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Objective To observe the efficacy of ganglion glycosides in the treatment of elderly patients with Parkinson's disease and its influence on the serum tumor necrosis factor -alpha(TNF -α).Methods 60 elderly patients with Parkinson's disease were selected,and according to the different treatments,they were randomly divided into the observation group(n =30)and control group(n =30).The control group was given routine treatment,and the observation group was given ganglion glycosides treatment on the basis of routine treatment.The comprehensive rating scale score changes were observed,and the curative effect,serum TNF -αlevel changes were compared between two groups.Results The total effective rate of the observation group was 53.3%,which was higher than 23.3% of the control group(χ2 =6.721,P <0.05).After treatment,Parkinson's disease rating scale score of the indexes (spirit, behavior,emotions and daily activities and motor function)of the two groups were significantly lower(t =3.571, 5.726,7.153,all P <0.05).The serum TNF -αconcentrations before and after treatment of the observation group were (27.4 ±6.1)μg/L,(13.1 ±3.4)μg/L,respectively,and those of the control group were (27.6 ±6.0)μg/L, (20.3 ±4.7)μg/L respectively.After treatment,the serum TNF -αlevels of the two groups were significantly lower than before treatment (t =5.614,8.352,all P <0.05 ),and after treatment,the serum TNF -α level of the observation group was significantly lower than that of the control group (t =4.241,P <0.05).Conclusion Ganglion glycosides in the treatment of elderly patients with Parkinson's disease can make slow markedly improved,lower levels of serum TNF -α,has significant clinical therapeutic effect.
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Objective To compare the short term prognostic values between the four scores including ABCD,ABCD2,ABCD+ low density lipoprotein (ABCD+ LDL),ABCD2 + LDL after transient ischemic attack (TIA).Methods 235 TIA patients were evaluated according to ABCD score,ABCD2 score,ABCD + LDL score and ABCD2 + LDL score.The occurrence of cerebral infarction was observed at day 2 and 7.The predictive value was compared between the four scores by using receiver operating characteristic (ROC) curve.Patients were classified into 3 risk groups:lowrisk group,moderate-risk group and high-risk group according to ABCD2 L score,and the stroke incidence was compared between the 3 groups by using x2 test.Results The area under ROC curves (AUCs) of ABCD、ABCD2、ABCDL and ABCD2L was 0.68 (95％CI:0.59-0.76),0.71 (95％CI:0.62-0.80),0.73 (95％CI:0.65-0.82) and 0.77 (95％CI:0.69-0.84) in predicting the risk of cerebral infarction at day 2,and were 0.73 (95％CI:0.66-0.81),0.77 (95％CI:0.70 0.84),0.80(95％CI:0.74-0.87) and 0.83 (95％CI:0.76-0.89) in predicting the risk of cerebral infarction at day 7 respectively.Patients were divided into 3 groups:low-risk group (score 0-2) (n =28),moderate-risk group (score 3-5) (n=143) and high-risk group (score 6-8) (n=45) according to ABCD2L score.There were significant differences in stroke incidence at day 2 and 7 between the 3groups (0％,9.1％ vs.32.8％,0％,11.9％ vs.56.3％,x2=26.15,58.87,both P＜0.05).Conclusions ABCD2 score is better than ABCD score in predicting the short-term prognosis of transient ischemic attack.Combining ABCD2 score with LDL can significantly increase the predictive value of ABCD2 score.
