Objective To evaluate the effects of Deng Zhan Sheng Mai (DZSM) capsule, a compound made of Chinese herbs, on secondary and tertiary prevention of ischemic stroke. Methods A hospital-based randomized open-blinded clinical trial was conducted among people with a prior history of ischemic stroke. Hospitals were assigned to treatment group, in which all of the participants took DZSM capsules for 3 months, or control group, in which no DZSM capsules was administrated. The primary endpoint was the reduction of levels of blood lipids, fasting blood glucose (FBG) and fibrinogen in the 3rd month. The secondary endpoints were recurrence of stroke, incidence of cardiovascular event (CVD) and all-cause mortality in the 18th month. Results 495 people were enrolled in the treatment group and 504 in the control group, respectively. In the 3rd month, the levels of total cholesterol(TC),FBG and fibrinogen were significantly reduced by 1.7%,4.3 and 8.2%(t values were 4.13,6.65 and 8.50 respectively),and the levels of HDL-C and HDL-C/TC were increased by 7.6%and 1 1.6%(t values were 2.15 and 3.67)in the treatment group, respectively(all P＜0.05＝.The levels of TC,HDL-C and HDL-C/TC decreased significantly in the eontrol group(all P＜0.05＝.The incidence of recurrent stroke and CVD events were lower in the treatment group than those in the control group, but the differences did not reach the significant levels. The prevalence of post-stroke depression (PSD) was also decreased in the 3rd mouth while it remained stable in the controls (P for trend equals to 0.0027). The mortality was significantly lower in the treatment group (P=0.008). Conclusion The levels of TC,FBG and fibrinogen as well as the prevalence of PSD and all-cause mortality have decreased significantly in treatment group treated with DZSM capsule for 3 months as compared with the control group.

Objective To estimate the prevalence and related risk factors of post-stroke depression (PSD) in ischemic stroke survivors from community-based medical centers in urban areas of Beijing.Methods Five community-based medical centers in urban areas of Beijing were selected.Patients with first-ever or recurrent ischemic stroke were evaluated from January 2003 to December 2006. The prevalence of PSD was evaluated by Self-Rating Depression Scale (SDS), and the information on the onset of stroke, vascular risk factors and living style was also collected.Results Totally 1089 stroke patients were registered, 1074 cases among which had complete information and met inclusion criteria. The mean age of the patients was (65.0 ± 8.9) years with a median stroke course of 13.0 months. The overall prevalence of PSD was 49.9% (536/1074), and the proportions of mild, moderate and major PSD were 52.2%, 36.0% and 11.8%, respectively. There were no significant differences in prevalence of PSD among different stages of stroke and the prevalence of PSD was 51.3% within 6 months after stroke onset, 47. 1% during 6-18 months and 53.2% after 18months. Low education, activities of Daily Living (ADL) dependence, cognition impairment and recurrence of stroke were independent risk factors for PSD.Conclusions The prevalence of PSD among ischemic stroke patients is higher in community-based medical centers, but most of PSD patients are mild or moderate. More effective early intervention should be adopted to decrease PSD,promote the recovery of neural function and improve their quality of life.

Objective To summarize our preliminary experience on diagnosis and treatment of aorta pseudoaneurysms due to deceleration injury. Methods Retrospective analysis was made on 8 cases of aorta pseudoaneurysms due to deceleration injury regarding its clinical findings, imagines and surgical operations or endografting treatment. Results Diagnosis was confirmed by imaging examinations. Among two cases who refused a surgery one died and the other lost follow-up after discharge. Surgery was successful in the remaining six cases including two cases treated by open surgery and four cases by intervensive endografting. Conclusions Aorta pseudoaneurysms due to deceleration injury can be correctly diagnosed by imaging examinations. Aorta pseudoaneurysms should be treated timely since spontaneous cure is almost impossible. Traditional surgical operations is effective, however, endografting is a relatively safe, less traumatic procedure.

Objective To evaluate therapeutic results of radiofrequency endovenous obliteration (RFO) for the treatment of varicose veins of the lower limbs. Methods Fifty six cases (56 limbs) of primary greater saphenous vein tributary varicose veins were randomly assigned to RFO group (n=28) and conventional stripping operation group (n=28). In RFO group, the wall of the greater saphenous vein was treated at 85℃ with the catheter to occlude the whole length of the vein. The other 28 cases underwent stripping procedure. The scattered superficial varicose veins in calf in both groups were managed by phlebectomy. The number of surgical incision, postoperative pain, average hospital days and the short-term results were compared. Results Patients in RFO group have less surgical incisions and less postoperative pain, without subcutaneous hematoma. The average hospital stay was 2.5?1.00 days in RFO group compared to 4.14?0.85 days in stripping operation group. Conclusions RFO effectively obliterates the whole length of the great saphenous vein and is of less trauma,faster recovery, and less scars.

