Nuclear resonance fluorescence drug inspection.

There is an increasing challenge to prevent illicit drug smuggling across borders and seaports. However, the existing techniques in-and-of-themselves are not sufficient to identify the illicit drugs rapidly and accurately. In the present study, combining nuclear resonance fluorescence (NRF) spectroscopy and the element (or isotope) ratio approach, we present a novel inspection method that can simultaneously reveal the elemental (or isotopic) composition of the illicit drugs, such as widely abused methamphetamine, cocaine, heroin, ketamine and morphine. In the NRF spectroscopy, the nuclei are excited by the induced photon beam, and measurement of the characteristic energies of the emitted [Formula: see text] rays from the distinct energy levels in the excited nuclei provides "fingerprints" of the interested elements in the illicit drugs. The element ratio approach is further used to identify drug elemental composition in principle. Monte Carlo simulations show that four NRF peaks from the nuclei [Formula: see text]C, [Formula: see text]N and [Formula: see text]O can be detected with high significance of 7-24[Formula: see text] using an induced photon beam flux of [Formula: see text]. The ratio of [Formula: see text]/[Formula: see text] and/or [Formula: see text]/[Formula: see text] for illicit drugs inspected are then extracted using the element ratio approach. It is found that the present results of simulations are in good agreement with the theoretical calculations. The feasibility to detect the illicit drugs, inside the 15-mm-thick iron shielding, or surrounded by thin benign materials, is also discussed. It is indicated that, using the state-of-the-art [Formula: see text]-ray source of high intensity and energy-tunability, the proposed method has a great potential for identifying drugs and explosives in a realistic measurement time.

Photo-excitation production of medically interesting isomers using intense γ-ray source.

Photon-induced nuclear excitation (i.e. photo-excitation) can be used for production of nuclear isomers, which have potential applications in astrophysics, energy storage, medical diagnosis and treatment. This paper presents a feasibility study on photo-excitation production of four nuclear isomers (103mRh, 113m,115mIn and 176mLu) with intense γ-ray source based on laser-electron Compton scattering (LCS). The decay properties of these isomers and their potential applications in medical diagnosis and treatment were reviewed. The cross-section curve, simulated yield and activity of product of each photo-excitation process were calculated. The cutoff energy of LCS γ-ray beam was optimized by adjusting electron beam energy in order to maximize the isomer activity. It is found that the specific activity of the above-mentioned isomers can exceed ~0.2 GBq/g for 6-h target irradiation at an intensity of 1013 γ/s. Our simulation results suggest the prospect of producing medically interesting radionuclides with photo-excitation using the state-of-art LCS γ-ray beam facility.

The construction and application of image-thinking in traditional Chinese medicine treatment system of membranous nephropathy / 中国中西医结合急救杂志

As the core original thinking of traditional Chinese medicine (TCM), image-thinking has profoundly influenced the occurrence and development of TCM. The clinical application of TCM image thinking in membranous nephropathy is manifested in the pathogenesis, treatment principles and methods, use of drugs, prescription selection and other aspects. This paper expounds the role of image-thinking in the establishment of TCM treatment system of membranous nephropathy from the aspects of theory, method, prescription and medicine. It provides a holistic approach of syndrome differentiation and treatment for membranous nephropathy, and the therapeutic effect is obvious.

Non-contact Coculture Reveals a Comprehensive Response of Chondrocytes Induced by Mesenchymal Stem Cells Through Trophic Secretion

Coculture between mesenchymal stem cells (MSCs) and chondrocytes has significant implications in cartilage regeneration. However, a conclusive understanding remains elusive. Previously, we reported that rabbit bone marrow-derived MSCs (rbBMSCs) could downregulate the differentiated phenotype of rabbit articular chondrocytes (rbACs) in a non-contact coculture system for the first time. In the present study, a systemic investigation was performed to understand the biological characteristics of chondrocytes in coculture with MSCs. Firstly, cells (MSCs and chondrocytes) from different origins were cocultured in transwell system. Different chondrocytes, when cocultured with different MSCs respectively, consistently demonstrated stimulated proliferation, transformed morphology and declined glycosaminoglycan secretion of chondrocytes. Next, cell surface molecules and the global gene expression of rbACs were characterized. It was found that cocultured rbACs showed a distinct surface molecule profile and global gene expression compared to both dedifferentiated rbACs and rbBMSCs. In the end, cocultured rbACs were passaged and induced to undergo the chondrogenic redifferentiation. Better growth and chondrogenesis ability were confirmed compared with control cells without coculture. Together, chondrocytes display comprehensive changes in coculture with MSCs and the cocultured rbACs are beneficial for cartilage repair.

