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Table of Content

    20 September 2011, Volume 6 Issue 09
    主编手记
    People Regard Food as Their Prime Want
    WANG Yong-Jun
    2011, 6(09):  677-679. 
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    述评
    Stroke Patient’s Nutrition Support: Should Not Be Forgotten
    YU Wen-Gui
    2011, 6(09):  680-683. 
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    论著
    Nutrition Effect Comparison of Percutaneous Endoscopic Gastrostomy and Nasogastric Feeding in Post-Stroke Patients with Dysphagia
    QIN Yan-Jing;LI Wei;WU Dong-Yu;et al
    2011, 6(09):  684-688. 
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    Objective To compare the enteral nutrition efficiency of percutaneous endoscopicgastrostomy(PEG) with nasogastric feeding(NGF) in post-stroke patients with dysphagia.Methods Seventy-six patients with post-stroke dysphagia were divided into 2 groups:PEG enteralnutrition group(n=36) and nasogastric feeding(NGF) group(n=40). Patients in both groups werefed with same nutrient fluids. Complications such as pulmonary infections, reflux esophagitis,gastrointestinal hemorrhage, hypoalbuminemia and electrolyte disturbances were also compared.Results The incidences of above complications were 7.5%、7.5%、5%、5% and 2.5% for thePEG group, 25%、27.8%、22.2%、22.2% and 16.7% for the NGF group. The incidences of allcomplications in PEG enteral nutrition group were significantly lower than those in NGF group(allP <0.05, respectively).Conclusion PEG enteral nutrition had an advantage over NGF in improving nutritional status ofpatients and in reducing complications, and it may be a better way to improve the nutrition state inpatients with post-stroke dysphagia.\
    Radiation Dose from “One-Stop-Shop” Computed Tomography Imaging for AcuteIschemic Stroke
    JING Li-Na;GAO Pei-Yi;LIN Yan;et al
    2011, 6(09):  689-694. 
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    Objective To determine the radiation dose delivered during “one-stop-shop” computedtomography(CT) imaging for acute ischemic stroke.Methods "One-stop shop" CT examination was performed in 34 patients with symptoms ofacute stroke less than 9 hours. The Protocol includes an un-enhanced CT(NECT) head, CTperfusion(CTP), and CT angiography(CTA) from cranial base to vertex. The weighted volumeCT dose index(CTDIvol) and dose-length products(DLP) were recorded during the CT scanning.Effective doses for each examination were calculated using the DLP and normalized values ofeffective dose per DLP appropriate for the head regions imaged.Results In 34 patients, mean CTDIvol was 845.96±23.78 mGy; mean DLP was2748.92±129.25 mGy×cm; the effective doses ranged from 5.96 to 7.81 mSv, mean effective dosewas 6.32±0.03 mSv. Largest contribution to effective dose was the CTP with a mean effectivedose of 3.51 mSv. Mean effective doses for the NECT, CTA were 2.14±0.27 mSv, 0.67±0.07 mSv,respectively.Conclusion Parameters of “one-stop-shop” CT comply with the standards that American food anddrug administration recommends, and the radiation doses are reasonable, furthermore, “one-stopshop”CT plays a key role in the management of the patients with acute ischemic stroke.
    Relationship Between Serum Bilirubin and Carotid Atherosclerotic Plaque in Physical Examination Population
    LIU Xiu-Rong;WANG Li-Ye;SHI Xian-Quan;et al
    2011, 6(09):  695-699. 
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    Objective To investigate the relationship between the bilirubin level in serum and carotidatherosclerotic plaque.Methods We selected 475 subjects of Kaluan Group who had received a physical examinationin the period from September to October in 2009. The subjects were divided into two groupsaccording to carotid artery plague examined with colour doppler ultrasonography(111 cases ofcarotid atherosclerotic plaque group and 364 cases of control group) and were divided into fourgroups according to the level of total bilirubin.Results ①There was significant difference(P <0.05) in group of carotid atheroscleroticplaque(12.61±5.17 μmol/L) compared to in control group(13.83±5.31 μmol/L). ②There wasno significant difference(P =0.067) in different serum bilirubin levels. However, the formationrate of carotid atherosclerotic plague showed decrease trend with the serum bilirubin levelincreased. ③Higher serum bilirubin level is one of the protective factors for carotid atheroscleroticplaque(OR 0.43; 95%CI 0.23~0.81). ④correcting other affected factors, higher serum bilirubinlevel still is a protective factor for carotid atherosclerotic plaque.Conclusion There was some relationship between serum bilirubin and carotid atheroscleroticplaque. Higher serum bilirubin level had certain protective effects on artery atherosclerotic plaque.

