Table of Content

20 June 2010, Volume 5 Issue 06

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主编手记

Bottom Line

WANG Yong-Jun

2010, 5(06):  427-428. 

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述评

To Build a Bridge between Guidelines and Practice and to Regulate the Secondary Prevention of Ischemic Stroke and Transient Ischemic Attack in China

XU An-Ding

2010, 5(06):  429-430. 

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论著

Relationship between Carotid B-Ultra Sound Changes and Glucose Metabolism in Transient Ischemic Attack Patients

ZHANG Cheng-Guo;ZENG Guang-Lun;HUANG Shu-Yun;et a

2010, 5(06):  431-435. 

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Objective To explore the Carotid B-Ultrasound changes in transient ischemic attack (TIA) inpatients,and to study the relationship between carotid atherosclerosis and glucose metabolism disorders.Methods One hundred and twenty nine cases of TIA patients were collected from the department of neurology in our hospital from July 2007 to March 2009. We recorded the clinical information of the patients. The biochemical tests and carotid artery ultrasonography were performed.Results There were 92 patients with different degrees of carotid atherosclerosis, the incidence rate was 71.3%. There were 70 patients with carotid atherosclerosis plaques, 78 patients with carotid artery intima-media thickening, 16 patients with moderate to severe carotid artery stenosis. Age, history of hypertension, BMI(body mass index, BMI), LDL-C(Low density lipoprotein -cholestrol, LDL-C), 2hPG(2 hours plasma glucose, 2hPG) and HbA1c(Glycosylated hemoglobin, HbA1c) were independent risk factors for TIA patients’ carotid atherosclerosis(CAS). The carotid artery ultrasound indicators of TIA patients with impaired glucose regulation and Diabetes mellitus (DM)were higher than patients with normal glucose tolerance. (P<0.05); Although there was a gradual upward trend of the above indicaters, the difference was not statistically significant between patients with impaired glucose regulation and patients with DM(P>0.05).Conclusion Most of TIA patients have different degrees of carotid atherosclerosis, which is related to age, history of hypertension, BMI, LDL-C, 2hPG and HbA1c. Most of TIA patients have abnormal glucose and obvious lesion of CAS. Its extent is similar with diabetes patients.

Relationship between Vascular Cognitive Impairment with Serum Homocysteine and Carotid Artherosclerosis

WANG Xiao-Juan;LI Jun-Tao;PENG Wei-Ping;et al

2010, 5(06):  436-439. 

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Objective To investigate the relationship between vascular cognitive impairment with serum homocysteine(Hcy)and carotid artherosclerosis.Methods One hundred and forty-seven cerebral infarction patients from February 2007 to July 2009 were selected. According to the Neuropsychologic examination, they were divided into two groups: vascular congnitive impairment(VCI) group and normal cognitive group. Ultrasonography of carotid artery were performed in all patients. The concentration of serum Hcy were tested in two groups. The Neuropsychologic examination of both groups were compared.Results The concentration of Hcyin vascular cognitive impairment group was higher than that of control group(P<0.05). The scores of MMSE in the intima-media thickness(IMT)<1.0mm group were higher than that in the IMT>1.0mm group(P<0.05).Conclusion Vascular cognitive impairment was related to serum Hcy and Carotid artherosclerosis.

Survey on the Knowledge, Attitude, Practice about Hypertension and Prevention of Stroke among Aged ≥ 50 of the Community Population

RU Xiao-Juan;WANG Wen-Zhi;WU Sheng-Ping;et al.

2010, 5(06):  440-444. 

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Objective To know the situation of knowledge, attitude, practice about hypertension and prevention of stroke among the selected community population.Methods One thousand three hundred and fifty-two non-stroke subjects aged ≥50 years were selected by cluster random sampling from two districts of Beijing including 50,000 people respectively, to investigate the level of knowledge, attitude, practice about risk factors and prevention of stroke.Results Chongwen group and Shijingshan group in education showed different, Chongwen group was higher than Shijingshan group, and the difference was statistically significant(P<0.01). But there was no difference in sex, age as well as blood pressure. In the aspect of knowledge, the awareness rate of simple diagnosis standard of hypertension in Chongwen group was higher than that in Shijingshan group. Whereas the awareness rate about hypertension leading to ischemic and hemorrhagic stroke is opposite. In the aspect of attitude and practice, the subjects who thought it necessary to often measure blood pressure were both more than 80% in two groups. The subjects who had ever examined blood pressure in two groups both achieved 90%, but it was higher in Shijingshan group than that in Chongwen group. Hypertension patients accepting antihypertensive treatment in two groups were more than 85%.Conclusion Due to high prevalence of hypertension in aged ≥ 50 of community population, it’s necessary to further improve the health education about prevention of hypertension and stroke.

