Table of Content

20 October 2009, Volume 4 Issue 10

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What Can I Do ?——Writing for the Coming 2009 World Stroke Day

WANG Yong-Jun

2009, 4(10):  779-781. 

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To Establish a Platform for the International Exchange, to Show Stroke Study in China

LIU Li-Ping

2009, 4(10):  782-783. 

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For physicians in Xining, China

Luois R Caplan

2009, 4(10):  784-786. 

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To Improve Education Work on Stroke Rehabilitation

ZHANG Tong

2009, 4(10):  787-789. 

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Analysis on Prognostic Factors on the Walking Ability of Lower Limb Function inPatients with Left Hemiplegia

CHEN Wei;LU Hai-Tao;ZHANG Qi;et al

2009, 4(10):  790-794. 

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Objective To explore the associated factors that influence the walking ability of lower limb in patients with hemiplegia and to provide a basis of prognosis for walking ability of lower limb function. Methods Sixty-four stroke patients with left side hemiplegia were received comprehensive rehabilitation regularly for 1 month. The assessment procedure for cognitive function were performed by MMSE(mini-mental status examination), LOTCA(Loewenstein Occupational Therapy Cognitive Assessment), MI(Motor Impersistence), Schenkenberg line bisection test before treatment. Brunnstrom stage, Modified Barthel Index, Berg balance assessment scale(sitting and standing balance), Ueda, Bin hemiplegic finger function assessment scale, Holden walking function classification were graded for the lower limb function and the walking ability before and after training. The multivariant logistic regression analysis was used to analyze the relationship between those factors and the lower limb function and the walking ability. Results The results showed that the extent of resumption of walking ability of the lower limb was positively correlated with the score of operational thinking ability in LOTCA before treatment and also the standing balance ability in Berg balance scale(P <0.01) before training. However, it was negatively correlated with the score of the Motor impersistence and the extent of the attention(P <0.01). Conclusion The ability of operational thinking in LOTCA, the standing balance ability in Berg balance scale, attention ability and the scores of MI before training were helpful in prognosis for the walking ability of the lower limb function in patients with left side hemiplegia.

Different Characters of Acalculia in Patients with Left or Right Cerebral Hemisphere Injury

PANG Hui;YUN Xiao-Ping.

2009, 4(10):  795-798. 

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Objective To compare the scores of number processing and calculation standardized test(NPC test) between patient group and normal control group. To investigate features of acalculia in patients with different lateral brain injury. Methods Forty patients with brain injury (twenty left-brain damaged cases, nine right-brain damaged cases and eleven bilateral brain damaged cases) and forty-eight normal persons were tested with NPC. The data of all subjects were statistical analyzed. Results Patient group had lower total scores and items’ scores for number sequences, numerical comprehension, numerical transcodings, calculation than normal control group in NPC test(P <0.01). LBD patients’ total scores and items’ scores for numerical transcodings, calculation in NPC test were lower than RBD group(P <0.05). The scores did not significantly differ between BBD group and LBD group, or between BBD group and RBD group(P >0.05). Conclusion The abilities of number processing and calculation in patient group are lower than those in normal group. The impairment performance of number processing and calculation in LBD patients is closely associated with verbal ability. The impairment performance in RBD patients has relation with non-verbal cognitive ability, such as visual-spatial ability.

Effect of Statins on Flow-mediated Dilation in Patients with Cerebral Infarction in the Territory of Middle Cerebral Artery

CHEN Ya-Ling;DONG Qiang.

2009, 4(10):  799-804. 

