Background Delirium is a form of acute brain dysfunction and geriatric patients are particularly vulnerable to this health problem.The aim of the study was to assess the incidence of delirium and determine the risk fa...Background Delirium is a form of acute brain dysfunction and geriatric patients are particularly vulnerable to this health problem.The aim of the study was to assess the incidence of delirium and determine the risk factors for delirium in patients≥60 years of age hospitalized due to acute myocardial infarction(AMI).Methods The study included 405 consecutive patients(mean age:73.1±8.5,males:61%)hospitalized due to AMI divided and characterized according to the in-hospital delirium presence.Results Of 405 patients,57(14%,mean age:80.9±7.3,males:58%)experienced delirium.Patients with delirium were older(80.9±7.3 vs.71.82±8.1 years),all of them presented multimorbidity,they more frequently used polypharmacy(96.5 vs.30.2%)and their hospitalization was longer(8.0±1.4 vs.4.6±1.0 days)as compared to the patients without delirium.Patients with delirium more frequently experience periprocedural complications as well as the in-hospital reversible problems:fever(40.4 vs.0.9%),infections(78.9 vs.3.7%),pulmonary oedema(73.7 vs.0.6%),hypoxemia(91.1 vs.98.3%),urinary catheter(96.5 vs.17.2%),dehydration(89.5 vs.6.6%),and insomnia(71.9 vs.0.3%)compared to patients without delirium(P<0.001 for all).Valvular heart disease(OR=4.78;95%CI:1.10-2.70;P<0.001,pulmonary oedema(OR=66.79;95%CI:12.04-370.34,P<0.001),and dehydration(OR=37.26;95%CI:10.50-132.27,P<0.001)were risk factors for delirium occurrence.Conclusions The in-hospital course of AMI is complicated by delirium occurrence in 14%of patients≥60 years old.Recognizing and modification of potential,reversible risk factors associated with AMI can reduce the risk of delirium.展开更多
Objectives To study the relationship between plasma BNP and cardiac structural, functional changes after AMI, and to evaluate the application of plasma BNP determination in predicting the early phase of ventricle remo...Objectives To study the relationship between plasma BNP and cardiac structural, functional changes after AMI, and to evaluate the application of plasma BNP determination in predicting the early phase of ventricle remodeling after AMI. Methods AMI group included 37 patients, all patient underwent strict medical treatment; 32 healthy individuals were enrolled as controls. Plasma BNP was determinated by immunofluorescence. Echocardiograrn examination was used to determinate LVEF, VE , VA , VE/ VA , LVEDd, LVEDV ; All patients underwent the examinations at 72 h, 30 days and 90 days after AMI occurred, respectively, and were compared with healthy controls. Results In comparing to controls, Plasma BNP in AMI 72 h, 30 days and 90 days elevated significantly. LVEDd and LVEDV were increased significantly in all 3 phases of AMI, and EF, VE/ Va were significantly lower than in controls. Correlation analysis revealed that plasma BNP level in 72 h after AMI was positively correlated to LVEDd, LVEDV, and was positively correlated to EF, VE/ VA in 30 days and 90 days after AMI. Conclusions Plasma BNP level in 72 h after AMI is a powerful index to predict left ventricle remodeling and ventricle function as plasm BNP level is positively correlated to ventricle remodeling; lowering the plasm BNP level might be used as an end point for treatment of heart failure. （ S Chin J Cardiol 2009 ; 10（4） ： 208 -211）展开更多
Objectives To observe the efficacy and safety of recombinant human brain natriuretic peptide(rh-BNP) on patients with acute myocardial infarction complicating congestive heart failure.Methods 40 patients with acute my...Objectives To observe the efficacy and safety of recombinant human brain natriuretic peptide(rh-BNP) on patients with acute myocardial infarction complicating congestive heart failure.Methods 40 patients with acute myocardial infarction complicated by congestive heart failure were randomly divided into control group and treatment group of 20 cases.The control group,15 cases of acute anterior myocardial infarction,5 cases of acute inferior wall myocardial infarction, 15 males and 5 females,aged 55-70 years,mean age 58±12 years;treated 16 cases of acute anterior myocardial infarction,4 cases of acute myocardial infarction,16 males and 4 females,aged 56-70 years,mean age 59±11 years;two groups of age,gender,severity of disease and vascular lesions no significant difference and comparable(P】0.05).Conventional group were given aspirin,clopidogrel, statins,Inotropic,diuretic and vasodilator therapy.In the con- ventional treatment group based on the use of recombinant human brain natriuretic peptide(new bios,Tibet Pharmaceutical Co.,Ltd.Chengdu Nuodikang biopharmaceutical production, usage:1.5μg/Kg intravenous injection(impact), then 0.0075μg-0.01μg/(kg·min)infusion rate).Continuous medication 72 h.The clinical symptoms observed for 3 days in patients before treatment and after treatment,heart rate,blood pressure and left ventricular ejection fraction (LVEF) and tumor necrosis factor(TNF-α),brain natriuretic peptide(BNP) levels were measured.Results In control group,8 cases markedly effect,5 cases effect and 7 cases no effect,the total effective rate was 65%;In treatment group,13 cases markedly effect,6 cases effect and 1 cases no effect,the total effective rate was 95%,compared with two groups P New bios treatment group significantly increased cardiac index(CI) in patients with heart failure and left ventricular ejection fraction(LVEF) than the control group(all P【0.05),further reduce the levels of tumor necrosis (TNF-α) and brain natriuretic peptide(BNP).Conclusions rh-BNP can improve symptoms and heart function,reduced plasma tumor necrosis factor(TNF-α) and BNP levels of acute myocardial infarction patients with congestive heart failure,the treatment safe and reliable.As small sample size observed,larger sample to be accumulated to further evaluate its efficacy and safety.展开更多
Objective: To study the prevalence of silent cerebral infarction in Type II diabetes mellitus. Patients and Methods: The study was a prospective on 80 patients recruited from neurology, endocrine outpatient clinics. P...Objective: To study the prevalence of silent cerebral infarction in Type II diabetes mellitus. Patients and Methods: The study was a prospective on 80 patients recruited from neurology, endocrine outpatient clinics. Patients were type II diabetics as described by the American Diabetes Association, 2011 criteria. All patients underwent full metabolic profiles to diagnose diabetes mellitus and MRI brain scans to detect cerebral infarction. Results: Silent cerebral infarctions were detected in 60% of patients (48/80 patients) predominately along periventricular white matter area and subcortical areas (Basal ganglia, Thalamus). Conclusion: Asymptomatic Type II diabetes mellitus patients could have vascular cerebral changes without neurological symptoms. MRI brain scans could be recommended as routine diagnosis (if possible) for early cerebral infarct detection in type II diabetic patients.展开更多
Objective:To evaluate the clinical efficacy of intravenous recombinant human brain natriuretic peptide(rhBNP)in patients with acute myocardial infarction after on-pump coronary artery bypass grafting(CABG).Methods:40 ...Objective:To evaluate the clinical efficacy of intravenous recombinant human brain natriuretic peptide(rhBNP)in patients with acute myocardial infarction after on-pump coronary artery bypass grafting(CABG).Methods:40 cases of coronary heart disease,left ventricular ejection fraction<50%and(plasma brain natriuretic peptide in type N terminal)NT-proBNP>300 pg/ml underwent on-pump coronary artery bypass surgery with cardiopulmonary bypass were enrolled and randomly divided into two groups,experimental group of 20 patients after operation on the basis of conventional therapy plus recombinant human brain natriuretic peptide treatment(first loading dose of 1.5μg/kg intravenously,to maintain dose of 0.01μg/kg/min continuous infusion of 72h),20 cases of the control group was given routine treatment,observe two groups of patients before and after treatment of blood pressure,heart rate,urine volume,blood creatinine and NT-proBNP,and to observe the left ventricular ejection fraction(LVEF),echocardiography and the length of time the index.Results:the experimental group after treatment,urine volume,left ventricular ejection fraction(LVEF),cardiac index(CI)was significantly higher than that before treatment,the serum creatinine,plasma N-terminal pro brain natriuretic peptide(NTproBNP),the content of serum troponin T peptide(cT nT),creatine kinase isoenzyme(CK MB)was significantly lower than before treatment.Conclusion:Recombinant human brain natriuretic peptide can improve cardiac and renal function in patients with acute period of acute myocardial infarction underwent coronary artery bypass surgery,shorten the hospitalization time,and it is safe and feasible.展开更多
