CONTRAST STUDY ON CT AND BA IN DIAGNOSIS OF PATIENTS WITH ATHEROTHROMBOTIC BRAIN INFARCTION

Objectives: To explore applied value on CT and BA in diagnosis of patients with athero-thrombotic brain infarction. Methods :CT and BA were examined in 246 patients with atherothrombotic brain infarction. Results:The different change of CT and BA were showed in 246 patients with atherothrombotic brain infarction. Conclusions: There were separately different advantage and shortcoming in CT and BA in diagnosis of atherothrombotic brain infarction. The value of clinical application of BA was important in diagnosis of atherothrombotic brain infarction.

Therapeutic effect of nerve growth factor on cerebral infarction in dogs using the hemisphere anomalous volume ratio of diffusion-weighted magnetic resonance imaging

A model of focal cerebral ischemic infarction was established in dogs through middle cerebral artery occlusion of the right side.Thirty minutes after occlusion,models were injected with nerve growth factor adjacent to the infarct locus.The therapeutic effect of nerve growth factor against cerebral infarction was assessed using the hemisphere anomalous volume ratio,a quantitative index of diffusion-weighted MRI.At 6 hours,24 hours,7 days and 3 months after modeling,the hemisphere anomalous volume ratio was significantly reduced after treatment with nerve growth factor. Hematoxylin-eosin staining,immunohistochemistry,electron microscopy and neurological function scores showed that infarct defects were slightly reduced and neurological function significantly improved after nerve growth factor treatment.This result was consistent with diffusion-weighted MRI measurements.Experimental findings indicate that nerve growth factor can protect against cerebral infarction,and that the hemisphere anomalous volume ratio of diffusion-weighted MRI can be used to evaluate the therapeutic effect.

Resuscitating acupuncture therapy for glucose metabolism in acute cerebral infarction of basal ganglia

BACKGROUND： Acupuncture can improve motor function in patients with cerebral infarction, and activate brain glucose metabolism in relevant brain areas. However, the association between encephalic region activation and acupuncture, as well as the clinical significance of activation remain unclear. OBJECTIVE： Through the use of positron emission tomography-computed tomography （PET-CT）, acute cerebral infarction patients were analyzed for global cerebral metabolism, cerebral infarction focus, peripheral edema, and pyramidal tract pathway changes, which were directly related to clinical symptoms. The influence of resuscitating acupuncture on cerebral glucose metabolism was analyzed in patients with acute cerebral infarction in basal ganglia. DESIGN, TIME AND SETTNG： Randomized, controlled, clinical trials were performed from March 2007 to October 2008 at the PET-CT Center of the General Hospital of Tianjin Medical University, China. PARTICIPANTS： Twelve patients with acute basal ganglia infarction were recruited from the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin Chinese Medicine Hospital, and Affiliated Hospital of Medical College of Chinese People＇s Armed Police Force. METHODS： The cerebral infarcted patients were randomly assigned to acupuncture and control groups. In addition to routine treatment, the acupuncture group was treated by acupuncture at the main acupoints for resuscitation [Neiguan （PC 6）, Renzhong （DU 26）, and Sanyinjiao （SP 6）], while the control group received routine treatment. MAIN OUTCOME MEASURES： Before and after treatment, patients with acute cerebral infarction were evaluated for global brain, cerebral infarction focus, and surrounding edema and glucose metabolism in encephalic region of pyramidal tract conduction by 18-labeled fluorodeoxyglucose for PET-CT imaging. RESULTS： The resuscitating acupuncture therapy can significantly activate the metabolism of global brain, infarction center and surrounding edema in patients with cerebral infarction in basal ganglia, also has effects on the activation of glucose metabolism in the encephalic regions of pyramidal tract pathway （P 〈 0.05）. CONCLUSION： Resuscitating acupuncture was superior to routine treatment for significantly activating glucose metabolism in patients with acute cerebral basal ganglia infarction.

