Objective To explore the possibility of diagnosis types of acute stroke, elevating treatment quality and promoting prognosis with acute stroke clinical measuring scale . Methods To gain a measuring scale formula and s...Objective To explore the possibility of diagnosis types of acute stroke, elevating treatment quality and promoting prognosis with acute stroke clinical measuring scale . Methods To gain a measuring scale formula and simplify this formula after stepwise regression Fisher distinguish analysis to 18 clinical variable of 184 acute stroke patients and to validate its sensitivity, specificity and positive foretell value to diagnosis of acute stroke. Results We gained scale that Y=0.617×action+0.485×BP+1.241×headache+0.74×vomiting+0.955×cervical resistance-1.215×TIA-0.727×heart disease-2.78;sensitivity of this formula to diagnosis of cerebral infarction and cerebral hemorrhage was 90.5%and 70%respectively,its specificity was 70%and 90.5%respectively,positive foretell value was 71.7%and 89.7%(Y≥0 means cerebral hemorrhage,Y<0 means cerebral infarction). Simple formula is S=0.5×action+0.5×BP+1×headache+1×vomiting+1×cervical resistance-1×TIA-1×hear disease-3;its sensitivity was 89.3%and 68%,specificity was 68%and 89.3%,positive foretell value was 70.1%and 88.3%.There was no apparent difference in sensitivity; specificity and positive foretell value between two formulas. Conclusion Acute stroke clinical measuring scale can help early diagnosis, treatment and rehabilitation of cerebral stroke patients.展开更多
The purpose of the present study was to investigate the association between admission clinical characteristics and outcomes at discharge among acute ischemic stroke patients in the Chinese population. A total of 2,673...The purpose of the present study was to investigate the association between admission clinical characteristics and outcomes at discharge among acute ischemic stroke patients in the Chinese population. A total of 2,673 patients with acute ischemic stroke were included in the present study. The clinical characteristics at admission and other study variables were collected for all patients. The study outcome was defined as neurological deficiency （National Institute of Health Stroke Scale score ≥ 10） at discharge or in-hospital death. Compared with the subjects without neurological deficiency at discharge or in-hospital death, the subjects with neurological deficiency at discharge or in-hospital death had a significantly higher prevalence of hyperglycemia or history of atrial fibrillation at admission. Age ≥ 80 years, hyperglycemia, hypertension, and history of atrial fibrillation were significantly associated with neurological deficiency at discharge or in-hospital death after adjustment for other variables. It is concluded that old age （ ≥ 80 years）, hyperglycemia, hypertension and history of atrial fibrillation are significantly associated with neurological deficiency at discharge or in-hospital death among patients with acute ischemic stroke.展开更多
It is unanimously accepted that stroke is a highly heterogeneous disorder. Different subtypes of ischemic stroke may have different risk factors, clinical features, and prognoses. The aim of this study was to evaluate...It is unanimously accepted that stroke is a highly heterogeneous disorder. Different subtypes of ischemic stroke may have different risk factors, clinical features, and prognoses. The aim of this study was to evaluate the risk factors, clinical characteristics, and prognoses of different subtypes of ischemic stroke defined by the Trial of ORG10172 in Acute Stroke Treatment （TOAST） criteria. We prospectively analyzed the data from 530 consecutive patients who were admitted to our hospital with acute ischemic stroke within 7 days