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1.
Chinese Journal of Trauma ; (12): 558-569, 2023.
Article in Chinese | WPRIM | ID: wpr-992635

ABSTRACT

Severe traumatic brain injury (sTBI) is characterized by critical condition, high lethality and poor prognosis. Its development and progression will lead to the damage and death of a large number of nerve cells, eventually causing a series of serious complications. The current treatments of sTBI and its complications are not optimistic due to problems such as unclear mechanism of action, challenges in treatment, and lack of effective prevention strategies. In recent years, more research evidences have shown that oxidative stress plays an important role in the development and progression of sTBI and its related complications. Therefore, it is of great significance to clarify the relationship of oxidative stress with sTBI and its complications and to understand the way of oxidative stress participating in the development and progression of sTBI. However, relevant researches are scattered and there lacks comprehensive and systematic summaries of oxidative stress participating in sTBI and its related complications. To this end, the authors reviewed the progress of the mechanism by which oxidative stress involves in sTBI and its complications, hoping to provide references for the research, treatment and prevention of sTBI.

2.
Journal of Chinese Physician ; (12): 850-854, 2023.
Article in Chinese | WPRIM | ID: wpr-992388

ABSTRACT

Objective:To explore the correlation between the expression level of the serum CircRNA_ 0005853 and cognitive impairment in elderly patients with acute cerebral infarction (ACI).Methods:A total of 120 elderly patients with ACI admitted to Haikou Third People′s Hospital from January 2019 to March 2022 were retrospectively selected. According to the Montreal Cognitive Assessment (MoCA) score of the patients 4 weeks after treatment, they were divided into a cognitive impairment free group (MoCA score≥26, 55 cases) and a cognitive impairment group (MoCA score<26, 65 cases). The cognitive impairment group was redivided into mild group (MoCA score 21-25, 16 cases), moderate group (MoCA score 15-20, 38 cases), and severe group (MoCA score<15, 11 cases) based on the severity of cognitive impairment. The serum CircRNA_0005853 expression level of each group was compared. multivariate logistic regression analysis was applied to identify the risk factors for cognitive impairment after ACI. A receiver operating characteristic (ROC) curve was drown to analyze the value of CircRNA_0005835 expression level in predicting cognitive impairment. Using Pearson correlation analysis, the correlation between the expression level serum CircRNA_0005835 and MoCA score in patients with cognitive impairment was analyzed.Results:There were statistically significant differences in age, infarct size, and triglycerides between the cognitive impairment group and the non cognitive impairment group (all P<0.05). The MoCA score of the cognitive impairment group was lower than that of the non cognitive impairment group [(19.62±2.73)points vs (28.10±1.05)points, P<0.001]. The expression level of Serum CircRNA_0005835 in the cognitive impairment group was higher than that of the non cognitive impairment group (2.48±1.02 vs 1.25±0.46, P<0.001), and in the severe group, the expression level of the serum CircRNA_0005835 (2.90±1.26) was higher than that of the moderate group (1.87±0.84) and the mild group (0.92±0.35) ( P<0.001). Multivariate logistic regression analysis shew that age ( OR=1.662, 95% CI: 1.140-2.873), infarct size>3.0 cm 2 ( OR=1.853, 95% CI: 1.317-4.112), and CircRNA_0005835 ( OR=2.217, 95% CI: 1.635-5.540) were risk factors for cognitive impairment after ACI. The area under the curve (AUC) of CircRNA_0005835 expression level predicting cognitive impairment was 0.837(95% CI: 0.779-0.894), with a sensitivity of 80.2% and a specificity of 83.7%. The AUC of CircRNA_0005835 expression level predicting cognitive impairment was 0.837(95% CI: 0.779-0.894), with a sensitivity of 80.2% and a specificity of 83.7%. The correlation analysis shew that the expression level of serum CircRNA_0005835 in elderly ACI patients was negatively correlated with MoCA score ( r=-0.773, P<0.001). Conclusions:The increased expression level of serum CircRNA_0005853 is related to the occurrence and development of cognitive dysfunction after elderly ACI, and has certain value in predicting cognitive dysfunction.

3.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 486-491, 2023.
Article in Chinese | WPRIM | ID: wpr-991771

