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Objective@#To explore the correlation and consistency between thromboelastography (TEG) and traditional coagulation tests (CCTs) in ischemic cerebral vascular disease (ICVD).@*Methods@#Totally 108 ICVD patients admitted to Nanyang Central Hospital from May 1 to October 31 2018 were enrolled. Patients’ TEG parameters (R value, K value, Angle value, MA value, CI value and G value) and CCTs parameters (PT, APTT, TT, and FIB) were collected and analyzed retrospectively. The Spearman correlation coefficient was used to explore the correlation between TEG and CCTs parameters, and Kappa (κ) to explore the consistency in determining the coagulation status of the patients. The ROC curve was used to analyze the predictive value of TEG parameters for abnormal results of CCTs, and the results of TEG and CCTs were comprehensively analyzed to evaluate the ability to predict the coagulation status of patients.@*Results@#(1) PLT was positively correlated with MA value and G value; PT and APTT were positively correlated with K value; TT was positively correlated with R value and K value; FIB was positively correlated with Angle value, MA value and G value. TT was negatively correlated with Angle value and CI value; FIB was negatively correlated with K value. (2) PT and MA values, PT and G values, FIB and MA values, FIB and G values were accordant in valuing the hypoxic state of ICVD patients. (3) PLT and Angle values, PLT and MA values, PLT and CI values, PLT and G values were accordant in assessing hypercoagulable status of ICVD patients; FIB and Angle values, FIB and MA values, FIB and CI value, and FIB and G value were consistent in evaluating the hypercoagulable state of ICVD patients. (4) For detecting TT>20 s, the AUC of K value and Angle value were 0.648, 0.651, respectively; For detecting FIB>4 g/L, the AUC of Angle value and MA value were 0.717 and 0.747, respectively; For detecting PLT>300×109/L, the AUC of MA value was 0.808 (all P<0.05).@*Conclusions@#There is weak correlation and consistency between TEG and CCTs parameters in ICVD patients. The TEG parameters have good predictive value in evaluating the abnormal results of CCTs, but cannot replace the CCTs. Combination of these two methods can better reflect the coagulation status of patients, so as to afford assistance.
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Objective To explore the correlation and consistency between thromboelastograpby(TEG)and traditional coagulation tests(CCTs)in ischemic cerebral vascular disease(ICVD).Methods Totally 108 ICVD patients admitted to Nanyang Central Hospital from May 1 to October 31 2018 were enrolled.Patients' TEG parameters(R value,K value,Angle value,MA value,CI value and G value)and CCTs parameters(PT,APTT,TT,and FIB)were collected and analyzed retrospectively.The Spearman correlation coefficient was used to explore the correlation between TEG and CCTs parameters,and Kappa(κ)to explore the consistency in determining the coagulation status of the patients.The ROC curve was used to analyze the predictive value of TEG parameters for abnormal results of CCTs,and the results of TEG and CCTs were comprehensively analyzed to evaluate the ability to predict the coagulation status of patients.Results(1)PLT was positively correlated with MA value and G value; PT and APTT were positively correlated with K value; TT was positively correlated with R value and K value; FIB was positively correlated with Angle value,MA value and G value.TT was negatively correlated with Angle value and CI value; FIB was negatively correlated with K value.(2)PT and MA values,PT and G values,FIB and MA values,FIB and G values were accordant in valuing the hypoxic state of ICVD patients.(3)PLT and Angle values,PLT and MA values,PLT and CI values,PLT and G values were accordant in assessing hypercoagulable status of ICVD patients; FIB and Angle values,FIB and MA values,FIB and CI value,and FIB and G value were consistent in evaluating the hypercoagulable state of ICVD patients.(4)For detecting TT＞20 s,the AUC of K value and Angle value were 0.648,0.651,respectively;For detecting FIB＞4 g/L,the AUC of Angle value and MA value were 0.717 and 0.747,respectively; For detecting PLT＞ 300× 109/L,the AUC of MA value was 0.808(all P＜0.05).Conclusions There is weak correlation and consistency between TEG and CCTs parameters in ICVD Patients.The TEG parameters have good predictive value in evaluating the abnormal results of CCTs,but cannot replace the CCTs.Combination of these two methods can better reflect the coagulation status of patients,so as to afford assistance.
