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Objective@#To investigate the efficacy and outcome of transcatheter patent foramen ovale (PFO) closure in patients with cryptogenic stroke (CS).@*Methods@#Sixty consecutive patients with cryptogenic stroke who undertook transcatheter PFO closure between May 2015 and September 2017 in Beijing Tiantan Hospital were enrolled in this prospective study.Transcranial Doppler (TCD) bubble test was performed and right-left shunt(RLS) was confirmed in all patients.Closure success rate,effective closure rate, complications, recurrence of ischemic stroke and new onset atrial fibrillation were evaluated.@*Results@#A total of 60 patients (42 male,age range 24-68 (47±11)years) were included in the study.PFO size (motionless state) was (1.6±0.6)mm.RLS before closure was graded and 11 patients had moderate RLS and 48 patients had large RLS (include 41 patients who experienced shower or curtain effect).Closure success rate was 100% (60/60).No severe complications were observed.At 6 months,45 patients completed TCD bubble test.Of these, 4 patients suffered from moderate to large residual and thus effective closure rate was 91%(41/45).The mean follow-up period was 2-29 (median 12) months. During the follow-up, only 1 patient experienced recurrent cerebral infarction.New onset atrial fibrillation was not detected.@*Conclusion@#Transcatheter PFO closure is effective,safe and related with a good outcome in reduction of recurrent CS for patients with PFO.
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Objective To compare the difference of ultrasound and digital subtraction anginography (DSA) in diagnosing carotid atheriosclerosis. Methods A total of 340 patients of ischemic cerebrovascular disease with carotid atheriosclerosis were examined with ultrasound and DSA. They were divided into cerebral infarction group (n=235) and transient ischemic attack (TIA, n=105), and also were divided into the young-aged group (n=54), middle-aged group (n=137) and old-aged group (n=149) by age. Results Both of the ultrasound and DSA found that the incidence of carotid artery stenosis in cerebral infarction was higher than that in TIA (P<0.05);the incidence that of carotid artery stenosis in old-aged group were higher than that in middle-aged and young-aged group (P<0.05), and in middle-aged group was higher than that in young-aged group. Taking DSA as standard, the accordance rate of ultrasound in diagnosing stenosis, clot and both of them were 89.39%, 80.85%, 87.15%, respectively. Conclusion Carotid artery ultrasound has high sensitivity in diagnosis of carotid atheriosclerosis. Either carotid artery ultrasound or DSA has advantages. With combination of two methods, there will be an important significance in the diagnosis, clinical treatment, assess before operation and follow-up after operation in patients with carotid atheriosclerosis.
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@#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.