Remote ischemic conditioning-induced hyperacute and acute responses of plasma proteome in healthy young male adults: a quantitative proteomic analysis / 中华医学杂志(英文版)

BACKGROUND@#Long-term remote ischemic conditioning (RIC) has been proven to be beneficial in multiple diseases, such as cerebral and cardiovascular diseases. However, the hyperacute and acute effects of a single RIC stimulus are still not clear. Quantitative proteomic analyses of plasma proteins following RIC application have been conducted in preclinical and clinical studies but exhibit high heterogeneity in results due to wide variations in experimental setups and sampling procedures. Hence, this study aimed to explore the immediate effects of RIC on plasma proteome in healthy young adults to exclude confounding factors of disease entity, such as medications and gender.@*METHODS@#Young healthy male participants were enrolled after a systematic physical examination and 6-month lifestyle observation. Individual RIC sessions included five cycles of alternative ischemia and reperfusion, each lasting for 5 min in bilateral forearms. Blood samples were collected at baseline, 5 min after RIC, and 2 h after RIC, and then samples were processed for proteomic analysis using liquid chromatography-tandem mass spectrometry method.@*RESULTS@#Proteins related to lipid metabolism (e.g., Apolipoprotein F), coagulation factors (hepatocyte growth factor activator preproprotein), members of complement cascades (mannan-binding lectin serine protease 1 isoform 2 precursor), and inflammatory responses (carboxypeptidase N catalytic chain precursor) were differentially altered at their serum levels following the RIC intervention. The most enriched pathways were protein glycosylation and complement/coagulation cascades.@*CONCLUSIONS@#One-time RIC stimulus may induce instant cellular responses like anti-inflammation, coagulation, and fibrinolysis balancing, and lipid metabolism regulation which are protective in different perspectives. Protective effects of single RIC in hyperacute and acute phases may be exploited in clinical emergency settings due to apparently beneficial alterations in plasma proteome profile. Furthermore, the beneficial effects of long-term (repeated) RIC interventions in preventing chronic cardiovascular diseases among general populations can also be expected based on our study findings.

Endovascular versus Medical Management of Acute Basilar Artery Occlusion: A Systematic Review and Meta-Analysis of the Randomized Controlled Trials / 대한뇌졸중학회지

Background@#and Purpose The optimal management of patients with acute basilar artery occlusion (BAO) is uncertain. We aimed to evaluate the safety and efficacy of endovascular thrombectomy (EVT) compared to medical management (MM) for acute BAO through a meta-analysis of randomized controlled trials (RCTs). @*Methods@#We performed a systematic review and meta-analysis of RCTs of patients with acute BAO. We analyzed the pooled effect of EVT compared to MM on the primary outcome (modified Rankin Scale [mRS] of 0–3 at 3 months), secondary outcome (mRS 0–2 at 3 months), symptomatic intracranial hemorrhage (sICH), and 3-month mortality rates. For each study, effect sizes were computed as odds ratios (ORs) with random effects and Mantel-Haenszel weighting. @*Results@#Four RCTs met inclusion criteria including 988 patients. There were higher odds of mRS of 0-3 at 90 days in the EVT versus MM group (45.1% vs. 29.1%, OR 1.99, 95% confidence interval [CI] 1.04–3.80; P=0.04). Patients receiving EVT had a higher sICH compared to MM (5.4% vs. 0.8%, OR 7.89, 95% CI 4.10–15.19; P<0.01). Mortality was lower in the EVT group (35.5% vs. 45.1%, OR 0.64, 95% CI 0.42–0.99; P=0.05). In an analysis of two trials with BAO patients and National Institutes of Health Stroke Scale (NIHSS) <10, there was no difference in 90-day outcomes between EVT versus MM. @*Conclusion@#In this systematic review and meta-analysis, EVT was associated with favorable outcome and decreased mortality in patients with BAO up to 24 hours from stroke symptoms compared to MM. The treatment effect in BAO patients with NIHSS <10 was less certain. Further studies are of interest to evaluate the efficacy of EVT in basilar occlusion patients with milder symptoms.

