Predictive Factors for the Spontaneous Recanalization of Large and Middle Cerebral Arteries after Acute Occlusion.

OBJECTIVE: This study aims to investigate the predictive factors for the spontaneous recanalization of occluded arteries in patients with acute ischemic stroke. METHODS: A total of 139 patients with consecutive acute ischemic stroke were enrolled from June 2010 to June 2013. The clinical and biochemical parameters were measured in each participant. Occlusion and recanalization of the carotid artery, the middle cerebral artery, and the vertebral and basilar arteries were identified by using computed tomographic angiography or digital subtraction angiography. RESULTS: Among the 139 patients, 23 showed spontaneous recanalization, whereas 116 did not. In the patients with spontaneous recanalization, the proportion of atrial fibrillation was significantly lower (0% versus 29.31%, P= .01), whereas the proportion of stage 3 hypertension was significantly higher (60.87% versus 32.76%, P= .01) than that of those without recanalization. Logistic regression analysis showed that the proportion of atrial fibrillation was negatively (odds ratio [OR]: .117, 95% confidence interval [CI]: .015-.918, P= .04) associated with spontaneous recanalization, whereas the proportion of stage 3 hypertension was positively (OR: 4.316, 95% CI: 1.533-12.154, P= .01) associated with it. CONCLUSIONS: Atrial fibrillation is associated with reduced spontaneous recanalization of the large and middle cerebral arteries in patients after acute ischemic stroke-induced occlusion, whereas stage 3 hypertension may contribute to the promotion of the recanalization.

Impact of carotid artery stenosis on cognitive function in elderly patients: follow-up results / 中华神经医学杂志

Objective To assess the impact of carotid artery stenosis on the cognitive function of elderly patients. Methods A total of 215 elderly patients with normal cognitive function were recruited from the out-patients and in-patients in our department. According to the severity of carotid stenosis defined by digital subtraction angiography or CT angiography, these patients were divided into 4 groups with severe (stenosis≥70%), moderate (stenosis 30%-69%), mild (stenosis 10%-29%) carotid artery stenosis or basically normal carotid artery (stenosis 0%-9%). The patients were followed up for 1 year, and Mini-mental State Examination (MMSE) was used to evaluate the cognitive function of the 4 groups of patients at the end of the follow-up. Results At the end of the one-year follow-up, 43.1% of patients with severe carotid artery stenosis exhibited cognitive impairment, a rate significantly higher than that in patients with moderate (22%) and mild (8.3%) stenosis and the patients with basically normal carotid artery (8.7%)(P<0.05). The MMSE scores of the patients with severe, moderate, and mild carotid artery stenosis and those with normal carotid artery all decreased one year after the examination to 19.85± 7.54, 22.71±5.73, 25.32±4.22, and 25.25±4.36, respectively, and the patients with severe carotid artery stenosis had the lowest score. Conclusion Carotid artery stenosis may lead to cognitive impairment in the elderly, and the risk is positively correlated to the degree of carotid artery stenosis.

Effect of high-cholesterol diet on neuronal loss and Tau(ser202)phosphorylation in a rat model of Alzheimer's disease / 中华神经医学杂志

Objective To study the effect of high-cholesterol diet on neuronal loss and Tau (set202)phosphorylation in a rat model of Alzheimer's disease(AD). Methods Twenty rats were randomized into high-cholesterol diet+AD group,standard diet+AD group,high-cholesterol diet+PBS group,and standard diet+PBS group.In the former two groups,amyloid-β peptide(Aβ1-40)was injected into the right dentate gyms of the hippocampus to establish experimenml AD,and PBS was injected instead in the latter two groups.Corresponding feed was administered in the 4 groups aS indicated.The hippocampal neuronal loss in the rats Was assessed using Nissel staining,and the level of Tau(ser202)phosphorylation was estimated with immunohistochemistry.Result The mts in cholesterol+AD group exhibited serious neuronal loss at the rate of 30.9%±4.6%.which was significantly higher than those in standard diet+AD group(22.7%±1.9%),cholesterol+PBS group(7.0%±1.5%),and standard diet+PBS group(5.4%±1.1%).The numbers of Tau-positive cells in the dentate gyrus in the 4 groups were 65.5± 6.2,48.8±4.8,22.5±3.1,and 12.7±1.7,respectively. Conclusion High cholesterol diet aggravates neuronal loss and enhances Tan(ser202)phosphorylation in the dentate gyrus in AD rats.

