Use of various CT imaging methods for diagnosis of acute ischemic cerebrovascular disease

Thirty-four patients with cerebral infarction and 18 patients with transient ischemic attack were examined by multi-slice spiral CT scan, CT perfusion imaging, and CT angiography within 6 hours after onset. By CT perfusion imaging, 29 cases in the cerebral infarction group and 10 cases in the transient ischemic attack group presented with abnormal blood flow perfusion, which corresponded to the clinical symptoms. By CT angiography, various degrees of vascular stenosis could be detected in 41 patients, including 33 in the cerebral infarction group and eight in the transient ischemic attack group. The incidence of intracranial artery stenosis was higher than that of extracranial artery stenosis. The intracranial artery stenosis was located predominantly in the middle cerebral artery and carotid artery siphon, while the extracranial artery stenosis occurred mainly in the bifurcation of the common carotid artery and the opening of the vertebral artery. There were 34 cases （83%） with convict vascular stenosis and perfusion abnormalities, and five cases （45%） with perfusion abnormalities but without convict vascular stenosis. The incidence of cerebral infarction in patients with National Institutes of Health Stroke Scale scores 〉 5 points during onset was significantly higher than that in patients with National Institutes of Health Stroke Scale scores 〈 5 points. These experimental findings indicate that the combined application of various CT imaging methods allows early diagnosis of acute ischemic cerebrovascular disease, which can comprehensively analyze the pathogenesis and severity of acute ischemic cerebrovascular disease at the morphological and functional levels.

Significance of ultrasound evaluation of carotid atherosclerotic plaque for diagnosing ischemic cerebrovascular disease

BACKGROUND： Carotid artery is the main source for craniocerebral blood supply. Its intimal plaque formation and arterial stenosis degree both are the risk factors for ischemic cerebrovascular disease.Therefore, the close relationship of carotid atherosclerotic plaque and ischemic cerebrovascular disease, and ultrasound evaluation of carotid atherosclerotic plaque have become the hot spot in studying ischemic cerebrovascular disease.OBJECTIVE： This study was to detect the degree of carotid atherosclerosis of ischemic cerebrovascular disease patients by ultrasonography, and to analyze the situation of carotid atherosclerosis and its relationship with clinic.DESIGN： Clinical randomized concurrent control experiment.SETTING： Lintong Convalescent Hospital of Lanzhou Military Area Command of Chinese PLA.PARTICIPANTS： Totally 60 outpatients and inpatients with ischemic cerebrovascular disease, 42 males and 18 females, admitted to Lintong Convalescent Hospital of Lanzhou Military Area Command of Chinese PLA between January 2006 and December 2006 were involved in the patient group. They met the diagnosis criteria of ischemic cerebrovascular disease constituted by the 4th Cerebrovascular Disease Conference in 1996, and were confirmed to suffer from ischemic cerebrovascular disease by skull CT and MRI. Another 20 subjects who received healthy examination concurrently in the same hospital, 12 males and 8 females, were involved in the control group. Informed consents of detected items were obtained from involved subjects.METHODS： The plaque thickness of mid portion, distal end and crotch of common carotid artery （CCA）,internal carotid artery （ICA）, external carotid artery （ECA） and vertebral artery （VA） of involved subjects,who received health examination was separately detected with color Doppler ultrasonograph （HDI-5000）.Then, total integral of plaque was calculated. The intima-media thickness （IMT） was measured with two-dimensional ultrasonography. The inner diameter stenosis degree of subjects who had plaque was measured. Blood flow parameters were recorded, and stenosis degree and plaque area were calculated. Blood flow volume of bilateral carotid artery and VA was separately measured with ultrasound equipment software,and brain blood flow volume was calculated.MAIN OUTCOME MEASURES： Atherosclerotic degree and blood flow volume of patients of two groups.RESULTS： Sixty patients with ischemic cerebrovascular disease and twenty subjects who received health examination participated in the final analysis. ①The IMT thickness, total plaque score, and total plaque area of patient group was significantly superior to that of control group, respectively（ t=5.216 - 10.158, P 〈 0.05 ）.② There were significant differences in the stenosis degree of CCA, ICA and VA between patient group and control group （t=6.720 - 12.816, P 〈 0.05 ） . ③ The blood flow volume of CCA, ICA, VA and brain of patient group was significantly lower than that of control group, respectively （t=2.872 - 10.860, P 〈 0.05）.CONCLUSION： Ischemic cerebrovascular disease patients have different degrees of changes in atherosclerosis and arterial blood flow.

