BACKGROUND: The posterior circulation artery is characterized by small caliber, long traveling, many curves and branches, so a stronger resistance will be encountered when a stent is delivered.OBJECTIVE: To investigate the effects of coaxial double catheter technique on intracranial posterior circulation stenting.DESIGN, TIME AND SETTING: A retrospective case analysis was performed at the Department of Neurology, Affiliated People's Hospital of Yunyang Medical College between December 2004 and February 2008.PARTICIPANTS: A total of 21 patients, 11 males and 10 females, aged 50-76 years old, were se/ected from the Department of Neurology, Affiliated People's Hospital of Yunyang Medical College.METHODS: All patients were confirmed as posterior circulation intracranial stenosis (stenosis > 70%) by digital subtraction angiography (DSA), magnetic resonance angiography (MRA), or CT angiography (CTA). They underwent cerebrovascular stent implantation, during which, single catheter technique was first applied, if failed, a coaxial double catheter technique was followed. A conventional group (single catheter technique successfully applied) and a double catheter group (coaxial double catheter technique successfully employed) were set. A written informed consent was obtained from each patient.MAIN OUTCOME MEASURES: Therapeutic results and biocompatibility of implanted stents.RESULTS: The single catheter technique was applied in 21 patients and 6 of them (28.57%) had successful stent deployment, The remaining 15 patients were managed by a coaxial double catheter technique, and the stent was successfully released in these patients. There was only 1 patient presenting with subarachnoid hemorrhage, and the success rate of stent deployment was 93.33%. Chi-square tests results showed that the coaxial double catheter technique produced significantly higher success rate of stent implantation than the single catheter technique (P < 0.05). Except this, no other adverse reactions were found. All stents covered the stenosis lesions completely, and fitted well with the blood vessel wall without rejection, showing the good biocompatibility of selected stents with the host.CONCLUSION: The coaxial double catheter technique can increase the longitudinal supporting strength and enhance the success rate of the intracranial posterior circulation stenting. Meanwhile, the risks of this procedure are low. Therefore, the technique deserves to be popularized.

Objective To observe the influence of atorvastatin on the arteria carotis atheromatous plaque and blood lipid in old people. Methods 57 hospitalized patients who had cerebral infarction or transient ischemic attack(TIA) were examined for atheromatous plaque by the color Doppler. They were administered atorvastatin 20 mg/d for three months. The changes of diameter of arteria carotis, rate of flow and size of plaque were measured be-fore and after treatment. Results The diameter of arteria carotis was expanded [left ( 0.99 ± 0. 11 ) era, right (0.98 ± 0.08 ) cm vs left (0.94 ± 0.09 ) cm, right ( 0.95 ± 0.07 ) cm, P < 0.05], the hemorrheology was improved, the size of plaque was diminished[left(0.57±0.20)cm2, right (0.54± 0.18 )cm2 vs left (0.86±0. 17 ) cm2 and right (0.82 ±0. 16 )cm2, P < 0. 05], TC, TG, LDL-C were lowered and HDL-C was elevated with statistical signifi-cance ( P < 0. 05). Conclusions The atorvastatin has positive therapeutical effect in diminishing the size of plaque, adjusting blood lipid and improving hemorrheology.

Objective To investigate serum amino acid spectrum in patients with acute stroke in response to different nutritional support strategies and its effects on neurological function.Methods A total of 60 cases of acute stroke with dysphagia were randomly distributed into two groups:enteral nutrition group (30 cases) and control group (30 cases) using simple randomized design.Serum amino acid spectrum,hemoglobin,total protein,albumin,prealbumin,immunoglobulins,complement,and infection rate were assessed at three time points:within 48 hours,(7 ± 1) days and (14 ± 1) days after admission,and neurological deficit and activities of daily living are scored according to National Institutes of Health Stroke Scale (NIHSS) and Barthel Index (BI).Results (7 ± 1),(14 ± 1) days after admission,serum amino acid spectrum,hemoglobin,total protein,albumin,prealbumin,immunoglobulins,complement,and neurological deficit scores of enteral nutrition group patients were significantly better than those of non-enteral nutrition control group; and infection rate was lower than that of control group.Follow-up for a month,3 months,NIHSS of enteral nutrition group patients (9.0 ± 1.4,7.9 ± 1.3) were significantly better than nonenteral nutrition control group(11.1 ± 1.5,10.6 ± 1.4,F =46.042,P ＜ 0.05).While BI score seemed to be not insignificant different between enteral nutrition group (50.1 ± 1.8,52.0 ± 2.4) and control group (49.0±2.1,51.3 ±2.8,F=2.707,P＞0.05).Conclusion For patients suffering acute stroke with dysphagia,enteral nutrition support could reduce infectious complications,improve short-term neurological function and long-term prognosis by improving serum amino acids level and thus the whole body' s nutritional status.