Hepatoprotective mechanism of Lygodium microphyllum (Cav.) R.Br. through ultrastructural signaling prevention against carbon tetrachloride (CCl4)-mediated oxidative stress.

Plants have been consumed in medicinal practices for centuries. Lygodium microphyllum (Cav.) R.Br. (Lygodiaceae), also known as Old World Climbing Fern, is a medicinal plant used by local communities in Sabah for skin and dysentery ailments. This study aims to test aqueous extract of L. microphyllum leaves for hepatoprotective and immunosuppressive activity in rats. Animal studies were carried out to evaluate hepatoprotection of aqueous extract of L. microphyllum at different doses (200, 400 and 600mg/kg b.w.) against carbon tetrachloride (CCl4)-mediated liver injury and histopathological alterations. Total phenolic content in aqueous extract of L. microphyllum leaves was 206.38±9.62mg gallic acid equivalent/g. The inhibitory concentration (IC50) for free radical scavenging activity of L. microphyllum was reached at a concentration of 65µg/ml.L. microphyllum was able to prevent the increase in levels of serum alanine aminotransferase, serum aspartate aminotransferase and hepatic malondialdehyde formation in a dose-dependent manner. Immunohistochemical results evidenced the suppression of oxidative stress markers (4-hydroxynonenal, 8-hydroxydeoxyguanosine) and pro-inflammatory cytokines (Tumor Necrosis Factor-α, Interleukin-6, Prostaglandin E2). Histopathological and hepatocyte ultrastructural alterations showed protective effects by L. microphyllum against CCl4-mediated oxidative stress. Hepatoprotective mechanism of L. microphyllum can be attributed to its antioxidative effects through protection of ultrastructural organelles.

Comparative analysis between extend endoscopic endonasal and open transcranial resection for craniopharyngiomas / 中国神经精神疾病杂志

Objective To compare the efficacy and complications of the extend endoscopic endonasal approach (EEA) and open transcranial approach for resection of craniopharyngiomas. Methods The clinical data from 46 patients with craniopharyngiomas with extend EEA and 54 patients with transcranial route in our department was analyzed retrospectively. The gross total resection (GTR) rate,length of hospital stays and complications of the two groups were compared. Results The tumor diameters of were larger in the endoscopic group than in the transcranial group (3.5 ± 1.3cm vs. 3.0±0.8 cm, P<0.05). The endoscopic group had a greater GTR rate (67.4％vs. 46.3％, P<0.05)and improved visual outcome(84.2％ vs. 59.5％,P<0.05),but lower rate of hypopituitarism (56.5％ vs. 75.9％,P<0.05)and permanent diabetes insipidus (51.4％ vs.72.7％,P<0.05). On the contrast, the endoscopic group had a greater rate of cerebrospinal fluid leak(4.3％ vs. 0.0％,P>0.05)and longer hospital stays(17.0±3.6 d vs. 13.1±2.3 d,P<0.01). Hyposmia(34.8％)and hemorrhinia (2.2％)only happened in the endoscopic group. Conclusion Compared with transcranial route, the extend EEA for craniopharyngiomas is minimal invasion and effective, which can effectively improve the GTR rate and reduce the clinical symptoms.

Clinical comparative analysis of 3D and 2D laparoscopic partial nephrectomy for renal tumors / 第二军医大学学报

