1.Discussion of mechanisms of rats with depression in Parkinson′s disease treated with Chaigan Jieyou decoction
Dandan MA ; Chunye ZHENG ; Xiaodong LUO
The Journal of Practical Medicine 2014;(23):3732-3735
Objective To build rat models and observe changes of behavior and monoamine of PDD. Methods The rats were injected with 6-OHDA and accepted CUMS for the establishment of PDD model , so as to assess its behavior changes and detect brain tissue monoamine contents by ELISA. Results Significant behavioral and monoamine abnormalities can be observed in model rats. Behavioral and monoamine improvement can be observed after treated with Chaigan Jieyou. Conclusion The PDD model can be established by 6-OHDA and CUMS. Chaigan Jieyou decoction may reach therapeutic purposes by increasing monoamine contents.
2.The clinical efficacy of Parkinson's disease depression treated with Chaigan Jieyou decoction
Dandan MA ; Xiaodong LUO ; Chunye ZHENG
The Journal of Practical Medicine 2018;34(1):144-147
Objective To evaluate the clinical efficacy and safety of Chaigan Jieyou decoction in treating Parkinson's disease depression (PDD).Methods Applying the method of simple random contrast,this research collects 70 patients who meet the study criteria and divide the patients into two groups of 35 peoples each:Chaigan Jieyou decoction group,which received treatment of Chaigan Jieyou decoction and fluoxetine group with treatment of fluoxetine.Treatment period was 2 months.Apply the HAMD-17 (Hamilton Depression Scale),Beck Depression Scale (Beck Depression Inventory,BDI),Parkinson's composite score (unified Parkinson disease rating scale,UPDRS) and TCM symptoms rating scale to evaluate the clinical efficacy before and after treatment.Resuits Compared the two groups by HAMD Score reduction rate,there is no statistical significance in the general efficacy rate (P > 0.05);compared by the curative effect of TCM syndrome,Chaigan Jieyou decoction group is better than fluoxetine group (P < 0.05).There is statistical significance in the differences of all the HAMD,BDI,UPDRS Ⅱ,UPDRS Ⅲ scores between the two groups after the treatment (P < 0.01,P < 0.05).Compared the treatment efficacy by the HAMD scores,Chaigan Jieyou decoction can alleviate the clinical symptoms of patients of varying degrees.Conclusions Chaigan Jieyou decoction can significantly relieve depression of PDD patients,and there is exact curative effect to the mild and moderate PDD patients,improving their quality of life to a certain extent.
3.Efficacy of mechanical thrombectomy in acute ischemic stroke with large vessel occlusion and analysis of related factors affecting its prognosis
Lingming KONG ; Chunye MA ; Dapeng SUN ; Lin YIN
Chinese Journal of Geriatrics 2023;42(10):1166-1173
Objective:To compare the effectiveness of intravenous thrombolysis(IVT)alone versus mechanical thrombectomy(MT)in treating acute large vessel occlusive stroke(AIS-LVO).Amd to analyze the factors that are associated with the prognosis of MT.Methods:A total of 197 patients with acute ischemic stroke with large vessel occlusion(AIS-LVO)who received intravenous thrombolysis(IVT)and/or mechanical thrombectomy(MT)at the Stroke Center of the Second Hospital of Dalian Medical University from April 2016 to July 2021 were included in this retrospective analysis.Baseline data, clinical data, and 90-day Modified Rankin Scale(mRS)scores were collected for each group.The efficacy and risk of IVT alone and MT were compared using univariate and multivariate logistic regression analysis.Additionally, factors influencing the prognosis of MT were identified.Results:A total of 197 patients who met the inclusion criteria were included in this study.Out of these, 62 patients were in the IVT alone group and 135 patients were in the MT group.The results of the univariate analysis showed that the MT group had lower admission systolic blood pressure(147±23 vs.158±27 mmHg, P=0.003), higher baseline NIHSS score[15(12, 19) vs.12(8, 16), P=0.003], and there were also differences in vascular occlusion between the two groups( χ2=15.504, P=0.004).Specifically, the middle cerebral artery and basilar artery occlusion were higher in the MT group.In terms of outcome, the MT group had a higher percentage of good outcomes at 90 days[53(39%) vs.13(21%), χ2=6.381, P=0.012], and there was no significant difference in symptomatic intracranial hemorrhage(sICH)and mortality within 