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Objective To compare the impact of nimodipine combined with mannitol and mannitol only on the neurologic impairment score,cerebral hemodynamic parameters and clinical efficacy of hypertensive cerebral hemorrhage in acute phase.Methods 68 patients with hypertensive cerebral hemorrhage in acute phase were selected,and they were randomly divided into control group (34 cases) and study group(34 cases) by digital table method.The control group was treated with mannitol only,while the study group was treated with nimodipine combined with marmitol.The clinical efficacy,hematoma volume,area of cerebral edema,cerebral hemodynamic parameters,neurologic impairment score,Barthel score of the two grou.ps were compared,and the adverse drug reaction of the study group was observed.Results The total effective rate (82.4％ vs.94.1％) and efficiency rate (44.1％ vs.61.8％) of the two groups had statistically significant differences (x2 =5.688,4.956,all P ＜ 0.05).The neurologic impairment score [post-treatment of the control group (10.2 ± 9.3) points vs.pre-treatment (14.9 ± 11.6) points,t =4.607,P ＜ 0.05;post-treatment of the study group (6.0 ± 4.7) points vs.pre-treatment (14.4 ± 10.8) points,t =8.379,P ＜0.05],area of cerebral edema[post-treatment of the control group (3.7 ± 0.6) cm2 vs.pre-treatment (4.8 ±0.9) cm2,t =5.262,P ＜ 0.05;post-treatment of the study group (2.2 ± 0.8) points vs.pre-treatment (5.1 ±1.2) points,t =9.193,P ＜ 0.05],hematoma volume [post-treatment of the control group (12.5 ± 7.4) mL vs.pre treatment (18.9 ± 7.1) mL,t =6.033,P ＜ 0.05;post-treatment of the study group (8.6 ± 8.2) points vs.pre treatment (18.4 ± 7.3) points,t =10.437,P ＜ 0.05] and Barthel score [post-treatment of the control group (73.6 ±40.4) points vs.pre-treatment (32.8 ± 27.1) mL,t =7.827,P ＜ 0.05;post-treatment of the study group (85.6 ±46.8) points vs.pre-treatment (36.7 ± 28.6) points,t =10.966,P ＜ 0.05] of the two groups had statistically significant differences.The neurologic impairment score of the study group after treatment was much lower than that of the control group [(6.0 ± 4.7) points vs.(10.2 ± 9.3) points,t =3.955,P ＜ 0.05].There were statistically significant differences between after and before treatment of the control group in critical pressure [(9.3 ± 2.2)kPa vs.(9.6 ± 2.1) kPa,t =5.046,P ＜ 0.05],peripheral resistance [(1 788.2 ± 209.4) kPa · s-1 · mL-1 vs.(1 659.2 ±219.3)kPa·s-1 · mL-1,t =6.146,P＜0.05]and mean blood flow velocity[(6.4 ±1.1) mL/s vs.(7.9±1.2) mL/s,t =6.266,P ＜ 0.05].The cerebral hemodynamic parameters of the study group after treatment had statistical differences compared with before treatment in critical pressure [(8.9 ± 2.3) kPa vs.(8.2 ± 1.1) kPa,t =5.292,P ＜ 0.05],peripheral resistance [(1 794.3 ± 188.6) kPa · s-1 · mL-1 vs.(1 469.5 ± 161.8) kPa · s-1mL-1,t =4.693,P ＜ 0.05],mean blood flow velocity [(6.4 ± 1.3) mL/s vs.(8.6 ± 1.5) mL/s,t =4.069,P ＜0.05],mean blood flow volume [(13.3 ± 3.0) cm/s vs.(14.5 ± 3.3) cm/s,t =5.633,P ＜ 0.05].There were statistically significant differences between the two groups in critical pressure,peripheral resistance,mean blood flow velocity,mean blood flow volume (t =4.664,4.563,5.532,5.327,all P ＜ 0.05).There were 4 cases of facial flushing,2 cases of pulsatile headache,3 cases of blood pressure drop,and the symptoms were gradually relieved after slowing down.Conclusion In the acute phase of hypertensive cerebral hemorrhage,nimodipine can reduce the scope of hematoma in a timely manner,significantly improve the efficacy and the quality of life of patients,it is worthy of clinical pronotion.
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Objective To explore the effect of circadian rhythm disorder on cognitive decline and neurologic impairment after traumatic brain injury (TBI) in rats.Methods Rats were subjected to a weight-drop model of TBI,then the rat models were divided into 2 groups ac-cording to the environmental length of day and night ,namely,the whole day group (12 h light/12 h light) and the control group (12 h light/12 h dark).After 14 days,the Morris water maze test and step-down test were carried out to evaluate the memory of the rats in each group . HE staining and immunohistochemistry ( BrdU, Ki-67) were carried out to evaluate the degree of the neurologic impairment of the rats in each group.And the mRNA expressions of Caspase-3,Caspase-9,Bcl-2 and Bax were evaluated with realtime PCR .Results The memory function of the rats in whole day group was significant lower than control group ;the damage degree of the cells in the hippocampus and the cortical lesion volume in whole day group were significant higher than control group ;the cell proliferation rate and newborn cell survival rate in the whole day group decreased significantly compared with the control group ;the mRNA expression of Bcl-2 in whole day group was signifi-ant lower than control group ,and the mRNA expression of Caspase-3,Caspase-9 and Bax in whole day group was signifiant higher than control group.Conclusion Circadian rhythm disorder can worsen TBI-induced cognitive decline and neurologic impairment .
