This article reviews the recent advances in many aspects including classification,risk factors,treatment and prognosis of hemorrhagic transformation after cerebral infarction,which will provide references for the treatment and research of cerebral infarction.

There is evidence to show that the treatment in a stroke unit reduces mortality in patients with stroke and improves neurological functional recoxery.Early mobilization is benefit to improve the prognosis in patients stroke,however,there is a lack of high-quality evidence.The term of"early mobilization"after stroke is not well defined now.A number of medical workers lack enough understanding of the early mobilization.How to perform the early mobilization to get the best benefit is unclear.This article reviews the related studies about the early mobilization after stroke.

Objective To study the application of pressure regulated volume control ventilation in respiratory support after liver transplantation.Methods Twenty patients underwent liver transplantation were randomly averagely divided into two groups: pressure regulated vlume control ventilation(PRVCV) group and volume control(VC) group.The parameters of respiratory mechanics,hemodynamics and blood gas analysis of patients in two groups were compared,such as oxygen delivery(DO2),oxygen consumption(VO2),oxygen incepation ratio(O2ER),arteriovenous oxygen content difference(C(a-v)O2),cardiac output(CO),mean arterial pressure(mABP),mean pulmonary arterial pressure(mPAP),alveolar-arterial PO2 difference(P(A-a)O2),gas exchange index(PaO2/FiO2),ratio of shunted blood to total perfusion(Qs/Qt),peak inspiratory pressure(PIP) and mean airway pressure(mAP).Results The P(A-a)O2 and Qs/Qt were significantly decreased in PRVCV group than those in VC group(P(A-a)O2:(101.42?28.07) mm Hg vs.(136.76?39.13) mm Hg;Qs/Qt:(1.78?0.86)% vs.(3.28?0.99)%),P

AIM: To detect the role of cyclic nucleotides in the alleviation of hypoxic pulmonary vasoconstriction (HPV) in chronic hypoxic animals. METHODS: The intracellular cAMP and cGMP of the cultured porcine pulmonary arterial smooth muscle cells (PASMC) and endothelial cells (PAEC) were assayed by RIA. The length of single PASMC during acute hypoxia was measured by imaging analysis system. RESULTS: The basal levels of cAMP and cGMP in PASMC and cGMP in PAEC of Chronic hypoxic groups decreased remarkably compared with normoxic groups ( P

BACKGROUND: Acute renal insufficiency (ARI) usually occurred following liver transplantation due to the surgical trauma and the application of immunosuppressant, which lack of unified diagnostic criteria. OBJECTIVE: To investigate the experience of diagnosis and treatment of ARI following liver transplantation.DESIGN, TIME AND SETTING: The experiment was performed at the 458 Hospital of Chinese PLA from January 2004 to December 2006.PARTICIPANTS: A total of 37 cases received liver transplantation, including 35 males and 2 females, aged 37-67 years, mean aged (48.5±8.9) years. All cases were divided into the liver cancer group (n=16) and liver cirrhosis group (n=21). The liver cirrhosis group included 16 cases with posthepatitic type B cirrhosis, 4 with posthepatitic type C cirrhosis, and 1 with alcoholic cirrhosis. All these cases were in decompensation stage. The final diagnosis was performed by pathological examination. METHODS: The removal of kidney and construction of blood outflow tract was achieved by modified piggy-back liver transplantation. The arterial blood gas analysis, blood routine examination, renal function and liver function were examined more than twice per day. The cephalosporins, Fluconazole and ganciclovir or vancomycin were used for 5-7 days to prevent infections.MAIN OUTCOME MEASURES: The incidence rate of acute ARI, clinical features and outcomes of patients were observed.RESULTS: ARI developed in 19 patients with liver transplantation, 5 patients died, 14 patients recovered in 2-3 weeks. The incidence of ARI following liver transplantation was associated with infection, bleeding shock, respiratory failure and acute respiratory distress syndrome (P < 0.05). CONCLUSION: The incidence of ARI following liver transplantation was 51.35%, with 26.32% mortality rate. The early diagnosis and treatment are the key steps for increasing successful rate of ARI treatment following liver transplantation.

