Conglomerados espaciales de mortalidad por cáncer, cardiopatía isquémica y enfermedad cerebrovascular isquémica en la provincia de Santiago de Cuba / Space conglomerates of mortality due to cancer, ischemic heart disease and ischemic cerebrovascular disease in Santiago de Cuba province i: en

Introducción: Uno de los aspectos que más interés suscita en lo referente a la distribución geográfica de la mortalidad por cáncer es la formación de conglomerados espaciales. Objetivo: Identificar el patrón espacial de la mortalidad por cáncer, cardiopatía isquémica y enfermedad cerebrovascular isquémica mediante la detección y descripción de conglomerados espaciales en la provincia de Santiago de Cuba. Métodos: Se realizó un estudio ecológico exploratorio espacial de los fallecimientos por cáncer, cardiopatía isquémica y enfermedad cerebrovascular isquémica durante el período comprendido desde el 1 de enero hasta el 31 de diciembre de 2019 en la provincia de Santiago de Cuba, para lo cual se procedió a la detección de conglomerados espaciales de elevada y baja mortalidad por las causas antes citadas. Se empleó el método de escaneo espacial estadístico con el programa Satscan y las variables independientes fueron divididas en demográficas y clínicas. Resultados: De los 36 conglomerados espaciales de mortalidad detectados, 23 correspondieron al cáncer (65,8 %), 7 a cardiopatía isquémica (18,4 %) y 6 a enfermedad cerebrovascular isquémica (15,8 %); asimismo, 44,7 % del total eran de elevado riesgo y 55,3 % de bajo riesgo. Conclusiones: El patrón de la distribución espacial de mortalidad por cáncer de próstata, pulmón, mama, colon, esófago, cardiopatía isquémica y enfermedad cerebrovascular isquémica se caracterizó por la formación de conglomerados espaciales de elevada y baja mortalidad.

Introduction: One of the aspects that more interest raises regarding the geographical distribution of mortality due to cancer is the formation of space conglomerates. Objective: To identify the space pattern of mortality due to cancer, ischemic heart disease and ischemic cerebrovascular disease by means of the detection and description of space conglomerates in Santiago de Cuba province. Methods: A space exploratory ecological study of deaths due to cancer, ischemic heart disease and ischemic cerebrovascular disease was carried out during January 1st to December 31, 2019 in Santiago de Cuba province, for which space conglomerates of high and low mortality due to the abovementioned causes were detected. The statistical space escanning method was used with the Satscan program and the independent variables were divided in demographic and clinical. Results: Of the 36 space conglomerates of mortality detected, twenty three corresponded to cancer (65.8%), seven to ischemic heart disease (18.4%) and six to ischemic cerebrovascular disease (15.8%); also, 44.7% of the total was of high risk and 55.3% of low risk. Conclusions: The space distribution pattern of mortality due to prostate, lung, breast, colon, esophagus cancer, ischemic heart disease and ischemic cerebrovascular disease was characterized by the formation of high and low mortality space conglomerates.

Network Meta-analysis of single Hirudo prescriptions in treatment of ischemic cerebrovascular disease / 中国中药杂志

This study intended to evaluate the efficacy and safety of single Hirudo prescriptions in the treatment of ischemic cerebrovascular disease(ICVD) by frequency network Meta-analysis and traditional Meta-analysis. CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, and Cochrane Library databases were searched to collect the randomized controlled trial(RCT) of single Hirudo prescriptions for ICVD from the inception of the databases to May 2022. The quality of the included literature was evaluated by Cochrane risk of bias tool. Finally, 54 RCTs and 3 single Hirudo prescriptions were included. Statistical analysis was conducted by RevMan 5.3 and Stata SE 15. Network Meta-analysis showed that in terms of the clinical effective rate, the surface under the cumulative ranking curve(SUCRA) of intervention measures was as follows: Huoxue Tongmai Capsules+conventional treatment>Maixuekang Capsules+conventional treatment>Naoxuekang Capsules+conventional treatment>conventional treatment. Traditional Meta-analysis revealed that in terms of the safety of ICVD treatment, Maixuekang Capsules+conventional treatment had higher safety than conventional treatment alone. According to the network Meta-analysis and traditional Meta-analysis, it was found that conventional treatment combined with single Hirudo prescriptions improved the clinical efficacy of ICVD patients, and compared with that of conventional treatment alone, the incidence of adverse reactions of combined treatment was low and the safety was high. However, the methodological quality of the articles included in this study was generally low and there were large differences in the number of articles on the three combined medication. Therefore, the conclusion of this study needed to be confirmed by subsequent RCT.

