Table of Content

20 December 2017, Volume 12 Issue 12

Previous Issue    Next Issue

Moment of Youth

WANG Yong-Jun

2017, 12(12):  1073-1075.  DOI: 10.3969/j.issn.1673-5765.2017.12.001

Asbtract ( )   PDF (2256KB) ( )  

Related Articles | Metrics

The Prognosis Evaluation of Non-disabling Ischemic Cerebrovascular Events

GUO Yi-Nan,PEI Lu-Lu, SI Pan, XU Yu-Ming, SONG Bo

2017, 12(12):  1077-1080.  DOI: 10.3969/j.issn.1673-5765.2017.12.002

Asbtract ( )   PDF (1791KB) ( )  

References | Related Articles | Metrics

Clinical Study on Correlation between Levels of Serum Homocysteine, High Sensitivity C-reactive Protein and Subtypes of Ischemic Stroke

GUO Zhen-Fang, WANG Gui-Hua, GUI Yong-Kun,WANG Hao-Liang, YAN Hai-Qing, ZHANG Ping

2017, 12(12):  1081-1085.  DOI: 10.3969/j.issn.1673-5765.2017.12.003

Asbtract ( )   PDF (2166KB) ( )  

References | Related Articles | Metrics

Objective To investigate the differences of homocysteine (Hcy), high sensitivity C-reactive protein (hs-CRP) on large-artery atherosclerosis and small vessel occlusive ischemic stroke (IS), and the association between the two and complete IS and progressive IS. Methods A total of 217 participants with large-artery atherosclerosis (LAA) ischemic stroke (n =130) and small artery occlusive (SAO) ischemic stroke (n =87) based on trial of org 10 172 in acute stroke treatment (TOAST) were recruited in this study. The cases number of progressive stroke (PS) in LAA group and SAO group were 58 and 12 respectively. The level of serum Hcy and hs-CRP contents were measured and compared between two groups. Results (1) Hcy (P <0.019), hs-CRP (P =0.021), and low density lipoprotein (LDL) (P =0.012) were significantly different in the LAA and SAO groups by logistic regression analysis, and the levels of serum Hcy, hs-CRP and LDL in the LAA stroke group were significantly higher than those in the SAO group. (2) There were significant difference in Hcy (P <0.001), hs-CRP (P =0.017) and LAA (P =0.023) after correction of mixed factors in progressive and complete stroke, and serum levels of Hcy, hs-CRP and LAA were significantly higher in all patients with progressive stroke than those with complete stroke. (3) There were no significant difference in the levels of Hcy between PS and complete stroke in LAA, while the levels of hs-CRP were higher in PS. Conclusion Hcy, hs-CRP and LDL are the independent risk factors of LAA stroke. Hcy, hs-CRP, and LDL can be used as one of the indicators of IS classification. Hcy, hs-CRP and LAA are the independent risk factors of PS.

Study on the Relationship between Middle Cerebral Artery Plaque and Infarct Type by High-resolution Magnetic Resonance Imaging

XU Man-Man, XU Yun, ZHOU Fei, ZHANG Xin, ZHANG Bing,WANG Yi-Feng, LI Jing-Wei

2017, 12(12):  1086-1092.  DOI: 10.3969/j.issn.1673-5765.2017.12.004

Asbtract ( )   PDF (2324KB) ( )  

