Objective:To investigate the clinical effects of applying the magnetic resonance double mismatch technique to endovascular treatment of acute anterior circulation,large vessel occlusion with cerebral infarction in an ...Objective:To investigate the clinical effects of applying the magnetic resonance double mismatch technique to endovascular treatment of acute anterior circulation,large vessel occlusion with cerebral infarction in an unknown time window.Methods:The research work was carried out in our hospital,the work was carried out from November 2018 to November 2019,the patients with acute anterior circulation large vessel occlusion with cerebral infarction who were treated in our hospital during this period,100 patients,50 patients with an unknown time window and 50 patients with definite time window were selected,and they were named as the experimental and control groups,given different examination methods,were given to investigate the clinical treatment effect.Results:Patients’data on HIHSS score before treatment,the incidence of intracranial hemorrhage and rate of Mrs≤2 rating after 90 days of treatment were not significantly different(P>0.05),which was not meaningful.The differences in data between the two groups concerning HIHSS scores were relatively significant before,and after treatment(P<0.05).Conclusion:The magnetic resonance double mismatch technique will be applied in the endovascular treatment of acute anterior circulation large vessel occlusion with cerebral infarction of unknown time window.展开更多
Large animal models of cardiac ischemia-reperfusion are critical for evaluation of the efficacy of cardioprotective interventions prior to clinical translation.Nonetheless,current cardioprotective strategies/intervent...Large animal models of cardiac ischemia-reperfusion are critical for evaluation of the efficacy of cardioprotective interventions prior to clinical translation.Nonetheless,current cardioprotective strategies/interventions formulated in preclinical cardiovascular research are often limited to small animal models,which are not transferable or reproducible in large animal models due to different factors such as:(i)complex and varied features of human ischemic cardiac disease(ICD),which are challenging to mimic in animal models,(ii)significant differences in surgical techniques applied,and(iii)differences in cardiovascular anatomy and physiology between small versus large animals.This article highlights the advantages and disadvantages of different large animal models of preclinical cardiac ischemic reperfusion injury(IRI),as well as the different methods used to induce and assess IRI,and the obstacles faced in using large animals for translational research in the settings of cardiac IR.展开更多
目的探究急性大面积脑梗死患者开展开颅去大骨瓣减压联合康复治疗的临床效果。方法选择2021年2月—2023年2月高密市人民医院收治的46例急性大面积脑梗死患者为研究对象,按随机数表法分为研究组和对照组,各23例。所有患者全部开展开颅去...目的探究急性大面积脑梗死患者开展开颅去大骨瓣减压联合康复治疗的临床效果。方法选择2021年2月—2023年2月高密市人民医院收治的46例急性大面积脑梗死患者为研究对象,按随机数表法分为研究组和对照组,各23例。所有患者全部开展开颅去大骨瓣减压术治疗,对照组予以基础康复治疗,研究组予以综合康复治疗。比较两组患肢关节改良Ashworth分级(Modified Ashworth Scale,MAS)、美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)、Fugl-Meyer肢体运动功能量表(Fugl-Meyer Assessment,FMA)、Barthel指数(Barthel Index,BI)影响。结果治疗前,两组MAS评分、NIHSS评分、FMA评分、BI指数比较,差异无统计学意义(P均>0.05)。治疗后,研究组NIHSS评分(15.26±2.21)分、MAS评分(1.18±0.42)分,低于对照组的(17.21±2.70)分、(1.96±0.37)分,差异有统计学意义(t=2.680、6.683,P均<0.05)。治疗后,研究组FMA评分(59.90±8.23)分、BI指数(81.96±10.59)分,高于对照组的(55.50±3.69)分、(72.25±13.36)分,差异有统计学意义(t=2.340、2.708,P均<0.05)。结论急性大面积脑梗死患者开展开颅去大骨瓣减压联合综合康复治疗的效果显著,可改善神经受损情况,提升肢体功能、自理能力。展开更多
Motor weakness is a common and important sequela of stroke,and motor recovery is mostly achieved within 3 months following stroke(Jorgensen et al.,1995;Fujii and Nakada,2003),suggesting the importance of active rehabi...Motor weakness is a common and important sequela of stroke,and motor recovery is mostly achieved within 3 months following stroke(Jorgensen et al.,1995;Fujii and Nakada,2003),suggesting the importance of active rehabilitation during the early stage of stroke.Many studies have reported on neurological recovery during this period,however,little is known about pontine infarction(Jang et al.,2007;Kwon and Jang,2012;展开更多