Status of hyperhomocysteinemia in China: results from the China Stroke High-risk Population Screening Program, 2018 / 医学前沿

A nationwide survey was conducted from October 2018 to September 2019 to assess the prevalence of hyperhomocysteinemia (Hhcy) and its influencing factors in China. A standardized questionnaire was used to collect information. Hhcy was defined as the level of serum homocysteine (HCY) ⩾ 15.0µmol/L. The H-type hypertension (HHYP) was defined as hypertension with an elevated serum HCY 15.0µmol/L). Finally, 110 551 residents ⩾ 40 years of age from 31 provinces in the mainland of China were included. Overall, the median serum HCY level was 10.9µmol/L (interquartile range 7.9-15.1). A total of 28 633 participants (25.9%) were defined as Hhcy. The Hhcy prevalence ranged from 7.9% in Shanghai to 56.8% in Tianjin. The data showed that serum HCY levels were associated with age, male gender, cigarette smoking, hypertension, diabetes, ethnicity, endurance in exercise (inverse), and fruit and vegetable intake (inverse). In addition, 15 486 participants were defined as HHYP, and the rate was 14.0%. HHYP was an independent predictor of stroke with an adjusted odds ratio of 1.752 (95% CI 1.338-2.105). The geographical distribution pattern of the Hhcy epidemic reflects dynamic differences, and national strategies should be carried out to further improve the care of patients with Hhcy across China.

Interactions between remote ischemic conditioning and post-stroke sleep regulation / 医学前沿

Sleep disturbances are common in patients with stroke, and sleep quality has a critical role in the onset and outcome of stroke. Poor sleep exacerbates neurological injury, impedes nerve regeneration, and elicits serious complications. Thus, exploring a therapy suitable for patients with stroke and sleep disturbances is imperative. As a multi-targeted nonpharmacological intervention, remote ischemic conditioning can reduce the ischemic size of the brain, improve the functional outcome of stroke, and increase sleep duration. Preclinical/clinical evidence showed that this method can inhibit the inflammatory response, mediate the signal transductions of adenosine, activate the efferents of the vagal nerve, and reset the circadian clocks, all of which are involved in sleep regulation. In particular, cytokines tumor necrosis factor α (TNFα) and adenosine are sleep factors, and electrical vagal nerve stimulation can improve insomnia. On the basis of the common mechanisms of remote ischemic conditioning and sleep regulation, a causal relationship was proposed between remote ischemic conditioning and post-stroke sleep quality.

Establish the high-level clinical research platform to promote scientific and technological innovation ability in hospitals / 中华医学科研管理杂志

Objective:To establish the high-level clinical research platform to promote scientific and technological innovation ability in hospitals.Methods:Summarize and share the practical experience of integrating and optimizing the construction of scientific research platform in our hospital, this paper aimed to illustrate the important role of scientific research platform in promoting the innovation ability of science and technology in hospital.Results:According to the construction practice of clinical research platform in our hospital, the planning of clinical research platform should be guided by clinical needs and application. At the same time, having better understandings of relevant national policies, as well as the overall national development strategy layout play important roles in establishing a high-starting point clinical research platform from the very beginning.Conclusions:Accordingly, the key factors to improve the hospital's scientific and technological innovation ability mainly include the construction of scientific research platform, the cultivation of dominant and characteristic disciplines, the cultivation of innovative talents, the cross-disciplinary cooperation, the transformation of innovative achievements and the innovative management mechanism, among which the construction of high-level scientific research platform is the most basic guarantee to enhance the scientific and technological innovation ability.

