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    20 March 2014, Volume 9 Issue 03
    Collecting Shells at San Diego
    WANG Yong-Jun
    2014, 9(03):  165-170. 
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    Analysis of the Problems in Clinical Application of Transcranial Doppler and Carotid Artery
    Color Doppler Ultrasonography
    XING Ying-Qi, ZHANG Jie
    2014, 9(03):  171-182. 
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    Changes in Cerebrovascular Modulation in Anxiety before and after Treatment
    XING Ying-Qi*, GUO Zhen-Ni, YANG Le, YAN Shuo, YANG Yi.
    2014, 9(03):  183-187. 
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    【Abstract】 Objective To study cerebral blood flow regulation features in patients with anxiety before and after treatment. Methods Subjects with Hamilton anxiety scale scores ≥14 were enrolled, and the dynamic changes in their cerebral blood flow velocity (CBFV) in response to an orthostatic challenge were investigated using transcranial Doppler. Next, we provided the patients with treatment, and then they were followed-up for a period of 6 months. The dynamic changes in their CBFV values were then re-recorded. Results The CBFV changes from supine to upright differed between the anxious and the healthy groups. Anxious subjects showed more pronounced decreases in CBFV with abrupt standing (P <0.001). In the recovery group, the changes in the mean CBFV values from the supine to the upright position were significantly improved after treatment (P <0.001), and can restore to the healthy group level. Conclusion Our results indicate that cerebral blood flow regulation is compromised in anxiety; however, it can restore to normal after the disappearance of anxiety.

    Relationship between Microembolous and Artery Stenosis Degree in Symptomatic
    Intracranial and Extracranial Artery Stenosis
    WU Xiu-Juan*, LIU Kang-Ding, YANG Yi,WANG Zheng-Zheng, XING Ying-Qi.
    2014, 9(03):  188-192. 
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    【Abstract】 Objective To study and compare microembolic signal (MES) incidence in different degree artery stenosis in symptomatic intracranial and extracranial artery stenosis. Methods The patients diagnosed symptomatic intracranial or extracranial artery stenosis were recruited while the patients who have tandem stenosis in the intracranial and extracranial artery and potential embolic source were excluded. All the enrolled patients were divided into carotid artery stenosis group or middle cerebral artery stenosis group or vertebral-basilar artery stenosis group. In each group, they were further divided into different groups on the basis of the degree of the stenosed artery: mild stenosis group, middle stenosis group, severe stenosis group and occlusive group. And the frequency of MES was compared among the different groups. Results Two hundred and twenty seven patients were recruited in the study (including 73 symptomatic internal carotid stenosis, 126 symptomatic middle cerebral artery stenosis and 28 symptomatic vertebral-basilar artery stenosis). The MES incidence of the three groups were 34.25% (25/73), 38.89% (49/126) and 39.29% (11/28). There is no difference in MES incidence among the three groups (P >0.05). Further we divided all the symptomatic stenosis arteries into mild, middle, severe stenosis and occlusive group. By comparing the MES incidence, we found that the middle stenosis group and severe stenosis group were higher than the mild stenosis group (P <0.01) and the occlusive group (P <0.01). But there is no difference in the MES incidence between the mild stenosis group and the occlusive group (P >0.05). Conclusion MES is more frequently seen in patients with middle or severe vascular stenosis while the mild and occlusion groups have a low frequency of MES.

    Research of Incidence and Feature of Right-to-left Shunt in a Total of 195 Cases Normal
    Population
    WU Chun-Tao*, BAI Jing, GUO Zhen-Ni, WANG Zheng-Zheng, XING Ying-Qi.
    2014, 9(03):  193-196. 
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    【Abstract】 Objective To observe the incidence, shunt volume, shunt type of normal population, and compare RLS feature between two age groups. Methods Collect the clinical data of normal people who volunteered to undergo contrast-enhanced transcranial Doppler (cTCD). They are classified into two groups: young group (18 to 45 years old) and middle age group (more than 45 years old). Take the physiological saline activating via elbow intravenous injection as a contrast agent, and combine with Valsalva maneuver, diagnose RLS with mpTCD monitoring and grade the shunt volume. The distribution characteristics of different shunt volume and shunt type (the inherent and potential) in the study population were also analyzed. Results A total of 195 normal people were enrolled in our study, and RLS rate was 28.7%, with 39 cases as minor shunt (20%). RLS rate in young group was 28.9% (39/135), and RLS rate in middle age group 28.3% (17/60). There were no statistical differences between two groups in RLS rate and shunt volume distribution, and minor shunts take a predominate percent in all those shunts. Thirty four cases were inherent type (60.7%), and 22 cases potential type (39.3%). In young group, 25 cases were inherent type (64.0%), and 14 cases potential type (35.9%); in middle age group, 9 cases were inherent type (52.9%), and 8 cases potential type (47.1%). There was no statistical difference between two groups in shunt type distribution. Conclusion The incidence of RLS in the selected population in our study is about 28.7%, and the minor shunt takes a predominate percent. There are no significant differences between young group and middle age group in RLS incidence, shunt volume and shunt type.