Correlation between carotid atherosclerosis and serum high-sensitivity C-reactive protein in patients with cerebral infarction

BACKGROUND： Some researches demonstrate that high-sensitivity C-reactive protein may be a risk factor to cause carotid atherosclerosis in patients with cerebral infarction. Inflammatory reaction may participate in formation of carotid atherosclerosis in patients with acute cerebral infarction. OBJECTIVE： To investigate the correlation between levels of serum high-sensitivity C-reactive protein and carotid atherosclerosis in patients with acute cerebral infarction accompanied with carotid atherosclerosis. DESIGN： Contrast observation between two groups. SETTING： Department of Neurology, Zhenzhou Hospital, Shenyang Medical College. PARTICIPANTS： A total of 102 patients with acute cerebral infarction regarded as cerebral infarction group were selected from Department of Neurology, Shenzhou Hospital Affiliated to Shenyang Medical College from February 2005 to September 2006. There were 55 males and 47 females and their ages ranged from 55 to 86 years. All patients met the variously diagnostic points of cerebral infarction established by the Fourth National Cerebrovascular Disease Academic Meeting and were finally diagnosed with CT or MRI examination. Illness course was in an acute phase. A total of 96 healthy subjects were regarded as control group, including 51 males and 45 females aged from 48 to 78 years. All accepted subjects provided the confirmed consent. METHODS： ① Patients in the cerebral infarction group received carotid ultrasound Doppler examination and serum high-sensitivity C-reactive protein detection within 72 hours after onset. IMMAGE immune biochemical system and latex reinforcement particle-enhanced nephelometric ilnmunoassay （PENIA） were used for quantitative detection of serum high-sensitivity C-reactive protein. ② Healthy subjects in the control group received the same detection. SEQUOIA512 color Doppler ultrasound （Siemens Company, USA） was used to detect carotid artery of all subjects so as to observe intima media thickness of artery and formation of artery atherosclerostic plaques. If artery atherosclerostic plaques were formed, their properties and amounts were determined based on the characteristics of light-echo signals. Evaluating criteria： Intima media thickness of artery was the vertical dimension from crossed face between lumen and tunica intima to crossed face between tunica media and tunica adventitia. Intima media thickness ≤ 0.9 into was regarded as normal; 0.9 inm 〈 intima media thickness ≤ 1.2 inm was regarded as thickening; when local eminence thickening was processed towards to lumen, the intima media thickness was more than 1.2 into and plaque of tunica intima was formed at the same time. Properties of plaque were classified into 4 types： steady low-echo lipid malacoplakia, equal-echo fiber plaque, strong-echo or sound-imaging calcification hard plaque and unsteady-echo ulcer mixed plaque. Fiber plaque and calcification hard plaque were steady but malacoplakia and mixed plaque were unsteady. MAIN OUTCOME MEASURES： Thickness of tunica media, characteristics of plaque and level of serum high-sensitivity C-reactive protein in carotid artery in two groups. RESULTS： All 102 patients with cerebral infarction and 96 healthy subjects were involved in the final analysis. ①Comparisons of level of high-sensitivity C-reactive protein： Level of high-sensitivity C-reactive protein in normal tunica media was higher in the cerebral infarction group [（4.66±1.55） mg/L] than the control group [（3.49±1.24） mg/L, t =2.541, P 〈 0.05]. In addition, level of high-sensitivity C-reactive protein in patients with thickening tunica media and plaque was not significantly different between the cerebral infarction group and the control group （P 〉 0.05）. ② Correlation between various degrees of vascular lesion and level of high-sensitivity C-reactive protein in the cerebral infarction group： Level of high-sensitivity C-reactive protein was statistically significantly higher in patients with thickening tunica media [（8.16±2.42） mg/L] than patients with normal tunica media [（4.66±1.55） mg/L, t =4.132, P 〈 0.01]. In addition, level of high-sensitivity C-reactive protein was statistically significantly higher in patients with carotid plaque [（12.08±3.85） mg/L] than patients with normal tunica media （t =5.994, P 〈 0.01） and thickening tunica media （t =4.197, P 〈 0.01）. ③ Levels of high-sensitivity C-reactive protein in patients with various kinds of carotid plaque： Level of high-sensitivity C-reactive protein was statistically significantly higher in patients with unsteady carotid plaque [（13.54±2.62） mg/L] than patients with steady carotid plaque [（8.61±3.71） mg/L, t =2.002, P 〈 0.05]. That was to say level of serum high-sensitivity C-reactive protein in patients who suffered acute cerebral infarction combined with carotid atherosclerosis especially carotid plaque was higher than that in those patients who did not have carotid lesions. This suggested that serum high-sensitivity C-reactive protein had a certain correlation with onset of carotid atherosclerosis in patients with acute cerebral infarction. CONCLUSION： Serum high-sensitivity C-reactive protein certainly correlates with onset of carotid atherosclerosis in patients with acute cerebral infarction, while inflammatory reaction may participate in formation of carotid atherosclerosis in patients with acute cerebral infarction.

