Objective To improve the diagnosis of cerebral lobe hemorrhage (CLH) associated with cerebral amyloid angiopathy (CAA) according to its clinical characteristics and GRE/SWI.Methods Thirty-four CAA-related CLH patients admitted to Inner Mongolia People's Hospital for GRE/SWI from 2013-04-15 to 2015-07-19 were included in this study.Their demographic data,clinical data (age,gender,past history of hypertension,diabetes mellitus,use of antiplatelet drugs) and clinical manifestations were recorded.Results Of the 34 patients,5 were diagnosed with progressive dementia and hypomnesis,4 were diagnosed with epilepsy,7 were diagnosed with past cerebral hemorrhage,18 were diagnosed with hypertension.SWI showed that the CLH was round and oval in shape and was located in parietal lobe,occipital lobe,frontal lobe and temporal lobe respectively with single lobe hemorrhage occurred in 7 patients and multiple lobe hemorrhage occurred in 27 patients.Conclusion The clinical characteristics of CAA-related CLH are highly heterogeneous.SWI plays an important role in diagnosis of CLH and is thus worthy of popularizing its clinical application.

Objective To study the association between Essen stroke risk score (ESRS) and coronary heart disease (CHD).Methods One hundred and forty-six patients who underwent coronary angiography in our hospital from July 1,2015 to December 31,2016 were divided into CHD group (n=105) with their stenosis ≥50％ and non-CHD group (n=41) with their stenosis ＜50％.Their clinical,laboratory and coronary angiography data were recorded and analyzed by univariate logistic regression analysis and multivariate logistic regression analysis respectively.ROC curve of ESRS was plotted for diagnosing CHD.Results The age was significantly older,the incidence of hypertension,diabetes mellitus and myocardial infarction,the ESRS and fasting blood glucose level were significantly higher in CHD group than in non-CHD group (P＜0.05,P＜0.01).The age,history of smoking and alcohol drinking,and the incidence of abnormal blood lipid,AF,other heart diseases,peripheral artery disease,ischemic stroke or the serum levels of TIA,TC,TG,LDL-C,HDL-C and uric acid were significantly different between CHD group and non-CHD group (P＞0.05).Multivariate logistic regression analysis showed that ESRS was an independent risk factor for CHD (OR=2.070,95％CI:1.473-2.908,P＜0.01).The area under the ROC curve of ESRS for diagnosing CHD was 0.743 (95％CI:0.651-0.834,P＜0.01).The Youden's index was the highest when the ESRS was 2 with a sensitivity of 80.95％ and a specificity of 58.54％.Conclusion ESRS is related with CHD and can thus predict the occurrence of CHD.It is necessary to make an overall assessment of CHD when the ESRS is ≥2.

Objective To analyze the clinical factors associated with CT image in diagnosis of elderly brain atrophy patients with mental disorder.Methods Forty elderly brain atrophy patients with mental disorder served as group A,40 elderly brain atrophy patients without mental disorder served as group B,and 40 healthy people served as group C in this study.The chacteristics of their CT image were retrospectively analyzed.Their CT imaging indicators (including the width of ventricle,brain pool,brain ditch and the CT value of white matter) were recorded and analyzed.Results The width of ventricle,brain pool,brain ditch and the CT value of white matter were significantly different in 3 groups (P＜0.01).The width of ventricle,brain pool,brain ditch was significantly longer while the CT value of white matter was significantly lower in groups A and B than in group C (17.2±4.9 mm and 15.7±3.9 mm vs 12.2±3.0 mm,8.7±2.8 mm and 6.9±2.5 mm vs 3.9±1.0 mm,24.3±5.1 mm and 20.8±4.5 mm vs 14.3±3.2 mm,28.2±4.3 HU and 33.9±5.0 HU vs 38.1±6.3 HU,P=0.000).The width of brain ditch was significantly longer while the CT value of white matter was significantly lower in group A than in group B (P＜0.05).The incidence of ischemic stroke and white matter demyelination was significantly higher in group A than in group B (40.0％ vs 17.5％,P =0.26;47.5％ vs 25.0％,P=0.36).Conclusion Brain atrophy patients with mental disorder demonstrate worse CT findings and those with white matter demyelination and ischemic stroke are more prone to occur mental disorder.

