OBJECTIVE: To explore the relationship between serum lipoprotein-associated phospholipase A2 (Lp-PLA2) level and the risk of acute ischemic stroke (AIS) recurrence in hypertensive patients. METHODS: This retrospective case-control study was conducted among 211 hypertensive patients with AIS treated in Foshan First People's Hospital, including 35 patients with recurrence of AIS during the 1-year follow-up as confirmed by head CT/MR. In the overall patients, 60 had grade 1 hypertension (including 5 recurrent cases), 76 had grade 2 hypertension (with 11 recurrent cases), and 75 had grade 3 hypertension (with 19 recurrent cases). Univariate analysis, multivariate logistic regression analysis, trend analysis, and smooth curve fitting analysis were performed to explore the correlation between serum Lp-PLA2 level within 24 h after admission and the risk of AIS recurrence. The predictive efficacy of serum Lp-PLA2 level for AIS recurrence in different hypertension grades was evaluated using ROC curve analysis. RESULTS: Serum Lp-PLA2 level, age, NIHSS score at admission, mRS scores at 7 days, homocysteine level and smoking status differed significantly between patients with and without AIS recurrence (P < 0.05). After adjustment for confounding factors, multivariate regression analysis showed that the highest tertile of Lp-PLA2 level was associated with a 4.13-fold increase of AIS recurrence risk compared with the lowest tertile (OR=5.13, 95% CI: 1.35-19.40), and each 1 ng/mL increase of Lp-PLA2 level was associated with a 1% increase of AIS recurrence risk (OR= 1.01, 95% CI: 1.01-1.02). Serum Lp-PLA2 level was shown to positively correlate with AIS recurrence risk, and in patients with grade 3 hypertension, its areas under the ROC curve for predicting AIS recurrence was 0.869 with a specificity of 0.893 and a sensitivity of 0.737. CONCLUSION Serum Lp-PLA2 concentration is an independent risk factor and potentially an effective predictor for AIS recurrence in patients with grade 3 hypertension.
Humans ; Infant, Newborn ; 1-Alkyl-2-acetylglycerophosphocholine Esterase ; Acute Disease ; Biomarkers ; Brain Ischemia/etiology* ; Case-Control Studies ; Cerebral Infarction ; Hypertension/complications* ; Ischemic Stroke/complications* ; Retrospective Studies ; Risk Factors ; Stroke

In the clinical settings, disseminated intravascular coagulation (DIC) and complications such as hemorrhage are commonly seen in acute promyelocytic leukemia patients, whereas thrombosis is rarely reported. We reported a case here that the patient presented with cerebral infarction as the first manifestation. During the admission, the patient encountered differentiation syndrome, pulmonary embolism, pulmonary hemorrhage, and myocardial ischemia, as well as bleeding and thrombosis complications. Hence the patient was diagnosed as DIC. After the treatment of blood transfusion instead of anticoagulation, his condition was stable and the remission was completely achieved. The treatment experience provides guides for other patients with similar complications of simultaneous bleeding and thrombosis.
Blood Coagulation ; Cerebral Infarction ; Disseminated Intravascular Coagulation ; etiology ; Humans ; Leukemia, Promyelocytic, Acute ; complications ; Thrombosis

Adult ; Cerebral Infarction ; diagnosis ; diagnostic imaging ; etiology ; Heart Atria ; diagnostic imaging ; pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Myxoma ; complications ; diagnostic imaging

Cerebral Infarction ; complications ; Cerebral Veins ; pathology ; Humans ; Thrombosis ; Venous Thrombosis ; etiology

Acupuncture Therapy ; Aged ; Aneurysm, Dissecting ; complications ; Brain ; diagnostic imaging ; pathology ; Cerebral Infarction ; etiology ; therapy ; Female ; Glasgow Coma Scale ; Humans ; Postoperative Complications ; etiology ; therapy ; Tomography, X-Ray Computed

Acupuncture Points ; Acupuncture Therapy ; Aged ; Bulbar Palsy, Progressive ; etiology ; physiopathology ; therapy ; Cerebral Infarction ; complications ; Female ; Humans ; Male ; Middle Aged ; Pharynx ; physiopathology ; Treatment Outcome

