Table of Content

20 February 2010, Volume 5 Issue 02

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主编手记

New Journey

WANG Yong-Jun

2010, 5(02):  95-98. 

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述评

Ischemic Stroke Caused by Oxidative Stress And Atherosclerosis

BI Qi

2010, 5(02):  99-103. 

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论著

The Study of Relationship between hs-CRP and ABCD2 Score in TIA Patients

SONG Zhe;BI Qi;WANG Li-Feng

2010, 5(02):  104-108. 

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Objective This trail research the relationship between Inflammatory reaction and transientischemia attach (TIA) prognosis by the relationship between serum high sensitive C-reactive protein(hs-CRP) levels and ABCD2 score.Methods Taking the latest definition of TIA in 2009 as inclusion criteria, we retrospectivelyanalysis 70 TIA patients and compare average serum hs-CRP concentration between different risklevels by ABCD2 score.Results There was significant difference between low risk group (score 0-3),mid risk group (score4-5) and high risk group (score 6-7) respectively (P <0.05). There was no significant differencebetween low risk group and mid risk group. In the group of score 0-2, as the ABCD2 score increases,the level of serum hs-CRP becomes greater. The same trend appears in the group of score 3-7 andthe serum hs-CRP level is highest in group of score 7.Conclusion There was positive correlation between hs-CRP and ABCD2 score.

The Comparative Study of Ischemic Demyelination and Normal White Matter on Magnetic Resonance Elastography

SHEN Mi;GAO Pei-Yi;LIN Yan;et al.

2010, 5(02):  109-113. 

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Objective To compare the shear stiffness between ischemic demyelination and normal white matterby using Magnetic Resonance Elastography (MRE).Methods Patients group: 14 consecutive patients with ischemic demyelination at the grade ofFazekas scale II or above defined by routine MR sequences scan in 2009 were involved. Controlgroup: 16 human volunteers in 2009 were enrolled. All the subjects underwent head MRE. Afterpostprocessing raw images by computer, shear modulus of ischemic demyelination area withinsemioval centre in patients group and normal semioval centre in control group were seperativelymessured. We used independent-sample T test to analyze the difference between ischemicdemyelination and normal white matter.Results All the shear modulus of research areas in two groups were successfully obtained, with theresult of right side(8.7±3.0)kPa, and left side(10.9±2.5)kPa in patients group, while right side(16.6±4.5)kPa, and left side(16.4±3.7)kPa in control group, which were significant different.Conclusion The shear stiffness of ischemic demyelination was significantly lower than that ofnormal white matter.

The Value of Single-Photon Emission Computed Tomography Imaging in Extracranial-Intracranial Arterial Bypass Surgery

HE Jie;JI Xun-Ming;ZHANG Ren-Ling;et al.

2010, 5(02):  114-118. 

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Objective To observe the changes of brain blood flow in patients with ischemic stroke before andafter superficial temporal artery to middle cerebral artery (STA-MCA) bypass surgery using singlephoton emission computed tomography (SPECT). To find out the value of SPECT in extracranialintracranialarterial bypass surgery.Methods To analyse the results of 12 patients with ischemic stroke underwent SPECT perfusionscan of cerebral blood flow before and after STA-MCA bypass surgery. To compare the result ofcerebral blood flow perfusion scan of patients with collateral circulation or without before and afterSTA-MCA bypass surgery, respectively.Results The ratio of the impaired area to the opposite area in frontal and temporal lobe in 12patients has statistical significant difference before and after STA-MCA bypass surgery (P <0.01).But in parietal lobe, occipital lobe, basal ganglia and thalamus, that has no statistical significantdifference(P >0.05). Regardless of whether there is collateral circulation in preoperative orpostoperative patients with the above-mentioned parts of the impaired side to the correspondingarea in the contralateral side was no statistical difference in the ratio of radioactive counts (P >0.05).Conclusion Bypass surgery can improve the cerebral circulation less than compensatory braintissue perfusion. The blood flow perfusion of frontal and temporal lobe improved significantly.

The Relationship between the Clinical Outcomes and Changes of Systolic Pressure in Early Stage after Thrombolysis Treatment Using rt-PA in Patients with Ultra-Acute Cerebral Infarction

ZHANG Xin-Yu;WANG Li-Ping;FAN Dong-Sheng;et al.

2010, 5(02):  119-122. 