The role of nicotinamide phosphoribosyltransferase in ischemic stroke / 国际脑血管病杂志

At present,there is still no effective drug treatment for acute ischemic stroke except intravenous thrombolysis.Recently,nicotinamide phosphonbosyltransferase (NAMPT) has been found to reduce neurological deficit after cerebral ischemia and reperfusion.This article reviews the neuroprotective effect of NAMPT in ischemic stroke and its potential mechanisms.

Predictive effect of hypersensitive C-reactive protein and neutrophil and lymphocyte ratio on the prognosis of young patients with ischemic stroke / 中国脑血管病杂志

Objective To investigate the predictive effect of hypersensitive C-reactive protein(Hs-CRP)and neutrophil and lymphocyte ratio(NLR)on the prognosis in young patients with ischemic stroke. Methods From October 2016 to October 2017,110 consecutive young patients(18-45 years old)with ischemic stroke admitted to the Department of Neurology,Xuanwu Hospital,Capital Medical University were enrolled retrospectively. According to the modified Rankin scale(mRS)scores,they were divided into either a good prognosis group(mRS≤2;n=90)or a poor prognosis group(mRS>2;n=20).The patients completed the related examinations within 24 h after admission,including blood routine and Hs-CRP.The NLR value was calculated according to the count of neutrophils and lymphocyte in blood routine.The age,gender,underlying diseases(hypertension,diabetes,hyperlipidemia,hyperhomocysteinemia),histories of smoking and drinking,National Institutes of Health stroke scale(NIHSS)scores of both groups of patients were documented.The poor prognosis after discharge at 90 d was used as the dependent variable,the independent variables of P<0.05 in univariate analysis were further performed with multivariate logistic regression analysis.The receiver operating characteristic(ROC)curve was used to evaluate the sensitivity and specificity of the independent risk factors. The Youden index was calculated and the optimal cut-off value was determined. Results (1)Compared with the good prognosis group,the poor prognosis group had higher NIHSS score,NLR and Hs-CRP at admission.The differences between the 2 groups were statistically significant(9.0[4.5,13.0]vs.2.5[2.0,4.0],2.97[2.31,4.20]vs.2.13[1.76,2.70],4.65 [2.70,9.52]mg/L vs.2.06[0.87,4.54]mg/L;all P<0.05).There were no significant differences in other baseline data and clinical characteristics between the two groups(all P>0.05).(2)The results of the multivariate logistic regression analysis indicated that the high level of Hs-CRP(OR,1.086,95%CI 1.009-1.169)and higher NIHSS score(OR,1.487,95%CI 1.229-1.797)at admission were the independent risk factors for poor prognosis(all P < 0. 05),and there was no significant relation between NLR and prognosis(P>0.05).(3)The area under the ROC curve of the Hs-CRP levels at admission was 0.722(95%CI 0.591-0.853,P=0.002).When the predictive value of Hs-CRP level at admission was 3.365 mg/L,the maximum Youden index was 0.367,its corresponding sensitivity was 70.0%and specificity was 66.7%. Conclusions The higher Hs-CRP level and NIHSS score at admission may independently predict the poor prognosis of young patients with ischemic stroke at 90 d after discharge to a certain extent.It is not appropriate to use Hs-CRP≥3.365 mg/L alone for poor prognosis screening,but NLR may not be associated with the prognosis at admission.

Interventional study of endovascular treatment of in-hospital delay in patients with acute ischemic stroke in a tertiary hospital in Beijing / 中国脑血管病杂志

