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Table of Content

    20 July 2009, Volume 4 Issue 07
    述评
    Carotid artery ultrasound and clinic
    2009, 4(07):  0-552. 
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    主编手记
    Persistence
    2009, 4(07):  535-536. 
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    热点报道
    Highlight Report of XVIII European Stroke Conference
    2009, 4(07):  537-540. 
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    Explore • Pursue • Hope——Highlight Report of Tiantan International Stroke Conference 2009
    2009, 4(07):  541-546. 
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    论著
    A Monocentric Preliminary Research Result on Acute Stroke Complicating withUpper Gastrointestinal Bleeding
    2009, 4(07):  553-556. 
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    Objective To observe the incidence of upper gastrointestinal bleeding in acute stroke.Methods We choosed the acute stroke patients hospitalized in Tiantan hospital and registered by Registry of Acute Cerebrovascular Events in China (RACE-CHINA), retrospectively analyze their medical history records.Results From August 2007 to July 2008, 1 408 acute stroke cases were registed in RACECHINA of Tiantan hospital, only 40 cases were finally diagnosed upper gastrointestinal bleeding, the incidence of acute stroke complicating with upper gastrointestinal bleeding was 2.84%.The mean years of age of upper gastrointestinal bleeding patients was 63±9.The incidence of upper gastrointestinal bleeding in cerebral hemorrhage was a little higher than cerebral infarction and subarachnoid hemorrhage(2.98% vs 2.75%; 2.98% vs 2.84%). Acute stroke with conscious disturbance, larger volume cerebral hemorrhage and cerebral infarction in vertebrobasilar systemhad a tendency to complicate with upper gastrointestinal bleeding. Upper gastrointestinal bleeding often occurred one or two weeks after acute stroke and persistenced about one week. The mortality of acute stroke was 7.0%, but when upper gastrointestinal bleeding appeared, the mortality of acutestroke would go up to 30%. Conclusion Upper gastrointestinal bleeding was severe complication of acute stroke and was one of the main risk factors which hinted unfavorable prognosis . Age, gender, stroke type, hemorrhage volume and conscious state were possibly the principal risk factors. We should think highly of thecomplication and enhance the prevention and management on it.

    Neovascularization within Carotid Atherosclerotic Plaques with Contrast-enhanced ultrasonography Angiography----Preliminary Clinical Experience
    2009, 4(07):  557-561. 
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    Objective To observe composition of plaque and the features of neovascularization within human carotid atherosclerotic plaques with contrast-enhanced ultrasonography angiography.Methods Real-time contrast-enhanced ultrasonography(Contrast carotid duplex scanning) was performed in twenty patients with twenty-nine plaques of different degree of echogenicity. The features of plaques on contrast-enhanced ultrasonography were analyzed and compared with sizeand property of plaques.Results Twenty-eight plaques were enhanced on contrast-enhanced ultrasonography while nine plaques of them were enhanced from periphery of carotid wall to the center of the lesions withshort-line pattern and thirteen plaques were enhanced from periphery of carotid wall and carotidlumen to the center of the lesions with sparse spots pattern, and six plaques were enhanced fromcarotid lumen to the center of the lesions with sparse spots pattern. Nine plaques of enhancedatherosclerotic plaques were soft plaque. Fifteen plaques were mixed plaque. One of five hardplaques was unenhanced plaque.Conclusion The real-time contrast-enhanced ultrasonography is a more sensitive and noninvasiveway of demonstrating the hemodynamic of neovascularization within human carotid atheroscleroticplaques.
    Evaluate the Relationship between Asymmetrical Carotid Arteriosclerosis and Wall Shear Stress by Ultrasound
    2009, 4(07):  562-565. 
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    Objective To evaluate wall shear stress in both sides of asymmetrical carotid atherosclerosis patients, and analyze the relationship between wall shear stress and carotid atherosclerosis.Methods 78 participants screened by doppler ultrasound examination who presented unilateralplaque were enrolled. Internal diameter(ID), peak systolic velocity(Vp), and intima-media thickness (IMT) of common carotid were measured by doppler ultrasound independently.. Evaluate the difference of τ m and IMT between the carotids with and without atherosclerotic lesions,andanalyze the relationship between τ m and IMT by linear correlation analysis.Results ID is larger in the side with atherosclerotic lesions than in the side without lesions(6.7±0.9mm vs 6.1±0.8mm, P <0.01). IMT is thicker in the side with atherosclerotic lesions than in the side without lesions(1.3±0.2mm vs 0.8±0.1mm, P <0.01). τ m is lower in the side with atherosclerotic lesions than in the side without lesions(18±5 dynes·cm-2 vs 23±9 dynes·cm-2,P <0.01.) IMT is negatively correlated with τm.Conclusion In asymmetrical carotid atherosclerosis, wall shear stress is different between the different sides, which is lower in the carotid arteries where plaques are present than in plaque-free arteries obviously. The wall shear stress is negatively correlated with IMT. These findings providein vivo evidence for a association between wall shear stress and atherosclerotic lesions.
    Evaluation of Helicobacter Pylori Stool Antigen ImmunoCard STAT and ASSUREHelicobacter Pylori Rapid Test for the Detection of Helicobacter Pylori Current Infection in Patients with Cerebrovascular Infarction
    2009, 4(07):  566-571. 
