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Table of Content

    20 November 2009, Volume 4 Issue 11
    主编手记
    Craving
    WANG Yong-Jun
    2009, 4(11):  867-869. 
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    述评
    The Progression of Cerebrovascular Surgery in 2009
    ZHAO Yuan-Li
    2009, 4(11):  871-872. 
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    论著
    Study On Molecular Predictive Biomarkers For Early Hematoma Growth ofIntracerebral hemorrhage
    WANG Xian-Wei;WANG Yi-Long;ZHOU Yong;et al.
    2009, 4(11):  877-882. 
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    Objective To study dynamic change of hematoma volume, and the correlation between molecularbiological markers of peripheral blood and early hematoma growth in the patients with intracerebralhemorrhage, we aimed to identify the predictive factors of early hematoma growth, we also hope toexplore the possible pathophysiologic mechanism of early hematoma growth.Methods It was an open, prospective, single-centered cohort study. 67 spontaneous cerebralhemorrhagic patients within 6 hours after onset were collected consecutively from Apr. 2007 toDec. 2007, 54 patients were enrolled in the study based on inclusion and exclusion criteria. Clinicaldata and blood samples were collected. Cellular fibronectin, matrix metalloproteinase-9, tissueinhibitor of metalloproteinases-1 of spontaneous cerebral hemorrhagic 54 patients were measuredwith commercially available quantitative sandwich enzyme-linked immunosorbent assay kits,laboratory regular measures such as fibrinogen were collected. Patients were divide into two groupsby hematoma growth criterion, Potential predictors of early hematoma growth were analyzed byunivariate analysis or logistic regression.Results Among all recruited patients who were given CT scan at 24 hours after the onset ofICH, 16 cases appeared hematoma growth, thus the incidence of hematoma growth was 29.63%.Independent-Samples T Test revealed that the fibrinogen level was remarkably lower in hematomagrowth patients than that of non-hematoma growth patients(2.3±0.7 vs 2.9±0.7g/L, P =0.008), and χ2test revealed that the incidence of hematoma growth in patients with irregular-shaped hematoma oninitial CT scan was higher than that of patients with a round hematoma(50.0% vs 13.2%, P =0.011).Multivariate analysis of predictors of hematoma growth revealed that there were two independentrisk factors of hematoma growth, while c-Fn was not, MMP-9(OR=12.093, P =0.032) & fibrinogenlevel(OR=0.162, P =0.041) which may predict the growth of hematoma volume.Conclusion MMP-9 and fibrinogen level were two independent risk factors of hematoma growth,but cellular fibronectin and tissue inhibitor of metalloproteinases-1 were not related to hematomagrowth.

    Protective Effects of Etomidate Preconditioning Against Focal Cerebral Ischemia-Reperfusion Injury in Rats Subjected to Middle Cerebral Artery Occlusion
    FAN Yi-Fang;HAN Ru-Quan.
    2009, 4(11):  883-886. 
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    Objective To investigate the protective effect of etomidate preconditioning against transient focalcerebral ischemic injury in rats.Methods Eighteen male SD rats were divided randomly into 3 groups(n=6 per group) ofischemia-reperfusion group, etomidate preconditioning group and lipomicroballoons controlgroup respectively. All rats were subjected to middle cerebral artery occlusion(MCAO) withnylon monofilamen for 120 min and reperfusion for 24 hours. Etomidate 50mg&#8226;kg-1&#8226;h-1 orlipomicroballoons was infused 30 min before MCAO. Rectal temperature and blood glucose weremonitored during experiment. After 24 hours reperfusion the neurological score was evaluated byGarcia method and the infarct volume was assessed by TTC staining.Results The infarct volume of etomidate preconditioning group was significantly smaller than thatof lipomicroballoons control group(P <0.01) and smaller than that of ischemia-reperfusion group(P <0.05) at 24h after reperfusion.Conclusion Etomidate preconditioning significantly decreases the infarct volume induced byMCAO in rats.
    Cinical Studies Of Atorvastatin’s Therapy on Patients with Ischemic Stroke
    ZHANG Gui-Ru;YU Zhong-Feng.
    2009, 4(11):  887-891. 
