Newly detected atrial fibrillation is associated with cortex-involved ischemic stroke / 中华医学杂志(英文版)

Background@#Both cortical and cortical-subcortical (cortex-involved) lesions are typically associated with embolic stroke, of which atrial fibrillation (AF) is the common cause. The aim of this study was to find out the associations between cortex-involved stroke, vascular risk factors, and the subtypes (discovery time and duration) of AF.@*Methods@#This was an imaging study of the China Atrial Fibrillation Screening in Acute Ischemic Stroke Patients (CRIST) trial. Between October 2013 and June 2015, 1511 acute ischemic stroke or transient ischemic attack (TIA) patients within 7 days after stroke onset at 20 Chinese hospitals were enrolled in this prospective, multicenter cohort, cross-sectional study. The final analysis of this sub-study included 243 patients with AF with required magnetic resonance imaging (MRI) sequences. AF was diagnosed by 6-day Holter monitoring and classified by duration of 24 h. Two stroke specialists blinded to the clinical information reviewed MRI (diffusion-weighted MRI). The third stroke specialists, also blinded to the clinical information, assessed the conflicts. Adjusted large artery atherosclerosis as confounding factor, the associations between cortex-involved lesions, vascular risk factors, and the subtype of AF were evaluated by univariate and multivariate regression analyses.@*Results@#Of 243 acute ischemic stroke patients with AF, 190 were known AF and 53 were newly detected AF. There were 28 patients with AF persistent >24 h and 25 persistent ≤24 h in newly detected AF. Patients with newly detected AF were likely to have a fewer history of stroke or TIA (16.98% vs. 36.31%, P = 0.008) and lower fasting blood glucose (5.91 ± 1.83 mmol/L vs. 6.75 ± 3.83 mmol/L, P = 0.030) than patients with known AF. Among these 243 patients, 102 (41.98%) patients were with cortex-involved lesions. Cortex-involved lesions were significantly related to newly detected AF persistent >24 h (odds ratio [OR]: 4.517, 95% confidence interval [CI]: 1.490–13.696, P = 0.008), proteinuria (OR: 3.431, 95% CI: 1.530–7.692, P = 0.021), and glycosylated hemoglobin (OR: 0.632, 95% CI: 0.464–0.861, P = 0.004).@*Conclusions@#Compared to previously known AF, newly detected AF persistent >24 h was associated with cortex-involved ischemic stroke.@*Clinical trial registration@#NCT02156765, https://clinicaltrials.gov/ct2/show/record/NCT02156765

Newly detected atrial fibrillation is associated with cortex-involved ischemic stroke / 中华医学杂志(英文版)

BACKGROUND@#Both cortical and cortical-subcortical (cortex-involved) lesions are typically associated with embolic stroke, of which atrial fibrillation (AF) is the common cause. The aim of this study was to find out the associations between cortex-involved stroke, vascular risk factors, and the subtypes (discovery time and duration) of AF.@*METHODS@#This was an imaging study of the China Atrial Fibrillation Screening in Acute Ischemic Stroke Patients (CRIST) trial. Between October 2013 and June 2015, 1511 acute ischemic stroke or transient ischemic attack (TIA) patients within 7 days after stroke onset at 20 Chinese hospitals were enrolled in this prospective, multicenter cohort, cross-sectional study. The final analysis of this sub-study included 243 patients with AF with required magnetic resonance imaging (MRI) sequences. AF was diagnosed by 6-day Holter monitoring and classified by duration of 24 h. Two stroke specialists blinded to the clinical information reviewed MRI (diffusion-weighted MRI). The third stroke specialists, also blinded to the clinical information, assessed the conflicts. Adjusted large artery atherosclerosis as confounding factor, the associations between cortex-involved lesions, vascular risk factors, and the subtype of AF were evaluated by univariate and multivariate regression analyses.@*RESULTS@#Of 243 acute ischemic stroke patients with AF, 190 were known AF and 53 were newly detected AF. There were 28 patients with AF persistent >24 h and 25 persistent ≤24 h in newly detected AF. Patients with newly detected AF were likely to have a fewer history of stroke or TIA (16.98% vs. 36.31%, P = 0.008) and lower fasting blood glucose (5.91 ± 1.83 mmol/L vs. 6.75 ± 3.83 mmol/L, P = 0.030) than patients with known AF. Among these 243 patients, 102 (41.98%) patients were with cortex-involved lesions. Cortex-involved lesions were significantly related to newly detected AF persistent >24 h (odds ratio [OR]: 4.517, 95% confidence interval [CI]: 1.490-13.696, P = 0.008), proteinuria (OR: 3.431, 95% CI: 1.530-7.692, P = 0.021), and glycosylated hemoglobin (OR: 0.632, 95% CI: 0.464-0.861, P = 0.004).@*CONCLUSIONS@#Compared to previously known AF, newly detected AF persistent >24 h was associated with cortex-involved ischemic stroke.@*CLINICAL TRIAL REGISTRATION@#NCT02156765, https://clinicaltrials.gov/ct2/show/record/NCT02156765.

