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Changes of hemodynamic after carotid angioplasty and stenting in patients with carotid artery stenosis

Journal of Clinical Neurology.2015;(3):229-231.

Objective To explore the changes of hemodynamic after carotid angioplasty and stenting ( CAS) in patients with carotid artery stenosis .Methods Thirty-one carotid artery stenosis patients were treated with CAS , and were examined by color Doppler flow imaging ( CDFI) before operation and 1 d,3 months,one year after operation . Compared the carotid artery diameter , peak flow velocity (PSV) and end-diastolic velocity (EDV) before and after the operation.Results Compared with before operation , carotid artery diameter were significantly increased ,PSV, EDV were significantly decreased at each time point after operation ( all P<0.01 ) .Compared with 1 d after operation, there was no statistical difference on the CDFI results of carotid artery in 3 months after operation;compared with 1 d after operation the carotid artery diameter was significanty decreased in one year after operation ( P<0.05 ) , there was no statistical difference in PSV and EDV .Conclusions CAS can alleviate the carotid stenosis and improve the indicator of hemodynamics significantly .Vascular restenosis is found in some patients one year after operation , but there was no statistical difference in the indicator of hemodynamic .

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Effects of cerebrovascular reserve on progress and outcome in patients with internal border zone infarction induced by severe middle cerebral artery stenosis

Zhiyong ZHAI ; Yinan SUN ; Juan FENG

Journal of Clinical Neurology.2015;(3):218-220.

Objective To assess cerebrovascular reserve ( CVR) function in patients with internal border zone infarction(IBZI) induced by severe middle cerebral artery (MCA) stenosis, and investigate the impact on progression and outcome of the disease .Methods A total of 84 patients with unilateral severe MCA stenosis were selected . Hypercapnia was induced by holding breath .The change of blood flow velocity in MCA was measured by transcranial Doppler ( TCD ) to calculate CVR .According to CVR , patients were divided into impaired regional CVR group ( CVR <10%) and normal CVR group ( CVR ≥10%) .The NIHSS was used to evaluate neurological function in both groups within 14 d, and mRS was used to evaluate acute stage outcome of the patients at discharge .All the patients were followed-up for 6 months, the incidences of recurrence , complications and mortality in the two groups were analyzed .Results The incidence of progressive cerebral infarction in the impaired regional CVR group (67.39%) was significantly higher than that in the normal CVR group (42.11%) ( P<0.05).The impaired regional CVR group showed higher proportion of patients with poor clinical outcome at discharge ( mRS≥3 ) (63.04%)compared to the normal CVR group (36.84%) (P<0.05).In the followed-up 6 months, the incidences of recurrence and complications were 34.78% and 45.65% respectively in the impaired regional CVR group , they were significantly higher than that in normal CVR group (15.79%,23.68%)(P<0.05).The overall mortality rates did not differ significantly between the two groups ( P>0.05 ) .Conclusion Impaired regional CVR may be predictive of subsequent progressive cerebral infarction and poor clinical outcomes in patients with IBZI induced by severe MCA stenosis .

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Effect of p38 mitogen-activated protein kinase on expression of matrix metalloproteinase-9 and formation of cerebral edema in rats with cerebral ischemia-reperfusion

Guohui LI ; Yaohui WANG

Journal of Clinical Neurology.2015;(3):214-217.

Objective To investigate the effect of p 38 mitogen-activated protein kinase ( MARK) on expression of matrix metalloproteinase-9(MMP-9) and formation of cerebral edema in rats with cerebral ischemia-reperfusion. Methods Fifty-four SPF male SD rats were randomly divided into sham operation group ( Sham group ) , ischemia-reperfusion group(I/R group) and p38 inhibitor group(SB group).Middle cerebral artery ischemia-reperfusion model was made by modified line plug method .The neurologic exams were assessed at 24 h after reperfusion , Evans Blue method was used tomeasurement Blood-brain barrier`s permeability,the wet-dry ratio was used to measured to estimate cerebral edema ,Western blot was used to detect the expression of phosphorylation p 38 ( p-p38 ) and MMP-9 in the infarct region .Results Compared with Sham group , I/R group had aggravated neurological deficits ( P<0.05 );compared with the I/R group, SB group had alleviate neurological deficits (P<0.05).Compared with Sham group, blood-brain barrier permeability and brain water content of I /R group were significantly increased ( all P<0.05 );compared with the I/R group, blood-brain barrier permeability and brain water content of SB group were significantly decreased(all P<0.05).Compared with Sham group , the expression of p-p38, MMP-9 in margin of ischemia of I/R group were significantly increased (all P<0.05);compared with the I/R group, the expression of p-p38, MMP-9 in margin of ischemia of SB group were significantly decreased (all P<0.05).Conclusions p38 MAPK involved in the formation of brain edema in rats with cerebral ischemia-reperfusion , and its mechanism may be cerebral ischemia-reperfusion activates p38MAPK,and it make the expression of MMP-9 in margin of ischemia up-regulated,damaging blood-brain barrier permeability ,leading to cerebral edema .

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Study of non-motor symptoms in early stage newly diagnosed Parkinson's disease

Hui XU ; Weiguo LIU

Journal of Clinical Neurology.2015;(3):192-194.