Impact of Cerebrovascular Disease Mortality on Life Expectancy in China

Objective To evaluate the impact of cerebrovascular disease mortality on life expectancy （LE） in China in 2010 compared with 2005, and to identify the high-risk population （age, sex, and region） where cerebrovascular disease mortality has had a major impact on LE. Methods LE and cause-eliminated LE were calculated by using standard life tables which used adjusted mortality data from the Death Surveillance Data Sets in 2005 and 2010 from the National Disease Surveillance System. Decomposition was used to quantitate the impact of cerebrovascular disease in different age groups. Results LE in China was 73.24 years in 2010, which was higher in women and urban residents compared with men and rural residents. The loss of LE caused by cerebrovascular disease mortality was 2.26 years, which was higher in men and rural residents compared with women and urban residents. More than 30% of the loss of LE were attributed to premature death from cerebrovascular disease in people aged 〈65 years. Compared with 2005, LE in 2010 increased by 0.92 years. The reduction of cerebrovascular disease mortality in urban residents contributed 0.45 years to the increase of LE, but the increase of cerebrovascular disease mortality caused a 0.12-year loss of LE in rural residents. Conclusion Cerebrovascular disease mortality had a major impact on LE in China, with a significant difference between urban and rural residents. LE is likely to be further increased by reducing cerebrovascular disease mortality, and special attention should be paid to reducing premature deaths in people aged 〈65 years.

Effects of the information–knowledge–attitude–practice nursing model combined with predictability intervention on patients with cerebrovascular disease

BACKGROUND Cerebrovascular disease(CVD)poses a serious threat to human health and safety.Thus,developing a reasonable exercise program plays an important role in the long-term recovery and prognosis for patients with CVD.Studies have shown that predictive nursing can improve the quality of care and that the information–knowledge–attitude–practice(IKAP)nursing model has a positive impact on patients who suffered a stroke.Few studies have combined these two nursing models to treat CVD.AIM To explore the effect of the IKAP nursing model combined with predictive nursing on the Fugl–Meyer motor function(FMA)score,Barthel index score,and disease knowledge mastery rate in patients with CVD.METHODS A total of 140 patients with CVD treated at our hospital between December 2019 and September 2021 were randomly divided into two groups,with 70 patients in each.The control group received routine nursing,while the observation group received the IKAP nursing model combined with predictive nursing.Both groups were observed for self-care ability,motor function,and disease knowledge mastery rate after one month of nursing.RESULTS There was no clear difference between the Barthel index and FMA scores of the two groups before nursing(P>0.05);however,their scores increased after nursing.This increase was more apparent in the observation group,and the difference was statistically significant(P<0.05).The rates of disease knowledge mastery,timely medication,appropriate exercise,and reasonable diet were significantly higher in the observation group than in the control group(P<0.05).The satisfaction rate in the observation group(97.14%)was significantly higher than that in the control group(81.43%;P<0.05).CONCLUSION The IKAP nursing model,combined with predictive nursing,is more effective than routine nursing in the care of patients with CVD,and it can significantly improve the Barthel index and FMA scores with better knowledge acquisition,as well as produce high satisfaction in patients.Moreover,they can be widely used in the clinical setting.

Factors influencing ischemic cerebrovascular disease complicated by hyperhomocysteinemia