Impact of libido at 2 weeks after stroke on risk of stroke recurrence at 1-year in a chinese stroke cohort study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>There were few studies on the relation between changes in libido and incidence of stroke recurrence. The aim of this study was to investigate the relationship between libido decrease at 2 weeks after stroke and recurrent stroke at 1-year.</p><p><b>METHODS</b>It is a multi-centered, prospective cohort study. The 14 th item of the Hamilton Depression Rating Scale-17 was used to evaluate changes of libido in poststroke patients at 2 weeks. Stroke recurrence was defined as an aggravation of former neurological functional deficit, new local or overall symptoms, or stroke diagnosed at re-admission.</p><p><b>RESULTS</b>Among 2341 enrolled patients, 1757 patients had completed follow-up data, 533 (30.34%) patients had decreased libido at 2 weeks, and 166 (9.45%) patients had recurrent stroke at 1-year. Multivariate logistic regression analysis showed that, compared with patients with normal libido, the odds ratio (OR) of recurrent stroke in patients with decreased libido was reduced by 41% (OR = 0.59, 95% confidence interval [CI]: 0.40-0.87). The correlation was more prominent among male patients (OR = 0.52, 95% CI: 0.31-0.85) and patients of ≥60 years of age (OR = 0.57, 95% CI: 0.35-0.93).</p><p><b>CONCLUSIONS</b>One out of three stroke patients in mainland China has decreased libido at 2 weeks after stroke. Decreased libido is a protective factor for stroke recurrence at 1-year, which is more prominent among older male patients.</p>

A Comparison of Brain Death Criteria between China and the United States / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Criteria for determining brain death (BD) vary between China and the United States. We reported the results of an investigation designed to compare procedures to determine BD in two countries.</p><p><b>METHODS</b>The latest criteria in the United states were published in 2010. The latest criteria in China were published in 2009. We used these two types of BD criteria to evaluate patients who were considered to be BD. The time, cost, and accuracy of the diagnosis were compared.</p><p><b>RESULTS</b>From January 1, 2012 to October 8, 2013, there were 37 patients which were applied for BD evaluation in the Neurological Intensive Care Unit of Beijing Tiantan Hospital. The cause of coma were known as subarachnoid hemorrhage (18 patients, 48.6%), intracerebral hemorrhage (8 patients, 21.6%), cerebral ischemia (9 patients, 24.3%), brain stem tumor (1 patient, 2.7%), and intracranial infection (1 patient, 2.7%). The clinical examinations were done for all of the patients except 1 patient who had low blood pressure. Three patients had brainstem reflexes that were excluded from BD. Twenty-five patients had apnea tests, and 20 tests were completed that were all positive. Confirmatory tests were completed differently: Transcranial Doppler (30 patients, positive rate 86.7%), electroencephalogram (25 patients, positive rate 100%), and somatosensory evoked potential (16 patients, positive rate 100%). Thirty-three patients were diagnosed BD by criteria of the United States. Only 9 patients were diagnosed BD by Chinese criteria. The use of time and money in the USA criteria was obviously fewer than those in Chinese criteria (P = 0.000).</p><p><b>CONCLUSION</b>Compared with BD criteria of the United States, Chinese criteria were stricter, lower positive rate, more cost in money and time, and more reliable by families and doctors.</p>

