Objective To study effect of clopidogrel on neck blood vessel stenosis and plasma fibrinogen ( FIB ) in patients with stroke in progression(SIP).Methods 80 cases with SIP were selected from March 2014 to March 2015, they were divided into study group and control group according to the random number table method, 40 cases in each group, the control group was received conventional treatment, the study group was given clopidogrel on the basis of conventional treatment, evaluation of neurological function and living ability of patients with Stroke Scale (NIHSS) and daily living ability score ( ADL) , carotid artery stenosis were measured by color Doppler, the levels of FIB and C reactive protein ( hs-CRP) in two groups were also measured, adverse reactions in the two groups were compared.Results Carotid artery, internal carotid artery, external carotid artery diameter before treatment between two groups were no statistical significance,which all increased after treatment, and the study group was wider than the control group, the difference was statistically significant (P <0.05);NIHSS score and ADL score before the treatment between two groups was no statistical significance.NIHSS score and ADL score after treatment between two groups were significant improved, and the study group was better than the control group, the difference was statistically significant (P<0.05); FIB and hs-CRP before the treatment between two groups was no statistical significance, FIB and hs-CRP levels after treatment between two groups were significantly reduced, the study group was significantly lower than the control group, the difference was statistically significant (P<0.05); the adverse reactions of the two groups were not statistically significant.Conclusion Clopidogrel can significantly improve the neurological function, improve the degree of cervical vascular stenosis, reduce the level of FIB for SIP patients in recovery period.

Objective To observe the effect of intelligent trunk intensive training on motor and balance for patients with stroke. Methods 80 stroke patients were divided into treatment group (n=40) and control group (n=40) randomly. Both groups accepted routine rehabilitation,and the treatment group accepted intelligence trunk intensive training in addition for 6 weeks. They were assessed with Rivermead Movement Index (RMI), the Berg Balance Scale (BBS), Sheikh trunk control ability evaluation before and after treatment. Results All the scores improved after treatment in both groups (P<0.001), and improved more in the treatment group than in the control group (P<0.001).The score of trunk control positively correlated with the score of RMI and BBS respectively (r=0.576, r=0.592, P<0.05). Conclusion Intelligent trunk intensive training can further improve the motor and balance of patients with stroke.

Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.

Objective: To investigate the predictive value of CT-DRAGON score for clinical outcomes after endovascular treatment in patients with acute ischemic stroke. Methods: Patients with acute ischemic stroke underwent endovascular intervention in Xuzhou Central Hospital from May 2015 to June 2019 were enrolled retrospectively. CT-DRAGON score was performed before treatment, and the outcomes of patients were evaluated by the modified Rankin Scale (mRS) at 3 months after treatment, and good outcome was defined as mRS0-2. Multivariate logistic regression analysis was used to determine the independent factors for the outcomes. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of CT-DRAGON score for clinical outcome. Results: A total of 67 patients were enrolled. The age was 68.69±11.63 years. The median CT-DRAGON score was 5 (interquartile interval: 4-7), and the baseline NIHSS score was 17.45±5.19. Thirty-five patients (52.2%) had a good outcome and 32 (47.8%) had a poor outcome, of which 13 (19.4%) died. Multivariate logistic regression analysis showed that higher CT-DRAGON score was an independent predictor for poor outcome (odds ratio 1.997, 95% confidence interval 1.271-3.136; P=0.003). The ROC curve analysis showed that the area under the curve of CT-DRAGON score to clinical outcome was 0.808 (95% confidence interval 0.706-0.911; P<0.001). The optimal cutoff value was 5, the corresponding sensitivity was 65.6%, and the specificity was 80.0%. Conclusions Baseline CT-DRAGON score can effectively predict the clinical outcome of patients with acute ischemic stroke at 3 months after endovascular treatment.

BACKGROUNDCushing's disease (CD) presents a remarkable preponderance in female gender, and a significant minority of patients with CD presented with negative magnetic resonance imaging (MRI) findings. The aim of this study was to evaluate gender-related and MRI classification-related differences in clinical and biochemical characteristics of CD.

METHODSWe retrospectively studied 169 patients with CD, comprising 132 females and 37 males, and 33 patients had no visible adenoma on MRI.

RESULTSWe observed that male and MRI-positive patients presented with high adrenocorticotropic hormone (ACTH) values (P < 0.05). Female patients presented with higher prevalence of hirsutism and hyperpigmentation and lower prevalence of purple striae (P < 0.05). The prevalence of buffalo-hump and hypertension was greater in MRI-negative patients (P < 0.05). In addition, male patients with CD presented at a younger age compared with females (P < 0.05). Patients with fatigue and hypokalaemia presented significantly higher urinary-free cortisol, ACTH and cortisol levels compared with patients without these symptoms (P < 0.05). The prevalence of LH reduction, hyper total cholesterol (TC) and hyper low-density lipoprotein was more frequent in MRI-positive patients (P < 0.05). Hyper-TC levels and PRL reduction were more frequent in males (P < 0.05). T3, T4 and FT3 levels negatively correlated with age at diagnosis (r = -0.310, P < 0.01; r = -0.191, P < 0.05; r = -0.216, P < 0.05). T3, T4, FT3 and FT4 levels significantly negatively correlated with 8-am plasma cortisol levels (r = -0.328, P < 0.01; r = -0.195, P < 0.05; r = -0.333, P < 0.01; r = -0.180, P < 0.05). Females presented higher total protein level (P < 0.01) and lower blood urea nitrogen and serum creatinine levels (P < 0.01), compared with male patients.

CONCLUSIONSCarefulness and caution are required in all patients with CD, because of the complexity of clinical and biochemical characteristics in CD patients of different gender and MRI classification, particularly male patients and MRI-negative patients.

Adolescent ; Adult ; Aged ; Dyslipidemias ; diagnosis ; Female ; Humans ; Hypertension ; diagnosis ; Hypokalemia ; diagnosis ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pituitary ACTH Hypersecretion ; complications ; diagnosis ; Retrospective Studies ; Sex Factors ; Young Adult