BACKGROUND Treatment decision making is strictly associated with the outcomes in patients with ischemic stroke who show a large core infarct.Medical care alone may result in suboptimal treatment efficacy,and endovascu...BACKGROUND Treatment decision making is strictly associated with the outcomes in patients with ischemic stroke who show a large core infarct.Medical care alone may result in suboptimal treatment efficacy,and endovascular treatment may be accompanied by safety issues.Whether endovascular treatment is superior to medical care is not well investigated in the clinical studies.AIM To investigate the efficacy of endovascular treatment and drug therapy alone in mild ischemic stroke patients with large infarct cores.METHODS Fifty patients with mild ischemic stroke and 50 patients with acute ischemic stroke caused by anterior large vessel occlusion were selected at the First Affiliated Hospital of Hebei North University between January 2021 and December 2021.Patients were divided into an endovascular therapy group and a drug therapy group according to different treatment methods.In the endovascular therapy group,there were 28 patients with minor stroke and 22 patients with large infarct cores.The drug therapy group had 22 patients with minor stroke and 28 patients with large infarct cores.The National Institutes of Health Stroke Scale(NIHSS) scores were collected and compared between the two groups immediately after the operation and 24 h and 7 d after the operation.The modified Rankin scale(m RS) and/or activity of daily living were assessed at hospital discharge.RESULTS There was no significant difference in NIHSS scores between the two groups before the operation(P > 0.05).NIHSS scores were lower in the endovascular therapy group than in the drug therapy group at 24 h and 7 d after the operation and at hospital discharge(all P < 0.05).The incidence of early neurologic deterioration was significantly lower in the endovascular therapy group than in the drug therapy group(P < 0.05).At hospital discharge,the m RS score was lower in the endovascular treatment group than in the drug therapy group,and the activity of daily living score was better in the endovascular treatment group than in the drug therapy group(all P < 0.05).During a follow-up of 3 mo,17 patients(34.0%) had good prognosis(m RS ≤ 2),33 patients(66.0%) had poor prognosis(m RS > 2),and 11 patients(22.0%) died.In the medical treatment group,16 patients(m RS ≤ 2) had good prognosis(32.0%),34 patients(m RS > 2) had poor prognosis(68.0%),and 14 patients(28.0%) died.There was no significant difference in prognosis and mortality between the two groups(P > 0.05).CONCLUSION Endovascular therapy can improve NIHSS score and m RS score in patients with mild ischemic stroke and large infarct cores.It is suitable for clinical application.展开更多
A model of focal cerebral ischemic infarction was established in dogs through middle cerebral artery occlusion of the right side.Thirty minutes after occlusion,models were injected with nerve growth factor adjacent to...A model of focal cerebral ischemic infarction was established in dogs through middle cerebral artery occlusion of the right side.Thirty minutes after occlusion,models were injected with nerve growth factor adjacent to the infarct locus.The therapeutic effect of nerve growth factor against cerebral infarction was assessed using the hemisphere anomalous volume ratio,a quantitative index of diffusion-weighted MRI.At 6 hours,24 hours,7 days and 3 months after modeling,the hemisphere anomalous volume ratio was significantly reduced after treatment with nerve growth factor. Hematoxylin-eosin staining,immunohistochemistry,electron microscopy and neurological function scores showed that infarct defects were slightly reduced and neurological function significantly improved after nerve growth factor treatment.This result was consistent with diffusion-weighted MRI measurements.Experimental findings indicate that nerve growth factor can protect against cerebral infarction,and that the hemisphere anomalous volume ratio of diffusion-weighted MRI can be used to evaluate the therapeutic effect.展开更多
