Study of recurrent loci of cerebral infarctions / 实用医学杂志

Objective To research the location in cerebral circulations of recurrent stroke.Methods We included patients with acute cerebral infarction from the Department of Neurology of People's Hospital of Peking University within three years.We followed up the patients by telephone and electronic medical record to determine whether they belong to recurrent group or not.We recorded the clinical and image variables of recurrent group.We classified the recurrent group by whether the loci of recurrent stroke is in the same circulation.We determined the independent risk factors of the same circulation loci by Cox regression.Results There are 106 cases of recurrent stroke.Within 5 years,46.2％ of the cases had recurrent loci in the same circulation as first stroke loci.53.8％ of the cases had recurrent loci in the different circulation from first stroke loci.According to logistic regression,whether the recurrent loci was in the same circulation was not related to age,sex,hypertension,diabetes mellitus,smoking,but related to the survival time.The shorter the survival time was the more ratio of same circulation loci happened.The longer the survival time was the more ratio of different circulation loci happened.37％ of cases with recurrent strokes happened in the first year occupied the most cases in the 5 years.Conclusions With the long time study of the location of recurrent stroke,we get the conclusion that the longer the survival time is the more ratio of different circulation stroke happen.So we emphasize the importance of medicine for the stroke in long time.At the same time we conclude the rationality of endovascular treatments within 1 year from first stroke because recurrent loci is more often in the same circulation in 1 year.

A study of therapeutic efficacy of mycophenolate mofetil in the treatment of multiple sclerosis ;and neuromyelitis optica / 中国医师进修杂志

Objective To assess the efficiency and safety of mycophenolate mofetil (MMF) in patients with multiple sclerosis (MS) and neuromyelitis optica (NMO). Methods Twenty-seven patients with MS or NMO were selected, and the patients were divided into 2 groups:MMF group (MMF combined with glucocorticoid treatment group, 10 cases) and glucocorticoid group (only glucocorticoid treatment group, 17 cases). There were 5 cases with MS and 5 cases with NMO in MMF group. There were 13 cases with MS and 4 cases with NMO in glucocorticoid group. The therapeutic efficacy 6 months after treatment, expanded disability status scale (EDSS) before treatment and 6 months after treatment, and annualized relapse rate (ARR) were compared; and the safety was observed. Results There was no statistical difference in efficacy rate 6 months after treatment between MMF group and glucocorticoid group: 9/10 vs. 11/17, P>0.05. The EDSS scores 6 months after treatment in MMF group and glucocorticoid group were significantly lower than those before treatment: (2.41 ± 2.05) scores vs. (3.40 ± 2.05) scores and (1.17 ± 0.92) scores vs. (2.38 ± 1.28) scores, and there were statistical differences (P<0.05), particularly for the patients with MS. The ARR 6 months after treatment in MMF group was significantly lower than that before treatment: 0 time/year vs. 0.75 times/year, and there was statistical difference (P<0.05). The difference of ARR before and after treatment in MMF group was significantly higher than that in glucocorticoid group: 0.75 times/year vs.- 0.46 times/year, and there was statistical difference (P<0.01), particularly for the patients with MS. Only 1 female patient had myalgia when taking higher dosage of MMF, and the symptom tended to relieve after the dosage was reduced. Conclusions MMF is effective in the treatment of MS and NMO. MS can improve the neurological function and reduce the recurrence of the disease;and the safety is high.

Effect of the deferoxamine mesylate on the prognosis of patients with intracerebral hemorrhage / 中国综合临床

Objective To study the effect of the deferoxamine mesylate on the prognosis of patients with intracerebral hemorrhage(ICH) after one year. Methods From February 2013 to May 2014,spontaneous ICH patients diagnosed by computed tomography ( CT ) within 18 hours of onset in Mancheng District Hospital of Baoding were evaluated. Patients were randomly divided into experimental group and control group. The treatment of the two groups was similar except that the experimental group received deferoxamine mesylate. Patients were e?valuated by CT and neurology scale( NIHSS scale,GCS scale) at the time of admission and followed up for the first year by the RANKIN( mRS) scale. All clinical data of the two groups were compared. Results Forty?two patients were included in the study, including 21 cases in the experimental group and 21 cases in the control group,there was no significant difference in baseline data between the two groups at admission. There were 6 pa?tients with mRS ≥3 in the experimental group, and 6 patients with mRS ≥3 in the control group after one year. There was no statistically significant difference in the distribution of mRS score between the two groups after one year admission( P=1. 000) . Conclusion There may be no helpful on the prognosis of patients with intrace?rebral hemorrhage by intravenous infusion of deferoxamine mesylate,the further study is needed.