Measurement of oxygen concentration and distribution in brain is essential to understanding the pathophysiology of stroke. Although brain oxygen level is critical for brain tissue survival,
Objective:To observe the influence of tirofiban on the troponin, brain natriuretic peptide, heart function in patients with Acute Myocardial Infarction after PCI and provide scientific basis for treatment of acute myo...Objective:To observe the influence of tirofiban on the troponin, brain natriuretic peptide, heart function in patients with Acute Myocardial Infarction after PCI and provide scientific basis for treatment of acute myocardial infarction.Methods:A total of 100 cases of hypertensive cerebral hemorrhage patients in our hospital were selected and randomly divided into 2 groups: the control group (50 cases) and the observation group (50 cases). The conventional treatment of PCI was performed on both groups. Tirofiban injection was given to the observation group on the basis of conventional treatment. cTnI, BNP and echocardiography parameters (LVEF, LVEDD, LVESD) were detected before and after treatment.Results:The comparison of cTnI in the two groups before operation was not statistically significant. cTnI in the 2 groups increased 12 h and 24 h after operation. But the cTnI in observation group (0.10±0.23) ng/mL decreased more significantly than that in control group (0.24±0.31) ng/mL, the difference was considered to be statistically significant. The comparison of BNP in the two groups before operation was not statistically significant. BNP in the 2 groups decreased obviously 7 d and 30 d after operation. BNP in observation group decreased more significantly than that in control group and the difference was considered to be statistically significant LVEF in the observation group increased significantly compared with that in control group 7 d after operation. The comparison of LVEDD, LVESD were not considered to be statistically significant. LVEDD and LVESD in the observation group were lower than that in control group obviously 30 d after operation. While the LVEF in the observation group was still higher than that in the control group. The comparsion was considered to be statistically significant.Conclusion:Tirofiban can improve the troponin, brain natriuretic peptide, heart function in patients with Acute Myocardial Infarction after PCI. It can also decrease the heart injury as well as helping the recovery of heart function.展开更多
Objective:To investigate the effect of recombinant human brain natriuretic peptide (BNP) on inflammatory factors, neuroendocrine hormones and cardiac function indexes in patients with acute myocardial infarction compl...Objective:To investigate the effect of recombinant human brain natriuretic peptide (BNP) on inflammatory factors, neuroendocrine hormones and cardiac function indexes in patients with acute myocardial infarction complicated with heart failure.Methods:A total of91 cases of acute myocardial infarction with heart failure patients were divided into the control group (n=44) and observation group (n=47) according to the random data table, two groups of patients were given conventional treatment, based on this, the control group was given intravenous infusion of Nitroglycerin Injection treatment, the observation group received intravenous injection of recombinant human brain natriuretic peptide treatment, compared serum inflammatory factors, neuroendocrine hormone and cardiac function and other indexes of two groups before and after treatment.Results: there was no significant difference between the two groups before treatment. After treatment, the levels of TNF-α, hs-CRP, IL-6, MCP-1, LVESD and LVEDD in the two groups were significantly lower than those within the group before treatment, and the observation group was significantly lower than the control group;The two groups after treatment LVEF levels were significantly higher than those in the group before treatment, and the observation group was significantly higher than that of control group;the observation group after treatment PRA, Ang II and ALD and NE levels were significantly lower than those before treatment, and was significantly lower than the control group after treatment, the difference was significant, PRA, Ang, ALD and NE levels of control group before and after the treatment was no significant difference.Conclusion:recombinant human brain natriuretic peptide in the treatment of acute myocardial infarction with heart failure can effectively reduce the serum inflammatory factors and neuroendocrine hormone levels, improve heart function, and have a certain clinical value.展开更多
Objectives: To explore applied value on CT and BA in diagnosis of patients with athero-thrombotic brain infarction. Methods :CT and BA were examined in 246 patients with atherothrombotic brain infarction. Results:The ...Objectives: To explore applied value on CT and BA in diagnosis of patients with athero-thrombotic brain infarction. Methods :CT and BA were examined in 246 patients with atherothrombotic brain infarction. Results:The different change of CT and BA were showed in 246 patients with atherothrombotic brain infarction. Conclusions: There were separately different advantage and shortcoming in CT and BA in diagnosis of atherothrombotic brain infarction. The value of clinical application of BA was important in diagnosis of atherothrombotic brain infarction.展开更多
Neuroprotection by ischemic preconditioning has been confirmed by many studies, but the precise mechanism remains unclear. In the present study, we performed cerebral ischemic pre- conditioning in rats by simulating a...Neuroprotection by ischemic preconditioning has been confirmed by many studies, but the precise mechanism remains unclear. In the present study, we performed cerebral ischemic pre- conditioning in rats by simulating a transient ischemic attack twice （each a 20-minute occlusion of the middle cerebral artery） before inducing focal cerebral infarction （2 hour occlusion-reper- fusion in the same artery）. We also explored the mechanism underlying the neuroprotective effect of ischemic preconditioning. Seven days after ocdusion-reperfusion, tetrazolium chloride staining and immunohistochemistry revealed that the infarct volume was significantly smaller in the group that underwent preconditioning than in the model group. Furthermore, vascular endothelial growth factor immunoreactivity was considerably greater in the hippocampal CA3 region of preconditioned rats than model rats. Our results suggest that the protective effects of ischemic preconditioning on focal cerebral infarction are associated with upregulation of vascu- lar endothelial growth factor.展开更多
Previous studies have demonstrated the protective effect of hypoxic preconditioning on acute cerebral infarction, but the mechanisms underlying this protection remain unclear. To investigate the protective mechanisms ...Previous studies have demonstrated the protective effect of hypoxic preconditioning on acute cerebral infarction, but the mechanisms underlying this protection remain unclear. To investigate the protective mechanisms of hypoxic preconditioning in relation to its effects on angiogenesis, we in- duced a photochemical model of cerebral infarction in an inbred line of mice （BALB/c）. Mice were then exposed to hypoxic preconditioning 30 minutes prior to model establishment. Results showed significantly increased vascular endothelial growth factor and CD31 expression in the ischemic penumbra at 24 and 72 hours post infarction, mainly in neurons and vascular endothelial cells. Hypoxic preconditioning increased vascular endothelial growth factor and CD31 expression in the ischemic penumbra and the expression of vascular endothelial growth factor was positively related to that of CD31. Moreover, hypoxic preconditioning reduced the infarct volume and improved neu- rological function in mice. These findings indicate that the protective role of hypoxic preconditioning in acute cerebral infarction may possibly be due to an increase in expression of vascular endothelial growth factor and CD31 in the ischemic penumbra, which promoted angiogenesis.展开更多
