Assessment of the early effectiveness of a stroke unit in comparison to the general ward

Background Stroke unit is the most effective treatment method to benefit stroke patients. Our study is to evaluate the early effectiveness of a hospital stroke unit (SU). Methods Three hundred and ninety-two patients who had suffered from acute strokes and who were admitted to our hospital between December 2001 and January 2003 were recruited for this controlled study. All patients were sent at random to either the SU or the general ward (GW) for treatment. The following indices were measured by: Barthel Index (BI),National Institute of Health Stroke Scale (NIHSS),Oxford Handicap Scale (OHS). Results The mean change in BI score between the day of admission and the day of discharge was 20.00±24.36 for the SU group and 10.63±23.59 for the GW group. A difference that is statistically significant ( P =0.000). The mean change in NIHSS score was -2.01±6.61 for the SU group and 0.55±7.44 for the GW group. A difference that is also statistically significant ( P =0.000). Finally,the mean change in OHS score was -0.74±1.04 for the SU group and -0.28±0.98 for the GW group,also a statistically significant difference ( P =0.000). Among SU patients,patient satisfaction was higher ( P =0.000),the rehabilitation success rate was higher ( P =0.000),and there were fewer complications ( P =0.000).Conclusion Compared to GW patients,stroke patients treated in a special SU were able to return to normal daily activities earlier,with better social abilities,and have reduced neurological defects,without increasing the overall economic burden.

Establishing Stroke Unit on the Basis of TCM Characteristics

The evidence-based medicine proved that Stroke Unit （SU） works most effectively on stroke. Since SU is originated and developed in Europe and America, SU therapies are limited to Western medicine. We can make flexible clinical guidelines by combining TCM with the SU and establish SU mode with Chinese characteristics.

Comprehensive therapeutic effect of the stroke rehabilitation unit in a medium-sized comprehensive community hospital