Objective To study the relationship between basal ganglia ischemic stroke (BGIS) and paroxysmal atrial fibrillation (PAF) due to abnormal vagus nerve tension.Methods A total of 1483 elderly ischemic stroke patients who underwent head CT or MRI in our hospital from January 2013 to December 2014 were divided into BGIS group (n=1045) and non-BGIS group (n=438).Their heart rate variability and frequency parameters (SDNN,RMSSD,PNNS0) were recorded.The LF/HF ratio was analyzed.Results The incidence of PAF was significantly lower in ＜69 years old patients of BGIS group than in those of non-BGIS group (P＜0.05) and was significantly higher in ≥70 years old patients of BGIS group than in those of non-BGIS group (P＜0.05).The incidence of ischemic stroke with PAF was significantly higher in BGIS group than in nonBGIS group (56.8％ vs 41.0％,P=0.031).The incidence of PAF was significantly higher in ＞79 years old patients of BGIS group than in those of non-BGIS group (P＜0.05).The incidence of AF increased with the increasing age of ischemic patients between the two groups.The SDNN,RMSSD,PNN50 were significantly higher while the LF/HF ratio was significantly lower in nonPAF patients of BGIS group than in those of non-BGIS group (P＜0.05).Conclusion The incidence of BGIS shows a tendency to increase.PAF is prone to occur in BGIS patients.The vagus nerve tension is increased in BGIS patients with PAF.

Objective To analyze the incidence of atrial fibrillation (AF) and asymptomatic AF in sick sinus syndrome (SSS) and atrioventricular block (AVB) patients after dual-chamber pacemaker implantation.Methods Five hundred and fifteen SSS and AVB patients who underwent dual-chamber pacemaker implantation were divided into SSS group (n =221),AF group (n =106),non-AF group (n=115)and into AVB group (n=294),AF group (n=103),non-AF group (n=191).The clinical data,incidence of AF and asymptomatic AF,their influence factors in different groups were compared.Results The incidence of AF was 40.6％ in the 515 patients.The percentage of ventricular pacing (VP％) was significantly higher and the left ventricular end diastolic diameter was significantly longer in AVB group than in SSS group (P＜0.01).The age was significantly older,the incidence of CHD and the percentage of atrial pacing (AP％) were significantly higher,the left atrial diameter was significantly longer in AF group than in non-AF group (P＜0.05,P＜0.01).The age was significantly older,the incidence of CHD and the VP％ were significantly higher in asymptomatic AF group than in symptomatic AF group (P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that age,AP％ and amiodarone amnistration history were the risk factors for AF while age and VP％ were the risk factors for asymptomatic AF (OR=0.957,95％CI:0.925-0.990,P=0.011;OR=0.982,95％CI:0.972-0.992,P=0.000).Conclusion Pacemaker can effectively monitor AF,especially asymptomatic AF.

Objective To analyze the classification of etiology in 48 patients with acute isolated pontine infarction (IPI),a special subtype of ischemic stroke,according to the characteristics of Chinese ischemic stroke subclassification (CISS) and Kumral ischemic stroke subclassification.Methods The basic characteristics,risk factors,clinical manifestations of 48 acute IPI patients were analyzed according to the CISS and Kumral ischemic stroke subclassification.Results Hypertension (70.83 ％),smoking (64.58 ％),hyperlipidemia (50.00 ％),and abnormal glucose metabolism (37.50％) were the major risk factors for acute IPI.Of the 48 acute IPI patients,38 (79.17％) manifestated as hemiplegia and 15 (31.25％) manifestated as dizziness,33 (68.75％) were diagnosed as paramedian pontine infarction,a most common location of IPI,16 (33.33％) were diagnosed as large artery occlusion,a major subtype of IPI,according to the Kumral ischemic stroke subclassification,17 (35.42％) were diagnosed as intracranial and extracranial large artery atherosclerosis according to the CISS (P=0.830).Conclusion IPI is mainly manifested as paramedian pontine infarction.Large artery occlusion according to the Kumral ischemic stroke subclassification and intracranial and extracranial large artery atherosclerosis according to the CISS are the major subtypes of IPI.IPI is diagnosed when a large part of brainstem is involved.

Objective To study the characteristics of quantitative EEG in epilepsy patients after ischemic stroke.Methods Sixty-seven first-ever epilepsy patients after ischemic stroke served as an observation group and 74 age-matched healthy persons served as a control group in this study.The quantitative EEG power spectra of two groups,including δ (0.8-3.9 Hz),θ (4.0-7.7 Hz),α (7.8-12.9 Hz) and β (13.0-20.0 Hz),were analyzed using the Z2N-F32w EEG device made in Shanghai.The (δ+θ)/(α+β) power value on different regions of brain between the two groups was computerized and used as an observation index.Results The ischemic stroke size was not related with the (δ+θ)/(α+β) power value in observation group (P＞0.05).The (δ+θ)/(α+β)power value on the left frontal area (3.15±2.63 vs 1.97±1.42,P=0.002),right frontal area (3.17±2.53 vs 1.88±1.46,P=0.000),left central area (2.69±2.59 vs 1.65±1.28,P=0.004),left parietal area (2.58±2.45 vs 1.28±1.10,P=0.000),right parietal area (2.69±2.81 vs 1.21± 1.06,P=0.000),left occipital area,right occipital area,left temporal area and right temporal area was significantly higher in observation group than in control group (P＜0.01).No significant difference was found in (δ+θ)/(α+β) power value on the right central lobe and left occipital lobe between the two groups and between early and late onset epilepsy patients after ischemic stroke (P＞0.05).Conclusion Quantitative EEG plays an important role both in diagnosis of epilepsy and in assessment of abnormal brain electrical activity in epilepsy patients after ischemic stroke.