Efficacy of yindan xinnaotong soft capsule on cerebral infarction reconvalescents of static blood blocking collaterals syndrome: a randomized controlled study / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of Yindan Xinnaotong Soft Capsule (YXSC) on cerebral infarction (CI) reconvalescents of static blood blocking collaterals syndrome (SBBCS).</p><p><b>METHODS</b>Totally 118 CI reconvalescents of SBBCS were randomly assigned to the test group (treated by YXSC) and the control group [treated by Naoxintong Capsule (NC)], 59 in each group. The therapeutic course for all was 12 weeks. Changes of National Institute of Health Stroke Scale (NIHSS), Barthel Index (BI), modified Rankin Scale (mRS), Chinese medical syndrome scores, and serum lipid indices were observed in the two groups.</p><p><b>RESULTS</b>Compared with the control group, the patient proportion of improving activities of daily life by more than or equal to 75 score was elevated (80.7% vs 62.5%; P < 0.05). Compared with before treatment in the same group, the NIHSS score decreased at post-treatment 4, 8, and 12 weeks in the two groups (P < 0.05). The patient proportion of dropped NIHSS score by more than or equal to 5 score was lowered (80.7% vs 57.14%), and the total effective rate of improving Chinese medical syndromes was superior in the test group after 12-week treatment (89.47% vs 71.43%, all P < 0.05). After 12-week treatment there was no statistical difference in the patient proportion of lowering mRS lower than or equal to 2 or blood lipids between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>YXSC showed certain effect in improving activities of daily life, attenuating the neurological impairment, and elevating the total effective rate of improving Chinese medical syndromes in CI patients in the recovery stage.</p>

Association between blood pressure level and incidence of carotid artery plaque in middle-aged and elderly people / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the association between blood pressure level and incidence of carotid arterial plaque in middle-aged and elderly people.</p><p><b>METHODS</b>A total of 5852 individuals were randomly stratified from the 101 510 health examination survey participants in Tangshan Kailuan Company community during 2006-2007. A total of 5440 people (age above 40 years old, free of stroke, TIA and myocardial infarction) were enrolled in the final analysis. A questionnaire survey, blood biochemical analysis and carotid artery ultrasound examination were finished by trained medical staff. Sixteen individuals without carotid artery plaques information and 35 individuals without blood pressure information were excluded. Finally, a total of 5389 participants [3235 male, mean age: (54.7 ± 11.8) years] were analyzed. According to 2010 Chinese guideline to prevention and treatment of hypertension and blood pressure level classification, participants were divided into normotensive group (n = 1377), high normal blood pressure group (n = 1971) and hypertensive group (n = 2041). Multivariate logistic regression analysis was used to determine the risk factors of the carotid artery plaques.</p><p><b>RESULTS</b>Age, male gender, BMI, IMT, TG, FBG, smoking and alcohol drinking rate were significantly higher in high normal blood pressure group than in normotensive group (all P < 0.05), LDL-C, HDL-C, hs-CRP and TC were similar between these two groups. Incidence of carotid artery plaques in normotensive, high normal blood pressure and hypertensive groups was 24.8%, 37.4%, 60.2% respectively. The risk of carotid artery plaques was increased to 38% and 163% in high normal and hypertensive groups compared to normotensive group, the OR ratio was 1.38 (95%CI: 1.15-1.66) and 2.63 (95%CI: 2.18-3.18), respectively. After adjusting gender, age, smoking, alcohol consumption, TG, TC, HDL-C, FBG, hs-CRP and BMI, the risk of developing carotid artery plague was increased in proportion to increasing blood pressure and the OR value was 1.24 (95%CI:1.01-1.52) , 1.69 (95%CI:1.34-2.15) and 2.66 (95%CI:2.20-3.21) in high normal group I [SBP/DBP 121-129/80-84 mm Hg(1 mm Hg = 0.133 kPa)] and high normal group II (SBP/DBP 130-139/85-89 mm Hg) and hypertensive group, respectively.</p><p><b>CONCLUSIONS</b>The cardiovascular risk factors and prevalence of carotid artery plague increase in proportion to blood pressure level in this cohort. The detection rate of carotid artery plague is already significantly increased in individuals with high normal blood pressure.</p>

