Objective To investigate the relationship between plasma low-density lipoprotein (LDL) levels and hematoma enlargement of early intracerebral hemorrhage,outcome at 3 months and death.Methods A total of 316 patients with primary intracerebral hemorrhage were included in the study.Their general information was documented.The patients underwent CT scans at 6 and 24 hours after onset.The lipids,blood glucose,blood pressure,and the National Institutes of Health Stroke Scale (NIHSS) scores were detected at the same time.The patients were followed up for 3 months and their modified Rankin scale (mRS) scores and the number of death were recorded.Results The decreased plasma LDL level (odds ratio [OR] 0.323,95％ confidence interval [CI] 0.128 - 0.819; P =0.017) and the increased systolic pressure (OR 1.015,95％ CI 1.000 -1.029; P =0.043) were independently associated with the early hematoma enlargement.The decreased plasma LDL level (OR 0.253,95％ CI 0.102-0.629; P=0.003) and the increased blood glucose (OR 1.458,95％ CI 1.257 - 1.693; P ＜ 0.001 ) were the independent risk factors for poor outcome at 3 months after onset.The decreased plasma LDL level (OR 0.211,95％ CI 0.075 - 0.597; P =0.003),the increased bloot glucose level (OR 1.406,95％ CI 1.212 - 1.632; P =0.001) and the increased blood glucose level (OR 1.026,95％ CI 1.009 - 1.043; P =0.002) were the independent risk factors for death within 3 months.Receiver operating characteristic curves showed that the LDL level ＜ 2.58 mmol/L was an independent predictor for hematoma enlargement (sensitivity 71.79％,specificity 64.71％,positive predictive value 40.00％,and negative predictive value 87.50％ ).Conclusion The decreased plasma LDL level was the independent predictor for early hematoma enlargement,poor outcome and death at 3 months in patients with primary intracerebral hemorrhage.

Objective To investigate the impact of motor imaginary therapy on the recovery of upper limb function in acute cerebral infarction patients with bemiplegia. Methods Fifty cerebral infarction patients with hemiplegia were randomly divided into a control group (drug therapy + early exercise therapy) and a motor imaginary therapy group (drug therapy + early exercise therapy + motor imaginary therapy) using single-blind method (n = 25 in each group). Ipsilateral upper extremity function was assessed by the Fugl-Meyer assessment (FMA) before the treatment and at day 40. The active range of motion (AROM) of the ipsilateral wrist was measured by a conimeter. Eating, washing, dressing, and putting on and off clothes were assessed by the Functional Independence Measure (FIM) scale. Results The scores of FMA, AROM and FIM were increased more significantly than those before the treatment in both groups (P <0.05). All the scores in the motor imaginary therapy group after the treatment were superior to those in the control group (P <0. 05) (FMA 28.33 ± 8.63 versus 15.93 ± 5.39;AROM 19.55 ± 8.30 versus11.97 ± 6.59; FIM 16.83 ± 5.43 versus 12.51 ± 3.36).Conclusions Conventional motor rehabilitation training + motor imaginary therapy during the acute phase may promote the motor function reco,,ery in cerebral infarction patients with hemiplegia.

As a molecular switch,Rho can be transformed between the inactive GDP-bound form and the active GTP-bound form,transfering signals to downstream effector Rho kinase (ROCK),mediating specific biological effects,and participating in various neurological diseases, such as the pathological processes of ischemic stroke,cerebral vasospasm,and axonal regeneration after spinal cord injury.The application of ROCK inhibitor in the treatment of neurological diseases has achieved satisfactory effect.Rho/ROCK is expected to become a novel therapeutic target.

Objective To investigate the relation of event-related potentials (ERPs), which are evoked by calculating and number recognizing stimuli.Methods We examined 26 healthy undergraduate students with double-digit (Arabic numbers) and single-digit modify a prescription problems. While the stimulus information was presented, electroencephalogram (EEG) was recorded simultaneously. ERPs were extracted from EEG data, and then the feature and source of ERPs were analyzed.Results Both calculation and number recognizing induced positive and negative components of ERPs with similar wave form and different latency. The latency of ERPs was conspicuously shorter elicited by number recognizing than by calculating. Grand mean mapping showed the highest amplitudes of ERPs were presented in parietal lobe elicited both by calculating and number recognizing.Conclusion The processing of calculating is more complicated than number recognizing. Calculating and number recognizing may have different electrophysiological background, and they belong to diverse processing course in the brain. Parietal lobe is the functional domains of them.