Objectives To analyze the links of the in-hospital delay by investigating the status of in-hospital delay in patients with acute ischemic stroke in a tertiary hospital in Beijing and to shorten the in-hospital delay by intervention. Methods From August 2016 to July 2017,98 patients with ischemic stroke treated by endovascular therapy and met the inclusion criteria in the Xuanwu Hospital, Capital Medical University were collected prospectively. According to before and after intervention,the patients were divided into before intervention (from August 2016 to January 2017,n=44) and after intervention (from February to July 2017,n=54). The questionnaire was designed by the authors. The survey included the basic information of patients,clinical features,and key time point of hospital treatment process. The delay links were analyzed through the value flow diagram,and the targeted interventions were given to shorten the time of in-hospital delay. Results (1) The main links of the presence of in-hospital delay are physician evaluation,disease notification, signing of the informed consent, and preoperative preparation. ( 2 ) The intervention effect was significant. The median total nosocomial process time before and after intervention were 138. 0 (118. 5,188. 8) min and 93. 5 (80. 0,114. 0) min respectively. There was significant difference(Z=5. 929,P<0. 01). Compared with before intervention,the time of examination,imaging examination, preoperative preparation and femoral artery puncture were shorter ( 16. 5 [ 10. 0, 27. 2 ] min vs. 35. 0 [18. 2,51. 8] min;10. 0 [9. 0,11. 0] min vs. 12. 5 [10. 0,23. 8] min;48. 0 [30. 0,67. 5] min vs. 60. 5 [45. 5,90. 8] min;15. 0 [12. 0,18. 2] min vs. 21. 0 [13. 0,33. 0] min,Z=4. 150,3. 685,2. 801,and 2. 852,respectively;all P<0. 05). Conclusions The nosocomial process of endovascular treatment in patients with ischemic stroke is seriously delayed. Through continuous improvement of the nosocomial process,setting up a parallel treatment modality,strengthening the stroke team training,and improving the docking measures of the information system platform can significantly shorten the in-hospital time.

Investigation of prevalence and risk factors of H-type hypertension among middle-aged and elderly people in Beijing community / 中国医师进修杂志

Objective To investigate the prevalence and risk factors of H-type hypertension among middle-aged and elderly people in Beijing community. Methods A cross-sectional study by recruiting 1 458 middle-aged and elderly people from a cohort of the "Beijing Longitudinal Study of Aging" in 2009 was conducted. All participants were asked to complete a standardized questionnaire, physical examination and laboratory examinations. Hyperhomocysteinemia was defined as homocysteine (Hcy) > 15 μmol/L, and H- type hypertension was defined as having hypertension and hyperhomocysteinemia simultaneously. The prevalence of H-type hypertension was estimated by using the results of 2000 Beijing population census to weight the data. Multivariate Logistic regression analysis was preformed to estimate the associated factors of H-type hypertension. Results The age was (69.48 ± 8.09) years, and the distribution of Hcy was skewed with the median of 16.56 μmol/L. After weight, the prevalence of hyperhomocysteinemia was 57.20% (834/1 458), and the prevalence of H-type hypertension was 35.32% (515/1 458), accounting for 59.47% (515/866) in patients with hypertension. The ageing, male, hyperuricemia, estimated glomerular filtration rate (eGFR) and insufficiency of fishes/ shrimps were independent risk factors of H-type hypertension ( OR = 2.30, 1.04, 1.02, 0.95 and 0.67; 95% CI 1.54-3.44, 1.02-1.06, 1.04-1.06, 0.94-0.97 and 0.46-0.97; P＜0.01 or＜0.05). Conclusions The proportion of H-type hypertension is high in the middle-aged and elderly people in Beijing community. Lowering uric acid, protection of renal function and intake sufficient fishes and shrimps might prevent and control H-type hypertension.

Effect of repetitive normobaric hypoxic preconditioning on white matter lesions and cognitive impairment in chronic cerebral ischemia rats / 中华老年心脑血管病杂志