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Objective To investigate the safety and efficacy of intravenous thrombolytic therapy with recombinant tissue plasminogen activator(rtPA)in patients with isolated penetrating artery territory infarct (IPAI).Methods Data of retrospectively collected clinical,laboratory,and radiological from 75 consecutive patients with acute ischemic stroke treated with intravenous rtPA therapy from June 2009 to April 2011.Etiological classification was carried out according to the Chinese Ischemic Stroke Classification of Subgroups(CISS).The rates of hemorrhagic transformation(HT)and clinical outcomes of patients were compared between IPAI group and non-IPAI group.Results All 75 patients with mean age of 67.4years and 25(33.3％)fenale,were treated with intravenous rtPA.Before treatment,their average score of the National Institutes of Health Stroke Scale(NIHSS)was 12.3 ± 6.4,and mean length of time from onset to treatment was 239.6 ±97.5 minutes.After thrombolytic therapy,the radiological HT was found in 24 patients(32％).Symptomatic intracraneal hemorrhage(ICH)occurred in 4 patients(5.3％).Of 22 (29.3％)patients with IPAI,only one experienced HT.Logistic regression analysis suggested that IPAI wasan individualized predictor used alone for determining the low risk of HT.In the patients with IPAI,82％ of them had an individual clinical outcome(mRS ＜ 2)one month after onset,and the neurological outcomes were better in patients with IPAI than those in patients with non-IPAI(P ＜ 0.01).Conclusions The risk of hemorrhagic complication was low and the clinical outcome was good in patients with isolated penetrating artery territory infarct after intravenous thrombolytic therapy with rtPA.Imaging diagnosis of IPAI might facilitate the treatment with rtPA in this cohort of patients.
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Objective To explore the ability of ABCD2 score + Low density lipoprotein (LDL)(ABCD2L) in predicting early stroke risk after transient ischemic attack (TIA) . Method A total of 165TIA patients were evaluated and classified according to ABCD2 score and ABCD2L score. The occurrences of cerebral infarction were observed at 2th day or 7th day. ROC curve was used to compare the predictive vaule of two scores. Furthermore, according to these two scores, these patients were classified into three risk groups (low, moderate and high ), observed their stroke rate , and compared the differences of three groups with x2 test. Results The two-day risk of stroke was 13.33% and the seven-day risk of stroke was 20. 0% in 165 patients. When the occurrences of cerebral infarction were observed in two days, the area under the curves (AUC) of ABCD2 and ABCD2L was 0. 76 and 0. 80; observed in seven days, the AUC of two scores was 0. 73 and 0. 79. According to the risk stratification of ABCD2 score, in three risk groups,the two-day risk of stroke was 1.9%, 14. 9% and 30. 8%; the seven-day risk of stroke was 3. 8%, 21.8%and 46. 2% ( P ＜ 0. 05 ) . According to the risk stratification of ABCD2 L score, the two-day risk of stroke was 0%, 7. 8% and 31.1% ; the seven-day risk of stroke was 0%, 12. 6% and 44. 4% ( P ＜ 0. 05 ).Conclusions The predictive accuracy of the ABCD2L score is significantly higher than that of ABCD2 score. Furthermore, individuals at high early risk of stroke after TIA can be identified according to the risk stratification of ABCD2L score.
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A series of pathophysiologic changes in brain tissues will occur after intracerebral hemorrhage, including the enlargement of hematoma, metabolism abnormality in perihematoma tissues, and formation of cerebral edema. Recent researches have demonstrated that iron ions play an important role in the secondary brain injury after intracerebral hemorrhage. Iron chelator can block iron-induced injury process by specifically binding iron ions. This article reviews the changes of iron metabolism, iron-related mechanisms of brain injury, and the neuroprotective effect of iron chelator.
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AIM:To investigate the correlation between matrix metalloproteinase-9(MMP-9),tissue metalloproteinase inhibitor-1(TIMP-1),MMP-9/TIMP-1 and carotid atheromatous plaque stability in cerebral infarction patients.METHODS:80 patients with cerebral infarction were categorized as microemboli-negative group(n=70)and microemboli-positive group(n=10),20 normal human were served as control group.The MMP-9 and TIMP-1 levels in plasma were determined by mean of ELISA in 3 groups.RESULTS:The levels of MMP-9 and TIMP-1 in plasma were significantly higher in cerebral infarction patients than those in control group(P