A model of focal cerebral ischemic infarction was established in dogs through middle cerebral artery occlusion of the right side.Thirty minutes after occlusion,models were injected with nerve growth factor adjacent to...A model of focal cerebral ischemic infarction was established in dogs through middle cerebral artery occlusion of the right side.Thirty minutes after occlusion,models were injected with nerve growth factor adjacent to the infarct locus.The therapeutic effect of nerve growth factor against cerebral infarction was assessed using the hemisphere anomalous volume ratio,a quantitative index of diffusion-weighted MRI.At 6 hours,24 hours,7 days and 3 months after modeling,the hemisphere anomalous volume ratio was significantly reduced after treatment with nerve growth factor. Hematoxylin-eosin staining,immunohistochemistry,electron microscopy and neurological function scores showed that infarct defects were slightly reduced and neurological function significantly improved after nerve growth factor treatment.This result was consistent with diffusion-weighted MRI measurements.Experimental findings indicate that nerve growth factor can protect against cerebral infarction,and that the hemisphere anomalous volume ratio of diffusion-weighted MRI can be used to evaluate the therapeutic effect.展开更多
Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons,and high-frequency repetitive transcranial magnetic stimulation can increase the exc...Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons,and high-frequency repetitive transcranial magnetic stimulation can increase the excitability of cortical neurons.However,there are few studies concerning the use of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper-limb motor function after cerebral infarction.We hypothesized that different frequencies of repetitive transcranial magnetic stimulation in patients with cerebral infarction would produce different effects on the recovery of upper-limb motor function.This study enrolled 127 patients with upper-limb dysfunction during the subacute phase of cerebral infarction.These patients were randomly assigned to three groups.The low-frequency group comprised 42 patients who were treated with 1 Hz repetitive transcranial magnetic stimulation on the contralateral hemisphere primary motor cortex(M1).The high-frequency group comprised 43 patients who were treated with 10 Hz repetitive transcranial magnetic stimulation on ipsilateral M1.Finally,the sham group comprised 42 patients who were treated with 10 Hz of false stimulation on ipsilateral M1.A total of 135 seconds of stimulation was applied in the sham group and high-frequency group.At 2 weeks after treatment,cortical latency of motor-evoked potentials and central motor conduction time were significantly lower compared with before treatment.Moreover,motor function scores were significantly improved.The above indices for the low-and high-frequency groups were significantly different compared with the sham group.However,there was no significant difference between the low-and high-frequency groups.The results show that low-and high-frequency repetitive transcranial magnetic stimulation can similarly improve upper-limb motor function in patients with cerebral infarction.展开更多
BACKGROUND： Studies have demonstrated that the risk factors of vascular dementia following stroke are greatly different in region, race and other aspects. OBJECTIVE： To analyze the conditions and incidental risk fac...BACKGROUND： Studies have demonstrated that the risk factors of vascular dementia following stroke are greatly different in region, race and other aspects. OBJECTIVE： To analyze the conditions and incidental risk factors of vascular dementia in patients with acute cerebral infarction from Chongqing City. DESIGN： Case analysis. SETTING： Department of Neurology, Daping Hospital, Third Military Medical University of Chinese PLA. PARTICIPANTS： Altogether 546 inpatients with acute ischemic stroke admitted to Department of Neurology, Daping Hospital, Third Military Medical University of Chinese PLA between May 1999 and December 2002 were involved in this study. The involved patients, including 295 males and 251 females, aged 55 - 94 years, dwelled in Chongqing over 5 years. They were admitted to hospital within 48 hours of attack of acute ischemic stroke, and survived for over 3 months. Informed consents were obtained from all the involved subjects. METHODS： ① Following the same standard, cognitive and social function evaluations were conducted by one physician on admission and 3 months after admission, Unified questionnaire, consisting of general characteristics, vascular risk factors, stroke characteristics, neurological physical sign, and other 28 factors of involved subjects, was used in all the patients. According to the investigation results, the patients were assigned into 2 groups： dementia group and non-dementia group. ②Ischemic stroke was diagnosed according to acute ischemic brain disorder 〉 24 hours and CT or MRI imageology.③ Neurophysiological examination was conducted in all the patients at 7 to l0 days after stroke （score was two SD less than or equaled to normal level was considered as abnormal）. ④Diagnosis and statistics of dementia were carried out with Mini-Mental State Examination and The Diagnostic and Statistical Manual of Mental Disorders-Ⅳ （published by American Psychiatric Association） on admission and 3 months after admission. Neurologic deficit scoring was carried out with the National Institutes of Health Stroke Scale. ⑤ Chi-square test was used for categorical variable, and t test for quantitative variable between dementia group and non-dementia group. Dementia-related factors were performed multiple-factor Logistic regression model analysis. MAIN OUTCOME MEASURES： Incidence of dementia and dementia-related risk factors of patients. RESULTS： Altogether 546 patients with stroke were involved in this study, 403 of them participated in the final analysis, and 143 dropped out. A total of 342 were followed-up in the hospital and 61 at home. At 3 months after cerebral infarction, vascular dementia occurred in 87 （21.6%） of 403 patients. The main risk factors were age （OR 1.179; 95%CI 1.130 - 1.230）, low education level （OR 1.806; 95%CI 1.024 - 3.186）, daily alcohol drinking （OR 3.447; 95%（1/ 1.591 - 7.468）, stroke history （OR 2.531; 95%CI 1.419 - 4.512）, atrial fibrilation（OR 3.475; 95%CI 1.712 - 7.057）, dysphonia （OR 5.873; 95%6/2.620 - 13.163） and left carotid artery infarction （OR 1.975; 95%（1/1.152 - 3.388）. CONCLUSION： The incidence of vascular dementia is determined by synthetic action of multiple risk factors. Dysphonia is the most important influencing factor.展开更多
We investigated the effects of ipsilateral versus bilateral limb-training on promotion of endogenous neural stem cells in the peripheral infarct zone and the corresponding cerebral region in the unaffected hemisphere ...We investigated the effects of ipsilateral versus bilateral limb-training on promotion of endogenous neural stem cells in the peripheral infarct zone and the corresponding cerebral region in the unaffected hemisphere of rats with cerebral infarction. Middle cerebral artery occlusion was induced in Wistar rats. The rat forelimb on the unaffected side was either wrapped up with tape to force the use of the paretic forelimb in rats or not braked to allow bilateral forelimbs to participate in training. Daily training consisted of mesh drum training, balance beam training, and stick rolling training for a total of 40 minutes, once per day. Control rats received no training. At 14 days after functional training, rats receiving bilateral limb-training exhibited milder neurological impairment than that in the ipsilateral limb-training group or the control group. The number of nestin/glial fibrillary acidic protein-positive and nestin/microtubule-associated protein 2-positive cells in the peripheral infarct zone and in the corresponding cerebral region in the unaffected hemisphere was significantly higher in rats receiving bilateral limb-training than in rats receiving ipsilateral limb-training. These data suggest that bilateral limb-training can promote the proliferation and differentiation of endogenous neural stem cells in the bilateral hemispheres after cerebral infarction and accelerate the recovery of neurologic function. In addition, bilateral limb-training produces better therapeutic effects than ipsilateral limb-training.展开更多