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China is in the "high death zone" of the world cerebrovascular disease (CVD) map. The prevention and treatment of ischemic CVD (ICVD) have become the top priority in clinical practice. It has been demonstrated that acupuncture therapy has a positive role in bettering clinical symptoms of ICVD patients. Findings of recent experimental studies displayed that electroacupuncture (EA) intervention is effective in reducing the cerebral infarcted volume and cellular injury, promoting proliferation, migration and differentiation of nerve stem cells, facilitating the regeneration of nerve tissue, bettering dysneuria and limb locomotor ability, etc. in ICVD rats, which are closely associated with its effects in regulating different intracellular signaling pathways. In the present study, we review the progress of recent experimental studies on the underlying mechanisms of EA in improving ICVD from six major signaling pathways including Notch, mitogen-activated protein kinases (MAPK)/ extracellular signal regulated protein kinases (ERK), phosphatidy linositol-3-kinase (PI 3 K)/ protein kinase B (Akt), Janus kinase-signal transducer and activator of transcription (JAK-STAT), erythropoietin-producing hepatocyte receptor (Eph)/Ephrin, nuclear factor of kappa B (NF-κB) and their compositions, which may provide new therapeutic targets for acupuncture treatment of ICVD. More attention should be paid to the comparison of the efficacy of acupuncture of different acupoint combinations (traditional acupoint formulas) in relieving ICVD.
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Brain magnetic resonance imaging (MRI) of the elderly often reveals white matter changes (WMCs) with substantial variability across individuals.Our study was designed to explore MRI features and site-specific factors of ischemic WMCs.Clinical data of consecutive patients diagnosed with ischemic cerebral vascular disease who had undergone brain MRI were collected and analyzed.Multi-logistic regression analysis comparing patients with mild versus severe WMCs was performed to detect independent associations.Analyses of variance (ANOVAs) were used to detect regionally specific differences in lesions.We found that lesion distribution differed significantly across five cerebral areas,with lesions being predominant in the frontal lobe and parieto-occipital area.To explore WMCs risk factors,after adjusting for gender,diabetes mellitus,and hypertension,only age (P＜0.01),creatinine (P=0.01),alkaline phosphatase (ALP) (P=0.01) and low-density lipoprotein cholesterol (LDL-C) (P=0.03) were found to be independently associated with severe WMCs.Age (P＜0.001) was strongly associated with WMCs in the frontal lobe while hypertension was independently related to lesions in the basal ganglia (P=0.048) or infratentorial area (P=0.016).In conclusion,MRI of WMCs showed that ischemic WMCs occurred mostly in the frontal lobe and parieto-occipital area.The infratentorial area was least affected by WMCs.Typically,age-related WMCs were observed in the frontal lobes,while hypertension-related WMCs tended to occur in the basal ganglia and infratentorial area.
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Brain magnetic resonance imaging (MRI) of the elderly often reveals white matter changes (WMCs) with substantial variability across individuals.Our study was designed to explore MRI features and site-specific factors of ischemic WMCs.Clinical data of consecutive patients diagnosed with ischemic cerebral vascular disease who had undergone brain MRI were collected and analyzed.Multi-logistic regression analysis comparing patients with mild versus severe WMCs was performed to detect independent associations.Analyses of variance (ANOVAs) were used to detect regionally specific differences in lesions.We found that lesion distribution differed significantly across five cerebral areas,with lesions being predominant in the frontal lobe and parieto-occipital area.To explore WMCs risk factors,after adjusting for gender,diabetes mellitus,and hypertension,only age (P＜0.01),creatinine (P=0.01),alkaline phosphatase (ALP) (P=0.01) and low-density lipoprotein cholesterol (LDL-C) (P=0.03) were found to be independently associated with severe WMCs.Age (P＜0.001) was strongly associated with WMCs in the frontal lobe while hypertension was independently related to lesions in the basal ganglia (P=0.048) or infratentorial area (P=0.016).In conclusion,MRI of WMCs showed that ischemic WMCs occurred mostly in the frontal lobe and parieto-occipital area.The infratentorial area was least affected by WMCs.Typically,age-related WMCs were observed in the frontal lobes,while hypertension-related WMCs tended to occur in the basal ganglia and infratentorial area.
