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Objective To investigate the correlation between serum retinol-binding protein 4 (RBP4) level and stroke severity and short-term outcome in patients with acute ischemic stroke.Methods From January 2017 to December 2017,patients with acute ischemic stroke admitted to the Department of Neurobgy,the Third Affiliated Hospital of Anhui Medical University and who did not receive thrombolytic or endovascular treatment were enrolled retrospectively within 2 weeks of onset.The serum RBP4 levels were measured within 24 h of admission and the demographics and baseline clinical data of the patients were documented.On the day of admission,the National Institutes of Health Stroke Scale (NIHSS) was used to assess the degree of neurological deficit;≤8 was defined as mild stroke and ＞8 was defined as moderate to severe stroke.The modified Rankin scale was used to assess the short-term outcomes at the time of discharge or 14 days after onset;0 to 2 were defined as good outcomes,and ＞ 2 was defined as poor outcome.Results A total of 235 patients were enrolled,including 101 females (43％) and 134 males (57％);aged (66.8 ± 1.7) years (range 28-93 years).There were 200 mild strokes (85.1％) and 35 moderate to severe strokes (14.9％);171 (72.8％) had good outcomes and 64 (27.2％) had poor outcomes.Univariate analysis showed that the serum RBP4 level in the moderate to severe stroke group was significantly lower than that in the mild stroke group (29.28 ± 10.43 mg/L vs.36.88 ± 10.61 mg/L;t =3.920,P ＜ 0.001),and the RBP4 level in the poor outcome group was significantly lower than that in the good outcome group (32.03 ± 11.33 mg/L vs.37.14± 10.44 mg/L;t=3.264,P=0.001).Multivariate logistic regression analysis showed that the high serum RBP4 level was independently correlated with the milder stroke severity (odds ratio 0.917,95％ confidence interval 0.874-0.962;P ＜0.001) and short-term poor outcome (odds ratio 0.955,95％ confidence interval 0.927-0.983;P =0.002).Conclusion In patients with high serum RBP4 levels,acute ischemic stroke is less severe and better in short-term outcomes.
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Objective To investigate the risk factors and MRA manifests in the patients with cortical wa-tershed infarcts(CWSI)or internal watershed infarcts(IWSI).Methods We collected the patients with acute wa-tershed infarcts in our hospital from January 2013 to April 2016.According to the Bogousslavsky classification stan-dard,the patients were divided into two groups:CWSI and IWSI. The two groups were compared in terms of risk factors and MRA manifests. Results We included 36 CWSI and 11 IWSI patients in the study.There were signifi-cant differences in smoke,diabetes mellitus,fasting blood glucose levels and carotid atherosclerotic plaque be-tween the two groups,and so it was with the stenosis of ICA,MCA,ACA,PCA,VA and BA:The stenosis of ICA in the CWSI group was more serious than in the IWSI group,but the stenosis of MCA,ACA,PCA,VA and BA in the IWSI group was more serious than in the CWSI group. Conclusions The pathogenesis of CWSI may be related to the formation of carotid atherosclerotic plaques,carotid stenosis and arterial artery embolism,or plaque shedding and micro emboli removal.The pathogenesis of IWSI may be related to the decrease of the perfusion pres-sure at the end of the intracranial artery.The ratio of IWSI to diabetes mellitus is higher than that of CWSI,suggest-ing that the damage of diabetes to intracranial arteriole is earlier than that of intracranial and extracranial arteries.
