BACKGROUND: Abnormal hemorheologic index was often observed in patients with ischemic cerebrovascular disease. Although this alteration is not the main cause for the onset of cerebral infarction (CI), the changes of hemorrheology should not be ignored.OBJECTIVE: To study the hemorrheologic alterations of patients in different sexes with CI and transient ischemic attack (TIA), and investigate the significance of hemorrheologic index on the treatment of disease and the value of prognostic assessment.DESIGN: Non-randomized controlled and homochronous study based on patients and healthy people.SETTING: Medical physics institute in a university and a neurological department in a university hospital.PARTICIPANTS: Totally 91 CI patients, including 64 males and 27 females with the mean age of (64 ± 9), and 40 TIA patients, including 20 males and 20 females with the mean age of (58 ± 11 ), were selected from the Neurological Department of Qilu Hospital, Shandong University from January to December 2000. Another 84 healthy volunteers, including 52 males and 32 females with the mean age of (56 ± 10), were selected as the control group homochronously.METHODS: 2 mL fasting venous blood from elbow was taken in the morning and heparin was used against coagulation. Blood viscosity was assayed with NXE-1 cone-plate viscometer (made in Chengdu, China).MAIN OUTCOME MEASURES: High blood viscosity, low blood viscosity,plasma viscosity, hematocrit, erythrocyte aggregation index and fibrinogen content of CI or TIA patients in different sexes and the controls.RESULTS: Each item of hemorrheologic index of male CI or TIA patients was significant higher than that of the controls, and the differences were significant (P ＜ 0.05 -0.01 ). Each item of hemorrheologic index of female CI patients was significant higher than that of the controls, and the differences were significant ( P ＜ 0.05 - 0.01). Blood viscosity, plasma viscosity and fibrinogen content of female TIA patients were significant differences from those of the controls ( P ＜ 0.05).CONCLUSION: The increase of hematocrit and fibrinogen content are the main factor causing the increase in blood viscosity.

Uric acid is an end product of purine metabolism.Hyperuricemia is defined as serum uric acid level ＞420 μmol/L in man,and 360 μmol/L in woman.Several mechanisms can cause elevated serum uric acid levels.Systematic reviews and Meta-analyses have shown that hyperuricemia is significantly correlated with the increased morbidity and mortality in patients with ischemic stroke.However,as a powerful antioxidant and a radical scavenger,uric acid seems to have a neuroprotective effect in ischemic stroke.Uric acid administered early can enhance the effect of recombinant tissue plasminogen activator (rtPA) thrombolytic therapy in rats with thromboembolic stroke.Therefore,it is necessary to conduct a randomized controlled trial for the clinical effects of rtPA thrombolysis in combination with uric acid in patients with acute ischemic stroke.A phase 3 clinical trial is ongoing,and its results are worth waiting for.

Objective: To study the adjustment amplitude of blood pressure in patients with hypertensive intracerebral hemorrhage and the guiding significance in clinical practice in monitoring the changes of cerebral hemodynamics by transcranial Doppler (TCD). Methods: The blood pressures of sixty-four hospitalized patients with intracerebral hemorrhage were monitored dynamically within 10 hours after the onset. Among them, 38 patients had intracranial hematoma puncture and tube drainage within 24 hours of hospitalization (operation group), and 18 patients had conservative treatment (conservative group). Patients were monitored with TCD at the time of hospitalization on day 1, 4, 7, and 14. Another 8 unoperated patients (antihypertensive group) were monitored with TCD before and after antihypertensive treatment, and they were compared with the TCD parameters of 26 simple hypertensive patients (control group) before and after antihypertensive treatment. Results: There was no significant difference in TCD parameters in the control group before and after antihypertensive treatment, however, the blood flow velocity of bilateral middle cerebral arteries (MCA) decreased, and the pulsatility index (PI) increased after antihypertensive treatment in the antihypertensive group. The blood pressure in patients with intracerebral hemorrhage decreased gradually during the treatment, while the blood flow velocity of bilateral MCA decreased first, and then increased. The PI values of bilateral MCA increased first, and then decreased. The blood flow velocity in the conservative group decreased within the first week of the onset. It began to increase at week two and the changes of PI values were contrary to it. The blood flow velocity of MCA increased on day 7 and PI values decreased in the operation group, and there was significant difference between the 2 groups on day 14. The blood pressure decreased more significant in the operation group than that in the conservative group, and there were significant differences in systolic pressure between the 2 groups on day 14 (P