References | Related Articles | Metrics

to analyze the relationship between the stenosis of the middle cerebral artery (MCA) atherosclerosis and the type of infarction distribution, and further explored the different types of cerebral infarction and plaque nature, remodeling rate and the possible mechanism of stroke in patients. Methods The clinical data of patients with MCA blood supplied ischemic stroke and highresolution magnetic resonance imaging within 14 days of treatment from Nanjing Drum Tower Hospital in 2012-2016 were analyzed retrospectively. Perforating artery infarct (PAI), pial infarct (PI), border zone infarct (BZI) and mixed infarcts (PAI+PI, PAI+BZI, PI+BZI, PAI+PI+BZI) were performed on diffusion weighted imaging (DWI). The stenosis rate and remodeling rate of MCA M1 were measured on sagittal HRMRI, and the morphological indexes such as position, length and thickness were collected. The reconstruction rate of positive remodeling (PR) was more than 1.05 and negative remodeling (NR) was low than 0.95. Patients with PAI, PI, and BZI were divided into single type infarct group. Patients with PAI+PI, PAI+BZI, PI+BZ, PAI+PI+BZI were assigned to mixed type infarct group. Results A total of 51 patients with MCA stenosis ≤50% were included in the study. Among which, 32 cases were in single type infarct group and 19 cases were in mixed type infarct group. There were 22 cases of patients with PAI (68.8%), 6 patients with PI (18.7%) and 4 with BZI (12.5%), 22 patients with PR (68.8%) in single. In the mixed type infarct group, 7 were PAI+BZI (36.8%), 2 were PAI+PI (10.6%), 5 were PI+BZI (26.3%) 5 were PAI+PI+BZI (26.3%), and 17 were PR (89.5%). The degree of stenosis in the mixed type infarct group was more severe (P =0.01) and the plaque thickness was larger (P =0.001) than single type infarct group, which had significant difference. Conclusion Different degrees of middle cerebral artery stenosis had different distribution of infarction. In single type infarct group, the cerebral infarction pattern was mainly PAI, while PAI+BZI was most common in mixed. At the same time, HRMRI found that increased stenosis and plaque thickness might be associated with mixed infarction for patients with mild MCA stenosis.

Protective Effect of Troxerutin and Cerebroprotein Hydrolysate on Neurovascular Unit in Rats after Middle Cerebral Artery Occlusion

ZENG Jing, WANG Ru, LI Dan-Dan, ZHAO Hong-Yi,ZHANG Wei-Wei, HUANG Yong-Hua

2017, 12(12):  1097-1103.  DOI: 10.3969/j.issn.1673-5765.2017.12.006

Asbtract ( )   PDF (2585KB) ( )  

References | Related Articles | Metrics

Objective To investigate the protective effect of Troxerutin and Cerebroprotein Hydrolysate on neurovascular units after focal cerebral ischemia, and to explore the mechanism of its protective effects. Methods The middle cerebral artery occlusion (MCAO) was used to induce the focal cerebral ischemia model in rats. A total of 120 male SD rats were randomly divided into sham operation group (n =40), MCAO group (n =40), and MCAO + Troxerutin group (n =40). The MCAO + Troxerutin group was given Troxerutin 3 ml/kg, 1 time per day for 3 days after the operation by intraperitoneal injection. Modified Neurological Severity Score (mNSS) was used to evaluate the behavior changes of 3 d, 7 d and 14 d after embolization. Three days after embolization, the infarct area and blood flow was tested by T2 and ASL sequence of 7.0T high resolution MRI. Nissl staining was used to evaluate the survival rate and morphological changes of neurons. Immunofluores  staining was used to assess the expression of endothelial cells, astrocytes and tight junction markers in each group; furthermore, Western blot was used to evaluate the expression of 3-nitrotyrosine (3-NT), matrix metalloproteinase 9 (MMP-9) and inducible nitric oxide synthase (iNOS) in each group. Results Three days after MCAO, compared with the sham group, the ASL sequence of MCAO group showed a significant reduction of blood flow in the infarct area; nissl staining showed a reduction in neuronal survival, a large number of vacuoles, and pyknosis; immunofluorescence showed that endothelial cells and tight junction markers decreased and astrocytes increased; and Western blot demonstrated that iNOS, 3-NT and MMP-9 increased. While for MCAO + Troxerutin group, the blood flow of infarct area was significant decreased; the survival of neurons, the molecular marker of endothelial cells and tight junction were increased. Astrocytes and iNOS, 3-NT, MMP-9 were significant decreased compared with MCAO group. Conclusion Troxerutin and Cerebroprotein Hydrolysate could inhibit the expression of iNOS and MMP-9 and reduce the production of 3-NT, so as to play a role of protecting the neurovascular cells of MCAO rats.