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Objective To assess the cerebrovascular reserve (CVR)and the relationship of CVR with the short-term prognosis in patients with acute atherosclerotic cerebral infarction.Methods A total of 106 patients with unilateral acute (within 72 h) atherosclerotic cerebral infarction (trial group) were selected from December 2016 to December 2017 in the Department of Neurology of the First People's Hospital of Hefei,which were divided into two groups including the lesion group (106 cases) and the nonlesion group (106 cases).The median score of NIHSS in patients was 4(2,5).The control group included 40 healthy controls.The cerebral blood flow reserve and pulsatility index were measured by transcranial Doppler combined with CO2 inhalation test in both the trial group and the control group.According to the rate of change of cerebral blood flow velocity (CBFV),all subjects were divided into two groups including the normal group and the impaired cerebral blood flow reserve group.The changes of CBFV were compared in the control group and the trial group,which was divided into two groups including the group with lesion side and the group with non-lesion side.To evaluate the brain structure reserve the circle of Willis in the trial group was assessed by MRA.According to the integrity of the circle of Willis anterior and posterior circulation all subjects were divided into four groups (type Ⅰ,type Ⅱ,type Ⅲ and type Ⅳ).The effect of the factors,such as diabetes,hypertension,low density lipoprotein (LDL),high density lipoprotein (HDL),smoking,and drinking history,on cerebral blood flow reserve was measured by single-factor analysis.The correlation of NIHSS scores,infarct size and volume with CVR was also measured.All patients in the trial group were treated with drugs and were followed-up for three months.The modified Rankin Scale (Mrs) was used to evaluate the prognosis of the patients.It means poor prognosis if the value of Mrs was more than three.The effects of factors,such as sex,HDL,LDL,diabetes,hypertension,smoking history,drinking history,cerebral blood flow reserve,NIHSS scores,brain structure reserve,infarct location,age,on the prognosis were measured by multivariate Logistic regression.Results The increase rate of CBFV in the lesion-side of patients with atherosclerotic cerebral infarction was 5.94％ (2.18％,10.49％),and the increase rate of pulsatility index was 10.77％ (2.21％,22.62％),which were both lower than the control group (CBFV:11.54％ (5.01％,17.96％),Z =2.547,P＜0.05);pulsatility index:48.36％ (33.93％,64.51％),Z =6.604,P ＜ 0.01).There was significant difference (x2 =4.328,P ＜ 0.05) in the distribution of diabetes,which was 2/14 in the normal group and 43.48％ (40/92) in the impaired cerebral blood flow reserve group.And in the trial group the brain structural reserve was positively correlated to the infarct volume and the NIHSS score,and the rank correlation coefficient was 0.219 and 0.238 respectively (P ＜ 0.05).The prognosis of cerebral blood flow reserve in the normal group was better than the impaired group (x2 =4.155,P ＜ 0.05),for example,the proportion of patients with good prognosis and normal CBFV was 18.84％ (13/69),the proportion of patients with good prognosis but decreased CBFV was 81.16％ (56/69),the proportion of patients with poor prognosis but normal CBFV was 2.70％ (1/37),the proportion of patients with poor prognosis and decreased CBFV was 97.30％ (36/37).The proportion of patients with type Ⅰ and type Ⅲ of the brain structure reserve was 37.68％ (26/69) and 5.80％ (4/69) respectively,whose prognosis was better (x2 =8.456,P ＜ 0.05) than patients with type Ⅱ and type Ⅳ,whose proportion was 43.48％ (30/69) and 13.04％ (9/69).Multivariate Logistic regression analysis showed that NIHSS score,age,and brain structural reserve were risk factors for poor prognosis in the trial group.Normal cerebral blood flow reserve was a protective factor for good prognosis.Conclusions CVR in patients with acute atherosclerotic cerebral infarction is significantly reduced.CVR can be used as an index to evaluate the prognosis of patients who were followed-up for three months.