Neurological deterioration in the acute phase of minor ischemic stroke is an independent predictor of poor outcomes at 1 year: results from the China National Stroke Registry (CNSR) / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The risk of clinical deterioration still exists in the acute phase despite the fact that patients with minor stroke may display less severe symptoms. The impact of this clinical deterioration on long-term outcomes is unknown. We characterized the clinical features of neurological deterioration (ND) in the acute phase of minor ischemic stroke (MIS) and investigated its impact on mid- and long-term outcomes.</p><p><b>METHODS</b>This was a multi-centered, prospective clinical study involving patients with MIS (the National Institutes of Health Stroke Scale, NIHSS ≤3) recruited from the China National Stroke Registry. Patients were included who had been hospitalized within 24 hours of stroke onset. Baseline characteristics, complication rates during hospitalization, etiology of stroke, as well as 3-, 6-, and 12-month post-stroke outcomes were compared between patients with and without ND during the acute phase.</p><p><b>RESULTS</b>A number of 368 (15.2%) out of 2424 patients included in the study exhibited ND in the acute phase. Compared to patients without ND, patients with ND had longer hospital stay, increased rate of baseline diabetes, and multiple complications. Multivariate Logistic regression indicated that ND in acute phase was an independent factor predictive of increased dependence (adjusted odds ratio = 5.20, 95% CI, 3.51-7.70, P < 0.001) at 12-month post-stroke.</p><p><b>CONCLUSIONS</b>The risk of ND in the acute phase is high in patients with MIS. ND in the acute phase is an independent predictor for poor outcomes at 12 months post-stroke onset.</p>

Impact of systolic blood pressure on visit-to-visit blood pressure variability in middle-aged and elderly people / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the impact of systolic blood pressure (SBP) on visit-to-visit blood pressure variability (BPV) in middle-aged and elderly people.</p><p><b>METHODS</b>Visit-to-visit BPV was determined in 5440 workers in the Kailuan study cohort from 2006 to 2007. The subjects were ≥ 40 years-old and had no history of stroke, transient ischemic attack or myocardial infarction. Participants were divided into five groups according to different levels of SBP. Linear regression was used to analyze the related factors which might affect BPV.</p><p><b>RESULTS</b>Mean systolic BPV of all subjects was 10.35 mm Hg [coefficient of variation (CV 7.96%)]. The mean systolic BPV of males was 10.54 mm Hg (CV 7.90%) while the mean SBPV of females was 10.06 mm Hg (CV 7.90%). The BPV of males was significant higher than that of females (P < 0.001). CV of SBP was similar between males and females. Furthermore, higher SBP was associated with higher BPV. There were significant differences in BPV between different groups with different levels of SBP (P < 0.001). Linear regression analysis demonstrated that SBP, age, gender, high-sensitivity C-reactive protein (hsCRP) were affecting factors of BPV. Twenty mm Hg SBP increase was linked with 2.02 mm Hg BPV increase and 0.388%CV increase. Age increase of 1 year was associated with 0.044 mm Hg BPV increase and 0.029% CV increase.</p><p><b>CONCLUSION</b>SBP, age, gender and hsCRP are important factors affecting BPV in middle-aged and elderly people. Higher SBP is closely related to greater BPV in this cohort.</p>

In-hospital medical complications associated with patient dependency after acute ischemic stroke: data from the China National Stroke Registry / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The mortality of stroke patients is strongly affected by medical complications. However, there are limited data investigating the effect of in-hospital medical complications on the dependency of stroke patients worldwide. We prospectively and systematically investigated the effect of medical complications on dependency of patients at 3, 6 and 12 months after stroke using the China National Stroke Registry (CNSR).</p><p><b>METHODS</b>This prospective cohort study collected data of patients age > 18 years with acute ischemic stroke in 132 clinical centers distributed across 32 provinces and four municipalities (including Hong Kong region) of China, from September 2007 to August 2008. Data on medical complications, dependency and other information were obtained from paper-based registry forms. Medical complications associated with stroke outcomes were assessed using multivariable Logistic regression.</p><p><b>RESULTS</b>Of 11 560 patients with acute ischemic stroke, 1826 (15.80%) presented with in-hospital medical complications. In-hospital medical complications were independent risk factors for dependency of patients at 3 months (adjusted odds ratio (OR) 2.367, 95% confidence interval (CI) 2.021 - 2.771), 6 months (adjusted OR 2.257, 95%CI 1.922 - 2.650), and 12 months (adjusted OR 1.820, 95%CI 1.538 - 2.154) after acute ischemic stroke.</p><p><b>CONCLUSION</b>The results demonstrated that the short-term and long-term dependency of acute ischemic stroke patients is significantly associated with in-hospital medical complications in China.</p>

