Objective To explore the risk factors of earlier neurological function deterioration in acute cerebral infarction patient.Methods 157 cases with acute cerebral infarction had been studied,including the patient's history,general syndromes,clinical characteristic,CT or MRI and laboratory test.Multivarivate noncondition stepwise Logistic model analysis was made after single variable analysis.Results There were 58 patients with neurological function deterioration in 157 cases acute cerebral infarction patient.The morbidity was 36.3%.The following nine factors were associated with earlier neurological function deterioration in acute cerebral infarction i.e. the history of hypertension and diabetes,CT or MRI abnormal,higher WBC count,fever,higher blood sugar,lover mean arterial press,higher fibrin,higher serum Fe-protein;But age,sex,weight,the history of drink and smoker,blood lipemia lever were associated with the disease.Conclusion Earlier neurological function deterioration in acute cerebral infarction patient is caused by multiple factors.Singer test is not easy to calculate the result.To analyze generally patient's clinical material may calculate if earlier neurological function deterioration in acute cerebral infarction patient takes place.

Objective To investigate the change of serum C-reactive protein(CRP) levels in patients with acute cerebral infarction(ACI) and ACI with multiple organ dysfunction syndrome(MODS), and the relationship between serum CRP levels and incidence of MODS.Methods The serum CRP levels of 30 normal healthy people and 82 patients with ACI were detected by immune transmission turbidity method. The data from the patients with lacunar cerebral infarction(LCI), acute simple cerebral infarction(PACI) and ACI with MODS(ACI+MODS) were compared.Results The levels of serum CRP in patients with ACI significantly increased compared with the controls( P

Objective To investigate the degree of cognitive impairment and its clinical significance of Binswanger's disease(BD),leukoaraiosis(LA) and LA with cerebral infarction(LA+CI).Methods Mini-mental state examination(MMSE) and clinical memory scale (CMS) were used to evaluate the cognitive impairment in 33 patients with BD, 27 patients with LA, 31 patients with LA+CI and 30 healthy controls.Results (1)The scores of MMSE and CMS in BD group, LA group, LA+CI group were significantly lower than those in healthy control group( P

Objective To explore the mechanism of the acute cerebral infarction leading to systemic inflammatory response syndrome (SIRS) which causes multiple organ dysfunction syndrome (MODS), and to explore the role of tumor necrosis factor (TNF-?) and IL-1? in the mechanism from SIRS to MODS.Methods 68 cases of acute cerebral infarction (ACI) were divided into three groups. They were 36 cases of simple acute cerebral infarction (SACI group), 32 cases accompanied with SIRS (SIRS group) and 24 cases accompanied with MODS (MODS group). Enzyme linked immunosorbent assay (ELISA) method was used to measure serum TNF-? and IL-1? contents at different time after ACI and compared with 28 healthy persons.Results (1) 47.06% of the 68 cases were accompanied with SIRS, of whom 75.00% were accompanied with MODS.(2) The serum TNF-? and IL-1? levels were the highest in MODS group, next in SIRS group, then in SACI group, the lowest in control group. The differences were significant among 4 groups (all P

Objective To explore the possible mechanism of acute cerebral hemorrhage with systemic inflammatory response syndrome (SIRS) which caused multiple organ dysfunction syndrome (MODS), and to investigate the significance of serum nitric oxide (NO) and nitric oxide synthase (NOS) in the development of acute cerebral hemorrhage from SIRS to MODS.Methods The incidence rate of acute cerebral hemorrhage leading to SIRS and MODS was investigated. Serum NO and NOS levels in 73 patients with acute cerebral hemorrhage were detected dynamically by nitratase and chromometry methods. 20 normal healthy people were adopted as control group.Results The incidence rate of cerebral hemorrhage accompanied with SIRS was 47.95%(35/73),74.29%(26/35) of which leaded to MODS. 73 patients serum NO and NOS levels were elevated obviously, and the differences were significant compared with control group (all P