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Objective To investigate the effect of statins on flow-mediated dilation in patients with cerebral infarction in the territory of middle cerebral artery. Methods Thirty inpatients with first-ever middle cerebral artery(MCA) territory infarction were enrolled within 2 weeks after symptom onset, among whom twenty cases were in statins group and ten cases were in non-statins group. All patients went through FMD and TCD examination, and were followed up 3 months later. The correlation between FMD and hemodynamics of bilateral MCA was studied, and the correlation with prognosis was also assessed. Results The FMD of patients with continuous statins treatment significantly improved after three months[(9.10±2.56)% vs (6.13±1.60)%, P <0.01], and the improvement showed a significant inverse correlation with the change of PI of uninjured MCAs(rs =-0.432, P =0.031). In other words, the more FMD improved, the better compliance the uninjured MCA would get. FMD of non-statins group didn’t show a significant change. Three month FMD of all patients had a positive correlation with prognosis(P <0.05), while the improvement of FMD didn’t show association with the change of serum lipid(P >0.05). Conclusion Statin treatment may improve endothelial function of patients with MCA territory infacrtion by elevating FMD of brachial artery. The improvement of FMD may have an association with better compliance of uninjured MCAs and thus better outcome, and the effect might be lipidindependent.

Profiles of Neuropsychological Impairment in Vascular Dementia and Alzheimer’s Disease

ZHAO Jie-Hao;HUANG Zhi-Heng;WANG Shuo;et al.

2009, 4(10):  805-808. 

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Objective To study the neuropsychological characteristics between different severity of vascular dementia(VaD) and Alzheimer’s disease(AD). Methods The patients in Guangdong general hospital, 252 patients with(125 patients with AD, 127 patients with VaD) and 159 normal control cases were included. Patients underwent a series of neuropsychological assessment including Mini-mental state examination(MMSE), Fuld-Object- Memory Evaluation(FOM), Rapid Verbal Retrieve(RVR), Block Design(BD), and Digit Span(DS). We analyzed the neuropsychological characteristics in AD and VaD patients. Results Scores on all tests had significant differences between different severity groups(P <0.01). In mild group, VaD patients had poorer scores in MMSE, RVR than AD(P <0.05). In moderate and severe group, scores on all tests were no difference(P >0.05) between VaD and AD. Conclusion Neuropsychological assessment can help grade the severity of AD and VaD. RVR test can assist the differential diagnosis of mild AD and VaD.

The Subtypes of Cerebellar Infarctions and Angiopathy of Posterior Circulation

ZHAO Ying-Ying;WANG De-Xin;XU Zhong-Bao;et al.

2009, 4(10):  809-812. 

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Objective To investigate the characteristics of cerebellar infarction with or without occlusive diseases of large arteries, and the relationship between subtypes of cerebellar infarctions and arteries occlusive disease in the posterior circulation. Methods Thirty-five patients with cerebellar infarctions underwent both brain MR imaging and angiography(computed tomographic angiography, or magnetic resonance angiography, or digital subtraction angiography) in Beijing Friendship Hospital from Jan. 2006 to Mar. 2008. The infarction subtype on MRI and angiography features were analyzed. Results (1)The occlusive disease of large arteries were detected in 20 cases(57.1%), in which the intracranial segment of vertebral or basilar arteries were more common(10 cases, 50%) and among those the watershed infarctions appeared in 7 cases(70%). The next were extracranial segment of vertebral artery coexistent with the intracranial vertebral segment or basilar artery(8 cases, 40%) that most commonly with cerebellar infarction in territory supplied by posterior inferior cerebellar artery(PICA)(7 cases, 87.5%). Isolated occlusive disease of extracranial segment of vertebral arteries was detected only in 2 cases(10%) which showed no predilection for certain cerebellar subtypes. (2)In 15 patients(42.9%) with small artery disease, 9 patients(60%) showed watershed infarctions on MRI studies. Conclusion Because of the feature of peculiar blood-supply in the cerebellum, watershed and lacuna infarctions are more common than large territorial infarctions. There is no distinct difference in the subtype of cerebellar infarctions between patients with large artery disease and with small arterial occlusive disease.

The Study on the Risk Factor for Post-Stroke Seizure and it’s Recurrent

YU Dan-Dan;YANG Shi-Bing;ZHAO Xing-Quan;et al.

2009, 4(10):  813-816. 

