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Table of Content

    20 June 2009, Volume 4 Issue 06
    主编手记
    Princeton Forever
    WANG Yong-Jun
    2009, 4(06):  443-3. 
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    论文
    Highlight Report of Lecture in Shenzhen: Standards for the Diagnosis and Treatment ofCerebrovascular Diseases
    QIN Hai-Qiang;Zhang Ya-Qing;WANG Chun-Xue
    2009, 4(06):  446-2. 
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    述评
    Transient Ischaemic Attack Resarch: Yesterday, Today and Tomorrow
    BI Qi;WANG Li-Feng;SONG Zhe
    2009, 4(06):  448-6. 
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    论著
    Pilot Study of the Relationship between Cerebrovascular Stenosis and ABCD2 Score in Transient Ischemic Attack Patients
    WANG Li-Feng;BI Qi;SONG Zhe
    2009, 4(06):  454-4. 
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    Objective To evaluate the relationship between ABCD2 score and cerebrovacular stenosis of patients with transient ischemic attack(TIA).Methods We retrospectively reviewed the medical records of 88 patients with TIA; all of them were examined with the magnetic resonance angiography(MRA). All patients were divided into two groups according to cerebrovascular vascular stenosis ≥50% or not, and divided into two groups according to ABCD2 score ≥4 point or not. The relationship between ABCD2 score andcerebrovaculare vascular stenosis was analyzed.Results Group stenosis ≥50% were more likely to have ABCD2 score ≥4 compared with group stenosis <50%(74.4% vs 44.9%, OR =3.559, 95%CI 1.428-8.868, P =0.005). Group stenosis ≥50% were more likely to have stroke history than those stenosis <50%(33.3% vs 10.2%, OR =4.400,95%CI 1.408~4.869, P =0.01). The stroke within 2 days after TIA is higher in group cerebrovascular stenosis ≥50% than that in group stenosis <50%(10.3% vs 0%, OR =0.417, 95%CI 0.324-0.537,P =0.04).Conclusion The patients with ABCD2 score≥4 show higher rate of cerebrovascular stenosis. Patients with previous stroke more likely to undergo cerebrovascular vascular stenosis. The stroke within 2 days after TIA is higher in patients with cerebrovascualr stenosis ≥50%.
    Effect of Ginkgolides Against Brain Edema and Neuron Ultrastructural Injury on SAH Rats with Cerebral Lymphatic Blockade
    LIU Xi-Chang;ZHANG Gui-Ru;SUN Bao-Liang;et al.
    2009, 4(06):  458-6. 
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    【Abstract】Objective To determine the effect of cerebral lymphatic drainage pathway on brain water content and neuronic ultrastructure secondary to subarachnoid hemorrhage(SAH), and to observe the protective role of Ginkgolides.Methods 90 mature male Wister rats were randomly divided into six groups: negatived control group, SAH group, Cerebral lymphatic blockade(CLB)+SAH group, CLB+SAH+ Normal Sodium(NS) group, CLB+SAH+20mg/kg Ginkgolides group(Gl20) and CLB+SAH+80mg/kg Ginkgo ides group(Gl80). Cistern magna injection twice of freshly autologous arterial blood was used to induce SAH in rats, and CLB model in rats was established by occlusion of cervical lymphatic tubes and removal of cervical lymphatic nodes. 24h and 72h after induction of SAH,brain water content was detected. Electron microscope was used to observe neuronal ultrastructures 72h after SAH model inducted.Results SAH increased brain water content. Increasing of brain water content were more severe in CLB+SAH group than that in others group. Compared with SAH+CLB group, brain water content in CLB+SAH+Gl groups were decreased, brain water content were a remarkable decreased in SAH+CLB+Gl80 groups. The neuronal ultrastructures of the rats showed different extent of destruction except for the ras of negatived control group. The destruction of neuronal ultrastructures were more severe in CLB+SAH group.Conclusion Brain lymphatic drainage pathway might play important role in brain edema and neuronal ultrastructure injury after SAH. Ginkgolides may relieve brain edema and injury of neuronal ultrastructure after SAH rats with CLB.
    Blood Pressure Control in Patients with Ischemic Stroke and TIA in Beijing: a Cross-sectional Study
    WU Di;WANG Yi-Long;ZHOU Yong;et al.
    2009, 4(06):  464-6. 
