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Objective To investigate the risk factors of cognitive impairment associated with early post－acute stroke seizures (EPASS). Methods One hundred and sixty－eight eligible patients were recruited in the study. Patients were divided into cognitive impairment group and non－cognitive disorder group according to MMSE. General clinical data, severity of the stroke, location and extent of infarction, characteristics of epileptic seizures were compared between the two groups. Multivariate Logistic regression analysis was utilized to investigate the independent risk factors of EPASS related cognitive impairment. Results Multivariate logistic regression analysis showed that moderate to severe stroke (OR=4.386, P=0.006), cortical infarction (OR=6.430, P=0.012), general tonic clonic seizure (OR=8.189, P=0.004), seizure frequency≥1 time per day (OR=12.818, P＜0.001) were the independent risk factors for cognitive impairment in EPASS. Conclusions Patients with moderate to severe stroke, cortical infarction, general tonic clonic seizure and seizure frequency≥1 time per day may have a higher risk of cognitive impairment.
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Objective To investigate the risk factors of progressive motor deficit (PMD) in patients with acute middle cerebral artery occlusion (MCAO) beyond thrombolysis time.Methods The clinical data of 123 patients with acute MCAO beyond thrombolysis time,admitted to our hospital from March 2015 to March 2017,were analyzed retrospectively.According to whether patients having National Institute of Health Stroke Scale (NIHSS) scores increased＞2 within 5 d of admission and continued for 24 h,these patients were divided into two groups:PMD group and non-PMD group.Single factor analysis was performed on all clinical parameters that might influence PMD;in addition,the influencing factors of PMD were analyzed by multiple factor Logistic regression analysis.Results Fifty-one patients (41.5％) had PMD and 72 patients (58.5％) did not have PMD.Single factor analysis showed that the differences of randomized blood glucose level,ratio of patients with PH2 type hemorrhagic transformation,intracurricular infarct pattern,radiation crown infarct and collateral circulation pathway between the PMD group and the non-PMD group were statistically significant (P＜0.05).Multiple factor Logistic regression analysis showed that ratio of patients with PH2 type hemorrhagic transformation,radiation infarct site,internal watershed infarct model and collateral circulation pathway were significantly correlated to PMD (OR=2.857,95％CI:1.037-7.869,P=0.042;OR=2.585,95％CI:1.219-5.481,P=0.013;OR=2.876,95％CI:1.327-6.232,P=0.007;OR=2.332,95％CI:1.120-4.867,P=).024).Conclusion PH2 type hemorrhagic transformation,corona radiate infarct,intemal watershed infarct model and insufficient collateral circulation pathway are the important risk factors of PMD in patients with acute MCAO beyond thrombolysis time.
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Aptamers are DNA or RNA fragments that can specifically bind to target substances.Because of the excellent properties such as strong binding force,high specificity,small physical size,chemical synthesis and modification,good biocompatibility,and low immunogenicity aptamers show wide application propects in biomedical researches.Aptamers can also bind specifically to receptors on the surface of cell membranes,and mediate the endocytosis of nanoparticles into cells,making them ideal drug targeting ligands.Organic nanomaterials have excellent application value in nanodrug delivery system because of their good biocompatibility and degradability.In this paper,the recent research progress of aptamers and organic nanomaterials drug delivery systems was reviewed.
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Objective To study the effect of citicoline on mild cognitive impairment MCI) in pa tients with middle cerebral artery stenosis (MCAS).Methods Eighty-six MCAS patients with MCI were divided into citicoline group (n=44) and control group (n=42).The patients in citicoline group were treated with citicoline (0.2 g,3 times a day) for 6 months on the basis of conventional treatment.Cerebrovascular reserve,PI,BHI and Vm between the two groups were compared by transcranial Doppler ultrasonography after treatment.MCI between the two groups was assessed according to the MoCA after treatment.Results The rate of cerebrovascular reserve,PI,BHI and Vm were significantly higher in citicoline group than in control group (13.59％± 1.16％ vs 7.61％±1.12％,P＜0.01;0.51±0.16 vs 0.58±0.12,P＜0.05;1.36±0.08 vs 0.74±0.11,P＜ 0.01;32.63％ ±2.32％ vs 16.92％ ± 1.68％,P＜0.05).The total MoCA score,attention,language,visuospatial and executive function,abstract,naming,orientation and memory were significantly higher in citicoline group than in control group (P＜0.01).Conclusion Early citicoline treatment can improve cerebrovascular reserve and alleviate MCI in MCAS patients.