BACKGROUND： Hyperhomocysteinemia, as an important risk factor for ischemic cerebrovascular disease is receiving increasing attention. OBJECTIVE： To analyze whether differences of gender, age, cerebrovascular disease typing, and disease conditions exist when ischemic cerebrovascular disease occurs together with hyperhomocysteinemia. DESIGN： A controlled observation. SETTING： Department of Neurology, Tianjin Huanhu Hospital. PARTICIPANTS： A total of 601 acute ischemic cerebrovascular disease inpatients, comprising 386 males and 215 females, aged 33-90 years old, were admitted to the Department of Stroke, Tianjin Huanhu Hospital between August 2005 and April 2007, and were recruited for this study. All included patients consisted of 342 aged patients （≥ 60 years old） and 92 middle-aged and young patients （〈 60 years old）. Among these patients, 48 suffered from transient cerebral ischemic attack, 138 from lacunar cerebral infarction, 273 from atherosclerotic stroke, 38 from cardiogenic cerebral infarction, 44 from agnogenic ischemic stroke, and 6 from other factor-induced ischemic strokes. All included inpatients corresponded to the diagnosis criteria of acute ischemic cerebrovascular disease, formulated in the 4^th National Working Conference of Cerebrovascular Disease, and were confirmed as acute ischemic cerebral infarction by CT and/or MRI examinations. Informed consents of laboratory measurements were obtained from all subjects, and this study was approved by the Hospital＇s Ethics Committee. METHODS： Following admission, 2 mL venous blood was collected from each fasting patient on the third morning. Plasma homocysteine level was measured by an enzymatic cycling assay with a CX5 reader （Beckman, USA）. Plasma homocysteine levels ≥ 16μ mol/L were defined as hyperhomocysteinemia. Clinical neurological function deficit scoring was also performed for each ischemic stroke patient using Chinese stroke scales. Scores ranged from 0 45 （0-15： mild neurological function deficits, 16-30： moderate neurological deficits, and 31-45： severe neurological deficits）. The scores positively correlated with severity of stroke. MAIN OUTCOME MEASURES： Incidence of ischemic cerebrovascular disease patients complicated by hyperhomocysteinemia and the effects of patient age and gender; plasma homocysteine levels of each type of ischemic cerebrovascular disease; and effects of ischemic cerebrovascular disease conditions on plasma homocysteine levels. RESULTS： All 601 inpatients with acute ischemic cerebrovascular disease were included in the final analysis. The detection rate of homocysteine was significantly higher in aged patients than in middle-aged and young patients （ x^2 = 5.353 0, P 〈 0.05）. The incidence of hyperhomocysteinemia was significantly higher in male patients than in female patients （ x^2 = 9.484 4, P 〈 0.05）. There was no significant difference in the incidence of hyperhomocysteinemia among various types of ischemic cerebrovascular diseases （P 〉 0.05）. No significant difference in incidence of hyperhomocysteinemia existed between mild, moderate, and severe cerebrovascular disease patients （P 〉 0.05）. CONCLUSION： There is a greater chance of ischemic cerebrovascular disease complicated by hyperhomocysteinemia in older, male patients.

Systems pharmacology for traditional Chinese medicine with application to cardio-cerebrovascular diseases

Identified as a treasure of natural herbal products,traditional Chinese medicine(TCM)has attracted extensive attention for their moderate treatment effect and lower side effect.Cardio-cerebrovascular diseases(CCVD)are a leading cause of death.TCM is used in China to prevent and treat CCVD.However,the complexity of TCM poses challenges in understanding the mechanisms of herbs at a systems-level,thus hampering the modernization and globalization of TCM.A novel model,termed traditional Chinese medicine systems pharmacology(TCMSP)analysis platform,which relies on the theory of systems pharmacology and integrates absorption,distribution,metabolism,excretion and toxicity(ADME/T)evaluation,target prediction and network/pathway analysis,was proposed to address these problems.Here,we review the development of systems pharmacology,the TCMSP approach and its applications in the investigations of CCVD and compare it with other methods.TCMSP assists in uncovering the mechanisms of action of herbal formulas used in treating CCVD.It can also be applied in ascertaining the different syndrome patterns of coronary artery disease,decoding the multi-scale mechanisms of herbs,and in understanding the mechanisms of herbal synergism.

Meta-analysis of 5, 10-methylenetetrahydrofolate reductase gene polymorphism as a risk factor for ischemic cerebrovascular disease in a Chinese Han population

OBJECTIVE： To assess whether 5, 10-methylenetetrahydrofolate reductase （MTHFR） gene polymorphism （TT genotype or T allele） is a risk factor for ischemic cerebrovascular disease （ICVD）. DATA SOURCES： MEDLINE and PubMed databases from September 1997 to December 2009 were searched for case-control studies that examined MTHFR genotype in human ICVD using ＂MTHFR, gene, polymorphism, and ischemic cerebrovascular disease＂ as search key words. STUDY SELECTION： Eighteen associated studies were identified. The methods used to collect relevant information factors were similar between case and control groups, and diagnosis of ischemic cerebrovascular disease was in accordance with Trial of ORG 10172 in Acute Stroke Treatment criteria classification, with some referring to European Stroke Diagnostic Criteria. Quality of all included studies was evaluated, and meta-analysis was conducted using RevMan4.2 software （Cochrane Collaboration, http：//www.cochrane-handbook.org） following strict screening. MAIN OUTCOME MEASURES： The correlation between MTHFR gene TT genotype or T allele and ICVD was determined. RESULTS： Eighteen studies involving 4 295 patients with ICVD and 6 169 control subjects were included for this meta-analysis. There was a significant difference in MTHFR gene TT genotype or T allele frequency （x^2 = 15.737, 9.186, P 〈 0.01） between ICVD cases and controls. In addition, six Chinese Han population studies were specially reviewed by meta-analysis. Results showed no significant difference between ICVD and control groups with regard to frequency of MTHFR gene TT genotype and T allele （x^2 = 1.076, 2.434, P 〉 0.05） in the Chinese Han population. CONCLUSION： Results from the present meta-analysis suggested that the MTHFR gene TT genotype or T allele is a risk factor for ICVD. However, the TT genotype or T allele is not a risk factor for ICVD in the Chinese Han population.

