Stroke&Vascular Neurology(SVN)新近上线的文章“Risk factors of haemorrhagic transformation for acute ischemic stroke in Chinese patients receiving intravenous recombinant tissue plasminogen activator:a systematic r...Stroke&Vascular Neurology(SVN)新近上线的文章“Risk factors of haemorrhagic transformation for acute ischemic stroke in Chinese patients receiving intravenous recombinant tissue plasminogen activator:a systematic review and meta-analysis”,由四川大学华西医院神经内科何俐教授团队共同完成。展开更多
In this study, we used functional magnetic resonance imaging(fMRI) to investigate longitudinal changes in brain activation during a verbal working memory(VWM) task performed by patients who had experienced a transient...In this study, we used functional magnetic resonance imaging(fMRI) to investigate longitudinal changes in brain activation during a verbal working memory(VWM) task performed by patients who had experienced a transient ischemic attack(TIA). Twenty-five first-ever TIA patients without visible lesions in conventional MRI and 25 healthy volunteers were enrolled. VWM task-related fMRI was conducted 1 week and 3 months post-TIA. The brain activity evoked by the task and changes over time were assessed. We found that, compared with controls, patients exhibited an increased activation in the bilateral inferior frontal gyrus(IFG), right dorsolateral prefrontal cortex(DLPFC), insula, inferior parietal lobe(IPL), and cerebellum during the task performed 1 week post-TIA. But only the right IFG still exhibited an increased activation at 3 months post-TIA. A direct comparison of fMRI data between 1 week and 3 months post-TIA showed greater activation in the bilateral middle temporal gyrus, right DLPFC, IPL, cerebellum, and left IFG in patients at 1 week post-TIA. We conclude that brain activity patterns induced by a VWM task remain dynamic for a period of time after a TIA, despite the cessation of clinical symptoms. Normalization of the VWM activation pattern may be progressively achieved after transient episodes of ischemia in TIA patients.展开更多
Nonhuman primates are closest to humans in terms of lineage, and middle cerebral artery ischemia/reperfusion responses of nonhuman primates are most similar to ischemic stroke in humans. Therefore, nonhuman primates c...Nonhuman primates are closest to humans in terms of lineage, and middle cerebral artery ischemia/reperfusion responses of nonhuman primates are most similar to ischemic stroke in humans. Therefore, nonhuman primates could be utilized to simulate the process of ischemic stroke in the human. Few studies, however, have reported the use of endovascular technology to establish a rhesus monkey stroke model. In the present study, seven adult, male, rhesus monkeys were selected and, following anesthesia, a microcatheter was inserted into one side of the middle cerebral artery via the femoral artery to block blood flow, thereby resulting in middle cerebral artery occlusion. After 2 hours, the microcatheter was withdrawn to restore the middle cerebral artery blood flow and to establish ischemia/reperfusion. Results from angiography and magnetic resonance angiography confirmed occlusion and reopening of the middle cerebral artery. Magnetic resonance imaging revealed the existence of ischemic brain lesions, and neurological examination showed sustained functional deficits following surgery. The rhesus monkey middle cerebral artery ischemia/reperfusion models established by microcatheter embolization had the advantage of non-craniotomy invasion and reproducibility. The scope and degree of ischemic damage using this model was controllable. Therefore, this nonhuman primate model is an ideal model for cerebral ischemia and reperfusion.展开更多
