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Objective To study the efficacy and safety of carotid artery stenting(CAS) in elderly patients with internal carotid artery stenosis and its related factors.Methods Between January 2012 and July 2014,a total of 152 patients(over 65 years of age)with carotid artery stenosis were enrolled in this study,of whom 79 patients received drug treatment (control group) and 73 patients received CAS (intervention group).The two groups were followed up for one year.The patients'' scores of mRS(the modified Rankin Scale) and NIHSS(the National Institute of Health Stroke Scale) were observed and compared in the curative effect between the two groups.By means of logistic regression were analyzed the related safety factors in CAS treatment for elderly patients over 65 with extracranial stenosis of internal carotid artery.Results Both the median mRS (P<0.01) and NIHSS(P<0.05) scores were lower in intervention group than those in control group at 3,6 and 12 months follow-up,respectively.Thirty days after CAS,there occurred transient ischemic attack (TIA) in intervention group,whose incidence was significantly lower than that in control group (P<0.05).However,there was no statistical significant difference found between the two groups in the incidence of serious adverse events including TIA,cerebral hemorrhage,cerebral infarction and death(P>0.05)at one year follow-up.And logistic regression analysis showed that the previous history of cerebral infarction,residual stenosis or combined un-interferential cerebral arterial stenosis were all independent predictors of serious adverse events including TIA,cerebral infarction,cerebral hemorrhage,re-stenosis and death (P<0.05).Conclusion CAS is a safe and effective procedure for old patients with internal carotid artery stenosis.A history of cerebral infarction,combined un-interferential cerebral arterial stenosis or residual stenosis after CAS were all risk factors,which need to be effectively controlled before CAS.
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Objective: To investigate the morphological changes of cerebral blood vessels by digital subtraction angiography (DSA) in patients with central vertigo, so as to provide references for diagnosis and treatment of patients with central vertigo. Methods: Ninety-two patients suffering from central vertigo were subjected to cerebral angiography through femoral artery. The types, proportion, and distribution (site predilection and number of involved vessels) of the cerebrovascular abnormalities were observed and analyzed. Results: Of the 92 patients with central vertigo, cerebrovascular lesions were found in 137 sides, including 15 (10. 95%) anterior circulation lesions and 122 (89.05%) posterior circulation lesions. Thirty-one (33.7%) patients had 2 or more lesions. The most common lesion was vertibroarterial lesion accompanied with other cerebrovascular stenosis. The lesions included 39 (28.47%) sides with vertibro-basilar stenosis or occlusion, 13 (9.49%) sides with posterior cerebral artery stenosis or occlusion, and 59 (43.06%) sides with posterior circulation abnormalities. Conclusion: The posterior circulation stenoses or abnormalities might be the major reasons for central vertigo in middle- and old-age patients.
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<p><b>OBJECTIVE</b>To observe the therapeutic effect of acupuncture at different stages on pseudobulbar palsy. Methods Two hundred and forty cases of pseudobulbar palsy were divided into 4 groups according to different courses of disease, i.e. group I, the course within 10 days; group II, between 10-30 days; group III, between 1-3 months; group IV, between 3-6 months. They were treated with acupuncture at Fengchi (GB 20) for 2 courses, and then their therapeutic effects were ohserved.</p><p><b>RESULTS</b>The effective rate was 100.0% in the group I, 96.7% in the group II, 83.3% in the group III and 76.7% in the group IV, with a significant difference among the 4 groups (P < 0.01).</p><p><b>CONCLUSION</b>Acupuncture at Fengchi (GB 20) at any stage has therapeutic effect on pseudohulbar paisy, hut the earlier treatments, the better the therapeutic effects.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Acupuncture Points , Acupuncture Therapy , Methods , Pseudobulbar Palsy , TherapeuticsABSTRACT
<p><b>BACKGROUND</b>To date murine models of permanent focal cerebral ischemia have not been well characterized. The purposes of this paper were to compare three different permanent middle cerebral artery occlusion (MCAo) models with or without craniectomy, and to identify an ideal mouse model of permanent focal cerebral ischemia.</p><p><b>METHODS</b>Experiments were performed on 45 healthy adult male Kunming mice, weighing 28 to 42 g. The animals were randomly assigned to three groups (n = 15 in every group) based on surgical procedure: MCAo via the external carotid artery (ECA), MCAo via the common carotid artery (CCA), and direct ligation of the middle cerebral artery (MCA). Each day post-ischemia, the animals were scored using an eight-grade neurological function scale, and mortality was also recorded. Seven days post-ischemia, the brains were removed for lesion size determination using triphenyltetrazolium chloride staining. Correlation analysis of lesion volume and neurological score was carried out.</p><p><b>RESULTS</b>Mortality in the group receiving direct MCA ligation was lowest among the three groups, and there was a significant difference between the direct MCA ligation group and the two intraluminal occlusion groups (P < 0.05). In all groups, neurological scores gradually increased with prolongation of ischemic duration, peaking after two days, then gradually decreasing. In the direct MCA ligation group, however, neurological scores were relatively stable. There was a significant correlation between infarct volume and neurological score 7 days after MCAo in every group (all r > 0.7, P < 0.05), suggesting good reproducibility of lesion volume in the three groups, but the infarct volume was more constant in the direct MCA ligation group.</p><p><b>CONCLUSION</b>The direct ligation model of MCAo provides an optimal means of studying permanent focal cerebral ischemia, and is preferable to the models using intraluminal sutures.</p>