Study on Consistency and Accuracy of ASPECTS after the Initial Training

DENG Guo-Li,ZHOU Long-Jiang, ZHAO Yi, CHEN Bin, WANG Li-Tong, PENG Wei, WANG Wei

2017, 12(12):  1104-1110.  DOI: 10.3969/j.issn.1673-5765.2017.12.007

Asbtract ( )   PDF (2229KB) ( )  

References | Related Articles | Metrics

Objective To evaluate the consistency and accuracy of Alberta Stroke Program Early Computed Tomography Score (ASPECTS) after the initial training, so as to lay a foundation for the clinical applications and propagations. Methods Brief clinical materials of 30 patients with suspected acute ischemic stroke were collected within 6 hours after onset. A total of 28 employees (21 from imaging department and 7 from neurology department) with different professional working-year (18 people with 10 years or more as senior employees, and the other 10 with less than 10 years as junior employees) were selected to make ASPECTS for all the patients’ first admission noncontrast CT (NCCT) after their initial training. The ASPECTS was taken as a categorical variable. Its consistency was evaluated by Fleiss Kappa statistics, and its accuracy was assessed by the correct rate. Results The overall ASPECTS Kappa value was 0.102, and 95% confidence interval was (0.094, 0.110); the raters Kappa value and 95% confidence interval from imaging department was 0.116 (0.105, 0.128); the raters Kappa value and 95% confidence interval from neurology department was 0.067 (0.034, 0.099). Accuracy: the correct rate of 28 raters was 15.595% after 840 case-time ASPECTS in overall. With the method of dichotomy (ASPECTS ≥6 and <6) the correct rate was  73.571%. Statistics result of chi-square test for the two methods had significant difference (P <0.05). The dichotomy correct rate of imaging department and neurology department were 74.92% and 69.523% respectively, which had no significant difference. The correct rate of senior employees and junior ones were 74.814% and 61.665% respectively, which had no significant difference. Conclusion The consistency and the accuracy of ASPECTS were relatively low after the initial training, which indicated that more times and strict trainings were very essential and important and Dichotomy (ASPECTS ≥6 or ASPECTS <6) had a relatively good clinical application prospection.

Effect Observation of Butylphthalide Injection in Treating Acute Anterior Circulation Infarction

WU Yu-Fu, LIU Xiao-Hong, GUO Wei-Cheng, ZHAO Jie, WANG Hao-Ran, HE Fei-Fei

2017, 12(12):  1111-1114.  DOI: 10.3969/j.issn.1673-5765.2017.12.008

Asbtract ( )   PDF (2113KB) ( )  

References | Related Articles | Metrics

Objective To observe the clinical curative effect of Butylphthalide injection in treatment of acute cerebral infarction and its influence on collateral circulation. Methods A total of 100 cases with acute anterior circulation cerebral infarction were randomly divided into 2 groups: 50 cases in treatment group and 50 cases in control group. The control group was given routine treatment of Western medicine. On the basis of the control group, the treatment group was treated with butyphthalide injection via intravenous drip, 100 ml, bid, 14 days as 1 course of treatment. After treatment, the clinical efficacy, National Institutes of Health Stroke Scale (NIHSS) score and the compensation of collateral circulation were observed in the two groups. Results The number of cases of collateral circulation in treatment group was significantly higher than that in control group (P <0.05). After treatment for 14 d, the NHISS score of the treatment group was significantly lower than that of the control group (P <0.05). Conclusion Butylphthalide injection was effective establishment in treating acute cerebral infarction, which could promote the establishment of collateral circulation, and improve neurological function.