Anxiety Network of Brain Function in Patients with Acute Cerebral Infarction

Objective: To explore the characteristics of brain functional network with anxiety in patients with acute cerebral infarction. Methods: A total of 39 patients with acute cerebral infarction by cranial magnetic resonance examination were included, and all the patients were scored by the Hamilton Anxiety Scale. The anxiety scale is scored by a professional psychiatrist. There are a total of 14 items, including anxiety, nervousness, fear, insomnia, cognitive function, depressed mood, somatic anxiety, sensory system, etc. The total score ≥ 29 points may be severe;≥21 points, there must be obvious;≥14 points, there must be anxiety;a score of more than 7 may indicate anxiety. If the score is less than 7, there are no anxiety symptoms. All patients within 24 to 72 hours, complete the head examination magnetic resonance, computerized calculation of the DWI sequence images, according to the results of the calculation to superimpose the image of the lesion, image reconstruction in space, and carry out Binarization, defining the value of lesions as 1, and the value of non as 0. All lesions are superimposed into one image and integrated. The relationship between the lesions in this superimposed image and anxiety after cerebral infarction was analyzed. Results: The lesions were basically concentrated around the lateral ventricle, and they were mainly concentrated around the lateral ventricle. Conclusion: Patients with acute cerebral infarction in the lateral ventricle or basal ganglia are more prone to post-stroke anxiety. This has a certain evaluation value for the prognosis of future cerebral infarction, and has a certain understanding of the exploration of complications, and has a certain understanding of the exploration of complications.

Silent brain infarctions and leuko-araiosis in Chinese patients with first-ever acute lacunar strokes

We report on silent brain infarction (SBI) and leuko- araiosis (LA) of 23 patients with clinically diagnosed “first-ever” acute ischemic lacunar stroke. The lacunar syndromes were pure motor hemiparesis (10), pure sensory syndrome (2), ataxic hemiparesis (3), dysarthria clumsy hand syndrome (3), and sensory- motor deficit (5). Nineteen out of the 23 patients presented with completed strokes on arrival to the hospital, and 4 (17%) developed evolving-stroke within 24 hours of stroke onset. A lacune corresponded to the acute stroke could be found in all patients on brain magnetic resonance imaging (MRI), and in 18 (78%) on brain computed tomography (CT). MRI showed additional subclinical or asymptomatic “silent brain infarctions or lacunes” (SBI) in 19 (83%) of 23 patients, and leuko-araiosis (LA) of moderate to severe degree (> grade 2) was present in 61% of patients although dementia was absent. Hypertension is the risk factor in 78% of cases followed by diabetes mellitus, smoking, and elevated plasma cholesterol level. Independence of the types of lacunar syndromes, patients with hypertension and diabetes mellitus are associated with high grade LA. None with normal blood pressure and plasma glucose had grade 3 or grade 4 LA (p < 0.05). In conclusion, evolving-stroke occurs in one- fifth of patients with “first-ever” lacunar infarct within the first 24 hours of stroke onset. SBI was found in 83% of cases. Hypertension and diabetes mellitus are associated with additional SBI and high grade LA. The severity of leuko-araiosis per se dictates the cerebrovascular risks.