Objective To study the effect of repetitive normobaric hypoxic preconditioning (RNHP) on white matter lesions (WMLs) and cognitive impairment in chronic cerebral ischemia rats.Methods Twenty-four healthy adult male SD rats were divided into sham operation group,model group,and RNHP group (8 in each group).The bilateral common carotid arteries in sham operation group were isolated but not ligated in ambient air,those in model group were ligated in ambient air,and those in RNHP group were preconditioned for 2 weeks before ligation.Their cognitive function was assessed in Morris water maze test,their WMLs were caluculated with KlüverBarrera staining.The astroglia,microglia and oligodendrocyte in cerebral white matter were stained with immunolabelling technique using antibodies to glial fibrillary acidic protein,Iba-1 and CNPase.Results The percentage of target quadrant swimming time was significantly higher in RNHP group and sham operation group than in model group (27.26％ ± 2.06％,29.06％ ± 1.72％ vs 20.58％±2.23％,P＜0.05,P＜0.01).The scores of WMLs in corpus callosum,caudate putamen and anterior commissure were significantly lower,the number of astrocytes and microglias was significantly smaller while that of oligodendrocytes was significantly greater in RNHP group and sham operation group than in model group (P＜0.05,P＜0.01).Conclusion RNHP can improve WMLs and cognitive impairment in chronic cerebral ischemia rats.

Practice and reflection on international cooperation and exchange in hospital discipline construction / 中华医学科研管理杂志

Objective Discipline construction is the core for the development of a hospital and international cooperation and exchange play an important role in promoting discipline construction.This paper summarized the experiences of carrying out international cooperation and exchange in the hospital discipline construction.Methods Analyzed the exploration,practice and its effect in promotion of hospital discipline construction regarding to international cooperation in recent years.Results The international cooperation and exchange have effectively promoted the development of hospital disciplines,for instance,introduction and training of talents,organizing and holding of high-level international conferences,establishment of international academic journals and the joint construction of academic platforms.Conclusions In accordance with the requirements of discipline development strategy,the hospital can improve the overall level of discipline construction rapidly by carrying out all-dimensional cooperation with international top medical institutions.

Evaluation of the structure and hemodynamics of internal jugular veins by ultrasound in normal population / 中华超声影像学杂志

Objective To investigate the structure and hemodyanmics characteristics of internal jugular veins (IJV) in normal population . Methods A total of 126 individuals for stroke screening and IJV ultrasound examination from Oct 2017 to May 2018 in our hospital were enrolled .The the level of IJV influx into innominate vein ( J1) ,the level of superior thyroid vein influx into IJV ( J2) and the level of the segment equal to from the bifurcation of common carotid artery to out of skull ( J 3 ) of IJV were evaluated by ultrasound . The parameters included the maximum diameters of the three segments during the smooth respiration period ,cross section area (CSA) ,the maximum velocity (Vmax) ,mean flow volume (FVm) and the maximum pressure gradient ( PGmax) . The parameters of bilateral IJVs were compared . The effects of gender and age on these parameters were analyzed . Results The structures and hemodynamics parameters of left IJV were lower than those of right IJV ( all P < 0 .05) . There was no difference in the parameter left/right ratio between male and female( P >0 .05) . With aging ,the left/right ratio of Vmax and PGmax were decreased ,especially at J1 segment ( P < 0 .05 ) . Conclusions Color Doppler flow imaging can evaluate the IJV structures and hemodynamics by assessing the diameter ,CSA ,Vmax ,FVm and PGmax . Right IJV is the dominated outflow side in normal population . With aging ,the drainage of left IJV is decreased .

Incidence of Lower Limb Deep Venous Thrombosis and Coagulation Status in Severe Patients after Thoracic Surgery / 中国肺癌杂志

BACKGROUND@#The aim of this study was to analyze the incidence of lower limb deep venous thrombosis (DVT) and the corresponding coagulation status in severe patients after thoracic surgery.@*METHODS@#Severe patients after thoracic surgery who received mechanical prophylaxis of lower limb DVT between July 2016 and June 2018 were analysed retrospectively. Their general information, disease species, surgical treatment, and coagulation index were reviewed.@*RESULTS@#Fifty patients were finally included. There were 34 male and 16 female, aging from 22 to 80 years. The incidence of DVT was 22.0%, all of them were isolated calf DVT. The incidence was 29.4% in male patients, while 6.3% in female; 23.5% in malignant diseases and 18.6% in benign. All coagulation index presented no statistical difference between patients with and without DVT, except activated partial thromboplastin time (APTT).@*CONCLUSIONS@#Even on the basis of adequate mechanical prophylaxis, lower limb DVT is common in severe patients after thoracic surgery. Meanwhile, male patients and malignant diseases are more suscepted.