Auditory evoked magnetic fields were recorded from 15 patients with acute cerebral infarction and 11 healthy volunteers using magnetoencephalography.The auditory stimuli of 2 kHz pure tone were binaurally presented wi...Auditory evoked magnetic fields were recorded from 15 patients with acute cerebral infarction and 11 healthy volunteers using magnetoencephalography.The auditory stimuli of 2 kHz pure tone were binaurally presented with an interstimulus interval of 1 second.The intensity of stimuli was 90 dB and the stimulus duration was 8 ms.The results showed that the M100 was the prominent response, peaking approximately 100 ms after stimulus onset in all subjects.It originated from the area close to Heschl’s gyrus.In the patient group,the peak latency of M100 responses was significantly prolonged,and the mean strength of equivalent current dipole was significantly smaller in the affected hemisphere.The three-dimensional inter-hemispheric difference of the M100 positions was increased in the patient group.Our experimental findings suggested that impairment of cerebral function in patients with acute ischemic stroke can be detected using magnetoencephalography with the higher spatial resolution and temporal resolution.Magnetoencephalography could provide objective and sensitive indices to estimate auditory cortex function in patients with acute cerebral infarction.展开更多
Objective: To explore the characteristics of brain functional network with anxiety in patients with acute cerebral infarction. Methods: A total of 39 patients with acute cerebral infarction by cranial magnetic resonan...Objective: To explore the characteristics of brain functional network with anxiety in patients with acute cerebral infarction. Methods: A total of 39 patients with acute cerebral infarction by cranial magnetic resonance examination were included, and all the patients were scored by the Hamilton Anxiety Scale. The anxiety scale is scored by a professional psychiatrist. There are a total of 14 items, including anxiety, nervousness, fear, insomnia, cognitive function, depressed mood, somatic anxiety, sensory system, etc. The total score ≥ 29 points may be severe;≥21 points, there must be obvious;≥14 points, there must be anxiety;a score of more than 7 may indicate anxiety. If the score is less than 7, there are no anxiety symptoms. All patients within 24 to 72 hours, complete the head examination magnetic resonance, computerized calculation of the DWI sequence images, according to the results of the calculation to superimpose the image of the lesion, image reconstruction in space, and carry out Binarization, defining the value of lesions as 1, and the value of non as 0. All lesions are superimposed into one image and integrated. The relationship between the lesions in this superimposed image and anxiety after cerebral infarction was analyzed. Results: The lesions were basically concentrated around the lateral ventricle, and they were mainly concentrated around the lateral ventricle. Conclusion: Patients with acute cerebral infarction in the lateral ventricle or basal ganglia are more prone to post-stroke anxiety. This has a certain evaluation value for the prognosis of future cerebral infarction, and has a certain understanding of the exploration of complications, and has a certain understanding of the exploration of complications.展开更多
We report on silent brain infarction (SBI) and leuko- araiosis (LA) of 23 patients with clinically diagnosed “first-ever” acute ischemic lacunar stroke. The lacunar syndromes were pure motor hemiparesis (10), pure s...We report on silent brain infarction (SBI) and leuko- araiosis (LA) of 23 patients with clinically diagnosed “first-ever” acute ischemic lacunar stroke. The lacunar syndromes were pure motor hemiparesis (10), pure sensory syndrome (2), ataxic hemiparesis (3), dysarthria clumsy hand syndrome (3), and sensory- motor deficit (5). Nineteen out of the 23 patients presented with completed strokes on arrival to the hospital, and 4 (17%) developed evolving-stroke within 24 hours of stroke onset. A lacune corresponded to the acute stroke could be found in all patients on brain magnetic resonance imaging (MRI), and in 18 (78%) on brain computed tomography (CT). MRI showed additional subclinical or asymptomatic “silent brain infarctions or lacunes” (SBI) in 19 (83%) of 23 patients, and leuko-araiosis (LA) of moderate to severe degree (> grade 2) was present in 61% of patients although dementia was absent. Hypertension is the risk factor in 78% of cases followed by diabetes mellitus, smoking, and elevated plasma cholesterol level. Independence of the types of lacunar syndromes, patients with hypertension and diabetes mellitus are associated with high grade LA. None with normal blood pressure and plasma glucose had grade 3 or grade 4 LA (p < 0.05). In conclusion, evolving-stroke occurs in one- fifth of patients with “first-ever” lacunar infarct within the first 24 hours of stroke onset. SBI was found in 83% of cases. Hypertension and diabetes mellitus are associated with additional SBI and high grade LA. The severity of leuko-araiosis per se dictates the cerebrovascular risks.展开更多
Pulmonary arteriovenous malformation (PAVM), which is asymptomatic in most cases, is often identified in patients with central nervous system disorders such as brain abscesses and/or cerebral infarctions. We have repo...Pulmonary arteriovenous malformation (PAVM), which is asymptomatic in most cases, is often identified in patients with central nervous system disorders such as brain abscesses and/or cerebral infarctions. We have reported a patient with idiopathic multiple PAVM identified at the onset of cerebral infarction. A 69-year-old woman visited the Department of Neuropathic Internal Medicine at our hospital with chief complaints of numbness in her left hand and a feeling of weakness. The patient was given a diagnosis of subacute cerebral infarction. Multiple old lacunar infarctions were also observed in the deep white matter of the left frontal lobe. Chest computed tomography showed multiple nodular structures, mainly in the right lower lung field (S8), as well as continuous arteries and veins at the site;thus, the patient was finally diagnosed with multiple PAVM. Right lower thoracoscopic lobectomy was performed, as is typical surgical practice in such cases. The patient had a favorable postoperative course, and had no recurrence of cerebral infarction. Although the patient’s lesions were mainly restricted to S8, the fact that there were multiple lesions deemed a lobectomy as the appropriate course of treatment. This case emphasizes that attention should be paid to cases of multiple PAVM since cerebral infarction may arise from the disease.展开更多
To investigate the value of N-terminal prohormone brain natriuretic peptide （NT-proBNP） in the evaiuation of the coronary artery condition （ degree of the coronary artery lesion severity and complexity） in patient...To investigate the value of N-terminal prohormone brain natriuretic peptide （NT-proBNP） in the evaiuation of the coronary artery condition （ degree of the coronary artery lesion severity and complexity） in patients with ST-segment elevation myocardial infarction （STEMI）. Methods Eighty patients with STEMI diagnosed by electrocardiogram （ECG） were selected. The concentration of plasma NT-proBNP was measured by electrochemiluminescence immunoassay, and the value of NT-proBNP concentration to evaluate the degree of severity and complexity in coronary artery lesion by coronary angiography （CAG） was analyzed. Results The more serious and more complex of coronary artery lesion in patients with ST-segment elevation myocardial infarction, the higher the concentration of plasma NT-proBNP was （ P 〈 0. 05 ）. Conclusion The concentration of plasma NT-proBNP may be a useful marker to evaluate the degree of severity and complexity of coronary artery lesion in patients with ST-segment elevation myocardial infarction. （ S Chin J Cardiol 2009 ; 10 （ 1 ） ： 15-18）展开更多
基金supported by the First Department of Cardiology,School of Medicine in Katowice,Medical University of Silesia,Katowice,Poland.
