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Table of Content

    20 June 2011, Volume 6 Issue 06
    主编手记
    Power of Execution
    WANG Yong-Jun
    2011, 6(06):  427-428. 
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    述评
    Applications of New Ultrasonic Techniques in Cerebrovascular Disease
    HE Wen
    2011, 6(06):  429-433. 
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    论著
    Effection of a New Elastic Suspension Orthosis on the Walking Ability of Stroke Patients
    YU Da-Jun;LIU Zhi-Hua;ZHANG Hong-Cui;et al
    2011, 6(06):  434-439. 
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    Objective To evaluate the efficiency of a new elastic strap orthosis in improving the motor functionand waling ability of stroke patients.Methods Twenty-eight stroke patients with hemiplegia were divided randomly into a control groupand an elastic group. The patients in the control group accepted normal training without orthosis for8weeks; while the patients of the treatment group accepted the same training with the assistance ofthe orthosis. Before the treatment, after 4 weeks and after 8 weeks, the assessment were performedby the same therapist including the Fugl-Meyer scores (FMA), PCI (physical consume index), thetemporal spatial parameters of gait such as walking speed for 10m (at cosy speed and volant speed,separately), cadence, step length, toe out angle and stride width.Results After 4 weeks, the temporal spatial parameters of gait such as walking speed for 10m (atcosy speed and volant speed, separately), step length, cadence improved significantly in the twogroups (all P <0.01); whereas stride width and PCI decreased significantly in the two groups (allP <0.01). The treatment group improved significantly more than the control group with regard towalking speed for 10m (at cosy speed and volant speed, separately), step length (P =0.0298, 0.0225,0.025); while tride width and PCI decreased significantly more than the control group (P =0.001,0.026). There had no significant differences in scores of FMA, cadence and toe out between the twogroups.After 8 weeks, walking speed for 10m (at cosy speed and volant speed, separately), step length,cadence, scores of FMA improved significantly; stride width and PCI decreased significantly inthe two groups (all P <0.01). There had no significant difference of toe out in the two groups. Thetreatment group improved significantly more than the control group in walking speed for 10m (atcosy speed and volant speed, separately), step length, cadence, scores of FMA (P =0.042, 0.015,0.024, 0.024, 0.038); and decreased significantly in stride width and PCI (all P <0.01). Toe out anglehad no significant difference between the two groups.Conclusion The elastic suspension strap orthosis could help correct abnormal gait patterns,improve the temporal spatial parameters of gait, and decrease the energy expenditure in strokepatients.

    Decompressive Hemicraniectomy Surgery in Large Cerebral Infarction
    BAI Xue-Qing;FAN Wen-Sheng;SONG Quan-Sheng;et al
    2011, 6(06):  440-444. 
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    Objective To compare the clinical outcome of decompressive hemicraniectomy surgery incombination with medical treatment and medical treatment alone in large cerebral infarction.Methods This study is a prospective clinical research, and 71 patients with a large cerebralinfarction were involved. Twenty-three patients received decompressive hemicraniectomy surgeryin combination with medical treatment (surgery group), 48 patients only received medical treatment(conservative group). The outcome measure was the modified rankin scale (mRS) at 6 months afterthe onset of infarction.Results There were 39.1% of the patients in the surgery group got good outcomes in 6 monthsfollow-up, and 16.7% in conservative group (P =0.042).Conclusion Decompressive hemicraniectomy surgery in combination with medical treatment canimprove the clinical outcome of the large cerebral infarction patients.
    Clinical Trial of Urinary Kallikrein Combined with Batroxobin Therapy in Acute Ischemic StrokeYAN Xin, CHEN Jie, SUN Yu-Heng
    YAN Xin;CHEN Jie;SUN Yu-Heng
    2011, 6(06):  445-449. 
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    Objective To observe the effect and safety of urinary kallikrein combined with batroxobin in acuteischemic stroke patients.Methods A randomized 1:1 control clinical study was performed in 74 patients. The studygroup (n=37) was administrated kallikrein combined with batroxobin and the placebo group wasadministrated batroxobin. National Institutes of Health Stroke Scale (NIHSS) and Barthel Index(BI), which were used to evaluate defect of neurological function and daily living activity, werecompared between study group and placebo group before treatment, and after treatment on 21th dayand 90th day, in addition curative effect and adverse reaction were evaluated.Results NIHSS on the 21th day of study group and placebo group was 2.54±2.48 and 4.17±4.21(P =0.038) respectively. NIHSS on the 90th day of study group and placebo group was 1.40±1.54and 2.65±3.96 (P =0.013) respectively. NIHSS of study group was significant lower than placebogroup. BI on 21th day of study group and placebo group was 86.49±12.74 and 78.37±19.35(P =0.027) respectively. BI on 90th day of study group and placebo group was 94.73±7.06 and87.02±17.38 (P =0.002). BI of study group was significant higher than placebo group. Clinicaleffective rate (almost recovery and significant improvement) of study group (89.2%) was significanthigher than placebo group (62.1%) (P =0.011). One patient in study group had symptoms of flushedface, nausea and vomiting, but got improvement after symptomatic treatment.Conclusion Urinary kallikrein combined with batroxobin was more effective than batroxobin alonein acute ischemic stroke and had no obvious side effect.