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Objective To investigate the relationship between the clinical outcomes of thrombolysis treatmentusing recombinant tissue plasminogen activator (rt-PA) in patients with ultra-acute cerebralinfarction and the changes of systolic pressure in 24h and 72h after treatment.Methods One hundred and twelve patients with ultra-acute cerebral infarction treated byintravenous rt-PA were assigned to the poor outcome group[90d modified Rankin Score (mRS) 2-5]and the good outcome group (90d mRS 0-1). The changes of systolic pressure of enrolled patientswere recorded at time of pre-treatment and 24h and 72h post-treatment respectively. Then thesechanges were compared between two groups.Results The decreases of systolic pressure in 24h after treatment in poor outcome group was (7±8)mmHg, comparing with the (10±8) mmHg in good outcome group. There was a statisticallysignificant difference (t =-2.20, P =0.032) of systolic blood pressure variety between the two groups.The decreases of systolic pressure in 72h post-treatment in the two groups were (8±8)mmHg and(10±8)mmHg respectively. There was not a statistically significant difference (t =-1.52, P =0.13)between two groups.Conclusion The descending of systolic blood pressure in 24h after thrombolysis treatment ingood outcomes group was more obvious than that in poor outcomes group. But this difference didnot appear in 72h post-treatment. The degree of the systolic pressure decreasing in 24h after rt-PAthrombolysis potentially was related positively with benign prognosis after 90d.

The Study on Potential Target Cells for DL-3-n-Butylphthalide Protecting Against Ischemic Brain Injury

ZHAO Jia;LI Ling;PEI Zhong;et al.

2010, 5(02):  123-129. 

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Objective To investigate the potential cell types for neuroprotection of DL-3-n-butylphthalideagainst ischemic brain injury.Methods The Oxygen-Glucose Deprivation- Reperfusion models were created in rat adrenalpheochromocytoma (PC12) cells and rat artery endothelial cells (SUVRAEC) and the effect of DL-3-n-butylphthalide on stroke in different cell types was assessed using 3-(4,5-dimethylthiazole-2-yl)-2,5-biphenyl tetrazolium bromide (MTT) assay. The direct free-radical scavenging ability ofDL-3-n-butylphthalide was evaluated using 1,1-diphenyl-2-picrylhydrazyl (DPPH) assay.Results Different concentrations of DL-3-n-butylphthalide (1/10/100μmol/L) did not have anynegative effect on cell viability. DPPH assay did not reveal any direct free-radical scavengingability of DL-3-n-butylphthalide. DL-3-n-butylphthalide concentration-dependently attenuatedOGD-induced decrease in the cell viability in SUVRAEC but not neuron-like PC12 cells. DL-3-nbutylphthalideat an effective concentration could rescue 15% more cells than groups without it andapproximate 90% SUVRAEC in total were alive.Conclusion DL-3-n-butylphthalide selectively protects SUVRAEC against ischemic injury anddoes not have a direct free radical scavenging property.

The Symptomatic Intracraninal Hemorrhage After Local Intraarterial Thrombolysis in Acute Ischemic Stroke: Predicting by Pretherapeutic Imaging

WANG Peng;SUO Yao-Hua;LANG Xiao-Feng;et al.

2010, 5(02):  130-133. 

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Objective To evaluate the predicting of early symptomatic intracraninal hemorrhage (SICH) afterlocal intra-arterial thrombolysis by nonconstrast CT and digital subtraction angiography (DSA)imaging in acute ischemic stroke.Methods Sixty cases of acute ischemic stroke performed local intra-arterial thrombolysis wereretrospective analysis their nonconstrast CT and DSA. They were divided into two group accordingto whether the SICH were diagnosed after operation. The preoperative nonconstrast CT and DSAimages of the two groups were compared.Results SICH were diagnosed in 5 cases. There were statistically significant difference betweenthe two group in old low density on nonconstrast CT, collateral flow supply and the vessel stenosison DSA.Conclusion Local intra-arterial thrombolysis in cerebral infarction in a comprehensive analysis ofpre-imaging can help predict the occurrence of SICH.

Clinical Study of the Effect of Prubucal on Carotid Atherosclerotic Instable Plaque

LI Xiao-Jun;XIAO Wei-Jun.

2010, 5(02):  134-137. 