文摘Background Delirium is a form of acute brain dysfunction and geriatric patients are particularly vulnerable to this health problem.The aim of the study was to assess the incidence of delirium and determine the risk factors for delirium in patients≥60 years of age hospitalized due to acute myocardial infarction(AMI).Methods The study included 405 consecutive patients(mean age:73.1±8.5,males:61%)hospitalized due to AMI divided and characterized according to the in-hospital delirium presence.Results Of 405 patients,57(14%,mean age:80.9±7.3,males:58%)experienced delirium.Patients with delirium were older(80.9±7.3 vs.71.82±8.1 years),all of them presented multimorbidity,they more frequently used polypharmacy(96.5 vs.30.2%)and their hospitalization was longer(8.0±1.4 vs.4.6±1.0 days)as compared to the patients without delirium.Patients with delirium more frequently experience periprocedural complications as well as the in-hospital reversible problems:fever(40.4 vs.0.9%),infections(78.9 vs.3.7%),pulmonary oedema(73.7 vs.0.6%),hypoxemia(91.1 vs.98.3%),urinary catheter(96.5 vs.17.2%),dehydration(89.5 vs.6.6%),and insomnia(71.9 vs.0.3%)compared to patients without delirium(P<0.001 for all).Valvular heart disease(OR=4.78;95%CI:1.10-2.70;P<0.001,pulmonary oedema(OR=66.79;95%CI:12.04-370.34,P<0.001),and dehydration(OR=37.26;95%CI:10.50-132.27,P<0.001)were risk factors for delirium occurrence.Conclusions The in-hospital course of AMI is complicated by delirium occurrence in 14%of patients≥60 years old.Recognizing and modification of potential,reversible risk factors associated with AMI can reduce the risk of delirium.
文摘Objectives To study the relationship between plasma BNP and cardiac structural, functional changes after AMI, and to evaluate the application of plasma BNP determination in predicting the early phase of ventricle remodeling after AMI. Methods AMI group included 37 patients, all patient underwent strict medical treatment; 32 healthy individuals were enrolled as controls. Plasma BNP was determinated by immunofluorescence. Echocardiograrn examination was used to determinate LVEF, VE , VA , VE/ VA , LVEDd, LVEDV ; All patients underwent the examinations at 72 h, 30 days and 90 days after AMI occurred, respectively, and were compared with healthy controls. Results In comparing to controls, Plasma BNP in AMI 72 h, 30 days and 90 days elevated significantly. LVEDd and LVEDV were increased significantly in all 3 phases of AMI, and EF, VE/ Va were significantly lower than in controls. Correlation analysis revealed that plasma BNP level in 72 h after AMI was positively correlated to LVEDd, LVEDV, and was positively correlated to EF, VE/ VA in 30 days and 90 days after AMI. Conclusions Plasma BNP level in 72 h after AMI is a powerful index to predict left ventricle remodeling and ventricle function as plasm BNP level is positively correlated to ventricle remodeling; lowering the plasm BNP level might be used as an end point for treatment of heart failure. （ S Chin J Cardiol 2009 ; 10（4） ： 208 -211）
文摘Objectives To observe the efficacy and safety of recombinant human brain natriuretic peptide(rh-BNP) on patients with acute myocardial infarction complicating congestive heart failure.Methods 40 patients with acute myocardial infarction complicated by congestive heart failure were randomly divided into control group and treatment group of 20 cases.The control group,15 cases of acute anterior myocardial infarction,5 cases of acute inferior wall myocardial infarction, 15 males and 5 females,aged 55-70 years,mean age 58±12 years;treated 16 cases of acute anterior myocardial infarction,4 cases of acute myocardial infarction,16 males and 4 females,aged 56-70 years,mean age 59±11 years;two groups of age,gender,severity of disease and vascular lesions no significant difference and comparable(P】0.05).Conventional group were given aspirin,clopidogrel, statins,Inotropic,diuretic and vasodilator therapy.In the con- ventional treatment group based on the use of recombinant human brain natriuretic peptide(new bios,Tibet Pharmaceutical Co.,Ltd.Chengdu Nuodikang biopharmaceutical production, usage:1.5μg/Kg intravenous injection(impact), then 0.0075μg-0.01μg/(kg·min)infusion rate).Continuous medication 72 h.The clinical symptoms observed for 3 days in patients before treatment and after treatment,heart rate,blood pressure and left ventricular ejection fraction (LVEF) and tumor necrosis factor(TNF-α),brain natriuretic peptide(BNP) levels were measured.Results In control group,8 cases markedly effect,5 cases effect and 7 cases no effect,the total effective rate was 65%;In treatment group,13 cases markedly effect,6 cases effect and 1 cases no effect,the total effective rate was 95%,compared with two groups P New bios treatment group significantly increased cardiac index(CI) in patients with heart failure and left ventricular ejection fraction(LVEF) than the control group(all P【0.05),further reduce the levels of tumor necrosis (TNF-α) and brain natriuretic peptide(BNP).Conclusions rh-BNP can improve symptoms and heart function,reduced plasma tumor necrosis factor(TNF-α) and BNP levels of acute myocardial infarction patients with congestive heart failure,the treatment safe and reliable.As small sample size observed,larger sample to be accumulated to further evaluate its efficacy and safety.