Root resorption and interleukin-17 expression in a rat model of kidney deficiency uring orthodontic treatment / 中国组织工程研究

BACKGROUND:The mechanism underlying orthodontic-induced external root resorption is not yet clear, and it differs individual y. Kidney deficiency has been proved to be related to bone diseases which mediated by different cytokines. Interleukin-17 is an important cytokine involved in external root resorption. So figuring out whether kidney deficiency and interleukin-17 are related to root resorption wil be helpful for etiological research. OBJECTIVE:To explore the relationship between kidney deficiency physique, interleukin-17 and root resorption during orthodontic treatment in rats. METHODS:Thirty-six Wistar rats were selected and equivalently randomized into two groups, fol owed by modeled into kidney deficiency (kidney deficiency group) or injected with normal saline (control group), respectively. Afterwards, the right maxil ary of each rat served as an orthodontic force model, and the left maxil ary as a non-orthodontic force model. Al rats were respectively sacrificed under general anesthesia at the 3, 7 and 14 days after given orthodontic force. Then, the mesial surface of the root of maxil ary first molars and the expression level of interleukin-17 were observed through hematoxylin-eosin staining and immunohistochemical method. RESULTS AND CONCLUSION:Histological observation showed that significantly increasing root resorption in a time-dependent manner could be observed, and there were various absorbed lacunae of osteoclasts on the enamel in the kidney deficiency orthodontic force group. The alveolar bone resorption and widened periodontal membrane appeared in the control orthodontic force group. While no remarkable root and alveolar bone resorptions were found in the other two non-orthodontic force groups. The expression level of interleukin-17 in the kidney deficiency orthodontic force group was higher than that in the control orthodontic force group;the expression level of interleukin-17 in the kidney deficiency non-orthodontic force group was higher than that in the control non-orthodontic force group. In conclusion, kidney deficiency patients are easy to develop root resorption, the mechanism of which is maybe relevant to the upregulation of interleukin-17.

Effect of abnormal blood pressure circadian rhythm on subtypes of acute ischemic stroke / 中华老年心脑血管病杂志

Objective To study the effect of abnormal blood pressure (BP) circadian rhythm on subtypes of acute ischemic stroke (AIS) in hypertensive patients .Methods Ninety-seven AIS pa-tients with hypertension were divided into arterothrombosis (AT)group (n=66)and small artery disease (SAD)group (n=31)according to the modified TOAST classification .Their 24 h ambula-tory BP was monitored .The 24 h BP ,daytime and nighttime BP ,morning BP surge and BP circa-dian rhythm were compared between the two groups .Results The nighttime SBP was significant-ly higher in AT group than in SAD group (133 .86 ± 18 .17 mm Hg vs 124 .42 ± 16 .06 mm Hg , P0 .05) .Conclusion Absent BP circadian rhythm and elevated nighttime BP are related with AT type ischemic stroke .

Diagnostic criteria for multiple sclerosis: a comparison of the Poser and the McDonald criteria / 中华神经科杂志

Objective To compare the Poser and the McDonald diagnostic criteria for multiple sclerosis (MS).Methods Sixty-seven patients with clinical features suggestive of MS were re-evaluated by 2 neurologists utilizing both the Poser and the McDonald criteria.The Fisher' s exact test was used to statistically analyze the data from assessment by these two criteria.Results By the Poser criteria, 34 patients were classified as clinically definite MS, 24 patients as laboratory supported definite MS and 9 patients as possible MS.Under the new McDonald criteria, MS was diagnosed in 36 patients and 31 patients had possible MS.The results revealed significant differences in diagnosing MS between these 2 criteria (OR=5.549, 95% CI 2.37-13.00, P<0.01).Conclusions These 2 criteria showed remarkable differences in diagnosing MS, in particular definite MS, possibly due to greater reliance on paraclinical evidences in the Poser criteria and more stringent gnidlines of magnetic resonance imaging (MRI) in the McDonald criteria.The analysis of cerebrospinal fluid may increase the diagnostic rate of MS and specify pathologic abnormalities in MRI to some degree.

