Objective To explore the efficacy and safety of endovascular therapy in the treatment of symptomatic M1 stenosis of middle cerebral artery as well as the causes of perioperative complications.Methods Two hundred fifty-six patients with symptomatic M1 stenosis of middle cerebral artery (＞90％) confirmed by TCD,cerebral CT angiography and DSA was treated by endovascular intervention.The success rate,the changes of stenosis,longterm vascular patency rate,in-stent restenosis rate were analyzed.Results endovascular stent was successfully placed in 251 patients with the M1 part of symptomatic middle cerebral artery stenosis and the successful rate was 98.05％.Fifteen patients had complications (5.86％) which caused neurology deficits and deaths.The degree of vascular stenosis was significantly reduced after stenosis (Before vs After:92.26％±2.11％ vs 15.40％±2.60％).The mean mRS and NIHSS scores was decreased significantly.The average follow-up duration was (21.70±0.80) months,249 patients underwent a second DSA and the mean stenosis was (21.70％±0.80％).Twenty-three patients developed instent restenosis (ISR) and ISR rate was 9.24％.Recurrence ischemic stroke and transient ischemic attacks occurred in 5 patients and recurrence rate was 2.01％.Conclusion Endovascular therapy of symptomatic M1 stenosis of middle cerebral artery is safety and efficacy with low complications.The follow-up results reveal good patency rate and excellent prevention of anterior circulation ischemia.

Objective To explore the efficacy,safety and short-term effects of endovascular therapy in the treatment of the symptomatic high-grade basilar artery stenosis.Methods Two hundred thirteen patients with the symptomatic high-grade basilar artery stenosis (＞90％) confirmed by MRA,CTA or DSA was treated by endovascular intervention,the changes of clinical symptoms,the success rate and short-term follow-up results was analyzed.Results Endovascular stent was successfully placed in 209 patients with symptomatic high-grade basilar artery stenosis and the success rate was 98.12％.The degree of vascular stenosis was significantly reduced after stenosis (Before vs After:93.70％±2.51％ vs 11.60％±3.90％).Eight patients had complications (3.76％) including 7 cases of ischemic stroke and 1 case of subarachnoid hemorrhage.The average follow-up duration was 18.70±3.80 months.Two hundred two patients underwent a second DSA and the mean vascular stenosis was (13.80％±4.20％).Five patients developed in-stent restenosis (ISR),of which one was symptomatic.Conclusion Endovascular therapy of the symptomatic high-grade basilar artery stenosis is safety and efficacy.The 1.5 years follow-up results reveal good patency rate and excellent prevention of posterior circulation ischemia.

Objective:To observe the body fluid and cellular immune function of children with cerebral palsy (CP) in the plateau area, as well as the exchanges of these factors during the comprehensive rehabilitation treatment.Methods:A total number of 144 children admitted to Xining Hospital of Traditional Chinese Medicine from June 2018 to October 2019 were selected as the CP group for comprehensive rehabilitation treatment (consecutive courses). The peripheral blood immunoglobulin/complement (IgA, IgG, lgM, C3, C4) level, T lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+) and neuron-specific enolase (NSE) content was examined in the clinical specimens before and after treatment by using the immunoturbidimetry, flow cytometry, electrochemiluminescence analysis according to the Gross Motor Function Classification System (GMFCS) and Gross Motor Function Test Scale (GMFM-88). Children were divided as the different degrees to evaluate the rehabilitation efficacy. A total number of 50 healthy children taken a health check/physical examinations during the same period were considered as the control group. For statistical Analysis, the χ2 test and independent sample t test were performed. Results:The levels of humoral immune IgG, IgA, IgM, C3 and C4 in CP Group [(6.42±1.05), (0.64±0.13), (0.89±0.13), (0.80±0.08), (0.17±0.03) g/L, respectively] in CP groups′ children were lower than those in the control group [(10.25±0.62), (1.04±0.06), (1.06±0.17), (1.04±0.04), (0.27±0.04) g/L, respectively]. The humoral immune IgG and IgA levels [severe (5.40±0.69) and (0.55±0.09)g/L, moderate (6.63±0.30) and (0.66±0.14)g/L, mild (7.57±0.63) and (0.74±0.09)g/L, P<0.05] were also related to the children with CP of different GMFCS grades. Moreover, the level of T lymphocyte subsets (CD3+,CD4+,CD8+,CD4+/CD8+) in the CP group were not statistically different to that in the control groups children. Receiving the rehabilitation treatment, the levels of serum humoral IgG and IgA in CP Group (7.69±1.14) and (0.79±0.17) g/L were significantly enhanced; whereas the serum NSE (12.82±2.49) μg/L was lower than that before treatment (18.57±3.08) μg/L, and the total score of GMFM-88 (121.35±26.51) was higher than that before treatment (101.04±27.62). The differences were statistically significant ( P<0.05). IgM, C3, C4 and T lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+) had no significant difference compared with those before treatment ( P>0.05). Conclusions:Children with CP at high altitude have abnormal humoral immune function. IgG and IgA may be related to the severity of CP and neuronal damage. Comprehensive rehabilitation can not only improve the motor function of children with CP, relieve neuronal damage, but also enhance their humoral immunity status.