Impact of ideal health behaviors and health factors on the detection rate of the carotid plaques / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the impact of ideal health behaviors and health factors on the detection rate of the carotid plaques.</p><p><b>METHODS</b>Subjects with previous stroke, TIA, myocardial infarction were excluded from the study. A total of 5852 employees (active and retired employers from Tangshan Kailuan company) aged 40 years and over were included through stratified random sampling. Information was obtained from the unified questionnaire, measurements of blood biochemistry and carotid artery ultrasonography.</p><p><b>RESULTS</b>(1) The carotid artery plaque detection rates were 67.0%, 52.3%, 50.5%, 44.3%, 37.2%, 31.9%, 26.1% and 4.2% in the groups with 0, 1, 2, 3, 4, 5, 6 and 7 components of ideal cardiovascular health behaviors and health factors, respectively. (2) The carotid artery plaques total burden score [TBS: M (Q1, Q3)] were 7(7,7), 7(5,7), 7(5,7), 5(3,5), 5(3,5), 5(3,5), 3(3,3), 3(3,3) in the groups with 0, 1, 2, 3, 4, 5, 6 and 7 components of ideal cardiovascular health behaviors and health factors, respectively. (3) Multiple logistic regression analysis showed that 3, 4, 5 and greater than 5 components of ideal cardiovascular health behaviors and health factors were protective factors against carotid plaques compared to less than 2 components of ideal cardiovascular health behaviors and factors (all P < 0.05), the OR (95%CI) values were 0.78 (0.62 - 0.98), 0.53(0.62 - 0.98), 0.52 (0.39 - 0.71) and 0.40 (0.25 - 0.64), respectively.</p><p><b>CONCLUSION</b>Increasing ideal cardiovascular health behaviors and factors are negatively linked with the detection rate and TBS of the carotid plaques.</p>

Relations between serum homocysteinemia and carotid artery plapues / 中华流行病学杂志

Objective To explore the relation between homocysteinemia (HCY) and carotid artery plaque.Methods Subjects were derived from a cohort of Kailuan study,which was a community-based and cross-sectional.From June 2010 to June 2011,a total of 5852 subjects were selected from 101 510 working or retired employees at the Tangshan Kailuan Company in 2006-2007.Data was extracted from the results of health examination on the employees.Selecting process was carried out by those staff working on the clinical trials on stroke and from the research center of Tiantan Hospital,Capital Medical University.Subjects who were beyond 40 years of age but without histories as previous stroke,transient ischemic attack (TIA) or myocardial infarction were included and identified,to take part in the study through stratified random sampling.Finally,5440 eligible subjects were enrolled and data from 5377 subjects were analyzed.All the information was obtained through unified questionnaire,blood tests and carotid artery ultrasonography.Multivariate logistic regression was used to analyze the factors related to carotid artery plagues.Results ( 1 )The baseline results showed that the average age of the subjects (n=5377) was 55.18± 11.78 years old with 3215 as males.All the subjects were divided into three groups by tertbiles of HCY,with 1771 subjects in the first quantile group ( HCY ＜ 1 1.00 μmol/L ),1814 in the second quantile group ( 11.00-16.98 μmol/L)and 1792 in the third quantile group( ≥ 16.98 μmol/L).2300 subjects were identified as having carotid artery plaques.(2)The prevalence rates of carotid artery plaques in the three groups were 29.9％,43.3％ and 55.0％ respectively.(3) Afar multivariable adjustment,the third quantile HCY was still serving as a risk factor,affecting the formation of carotid artery plaques,with the OR values as 1.344 (95％CI:1.134-1.594).Conclusion High HCY was related to the increased prevalence of carotid artery plaque and thus served as a risk factor for carotid artery plaque.

