Investigation and study on the associated factors of hospitalization delay in stroke patients / 中国医师进修杂志

Objective To study the associated factors of hospitalization delay in stroke patients. Methods Verified questionnaires were used to investigate all of the 179 stroke patients. The patients were divided into two groups according to prehospital time within or after 6 h. The associated factors of hospitalization delay were analyzed. Results The average prehospital time among 179 patients was (26.2±0.1) h, the median time was 7.5 h. There were significant differences in previous cardiac disease, distance between stroke onset site to hospital, convulsion or disorders of consciousness onset, first visit in emergency room directly or not, arriving at hospital by ambulance or not, time on ambulance between stroke onset site to hospital, time on route to hospital between the two groups (P < 0.05). Logistic regression showed the following factors were related to hospitalization delay: long distance between the site where stroke onset occurred and hospital, long time in out-patient room. Conclusions The phenomena of hospitalization delay is especially eommon and there is a low treatment rate of thrombolysis therapy in iscbemie stroke. The main reason of hospitalization delay lies in ignorance of relevant risk factors, clinical symptoms of stroke and using emergence system sufficiently.

Clinical analysis of 32 patients with symptomatic carotid stenosis treated by eversion carotid endarterectomy / 中国医师进修杂志

Objective To review the experience and early clinical results of eversion carotid endartotectomy (eCEA) in treatment of patients with symptomatic carotid stenosis. Methods eCEA were performed on 32 patients who suffered from the extracranial carotid stonosis. The treatment results were retrospectively reviewed. Results Thirty-two patients were successfully treated with eCEA. The symptom in 17 patients with transient ischemia attach (TIA) admitted to hospital did not recurrence, the other original symptoms of the patients had different degrees of improvement or disappeared. Two patients had TIA during 72 h after surgery, but 24 h repeatedly CTA examination without infarcts oecurring, and recovered after the treatment of small doses of urokinase. Two cases of severe swelling appeared tracheal shift incision, and went smoothly through edema by treatment of tracheal intubatian. In 4 patients headache reliefed in 2-3 d after medical treatment of the dehydration. Seven patients appeared different degree of hoarseness, and got recovery through neurotrophic medication for 1 month. No other serious complication occurred. Follow-up by 6 months, no CTA carotid artery stenosis appeared again. Conclusion eCEA is an effective method to treat symptomatic carotid stenosis.

Correlation between eystathionine βsynthase T833C gene polymorphism and ischemic cerebral vascular disease / 中华神经科杂志

Objective To investigate the correlation between cystathionine β-synthase (CBS) T833C gene polymorphism and the plasma homocysteine (Hey) levels in patients with ischemic cerebral vascular disease(ICVD). Methods Three hundred and sixty patients with ICVD and 210 control subjects were enrolled. The T833C polymorphism of CBS gene was analyzed by the amplification refractory mutation system (ARMS). Plasma Hey levels were measured by high performance liquid chromatography-fluorescence detection(HPLC-FD). Results Plasma Hey levels in the ICVD group ((17.6±4.8) μmol/L) were higher than those in control group ((13.3±4.3) μmol/L, t = 10.716, P< 0.05) . There were no differences in genotype frequencies and allele frequencies between the ICVD group and contral group (χ2 = 0.785, 0.941 ,P>0.05). Plasma Hey levels in CC genotype or TC genotype were higher than those in TT genotype (F = 6.56, P< 0.05). Condusions High plasma Hey level is an independent risk factor of ICVD,but CBS T833C polymorphism may not associated with ICVD.