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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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Objective To observe the effect of 7 kinds of Chinese herbs(Pericarpium Arecae, Folium Sennae, Fructus Tsaoko, Fructus Amomi, Rhizoma Atractylodis Macrocephalae, Fructus Aurantii, Fructus Aurantii I mmaturus), and 2 kinds of active compounds (bornyl acetate, synephrine) of Chinese herbals on gastrointestinal motility of chronic experimental beagle model. Methods Six beagles were used for inducing chronic experimental model. The beagles’antrum, duodenum, jejunum, ileum and colon were implanted with strain gauges to record canine gastrointestinal motility. Gastric fistula was set up for the intake of Chinese medicine decoction, and the external jugular vein catheter was made for intravenous administration. After modeling, the fasting gastrointestinal motility features of the beagles were observed for 120 min every day, and for 7 continuous days. From the 7th day after modeling, fasting gastrointestinal motility before medication was recorded as fundamental control, and when the interdigestive migrating motor complex (MMC) I phase arrived, the gastrointestinal motilities were sequently recorded after treatment with the 7 kinds of herbs(gavage of 200 mL of the decoction of each herb through gastric fistula), normal saline(200 mL), bornyl acetate(active ingredient of Fructus Aurantii and Fructus Aurantii Immaturus, intravenous injection), and synephrine (active ingredient of Fructus Amomi, intravenous injection). All of the animals were treated with only one kind of Chinese herb one day , and the observation of each herb lasted for 2 continuous days. MMC cycle, frequency of contraction, sum of contraction, amplitude of contraction, average of amplitude, and motor index (MI) were observed by strain gauges. Results On postoperative day 1-6, the animals had gastrointestinal hypomotility and no MMC cycle was recorded. On postoperative day 7, the canine antrum, duodenum, jejunum and ileum showed typical MMC cycle while the colon had irregular MMC cycle at fasting interdigestive period. Compared with the gastrointestinal motilities before treatment and those of the normal saline group, the number of contraction waves and MI were significantly increased in the antrum, duodenum, jejunum, ileum and colon after intervention with Pericarpium Arecae and bornyl acetate, were increased in the duodenum, jejunum, ileum and colon after treatment with Folium Sennae and Fructus Tsaoko (P<0.05), and were also enhanced in the antrum and duodenum after administration of Fructus Amomi(P < 0.05). Treatment with Fructus Aurantii induced the decrease of MI in the jejunum, Fructus Aurantii Immaturus decreased MI of the jejunum and colon, and synephrine decreased the number of antrum contraction waves and MI of the antrum and jejunum(P < 0.05). Conclusion The chronic experimental model is effective for the screening of Chinese herbs for improving gastrointestinal motility. Pericarpium Arecae, Folium Sennae, Fructus Tsaoko, Fructus Amomi, and bornyl acetate can increase gastrointestinal motility, while Fructus Aurantii, Fructus Aurantii Immaturus and synephrine can inhibit the gastrointestinal movement, and Rhizoma Atractylodis Macrocephalae has no effect on gastrointestinal motility.