Investigation on Current Status of Rehabilitation in Stroke at Fengtai district in Beijing

WANG Yan;CHEN Sheng-Yun;ZHAO Xing-Quan;et al.

2010, 5(06):  445-448. 

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Objective To grasp the current status of rehabilitation knowledge in stroke patients and their caregivers, and the development of community based rehabilitation(CBR)service in Beijing.Methods Questionnaires were used for investigating 198 stroke residents and 194 of their caregivers at Fengtai district in Beijing. The samples gained by random sampling. The designed questionnaires were filled in.Results Only 9.7% patients and 9.3% caregivers said that they were familiar with rehabilitation. About 65.2% patients and 63.0% caregivers hoped to receive rehabilitation in community. But there were only 34.4% patients and 42.0% caregivers expressed that they had received community based rehabilitation.Conclusion This investigation showed that the awareness rate and practice rate about stroke rehabilitation in that district were in a low level. Education of rehabilitation knowledge should be strengthened and CBR for stroke residents should be developed further.

Study of Association between Matrix Metalloproteinase-3 Gene Promoter Polymorphisms and Carotid Artery Stenosis

SUN Xiao-Ming;SONG Yu-Qiang;ZHANGChen;et al.

2010, 5(06):  449-453. 

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Objective To detect a possible association between Matrix metalloproteinase-3 (MMP-3) promoter-1612 5A/6A polymorphisms and increased risk of carotid stenosis. To investigate the mechanisms by which MMP-3 polymorphisms are involved by examining serum concentrations of MMP-3.Methods A total of 421 carotid-artery stenosis patients who underwent carotid B-mode ultrasonography and control subjects without significant sternosis were selected into the study. The MMP-3 genotype was determined by polymerase chain reaction-restriction fragment length Polymorphism (PCR-RFLP) and the serum MMP-3 concentration was quantified with enzyme-linked immunosorbent assay (ELISA).Results The 6A/6A genotype was associated with carotid sternosis (OR=2.55, 95%CI 1.07-6.07, P=0.026), and the frequency of the 6A allele was significantly higher in patients with carotid sternosis (OR=1.58, 95%CI 1.08-2.33, P=0.014). Carotid sternosis patients had higher serum MMP-3 concentration than controls (19±9 vs 16±7μg/L, P<0.01). There was a strong association between MMP-3-1612 5A/6A genotype and serum concentrations of MMP-3.Conclusion MMP-3 promoter -1612 5A/6A polymorphisms are associated with carotid stenosis, and 6A allele predicts an increased risk of carotid stenosis, in which the increased serum concentration of MMP-3 is involved.

Analysis of Risk Factors of Ischemic Stroke Recurrence

DOU Ru-Xiang;LI Zhuo-Xing;LIN Kai-Si;et al.

2010, 5(06):  454-458. 

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Objective To investigate the risk factors and mechanism of ischemic stroke recurrence.Methods Data of 195 patients with ischemic stroke in our hospital were collected. Including age, smoking, history of hypertension or diabetes, the serum levels of lipid, homocysteic acid, fibrinogen, and high sensitivity C-reactive protein (hsC-RP), ultrasonic of the carotid arteries. We follow up the patients for 2 years. Patients were divided into 2 groups: ischemic stroke recurrence group and non-recurrence group. We analyzed the different of risk factors between these 2 groups.Results One hundred and ninety-five cases were included in the present study, 3 of them died of other system disease, 52 of 192 patients(27.1%)had ischemic stroke recurrence. Single factor analysis showed that age, level of hsC-RP and fibrinogen were higher in the ischemic stroke recurrence group than those in non-recurrence group; History of hypertension or diabetes, and carotid plaque were more frequent in the ischemic stroke recurrence group. Logistic regression analysis showed that: hsC-RP>3mg/L(OR 2.72; 95%CI 1.35~5.46;P=0.005)and Fg>4g/L(OR 2.31; 95%CI 1.16~4.58;P=0.017)were the independent predictors of ischemic stroke recurrence.Conclusion Higher hsC-RP and fibrinogen concentration in acute phase after ischemic stroke are the independent predictors of ischemic stroke recurrence.