Prognosis Factors Analysis of Subarachnoid Hemorrhage

ZHOU Hong, YE Shu-Ping, WANG Li-Jing,LIU Li-Ping

2017, 12(12):  1115-1117.  DOI: 10.3969/j.issn.1673-5765.2017.12.009

Asbtract ( )   PDF (2138KB) ( )  

References | Related Articles | Metrics

Objective To explore the prognosis factors of subarachnoid hemorrhage (SAH) and the methods of improving the prognosis. Methods A total of 120 patients of SAH that were recruited during July 2015 and August 2016 were divided into two groups. The patients who were given interventional therapy treatment after having digital subtraction angiography were included in intervention treatment group. The patients who were not given any interventional therapy treatment were included into control group. Results There were many risk factors influencing the prognosis of SAH, among which, age, smoking, hypertension, diabetes mellitus, and no interventional therapy treatment could increase the risk of poor prognosis. Compared with those patients who did not have bad outcomes, the patients with bad outcomes were older (56.7 vs 53.4 years old), and had higher proportion of smoking (48.9% vs 13.3%), higher proportion of hypertension and diabetes mellitus (93.3% vs 66.7%, 77.8% vs 39.9%). And patients with bad outcomes received lower proportion of interventional therapy treatment (37.8% vs 64.0%). Multivariate analysis showed that these risk factors continued to influence the occurrence of bad outcomes. Conclusion Re-bleeding and spasm of blood vessel of brain are the main factors to influence the prognosis. Therefore, the suggestion is to give interventional therapy treatment as early as possible.

Study Progress of Biomarker in Non-disabling Ischemic Cerebrovascular Disease

SI Pan, PEI Lu-Lu,FANG Hui, GUO Yi-Nan, XU Yu-Ming, SONG Bo

2017, 12(12):  1119-1122.  DOI: 10.3969/j.issn.1673-5765.2017.12.010

Asbtract ( )   PDF (2010KB) ( )  

References | Related Articles | Metrics

Transient ischemic attack (TIA), minor ischemic stroke and rapid remission of ischemic cerebrovascular events collectively are defined as non-disabling ischemic cerebrovascular events (NICE), with a high risk of recurrence of early stroke, which need serious and urgent interventions. However, there are no well-known biomarkers with high value in predicting prognosis after NICE. The researches focus on NICE biomarkers to predict outcome rapidly and accurately has become a hotspot. This review is to provide introduction about biomarkers of NICE from aspects of thrombosis factors, inflammatory factors, metabonomics abnormalities and gene, etc.

High Risk Non-disabling Ischemic Cerebrovascular Events and Cognitive Impairment

ZHOU Zhi-Wei,MA Meng-Meng, HE Li

2017, 12(12):  1123-1126.  DOI: 10.3969/j.issn.1673-5765.2017.12.011

Asbtract ( )   PDF (2119KB) ( )  

References | Related Articles | Metrics

Ischemic cerebrovascular disease (ICD) is a kind of cerebral vascular diseases which has high fatality rate and disability rate. ICD is divided into disabling ischemic cerebrovascular event (DICE) and non-disabling ischemic cerebrovascular events (NICE). NICE people are usually not taken seriously, however a large proportion of them are in an unstable state and relapse into severe stroke over a period of time, which is known as high risk non-disabling cerebrovascular events (HR-NICE). Cognitive impairment caused by HR-NICE is a common complication and affects the quality of life and survival time seriously. Therefore, it is of important clinical significance to identify of HR-NICE people and intervene at early stage. This paper is to review the definition, epidemiology, clinical features, evaluation methods and comprehensive intervention methods of HR-NICE, so as to improve the diagnostic and therapeutic level as well as the survival quality of patient.