Objective:To explore the changes of serum neuron-specific enolase (NSE) and myelin basic protein (MBP) in children with cerebral palsy at high altitude during comprehensive rehabilitation and their clinical significance.Methods:A clinical randomized controlled study design was used to select 144 children with cerebral palsy who were diagnosed and treated in the Rehabilitation Center of Xining Traditional Chinese Medicine Hospital of Qinghai Province from June 2018 to October 2019, including 83 males and 61 females, aged 3-5 years old. According to the order of admission, the random number table was used to divide into a conventional treatment group ( n=72, 40 males and 32 females) and a comprehensive treatment group ( n=72, 43 males and 29 females). The conventional treatment group was treated with conventional rehabilitation. The comprehensive treatment group was treated with monosialotetrahexose ganglioside sodium on the basis of conventional rehabilitation. In addition, 30 healthy children aged 3-5 years, 16 males and 14 females, were selected as the control group during the physical examination of the Pediatrics Department of Xining Hospital of Traditional Chinese Medicine, Qinghai Province. The serum levels of NSE and MBP in each group were detected, and the children′s GMFM-88 scores were evaluated before and after treatment. The SPSS19.0 software was used for statistical analysis, the count data was tested by χ 2. Results:The serum NSE and MBP levels of the control group were (5.96±0.80), (0.71±0.15) μg/L. Before treatment, the serum NSE and MBP levels of children with severe, moderate, and mild cerebral palsy were [(21.63±1.92), (3.63±0.49) μg/L], [(17.86±1.43) μg/L, (2.21±0.07) μg/L] and [(15.14±0.95), (1.76±0.30) μg/L], respectively. After treatment, the serum NSE and MBP levels of the conventional treatment group and the comprehensive treatment group were [(13.54±2.41), (2.07±0.85) μg/L] and [(12.09±2.37), (1.81±0.69) μg/L], respectively, and the GMFM-88 score was (116.75±27.41) points and (125.94±24.93) points. The levels of NSE and MBP in the serum of children with cerebral palsy were significantly higher than those of normal children in the control group, and their levels increased with the degree of disease, and the corresponding gross motor function scores were lower. After treatment, the GMFM-88 scale assessment scores of the two groups of children were significantly improved ( t values were 310.97 and 70.86, P values were both<0.05), and serum NSE and MBP levels decreased to varying degrees compared with before treatment. The decline in the comprehensive treatment group was greater than that in the conventional treatment group. Conclusions:Serum NSE and MBP levels in children with cerebral palsy at high altitude are significantly higher than those in healthy children, and their levels are closely related to the degree of impairment and GMFM-88 scores in children with cerebral palsy. Dynamic monitoring of changes in NSE and MBP levels may be responsible for the condition and treatment effects of children with cerebral palsy judgments based.