    Analysis of P-wave Dispersion and Myocardial Enzymes in Patients with Acute Intracerebral Hemorrhage
    LIN Hui;TIAN Jun-Ping;GAO Yan;et al
    2011, 6(06):  450-453. 
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    Objective To observe the change of P-wave dispersion (Pdisp) and myocardial enzymes in thepatients with acute intracerebral hemorrhage (AICH), and to explore the characteristics ofmyocardial damage.Methods Two-hundred and twenty-seven AICH patients were enrolled. The electrocardiogram wasexamined within 24-hour (24h) and on the seventh day (7d) after admission. The maximum P-wavetiming (Pmax) and minimum P-wave timing (Pmin) were measured, and the Pdisp was calculated. Thepatients were divided into three groups according to the Glasgow scale, including the mild (13-15scores), moderate (9-12 scores) and severe group (3-8 scores). The blood myocardial enzymes,including lactate dehydrogenase (LDH), alpha-hydroxybutyrate dehydrogenase (α-HBDH), creatinekinase (CK), and MB isoenzyme of creatine kinase (CK-MB) were examined within 24h andcompared among the three groups.Results The Pmin within 24h had no difference with that on the 7d (P =0.710). However, the AICHpatients showed significantly more prolonged Pmax (P =0.002) and Pdisp (P =0.006) within 24h thanthat on the 7d. The positive number of Pmax more than 110ms was significantly higher within 24h(19.8%) than that on the 7d (5.7%, P <0.01). Similarly, the positive number of Pdisp more than40ms was also higher within 24h (67.4%) than that on the 7d (58.1%, P =0.041). It showed markeddifferences in myocardial enzymes among the three groups (P <0.01). CK, CK-MB, LDH andα-HBDH in severe group were obviously higher than that of moderate and mild groups (P <0.01).The cardiac enzymes in moderate group were also higher than that of mild group (P <0.01).Conclusion The myocardial damage existed in AICH patients with different degrees; it was closelyrelated to the severe degree of the AICH.
    Statistics and Analysis of Scientific Articles of Cerebrovascular Subject included in SCI from a First Class Hospital during "The 11th Five" Periods
    CHEN Lu;REN Pei-Juan;WANG Yi-Long;et al
    2011, 6(06):  454-458. 
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    Objective To provide reference and information for scientific management and key subjectconstruction using bibliometrics to evaluate the current situation of cerebrovascular subject in a firstclass hospital.Methods To analyze the quantity, quality and influencing factors of the articles of cerebrovascularsubject included in science citation index (SCI) from this first class hospital from 2006 to 2010.Results There are 125 scientific articles of cerebrovascular subject included in SCI from the firstclass hospital during "The 11th Five" periods. The total impact factor (IF) is 223.913. These articleshad been published in 42 periodicals, and distributed in 4 subjects.Conclusion The scientific articles of cerebrovascular subject included in SCI from the first classhospital during "The 11th Five" periods have a higher quality, and show a good development trendof the subject.
    Ralationship between Intima-medial Thickness and Hemodynamic Parameter of IinternalCarotid Artery in Patients with Cerebral Infarction
    WEI Dong-Mei;HE Wen;ZHANG Hong-Xia;et al
    2011, 6(06):  459-462. 
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    Objective To study the relationship between intima-medial thickness (IMT) and hemodynamicparameter of internal carotid artery in patients with acute anterior circulation cerebral infarction.Methods One hundred patients of cerebral infarction were measured by color Doppler ultrasound.The IMT of the bifurcating part of carotid artery (CCA) was measured. Then the internal carotidartery diameter, the peak systolic velocity (PSV) and minimum end-diastolic flow velocity (EDV) ofinternal carotid artery (ICA), the resisitive index (RI) and the pulsatility index (PI) were measuredby color Doppler ultrasound. They were compared to each other. We regarded normal of IMT asgroup one, thick of IMT as group two, and plaque as group three. To compare the diffenences of thehemodynamic parameters among the three groups.Results Double side IMT of internal carotid artery had a weak correlation with RI and PI (P <0.05)[Correlation coefficient between left IMT (IMTL) and RI: r =0.269, P =0.007; Correlation coefficientbetween right IMT(IMTR)and RI: r =0.211,P =0.035; Correlation coefficient between IMTL and PI:r =0.267, P =0.006; Correlation coefficient between IMTR and PI: r =0.205 (P =0.040)]. Double sideIMT of internal carotid artery had no significant difference with the internal carotid artery diameter,the PSV and EDV.Group plaque had a significant difference with group normal on RI and PI. LeftRI(RIL) was (1.17±0.28) vs (1.03±0.30); right RI(RIL)was (1.16±0.33) vs (1.05±0.17); left PI(PIL)was (0.64±0.08) vs (0.59±0.12); right PI(PIL)was (0.63±0.10) vs (0.61±0.06). P value was 0.036,0.041, 0.040 and 0.048 respectively.Conclusion There is relevance between IMT and hemodynamic parameter (RI and PI) of ICA inpatients with acute anterior circulation cerebral infarction. We observe change of IMT in order tokeep monitoring the hemodynamic developments of ICA, especially the plaque in the carotid artery.
