Research progress of cerebral hemorrhage after intravenous thrombolytic therapy for acute cerebal infartion / 中国中西医结合急救杂志

Cerebral hemorrhage is a serious complication after intravenous thrombolysis of acute cerebral infraction (ACI), which leads to low thrombolysis rate. In this paper, the factors such as definition and type of cerebal hemorrhage after intravenous thrombolysis of ACI, the baseline NIHSS score, the time from onset to hrombolysis, age, blood pressure, atrial fibrillation (AF), blood glucose, etc were reviewed in combination with recent litrrature. The risk factors of cerebral hemorrhage were analyzed to provide basis for achieving individualized hrombolysis, improving thrombolytic efficacy and reducing the risk of hemorrhagic transformation.

Fever, cough, consciousness disturbance and physical activity disorder, is severe Mycoplasma pneumoniae pneumonia complicated with cerebral infarction? / 中华实用儿科临床杂志

The school-age boy was admitted to Tianjin Children's Hospital for "fever and cough for 6 days".After detail examinations,the diagnosis of severe Mycoplasma pneumoniae pneumonia was proved.Treatments:anti-infection with Azithromycin and Meropenem;the obstruction of air way was relieved;assisted with symptomatic and supportive treatment.During the treatment,disorder of consciousness and hemiplegia of right limbs occurred,cerebral infarction was proved later by magnetic resonance angiography(MRA).Severe Mycoplasma pneumoniae pneumonia complicated with cerebral infarction is clinically rare with a high morbidity and mortality.Attention should be paid to body examination and Laboratory test.Multi-disciplinary cooperation is helpful.

Awareness and control rates of diabetes and hyperlipidemia in hypertensive cerebral infraction patients / 现代临床护理

Objective To explore the prevalence of diabetes and hyperlipidemia in cerebral infraction patients with hypertension and look into the rates of awareness, treatment and control. Methods Blood pressure, blood glucose and blood lipids were measured in 238 cerebral infraction patients with hypertension. Meanwhile, the rate of awareness, treatment and control of hypertension, diabetes and hyperlipidemia were investigated by questionnaire. Results Among 79.41％of the patients had abnormal blood pressure and cerebral infaction on admission, the rates of awareness , treatment and control of hypertension were 74.79％, 67.23％, 20.59％. 10.11％of them never took antihypertensive drugs in spite of their awareness of hypertension. 32.35％ of the patients were combined with diabetes, the rates of awareness, treatment and control were 79.22％, 62.34％, 12.99％respectively, and among them 21.31％never tookantidiabetic drugs in spite of awareness of diabetes. 81.51％ of the patients were combined with hyperlipidemia, the rates of awareness, treatment and control were 23.20％, 6.70％, 1.55％respectively, and among them 71.11％never took lipid-lowering drugs with awareness of high blood lipid. Conclusions 79.41％ of the incidence of cerebral infraction was related to abnormal blood pressure. 32.35％cerebral infarction patients with hyperlipdemioa are complicated with hypertension diabetes;81.51％are complicated with 28.57％cerebral infraction patients with hypertension were complicated with diabetes and hyperlipidemia as well, but the rate of awareness, treatment and control were relatively low. In order to improve the secondary prevention, we should pay more attention to the stroke risk factors, and help make the individualized medicine-taking plan to improve the control rate.

Effects of Rosuvastatin Combined with Berberine Hydrochloride on Related Indexes of Patients with Acute Cerebral Infarction / 中国药房

OBJECTIVE:To investigate the effects of rosuvastatin combined with berberine hydrochloride on related indexes in patients with acute cerebral infarction.METHODS:Medical information of 120 patients diagnosed as acute ischemic cerebral infarction were analyzed retrospectively,and they divided into observation group (65 cases) and control group (55 cases) according to route of administration.Both groups were given routine treatment;control group was additionally given Rosuvastatin calcium tablets 10 mg orally before bedtime,once a day;observation group was additionally given Berberine hydrochloride tablets 0.3 g orally,3 times a day,on the basis of control group.Treatment courses of 2 groups lasted for 14 d.The levels of TC,TG,LDL-C,HDL-C,hs-CRP,ox-LDL,NIHSS score,ADL score,TPA,IMT,Crouse score,the number of unstable plaque and ADR were observed and compared between 2 groups before and after treatment.RESULTS:Before treatment,there was no statistical significance in above indexes between 2 groups (P＞0.05).After treatment,the serum levels ofTC,TG,LDL-C,hs-CRP and ox-LDL in 2 groups were significantly lower than before,and the observation group was significantly lower than the control group,with statistical significance (P＜0.05).After treatment,NIHSS score of 2 groups were significantly lower than before,and ADL score,HDL-C levels were significantly higher than before,with statistical significance (P＜0.05);there was no statistical significance between 2 groups (P＞0.05).After treatment,there was no statistical significance in IMT,Crouse score and the number of unstable plaque in control group compared to before treatment (P＞0.05),but in observation group were significantly lower than before treatment,and also lower than control group at corresponding period,with statistical significance (P＜0.05).There was no statistical significance in TPA between 2 groups before and after treatment(P＞0.05).There was no statistical significance in the indcidence of ADR between 2 groups during treatment(P＞0.05).CONCLUSIONS:Based on routine treatment,rosuvastatin combined with berberine hydrochloride could effectively reduce blood lipid levels in patients with acute cerebral infarction,stabilize or reverse atherosclerotic plaque,and reduce inflammation and oxidative stress with good safety.