Manifestaciones neuroftalmológicas en pacientes con enfermedad cerebrovascular isquémica / Neuro-ophthalmological manifestations in patients with ischemic cerebrovascular disease

La enfermedad cerebrovascular isquémica tiene una elevada incidencia y prevalencia en Cuba, y constituye la tercera causa de muerte en el país. Existen diferencias anatómicas y clínicas entre el infarto de la circulación anterior y la posterior. En ocasiones, los elementos distintivos que ayudan al diagnóstico topográfico de la enfermedad cerebrovascular isquémica son las manifestaciones neuroftalmológicas. Con el objetivo de profundizar en el conocimiento actual sobre las alteraciones neuroftalmológicas que se asocian a la enfermedad cerebrovascular isquémica, se realizó una revisión bibliográfica, donde se consultaron un total de 69 fuentes de información digital de los últimos 5 años. La circulación cerebral se divide de manera general en anterior y posterior. Los síntomas y signos principales del ictus que afecta la circulación anterior son la desviación conjugada de la mirada, la afectación de las sácadas, la hemianopsia homónima, la heminegligencia y la apraxia de la apertura ocular; mientras que las alteraciones asociadas a la afectación de la circulación posterior son el nistagmo, las anormalidades en la alineación y los movimientos oculares, así como la hemianopsia homónima con conservación macular. Se concluye que en la enfermedad cerebrovascular isquémica aparecen síntomas y signos como consecuencia de la afectación, tanto de la vía visual aferente, como de la eferente. La hemianopsia homónima es el signo más frecuente reportado(AU)

Ischemic cerebrovascular disease has a high incidence and prevalence in Cuba, and it is the third cause of death in the country. A number of anatomical and clinical differences distinguish anterior from posterior circulation infarction. On certain occasions the distinguishing elements that aid in the topographic diagnosis of ischemic cerebrovascular disease are its neuro-ophthalmological manifestations. With the purpose of gaining insight into the current knowledge about the neuro-ophthalmological alterations associated to ischemic cerebrovascular disease, a bibliographic review was conducted based on the analysis of 69 digital information sources from the last five years. Cerebral circulation is generally divided into anterior and posterior. The main symptoms and signs of the stroke that affects anterior circulation are conjugate gaze deviation, altered saccades, homonymous hemianopsia, heminegligence and eyelid opening apraxia, whereas the alterations associated to posterior circulation involvement are nystagmus, eye movement and alignment abnormalities, and homonymous hemianopsia with macular preservation. It is concluded that ischemic cerebrovascular disease presents symptoms and signs related to both the afferent and the efferent visual pathways. Homonymous hemianopsia is the most common sign reported(AU)

Advances in modern research on ischemic cerebrovascular diseases / 中国药理学通报

Stroke is a common disease; the vast majority of stroke cases are caused by transient or permanent cerebrovascu-lar occlusion of ischemic cerebrovascular disease (ischemic stroke) , which eventually leads to cerebral infarction. Many strategies have been studied in clinical trials to improve brain rescue and recovery for ischemic stroke, including antioxidant strategies, neuronal protection strategies, and even anti-inflammatory strategies. Therefore, it is an urgent problem to explore the pathologic mechanism of ischemic stroke and find effective drugs. In this paper, the recent advances in the study of ischemic cerebrovascular diseases are briefly summarized to provide i-deas for future research.

Hybrid surgical technique for the treatment of complex cerebrovascular diseases / 中国脑血管病杂志

The clinical application of hybrid surgical technique for treatment of cerebrovascular diseases has gone through a course of more than 10 years. From intraoperative angiography in the treatment of intracranial aneurysms and cerebral arteriovenous malformations at the begining to various applications for more complicated cases at present, hybrid operation has become a new world in the treatment of cerebrovascular diseases. At the same time we notice that the clinical application of hybrid surgery is lack of large-scale multicenter clinical control studies, and there are still different opinions on the indication, technical process,quality control,team building and so on. As a new technique and clinical hotspot,hybrid operation for cerebrovascular diseases has a good prospect,and need to be further standardized.