We report a successful case of a pregnant female positive for anti-cardiolipin antibodies who experienced two abnormal pregnancies with postpartum cerebral hemispheric infarctions. A 38-year-old female diagnosed as be...We report a successful case of a pregnant female positive for anti-cardiolipin antibodies who experienced two abnormal pregnancies with postpartum cerebral hemispheric infarctions. A 38-year-old female diagnosed as being positive for anti-cardiolipin antibodies was referred to our hospital due to her strong desire to have a baby. The administration of Japanese herbal medicine, Sairei-to, as immunosuppressive therapy, and low dose aspirin, as anti-coagulation therapy, were initiated prior to the patient’s pregnancy. Five months after beginning the treatment, the patient conceived spontaneously. At 34 weeks of gestation, emergency cesarean section was performed due to increasing genital bleeding resulting from coincidental placenta previa and the patient delivered an appropriate-for-date female infant (1970 g). Treatment with Japanese herbal medicine (Sairei-to) and low-dose aspirin is considered to be an effective treatment option for patients positive for anti-phospholipid antibodies with past histories of abnormal pregnancies.展开更多
Objective:Study the clinical effect of atorvastatin combined with clopidogrel on patients with progressive cerebral infarction of intracranial aortic stenosis.Methods: Chose eighty-eight patients with progressive cere...Objective:Study the clinical effect of atorvastatin combined with clopidogrel on patients with progressive cerebral infarction of intracranial aortic stenosis.Methods: Chose eighty-eight patients with progressive cerebral infarction in our hospital from June 2014 to October 2015. They were randomly divided into study group and study group, 44 cases in each group. The patients in the control group were treated with oral clopidogrel. On the basis of this, the patients in the study group were treated with atorvastatin;all patients were treated for 4 weeks. Compared the total effective rate, adverse reaction rate, coagulation function index and blood lipid level between the two groups, and compared the NIHSS score and daily life ability (ADL) score between the two groups before and after treatment.Results: The total effective rate (90.90%) was significantly higher in the study group than in the control group (72.73%). After treatment, the NIHSS score of the study group was significantly lower than that of the control group. The levels of LDL-C, TG and TC in the study group were significantly lower than those in the control group, and HDL-C was significantly higher than that in the control group. There was no significant difference between the two groups.Conclusion: Clopidogrel combined with atorvastatin has a significant effect on the patients with intracranial large artery stenosis and improve the neurological function and quality of life. It is safe and reliable. It is worthy to be popularized.展开更多
文摘Objective:To investigate the clinical effects of applying the magnetic resonance double mismatch technique to endovascular treatment of acute anterior circulation,large vessel occlusion with cerebral infarction in an unknown time window.Methods:The research work was carried out in our hospital,the work was carried out from November 2018 to November 2019,the patients with acute anterior circulation large vessel occlusion with cerebral infarction who were treated in our hospital during this period,100 patients,50 patients with an unknown time window and 50 patients with definite time window were selected,and they were named as the experimental and control groups,given different examination methods,were given to investigate the clinical treatment effect.Results:Patients’data on HIHSS score before treatment,the incidence of intracranial hemorrhage and rate of Mrs≤2 rating after 90 days of treatment were not significantly different(P>0.05),which was not meaningful.The differences in data between the two groups concerning HIHSS scores were relatively significant before,and after treatment(P<0.05).Conclusion:The magnetic resonance double mismatch technique will be applied in the endovascular treatment of acute anterior circulation large vessel occlusion with cerebral infarction of unknown time window.