Clinical study of recombinant human brain natriuretic peptide in patients with acute myocardial infarction complicating congestive heart failure

Objectives To observe the efficacy and safety of recombinant human brain natriuretic peptide(rh-BNP) on patients with acute myocardial infarction complicating congestive heart failure.Methods 40 patients with acute myocardial infarction complicated by congestive heart failure were randomly divided into control group and treatment group of 20 cases.The control group,15 cases of acute anterior myocardial infarction,5 cases of acute inferior wall myocardial infarction, 15 males and 5 females,aged 55-70 years,mean age 58±12 years;treated 16 cases of acute anterior myocardial infarction,4 cases of acute myocardial infarction,16 males and 4 females,aged 56-70 years,mean age 59±11 years;two groups of age,gender,severity of disease and vascular lesions no significant difference and comparable(P】0.05).Conventional group were given aspirin,clopidogrel, statins,Inotropic,diuretic and vasodilator therapy.In the con- ventional treatment group based on the use of recombinant human brain natriuretic peptide(new bios,Tibet Pharmaceutical Co.,Ltd.Chengdu Nuodikang biopharmaceutical production, usage:1.5μg/Kg intravenous injection(impact), then 0.0075μg-0.01μg/(kg·min)infusion rate).Continuous medication 72 h.The clinical symptoms observed for 3 days in patients before treatment and after treatment,heart rate,blood pressure and left ventricular ejection fraction (LVEF) and tumor necrosis factor(TNF-α),brain natriuretic peptide(BNP) levels were measured.Results In control group,8 cases markedly effect,5 cases effect and 7 cases no effect,the total effective rate was 65%;In treatment group,13 cases markedly effect,6 cases effect and 1 cases no effect,the total effective rate was 95%,compared with two groups P New bios treatment group significantly increased cardiac index(CI) in patients with heart failure and left ventricular ejection fraction(LVEF) than the control group(all P【0.05),further reduce the levels of tumor necrosis (TNF-α) and brain natriuretic peptide(BNP).Conclusions rh-BNP can improve symptoms and heart function,reduced plasma tumor necrosis factor(TNF-α) and BNP levels of acute myocardial infarction patients with congestive heart failure,the treatment safe and reliable.As small sample size observed,larger sample to be accumulated to further evaluate its efficacy and safety.

Whether chronic bronchitis is an independent risk factor for cerebral infarction in the elderly 1:1 case paired study

BACKGROUND： The inflammatory reaction already becomes an important risk factor of causing acute cerebral infarction; however, the correlation between chronic bronchitis and senile cerebral infarction is still unclear. OBJECTIVE： To study whether the chronic bronchitis is the risk factor for senile cerebral infarction. DESIGN： 1 ： 1 pair, case contrast, and risk factor study. SETTINGS： Department of Respiratory Medicine, Third Hospital of Tangshan; Department of Neurology, Affiliated Hospital of North China Coal Medical College. PARTICIPANTS： A total of 147 patients with acute cerebral infarction who were regarded as case group were selected from Department of Neurology, the Third Hospital of Tangshan from January 2004 to December 2006. All patients met the diagnostic criteria of the Fourth National Cerebrovascular Diseases Meeting. There were 87 males and 60 females, and their ages ranged from 65 to 83 years. Based on 1 ： 1 pair study, another 147 subjects without cerebrovascular disease were regarded as control group. Except the diseases about infection, there were 73 males and 74 females, and their ages ranged from 62 to 81 years. All subjects provided the confirm consent and agreed with the coordinate experiment. METHODS： ①Questionnaire of risk factor of cerebral infarction was designed to measure the following items： chronic bronchitis, hypertension, diabetes mellitus, hyperlipemia, coronary heart disease, primary cerebral infarction/transient ischemic attack and history of smoking. ②Cerebral infarction was regarded as the dependent variance, while chronic bronchitis, hypertension, diabetes mellitus, hypedipemia, primary cerebral infarction/transient ischemic attack, coronary heart disease and smoking were regarded as the independent variance for multiple regression analysis, MAIN OUTCOME MEASURES： Risk factors of senile cerebral infarction. RESULTS： All 147 patients with acute cerebral infarction and 147 subjects without cerebrovascular diseases were involved in the final analysis. ①Risk factor analysis of senile cerebral infarction： There were no significant differences in age, hyperlipemia and history of smoking between the two groups （P 〉 0.05）. But, chronic bronchitis, diabetes mellitus, hypertension, cerebral infarction/transient ischemic attack and history of coronary heart disease were higher in the case group than those in the control group （33.6% vs. 19.0%, 38.8% vs. 23.3%, 54.3% vs. 36.2%, 29.3% vs. 17.2%, 44.0% vs. 29.3%, P 〈 0.05- 0.01）. ②Multiple Logistic regression analysis of risk factor of senile cerebral infarction Hyperlipemia, smoking and coronary heart disease were not correlated with cerebral infarction （P 〉0.05）, but chronic bronchitis, hypertension, diabetes mellitus and cerebral infarction/transient ischemic attack were risk factors for senile cerebral infarction （OR =2.47, 2.28, 2.18, 2.01, P 〈 0.05 - 0.01）. CONCLUSION： The chronic bronchitis mac become an independent risk factor senile cerebral infarction.