Relationship between Carotid Artery Intima-media Thickness and PAI-1 in Patients with Metabolic Syndrome / 中国康复理论与实践

@#Objective To investigate the relationship between carotid artery intima-media thickness and plasminogen activator inhibitor-1(PAI-1)in patients with metabolic syndrome(MS).Methods According to the definition of MS by NCEP-ATP Ⅲ,323 patients were divided into the MS group(160 cases)and without MS group(163 cases).The PAI-1 level was assayed by ELISA.The carotid artery intima-media thickness(IMT)and atherosclerotic plaque were measured by high-frequency Doppler ultrasound.Results The PAI-1 level,carotid IMT and incidence rate of plaque of the MS group were 30.52±11.02 ng/ml,0.92±0.21 mm and 63.1% respectively.Those of the without MS group were 26.57±11.09 ng/ml,0.86±0.20 mm and 49.1% respectively.There was a significant difference between two groups(P<0.05～0.01).Moreover,with the increasing of the number of MS components,the carotid artery intima-media thickness(IMT)and incidence rate of plaque were gradually increased(P<0.05).The stepwise regression analysis showed that PAI-1 was independently associated with the carotid IMT(standardized coefficients=0.105,P<0.05).Conclusion MS tends to cause carotid atherosclerosis,the increase of PAI-1 is possibly correlated with carotid artery atherosclerosis.

Effects of dl-3-butylphthalide soft capsules on treatment of acute ischemlC stroke: multi-center, randomized, double-blind, double-dummy and aspirin-control study / 中华神经科杂志

Objective To assess the efficacy and safety of dl-3-butylphthalide on the treatment of acute ischemic stroke. Methods A total of 197 patients who were in the period of 72 hours of first attack of ischemic stroke of internal carotid artery with NIHSS from 5 to 25 scores were enrolled in this multi-center, randomized, double-blind and aspirin-control study. Compound " Dan Shen" was used as a baseline therapy. Results Basical recovery plus significant improvement was seen in 74.7% of the patients in dl-3-butylphthalide group and 60.9% in aspirin group (CMH value 4.0,P=0.047);There was a significant improvement for dl-3-butylphthalide group regarding NIHSS total score, total score difference value and Barthel index on the day 11th and 21st after treatment compared with control group. The main adverse reaction of dl-3-butylphthalide was increased aminotransferase and mainly the slight increase of aspartate aminotransferase, by 4.34% and 0 respectively. Conclusion dl-3-butyiphthalide should be regarded as an effective and safe treatment for ischemic stroke and a treatment without severe side effects.

Risk factors in ischemic stroke following total hip replacement / 中国康复理论与实践

@#ObjectiveTo investigate the risk factors in ischemic stroke following total hip replacement. MethodsThe clinical data of 18 patients who suffered ischemic stroke following total hip replacement were compared with other 142 patients without ischemic stroke following total hip replacement who were randomly selected as control. ResultsThe incidence rate of ischemic stroke following total hip replacement in our hospital was 1.8%. Age,hypertension, history of stroke,falling of systolic pressure and diastolic pressure during opereration were significantly different between patients and controls(P<0.05).There was no significantly different in sex,previous cardiac diseases, diabetes, hyperlipemia,and the bleeding in operation between patients and controls(P>0.05).ConclusionAge,hypertension, history of cerebrovascular disease,falling of systolic pressure and diastolic pressure during opereration are the important risk factors of ischemic stroke following total hip replacement.

Study on memory T cell subsets in peripheral blood of patients with multiple sclerosis / 中国免疫学杂志

Objective:To explored the mechanisms that lead to the changes of the memory T cell subsets.Methods:By using of flow cytometry and enzyme-linked immunosorbent assay(ELISA), we detected the percentage of memory T cell subsets and plasma concentration of interleukin-15(IL-15) in peripheral blood of MS patients and healthy individuals. Furthermore, MS patients were subdivided into both relapse-remission MS(RRMS) and chronic progressive MS(CPMS) group according to the clinical features.Results:Compared to healthy controls, there was an increase and decrease in CD8~+T_ CM and terminal effector memory CD8~+T cell in MS patients(P

The expression of 4-1BB and GITR on CD4~+CD25~(high) T cells in peripheral blood of patients with multiple sclerosis / 中国免疫学杂志

0.05).Conclusion:The decrease in 4-1BB expression,rather than the GITR expression,on CD4+CD25high T cells of MS patients suggests that 4-1BB may be involved in the lower immunoactivity of the cell population,while the GITR may play a minor or fine role in the immunoregulation of the cells.