Objective To assess the right ventricular function in pulmonary hypertension (PH) patients according to their tricuspid annular plane systolic excursion.Methods Ninety PH patients admitted to our hospital from October 2014 to September 2015 were divided into mild PH group (n=30),moderate PH group (n=30) and severe PH group (n=30) with 30 individuals undergoing physical examination served as a control group.Their right ventricular transverse diameter,right atrial transverse diameter,main pulmonary artery diameter,and respiration variations of inferior vena cava,tricuspid annular plane systolic excursion of right ventricular free wall were measured by ultrasonography.Results The right ventricular transverse diameter,right atrial transverse diameter,main pulmonary artery diameter were significantly longer and the suction collapse rate was significantly lower in mild PH group,moderate PH group and severe PH group than in control group (P＜0.05,P＜0.01).The tricuspid annular plane systolic excursion was significantly shorter in moderate PH group and severe PH group than in control group (12.9± 3.2 cm,10.1±3.1 cm vs 23.4±2.2 cm,P＜0.01).However,no significant difference was found in tricuspid annular plane systolic excursion between moderate PH group and control group (P＞ 0.05).Conclusion The tricuspid annular plane systolic excursion is shorter and the right ventricular function is lower in PH patients.Tricuspid annular plane systolic excursion can sensitively show the right ventricular function in PH patients and is thus a reliable predictor for their right ventricular function.

Objective To study the effect of siRNA-interfered endogenous Kir6.2 gene deletion on rotenone-induced cell damage and signal pathway according to the expression of siRNA-interfered endogenous Kir6.2 gene.Methods The expression of endogenous Kir6.2 gene in PC12 cells was detected by RT-PCR and Western bolt.The viability of PC12 cells was tested using WST-1.The expression of PKC and phosphorylated PKC in PC12 cells was detected by Western blot in negative control group,siRNA/Kir6.2 group,siRNA/Kir6.2 + rotenone group,siRNA/Kir6.2+ rotenone+PKC inhibitor group before and afer treatment with rotenone.Results RT-PCR showed that the interference was successful in siRNA/Kir6.2/group 1 and siRNA/Kir6.2/ group 2.Western blot displayed that the expression level of endogenous Kir 6.2 gene was significantly lower in siRNA/Kir6.2/ group 1 than in negative control group (0.55±0.07 vs 0.89±0.09,P＜ 0.05).WST-1 revealed that the viability of PC12 cells was significantly lower in siRNA/Kir6.2 group than in negative control group (P＜0.05).Western blot demonstrated that the expression of PKC and phosphorylated PKC was significantly lower in siRNA/Kir6.2+-rotenone+PKC inhibitor group than in the other three group (P＜0.05).Conclusion Endogenous Kir6.2 can protect PC12 cells against the toxicity of rotenone and plays an important role in regulating the rotenone-induced viability of PC12 cells by activating the phosphorylated PKC.

Objective To study the mechanism of high glucose level underlying the dysfunction of HUVEC.Methods The HUVEC were divided into normal control group,mannitol control group,and high glucose (33 mmol/L) control group after they were isolated and cultured.Expression of RICTOR protein was detected by RT-PCR and Western blot respectively.RICTOR-transfected overexpressed adenovirus served as a high glucose adenovirus group and RICTOR-transfected AD-GFP served as a high glucose blank virus group.The phosphorylation of Akt and eNOS was detected by Western blot and the volume of released NO was measured with nitrate reductase.Results The expression level of RICTOR protein was significantly lower in high glucose control group than in normal control group (1.00±0.16 vs 2.69±0.07,P＜0.01) and was significantly higher in high glucose adenovirus group than in high glucose blank virus group (0.57±0.03 vs 0.29 ± 0.02,P＜0.01).The phosphorylation of Akt and eNOS was significantly higher and the volume of released NO from HUVEC was significantly larger in high glucose adenovirus group than in high glucose blank virus group (0.95±-0.05 vs 0.56±0.04,P＜0.01;0.97±0.05 vs 0.55±0.07,P＜0.01;0.85±0.06 vs 0.56±0.04,P＜0.05).Conclusion Upregulating the expression of RICTOR protein can improve high glucose-induced dysfunction of HUVEC.