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Objective To investigate and analyze if there is association between ischemic cerebral vascular disease (ICVD)and the time factor of dentition defect or not by the way of questionnaire.The investigation and analy-sis will provide the theoretical basis and reference in order to study the relationship between oral disease and brain functional disease as well as ICVD.Methods 159 elderly patients who diagnosed definitely as brain functional dis-ease and dentition defect or oral prosthesis at the same time were selected.The oral condition and cerebral vascular disease history were recorded and analyzed.Results There were only 27 individuals who had teeth missing without ICVD,accounted for 16.98%.The rest of 132 individuals who had both teeth missing and ICVD accounted for 83.02%.The number of individuals who lose back teeth was larger than the number of that who suffered from ICVD (χ2 =32.360,P <0.01).The longer length of time that losing teeth took,the bigger risk that patients suffered from ICVD.Spearman rank correlation analysis result was r =0.437,P <0.01.It meaned that time was another factor. Conclusion There is certain association between the length of lacking teeth and ICVD.Missing back teeth has a bigger effect on ICVD than missing front teeth.Furthermore,the longer time that losing teeth takes,the higher risk that patients suffer from ICVD.However,it is not clear how the length of time effects ICVD.Further study is still needed.
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Objective To investigate the possible roles of serum bilirubin and uric acid in the course of carotid artery intima thicken/plaque formation. Methods Patients with ischemic cerebral vascular disease were divided into the control group, intima thicken group and plaque formation group according to the carotid artery intimamedia thickness (IMT) examination by B-mode ultrasound. The serum bilirubin and uric acid were detected by Automatic Chemistry Analyzer. Results The serum level of uric acid of (391.22 ± 27.52) μmol/L in intima thicken group was significantly higher than that in the control group and plaque formation group((307.32 ± 13.68)μmol/L and (327.84 ± 17.96)μmol/L, P ＜ 0.05). The serum level of indirect bilirubin and total bilirubin in plaque formation group was (10.96 ± 0.58) μmol/L and (15.91 ± 0.71) μmol/L respecitively, which were significantly lower than those in the control group ((15.09 ± 2.21) μmol/L and (20.59 ± 2.43) μmol/L,respectively) and the intima thicken group((15.09 ± 2.21) μmol/L and (20.59 ± 2.43) μmol/L, respectively) (Psignificantly lower than that of (5.70 ± 0.28) μmol/L in the control group(P ＜ 0.05). Conclusions Bilirubin and uric acid play different roles in carotid artery plaque formation during different stage.
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Objective To study the length of hypertension history and its related factors in patients with both ischemic cerebral vascular disease(ICVD) and hypertension.Methods The profile of hypertension history in ICVD patients from our hospital between 1990 and 1999 was summarized.Hypertension history meant the time interval between onset of first symptomatic ICVD and establishment of diagnosis of hypertension.The related factors' influence on the length of hypertension history was analyzed by means of multiple linear regression model.Results In ICVD patients with hypertension,the mean length of hypertension history was 14.29?10.63 years,the median was 11 years.In multiple linear regression model,increased age when hypertension was diagnosed,diabetes mellitus,smoking,peasant(army man as control group) were independent factors that shortened hypertension history.Antihypertensive treatment independently lengthened hypertension history.Conclusion The length of hypertension history varies greatly,50% of patients developed the first ICVD in 11 years after the diagnosis of hypertension was established .Coexisting smoking and diabetes mellitus hasten while control of arterial blood pressure postpone onset of ICVD in patients with hypertension.
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0.05) . Conclusions The A-allele in rs918592 may one of the risk factors in development of ICVD in the Han people in China. PDE4D gene may be not included glycometabolic mechanism to effect ICVD.