Objective To study the role of serum C-reactive protein (CRP) ,supplement C3 and CA in sys-temic inflammatory response syndrome (SIRS) induced by acute cerebral infarction(ACI).Methods The levels of CRP,C3 and CA were measured by automatic immunoturbidimetry in 52 ACI cases accompanied with SIRS (SIRS group) ,50 cases of acute simple cerebral infarction(SACI group) and 46 normal cases (control group).Results The serum CRP, C3 ,and CA levels were significantly different among the three groups( F=720.6,580.8,94.1 ,P <0.01) ,the serum CRP levels in SIRS group were significantly higher than those in SACI group(P <0.01 ).The ser-um C3 and CA levels in SIRS were significantly lower than those in SACI group(P <0.01).With the diagnosis crite-rion items increasing, the serum CRP levels tended to be higher (t = 7.69 ,P < 0.01 ), and the serum C3, CA levels tended to be lower meeting SIRS diagnosis criterion numbers increasing respectively (t=10.68 and 10.53, P <0.01).Conclusion The serum ClIP levels are higher significantly and the serum levels of C3 and C4 are lower sig-nificantly when ACI progresses to SIRS.The serum CRP,C3,CA level changes can be used as an index for judging the progress of ACI progressed to SIRS.

Objective To assess the effectiveness of balloon dilation and airway stenting performed under fluoroscopic guidance for the treatment of benign and malignant tracheal stenosis. Methods Under fluoroscopic guidance,balloon dilation and airway stenting were performed in 45 patients with tracheobronchial stricture. Of the 45 patients, malignant tracheal stenosis was seen in 37, including mediastinal nodal metastases (n = 14), esophageal carcinoma (n=13), lung carcinoma (n = 4), adenocarcinoma of bronchus (n = 3), lymphoma (n = 2) and laryngocarcinoma (n = 1), and benign tracheal stenosis was seen in 8, including endobronchial tuberculosis (n = 6), retrosternal thyroid adenoma (n = 1) and endotracheal intubation (n = 1). Airway stenting with serf-expandable metal stent was employed in 38 patients and balloon dilation in 7 patients. All the procedures were performed under fluoroscopic guidance. Results A total of 53 self-expandable metal stents was implanted in 38 patients. The clinical symptoms were immediately relived after the procedure in all patients except for one patient who died from choking of sputum. No stent migration was observed. Restenosis developed in 4 patients, which was successfully treated with repeated stenting and balloon dilation. Nineteen times of balloon dilation procedure were accomplished in 7 patients. Marked remission of clinical symptoms was seen in most cases. During a follow-up period (ranged from 0 to 124 months with a mean of 24.5 months) 31 patients died. Conclusion For both benign and malignant tracheal stenosis, balloon dilation with airway stenting performed under fluoroscopic guidance is a safe and efficient therapy with instant curative effect in relieving clinical symptoms.