Effect of scalp acupuncture stimulation on cerebral infarct volume and expression of IL-10, IL-6 and IL-1β in para-hippocampal gyrus in acute ischemic cerebrovascular disease rats / 针刺研究

OBJECTIVE: To observe the influence of scalp acupuncture on cerebral infarct size and expression of IL-10, IL-6, and IL-1β in the para-hippocampal gyrus in acute ischemic cerebrovascular disease(AICD) rats, so as to investigate its mechanisms underlying improvement of AICD. METHODS: Forty-eight male SD rats were randomly allocated to normal control (control), AICD model, medication, and scalp acupuncture groups (n＝12 per group). The AICD model was established by occlusion of the middle cerebral artery (MCAO). Rats of the medication group received intraperitoneal injection of Ammonium 1-Pyrrolidinedithiocarbamate (APDC, 100 mg•kg－1•d－1), once daily for 7 days. Scalp acupuncture stimulation was applied to bilateral "Dingnieqianxiexian" (MS6) once daily for 7 days. Before and after intervention, the neurologic deficit score (NDS) and the neurological score (NS) were evaluated according to Longa's and Schäbitz's methods, respectively. At the end of the intervention, the para-hippocampal gyrus and whole brain were collected respectively. The expression levels of IL-10, IL-6 and IL-1β in the para-hippocampal gyrus tissue were detected by immunohistochemistry, and the cerebral infarct volume of the brain was detected by triphenyltetrazollium chloride (TTC) staining after sectioning. RESULTS: Following modeling, the NDS, NS and the expression of IL-10, IL-6 and IL-1β in para-hippocampal gyrus were significantly increased in the model group compared with the control group (P0.05). The effect of scalp acupuncture was obviously superior to that of medication in up-regulating IL-10 expression level (P0.05). CONCLUSION: Scalp acupuncture can improve neurological function and reduce infarct volume in AICD rats, which may be associated with its function in up-regulating the expression of IL-10 and in inhibiting the expression of IL-6 and IL-1β to reduce inflammation reaction.

Síndrome de Foix-Chavany-Marie por infarto biopercular con mecanismo cardioembólico / Foix-Chavany-Marie syndrome sue to biopercular infarction with cardioembolic mechanism

El síndrome de Foix-Chavany-Marie o síndrome biopercular fue descrito como una diplejía labio-facio-faringo-laringo-gloso-masticatoria, con disociación automática del movimiento. Los pacientes que padecen este síndrome presentan alteración del habla (disartria o anartria), disfagia y no pueden abrir la boca, cerrar los párpados o protruir la lengua por voluntad propia, pero pueden sonreír, llorar y bostezar automáticamente. La etiología más frecuente en la edad adulta es la isquémica, a nivel opercular bilateral. Se presenta el caso clínico de un paciente con enfermedad cerebrovascular isquémica de la arteria cerebral media derecha con parálisis pseudobulbar con conversión hemorrágica por mecanismo cardioembólico, con trastorno de la deglución. Tuvo una evolución favorable(AU)

Foix-Chavany-Marie syndrome or biopercular syndrome was described as a lip-facio-pharyngo-laryngeal-glosso-chewing diplegia, with automatic dissociation of movement. Patients with this syndrome have speech impairment (dysarthria or anarthria), dysphagia and cannot open their mouths, close their eyelids or protrude their tongue freely, but they can smile, cry and yawn spontaneously. The most frequent etiology in adulthood is ischemic, at the bilateral opercular level. We report a clinical case of a female patient with ischemic cerebrovascular disease of the right middle cerebral artery with pseudobulbar paralysis, hemorrhagic conversion by cardioembolic mechanism, and swallowing disorder. She evolved favorably(AU)

Citicolina, ¿deberíamos seguir indicándola en ECV isquémica? / Citicolina, devemos continuar a indicá-lo nA DCbV isquemica? / Citicoline, should we continue to indicate it in ischemic CVD?