Clinical Study of PTAS Therapy for Patients with Ischemia Cerebrovascular Disease Caused by Artery Stenosis

The curative efficacy of percutaneous transluminal angioplasty and stenting（PTAS） in the treatment of patients with ischemia cerebrovascular disease caused by artery stenosis was explored.The clinical data of 111 patients with ischemia cerebrovascular disease receiving PTAS in Guangdong Province General Hospital from Aug.2007 to Nov.2009 were retrospectively analyzed.In total 132 stents were implanted in the 111 patients.The mortality and rate of neural and non-neural complications were assessed perioperatively.Outcomes [including the frequency of transient ischemic attack（TIA）,stroke,or death from vascular diseases） were assessed after operation.NIHSS rating was performed in all cases before and at first week,6th month and 12th month after the operation.The PTAS success rate was 100%.The degree of stenosis was reduced after PTAS.The total complication rate during perioperative period was 15.3%（the rate of neural complications was 3.6%）.Sixty-seven patients were followed up.Three patients（4.48%） developed cerebrovascular events within 1 month,containing one case of TIA,one case of ipsilateral mild stroke and one case of contralateral mild stroke.No severe stroke or death was observed.During a follow-up period of 12 months 7 patients had cerebrovascular events（10.44%）,including 2 cases of ipsilateral TIA（2.99%）,2 cases of ipsilateral mild stroke and 2 cases of contralateral mild stroke（2.99%）,one case of severe stroke（1.49%）.In 13 patients receiving DSA re-examination one year after PTAS,2 patients（15.38%） had in-stent restenosis.NIHSS scores were obviously decreased during a follow-up period as compared with those pre-operation（P〈0.05）.It was concluded that PTAS could significantly alleviate the neural function deficit of the patients with ischemia cerebrovascular disease.The success rate of PTAS was high,and the rate of complications was lower and the clinical outcomes were satisfactory.PTAS is a safe and effective therapeutic method,though the long-term outcomes need further study.

Relationship of Cardiovascular and Cerebrovascular Diseases to Meteorological Conditions and Forecast Method in Nanjing City

[Objective] The study aimed to discuss the relationship of cardiovascular and cerebrovascular diseases to meteorological conditions and forecast method in Nanjing City. [Method] Based on daily cases of cardiovascular and cerebrovascular diseases from a hospital in Nanjing City as well as daily meteorological data from Nanjing Meteorological Station from January 2003 to July 2008, the monthly and seasonal variations in quantity of patients suffedng from cardiovascular and cerebrovascular diseases in Nanjing City were analyzed firstly, and then the relationship between mete- orological elements and incidence of the diseases was discussed, finally the forecast model for the incidence of the diseases was established using the stepwise regression method. [Result] Cardiovascular and cerebrovascular diseases in Nanjing City happened all the year round, and the inci- dance was high in the seasonal transition phase from autumn to winter. Daily incidence of the diseases in Nanjing City correlated negatively with dai- ly maximum, minimum and average vapor pressure, daily minimum relative humidity and so forth, but their incidence had positive correlations with diumal range of daily temperature, daily maximum, minimum and average pressure. Daily average number of patients suffering from the diseases obviously correlated with daily average temperature, daily maximum vapor pressure and daily average relative humidity. [ Conclusion] The research could provide scientific references for the prevention and forecast of cardiovascular and cerebrovascular diseases in future.