文摘Objective: To study the prevalence of silent cerebral infarction in Type II diabetes mellitus. Patients and Methods: The study was a prospective on 80 patients recruited from neurology, endocrine outpatient clinics. Patients were type II diabetics as described by the American Diabetes Association, 2011 criteria. All patients underwent full metabolic profiles to diagnose diabetes mellitus and MRI brain scans to detect cerebral infarction. Results: Silent cerebral infarctions were detected in 60% of patients (48/80 patients) predominately along periventricular white matter area and subcortical areas (Basal ganglia, Thalamus). Conclusion: Asymptomatic Type II diabetes mellitus patients could have vascular cerebral changes without neurological symptoms. MRI brain scans could be recommended as routine diagnosis (if possible) for early cerebral infarct detection in type II diabetic patients.
文摘Objective:To evaluate the clinical efficacy of intravenous recombinant human brain natriuretic peptide(rhBNP)in patients with acute myocardial infarction after on-pump coronary artery bypass grafting(CABG).Methods:40 cases of coronary heart disease,left ventricular ejection fraction<50%and(plasma brain natriuretic peptide in type N terminal)NT-proBNP>300 pg/ml underwent on-pump coronary artery bypass surgery with cardiopulmonary bypass were enrolled and randomly divided into two groups,experimental group of 20 patients after operation on the basis of conventional therapy plus recombinant human brain natriuretic peptide treatment(first loading dose of 1.5μg/kg intravenously,to maintain dose of 0.01μg/kg/min continuous infusion of 72h),20 cases of the control group was given routine treatment,observe two groups of patients before and after treatment of blood pressure,heart rate,urine volume,blood creatinine and NT-proBNP,and to observe the left ventricular ejection fraction(LVEF),echocardiography and the length of time the index.Results:the experimental group after treatment,urine volume,left ventricular ejection fraction(LVEF),cardiac index(CI)was significantly higher than that before treatment,the serum creatinine,plasma N-terminal pro brain natriuretic peptide(NTproBNP),the content of serum troponin T peptide(cT nT),creatine kinase isoenzyme(CK MB)was significantly lower than before treatment.Conclusion:Recombinant human brain natriuretic peptide can improve cardiac and renal function in patients with acute period of acute myocardial infarction underwent coronary artery bypass surgery,shorten the hospitalization time,and it is safe and feasible.
文摘Measurement of oxygen concentration and distribution in brain is essential to understanding the pathophysiology of stroke. Although brain oxygen level is critical for brain tissue survival,
文摘Objective:To observe the influence of tirofiban on the troponin, brain natriuretic peptide, heart function in patients with Acute Myocardial Infarction after PCI and provide scientific basis for treatment of acute myocardial infarction.Methods:A total of 100 cases of hypertensive cerebral hemorrhage patients in our hospital were selected and randomly divided into 2 groups: the control group (50 cases) and the observation group (50 cases). The conventional treatment of PCI was performed on both groups. Tirofiban injection was given to the observation group on the basis of conventional treatment. cTnI, BNP and echocardiography parameters (LVEF, LVEDD, LVESD) were detected before and after treatment.Results:The comparison of cTnI in the two groups before operation was not statistically significant. cTnI in the 2 groups increased 12 h and 24 h after operation. But the cTnI in observation group (0.10±0.23) ng/mL decreased more significantly than that in control group (0.24±0.31) ng/mL, the difference was considered to be statistically significant. The comparison of BNP in the two groups before operation was not statistically significant. BNP in the 2 groups decreased obviously 7 d and 30 d after operation. BNP in observation group decreased more significantly than that in control group and the difference was considered to be statistically significant LVEF in the observation group increased significantly compared with that in control group 7 d after operation. The comparison of LVEDD, LVESD were not considered to be statistically significant. LVEDD and LVESD in the observation group were lower than that in control group obviously 30 d after operation. While the LVEF in the observation group was still higher than that in the control group. The comparsion was considered to be statistically significant.Conclusion:Tirofiban can improve the troponin, brain natriuretic peptide, heart function in patients with Acute Myocardial Infarction after PCI. It can also decrease the heart injury as well as helping the recovery of heart function.
基金Basic Research Program of Jiangsu Province(Natural Science Foundation of China)(BK2015125).
文摘Objective:To investigate the effect of recombinant human brain natriuretic peptide (BNP) on inflammatory factors, neuroendocrine hormones and cardiac function indexes in patients with acute myocardial infarction complicated with heart failure.Methods:A total of91 cases of acute myocardial infarction with heart failure patients were divided into the control group (n=44) and observation group (n=47) according to the random data table, two groups of patients were given conventional treatment, based on this, the control group was given intravenous infusion of Nitroglycerin Injection treatment, the observation group received intravenous injection of recombinant human brain natriuretic peptide treatment, compared serum inflammatory factors, neuroendocrine hormone and cardiac function and other indexes of two groups before and after treatment.Results: there was no significant difference between the two groups before treatment. After treatment, the levels of TNF-α, hs-CRP, IL-6, MCP-1, LVESD and LVEDD in the two groups were significantly lower than those within the group before treatment, and the observation group was significantly lower than the control group;The two groups after treatment LVEF levels were significantly higher than those in the group before treatment, and the observation group was significantly higher than that of control group;the observation group after treatment PRA, Ang II and ALD and NE levels were significantly lower than those before treatment, and was significantly lower than the control group after treatment, the difference was significant, PRA, Ang, ALD and NE levels of control group before and after the treatment was no significant difference.Conclusion:recombinant human brain natriuretic peptide in the treatment of acute myocardial infarction with heart failure can effectively reduce the serum inflammatory factors and neuroendocrine hormone levels, improve heart function, and have a certain clinical value.
文摘Objectives: To explore applied value on CT and BA in diagnosis of patients with athero-thrombotic brain infarction. Methods :CT and BA were examined in 246 patients with atherothrombotic brain infarction. Results:The different change of CT and BA were showed in 246 patients with atherothrombotic brain infarction. Conclusions: There were separately different advantage and shortcoming in CT and BA in diagnosis of atherothrombotic brain infarction. The value of clinical application of BA was important in diagnosis of atherothrombotic brain infarction.
文摘Neuroprotection by ischemic preconditioning has been confirmed by many studies, but the precise mechanism remains unclear. In the present study, we performed cerebral ischemic pre- conditioning in rats by simulating a transient ischemic attack twice （each a 20-minute occlusion of the middle cerebral artery） before inducing focal cerebral infarction （2 hour occlusion-reper- fusion in the same artery）. We also explored the mechanism underlying the neuroprotective effect of ischemic preconditioning. Seven days after ocdusion-reperfusion, tetrazolium chloride staining and immunohistochemistry revealed that the infarct volume was significantly smaller in the group that underwent preconditioning than in the model group. Furthermore, vascular endothelial growth factor immunoreactivity was considerably greater in the hippocampal CA3 region of preconditioned rats than model rats. Our results suggest that the protective effects of ischemic preconditioning on focal cerebral infarction are associated with upregulation of vascu- lar endothelial growth factor.