Electro-Acupuncture for Treatment of Dysequillibrium Due to Cerebellum or Brain Stem Infarction

The authors treated 26 cases of dysequillibrium due tocerebellum or brain stem infarction byelectro-acupuncture from Aug 2000 - April 2002. Theresults were quite satisfactory and reported as follows.

Silent Cerebral Infarctions in Type II Diabetes Mellitus Patients;Could Brain MRI Be a Routine Investigation?

Objective: To study the prevalence of silent cerebral infarction in Type II diabetes mellitus. Patients and Methods: The study was a prospective on 80 patients recruited from neurology, endocrine outpatient clinics. Patients were type II diabetics as described by the American Diabetes Association, 2011 criteria. All patients underwent full metabolic profiles to diagnose diabetes mellitus and MRI brain scans to detect cerebral infarction. Results: Silent cerebral infarctions were detected in 60% of patients (48/80 patients) predominately along periventricular white matter area and subcortical areas (Basal ganglia, Thalamus). Conclusion: Asymptomatic Type II diabetes mellitus patients could have vascular cerebral changes without neurological symptoms. MRI brain scans could be recommended as routine diagnosis (if possible) for early cerebral infarct detection in type II diabetic patients.

Clinical Efficacy of Recombinant Brain Natriuretic Peptide in Patients with Acute Myocardial Infarction After On-Pump Coronary Artery Bypass Grafting (CABG)

Objective:To evaluate the clinical efficacy of intravenous recombinant human brain natriuretic peptide(rhBNP)in patients with acute myocardial infarction after on-pump coronary artery bypass grafting(CABG).Methods:40 cases of coronary heart disease,left ventricular ejection fraction<50%and(plasma brain natriuretic peptide in type N terminal)NT-proBNP>300 pg/ml underwent on-pump coronary artery bypass surgery with cardiopulmonary bypass were enrolled and randomly divided into two groups,experimental group of 20 patients after operation on the basis of conventional therapy plus recombinant human brain natriuretic peptide treatment(first loading dose of 1.5μg/kg intravenously,to maintain dose of 0.01μg/kg/min continuous infusion of 72h),20 cases of the control group was given routine treatment,observe two groups of patients before and after treatment of blood pressure,heart rate,urine volume,blood creatinine and NT-proBNP,and to observe the left ventricular ejection fraction(LVEF),echocardiography and the length of time the index.Results:the experimental group after treatment,urine volume,left ventricular ejection fraction(LVEF),cardiac index(CI)was significantly higher than that before treatment,the serum creatinine,plasma N-terminal pro brain natriuretic peptide(NTproBNP),the content of serum troponin T peptide(cT nT),creatine kinase isoenzyme(CK MB)was significantly lower than before treatment.Conclusion:Recombinant human brain natriuretic peptide can improve cardiac and renal function in patients with acute period of acute myocardial infarction underwent coronary artery bypass surgery,shorten the hospitalization time,and it is safe and feasible.