基金supported by the Early Career Scheme(ECS)2022/23(CUHK 24110822)from the Research Grants Council of Hong Kongthe Direct Grant for Research 2020/21(2020.035)+3 种基金Project Impact Enhancement Fund(PIEF)(PIEF/Ph2/COVID/08)Improvement on Competitiveness in Hiring New Faculties Funding Scheme from CUHK as well as the Centre for Cardiovascular Genomics and Medicine(CCGM)of the Lui Che Woo Institute of Innovative Medicine CUHK(to S.B.O.)a CUHK Department of Medicine&Therapeutics(MEDT)-funded PhD studenta CUHK Vice-Chancellor’s PhD Scholarship holder。
文摘Large animal models of cardiac ischemia-reperfusion are critical for evaluation of the efficacy of cardioprotective interventions prior to clinical translation.Nonetheless,current cardioprotective strategies/interventions formulated in preclinical cardiovascular research are often limited to small animal models,which are not transferable or reproducible in large animal models due to different factors such as:(i)complex and varied features of human ischemic cardiac disease(ICD),which are challenging to mimic in animal models,(ii)significant differences in surgical techniques applied,and(iii)differences in cardiovascular anatomy and physiology between small versus large animals.This article highlights the advantages and disadvantages of different large animal models of preclinical cardiac ischemic reperfusion injury(IRI),as well as the different methods used to induce and assess IRI,and the obstacles faced in using large animals for translational research in the settings of cardiac IR.
文摘目的探究急性大面积脑梗死患者开展开颅去大骨瓣减压联合康复治疗的临床效果。方法选择2021年2月—2023年2月高密市人民医院收治的46例急性大面积脑梗死患者为研究对象,按随机数表法分为研究组和对照组,各23例。所有患者全部开展开颅去大骨瓣减压术治疗,对照组予以基础康复治疗,研究组予以综合康复治疗。比较两组患肢关节改良Ashworth分级(Modified Ashworth Scale,MAS)、美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)、Fugl-Meyer肢体运动功能量表(Fugl-Meyer Assessment,FMA)、Barthel指数(Barthel Index,BI)影响。结果治疗前,两组MAS评分、NIHSS评分、FMA评分、BI指数比较,差异无统计学意义(P均>0.05)。治疗后,研究组NIHSS评分(15.26±2.21)分、MAS评分(1.18±0.42)分,低于对照组的(17.21±2.70)分、(1.96±0.37)分,差异有统计学意义(t=2.680、6.683,P均<0.05)。治疗后,研究组FMA评分(59.90±8.23)分、BI指数(81.96±10.59)分,高于对照组的(55.50±3.69)分、(72.25±13.36)分,差异有统计学意义(t=2.340、2.708,P均<0.05)。结论急性大面积脑梗死患者开展开颅去大骨瓣减压联合综合康复治疗的效果显著,可改善神经受损情况,提升肢体功能、自理能力。
基金supported by the National Research Foundation of Korea(NRF)grant funded by the Korea government(MSIP)(NRF-2015R1A2A2A01004073)
文摘Motor weakness is a common and important sequela of stroke,and motor recovery is mostly achieved within 3 months following stroke(Jorgensen et al.,1995;Fujii and Nakada,2003),suggesting the importance of active rehabilitation during the early stage of stroke.Many studies have reported on neurological recovery during this period,however,little is known about pontine infarction(Jang et al.,2007;Kwon and Jang,2012;
基金Supported by Scientific Research Fund of Hebei Health Commission 2022,No.20220591。
文摘BACKGROUND Treatment decision making is strictly associated with the outcomes in patients with ischemic stroke who show a large core infarct.Medical care alone may result in suboptimal treatment efficacy,and endovascular treatment may be accompanied by safety issues.Whether endovascular treatment is superior to medical care is not well investigated in the clinical studies.AIM To investigate the efficacy of endovascular treatment and drug therapy alone in mild ischemic stroke patients with large infarct cores.METHODS Fifty patients with mild ischemic stroke and 50 patients with acute ischemic stroke caused by anterior large vessel occlusion were selected at the First Affiliated Hospital of Hebei North University between January 2021 and December 2021.Patients were divided into an endovascular therapy group and a drug therapy group according to different treatment methods.In the endovascular therapy group,there were 28 patients with minor stroke and 22 patients with large infarct cores.The drug therapy group had 22 patients with minor stroke and 28 patients with large infarct cores.The National Institutes of Health Stroke Scale(NIHSS) scores were collected and compared between the two groups immediately after the operation and 24 h and 7 d after the operation.The modified Rankin scale(m RS) and/or activity of daily living were assessed at hospital discharge.RESULTS There was no significant difference in NIHSS scores between the two groups before the operation(P > 0.05).NIHSS scores were lower in the endovascular therapy group than in the drug therapy group at 24 h and 7 d after the operation and at hospital discharge(all P < 0.05).The incidence of early neurologic deterioration was significantly lower in the endovascular therapy group than in the drug therapy group(P < 0.05).At hospital discharge,the m RS score was lower in the endovascular treatment group than in the drug therapy group,and the activity of daily living score was better in the endovascular treatment group than in the drug therapy group(all P < 0.05).During a follow-up of 3 mo,17 patients(34.0%) had good prognosis(m RS ≤ 2),33 patients(66.0%) had poor prognosis(m RS > 2),and 11 patients(22.0%) died.In the medical treatment group,16 patients(m RS ≤ 2) had good prognosis(32.0%),34 patients(m RS > 2) had poor prognosis(68.0%),and 14 patients(28.0%) died.There was no significant difference in prognosis and mortality between the two groups(P > 0.05).CONCLUSION Endovascular therapy can improve NIHSS score and m RS score in patients with mild ischemic stroke and large infarct cores.It is suitable for clinical application.