    Clinical Application and Research on Transcranial Doppler Ultrasonic
    Xing Ying-Qi
    2014, 9(03):  197-197. 
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    Clinical Application of Transcranial Doppler Ultrasound in the Perioperative Period
    of Carotid Endarterectomy
    WU Chun-Tao*, XING Ying-Qi, BAI Jing.
    2014, 9(03):  198. 
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    【Abstract】 Carotid artery atherosclerotic stenosis, a common important cause of the elderly ischemic stroke, can result in patients with disability, even death. Currently the standard surgery for carotid atherosclerotic stenosis in clinical pratice is carotid endarterectomy (CEA), and transcranial Doppler (TCD) has an important clinical value in preoperative screening, intraoperative monitoring and postoperative assessment of CEA. This paper reviews the application of TCD in the perioperative period of CEA

    Transcranial Color-coded Sonography for the Diagnosis of Parkinson's Disease
    XU Xiao-Yan*, SONG Xiao-Nan, XING Ying-Qi.
    2014, 9(03):  204-209. 
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    Abstract】 Parkinson's disease is a progressive neurological disorder, which results from the degeneration of dopamine-producing cells in the substantia nigra (SN). Clinical symptoms typically include static tremor, bradykinesia, myotonia, and postural instability. However, clinical features in the early stages of Parkinson's disease are atypical. Therefore, it is important to develop a diagnostic tool aimed to recognize the early stages of Parkinson's disease. Transcranial color-coded sonography as a non-invasive technology has become an important instrument in the diagnosis of Parkinson's disease and in the differential diagnosis of Parkinsonism. Above all, transcranial colorcoded sonography has the capability of detecting substantia nigra hyperechogenicity and shows stenosis of vessels, which plays an important role in diagonosing Parkinson's disease in its early stages and differentiating Parkinson's disease and vascular parkinsonism. The main purpose of the current article is to summarize the significance of transcranial color-coded sonography in the diagnosis and differential diagnosis of Parkinson's disease.

    Recent Advances in Cerebral Autoregulation of Stroke
    LV Cun-Ling*, YANG Yi, GUO Zhen-Ni, XING Ying-Qi.
    2014, 9(03):  210-214. 
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    【Abstract】 Cerebral autoregulation is the main mechanism that maintains relatively constant blood flow to the brain, which is critical for the normal functioning of physiological functions, as well as the occurrence, development and prognosis of a variety of diseases. With the continuous development of measurement techniques, the assessment of cerebral autoregulation has been applied to various clinical fields, and gradually began to provide more and more clinical reference information. In this review, we investigate the status of cerebral autoregulation under disease and the relation between the function of cerebral autoregulation and outcome.

    Diagnosis and Follow-up of One Case of Bilateral Vertebral Artery Dissection by Carotid
    Artery Ultrasound and Transcranial Color Doppler
    CHEN Ying, FENG Jia-Chun, LIU Ying,et al
    2014, 9(03):  215-219. 
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    Radiation-Induced Carotid Artery Occlusion in a Patient with Nasopharyngeal Carcinoma
    YAN Shuo, YANG Yi, XING Ying-Qi
    2014, 9(03):  220-222. 
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    2013 ESH/ESC Guidelines for the Management of Arterial Hypertension (Part 3)
    YAO Jing-Pan, YANG Jun, JIA Jiao-Kun, et al.
    2014, 9(03):  223-234. 
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    Prevalence and Extent of Right-to-left Shunt in Migraine:a Survey of 217 Chinese
    Patients
    YANG Yi*, GUO Zhen-Ni, WU Jiang, JIN Hang, WANG Xiao-Cong, XU Jing,
    2014, 9(03):  235-240. 
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    Review of Pathogenesis of Early Brain Injury after Subarachnoid Hemorrhage
    LI Zhao-Xia, ZHAO Xing-Quan.
    2014, 9(03):  241. 
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    【Abstract】 Spontaneous subarachnoid hemorrhage is a common cerebrovascular disease, with high mortality and disability. Although drugs and surgery technology progress gradually, there is no obvious improvement on functional outcomes in survivors. Traditional views consider vasospasm is the main cause of death and disability of subarachnoid hemorrhage, and a great progress has been made in the treatment of vasospasm in recent years, but the prognosis of patients is still bad. At present, many foreign studies have found that early brain injury may be a main factor of poor prognosis of subarachnoid hemorrhage.

    Progress of Genetic Epidemiology of Ischemic Stroke
    SONG Yan-Li, CAI Jin-Le, PAN Yue-Song, LIU Gai-Fen.
    2014, 9(03):  246-251. 
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    【Abstract】 Stroke is one of the most serious diseases that threaten human health with heavy disease burden. Ischemic stroke is the most common type of stroke, which accounts for about eighty percent. Genetics and epidemiological study of twin and family has indicated that stroke has obvious genetic predisposition. Recently, candidate gene study and genome-wide association study on stroke has been developing rapidly. In this review, we discussed the progress of previous studies focused on the predisposing genes associated with ischemic stroke onset, e.g. lipid metabolism, inflamtation, renin-angiotensin-aldosterone system, homocysteine metabolism, nitric oxide synthase, as well as the genes associated with heart disease.

    Developments in Ischemic Stroke with Atrial Fibrillation
    LI Shu-Ya, WANG Yi-Long,WANG Yong-Jun.
    2014, 9(03):  252-361. 
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    【Abstract】 Atrial fibrillation (AF) is a common clinical arrhythmia, the prevalence of which increased with age. Because of nonsymptomatic atrial fibrillation, atrial fibrillation incidence and prevalence are undervalued. Patients with AF are at high risk of stroke and, in particular, severe stroke. Oral anticoagulants are the most effective way to prevent thromboembolic complications of AF. Patients of ischemic stroke with AF are an important target population for reducing the overall burden of stroke. Related research hotspots are reviewed in this paper.

    Teaching Practice of Intraoperative Ultrasound in the Surgery for Cerebrovascular Malformation
    ZHOU Da-Biao, KANG Shuai, YE Xun, et al.
    2014, 9(03):  262-264. 
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