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Objective:To evaluate the efficacy and safety of dl-3-butylphthalide ( NBP) injection and soft capsules in the treat-ment of acute middle cerebral artery infarction. Methods:Sixty-one patients with acute cerebral infarction in the left middle cerebral artery in 72 hours of onset of ischemic stroke with score of 5-25 according to the national institutes of health stroke scale ( NIHSS) were randomly divided into the observation group (n=31) and the control group (n=30). The control group was treated with the routine treatment, while the observation group was sequentially treated with NBP injection and soft capsules additionally. The treatment course was 90 days. Before the treatment, the NIHSS score was evaluated in both groups to compare the neurologic impairment degree. After the treatment, the daily living skills assessment was performed by Barthel index ( BI) and modified Rankin score ( mRS) , and the ad-verse reactions were recorded. Results:Before the treatment, the NIHSS score in the two groups had no statistical significance ( P>0. 05). After the treatment, the BI in the observation group and the control group was (88. 55 ± 16. 74) and (70. 67 ± 26. 18), and mRS was (1. 87 ± 1. 02) and (2. 53 ± 1. 40), respectively, suggesting the observation group had more favorable outcome than the con-trol group (P≤0. 05). The incidence of adverse reactions had no significant difference between the groups. Conclusion: dl-3-Bu-tylphthalide sequential therapy should be regarded as an effective and safe method for acute cerebral infarction, which can improve the daily living skills and 90-day outcome of patients.
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OBJECTIVE:To observe clinical efficacy of urinary kallidinogenase in the treatment of acute cerebral watershed in-farct (WSI). METHODS:128 patients with WSI were randomly divided into control group and treatment group,each of the 64 cases. Control group was given Shuxuening 15 ml added into 0.9% Sodium chloride 250 ml,ivgtt,qd;treatment group received urinary kallidinogenase 0.15 PNA added into 0.9% Sodium chloride 100 ml,ivgtt,qd. Both groups were treated for consecutive 14 days. Neurologic impairment score(NIHSS)and clinical efficacy were observed in 2 groups before treatment and 3,7 and 14 days after treatment. The blood specimens were collected after 7 and 14 days treatment,to determine serum levels of TCC. RESULTS:After treatment,NIHSS and total effective rate of treatment group were significantly higher than those of control group,with statis-tical significance(P0.05);7 days af-ter treatment,TCC level of 2 groups increased significantly,to 14 days,and a declive;the treatment group was higher than the control group,with statistical significance (P<0.05). CONCLUSIONS:Urinary kallidinogenase can improve clinical efficacy of WSI significantly,and promote neurologic impairment symptom and TCC levels.
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Objective To observe the influence of Maixuekang therapy on hematoma absorption,cerebral edema and neural function in patients with acute intracerebral hemorrhage within 3 weeks.Methods A total of 89 patients with acute intracerebral hemorrhage were divided into control group (45 cases) and treatment group (44 cases) by random digits table method.The two groups were implemented routine therapy and individualized rehabilitation treatment.Furthermore,the patients in treatment group were treated with Maixuekang (1.0 g,thrice a day for 3 weeks),if reexamination result of cerebral CT showed no expanding hematoma after 24 h from the onset of intracerebral hemorrhage.Cerebral hematoma and edema volume was measured by brain CT before therapy and on the 7th,14th and 21st day after therapy,and neurologic impairment was scored at the same time points by neurological impairment scale(NIS).The results were analyzed with statistics.Results The cerebral hematoma volume,edema volume and NIS before therapy,on the 7th,14th and 21st day after therapy in two groups respectively was (22.4 ± 8.4) ml,(9.5 ±2.6) ml,(25.4 ±3.8) scores,(21.7 ±7.6) ml,(19.9 ±7.1) ml,(25.3 ±3.4) scores,(18.9 ±6.7) ml,(18.3 ± 5.7) ml,(23.8 ± 3.0) scores,(15.3 ± 5.4) ml,(14.5 ± 4.8) ml,(21.7 ± 2.5) scores in control group; (22.3 ± 8.6) ml,(9.4 ± 2.5) ml,(25.3 ±3.6) scores,(19.6 ± 7.0) ml,(17.3 ± 6.4) ml,(23.9 ± 3.2) scores,(15.5 ±5.9) ml,(15.1 ±4.5) ml,(20.5 ±2.8) scores,(11.2 ±4.5) ml,(10.7 ±3.3) ml,(17.4 ± 2.1) scores in treatment group.The cerebral hematoma volume and edema volume was significantly smaller in treatment group than that in control group after therapy (P ＜ 0.05 or ＜ 0.01),but did not show significant difference compared with that before therapy (P ＞ 0.05).Conclusion Maixuekang therapy can significantly reduce cerebral edema and contribute to hematoma absorption and nerve functional recovery in patients with acute intracerebral hemorrhage.