Apolipoprotein E gene polymorphism in cerebrovascular diseases of the Chinese Naxi populations from Yunnan province

Currently it is not well known whether apolipoprotein E （ApoE） is a genetic susceptibility factor for cerebrovascular diseases in the Chinese Naxi population. The present study detected and sequenced ApoE polymorphisms of 90 patients with cerebrovascular diseases （58 cases of cerebral infarction and 32 cases of intracerebral hemorrhage）, and 50 normal people of Naxi nationality from Yunnan province, China. The populations were used to analyze the relationship of ApoE polymorphisms with cerebral infarction and intracerebral hemorrhage. Results showed an association between ApoE gene polymorphism and the onset of cerebral infarction, and a possibility that the ε4 allele is a susceptibility locus for the risk of cerebral infarction. However, there was no evidence of a relationship between the ApoE gene polymorphism and cerebral hemorrhage.

Genetic relationship between serum pregnancy-associated plasma protein-A gene polymorphism and ischemic cerebrovascular disease in a Northern Han Chinese population

The present study recruited 193 patients with ischemic cerebrovascular disease from Inpatient and Outpatient Departments at the Affiliated Hospital of Qingdao University Medical College, China from August 2008 to May 2010, as well as 120 healthy volunteers from the Medical Examination Center at the Affiliated Hospital of Qingdao University Medical College, China, who served as controls for this study. Patients and control subjects were from the Han population in northern China. Enzyme- linked immunosorbent assay analysis revealed increased levels of serum pregnancy-associated plasma protein-A （PAPP-A） in ischemic cerebrovascular disease patients compared with healthy controls. In addition, the patients exhibited greater frequency of genotype CC and C alleles in a missense A/C （Tyr/Ser） polymorphism （dbSNP： rs7020782） of exon 14 in the PAPP-A gene. Multiple-factor logistic regression analysis on correction of age, gender, history of smoking, hypertension, diabetes mellitus, hypercholesteremia, and ischemic stroke family history showed that the risk for ischemic cerebrovascular disease in the population without the A allele at the A/C genetic locus in exon 14 of the PAPP-A was 2-folds greater than the population expressing the A allele. These experimental findings suggested that ischemic cerebrovascular disease correlated with the C allele in exon 14 of PAPP-A. In addition, the A allele is likely a protective gene; individuals carrying the A allele were less prone to ischemic cerebrovascular disease compared with individuals without the A allele.

Effects of hypoxia-inducible factor 1 on ischemic cerebrovascular disease

Hypoxia-inducible factor 1, a nuclear transcription factor, is induced by hypoxia. Hypoxia-inducible factor 1, a heterodimeric DNA-binding protein, is composed of hypoxia-inducible factor 1α and hypoxia-inducible factor 1βsubunits, which are family members of the basic helix-loop-helix-PER, ARNT, SIM （PAS） protein. O2 concentration regulates hypoxia-inducible factor 1 activity via this subunit. Hypoxia-inducible factor 1α plays a major role in response to hypoxia and transcriptional activation, as well as in the target gene specificity of the DNA enhancer. Hypoxia-inducible factor 1β cannot be induced by hypoxia. This effect may be due to hypoxia-inducible factor 1 stability and activated conformation due to dimerization. Previous studies have shown that hypoxia-inducible factor 1 mRNA expression increases in the penumbra following ischemia/hypoxia. Hypoxia-inducible factor 1 plays an important role in brain tissue injury after ischemia by affecting a series of target genes, elevating tolerance to hypoxia, and ensuring survival of neural cells. This article summarizes the structure, function, expression, regulatory mechanisms, biological effects, and significance of hypoxia-inducible factor 1 in patients with ischemic cerebrovascular disease. As a transcriptional activator, hypoxia- inducible factor 1 plays a key role in hypoxic responses by stabilizing the internal environment. It also has been shown to regulate the expression of several genes. The regulatory effects of hypoxia-inducible factor 1 in patients with ischemic cerebrovascular disease have been described. The present review re-examined the concept of brain protection at the level of gene regulation.

Association of Fibrin Monomer Polymerization Function, Cerebrovascular Risk Factors and Ischemic Cerebrovascular Disease in Old People