Objective To assess the safety among acute ischemic stroke patients with asymptomatic intracranial aneurysm after the administration of intravenous thrombolysis.Methods We searched database including Wanfang,CNKI,VIP,Pubmed,EMBASE,EBSCO HOST and Metstr data for all the cohort studies on the use of thrombolysis for acute ischemic patients with asymptomatic intracranial aneurysm,and ascended the correlated references listed on the articles.Meta-analysis was conducted based on the methods recommended by the Cochrane collaboration.The outcomes of the meta-analysis were intracerebral hemorrhage (ICH),symptomatic intracerebral hemorrhage (sICH),subarachnoid hemorrhage (SAH).Results Four cohort studies included 707 patients,of whom 48 patients had asymptomatic cerebral aneurysms.The risk ratio prevalence of ICH among those patients did not differ statistically with those without aneurysms (RR =1.17,95％ CI 0.69-1.99,P =0.56).No statistical differences were found in both odds ratio prevalence of sICH (OR =1.70,95％ CI 0.44-6.59,P =0.45) and SAH (OR =1.13,95％ CI 0.20-6.27,P =0.89) between the patients with asymptomatic cerebral aneurysms and those without.Conclusion Current evidence did not indicate that the risk of hemorrhage increased in acute ischemic stroke patients with asymptomatic intracranial aneurysm after the administration of intravenous thrombolysis.

Objective To study the effects of exercises training on the recovery of neurological function and the expression of matrix metalloproteinase-9 (MMP-9) in perihematomal brain tissue after intra cerebral hemorrhage (ICH) in rats. Methods Sixty-four male adult Sprague-Dawley rats were randomly divided into exercises group and control group. ICH model was induced by autobiood injection. The rats in exercises group were given balance, grasping and walking exercises every day. The rats in control group exercised freely in standard cages. Neurological function in both groups was measured at the 3rd, 7th, 14th and 21st d. All the rats were sacrificed and the concentration of MMP-9 was measured with immunohistochemical method and in situhybridization. Results In both groups neurological function scores was lowest at the 3rd d, were highest at the 21st d. There was no significant difference between two groups at the 3rd d, but at the 7th, 14th and 21st d the differences between two groups were significant ( P < 0.05 ). In exercises group, MMP-9 expressed weakly at the 3rd d, and peaked at the 7th d, then declined gradually. In control group, MMP-9 expression peaked at the 3rd d, then decreased slowly. MMP-9 protein expression was in accord with mRNA. MMP-9 expression in exer-cises group was significantly different from control group on the 3rd and 7th d (P < 0.05 ) , but not at the 14th and 21st d ( P > 0.05 ). Conclusions Early exercises can inhibit the expression of MMP-9 that could play a role in protecting neurons. Daily exercises can stimulates the expression of MMP-9 so as to have a positive role in midstage of disease. MMP-9 may be involved in tissue remodelling and vascular repairing, which prompt neu-rofunction recovery.

OBJECTIVETo observe the impact of Rhizoma Coptidis (drug-chemical extract parts-components) on 3T3-L1 pre-adipocytes differentiation and adipocytes insulin resistance, and reveal the pharmacodyamic material basis of Rhizoma Coptidis on insulin resistance.

METHOD3T3-L1 pre-adipocytes were well cultured, and then induced to differentiate into fat cells by using dexamethasone, 3-isobutyl-1-methyl-xanthine and insulin together, and establish the insulin resistance model. Based on the experience of traditional medicine use, the adipocytes differentiation and the glucose consumption in the cell culture medium were observed independently.

RESULTAqueous extract, different chemical extract fraction and different alkaloid extract from the herb showed inhibitory effects on 3T3-L1 pre-adipocytes differentiation, especially the compound coptisine significantly inhibited the differentiation in the concentration of 16.5 micromol x L(-1), but non-alkaloid extract from the herb promoted cell differentiation significantly in the concentration of 6.0 micromol x L(-1). Each treatment group, especially jatrorrhizine hydrochloride (in the concentration of 10.5 micromol x L(-1)) significantly decreased the concentration of glucose in 3T3-L1 adipocytes culture, at the same time improved insulin resistance. These effects are similar to the role of rosiglitazone maleate.