Resumen: La enfermedad cerebrovascular (ECV) isquémica es una condición médica que implica, según su grado, discapacidad importante para el paciente, además de altos costos para su tratamiento agudo y crónico, así como en el manejo de la discapacidad con alta incidencia y prevalencia a nivel mundial. Desde el punto de vista fisiopatológico, representa una catástrofe en el funcionamiento cerebral que involucra daño estructural y funcional. Se han desarrollado múltiples estrategias para el manejo de esta patología; actualmente, el estándar de oro para su manejo es el rt-PA; sin embargo, por sus características, pocos pacientes tienen acceso al mismo. Razón por la que se han desarrollado estrategias farmacológicas diversas para su manejo: la citicolina se ha usado durante años, no obstante, genera controversias dado que su utilidad, demostrada en estudios experimentales, no se ha reproducido en la práctica clínica; más aún, algunos estudios sugieren que podría empeorar el pronóstico del paciente, lo que justificaría el abandono de su uso en el tratamiento de ECV isquémica (ictus). Por tal motivo ofrecemos esta revisión del tema con el fin de brindar herramientas que permitan aclarar dicha controversia.

Abstract: Ischemic cerebrovascular disease (CVD) is a medical condition that, according to its extension, implies significant disability for the patient, as well as high costs for its acute and chronic treatment, as well in the management of disability, with high incidence and worldwide prevalence, from the physiopathological point of view represents a catastrophe in brain functioning that involves structural and functional damage. Multiple strategies have been developed for the management of this pathology, currently the gold standard for its management is the rt-PA, however, due to its characteristics, and few patients have access to it, because it various pharmacological strategies have been developed. Citicoline has been used for years, nevertheless generates controversies since its usefulness, demonstrated in experimental studies, has not been reproduced in clinical practice but some studies suggest that it could worsen the patient's prognosis, which would justify the abandonment of its use in the treatment of ischemic CVD (ictus), for this reason we offer this review of the subject in order to provide tools to clarify this controversy.

Resumo: A doença cerebrovascular (DCbV) isquêmica é uma condição clínica que de acordo com sua extensão, implica em uma significativa incapacidade para o paciente, ademais de altos custos para seu tratamento agudo e crônico, bem como no manejo da incapacidade com alta incidência e prevalência a nível mundial. Do ponto de vista fisiopatológico representa uma catástrofe no funcionamento do cérebro que envolve danos estruturais e funcionais. Múltiplas estratégias têm sido desenvolvidas para o tratamento dessa patologia, atualmente o padrão ouro para o seu manejo é o rt-PA, porém, devido às suas características, poucos pacientes têm acesso a ele, razão pela qual várias estratégias farmacológicas foram desenvolvidas, a citicolina vem sendo utilizada há anos, gera controvérsias, uma vez que sua utilidade, demonstrada em estudos experimentais não foi reproduzida na prática clínica, mas alguns estudos sugerem que ela poderia piorar o prognóstico do paciente, o que justificaria o abandono do seu uso no tratamento de DCbV isquêmica (ictus), por esse motivo oferecemos esta revisão, a fim de fornecer ferramentas para esclarecer esta controvérsia.

Drug combination characteristics of Shenxiong glucose injection in treating ischemic cerebrovascular disease in real world / 中国中药杂志

To analyze the clinical drug use characteristics of Shenxiong glucose injection in the treatment of ischemic cerebrovascular disease. From hospital information system (HIS) of 19 hospitals over China, the basic information of patients with Shenxiong glucose injection for ischemic cerebrovascular disease, traditional Chinese medicine and Western medicine diagnosis information, order information, and laboratory examination information were extracted. Then Apriori algorithm was used to construct the model, and the association analysis was performed by using Clementine 12 to analyze the clinical drug use characteristics of Shenxiong glucose injection in the real world. A total of 411 kinds of Western medicines and 110 kinds of traditional Chinese medicines were included in 784 cases of drug combination. In the drug combination, aspirin had the highest frequency in Western medicine, which was used in 515 cases (65.69%); Ginkgo biloba extract had the highest frequency in Chinese medicine, which was used in 121 cases (15.43%). Atorvastatin+aspirin (association rules of 10.15%) was the most common Western medicine pairs; atorvastatin+clopidogrel+aspirin (association support 5.56%) was the most common triple Western medicine therapy, often combined with antibiotics and blood stasis drugs in use. Results showed that Shenxiong glucose injection was often combined with antiplatelet drugs and blood stasis drugs in the treatment of ischemic cerebrovascular disease clinically, contributing to the enhancement of platelet aggregation and blood stasis. The incompatibility of combined application of drugs shall be noted to ensure the clinical medication safety and efficacy of the combined drug use.