Objective To compare the clinical efficacies of 3D and 2D laparoscopic partial nephrectomy for renal tumors and to investigate the pros and cons of 3D laparoscopic partial nephrectomy. Methods We retrospectively analyzed the clinical data of 134 patients with renal tumors; they underwent laparoscopic partial nephrectomy between Aug. 2013 and Mar. 2016 by the same surgical group in Changhai Hospital and Changzheng Hospital, Second Military Medical University. Fifty-three cases were included in the 3D laparoscopic partial nephrectomy group and 81 cases in the 2D laparoscopic partial nephrectomy group. The perioperative and follow-up data subjected to comparison and analysis included operative time, estimated blood loss, intraoperative transfusion, warm ischemic time, recovery time of bowel function, length of hospitalization, perioperative complications, and pre- and post-operative glomerular filtration rate (GFR). Results All operation procedures of this study were completed uneventfully without conversion to open surgery or radical nephrectomy, and surgical margins were negative in all cases. The operative time ([193.40±45.14] vs [217.00±59.19] min, P = 0.015), warm ischemic time ([23.70±6.96] vs [26.60±8.10] min, P = 0.032) and decrease of GFR of the operated kidney ([12.70 + 6.49] vs [15. 10 + 6. 45] mL • min-1 • 1. 73 m2, P = 0. 036) in the 3D group were significantly improved compared with those in the 2D group. However, the estimated blood loss, intraoperative transfusion, recovery time of bowtt function, length of hospitalization and perioperative complications were not significantly different between the two groups (P>0. 05). Att the patients with complications were discharged from the hospitat after conservative therapy. During a follow-up of 1-32 months, no patients had acute or chronic renat failure, local recurrence or distant metastasis, and there was no death case. Conclusion Compared with 2D laparoscopic partial nephrectomy, 3D laparoscopic technology can reduce operative time and warm ischemic time, which can help to better conserve renal function.

Nerve growth factor for the treatment of spinocerebellar ataxia type 3: an open-label study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Spinocerebellar ataxia type 3 (SCA3) is the most common subtype of SCA worldwide, and runs a slowly progressive and unremitting disease course. There is currently no curable treatment available. Growing evidence has suggested that nerve growth factor (NGF) may have therapeutic effects in neurodegenerative diseases, and possibly also in SCA3. The objective of this study was to test the efficacy of NGF in SCA3 patients.</p><p><b>METHODS</b>We performed an open-label prospective study in genetically confirmed adult (>18 years old) SCA3 patients. NGF was administered by intramuscular injection (18 μg once daily) for 28 days consecutively. All the patients were evaluated at baseline and 2 and 4 weeks after treatment using the Chinese version of the scale for assessment and rating of ataxia (SARA).</p><p><b>RESULTS</b>Twenty-one SCA3 patients (10 men and 11 women, mean age 39.14 ± 7.81 years, mean disease duration 4.14 ± 1.90 years, mean CAG repeats number 77.57 ± 2.27) were enrolled. After 28 days of NGF treatment, the mean total SARA score decreased significantly from a baseline of 8.48 ± 2.40 to 6.30 ± 1.87 (P < 0.001). Subsections SARA scores also showed significant improvements in stance (P = 0.003), speech (P = 0.023), finger chase (P = 0.015), fast alternating hand movements (P = 0.009), and heel-shin slide (P = 0.001).</p><p><b>CONCLUSIONS</b>Our preliminary data suggest that NGF may be effective in treating patients with SCA3.</p>

Study of clinical practical model of urinary system injury / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In order to improve the clinical treatment level of urinary system injury, it is necessary to build up an animal model of urinary system wound, which is not only analogous to real clinical practice, but also simple and practical.</p><p><b>METHODS</b>We have developed the third generation of firearm fragment wound generator based on the first and the second producer. The best explosive charge of the blank cartridge was selected by gradient powder loading experiments. The firearm fragment injuries were made to the bulbous urethra of 10 New Zealand male rabbits. One week preoperatively and 2, 4 and 8 weeks postoperatively, all the animals underwent urethroscopy and urethrography. At 2, 4 and 8 weeks postoperatively, two animals were randomly selected and killed, and the urethra was cut off for pathological examination.</p><p><b>RESULTS</b>The shooting distance of the third generation of firearm fragment wound generator is 2 cm. The best explosive charge of the blank cartridge is 1 g of nitrocotton. All rabbits survived the procedures and stayed alive until they were killed. Injuries were limited to bulbous urethra and distal urethra. Round damaged areas, 1-1.5 cm in length, on the ventral wall were observed. Ureteroscopy results showed that canal diameter gradually shrank by over 50% in 9 rabbits. The rate of success was 90%. Urethrography result noted that a 1-1.3 cm stricture was formed at the bulbous urethra. Histology results of injured stricture urethra showed that fibrous connective tissue hyperplasia and hyaline degeneration caused further stricture in the canal.</p><p><b>CONCLUSIONS</b>The third generation of firearm fragment wound generator imitates the bullet firing process and is more accurate and repeatable. The corresponding rabbit model of traumatic complex urethral stricture simulates the real complex clinical conditions. This animal model provides a standardized platform for clinical researches on treating traumatic injuries to the urinary system.</p>

Determination of Heavy Metal Levels in Fishes from the Lower Reach of the Kelantan River, Kelantan, Malaysia.