Effect of prehospital transport mode on delay care in patients with acute stroke in a tertiary hospital in Beijing / 中国脑血管病杂志

Objective To investigate the effect of prehospital transport mode on delay care in patients withacutestroke.Methods From March 2016 to August 2016,a total of 255 consecutive patients with acute stroke who met the inclusion criteria in Xuanwu Hospital,Capital Medical University were analyzed prospectively. Seven patients were excluded because of incomplete data. A total of 248 valid cases were enrolled. They were divided into either an ambulance transport group (n=88)or a non-ambulance transport group (n=160)according to whether they were transported by ambulance or not. The differences of the baseline data,prehospital status,onset-to-door time,door-to-examination time,door-to-CT scan time,door-to-intravenous thrombolysis time of the 2 groups were compared,and the related factors of ambulance use were analyzed in patients with acute stroke. Results (1)The ambulance utilization rate of 248 patients was 35. 5%. The age,the coronary heart disease rate,National Institutes of Health Stroke Scale (NIHSS)score of the patients in the ambulance transport group were higher than those of the non-ambulance transport group. There were significant differences between the two groups (65 ± 11 vs. 61 ± 11 years,15. 9%[14/88]vs. 5. 6%[9/160],9 [3,17]vs. 2 [1,5];all P <0. 05). The stroke rate of the patients in the ambulance transport group was lower than that of the non-ambulance transport group(23. 9%[21/88]vs. 37. 5%[60/160],P<0. 05). (2)There were significant differences in self-identified acute disease and self-health care consciousness between the ambulance transport group and the non-ambulance transport group (all P<0. 01). (3)Compared with the non-ambulance transport group,the onset-to-door time,door-to-examination time,door-to-CT scan time,door-to-intravenous thrombolysis time were shorter in patients of the ambulance transport group (102[64,150]min vs. 136[86,230]min,3[1,8]min vs. 7[4,11]min, 15[18,23]min vs. 16[22,27]min,and 41 ± 9 min vs. 50 ± 10 min;all P <0. 05). (4)The result of Logistic regression analysis showed that the acute stroke patients with advanced age (OR,1. 04,95%CI 1. 01-1. 08,P =0. 01),higher NIHSS score (OR,1. 13,95%CI 1. 08-1. 19,P <0. 01),they or the insiders thought that the disease was emergent (OR,17. 08,95%CI 5. 78-50. 41,P<0. 01),they would seek medical advice in time when they felt sick (OR,38. 13,95%CI 10. 13-143. 61,P<0. 01),and they would take medicine by themselves when they felt sick (OR,6. 82,95%CI 2. 33-19. 99,P<0. 01)were more likely to be transported to hospital by ambulance.Conclusion Using ambulance can reduce the treatment de-lay for patients with acute stroke. The patients with self-health care consciousness are more likely to choose am-bulance transport. The importance of using ambulance should be strengthened for patients with stroke.

Relationship between self-rated health of the elderly in Beijing and the occurrence of stroke based on a competitive risk model:a cohort study / 中国脑血管病杂志