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    Objective To assess the current status of blood pressure control and antihypertensive drugs use in patients with ischemic stroke and transient ischemic attack (TIA), and to identify the potential factors associated with the use of these drugs in Beijing.Methods We conducted a cross-sectional survey to investigate the administration of antihypertensive drugs in patients with IS or TIA at 11 neurological clinics in Beijing from July 01 to August 15, 2006. All subjects diagnosed with chemic stroke or transient ischemic attack (TIA) were enrolled consecutively.Results Overall, 1247 patients were included. Hypertension was diagnosed in 919 (73.7%) of total patients, of whom 413 (46.8%) had systolic blood pressure (SBP) <140mmHg and diastolic blood pressure (DBP) <90mmHg. In addition, only 39 (13.1%) of 297 patients with diabetes had BP under control (SBP<130mmHg and DBP<80mmHg). Of 919 patients with hypertension, 739 patients had at least an antihypertensive therapy prescription. The percentages of different types were as follows: calcium channel blocker (CCB), 61.2%(452/739); angiotensin converting enzyme inhibitor (ACEI), 26.8% (198/739);β-receptor blocker, 15.7% (116/739); compound preparation, 15.2% (112/739); diuretics, 8.0% (59/739); angiotensin-II receptor blocker (ARB), 7.7% (57/739);α-receptor blocker, 1.3% (13/739). The main reasons for non-use of antihypertensive drug were patients thought their condition turning better (42.7%) and lacked of doctors’ recommendation (29.8%).Conclusion The adherences to guideline of secondary prevention among ischemic stroke or TIA patients in the hospitals in Beijing are very poor. BP control among ischemic stroke or TIA patients in the hospitals of major metropolitan cities in China does not reach the BP goals recommended by clinical guidelines, especially in the patients with diabetes. Effective strategies must be implemented to close the gap between clinical guidelines and practice.
    Analyze the Pathogenesis by the Iconography Categories and Risk Factors of Stroke of Non Valvular Atrial Fibrillation
    FENG Shao-Dan;WU Gang.
    2009, 4(06):  470-5. 
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    Objective To study the pathogenesis of cerebrovascular disorders by analyzing the categories of cerebral infarct and the related risk factors of the NVAF patients. Methods From 2005 to 2007, we investigated the patients of cerebrovascular disorders of the NVAF in the first affiliated hospital of Fujian Medical University, and analyzed the categories of cerebral infarct and their related factors of NVAF and VAF by CT and MRI of brain. Results We found the same risk factors of the stroke patients with NVAF and VAF were heart failure and hyperfibrinogenemia, and the different factors were that the VAF-related cerebrovascular disorders was closely relation with the faster ventricular rate and the NVAF -related cerebrovascular disorders was closely related to hypertension, carotid plaques, diabetes mellitus and hyperlipemia(χ2=8.80, P=0.003; χ2=17.75, P<0.001; χ2=4.06, P<0.05; χ2=6.50, P=0.01). The distribution ratio of categories of them were different, and the reason of the stroke patients of the VAF was mainly aortic embolism(χ2=23.98, P<0.001), however, the NVAF was aortic embolism, cortical branch infarct, watershed infarct and lacunar infarct and so on, especially watershed infarct(χ2=15.08, P<0.001). Conclusion NVAF patients may suffer from a variety of cerebral infarctions, especially watershed infarct. In the meantime, they were closely related to the risk factors of atherosclerosis (including hypertension, hyperlipemia and hyperglycemia). We thought that hemodynamic changes may be one of the important pathogenesis of cerebral infarct.
    Effect of rt-PA and Edaravone on the Expression of MMP-9 in Rats with Cerebral Ischemic Injury
    HU Ying;LI Xiao-Gang.
    2009, 4(06):  475-5. 
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    【Abstract】 Objective To study the protection mechanism of Edaravone following thrombolytic therapy in rt-PA against focal cerebral ischemia reperfusion injury in rats.Methods A rat model of embolic stroke was set up in each of the rats of groups embolizing the middle cerebral artery by thrombus(MCAO). 112 SD rats were randomly divided into 4 groups: A the sham operation group(n=28), B the model group without treatment(n=28), C rt-PA group(n=28), D combined edaravone with rt-PA group (n=28). The infarction volume of brain was investigated by 2, 3, 5-Triphenyl tetrazolium chloride (TTC) coloring and the neurologic deficit scores of rats were documented. The histological morphological damage of brain was investigated by hematoxylin-eosin (HE) staining. The expression of matrix MMP-9 in brain tissue was observed by immunohistochemistry method.Results Contrast to group B, the volume of brain infarction in rats of group C was obviously smaller (P<0.01), the score of neurologic impairment assessment was lower(P<0.05), the expression of MMP-9 was obviously decreased(P<0.05); Contrast to group C, the volume of brain infarction in rats of group D was obviously smaller(P<0.01), the score of neurologic impairment assessment was lower(P<0.05), the expression of MMP-9 was obviously decreased(P<0.05).Conclusion It is assumed that combination Edaravone with rt-PA thrombolysis may inhibit MMP-9 expression, then relieve the damage of reperfusion to BBB, and may prolong the thrombolytic therapeutic time window. Our study suggest that Edaravone could be potent neuroprotector against brain ischemia injury.