EFFECT OF ACUPUNCTURE ON β-EP CONTENT IN THE BRAIN TISSUE OF RATS WITH ACUTE CEREBRAL INFARCTION

Objective: To study the mechanisms of acupuncture in treatment of acute cerebral infarction. Methods: 90 SD rats were randomly divided into normal control group (n=10), model group (n=40) and electroacupuncture (EA) group (n=40). Shuigou (GV 26), bilateral Neiguan (PC 6) and Zusanli (ST 36) were stimulated with EA for 20 min. Acute cerebral infarction (ACI) was produced by blocking blood flow of the cerebral middle artery. Changes of β EP content in the brain tissue after ACI and EA were detected by radioimmunoassay (RIA). Results: 24 hour after ACI, plasma β EP content increased significantly to 1120.41±33.79 ng/L from 401.72±266.47 ng/L before ACL. While after acupuncutre, the increased β EP content lowered evidently in comparison with that of model group but was close to that of normal group. Conclusion: Acupuncture may adjust the neuroendocrine disturbance in rats with acute cerebral infarction to minimize the injury of the brain tissue.

Effect of DF-521 on functional recovery of nerve defect in patients with acute brain infarction

Objective To observe the effect of DF 521 on acute brain infarction and its’ safety.Method Patients were randomly divided into DF 521 group and control group.Neurological defect scoring were done before and after treatment.Clinical effect was evaluated.Result Total effective rate was more favorable in DF 521 group than that in control group(P<0.01).Conclusion DF 521 is effective in treating brain infarction without inducing significant adverse effects.

Effect of brain reflex instrument combined with acupuncture on convalescent neurotrophic status and nerve cell apoptosis in patients with cerebral infarction

Objective:To study the effect of brain reflex instrument combined with acupuncture on convalescent neurotrophic status and nerve cell apoptosis in patients with cerebral infarction. Methods:A total of 116 patients with convalescent cerebral infarction who were treated in Chinese Medicine Hospital Affiliated to Xinjiang Medical University between October 2014 and December 2016 were selected and randomly divided into two groups, intervention group received brain reflex instrument combined with acupuncture intervention + conventional intervention, and the control group only received conventional intervention. Serum levels of neurotrophic cytokines, monoamine neurotransmitter, and nerve cell apoptosis molecules were detected before intervention as well as 10, 20 and 30 d after intervention.Results:Serum BDNF, VEGF, bFGF, NE, E, 5-HIAA, DOPAC, HVA and Bcl-2 levels of both groups 10, 20 and 30 d after intervention were significantly higher than those before intervention while sFas, sFasL and sTRAIL levels were significantly lower than those before intervention, and serum BDNF, VEGF, bFGF, NE, E, 5-HIAA, DOPAC, HVA and Bcl-2 levels of intervention group 10, 20 and 30 d after intervention were significantly higher than those of control group while sFas, sFasL and sTRAIL levels were significantly lower than those of control group.Conclusions: Brain reflex instrument combined with acupuncture can significantly improve the convalescent neurotrophic status and nerve cell apoptosis in patients with cerebral infarction.

The influence of tirofiban on the troponin, brain natriuretic peptide, heart function in patients with Acute Myocardial Infarction after PCI

Objective:To observe the influence of tirofiban on the troponin, brain natriuretic peptide, heart function in patients with Acute Myocardial Infarction after PCI and provide scientific basis for treatment of acute myocardial infarction.Methods:A total of 100 cases of hypertensive cerebral hemorrhage patients in our hospital were selected and randomly divided into 2 groups: the control group (50 cases) and the observation group (50 cases). The conventional treatment of PCI was performed on both groups. Tirofiban injection was given to the observation group on the basis of conventional treatment. cTnI, BNP and echocardiography parameters (LVEF, LVEDD, LVESD) were detected before and after treatment.Results:The comparison of cTnI in the two groups before operation was not statistically significant. cTnI in the 2 groups increased 12 h and 24 h after operation. But the cTnI in observation group (0.10±0.23) ng/mL decreased more significantly than that in control group (0.24±0.31) ng/mL, the difference was considered to be statistically significant. The comparison of BNP in the two groups before operation was not statistically significant. BNP in the 2 groups decreased obviously 7 d and 30 d after operation. BNP in observation group decreased more significantly than that in control group and the difference was considered to be statistically significant LVEF in the observation group increased significantly compared with that in control group 7 d after operation. The comparison of LVEDD, LVESD were not considered to be statistically significant. LVEDD and LVESD in the observation group were lower than that in control group obviously 30 d after operation. While the LVEF in the observation group was still higher than that in the control group. The comparsion was considered to be statistically significant.Conclusion:Tirofiban can improve the troponin, brain natriuretic peptide, heart function in patients with Acute Myocardial Infarction after PCI. It can also decrease the heart injury as well as helping the recovery of heart function.

