A multicenter randomized controlled study of Anthocyanins for the treatment of Alzheimer's disease / 中华老年医学杂志

Objective:To assess the safety and efficacy of Anthocyanins for the treatment of Alzheimer's disease.Methods:From November 2018 to December 2020, a multicenter, double-blind, randomized controlled clinical study was conducted in 6 hospitals.The regular medication for the two groups was memantine, with the addition of a combination preparation containing Anthocyanins for the experimental group and a placebo for the control group.The Mini-Mental State Scale(MMSE), Montreal Cognitive Assessment Scale(MoCA), Alzheimer's Disease Assessment Scale-Cognitive Subscale(ADAS-cog), Activities of Daily Living Scale(ADCS-ADL)and Hamilton Depression Scale(HAMD)were used for assessment at the beginning.After 16 weeks of treatment, MMSE, MoCA, ADCS-ADL, ADAS-cog and the Clinician's Interview-Based Impression of Change Plus Caregiver Input(CIBIC-Plus)Scale were conducted and adverse events were recorded.Results:A total of 66 patients were enrolled, with 33 in the control group and 33 in the experimental group.There were no significant differences in cognitive function scores between the two groups before enrollment.Differences in MMSE scores, MOCA scores and ADAS-cog scores before and after treatment between the control group and the experimental group were 1.9±2.4 vs.3.4±2.0( t=2.62, P=0.011), 1.8±1.9 vs.2.9±1.4( t=2.45, P=0.018)and 3.0±2.3 vs.5.3±4.6( t=2.45, P=0.019), respectively.The differences were statistically significant.Instrumental activities of daily living(IADL)scores before and after treatment in the control group were 21.6±5.7 vs.22.6±6.2( t= 2.09, P= 0.046), and those in the experimental group were 22.7±5.4 vs.23.4±5.4( t= 2.45, P= 0.021). The differences between the two groups before and after treatment were statistically significant. Conclusions:Treatment with Anthocyanins can delay the decline of cognitive function and activities of daily living ability in patients with Alzheimer's disease.Anthocyanins may be a promising therapeutic drug for Alzheimer's disease in the future.

Application of cerebral venous sinus pressure measurement in guiding stent angioplasty for venous sinus stenosis: evaluation of its curative effect / 介入放射学杂志

Objective To evaluate the efficacy of cerebral venous sinus pressure measurement with a microcatheter in guiding stent angioplasty for the treatment of venous sinus stenosis.Methods A total of 42 patients with idiopathic intracranial hypertension (IIH) complicated by localized venous sinus stenosis were enrolled in this study.Microcatheter venous sinus venography with DSA and venous sinus pressure measurement were performed in all patients.Of the 42 patients,the pressure difference between the distal end and the proximal end of venous sinus ＞12 mmHg was found in 32,for whom balloon dilatation together with stent angioplasty was carried out.The venous sinus pressure was measured again after the treatment.The improvement of postoperative clinical symptoms was evaluated.The occurrence of complications,the symptom relapse and the patency of venous sinus were checked up.Results Successful venous sinus stent angioplasty was achieved in all 32 patients.The symptoms of intracranial hypertension were remarkably relieved,and no procedure-related complications occurred.The postoperative pressure difference between the distal end and the proximal end of venous sinus was significantly different from the preoperative one (P＜0.05),and the pressure showed a parallel correlation with the pressure of lumbar puncture.One week after the treatment,the headache was strikingly rclieved although visual acuity showed no obvious improvement.The patients were followed up for 12 months,no recurrence of clinical symptoms was seen,and magnetic resonance venography (MRV) or DSA examination showed that venous sinus blood flow was unobstructed and no restenosis was detected.Conclusion For the treatment of IIH stenosis complicated by localized venous sinus stenosis,endovascular stent angioplasty is relatively safe and effective,and the cerebral venous sinus pressure measurement with a microcatheter is of clinical significance for the selection of suitable patients as well as for the evaluation of curative effect.