Risk Factors of Cerebral Ischemia and Alzheimer's Disease / 国际脑血管病杂志

Alzheimer's disease (AD) is the most frequent type of dementia in elderly,which has been regarded as a neurodegenerative disease.The traditional point of view considers that AD and vascular dementia are two different types of dementias both from their pathogenesis and treatment;however,in recent years,a growing body of evidence indicates that the vascular factors are playing an important role in the development and occurrence of AD.This article reviews cerebral ischemia and its risk factors including the effects of hypertension,diabetes,and cholesterol in the development and occurrence of AD,so as to provide new strategies in preventing,and delaying the occurrence and progression of AD.

Clinical observation on effect of yangxue qingnao granule in treating patients with cerebral arteriosclerosis / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the efficacy of Yangxue Qingnao granule (YXQN) in treating cerebral arteriosclerosis and to explore its mechanisms.</p><p><b>METHODS</b>One hundred and sixty-seven patients with arteriosclerosis were randomly divided into the treated group treated with conventional medical treatment plus YXQN and the control group treated with conventional medical treatment alone, to observe the changes before and after treatment in scores of chief symptoms, mean velocity of cerebral blood flow (VM), plasma nitric oxide (NO), calcitonin gene related peptide (CGRP) and endothelin (ET) levels.</p><p><b>RESULTS</b>(1) After treatment in treated group, the scores of chief symptoms such as vertigo, headache and tinnitus were significantly lower than those in the control group (P < 0.05 or P < 0.01); (2) NO and CGRP level in the treated group after treatment obviously elevated, and ET and VM markedly reduced (P < 0.01), while no evident change of these parameters was found in the control group (P < 0.01).</p><p><b>CONCLUSION</b>The efficacy of YXQN in treating cerebral arteriosclerosis is definite, modulating the level of vasoactive factors was its important mechanism.</p>

Study of doppler ultrasounic scanning on carotid artery in patients with ischemic cerebrovascular diseases / 第三军医大学学报

Objective　To study the relationship between atherosclerotic plaques in carotid artery and ischemic cerebrovascular diseases. Methods　The extracranial carotid arteries (ECA) and middle cerebral artery (MCA) of 54 patients with transient ischemic attack (TIA) or cerebral infarction (CI) were examined with doppler ultrasound. The distribution of atherosclerotic plaque, degree of stenosis and ultrasounic classification of ECA and the mean velocity of blood flow in MCA were examined. Results　①Stenosis over middle-grade on asymptomatic side in extracranial internal carotid artery (EICA) in group of patients with TIA was significantly higher than symptomatic side(P<0.01). Stenosis over high-grade on asymptomatic side in ELCA in group of patients with CI was significantly higher than symptomatic side (P<0.01). ②Flat and soft plaque are most common in group of patients with TIA or CI, then are hard and ulcerative plaques. Incidence of soft plaques on asymptomatic side in group of patients with TIA or CI are significantly higher than symptomatic side (P<0.01); ③Among the group of patients with CI, mean velocity of MCA decreased on asymptomatic side in 31 cases (68.9%), and significantly higher than symptomatic side (P<0.01). Conclusion　Atheroclerotic plaques in carotid artery and intracranial hemodynamic characteristics are the important risk factors for ischemic cerebrovascular diseases. These findings have important values in predicting subsequent TIA or CI in asymptomatic subjects.

Study of doppler ultrasounic scanning on carotid artery in patients with ischemic cerebrovascular diseases / 第三军医大学学报

Objective　To study the relationship between atherosclerotic plaques in carotid artery and ischemic cerebrovascular diseases. Methods　The extracranial carotid arteries (ECA) and middle cerebral artery (MCA) of 54 patients with transient ischemic attack (TIA) or cerebral infarction (CI) were examined with doppler ultrasound. The distribution of atherosclerotic plaque, degree of stenosis and ultrasounic classification of ECA and the mean velocity of blood flow in MCA were examined. Results　①Stenosis over middle-grade on asymptomatic side in extracranial internal carotid artery (EICA) in group of patients with TIA was significantly higher than symptomatic side(P<0.01). Stenosis over high-grade on asymptomatic side in ELCA in group of patients with CI was significantly higher than symptomatic side (P<0.01). ②Flat and soft plaque are most common in group of patients with TIA or CI, then are hard and ulcerative plaques. Incidence of soft plaques on asymptomatic side in group of patients with TIA or CI are significantly higher than symptomatic side (P<0.01); ③Among the group of patients with CI, mean velocity of MCA decreased on asymptomatic side in 31 cases (68.9%), and significantly higher than symptomatic side (P<0.01). Conclusion　Atheroclerotic plaques in carotid artery and intracranial hemodynamic characteristics are the important risk factors for ischemic cerebrovascular diseases. These findings have important values in predicting subsequent TIA or CI in asymptomatic subjects.