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    Objective To explore the effects of atorvastatin on carotid atherosclerotic plaque in patientssuffering with cerebral infarction(CI) or transient ischemic attack(TIA).Methods One hundred and twenty patients with CI or TIA were randomly divided into therapygroup and control group. The patients in control groups were given anti-platelet aggregation asroutine treatment, and the patients in therapy group were administered anti-platelet aggregation and20mg atorvastatin every night. In the time before treatment, 1 months and 6 months after treatment,Totalcholesterol(TC), Low density lipoprotein-cholesterol(LDL-C) and hige density lipoproteincholesterol(HDL-C) were detectd, while quality and intima-media thickness(IMT) of carotidatherosclerotic plaque were assessed.Results In therapy group, the levels of TC and LDL-C in therapy group were all obviouslydecreased after 1 month and 6 months(P <0.01), and the IMT of carotid atherosclerotic plaque intherapy group were lessened after 6 months(P <0.01). Compared with control group, proportion oflow and mix reverberation plaque of carotid atherosclerotic in therapy group were all obviouslydecreased after 1 month and 6 months(P <0.01), and proportion of high reverberation plaque ofcarotid atherosclerotic had increased(P <0.01). In therapy group, proportion of high reverberationplaque of carotid atherosclerotic in 6 months were increased than one in 1 months(P <0.01). Incontrol group, the reverberation plaque of carotid atherosclerotic were no significant differencesbetween before and after treatment.Conclusion Atorvastatin can decrease the level of LDL-C and TC, and good for stabilize andinverse carotid atherosclerotic plaque.
    The Study on Effect of Deep Dyslexia through Cognitive Neuropsychology Rehabilitation
    SONG Lu-Ping;ZHENG Xiu-Li;SHEN Shu;et al.
    2009, 4(11):  892-895. 
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    Objective Evaluating the targeted rehabilitation training effect of Chinese patient with deepdyslexia in order to observe the effectiveness of the cognitive neuropsychology rehabilitation.Methods We evaluate the cognitive neuropsychological rehabilitation training effect of apatient with deep dyslexia using longitudinal comparative study, and comparing transversalythe rehabilitation effect of three patients who have deep dyslexia with/without cognitive neurorehabilitationtraining techniques and through natural recovery progress as well.Results Patient who has targeted cognitive neuro-rehabilitation improves the reading test by65.24%, also decreases both semantic and orthographic errors, however three patients who recoveronly through natural recovery process improve by 13.73%-30.47%.Conclusion The targeted cognitive neuro-rehabilitation training for patients with deep dyslexia hasa certain good effect, and this method has a potential future in the clinical application.
    A Study of White Matter Lesions on Cognitive Function in Patients with Ischemic Cerebrovascular Disease
    SUN De-Jin;ZHANG Yi;LIANG Xi-Hong;et al.
    2009, 4(11):  896-901. 
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    Objective To investigate different degrees of white matter lesions on cognitive function in patientswith ischemic cerebrovascular disease.Methods Patients with ischemic cerebrovascular disease were consecutively included. Stroke riskfactors were recorded. Neuropsychological tests, such as the Montreal cognitive assessment(MoCA),were carried out. Age-related white matter changes rating scale(ARWMCRs) was used to semiquantitativescore white matter lesions following neuroimaging examination. According to theARWMCRs scores, patients were divided into three groups: mild, moderate and severe group. Thedifference of neuropsychology, neural electrophysiology and the ability of daily life were comparedamong the three groups.Results The moderate and severe groups got lower neuropsychological testing scores(P <0.01)compared with the mild group. Correlation analysis showed that white matter lesions had a negativerelationship with neuropsychological tests(MoCA)(r =-0.677, P <0.01).Conclusion White matter lesions impact patients with ischemic cerebrovascular disease incognitive function, the more serious of white matter lesions, the more significant decline incognitive function.
    The Study of Neovascularization within Carotid Atherosclerotic Plaques of Contrastenhanced Ultrasonography on Ischemic Stroke
    WEI Li-Ya;HE Wen;ZHANG Hong Xia;et al.
    2009, 4(11):  902-906. 
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    Objective To quantitatively assess the neovascularization within human carotid atheroscleroticplaque in patients with ischemic stroke by real-time contrast-enhanced ultrasonography.Methods Ninety-six patients with carotid atherosclerotic plaques were examined with real-timecontrast-enhanced ultrasonography and divided into two groups: Stroke group including sixtyeightpaitents with ischemic stroke and non-stroke group including twenty-eight patients withoutischemic stroke. Carotid atherosclerotic plaques were detected using the real-time contrastenhancedultrasonography and analyzed using coded phase-inversion harmonic ultrasound(CPI)technology analysis software. The results of the two groups were compared.Results The enhanced rate and enchanced intensity of stroke group was significantly higher thanthat of non-stroke group(P <0.05). The arrival time(AT) and the time to peak(TTP) have significantlydifference in different position of the same group(P <0.05), and did not have significantly differencein the same position of different group(P >0.05).Conclusion The real-time contrast-enhanced ultrasonography can assess the neovascularizationwithin carotid atherosclerotic plaque non-invasively and quantitatively, and provide valuableinformation for plaque risk stratification. The density of intraplaque nevascularization in carotidarteries on ischemic stroke is higher than that of the control group.