Correlation study between cerebral microbleeds and white matter lesions in patients with ischemic cerebrovascular disease / 中华行为医学与脑科学杂志

Objective To explore distribution characteristics and risk factors of cerebral microbleeds (CMBs),and the correlation between CMBs and white matter lesions (WML) in patients with ischemic cerebrovascular disease(ICVD).Methods 180 patients with ICVD in neurology department of Hebei General Hospital from February 2015 to January 2017 were recruited.Those patients were underwent brain magnetic resonance imaging (MRI),and magnetic susceptibility weighted imaging (SWI).Recorded the baseline data and risk factors of high blood pressure,diabetes,hyperlipidemia,and high homocysteine were recorded.Patients with CMBs were counted and graded to understand the characteristics of CMBs distribution.Logisitic regression analysis was used to analyze the influencing factors.ICVD patients were divided into CMBs group and non CMBs group.CMBs group was further divided into 4 groups according to the severity,which was divided into level 1-3.The correlation between CMBs influencing factors and classification was further studied.Then patients with ICVD were divided into WML group and non WML group.WML group scored each region with age-related white matter changes rating scale (ARWMCrs).The correlation between WML and CMBs classification was further studied.Results (1) The overall prevalence of CMBs in patients with ICVD was 61.7％ (111/180).The most common location of CMBs in patients with ICVD was the cortical and subcortical regions (80/111,72.1％),followed by the basal ganglia and thalamus regions (61/111,55.0％),and the infratentorial regions(38/111,34.2％).The difference between them were significant (x2 =32.061,P=0.000).In cortical and subcortical regions of CMBs,temporal lobe was the most common (61.3％).(2) Age(B=0.046,Or=1.047,95％CI =1.017～ 1.077,P=0.002) and the high homocysteine (B =1.458,Or=4.299,95％ CI =2.114 ～ 8.744,P＜0.001) were the risk factors for CMBs.(3) Four classification of CMBs was positively correlated with and WML total score (r=0.393,P=0.393).Conclusion The temporal lobe was the most common region for CMBs in patients with ICVD.Age and high homocysteine were risk factors for CMBs.With the increase of WML total score,severity of CMBs was also increased.

Application of Vaso CT in the recanalization of vertebrobasilar junction occlusion / 中国脑血管病杂志

Objective To investigate the risk assessment,guiding role,and clinical value of Vaso CT image features for recanalization of vertebrobasilar junction occlusion. Methods From January 2016 to May 2017,14 patients with vertebrobasilar junction occlusion admitted to the Department of Neurology, Chinese PLA General Hospital were analyzed retrospectively. Preoperative cerebral angiography confirmed vertebrobasilar junction occlusion. Vaso CT was used to measure the length of the occluded vessels and vascular direction at both ends. According to these results, the operative risks were evaluated and the recanalization of vertebrobasilar junction occlusion were guided. Results The length of vertebrobasilar junction occlusion was 2. 56-19. 09 mm (mean 4. 5 ± 2. 1 mm) in 14 patients,and 13 of them were treated with the recanalization of vertebrobasilar artery occlusion,the blood vessels of 12 cases were successfully recanalized and stent placement was performed after the recanalization,among them,8 Solitaire stents and 4 Wingspan stents were implanted;One patient did not perform recanalization because of longer length of occlusion (19. 09 mm). All patients operated did not have any perioperative complications, and the neurological symptoms were significantly improved after procedure. Conclusion Vaso CT can accurately determine the surgical risk of the recanalization of vertebrobasilar junction occlusion,and can guide the surgical pathways,reduce the incidence of perioperative complications,and improve the success rate of the operation.

Application of Vaso CT in the recanalization of vertebrobasilar junction occlusion / 中国脑血管病杂志