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    Objective To evaluate the diagnostic efficacy of Helicobacter pylori(Hp) stool antigen test (ImmunoCard STAT HpSA) and serological test (helicobacter pylori rapid test with current infection marker, CIM Hp RT) for Hp current infection in patients with cerebrovascular infarction.Methods Stool and boold samples of 93 patients were taken. The patients were evaluated with ImmunoCard STAT HpSA and CIM Hp RT. HpSA was detected using a lateral flow chromatography technique based on monoclonal antibody and Serology was done elsewhere using CIM Hp RT. Theresult assessment was taken by masked fashion. Analysis was carried out by paired Chi-square test(Mc Nemar Test) and the consistency of two determinations was evaluated using Kappa statistics.Results The prevalence of Hp current infection in patients with cerebrovascular infarction of ImmunoCard STAT HpSA and CIM Hp RT was 47.3%(44/93) and 52.7%(49/93), respectively.The total coincidence rate was 75.3%(70/93). There was no significant difference between the twodeterminations(P =0.405). The Kappa value for consistency was 0.507(95%CI 0.333-0.681, P <0.01).Conclusion The two determinations are helpful tools in the detection of Hp current infection in patients with cerebrovascular infarction and show moderate consistency.
    Imaging Features of Dural Arteriovenous Fistula
    2009, 4(07):  572-575. 
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    Objective To discuss the imaging features of dural arteriovenous fistula(DAVF).Methods The imaging features of DAVF patients after 2005 were analyzed retrospectively.Results Thirty-two cases suffering from DAVF were treated from 2005. CT and MRI examintionscould well show the intracranial lesions secondary to DAVF including the enlarged draining veins,hemorrhage, and narrow and occluded venous sinus. DSA could exactly show the orifices, feedingateries and draining veins of DAVF, and distribution of the intraranial blood flow, but not thecerebral parenchyma lesion secondry to of DAVF.Conclusion DSA is an ideal and reliable method for the diagnosis of DAVF. CT and MRI canprovide the useful information for the diagnosis of DAVF.
    Expression of MMP-9, TIMP-1 in Tissue of CAVM and Their Relationship withHemorrhagic History in CAVM
    2009, 4(07):  576-580. 
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    Objective To examine the expression of matrix metalloproteinase-9 (MMP-9) and tissue inhibitors of metalloproteinase1(TIMP-1) in cerebullar arteriovenous malformations (CAVM) and their relationship with hemorrhagic history in CAVM.Methods 48 patients who suffered with CAVM were studied, including 24 patients with hemorrhagic history (CAVM H group) and 24 patients without hemorrhagic history (CAVM N group). 24 patients suffered with essential epilepsy were control group (CG). All of the patients admitted during May 2007-September 2008 and were given operation. We studied their history,clinical symptom and radiologic manifestation. examined the expression of MMP-9, TIMP-1 in patients brain tissue by immunohistochemistry.Results Compared with control samples, CAVM samples had higher levels of MMP-9, TIMP-1(P <0.01).There was no significant difference in levels of MMP-9, TIMP-1(P >0.05) between CAVM H Group and CAVM N Group, But, Compared with CAVM N Group, CAVM H Group had higher levels of MMP-9/TIMP-1(P <0.05).Conclusion ①Maybe MMP-9 is a essential factor lead to structural instability, growth and abnormal extension of vessels in CAVMs. MMP-9 is one of the factors to promote expression of TIMP-1. ②MMP-9 can lead hemorrhage in CAVMs, as the endogenous specific inhibitor of MMP-9, TIMP-1 is a protective factor to prevent hemorrhage in CAVMs.Perhaps disbalance ofMMP-9 and TIMP-1, MMP-9 is higher relatively is a important reason of hemorrhage in CAVMs.
    Effect of Urinary Kallidinogenase Injection on Cerebrovascular Reserve Capacity in Patients with Ischemic Stroke
    2009, 4(07):  581-584. 
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    Objective To observe the influences of Urinary Kallidinogenase injection in patients with ischemic stoke.Methods 154 patients with middle cerebral artery territory stroke were included in this trial and all patients were randomly divided into two groups. 76 patients in treatment group were treated with Urinary Kallidinogenase injection and basic therapy for 10 days after inclusion, while control groupwere treated with physiological saline and basic therapy. We performed 5% CO2 inhalation test to evaluate the cerebrovascular reserve(CVR), for all patients pre and post therapy using transcranial Doppler ultrasound.Results Function impairment of all patients had different degree of improvement. Patients treated with Urinary Kallidinogenase injection appeared obvious improvement than control group.Conclusion Urinary Kallidinogenase injection may improve the CVR in patients with ischemic stroke.
    编者按
    ultrasound and stroke
    2009, 4(07):  585-585. 
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    专题论坛
    Research status of Neovascularization in Carotid Artery Plaque
    2009, 4(07):  586-590. 
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    Research Status of Patent Foramen Ovale Related Ischemic Stroke
    2009, 4(07):  590-593. 
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    病例讨论
    Case of Diffusion Weighted Imaging Positivity Classic TIA Progress to Infarction
    2009, 4(07):  594-597. 
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    指南与规范
    Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage.(Recommendations)
    2009, 4(07):  598-600. 
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    综述
    The Diagnostic Biomarkers of Vascular Dementia
    2009, 4(07):  601-606. 
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