Clinical Observation of Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection in the Treatment of Vertebro-basilar Artery Insufficiency after Cerebral Infraction / 中国药房

OBJECTIVE:To investigate therapeutic efficacy and safety of Salviae miltiorrhizae and ligustrazine hydrochloride injection in the treatment of vertebro-basilar artery insufficiency(VBI)after cerebral infraction. METHODS:128 patients with VBI after cerebral infraction were divided into observation group and control group according to random number table,with 64 cases in each group. Both group received general treatment. Control group was additionally given Shuxuetong injection 6 ml added into 0.9%Sodium chloride injection 250 ml,ivgtt,qd. Observation group was additionally given Salviae miltiorrhizae and ligustrazine hy-drochloride injection 10 ml into 0.9% Sodium chloride injection 250 ml,ivgtt,qd. Both groups received treatment for consecutive 2 weeks. Clinical efficacies of 2 groups were observed as well as blood lipid,vertebro-basilar artery blood velocity and blood viscosity before and after treatment. The occurrence of ADR was compared between 2 groups. RESULTS:The total effective rate of observa-tion group was 95.31%,which was significantly higher than 79.69% of control group,with statistical significance(P0.05). After treatment,above indexes of 2 groups were improved significantly,and blood lipid and vertebro-basilar ar-tery blood velocity of observation group were significantly better than control group,with statistical significance(P<0.05). No obvi-ous ADR was found in 2 groups. CONCLUSIONS:Salviae miltiorrhizae and ligustrazine hydrochloride injection shows significant therapeutic efficacy for VBI after cerebral infraction,can significantly improve blood lipid,vertebro-basilar artery blood velocity and blood viscosity with good safety.

Treatment effect of 650 nm LLLT on cerebral infraction combined with hypertension / 国际生物医学工程杂志

Objective To explore the therapeutic effect of low level laser irradiation (LLLI) on cerebral infraction combined with hypertension.Methods Two groups were divided, conventional treatment group and laser irradiation combined with conventional treatment group.LLLI (650 nm, 20 mW, 20 min, twice a day, two weeks therapy) was used by extravascular way in addition to conventional treatment, while control group employed conventional treatment only.Whole blood viscosity, plasma blood pressure, lipid and neurological function were assessed by comparing the index of the two groups.Results Whole blood viscosity, plasma viscosity, whole blood high shear reductive viscosity, hematokit (HTC), erythrocyte deformation index, erythrocyte rigidity index, fibrinogen and blood lipid level of both groups decreased and the decrease of the testing group was more significant than that of control group (P＜0.05 or P＜0.01).Neurological deficit score an blood pressure of both groups showed significant decrease (P＜0.05), and the decrease in blood pressure of testing group was significant than that of the control group (P＜0.05 or P＜0.01).Conclusions 650 nm extravascular LLLI may be effective in treatment of cerebral infraction combined with hypertension, and has a good application prospect.

Multiple Cerebral Infarctions with Neurological Symptoms and Ophthalmic Artery Occlusion after Filler Injection

PURPOSE: To report a case of visual loss, side weakness and facial palsy due to ophthalmic artery occlusion with diffuse multiple cerebral infarctions after injection of hyaluronic acid. CASE SUMMARY: A 50-year-old female visited our clinic for visual loss in the left eye after filler injection in the glabella. Her best corrected visual acuity was 1.0 in the right eye and hand motion in the left eye. The intraocular pressure was 8 mm Hg in the right eye and 14 mm Hg in the left eye. In the left eye, there was abnormal pupillary light reflex and complete extra-ocular muscles palsy with blepharoptosis. A pale retina with a cherry-red-spot also appeared in the left fundus. A central retinal artery occlusion was observed on fluorescein angiography and brain magnetic resonance imaging showed multiple cerebral infarctions at the frontal, temporal, parietal and occipital lobes. Four days later, the motor weakness was aggravated and dysarthria and aphasia became worse. According to symptoms, a hemorrhagic transformation in subacute infarctions developed based on brain computed tomography. After 3 months of follow up, the visual acuity in the left eye was no light perception. However, the general conditions including ophthalmoplegia and motor weakness were improved.