In order to investigate the association of fibrin monomer polymerization function (FMPF) with traditional cerebrovascular risk factors and ischemic cerebrovascular disease in old people. 1∶1 paired case-control comparative study was performed for FMPF and traditional cerebrovascular risk factors on 110 cases of old ischemic cerebrovascular disease and 110 controls matched on age, sex and living condition. The results showed that cerebrovascular risk factors were more prevalent in case group than in control group. In the case group, FMPF was significantly higher than in control group. There was a significant positive correlation between hypertension and fibrin monomer polymerization velocity (FMPV), hypertension and fibrinogen (Fbg), alcohol consumption and Fbg, but no significant correlation between diabetic mellitus, smoking and FMPF was found. Among the parameters of blood lipids, there were significant positive correlations between total cholesterol (TC) and parameters of FMPF to varying degrees, triglycerides (TG) and FMPV, TG and Fbg. Our results also showed there were significant linear trends between TC and FMPV (P<0. 001), TC and Fbg (P=0. 0087), TG and FMPV/Amax (maximum absorbance)(P=0. 0143) respectively. Multiple logistic regression analysis revealed that FMPF in case group remained significantly higher than control group after adjustment of all risk factors that were significant in univariate analysis. It was concluded that there is a possible pathophysiological link between FMPF and cerebrovascular risk factors. An elevated FMPF is associated with ischemic cerebrovascular disease and an independent risk factor of this disease. In old people, detection of FMPF might be a useful screening to identify individuals at increased cerebrothrombotic risk.

Risk factors of mortality and severe disability in the patients with cerebrovascular diseases treated with perioperative mechanical ventilation

BACKGROUND The prognosis of cerebrovascular diseases treated with mechanical ventilation during perioperative has not been clearly reported.AIM To analyze mortality and functional disability and to determine predictors of unfavorable outcome in the patients with cerebrovascular diseases treated with mechanical ventilation.METHODS A retrospective follow-up study of 111 cerebrovascular disease patients who underwent mechanical ventilation during the perioperative period in the First Hospital of Jilin University from June 2016 to June 2019 was performed.Main measurements were mortality and functional outcome in-hospital and after 3-month follow-up.According to the modified rankin scale(mRS),the functional outcome was divided into three groups:Good recovery(mRS≤3),severe disability(mRS=4 or 5)and death(mRS=6).Univariate analysis was used to compare the differences between three functional outcomes.Multivariate logistic regression analysis was used to for risk factors of mortality and severe disability.RESULTS The average age of 111 patients was 56.46±12.53 years,59(53.15%)were males.The mortality of in-hospital and 3-month follow-up were 36.9% and 45.0%,respectively.Of 71 discharged patients,46.47% were seriously disabled and 12.67% died after three months follow-up.Univariate analysis showed that preoperative glasgow coma scale,operation start time and ventilation reasons had statistically significant differences in different functional outcomes.Multiple logistic regression analysis showed that the cause of ventilation was related to the death and poor prognosis of patients with cerebrovascular diseases.Compared with brainstem compression,the risk of death or severe disability of pulmonary disease,status epilepticus,impaired respiratory center function,and shock were 0.096(95%CI:0.028-0.328),0.026(95%CI:0.004-0.163),0.095(95%CI:0.013-0.709),0.095(95%CI:0.020-0.444),respectively.CONCLUSION The survival rate and prognostic outcomes of patients with cerebrovascular diseases treated with mechanical ventilation during the perioperative period were poor.The reason for mechanical ventilation was a statistically significant predictor for mortality and severe disability.

Correlation between serum fructosamine and hyperglycemia in patients with acute cerebrovascular disease

