ABSTRACT
BACKGROUND: Cognitive function of simple leukoaraeosis (LA) and subcortical arterioselerotic encephalopathy (SAE) is a part of research in cerebrovascular neuropsychology, however, there is no contrast study on cognitive function between the two diseases. OBJECTIVE: To investigate the different features in cognitive function among patients with simple leukoaraeosis, subcortical arterioselerotic encephalopathy and simple leukoaraeosis combined with cerebral infarction. DESIGN: Randomized controlled observation SETTING: Department of Neurological Medicine, Qilu Hospital, ShandongUniversity. PARTICIPANTS: A total of 91 cases of patients with cerebrovasculardisease diagnosed in Department of Neurological Medicine of Qilu Hospital of Shandong University from March 1997 to May 2000 were selected. All the patients participated in the observation voluntarily. They were divided into 3 groups according to the type of disease, with 27 cases in simple leukoaraeosis group, 33 cases in subcortical arterioselerotic encephalopathygroup and 31 cases in simple leukoaraeosis + cerebral infarction group.Additionally, 30 healthy cases were selected as control group. All the subjects in the above groups participated in the observation voluntarily. METHODS: Assessment on cognitive function and memory ability was conducted on the subjects in each group, and contrast analysis was performed. Mini-mental state examination was used for detecting cognitive function. Patients whose score was less than 17, 20, 22, 23 respectively according to different educational degree (illiteracy, primary school, middle school, university), would be diagnosed as dementia. Clinical me mory scale A edited by Psychology Institute of Chinese Academy of Medical Sciences was used for detecting memory ability including associative learning, directive memory, recognition of nonsense figure, image free recall and portrait characteristics associative recall. Conversed the above 5 items of detecting results to scores of scales and calculated out the memory quotients. MAIN OUTCOME MEASURES: State of cognitive disorder and scoresof mini-mental state examination and clinical memory scale of subjects in each group. RESULTS: All the 91 cases of patients with cerebrovascular disease and 30 healthy control cases entered results analysis without any drop out. ① Comparison of the state of cognitive disorder among subjects in each group: There were 21 cases of mild cognitive disorder (77.8%) in simpleleukoaraeosis group, 8 cases of moderate cognitive disorder (24.2%) and 25 cases of dementia (75.8%) in subcortical arterioselerotic encephalopathy group, 6 cases of moderate cognitive disorder (19.4%) and 24 cases of dementia (77.4%) in simple leukoaraeosis + cerebral infarction group. ② Comparison of the scores of mini-mental state examination among and clinical memory scale: Scores of the two scales in simple leukoaraeosis group, subcortical arterioselerotic encephalopathy group and simple leukoaraeosis + cerebral infarction group were significantly lower than those in healthy control group (t=2.14-3.81, P ＜ 0.05-0.01). The scores in subcortical arterioselerotic encephalopathy group and simple leukoaraeosis+ cerebral infarction group were significantly lower than those in simple leukoaraeosis group (t=2.13-3.37, P ＜ 0.05-0.01).CONCLUSION: ① The cognitive impairment in simple leukoaraeosis is mainly mild cognitive disorder. ② The cognitive impairments in subcortical arterioselerotic encephalopathy and simple leukoaraeosis + cerebral infarction are mainly moderate cognitive disorder and dementia which are obviously severer than mild cognitive disorder. Cognitive function can be used as reference indicator for assessing simple leukoaraeosis and subcortical arterioselerotic encephalopathy.Liang LP, He Y, Guo HZ.A contrast between the cognitive function of patients with simple leukoaraeosis and subcortical arterioselerotic encephalopathy.