Objective To explore the treatment of left renal entrapment syndrome. Methods A retrospective analysis was made on the treatment of left renal entrapment syndrome. Diagnosis was established with ultrasonography, magnetic resonance angiography ( MRA) and left renal venography. The transposition of the superior mesenteric artery(SMA) was performed in three cases, the transposition of left renal vein( LRV) in two, and the stent implantation of the LRV in 15. Results Ultrasonography showed that the flow velocity of the proximal end of the LRV at horizontal position accelerates remarkably, and the acceleration is more obvious after standing for 15 minutes; The inner diameter ratio of the broadest place to the narrowest of the LRV at horizontal position is 4. 4?1. 6, while it is 8. 1?1.7 after standing for 15 minutes. MRA illustrated the angle between the abdominal aorta and the SMA was (30?5)?, the control was (64?16)?. The average pressure difference between the LRV and the inferior vena cava (IVC) was ( 14?5) mmHg and (2. 9?1. 4) mmHg before and after stent implantation. The surgical and interventional therapy was successful in all 20 cases. Follow-up from 6 months to 6 years revealed that macroscopic hematuria and symptom disappeared in all patients. Conclusion Ultrasonography, MRA and renal venography are decisive for the establishment of final diagnosis of left renal entrapment syndrome. The stent implantation is the choice of therapy because of less invasion.

OBJECTIVETo investigate the expression pattern of resistin (RSTN) in skeletal muscle tissue and its influence on glycometabolism in rats with traumatic brain injury (TBI).

METHODSSeventy-eight SD rats were randomly divided into traumatic group (n=36), RSTN group (n=36) and sham operation group (n=6). Fluid percussion TBI model was developed in traumatic and RSTN groups and the latter received additional 1 mg RSTN antibody treatment for each rat. At respectively 12 h, 24 h, 72 h, 1 w, 2 w, and 4 w after operation, venous blood was collected and the right hind leg skeletal muscle tissue was sampled. We used real-time PCR to determine mRNA expression of RSTN in skeletal muscles, western blot to determine RSTN protein expression and ELISA to assess serum insulin as well as fasting blood glucose (FBG) levels. Calculation of the quantitative insulin sensitivity check index (Q value) was also conducted. The above mentioned indicators and their correction were statistically analyzed.

RESULTSCompared with sham operation group, the RSTN expression in the skeletal muscle as well as serum insulin and FBG levels revealed significant elevation (P<0.05), and reduced Q value (P<0.05) in traumatic group. Single factor linear correlation analysis showed a significant negative correlation between RSTN expression and Q values (P<0.001) in traumatic group.

CONCLUSIONThe expression of RSTN has been greatly increased in the muscular tissue of TBI rats and it was closely related to the index of glycometabolism. RSTN may play an important role in the process of insulin resistance after TBI.

Animals ; Brain Injuries ; metabolism ; Glucose ; metabolism ; Insulin Resistance ; Male ; Muscle, Skeletal ; chemistry ; metabolism ; Rats, Sprague-Dawley ; Resistin ; analysis

OBJECTIVEA retrospective study was undertaken to examine therapeutic strategies used in 6 patients with left renal venal nutcracker phenomenon.

METHODSThree patients underwent surgical transposition of the superior mesenteric artery. Three patients underwent endograft stent implantations with intervention.

RESULTSAll 6 cases were completely relieved of left renal vein compression after the operations, leading to improved clinical symptoms and normal urine tests.

CONCLUSIONSTransposition of the superior mesenteric artery is a feasible method, but leads to complications and great trauma. Treating left renal venal nutcracker phenomenon with endografting techniques is minimally invasive in certain cases, and seems to have a prospective future.

Adolescent ; Adult ; Constriction, Pathologic ; surgery ; Humans ; Male ; Mesenteric Artery, Superior ; surgery ; Renal Veins ; Retrospective Studies ; Stents ; Syndrome

OBJECTIVETo observe the association between high-density lipoprotein cholesterol (HDL-C) level and rate of ischemic stroke recurrence.

METHODSA total of 1 059 patients with ischemic stroke were enrolled from 5 community health centers and underwent baseline surveys during the period of January 2003 to December 2006. After baseline surveys, patients were followed up every 6 months until December 31, 2008. The new stroke events were recorded as the primary study endpoint. The association between HDL-C, HDL-C/TC and ischemic stroke recurrence was analyzed by Cox regression analysis.

RESULTSThe proportions of stroke patients with high ( ≥ 1.55 mmol/L), moderate (1.04-1.54 mmol/L) and low (<1.04 mmol/L) HDL-C levels were 15.58% (165/1 059) , 54.58% (578/1 059) and 29.84% (316/1 059) respectively. During a mean of (3.21 ± 1.04) years follow-up, recurrent ischemic stroke was recorded in 137 patients. Compared with HDL-C ≥ 1.40 mmol/L group, multivariate Cox regression analysis showed that stroke recurrence rates of patients with HDL-C ≤ 1.00 mmol/L and ranged from 1.01 to 1.19 mmol/L increased by 0.944 (HR = 1.944, 95%CI:1.033-3.659, P = 0.039) and 1.027 (HR = 2.027, 95%CI:1.116-3.682, P = 0.020)fold , respectively. Recurrence rates increased 1.237 (HR = 2.237, 95%CI:1.208-4.144, P = 0.010) fold in patients with HDL-C/TC ≤ 0.19 mmol/L compared to patients with HDL-C/TC ≥ 0.28 mmol/L.

CONCLUSIONThe risk of ischemic stroke recurrence increases with decreasing HDL-C level or HDL-C/TC ratio.

Aged ; Cholesterol, HDL ; blood ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Recurrence ; Risk Factors ; Stroke ; blood ; epidemiology