ABSTRACT

Objective:To investigate the effects of intravenous thrombolysis combined with Xingnaojing injection on hemodynamic indexes and neurological function in patients with cerebral infarction. Methods:A total of 142 patients with cerebral infarction who were treated in Xing An Meng Hospital from April 2020 to May 2021 were included in this study. They were randomly divided into a control group ( n = 71, intravenous thrombolysis) and a Xingnaojing injection group ( n = 71, intravenous thrombolysis + Xingnaojing injection). Intracranial arterial hemodynamic indexes, National Institutes of Health Stroke Scale score, Fugl-Meyer Assessment Scale score, serum inflammatory factors, oxidative stress indexes, brain injury markers, and the incidence of adverse reactions were compared between the two groups. Results:After treatment, serum levels of interleukin-1β, interleukin-6, and tumor necrosis factor-α were significantly lower in the Xingnaojing injection group than the control group [interleukin-1β: (4.05 ± 0.83) ng/L vs. (6.85 ± 1.02) ng/L, interleukin-6: (43.61 ± 5.14) ng/L vs. (60.31 ± 7.04) ng/L, tumor necrosis factor-α: (35.93 ± 4.25) ng/L vs. (20.93 ± 3.11) ng/L, t = 17.94, 16.14, 15.37, all P < 0.001]. After treatment, the mean blood flow velocities of the anterior cerebral artery, middle cerebral artery, and posterior cerebral artery in the Xingnaojing injection group were significantly higher than those in the control group [anterior cerebral artery: (49.36 ± 5.28) cm/s vs. (41.15 ± 5.12) cm/s, middle cerebral artery: (61.27 ± 7.02) cm/s vs. (50.19 ± 6.08) cm/s, posterior cerebral artery: (44.92 ± 5.63) cm/s vs. (37.26 ± 4.93) cm/s, t = 9.40, 10.05, 8.62, all P < 0.001]. After treatment, the National Institutes of Health Stroke Scale score and Fugl-Meyer Assessment Scale score in the Xingnaojing injection group were superior to those in the control group [National Institutes of Health Stroke Scale score: (10.36 ± 1.52) points vs. (14.62 ± 2.05) points, Fugl-Meyer Assessment Scale score: (76.19 ± 8.08) points vs. (65.28 ± 7.14) points, t = 14.06, 8.52, both P < 0.05]. After treatment, the serum level of malondialdehyde in the Xingnaojing injection group was significantly higher than that in the control group [(6.35 ± 1.02) μmol/L vs. (10.05 ± 1.63) μmol/L), t = 16.21, P < 0.001]. The serum level of superoxide dismutase in the Xingnaojing injection group was significantly lower than that in the control group [(114.31 ± 13.69) U/L vs. (92.25 ± 10.16) U/L), t = 10.90, P < 0.001]. Serum levels of neuron-specific enolase and S100β in the Xingnaojing injection group were significantly lower than those in the control group [neuron-specific enolase: (24.01 ± 3.24) IU/L vs. (30.31 ± 4.02) IU/L, S100β: (0.73 ± 0.17) ng/L vs. (1.13 ± 0.22) ng/L, t = 10.28, 12.12, both P < 0.001). There was a significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Intravenous thrombolysis combined with Xingnaojing injection for the treatment of cerebral infarction can improve intracranial hemodynamics, reduce the inflammatory response and oxidative stress, and alleviate brain tissue injury. The combined therapy is beneficial to protect the neurological function of patients with cerebral infarction and is highly safe.

4.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 428-432, 2023.
Article in Chinese | WPRIM | ID: wpr-991767

ABSTRACT

Objective:To investigate the effects of butylphthalide combined with ozagrel sodium on the National Institutes of Health Stroke Scale (NIHSS) score, activities of daily living (ADL) score, and coagulation function in patients with acute cerebral infarction.Methods:Ninety-four patients with acute cerebral infarction who were admitted to Gujiao Medical Group Central Hospital from January 2019 to November 2021 were included in this study. They were randomly assigned to undergo treatment with either ozagrel sodium (control group, n = 47) or butylphthalide combined with ozagrel sodium (observation group, n = 47) for 14 consecutive days. Before and after treatment, NIHSS score, ADL score, coagulation function (thrombin time, prothrombin time, D-dimer, activated partial thrombin time), bilateral middle cerebral artery blood flow status (mean blood flow velocity (Vm), resistance index, pulsatility index), brain tissue damage factor (brain natriuretic peptide, neuron-specific enolase, S100 β protein) and the incidence of adverse drug reactions were compared between the two groups. Results:Before treatment, there were no significant differences in NIHSS and ADL scores between the two groups (both P > 0.05). After treatment, the NIHSS score was significantly lower in the observation group than that in the control group [(8.70 ± 1.62) points vs. (9.45 ± 1.2) points, t = 2.51, P < 0.05]; the ADL score was significantly higher in the observation group than that in the control group [(65.15 ± 7.41) points vs. (61.20 ± 6.32) points, t = 2.78, P < 0.05]. Before treatment, there were no significant differences in thrombin time, prothrombin time, D-dimer, and activated partial thrombin time between the two groups (all P > 0.05). After treatment, thrombin time, prothrombin time, and activated partial thrombin time were significantly higher in the observation group than those in the control group ( t = 4.34, 3.00, 2.63, all P < 0.05). After treatment, D-dimer level in the observation group was significantly lower than that in the control group ( t = 3.39, P < 0.05). Before treatment, mean blood flow velocity, resistance index, and pulsatility index were similar between the two groups (all P > 0.05). After treatment, the mean blood flow velocity in the observation group was significantly higher than that in the control group ( t = 3.23, P < 0.05). The pulsatility index and resistance index were significantly lower in the observation group than those in the control group ( t = 2.14, 3.16, both P < 0.05). Before treatment, there were no significant differences in brain natriuretic peptide, neuron-specific enolase, and S100 β protein levels between the two groups (all P > 0.05). After treatment, brain natriuretic peptide, neuron-specific enolase, and S100 β protein levels in the observation group were significantly lower than those in the control group ( t = 3.09, 2.18, 3.33, all P < 0.05). There was no significant difference in incidence of adverse reactions between the observation and control groups [6.38% (3/47) vs. 2.13% (1/47), P > 0.05]. Conclusion:Butylphthalide combined with ozagrel sodium for the treatment of acute cerebral infarction can reduce neurological dysfunction and brain tissue injury, and improve coagulation function, hemodynamic state of the middle cerebral artery, and activities of daily life, without increasing adverse reactions.