Objective:To explore the changes of serum neuron-specific enolase (NSE) and myelin basic protein (MBP) in children with cerebral palsy at high altitude during comprehensive rehabilitation and their clinical significance.Methods:A clinical randomized controlled study design was used to select 144 children with cerebral palsy who were diagnosed and treated in the Rehabilitation Center of Xining Traditional Chinese Medicine Hospital of Qinghai Province from June 2018 to October 2019, including 83 males and 61 females, aged 3-5 years old. According to the order of admission, the random number table was used to divide into a conventional treatment group ( n=72, 40 males and 32 females) and a comprehensive treatment group ( n=72, 43 males and 29 females). The conventional treatment group was treated with conventional rehabilitation. The comprehensive treatment group was treated with monosialotetrahexose ganglioside sodium on the basis of conventional rehabilitation. In addition, 30 healthy children aged 3-5 years, 16 males and 14 females, were selected as the control group during the physical examination of the Pediatrics Department of Xining Hospital of Traditional Chinese Medicine, Qinghai Province. The serum levels of NSE and MBP in each group were detected, and the children′s GMFM-88 scores were evaluated before and after treatment. The SPSS19.0 software was used for statistical analysis, the count data was tested by χ 2. Results:The serum NSE and MBP levels of the control group were (5.96±0.80), (0.71±0.15) μg/L. Before treatment, the serum NSE and MBP levels of children with severe, moderate, and mild cerebral palsy were [(21.63±1.92), (3.63±0.49) μg/L], [(17.86±1.43) μg/L, (2.21±0.07) μg/L] and [(15.14±0.95), (1.76±0.30) μg/L], respectively. After treatment, the serum NSE and MBP levels of the conventional treatment group and the comprehensive treatment group were [(13.54±2.41), (2.07±0.85) μg/L] and [(12.09±2.37), (1.81±0.69) μg/L], respectively, and the GMFM-88 score was (116.75±27.41) points and (125.94±24.93) points. The levels of NSE and MBP in the serum of children with cerebral palsy were significantly higher than those of normal children in the control group, and their levels increased with the degree of disease, and the corresponding gross motor function scores were lower. After treatment, the GMFM-88 scale assessment scores of the two groups of children were significantly improved ( t values were 310.97 and 70.86, P values were both<0.05), and serum NSE and MBP levels decreased to varying degrees compared with before treatment. The decline in the comprehensive treatment group was greater than that in the conventional treatment group. Conclusions:Serum NSE and MBP levels in children with cerebral palsy at high altitude are significantly higher than those in healthy children, and their levels are closely related to the degree of impairment and GMFM-88 scores in children with cerebral palsy. Dynamic monitoring of changes in NSE and MBP levels may be responsible for the condition and treatment effects of children with cerebral palsy judgments based.

Objective:To analyze and evaluate the items of the general module of multidimensional health measurement instruments system for elderly patients with chronic disease (MHIEC-GM)(V1.0) based on classical test theory (CTT) and item response theory (IRT).Methods:A self-administered survey of 2 375 elderly patients with chronic diseases was conducted using the MHIEC-GM(V1.0) scale. The quality of items was analyzed using the variability method, correlation coefficient method, factor analysis method, and Cronbach's α coefficient method based on CTT. The difficulty coefficient, differentiation coefficient, and information content of items were analyzed using the IRT analysis software MULTILOG 7.03.Results:The CTT results showed that the standard deviations of all nine items were greater than 0.9. The results of the correlation coefficient method, the factor analysis method and the Cronbach′s α coefficient method showed that except for the GMI9 item, the correlation coefficients between the other items and the total scale were all greater than 0.5, and the factor loads were all greater than 0.5, and the Cronbach′s α coefficients after the deletion of the items were all less than 0.763. Based on the results of the four analysis methods, except for the GMI9 item, all the other items had good characteristics. The IRT results showed that the information contents of all items were >0.333 (5/15) except for the GMI4, GMI6, and GMI8, and the differentiation coefficient of each item was 1.44. The items that difficulty coefficient met the [-4, 4] inclusion criteria were the GMI2, GMI3, GMI5, GMI7 and GMI9, showing a monotonically increasing trend with increasing difficulty level. The items of GMI1, GMI4, GMI6, and GMI8 needed further improvement.Conclusion:Most of items of the MHIEC-GM(V1.0) scale have good psychometric properties, but some items need to be further revised and validated according to the characteristics of chronic diseases in the elderly.