Effect of in-hospital medical complications on case fatality post-acute ischemic stroke: data from the China National Stroke Registry / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In-hospital medical complications are associated with poorer clinical outcomes for stroke patients after disease onset. However, few studies from China have reported the effect of these complications on the mortality of patients with acute ischemic stroke. In this prospective work, the China National Stroke Registry Study, we investigated the effect of medical complications on the case fatality of patients with acute ischemic stroke.</p><p><b>METHODS</b>From September 2007 to August 2008, we prospectively obtained the data of patients with acute stroke from 132 clinical centers in China. Medical complications, case fatality and other information recorded at baseline, during hospitalisation, and at 3, 6, and 12 months after stroke onset. Multivariable Logistic regression was performed to analyze the effect of medical complications on the case fatality of patients with acute ischemic stroke.</p><p><b>RESULTS</b>There were 39 741 patients screened, 14 526 patients with acute ischemic stroke recruited, and 11 560 ischemic stroke patients without missing data identified during the 12-month follow-up. Of the 11 560 ischemic patients, 15.8% (1826) had in-hospital medical complications. The most common complication was pneumonia (1373; 11.9% of patients), followed by urinary tract infection and gastrointestinal bleeding. In comparison with patients without complications, stroke patients with complications had a significantly higher risk of death during their hospitalization, and at 3, 6 and 12 months post-stroke. Having any one in-hospital medical complication was an independent risk factor for death in patients with acute ischemic stroke during hospital period (adjusted OR = 6.946; 95%CI 5.181 to 9.314), at 3 months (adjusted OR = 3.843; 95%CI 3.221 to 4.584), 6 months (adjusted OR = 3.492; 95%CI 2.970 to 4.106), and 12 months (adjusted OR = 3.511; 95%CI 3.021 to 4.080). Having multiple complications strongly increased the death risk of patients.</p><p><b>CONCLUSION</b>Short-term and long-term outcomes of acute stroke patients are affected by in-hospital medical complications.</p>

Effects of systolic blood pressure and low density lipoprotein on carotid plaques / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the different effects of systolic blood pressure (SBP) and low density lipoprotein on carotid plaques (LDL-C).</p><p><b>METHODS</b>A total of 101 510 serving and retired workers of a company who participated in the health examination in 2006-2009, 5852 participants were selected as study subjects by stratified random sampling according to the age and sex ratio. These subjects took their health examination in 2010-2011 including the carotid ultrasound. Finally, 5361 eligible participants with complete data were included in the analysis. The detection and weighted rates of carotid plaques were calculated for four groups: normal SBP and LDL-C group (3524 subjects), normal SBP and high LDL-C group (356 subjects), elevated SBP and normal LDL-C group (1308 subjects) and elevated SBP and high LDL-C group (173 subjects). The effects of different baseline SBP and LDL-C on detection rates of the carotid artery plaques were analyzed by logistic regression.</p><p><b>RESULTS</b>The detection rate of carotid plaques in normal SBP and LDL-C group, normal SBP and high LDL-C group, elevated SBP and normal LDL-C group, elevated SBP and high LDL-C group was 33.7% (1186/3524), 41.3% (147/356), 64.8% (847/1308), 68.8% (119/173) (χ(2) = 425.75, P < 0.05) and the weighted detection rate was 36.0%, 42.0%, 64.5% and 68.3% respectively. For men, the detection rate was 44.2% (877/1985), 51.1% (97/190), 70.6% (657/930), 71.3% (82/115) (χ(2) = 194.02, P < 0.05) and the weighted detection rate was 31.2%, 36.1%, 49.8% and 50.3% respectively. For women, the detection rate was 20.1% (309/1539), 30.1% (50/166), 50.3% (190/378), 63.8% (37/58) (χ(2) = 180.17, P < 0.05) and the weighted detection rate was 30.9%, 46.3%, 70.3%, and 88.1% respectively. After adjusted for other risk factors, the OR (95%CI) value was 1.37 (1.05 - 1.78), 2.05 (1.74 - 2.43) and 2.12 (1.45 - 3.12) for normal SBP and high LDL-C group, elevated SBP and normal LDL-C group and elevated SBP and high LDL-C group respectively compared with normal SBP and LDL-C group.</p><p><b>CONCLUSION</b>Elevated SBP and high LDL-C were risk factors of the carotid artery plaques. Compared with high LDL-C, elevated SBP may add a higher risk for carotid plaques.</p>

Effect of Rehabilitation and Local Injection of Botulinum Aoxic A on Spastic Cerebral Palsy / 中国康复理论与实践

@#ObjectiveTo evaluate the efficacy of rehabilitation associated with local intramuscular injection of botulinum toxic A (BTX-A) on spastic cerebral palsy (CP).Methods60 children with spastic CP were divided into experimental group and control group with 30 cases in each group. Cases of experimental group were treated with rehabilitation associated with local intramuscular injection of BTX-A. Cases of control group were treated only with rehabilitation treatment. The therapeutic efficacies of two groups were evaluated with physician rating scale (PRS) and activities of daily living (ADL) evaluation systems.ResultsImprovement of clinical evaluations index-PRS and ADL in experimental group was much more significant than that of control group (P<0.05). ConclusionRehabilitation associated with local intramuscular injection of BTX-A can improve the efficacy of spastic CP.