BACKGROUND: Diabetes mellitus is one of the risk factors in patients with acute cerebral disease, and always leads to stroke or get it worse. There is often a high level of blood glucose in those patients with diabetes mellitus and cerebral disease, but it is hard to distinguish from both kinds of hyperglycemia. Serum fructosamine is said to be correlated with blood glucose. OBJECTIVE: To explore the relationship between serum fructosamine and blood glucose in patients with acute cerebrovascular disease. DESIGN: A case-controlled study. SETTINGS: Department of Clinical Laboratory, Health Department for Cadres and Department of Neurology of Affiliated Hospital, Qingdao University Medical College. PARTICIPANTS: Forty-eight inpatients and outpatients with cerebrovascular diseases were selected from the Department of Neurology, Affiliated Hospital of Qingdao University Medical College from December 2004 to April 2005. All the patients were confirmed with CT and MRI. There were 25 patients with diabetes mellitus secondary cerebrovascular diseases, who met the diagnostic standards of diabetes mellitus set by WHO, including 12 males and 13 females with an average of (60±8) years old, the course of diabetes mellitus ranged from 1 to 21 years.. The other 23 patients had no diabetes mellitus (without diabetes mellitus group), including 14 males and 9 females with an average of (62±6) years old. Meanwhile, another 50 healthy physical examinees in the hospital were selected as control group, including 26 males and 24 females with the average age of (62±5) years old. Informed content was obtained from all the participants. METHODS: Venous blood was drawn from all the participants, and content of blood glucose was assayed by means of glucose oxidase, and the concentration of serum fructosamine was determined by nitroblue tetrazolium colorimetric method. Comparison between groups was performed by the analysis of variance and q test, and the correlation was tested by linear regression analysis. MAIN OUTCOME MEASURES: ① Comparison of blood glucose and serum fructosamine among the groups; ② Correlation between serum fructosamine and blood glucose in patients with diabetes mellitus secondary cerebrovascular diseases and those without diabetes mellitus. RESULTS: All the 48 patients with cerebrovascular disease and 50 healthy subjects were involved in the analysis of results. ① Contents of blood glucose and serum fructosamine: There were obvious differences in the contents of blood glucose and serum fructosamine among the diabetes mellitus group, without diabetes mellitus group and control group (F =577.7, 115.1, P < 0. 01). The content of serum fructosamine in the diabetes mellitus group [(4.25±1.35) mmol/ L] was obviously higher than those in the control group and without diabetes mellitus group [(1.65±0.27), (1.96±0.25) mmol/ L, q =1.47, 1.30, P < 0.01], whereas there was no significant difference between the without diabetes mellitus group and control group (P > 0.05). The content of blood glucose was obviously higher in the patients with and without diabetes mellitus groups [(15.80±2.13), (9.50 ±1.78) mmol/L] than in the control group [(4.56 ±0.77) mmol/L, q =1.86, 2.46, P < 0.01], also markedly higher in the with diabetes mellitus group than in the without diabetes mellitus group (q =1.42, P < 0.01). ② Results of correlation analysis: The content of serum fructosamine was positively correlated with the level of fasting blood glucose in the patients with diabetes mellitus secondary cerebrovascular diseases (r = 0.603, P < 0.01). But there was no relationship between serum fructosamine and fasting blood glucose in the patients without diabetes mellitus (r =0.357, P > 0.05). CONCLUSION: The contents of blood glucose and serum fructosamine were obviously different among the diabetes mellitus group, without diabetes mellitus group and control group. There are closer relations between serum fructosamine and blood glucose in patients with diabetes mellitus secondary cerebral disorders, which are not observed in the patients without diabetes mellitus. Fructosamine is significant in differentiating the reasons for the increased blood glucose in patients with acute cerebrovascular disease.

An Analysis of Risk Factors Affecting Cerebrovascular Disease

Background: Cerebrovascular disease is a worldwide health problem. Stroke, a type of cerebrovascular disease, caused by sudden loss of blood flow to parts of the brain, is the world’s second-leading cause of death and third-leading cause of disability. It is critical to analyze risk factors to prevent cerebrovascular disease. Data and Methods: The risk factors for cerebrovascular disease were analyzed using data from 2,678,054 medical checkups obtained from the JMDC Claims Database. Logit models were used, and the odds ratio (OR) and confidence interval (CI) were calculated. The sample period was from January 2005 to September 2019. Results: Age and heart disease history were very important nonmodifiable factors. The OR comparing persons aged 70 to those aged 50 was 2.05 with a 95% CI of 1.92 - 2.05. A heart disease history was also an especially important factor (OR 2.29, 95% CI 2.18 - 2.41). Among the modifiable factors, triglyceride level and recent large weight change were very important factors, changing the risk of cerebrovascular disease by about 30%. Other significant modifiable factors were diastolic blood pressure, urine protein, having breakfast, walking ability and smoking;each of these changed the risk of cerebrovascular disease by about 10%. Taking medications to control hypertension, hyperglycemia and hypercholesterolemia respectively increased the risk of cerebrovascular disease. In particular, taking antihypertensive medications nearly doubled the risk (OR 1.93, 95% CI 1.86 - 2.00). Conclusion: It is very important for individuals with risk factors to improve their physical conditions to prevent cerebrovascular disease. Taking medications to control blood pressure, glucose level, and cholesterol might introduce risks for cerebrovascular disease. Since all medications have side effects, it is necessary to carefully manage the use of these medications to minimize the negative side effects. Limitations: The dataset was observatory. There were no experimental interventions. Further, the dataset contains only information of Japanese individuals, and the results might differ in other countries. As the data comprised claims from employment-based health insurance, the dataset includes no subjects aged 76 or over and relatively few aged 70 - 75. We need to analyze data of other countries and elderly people.