BACKGROUND: Cognitive function of simple leukoaraeosis (LA) and subcortical arterioselerotic encephalopathy (SAE) is a part of research in cerebrovascular neuropsychology, however, there is no contrast study on cognitive function between the two diseases. OBJECTIVE: To investigate the different features in cognitive function among patients with simple leukoaraeosis, subcortical arterioselerotic encephalopathy and simple leukoaraeosis combined with cerebral infarction. DESIGN: Randomized controlled observation SETTING: Department of Neurological Medicine, Qilu Hospital, ShandongUniversity. PARTICIPANTS: A total of 91 cases of patients with cerebrovasculardisease diagnosed in Department of Neurological Medicine of Qilu Hospital of Shandong University from March 1997 to May 2000 were selected. All the patients participated in the observation voluntarily. They were divided into 3 groups according to the type of disease, with 27 cases in simple leukoaraeosis group, 33 cases in subcortical arterioselerotic encephalopathygroup and 31 cases in simple leukoaraeosis + cerebral infarction group.Additionally, 30 healthy cases were selected as control group. All the subjects in the above groups participated in the observation voluntarily. METHODS: Assessment on cognitive function and memory ability was conducted on the subjects in each group, and contrast analysis was performed. Mini-mental state examination was used for detecting cognitive function. Patients whose score was less than 17, 20, 22, 23 respectively according to different educational degree (illiteracy, primary school, middle school, university), would be diagnosed as dementia. Clinical me mory scale A edited by Psychology Institute of Chinese Academy of Medical Sciences was used for detecting memory ability including associative learning, directive memory, recognition of nonsense figure, image free recall and portrait characteristics associative recall. Conversed the above 5 items of detecting results to scores of scales and calculated out the memory quotients. MAIN OUTCOME MEASURES: State of cognitive disorder and scoresof mini-mental state examination and clinical memory scale of subjects in each group. RESULTS: All the 91 cases of patients with cerebrovascular disease and 30 healthy control cases entered results analysis without any drop out. ① Comparison of the state of cognitive disorder among subjects in each group: There were 21 cases of mild cognitive disorder (77.8%) in simpleleukoaraeosis group, 8 cases of moderate cognitive disorder (24.2%) and 25 cases of dementia (75.8%) in subcortical arterioselerotic encephalopathy group, 6 cases of moderate cognitive disorder (19.4%) and 24 cases of dementia (77.4%) in simple leukoaraeosis + cerebral infarction group. ② Comparison of the scores of mini-mental state examination among and clinical memory scale: Scores of the two scales in simple leukoaraeosis group, subcortical arterioselerotic encephalopathy group and simple leukoaraeosis + cerebral infarction group were significantly lower than those in healthy control group (t=2.14-3.81, P ＜ 0.05-0.01). The scores in subcortical arterioselerotic encephalopathy group and simple leukoaraeosis+ cerebral infarction group were significantly lower than those in simple leukoaraeosis group (t=2.13-3.37, P ＜ 0.05-0.01).CONCLUSION: ① The cognitive impairment in simple leukoaraeosis is mainly mild cognitive disorder. ② The cognitive impairments in subcortical arterioselerotic encephalopathy and simple leukoaraeosis + cerebral infarction are mainly moderate cognitive disorder and dementia which are obviously severer than mild cognitive disorder. Cognitive function can be used as reference indicator for assessing simple leukoaraeosis and subcortical arterioselerotic encephalopathy.Liang LP, He Y, Guo HZ.A contrast between the cognitive function of patients with simple leukoaraeosis and subcortical arterioselerotic encephalopathy.

Objective To explore the dynamic alteration of intracellular free calcium concentration([ Ca2+]i),ATP level and membrane Ca2+-Mg2+ATPase acti vity of erythrocyte in the patients with acute cerebral infarction(CI).Methods we examined [Ca2+]i,ATP level and membrane Ca2+-Mg2+ATPase activity of erythrocyte in 30 patients with acute CI and 28 health controls by Fluorescence Activated Cell Sorter. Results [Ca2+]i in erythrocyte increased significantly in CI group(P<0.01),while the ATP level and membrane Ca2+-Mg 2+ATPase activity were lower than the controls(P<0.05,P<0.0 01).The above result was more remarkable in the elderly group than the young one .The dynamic alteration of [Ca2+]i in erythrocyte increased obv iously during 1～2 days after the attack,and reached the peak in 3～7 day s,it decreased slowly to the slightly low level at the beginning of th e attack in about two weeks,but it was still higher than the controls.The dynamic alteration of ATP level and Ca2+-Mg2+ATPase activit y after acute CI,it decreased significantly during 1～2 days after the at tack,and reached the lowest in 3～4 days.this status could last about one week.Then both of them increased slightly. There was remarkable negative correlation betwe en RBC [Ca2+]i and ATP level or membrance Ca2+-Mg2+ A TPase activity (r=-0.904,r=-0.978,P<0.05).There was positive correl ation between ATP lev el and membrane Ca2+-Mg2+ATPase activity(r=0.835,P<0.05 ).Conclusion There was calcium overload [Ca2+]i in th e intracellular of erythrocyte in acute CI,ATP level and membrane Ca2+ -Mg2+ATPase activity of erythrocyte CI was involved in the pathologi cal course of calcium overload,and related to the age.

Objective To investigate the effect of nitric oxide synthase inhibitor on learning and memory abilities and to observe the change of nitric oxide (NO) contents in the hippocampi and the effect of nimodipine in rats.Methods With the administration of L ? nitro L arginine(L NA) into bilateral hippocami,the rat model with disorders of learning and memory abilities was established.Then the intraperitoneal injections of nimodipine were given, Y maze tests were performed, and the NO contents in the hippocampi were measured in turn.Results The experiment showed that the learning and memory abilities of model and intervention rats were worse than those of the control rats ( P