BACKGROUND： Acute stroke unit （stroke care unit） is developing in some domestic large-sized hospitals, but most stroke patients need stroke rehabilitation unit therapy, so setting stroke rehabilitation unit in medium-sized comprehensive community hospital （secondary hospital）, where medical facility is relatively insufficient, is a new pathway to satisfy stroke patients. OBJECTIVE： To observe the comprehensive effect of developing stroke rehabilitation unit based on the facility of secondary hospital and its feasibility. DESIGN： Non-randomized concurrent controlled observation SETTING： Department of Neurology, Beijing Longfu Hospital PARTICIPANTS： Totally 264 stroke reconvalescents who suffered stroke for 7 days and received treatment in the Department of Neurology, Beijing Longfu Hospital during June 2003 to June 2005 were involved in the study. All the involved patients were confirmed by CT or MRI. The patients were scored by using Modified Edinbergh-Scandinavia stroke scale （SSS） 〉 16 points. Written informed consents were obtained from all the patients. The patients were assigned into 2 groups according to the willing of patients and their relatives： （1）treatment group, in which, there were 134 patients, 76 males and 58 females, aged 43 to 74 years; cerebral infarction was found in 116 cases and cerebral hemorrhage in 18 cases;（2） control group, in which, there were 130 patients, 66 males and 64 females, aged 45 to 77 years, cerebral infarction was found in 115 cases and cerebral hemorrhage in 15 cases. There were significant differences in baseline data of the patients between two groups. METHODS： A same basic treatment was conducted in the patients of the two groups. （1） Patients in the treatment group admitted to stroke rehabilitation unit and received comprehensive rehabilitation treatment. The rehabilitation flow-sheet： randomization-letting the patients of treatment group go into the unit-making comprehensive assessment in the initial stage-making therapy plan-talking with patients and their other family members-general rehabilitation-making metaphase assessment-adjusting therapy plan-making final assessment-letting the patients discharge and doing follow-up visits. （2） The patients in the control group admitted to common wards, and they were encouraged to do activities by themselves in the early stage, but did not receive rehabilitation training under the instructions from professional physicians. MAIN OUTCOME MEASURES： The following assessments were conducted on admission and 7 and 28 days after admission： （1） Severity of stroke and motor function： scored as 0 to 45 points by SSS, the higher points, the severer damage. （2）Activities of daily living： Evaluated by Barthel index, 110 points in total, 110 points meant normal, 0 point meant extremely poor. （3）Mental status： evaluated by Hopkin＇s symptom scale with a 5-point scoring. The symptom was scored with low to high points. （4）Cognitive function： Quantification measurement was conducted with LOTCA method. The higher points, the better therapeutic effects. RESULTS： （1） Three cases dropped out and one died in the treatment group, 11 cases dropped out and 4 died in the control group. （2）The neurologic impairment points on 7 and 28 days after therapy in the treatment group were lower than those in the control group separately [7 days：（9.73±6.43） points vs. （12.63± 7.87） points, t =2.28, P〈 0.05;28 days：（7.88±4.81） points vs. （9.84±7.03）points, t =2.04, P〈 0.05]. Barthel index on 7 and 28 days after therapy in the treatment group were higher than those in the control group separately [7 days：（54.28±8.38） points vs. （39.76±7.31） points, t =2.206, P 〈 0.05; 28 days： （89.72±7.94） points vs. （67.34±8.63） points, t =2.812, P 〈 0.01]. （4） Patients were allocated into different age groups based on age and evaluated with LOTCA. Results showed that there were no significant differences among different age groups （P 〉 0.05）. （5） Totally 160 patients in the two groups accomplished the Hopkin＇s test, among them, 94 （58.7%） had different mental disorders; Among the patients with mental disorder, depression, obsessive-compulsive and anxiety were found mostly, being 53.8%, 52.5% and 46.2%, respectively. CONCLUSION： （1） Developing stroke rehabilitation unit therapy in the secondary hospital can obviously improve the motor function and activities of daily living of stroke reconvalescents. （2） More than half of the stroke reconvalescents accompany the symptoms of depression, obsessive-compulsive, anxiety and other mental disorders. （3） The cognitive function of stroke reconvalescents is not related to age.

Occupational Therapy Evaluation for Stroke Adults in the United States

Of the 700,000 people in the United States who experience a new or recurrent stroke each year,more than 500,000 survive(American Stroke Association,2007)[1]. Occupational therapy practitioners are critical rehabilitation professionals for stroke survivors.

集束化护理在高依赖病房脑卒中后肩手综合征患者康复中的作用

目的:探讨集束化护理在高依赖病房(high dependency unit,HDUs)脑卒中后肩手综合征(SHSAS)患者康复中的作用。方法:收集2021年8月至2023年1月收治的SHSAS患者50例,采用随机数字表法分为对照组和观察组各25例。对照组采取常规康复护理,观察组实施集束化HDUs康复护理,两组均干预4周。比较两组肩部疼痛、手部肿胀、临床干预效果、上肢功能和日常生活能力。结果:两组干预前肩部疼痛、手部肿胀、上肢功能和日常生活能力比较差异无统计学意义(P>0.05)。观察组干预后视觉模拟评分低于对照组,患手肿胀体积小于对照组(P<0.05)。观察组治疗有效率为96%(24/25),高于对照组的76%(19/25,P<0.05)。观察组干预后上肢简化运动功能量表评分高于对照组,日常生活能力量表评分低于对照组(P<0.05)。结论:集束化HDUs康复护理可促进患者上肢功能恢复,提升患者日常生活能力。