90 days.Among the 135 patients who underwent MT, 53 patients were classified as having a good prognosis, while 82 patients were classified as having a poor prognosis.Multivariate analysis revealed that age( OR=1.078, 95% CI: 1.025-1.133, P=0.003), neutrophil to lymphocyte ratio(NLR)( OR=1.164, 95% CI: 1.013-1.338, P=0.032), time from onset to recanalization( OR=1.004, 95% CI: 1.000-1.007, P=0.049), sICH( OR=15.585, 95% CI: 1.397-173.865, P=0.026), ASPECTS/pc-ASPECTS score( OR=0.524, 95% CI: 0.017-0.582, P=0.024), and good recanalization( OR=0.099, 95% CI: 1.718-59.046, P=0.010)were identified as independent prognostic factors.The results indicate that percutaneous transluminal angioplasty, stent implantation, and the use of tirofiban and butylphthalide did not significantly affect the prognosis of the MT group. Conclusions:The use of mechanical thrombectomy(MT)in patients with acute ischemic stroke due to large vessel occlusion(AIS-LVO)is more effective than intravenous thrombolysis(IVT)alone and has a similar safety profile.However, there are certain factors that can influence the prognosis of MT treatment.Older age, higher neutrophil-to-lymphocyte ratio(NLR), longer time from symptom onset to recanalization, and the occurrence of postoperative symptomatic intracranial hemorrhage(sICH)were identified as independent predictors of poor prognosis in MT treatment.On the other hand, a higher ASPECTS/pc-ASPECTS score and successful recanalization were found to be protective factors associated with a favorable prognosis in MT treatment.
4.Comparison of clinical prognoses of anterior and posterior circulatory large vessel occlusive ischemic stroke after successful endovascular recanalization
Yutao SI ; Lin YIN ; Chunye MA ; Dapeng SUN
Chinese Journal of Neuromedicine 2023;22(10):1016-1022
Objective:To analyze the clinical characteristics of patients with anterior and posterior circulation large vessel occlusion ischemic stroke and clinical prognoses after successful endovascular recanalization.Methods:A retrospective analysis was performed; 170 patients with large vessel occlusive ischemic stroke, admitted to Stroke Center, Second Hospital of Dalian Medical University from January 2016 to September 2022 were chosen; these patients had modified Thrombolysis in Cerebral Infarction (mTICI) 2b or 3 after endovascular treatment. These patients were divided into anterior-circulation large vessel occlusion group ( n=138) and posterior-circulation large vessel occlusion group ( n=32) according to the locations of vessel occlusion. Clinical data, parameters related to endovascular treatment, and clinical prognoses of the 2 groups were collected and compared. Results:Posterior-circulation large vessel occlusion group had significantly higher percentages of male patients and patients with atherosclerotic type (81.3% vs. 61.6%; 78.1% vs. 47.1%), significantly higher ratio of neutrophil to lymphocyte and NIHSS scores (3.78 [1.93, 10.86] vs. 2.77[1.77, 4.72]; 20.50±8.96 vs. 14.83±4.67), significantly lower percentage of patients with atrial fibrillation (21.9% vs. 58%), and significantly longer times from onset to puncture, onset to recalculation, admission to puncture, and admission to recalculation (367.50 [246.25, 630.00] min vs. 240.00 [198.75, 330.00]; 515.00 [292.50, 701.25] vs. 345.50 [270.00, 425.75] min; 163.00 [123.25, 218.50] min vs. 125.50 [97.00, 161.00]; 258.00 [200.25,389.00] vs. 219.50 [178.00, 276.25]) than anterior-circulation large vessel occlusion group ( P<0.05). The NIHSS scores 24 h after endovascular treatment, NIHSS scores at discharge, and mortality within 90 d in posterior-circulation large vessel occlusion group were significantly higher than those in anterior-circulation large vessel occlusion group (21.31±9.23 vs. 15.74±6.53; 25.5 [4.25, 40.25] vs. 10.00 [4.00, 18.25]; 40.6% vs. 20.3%, P<0.05); however, no significant differences in symptomatic intracranial hemorrhage, incidence of intracranial hemorrhage, in-hospital mortality or 90-d good prognosis were noted between the 2 groups ( P>0.05). Conclusion:Posterior circulation large vessel occlusion ischemic stroke patients have higher neurological impairment at onset than anterior circulation acute large vessel occlusion ischemic stroke patients; both patients enjoy similar results in terms of 90-d good prognosis and complications, but 90-d mortality is higher than that in anterior ones.