    Inhibition Effect of Probucol on the Level of MMP-9 in Acute Stage of Cerebral Infarction
    HUANGFU Chun-Mei;LU Xue-Hai;YUAN Jian-Xin.
    2009, 4(06):  480-4. 
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    Objective To observe the effect of probucol on the level of MMP-9 in acute stage of cerebral infarction.Methods Using a random and single blind control test ,82 patients with cerebral infarction in acute stage were randomed into probucol group (n=42) and control group (n=40). With the method of ELISA, the levels of MMP-9in serum were measured before and after therapy.Results (1) The serum MMP-9 levels of Probucol group pre-treatment was 398.67±84.92ng/ml, two weeks after treatment 173.80±55.68ng/ml, significantly lower than that before treatment (P<0.05); The serum MMP-9 levels of control group pre-treatment serum levels was 401.12±62.56ng/ml, two weeks after treatment 352.98±89.65ng/ml, no significant difference between before and after treatment (P>0.05); (2) At the end of two weeks after treatment, the serum MMP-9levels of robucol group was significantly lower than that of control group (P<0.05).Conclusion Probucol can reduce the level of MMP-9 in acute stage of cerebra linfarction, thus may relieve the ischemic brain injury.
    专题论坛
    Significance of DWI Abnormalities in the Study of TIA
    LI Xiao-Qing
    2009, 4(06):  485-4. 
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    Redefinition and Pathophysiology of Transient Ischemic Attack
    LI Xiao-Gang
    2009, 4(06):  490-5. 
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    Relationship between Transient Ischemic Attack and Stroke, Cardiovascular Disease and Peripheral Arterial Disease
    YANG Lei;HU Wen-Li
    2009, 4(06):  495-5. 
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    病例讨论
    Case of Negative Diffusion-Weighted Image in Cerebral Infarction
    XU Zhi-Qi;ZHENG Xiao-Hong
    2009, 4(06):  500-3. 
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    指南与规范
    National Clinical Guideline for Diagnosis and Initial Management of Acute Stroke and Transient Ischaemic Attack(TIA)(Part Three)
    GONG Jie-Qin;LIANG Hui
    2009, 4(06):  503-16. 
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    综述
    Progress in Animal Models of Cerebral Vasospasm in vivo
    JIA Li;ZHANG Lei;SUN Bao-Liang.
    2009, 4(06):  519-5. 
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    【Abstract】 Cerebral vasospasm caused by subarachnoid hemorrhage is a major cause of poor prognosis, but the pathogenesy has not been understood completely until now. Therefore, establishing an ideal animal model of cerebral vasospasm following subarachnoid hemorrhage will have an enormous advanced effect on research of pathogenesy, clinical prevention and cure of cerebral vasospasm. However, there is still not an ideal model used for studying symptomatic cerebral vasospasm following subarachnoid hemorrhage. The author reviewed the advancement of different animal models of cerebral vasospasm.
    Research Advance in Risk Factors of Youth Stroke
    LIU Cong;Tong Xiao-Xin
    2009, 4(06):  524-5. 
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    Although stroke usually occurring in the elderly, the incurrence of stroke in youth is increasing year by year. There are many diverse causes of stroke in young adults. Principal causes are premature atherosclerosis, cervical artery dissection, cardioembolism, immunological disorders and so on. This article reviews the etiology and risk factors of youth stroke.
    教学园地
    Using Case-Based Study as Teaching Tools for Clinical Practice Courses of Vascular Neurology
    CHEN Sheng-Yun;ZHAO Xing-Quan;ZHANG Xing-Hu
    2009, 4(06):  529-3. 
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    Teaching Experience of Diagnosis and Treatment Related to Post-Stroke Epilepsy
    DING Cheng-Yun;HUANG Shang-Meng;ZHAO Yuan;YU Dan-Dan
    2009, 4(06):  532-3. 
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