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Objective To investigate the effect of insular on the addiction of nicotine after insular infarction. Methods Totally 35 patients with lesions involving insular infarction were enrolled in insular damage group. The patients matched with the demographic data of the study subjects who did not involve in-sular infarction were the control group(n=114). All patients were given the internationally popular question-naire of smoking urges ( QSU) and fagerstrom test for nicotine dependence( FTND) during hospitalization, and they were followed up 3 months after stroke. The QSU and the minnesota nicotine withdrawal scale ( MNWS) were assessment for patients who did not smoke again and did not relapse,and the QSU and FTND scale were used for the patients who still smoke. Results After 3 months follow-up,the rate of withdrawal from insular damage was 77. 14%,and that in non-insular damage was 52. 63%(χ2=6. 62,P=0. 01),and the MNWS in two groups(insular damage patients (0. 59±0. 97) and non-insular damage patients(1. 15± 1. 29)),the difference was statistically significant (t=-2. 00,P=0. 04). All subjects were evaluated by questionnaire of smoking urges (QSU),among which QSU score was (19. 40±9. 63) in insular damage group and (24. 47±10. 39) in non-insular group,the difference was statistically significant (t=-2. 57,P=0. 01) . Conclusion Patients with insular lesion are more likely to cause withdrawal of nicotine addiction, suggesting that insular may be involved in cognitive processing of addiction.
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Objective To investigate the emotional memory changes in patients with thalamic infarction on different laterals and explore the impact of different emotional valence pictures on the thalamic infarction(TI) patients' memory.Methods 28 patients with thalamic infarction (TI group)and 28 patients who were hospitalized without TI during the same period (control group) were given emotional memory test,a test where they use their emotional memory to evaluate and recognize pictures with different emotional valence,including positive,neutral,and negative valence.Results (1) At the stage of evaluating emotional images,there were no significant difference between patients with TI and control group in positive evaluation (P＞0.05).Compared with control group (neutral(12.96±1.62),negative(13.57±1.37),respectively),neutral and negative recognition scores for emotional pictures of patients with TI (neutral (10.79±2.07),negative (10.96±2.05),respectively) were decreased significantly (positive t =-4.5 and negative t=-5.6,both P＜0.05).(2)At the stage of emotional images memorizing tests,TI group's total scores on re-accessing total emotional pictures were significantly lower than those in control group ((36.14 ± 3.24) vs(41.89 ± 3.43) respectively)) (t=-6.44,P＜0.05).Compared with control group (positive (14.04± 1.29),neutral (13.68±1.56)),patients with TI (positive (10.93± 1.96),neutral(11.25± 1.67)) were decreased significantly in the emotional pictures memorizing tests (t=-7.00,5.61,P＜0.05).But there were no difference in negative stimulus between the two groups (P＞0.05).(3)The score of emotional pictures recognition in patients with LTI (34.43 ± 3.48) were decreased significantly than that in patients with RTI (37.86± 1.83) (t =3.26,P＜ 0.05).The score in recognizing neutral valence images in patients with LTI(10.43± 1.55) were significantly decreased than those in RTI (12.07± 1.38) (t=2.95,P＜0.05).Conclusion Patients with TI may rely on different neural mechanisms to affect the different valence of the emotional memory loop process.The emotional memory impairment in patients with TI at different sides is different.The left thalamus has a greater influence on memory.
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Objective To investigate the emotional memory changes in patients with thalamic infarction on different laterals and explore the impact of different emotional valence pictures on the thalamic infarction(TI) patients' memory.Methods 28 patients with thalamic infarction (TI group)and 28 patients who were hospitalized without TI during the same period (control group) were given emotional memory test,a test where they use their emotional memory to evaluate and recognize pictures with different emotional valence,including positive,neutral,and negative valence.Results (1) At the stage of evaluating emotional images,there were no significant difference between patients with TI and control group in positive evaluation (P＞0.05).Compared with control group (neutral(12.96±1.62),negative(13.57±1.37),respectively),neutral and negative recognition scores for emotional pictures of patients with TI (neutral (10.79±2.07),negative (10.96±2.05),respectively) were decreased significantly (positive t =-4.5 and negative t=-5.6,both P＜0.05).(2)At the stage of emotional images memorizing tests,TI group's total scores on re-accessing total emotional pictures were significantly lower than those in control group ((36.14 ± 3.24) vs(41.89 ± 3.43) respectively)) (t=-6.44,P＜0.05).Compared with control group (positive (14.04± 1.29),neutral (13.68±1.56)),patients with TI (positive (10.93± 1.96),neutral(11.25± 1.67)) were decreased significantly in the emotional pictures memorizing tests (t=-7.00,5.61,P＜0.05).But there were no difference in negative stimulus between the two groups (P＞0.05).(3)The score of emotional pictures recognition in patients with LTI (34.43 ± 3.48) were decreased significantly than that in patients with RTI (37.86± 1.83) (t =3.26,P＜ 0.05).The score in recognizing neutral valence images in patients with LTI(10.43± 1.55) were significantly decreased than those in RTI (12.07± 1.38) (t=2.95,P＜0.05).Conclusion Patients with TI may rely on different neural mechanisms to affect the different valence of the emotional memory loop process.The emotional memory impairment in patients with TI at different sides is different.The left thalamus has a greater influence on memory.