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Objective To explore the possible risk factors for single seizure and recurrent seizures occurred in post-stroke cases in terms of seizure medical control and prevention purpose. Methods One hundred and twenty-two cases admitted into hospital with post-stroke seizures were included and followed up for six months to five years period(from 2004-2008) in this study. All included subjects were divided into two groups: single seizure group defined as unique seizure followed up at least six months(26 cases), while recurrent seizures defined as ≥2 seizures(96 cases). The demographic and clinical features, the seizure type and initial onset time, the infarct location and the electroencephalographic(EEG) findings were compared between the two groups. Results Univariately statistics indicated that patients with later onset post-stroke seizures(defined as seizures occurred >14 days after stroke) had a tend to be associated with recurrent seizures compared to patients with early onset one(defined as seizures occurred within 14 days after stroke). Meanwhile, final multiple regression model study further showed that recurrent seizures was greatly associated with partial seizures(OR=10.50; 95%CI 1.35-81.97) and late seizures(OR=3.628; 95%CI 1.237-10.638). Conclusion Patients with late post-stroke onset seizures or partial seizures are more at risk of recurrent seizures.

The Efficacy and Safety of Urinary Kallidinogenase in Treatment of Acute Cerebral Infarction

SONG Yan-Yan;WANG Shao-Shi;CHEN Zhen-Li.

2009, 4(10):  817-820. 

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Objective To investigate the efficacy and safety of Urinary Kallidinogenase in the treatment of acute cerebral infarction(ACI). Methods Two hundred patients with ACI were randomly divided into the control group and treatment group. The two group patients were all given a basic therapy, but the patients in the treatment group were given the extra treatment with Kallidinogenase injection for seven to fourteen days. They were all given etiological treatment and neurological rehabilitation. All patients were evaluated by the National Institute of Health Stroke scale(NIHSS), Activity of Daily Living Scale(ADL) and the modified Rankin scale(mRS) before the therapy and after the therapy. Results The improvement in NIHSS, ADL and mRS scores of these patients was significant after treatment, and the treatment group has a significant improvment than the control group. In our study, there was not different between the two groups in the side-effect of Urinary Kallidinogenase. Conclusion Urinary Kallidinogenase showed a relatively confirmative effect on improving cerebral functions and activities of daily living in patients with ACI.

Relationship between Blood Glucose Level of Community Patient and Stroke Severity and Prognosis

LIU Chun-Yan;LI Wei-Yang.

2009, 4(10):  821-823. 

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Objective To explore the relationship between blood glucose level and both condition and prognosis of the community type 2 diabetes mellitus patients complicated with stroke. Methods One hundred and twenty community patients suffered from type 2 diabetes mellitus complicated with stroke were enrolled and divided into 3 groups according to their blood glucose level. Relationship between patients’ blood glucose level and both condition and prognosis were observed and analyzed. Results Compared to patients in group 7.8≤Glu≤11.1, patients in group 11.1<Glu≤16.7 showed no significant deterioration(P=0.023), and no difference in prognosis(P=0.316). Patients in group Glu>16.7 showed deterioration significantly than the patients in group 11.1<Glu≤16.7, but no difference in prognosis(P<0.001). Conclusion Type 2 diabetes mellitus patients complicated with stroke in community who had a severely elevated blood glucose level would have a serious condition and poor prognosis. Prognosis may be improved if blood glucose level administration was enhanced.

Effect of Motor Relearning Program on Recovery of Motor Ability and P300 Potential of the Cerebral Infarction Patients

YU Qian;LI Xiao-Hong;QIN Bo;et al.

2009, 4(10):  824-827. 

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Objective To investigate the function of motor relearning program with rehabilitation on motor and P300 potential function of cerebral infarction patients. Methods All fifty-two patients were treated with motor relearning program. After 12 weeks, then they were evaluated with Fug-Meyer balance accumulated points, sheikh accumulated points; Fug-Meyer sports accumulated points; Holdon accumulated points and P300 potential. Results Berg accumulated points; Fug-Meyer accumulated points, Sheikh accumulated points and Holdon accumulated points increased significantly. The latency of P300 decreased significantly (P<0.01), and the amplitude of P300 increased significantly in the cerebralin farction patients. Conclusion Motor relearning program may have a positive effect on effectively recovering the P300 and sports function of cerebralin infarction patients.