ObjectiveTo find the cognitive function impairment in children with benign epilepsy with centro-temporal spikes and to find a sensitive index which can reveal the cognitive function impairment.Methods21 patients with benign epilepsy with centro-temporal spikes participated in this study. 21 normal subjects, matched for age, gender, years of education and family socioeconomic status, served as controls. Subjects were asked to judged weather the two sequentially presented numbers (S1 and S2) in a digit pair were identical or not, while event-related potential (ERPs) were recorded from electrodes on their scalp.ResultsN270 was evoked by S2 of the conflict condition in either controls or patients. Compared with control group, N270 latency was significantly prolonged and the amplitude decreased in the patient group. However, the peak latency and amplitude of P300 were not changed significantly in patient group. ConclusionChildren with benign epilepsy with centro-temporal spikes as a group show cognitive function impairment. Conflict negative N270 can be employed as a method for evaluating cognitive disturbance, which seems subtler than P300 in detecting mild cognitive function impairment.

Objective To study the changes of low-frequency-component of intracranial pressure (ICP) fluctuation during intracranial hypertension. Methods 15 healthy mongrel dogs were used to make models of intracranial hypertension by arranging latex sacculus epidurally.The different amount of normal that was injected into latex sacculus led to fluctuation of ICP and alteration of intracranial volume. The pressures in ventricle and lumbar spinal canal were recorded continuously by baroceptor, and the changes of low-frequency-component of ICP fluctuation were studied by frequency-spectrum analysis. Results After increase of intracranial pressure and volume,pulse wave (M wave) with its frequency at 0.1～0.2 Hz showed continually. Conclusion Emerge of M wave may reflect some decrease of intracranial compliance and the beginning of volume compensation failure.

Objective To investigate the relationship between the variation of cerebrospinal fluid pulse pressure and that of intracranial perfusion pressure during the process of increasing intracranial pressure.Methods Fourteen dogs were installed epidurally with latex sacculus to establish models of increased intracranial pressure. The degree of intracranial pressure and volume could be altered by changing the volume of fluid in the sacculus. During the process, pressure transducers were arranged to monitor and record the systematic blood pressure and the variation of the pressure of cerebral ventricle and lumbar subarachnoid space.Results With the continual increasement of intracranial pressure, the cerebral perfusion pressure decreased, and the cerebrospinal fluid pulse pressure correspondingly increased. A positive linear relationship between the variation of intracranial pressure and that of cerebrospinal fluid pulse pressure and a negative linear relationship between the variation of cerebral perfusion pressure and that of cerebrospinal fluid pulse pressure were found.Conclusion During the experimental process of increased intracranial pressure, with the decrease of cerebral perfusion pressure , the cerebrospinal fluid pulse pressure increases. The relationship of variations between them shows a negative linear one. It seems that in the circumstances when the autoregulation of cerebral vessel is injured, the variations of cerebrospinal fluid pulse pressure may produce some useful information as to the changes of intracranial blood flow.

AIM: To investigate the changes of expression of Nogo-A at different time points in brain ischemic infarct rats.METHODS: The model of 80 cases of middle cerebral artery occlusion(MCAO) in rats was established.The expression of Nogo-A mRNA and protein were determined by Western blotting and hybridization,and the relationship between functional scoring and Nogo-A was also evaluated.RESULTS: In the brain of MCAO rats,Nogo-A mRNA expression was decreased on day 3 and increased significantly on day 7.The highest level was observed at the 21th d,keeping the same level at the 28th d.Nogo-A protein expression showed the same results.These results were correlated with the brain function scoring.CONCLUSION: Expression of Nogo-A does not increase in the early stage,but increases significantly in the late stage of MCAO,suggesting that Nogo-A expression may play an important role in the nerve regeneration of brain ischemic injury.