5.
Chinese Journal of Postgraduates of Medicine ; (36): 494-498, 2023.
Article in Chinese | WPRIM | ID: wpr-991043

ABSTRACT

Objective:To investigate the efficacy and adverse reactions of ticagrelor combined with atorvastatin in the treatment of acute cerebral infarction (ACI).Methods:A total of 80 patients with ACI who were diagnosed and treated in Anhui Suixi County Hospital from October 2021 to October 2022 were selected retrospectively and randomly divided into the control group and observation group, each group with 40 cases. The patients in the control group were treated with routine basic treatment and atorvastatin for ACI. The patients in the observation group was treated with ticagrelor on the basis of the control group. The clinical efficacy, neurological function, daily living ability, platelet function (platelet count, platelet inhibition rate), inflammatory factors including high sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6) and adverse reactions of the two groups were compared.Results:The total effective rate of the observation group was higher than that of the control group: 92.50%(37/40) vs. 72.50% (29/40), there was statistical differences ( P<0.05). After treatment, the score of National Institute of Health Stroke Scale of the observation group was lower than that of the control group: (9.37 ± 2.91) points vs. (14.20 ± 3.39) points, and the score of Barthel index scale (BI) was higher than that of the control group: (72.26 ± 13.27) points vs. (58.93 ± 9.43) points, there were statistical differences ( P<0.05). After treatment, the platelet count and platelet adenosine diphosphate (ADP) inhibition rate of the observation group were higher than those of the control group: (284.65 ± 41.58) × 10 9/L vs. (210.46 ± 36.12) × 10 9/L, (79.43 ± 16.42)% vs. (62.40 ± 13.95)%, there were statistical differences ( P<0.05). After treatment, the serum hs-CRP and IL-6 levels of the observation group were lower than those of the control group: (11.64 ± 2.96) mg/L vs. (19.75 ± 4.57) mg/L, (4.26 ± 0.93) ng/L vs. (8.95 ± 1.83) ng/L, there were statistical differences ( P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups after treatment ( P>0.05). Conclusions:Ticagrelor combined with atorvastatin has a better therapeutic effect on ACI, which can effectively improve the neurological deficit and the ability of self-care.

6.
Chinese Journal of Postgraduates of Medicine ; (36): 159-163, 2023.
Article in Chinese | WPRIM | ID: wpr-990983

ABSTRACT

Objective:To explore the predictive values of serum monocyte chemoattractant protein-1 (MCP-1), high mobility protein B1 (HMGB1), adiponectin (APN) and oxidized low density lipoprotein (ox-LDL) levels on poor prognosis of patients with acute cerebral infarction(ACI).Methods:One hundred and sixty-fivepatients with ACI in Zibo Hospital, Shandong Guoxin Nursing Group from October 2018 to December 2020 were selected as the observation group, and 147 healthy people in the same period were selected as the normal control group. The levels of serum MCP-1, HMGB1, APN and ox-LDL were detected. In addition, the observation group was followed up for 3 months after discharge, and the observation group was divided into good prognosis group and poor prognosis group by modified Rankin Scale score. The levels of serum MCP-1, HMGB1, APN and ox-LDL between the poor prognosis group and the good prognosis group were compared. The influencing factors of poor prognosis in patients with ACI and the predictive value of serum MCP-1, HMGB1, APN and ox-LDL levels on poor prognosis were analyzed by Logistic multiple regression analysis and receiver operating characteristic (ROC) curve.Results:The levels of serum MCP-1, HMGB1 and ox-LDL in the observation group were higher than those in the normal control group: (322.61 ± 65.27) ng/L vs. (163.18 ± 15.12) ng/L, (6.61 ± 3.54) μg/L vs. (2.90 ± 0.41) μg/L, (481.11 ± 177.67) mg/L vs. (247.47 ± 27.13) mg/L; but the level of serum APN was lower than that in the normal control group: (10.63 ± 3.80) μg/L vs. (17.65 ± 2.87) μg/L, there were statistical differences ( P<0.05). After 3 months of follow-up, the incidence rate of poor prognosis in the observation group was 35.15%(58/165). The serum levels of MCP-1, HMGB1 and ox-LDL in the poor prognosis group were higher than those in the good prognosis group: (372.15 ± 71.33) ng/L vs. (295.76 ± 42.23) ng/L, (9.74 ± 3.96) μg/L vs. (4.91 ± 1.62) μg/L, (631.03 ± 196.84) mg/L vs. (399.85 ± 95.07) mg/L; but the serum APN level was lower than that in the good prognosis group: (7.62 ± 2.83) μg/L vs. (12.27 ± 3.22) μg/L, there were statistical differences ( P<0.05). The results of Logistic multiple regression analysis showed that age, hypertension, hyperlipidemia, infarct volume, nerve function defect score, time from onset to treatment and MCP-1, HMGB1, APN and ox-LDL levels were the influencing factors of poor prognosis in patients with ACI ( P<0.05). The results of ROC curve analysis showed that the sensitivity and area under the curve of serum MCP-1, HMGB1, APN and ox-LDL levels in combined predicting the poor prognosis were 98.28% and 0.954, which were higher than the single index evaluation ( P<0.05). Conclusions:The serum levels of MCP-1, HMGB1 and ox-LDL are closely related to the prognosis of ACI patients, and all of them have a certain predictive value for the poor prognosis of patients, but the combined prediction efficiency of four items is more higher.

7.
Chinese Journal of Practical Nursing ; (36): 1396-1402, 2023.
Article in Chinese | WPRIM | ID: wpr-990349

ABSTRACT

Objective:To observe the level of mindfulness and coping style in patients with acute cerebral infarction (ACI) after interventional therapy, and analyze the intermediary effect of benefit finding between them, so as to provide a theorectical basis of implement mindfulness intervention in clinical practice.Methods:The 130 patients with ACI after interventional treatment in the First Affiliated Hospital of Zhengzhou University from October 2019 to October 2021 were included in this cross-sectional survey study. The general data questionnaire, Five-factor Mindfulness Scale (FFMQ), Benefit Finding Rating Scale (BFS), and Simple Coping Style Questionnaire (SCSQ) were used to analyze the relationship between benefit finding, mindfulness level and coping style, and the intermediary effect of benefit finding between them.Results:The total FFMQ score of 130 ACI patients after interventional therapy was (123.34 ± 5.14) points. The BFS score, positive coping score and negative coping score were (49.73 ± 3.41), (20.35 ± 2.25), (13.18 ± 1.45) points, respectively. The level of mindfulness and benefit were positively correlated with positive coping ( r=0.687, 0.737, both P<0.05). The level of mindfulness and benefit were negatively correlated with negative coping( r=-0.654, -0.779, both P<0.05). It was found that mindfulness level played a partial intermediatory effect on positive coping and negative coping in ACI patients after interventional therapy, with contribution rates of 49.71% and 64.58%, respectively. Conclusions:Benefit finding plays a partial intermediary effect on the level of mindfulness and coping style of patients with ACI after interventional therapy.