基金supported by the National Natural Science Foundation of China,No.30870854the Natural Science Foundation of Beijing,No.7111003the Natural Science Foundation of Shandong Province,No.ZR2010HM029
文摘Previous studies have demonstrated the protective effect of hypoxic preconditioning on acute cerebral infarction, but the mechanisms underlying this protection remain unclear. To investigate the protective mechanisms of hypoxic preconditioning in relation to its effects on angiogenesis, we in- duced a photochemical model of cerebral infarction in an inbred line of mice （BALB/c）. Mice were then exposed to hypoxic preconditioning 30 minutes prior to model establishment. Results showed significantly increased vascular endothelial growth factor and CD31 expression in the ischemic penumbra at 24 and 72 hours post infarction, mainly in neurons and vascular endothelial cells. Hypoxic preconditioning increased vascular endothelial growth factor and CD31 expression in the ischemic penumbra and the expression of vascular endothelial growth factor was positively related to that of CD31. Moreover, hypoxic preconditioning reduced the infarct volume and improved neu- rological function in mice. These findings indicate that the protective role of hypoxic preconditioning in acute cerebral infarction may possibly be due to an increase in expression of vascular endothelial growth factor and CD31 in the ischemic penumbra, which promoted angiogenesis.
基金supported by the Hebei Provincial Medical Science Research Key Youth Project,No.20100078
文摘A model of focal cerebral ischemic infarction was established in dogs through middle cerebral artery occlusion of the right side.Thirty minutes after occlusion,models were injected with nerve growth factor adjacent to the infarct locus.The therapeutic effect of nerve growth factor against cerebral infarction was assessed using the hemisphere anomalous volume ratio,a quantitative index of diffusion-weighted MRI.At 6 hours,24 hours,7 days and 3 months after modeling,the hemisphere anomalous volume ratio was significantly reduced after treatment with nerve growth factor. Hematoxylin-eosin staining,immunohistochemistry,electron microscopy and neurological function scores showed that infarct defects were slightly reduced and neurological function significantly improved after nerve growth factor treatment.This result was consistent with diffusion-weighted MRI measurements.Experimental findings indicate that nerve growth factor can protect against cerebral infarction,and that the hemisphere anomalous volume ratio of diffusion-weighted MRI can be used to evaluate the therapeutic effect.
基金several colleague therapists of the Rehabilitation Medicine Department of the Affiliated Hospital of Qingdao University of China for their support and selfless help
文摘Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons,and high-frequency repetitive transcranial magnetic stimulation can increase the excitability of cortical neurons.However,there are few studies concerning the use of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper-limb motor function after cerebral infarction.We hypothesized that different frequencies of repetitive transcranial magnetic stimulation in patients with cerebral infarction would produce different effects on the recovery of upper-limb motor function.This study enrolled 127 patients with upper-limb dysfunction during the subacute phase of cerebral infarction.These patients were randomly assigned to three groups.The low-frequency group comprised 42 patients who were treated with 1 Hz repetitive transcranial magnetic stimulation on the contralateral hemisphere primary motor cortex(M1).The high-frequency group comprised 43 patients who were treated with 10 Hz repetitive transcranial magnetic stimulation on ipsilateral M1.Finally,the sham group comprised 42 patients who were treated with 10 Hz of false stimulation on ipsilateral M1.A total of 135 seconds of stimulation was applied in the sham group and high-frequency group.At 2 weeks after treatment,cortical latency of motor-evoked potentials and central motor conduction time were significantly lower compared with before treatment.Moreover,motor function scores were significantly improved.The above indices for the low-and high-frequency groups were significantly different compared with the sham group.However,there was no significant difference between the low-and high-frequency groups.The results show that low-and high-frequency repetitive transcranial magnetic stimulation can similarly improve upper-limb motor function in patients with cerebral infarction.
文摘BACKGROUND： Studies have demonstrated that the risk factors of vascular dementia following stroke are greatly different in region, race and other aspects. OBJECTIVE： To analyze the conditions and incidental risk factors of vascular dementia in patients with acute cerebral infarction from Chongqing City. DESIGN： Case analysis. SETTING： Department of Neurology, Daping Hospital, Third Military Medical University of Chinese PLA. PARTICIPANTS： Altogether 546 inpatients with acute ischemic stroke admitted to Department of Neurology, Daping Hospital, Third Military Medical University of Chinese PLA between May 1999 and December 2002 were involved in this study. The involved patients, including 295 males and 251 females, aged 55 - 94 years, dwelled in Chongqing over 5 years. They were admitted to hospital within 48 hours of attack of acute ischemic stroke, and survived for over 3 months. Informed consents were obtained from all the involved subjects. METHODS： ① Following the same standard, cognitive and social function evaluations were conducted by one physician on admission and 3 months after admission, Unified questionnaire, consisting of general characteristics, vascular risk factors, stroke characteristics, neurological physical sign, and other 28 factors of involved subjects, was used in all the patients. According to the investigation results, the patients were assigned into 2 groups： dementia group and non-dementia group. ②Ischemic stroke was diagnosed according to acute ischemic brain disorder 〉 24 hours and CT or MRI imageology.③ Neurophysiological examination was conducted in all the patients at 7 to l0 days after stroke （score was two SD less than or equaled to normal level was considered as abnormal）. ④Diagnosis and statistics of dementia were carried out with Mini-Mental State Examination and The Diagnostic and Statistical Manual of Mental Disorders-Ⅳ （published by American Psychiatric Association） on admission and 3 months after admission. Neurologic deficit scoring was carried out with the National Institutes of Health Stroke Scale. ⑤ Chi-square test was used for categorical variable, and t test for quantitative variable between dementia group and non-dementia group. Dementia-related factors were performed multiple-factor Logistic regression model analysis. MAIN OUTCOME MEASURES： Incidence of dementia and dementia-related risk factors of patients. RESULTS： Altogether 546 patients with stroke were involved in this study, 403 of them participated in the final analysis, and 143 dropped out. A total of 342 were followed-up in the hospital and 61 at home. At 3 months after cerebral infarction, vascular dementia occurred in 87 （21.6%） of 403 patients. The main risk factors were age （OR 1.179; 95%CI 1.130 - 1.230）, low education level （OR 1.806; 95%CI 1.024 - 3.186）, daily alcohol drinking （OR 3.447; 95%（1/ 1.591 - 7.468）, stroke history （OR 2.531; 95%CI 1.419 - 4.512）, atrial fibrilation（OR 3.475; 95%CI 1.712 - 7.057）, dysphonia （OR 5.873; 95%6/2.620 - 13.163） and left carotid artery infarction （OR 1.975; 95%（1/1.152 - 3.388）. CONCLUSION： The incidence of vascular dementia is determined by synthetic action of multiple risk factors. Dysphonia is the most important influencing factor.