Advances in arterial spin labeled cerebral perfusion imaging in cerebrovascular diseases

Cerebrovascular disease is a disease with high morbidity,disability and mortality rates,which seri-ously affects the daily life of patients and is a heavy burden on families and society.Arterial spin labeling(ASL)is a magnetic resonance imaging(MRI)technology that uses the magnetic labeling of hydrogen atoms in arterial blood as tracers to noninvasively evaluate brain blood flow.ASL does not require injection of an exogenous contrast agent,and has the advantages of no radiation,simplicity and low cost.In cerebrovascular diseases,ASL can evaluate the collateral cerebrovascular circulation and abnormal perfusion of brain tissue,which can provide a reliable basis for early diagnosis and clinical decision-making.This study reviewed ASL and its application in the diagnosis,treatment and prognosis of cerebrovascular diseases.

China Association of Chinese Medicine Paper notice for seminar on clinical application of new technology of integrated Chinese and western medicine in treating sequelae of cerebrovascular diseases

Hosted by ChinaAssociation of Chinese Medicine,and organized by World Journal of Integrated traditional and western Medicine,seminar on clinical application of new technology of integrated Chinese and western medicine in treating sequelae of cerebrovascular diseases is planned to be held in Nanning,Guangxi in August.

Mortality from cerebrovascular diseases in China:Exploration of recent and future trends

Background:Cerebrovascular disease(CVD)ranks among the foremost factors responsible for mortality on a global scale.The mortality patterns of CVDs and temporal trends in China need to be well-illustrated and updated.Methods:We collected mortality data on patients with CVD from Chinese Center for Disease Control and Prevention’s Disease Surveillance Points(CDC-DSP)system.The mortality of CVD in 2020 was described by age,sex,residence,and region.The temporal trend from 2013 to 2019 was evaluated using joinpoint regression,and estimated rates of decline were extrapolated until 2030 using time series models.Results:In 2019,the age-standardized mortality in China(ASMRC)per 100,000 individuals was 113.2.The ASMRC for males(137.7/10^(5))and rural areas(123.0/10^(5))were both higher when stratified by gender and urban/rural residence.The central region had the highest mortality(126.5/10^(5)),the western region had a slightly lower mortality(123.5/10^(5)),and the eastern region had the lowest mortality(97.3/10^(5)).The age-specific mortality showed an accelerated upward trend from aged 55-59 years,with maximum mortality observed in individuals over 85 years of age.The age-standardized mortality of CVD decreased by 2.43%(95%confidence interval,1.02-3.81%)annually from 2013 to 2019.Notably,the age-specific mortality of CVD increased from 2013 to 2019 for the age group of over 85 years.In 2020,both the absolute number of CVD cases and the crude mortality of CVD have increased compared to their values in 2019.The estimated total deaths due to CVD were estimated to reach 2.3 million in 2025 and 2.4 million in 2030.Conclusion:The heightened focus on the burden of CVD among males,rural areas,the central and western of China,and individuals aged 75 years and above has emerged as a pivotal determinant in further decreasing mortalities,consequently presenting novel challenges to strategies for disease prevention and control.

Long-term exposure to air pollution and cerebrovascular disease:findings from Beijing Health Management Cohort study

The relationship between air pollution and cerebrovascular disease has become a popular topic,yet research findings are highly heterogeneous.This study aims to investigate this association based on detailed individual health data and a precise evaluation of their exposure levels.The integrated models of generalized additive model,land use regression model and back propagation neural network were used to evaluate the exposure concentrations.And doubly robust additive model was conducted to explore the association between cerebrovascular disease and air pollution after adjusted for demographic characteristics,physical examination,disease information,geographic and socioeconomic status.A total of 25097 subjects were included in the Beijing Health Management Cohort from 2013 to 2018.With a 1µg/m^(3)increase in the concentrations of PM_(2.5),SO_(2)and NO_(2),the incidence risk of cerebrovascular disease increased by 1.02(95%CI:1.008–1.034),1.06(95%CI:1.034–1.095)and 1.02(95%CI:1.010–1.029)respectively.Whereas CO exposure could decrease the risk,with an odds ratio of 0.38(95%CI:0.212–0.626).In the subgroup analysis,individuals under the age of 50 with normal BMI were at higher risk caused by PM2.5,and So2 was considered more hazardous to women.Meanwhile,the protective effect of CO on women and those with normal BMI was stronger.Successful reduction of long-term exposure to PM2.5,SO_(2)and NO_(2)would lead to substantial benefits for decrease the risk of cerebrovascular disease especially for the health of the susceptible individuals.