Clinical research of curative effect and safety of deproteinised calf serum enteric capsules on nerve function defect caused by cerebral ischemia damage / 中华神经科杂志

Objective To observe the clinical curative effect and security of the deproteinised calf serum enteric capsules on nerve functions defect caused by cerebral isehemia damage.Methods A randomized,double-blind,multicentric trial design was conducted.Treatment group:based on routine treatment,the patients were given deproteinised calf serum enteric capsules for 90 days.Control group: based on routine treatment,the patients were given placebo for 90 days.The NIHSS,BI,mRS measuring scale were used for evaluation on the 7th,14th and 28th day before and after treatment.BI and mRS measuring scale were used for evaluation on the 90th day.The change of numerical value was inspected before and after treatment.Results Before treatment,there was no significant difference in the NIHSS,BI and mRS measuring scale evaluation between the groups of treatment and control.After treatment,there were significant differences in the NIHSS,BI and mRS measuring scale evaluation between the groups of treatment and control on the 14th and 28th day (P

Secondary injury to perihematoma in intracerebral haemorrhage rats / 中国康复理论与实践

@#ObjectiveTo study possible mechanism through investigating the pathological and ultrastructural characters of secondary injury to perihematoma in intracerebral haemorrhage (ICH) rats.MethodsSprague Dawley male rats were subjected to ICH models. They were randomly divided into test group and control group. The rats in the test group were divided into 7 subgroups at 1h,3h,12h,24h,48h,72h and 7d after ICH; while those in control group were divided into 3 subgroups at 3h,24h,72h after saline injection. Each subgroup contained 5 rats. 2 rats from each group were stained by 2% triphenyltetrazolium chloride(TTC) to observe the pathological change.3 rats were picked up from each group to do optical microscope and electric microscope investigation on perihematoma tissue and ipsilateral cortex.ResultsHematoma tissue was demonstrated as black brown by TTC staining, no white infarcted area was detected around hematoma. In addition, there was a transitional zone between hematoma and normal tissue under microscopy; the involved tissue looked loose with varied edematous cells. Astrocytes appeared swollen and neural cells looked degenerated and necrosis. Meanwhile, capillary hyperplasia around hematoma with foot plate swollen were detected, no remarkable neural cells change was observed. 24 h after blood injection, astrocytes started to swell, part of them became degenerated and necrosis. Neural cells appeared mild degenerated and blood brain barrier were destroyed. 72 h after ICH, astrocytes showed highly swollen with neural cells degenerated.ConclusionSecondary injury to perihematoma has been identified and the pathological and ultrastructural changes have been observed.

Continuous assessment of cerebral autoregulation in subarachnoid hemorrhage / 中国康复理论与实践

@#ObjectiveTo examined how autoregulation is affected by vasospasm after subarachnoid hemorrhage (SAH) by using transcranial Doppler. MethodsThe moving correlation coefficient between slow changes of arterial blood pressure and mean or systolic flow velocity (FV), termed Mx and Sx, respectively, was used to characterize cerebral autoregulation. Vasospasm was declared when the mean FV increased to more than 120 cm/s and the Lindegaard ratio was more than 3. This occurred in 15 of 32 SAH patients.On the basis of the bilateral transcranial Doppler recordings of the middle cerebral artery in vasospastic patients, Mx and Sx were calculated for baseline and vasospasm. ResultsMx increased during vasospasm (0.46±0.32) and was significantly higher (P=0.03) than at baseline (0.21±0.24) Sx was also increased (0.22±0.26 vs 0.05±0.21,P=0.03). Mx correlated with mean FV (P=0.577, P=0.006) and the Lindegaard ratio (r=0.672,P<0.01).Mx(P=0.006) and Sx (P=0.044) were higher on the vasospastic side compared with the contralateral side.ConclusionThe increased Mx and Sx during cerebral vasospasm demonstrate impaired cerebral autoregulation. Mx and Sx provide additional information on changes in autoregulation in SAH patients.