Effects of occupational therapy on the cognitive function and event-related potentials of patients with acute cerebral infraction / 中华物理医学与康复杂志

Objective To explore the effect of occupational therapy on the cognitive function and P300 event-related potentials (ERPs) of patients with acute cerebral infraction.Methods Ninety-eight acute cerebral infarction patients with cognitive impairment were selected using the mini-mental state examination (MMSE).They were randomly divided into an observation group (n =49) who received occupational therapy plus routine rehabilitation treatment and a control group (n =49) who received only the routine rehabilitation treatment.Before and after 8 weeks of treatment,the patients' cognitive function and their ability in the activities of daily living(ADL) were evaluated using the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) and the modified Barthel index (MBI),respectively.P300 ERPs were also detected.Results There was no significant difference between the two groups with regard to various scores before the treatment (P ＞ 0.05).After 8 weeks of treatment,the LOTCA and MBI scores and the latency and amplitude of ERPs were significantly better than those before treatment in both groups (P ＜ 0.05).In the observation group,the scores of LOTCA (99.4 ± 8.4),MBI (80.7 ± 5.9) and the latency and amplitude of ERPs [(373.45 ± 52.13) ms and (5.87 ± 2.63) μV,respectively] were significantly better than those in the control group(P ＜ 0.05).Conclusion Occupational therapy program based on conventional rehabilitation training can promote the ADL ability and cognitive function of patients with acute cerebral infraction.It is worth applying in clinical practice.

Decision-making processing on patients with cerebral infraction in different regions / 中华行为医学与脑科学杂志

Objective To explore the decision-making processing changes of patients with cerebral infarction in different regions.Methods The patients with cerebral infarction were divided into 21 cases of frontal lobe infarction,11 cases of temporal lobe infarction,19 cases of the medial temporal lobe infarction,25 cases of basal ganglia infarction;25 cases of the anterior infarction,51 cases of the posterior infarction,62 cases of depression,64 cases of anxiety ;and there were 125 cases in normal control group.All subjects completed the test of the six kinds of choice situational problems,and used MMSE to evaluate cognitive function,the Hamilton Depression and anxiety Scale Evaluation to evaluate emotion.Results All cerebral infarction patients (CI group) and normal control group in low-risk and no-risk of loss situation(choice scenario 2),high-risk and the no-risk of gain or loss situation(choice scenario 3 and 4),high-risk and low-risk of gain or loss situation(choice scenario 5 and 6) tended to choose conservative scheme,and the selection probability of conservative scheme were obviously higher than that of the normal group,and the differences were statistically significant (P ＜ 0.05).In choice scenario 3,the basal ganglia infarction group with frontal lobe infarction group,the medial temporal lobe infarction group comparison,the conservative income scheme selection probability increased significantly,all difference were statistically significant (P ＜ 0.01,P ＜ 0.05).In choice scenario 5 of the posterior infarction group,a higher probability of conservative income scheme was selected than the anterior infarction,and the difference was statistically significant (P ＜0.05).Accompanied with depression and anxiety,the basal ganglia infarction tended to select more conservative income program than the frontal lobe infarction group and the medial temporal lobe infarction group in choice scenario 3,and the program infarction group selected a higher probability comparative differences were statistically significant (P＜ 0.01,P＜ 0.05).The posterior infarction group selected a higher probability of conservative income scheme than the anterior infarction in choice scenario 5,and the difference was statistically significant (P ＜ 0.05).Conclusion Cerebral infarction in patients exist decision-making processing abnormally,and perform as income conservative and loss risk averse.Whether associated with depression,anxiety,the basal ganglia infarction and posterior cerebral infarction patients are inclined to income conservative.

