Cerebral blood flow of 10 asphyxiated term newborns was continuously measured during the first 7 days of life and compared with that of 10 normal term infants by CDI. Frequency spectrum and blood flow variables in the...Cerebral blood flow of 10 asphyxiated term newborns was continuously measured during the first 7 days of life and compared with that of 10 normal term infants by CDI. Frequency spectrum and blood flow variables in the anterior, middle and posterior cerebral arteries were studied. The results showed evidently lower systolic amplitude in patients than that in normal subjects. End diastolic amplitude was zero in part of vessels, and values of bloed flow variables were all lower in day 1 of the life as compared with the control groups. Frequency spectrum recovered to normal patterns in 9 survived infants in day 2. but blood flow variables recovered to normal by day 7. Values of resistance index (RI) rose to 1 in some vessels of moderate hypoxic ischemic encephalopathy (HIE) infants and stayed at 1 in the severe HIE infants. It is concluded that low CBF plays a key role in brain damage of post-asphyxiated newborns and RI may be an important parameter in the evaluation prognosis.展开更多
In experiments on newbom rats with stress related intracrani al hemorhage(ICH)using Doppler optical coberence tomognaphy(DOCT)we have shown that latent stage of ICH(4 h after stress)is characterized by decrease of ven...In experiments on newbom rats with stress related intracrani al hemorhage(ICH)using Doppler optical coberence tomognaphy(DOCT)we have shown that latent stage of ICH(4 h after stress)is characterized by decrease of venous blood outflow and the loss of sensitivity of sagittal vein to vasoconstrictor ffect of adrenaline.The incidence of ICH(24 h after stress)was accompanied by progressi on of early pathological changes in cerebral venous blood flow(CVBF)and development of venous insufficiency.Taking into consideration of this fact,we suggest that the suppression of CVBF related to the severity to the deleterious effect of stress on the brain hemodynamics in newborn rats.These facts allow us to conclude that the venous insufficiency with the loss of vasoconstrictor response to adrenaline is an informative and sensitive component of pattern of CVBF that can be important diagnostic criteria of risk of ICH development in newborns.展开更多
Blood-brain barrier(BBB)disruption underlies the vasogenic edema and neuronal cell death induced by acute ischemic stroke.Reducing this disruption has therapeutic potential.Transcranial focused ultrasound stimulation ...Blood-brain barrier(BBB)disruption underlies the vasogenic edema and neuronal cell death induced by acute ischemic stroke.Reducing this disruption has therapeutic potential.Transcranial focused ultrasound stimulation has shown neuromodulatory and neuroprotective effects in various brain diseases including ischemic stroke.Ultrasound stimulation can reduce inflammation and promote angiogenesis and neural circuit remodeling.However,its effect on the BBB in the acute phase of ischemic stroke is unknown.In this study of mice subjected to middle cerebral artery occlusion for 90 minutes,low-intensity low-frequency(0.5 MHz)transcranial focused ultrasound stimulation was applied 2,4,and 8 hours after occlusion.Ultrasound stimulation reduced edema volume,improved neurobehavioral outcomes,improved BBB integrity(enhanced tight junction protein ZO-1 expression and reduced IgG leakage),and reduced secretion of the inflammatory factors tumor necrosis factor-αand activation of matrix metalloproteinase-9 in the ischemic brain.Our results show that low-intensity ultrasound stimulation attenuated BBB disruption and edema formation,which suggests it may have therapeutic use in ischemic brain disease as a protector of BBB integrity.展开更多
<strong>Objective</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"><strong>: </strong>To evaluate the clinical value of...<strong>Objective</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"><strong>: </strong>To evaluate the clinical value of transcranial color Doppler ultrasound (TCCD) in assessing cerebral function after cardiopulmonary resuscitation (CPR). </span><b><span style="font-family:Verdana;">Methods</span></b><span style="font-family:Verdana;">: A prospective study was conducted in 52 patients with cardiac arrest treated by CPR from January 2018 to January 2020, and its clinical data were analyzed</span></span><span style="font-family:Verdana;">. </span><span style="font-family:;" "=""><span style="font-family:Verdana;">According to classification of cerebral performance category (CPC), 31 cases (CPC grade 1 - 2) were selected in the good prognosis group and 21 cases (CPC grade 3 - 5) in the poor prognosis group. The cerebral blood flow was measured by transcranial Doppler ultrasound (TCCD) 24 h after