Objective To investigate the risk assessment,guiding role,and clinical value of Vaso CT image features for recanalization of vertebrobasilar junction occlusion. Methods From January 2016 to May 2017,14 patients with vertebrobasilar junction occlusion admitted to the Department of Neurology, Chinese PLA General Hospital were analyzed retrospectively. Preoperative cerebral angiography confirmed vertebrobasilar junction occlusion. Vaso CT was used to measure the length of the occluded vessels and vascular direction at both ends. According to these results, the operative risks were evaluated and the recanalization of vertebrobasilar junction occlusion were guided. Results The length of vertebrobasilar junction occlusion was 2. 56-19. 09 mm (mean 4. 5 ± 2. 1 mm) in 14 patients,and 13 of them were treated with the recanalization of vertebrobasilar artery occlusion,the blood vessels of 12 cases were successfully recanalized and stent placement was performed after the recanalization,among them,8 Solitaire stents and 4 Wingspan stents were implanted;One patient did not perform recanalization because of longer length of occlusion (19. 09 mm). All patients operated did not have any perioperative complications, and the neurological symptoms were significantly improved after procedure. Conclusion Vaso CT can accurately determine the surgical risk of the recanalization of vertebrobasilar junction occlusion,and can guide the surgical pathways,reduce the incidence of perioperative complications,and improve the success rate of the operation.

Comparative analysis of endovascular interventional therapy and simple drug therapy in patients with ischemic cerebrovascular disease / 中国生化药物杂志

Objective this research mainly analysis in the treatment of patients with ischemic cerebrovascular disease by comparison of clinical therapeutic effect of endovascular treatment and simple drug treatment. Methods 60 cases of patients with ischemic cerebrovascular disease admitted in our hospital from January 2016 to January 2017, and were randomly divided into control group and observation group, 30 cases in each group. The control group were treated by endovascular treatment, the observation group were treated with simple drug treatment, the two groups of patients treated for 6 months, 12 months to improve blood flow, the incidence of cerebrovascular events, mortality, prognosis Quality of life scores as a comparison basis.Results The patients in the observation group were treated for 6 months, 12 months after the blood flow improved superior to the patients in the control group (P<0.05); the patients in the observation group were treated for 6 months, 12 months of cerebrovascular disease incidence rate lower than that of the control group (P<0.05); the observation group after 6 months treatment and mortality of patients in the control group had no significant difference; the patients in the observation group after 12 months of treatment the mortality rate lower than that of the control group (P<0.05). The patients in the observation group survival quality scores were excellent in the control group (P<0.05). Conclusion The study proves that, in the treatment of patients with ischemic cerebrovascular disease in the treatment can effectively improve the treatment effect of endovascular intervention, improve the blood flow status of patients, reduce the events in patients with cerebrovascular disease incidence and mortality.

Clinical comparative of aspirin and clopidogrel combined with atorvastatin calcium in the treatment of acute ischemic cerebrovascular disease / 中国生化药物杂志

Objective To study the clinical effects of aspirin and clopidogrel combined with atorvastatin calcium in patients with acute ischemic cerebrovascular disease. Methods 27 cases of patients with acute ischemic cerebrovascular disease from March 2015 to March 2016 in Hainan general hospital were selected,and randomly divided into control group and observation group,13 patients in the control group,treated with aspirin and clopidogrel,14 cases in the observation group,treat with atorvastatin calcium based on the control group,both two groups were treatment for three months.The total effective rate were compared between the two groups after treatment,NIHSS score and serum lipid level were compared before and after treatment. Results After treatment,the total effective rate of observation group was 92.9%,significantly higher than the control group 53.8%(P<0.05).Compared with before treatmeng,the NIHSS score of two groups were decreased,the levels of TC,TG and LDL-C in two groups were decreased,HDL-C was increased (P<0.05);Compared with control group,the NIHSS score of observation group was lower,TC,TG and LDL-C were lower,HDL-C was higher (P<0.05). Conclusion Aspirin and clopidogrel combined with atorvastatin calcium in treatment with acute ischemic cerebrovascular disease has significant effect,can reduce the patient's NIHSS score,improve blood lipid levels.

Effects of hypotonic nonionic contrast agents on serum creatinine,blood urea and renal function in elderly patients withischemic cerebrovascular disease / 中国生化药物杂志