中医药整体调节缺血性中风后神经血管单元的研究进展

神经血管单元(NVU)的出现,让人们意识到缺血性中风(IS)所引发的脑损伤是一个复杂的病理过程,仅依靠现有的脑保护剂无法应对多靶点及NVU不同损伤特点的全面调节。越来越多的研究表明,中医药具有整体辨证调节的优势和特点,符合NVU的治疗方针。笔者通过查阅中国知网(CNKI)、PubMed等数据库近十年发表的文献资料,基于多年来中医治疗IS的有效性,分析、整理、总结运用“益气活血法”“清热解毒法”“祛风通络法”“补肾填精法”等中医辨证治法对NVU整体调节作用,以期为中医药治疗IS的临床研究提供一定参考。

移动卒中单元在急性缺血性脑卒中静脉溶栓患者中的应用效果

目的探讨移动卒中单元在急性缺血性脑卒中患者静脉溶栓中的应用效果。方法选取2021年3月至9月聊城市人民医院脑科医院卒中中心收治的98例急性缺血性脑卒中静脉溶栓患者作为研究对象,将其分为观察组(43例)和对照组(55例),应用移动卒中单元进行静脉溶栓的患者为观察组,使用传统溶栓模式进行静脉溶栓的患者为对照组。比较两组患者静脉溶栓流程中各时间节点:入院/上车至静脉溶栓时间、发病至CT检查完成时间、发病至静脉溶栓时间、呼叫120至静脉溶栓时间,两组患者静脉溶栓后7、14 d的美国国立卫生院卒中量表(NIHSS)评分,溶栓后90 d的改良Rankin量表(mRS)评分,溶栓后90 d神经功能转归良好(mRS评分0~2分)率。结果观察组患者入院/上车至静脉溶栓时间、发病至CT检查时间、发病至静脉溶栓时间和呼叫120至静脉溶栓时间均短于对照组,差异有统计学意义(P<0.05)。两组患者静脉溶栓后7、14 d的NIHSS评分均低于本组溶栓前,差异有统计学意义(P<0.05);对照组静脉溶栓后14 d的NIHSS评分与溶栓后7 d比较,差异无统计学意义(P>0.05),观察组患者静脉溶栓后14 d的NIHSS评分低于本组溶栓后7 d,低于对照组溶栓后14 d,差异有统计学意义(P<0.05)。两组患者溶栓后90 d的mRs评分均低于本组溶栓前,差异有统计学差异(P<0.05)。两组患者静脉溶栓后90 d的mRs评分、功能转归良好率(mRs评分0~2分)比较,差异无统计学意义(P>0.05)。结论运用移动卒中单元对急性缺血性脑卒中患者进行救治,可以明显缩短入院/上车至静脉溶栓时间、发病至CT检查时间、发病至静脉溶栓时间以及呼叫至静脉溶栓时间,提高救治率,改善患者症状,但对于急性脑卒中患者静脉溶栓的救治效果还需要多中心大样本研究进一步验证。

缺血性脑卒中神经血管单元研究热点与趋势的文献计量可视化分析

目的分析全球视野下缺血性脑卒中神经血管单元(neurovascular unit,NVU)的研究进展和未来趋势,以期为该领域的研究者提供参考。方法检索2003-1-1—2023-6-30 Web of science核心数据库收录的有关缺血性脑卒中NVU的研究文献,运用文献计量学方法从发文趋势、发文作者、发文机构、关键词共现、发文期刊等角度对收集的文献进行定量和定性分析。采用VOSviewer软件绘制关键词共现图谱,采用Citespace软件生成爆发词图谱。结果共纳入716篇文献,发表在267种期刊中,共涉及41个国家、801家研究机构、3271名作者。近年来,该研究领域发文趋势不断上升,高被引文章显示引用前10的文献研究内容主要聚焦缺血性脑卒中后血脑屏障、神经炎症、小胶质细胞和星形胶质细胞方面。涉及3340个关键词,其中有67个关键词至少出现了20次,结合2017—2023年爆发词分析显示,其中“细胞凋亡”“血脑屏障”“中医药”“信号通路”“胶质细胞”等关键信息在此阶段受到广泛关注。结论有关缺血性脑卒中NVU研究逐渐引起学者关注,神经元可以接受NVU其他组分的信号调节,通过靶向NVU、保护血脑屏障完整性可减少缺血性脑卒中后细胞凋亡,发挥神经保护作用,这为新药的研发提供了可能性;此外探索针对NVU的缺血性脑卒中发生的生物标志物或许能为缺血性脑卒中疾病鉴定提供更为全面的依据。