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The atherosclerotic plaque and stenosis in the carotid artery are the important causes of ischemic stroke. Evaluation of cerebrovascular reserve capacity in patients with carotid stenosis is beneficial to screening high-risk stroke patients. This article reviews the evaluation methodology of cerebrovascular reserve and its application in patients with carotid stenosis.
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Objective To investigate the emotional memory characteristic in patients with leuloaraiosis(LA) and explore the neurobiological mechanisms through observing the changes of emotional memory.Methods Different valence images (including positive,neutral and negative pictures) were used to test twenty-four patients with Leuloaraiosis(LA group)and twenty-four healthy colltrols(HC group) at the same time.The emotional memory was evaluated by the recognition of emotional pictures.Results In appraisal of the emotional pictures,there was no significant difference between patients with LA (positive (10.42±2.30) and neulral (12.87±2.29),respectively) and healthy controls (positive (11.38 ± 3.25) and neutral (12.75 ± 2.86),respectively) in positive and negative appraisal (all P＞0.05).But the negative appraisal decreased between LA group (11.63 ± 1.81) and HC group (12.75 ± 2.02) (P＞ 0.05).Compared with healthy controls (38.08+±5.45),patients with LA(33.67±7.10) showed sharply decline in the emotional images memorizing task(P＜0.05).And the accuracy in recognizing positive and netural valence pictures in patients with LA ((Positive(11.04±2.40) and neulral (10.42±2.93)) was significantly lower than that in healthy controls ((positive(12.79±2.17) and neutral(12.08±2.59))(P＜0.05).But in negative stimulus,there was no significant difference between LA group(13.20± 1.86)and HC group(12.20±2.65) (P＞0.05).In addition the total correct recognition,positive and neutral valence in pictures recognition were negativly correlated with the se verity of white matter lesions in the LA patients group(r=-0.308,P=0.033;r=-0.462,P=0.003;r=-0.352,P=0.014).Conclusion The emotional memory is impaired in patients with LA,and the degree of damage is accompornied with the severity degree of LA.The emotional memory for positive and neutral vanlence pictures is impaired but the emotional memory for neutral is relatively reserved in patients with LA in pictures recognition phase.It suggests that impaired emotional memory with different valences may be related to different neuromechanisms.