CPR, and the differences were compared between the two groups in stroke index, diastolic blood flow velocity (Vd), systolic peak blood flow velocity (Vs) and mean peak blood flow velocity (Vm). The ROC curve of cerebral blood flow after CPR was drawn to predict the prognosis of brain function. </span><b><span style="font-family:Verdana;">Results</span></b><span style="font-family:Verdana;">: The data showed that the pulsatility index of middle cerebral artery of the poor prognosis group decreased within 24 h</span></span><span style="font-family:Verdana;">;</span><span style="font-family:Verdana;">the difference between the two groups was statistically significant (p < 0.05);the Vd, Vs, Vm increased in the good prognosis group</span><span style="font-family:Verdana;">;</span><span style="font-family:;" "=""><span style="font-family:Verdana;">the difference between the two groups was statistically significant (p < 0.05). The ROC curve of cerebral blood flow after CPR was drawn to predict the prognosis of brain function, and the results showed that the area under the curve and the optimal critical value of cerebral blood flow were 0.731 and 5.69. The sensitivity and specificity were 67.3% and 79.1% respectively. </span><b><span style="font-family:Verdana;">Conclusion</span></b><span style="font-family:Verdana;">: The cerebral blood flow increase in the early stage of successful CPR is positively correlated with the prognosis of cerebral functional resuscitation. Monitoring intracranial blood flow after CPR by TCCD has clinical value to evaluate prognosis of brain function.</span></span>展开更多
Objective Cerebral autoregulation （CA） is the mechanism by which constant cerebral blood flow is maintained despite changes in cerebral perfusion pressure. CA can be evaluated by dynamic monitoring of cerebral blood...Objective Cerebral autoregulation （CA） is the mechanism by which constant cerebral blood flow is maintained despite changes in cerebral perfusion pressure. CA can be evaluated by dynamic monitoring of cerebral blood flow velocity （CBFV） with transcranial Doppler sonography （TCD）. The present study aimed to explore CA in chronic anxiety. Methods Subjects with Hamilton anxiety scale scores 〉14 were enrolled and the dynamic changes of CBFV in response to an orthostatic challenge were investigated using TCD. Results In both the anxious and the healthy subjects, the mean CBFV was significantly lower in the upright position than when supine. However, the CBFV changes from supine to upright differed between the anxious and the healthy groups. Anxious subjects showed more pronounced decreases in CBFV with abrupt standing. Conclusion Our results indicate that cerebrovascular modulation is compromised in chronic anxiety; anxious subjects have some insufficiency in maintaining cerebral perfusion after postural change. Given the fact that anxiety and impaired CA are associated with cardiovascular disease, early ascertainment of compromised cerebrovascular modulation using TCD might suggest interventional therapies in the anxious population, and improve the primary prevention of cardiovascular disease.展开更多
Background Standard superficial temporal artery-middle cerebral artery （STA-MCA） bypass surgery is an effective treatment for moyamoya disease, but recent evidence suggests that postoperative cerebral hyperperfusion...Background Standard superficial temporal artery-middle cerebral artery （STA-MCA） bypass surgery is an effective treatment for moyamoya disease, but recent evidence suggests that postoperative cerebral hyperperfusion can occur. In this study, the trendline of changes in regional cerebral blood flow （rCBF） after surgery were continually monitored near the site of anastomosis in order to investigate both the efficacy of the procedure for improving rCBF and the possible risk of hyperperfusion . Methods Standard STA-MCA bypass surgery was performed on 13 patients, rCBF was measured continually using laser Doppler flowmetry （LDF） until the 5th day after the operation with the LDF probe implanted adjacent to the area of the anastomosis. The trendline of rCBF changes postoperatively was recorded for the analysis performed using SPSS 13.0. Results The baseline LDF value of cortical rCBF was （84.68±14.39） perfusion unit （PU）, which was linear relative to absolute perfusion volume before anastomosis and （88.90±11.26） PU immediately after anastomosis （P 〉0.05）. The value changed significantly from before to after anastomosis （P 〈0.05）; it was （417.72±21.35） PU on the 1st day after surgery, and （358.99±18.01） PU, （323.46±17.38） PU, （261.60±16.38） PU and （375.72±18.45） PU on the following 4 days, respectively. The rCBF decreased gradually from the 2nd day until the 4th postoperative day, but still was at a high level （P 〈0.05）. However, on the 5th postoperative day the rCBF increased again to the second highest level, which was significantly different compared with the baseline value （P 〈0.05）, but not significantly different compared with the values on the other 4 days （P〉0.05）. Conclusions STA-MCA anastomosis improves the cerebral blood supply significantly in the early stage after surgery, however, the risk of symptomatic hyperperfusion may exist, which may possibly occur on the 1st day and 5th day after surgery. A LDF is useful for postoperative monitoring for both the efficacy of bypass and possible risk of neurologic deterioration or bleeding from hyperperfusion.展开更多