This study aimed to assess the concentrations of cadmium (Cd), nickel (Ni) and lead (Pb) in the tissues of fish collected from the lower reach of the Kelantan River, Malaysia. Fishes were collected using gill nets during the dry and wet seasons. A total of 78 individual fish were caught and comprised 6 families, 11 genera and 13 species. The dorsal muscle was analysed using a graphite furnace Atomic Absorption Spectrometer (AAS). The mean concentration of Cd in Chitala chitala (0.076 mg/kg) was above the critical limit values of the European Commission (EC), World Health Organization (WHO) and Food and Agriculture Organization (FAO). The mean concentrations of Cd in Barbonymus gonionatus and Tachysurus maculatus were already at the level of concern, whereas the other species were approaching the limits of permissible levels. No fish samples were found to have a Ni level higher than the permissible limit of 0.5-0.6 mg/kg set by the WHO (1985). Osteochilus hasseltii (0.169 mg/kg) and T. maculatus (0.156 mg/kg) showed high Pb concentrations. The concentrations of heavy metals were found to be elevated in the wet season (p<0.05). Omnivorous fish were detected with elevated concentrations of Cd and Ni, whereas carnivorous fish had the highest concentration of Pb. The concentrations of Cd and Pb in fish tissues were positively correlated with fish weight (p<0.05). This study determined that the fish species caught in the Kelantan River were contaminated with non-essential metals (Cd, Ni and Pb). Nevertheless, the heavy metal concentration in the fish tissues, with the exception of C. chitala, O. hasseltii and T. maculatus, did not exceed the EC, FAO, Malaysian Food Act (MFA) or WHO guidelines.

Reliability and validity of the Chinese version of the Scale for Assessment and Rating of Ataxia / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The Scale for the Assessment and Rating of Ataxia (SARA) was shown to be a reliable and valid measurement for patients with spinocerebellar ataxia (SCA). The Brazilian version and the Japanese version of SARA were favorable for good reliability and validity. This study aimed to translate SARA into Chinese and test its reliability and validity in measurement of cerebellar ataxia.</p><p><b>METHODS</b>SARA was translated into Chinese. A total 39 patients with degeneration cerebellar ataxia were evaluated independently by two neurologists with the Chinese version of SARA. Then the patients were evaluated by one of above neurologists with International Cooperative Ataxia Rating Scale (ICARS). The statistical analyses were performed using SPSS 17.0 for Windows.</p><p><b>RESULTS</b>The Cronbach's alpha coefficient of the Chinese version of SARA was 0.78, which represents a good internal consistence. The correlation coefficient of the Chinese version of SARA scores between the two evaluators was 0.86, illustrating that the inter-rater reliability of Chinese version of SARA was good. The correlation coefficient between the Chinese version of SARA and ICARS was 0.91, illustrating that the criterion validity of Chinese version of SARA was not bad.</p><p><b>CONCLUSIONS</b>The Chinese version of SARA is reliable and effective for the assessment of degeneration cerebellar ataxia. Compared with ICARS, the evaluation of Chinese version of SARA is more objective, the assessment time is shortened, and the maneuverability is better.</p>

Predictive value of the early modified National Institutes of Health Stroke Scale for the prognosis of ischemic stroke / 中华神经科杂志