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Objective To investigate the emotional memory impairment in patients with primary insomnia (PI) and explore the neurobiological mechanisms underlying primary insomnia through emotional memory tasks involving different valance of emotional pictures.Methods Thirty patients with primary insomnia(PI group) and twenty healthy controls(HC group) were given emotional memory tasks using positive,neutral and negative valence images.The emotional memory was evaluated by the recognition of emotional pictures.Results Compared with healthy controls (positive (11.60±4.00) , neutral (11.05± 3.73) and negative (12.60± 2.06) , respectively), patients with PI (positive (11.30±3.75),neutral (11.47±3.21) and negative (11.43±4.12) ,respectively) showed no significant difference in appraisal of the emotional pictures (P＞0.05).Compared with healthy controls (43.40± 4.88) for the emotional images memorizing task,patients with PI (39.40±6.43) exhibited evident deficit of all emotional images (P＜0.05).Furthermore, the accuracy in recognizing both positive (12.60± 2.42) and neutral (12.87±3.18) valence pictures were significantly lower in patients with P1 than those in healthy controls(positive (14.05±2.19) and neutral (14.75± 1.80)) (P＜0.05).There was no significant difference in negative stimulus between PI group(13.93±1.76) and HC group(14.70±1.59) (P＞0.05).Conclusion The results suggest thant emotional memory is impaired in patients with PI.Moreover,the emotional memory for positive and neutral vanlence pictures is impaired but the emotional memory for negative is relatively spared in patients with primary insomnia.The results also indicate that impaired emotional memory with different valences may relate with distinct neuromechanisms.
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Objective To acquire normative values of anorectal manometry and sensation in population of our country with different gender and age.Methods Healthy individuals from four medical centers were collected and divided into three group according to their age,group Ⅰ 18 - 39 years old, group Ⅱ 40-59 years old and group Ⅲ ≥60 years old.The parameters of anal of subjects at resting status was examined by pneumohydraulic capillary perfusion system and high resolution PC Polygraf HR desktop gastrointestinal dynamic monitoring system.Subjects were asked to simulate defecation and then the defecation related indexes were recorded.In the end rectoanal inhibitory reflexes (RAIR)and rectal sensation were assessed by aired balloon.One-way analysis of variance and independent sample test were performed to compare indexes among three groups with different age and between different genders. Results A total of 166 healthy subjects were enrolled,79 in group Ⅰ with 40 male,68 in group Ⅱ with 29 male and 19 in group Ⅲ with 11 male.There was no significant difference in anal sphincter length (ASL),valid anal sphincter length (VASL),resting anal sphincter pressure (RASP),squeeze anal sphincter pressure (SASP)and duration of valid squeeze anal sphincter pressure (VSASP)among three groups with different age (all P > 0.05 ).Compared between male and female,only SASP of male ((180.13±8.10)mmHg,1 mmHg=0.133 kPa)was significantly higher than that of female ((143.93± 6.59)mmHg,t = -3.489,P 0.05 ). There was no significant difference in rectal pressure (RP),rectoanal pressure gradient (RAPG),anal sphincter relaxation rate (ASRR),and rectoanal coordination (RAC)among three groups (all P >0.05). During simulated defecation,RP and RAPG of men ((61 .23±3.46)mmHg and (40.04±4.08)mmHg) were significantly higher than those of women ((44.47 ± 2.32)mmHg and (24.00 ± 2.59 )mmHg, t=-4.075 ,-3.367,both P 0.05).All participants had RAIR,and there was no significant difference neither among three groups nor between men and women (both P >0.05).There was no significant difference in first rectal sensation (FRS)and constant rectal sensation (CRS)among three groups with different age (all P >0.05).However,the maximum rectal tolerable sensation (MRTS)of group Ⅱ and group Ⅲ was significantly higher than that of group Ⅰ ((194.41 ±6.32)mL and (200.00±12.75)mL vs (167.80 ± 5 .00)mL,F = 6.698,P = 0.002).There was no significant difference in rectal sensation between different gender (all P >0.05 ).Conclusions In our country,SASP,RP and RAPG during simulated defecation of male are higher than those of female.The value of MRTS increases along with the age.