Clinicl Comparative Study on Urinary Kallidinogenase Treatment for Acute Cerebral Infarction

SHAO Jing-Shan;YAN Zhi-Min;FENG Yu-Lan;et al.

2010, 5(06):  459-462. 

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Objective To explore the curative effect and security of Urinary Kallidinogenase for acute cerebral infarction comparing to cerebral protective agent Edaravone injection.Methods One hundred and seventy-eight cases of patients with acute cerebral infarction were randomly divided into Urinary Kallidinogenase treatment group and Edaravone control group. The treatment group: 88 cases were treated with Urinary Kallidinogenase 0.15PNA solved in normal saline 250ml intravenous drip once a day for two weeks. The control group: 90 cases were treated with Edaravone 30mg solved in normal saline 250ml intravenous drip twice a day for two weeks (a total of 14 days for one course of treatment). To compare the National Institutes of Health Stroke Scale (NIHSS) score, Barthel index score and monitor these biochemical indexes of CRP, NSE pre-treatment, 14 days post-treatment , and 90 days post-treatment.Results The NIHSS score of treatment group and control group both showed significant difference between pre-treatment and post-treatment (P<0.01); But the comparison of the NIHSS score between the two groups showed no significant difference (P=0.5867). Barthel Index score comparison: the Barthel Index score between the two groups showed no significant difference 14 days after treatment (P=0.2839); but the two groups showed significant difference 90 days after treatment (P=0.004). The NSE and C-RP values of treatment group and control group both showed significant difference between pre-treatment and post-treatment, but NSE and C-RP values of the treatment group showed no significant difference compared with the control group.Conclusion The effect of the treatment of Urinary Kallidinogenase for acute cerebral infarction is not less than edaravone, and Urinary Kallidinogenase has better long-term effect than edaravone.

编者按

Speical Forum: Interpretations of the Secondary Prevention Guidelines of Ischemic Stroke and Transient Ischemic Attack in China

XU An-Ding

2010, 5(06):  463-463. 

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专题论坛

Non-drug Therapy of Patients with Large-artery Atherosclerotic Stroke

GAO Shan;ZHOU Li-Xin

2010, 5(06):  464-467. 

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Control of Stroke Risk Factors: Hypertension

WANG Jie

2010, 5(06):  468-471. 

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Antithrombotic Therapy of Cardiogenic Cerebral Embolism

WANG Jie

2010, 5(06):  472-478. 

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Control of Stroke Risk Factors: Glucose Metabolism Disorders

ZHONG Li-Yong

2010, 5(06):  479-483. 

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病例讨论

One Case of Dural Arteriovenous Fistula Leading to Malignant Tumour-like Brain Edema

LI Lin-Xin;DONG Qiang;HUANG Lei;et al

2010, 5(06):  484-486. 

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指南与规范

Medication Errors in Acute Cardiovascular and Stroke Patients ——A Scientific Statement From the American Heart Association (Part 1)

BAI Ying;WAGN Chun-Yu

2010, 5(06):  487-490. 

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综述

Advances in Study of the “Weekend Effect” on Stroke

XU Ying-Xin;WANG Chun-Xue;CHEN Li-Yun;et al.

2010, 5(06):  491-495. 

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In the research of the relationship between admission time and mortality, experts found that the mortality of weekend admission is higher than workday admission's. This phenomenon is called ‘Weekend Effect’. There are considerable studies have been conducted all over the world in order to reduce stroke mortality and disability. The purpose of this article is to give a review on the weekend effect on stroke and further recognizing on the weekend effect, such as background, mechanism and prevention in recent years.

Advances of Research on Magnetic Resonance Imaging for Patients with Post-stroke Depression

HOU Jing-Jing;ZHANG Ning;WANG Chun-Xue;et al.

2010, 5(06):  496-505. 

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Post-stroke depression (PSD) is a common complication of cerebrovascular disease. To strengthen the recognition of PSD and to improve the understanding of PSD mechanism and diagnostic means will redound to improve the diagnostic and therapeutic level of PSD. This article reviews the advances of the research on magnetic resonance imaging for the patients with PSD, including magnetic resonance spectroscopy (MRS), diffusion tensor imaging (DTI) and resting-state functional magnetic resonance imaging (rfMRI).

教学园地

Practice of Clinic Teaching in CVD Intensive Care Uni

SHI Guang-Zhi;ZHOU Jian-Xin

2010, 5(06):  506-508. 

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