Evaluation of symptomatic middle cerebral arterial atherosclerotic plaque by three dimensional-sampling perfection with application optimized contrasts using different flip angle evolutions of high-resolution magnetic resonance imaging / 中华神经科杂志

Objective To analyze characteristics and clinical significance of affected and unaffected side plaques in patients with symptomatic middle cerebral artery (MCA) atherosclerosis by three dimensional-sampling perfection with application optimized contrasts using different flip angle evolutions (3D-SPACE) of 3.0 T high-resolution magnetic resonance imaging (MRI).Methods During the period from September 2016 to June 2017,31 patients admitted to the Peking University Aerospace School of Clinical Medicine were enrolled in this study.Routine MRI and high-resolution MRI were performed respectively.Patient's affected and unaffected sides were distinguished based on the conventional MRI on the presence or absence of signs of ischemia.The characteristics of bilateral MCA plaques were studied by high-resolution MRI 3D-SPACE sequences.The stenosis rate,plaque load,eccentricity index were quantitatively analyzed,and the degree of plaque enhancement and remodeling were qualitatively analyzed.Results Thirty-one MCAs in affected and unaffected sides were respectively collected,and 124 MCA plaques and reference plane images were obtained.Among all the patients,tihe MCA in unaffected side was larger in lumen area and had atherosclerotic plaques,and some MCAs had varying degrees of thickening of the wall.The stenosis rate,plaque burden and significantly enhanced plaque proportion of MCA in affected side were significantly higher than those in unaffected side (stenosis rate:76.2％ ± 11.5％ vs 51.7％ ± 13.1％,t =7.801,P＜0.01;plaque burden:81.6％ ±8.0％ vs 56.7％ ±13.9％,t =8.614,P＜0.01;significantly enhanced plaque proportion:50.0％ (13/26) vs 0 (0/26),x2 =17.333,P＜ 0.01).There was no statistically significant difference in plaque distribution between the two sides.Positive remodeling blood vessels had more vessel area than negative remodeling blood vessels ((13.8 ± 2.9) mm2 vs (11.3 ± 2.8)mm2,t =2.389,P =0.024).Conclusion The high resolution MRI 3D-SPACE sequence clearly shows the MCA wall and plague,and can analyze the enhancement degree and morphological features of affected and unaffected side atherosclerotic plaques simultaneously,thus it is beneficial for risk stratification assessment and individualized treatment for stroke Patients in clinical practice.

Risk of bloodstream infection in relation with peripherally inserted central venous catheter in hospitalized patients / 中华老年心脑血管病杂志

Objective To study the risk of bloodstream infection in relation with peripherally inserted central venous catheter (PICC) in hospitalized non-cancer patients.Methods Clinical data of 172 non-cancer patients admitted to our hospital for PICC were collected.The risk of PICC-related bloodstream infection (CRBSI) in domestic hospitalized non-cancer patients was analyzed and systematically assessed.Results Of the 183 PICCs placed in 172 patients included in this study,61.7％ were placed in general wards,38.3％ were placed in ICU,87.8％ were placed in combination with indwelling urinary catheter,29.7％ were placed in combination with mechanical ventilation.The median PICC indwelling time was 35 days.CRBSI occurred in 6 patients with an incidence of 0.6/1000 PICCs/day.The risk of CRBSI was centralized in domestic tumor patients after PICC.The reported CRBSI was significantly different in hospitalized non-cancer patients (0.26-33.10/100 PICC).Conclusion The risk of CRBSI is lower in hospitalized patients after PICC placement than after traditional central venous catheter placement.Further studies are needed to assess its value in ICU.

Guiding endovascular treatment of symptomatic atherosclerotic stenosis of middle cerebral artery with high-resolution magnetic resonance imaging / 国际脑血管病杂志