Objective To investigate the risks of self-rated health in the ≥55-year elderly in Beijing and the occurrence of stroke.Methods The subjects (n=2 101;aged ≥55) from Beijing longitudinal study of aging (BLSA) were collected by Xuanwu Hospital,Capital Medical University from January 1992 to December 2016.One hundred and twenty-one subjects with stroke at baseline and 92 with incomplete information were excluded,and finally,1 888 elderly patients without cerebrovascular disease at baseline were included in the analysis.Based on the actual situation,the self-rated health was to identify an item that matched their current state from good,general to poor.The deadline for the survey was December 31,2012.The competitive risk model was used to assess the health self-rated status and the risk of stroke.Non-stroke deaths,including cancer and car accidents were treated as competitive events.Results Of the 1 888 subjects enrolled,946 (50.1%) self-rated health were good,616 (32.6%) were general,and 326 (17.3%) were poor;438 (23.2%) had stroke,751 (37.8%) had non-stroke death,and 699 (37.0%) were right censored data.Using the competing risk model and adjusting the age,sex,living area,marital status,education level,smoking,alcohol consumption,physical exercise,hypertension,diabetes mellitus,coronary heart disease,and body mass index,the occurrence of stroke in patients with poor self-rated health was 1.44 times (95%CI 1.11-1.87,P<0.01) as good as those who were good.Conclusion In the self-rated health of the elderly ≥55 years old in Beijing,the people with poor self-rated health increased the occurrence of stroke after considering the competitive risks.

Value of high-resolution magnetic resonance black-blood imaging for evaluation of the stage of disease in intracranial venous and sinus thrombosis / 中国脑血管病杂志

Objective To evaluate the value of magnetic resonance black-blood thrombus imaging (BTI) of the stage of disease in intracranial venous and sinus thrombosis(CVT).Methods From June 2015 to October 2016,37 patients with CVT diagnosed with routine imaging examinations in Beijing Xuanwu Hospital,Capital Medical University were enrolled prospectively,and they also underwent BTI examination.The patients were randomly divided into either a acute group (≤14 d,n=23) or a chronic group (>15 d,n=14) according to the time from the onset of symptoms to BTI.Signal to noise ratio(SNR) and contrast to noise ratio(CNR) difference between acute and chronic CVT groups were compared.The magnetic resonance venography (MRV) examination was used as a reference to calculate the accuracy of BTI on per-segment level.Results (1) The SNR and CNR of thrombosis in the acute group and chronic group were 206±97 and 94±41,201±96 and 86±40,respectively.There was significant difference between two groups (t=4.9 and 5.0 respectively;all P<0.01).(2) In 37 patients with CVT,the thrombi in 159 cerebral veins and venous sinus segments were detected with MRV.BTI identified the thrombi accurately in 152 vascular segments,and the thrombi in 352 vascular segments were eliminated.The diagnostic sensitivity and specificity were 95.6% (152/159) and 98.0% (352/359) respectively.Conclusion Achieving direct angiography of cerebral venous thrombosis,BTI technique can accurately differentiate acute or chronic thrombus.It has higher accuracy.

The characteristics of clinical manifestations in patients with anti-γ-aminobutyric acid B receptor encephalitis / 中华神经科杂志

Objective To analyze the clinical features and prognosis in adult Chinese patients with anti-γ-aminobutyric acid B receptor (GABA-BR) encephalitis.Methods We reviewed the clinical manifestations,cerebrospinal fluid (CSF) examinations,brain magnetic resonance imaging and prognosis of 12 patients who were diagnosed as anti-GABA-BR encephalitis in Capital Medical University Xuanwu Hospital from March 2013 to December 2015.Results The major clinical features of anti-GABA-BR encephalitis patients included seizures (12/12),cognitive disorder (10/12),psychiatric symptoms (10/12),sleep disorders (3/12),visual hallucination (2/12),involuntary movements (2/12),decreased consciousness (3/12),cerebellar signs (2/12),fever (2/12).GABA-BR-antibody was positive in CSF and serum of all the patients.Electroencephalogram revealed epileptic discharges in 4/12 patients.Brain MRI showed abnormal signal in up to 9/12 patients,located in the hippocampus,temporal lobes,thalamus and periventricular area.PET or SPECT indicated hypometabolism in 5/6 patients.After the average of fourteen months follow-up,9/12 patients had good prognosis,3 patients did not.Of 3 patients with poor outcome,2 had small cell lung cancer.Conclusions The predominant clinical features of the anti-GABA-BR encephalitis are seizures,cognitive disorder and psychiatric symptoms.The lesions are not only located in limbic system.Early diagnosis and immune modulation may provide a good outcome.

