RÉSUMÉ
Objective Cardio-cerebral infarction(CCI)is a severe clinical syndrome in which acute myocardial infarction(AMI)and acute ischemic stroke(AIS)occurs simultaneously(synchronous CCI,SCCI)or successively(metachronous CCI,MCCI).The study aims to explore its clinical profile,management and outcomes.Methods This is a single-center retrospective study of inpatients with CCI who presented to Xuanwu hospital from January 2014 to December 2021.The study collected and analyzed demographic informa-tion,clinical profile,management and outcomes(all-cause death,MACE events,mRS scores,bleeding events).Results Totally 137 patients with CCI were enrolled in the study,including 28 SCCI and 109 MCCI.Hypertension,smoking and diabetes were prominent risk factors for CCI.The heart function decreased significantly,including 42.9％suffered Killip Ⅲ-Ⅳ and 40.0％suffered decreased left ventricular ejection fraction.Large artery atherosclerosis was the most predominant etiology of AIS.The average NIHSS score was 11.24± 10.50.The rate of emergency reperfusion therapy was low(29.2％).Compared to the group that did not received emergence reperfusion therapy,the patients received emergency reperfusion therapy had a lower in-hospital mortality(P=0.042).All-cause mortality oc-curred in up to 27.0％,including 11.7％cardiovascular death.Heart failure(43.8％)was the most frequent MACE events.34.3％pa-tients had good neurological function(mRS 0-2)at discharge.27 patients(19.7％)experiencing major bleeding events,including 19 patients(13.9％)had the hemorrhagic transformation of AIS.Conclusion The CCI therapy still faces challenges,such as low reperfu-sion rate,differentiated antithrombotic options,and poor clinical prognosis.Large clinical research is need for promote the optimization of CCI treatment.
RÉSUMÉ
Rotational vertebral artery occlusion syndrome, also known as Bow Hunter Syndrome (BHS), is a rare clinical syndrome that causes mechanical occlusion or stenosis of the vertebral artery during head and neck rotation or extension. Ischemia symptoms of the vertebral-basilar artery system often occur during head rotation and could rapidly improve with neutral position. In a few cases, BHS may result in arterio-arterial embolic infarction due to secondary thrombosis from intimai injury caused by repeated compression of the vertebral artery. The author reported a case of a young female patient with repeated posterior circulatory infarction caused by BHS. The patient suffered from sudden unresponsiveness,memory decline,and right limb inflexibility. There were no vascular risk factors in her past history,and no correlation between clinical symptoms and neck rotation. Neck rotation test by carotid ultrasound showed the blood flow of left vertebral artery was decreased and reversed when the neck rotated to the right. Head and neck CT angiography (CTA) and DSA examination showed left vertebral artery local protrusion at the junction of V3 and V4,which was considered as dissection or pseudoaneurysm. Left vertebral artery segment after axial transverse foramen was not visible on CTA during right head rotation. High resolution MR showed a membranous structure protruding into the lumen at the V3-V4 junction of the left vertebral artery. It is suggested that the clinical symptoms of BHS may be unrelated to neck rotation, but could only present as posterior circulation area infarction combined with ipsilateral vertebral artery imaging characteristics of limited range of dissection or pseudoaneurysm. Missed diagnosis and misdiagnosis may occur if the clinicians lack the corresponding understandings and knowledge. Therefore, in young patients with posterior circulation cryptogenic stroke,morphological changes of posterior circulation vessels should be carefully analyzed. If necessary,carotid ultrasound neck rotation test or dynamic DAS should be conducted to clarify whether BHS is involved.
RÉSUMÉ
Objective To observe the effect of core stability training on motor function, balance and activities for children with cerebral palsy. Methods 100 children with cerebral palsy were divided into control group (n=50) and treatment group (n=50). The control group ac-cepted routine physical therapy, occupational therapy, acupuncture, sensory integration training and conductive education;while the treat-ment group accepted core stability training in addition, 3 hours a day for 12 weeks. They were assessed with Gross Motor Function Measure (GMFM-88), Berg Balance Scale (BBS) and Comprehensive Functional Assessment for Disabled Children (CFA-DC) before and after treat-ment. Results The scores of GMFM-88, BBS and CFA-DC improved more in the treatment group than in the control group (P<0.05). Con-clusion Core stability training can further promote the recovery of motor, balance and activities in children with cerebral palsy.
RÉSUMÉ
objective To investigate the recurrence of stroke,clinical prognosis and vascular changes in patients with ischemic stroke due to middle cerebral artery stenosis. Methods The ischemic stroke patients with symptomatic middle cerebral artery stenosis were enrolled continuously and followed up prospectively for six months. The recurrence of ipsilateral stroke,clinical prognosis and dynamic changes of vessels were analyzed. Results Eighty patients were included,and 20.0% of the patients(16 cases)presented with recurrence of ipsilateral ischemic stroke and 56 cases (70.0%)with a good outcome(modified Rankin scale[mRS]≤1)during the 6 months follow-up;38.6% patients (27 cases) presented with significant vascular changes with progression in 12 cases (17.1%)and regression in 15 cases (21.4%). Conclusion The patients with simple symptomatic middle cerebral artery stenosis have an high rate recurrence of ipsilateral stroke but have good prognosis;Lesioned artery of the majority of patients in the short period after stroke was stable,but vascular stenosis in some patients could appear progression or remission.
RÉSUMÉ
@#Objective To observe the effect of core stability training on motor function, balance and activities for children with cerebral palsy. Methods 100 children with cerebral palsy were divided into control group (n=50) and treatment group (n=50). The control group accepted routine physical therapy, occupational therapy, acupuncture, sensory integration training and conductive education; while the treatment group accepted core stability training in addition, 3 hours a day for 12 weeks. They were assessed with Gross Motor Function Measure (GMFM-88), Berg Balance Scale (BBS) and Comprehensive Functional Assessment for Disabled Children (CFA-DC) before and after treatment. Results The scores of GMFM-88, BBS and CFA-DC improved more in the treatment group than in the control group (P<0.05). Conclusion Core stability training can further promote the recovery of motor, balance and activities in children with cerebral palsy.
RÉSUMÉ
Objective To study the effects of hypoxia and reoxygenation on expression of a disintegrin and metalloprotease10(ADAM10),?-amyloid precursor protein cleaving enzyme(BACE1) mRNA in SH-SY5Y cells.Methods SH-SY5Y cells were grouped into hypoxic and control groups.The hypoxic cells were incubated in hypoxic condition(95%N_2,5%CO_2) for 12 hours and 24 hours,and then cells were reoxygenated for 0 hours,12 hours and 24 hours.The expression of ADAM10,BACE1 mRNA were tested respectively at different time points after reoxygenation by RT-PCR.Control groups were incubated in normal conditions,seeded and treated at the same time with the hypoxic cells.Results The expression of ADAM10 mRNA was down-regulated by 19.8%,41.4% and 64.6%(P=0.005,0.038,0.001) at different time after reoxygenation with 12 hours hypoxia and down-regulated by 30.1%,75.9% and 86.5%(P=0.009,0.005,0.043)after reoxygenation with 24 hours hypoxia.The expression of BACE1 mRNA was up-regulated by 31.5% and 35.1%(P=0.028,0.005)only at 12 hours and 24 hours points after reoxygenation with 24 hours hypoxia.Conclusion Hypoxia and reoxygenation might alter the expression of ADAM10 and BACE1,which demonstrates that the vascular factors should make the amyloid precursor protein easy to be processed by ?-secrease pathway,thus to involve the pathology of Alzheimer's disease.