8.
Chinese Journal of Practical Nursing ; (36): 908-914, 2023.
Article in Chinese | WPRIM | ID: wpr-990272

ABSTRACT

Objective:To construct a sensitive index system of nursing quality for patients with acute ischemic stroke patients undergoing interventional thrombectomy, so as to provide a scientific basis for interventional thrombectomy care for acute ischemic stroke.Methods:Taking the "structure-process-result" three-dimensional quality model as the theoretical framework, through evidence-based literature search, the item pool was drawn up, and finally the indicators and their weights at each level were determined by two rounds of Delphi method in December 2021 and January 2022 and analytic hierarchy process.Results:The positive coefficients of the two rounds of inquiries to experts were 0.92 and 1.00, respectively, the authority coefficients were 0.913 and 0.917, and the Kendall coefficients were 0.141 and 0.202, respectively. The final index system consisted of 3 primary indicators, 9 secondary indicators and 50 three-level indicators.Conclusions:The nursing sensitive quality index system for patients with acute stroke patients undergoing interventional thrombectomy constructed in this study has high reliability and scientificity, which can provide target incentives for clinical nurses and provide reference for the development of specialized nursing sensitive quality indicators.

9.
International Journal of Traditional Chinese Medicine ; (6): 755-759, 2023.
Article in Chinese | WPRIM | ID: wpr-989701

ABSTRACT

Objective:To systematically evaluate the clinical efficacy and safety of Xixian Tongshuan Capsules/Pills combined with Western medicine in treating cerebral infarction.Methods:All RCTs about Xixian Tongshuan Capsules/Pills combined with Western medicine in treating cerebral infarction were retrieved from CNKI, Wanfang Database, VIP database, PubMed and CBM. The search period was from the database establishment to December 31, 2021. Two researchers independently extracted the basic literature data and evaluated the methodological quality, then used RevMan5.4 software for meta-analysis.Results:Totally 9 articles were included, involving a total of 988 patients, including 505 cases in the observation group and 483 cases in the control group. Meta-analysis showed that the total effective rate of Xixian Tongshuan Capsules/Pills combined with Western medicine in treating cerebral infarction was higher than that of conventional Western medicine [ RR=1.20, 95% CI (1.13, 1.27), P<0.05]. At the same time, the effect of NIHSS score, Barthel score and FIB were better than those of conventional Western medicine [respectively: MD=-3.21, 95% CI (-4.45, -1.97), P<0.05; MD=11.83, 95% CI (10.66, 13.00), P<0.05; MD=-0.95, 95% CI (-1.36, -0.54), P<0.05]. After treatment with Xixian Tongshuan Capsules/Pills combined with Western medicine, the adverse reactions mainly included dizziness, nausea, indigestion, rash, facial blushing, etc. There was no statistically significant difference in safety between the two groups [ RR=1.50, 95% CI (0.75, 3.01), P>0.05]. Conclusions:Under the treatment of conventional Western medicine, the addition of Xixian Tongshuan Capsules/Pills can improve the clinical efficacy of cerebral infarction treatment, effectively improve the symptoms of neurological impairment, improve the ability of daily life, and promote the prognosis and recovery, and without increasing the incidence of adverse reactions. However, large sample and high quality studies are still needed to support the conclusion.

10.
International Journal of Traditional Chinese Medicine ; (6): 543-547, 2023.
Article in Chinese | WPRIM | ID: wpr-989673

ABSTRACT

Objective:To explore the effect of Qixian Tongluo Prescription fumigation on nerve function and rehabilitation effect in patients with hemiplegia after cerebral infarction of qi-deficiency blood stasis syndrome.Methods:Randomized controlled trial. Sixty-eight patients with hemiplegia after cerebral infarction of qi-deficiency blood stasis syndrome in the hospital were enrolled between October 2020 and December 2021. According to random odd-even numbering method, participants were divided into the control group (routine western medicine) and the observation group (Qixian Tongluo Prescription fumigation on basis of control group), 34 in each group. All were continuously treated for 8 weeks. TCM syndromes were scored before and after treatment. The severity of neurological impairment was evaluated by National Institutes of Health Stroke Scale (NIHSS). The severity of limb movement disorder was evaluated by Fugl-Meyer Assessment (FMA). The levels of central nervous specific protein (S-100β), neuron-specific enolase (NSE), endothelin (ET), nitric oxide (NO), C-reactive protein (CRP) and superoxide dismutase (SOD) were detected by ELISA. The clinical response rate was assessed.Results:There were significant differences in total response rate between the observation group and the control group [94.12% (32/34) vs. 76.47% (26/34); χ2=4.22, P=0.040]. After treatment, scores of hemiplegia, shortness of breath, palpitation and limbs swelling in observation group were significantly lower than those in the control group ( t=3.44, 2.37, 2.72, 3.89, P<0.05 or P<0.01), NIHSS score was significantly lower than that of the control group ( t=6.56, P<0.01), and FMA scores of upper and lower limbs were significantly higher than those in the control group ( t=2.17, 2.78, P<0.05). After treatment, levels of serum S-100β [(0.69±0.27) μg/L vs. (0.85±0.36) μg/L, t=2.07], NSE [(8.36±3.69) μg/L vs. (11.34±4.93) μg/L, t=2.82] and ET [(53.16±12.12) ng/L vs. (61.25±11.31) ng/L, t=2.85] in observation group were significantly lower than those in the control group ( P<0.05 or P<0.01), while NO [(82.26±14.53) μmol/L vs. (70.16±12.27) μmol/L, t=3.71] was significantly higher than that of the observation group ( P<0.01). The level of serum CRP in observation group was significantly lower than that of the control group ( t=2.74, P<0.01), and SOD activity was significantly higher than that of the control group ( t=2.49, P<0.05). Conclusion:Qixian Tongluo Prescription fumigation can promote the recovery of nerve function and vascular endothelial function in patients with hemiplegia after cerebral infarction, improve limb disorders and clinical effect.

