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Objective:To comprehensively evaluate the correlation between migraine and the risk of hemorrhagic stroke using Meta-analysis.Methods:The published observational studies on migraine and the risk of hemorrhagic stroke in PubMed, EMbase, Cochrane library, Chinese Biomedical Database, China Journal Full-text Database, Wanfang Database and VIP Database were retrieved by computers. The retrieval time limit was from the establishment of the databases to December 31, 2019. Two reviewers independently conducted the literature screening and data extraction, and evaluated the quality according to Newcastle Ottawa scale. Stata SE 12.1 software was used for Meta-analysis.Results:Six case-control studies and 7 cohort studies met the inclusion criteria, all of which were in English. The results of Meta-analysis showed that exposure to migraine increased the risk of hemorrhagic stroke (odds ratio [ OR] 1.47, 95% confidence interval [ CI] 1.23-1.76; P<0.001). Sensitivity analysis showed that the results were robust. Subgroup analysis showed that migraine with aura ( OR 1.38, 95% CI 1.05-1.81; P=0.019), migraine without aura ( OR 1.46, 95% CI 1.19-1.80; P<0.001), male ( OR 2.10, 95% CI 1.72-2.56; P<0.001) and female ( OR 1.53, 95% CI 1.22-1.92; P<0.001) migraine could increase the risk of hemorrhagic stroke. Conclusion:Regardless of the gender of patients and presence or absence of migraine aura, migraine can significantly increase the risk of hemorrhagic stroke.
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Objective:To explore the effect of combining hyperbaric oxygen inhalation with wet healing in the treatment of chronic refractory ulcers of the skin.Methods:Sixty male Sprague-Dawley rats were randomly formed into a general treatment group (group A), a wet healing group (group B), and a hyperbaric oxygen + wet healing group (group C), each of 20. Chronic and refractory skin ulcers were induced on all of the rats after one week of routine feeding and 6 hours of fasting. Six courses (once daily for 10 days/course)of the three treatments were then administered. After 2, 4 and 6 courses of treatment the wound healing rate and recovery were analyzed using histopathological methods.Results:After 2, 4 and 6 courses of treatment, the average wound healing rates of groups B and C were significantly higher than group A′s average, and that of group C was significantly better than that of group B. After 6 courses of treatment, group C′s average histopathology score was significantly higher than that of group B, and those of groups B and C were both significantly higher than group A′s average.Conclusion:Single wet healing is better than common treatment for chronic skin ulcers, but hyperbaric oxygen inhalation can further improve its effectiveness.
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Objective@#To systematically evaluate the effects of hyperbaric oxygen on the hemodynamics and intracranial pressure of patients with severe craniocerebral injury (STBI).@*Methods@#Reports of randomized and controlled trials applying hyperbaric oxygen in the treatment of STBI were retrieved from the Pubmed, Cochrane Library, Embase, CBM, CNKI, VIP and Wan Fang databases. Each report found was evaluated by two researchers independently applying pre-defined inclusion and exclusion criteria. The data were extracted and combined and a meta-analysis was performed.@*Results@#Eight trials involving 725 patients were included in the meta-analysis. They combined to demonstrate that intracranial pressure, oxygen uptake and scores on the Glasgow coma scale improved significantly more in the hyperbaric oxygen group than in the control group after between 3 and 10 days of treatment.@*Conclusion@#Hyperbaric oxygen therapy is effective in treating severe craniocerebral injury and it is worthy of clinical application.
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Objective To observe the effect of hyperbaric oxygen (HBO) therapy on neurological functioning in rats modelling cerebral hemorrhage (ICH).Methods Sixty Sprague-Dawley rats had intracerebral hemorrhage induced by injecting autologous blood.They were then randomly divided into an HBO-free group and an HBO group,each of 30 according to a random number table.The HBO group was further divided into HBO 3 h,HBO 6 h,HBO 1 d,HBO 2 d and HBO 7 d groups which received HBO therapy for 3 hours,6 hours,1 day,2 days and 7 days respectively.Each had 6 members.The HBO-free rats were also divided into analogous HBO-free 3 h,HBO-free 6 h,HBO-free 1 d,HBO-free 2 d and HBO-free 7 d groups,and give no HBO intervention.All of the rats were evaluated for neurological impairment using the Longa scoring method before the treatment and 10 days,20 days and 30 days afterward.Results After 10,20 and 30 days of HBO treatment,there were significant differences in neurological functioning between each pair of HBO-free and HBO-treated groups.After 10 and 20 days of HBO treatment the average neurological function score of the HBO 3 h group was significantly different from that of the HBO 2 d group.The average score in the HBO 7 d group was also significantly different from that of the HBO 3 h,HBO 6 h,HBO 1 d and HBO 2 d groups after 10,20 and 30 days of HBO treatment.The average scores of the HBO 3 h,HBO 6 h,HBO 1 d and HBO 2 d groups improved significantly between 10 and 20 days after the treatment.The average score of the rats which received 30 days of treatment was also significantly different from those after 10 and 20 days.Conclusion HBO treatment can improve neurological function after cerebral hemorrhage,at least in rats.The best time to start HBO treatment is no later than 24 hours after the hemorrhage.The curative effect increases with extension of the treatment's duration.