Effect of CT-aided Scalp Surrounding Needling on Infarction Dementia by Retaining Long Time / 中国康复理论与实践

@#Objective To observe the effect of CT-aided scalp surrounding needling on infraction dementia by retaining long time. Methods 53 infraction patients following dementia were randomly divided into treatment group (n=26) and control group (n=27). The control group was treated with CT-aided scalp surrounding needling for 30 minutes, while the treatment group was treated with CT-aided scalp surrounding needling for 3 hours. The course was 8 weeks. The therapeutic effect was assessed by Mini-Mental State Examination(MMSE), Hasegawa Dementia Scale(HDS-R) and Activities of Daily Living (ADL). Results The scores of ADL, MMSE, and HDS-R improved obviously after treatment in two groups (P<0.05), and the treatment group was better than the control group (P<0.05). Conclusion CT-aided scalp surrounding needling by retaining long time may facilitate to enhance the clinical effect on infarction dementia.

Effects of Drug Therapy and Rehabilitation Training on 60 Strokes with Progressive Cerebral Infraction / 中国康复理论与实践

@# ObjectiveTo observe the effects and safety of combination of Ozagrel and low molecular weight heparin and rehabilitation training in the treatment of progressive cerebral infraction. Methods60 patients with progressive cerebral infraction were divided into the observation group and the control group with 30 patients in each group. 80 mg Ozagrel plus 250 ml normal saline infusion were used in the observation group, once every 12 hours, 14 days for a course of treatment, 0-4 ml low molecular weight heparin was used with subcutaneous injection every 12 hours interval time, 14 days for a course of treatment. But only Ozagrel was used in the control group. The same treatment was used in the two groups, all patients received routine rehabilitation training. Platelet and activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (Fg) were examined before and 14 days after treatment. The NIHSS score was assessed.ResultsAfter treatment, NIHSS score in both groups decreased significantly(P<0-01) while the observation group was significantly better than the control group (P<0-01). The efficiency of the observation group was 86-7%, the control group was 60-0%, the observation group was significantly higher than the control group(P<0-05). Platelet count, PT, APTT, and Fg of the two groups were in the normal range, and there was no obvious adverse reaction.ConclusionOzagrel and low molecular weight heparin and rehabilitation training is safe and effective in the treatment of progressive cerebral infraction.

Cerebral Infraction after Cementless Total Hip Arthroplasty: A Case Report

A seventy-two year old male patient who had degenerative osteoarthritis due to acetabular dysplasia on the left hip joint was operated upon for cementless total hip arthroplasty. Sudden left hemiparesis developed on the day after the operation, so we immediately carried out brain computed tomography and magnetic resonance imaging. This showed multiple occlusions of the brain vessels at the right cerebral hemisphere. There was no arterial-venous shunt on the preoperative echocardiogram, yet the ultrasonogram of the right carotid artery showed over 70% postoperative stenosis. There was no evidence of pulmonary embolism on the chest computed tomography. We report here on a case of cerebral infarction that was caused by multiple microemboli after cementless total hip arthroplasty and we review the related medical literature.

A study of the functional prognosis and influential factors of cerebral infractions in stroke unit / 中华物理医学与康复杂志

Objective To observe the prognostic factors of functional outcome of patients with cerebral infraction treated in stroke unit.Methods The data of patients with cerebral infractions treated in stroke unit in our hospital were prospectively collected from April 2004 to December 2005 continuously.All the patients They were fol lowed up either by their regular visits to our outpatient clinics or by phone interview.The modified Rankin scale(mRS)score was used as the index of primary outcome.The prognostic factors of the functional outcome were analyzed by monovariate and multivariate logistic regression.Results A total of 150 cases were collected,of whom 98 were with good outcome,52 cases with poor outcome.The multivariate logistic regression showed that the poor outcome was associated with aging,previous history of stroke,high NIHSS scores,complications,and time from onset of the disease to admission to stroke unit.Conclusion The results suggested that older age,having stroke history,higher NIHSS total scores,having complications and delayed hospitalized time were influence factors to functional outcome of cerebral infractions in stroke unit.

Clinical Effects of Acupuncture Combined with Herbal Medicine with the Functions of Detoxication and Purging Fu-organ on Patients with Constipation of Phlegm-heat and Bowel-repletion Type in Acute Cerebral Infraction / 国际中医中药杂志