11.
International Journal of Traditional Chinese Medicine ; (6): 81-89, 2023.
Article in Chinese | WPRIM | ID: wpr-989594

ABSTRACT

Objective:To explore the mechanism of Fuyuan Xingnao Decoction in treatment of cerebral infarction based on network pharmacology and molecular docking.Methods:The active components and action targets of Fuyuan Xingnao Decoction were screened by using Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP),Traditional Chinese Medicine Integrated Database (TCMID),Bioactivity data of small organic molecules (PubChem),Universal Protein (Uniprot) and Swiss Target Prediction database platform. The databases of GeneCards, Online Mendelian Inheritance in Man (OMIM), Therapeutic Target Database (TTD), and Drug Bank and Pharmacogenomics Knowledgebase (PharmGKB) were used to screen targets of cerebral infarction. The drug target genes in Fuyuan Xingnao Decoction were intersected with those of cerebral infarction, the intersecting targets were introduced into Cytoscape 3.8.2 software to construct the component target network, and the PPI protein interaction network was constructed by using STRING analysis platform and Cytoscape 3.8.2 software to screen the core targets. Gene Ontology (GO) function enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) function enrichment analysis were carried out on the common target genes of Fuyuan Xingnao Decoction and cerebral infarction disease to obtain the relevant signal pathways. Finally, AutoDock and Pymol software were used for molecular docking between the predicted target and its corresponding components.Results:After screening, 80 effective components of Fuyuan Xingnao Decoction for treatment of cerebral infarction and 214 common targets of Fuyuan Xingnao Decoction and cerebral infarction were obtained. The core targets such as MAPK1, RELA, TP53, JUN, AKT1 and HSP90AA1 were related to the key targets of cerebral infarction, and they participated in the biological process of regulating the response to drugs, lipopolysaccharide and oxygen level, etc. The cell composition involved membrane raft, membrane micro region and nerve cell body, etc. Molecular functions mainly focused on nuclear receptor activity, ligand activated transcription factor activity, DNA binding transcription factor binding, etc.; it also involved in signal pathway of lipid and atherosclerosis, chemical carcinogen and receptor activation, fluid shear stress and atherosclerosis, etc. Molecular docking showed that good binding activities were seen between Quercetin and HSP90AA1 (-9.4 kJ/mol), between Kaempferol and HSP90AA1 (-9.4 kJ/mol), between Isorhamnetin and HSP90AA1 (-9.1 kJ/mol), and between Quercetin and JUN (-8.6 kJ/mol).Conclusion:Fuyuan Xingnao Decoction can prevent and treat cerebral infarction by regulating vascular endothelial function, promoting blood circulation, repairing and improving neural function, protecting blood-brain barrier, reducing cell apoptosis, and regulating immune and inflammatory response.

12.
Chinese Journal of Perinatal Medicine ; (12): 53-58, 2023.
Article in Chinese | WPRIM | ID: wpr-995063

ABSTRACT

Objective:To summarize the clinical characteristics of neonatal cerebral infarction and its risk factors, so as to provide a reference for clinical diagnosis and early prevention of the disease.Methods:This study retrospectively analyzed the demographic data, clinical manifestations and brain imaging features of neonates with cerebral infarction ( n=45) admitted to the Department of Neonatal Critical Care Medicine of the Affiliated Children's Hospital of Xi'an Jiaotong University from June 2012 to July 2020. Ninety newborns without cerebrovascular disease matched for date of birth and gestational age were selected as the control. Two independent sample t-test, rank-sum test, Chi-square or corrected Chi-square test were used for univariate analysis and binary logistic regression were applied for analyzing the risk factors for neonatal cerebral infarction. Results:A total of 45 infants with clinically diagnosed neonatal cerebral infarction were enrolled, including eight small for gestational age and three macrosomia infants. The median age at disease onset was 1 d (1-2 d). There were 71% (32/45) presenting with convulsions as the first symptom, 4% (2/45) admitted with apnea and respiratory distress as the chief complaints, respectively,11% (5/45) having poor response and 9% (4/45) showing no obvious clinical manifestations. Cranial MRI and magnetic resonance angiography identified left hemisphere lesion in 25 cases (56%), right hemisphere lesion in 16 (36%) and both in four (9%). Thalamus and basal ganglia were involved in 11 cases. The lesions were supplied by middle cerebral artery [38% (17/45)], anterior cerebral artery ( n=1), posterior cerebral artery ( n=4), anterior and middle cerebral arteries ( n=4), middle and posterior cerebral arteries ( n=16), or anterior, middle and posterior cerebral arteries ( n=3). Univariate analysis showed that the proportions of small for gestational age [18% (8/45) vs 6% (5/90), χ 2=5.15], cesarean section after failure of trial of labor [18% (8/45) vs 1% (1/90), χ 2=10.85], meconium stained amniotic fluid [33% (15/45) vs 9% (8/90), χ 2=12.68], fetal distress [20% (9/45) vs 3% (3/90), χ 2=8.34] and neonatal asphyxia [16% (7/45) vs 2% (2/90), χ 2=6.56] were all higher in the infarcted infants than those in the control (all P<0.05). Binary logistic regression analysis revealed that small for gestational age ( OR=3.981, 95% CI: 1.075-14.742, P=0.039), cesarean section after failure of trial of labor ( OR=17.959, 95% CI: 2.032-158.698, P=0.009) and fetal distress ( OR=5.756, 95% CI: 1.129-29.331, P=0.035) were independent risk factors for neonatal cerebral infarction. Conclusions:Most neonates with cerebral infarction would have convulsions initially, while some are asymptomatic. Middle cerebral arteries are often involved in the lesion. The risk of this disease may be increased in small for gestational age infants, cesarean section after failure of trial of labor and fetal distressed cases.