The ophthalmic artery （OA） is a main branch of the internal carotid artery （ICA）. Severe internal carotidartery stenosis or occlusion may not only affect the blood supply to the brain, but may also cause OA insuff...The ophthalmic artery （OA） is a main branch of the internal carotid artery （ICA）. Severe internal carotidartery stenosis or occlusion may not only affect the blood supply to the brain, but may also cause OA insufficiency, leading to ocular ischemia. Therefore, research on the hemodynamic changes in the OA in patients with ICA stenosis or occlusion has increasingly attracted more ophthalmologists＇ attention.1 Transcranial Doppler （TCD） is simple and noninvasive, has been widely used in the inspection of cerebrovascular disease,展开更多
Objective To evaluate the effect of carotid artery stenting combined with nimodipine on cerebral hemodynamics by comparing and analyzing the change of anterior cerebral blood flow before and after treatment through tr...Objective To evaluate the effect of carotid artery stenting combined with nimodipine on cerebral hemodynamics by comparing and analyzing the change of anterior cerebral blood flow before and after treatment through transcranial Doppler (TCD). Methods Twenty patients with ischemic cerebrovascular disease were detected in blood flow velocity of bilateral middle cerebral arteries (MCA) and anterior cerebral arteries (ACA) and artery pulsatility index with TCD before and two weeks after treatment. Results After treatment, TCD examination showed dynamic changes in blood flow significantly. Ipsilateral MCA flow velocity significantly increased; ipsilateral ACA flow velocity did not change significantly; there was no significant increase in the contralateral MCA flow velocity; flow rate decreased significantly in contralateral ACA. Conclusion Carotid artery stenting combined with nimodipine treatment can cause anterior cerebral hemodynamic changes in ipsilateral hemisphere and significantly improve blood flow.展开更多
文摘Cerebral blood flow of 10 asphyxiated term newborns was continuously measured during the first 7 days of life and compared with that of 10 normal term infants by CDI. Frequency spectrum and blood flow variables in the anterior, middle and posterior cerebral arteries were studied. The results showed evidently lower systolic amplitude in patients than that in normal subjects. End diastolic amplitude was zero in part of vessels, and values of bloed flow variables were all lower in day 1 of the life as compared with the control groups. Frequency spectrum recovered to normal patterns in 9 survived infants in day 2. but blood flow variables recovered to normal by day 7. Values of resistance index (RI) rose to 1 in some vessels of moderate hypoxic ischemic encephalopathy (HIE) infants and stayed at 1 in the severe HIE infants. It is concluded that low CBF plays a key role in brain damage of post-asphyxiated newborns and RI may be an important parameter in the evaluation prognosis.
基金This work was supported in part by RF Govern-mental contracts 11.519.11.2035,14.B37.21.0728,14.B37.21.056314.B37.21.0216 and grants:FiDiPro,TEKES Program(40111/11),Finland+1 种基金SCOPES EC,Uzb/Switz/RF,Swiss NSF,IZ74ZO_137423/1RF President's grant"Scientific Schools",1177.2012.2.,Russian Foundation for Basic Research Grant No.12-02-31204 mol-a and No.a-11-02-00560.
文摘In experiments on newbom rats with stress related intracrani al hemorhage(ICH)using Doppler optical coberence tomognaphy(DOCT)we have shown that latent stage of ICH(4 h after stress)is characterized by decrease of venous blood outflow and the loss of sensitivity of sagittal vein to vasoconstrictor ffect of adrenaline.The incidence of ICH(24 h after stress)was accompanied by progressi on of early pathological changes in cerebral venous blood flow(CVBF)and development of venous insufficiency.Taking into consideration of this fact,we suggest that the suppression of CVBF related to the severity to the deleterious effect of stress on the brain hemodynamics in newborn rats.These facts allow us to conclude that the venous insufficiency with the loss of vasoconstrictor response to adrenaline is an informative and sensitive component of pattern of CVBF that can be important diagnostic criteria of risk of ICH development in newborns.