Objective To investigate the effects of transcranial magnetic stimulation(TMS)on the recovery of neurological function and the expression of neurofilament protein(NFP)-200 in rats with cerebral infarction.Methods The string-fastening method was used to establish focal ischemia-reperfusion models in 60 Sprague-Dawley rats and the rats were divided into the TMS group and the sham TMS group(composed of 30 rats each).Then each group were divided into the treated 1 d,3 d,7 d,14 d and 21 d subgroups(composed of 6 rats each).TMS group rats were administered with 2 sessions of TMS(200 pulses total)daily,keeping on corresponding days in different groups.The recovery of neurological function and the optical density of NFP-200 by immunohistochemistry in the infarct peripheral zone in two groups were detected after therapy.Results At the 14 d and 21 d after treatment,neurological deficit scores of TMS group(2.67?0.82,1.50?0.55) were significantly lower than those of the sham TMS group(3.67?0.52,3.17?0.75)(P

Objective To investigate the influence of antiepileptic drugs (AEDs) on levels of serum homocysteine (Hcy),folate,vitamin B12 and B6 in patients with post-stroke epilepsy (PSE).Methods The serum levels of Hcy,folate,vitamin B12 and B6 of 194 PSE patients with AEDs treatment for more than 1 year (AEDs treatment group) and 40 newly diagnosed PSE patients without AEDs therapy (control group) were detected.The effects of AEDs on above indexes were analyzed.Results Compared with control group,the serum level of serum Hcy was significantly increased,and the serum levels of folate,B12 were significantly decreased in AEDs treatment group (all P<0.05).The difference of the serum levels of vitamin B6 among the groups was not significant.Compared with monothetapy subgroup,the serum levels of Hcy was significantly increased in the combination therapy subgroup (P<0.05).Compared with control group,the serum levels of Hcy were significantly increased in patients with Valproate (VPA),Carbamazepine (CBZ) and Oxcarbazepine (OXC) monotherapy,the serum levels of folate were significantly decreased in patients with VPA and CBZ monotherapy,and the serum level of B12 was significantly decreased in patients with VPA monotherapy (all P<0.05).Compared with control group,the serum levels of Hcy were significantly increased in patients with 2 kinds of AEDs combination treatment [VPA+CBZ,VPA+Levetiracetam (LEV),VPA+OXC,CBZ+LEV] or ≥3 kinds of AEDs combination treatment,the serum levels of folate was significantly decreased in patients with 2 kinds of AEDs combination treatment (VPA+LEV,VPA+OXC,CBZ+LEV) or ≥3 kinds of AEDs combination treatment,the serum levels of B12 were siginificantly decreased in patients with 2 kinds of AEDs combination treatment (VPA+CBZ,VPA+OXC,CBZ+LEV) or ≥3 kinds of AEDs combination treatment (all P<0.05).The incidence of hyperhomocysteinemia (HHcy) in AEDs treatment group (36.6%) was significantly higher than that in control group (20.0%) (χ2=4.085,P=0.043).And the difference of HHcy incidence between the combination therapy subgroup (47.6%) and the control group was statistical significant (χ2=6.950,P=0.008).The difference of HHcy incidence between the monotherapy subgroup (33.6%) and the control group was not significant.The HHcy incidence of patients with VPA and CBZ monotherapy (40.5%;43.8%) were significantly higer than those in the control group (χ2=3.871,P=0.049;χ2=4.726,P=0.030).The differences of HHcy incidence between patients with OXC,LEV monotherapy (29.2%;22.9%) and the control group were not significant.Conclusions AEDs therapy has little influence on the serum levels of vitamin B6,while has great influence on the serum levels of Hcy,folate and vitamin B12.Combination treatment of AEDs and monotherapy of VPA,CBZ may increase the incidence of HHcy in PSE patients.