13.
Chinese Journal of Neurology ; (12): 654-660, 2023.
Article in Chinese | WPRIM | ID: wpr-994877

ABSTRACT

Objective:To characterize clinical and neuroimaging features, etiologies, and mechanisms of bilateral middle cerebellar peduncle (MCP) infarctions.Methods:Consecutive patients with bilateral MCP infarctions treated in the Beijing Tiantan Hospital, Capital Medical University between January 1, 2020 and April 30, 2022 were enrolled in this retrospective study. The demographic data, vascular risk factors, clincial manifestations and the National Institutes of Health Stroke Scale (NIHSS) scores were collected. Brain diffusion-weighted imaging was used to assess the regions of cerebral infarction, and the extracranial and intracranial segments of the vertebrobasilar artery were evaluated using magnetic resonance angiography, or computed tomography angiography. The stroke etiology and underlying mechanism were evaluated according to the Chinese Ischemic Stroke Subclassification.Results:Ten patients with bilateral MCP infarctions (8 men and 2 women) were analyzed ultimately. The onset age were 51.0-86.0 (64.8±11.4) years. NIHSS scores were 2.0-12.0 (4.9±2.9) points at admission. All patients had vascular risk factors, most of which were hypertension (10 cases) and dyslipoproteinemia (8 cases). The most common clinical manifestations were vertigo (10 cases), followed by ataxia (9 cases) and dysarthria (8 cases). Four cases were isolated bilateral MCP infarctions, while 6 patients were combined with other vertebrobasilar artery infarctions, 4 of which were combined with cerebellar hemisphere infarctions, consistent with the clinical symptoms. The etiology in all patients was large atherosclerosis (severe stenosis or occlusion of V4 segment of vertebral artery and anterior inferior cerebellar artery; 9 cases). Five patients were classified as hypoperfusion/impaired emboli clearance, while 4 patients were considered as artery-to-artery embolism, and 1 was considered as the parent artery (plaque or thrombosis) occluding penetrating artery.Conclusions:Bilateral MCP infarctions are an extremely rare cerebrovascular disease characterized by vertigo, ataxia, and dysarthria. Cerebral infarction can be isolated or often combined with cerebellar hemisphere infarction. The etiology was mostly stenosis or occlusion of V4 segment of vertebral artery and anterior inferior cerebellar artery.

14.
Chinese Journal of Internal Medicine ; (12): 1121-1125, 2023.
Article in Chinese | WPRIM | ID: wpr-994420

ABSTRACT

Objective:To analyze the clinical and imaging features of patients with sudden sensorineural deafness and acute cerebral infarction in order to provide evidence for early recognition of such diseases.Methods:This was a case series reporting study. A retrospective analysis was performed on the clinical and imaging data of 29 patients with sudden hearing loss (SHL) who admitted to the Otolaryngology Head and Neck Surgery Department of Beijing Tiantan Hospital from January 2017 to December 2021 and diagnosed with acute cerebral infarction using MRI-DWI.Results:The patients were aged 31-71 years, with an average age of 56±12 years, and 82.8% (24/29) were men. In total, 82.8% (24/29) of the patients had three or more atherosclerotic risk factors, and 24.1% (7/29) had a history of SHL. The hearing types were flat and total deafness: 86.2% (25/29) of the patients had severe hearing loss, 27.6% (8/29) had bilateral SHL, 17.2% (5/29) had further hearing loss during hospitalization, and 82.8% (24/29) had dizziness or vertigo at the onset. The signs of central nervous system involvement mainly included speech impairment, diplopia, dysphagia, central facial paralysis, facial and limb hypoesthesia, ataxia, and decreased muscle strength. Imaging evaluation showed that 21 cases were located in the posterior circulation supply area and 8 cases in the anterior circulation supply area. Additionally, 82.8% (24/29) patients had vertebrobasilar artery stenosis, and 58.6% (17/29) patients had severe vertebrobasilar artery stenosis or occlusion.Conclusions:Patients with SHL who progress to cerebral infarction often have multiple atherosclerotic risk factors and SHL. Most of the patients are middle-aged and older men who often complain of dizziness or dizziness accompanied by severe flat and total deafness with unilateral or bilateral SHL. Imaging findings suggest that most patients have posterior circulation infarction, often accompanied by severe stenosis or occlusion of the vertebrobasilar artery.

15.
Arq. neuropsiquiatr ; 80(10): 985-993, Oct. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1420224

ABSTRACT

Abstract Background Brain natriuretic peptide (BNP) and troponin have a close relationship with cardiogenic cerebral embolism (CCE), but their relationship with noncardiogenic patients with anterior circulation ischemia (ACI) and posterior circulation ischemia (PCI) is not clear. Objective To explore the predictive value of serum initial BNP and troponin on the functional prognosis of patients with noncardiogenic ACI and PCI. Methods Consecutive patients with first-episode cerebral infarction within 12 hours of symptom onset were enrolled in the present 1-year prospective cohort study. Serum levels of BNP and troponin were collected within 12 hours of onset. Infarction location was classified as ACI and PCI by magnetic resonance imaging (MRI). According to the modified Rankin Scale (mRS) score at 90 days after onset, ACI and PCI cases were respectively divided into a good prognosis group (mRS score between 0 and 2) and a poor prognosis group (mRS score between 3 and 6). The general state of health and results of laboratory examinations and other auxiliary examinations of all patients were recorded. Single-factor analysis and multivariate logistic regression analysis were used to assess the relationship between serum levels of BNP, troponin, and functional outcome. Results The multivariate logistic regression found that higher levels of initial BNP (odds ratio [OR] = 1.024; 95% confidence interval [CI]: 1.006-1.041; p = 0.007) and C-reactive protein (CRP) (OR = 1.184; 95%CI: 1.024-1.369; p = 0.022) were independent predictors of poor functional prognosis of noncardiogenic PCI at 90 days after onset after adjusting for age, gender, ethnicity, history of hypertension and of diabetes. Conclusions The levels of initial BNP and CRP were related to poor functional outcomes in noncardiogenic PCI patients at 3 months, independent of troponin.


