KB) ( )

References | Related Articles | Metrics

Objective To explore the effect of problem base-learning (PBL) in teaching vascular dementia. Methods PBL and classical methods were applied separately in teaching vascular dementia to 28 medical students of capital medical university, who were randomized into 2 groups . The effect of two teaching methods were evaluated by questionnaire survey among these students. Results Compared with the classical teaching method, PBL method could significantly improve student ability of independent learning, finding problem, solving problem, medical practice, and working as a team. Conclusion PBL teaching method can improve interest and motivation of students, and develop their scientific thinking. So PBL is worth popularizing.

Table of Content