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Objective: To investigate the interaction between methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism and sleeping duration on risk of stroke in a Chinese Han ethnic population. Methods: In the case-control study and epidemiological investigation, the self-reported sleep duration and MTHFR C677T polymorphism of 245 patients with cerebral infarction, 222 patients with cerebral hemorrhage and 282 controls were collected. Multiple logistic regression was performed to analyze the interaction between MTHFR C677T polymorphism and sleeping duration on risk of stroke. Results: After adjustment for major confounding variables, multiple logistic regression analysis showed that: (1) There was significant association between long sleep duration (>8 hours of sleep per night) and cerebral infarction (OR=3.90; 95% CI:2.43-6.26), but not for cerebral hemorrhage (OR=1.16, 95% CI: 0.71-1.92). On the other hand, insomnia (sleep duration less than 6 hours) was neither associated with cerebral infarction nor hemorrhage. (2) MTHFR TT genotype increased the risk of cerebral infarction significantly (OR=2.01; 95% CI:1.12-3.61), but not for cerebral hemorrhage (OR=1.16,95% CI:0.71-1.92). (3) There was a significant synergistic effect of interaction between MTHFR TT677 genotype and long sleep duration on risk of cerebral infarction (OR=6.22; 95% CI:2.44-15.83). Conclusion: MTHFR TT677 genotype and long sleep duration increase the risk of cerebral infarction independent of confounding factors, respectively. Furthermore, there is a significant synergistic effect between MTHFR TT677 genotype and long sleep duration on risk of cerebral infarction in the Chinese Han ethnic population.
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@#ObjectiveTo observe the efficacy and safety of dihydroergotoxine in the treatment of acute ischemic stroke. Methods30 patients with acute ischemic stroke were randomly given dihydroergotoxine 0.6 mg(group 1), 1.5 mg (group 2) or Danshen injection 40 ml (group 3) respectively each day for 14 days,each for 10 cases. ResultsBefore and after treatment, the Scandinavian stroke scores of the three groups were increased(P<0.05). There was no significant difference(P>0.05) between the scores of group 1 and the group 3, but the scores of group 2 was higher than that of the group 3 and group 1(P<0.05). The common side-effect of both dihydroergotoxine groups were nausea, vomit, headache, palpitation and transient hypotention, which was more frequently apeared in group of 1.5 mg. ConclusionDihydroergotoxine and Danshen injection are all useful in the treatment of acute ischemic stroke. It is more efficient using higher dose of dihydroergotoxine. But as the dose going on, there will be more side-effect.
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Objective To summarized the diseases which were demonstrated as hyperintensity lesions on high diffusion sensitive gradien(high b value) diffusion weighted imaging(DWI) To investigate the differential diagnosis of the diseases and to discuss the corresponding biophysics mechanism Methods 90 cases were studied, which were clinically highly suspected of brain ischemic stroke onset and in which hyperintensity lesions were demonstrated on DWI The patients were divided to 2 groups according to the time between the onset and the MR examination:group A(1 5-6 0 h)with 13cases, group B(7 h to 8 d)with 77cases The appearances of the lesions on conventional MRI, ADC values and anistropy(CV )of the lesions were studied Results hyperintensity lesions on high b value DWI were demonstrated in following diseases: acute ischmia, hematoma, abcesses, mengioma, mutiple sclerosis(MS) The ADC value was decreased to(5 87?1 02)(10 -4 mm 2/s in superacute cerebral ischemia, while the ADC value increased to (8 08?1 15)?10 -4 mm 2/s in active MS The CV in cerebral ischemia lesions was higher than the control group( P
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Objective To summarize the appearances of MS lesions on DWI, and to quantitatively study the ADC and AI values in different clinical MS subgroups Methods One hundred and eighty seven lesions were studied in 18 cases of MS at different clinical stages Routine MR and DWI were performed in all cases ADC and AI were calculated in the lesions,NAWM, and normal control group Results Hyperintensity (edema like on T 2WI) was demonstrated on DWI at acute primary progressive MS lesions Hyperintense ring sign was found at acute relapse MS lesions ADC increased in all subgroups of MS Significant difference of ADC was demonstrated among MS lesions, NAWM, and normal control groups Significant decrease of AI was demonstrated at later stages Hyperintensity was found in all MS lesions on T 2WI The hyperintensity lesions on DWI had enhanced or non enhanced appearances on CE T 1WI The ADC value of enhanced MS lesions was less than that of the non enhanced lesions ( t =4 19, P 0 05) Conclusion DWI could give quantitative information for different pathological changes in MS lesions of different clinical subgroups Quantitative measurement of diffusion has great potential value in the diagnosis, differential diagnosis, and the prediction of prognosis in MS
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Objective： To study the changes of water molecular diffusion in the ischemic region by using MR dephase technique and discuss the potential mechanism of the diffusion changes at early stage. Methods: Totally 43 cases were studied retrospectively. There were 10 cases whose MRI examinations were performed within 6 hours，12 cases from 7－24 hours，7 cases from 2－7 days, 8 cases from 8－14 days, 6 cases from 15 days to 2 months. The apparent diffusion coefficients in the ischemic region were calculated. Results: The ADCav in the grey matter was 8.61×10－4mm2*s－1. The ADCav decreased to (4.72×10－4±1.51×10－4) mm2*s－1 in ischemic region at superacute stage, ADCav ratio to contralateral corresponding region was 0.55±0.18, and ADCav increased to (5.68×10－4±1.22×10－4) mm2*s－1 during the time range of 2-7 days, （9.22×10－4±2.07×10－4） during the time range of 8－14 days, and approaching （26.42×10－4+9.65×10－4） mm2*s－1 during the time range of 2 months. The pearson product- moment correlation between the changes of diffusion value and time was sighificent (r=0.95, P<0.001). ADCv increased at superacute stage and decreased over time. Conclusion: The diffusion of water molecules in ischemic region decreased at superacute stage, and the ADC increased over time. The anisotropy increased at superacute stage and decreased as the course developed. DWI could detect ischemic lesion much earlier than CT and routine MR examination. DWI has great value in the diagnosis of superacute stroke. The mechanism of the diffusion changes at early stage may be the intracellular toxicity edema.