Objective To investigate the predictive value of the modified National Institutes of Health Stroke Scale ( mNIHSS),measured within 9 days after stroke,for the outcome in terms of modified Rankin Scale (mRS) at 6 months after stroke.Methods AII 161 patients with acute anterior circulation ischemic stroke were recruited consecutively from July 2010 until November 2010.The mNIHSS score was assessed within 3 days,4 to 6 days and 7 to 9 days after stroke,and the mRS score at 6 months after stroke was assessed by a neurology resident.Spearman rank correlation and ROC curve were used for statistic analysis.Results One hundred and sixty-one patients were assessed within 3 days,at 4 to 6 days and 7 to 9 days after stroke.Significant Spearman rank correlation coefficients were found between mRS at 6 months and mNIHSS scores within 3 days (rs =0.592,P＜0.01 ),4 to 6 days (rs =0.597,P＜0.01 ) and 7 to 9days (rs =0.595,P＜0.01).At 6 months after stroke,the AUC ranged from 0.789 (95％ CI 0.708-0.856) for measurements within 3 days to 0.792 (95％ CI 0.712-0.857 ) and 0.799 ( 95％ CI 0.721-0.864) for 4 to 6 days and 7 to 9 days,respectively. There was no significant difference for the AUCbetween them.The optimal cut-off values for the prediction of prognosis at 6 months were 8,7 and 6 points of mNIHSS score within 3 days,4 to 6 days and 7 to 9 days,respectively.The negative predictive value gradually increased from 0.847 for assessment within 3 days to 0.867 ( 95％ CI 0.578-0.765 ) for 7 to 9 days,whereas positive predictive value declined from 0.601 for assessment within 3 days to 0.533 for 7 to 9 days.The overall accuracy of predtictions decreased from 0.753 for assessment within 3 days to 0.709 for 7 to 9 days.Conclusions When measured within 9 days,the mNIHSS has a good predictive value for final outcome in terms of mRS at 6 months after stroke.However,the optimal cut-off values for the prediction of prognosis at 6 months are different when early mNIHSS scores were assessed at different periods.

Study on the application and compliance of statins in secondary prevention of ischemic stroke and transient ischemic attacks / 中华神经科杂志

Objective To investigate the application of statins in secondary prevention of ischemic stroke and transient ischemic attacks (TIA) in different risk groups,and to identify the factors influencing the compliance of statins. Methods Data were prospectively collected on consecutively encountered ischemic stroke or TIA patients admitted to the First Affiliated Hospital of Zhengzhou University from April 2009 to January 2010.All clinical characteristics and possible factors influencing the compliance of statins were collected; the application of statins was investigated at 3-month follow-up.The multivariate Logistic regression analysis was used for the analysis of influence factors of the compliance of statins.Results All 369 patients were collected,52.8％ of cases were prescribed statins for therapy during hospitalization.The application rate of statins in accordance with guidelines in high-risk group,extremely high-risk Ⅱ group and extremely high-risk Ⅰ group was 25.0％ (16/64),44.1％ (30/68) and 71.4％ (135/189),respectively. Logistic regression analysis showed that the statins application during hospitalization was associated with diabetes history ( P =0.032,OR =1.789,95％ CI 1.052-3.043 ) and the presence of carotid vulnerable plaques(P =0.000,OR =5.308,95％ CI 3.340-8.434).The general application rate of statins was 22.3％ (81/363),which was significantly lower than that during hospitalization. The application rate of statins in accordance with guidelines in high-risk group,extremely high-risk Ⅱ group and extremely high-risk Ⅰ group was 9.7％ ( 6/62 ),25.8％ (17/66) and 29.4％ (55/187) respectively.Logistic regression analysis showed that good compliance of statins was associated with discharge instructions on statins application ( P =0.000,OR =34.852,95％ CI 14.673-175.452 ). Conclusions The compliance of statins in secondary prevention of ischemic stroke and TIA is poor,and there is still a large gap between clinical practice and guidelines; Discharge instructions on statins application increase the compliance of statins.

Blood pressure variability and stroke / 国际脑血管病杂志

Hypertension is an indep endent risk factor for stroke.Blood pressure variability is the result of the overall balance of in vivo dynamic regulation of the neuroendocrine system It is one of the essential characters of blood pressure.It is associated with the effects of the sensitivity of baroreceptor,physical activity,diseases and other factors.Blood pressure variability is closely associated with the target organ damage.An increasing number of studies have shown that blood pressure variability plays an important role in the occurrence and prognosis of stroke.It has a profound significance in the prevention and treatment of stroke.