ABSTRACT
BACKGROUND: Leukoaraiosis is a group of changes in image. Since the firm pathogenic mechanism on leukoaraiosis has been unknown, the evaluation at the earlier stage of the disease has not been emphasized commonly and there is rather less recognition of the alternations on its electrophysiological system.OBJECTIVE: To probe into the clinical characteristics and alternations on image and evoked potential in simple leukoaraiosis and subcortical arteriosclerotic encephalopathy(Binswanger' s disease) and carry on the comparison with healthy people.DESIGN: Retrospective comparative study based on patients and healthy people.SETTING: Department of neurological internal medicine of one university hospital and department of neurological internal medicine of one railway central hospital.PARTICIPANTS: Outpatients or inpatients with cerebral vascular disorders in Qilu Hospital Affiliated to Shandong University were collected from August 1995 to March 2000. Totally 114 cases were leukoaraiosis, of which, 79 cases were males and 35 cases females. And 41 cases were Binswanger' s disease,of which, 28 cases were males and 13 cases females. Fifty healthy aged people who received routine physical check were randomized from the clinic of the hospital as the control.METHODS: The analysis was carried on the risk factors, clinical characteristics and CT exam in 114 cases of leukoaraiosis and 41 cases of Binswanger' s disease, of which, 74 leukoaraiosis cases and 35 Binswanger' s disease cases had received cranial MRI exam. Of those, 43 cases of simple leukoaraiosis associated with hypertension, 30 cases of Binswanger' s disease and 50 cases in the normal control were selected to carry on the examinations of body-sensory evoked potential, brain stem auditory evoked potential and visual evoked potential.coronary heart disease, diabetes, hyperlipemia, smoke, cerebral apoplexy,evoked potential and visual evoked potential.RESULTS: According to practical management analysis, 114 cases of leukoaraiosis, 41 cases of Binswanger' s disease and 50 cases in the control were diversification, mainly characterized as slightly declining of memory and loss of gait stability. Hypertension is predominated anong risk factors in Binswanger' s disease group (95.1% ), mainly characterized as physical signs of local neural focus, obvious cognitive disturbance and cerebral in CT exam that 70.2% (80/114) of cases presented brain whiter-matter abnormity in type Ⅰ. It was indicated in MRI exam that 72% (53/74) of cases presented brain whiter-matter abnormity, type Ⅰ, 27% (20/74) presented type Ⅱ and 1% (1/74) presented type Ⅲ. For Binswanger's disease patients, it was indicated in MRI exam that 54% (19/35) of cases presented brain white-matter abnormity, type Ⅲ, and 46% (16/35) presented type Ⅳ.Symmetrical extension of bilateral ventricles presented in Binswanger' s disbody-sensory evoked potential was 84% (36/43), of which, the mild abnormity occupied 60% (26/43) and moderate abnormity 23% (10/43); The abnormity rate of brain stem auditory evoked potential was 63% (27/43) and that of visual evoked potential was 54% (23/43). In Binswanger' s disease group, the abnormity rate of body-sensory evoked potential was 97% (29/30),of which, mild abnormity was 7% (2/30), moderate abnormity was 47%(14/30) and severe abnormity was 43% (13/30); The abnormity rate of brain stem auditory evoked potential was 87% (26/30) and that of auditory evoked potential was 83% (25/30).CONCLUSION: The risk factors of simple leukoaraiosis are diversified,without obvious physical signs of local neural focus. The diagnosis of it is mainly depended on abnormity Ⅰ of brain white matter described in images,manifested as remarkable dysfunction of cerebral eletrophysiology. Binswanger' s disease patients are mainly characterized as hypertension, relevantly obvious cognitive disturbance and common seizure of cerebral apoplexy. Abnormity Ⅲ of brain white matter indicated in CT exam, abnormity Ⅲ or Ⅳ of that in MRI exam are the image evidence for diagnosis. Remarkable abnormity also presents in cerabral electrophysiology, in which, abnormal body-sensory evoked potential is especially significant.