BACKGROUND: Insulin-like growth factor-1 (IGF-1) is a peptide hormone, it has been proved a promotion role on the proliferation of precursor cells. OBJECTIVE: To explore the intravenous injection of IGF-1 on the proliferation, migration and differentiation of neural stem cells in rats after cerebral ischemia. METHODS: Eight adult male SD rats were randomly divided into control group and experimental group, with 40 rats in each group. The rats in two groups were used to prepare models of focal cerebral ischemia using modified suture method, the rats in the experimental group were treated with tail vein injection of IGF-1, according to 100 μg/kg computation, the injection was given for 6 continuous days; in the control group, rats were given equal volume of saline. The rats were decapitated at 7, 14, 21, 28 days following intervention, respectively, and rats in each group were given intraperitoneal injection of the BrdU at 1 day before death. Immunohistochemistry and double staining were applied to detect the expressions of BrdU-positive cells, PSA-NCAM-positive cells, BrdU + PSA-NCAM double-positive cells, and BrdU + MAP2 double-positive cells. RESULTS AND CONCLUSION: The number of BrdU-positive cells and PSA-NCAM positive cells reached the peak at 7 days after ischemia; BrdU + PSA-NCAM double-labeled-positive cells could be detected in ischemic bilateral subependymal zone and dentate gyrus, the number was the most at 7 days, then followed by a gradual decrease; the BrdU + MAP2 double-positive cells began to increase from 14 days, and then gradually increased along with the decrease of BrdU + PSA-NCAM double-positive expression, showing a reverse trend. Intravenous injection of IGF-1 can induce the proliferation, differentiation and migration of neural stem cells in rats following ischemic brain injury.

Aim To explore the effect of exogenous nerve growth factor(NGF) on tau hyperphosphorylation in rat hippocampus during focal cerebral ischemia/reperfusion(I/R).Methods Focal cerebral ischemi-a/reperfusion model was induced by occlusion of the right middle cerebral artery using the intraluminal suture method.The level of tau hyperphosphorylation at Ser199/202 site and total tau in rat ispolateral hippocampal CA1 regions during focal cerebral ischemia/reperfusion were detected by SABC immunohistochemical method and Western blot,and the positive products were analyzed by image analysis system.Results The level of tau hyperphosphorylation at Ser199/202 site and total tau in rat hippocampal CA1 regions were significantly higher in I/R group than that in sham group(P

AIM:To investigate the effect of calcitonin gene related peptide(CGRP)on the expression of cyclic AMP response element binding protein(CREB)and phosphorylated-CREB in rat parietal cortex during focal cerebral ischemia/reperfusion(I/R).METHODS:Focal cerebral ischemia/reperfusion model was induced by occlusion of the right middle cerebral artery using the intraluminal suture method.The expressions of CREB and phospho-CREB in the parietal cortex in different groups(sham group,focal cerebral ischemia/reperfusion group and CGRP group)were detected with immunohistochemistry and Western blotting,and the positive products were analyzed by image analysis system.RESULTS:There was definite expression of CREB in right parietal cortex in sham group,while it was lesser in I/R group than that in sham group,but it became more in CGRP group than that in I/R group(P

Objective To observe the effect of hyperbaric oxygen,rehabilitation training or acupuncture at Fengchi acupoint on pseudobulbar paralysis after stroke.Methods 90 patients were divided into group Ⅰ(A,B,C) or Ⅱ(A,B,C) randomly.Patients in all groups were given conventional therapy,while those in groups ⅠB and ⅡB were given hyperbaric oxygen,ⅠC and ⅡC were given swallowing training and group Ⅱ was given acupuncture at Fengchi acupoint additionally.They were assessed with Modified Kubota-Chiari's swallowing functional classification before and after treatment.Results In all groups except ⅠA,swallowing function scores improved after treatment significantly(P<0.05).The scores were different significantly between group Ⅰ and group Ⅱ after treatment(P<0.05).Except 3 d after treatment,the scores were different significantly between sub-group of group Ⅰ or group Ⅱon other time points(P<0.05).Conclusion The hyperbaric oxygen is more effective than conventional therapy on pseudobulbar paralysis,but less than swallowing training.Acupuncture at Fengchi acupoint can improve their efficacy.

Objective To observe the clinical therapeutic effect of hyperbaric oxygen (HBO) therapy and swallowing training combined with Fengchi acupoint acupuncture on dysphagia caused by pseudobulbar paralysis after stroke. Methods Seventy-five patients were randomly divided into control group, HBO therapy group, swallow training group, acupuncture group and combined treatment group (n = 15). Patients in all groups were given cerebro-vascular disease routine treatment. In addition, the patients in HBO therapy group, swallowing training group and ac-upuncture group were given HBO therapy, swallowing training and Fengehi (GB20) acupoint acupuncture simultane-ously, respectively. The patients in combined treatment group were given HBO therapy combined with swallowing training and Fengchi acupoint acupuncture. Modified Kubota-Chiari's swallowing functional classification was used to assess swallowing function before and on the 3rd d,6th d,9th d, 12th d, 15th d, 18th d and 21st d after treatment. Results It was shown that the patients in all groups but the control group got significant improvement in swallowing after treatment, as demonstrated by the swallowing function scores (P < 0.05). Moreover, the priority order in im-provement of swallowing function and recovering rate were: combined treatment group > acupuncture group > swal-low training group > HBO therapy group > control group(P < 0.05). Conclusion The combination of HBO ther-apy, swallowing training and Fengchi acupoint acupuncture could act synergically to ameliorate dysphagia caused by pseudobulbar paralysis after stroke.