CONCLUSIONRhizoma Coptidis significantly improved insulin resistance, prevented pre-adipocytes differentiation. Its efficacy may be the synergistic effect of various components. Meanwhile, its role in inhibiting differentiation of pre-adipocytes indicates that coptis to increasing glucose uptake dose not cause fat accumulation and weight increasing. This has some clinical significance in the insulin resistance and metabolic syndrome.

3T3-L1 Cells ; Adipocytes ; cytology ; drug effects ; metabolism ; Animals ; Cell Differentiation ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Glucose ; metabolism ; Insulin Resistance ; Mice ; Rhizome ; chemistry

Objective To observe the effect of hyperbaric oxygen (HBO) therapy on neurological functioning in rats modelling cerebral hemorrhage (ICH).Methods Sixty Sprague-Dawley rats had intracerebral hemorrhage induced by injecting autologous blood.They were then randomly divided into an HBO-free group and an HBO group,each of 30 according to a random number table.The HBO group was further divided into HBO 3 h,HBO 6 h,HBO 1 d,HBO 2 d and HBO 7 d groups which received HBO therapy for 3 hours,6 hours,1 day,2 days and 7 days respectively.Each had 6 members.The HBO-free rats were also divided into analogous HBO-free 3 h,HBO-free 6 h,HBO-free 1 d,HBO-free 2 d and HBO-free 7 d groups,and give no HBO intervention.All of the rats were evaluated for neurological impairment using the Longa scoring method before the treatment and 10 days,20 days and 30 days afterward.Results After 10,20 and 30 days of HBO treatment,there were significant differences in neurological functioning between each pair of HBO-free and HBO-treated groups.After 10 and 20 days of HBO treatment the average neurological function score of the HBO 3 h group was significantly different from that of the HBO 2 d group.The average score in the HBO 7 d group was also significantly different from that of the HBO 3 h,HBO 6 h,HBO 1 d and HBO 2 d groups after 10,20 and 30 days of HBO treatment.The average scores of the HBO 3 h,HBO 6 h,HBO 1 d and HBO 2 d groups improved significantly between 10 and 20 days after the treatment.The average score of the rats which received 30 days of treatment was also significantly different from those after 10 and 20 days.Conclusion HBO treatment can improve neurological function after cerebral hemorrhage,at least in rats.The best time to start HBO treatment is no later than 24 hours after the hemorrhage.The curative effect increases with extension of the treatment's duration.

Objective:To comprehensively evaluate the correlation between migraine and the risk of hemorrhagic stroke using Meta-analysis.Methods:The published observational studies on migraine and the risk of hemorrhagic stroke in PubMed, EMbase, Cochrane library, Chinese Biomedical Database, China Journal Full-text Database, Wanfang Database and VIP Database were retrieved by computers. The retrieval time limit was from the establishment of the databases to December 31, 2019. Two reviewers independently conducted the literature screening and data extraction, and evaluated the quality according to Newcastle Ottawa scale. Stata SE 12.1 software was used for Meta-analysis.Results:Six case-control studies and 7 cohort studies met the inclusion criteria, all of which were in English. The results of Meta-analysis showed that exposure to migraine increased the risk of hemorrhagic stroke (odds ratio [ OR] 1.47, 95% confidence interval [ CI] 1.23-1.76; P<0.001). Sensitivity analysis showed that the results were robust. Subgroup analysis showed that migraine with aura ( OR 1.38, 95% CI 1.05-1.81; P=0.019), migraine without aura ( OR 1.46, 95% CI 1.19-1.80; P<0.001), male ( OR 2.10, 95% CI 1.72-2.56; P<0.001) and female ( OR 1.53, 95% CI 1.22-1.92; P<0.001) migraine could increase the risk of hemorrhagic stroke. Conclusion:Regardless of the gender of patients and presence or absence of migraine aura, migraine can significantly increase the risk of hemorrhagic stroke.