Resumo Antecedentes O peptídeo natriurético cerebral (BNP, na sigla em inglês) e a troponina estão intimamente relacionados com a embolia cerebral cardiogênica (CCE, na sigla em inglês), mas a relação com pacientes não cardioembólicos com isquemia de circulação anterior (ICA) e isquemia de circulação posterior (ICP) não é clara. Objetivo Investigar o valor preditivo dos níveis séricos iniciais do BNP e da troponina no prognóstico de pacientes com AVC isquêmico não cardiogênico. Métodos Os níveis séricos de BNP e de troponina foram recolhidos de pacientes com primeiro episódio de acidente vascular cerebral (AVC) isquêmico dentro de 12 horas após o início dos sintomas, com localização classificada como ICA e ICP de acordo com exame de ressonância magnética (RM). De acordo com a pontuação modificada da escala de Rankin (mRS), aos 90 dias após o início dos sintomas, ICA e ICP foram divididas respectivamente em um grupo de bom prognóstico (mRS entre 0 e2) e em um grupo de mau prognóstico (mRS entre 3 e 6). Foram registrados exames laboratoriais e outros exames complementares de todos os pacientes. Foram utilizadas análise fatorial única e análise de regressão logística multivariada para investigar a relação entre os níveis séricos de BNP e de troponina e o resultado funcional. Resultados A regressão logística multivariada evidenciou que os níveis mais altos de BNP inicial (odds ratio [OR] = 1,024, intervalo de confiança [IC] de 95%: 1,006-1,041; p = 0,007) e proteína C reativa (CRP, na sigla em inglês) (OR = 1,184; 95%CI: 1,024-1,369; p = 0,022) foram preditores independentes de mau prognóstico funcional da ICP não cardiogênica aos 90 dias após o início dos sintomas. Conclusões Os níveis iniciais de BNP e CRP se associaram a maus resultados funcionais em pacientes com ICP não cardiogênica aos três meses, independentemente da troponina.

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Chinese Journal of Neurology ; (12): 234-237, 2022.
Article in Chinese | WPRIM | ID: wpr-933787

ABSTRACT

Infective endocarditis (IE) is an infectious disease that affects the inner surface of the heart. Its first symptom often manifests as a localized neurological deficit, which can conceal the diagnosis of IE and delay the treatment. Here is a report of a severe case of IE with complicated central nervous system complications admitted to the First Hospital of Jilin University, so as to improve clinicians′ attention to the diagnosis and treatment of such conditions.

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Chinese Journal of Geriatrics ; (12): 417-422, 2022.
Article in Chinese | WPRIM | ID: wpr-933097

ABSTRACT

Objective:To investigate the risk factors of infarct growth rate of elderly acute ischemic stroke(AIS)patients with endovascular treatment(EVT)and its influence on prognosis.Methods:Elderly AIS patients who underwent EVT at Beijing hospital from June 2016 to October 2020 were retrospectively included.Infarct growth rate(ml/h)=infarct core volume(ml)/time from stroke onset to CTP examination(h).Based on the rate of infarct growth and the patient's clinical severity, ROC curve was established, and the cut-off value of the ROC curve was obtained.By the cut-off value of the rate of infarct growth, the patients were divided into cerebral infarct slow-growth group and rapid-growth group.Predictors of rapid growth in infarct were analyzed by univariate and multivariate analysis.The patients were divided into good prognosis group(mRS score 0-2)and poor prognosis group(mRS score 3-6)according to the mRS score at the day 90 and the predictors of poor prognosis were analyzed separately.Results:A total of 67 elderly AIS patients were included with age ranging from 65-96 years and an average of(78.8±7.6)years.(1)The cut-off value of the optimal infarct growth rate for patients with good and poor prognosis was 8.89 ml/h.The patients were divided into fast-growth group(26 patients)and slow-growth group(41 patients)according the cut-off value.(2)Multivariate logistic regression showed that only poor collateral circulation was an independent predictor for fast infarct growth( OR=0.162, 95% CI: 0.053-0.489).(3)Faster infarct growth rate( OR=1.173, 95% CI: 1.044-1.318)and high NIHSS score( OR=1.146, 95% CI: 1.018-1.291)were predictors of poor prognosis. Conclusions:Collateral circulation status is a major influencing factor for the infarct growth rate, and a faster infarct growth rate is a predictor of poor prognosis for elderly AIS patients after endovascular treatment.