Objective To investigate the clinical characteristics of non-motor symptoms ( NMS) in early stage newly diagnosed Parkinson 's disease ( PD) patients in different age group and different subtypes .Methods Total 96 newly diagnosed PD patients without taking any drugs and 102 normal controls were collected in outpatient visits , and their clinic information and related scales were evaluated and compared .Results Ninety-one(93.83%) PD patients had at least one NMS, common symptoms were, in order, recent memory (70.83%,68 cases)、constipation (48.96%,47 cases)、attention dysfunction (47.92%,46 cases), and they were significantly higher than PD group (all P<0.01).The incidence of anxiety and panic in patients≤60 years old was significantly higher than that in patients>60 years old (P<0.01).The incidence of urgency in rigidity type was significantly higher than in tremor type(P<0.01).Conclusions NMS in patients with newly diagnosed PD are complex and diverse .The performance in different age groups and different clinical subtypes are also different .

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Study of cognitive impairments caused by the white matter lesions in the frontal lobe in patients with subcortical ischemic vascular disease

Quan DONG ; Qun XU ; Yansheng LI

Journal of Clinical Neurology.2015;(3):177-180.

Objective To explore the pattern of cognitive impairments mainly caused by the white matter lesions(WML) in the frontal lobe in patients with subcortical ischemic vascular disease (SIVD).Methods Fifty SIVD patients were divided into severe WML group (visual score >3, n=27) and mild WML group(visual score ≤3, n=23) according to their severities of the WML in frontal lobe .Seven patients without SIVD were collected as controls .All patients underwent a set of neuropsychological battery ,and the results were analyzed .Results There was no statistical significance among three groups on basic data .Compared with mild WML group and control group , non frontal white matter scores and numbers of lacunes in frontal lobe of severe WML group were significantly higher ( all P=0.000).Compared with mild WML group,the Montreal cognitive assessment scale in severe WML group were significantly lower ( P=0.047 ) , and scores related to the executive function were significantly lower ( P=0.006 ) , even after adjusting the numbers of lacunes in frontal lobe ,there was statistically significant difference (P=0.038). Multiple regression confirmed that the Z scores of executive functions were mainly affected by white matter lesions located in the frontal lobe ( P=0.000 ) .Conclusion WML located in the frontal lobe mainly affect the executive function in patients with SIVD .

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Relationship between metabolic syndrome and cerebral stroke type,complication and prognosis

Ying LIU ; Lidong DING

Journal of Clinical Neurology.1997;0(06):-.

Objective To explore the relationship between metabolic syndrome(MS) and cerebral stroke type,complication and prognosis.Methods Clinical data of 568 cerebral stroke patients with MS(MS group) and 209 cerebral stroke patients without MS(no-MS group) were compared and analyzed.Results In MS group,the incidence of cerebral infarction was significantly higher(93.0%) than that in the no-MS group(85.2%)(P

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Pituitary apoplexy (a report of five cases).

Yuguang LIU

Journal of Clinical Neurology.1992;0(01):-.

Five cases of pituitary apoplexy were reported and the literature was reviewed in clinical aspects. Our diagnosis criteria consisted of 1. sudden onset of maked visual impairment, bitemporal hemianopsia ,severe headache, yore-Ring, etc; 2. with or without a history of pituitary adenoma, but radiological examinations suggest evidences of pituitary apoplexy; 3. exeluding cases with asymptomatic hemorrhage verified at operation. CT scan, treatment with corticosteroids and craniotomy or transsphenoidal decompression will lead a successful outcome in most cases of pituitary apoplexy. One case in this series died of herniation, the prognosis of other four patients was satisfactory.

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Viscosity factors of blood. A laboratory study in repeated blood donors, normal adults and patients with acute cerebral infarction

Yon ZHANG

Journal of Clinical Neurology.1992;0(01):-.

Viscosity of blood was compared among repeated blood donors, normal adults and patients with acute cerebral infarction. Date of viscosity in 51 male donors and 39 female donors were lower than that of the nomal adults. Data of viscosity of bloocl in patients with acute cerebral infarction were higher than that of normal adults, and significantly higher than that of blood donors (P

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Clinical significance and alterations of blood anti- oxidative system in patients with cerebrovascular diseases

Youyao LIU

Journal of Clinical Neurology.1992;0(01):-.

Blood of 109 eases with cerebrovascular diseases were investigated. The results indicated that the contents of blood SOD, GSH-PX were remarkably decreased, while those of plasma LPO were increased. Compared with healthy individuals there was significant difference m these figures (P0.05). The SOD/LPO rate was lower than control group. The authors considered that the balance between anti-oxidase and LPO was disturbed in patients with cerebrovascular diseases.

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Clinical study of senile dementia of Alzheimer's type

Chengzheng LIU

Journal of Clinical Neurology.1992;0(01):-.

This study was caned out on 27 SDAT cases (male 14 female 13),age ranged 50 -78,anda group of normal persons of the same age,sex, and similar educational background was used ascontrol subjects. The results showed that the risk factors of SDAT were relative to serum Aluminium level, however, Vitamin C ingestion showed as protecting factors. Aging adults with highserum aluminum level for a long time should actively make effort to decrease their body aluminum loadings and take food containing more ascorbic acid.

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