Quantitative Evaluation of Common Carotid Artery Elasticity by Echo-Tracking Technique in Internal Carotid Artery Occlusion of Cerebral Infarction

WU Dong-Fang;HE Wen;YAN

2009, 4(10):  828-831. 

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Objective To investigate the elastic properties of the common carotid arteries(CCA) in the right Internal carotid artery occlusion of cerebral infarction with high resolution ultrasound and echo-tracking technique. Methods Twenty cases with right cerebral infarction in hospital were investigated. Twenty healthy volunteers were selected as controls. The carotid arteries were scanned using a high frequency linear array probe. In cerebral infarction groups, the CCA were measured. Pressure-strain elasticmodulus(Ep), stiffness(β) and the arterial compliance(AC), augmentation index(AI), one-point pulse wave velocity(PWVβ) were obtained by echo-tracking technique. Results Ep, β, AI and PWVβ in Internal carotid artery occlusion group were significantly higher than those of control group, AC was lower than that of control group. There was positive correlations between Ep, AC, AI, PWVb, Ds, Dd and the sex. Conclusion Echo-tracking technique may be assess CCA elastic properties accurately and quantitatively. It is a simplicity method in assessing the artery elasticity.

Clinical Analysis of Cerebrovascular Diseases Related to Pregnancy

FENG Bi-Bo;WEN Ting-Ru;ZHAI Jian-Jun.

2009, 4(10):  832-835. 

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Objective To explore the risk factors, clinical features and maternal-fetal outcome with cerebrovascular diseases related to pregnancy. Methods Clinical data of 7 cases with cerebrovascular diseases related to pregnancy were analysed retrospectively in our hospital from May 1999 to May 2009. Results All the patients occurred in the 3rd trimester or puerperium. Among 7 cases, 5 were diagnosed with preeclampsia/eclampsia, including 1 with cerebral vessel malformation, 1 with nephrotic syndrome, 1 with anemia. 1 with infection, among whom, 3 mothers died, 1 fetus died. Conclusion Preeclampsia/eclampsia is the major leading cause of cerebrovascular diseases related to pregnancy. A better outcome will be achieved if the diagnosis and treatment were given in time.

The Classification Diagnosis Procedure and Treatment Evidence of Cerebral Infarction

CHEN Xin-Ping;YU Feng-Chun

2009, 4(10):  836-839. 

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Alberta Provincial Stroke Strategy——Inpatient Care for Acute Stroke Admissions

GUO Xu;CHE Feng-Li;LUAN Jing-Yu

2009, 4(10):  840-842. 

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综述

The Assessment of Implicit Memory and its Rationale

LU Li-Ping;YUN Xiao-Ping.

2009, 4(10):  843-849. 

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The review introduced the assessment of priming effect and skill learning in implicit memory area and its rationale. It provides better choice for clinical assessment of implicit memory. Because the domains in implicit memory are not only correlate but also different each other, many measures of implicit memory only aim directly at a certain domain or class. Then, we should choose the representative assessment, and consider conducting a comprehensive and focused one.

Advances about Hazardness in the Silent Stroke

周娟;秦海强;王春雪

2009, 4(10):  850-853. 

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As the availability and quality of imaging techniques improve, the silent stroke has been deeply impressed. Silent stroke is prevalent in the old populations, and the studys about its etiology, pathogenesis, inspection means, prevalence rate and risk factors have been reported largely. However, we still lack of the knowledge about the hazardnesses, especially the cognitive impairments .The silent stroke should be paid more attention in the early time and dealed with as soon as possible.

临床研究与临床试验

The Significance, Calculation Methods and Attention about Sample Size in the Clinical Research

DONG Fen;LI Chao;PENG Xiao-Xia;et al

2009, 4(10):  854-859. 

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教学园地

The Teaching Explore on Single-Gene Hereditary Cerebral Small Vessel Disease

LI Wei;LI Gui-Lin;WANG Yong-Jun

2009, 4(10):  860-862. 

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