of stroke onset during the study period. Standardized data assessment was used and the cause of ischemic stroke was classified according to the TOAST criteria. Patients were followed up till 30 and 90 days after stroke onset. It was found that large-artery atherosclerosis was the most frequent etiology of stroke （37.4%）, and showed the highest male preponderance, the highest prevalence of previous transient ischemic attack, and the longest hospital stay among all subtypes. Small artery disease （36.4%） was associated with higher body mass index, higher plasma triglycerides, and lower plasma high-density lipoprotein cholesterol than cardioembolism. Cardioembolism （7.7%）, which was particularly common in the elderly （i.e., individuals aged 65 years and older）, showed the highest female preponderance, the highest prevalence of atrial fibrillation, the earliest presentation to hospital after stroke onset, the most severe symptoms on admission, the maximum complications associated with an adverse outcome, and the highest rate of stroke recurrence and mortality. Our results suggest that ischemic stroke should be regarded as a highly heterogeneous disorder. Studies involving risk factors, clinical features, and prognoses of ischemic stroke should differentiate between etiologic stroke subtypes.展开更多
In this paper, the authors sum their research results about the effect of blood-letting of Jing (Well)-point on cerebral blood flow both in stroke patients and in experimental cerebral ischemia, cerebral hematoma and ...In this paper, the authors sum their research results about the effect of blood-letting of Jing (Well)-point on cerebral blood flow both in stroke patients and in experimental cerebral ischemia, cerebral hematoma and hypertension rabbits. In 30 cases of stroke (cerebral hemorrhage and cerebral infarction) patients, blood flow state of the anterior cerebral artery (ACA), middle cerebral artery (MCA) and the posterior cerebral artery (PCA), and the blood flow velocity of the bilateral vertebral artery (VA) and the basil artery (BA) are determined before and after pricking blood of the Twelve Jing-points. In experimental cerebral ischemia (by occlusion of the common carotid artery) rabbits, cerebral hematoma model rabbits and intravenous injection of noradrenaline induced hypertension rabbits, rheoencephalogram (REC) is detected before and after blood letting of the twelve "Jing"-points. In these 30 stroke patients, ultrasound Doppler examination’s results show that in 22 cases (73.33%) whose blood flow velocity decreases, after blood-letting of the 12 Jing-points, it increases significantly (P<0.01); in the rest 8 cases ( 26.67%) whose blood flow velocity speeds up, after treatment, it decreases evidently (P<0.01), showing a good dual-directional regulative effect of blood-letting therapy. In experimental cerebral ischemia rabbits, cerebral hematoma rabbits and hypertension rabbits whose REG lowers in the amplitude apparently (P<0.01), after blood letting stimulation of the 12 Jing-points, it increases at different degrees. Three patterns of stimulation as blood letting stimulation, pain stimulation and Jing-point stimulation, also the 3 factors of blood-letting therapy, may contribute to their effect on improvement of the cerebral blood flow. Somatic afferent nerve, sympathetic nerve of the vascular wall, central cholinergic nerve (M receptors) and adrenergic nerve (α receptors) participate in the effect of blood letting on cerebral blood flow.展开更多