    Primary Application of Transcranial Contrast Enhanced Ultrasound in the Stenosis of Intracranial Vertebro-Basilar Artery
    YANG Song;HE Wen;DU Li-Juan;et al
    2011, 6(06):  463-467. 
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    Objective To explore the clinical value of contrast-enhanced transcranial color-codedsonography(CE-TCCS) in diagnosing intracranial vertebro-basilar stenosis and occlusion.Methods Transcranial color-coded sonography(TCCS) was performed in 14 patients who werefirstly diagnosed with stenosis and occlusion of vertebro-basilar artery(VBA) before and afterinjection of ultrasound contrast agent. These two methods were compared with digital subtractionangiography in the diagnosis of VBA stenosis and showed the degree of coincidence.Results A total of 14 patients ,who were suspected to have VBA stenosis including 42 arteries(28vertebro arteries and 14 basilar arteries). The CE-TCCS showed 29 arteries stenosis or occlusionand DSA showed 28 arteries stenosis or occlusion finally. The CE-TCCS showed 13 normal VBAand 12 of them were confirmed by DSA. The TCCS showed 21 arteries stenosis or occlusion andDSA showed 19 arteries stenosis or occlusion finally. The TCCS showed 21 normal VBA andonly 11 of them were confirmed by DSA.The measure of agreement Kappa between TCCS andangiography was 0.429, P <0.05. Meanwhile, the measure of agreement Kappa between CE-TCCSand angiography was 0.889(P <0.01).Conclusion Contrast-enhanced transcranial color-coded sonography greatly improved the signalsof blood flow in the diagnosis of vertebrobasilar artery stenosis and showed higher consistencywith the results of angiography compared to that of TCCS.
    专题论坛
    Relationship of the Patent Foramen Ovale and Stroke
    NING Bin;HE Wen;XIANG Ying-Dong;et al
    2011, 6(06):  469-472. 
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    Application of Contrast-Enhanced Ultrasound in Cerebrovascular Disease
    WU Dong-Fang;HE Wen
    2011, 6(06):  473-476. 
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    病例讨论
    One Case of Carotid Artery Parietal Thrombus Identified by Color Doppler Ultrasound
    2011, 6(06):  477-479. 
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    指南与规范
    Management of Patients with Stroke: Identification and Management of Dysphagia: A National Clinical Guideline
    HUA Rong-Rong;DING Ze-Yu;WANG Chun-Yu
    2011, 6(06):  480-494. 
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    综述
    Application of Contrast Enhanced Ultrasound in Patent Foramen Ovale
    HUANG Wen- Yan;HE Wen;DU Li-Juan;et al
    2011, 6(06):  495-498. 
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    There are three major examination methods of diagnosis patent foramen ovale (PFO):transesophageal echocardiography (TEE), transthoracic echocardiography (TTE) and transcranialDoppler ultrasonography (TCD). Recently, contrast ultrasonography is applied extensively inclinical diagnosis, and it improves the diagnostic accuracy of PFO significantly. The paper willsummarize the value of three contrast enhanced ultrasound methods in diagnosing of PFO, andprovide more accurate and effective information for the clinicians.
    Progress of Ultrasound Imaging Techniques for Detecting Vertebro-Basilar Stenosis andOcclusion
    YANG Song;HE Wen;DU Li-Juan
    2011, 6(06):  499-502. 
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    Vertebro-basilar stenosis and occlusion can cause ischemia of the posteriorcirculation, and increase risk of stroke recurrence. Intra-arterial angiography is the gold standardof identify vertebro-basilar stenosis and occlusion. Recently, the new techniques associated withultrasound have been developed rapidly. It is possible to use ultrasound to identify vertebro-basilarstenosis and occlusion in the early stage. This article summarize the progress of ultrasound imagingtechniques for detecting vertebro-basilar stenosis and occlusion, to increase the understanding ofultrasound imaging for detecting the vertebro-basilar stenosis and occlusion.