18.
Chinese Journal of Geriatrics ; (12): 158-161, 2022.
Article in Chinese | WPRIM | ID: wpr-933051

ABSTRACT

Objective:To evaluate the predictive value of the National Institutes of Health Stroke Scale(NIHSS)score and the Glasgow Coma Scale(GCS)score for bleeding in patients with acute cerebral infarction after thrombolytic therapy.Methods:A total of 281 patients with acute cerebral infarction were enrolled at Henan Provincial People's Hospital and were treated with urokinase or recombinant human tissue plasminogen activator(rt-PA)for thrombolysis.The patients were followed up for up to 1 month after thrombolysis.Data on age, sex, time to thrombolysis, smoking, systolic blood pressure, platelets, prothrombin time, international normalized ratio, and NIHSS and GCS scores were collected.Logistic regression analysis was used to identify related factors for bleeding after thrombolysis in acute cerebral infarction and the receiver-operating characteristic curve(ROC)was used to assess the predictive values of these factors through calculating the area under the curve(AUC).Results:Logistic regression analysis showed that time to thrombolysis, prothrombin time before thrombolysis, NIHSS score before thrombolysis, NIHSS score 24 h after thrombolysis, GCS score before thrombolysis, and GCS score 24 h after thrombolysis were independent factors for hemorrhage after thrombolytic therapy( OR=23.318, 0.238, 17.099, 4.561, 0.004, and 0.258, P=0.038, 0.021, 0.038, 0.027, 0.006, and 0.040, respectively).ROC curve analysis showed that NIHSS score before thrombolysis, NIHSS score 24 h after thrombolysis, and time to thrombolysis were important factors for predicting bleeding after thrombolysis(AUC=0.833, 0.795, and 0.714, respectively, all P=0.000). Conclusions:For patients with acute cerebral infarction, the risk of bleeding after thrombolysis is significantly increased if the NIHSS score is unfavorable before thrombolysis or 24 h after thrombolysis, or the duration of acute cerebral infarction is long.Attention to risk factors and early intervention are warranted.

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Chinese Journal of Primary Medicine and Pharmacy ; (12): 747-752, 2022.
Article in Chinese | WPRIM | ID: wpr-931690

ABSTRACT

Objective:To correlate multiphase CT angiography (mCTA), serum lipid peroxidation (LPO) and thrombus precursor protein (TpP) levels with recurrence of acute cerebral infarction (ACI) in older adults and investigate the value of these indicators in the predication of ACI recurrence.Methods:A total of 128 older adult patients with ACI who received treatment in Ningbo Medical Center Lihuili Hospital, China between January 2019 and January 2020 were included in this study. All of them were followed up for 1 year. They were divided into ACI recurrence group ( n = 29) and no ACI recurrence group ( n = 99) according to whether they had recurrent cerebral infarction. All patients underwent mCTA. Maas system and Tan score were used according to mCTA images. Serum TpP level was measured using enzyme-linked immunosorbent assay. Serum LPO level was measured using Yagi's fluorescence method. Multiple linear regression analysis was used for correlation analysis. The receiver operating characteristic (ROC) curve was used to evaluate the efficacy of mCTA and serum LPO and TpP levels in the diagnosis of ACI. Results:Tan score in the ACI recurrence group was significantly lower than that in the no ACI recurrence group [(1.06 ± 0.26) points vs. (1.89 ± 0.82) points, t = 5.35, P < 0.05]. Serum TpP and LPO levels in the ACI recurrence group were (7.22 ± 1.35) mmol/L and (11.23 ± 2.58) nmol/mL, respectively, which were significantly higher than those in the no ACI recurrence group [(3.06 ± 0.28) mmol/L, (7.23 ± 0.37) nmol/mL, t = 28.86, 15.04, both P < 0.001]. ACI recurrence in older adult patients was correlated with Tan score and serum LPO and TpP levels (both P < 0.05). The sensitivity of mCTA combined with serum LPO and TpP levels in the diagnosis of ACI in older adults was 93.10%-96.60% and its specificity was 100.00%. The ROC curve analysis showed that the area under the ROC of mCTA, LPO and TpP in the prediction of ACI recurrence in older adults was 0.986 (95% CI = 0.966-1.000), 0.976 (95% CI = 0.930-1.000) and 0.968 (95% CI = 0.905-1.000), respectively. Conclusion:ACI recurrence in older adults is correlated with Tan score and serum LPO and TpP levels. mCTA, Tan score, and serum LPO and TpP levels have high sensitivity and specificity in the diagnosis of ACI recurrence in older adults, and therefore have a high diagnostic value.

20.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 559-562, 2022.
Article in Chinese | WPRIM | ID: wpr-931659

ABSTRACT

Objective:To investigate the clinical efficacy of alteplase combined with rosuvastatin calcium in the treatment of acute cerebral infarction.Methods:A total of 100 patients with acute cerebral infarction who received treatment in Zhejiang Xin'an International Hospital from October 2019 to October 2020 were included in this study. They were randomly assigned to undergo either rosuvastatin calcium (control group, n = 50) or alteplase combined with rosuvastatin calcium (study group, n = 50). The National Institute Health of Stroke Scale (NIHSS) score, serum viscosity, blood lipid change, and clinical efficacy were assessed before and after treatment. Results:Response rate was significantly higher in the study group than in the control group [90% (45/50) vs. 80% (40 /50), χ2 = 4.52, P < 0.05]. NIHSS score, soluble intercellular adhesion molecule-1 level, and soluble vascular cell adhesion molecule 1 level in the study group were (7.29 ± 1.46) points, (132.68 ± 15.20) μg/L, and (118.67 ± 112.60) μg/L, respectively, which were significantly lower than those in the control group [(11.47 ± 2.80) points, (189.22 ± 9.40) μg/L, (1 372.59±125.70) μg/L, t = 4.21, 3.21, 5.12, all P < 0.05]. Insulin-like growth factor 1 level was significantly higher in the study group than in the control group [(485.41 ± 51.30) μg/L vs. (364.23 ± 44.50) μg/L, t = 6.32, P < 0.05]. Total cholesterol and low density lipoprotein cholesterol levels in the study group were (3.29 ± 1.46) mmol/L and (3.04 ± 0.15) mmol/L, respectively, which were significantly lower than those in the control group [ (4.47 ± 2.80) mmol/L, (3.22 ± 0.41) mmol/L, t = 4.54, 3.87, both P < 0.05]. Conclusion:Alteplase combined with rosuvastatin calcium can greatly improve blood circulation, reduce blood viscosity, and restore neurological function in patients with acute cerebral infarction. This study is highly innovative and scientific.

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