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Objective To investigate the ability of social cognition in patients with right temporal lobe infarction.Methods Fifteen patients with temporal lobe infarction (TLI) and 20 healthy controls (HC) were examined with the recognition of faux pas and reading the mind in the eyes tasks for assessing the ability of social cognition.Results The TLI group performed significantly worse when compared with the HC group (28.6 ± 6.1,36.4 ± 4.3 respectively) as revealed in the total faux pas-related scores (U =41.00,P ＜0.01).For the control question,there was no significant difference between the TLI group and the HC group (9.86 ±0.35,10.00 ± 0.00 ; U =130.00,P =0.097).In the reading the mind in the eyes task,patients with TLI performed worse than the HC group(17.13 ±6.41,29.75 ±2.07 respectively),and the difference had statistical significance (U =0.00,P ＜ 0.01).But there was no significant difference in gender recognition judgment (30.37 ± 1.16,31.35 ± 1.08 respectively; U =106.00,P =0.129).Conclusions The right temporal lobe involves in social cognition.Moreover,the right temporal lobe not only involves in the verbal related social cognitive processing,but also involves in the no-verbal related social cognitive processing.
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Objective To characterize social-perceptual component and social-cognitive component of theory of mind(TOM) in patients with Parkinson's disease.Methods A total of 19 patients with idiopathic PD and 20 demographic-matched health subjects were included in this study.They were assessed by using Reading the Mind in the Eyes and Faux Pas task involving ToM socialperceptual component and social-cognitive component.The severity of PD was assessed by the Hoehn and Yahr scale.Results Significant difference was found between PD group and health controls in task involving ToM social-perceptual component (mind Reading:17.1 ± 3.1 vs.30.4 ± 1.7,F =278.756,P＜ 0.001),test involving social-cognitive component (Faux Pas Questions:29.0 ± 4.0 vs.41.2±4.4,F=81.647,P＜0.001).While the ability to identify sex and control questions of the Faux Pas showed no significant difference as compared to health controls group (F=3.508,P=0.069;F=1.063,P =0.309).Conclusions The ToM social-perceptual component and social-cognitive component are both impaired in patients with Parkinson's disease.
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Objective To characterize social-perceptual component and social-cognitive component of theory of mind in patients with Parkinson's disease.Methods A total of 19 patients with idiopathic PD and 20 demographic-matched health subjects were included in this study.They were assessed using Reading the Mind in the Eyes and faux pas task involving ToM social-perceptual component and social-cognitive component.The severity of PD was assessed on the Hoehn and Yahr scale.Results Significant difference was found between PD group and health controls on task involving ToM social-perceptual component (mind Reading:17.1 ± 3.1 vs.30.4 ± 1.7,F=278.756,P ＜0.001),test involving social-cognitive component (Faux pas Questions:29.0± 4.0 vs.41.2 ± 4.4,F =81.647,P＜0.001).While the ability to identify sex and control questions of the faux pas showed no significant difference compared to health controls group (F =3.508,P =0.069 ; F =1.063,P =0.309).Conclusions The ToM social-perceptual component and social-cognitive component are both impaired in patients with Parkinson's disease.
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ObjectiveTo establish normative values of esophageal manometry in different age groups and standard test method.Methods The values of esophageal manometry were tested in healthy subjects of 3 different age groups (Group Ⅰ: 18-39 years,Group Ⅱ: 40-59 years,Group Ⅲ:≥60 years) with pneumohydraulic capillary perfusion system.The repeatability and stability of this method in lower esophageal sphincter (LES) testing were observed. Results There were no significant differences of LES length (LESL),LES pressure (LESP) at the end of expiration,average LESP,residual pressure of LES and LES relaxation rate (LESRR) in three groups (P＞0.05).The LESP at the end of inspiration in Group Ⅰ (28.98± 1.11 ) mm Hg was significantly lower than that of Group Ⅲ (34.35±1.96) mm Hg (P＜0.05).Trandiaphragmatic pressure (Pdi) in Group Ⅰ (9.55±0.62) mm Hg was significantly lower than that of Group Ⅱ (13.05±0.76) mm Hg (P＜0.05).There were no significant differences in contraction amplitude and duration of proximal and distant esophagus in 3 groups (P＞0.05).UES pressure (UESP) of Group Ⅲ was significantly lower than that of Group Ⅰ and Ⅱ (P＜0.05).As for repeatability,the second recording of LESP in Group Ⅰ and Ⅱ were significantly higher than first recording (P＜0.05).Amplitude of distant esophageal peristaltic contraction (DEPC) of female was significantly higher than of male (P＜0.05).However,there was no significant difference in amplitude of proximal esophageal peristaltic contraction (PEPC)between femal and male (P＞0.05).ConclusionsThe normative values of esophageal manometry in different age groups have been obtained.The dynamic parameters of LES do not change with age.Between age 40 to 59 years old,the contraction of esophageal body is strongest.UESP decreases significantly in old people.If the subjects have enough time to adapt before test,it will help to get accurate and reliable dynamic parameters of LES.