Objective To investigate the influence of vitamin B supplementation on the plasma total homocysteine (Hcy), serum folate, serum vitamin B12, serum vitamin B6, and clinical state of senile epilepsy.Methods A total of 132 senile epilepsy patients with hyperhomocysteinemia, who visited the Second Affiliated Hospital of Soochow University from January 2013 to July 2015, were enrolled into this study.Eighty-three patients who accepted the therapy of vitamin B supplementation (folate 2.5 mg/d, vitamin B6 10.0 mg/d, vitamin B12 1.5 mg/d) were selected as treatment group, and 49 patients with no vitamin B supplementation were selected as control group.All patients were followed-up for one year.The differences of serum Hcy, folate, vitamin B12, vitamin B6 and seizure frequency, MMSE scores, Hamilton Depression Rating Scale (HDMA) scores between the treatment and the control groups were compared.According to the concentration of serum Hcy, 132 patients were divided into two groups: 75 patients (46 patients in the treatment group and 29 patients in the control group) with mild hyperhomocysteinemia (Hcy: 15.0-29.9 μmol/L), 57 patients (37 patients in the treatment group and 20 patients in the control group) with moderate-severe hyperhomocysteinemia (Hcy≥30.0 μmol/L).The differences of serum Hcy, folate, vitamin B12, vitamin B6 and seizure frequency, MMSE scores, HDMA scores between the treatment and the control group in the mild hyperhomocysteinemia group and in the moderate-severe hyperhomocysteinemia group were compared.And the influence factors of Hcy were analyzed.Results Correlation analysis revealed that Hcy was positively correlated with age (r=0.269, P=0.002), and negatively correlated with folate (r=-0.222, P=0.010).Hcy was associated with smoking (χ2=7.363,P=0.007), hypertension (χ2=6.187,P=0.013), and two or more antiepileptic drugs polytherapy (χ2=4.708,P=0.030).After vitamin B supplementation in the group of moderate-severe hyperhomocysteinemia, serum Hcy concentration ((15.68±4.85) μmol/L in the treatment group vs (31.14±11.18) μmol/L in the control group, t=5.890, P<0.01), seizure frequency (4.85±2.78 vs 6.15±1.95, t=2.028, P=0.047) and HDMA scores (15.22±7.55 vs 17.70±4.90, t=2.862, P=0.005) decreased, whereas serum folate ((9.08±3.33) ng/ml vs (5.87±2.91) ng/ml, t=3.618, P=0.001), vitamin B12 ((556.39±276.76) pg/ml vs (419.71±164.53) pg/ml, t=2.336, P=0.023), vitamin B6 ((22.94±5.59) μmol/L vs (21.09±4.87) μmol/L, t=2.029, P=0.047) and MMSE scores (26.89±1.94 vs 25.75±2.20, t=2.024,P=0.048) increased in the treatment group compared with the control group.While in the group of mild hyperhomocysteinemia, the differences of seizure frequency, HDMA and MMSE scores were not statistically significant between the treatment group and the control group (all P>0.05).Conclusions It is necessary to monitor serum Hcy for senile epilepsy.Vitamin B supplementation is a safe and inexpensive way to reduce the concentration of Hcy, assist to control seizures and improve the clinical symptom of depression and cognitive impairment for senile epilepsy with moderate-severe hyperhomocysteinemia.

With the improvement of radiation therapy technology and the comprehensive treatment of malignant tumors,the survival time of patients with malignant tumors is gradually extended.In recent years,carotid stenosis and cerebrovascular disease complications after radiation therapy have received increasing attention.Existing studies have shown that carotid stenosis after radiation therapy is not only associated with atherosclerosis,it is likely to be an independent vascular lesion.This article reviews the correlation between head,neck and cerebral ischemic events,characteristics and mechanisms of vascular injury after radiation therapy,as well as the risk factors for carotid stenosis,clinical manifestations,and diagnosis and treatment methods after radiation therapy.

Malnutrition in patients with acute stroke is quite common. It is an independent risk factor affecting stroke prognosis. Early enteral nutrition can improve the nutritional status of the stroke patients, lower infection rate and mortality, promote recovery of neurological function, and improve the quality of life. Therefore, under the premise of the gastrointestinal tolerance, the patients with severe stroke should select early enteral nutrition as early as possible.

Lipoprotein-associated phospholipase A2(Lp-PLA2) can rapidly hydrolize and oxidize the oxidized phosphatidylcholine molecules produced in low density lipoprotein and atherogenic lipoprotein (a),generating the soluble proinflammatory and proapoptotic mediatorslyso-phosphatidylcholine and oxidized free fatty acids.It stimulates aggregation and activation of monocyte-macrophage system and induces apoptosis and damages the removal of dead cells.It plays an important role in the development of lipid necrotic core of atherosclerosis.Lp-PLA2 is not an independent risk marker of coronary artery disease and ischemic stroke,but also plays an important role in the development of atherosclerotic plaques.Selective Lp-PLA2 inhibitor reduces the development of necrotic cores.It may play a role in the stabilization of atherosclerotic plaques.At the same time,it may represent a novel target for the treatment of atherosclerosis.