Objective To analyze the effect of serum creatinine, blood urea and renal function with angiography low permeability of non-ionic contrast agent in elderly patients with ischemic cerebrovascular disease,and provide reference for clinical treatment.Methods 100 elderly patients with ischemic cerebrovascular disease in hospital from April 2011 to May 2016 were selected,patient were given cerebrovascular, renal arteriography.The changes of serum creatinine and urea were detected at different time before and after 3 days, and the changes of renal function were detected.Results In 100 cases, 12 cases of contrast induced nephropathy, the incidence rate was 12%.Contrast nephropathy in patients with diabetes mellitus group proportion, renal insufficiency, the proportion of severe renal artery stenosis was significantly higher than the proportion of non contrast nephropathy group (P<0.05).Contrast nephropathy group contrast 1 days and contrast 2 days blood urea, serum creatinine and creatinine clearance rate were significantly increased (P<0.05), contrast to 6 days gradually returned to normal, no obvious change of non contrast nephropathy in patients with renal function index.Diabetes mellitus (OR=6.973), severe renal artery stenosis (OR=4.286) and renal insufficiency (OR=7.680) are the risk factors of contrast induced nephropathy (P<0.05).Conclusion Vascular elderly patients with ischemic cerebrovascular disease using non-ionic contrast medium hypotonic angiography safer, diabetes, renal patients need to continue to pay attention to changes in renal function.

Research Progress of Ozone Oxidation and Ischemia-reperfusion Injury (review) / 中国康复理论与实践

As an active oxygen, ozone can induce oxidative stress, however, small doses of ozone pretreatment of the body may devel-op to oxidation toleration, even anti-oxidative damage, thereby protecting organ from ischemia-reperfusion injury. This paper reviewed the status of ozone pretreatment in organ ischemia-reperfusion, such as heart, kidney, liver, skeletal muscle, gonads and brain. Ozone therapy may have potential application values in organ transplants and cardiovascular diseases. Meanwhile, whether clinical application of ozone big autohemotherapy in ischemic cerebrovascular disease is reasonable or not in nearly 10 years was put forward.

Effects of Cerebral Microbleeds on the Incidence of Cerebral Events in Patients with Ischemic Cerebrovas-cular Disease at the Last Stage of Antiplatelet Agent / 中国药房

OBJECTIVE:To compare the incidence of cerebral events in patients with ischemic cerebrovascular disease compli-cating with cerebral microbleeds(CMBs)at the last stage of antiplatelet agent use. METHODS:140 patients with ischemic cerebro-vascular disease were selected from Beijing Anzhen Hospital Affilicated to Capital Medical University during Jan. 2013-Jan. 2014, and then divided into CMBs group and non-CMBs group according to whether complicated with CMBs,with 70 cases in each group. After followed up for 1 year(regular use of aspirin 100 mg/d and/or clopidogrel 75 mg/d),the incidence of recurrent cere-bral infarction and cerebral bleeding and mortality were compared. RESUTLS:The incidence of recurrent cerebral infarction was 12.9% in CMBs group and 8.6% in non-CMBs group,without statistical significance(P=0.412);the incidence of cerebral bleed-ing was 10.0% in CMBs group and 1.4% in non-CMBs group,with statistical significance(P=0.029);the mortality of cerebro-vascular event at the last stage was 5.7% in CMBs group and 4.3% in non-CMBs group,without statistical significance (P=0.698). CONCLUSIONS:The risk of cerebral bleeding increase in patients with ischemic cerebrovascular disease complicating with CMBs after the application of antiplatelet agent. For patients with ischemic cerebrovascular disease complicating with CMBs,the application of antiplatelet agent should be based on the complete judgment and weighing of benefit and bleeding risk.

Assessment value of multimodal CT for cerebral collateral circulation in ischemic stroke / 中国脑血管病杂志

Objective To investigate the assessment value of multimodal CT examination for collateral circulation after cerebral ischemia. Methods Within 3 days of admission,39 patients with ischemic stroke received multimodal CT examinations,including CT scan,CT perfusion (CTP)imaging,and CT angiography (CTA). The postprocessing software of the German SIEMENS 64-slice spiral CT system was used to evaluate the state of brain tissue perfusion and the conditions of head blood vessels of the subjects. The cerebral blood flow(CBF),cerebral blood volume(CBV),mean transit time(MTT),time to peak(TTP) and the score of the modified Rankin scale (mRS)in the 90 d after discharge were compared between the patients with good collateral circulation and poor collateral circulation. Results Among 39 patients, multimodal CT examination revealed that 2 patients were negative,one of them was followed up by head MR and was clinically proven as transient ischemic attack,and the other was lacunar infarction. Thirty-seven patients were positive. Multimodal CT examination found 24 patients had offending vessels occlusion and/or stenosis on the lesion sides,the collateral circulation formation in 11 of them was observed on the lesion sides;another 13 patients had poor collateral circulation on the lesion sides. The comparison of lesion sides and contralateral sides,the patients with good collateral circulation showed the CBF decreased (t= -5. 92),the MTT and TTP prolonged (t=4. 27 and 3. 17 respectively). There were significant differences (all P<0. 01). The CBV and CBF in patients with poor collateral circulation were decreased significantly (t= -14.27 and-14.82 respectively),MTT and TTP prolonged (t=7. 26 and 7. 54 respectively). There were significant differences (all P <0. 01). There were significant differences in CBF,CBV,and TTP on the lesion sides between the two groups of patients (t=3. 24,4. 11,and -2. 34,respectively;all P<0. 05). The 90 d mRS scores for patients with good collateral circulation and poor collateral circulation were 1. 3 ± 0.6 and 4. 0 ± 0. 9 respectively. There was significant difference (t = -8. 29,P <0. 01). The patients of having collateral circulation formation had good prognosis. Conclusion Multimodal CT examination has certain clinical significance for evaluation of cerebral perfusion state,understanding the establishment or patency of cerebral collateral circulation,and determining the clinical prognosis.

