Objective To investigate the serum level of NT-pro-BNP in patients with acute ischemic stroke and to determine whether NT-pro-BNP levels were associated with the death within 15 days of stroke onset. Methods Two hundard twenty-six consecutive patients with acute ischemic stroke within 48 hours of onset were enrolled in this study. We measured plasma NT-pro-BNP within 72 h and recorded the NIHSS score on admission. Patients were divided into two groups: the deceased group, who died within 15 days, and the survival group. The factors associated with the death within 15 d of stroke onset were investigated by using multivariate logistic regression analysis. Results Twenty-four (10.6%) patients died with 15 days of stroke onset. The incidence of atrial fibrillation, cardioembolism and large infarc?tion, the mean ± SD of NIHSS score, age, glucose level and creatinine were significantly higher in the deceased group than in the survival group (P<0.001). On the other hand, the mean ± SD of LVEF, albumin, LDL-C, and total-cholester?ol were significantly lower in the deceased group than in the survival group(P<0.05 ). The median of the plasma NT-pro-BNP level was significantly higher in the deceased group than in the survival group (2598.5 vs. 190.4 pg/mL, P<0.001). The optimal cut-off level, sensitivity, specificity and ROC area of NT-pro-BNP levels to distinguish the de?ceased group from the survival group were 955.2 pg/mL, 83.3%and 82.2%, 0.906, respectively. Binary logistic regression analysis demonstrated that NIHSS score of ≥13 (OR=56.18, 95% CI=9.06 to 348.40, P =0.000) , plasma Lg NT-Pro-BNP level (OR=38.79, 95%CI=6.52 to 230.95, P=0.000) , and the size of infarction (OR=8.73, 95%CI=1.11~68.88, P=0.040) were independent factors associated with the death within acute phase of stroke. Conclusions The plas?ma NT-pro-BNP level can predict the death of stroke patients within 15 days of stroke onset.

Objective To study the impact of human urinary kallidinogenase (HUK) on collateral circulation and blood perfusion in patients with acute cerebral ischemia (ACI) using multi-modality CT methods. Methods In a randomized controlled clinical trial, 75 patients diagnosed with ACI were enrolled and divided into experiment group (treated with HUK)and control group (untreated with HUK). All participants underwent computer technology perfusion (CTP) and computed tomographic angiography (CTA) examination before and fourteenth day after treatment. The CT cerebral perfusion imaging (CTP), CT cerebrovascular imaging (CTA) and National Institutes of Health Stroke Scale (NIHSS) score were analyzed in two groups. The NIHSS score, cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), and time to peak (TTP) were compared between the two groups before and after 14 days therapy. Results ① After treatment, The two group showed increased CBF and CBV values and decreased MTT and TTP values. The CBF improvement was significantly better in the HUK-treated group than in the control group (t=2.470,P<0.05).②MTT and TTP were shorter in the HUK-treated group than in the control group (t=2.126, t=2.213, P<0.05).③ CTA maximum intensity projection (MIP) sequence revealed that the number of patients collateral vessels was significantly increased in the HUK-treated group than in the control group ( x2=4.265, P<0.05). ④The NIHSS score improvement was significantly better in the HUK-treated group after 14 days treatment than in the control group (t=4.330, P<0.05). Conclusion Human urinary kallidinogenase can improve blood perfusion and ameliorates neurological deficits. It is a safe and effective drug for treating ACI patients. The multi-modality CT methods are effective measure to assess blood perfusion and collateral circulation in patients with acute cerebral ischemia.