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Objective To explore visual-spatial working memory deficits of patients with basal ganglia damage, based on which tried to provide the new method for detecting the injuries in basal ganglia. Methods Twenty-five patients with lesions in the basal ganglia and twenty-five healthy controls performed visual-spatial working memory tasks, including a face-recognition and a spatial delayed-response. Results For the basal ganglia damage group ,the correct rate of both visual- face ( 54.5 ± 9.6 ) % and visual-spatial ( 80.0 ± 11.7 ) % working memory tasks was significantly lower than that of the control group ( ( 64.3 ± 9.5 ) %, ( 93.6 ± 4.9) %, respectively) ,and the difference was statistically significant ( u= - 147.5,80.5, P＜0. 01 ). For the patients injured in the left basal ganglia, the correct rate of visual- face working memory (48.5 ± 5.4 )% was obviously lower than that of patients injured in the right basal ganglia ( 59.2 ± 9.8 ) %, and the difference was statistically significant ( u =25.5, P＜0. 01 ) ;but the difference of correct rate for the visual-space working memory was not statistically significant( u = 52.5, P＞ 0.05 ). In contrast to the controls, both the visual-face and visual-space working memory of the group with injuries in basal ganglia,had appeared to be disable. Conclusions The results confirmed that patients with lesions in basal ganglia had deficits of visual-spatial working memory,and that injuries either in the left or the right basal ganglia can probably cause the shiftiness of cognitive function. Therefore, the injuries in basal ganglia can be detected by the visual-spatial working memory tests.
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Objectives To compare the migrating motor complex (MMC) in irritable bowel syndrome (IBS) patients with that in healthy controls. To explore whether discrete clustered contractions (DCC) are connected with abdominal pain in IBS patients. To improve the method of measuring gastroenteric motility (esp. jejunum). Methods By using 16-channel water-perfused catheter and manometry instruments, MMC in 16 cases of IBS with constipation (IBS-C), 18 cases of IBS with diarrhea (IBS-D) and 18 cases of healthy controls were monitored. Results The MMC durations of IBS-C and IBS-D patients were (127.5±25.5) min and (74.5±18.7) min, respectively. Comparision with those in the control group [(87.5±24.2) min]showed significant differences (P<0. 001). The contraction amplitudes of stage Ⅲ in different sites of IBS-C patients decreased significantly as compared with those in the controls [jejunum, (39.8±11.7) mm Hg vs. (61.1±14.1) mm Hg,P<0.001,1 mm Hg=0.133 kPa]. The propagation velocities of stage Ⅲ in different sites of IBS-C patients also decreased significantly as compared with those in the controls [jejunum, (1.8±0.9) cm/min vs. (2.6±0.8) cm/min,P<0.01].The contraction amplitudes of stage Ⅲ in different sites of IBS-D patients increased significantly as compared with those in the controls [jejunum, (69.7±20.5) mm Hg vs. (61.1±14.1) mm Hg, P<0.01]. The propagation velocities of stage Ⅲ in different sites of IBS-D patients also increased significantly as compared with those in the controls [jejunum, (4.1±2.5) cm/min vs. (2.6±0.8) cm/min, P < 0. 01]. DCC incidences of IBS-C and IBS-D were 87.5% and 88. 8%, respectively. Comperision with those in the normal group (83.3%) did not show significant difference (P>0.05). The prevalences of abnormal stage Ⅲ contractions (include disturbances and interferences of stage Ⅲ contractions) in IBS-C and IBS-D patients were 68.8% and 66. 7%, respectively; there were no significant differences between the two groups (P > 0. 05). However abnormal stage Ⅲ contractions did not exist in healthy controls. Conclusions (1) The MMC of IBS-C and IBS-D patients are changed, as compared with that in healthy people; this implies that small intestinal motility dysfunction is one of the pathogenetic factors of IBS. The abnormal stage Ⅲ contractions in jejunum may be a predominant change in IBS gastroenteric motility. (2) No apparent connection is found between DCC and pain in IBS. (3) By using 16-channel water-perfused catheter, we first carried out the method of monitoring jejunum contractions in China. Parameters of MMC in Chinese healthy people were investigated, esp. those of jejunum.