Stroke: The Position of Life Style Intervention in the Secondary Prevention of Stroke

YANG Zhong-Hua

2017, 12(12):  1127-1127.  DOI: 10.3969/j.issn.1673-5765.2017.12.012

Asbtract ( )   PDF (1677KB) ( )  

References | Related Articles | Metrics

Neurology: The Position of Physical Exercise in The Secondary Prevention of Stroke

YANG Zhong-Hua

2017, 12(12):  1128-1128.  DOI: 10.3969/j.issn.1673-5765.2017.12.013

Asbtract ( )   PDF (1709KB) ( )  

References | Related Articles | Metrics

Story about Stroke—Lallemand was the First to Raise the Inflammation Theory of Stroke

2017, 12(12):  1129-1131.  DOI: 10.3969/j.issn.1673-5765.2017.12.014

Asbtract ( )   PDF (1917KB) ( )  

Related Articles | Metrics

A Case Report on Onset of Cavernous Sinus Thrombosis Caused by Acute Fulminant Rhinocerebral Mucormycosis Infection

SUN Ya-Nan, LI Xiao-Hong

2017, 12(12):  1132-1134.  DOI: 10.3969/j.issn.1673-5765.2017.12.015

Asbtract ( )   PDF (1885KB) ( )  

References | Related Articles | Metrics

A Case Report on Midbrain Infarction with Sole Manifestation of Oculomotor Paresis without Pupil Involvement

WANG Li-Qun, CAI Hong-Bin, WU Chuang, ZHOU Heng

2017, 12(12):  1135-1138.  DOI: 10.3969/j.issn.1673-5765.2017.12.016

Asbtract ( )   PDF (1854KB) ( )  

References | Related Articles | Metrics

Clopidogrel Loading Dose Versus Maintenance Dose to Treat Patients with Acute Ischaemic Stroke：Which One Is Better?

XU An-Ding

2017, 12(12):  1139-1140.  DOI: 10.3969/j.issn.1673-5765.2017.12.017

Asbtract ( )   PDF (2034KB) ( )  

Related Articles | Metrics

Stroke Recovery and Rehabilitation: A Year in Review of Basic Science and Clinical Science

ZHAO Chuan-Sheng

2017, 12(12):  1141-1143.  DOI: 10.3969/j.issn.1673-5765.2017.12.018

Asbtract ( )   PDF (1751KB) ( )  

Related Articles | Metrics

Analysis of Sympathetic Skin Response in Patients with Cerebral Infarction

NIU Xin, LI Guo-Zhong,ZHONG Di, CHEN Hong-Ping

2017, 12(12):  1144-1147.  DOI: 10.3969/j.issn.1673-5765.2017.12.019

Asbtract ( )   PDF (2003KB) ( )  

References | Related Articles | Metrics

Sympathetic skin response (SSR) is the change of skin transient potential evoked by endogenous or exogenous stimuli, which belongs to the sympathetic sweating movement involving the brain and spinal cord. This paper provides an overview of recent clinical studies of sympathetic skin response in patients with cerebral infarction and application value, expounds its clinical effect on autonomic nerve dysfunction in patients with cerebral infarction, correlation and motor function in patients with cerebral infarction, and the value of SSR in the central pathway of sympathetic nerve in inference.

The Research Progress of Vascular Cognitive Impairment-no Dementia

CHEN Hong-Xia,GUO Shan-Shan, WU Yi-Ping, SONG Yan-Li, LIN Jie

2017, 12(12):  1148-1153.  DOI: 10.3969/j.issn.1673-5765.2017.12.020

Asbtract ( )   PDF (2057KB) ( )  

References | Related Articles | Metrics

Vascular cognitive impairment (VCI) is a group of clinical syndromes from mild cognitive impairment to dementia, caused by cerebrovascular disease risk factors (such as high blood pressure, diabetes, hyperlipidemia and high homocysteine levels, etc), the dominant cerebrovascular disease (hemorrhagic and ischemic stroke) and the non-dominant cerebrovascular disease (leukoaraiosis and chronic cerebral hypoperfusion, etc). Vascular cognitive impairmentno dementia (VCIND) is an early stage of VCI, of which about half of patients will progress to dementia within 5 years. The effective treatment of vascular dementia (VD) has not yet been found, but it's the only type of dementia that can be prevented. The discovery of risk factors of VCIND and early intervention is critical for secondary prevention strategies seeking to slow or delay dementia progression. The concept, epidemiology, diagnostic criteria and influencing factors of VCIND are reviewed in order to identify relevant risk factors and prevent vascular cognitive impairmen