ICU缺血性脑卒中患者下肢深静脉血栓形成危险因素分析

目的:分析重症监护室(ICU)缺血性脑卒中患者下肢深静脉血栓形成(DVT)发生的危险因素。方法:回顾性分析2021年5月—2023年4月贵州医科大学附属医院收治的96例ICU缺血性脑卒中患者的临床资料,统计其DVT发生率;收集患者的年龄、性别等资料,分析患者DVT发生的危险因素。结果:96例ICU缺血性脑卒中患者中,共有28例发生DVT,占比29.17%。单因素分析显示:发生组的年龄>60岁、体重指数(BMI)>24 kg/m^(2)、有高血压史、有糖尿病史、C反应蛋白(CRP)水平>10 mg/L、D-二聚体(D-D)水平>0.5 mg/L占比均高于未发生组,差异均有统计学意义(P<0.05);两组性别、吸烟史、饮酒史、高脂血症占比相比,差异均无统计学意义(P>0.05)。logistic回归分析显示:年龄>60岁[OR=7.459,95%CI(2.804,19.846)]、BMI>24 kg/m^(2)[OR=2.833,95%CI(1.144,7.017)]、有高血压史[OR=3.796,95%CI(1.464,9.846)]、有糖尿病史[OR=5.160,95%CI(1.923,13.849)]、CRP>10 mg/L[OR=7.667,95%CI(2.721,21.601)]、D-D>0.5 mg/L[OR=2.908,95%CI(1.165,7.258)]是ICU缺血性脑卒中患者DVT发生的独立危险因素(P<0.05)。结论:ICU缺血性脑卒中患者DVT发生风险较高,其发生的危险因素包括年龄>60岁、BMI>24kg/m^(2)、有高血压史、有糖尿病史、CRP>10mg/L、D-D>0.5mg/L。

移动卒中单元在急性缺血性脑卒中院前急救中的应用现状

目的对移动卒中单元的发展及其在急性缺血性脑卒中院前急救的应用现状进行综述,以期为完善我国急救体系、促进医疗模式的转变提供新思路和新方向。方法检索国内外相关文献,对移动卒中单元的发展历史、在急性缺血脑卒中院前急救的应用现状及应用发展的难点问题进行分析和总结。结果移动卒中单元可缩短患者静脉溶栓时间、降低院前延误、提升院前急救质量。结论移动卒中单元对缺血性脑卒中院前急救有重大意义,但其应用与发展仍有不足,未来可开展进一步研究,以完善移动卒中单元的应用。

油田区块机采井综合能源利用及效果分析

随着油田开发进入“双高”阶段,区块机采系统出现运行参数调整难度大、低产低效井增多等问题,为了有效解决生产中存在的问题。文中通过对区块采用塔架式抽油机、长冲程抽油机等先进的节能技术,按照“地上与地下一体化、技术与管理协同化”的工作思路,开展区块综合能源利用工程建设,可实现年节电1408.61×104 kWh,实现减少碳排放10943.49 t。同时对形成的典型经验做法进行推广,探索机采井提质增效模式,使模式具有可推广、可复制,发挥示范引领作用,推动油田绿色低碳、节能减排之路,实现高质量发展。