No abstract available.
Aneurysm, Dissecting/diagnosis/*etiology/physiopathology/therapy ; Anticoagulants/therapeutic use ; Aortic Aneurysm/diagnosis/*etiology/physiopathology/therapy ; Behcet Syndrome/*complications/diagnosis/drug therapy ; Cerebral Infarction/diagnosis/etiology ; Diffusion Magnetic Resonance Imaging ; Echocardiography, Doppler, Color ; Electrocardiography ; Hemodynamics ; Humans ; Immunosuppressive Agents/therapeutic use ; Male ; Middle Aged ; *Sinus of Valsalva/physiopathology/ultrasonography ; Thrombosis/diagnosis/drug therapy/*etiology/physiopathology ; Ventricular Septal Rupture/diagnosis/*etiology/physiopathology/therapy

OBJECTIVETo study the impacts of electroacupuncture (EA) on memory impairment after cerebral infarction through the observation of hydrogen proton magnetic resonance spectroscopy (1H-MRS) of brain tissue metabolites in the patients of cerebral infarction.

METHODSSixty cases of memory impairment after cerebral infarction were randomized into an observation group and a control group, 30 cases in each one. The conventional rehabilitation training and medication were applied to all the patients. In the observation group, beside the basic treatment, EA was applied to bilateral Ezhongxian (MS 1), Dingzhongxian (MS 5), Dingniehouxiexian (MS 7), Hegu (LI 4), Taichong (LR 3), Zusanli (ST 36), Taixi (KI 3), Xuanzhong (GB 39) and Fengchi (GB 20). The treatment was given once a day, 5 times a week, for 8 weeks. The clinical memory scale was used for the score evaluation before and after treatment in all the patients. The magnetic resonance image (MRI) and 1H-MRS scanning were applied to the head. The ratio of N-acetyl aspartate (NAA) and creatine (Cr) and the ratio of choline (Cho) and Cr were determined in the foci of cerebral infarction.

RESULTSEight weeks later, the scores of clinical memory scale were all increased after treatment as compared with those before treatment in the two group (all P<0. 01). The ratio of NAA and Cr was increased as compared with that before treatment (P<0. 05); the ratio of Cho and Cr was reduced as compared with that before treatment (P<0. 05). The changes in the observation group were more obvious than those in the control group (all P<0. 05).

CONCLUSIONOn the basis of the conventional medication and rehabilitation training, EA improves the metabolism of brain tissue and memory function of the patients. The efficacy of this therapy is better than that of medication combined with rehabilitation training.

Adult ; Aged ; Aged, 80 and over ; Brain ; diagnostic imaging ; Cerebral Infarction ; complications ; diagnostic imaging ; Electroacupuncture ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Memory ; Memory Disorders ; etiology ; psychology ; therapy ; Middle Aged ; Radiography

Acupuncture Therapy ; Cerebral Hemorrhage ; complications ; Cerebral Infarction ; etiology ; therapy ; Humans ; Male ; Middle Aged

PURPOSE: In this study, we investigated the stroke mechanism and the factors associated with ischemic stroke in patients with nonvalvular atrial fibrillation (NVAF) who were on optimal oral anticoagulation with warfarin. MATERIALS AND METHODS: This was a multicenter case-control study. The cases were consecutive patients with NVAF who developed cerebral infarction or transient ischemic attack (TIA) while on warfarin therapy with an international normalized ratio (INR) > or =2 between January 2007 and December 2011. The controls were patients with NVAF without ischemic stroke who were on warfarin therapy for more than 1 year with a mean INR > or =2 during the same time period. We also determined etiologic mechanisms of stroke in cases. RESULTS: Among 3569 consecutive patients with cerebral infarction or TIA who had NVAF, 55 (1.5%) patients had INR > or =2 at admission. The most common stroke mechanism was cardioembolism (76.0%). Multivariate analysis demonstrated that smoking and history of previous ischemic stroke were independently associated with cases. High CHADS2 score (> or =3) or CHA2DS2-VASc score (> or =5), in particular, with previous ischemic stroke along with > or =1 point of other components of CHADS2 score or > or =3 points of other components of CHA2DS2-VASc score was a significant predictor for development of ischemic stroke. CONCLUSION: NVAF patients with high CHADS2/CHA2DS2-VASc scores and a previous ischemic stroke or smoking history are at high risk of stroke despite optimal warfarin treatment. Some other measures to reduce the risk of stroke would be necessary in those specific groups of patients.
Aged ; Aged, 80 and over ; Anticoagulants/adverse effects/*therapeutic use ; Atrial Fibrillation/*complications ; Cardiovascular Diseases ; Case-Control Studies ; Cerebral Infarction/complications ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Risk Factors ; Stroke/etiology/*prevention & control ; Warfarin/adverse effects/*therapeutic use