Objective:To observe the effects of transurethral split of the prostate (TUSP) on the urodynamics, the sexual function and the quality of life of benign prostatic hyperplasia.Methods:Eighty patients with benign prostatic hyperplasia admitted to the Deqing People′s Hospital of Zhejiang Province from January 2017 to June 2019 were enrolled into the research objects prospectively. According to the random digits table method, they were divided into group A and group B, with 40 cases in each group. The group A was treated with TUSP, while the group B was treated with bipolar transurethral plasma kinetic prostatectomy (TUPKP). The operation time, intraoperative blood loss, bladder irrigation time, urinary catheter indwelling time, hospitalization time of the two groups were compared and surgical effects were evaluated. The changes of hemoglobin (Hb), serum sodium (Na), post-void residual volume (PVR), maximum urinary flow rate (Q max), international prostate symptom score (IPSS) and international index of erectile function score (IIEF-5), the quality of life index (QOL) of 2 groups before and after the operation were measured. Surgical complications were recorded. Results:The operation time, bladder irrigation time, urinary catheter indwelling time and hospital stay in group A were all shorter than that in group B: (15.63 ± 4.17) min vs. (58.79 ± 10.45) min, (6.26 ± 1.17) h vs. (45.51 ± 10.03) h, (3.07 ± 0.68) d vs. (5.67 ± 1.51) d, (3.63 ± 0.43) d vs. (6.08 ± 1.72) d, (18.32 ± 2.79) ml vs. (65.26 ± 20.64) ml, and there were statistical differences ( P<0.05); there were no statistical difference between 2 groups in surgical curative effect grade and Na 1 d after operation ( P>0.05); 1 day after operation, Hb in group A was higher than that in group B: (115.63 ± 9.78) g/L vs. (109.65 ± 8.36) g/L, and there was statistical difference ( P<0.05); PVR, Q max, IPSS, IIEF-5 and QOL 3 and 6 months after surgery were improved in 2 groups ( P<0.05), but the difference between 2 groups was not statistically significant ( P>0.05); the total complication rate in group A was lower than that in group B: 10.00% (4/40) vs. 27.50% (11/40), and there was statistical difference ( P<0.05). Conclusions:TUSP and TUPKP are equally effective in the treatment of benign prostatic hyperplasia, both of which can improve the symptoms of prostatic hyperplasia, improve the quality of life and improve sexual function. But TUSP has less intraoperative bleeding, shorter operation time, faster postoperative recovery, fewer complications, and higher safety.

Objective To evaluate the cognitive impairment in epilepsy patients with Topiramate (TPM) or Valproate (VPA) treatment by using WAIS-CR. Methods30 untreated epilepsy patients were divided into two groups receiving TPM or VPA, respectively. All the patients were examined with WAIS-CR before and 3 months after treatment. ResultsThe IQ of TPM group decreased 3 months after treatment (P<0.05). ConclusionTPM may impair the cognitive function in epileptics reflected by decreased IQ.

ObjectiveTo evaluate the cognitive impairment in epilepsy patients with topiramate (TPM) or valproate (VPA) treatment by using visual completion negativity of faces.Methods30 epileptic patients were divided into two groups receiving TPM or VPA, respectively. 15 healthy volunteers were included as controls. Unfamiliar grey-scale photographs of faces (front view) were used as stimuli. Two types of visual stimuli were presented randomly: pictures of complete faces, pictures of incomplete faces (the occluded part was the left-top quadrant).ResultsN170 were elicited in all participants in each condition. The peak latency of N1 elicited by incomplete faces was delayed compared with complete faces in two groups. Under incomplete faces, a decreased and delayed N170 was observed only in TPM group (P<0.05). N170 amplitude and latency did not change in VPA group (P>0.05).ConclusionChanges of N170 is more obvious in patients with TPM than VPA. Cognitive impairment was not present in epilepsy patients with VPA treatment.