Large artery intracranial occlusive disease / 国际脑血管病杂志

Large artery intracranial occlusive disease is a important and common vascular lesion type.It is closcly associated with the onset and recurrence of ischemic stroke; however,at present there are many inadequacies in the study of its etiology and treatment.This article mainly reviews the understanding process of the large artery intracranial occlusive disease,present research results and problems need to be solved.

Sex-dependent association of phosphodiesterase 4D gene polymorphisms with ischemic stroke in Henan Han population / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Recent evidence has implicated the gene for phosphodiesterase 4D (PDE4D) as susceptibility gene for ischemic stroke (IS) in Icelandic population. However, there are few reports on the associations between PDE4D gene polymorphisms and IS in Chinese individuals. The present study aimed to investigate the possible association of genetic polymorphisms in PDE4D gene with IS in Henan Han population.</p><p><b>METHODS</b>A total of 400 patients with IS and 400 matched controls were examined using a case-control design. Two single nucleotide polymorphism (SNPs) (rs918592 and rs2910829) in PDE4D gene were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Odds ratios (OR) and 95% confidence intervals (95%CI) were calculated to test the association between the genetic factors and IS. Genetic parameter and association studies were carried out with SPSS 16.0.</p><p><b>RESULTS</b>Among the two SNPs tested, the rs918592 was significantly associated with IS (OR: 1.351, 95%CI: 1.110 - 1.645), especially in male patients (OR: 1.427, 95%CI: 1.105 - 1.844). Haplotype analysis showed that A-T was associated with an increased risk of the IS (OR: 2.114, 95%CI: 2.005 - 2.230) while G-T was associated with decreased risk of IS (OR: 0.419, 95%CI: 0.302 - 0.583). Protecting effect of haplotype G-T was also significant in males (OR: 0.264, 95%CI: 0.162 - 0.431).</p><p><b>CONCLUSIONS</b>The present study demonstrated a strong association of rs918592 with IS. Haplotype A-T increased the risk of IS while haplotype G-T had a protective effect in Henan Han population. The association was sex-dependent with male patients showing stronger effect.</p>

Involvement of cytoskeleton-associated proteins in the commitment of C3H10T1/2 pluripotent stem cells to adipocyte lineage induced by BMP2/4.

The developmental pathway that gives rise to mature adipocytes involves two distinct stages: commitment and terminal differentiation. Although the important proteins/factors contributing to terminal adipocyte differentiation have been well defined, the proteins/factors in the commitment of mesenchymal stem cells to the adipocyte lineage cells have not. In this study, we applied proteomics analysis profiling to characterize differences between uncommitted C3H10T1/2 pluripotent stem cells and those that have been committed to the adipocyte lineage by BMP4 or BMP2 with the goal to identify such proteins/factors and to understand the molecular mechanisms that govern the earliest stages of adipocyte lineage commitment. Eight proteins were found to be up-regulated by BMP2, and 27 proteins were up-regulated by BMP4, whereas five unique proteins were up-regulated at least 10-fold by both BMP2/4, including three cytoskeleton-associated proteins (i.e. lysyl oxidase (LOX), translationally controlled tumor protein 1 (TPT1), and αB-crystallin). Western blotting further confirmed the induction of the expression of these cytoskeleton-associated proteins in the committed C3H10T1/2 induced by BMP2/4. Importantly, knockdown of LOX expression totally prevented the commitment, whereas knockdown of TPT1 and αB-crystallin expression partially inhibited the commitment. Several published reports suggest that cell shape can influence the differentiation of partially committed precursors of adipocytes, osteoblasts, and chondrocytes. We observed a dramatic change of cell shape during the commitment process, and we showed that knockdown of these cytoskeleton-associated proteins prevented the cell shape change and restored F-actin organization into stress fibers and inhibited the commitment to the adipocyte lineage. Our studies indicate that these differentially expressed cytoskeleton-associate proteins might determine the fate of mesenchymal stem cells to commit to the adipocyte lineage through cell shape regulation.

The evolution of the definition and risk stratification of transientischemic attack / 国际脑血管病杂志

Transient ischemic attack (TIA) is a common acute ischemic cerebrovascular disease.It is a risk warning sign and needs to be evaluated and treated urgently.This article reviews the development history of the definition of TIA and its evolution,and TIA prognostic rating scale in order to conduct a comprehensive evaluation,risk stratification and appropriate treatment in patients with TIA,thereby reducing the risk of stroke after TIA.