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Objective To assess the safety among acute ischemic stroke patients with asymptomatic intracranial aneurysm after the administration of intravenous thrombolysis.Methods We searched database including Wanfang,CNKI,VIP,Pubmed,EMBASE,EBSCO HOST and Metstr data for all the cohort studies on the use of thrombolysis for acute ischemic patients with asymptomatic intracranial aneurysm,and ascended the correlated references listed on the articles.Meta-analysis was conducted based on the methods recommended by the Cochrane collaboration.The outcomes of the meta-analysis were intracerebral hemorrhage (ICH),symptomatic intracerebral hemorrhage (sICH),subarachnoid hemorrhage (SAH).Results Four cohort studies included 707 patients,of whom 48 patients had asymptomatic cerebral aneurysms.The risk ratio prevalence of ICH among those patients did not differ statistically with those without aneurysms (RR =1.17,95％ CI 0.69-1.99,P =0.56).No statistical differences were found in both odds ratio prevalence of sICH (OR =1.70,95％ CI 0.44-6.59,P =0.45) and SAH (OR =1.13,95％ CI 0.20-6.27,P =0.89) between the patients with asymptomatic cerebral aneurysms and those without.Conclusion Current evidence did not indicate that the risk of hemorrhage increased in acute ischemic stroke patients with asymptomatic intracranial aneurysm after the administration of intravenous thrombolysis.
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This article reviews the recent advances in many aspects including classification,risk factors,treatment and prognosis of hemorrhagic transformation after cerebral infarction,which will provide references for the treatment and research of cerebral infarction.
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Objective To study the effects of exercises training on the recovery of neurological function and the expression of matrix metalloproteinase-9 (MMP-9) in perihematomal brain tissue after intra cerebral hemorrhage (ICH) in rats. Methods Sixty-four male adult Sprague-Dawley rats were randomly divided into exercises group and control group. ICH model was induced by autobiood injection. The rats in exercises group were given balance, grasping and walking exercises every day. The rats in control group exercised freely in standard cages. Neurological function in both groups was measured at the 3rd, 7th, 14th and 21st d. All the rats were sacrificed and the concentration of MMP-9 was measured with immunohistochemical method and in situhybridization. Results In both groups neurological function scores was lowest at the 3rd d, were highest at the 21st d. There was no significant difference between two groups at the 3rd d, but at the 7th, 14th and 21st d the differences between two groups were significant ( P < 0.05 ). In exercises group, MMP-9 expressed weakly at the 3rd d, and peaked at the 7th d, then declined gradually. In control group, MMP-9 expression peaked at the 3rd d, then decreased slowly. MMP-9 protein expression was in accord with mRNA. MMP-9 expression in exer-cises group was significantly different from control group on the 3rd and 7th d (P < 0.05 ) , but not at the 14th and 21st d ( P > 0.05 ). Conclusions Early exercises can inhibit the expression of MMP-9 that could play a role in protecting neurons. Daily exercises can stimulates the expression of MMP-9 so as to have a positive role in midstage of disease. MMP-9 may be involved in tissue remodelling and vascular repairing, which prompt neu-rofunction recovery.
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There is evidence to show that the treatment in a stroke unit reduces mortality in patients with stroke and improves neurological functional recoxery.Early mobilization is benefit to improve the prognosis in patients stroke,however,there is a lack of high-quality evidence.The term of"early mobilization"after stroke is not well defined now.A number of medical workers lack enough understanding of the early mobilization.How to perform the early mobilization to get the best benefit is unclear.This article reviews the related studies about the early mobilization after stroke.