Objective To identify risk factors for haemorrhagic transformation in Chinese patients with acute ischaemic stroke treated with recombinant tissue plasminogen activator.Methods We searched electronic databases includi...Objective To identify risk factors for haemorrhagic transformation in Chinese patients with acute ischaemic stroke treated with recombinant tissue plasminogen activator.Methods We searched electronic databases including PubMed,EMBASE,CNKI and WanFang Data for studies reporting risk factors of haemorrhagic transformation after intravenous thrombolysis.Pooled OR,weighted mean difference(WMD)and 95%CI were estimated.Meta-analysis was performed by using Stata V.14.0 software.results A total of 14 studies were included.The results indicated that older age(WMD=3.46,95%CI 2.26 to 4.66,I^(2)=47),atrial fibrillation(OR 2.66,95%CI 1.85 to 3.81,I^(2)=28),previous stroke(OR 1.68,95%CI 1.08 to 2.60,I^(2)=14),previous antiplatelet treatment(OR 1.67,95%CI 1.17 to 2.38,I^(2)=0),higher National Institute of Health stroke scale scores(OR 1.10,95%CI 1.05 to 1.15,I^(2)=36),systolic(WMD=4.75,95%CI 2.50 to 7.00,I^(2)=42)or diastolic(WMD=2.67,95%CI 1.08 to 4.26,I^(2)=35)pressure,and serum glucose level(WMD=1.44,95%CI 0.62 to 2.26,I^(2)=66)were associated with increased risk of post-thrombolysis haemorrhagic transformation.Conclusion The current meta-analysis identified eight risk factors for post-thrombolysis haemorrhagic transformation in Chinese patients with acute ischaemic stroke.Given the risk of bias,these results should be explained with caution and do not justify withholding intravenous thrombolysis.展开更多
Objective:Various risk scoring models have been developed to predict stroke-associated pneumonia(SAP).We aim to determine whether these risk models could effectively predict SAP in Chinese patients with ischaemic stro...Objective:Various risk scoring models have been developed to predict stroke-associated pneumonia(SAP).We aim to determine whether these risk models could effectively predict SAP in Chinese patients with ischaemic stroke(IS).Methods:Consecutive patients with IS in West China hospital between January 2011 and September 2013 were included to assess the predictive performance of risk scoring models,including Chumbler’s score,A^(2)DS^(2) and AISAPS.The area under the receiver operating characteristic curve(AUROC)was used to evaluate the performance of each risk model in predicting pneumonia.Results:A total of 1569 consecutive patients with IS within 30 days of onset in West China hospital were included.The incidence of pneumonia is 15.3%.The AUROC of Chumbler’s score,A^(2)DS^(2) and AISAPS was 0.659,0.728 and 0.758,respectively,and AISAPS had the highest AUROC.Conclusions:A^(2)DS^(2) and AISAPS had acceptable discriminatory abilities to predict SAP in Chinese patients with IS within 30 days of onset.展开更多
文摘Stroke&Vascular Neurology(SVN)新近上线的文章“Risk factors of haemorrhagic transformation for acute ischemic stroke in Chinese patients receiving intravenous recombinant tissue plasminogen activator:a systematic review and meta-analysis”,由四川大学华西医院神经内科何俐教授团队共同完成。
基金supported by the National Natural Science Foundation of China (81300943 and 81472162)the Postdoctoral Science Special Foundation of China (2014T70867)
文摘In this study, we used functional magnetic resonance imaging(fMRI) to investigate longitudinal changes in brain activation during a verbal working memory(VWM) task performed by patients who had experienced a transient ischemic attack(TIA). Twenty-five first-ever TIA patients without visible lesions in conventional MRI and 25 healthy volunteers were enrolled. VWM task-related fMRI was conducted 1 week and 3 months post-TIA. The brain activity evoked by the task and changes over time were assessed. We found that, compared with controls, patients exhibited an increased activation in the bilateral inferior frontal gyrus(IFG), right dorsolateral prefrontal cortex(DLPFC), insula, inferior parietal lobe(IPL), and cerebellum during the task performed 1 week post-TIA. But only the right IFG still exhibited an increased activation at 3 months post-TIA. A direct comparison of fMRI data between 1 week and 3 months post-TIA showed greater activation in the bilateral middle temporal gyrus, right DLPFC, IPL, cerebellum, and left IFG in patients at 1 week post-TIA. We conclude that brain activity patterns induced by a VWM task remain dynamic for a period of time after a TIA, despite the cessation of clinical symptoms. Normalization of the VWM activation pattern may be progressively achieved after transient episodes of ischemia in TIA patients.