    Impact of Different Operation Methods on Subarachnoid Hemorrhage Prognosis
    YAN Jing;BAI Ying;BIAN Li-Heng;et al
    2011, 6(09):  700-704. 
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    Objective To compare the short-term prognosis of endovascular coiling with neurosurgicalclipping in aneurysmal subarachnoid hemorrhage.Methods We enrolled 86 patients with aneurysmal subarachnoid hemorrhage and assigned themto neurosurgical clipping group(n=51) or endovascular treatment group(n=35). National Institutesof Health Stroke Scale(NIHSS), Glasgow Coma Scale(GCS), and mortality were assessed at 7days after treatments, modified Ranking Scale(mRS) were assessed at 30 days after treatments. Tocompare the prognosis of the two groups.Results There were no significant differences of NIHSS, GCS and mortality at 7 days aftertreatments in neurosurgical clipping group and endovascular treatment group, but unfavorableprognosis rate(mRS>2) in neurosurgical clipping group was higher than that in endovasculartreatment group(35.3% vs 14.3%, P =0.031).Conclusion Short-term prognosis of endovascular coiling was better than neurosurgical clipping inaneurysmal subarachnoid hemorrhage patients.
    Evaluation of rCBF by Xenon Computer Tomography in Ischemic Stroke Patients with Cerebrovascular Stenosis
    CAO Wen-Jie;DONG Qiang
    2011, 6(09):  705-710. 
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    Objective To evaluate the regional cerebral blood flow(rCBF) in ischemic stroke patients withcerebrovascular stenosis by Xenon-enhanced computer tomography(CT).Methods Thirty-two subjects participated in this study. Twenty-two of them were selected fromthe inpatients with cerebrovascular stenosis who had experienced ischemic stroke in the past 6months. The other ten were normal volunteers. All subjects were examined by Xenon-enhancedCT. Four image analysis methods were applied to rCBF, including the manual analysis of wholebrain, cerebral hemispheres, the region of middle cerebral HYPERLINK "http://www.iciba.com/artery/"\t"_blank" artery and the analysis of related cortex by software.Results In control group, the perfusion in each regions was in good balance. Comparedtwo groups, we found:There was no significant difference in resting rCBF of wholebrain[(38.9±10.3) vs (44.7±7.1) ml·100 g-1·min-1, P >0.05]. The difference of twocerebral hemispheres in case group was significantly higher than that in controlgroup[(7.2±5.6) vs (3.2±2.5) ml·100 g-1·min-1, P =0.008]. The resting rCBF of criminalMCA region in case is lower than that in control, significantly in left criminal MCA region[(34.3±11.2) vs (48.1±6.4) ml·100 g-1·min-1, P =0.03]. In case group the rCBF of cortexin criminal MCA region divided by software was significantly lower than the contrastside[(45.8±15.2) vs (55.4±14.5) ml·100 g-1·min-1, P =0.039]. Conclusion:The application of XenonCT is useful to measure rCBF. The manual analysis of whole brain, cerebral hemispheres, theregion of MCA and the analysis of related cortex by software make it clear that the stenosedcerebral artery related rCBF decrease is an significant character in ischemic stroke patients.
    Abnormal Expression of Osteocalcin on Circulating Endothelial Progenitor Cells in Patients with Ischemic Cerebrovascular Diseases
    LIU Li;LI Fen-E;WANG Ya-Jie;et al
    2011, 6(09):  711-716. 
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    Objective To explore whether endothelial progenitor cells(EPCs) in patients with cerebrovasculardiseases could express high level of osteocalcin.Methods We studied 51 patients with acute cerebrovascular diseases and 30 sex- and age- matchedcontrol subjects. EPCs in peripheral blood mononuclear cells were analyzed by flow cytometry.Results Patients with cerebral ischemia had about three-fold increase of the number and thepercentage of osteocalcin positive(OCN+) EPCs compared with control group(P <0.01). Patients withvessel calcification had higher percentage of OCN+EPCs than those without calcification(P =0.033).However, the degree of stenosis had no direct correlation with osteocalcin expression(P =0.672).Logistic analysis showed that the percentage of OCN+EPCs was an independent risk factor forcerebral ischemia(odds ratio=1.143, 95% confidence intervals 1.060-1.232).Conclusion Circulating endothelial progenitor cells in patients suffering from cerebral ischemiacan express osteocalcin and act as a negative factor for vascular lesion rather than normal repair.The percentage of OCN+EPCs may be used as a potential cell marker for ischemic cerebrovasculardiseases.
    专题论坛
    Nutritional Risk Assessment and Nutritional Management Strategies of Stroke Patients
    WANG Yan;ZHANG Yu-Mei;WANG Chun-Xue
    2011, 6(09):  718-723. 
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    病例讨论
    Two Cases of Vertebral Artery without Reverse Blood Flow Caused by Severe Stenosis or Occlusion of the Proximal Subclavian Artery Accompany with Origin Variation of Ipsilateral Vertebral Artery
    ZHANG Hong-Xia;FENG Hao;ZHANG Hui-Qin;et al
    2011, 6(09):  724-726. 
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    指南与规范
    Guidelines for the Primary Prevention of Stroke. A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association(Part 2)
    DU Wan-Liang;SUN Hai-Xin;JIA Qian;et al
    2011, 6(09):  727-755. 
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    综述
    Change of Neuroendocrine Function at Different Periods of Hemorrhagic Cerebrovascular Disease
    WANG Dan-Dan;XU Jian;ZHAO Xing-Quan
    2011, 6(09):  756-760. 
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    Hemorrhagic cerebrovascular disease has a high morbidity in our country. Some researches showthat in the acute phase of the cerebral hemorrhage and 1-2 years after subarachnoid hemorrhage, thepatients mostly suffer an endocrine change, differ from the severity of the disease and the site ofhemorrhage. In this review we will show the detail of the hormones change by some reported andrepresentative trials.

    Empiric and Targeted Therapy for Stroke Associated Pneumonia
    GUO Wei;ZHANG Jie
    2011, 6(09):  761-764. 
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    To summarize the anti-infection treatment strategy of stroke associated pneumonia:empiricaltherapy and targeted therapy. To report the selection of medications for early empirical therapy ofstroke associated pneumonia according to epidemiologic regular pattern, local resistance status andpublished literatures. Targeted therapy means to adjust antibiotics exactly according to pathogenand drug sensitivity test results based on empirical therapy, especially emphasizing that the keyis determination of pathogen and correct sampling and standard management of various etiologyspecimen so as to elevate positive rate of test and provide evidence for targeted therapy.