Basic characteristics and functional outcomes of 3123 consecutive patients in Chengdu stroke registry / 中华神经科杂志

Objective To analyze basic data and outcomes in Chengdu Stroke Registry.Methods The stroke patients consecutively admitted to Department of Neurology,West China Hospital,Sichuan University since March 1,2002 were prospectively registered.The baseline demographic,risk factors,treatment,and outcome data was recorded with standardized stroke register form by trained specialists.The patients were followed up at seven days,one,three,six months and one year after onset of the stroke for death and disability.Results A total of 3123 consecutive patients were registered between March 1,2002 and August 31,2006,of which 65.5％ came from urban areas and 34.5％ from rural areas.The age was (63.05 ± 17.98) years old and male accounted for 60.3％.Ninety-seven percent (3028/3123) of patients completed CT or MRI scanning during hospitalization.A total of 1804 patients were included between March 2002 and September 2004,of which ischemic stroke accounted for 62.1％ (1120/1804),intracranial hemorrhage 28.4％ (513/1804),subarachnoid hemorrhage 4.0％ (72/1804) and TIA 5.5％ (99/1804).The median NIHSS score on admission was 8(3-15) points in patients with cerebral hemorrhage,and 5(2-10) points in patients with ischemic stroke.Compared with the patients with intracranial hemorrhage,patients with ischemic stroke more frequently had a history of diabetes (OR =2.427,95％ CI 1.811- 3.253,P=0.000),atrial fibrillation (OR=6.121,95％ CI3.535-10.60,P=0.000),coronary heart disease (OR=4.144,95％ CI 2.944-5.832,P =0.000) and TIA (OR=4.342,95％ CI 1.726-10.92,P =0.001 ),and less alcohol consumption ( OR =0.740,95％ CI 0.611-0.896,P =0.002 ).The proportion of in-hospital treatments were thrombolysis 0.9％,anti-platelet therapy 83.0％,mannitol 23.5％,neuroprotective agents (citicoline) 68.1％,and Chinese herbal medicine 89.7％.Case fatality rate was 10.7％ and 13.9％ respectively at 7 days and one month for patients with intracranial hemorrhage,3.0％ and 5.2％ respectively for ischemic stroke.Death or disability was 40.4％,40.3％ and 38.9％ in patients with intracranial hemorrhage and 37.1％,35.0％ and 33.4％ for ischemic stroke at the end of 3,6,12 months respectively.Conclusions Our stroke registry is featured with the largest sample,and the longest period of consecutively registration.It provides an important platform for clinical investigation of stroke.Our study suggested case fatality and disability is lower in this group than in other ethics.Above features should be considered in design of future clinical trials in China.

Effect of the side of cerebral lesion on the outcome in patients with acute ischemic stroke / 国际脑血管病杂志

Objective To investigate the effect of the side of cerebral lesion on the outcome in patients with ischemic stroke.Methods A total of 407 consecutive anterior circulation ischemic stroke patients within 14 days after symptom onset were recruited prospectively.The basic data ofthe e,~ISes were collected,such as the National Institutes ofHealth Stroke Scale (NU-ISS)and the side ofcerebral lesion.The modified Rankin Scale(mRS)was used to evaluate the prognosis of the patients at 6 raomhs.Results Of the 407 patients recruited,230 patients (56.5%)Were left hemisphere stroke,177(43.5%)were fight hemisphere stroke.After multivariable logistic recession analysis,the age(odds ratio[OR]1.022,95% confidence interval[CI]1.001-1.043,P=0.040),the side of lesion(OR 1.999.95%CI1.179.3.389.P=0.010),the time from onset to admission(OR1.006,95%(7/1.002-1.010,P=0.007),the outcome of the anterior circulation ischcmic stroke at 6 months aftel"onset.The outcome of the right hemisphere stroke Was significantly worse than that of the left hemisphere stroke.The onset-admission time in patients with right hemisphere stroke(median 12 h,median 39.61 h)was significantly delayed compared to the patients with left hemisphere stroke(median 12 h,median 22.72 h;Z=-2.962,P=0.003).Condusions The outcome of the left hemisphere stroke at 6 months after onset is superior to the right hemisphere stroke,and it mau be associated with the delayed admission.