基金supported by the National Natural Science Foundation of China,Nos.81802232(to JXW),81801170(to YHT),82071284(to YHT),2019YFA0112000(to YHT)the Scientific Research and Innovation Program of Shanghai Education Commission,No.2019-01-07-00-02-E00064(to GYY)+1 种基金Scientific and Technological Innovation Act Program of Shanghai Science and Technology Commission,No.20JC1411900(to GYY)Science and Technology Commission of Shanghai,No.19441907900(to JFS).
文摘Blood-brain barrier(BBB)disruption underlies the vasogenic edema and neuronal cell death induced by acute ischemic stroke.Reducing this disruption has therapeutic potential.Transcranial focused ultrasound stimulation has shown neuromodulatory and neuroprotective effects in various brain diseases including ischemic stroke.Ultrasound stimulation can reduce inflammation and promote angiogenesis and neural circuit remodeling.However,its effect on the BBB in the acute phase of ischemic stroke is unknown.In this study of mice subjected to middle cerebral artery occlusion for 90 minutes,low-intensity low-frequency(0.5 MHz)transcranial focused ultrasound stimulation was applied 2,4,and 8 hours after occlusion.Ultrasound stimulation reduced edema volume,improved neurobehavioral outcomes,improved BBB integrity(enhanced tight junction protein ZO-1 expression and reduced IgG leakage),and reduced secretion of the inflammatory factors tumor necrosis factor-αand activation of matrix metalloproteinase-9 in the ischemic brain.Our results show that low-intensity ultrasound stimulation attenuated BBB disruption and edema formation,which suggests it may have therapeutic use in ischemic brain disease as a protector of BBB integrity.
文摘<strong>Objective</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"><strong>: </strong>To evaluate the clinical value of transcranial color Doppler ultrasound (TCCD) in assessing cerebral function after cardiopulmonary resuscitation (CPR). </span><b><span style="font-family:Verdana;">Methods</span></b><span style="font-family:Verdana;">: A prospective study was conducted in 52 patients with cardiac arrest treated by CPR from January 2018 to January 2020, and its clinical data were analyzed</span></span><span style="font-family:Verdana;">. </span><span style="font-family:;" "=""><span style="font-family:Verdana;">According to classification of cerebral performance category (CPC), 31 cases (CPC grade 1 - 2) were selected in the good prognosis group and 21 cases (CPC grade 3 - 5) in the poor prognosis group. The cerebral blood flow was measured by transcranial Doppler ultrasound (TCCD) 24 h after CPR, and the differences were compared between the two groups in stroke index, diastolic blood flow velocity (Vd), systolic peak blood flow velocity (Vs) and mean peak blood flow velocity (Vm). The ROC curve of cerebral blood flow after CPR was drawn to predict the prognosis of brain function. </span><b><span style="font-family:Verdana;">Results</span></b><span style="font-family:Verdana;">: The data showed that the pulsatility index of middle cerebral artery of the poor prognosis group decreased within 24 h</span></span><span style="font-family:Verdana;">;</span><span style="font-family:Verdana;">the difference between the two groups was statistically significant (p < 0.05);the Vd, Vs, Vm increased in the good prognosis group</span><span style="font-family:Verdana;">;</span><span style="font-family:;" "=""><span style="font-family:Verdana;">the difference between the two groups was statistically significant (p < 0.05). The ROC curve of cerebral blood flow after CPR was drawn to predict the prognosis of brain function, and the results showed that the area under the curve and the optimal critical value of cerebral blood flow were 0.731 and 5.69. The sensitivity and specificity were 67.3% and 79.1% respectively. </span><b><span style="font-family:Verdana;">Conclusion</span></b><span style="font-family:Verdana;">: The cerebral blood flow increase in the early stage of successful CPR is positively correlated with the prognosis of cerebral functional resuscitation. Monitoring intracranial blood flow after CPR by TCCD has clinical value to evaluate prognosis of brain function.</span></span>
基金supported by grants from China Scholarship Council
文摘Objective Cerebral autoregulation （CA） is the mechanism by which constant cerebral blood flow is maintained despite changes in cerebral perfusion pressure. CA can be evaluated by dynamic monitoring of cerebral blood flow velocity （CBFV） with transcranial Doppler sonography （TCD）. The present study aimed to explore CA in chronic anxiety. Methods Subjects with Hamilton anxiety scale scores 〉14 were enrolled and the dynamic changes of CBFV in response to an orthostatic challenge were investigated using TCD. Results In both the anxious and the healthy subjects, the mean CBFV was significantly lower in the upright position than when supine. However, the CBFV changes from supine to upright differed between the anxious and the healthy groups. Anxious subjects showed more pronounced decreases in CBFV with abrupt standing. Conclusion Our results indicate that cerebrovascular modulation is compromised in chronic anxiety; anxious subjects have some insufficiency in maintaining cerebral perfusion after postural change. Given the fact that anxiety and impaired CA are associated with cardiovascular disease, early ascertainment of compromised cerebrovascular modulation using TCD might suggest interventional therapies in the anxious population, and improve the primary prevention of cardiovascular disease.