CORRELATION BETWEEN SERUM hs-CRP LEVELS AND MR IMAGING IN ISCHEMIC CEREBROVASCULAR PATIENTS / 现代医院

Objective To analyze the correlation between serum hs -CRP levels and MR Imaging in ischemic cerebrovascu-lar patients.To explore the hs -CRP serum levels in ischemic cerebrovascular patients incidence of early diagnosis and prognosis e-valuation application value.Methods 300 cases of ischemic cerebrovascular disease as the research object were selected from May 2013 to December 2014.The disease is classified into acute cerebral infarction group 100 cases, acute phase of cerebral infarction group 140 cases and transient ischemic attack 60 cases.Among 100 cases of patients with acute cerebral infarction group, in accord-ance with the MR Imaging data, they can be subdivided into three groups.Group A: lacunar infarction group 28 cases; Group B:small area of infarction group 50 cases and group C: large area of infarction group 22 cases.Another 40 healthy physical examination were selected as control group.The hs -CRP serum levels were made correlation analysis with MR Imaging.Results The acute cerebral infarction and transient ischemic attack group serum hs -CRP level difference compared with the control group with statisti-cal significance (p<0.05); The SPSS Spearman correlation analysis result shows that the hs -CRP serum levels and MR Imaging data shown in the infarction area and the body has a direct correlation .Conclusion The ischemic cerebrovascular disease patients se-rum hs-CRP level with MR Imaging have shown increased infarct size and raise.Damage area is bigger, and the corresponding serum hs-CRP levels changes more violently.

Correlation between psychological flexibility and anxiety,depression in patients with ischemic cerebrovascular disease / 重庆医学

Objective To explore the relationship of psychological flexibility and the anxiety ,depression in ischemic cerebrovas‐cular disease (ICVD) patients .Methods Two hundred cases of ischemic cerebrovascular disease were collected ,and their anxiety and depression level and psychological flexibility were measured by self‐evaluation of anxiety scale (SAS) ,self‐evaluation of depres‐sion scale (SDS) ,acceptance and action questionnaire‐Ⅱ (AAQ‐Ⅱ ) and cognitive fusion questionnaire (CFQ ) .According to the test results ,the patients with anxiety and depression were divided into different degree :degrees :normal ,mild ,moderate or severe . Results The AAQ‐Ⅱ and CFQ of the patients with anxiety depression were significantly higher than normal emotional ICVD pa‐tients (P<0 .01);there were statistical significance in the difference of the level of AAQ‐Ⅱ and CFQ and the degree of anxiety and depression in these patients (P<0 .01);the level of AAQ‐Ⅱ and the degree of anxiety depression was positively correlated (r=0 .778 ,P<0 .01 ;r=0 .759 ,P<0 .01);the level of CFQ and the degree of anxiety depression was positively correlated (r=0 .785 , P<0 .01 ;r=0 .774 ,P<0 .01);with SAS ,SDS ,as dependent variable ,the AAQ‐Ⅱ ,CFQ as independent variables ,through multiple linear regression analysis ,suggested that psychological flexibility was the impact factor of anxiety depression .Conclusion For pa‐tients with ICVD ,psychological flexibility is closely related to the degree of anxiety depression .Psychological flexibility is one of the predictor of anxiety depression .