Age features of pure leukoaraiosis in non-demented outpatients / 中华内科杂志

Objective To investigate the aging features of pure leukoaraiosis (LA) in nondemented outpatients. Methods The outpatients with age older than 40 years, without taking cholesterol lowering and B vitamin medications and with mini-mental state examination more than 24 scores were selected from July 2008 to December. 2009 in Beijing Tiantan Hospital. LA was defined with MRI. Patients were classified into two groups i. e. LA group consisting of 138 patients with leukoaraiosis but without lacunar lesions and cortical infarcts and a control group consisting of 124 patients without any lesion in brain. Age and other vascular risk factors were also investigated. Results Age of the patients in the LA group was significantly higher than that in the control group (P< 0.001). Multivariable logistic regression analysis showed that age was independently associated with pure LA ( OR 1.080, 95% CI 1.042-1.120), after adjusting sex, vascular risk factors and presence of atherosclerosis in cervical arteries. If age-stratification was further considered, logistic regression analysis showed that OR (95% CI) for LA was 2.693 (95% CI 1.103-6.575) in a 60-69 year group and 13. 527(95%CI 3.319-55.131) in a≥70 year group as compared with a 40-49 year group. Conclusion Age is a determining risk factor for pure LA and patients with age older than 60 years are at high risk of LA.

Effect of Tolcapone Added in Treatment on Parkinson's Disease / 中国康复理论与实践

@#Objective To observe the effect of catechol-O-methyltransferase inhibitor (COMTI) tolcapone on levodopa-treated patients with Parkinson's disease (PD) and on the motor function fluctuation, and safety taking this drug.Methods50 PD patients treated with levodopa were divided into the trial group and control group with 25 cases in each group. The patients in the trial group were given tolcapone 100 mg three times per day. The cases in the control group were given placebo with the same dose. The hepatic function of the patients was examined every month after administration. The time variety of patients' motor function fluctuation was recorded by the diary. The time of clinical observation was 6 months.ResultsThe UPDRS scores of the trial group in the first and second months after taking tolcapone were not significantly different from that of the control group ( P>0.05), but scores of the third to sixth months were significantly different from that of the control group ( P<0.05～0.01). There was a significant difference between UPDRS scores of the trial group before and after treatment ( P<0.01～0.001). The Honhe-Yahr scores of the trial group in the first and second months after treatment were not significantly different from that before treatment ( P>0.05), but scores of the third to sixth months were significantly different from that before treatment ( P<0.05). The motor function fluctuation of the patients in the trial group improved significantly after treatment ( P<0.05). The numbers of the cases had dry mouth, nausea and astriction were 3 respectively; those had acratia, insomnia and diarrhea were 2 respectively; those had muscular soreness, abdominal distention, hidrosis and fidget were 1 respectively. All adverse effects had a little influence to administration. The hepatic function of all patients had no significant change.ConclusionTolcapone can increase the curative effect of PD patients treated with levodopa and improve the motor function fluctuation, and is safety after taken.

CT perfusion imaging and CT subtraction angiography in the diagnosis of ischemic cerebrovascular disease within 24 hours / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the value of the clinical use of CT perfusion imaging (CTPI) and CT subtraction angiography (CTSA) for diagnosing acute ischemic cerebrovascular disease (AICVD).</p><p><b>METHODS</b>Twenty-four patients with AICVD onset within 24 hours were examined with regular CT, CTPI, and CTSA. Some cases received CTPI, magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), digital subtraction angiography (DSA) or single photon emission computer tomography (SPECT) during follow-up examinations.</p><p><b>RESULTS</b>Of the 24 cases, 11 had negative results from regular CT scans 3 - 6 hours after onset of stroke in 6 cases, 6 - 12 hours in 3 cases, and 12 - 24 hours in 2 cases. Ten of these cases were then confirmed by CTPI as having ischemic lesions, 2 with middle cerebral artery occlusion (MCAO), and 1 case with transient ischemic attack (TIA) with CTPI negative. Of the 24 cases, 13 had positive results from regular CT, 9 were diagnosed with ischemic lesions larger by using CTPI than regular CT, 1 case had MCAO and 1 had internal carotid artery occlusion (ICAO). There were 4 cases with ischemic lesions observed with regular CT having nearly the same range as that of lacunar infarctions using CTPI. Another 4 cases had more than 2 lesion areas. The peak time (PT), mean transit time (MTT) and relative flow (RF) of 24 cases were markedly different. The sides of ischemic lesions compared to each other and the core of the lesion compared to peripheral zones were also altered significantly (P < 0.01).</p><p><b>CONCLUSIONS</b>Combined CTPI with CTSA can detect acute ischemic lesions at early and hyper-early stages and could distinguish between TIA, lacunar infarction and a larger area of infarction. Using semiquantitative blood perfusion analysis status, CTPI with CTSA could define position, area and range of the ischemic lesion and penumbra. These scans can also analyze the brain blood perfusion status. It is important to early diagnose the occlusion of the entire division of the internal carotid artery or middle cerebral artery and it is meaningful to assess prognosis and assignment of therapy.</p>

CT perfusion imaging and CT subtraction angiography in diagnosing acute ischemic cerebrovascular disease / 中华神经科杂志

Objective To evaluate the clinical application of CT perfusion imaging (CTPI) and CT subtraction angiography (CTSA) in the diagnosis of acute ischemic cerebrovascular disease (AICVD). Methods 24 cases with AICVD onset within 24 hours were examined with regular CT, CTPI and CTSA. Some of them took CTPI, MRI, MRA, DSA, SPECT by follow up examinations. Results In 24 cases 11 had regular CT negative results after onset of stroke 3～6 hours in 6 cases,6～12 hours in 3 cases,12～24 hours in 2 cases. Ten cases of them were confirmed by CTPI as having ischemic lesions, 2 cases had middle cerebral artery occlusion (MCAO), and 1 had transient ischemic attack (TIA) with CTPI negative. In 24 cases 13 had regular CT positive rseults, 9 cases had ischemic lesions larger in CTPI than in regular CT,1 case had MCAO and 1 case had internal carotid artery occlusion(ICAO). There were 4 cases with ischemic lesions on regular CT almost having the same range as that of lacunar infarction in CTPI. The peak value of time(PT), mean transit time(MTT), relative flow (RF) in all 24 cases were found obviously changed. The side of ischemic lesion as compared with the opposite side, and the core of ischemic lesion as compared with peripheral zone were found changed significantly ( P