基金supported by the Hebei Provincial Medical Science Research Key Youth Project,No.20100078
文摘A model of focal cerebral ischemic infarction was established in dogs through middle cerebral artery occlusion of the right side.Thirty minutes after occlusion,models were injected with nerve growth factor adjacent to the infarct locus.The therapeutic effect of nerve growth factor against cerebral infarction was assessed using the hemisphere anomalous volume ratio,a quantitative index of diffusion-weighted MRI.At 6 hours,24 hours,7 days and 3 months after modeling,the hemisphere anomalous volume ratio was significantly reduced after treatment with nerve growth factor. Hematoxylin-eosin staining,immunohistochemistry,electron microscopy and neurological function scores showed that infarct defects were slightly reduced and neurological function significantly improved after nerve growth factor treatment.This result was consistent with diffusion-weighted MRI measurements.Experimental findings indicate that nerve growth factor can protect against cerebral infarction,and that the hemisphere anomalous volume ratio of diffusion-weighted MRI can be used to evaluate the therapeutic effect.
文摘We report a successful case of a pregnant female positive for anti-cardiolipin antibodies who experienced two abnormal pregnancies with postpartum cerebral hemispheric infarctions. A 38-year-old female diagnosed as being positive for anti-cardiolipin antibodies was referred to our hospital due to her strong desire to have a baby. The administration of Japanese herbal medicine, Sairei-to, as immunosuppressive therapy, and low dose aspirin, as anti-coagulation therapy, were initiated prior to the patient’s pregnancy. Five months after beginning the treatment, the patient conceived spontaneously. At 34 weeks of gestation, emergency cesarean section was performed due to increasing genital bleeding resulting from coincidental placenta previa and the patient delivered an appropriate-for-date female infant (1970 g). Treatment with Japanese herbal medicine (Sairei-to) and low-dose aspirin is considered to be an effective treatment option for patients positive for anti-phospholipid antibodies with past histories of abnormal pregnancies.
文摘Objective:Study the clinical effect of atorvastatin combined with clopidogrel on patients with progressive cerebral infarction of intracranial aortic stenosis.Methods: Chose eighty-eight patients with progressive cerebral infarction in our hospital from June 2014 to October 2015. They were randomly divided into study group and study group, 44 cases in each group. The patients in the control group were treated with oral clopidogrel. On the basis of this, the patients in the study group were treated with atorvastatin;all patients were treated for 4 weeks. Compared the total effective rate, adverse reaction rate, coagulation function index and blood lipid level between the two groups, and compared the NIHSS score and daily life ability (ADL) score between the two groups before and after treatment.Results: The total effective rate (90.90%) was significantly higher in the study group than in the control group (72.73%). After treatment, the NIHSS score of the study group was significantly lower than that of the control group. The levels of LDL-C, TG and TC in the study group were significantly lower than those in the control group, and HDL-C was significantly higher than that in the control group. There was no significant difference between the two groups.Conclusion: Clopidogrel combined with atorvastatin has a significant effect on the patients with intracranial large artery stenosis and improve the neurological function and quality of life. It is safe and reliable. It is worthy to be popularized.