Objective To observe the effects of San-huang-sheng-fu oil (S) on peripheral circulatory disorders and foot ulcers in diabetic rats and the relevant mechanisms.Methods (1) Twenty-five Wistar rats were divided into non-diabetes (N),diabetes and sham treatment (DS),metformin (M),S,and combined treatment (CT) groups according to the random number table,with 5 rats in each group.Rats in group N were injected with sodium citrate buffer solution,while rats in the other 4 groups were injected with 10 mg/mL streptozotocin to induce diabetes.In post injection week (PIW) 3,feet of rats in all the 5 groups received an ice-cold stimulation to induce peripheral circulatory disorders.From PIW 9 to 12,rats in groups N and DS were gavaged with saline and applied with sesame oil on pelma of both hind limbs;rats in group M were gavaged with diluted M and applied with sesame oil on pelma of both hind limbs;rats in group S were gavaged with saline and applied with S on pelma of both hind limbs;rats in group CT were gavaged with diluted M and applied with S on pelma of both hind limbs.In PIW 9 before treatment (hereinafter referred to as before treatment) and post treatment week (PTW) 1,2,and 3,plantar temperature and hot pain threshold of rats were detected by infrared thermometer and foot tester respectively.(2) Another 25 rats were divided and induced with diabetes (expect for group N) as above.In PIW 9,rats in the 5 groups were inflicted with foot ulcer in the left pelma of hind limb by steam and received the corresponding treatment.On post treatment day (PTD) 3,7,21,and 35,the general condition and area of wounds were observed and measured respectively.All the rats were sacrificed on PTD 35,and wound tissue was collected for histomorphological observation and determination of expressions of cyclooxygenase-2 (COX-2) and vascular endothelial growth factor (VEGF) using HE staining and immunohistochemical staining respectively.Data were processed with analysis of variance for repeated measurement,one-way analysis of variance,and Bonferroni post hoc test.Results (1) The experiment of peripheral circulatory disorders in diabetes.Compared with the plantar temperature of rats in group N,except for that in group CT in PTW 2 and groups M,S,and CT in PTW 3 (with t values from 0.258 to 2.647,P values above 0.05),the plantar temperature of rats with diabetes in the 4 groups at each time point was lowered significantly (with t values from 2.811 to 6.066,P values below 0.05).Compared with the plantar temperature of rats in group DS,except for that in group CT in PTW 2 and 3 significantly increased (with t values respectively 3.419 and 2.863,P values below 0.05),the plantar temperature of rats in groups M,S,and CT showed no significant difference at each time point (with t values from 0.128 to 1.654,P values above 0.05).The plantar hot pain threshold of rats was significantly decreased in group N than in the other 4 groups before treatment and group S in PTW 1 (with t values from 2.836 to 4.456,P values below 0.05).The plantar hot pain thresholds of rats in groups M,S,and CT were close to the hot pain threshold in group DS (with t values from 0.312 to 1.611,P values above 0.05).(2) The experiment of diabetic foot ulcers.Edema existed in all the wounds of rats on PTD 3.The wound areas of all the rats continued to increase with swelling and scar formation on PTD 7.On PTD 21,the scar of rats in groups N,S,and CT fell off;the wounds of rats in group DS were still swollen;scar of rats did not fall off with dark red in the skin around the wound in group M.On PTD 35,wounds of rats in groups N,S,and CT were nearly healed;while wounds of rats in groups DS and M were still swollen and the scar around the wound failed to fall off.On PTD 3 and 7,the wound areas of rats with diabetes in the 4 groups were close to those in group N (with t values from 0.111 to 1.476,P values above 0.05).On PTD 21,the wound area of rats in group DS was significantly larger than that in group N (t =5.502,P ＜ 0.01),while the wound areas of rats with diabetes in the other 3 groups were close to the area in group N (with t values from 0.544 to 1.676,P values above 0.05).On PTD 21,the wound area of rats in group M was close to that in group DS (t =1.895,P ＞ 0.05),while the wound areas of rats in groups S and CT were significantly smaller than the area in group DS (with t values respectively 5.809 and 3.426,P ＜ 0.05 or P ＜ 0.01).On PTD 35,the wound areas of rats in groups DS and M were significantly larger than the area in group N (with t values respectively 8.495 and 4.108,P values below 0.01),while the wound areas of rats in groups S and CT were close to the area in group N (with t values respectively 0.291 and 2.195,P values above 0.05).On PTD 35,the wound area of rats in group M was close to that in group DS (t =0.897,P ＞0.05);while the wound areas of rats in groups S and CT were significantly smaller than the area in group DS (with t values respectively 6.923 and 6.583,P values below 0.01).On PTD 35,the structures of wound tissue were in better integrity with less inflammatory cells and more regularly arranged collagen fibers around the wounds of rats in groups N,S,and CT than in groups DS and M.On PTD 35,the expression levels of COX-2 and VEGF in the wounds of rats in group DS [respectively (222 ± 89)％ and (55 ± 12)％] were close to those in group M [respectively (137 ± 24) ％ and (94 ± 36) ％,with t values respectively 3.046 and 2.653,P values above 0.05].On PTD 35,the expression level of COX-2 in the wounds of rats in group DS was significantly higher than the expression levels of COX-2 in groups N,S,and CT [respectively (100± 35)％,(91 ±42)％,and (109 ± 17)％,with t values from 4.039 to 4.653,P values below 0.01],while the expression level of VEGF in the wounds of rats in group DS was significantly lower than the expression levels of VEGF in groups N,S,and CT [respectively (100 ±28)％,(143 ± 12)％,and (120 ±13)％,with t values from 3.363 to 5.905,P ＜0.05 orP ＜0.01].Conclusions S can improve the plantar temperature decrease and pain dysesthesia of rats caused by diabetic peripheral circulatory disorders.It also can promote wound healing of diabetic foot ulcers in rats with down-regulation of COX-2 and up-regulation of VEGF.