文摘Background Standard superficial temporal artery-middle cerebral artery （STA-MCA） bypass surgery is an effective treatment for moyamoya disease, but recent evidence suggests that postoperative cerebral hyperperfusion can occur. In this study, the trendline of changes in regional cerebral blood flow （rCBF） after surgery were continually monitored near the site of anastomosis in order to investigate both the efficacy of the procedure for improving rCBF and the possible risk of hyperperfusion . Methods Standard STA-MCA bypass surgery was performed on 13 patients, rCBF was measured continually using laser Doppler flowmetry （LDF） until the 5th day after the operation with the LDF probe implanted adjacent to the area of the anastomosis. The trendline of rCBF changes postoperatively was recorded for the analysis performed using SPSS 13.0. Results The baseline LDF value of cortical rCBF was （84.68±14.39） perfusion unit （PU）, which was linear relative to absolute perfusion volume before anastomosis and （88.90±11.26） PU immediately after anastomosis （P 〉0.05）. The value changed significantly from before to after anastomosis （P 〈0.05）; it was （417.72±21.35） PU on the 1st day after surgery, and （358.99±18.01） PU, （323.46±17.38） PU, （261.60±16.38） PU and （375.72±18.45） PU on the following 4 days, respectively. The rCBF decreased gradually from the 2nd day until the 4th postoperative day, but still was at a high level （P 〈0.05）. However, on the 5th postoperative day the rCBF increased again to the second highest level, which was significantly different compared with the baseline value （P 〈0.05）, but not significantly different compared with the values on the other 4 days （P〉0.05）. Conclusions STA-MCA anastomosis improves the cerebral blood supply significantly in the early stage after surgery, however, the risk of symptomatic hyperperfusion may exist, which may possibly occur on the 1st day and 5th day after surgery. A LDF is useful for postoperative monitoring for both the efficacy of bypass and possible risk of neurologic deterioration or bleeding from hyperperfusion.
基金This study was supported by grants from the National Natural Science Foundation of China ＂Study on protective mechanism of the retinal ganglial cell （RGE） of ocular ischemic syndrome （OIS）＂ （No. 81173412）, Beijing Natural Science Foundation ＂Study on correlation between the hemodynamic changes of ocular ischemic syndrome and Toll-like receptors signal pathway （No. 7122046）, and Capital Medical Academy of Key Laboratory Ophthalmology Open Research Topic ＂Study on injury mechanism of the retinal ganglial cell （RGE） of ocular ischemic syndrome （OIS）＇.
文摘The ophthalmic artery （OA） is a main branch of the internal carotid artery （ICA）. Severe internal carotidartery stenosis or occlusion may not only affect the blood supply to the brain, but may also cause OA insufficiency, leading to ocular ischemia. Therefore, research on the hemodynamic changes in the OA in patients with ICA stenosis or occlusion has increasingly attracted more ophthalmologists＇ attention.1 Transcranial Doppler （TCD） is simple and noninvasive, has been widely used in the inspection of cerebrovascular disease,
基金Supported by the Shaanxi Scientific and Technical Plan(2009K18-02)
文摘Objective To evaluate the effect of carotid artery stenting combined with nimodipine on cerebral hemodynamics by comparing and analyzing the change of anterior cerebral blood flow before and after treatment through transcranial Doppler (TCD). Methods Twenty patients with ischemic cerebrovascular disease were detected in blood flow velocity of bilateral middle cerebral arteries (MCA) and anterior cerebral arteries (ACA) and artery pulsatility index with TCD before and two weeks after treatment. Results After treatment, TCD examination showed dynamic changes in blood flow significantly. Ipsilateral MCA flow velocity significantly increased; ipsilateral ACA flow velocity did not change significantly; there was no significant increase in the contralateral MCA flow velocity; flow rate decreased significantly in contralateral ACA. Conclusion Carotid artery stenting combined with nimodipine treatment can cause anterior cerebral hemodynamic changes in ipsilateral hemisphere and significantly improve blood flow.