ABSTRACT
BACKGROUND: There is much clinical datum analysis on multi-organ dysfunction syndromes induced by cerebral hemorrhage, but there is lack of experiment on dysfunction of peripheral organs induced by acute cerebral vascular disease.OBJECTIVE: Collagenase of two dosages together with proper amount of heparin were used to duplicate animal model of multi-organ dysfunction syndromes induced by cerebral hemorrhage so as to probe into the best experimental prerequisite.DESIGN: Complete randomized control experiment.SETTING: Departments of Dermatology, Neurology and Cardiac Surgery of Qilu Hospital Affiliated to Shandong University and Department of Neurology of Jinan Railway Center Hospital.MATERIALS: The experiment was performed in Institute of Basic Medicine of Shandong Medical Scientific Academy from September to December 2002. Totally 96 adult healthy male Wistar rats were employed and randomized into normal control (6 rats), sham-operation group (6 rats), first hemorrhage group (42 rats) and second hemorrhage group (42 rats). Seven sub-groups of 4 hours, 8 hours, 12 hours, 24 hours, 36 hours, 48 hours and 72 hours successively were divided in first and second hemorrhage groups respectively, 6 rats in each sub-group.INTERVENTIONS: In the first hemorrhage group, mixed solution 2 μL of Ⅶ collagenase 0.4 U and heparin sodium 3.2 IU was infused slowly to the brain. In the second hemorrhage group, mixed solution 2 μL of Ⅶ collagenase 0.8 U and heparin sodium 3.2 IU was infused slowly to the brain. In sham-operation group, physiological saline of same volume was injected. The general situation of animals at every phasic point was observed after operation, including consciousness, mental state and limb movement, as well as the alternations on body temperature, respiration and heart rate. Examinations were done on blood routine, liver function (alanine aminopherase, ALT;aspartic acid translocase, AST), kidney function (urea nitrogen, BUN; creatinine CRE) and myocardial zymology (creatine kinase, CK; lactic dehydrogenase, LDH). Modified matrix coloration method was used to determine endotoxin content in plasma. Pathological alternations were observed optic microscopically on brain, lung, liver, small intestine and kidney.ternations on main organs of experimental animals.experimental animals after operation: In the first and second hemorrhage groups, body temperature, respiration, heart rate and leukocyte content were all higher remarkably than normal group and sham-operation group (P ＜ 0.05).Those in the first hemorrhage group were higher than second group [(39.56±0.59)C, (37.98±0.52)C;(124.23±4.12) times/minute, (92.56±2.95)times/minute; (325.96±84.53) times/minute, (258.16±75.42) times/minute,(P ＜ 0.05)], and the difference in peripheral leukocyte content was specially nation of ALT activity, AST activity, BUN content, CRE content, CK activity,LDH activity and endotoxin content in plasma: Those in the first and second hemorrhage groups were higher than normal group and sham-operation group (P ＜ 0.05 -0.01). Those in the first hemorrhage group were higher than second hemorrhage group [(35.04±7.54) μkat /L, (24.25±5.42) μkat/L;(51.61±10.47) μkat/L, (33.77±7.44) μkat/L; (21.12±2.93) mmol/L,(9.78±1.45) nmol/L; (68.57±5.24) μnol/L, (40.54±3.95) μmol/L; (706.44±44.92) μkat/L, (189.23±25.08) μkat/L; (357.96±40.95) μkat/L, (149.60±19.10)(P ＜ 0.05)] and the difference was especially remarkable in endotoxin content logical alternations on main organs of experimental animals: Inflammatory damage of various degrees presented in all of animal organ tissues at various phasic points during cerebral hemorrhage in rats. In the first hemorrhage group, pathological change of organs reached the peak in 24-36 hours, which recovered to be normal in 72 hours. In the second hemorrhage group, the inflammatory damage was more remarkable and persistent compared with first group, in which, pathological change of organs reached the peak in 24-48hours and inflammatory damage was still visible in 72 hours.CONCLUSION: It is indicated that 0.8 U collagenase model is a successful model of multi-organ dysfunction syndromes induced by cerebral hemorrhage. Such model is in conformity with the common induced factors in clinic and various index changes of functions in every organ and can reflect dynamically the occurrence of multi-organ dysfunction syndromes.