Background: As a common and high incidence of disease, the minor ischemic stroke (MIS) has become an important public health problem. The aim of this study was to address whether patients with MIS have different types...Background: As a common and high incidence of disease, the minor ischemic stroke (MIS) has become an important public health problem. The aim of this study was to address whether patients with MIS have different types and outcome in the elderly in northern China. Methods: A retrospective cohort of consecutive patients was selected for study;all registered neurologic outpatients of the tertiary teaching hospital in northern Jiangsu, China between February, 2011 and February, 2012. A total of 433 outpatients, clinically only having had an initial visit and a MRI study of the brain, were enrolled. Results: Of 433 outpatients, 247 (57.0%) patients with MIS were diagnosed. The clinical types of MIS included stable MIS in 58.3%, acute progressive MIS in 5.3%, and chronic progressive MIS in 36.4% of patients. After adjusted Odd ratio (OR), only aged (OR, 1.0;95% confidence interval [CI], 1.007 - 1.087, p = 0.021), episode duration (OR, 1.8;95% CI, 1.011 - 1.024, p = 0.001), initial number of MIS (OR, 1.1;95% CI, 1.047 - 1.207, p = 0.001), and infarcts volume (OR, 1.8;95% CI, 1.253 - 2.681, p = 0.002) were independently associated with stable MIS and progressive MIS. Total survival was favorable among groups (p = 0.094), but the followed mRS score was significantly higher among those progressive MIS than those stable MIS (2.3 ± 1.0 vs 0.1 ± 0.3, p Conclusion: MIS had a very high prevalence and different clinical types. Stable MIS is a benign stroke, whereas those progressive MIS may have long-term instability or acute and chronic progressive trend. This information is important in prospectively determining outcome of MIS and in patient treatment.展开更多
目的观察手动抽吸取栓术(MAT)在急性脑动脉闭塞治疗中的可行性、安全性及临床疗效。方法选择急性脑动脉闭塞首次采用MAT技术治疗的患者27例,其中行MAT的患者共19例,作为MAT组;行MAT联合支架取栓治疗的患者共8例,作为MAT+支架组。记录两...目的观察手动抽吸取栓术(MAT)在急性脑动脉闭塞治疗中的可行性、安全性及临床疗效。方法选择急性脑动脉闭塞首次采用MAT技术治疗的患者27例,其中行MAT的患者共19例,作为MAT组;行MAT联合支架取栓治疗的患者共8例,作为MAT+支架组。记录两组患者性别、年龄、吸烟、高血压、糖尿病、心房颤动、高脂血症、冠心病、风湿性心脏病、静脉溶栓、取栓部位、穿刺至再通时间、血管再通标准(mTICI)分级、血栓逃逸、脑出血、术前美国国立卫生研究院卒中量表(NIHSS)评分、术后7 d NIHSS评分、90 d改良Rankin评分量表(mRS)评分≤2分、死亡情况。结果27例患者首次进行MAT,男性16例(59.3%),女性(40.7%);年龄(67.2±11.5)岁;静脉溶栓有9例(33.3%);取栓部位为颈内动脉有5例(18.5%),大脑中动脉有18例(66.7%),基底动脉有3例(11.1%),大脑后动脉有1例(3.7%);穿刺至再通时间为65(48,90)min。有26例(96.3%)患者实现血管再通。mTICI分级为2b级有12例(44.4%),3级有14例(51.9%);血栓逃逸有5例(18.5%);症状性脑出血有2例(7.4%),无症状脑出血有1例(3.7%);术前NIHSS评分为(13.9±3.8)分,术后7 d NIHSS评分为(8.4±6.6)分,术后7 d NIHSS评分低于术前(P<0.05);90 d mRS评分≤2分有14例(51.9%);死亡3例(11.1%),其中2例是取栓后出现症状性脑出血导致,1例是因为肺动脉栓塞导致的。结论MAT在急性脑动脉闭塞中治疗是可行、安全及有效的。展开更多
文摘Objective To explore the possibility of diagnosis types of acute stroke, elevating treatment quality and promoting prognosis with acute stroke clinical measuring scale . Methods To gain a measuring scale formula and simplify this formula after stepwise regression Fisher distinguish analysis to 18 clinical variable of 184 acute stroke patients and to validate its sensitivity, specificity and positive foretell value to diagnosis of acute stroke. Results We gained scale that Y=0.617×action+0.485×BP+1.241×headache+0.74×vomiting+0.955×cervical resistance-1.215×TIA-0.727×heart disease-2.78;sensitivity of this formula to diagnosis of cerebral infarction and cerebral hemorrhage was 90.5%and 70%respectively,its specificity was 70%and 90.5%respectively,positive foretell value was 71.7%and 89.7%(Y≥0 means cerebral hemorrhage,Y<0 means cerebral infarction). Simple formula is S=0.5×action+0.5×BP+1×headache+1×vomiting+1×cervical resistance-1×TIA-1×hear disease-3;its sensitivity was 89.3%and 68%,specificity was 68%and 89.3%,positive foretell value was 70.1%and 88.3%.There was no apparent difference in sensitivity; specificity and positive foretell value between two formulas. Conclusion Acute stroke clinical measuring scale can help early diagnosis, treatment and rehabilitation of cerebral stroke patients.