基金the National High Technology Program of China,No.2006AA02A117
文摘Nonhuman primates are closest to humans in terms of lineage, and middle cerebral artery ischemia/reperfusion responses of nonhuman primates are most similar to ischemic stroke in humans. Therefore, nonhuman primates could be utilized to simulate the process of ischemic stroke in the human. Few studies, however, have reported the use of endovascular technology to establish a rhesus monkey stroke model. In the present study, seven adult, male, rhesus monkeys were selected and, following anesthesia, a microcatheter was inserted into one side of the middle cerebral artery via the femoral artery to block blood flow, thereby resulting in middle cerebral artery occlusion. After 2 hours, the microcatheter was withdrawn to restore the middle cerebral artery blood flow and to establish ischemia/reperfusion. Results from angiography and magnetic resonance angiography confirmed occlusion and reopening of the middle cerebral artery. Magnetic resonance imaging revealed the existence of ischemic brain lesions, and neurological examination showed sustained functional deficits following surgery. The rhesus monkey middle cerebral artery ischemia/reperfusion models established by microcatheter embolization had the advantage of non-craniotomy invasion and reproducibility. The scope and degree of ischemic damage using this model was controllable. Therefore, this nonhuman primate model is an ideal model for cerebral ischemia and reperfusion.
基金This work was supported by the National Natural Science Foundation of China(grant no.81571153).
文摘Objective To identify risk factors for haemorrhagic transformation in Chinese patients with acute ischaemic stroke treated with recombinant tissue plasminogen activator.Methods We searched electronic databases including PubMed,EMBASE,CNKI and WanFang Data for studies reporting risk factors of haemorrhagic transformation after intravenous thrombolysis.Pooled OR,weighted mean difference(WMD)and 95%CI were estimated.Meta-analysis was performed by using Stata V.14.0 software.results A total of 14 studies were included.The results indicated that older age(WMD=3.46,95%CI 2.26 to 4.66,I^(2)=47),atrial fibrillation(OR 2.66,95%CI 1.85 to 3.81,I^(2)=28),previous stroke(OR 1.68,95%CI 1.08 to 2.60,I^(2)=14),previous antiplatelet treatment(OR 1.67,95%CI 1.17 to 2.38,I^(2)=0),higher National Institute of Health stroke scale scores(OR 1.10,95%CI 1.05 to 1.15,I^(2)=36),systolic(WMD=4.75,95%CI 2.50 to 7.00,I^(2)=42)or diastolic(WMD=2.67,95%CI 1.08 to 4.26,I^(2)=35)pressure,and serum glucose level(WMD=1.44,95%CI 0.62 to 2.26,I^(2)=66)were associated with increased risk of post-thrombolysis haemorrhagic transformation.Conclusion The current meta-analysis identified eight risk factors for post-thrombolysis haemorrhagic transformation in Chinese patients with acute ischaemic stroke.Given the risk of bias,these results should be explained with caution and do not justify withholding intravenous thrombolysis.
文摘Objective:Various risk scoring models have been developed to predict stroke-associated pneumonia(SAP).We aim to determine whether these risk models could effectively predict SAP in Chinese patients with ischaemic stroke(IS).Methods:Consecutive patients with IS in West China hospital between January 2011 and September 2013 were included to assess the predictive performance of risk scoring models,including Chumbler’s score,A^(2)DS^(2) and AISAPS.The area under the receiver operating characteristic curve(AUROC)was used to evaluate the performance of each risk model in predicting pneumonia.Results:A total of 1569 consecutive patients with IS within 30 days of onset in West China hospital were included.The incidence of pneumonia is 15.3%.The AUROC of Chumbler’s score,A^(2)DS^(2) and AISAPS was 0.659,0.728 and 0.758,respectively,and AISAPS had the highest AUROC.Conclusions:A^(2)DS^(2) and AISAPS had acceptable discriminatory abilities to predict SAP in Chinese patients with IS within 30 days of onset.