Objective To probe into the clinical effect of acupuncture combined with herbal medicine with the functions of detoxication and purging fu-organ on patients with constipation of phlegm-heat and bowel-repletion type in acute cerebral infarction.Methods The enrolled cases were randomly assigned to an observation group of 35 cases and a control grouD of 35 cases.Besides both groups were treated with routine neurological treatment and acupuncture with the flinchon of brain activating,the observation group was treated by acupuncture combined with herbal medicine with the functions of detoxication and purging fu-organ and the control group was treated with Dilute Glycerol.Such indexes of patients in both groups were observed 7 days and 21 days before and after the treatment as clinical effect of constipation,scores of related symptoms,and scores of traditional Chinese medical category and clinical effect.Results The effective rates of eonstipation 7 davs and 21 days after treatment were 93.7% and96.9% in the observation group,and 61.8% and79.4% in the control group,with significant differences between the two groups(P＜0.01).After the treatment for 7 days and 21 days,the symptoms of constipation.dark tongue,yellow and greasy fur were improved significantly in the observation group than those in the control group(P＜0.05);The observation group also showed a definite therapeutic effect than the control group on treating the svmptoms of upset minded,constipation,red or dark tongue,yellow and greasy fur(P＜0.01).The scores of traditional Chinese medical category of the observation group were lower than that of the control group(P＜0.01)after treatment for21 days.The total improvement rate was 97.0% in the observation group comparing 55.8%in the control group,showing significant difference(P＜0.01).Conclusion The method of acupuncture combined with herbal medicine with the functions of detoxication and purging fu-organ has a definite therapeutic effect on treating constipation of phlegm-heat and bowel-repletion in acute cerebral infarction.It can also improve clinical effects of these patients,which is worth generalizing in the clinical practice.

Effects of Sodium Ozagrel and Low Molecular Heparin on Progressive Cerebral Infraction / 中国康复理论与实践

@#ObjectiveTo observe the combined effect and safety of Sodium Ozagrel and Low Molecular Heparin in the treatment of progressive cerebral infraction.Methods80 patients with progressive cerebral infraction were divided into experiment group and control group with 40 patients in each group. Sodium Ozagrel and Clexane both were used in the experimental group, but only Sodium Ozagrel was used in the control group. Platelet packing fraction and 4 items of blood clotting were examined before and 14 d after treatment. Neurofunctional defect was evaluated at the same time in the 2 groups.ResultsPlatelet packing fractions were significantly different when examined before treatment and 14 d after treatment both in 2 groups (P<0.05), but no difference between the 2 groups. The value of APTT 14 d after treatment in the experimental group was significantly increased (P<0.05), while this was not observed in the control group. Total effective power in experimental group was 89.7%, which was much higher than that in control group (77.5%). Neurofunctional defect evaluation in experimental group was significantly improved after treatment(P<0.05) compared with that in control. ConclusionSodium Ozagrel combined with Clexane is more effective on progressive cerebral infraction.

Quantified Grading of TCM Syndrome Manifestations of Cerebral Infraction / 中医杂志

Objective To explore the standard of quantified grading of TCM syndrome manifestations of cerebral infraction.Methods The epidemiological investigation was carried out in the 841 cases of cerebral infarction with different TCM syndrome manifestations. The data obtained was analyzed with the step discriminant method of multivariate statistical analysis to build up the distinction equation mathematical expression. Self-validation, cross-validation, and prospective validation were applied to verify this grading and standard grading. Results Corss-validation: the Kappa coefficient of wind and blood stasis syndrome, qi deficiency syndrome, phlegm damp syndrome, fire heat syndrome, and yin deficiency syndrome was 0.919, 0.896, 0.872, 0.786, and 0.888 respectively. Prospective validation: the Kappa coefficient of wind and blood stasis syndrome, qi deficiency syndrome, and phlegm damp syndrome was 0.987, 0.757, and 0.795 respectively. The distinction equation mathematical expressions and scales of mild, medium, and severe cases of all syndromes of cerebral infarction were established.Conclusion The expressions created in this study were stable and qualified clinical practice well. The grading diagnosis based on these expressions was repeatable and provided the practical mathematical method for quantified grading of cerebral infraction.

Neuroprotective effect of sodium oxybate against focal cerebral ischemia-reperfusion injury and the relation to GABA in rats / 中国药理学通报

AIMTo study the protective effect of sodium oxybate (SO) against focal cerebral ischemia-reperfusion injury in rats, and the relationship between the effects of SO and ?-aminobutyric acid (GABA). METHODSThe reversible middle cerebral artery occlusion (MCAO)model in rats was established to investigate the role of SO. The scores of neurological deficits was detected by Longa EZ method in MCAO rats. The extracellular levels of glutamate (Glu) and GABA in CSF were measured by high performance liquid chromatography-fluorometer (HPLC-FR) method, and the weight of cerebral infraction was detected. RESULTSThe scores of neurological deficits and the weight of cerebral infraction markedly decreased by SO while the ratio of GABA/Glu obviously increased administered SO in MCAO rats. CONCLUSIONSSO could prevent MCAO rats from ischemia-reperfusion injury, the protective effect is related to SO keeping dynamic balance of excition-inhibition, and persisting inhibition-depended effect.