基于关联规则的缺血性脑卒中患者脱水发生特征分析

目的了解缺血性脑卒中患者脱水发生特征,探索各特征之间的关联性,为制定脱水预防措施提供参考。方法基于数据挖掘的原理和方法,采集神经重症监护病房351例缺血性脑卒中并发脱水患者的11559项数据,采用Apriori算法对脱水发生特征进行关联规则分析。结果共得到279条强关联规则,结合专业知识分析,获取具有临床实际意义的强关联规则9条,脑卒中脱水患者具有自理能力重度依赖、留置胃管、意识障碍的特征表现,关联因素包括美国国立卫生研究院卒中量表分级为重度、年龄≥65岁、有糖尿病及高血压史、发热、使用呼吸机、利尿剂等。结论缺血性脑卒中患者脱水的发生有一定的特征表现,护理人员可根据强关联规则早期识别易导致脱水的高危人群及因素,及时采取防范措施。

基于危险因素筛查的干预策略结合体感音乐疗法对重症脑卒中重症监护病房获得性神经肌肉障碍的预防价值

目的探究基于危险因素筛查的干预策略结合体感音乐疗法对重症脑卒中重症监护病房获得性神经肌肉障碍(ICU-AW)的预防价值。方法选择2019年3月至2021年5月收治的108例重症脑卒中患者为研究对象,以随机数字表法将其分为对照组和观察组,各54例。对照组接受常规护理,观察组在对照组基础上实施基于危险因素筛查的干预策略结合体感音乐疗法。比较两组的干预效果。结果出ICU时,观察组的英国医学研究理事会量表(MRCs)评分、肌肉总含量、骨骼肌含量高于对照组(P<0.05);观察组的ICU-AW发生率低于对照组(P<0.05)。出ICU时,观察组的多巴胺(DA)、五羟色胺(5-HT)水平高于对照组(P<0.05)。出ICU时,观察组的抑郁自评量表(SDS)、焦虑自评量表(SAS)评分低于对照组(P<0.05)。结论基于危险因素筛查的干预策略结合体感音乐疗法用于重症脑卒中患者中不仅可以改善肌肉功能,降低ICU-AW发生率,还能调节神经递质水平,改善心理状态,值得推广。

外科术后急性缺血性卒中影响因素及预测分析

目的探讨重症监护室(intensive care unit,ICU)患者外科术后30 d内发生急性缺血性卒中(acute ischemic stroke,AIS)的影响因素和预测模型。方法采用巢式病例对照研究方法,选取2018年7月至2023年3月首都医科大学附属北京朝阳医院重症医学科的非神经系统、非心脏大血管外科术后患者5180例,建立研究队列并留取基线资料,分析患者术后30 d内AIS的发生情况。随访30 d后,将术后30 d内新发AIS的患者作为病例组,按照病例组与对照组1∶4的匹配方法,根据性别、年龄、手术类型等,选取术后30 d未发生AIS的生存者为对照组,采用多因素条件logistic回归方程分析患者术后30 d内发生AIS的影响因素,并构建风险预测模型。结果5180例患者中41例术后30 d内发生AIS,发生率为0.79%。共匹配对照组患者164例。多因素回归分析结果显示,既往脑血管病史(OR=5.003,95%CI:1.586~15.783,P=0.006)、术中严重低血压(OR=30.104,95%CI:3.609~251.110,P=0.002)、术后24 h内血乳酸水平升高(OR=1.724,95%CI:1.071~2.776,P=0.025)以及术后24 h内FIB水平升高(OR=1.009,95%CI:1.001~1.016,P=0.019)是外科患者术后30 d内发生AIS的危险因素。基于上述4个危险因素构建预测模型的ROC曲线的AUC为0.922(95%CI:0.863~0.982,P<0.001)。结论根据患者术后30 d内发生AIS的危险因素构建的预测模型和列线图可以量化患者的发病风险。需仔细询问非神经、非心脏大血管术后患者既往脑血管病等病史及术中情况,密切注意患者乳酸及FIB水平,警惕术后AIS的发生。