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Objective To investigat the effects of Prubucal on the soft plaque in the carotid atheroscleroticplaque.Methods One hundred and twenty patients were randomly divided into the treatment group andthe control group, 60 cases in each group.The patients in control group were treated with routinetherapy, whereas patients in treatment group with routine therapy were treated by routine therapyplus prubucal 500 mg bid/day for a course of six months. After six months color Doppler ultrasoundwas performed to examine the plaques’ characteristics, sizes and number, meanwhile blood glucoseand blood lipids were detected and the incidence of adverse events were recorded.Results (1) There was no significant difference in terms of age, sex and size the plaque betweenthe two groups (P >0.05). (2) There was a statistically significant difference in the decrease ofvolume and numbers of soft plaque between two groups (P <0.05). (3) After 6 months treatmentthe incidence of cerebrovascular diseases and cardiovascular diseases in treatment group wassignificantly reduced,as compared to that in control group. This indicated that there was asignificant difference between two groups (P <0.05).Conclusion Prubucal can intervene effectively the development of the soft plaque in thecarotid atherosclerotic plaque,and reduce the incidence of cerebrovascular diseases andcardiovasculardiseases.

专题论坛

Oxidative Stress and Acute Ischemic Stroke Events

GONG Tao

2010, 5(02):  139-142. 

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The Clinical Application Status of Antioxidant

LI Xiao-Gang

2010, 5(02):  143-149. 

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病例讨论

Case of Vertebrobasilar Dolichoectasia

TAI Hong-Fei;ZHANG Zai-Qiang

2010, 5(02):  150-153. 

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指南与规范

Alberta Provincial Stroke Strategy--Secondary Stroke Prevention

WANG Yu-Cai;QIN Hai-Qiang

2010, 5(02):  154-159. 

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综述

The Early Identification and Prevention of Acute Post-stroke Pneumonia Patients at High Risk

HAO Jun-Jie;WANG Shao-Shi;ZHENG Tian-Heng.

2010, 5(02):  161-167. 

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Acute post-stroke pneumonia is one of the most serious complications in strokepatients, and it is the most important cause of bad prognosis and death for acute stroke patients.Understanding its risk factors and immunity function markers for its prediction will be in favor ofthe early identification of high risk patients with acute post-stroke pneumonia. The study of Stroke-Induced Immunodepression System(SIDS) points out a new direction for prevention of the infectionafter acute stroke in clinical. In order to demonstrate the active preventive effects of PreventiveAntibacterial Therapy (PAT), more experiments is needed. Currently, comprehensive interventionmeasures, such as clinical pathway for stroke patients and stroke unit, may be the right choicefor decreasing the occurrence of acute post-stroke pneumonia and promotion of stroke patientsrecovery.

Blood-Brain Barrier and Cerebral Small Vessel Disease

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

2010, 5(02):  168-171. 

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Cerebral small vessel disease is a Microangiopathic disease of a variety of causes,mainly involving the cerebral small artery about diameter of 400μm below. Clinical manifestationsof cerebral small vessel disease as a static cerebral lesions, all kinds of lacunar syndrome andvascular cognitive impairment, imagings show lacunar infarct, white matter ischemic damage,micro-bleeding and vascular space to expand. Changes of blood-brain barrier permeability andcerebral small vessel disease have important relationships, namely, the dysfunctions of vascularendothelial and related structures leading to increased blood-brain barrier permeability, causingleakage of blood components to the tissues around blood vessels and brain parenchyma, secondarythe corresponding pathophysiological changes, which leads to cerebral small vessel disease relatedto imaging and pathological changes.

The Correlation of the White Matter Lesions and Chronic Cerebral Ischemic

WANG Juan;ZHANG Wei-Wei;WEI Wei.

2010, 5(02):  172-177. 

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White matter Lesions are mostly results of the chronic cerebral ischemia, butcerebral white matter lesions can destroy neurons between the cortex and subcortical signaltransmission , resulting in cognitive dysfunction and gait abnormalities. Ultimately lead topersistent or progressive cognitive and neurological dysfunction. It should arouse our attention.This paper describes the vulnerability of white matter lesions factors, the mechanisms of chroniccerebral ischemia-induced white matter lesions and after ischemia white matter recovery.

教学园地

How Can Have Both The Fish And Bear's Paw?--A Preliminary Study on Vascular Neurology Postgraduate Training Model of Integration of Clinical Research

WAGN Chun-Xue;CHEN Pan;ZHAO Xing-Quan;et al

2010, 5(02):  178-180. 

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