文摘The purpose of the present study was to investigate the association between admission clinical characteristics and outcomes at discharge among acute ischemic stroke patients in the Chinese population. A total of 2,673 patients with acute ischemic stroke were included in the present study. The clinical characteristics at admission and other study variables were collected for all patients. The study outcome was defined as neurological deficiency （National Institute of Health Stroke Scale score ≥ 10） at discharge or in-hospital death. Compared with the subjects without neurological deficiency at discharge or in-hospital death, the subjects with neurological deficiency at discharge or in-hospital death had a significantly higher prevalence of hyperglycemia or history of atrial fibrillation at admission. Age ≥ 80 years, hyperglycemia, hypertension, and history of atrial fibrillation were significantly associated with neurological deficiency at discharge or in-hospital death after adjustment for other variables. It is concluded that old age （ ≥ 80 years）, hyperglycemia, hypertension and history of atrial fibrillation are significantly associated with neurological deficiency at discharge or in-hospital death among patients with acute ischemic stroke.
文摘It is unanimously accepted that stroke is a highly heterogeneous disorder. Different subtypes of ischemic stroke may have different risk factors, clinical features, and prognoses. The aim of this study was to evaluate the risk factors, clinical characteristics, and prognoses of different subtypes of ischemic stroke defined by the Trial of ORG10172 in Acute Stroke Treatment （TOAST） criteria. We prospectively analyzed the data from 530 consecutive patients who were admitted to our hospital with acute ischemic stroke within 7 days of stroke onset during the study period. Standardized data assessment was used and the cause of ischemic stroke was classified according to the TOAST criteria. Patients were followed up till 30 and 90 days after stroke onset. It was found that large-artery atherosclerosis was the most frequent etiology of stroke （37.4%）, and showed the highest male preponderance, the highest prevalence of previous transient ischemic attack, and the longest hospital stay among all subtypes. Small artery disease （36.4%） was associated with higher body mass index, higher plasma triglycerides, and lower plasma high-density lipoprotein cholesterol than cardioembolism. Cardioembolism （7.7%）, which was particularly common in the elderly （i.e., individuals aged 65 years and older）, showed the highest female preponderance, the highest prevalence of atrial fibrillation, the earliest presentation to hospital after stroke onset, the most severe symptoms on admission, the maximum complications associated with an adverse outcome, and the highest rate of stroke recurrence and mortality. Our results suggest that ischemic stroke should be regarded as a highly heterogeneous disorder. Studies involving risk factors, clinical features, and prognoses of ischemic stroke should differentiate between etiologic stroke subtypes.
文摘In this paper, the authors sum their research results about the effect of blood-letting of Jing (Well)-point on cerebral blood flow both in stroke patients and in experimental cerebral ischemia, cerebral hematoma and hypertension rabbits. In 30 cases of stroke (cerebral hemorrhage and cerebral infarction) patients, blood flow state of the anterior cerebral artery (ACA), middle cerebral artery (MCA) and the posterior cerebral artery (PCA), and the blood flow velocity of the bilateral vertebral artery (VA) and the basil artery (BA) are determined before and after pricking blood of the Twelve Jing-points. In experimental cerebral ischemia (by occlusion of the common carotid artery) rabbits, cerebral hematoma model rabbits and intravenous injection of noradrenaline induced hypertension rabbits, rheoencephalogram (REC) is detected before and after blood letting of the twelve "Jing"-points. In these 30 stroke patients, ultrasound Doppler examination’s results show that in 22 cases (73.33%) whose blood flow velocity decreases, after blood-letting of the 12 Jing-points, it increases significantly (P<0.01); in the rest 8 cases ( 26.67%) whose blood flow velocity speeds up, after treatment, it decreases evidently (P<0.01), showing a good dual-directional regulative effect of blood-letting therapy. In experimental cerebral ischemia rabbits, cerebral hematoma rabbits and hypertension rabbits whose REG lowers in the amplitude apparently (P<0.01), after blood letting stimulation of the 12 Jing-points, it increases at different degrees. Three patterns of stimulation as blood letting stimulation, pain stimulation and Jing-point stimulation, also the 3 factors of blood-letting therapy, may contribute to their effect on improvement of the cerebral blood flow. Somatic afferent nerve, sympathetic nerve of the vascular wall, central cholinergic nerve (M receptors) and adrenergic nerve (α receptors) participate in the effect of blood letting on cerebral blood flow.
