Table of Content

20 April 2014, Volume 9 Issue 04

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Conquest

WANG Yong-Jun

2014, 9(04):  265-267. 

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Highlight Report of International Stroke Conference 2014

WANG Jing, LIAO Xiao-Ling,WANG Yi-Long, et al.

2014, 9(04):  269-273. 

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Individualized Therapy of Ischemic Cerebrovascular Diseases

XU Yun

2014, 9(04):  274-277. 

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Comparison of Intravenous Thrombolytic Effect of Acute Ischemic Stroke Patients
with Different Large Vessel Occlusion

LIAO Xiao-Ling*, WANG Yi-Long, PAN Yue-Song,WANG Chun-Juan, ZHAO Xing-Quan, WANG Chun-Xue, LIU Li-Ping, WANG Yong-Jun.

2014, 9(04):  278-284. 

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Objective To compare the intravenous thrombolytic therapeutic effect of the acute ischemic stroke patients with different large vessel occlusion and to investigate which occlusion subtype of patients are suitable for intravenous thrombolytic treatment. Methods Data were analyzed from the Thrombolysis Implementation and Monitoring of Acute Ischemic Stroke in China (TIMS-China). Patients who accomplished multiple parameter computed tomography (CT) or magnetic resonance (MR) and CT angiography or MR angiography showed large vessel occlusion were included. The safety and efficacy outcome were compared. Results A total of 122 patients were included. The rates of recanalization were:middle cerebral artery (MCA) occlusion group 55.2%, internal carotid artery (ICA) occlusion group 0% and basilar artery (BA) occlusion group 40%. For the functional independence outcome at 90 days, MCA occlusion group was significantly better than ICA occlusion group (53.9% vs 21.1%, P =0.007, [odds ratio, OR]=5.68). For excellent recovery outcome at 90 days, MCA occlusion group was also significantly better than ICA occlusion group (42.7% vs 21.1%, P =0.041, OR=3.76). For mortality, MCA group was significantly lower than ICA group (4.5% vs 47.4%, P <0.001, OR =0.03). There were no significant differences between MCA group and ICA group in the symptomatic intracranial hemorrhage (1.1% vs 0%, P =0.962). Conclusion The intravenous thrombolytic therapeutic effect of the acute ischemic stroke patients with different large vessel occlusion was significantly different. The recanalization rate of MCA occlusion group was highest, and the therapeutic effect was significantly better than ICA occlusion group.

The Rate of Residents' Awareness about Stroke in One of the Communities of Suburban
County in Shanghai:A Research Survey

WANG Xiao*, GAO Jian, WANG Shao-Shi.

2014, 9(04):  285-288. 

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Objective To obtain the information of the current situation of awareness related to the stroke knowledge among the residents in the community of suburban county of Shanghai. Methods The questionnaires of relevant stroke knowledge were conducted in this study to investigate the awareness rate of risk factors and early warning signs of stroke among the residents living in one of the suburban communities of Songjiang District in Shanghai. Results (1) In total of 700 questionnaires which were selected to the standard level and successfully completed, 659 ones were effective. The awareness rate of nine risk factors of stroke:57.2% of residents who answered questions could recognize at least two risk factors 28% of residents were able to recognize at least three risk factors, only 8% of residents were able to recognize at least four risk factors; 19.9%~87.6% of the residents were able to be aware of the fact that hypertension, central (abdominal) obesity, smoking, dyslipidemia can cause ischemic stroke, however 87.6% of residents believed that hypertension is one of risk factors of stroke; but only 4.0%~10.6% of the residents could realize that alcoholism, heart disease, bad life style, e.g. poor diet, lack of exercise can lead to stroke. (2) The awareness circumstance of early warning signs of stroke:the percentage of residents' awareness of early warning signs of stroke in this community is 58.1% ~70.3%. Conclusion The level of residents' awareness of stroke risk factors and early warning signs in the community of suburban county of Shanghai is not significantly high as expected. It is important to provide health education of stroke prevention to the residents in Shanghai suburban community.

Analysis on the Usage of Selective Serotonin Reuptake Inhibitors in Thirty Community
Hospitals in Beijing from 2010 to 2012

MA Zhao-Zhao, TIAN De-Qiang, GAO Ying-Chang,ZHAO Zhi-Gang.

2014, 9(04):  289-293. 

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Objective To investigate the usage of selective serotonin reuptake inhibitors in 30 community hospitals in Beijing from 2010 to 2012. Methods The data of the usage of selective serotonin reuptake inhibitors in 30 community hospitals in Beijing from 2010 to 2012 were statiscally analysed. Results The doses and expense of selective serotonin re-uptake inhibitors for 30 community hospitals in Beijing from 2010 to 2012 are increasing. Those drugs are listed as follows, according to their doses and percentage: paroxetine (44.84%), citalopram (32.4%), fluoxetine (11.60%), sertraline (10.9%) and fluvoxamine (0.1%). There are a total of 29 manufacturers involved in our study. Smith Kline, and Janssen took the big share of the market, which account for 42.40% and 14.25%, respectively. Conclusion The doses and expense of selective serotonin reuptake inhibitors for community hospitals in Beijing are increasing. The frequently used selective serotonin reuptake inhibitors are paroxetine and citalopram, and overseas-funded medicine enterprises take the majority market share.

Research Progress of Individualized Intravenous Thrombolysis with Recombinant
Tissue Plasminogen Activator

ZHAO Qiu-Yun, DING Hong, XU Yun

2014, 9(04):  294-302. 