文摘We investigated the effects of ipsilateral versus bilateral limb-training on promotion of endogenous neural stem cells in the peripheral infarct zone and the corresponding cerebral region in the unaffected hemisphere of rats with cerebral infarction. Middle cerebral artery occlusion was induced in Wistar rats. The rat forelimb on the unaffected side was either wrapped up with tape to force the use of the paretic forelimb in rats or not braked to allow bilateral forelimbs to participate in training. Daily training consisted of mesh drum training, balance beam training, and stick rolling training for a total of 40 minutes, once per day. Control rats received no training. At 14 days after functional training, rats receiving bilateral limb-training exhibited milder neurological impairment than that in the ipsilateral limb-training group or the control group. The number of nestin/glial fibrillary acidic protein-positive and nestin/microtubule-associated protein 2-positive cells in the peripheral infarct zone and in the corresponding cerebral region in the unaffected hemisphere was significantly higher in rats receiving bilateral limb-training than in rats receiving ipsilateral limb-training. These data suggest that bilateral limb-training can promote the proliferation and differentiation of endogenous neural stem cells in the bilateral hemispheres after cerebral infarction and accelerate the recovery of neurologic function. In addition, bilateral limb-training produces better therapeutic effects than ipsilateral limb-training.
基金supported by the Technology Foundation for a Selected Overseas Chinese Scholar,Ministryof Human Resources and Social Security of China,No.2009-11-6the Natural Science Foundation of HebeiProvince of China,No.C2009001483
文摘Auditory evoked magnetic fields were recorded from 15 patients with acute cerebral infarction and 11 healthy volunteers using magnetoencephalography.The auditory stimuli of 2 kHz pure tone were binaurally presented with an interstimulus interval of 1 second.The intensity of stimuli was 90 dB and the stimulus duration was 8 ms.The results showed that the M100 was the prominent response, peaking approximately 100 ms after stimulus onset in all subjects.It originated from the area close to Heschl’s gyrus.In the patient group,the peak latency of M100 responses was significantly prolonged,and the mean strength of equivalent current dipole was significantly smaller in the affected hemisphere.The three-dimensional inter-hemispheric difference of the M100 positions was increased in the patient group.Our experimental findings suggested that impairment of cerebral function in patients with acute ischemic stroke can be detected using magnetoencephalography with the higher spatial resolution and temporal resolution.Magnetoencephalography could provide objective and sensitive indices to estimate auditory cortex function in patients with acute cerebral infarction.
文摘Objective: To explore the characteristics of brain functional network with anxiety in patients with acute cerebral infarction. Methods: A total of 39 patients with acute cerebral infarction by cranial magnetic resonance examination were included, and all the patients were scored by the Hamilton Anxiety Scale. The anxiety scale is scored by a professional psychiatrist. There are a total of 14 items, including anxiety, nervousness, fear, insomnia, cognitive function, depressed mood, somatic anxiety, sensory system, etc. The total score ≥ 29 points may be severe;≥21 points, there must be obvious;≥14 points, there must be anxiety;a score of more than 7 may indicate anxiety. If the score is less than 7, there are no anxiety symptoms. All patients within 24 to 72 hours, complete the head examination magnetic resonance, computerized calculation of the DWI sequence images, according to the results of the calculation to superimpose the image of the lesion, image reconstruction in space, and carry out Binarization, defining the value of lesions as 1, and the value of non as 0. All lesions are superimposed into one image and integrated. The relationship between the lesions in this superimposed image and anxiety after cerebral infarction was analyzed. Results: The lesions were basically concentrated around the lateral ventricle, and they were mainly concentrated around the lateral ventricle. Conclusion: Patients with acute cerebral infarction in the lateral ventricle or basal ganglia are more prone to post-stroke anxiety. This has a certain evaluation value for the prognosis of future cerebral infarction, and has a certain understanding of the exploration of complications, and has a certain understanding of the exploration of complications.
文摘We report on silent brain infarction (SBI) and leuko- araiosis (LA) of 23 patients with clinically diagnosed “first-ever” acute ischemic lacunar stroke. The lacunar syndromes were pure motor hemiparesis (10), pure sensory syndrome (2), ataxic hemiparesis (3), dysarthria clumsy hand syndrome (3), and sensory- motor deficit (5). Nineteen out of the 23 patients presented with completed strokes on arrival to the hospital, and 4 (17%) developed evolving-stroke within 24 hours of stroke onset. A lacune corresponded to the acute stroke could be found in all patients on brain magnetic resonance imaging (MRI), and in 18 (78%) on brain computed tomography (CT). MRI showed additional subclinical or asymptomatic “silent brain infarctions or lacunes” (SBI) in 19 (83%) of 23 patients, and leuko-araiosis (LA) of moderate to severe degree (> grade 2) was present in 61% of patients although dementia was absent. Hypertension is the risk factor in 78% of cases followed by diabetes mellitus, smoking, and elevated plasma cholesterol level. Independence of the types of lacunar syndromes, patients with hypertension and diabetes mellitus are associated with high grade LA. None with normal blood pressure and plasma glucose had grade 3 or grade 4 LA (p < 0.05). In conclusion, evolving-stroke occurs in one- fifth of patients with “first-ever” lacunar infarct within the first 24 hours of stroke onset. SBI was found in 83% of cases. Hypertension and diabetes mellitus are associated with additional SBI and high grade LA. The severity of leuko-araiosis per se dictates the cerebrovascular risks.
文摘Pulmonary arteriovenous malformation (PAVM), which is asymptomatic in most cases, is often identified in patients with central nervous system disorders such as brain abscesses and/or cerebral infarctions. We have reported a patient with idiopathic multiple PAVM identified at the onset of cerebral infarction. A 69-year-old woman visited the Department of Neuropathic Internal Medicine at our hospital with chief complaints of numbness in her left hand and a feeling of weakness. The patient was given a diagnosis of subacute cerebral infarction. Multiple old lacunar infarctions were also observed in the deep white matter of the left frontal lobe. Chest computed tomography showed multiple nodular structures, mainly in the right lower lung field (S8), as well as continuous arteries and veins at the site;thus, the patient was finally diagnosed with multiple PAVM. Right lower thoracoscopic lobectomy was performed, as is typical surgical practice in such cases. The patient had a favorable postoperative course, and had no recurrence of cerebral infarction. Although the patient’s lesions were mainly restricted to S8, the fact that there were multiple lesions deemed a lobectomy as the appropriate course of treatment. This case emphasizes that attention should be paid to cases of multiple PAVM since cerebral infarction may arise from the disease.
文摘To investigate the value of N-terminal prohormone brain natriuretic peptide （NT-proBNP） in the evaiuation of the coronary artery condition （ degree of the coronary artery lesion severity and complexity） in patients with ST-segment elevation myocardial infarction （STEMI）. Methods Eighty patients with STEMI diagnosed by electrocardiogram （ECG） were selected. The concentration of plasma NT-proBNP was measured by electrochemiluminescence immunoassay, and the value of NT-proBNP concentration to evaluate the degree of severity and complexity in coronary artery lesion by coronary angiography （CAG） was analyzed. Results The more serious and more complex of coronary artery lesion in patients with ST-segment elevation myocardial infarction, the higher the concentration of plasma NT-proBNP was （ P 〈 0. 05 ）. Conclusion The concentration of plasma NT-proBNP may be a useful marker to evaluate the degree of severity and complexity of coronary artery lesion in patients with ST-segment elevation myocardial infarction. （ S Chin J Cardiol 2009 ; 10 （ 1 ） ： 15-18）