    An Abnormal Swallowing Mode in Dysphagia Patients After Ischemic Stroke
    ZHANG Jing;WEI Na;YANG Ya-Qin;et al.
    2009, 4(11):  907-910. 
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    Objective To identify the nature of an abnormal swallowing mode of dysphagia patients afterstroke.Methods Twenty-one ischemic stroke patients undertook the videofluoroscopic swallowstudy(VFSS) by drinking 5ml 60%w/v barium. From admission to VFSS, the median was5 days(0-9). During larynx elevation, the distance of larynx antedisplacement(“y” mm) andelevation(“x” mm) in every 0.03s were recorded. The value of y/x means the antedisplacementdistance of larynx in every millimeter of larynx elevation. The locus line was drawn in thecoordinate system with y/x to be the y axis, time was the x axis.Results Total 6 patients demonstrated a special kind of abnormal swallowing mode different fromthe other patients in the 21 patients. From the lateral image of swallow, abnormal swallow modecould be identified with the characteristics of significant antedisplacement of larynx during itselevation. Between patients group with or without abnormal mode, the maximum(P =0.002) of y/xdiffered significantly. In the locus line, six lines showed biggest y/x value more than 1.5mm, whileother lines centralized in the area with the upper margin lower than 1.5mm.Conclusion There may be abnormal swallow mode of significant antedisplacement of larynx instroke patients, which was associated with the strengthened contraction of suprahyoid muscles.
    专题论坛
    The Application of Intraoperative Neurophysiologic Monitoring in Surgical Treatment for Intracranial Aneurysm
    LIN Jia;ZHAO Ji-Zong;ZHAO Yuan-Li;et al
    2009, 4(11):  912-919. 
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    Research Progress of the Treatment of Cerebral Ischemic Disease with Adipose-Derived Stem Cells
    CHU Chun;ZHAO Yuan-Li
    2009, 4(11):  920-923. 
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    病例讨论
    A Case Report on the Seizures and Epilepsy After the Internal Cerebral Watershed Infarction
    MAO Rui;JIN Ling-Jing;NIE Zhi-Yu
    2009, 4(11):  924-926. 
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    综述
    Pathological Changes of the Moyamoya Disease Vessels
    HE Jin;ZHANG Dong;ZHAO Yuan-Li;et al.
    2009, 4(11):  933-936. 
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    Moyamoya disease (MMD) is a rare cerebral vascular disease. And it is characterizedby the stenosis or even occlusive patent. The cardinal and basic pathological change is the fibercell-alike intimal thickening at the stenosis part of the cerebral artery, accompanied by the thinnedsmooth muscular layer and proliferated intimal elastic layer. Usually, the terminal ICA and its mainbranches, such as the ACA and MCA are the most common lesions. However, further researchesrevealed that the pulmonary artery and renal artery may have similar changes. Besides, the MCAwere proved with significant apoptosis.
    Near-Infared Spectroscopy Apply to Cerebral Ischemia
    ZHANG Shu-Kun;CAI Ding;WU Shi-Zheng.
    2009, 4(11):  937-940. 
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    In recent years, the incidence of cerebral ischemia is increasing. It is of greatimportance to make an early diagnosis and timely treatment to reduce the morbility and mortality.Generally, the cerebral ischemia can be cured if the disease could be diagnosed within half anhour. Therefore many scholars thought that forecast and prevention were more important thantreatment. Near infrared spectroscopy(NIRS) can be used for non-invasive assessment of thebrain function through an skull in human subjects by detecting changes in blood hemoglobinconcentrations associated with neural activity and monitoring oxygen saturation degree and bloodstream dynamics of partial cerebrum in real time. NIRS have many excellent characteristics such astime and space resolution, portable and bedside monitoring. NRIS has become a useful method forclinical brain physiology examination. It has been widely used for diagnosis, treatment, monitoring,and rehabilitation by monitoring the values of Hb, OxyHb and cerebral blood flow despite certainlimitations. NIRS is safe, non-invasively and easy to operation. NIRS will be widely used in clinicalpractice.
    教学园地
    Improving the Teaching Quality of Vascular Neurology in China According to Global Minimum Essential Requirements in Medical Education
    LI Jing-Jing;JU Yi;ZHAO Xing-Quan;et al
    2009, 4(11):  941-944. 
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