Evaluation of the treatment effect of internal jugular vein intervention therapy in patients with cerebral venous sinus thrombosis with color Doppler ultrasound / 中国脑血管病杂志

Objective To investigate the feasibility and effectiveness of internal jugular vein (IJV) intervention therapy in patients with cerebral venous sinus thrombosis (CVST)with color Doppler ultrasound (CDU). Methods Twelve patients with CVST diagnosed by CDU and the 13 IJV lesions (localized luminal stenosis in 9 cases,venous long-segment slender in 2 cases,and right IJV localized luminal stenosis,and long-segment slender on the left in 1 case)confirmed by magnetic resonance venography (MRV)and/ or digital subtraction angiography (DSA)were enrolled retrospectively. CDU examinations were used at 1 week before and after IJV intervention therapy,6 months,1 year,and 2 years. The changes of the maximum diameter and the maximum velocity (V max )of the IJV were compared. The success rate and the long-term efficacy of the intervention therapy were analyzed. Results One week after treatment,the CDU examinations showed that the diameter of IJV stenosis in 13 IJV were increased significantly compared with those before procedure (4. 7 ± 2. 1 mm vs. 2. 3 ± 1. 3 mm;t = 5. 325,P < 0. 01). The velocity of blood flow of IJV was improved compared with before procedure (localized stenosis in 10 IJV[50 ± 15 cm/ s vs. 87 ± 24 cm/ s];t = 6. 285,P < 0. 01). Six of the 12 patients were followed up for a mean of 18 ± 7 months, two patients had restenosis after balloon dilatation. Conclusions For CVST patients with IJV lesions,the preliminary observation has indicated that IJV intervention therapy may improve the lesion lumen and hemodynamics. However,the intervention therapy,especially after balloon dilatation,the incidence of restenosis is higher. CDU can be used as an objective evaluation means for the long-term efficacy of IJV stenosis.

Changes of ubiquitin C-terminal hydrolase-L1 and glial fibrillary acidic protein levels in acute phase of cerebral infarction / 中国脑血管病杂志

Objective To investigate the changes of ubiquitin C-terminal hydrolase-L1 (UCH-L1) and glial fibrillary acidic protein (GFAP)in acute phase of cerebral infarction. Methods From March 2011 to June 2012,95 patients with early cerebral infarction from the Neurology Clinic,the Emergency Department and the Cerebral Apoplexy Screening Project Base,and the Neurology Ward of Renhe Hospital were used as an infarction group;61 non-stroke subjects received physical examination in the Physical Examination Center of our hospital in the same period were used as a control group. The cerebral infarction group and the patients with cerebral infarction in different onset of time groups (an onset 0. 05). The analysis results of ROC curve of UCH-L1 and GFAP for diagnosis of acute cerebral infarction showed that when the plasma UCH-L1 was ≥0. 18 μg/ L,the sensitivity and specificity of UCH-L1 were 68% and 74%respectively;When the plasma GFAP was ≥0. 11 μg/ L,the sensitivity and specificity of GFAP were 70% and 86% respectively. The area under the ROC curve of UCH-L1 and GFAP diagnosis of cerebral infarction were 0. 64 and 0. 71 respectively. Conclusions UCH-L1 and GFAP have obvious change in acute phase of cerebral infarction. UCH-L1 and GFAP may have certain correlation with the severity of stroke.

Models and mechanisms for international cooperation and exchange in the disciplines development / 中华医学科研管理杂志

International cooperation and exchanges plays an important role in the disciplines development in hospital,and can indirectly improve the overall capacity and quality of healthcare..This paper draw on 10 years of international cooperation and exchange in the practice of discipline development,,analyzed working patterns and mechanisms to strengthen international scientific cooperation.