Research Progress of Diagnostic Biomarkers Related to Cerebral Infarction

GAO Shuo-Jun,ZHANG Xiang-Jian, ZHANG Pei-Pei

2017, 12(12):  1154-1157.  DOI: 10.3969/j.issn.1673-5765.2017.12.021

Asbtract ( )   PDF (2035KB) ( )  

References | Related Articles | Metrics

In current clinical practice, diagnosis of stroke mainly depends on the physical examination of symptoms and signs as well as imaging examinations. However, many diseases such as migraine, epilepsy may have similar symptoms with stroke, and imaging examination also has certain degree of limitations. With the development of science and technology, more and more diagnostic biomarkers related to cerebral infarction are found, especially the study on nascent proteomics and miRNA family has guiding significance in the diagnosis of cerebral infarction.

Advancements of Diffusion Weighted Imaging and Fluid Attenuated Inversion Recovery Mismatch in Wake-up Ischemic Stroke

SONG Lei, GAO Bo, SHEN Gui-Quan

2017, 12(12):  1158-1162.  DOI: 10.3969/j.issn.1673-5765.2017.12.022

Asbtract ( )   PDF (602KB) ( )  

References | Related Articles | Metrics

Wake-up stroke, with an unknown time of onset during sleep, is a type of ischemic stroke. Limited by the onset time window, intravenous thrombolysis is difficult to implement. As an objective imaging index for judging the time window of the onset of stroke, diffusion weighted imaging (DWI)-fluid attenuated inversion recovery (FLAIR) mismatch has been widely used in recent years. This paper will give a brief overview of the basic principle of DWI-FLAIR mismatch and analysis of its application value, and explore the feasibility and application status of its technology in guiding intravenous thrombolytic therapy of wake-up ischemic stroke by comparing the clinical and imaging characteristics of ischemic stroke with clear onset time window.

Study on Correlation between Postprandial Hyperglycemia and Lower Extremity Venous Hemodynamics in Cerebral Ischemic Stroke Patients

FENG Li-Dan, ZHONG Chi, ZHANG Rui, LI Wen,ZHANG Xiao-Hong

2017, 12(12):  1193-1196.  DOI: 10.3969/j.issn.1673-5765.2017.12.005

Asbtract ( )   PDF (2221KB) ( )  

References | Related Articles | Metrics

Objective To investigate correlation between postprandial hyperglycemia and lower extremity venous blood flow mechanics in patients with ischemic stroke. Methods According to the results of 2-h plasma glucose in the oral glucose tolerance test (2hPG), 162 inpatients with anterior circulation light stroke were selected. They were divided into experimental group with postprandial hyperglycemia (n =90), and control group with normal blood glucose (n =72). After admission, color Doppler ultrasonography was used to examine the morphology and structure of the deep veins of the lower extremities in two groups, and the venous diameter and peak flow velocity of the lower extremities were measured. The biochemical indexes of the two groups were measured by automatic biochemical analyzer. Results There was no significant difference between the two groups in sex, age, smoking, alcohol consumption, hypertension, national institute of health stroke scale (NIHSS) score, body mass index (BMI), total cholesterol (TC), triglyceride (TG), low density lipoprotein-cholesterol (LDL-C), and high density lipoprotein-cholesterol (HDL-C) levels. The 2hPG level in experimental group was higher than normal group (P <0.05). The diameters of common iliac vein, iliac vein, femoral vein, popliteal vein in experimental group was greater than that of the control group (P <0.05). The peak velocity of common iliac vein, iliac vein, femoral vein, popliteal vein in experimental group was lower than control group (P <0.05), which had significant difference. Conclusion In patients with ischemic stroke accompanied by postprandial hyperglycemia, the blood flow velocity of the lower limb vein became slower and the diameter of the vein increased accordingly, which might increase the risk of venous thrombosis in the lower extremities and was unfavorable to the prognosis of the patients.