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Objective:To investigate the correlation between white matter hyperintensities (WMHs) and the outcomes after reperfusion therapy in patients with acute ischemic stroke (AIS).Methods:Patients with AIS treated with reperfusion therapy (intravenous thrombolysis, endovascular mechanical thrombectomy or bridging therapy) in the Stroke Center of Zhongshan Hospital of traditional Chinese Medicine from January 2014 to December 2019 were retrospectively enrolled. The clinical baseline data of the patients were collected. The Fazekas scale was used to evaluate the severity of WMHs according to the MRI images. At 90 d after discharge, the modified Rankin Scale was used to evaluate the outcomes. A score of ≤ 2 was defined as good outcome, and a score of >2 was defined as poor outcome. Binary multivariate logistic regression analysis was used to determine the independent risk factors for hemorrhagic transformation (HT), symptomatic intracranial hemorrhage (sICH), and poor outcomes. Results:A total of 676 patients with AIS treated with reperfusion therapy were enrolled. Among them, 506 patients (74.9%) were complicated with WMHs, and 80 (11.8%) had severe WMHs. One hundred and thirty-two patients (19.5%) had HT, 34 (5.0%) had sICH, and 306 (45.3%) had a poor outcome. Multivariate logistic regression analysis showed that severe WMHs was an independent risk factor for the occurrence of HT (odds ratio [ OR] 1.890, 95% confidence interval [ CI] 1.047-3.413; P=0.035) and poor outcomes ( OR 3.366, 95% CI 1.567-7.232; P=0.002) after reperfusion treatment in patients with AIS, but there was no independent correlation with sICH ( OR 8.403, 95% CI 0.891-79.294; P=0.063). Conclusion:Severe WMHs is an independent risk factor for the occurrence of HT and poor outcomes in patients with AIS after reperfusion treatment, but it has no independent correlation with sICH.
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Reperfusion therapy has become a standard treatment for acute ischemic stroke, which can effectively improve the outcomes of patients and reduce the mortality. Some studies have found that reperfusion therapy may increase the incidence of post-stroke seizures and post-stroke epilepsy, but this view is still controversial. This article reviews the recent studies on reperfusion therapy and post-stroke seizures and post-stroke epilepsy.
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Objective To investigate the changes of middle cerebral artery(MCA) in patients with ischemic cerebrovascular re-serve capacity(CVR) and its related factors .Methods 80 patients of MCA stenosis diagnosed by transcranial Doppler(TCD) and (or) magnetic resonance imaging(MRI) were divided into asymptomatic group(n=52) and symptom group(n=28) ,and selected 30 healthy people without cerebral vascular stenosis and stroke risk factors as control group .All subjects underwent TCD combined with breath holding test in patients with CVR ,clinical data were compared in patients with cerebrovascular stenosis ,Logistic appli-cation of single factor and multi factor regression were used to analyed the factors affecting CVR .Results The breath holding index (BHI)of symptom group was 0 .44 ± 0 .14 ,significantly lower than that of the asymptomatic group 0 .75 ± 0 .22 and control group 0 .98 ± 0 .27(P<0 .05) .Patients with smoking index ,symptom group drinking index ,hypertension ,hyperlipidemia ,diabetes ,family history of stroke ,carotid intima-media thickness(IMT) were significantly higher than that in the asymptomatic group(P<0 .05) . Logistic regression analysis showed that smoking ,hypertension ,hyperlipemia ,diabetes ,IMT were associated with BHI(P<0 .05) . Conclusion Symptomatic MCA ischemia in patients with decreased CVR ,CVR changes and smoking index in patients with stroke risk index ,drinking ,hypertension and other factors are related to lower CVR ,and has a certain value in cerebral ischemic event pre-diction .
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@#Objective To investigate the neuroprotective effect of extraction of gastrodia elata on status epilepticus induced by Li-pilocarpine in rats. Methods 144 SD rats were randomly divided into 4 groups: saline control (5 ml/kg twice daily), small dose gastrodia group (5 ml/kg twice daily), large dose gastrodia group (10 ml/kg twice daily) and lamotrigine group (20 mg/kg twice daily). The status epilepticus was induced 3 d after treatment. The duration of status epilepticus, neuron loss, the rate of spontaneous seizure and the score of mossy fiber sprouting were analyzed. Results Large dose gastrodia or lamotrigine administration can shorten the duration of status epilepticus and decrease the neuron loss compared with the small dose gastrodia and control administration. But all treatments cannot prevent mossy fiber sprouting and spontaneous seizures. Conclusion 20 ml/kg gastrodia or 40 mg/kg lamotrigine administration can shorten the duration of status epilepticus induced by Li-pilocarpine, and decrease the neuron loss of CA1, CA3 of hippocampus and hilus of dentate gyrus, but cannot prevent epileptogenesis after brain insult.
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@#Objective To investigate the therapeutic effect of topiramate on diabetic peripheral neuropathy.MethodsEighty three patients with diabetic peripheral neuropathy were randomly divided into the control group (n=40) and treatment group (n=43). All patients of two groups were given antidiabetic drugs and vitamine B treatment. While the treatment group was added with topiramate orally for 1 month.ResultsThe total effective rate of the treatment group and control group were 90.7% and 67.5% respectively with a significant difference between two groups ( P<0.05). The velocity of sensory and motor conduction of all patients obviously increased after one month treatment, but the nerve conductive velocity of the patients in the treatment group was significantly higher than that in the control group ( P<0.001).ConclusionOn the basis of lowing blood glucose, using topiramate is more effective on diabetic peripheral neurophy and without obvious side effect.
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To investigate the curative effect of individualized treatment on peripheral facial paralysis. Methods:A treatment group of 121 patients was treated with acupuncture under an individualized plan based on the condition of disease. For a control study,118 patients were treated with conventional acupuncture. The courses of treatment and the curative effects were compared. Results:The cure and marked efficacy rate was 90.9% in the treatment group and 69.5% in the control group. There was a significant difference (P＜0.01).There was also a significant difference in the cure and marked efficacy rate in each courses of treatment between the two groups (P＜0.01). Conclusion:Individualized acupuncture treatment is better in the effect and shorter in the courses than conventional acupuncture treatment for peripheral facial paralysis.
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@#ObjectiveTo investigate the effect of acupuncture using Xingnao Kaiqiao needling method on patients with post-stroke depression (PSD).Methods172 PSD patients were randomly divided into the acupuncture group and control group with 86 cases in each group. The acupuncture group was treated with acupuncture using Xingnao Kaiqiao needling method, and different symptoms were also punctured various acupoints; the control group was given fluoxetine treatment, 20 mg/d. Two groups were given the same routine treatment and early rehabilitation, 8 weeks being a course.ResultsThe total effective rates of the acupuncture group and control group were individually 89.54% and 73.26%, and there was a significant difference between two groups (P< 0.05).ConclusionAcupuncture treatment using Xingnao Kaiqiao needling method can effectively treat post-stroke depression without obvious side effect.