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Objective To investigate the characteristics of the executive function and working memory in patients with mild cognitive impairment (MCI), and the relations between working memory and executive function and the effects of working memory on patient' s daily functioning.Methods Thirty patients with MCI and 30 healthy elderly subjects were tested with a wide neuropsychoingical battery of tests including those of executive function, working memory and other cognition domain tests.Executive function was evaluated by using the verbal fluency test (VFT), color trail test (CTT), digital span (DS).Results The results showed the presence of significant executive function and working memory impairment in MCI patients as compared with the healthy controls.The scores of executive function test in MCI patients were decreased significantly in CTT (130.8±58.2 vs 52.0±13.5), CTT-B (210.2±81.8 vs 121.0±33.4),DS (3.4±0.9 vs 4.2±1.1), VFT (8.9±5.4 vs 16.4±5.4) and visuo-objective working memory (0.73±0.12 vs 0.85±9.18) respectively (t = 7.108, 5.159,-2.544,-4.879, and-4.351, all P <0.01 or P < 0.05) .In the stepwise liner regression analysis objective working memory test made a significant independent contribution to ADL (β =-0.720, t =-3.571, P < 0.01).Conclusion The patients with MCI have the deficit in executive function and working memory.Visuo-objective working memory is closely correlated with general cognitive function such as daily function, resulting in daily function decline.
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As a classic cerebral revascularization procedure, carotid endarterectomy (CEA) has been widely used in the treatment of high-grade extracranial carotid artery stenosis. In recent years, carotid artery stenting (CAS) has a trend to replace CEA gradually. A large number of clinical studies have found that in addtion to perioperative complications, carotid restenosis after CEA and CAS also has important influence on the prognosis of patients. This article reviews the current status of diagnosis and treatment of restenosis after CEA and CAS.
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Objective To study the clinical therapeutic effects of early rehabilitation training combined with acupuncture on dysphagia after acute cerebral infarction.Methods One hundred patients with dysphagia caused by acute cerebral infarction were randomly divided into 4 groups:a comprehensive treatment group(25 cases,received rehabilitation training,acupuncture and routine medication),a routine drug group(25 cases,routine medication),a rehabilitation group(25 cases,received comprehensive rehabilitation training and routine mediciation)and an acu-puncture group(25 cases,received acupuncture therapy and routine medication).Dysphagia was evaluated with videofluoroscopic swallowing study(VFSS),and the incidence of pneumonia was observed before treatment and at the 14th day after daily treatment. Results After treatment,the VFSS scores of the 4 groups were significantly higher than before treatment,and VFSS scores in the comprehensive treatment group were significantly higher than those in the other groups.The effectiveness rate in the comprehensive treatment group was significantly higher than that in the other three groups.and the incidence of pneumonia was significantly lower.Conclusions Early rehabilitation com-bined with acupuncture can improve swallowing and reduce the incidence of aspiration pneumonia in acute stroke pa-tients.
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0.05). Conclusion We di d not find the difference between the two CYP2C19 phenotypes in relation to the acid-suppressing effect of esomeprazole.