卒中中心建设及质量控制研究进展

卒中中心建设及质量控制是近年来卒中救治领域的热点话题。我国的卒中中心建设通过医疗资源整合,多学科协作,形成了一个集院前识别与转运、急性期救治、早期康复、二级预防、随访宣教、质量检测及改进于一体的区域组织化卒中救治网络,建立了一套标准、高效、规范的卒中救治及质量控制体系,对规范和提升医疗机构卒中诊疗和效率,促进医疗服务质量改进,降低疾病负担起到了重要作用。急救地图建设着眼于如何在急救响应及急性期治疗环节减少包括院前识别、急救派遣等环节的时间延误,我国逐步构建了“国家-省-地级市”三级卒中急救地图体系,建设以地级市为中心的“区域卒中急救地图”。我国卒中急诊绿色通道建设近10年来发展迅速。各级医疗机构通过成立急性卒中诊治多学科团队,就诊流程从串联变并联,开展精细化质量检测及持续改进,借助信息化手段逐步提升效率,有效缩短院内延误,提高了溶栓率,改善了临床疗效。基层医疗机构更为直接面对广大卒中人群,但由于在医疗硬件、人才储备、体制机制等各方面的劣势,打通卒中救治的“最后一公里”困难重重。河南省进行的积极探索值得借鉴参考。卒中单元可以显著改善急性卒中患者的临床结局,其建设涵盖了卒中患者的急性期治疗、二级预防、早期康复和健康宣教等环节,需要加强多学科协作水平。移动卒中单元是一种将卒中救治延伸到院前阶段的创新模式,可以显著缩短发病到决定溶栓的时间,并且安全性较高,其推广应用对于提高卒中患者的救治水平具有重要意义。在卒中中心质控方面,我国初步形成“国家-省-地级市”的三级质控网络,形成覆盖全国不同层级的较健全的质控工作网络体系,但面对巨大的社会经济发展差异,未来卒中中心建设及质量控制工作依然任重道远。

中国脑血管病临床管理指南(第2版)(节选)——第2章卒中组织化管理推荐意见

卒中是我国成人致死、致残的首位病因,给患者及社会发展带来了沉重负担。组织化管理方法能够一定程度上提升卒中医疗质量,但医疗机构后勤服务支撑能力的异质性为卒中组织化管理的效果带来不确定影响。为进一步完善卒中组织化管理模式,提升卒中治疗的科学性及系统性,本指南就院前急救系统及卒中急诊的组织化管理、急诊多学科协作团队的管理、绿色通道的持续质量改进、卒中单元及卒中门诊的组织化管理、卒中中心的区域协同网络建设、医疗质量评估与改进等多个方面,形成了推荐意见。

What Strategy for a Severe Stroke in Africa: Palliative Care or Unreasonable Obstinacy?

Introduction: Palliative care, firstly used for chronic diseases, is currently indicated for some acute pathology such as Stroke. Its implementation improves the quality of care for end-of-life patients. The aim of our study is to report a series of patients who died in the intensive care stroke unit of Brazzaville. Method: It was a descriptive study of a series of 13 cases of severe stroke, admitted to the intensive care unit of the university hospital of Brazzaville, between January 2015 and December 2017. Sociodemographic, clinical, paraclinical and prognostic variables were studied. Result: The mean age of the patients was 46 ± 11.5 years with a male predominance in 69.2% (n = 9). They were all hypertensive. The motor deficit and consciousness disorder association was the reason for admission in 84.6% (n = 11) and an epileptic seizure of 15.4% (n = 2). The mean NIHSS at admission was 21 ± 5, that of Glasgow 6 ± 3. Stroke was hemorrhagic in 84.6% (n = 11) and malignant infarction in 15.4% (n = 2). All of these patients received invasive resuscitation with assisted ventilation and all died within 8 days of admission. Conclusion: The issue of limitation of care deserves to be debated, and is proposed on a case-by-case basis, in the face of a serious stroke. Therapeutic relentlessness is not only expensive, but also raises the problem of suffering of the individual at the end of life.