Objective To investigate the application value of high-resolution magnetic resonance imaging (HR-MRI) as an auxiliary means to evaluate the atherosclerotic stenosis of middle cerebral artery (MCA) before endovascular intervention.Methods Patients with the new infarction or transient ischemic attack in the MCA territories were examined with HR-MRI and digital subtraction angiography (DSA).HR-MRI was used to study the characteristics of atherosclerotic plaques of MCA,qualitatively analyze vascular stenosis rate and plaque load,and qualitatively analyze the plaque location,enhancement degree,and remodeling pattern.The results of HR-MRI examination were used to guide the selection of treatment methods,and the perioperative complications and 3-month outcome of patients treated with intravascular interventional therapy were statistically analyzed.Correlation analysis and consistent evaluation of MCA stenosis rate and stenosis degree measured by DSA and HR-MRI were conducted.Results Atherosclerotic plaques and luminal stenosis in the MCA were found in 25 patients.Among them,13 (52.0％) had positive remodeling,10 (40.0％) had negative remodeling,and 8 (32.0％) had plaques on the sides of perforator arteries.Of the 17 patients who underwent enhanced scan,11 (64.7％) had mild enhancement and 6 (36.3％) had obvious enhancement.Six patients (24％) were treated with endovascular treatment without perioperative complications.Five patients had good outcome and 1 had poor outcome.The stenosis rates of MCA measured by DSA and HR-MRI were 68.05％ ± 21.65％ and 70.9％ ± 20.7％,respectively (t =1.673,P=0.107).The two methods had good correlation (r=0.917,P＜ 0.001).In addition,in the diagnosis of mild (P =0.500),moderate (P =0.063) and severe (P =0.250) stenoses,DSA and HR-MRI also had good consistency.Conclusion HR-MRI can clearly show the characteristics of the middle cerebral artery lumen and plaque.As a preoperative evaluation means for assisted endovascular treatment of atherosclerotic stenosis,it has an important application value.

Effects of carotid endarterectomy and carotid artery stenting on high-risk carotid stenosis patients

To analyze the clinical effects and safety of carotid endarterectomy [CEA] and carotid artery stenting [CA5] in the treatment of high-risk carotid stenosis patients. Total 63 patients who underwent CEA or CAS in our hospitals from January 2007 to December 2012 were selected in this study, and were randomly divided into an observation group and a control group. The patients in the observation group were subjected to CAS and those in the control group were subjected to CEA to compare the primary and secondary endpoints of the treatment. The arrival rates of the primary and secondary endpoints were 7.14% and 10.71% respectively in the observation group, while those were 11.43% and 11.43% respectively in the control group. There were no significant differences in the arrival rates of primary and secondary endpoints between the two groups [P > 0.05]. The efficacies and safety of CAS and CEA are similar in treating high-risk carotid stenosis patients

Effect of Low Frequency Electrical Stimulation on Dysphagia after Stroke / 中国康复理论与实践

@#Objective To observe the effect of low frequency electrical stimulation on dysphagia after stroke. Methods 60 patients with dysphagia after stroke were divided into treatment group and control group with 30 cases in each group. The control group was treated with swallowing exercise, while the treatment group was treated with low frequency electrical stimulation in addition. They were assessed with Fujishima's swallowing evaluation before and after treatment. Results The score increased after treatment in both groups (P<0.05), and increased more in the treatment group than in the control group (P<0.05). Conclusion Low frequency electrical stimulation can improve the effects of swallowing exercise on dysphagia after stroke.

Experimental study and clinical application of umbilical cord blood stem cells / 中国组织工程研究

Many studies have shown that experimental umbilical cord blood stem calls are even more primitive, more self-renewal, differentiation and reproductive potential of ex vivo expansion than bone marrow stem cells and peripheral blood stem calls. The preservation of cord blood stem cells and umbilical cord blood transplantation, and other clinical applications have made significant progress, but blood is also facing many problems. This article reviewed a variety of cord blood stem/progenitor calls of the biological characteristics of liver calls proliferation, differentiation, and the building of umbilical cord blood bank of neurology in clinical application.

Effect of Ginsenoside Rg1 on the expression of neuron specific enolase following focal cerebral ischemia in rats and its significance / 临床神经病学杂志

Objective To investigate the effect and significance of Ginsenoside Rg1 on the expression of neuron specific enolase (NSE) after focal cerebral ischemia in adult rats.Methods Ginsenoside Rg1 was given intraperitoneally in the rats twice a day at dose of 20 mg/kg for 5 days. Then the models of cerebral ischemia were made by occluding middle cerebral artery using an intraluminal filament method. At 3, 24, 48 and 72 h after focal cerebral ischemia, the neurological deficit score was evaluated and immunohistochemistry technique was used to observe the expressions of NSE. The above parameters were compared to control group and sham operation group.Results Compared with control group,at all the time points the neurological deficit scores were significantly decreased in Ginsenoside Rg1 group (all P