ABSTRACT
Objective To study changes of serum endotoxin and its receptor CD14 gene expression in lung, liver, intestines, kidney tissues in model of acute forebrain ischemia complicated by multiple organ dysfunction syndrome(MODS), and to investigate the pathogenesis of cerebrogenic MODS. Methods 54 Wistar rats were randomly divided into seven groups: normal control group(n=6)、sham-operative group(n=8) and 5 ischemia groups(n=40)including 12 h, 24 h, 36 h, 48 h, 72 h five time points. Model of cerebral infarction was established. The content of endotoxin in plasma was evaluated with a test kit. The area density and optical density of positive staining of CD14mRNA expressing were analyzed for the relative content of CD14mRNA using in-situ hybridization and CMIA medical imaging analysis system. Results Plasma endotoxin level were markedly high at 12 h (0.184?0.055)Eu/L after acute forebrain ischemia, peaking at 24 h (0.639?0.064)Eu/L and it was somewhat decreased at 72 (0.117?0.024)Eu/L. The CD14mRNA expression in lung, liver, intestines, kidney tissues increased after brain ischemia, reaching the peak at the 24~36 h, and decreased after 48 h. The highest change of CD14mRNA expression was found in lung(P
ABSTRACT
Objective To investigate the efficacy and safety of three kinds of immunosuppressant on systemic lupus erythematosus encephalopathy. Methods 44 cases with systemic lupus erythematosus encephalopathy were randomly assigned to receive high dose of Methyllprednisolone, Cytoxan (CTX) or Ifosfamide (IFO). The levels of ESR and serum C_3 were detected at different time after treatments. The effect and safety of these treatments were evaluated. Results (1) After treatment, the levels of ESR decreased significantly ((P)0.05). More decrease of ESR was found in CTX group and IFO group than in Methyllprednisolone group (all (P
ABSTRACT
Objective To discuss the efficacy of Neurotropin in the treatment of senile postherpes neuralgia.Methods 58 senile patients with postherpes neuralgia were randomly divided into Neurotropin group and Carbamazepine group. Before and after treatment, symptoms and signs of neuropathy including pain and numbness were evaluated by vision ambiguity scales(VAS). The side effects of drugs were also observed.Results 2,4,6 weeks of post-therapy,the VAS of Neurotropin group was decreased obviously than that of pretherapy (all P
ABSTRACT
Objective To investigate the changes of serum endotoxin and its receptor CD 14 gene expression in multiple organs in models of acute forebrain ischemia complicated with multiple organ dysfunction syndrome (MODS), and the pathogenesis of cerebrogenic multiple organ dysfunction syndrome (CMODS). Methods 54 Wistar rats were randomly divided into normal control group ( n=6), sham-operative group ( n=8) and forebrain ischemic group ( n=40). The rats in forebrain ischemic group were randomly divided into 5 subgroups: 12, 24, 36, 48, and 72 h (8 rats in each group). The contents of endotoxin in plasma were determined after models of acute forebrain infarction established. The area density and optical density of positive staining expressing CD 14mRNA in lung, liver, intestine and kidney were analyzed for the relative content of CD 14mRNA using in situ hybridization and CMIA medical image analysis system.Results Plasma endotoxin level was markedly high at 12 hours after acute forebrain ischemia, peaked at 24 hours and somewhat decreased at 72 hours. The CD 14mRNA expression in lung, liver, intestine, and kidney tissues increased after brain ischemia, reached the peak at 24~36 h, and decreased after 48 hours. The highest change of CD 14mRNA expression was found in lung ( P
ABSTRACT
Objective To investigate the incidence of the post-stroke emotion disorder, the relationship between post-stroke emotion disorder and the location of stroke, and the effects of Paroxetine combined with psychotherapy in treating post-stroke emotion disorder. Methods 181 patients with acute brain stroke were assessed by SDS and SAS. Of these patients, 54 patients met the criteria of depression and anxiety after acute brain stroke. These 54 patients were divided into 2 groups randomly. They were treated with routine anti-stroke medication, routine anti-stroke medication with Paroxetine combined with psychotherapy for 6 weeks, respectively. The rating scales such as SSS, HAMD, HAMA, TESS and so on were used to evaluate the improvement of symptoms and side effects. Results According to the evaluation of SDS or SAS, there were 81 patients (44.75%) with post-stroke emotion disorder. The rate of post-stroke depression with anxiety was 66.67%. Post-stroke depression with anxiety was related to the location of brain stroke, such as frontal cortex,left cerebral hemisphere and basal ganglia (P