5.Study on the Correlation between the Severity of Leukoaraiosis and the Prognosis of Acute Ischemic Stroke with Large Vessel Occlusion treated with Mechanical Thrombectomy
Yong XI ; Chunye MA ; Dapeng SUN
Journal of Apoplexy and Nervous Diseases 2022;39(9):794-798
To explore whether the severity of LA in patients with acute ischemic stroke(AIS)with large vessel occlusion(AIS-LVO) was related to the prognosis of MT treatment. Methods A total of 75 AIS-LVO patients who received intravenous thrombolysis(IVT) bridging MT or MT alone were selected in the stroke center of our hospital from April 2016 to October 2021.According to the Fazekas score scale,the severity of LA was divided into non-mild group(0-2 points,n=44) and moderate-severe group(3~6 points,n=31). The baseline data and postoperative outcome of MT were compared between the two groups. The prognosis at 90 days after operation was evaluated by modified Rankin scale(mRS). The results were divided into two groups:good prognosis group(0~2 points,n=32) and poor prognosis group(3~6 points,n=43). Univariate analysis and multivariate Logistic regression analysis were used to determine whether LA was related to the prognosis of at 90 days after MT.Results Univariate analysis showed that compared with the non-mild LA group,the moderate-severe LA group had an older age[(73.77±8.25) vs(63.00±10.50) years old],higher female proportion(58.1% vs 22.7%),higher proportion of atrial fibrillation(61.3% vs 36.4%),lower proportion of hyperlipidemia(9.7% vs 29.5%),higher incidence of postoperative hemorrhage transformation(38.7% vs 13.6%),higher incidence of sICH at 72 hours after operation(19.4% vs 2%),higher rate of futile recanalization(78.6% vs 39.0%),and higher incidence of 90-day poor prognosis after operation(80.6% vs 40.9%). There were significant differences between two groups(all P<0.05). Univariate analysis showed that compared with the good prognosis group,the poor prognosis group had an older age[69.0(63.0,77.0)vs 63.5(53.0,75.5)years old],higher baseline NIHSS score [(17.8±6.8) vs(12.3±4.9) points],higher fasting blood glucose level[6.78(5.71,10.43) vs 5.88(5.29,6.95)] mmol/L],higher neutrophil to lymphocyte ratio(NLR) [4.48(1.92,8.11) vs 2.4(1.43,3.06)],higher proportion of diabetes(37.2% vs 12.5%),and higher proportion of moderate-severe LA(58.1% vs 18.8%). There were significant difference between two groups(all P<0.05).Multivariate Logistic regressionanalysis showed that moderate-severe LA(OR=6.796,95%CI 1.564~29.530,P=0.011)and baseline NIHSS score(OR=1.156,95%CI 1.015~1.317,P=0.029) were independent risk factors for poor 90-day functional prognosis after MT.Conclusion Moderate-severe LA can independently predict the poor prognosis of patients with AIS-LVO after MT.