Stroke Care in an Australian Rural Private Health Care Setting

Stroke is a leading cause of disability and death in Australia. There is a clear benefit in caring for stroke patients in stroke care units. Access to these centres is limited particularly in the rural setting. Certified stroke care units in the private health care setting are also unheard of. The superiority of these units is thought to be due to better adherence to processes of care (early utility of CT scan, allied health input within 24 hours, neurological observations, DVT prophylaxis and appropriate use of antiplatelet and anticoagulant use). We audited care of 100 patients who presented to the St. John of God Hospital (rural private hospital) over a period of 3 years. This included baseline demographics, adherence of processes of care, utility of appropriate investigations, and outcome measures such as discharge destination, level of function at discharge and complication rates. These data were compared with the national stroke report (AuSCR) and adherence to processes of care was compared with the SCOPE study (the first study to establish the benefit of POC). When compared with data from the AuSCR national report 2012, we found a higher mortality rate, an increased rate of disability on discharge, and a mixed adherence to processes of care. We also found a significant proportion of patients (40%) who were eligible to receive thrombolysis but did not. Overall we found that there were significant strengths to be drawn upon in the rural private healthcare setting and a more organised approach could improve outcomes.

Hyodeoxycholic acid protects the neurovascular unit against oxygen-glucose deprivation and reoxygenation-induced injury in vitro

Calculus bovis is commonly used for the treatment of stroke in traditional Chinese medicine. Hyodeoxycholic acid(HDCA) is a bioactive compound extracted from calculus bovis. When combined with cholic acid, baicalin and jas-minoidin, HDCA prevents hypoxia-reoxygenation-induced brain injury by suppressing endoplasmic reticulum stress-mediated apoptotic signaling. However, the effects of HDCA in ischemic stroke injury have not yet been studied. Neurovascular unit(NVU) dysfunction occurs in ischemic stroke. Therefore, in this study, we investigated the effects of HDCA on the NVU under ischemic conditions in vitro. We co-cultured primary brain microvascular endothelial cells, neurons and astrocytes using a transwell chamber co-culture system. The NVU was pre-treated with 10.16 or 2.54 μg/mL HDCA for 24 hours before exposure to oxygen-glucose deprivation for 1 hour. The cell counting kit-8 assay was used to detect cell activity. Flow cytometry and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling were used to assess apoptosis. Enzyme-linked immunosorbent assay was used to measure the expression levels of inflammatory cytokines, including interleukin-1β, interleukin-6 and tumor necrosis factor-α, and neurotrophic factors, including brain-derived neurotrophic factor and glial cell line-derived neurotrophic factor. Oxidative stress-related factors, such as superoxide dismutase, nitric oxide, malondialdehyde and γ-glutamyltransferase, were measured using kits. Pretreatment with HDCA significantly decreased blood-brain barrier permeability and neuronal apoptosis, significantly increased transendothelial electrical resistance and γ-glutamyltransferase activity, attenuated oxidative stress damage and the release of inflammatory cytokines, and increased brain-derived neurotrophic factor and glial cell line-derived neurotrophic factor expression. Our findings suggest that HDCA maintains NVU morphological integrity and function by modulating inflammation, oxidation stress, apoptosis, and the expression of neurotrophic factors. Therefore, HDCA may have therapeutic potential in the clinical management of ischemic stroke. This study was approved by the Ethics Committee of Experimental Animals of Beijing University of Chinese Medicine(approval No. BUCM-3-2016040201-2003) in April 2016.

柔性光杆超长冲程抽油机的设计

设计了一种柔性光杆超长冲程抽油机,实现了超长冲程、超低冲次、传动效率高、系统效率高、运行可靠、节能;并对抽油机机架、驱动、平衡、让位等结构进行了优化,结构紧凑,冲程达到18m,进行了试验验证。下一步根据现场应用情况,进一步对其结构进行优化,并推广应用,提高抽油系统效率。