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Ischemic stroke has a serious impact on human life. It has been proven that intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) is currently the only effective therapy for acute ischemic stroke by evidence-based medicine. However, some questions appear when doctors make prescription, such as narrow time window, with decreased level of consciousness, age, dosage of rt-PA. It suggests that individual therapy should be taken based on standard guide that could increase the efficacy and safety on the thrombolysis. Here, we review the latest developments of intravenous thrombolysis involving individualized clinical studies.

Genetic Polymorphisms and Anticoagulation Therapy with Individualizing

WU Yan-Feng, DING Hong, LIU Qing-Ping, WANG Hui.

2014, 9(04):  303-308. 

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Anticoagulation therapy is currently prescribed for treatment on thrombotic disorders, such as acute coronary syndromes, atrial fibrillation, vein thrombosis, pulmonary embolism. Currently, anticoagulants include heparin, warfarin, dabigatran, rivaroxaban, apixaban and so on. However, anticoagulants vary in dose on individual patient. One of the hot researches is how to increase the efficacy and safety of anticoagulation. Genetic polymorphisms are thought to contribute to the wide intraindividual variability in anticoagulant drug response. Here, we review the genetic mechanisms contributing to the variability in response to warfarin and dabigatran, and propose the personal management of anticoagulation therapy.

Genetic Polymorphisms and Antiplatelet Drug Individualized Treatment

SHAO Yuan*,DING Hong, XU Yun.

2014, 9(04):  309-316. 

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Platelet activation and aggregation play a crucial role in the pathophysiology of atherothrombosis. Aspirin and clopidogrel have become common drugs in treating and preventing ischemic stroke by inhibiting platelet activation and aggregation. There is a great difference of antiplatelet drugs' inhibition effects on platelet aggregation in individual patients. Resistance on anti-platelet drugs could increase risk of stroke relapse. The exact mechanism of variable response to antiplatelet drugs is still unclear. Multiple potential mechanisms have been proposed. In this article, we will discuss the genetic polymorphisms and antiplatelet drug resisitance, in order to guide individualized treatment.

Analysis of Three Cases about Individualized Treatment of Cerebral Artery Dissection

ZHAO Qiu-Yun, LI Jing-Wei

2014, 9(04):  317-323. 

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Drug-induced Myositis Caused by Combined Application of Atorvastatin and Roxithromycin
after Stroke: A Case Report

CHE Jing-Hua, LI Xiao-Jiu, CHEN Xiao-Hong

2014, 9(04):  324-327. 

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2013 ESH/ESC Guidelines for the Management of Arterial Hypertension (Part 4)

YAO Jing-Pan, YANG Jun, JIA Jiao-Kun, et al.

2014, 9(04):  328-344. 

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Research Progress of Stroke Risk Factors

KANG Jin, TANG Li-Hong, GUO Hong-Bo.

2014, 9(04):  345-349. 

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The classical risk factors of stroke are hypertension, diabetes mellitus, dyslipidemia, asymptomatic carotid artery stenosis, coronary artery disease, hyperhomocysteinemia, transient ischemic attack (TIA), atrial fibrillation, smoking, drinking, obesity, and age, etc. Those risk factors have been researched a lot, confirmed repeatedly, and published in the journals both at home and abroad. In order to make the general scholars know more about the potential risk factors which have not been recognized, this article mainly reviews the recent studies of the risk factors of stroke such as coronary artery calcification, adiponectin, hyperuricemia, urinary microalbumin, temperature and trimetlylamine oxide.

Development of Evaluation Structure, Process and Outcome of Stroke Care

LI Zi-Xiao*,WANG Yi-Long, ZHAO Xing-Quan, WANG Chun-Xue, WANG Yong-Jun.

2014, 9(04):  350-357. 

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Stroke is one of the leading causes of death and the leading causes of adult disability worldwide, which brings the heavy burden throughout the world. Measure, evaluation and improvement of quality of stroke care have become one of important means of improving healthcare and outcome of patients with stroke. The basic framework of healthcare quality assessment is "structure-process-outcome". We make a review about the development of "structureprocess- outcome" in quality of stroke care to evaluate the progression of the field of evaluation, monitoring and improvement of quality of stroke care.

Development of Cerebrovascular Disease Subject Provides Insight into the Role of
Discipline Evaluation for Hospital

ZHANG Lin, ZHAO Ling-Xiu, REN Pei-Juan, CHEN Lu, XU Bei-Bei, WANG Yi-Long.

2014, 9(04):  358-362. 

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Objective To get insight into the advantages and disadvantages of hospital development through discipline evaluation. Methods We make a SWOT analysis according to strength, weakness, opportunity and constraint factors, through assessment for 39 clinical medical subjects of Beijing Tiantan Hospital in 2012, and compare it with the evaluation data in 2006 and 2009. Results In 2006 and 2009, the number of subjects with 600 points or more is 2 and 9 respectively, while the number of subjects increases to 14 in 2012. Medical treatment, scientific research, teaching, discipline team and supporting conditions have been improved significantly. In discipline evaluations in 2006, 2009, 2012, cerebrovascular disease subjects in neurology and neurosurgery have always taken the first two place, as obviously advantageous discipline. Conclusion The subject level of our hospital has been well-developed generally, and cerebrovascular disease has always been the preponderant discipline.

Importance of Proteomics Research Work to Improve the Teaching Quality of Vascular Neurology Graduate Students

FENG Jie, WAN Hong

2014, 9(04):  363-364. 

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