Multiple cerebral infarction complicated with vascular Parkinsonism on cognitive function in patients / 公共卫生与预防医学

Objective To analyze the influence of patients with multiple cerebral infarction complicated with vascular Parkinsonism (VaP) on cognitive function, and to provide a theoretical basis for the diagnosis and treatment of patients with multiple cerebral infarction complicated with VaP. Methods A toatl of 206 patients with multiple cerebral infarction admitted to Ningde municipal hospital of ningde normal university from January 2020 to January 2022 were selected and divided into VaP group (n=58) and control group (n=148) according to whether they were complicated with VaP. Montreal Cognitive Assessment Scale (MoCA) was used to evaluate the cognitive function of patients. The scale included 8 cognitive domains including attention and concentration, executive function, memory, language, visual structure skills, abstract thinking, calculation and orientation. Pearson was used to analyze the correlation between VaP and MoCA score in patients with multiple cerebral infarction. Age, sex, years of education, white matter disease, diabetes mellitus, coronary heart disease and other vascular risk factors were compared between the two groups. The independent risk factors for VaP in multiple cerebral infarction were analyzed by multiple linear regression. Results MoCA score in VaP group was significantly lower than that in control group (P<0.05). In terms of each item, scores of attention and concentration, memory, language and computation in VaP group were significantly lower than those in control group (P<0.05). Pearson correlation analysis showed that attention and concentration, memory, language and computational scores were correlated with VaP in patients with multiple cerebral infarction (r=-0.475, -0.314 , -0.302 , -0.389, P<0.05). There were statistically significant differences between the two groups in white matter lesions, lesion sites in left hemisphere and frontal lobe, diabetes mellitus and carotid artery plaque (P<0.05).White matter lesions (OR=2.571), diabetes mellitus (OR=2.369) and lesion location in the left hemisphere (OR=2.958) were independent risk factors for VaP in patients with multiple cerebral infarction (P<0.05). Conclusion The risk of VaP in multiple cerebral infarction is high, which is related to the cognitive function of patients. Early intervention such as brain function training should be given to patients with white matter lesions, diabetes and lesions in the left hemisphere. , can significantly improve patients' cognitive function and reduce the occurrence of VaP.

Characterization and pathophysiological changes of cerebral infarction rat model with qi-deficiency and blood-stasis Syndrome / 中国中药杂志

This study aimed to observe the general state and changes in pathophysiological indexes of multiple cerebral infarction rat model with Qi-deficienty and Blood-stasis syndrome. Rats were randomly divided into 4 groups(with 30 in each group): the normal group, the sham group, the model group and the Yiqi Huoxue recipe group. Rats in the model group and Yiqi Huoxue group were provided with interruptable sleep deprivation for 7 days before the multiple cerebral infarction operation, and followed by another 4 weeks of sleep deprivation; rats in the Yiqi Huoxue group were intragastrically administrated with drug at a dose of 26 g·kg⁻¹, once a day for 4 weeks. The general state was observed, and the pathophysiological indexes were measured at 48 h, 2 weeks and 4 weeks after administration. The results showed that rats in the normal group and the sham group represented a good general state and behaviors, with a normal morphological structure of brain tissues; rats in the model group featured yellow fur, depression, accidie, loose stools and movement disorder, with obvious brain histomorphological damage, which became aggravated with the increase of modeling time; rats in the Yiqi Huoxue group showed release in the general state and above indexes. Compared with the sham group at three time points, rats in the model group showed decrease in body weight, exhaustive swimming time and RGB value of tongue surface image, and increase in whole blood viscosity of the shear rate under 5, 60 and 150 S⁻¹, reduction in cerebral cortex Na⁺-K⁺-ATPase, Ca²⁺-ATPase activity and contents of 5-HT, rise in TXB2 levels and decline in 6-keto-PGF1a in serum(<0.05, <0.01). Compared with the model group, rats in the Yiqi Huoxue group showed alleviations in the above indexes at 2 w and 4 w(<0.05, <0.01). The results showed that the characterization and pathophysiological indexes in the multiple cerebral infarction rat model with Qi-deficiency and blood-stasis syndrome were deteriorated; Yiqi Huoxue recipe could significantly alliviate the abnormal conditions, which suggested of the model was stable and reliable and the pathophysiologic evolutionary mechanism might be related to energy metabolism dysfunction, vasoactive substance abnormality and changes in neurotransmitters.

On the Relationship between Oketsu Syndrome and the Distribution of Multiple Cerebral Infarction on Magnetic Resonance Imaging / 日本東洋医学雑誌

The authors examined the ralationship between ‘Oketsu’ syndrome and multiple cerebral infarction. In the 59 patients (62.8±9.5 years of age; 43 male and 16 female) with multiple cerebral infarction who had undergone MRI examinations, the authors evaluated the ‘Oketsu’ score, DEA (maximum diameter of the column of intravasclar erythrocyte aggregation) and erythrocyte aggregability.<br>The control group, 18 subjects (61.2±9.3 years of age; 11 male and 7 female) had no findings of cerebral infaction upon MRI examination.<br>In the patient group, the ‘Oketsu’ score was higher than the control group (P<0.0001) and microcirculation was significantly impaired (P<0.01).<br>According to localization of foci in the MRI study, the microcircuation was particularly impaired when infarctions occurred in areas controlled by the cortical branches (P<0.05).<br>Both symptomatic and asymptomatic infarctions presented high ‘Oketsu’ scores and impairment of microcirculation.<br>Erythrocyte aggregability significantly increased in patients in the multiple infarction symptomatic group (P<0.05). Particulaly, patients suffering from cerebral infarctions in the cortical branches had more severe erythrocyte aggregation.