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Objective To study glucose,creatinine,urea nitrogen and serum ET-1 of patients with acute cerebral infarction,and to explore the relationship between neurologic impairment and ET-1 levels.Methods The glucose,creatinine,urea nitrogen and serum ET-1 were retrospectively analyzed in 50 patients with acute cerebral infarction ( ＜ 24 h) and 50 patients with non-neurological diseases.ET-1 determined by 125I radioimmunoassay.Results There were no significant differences in glucose,creatinine and urea nitrogen of acute cerebral infarction ( P ＞ 0.05 ) ; Compared to the control groups,ET-1 levels was significantly higher ( P ＜ 0.01 ),and levels of serum ET-1 in acute cerebral infarction were significantly correlated with their neurological deficits ( P ＜ 0.01 ).Conclusions Levels of serum ET-1 can severd as diagnostic and prognostic indicator of acute cerebral infarction.
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Objective To investigate dynamic changes and clinical significance of the high-sensitive Creactive protein(hs-CRP) level in acute cerebral infarction patients with different etiological types.Methods 136 patients with acute cerebral infarction were recruited.These patients were classified into five subtypes based on Trial of Org 10172 in Acute Stroke Treatment(TOAST) criteria.Serum hs-CRP levels on the 1st,3rd,5th,7th,14th day after onset from patients and 42 healthy controls were measured with immunoturbidimetry.The neurologic impairmentscore was determined with NIHSS.Results Serum hs-CRP levels is higher on the 1th,3rd,5th,7th,14th day than that of the control group ( (4.26 ± 1.31 ),( 12.57 ± 6.29 ),( 10.23 ± 4.49 ),(7.54 ± 2.33 ),(4.25 ± 1.77) mg/Land (2.56 ± 0.86) mg/L,t = 7.89,10.26,10.99,13.55,5.97,P ＜ 0.05 ).Among 5 subtypes,serum hs-CRP was the highest in large-artery atherosclerosis group after acute ischemic stroke,and cardioembolism group was the next.Serum hs-CRP reached the highest on three or five days after disease onset and decreased slowly.High levels of hs-CRP in large-artery atherosclerosis group indicated severe neurologic functional impairment and worsen prognosis.Conclusions ACI is closely related to serum hs-CRP level,which can be used as an subjective index for severity and prognosis with the lasting,high levels of hs-CRP levels predict poor prognosis.
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Objective To investigate the therapeutic effect of shuxuetong injection on acute ischemic stroke.Methods A total of 120 cases were randomized into a treatment group and a control group, with 60 cases in each. The treatment group was treated with Shuxuetong injection, 6ml added into 250ml sodium chloride injection, once daily; and the control group was treated with Mailuoning injection, 20ml added ionto 250ml sodium chloride injection, once daily. The course of treatments lasted 10 days. Neurologic impairment and the changes of TCM syndrome were observed. Results The efficiency was 61.7% and 43.3% in the treatment group and the control group respectively. TCM Syndrome was obviously improved in the treatment group. Conclusion Shuxuetong injection was safe and effective on AIS.
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@# Objective To study the effects of stereotactic technique on hypertensive basal ganglion hemorrhage. Methods 160 patients with hypertensive basal ganglion hemorrhage were divided into 2 groups: surgical group （132 cases）and conservative group （28 cases）. They were assessed with clinical neurologic impairment scale before and 2 weeks and 4 weeks after treatment. The incidence of rehemorrhage was compared. Results The neurologic impairment scores in surgical group and conservative group were (33.90±3.54) and (33.61±3.82) before treatment (P>0.05), (20.89±3.10) and (26.18±3.61) 2 weeks after treatment (P<0.01), (10.28±2.01) and (15.68±3.28) 4 weeks after treatment (P<0.01), respectively. The incidence of rehemorrhage in surgical group and conservative group were 6.1% and 10.7% (P>0.05), respectively. Conclusion The stereotactic technique may recover neurological function much faster.
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Objective To investigate the relationship between levels of serum matrix metalloproteinases(MMPs)and brain edema and neurologic impairment in patients with intracerebral hemorrhage(ICH).Methods The levels of serum MMP-9 and MMP-2 in 31 patients with ICH were tested with ELISA for at 1 d,3 d,7 d and 2 weeks after onset.The volumes of hematoma and its peripheral edema were evaluated by CT,the neurologic impairment was evaluated by NIHSS at 1 d and 14 d after onset.Results Levels of serum MMP-9 and MMP-2 were significant higher in ICH group at each time point after onset than those in normal control group(allP