文摘Background: As a common and high incidence of disease, the minor ischemic stroke (MIS) has become an important public health problem. The aim of this study was to address whether patients with MIS have different types and outcome in the elderly in northern China. Methods: A retrospective cohort of consecutive patients was selected for study;all registered neurologic outpatients of the tertiary teaching hospital in northern Jiangsu, China between February, 2011 and February, 2012. A total of 433 outpatients, clinically only having had an initial visit and a MRI study of the brain, were enrolled. Results: Of 433 outpatients, 247 (57.0%) patients with MIS were diagnosed. The clinical types of MIS included stable MIS in 58.3%, acute progressive MIS in 5.3%, and chronic progressive MIS in 36.4% of patients. After adjusted Odd ratio (OR), only aged (OR, 1.0;95% confidence interval [CI], 1.007 - 1.087, p = 0.021), episode duration (OR, 1.8;95% CI, 1.011 - 1.024, p = 0.001), initial number of MIS (OR, 1.1;95% CI, 1.047 - 1.207, p = 0.001), and infarcts volume (OR, 1.8;95% CI, 1.253 - 2.681, p = 0.002) were independently associated with stable MIS and progressive MIS. Total survival was favorable among groups (p = 0.094), but the followed mRS score was significantly higher among those progressive MIS than those stable MIS (2.3 ± 1.0 vs 0.1 ± 0.3, p Conclusion: MIS had a very high prevalence and different clinical types. Stable MIS is a benign stroke, whereas those progressive MIS may have long-term instability or acute and chronic progressive trend. This information is important in prospectively determining outcome of MIS and in patient treatment.
文摘目的观察手动抽吸取栓术(MAT)在急性脑动脉闭塞治疗中的可行性、安全性及临床疗效。方法选择急性脑动脉闭塞首次采用MAT技术治疗的患者27例,其中行MAT的患者共19例,作为MAT组;行MAT联合支架取栓治疗的患者共8例,作为MAT+支架组。记录两组患者性别、年龄、吸烟、高血压、糖尿病、心房颤动、高脂血症、冠心病、风湿性心脏病、静脉溶栓、取栓部位、穿刺至再通时间、血管再通标准(mTICI)分级、血栓逃逸、脑出血、术前美国国立卫生研究院卒中量表(NIHSS)评分、术后7 d NIHSS评分、90 d改良Rankin评分量表(mRS)评分≤2分、死亡情况。结果27例患者首次进行MAT,男性16例(59.3%),女性(40.7%);年龄(67.2±11.5)岁;静脉溶栓有9例(33.3%);取栓部位为颈内动脉有5例(18.5%),大脑中动脉有18例(66.7%),基底动脉有3例(11.1%),大脑后动脉有1例(3.7%);穿刺至再通时间为65(48,90)min。有26例(96.3%)患者实现血管再通。mTICI分级为2b级有12例(44.4%),3级有14例(51.9%);血栓逃逸有5例(18.5%);症状性脑出血有2例(7.4%),无症状脑出血有1例(3.7%);术前NIHSS评分为(13.9±3.8)分,术后7 d NIHSS评分为(8.4±6.6)分,术后7 d NIHSS评分低于术前(P<0.05);90 d mRS评分≤2分有14例(51.9%);死亡3例(11.1%),其中2例是取栓后出现症状性脑出血导致,1例是因为肺动脉栓塞导致的。结论MAT在急性脑动脉闭塞中治疗是可行、安全及有效的。