Influence of ginkgolide combined with edaravone on the brain function of elderly patients with acute cerebral infarction and its preventive effect on ischemia reperfusion injury

Objective: To explore the influence of ginkgolide combined with edaravone on the brain function of elderly patients with acute cerebral infarction and its preventive effect on ischemia reperfusion injury. Methods: A total of 126 patients with acute cerebral infarction who were treated in Dazhou Central Hospital between February 2016 and May 2017 were divided into the control group (n=67) and ginkgolide group (n=59) according to different therapies. Control group received routine intravenous thrombolysis + edaravone therapy, and ginkgolide group received routine intravenous thrombolysis + edaravone + ginkgolide therapy. The differences in brain function and nerve ischemia reperfusion injury extent were compared between the two groups. Results: At T1 and T2, serum nerve function indexes NT-proBNP and NSE levels of ginkgolide group were lower than those of control group whereas BDNF levels were higher than those of control group;serum inflammatory mediators MCP-1, NF-κB, CRP and TNF-α levels were lower than those of control group;serum apoptosis molecules caspase-3 and Bax levels were lower than those of control group whereas Bcl-2 levels were higher than those of control group. Conclusion: Ginkgolide combined with edaravone therapy on the basis of intravenous thrombolysis can effectively optimize the brain function and alleviate the ischemia reperfusion injury caused by inflammatory response and apoptosisis in elderly patients with acute cerebral infarction.

Effect of recombinant human brain natriuretic peptide on serum inflammatory factors, neuroendocrine hormones and cardiac function in patients with acute myocardial infarction complicated with heart failure

Objective:To investigate the effect of recombinant human brain natriuretic peptide (BNP) on inflammatory factors, neuroendocrine hormones and cardiac function indexes in patients with acute myocardial infarction complicated with heart failure.Methods:A total of91 cases of acute myocardial infarction with heart failure patients were divided into the control group (n=44) and observation group (n=47) according to the random data table, two groups of patients were given conventional treatment, based on this, the control group was given intravenous infusion of Nitroglycerin Injection treatment, the observation group received intravenous injection of recombinant human brain natriuretic peptide treatment, compared serum inflammatory factors, neuroendocrine hormone and cardiac function and other indexes of two groups before and after treatment.Results: there was no significant difference between the two groups before treatment. After treatment, the levels of TNF-α, hs-CRP, IL-6, MCP-1, LVESD and LVEDD in the two groups were significantly lower than those within the group before treatment, and the observation group was significantly lower than the control group;The two groups after treatment LVEF levels were significantly higher than those in the group before treatment, and the observation group was significantly higher than that of control group;the observation group after treatment PRA, Ang II and ALD and NE levels were significantly lower than those before treatment, and was significantly lower than the control group after treatment, the difference was significant, PRA, Ang, ALD and NE levels of control group before and after the treatment was no significant difference.Conclusion:recombinant human brain natriuretic peptide in the treatment of acute myocardial infarction with heart failure can effectively reduce the serum inflammatory factors and neuroendocrine hormone levels, improve heart function, and have a certain clinical value.

Tongguan Liqiao acupuncture therapy improves dysphagia after brainstem stroke

Tongguan Liqiao acupuncture therapy has been shown to effectively treat dysphagia after stroke-based pseudobulbar paralysis. We presumed that this therapy would be effective for dysphagia after bulbar paralysis in patients with brainstem infarction. Sixty-four patients with dysphagia following brainstem infarction were recruited and divided into a medulla oblongata infarction group（n = 22）, a midbrain and pons infarction group（n = 16）, and a multiple cerebral infarction group（n = 26） according to their magnetic resonance imaging results. All patients received Tongguan Liqiao acupuncture for 28 days. The main acupoints were Neiguan（PC6）, Renzhong（DU26）, Sanyinjiao（SP6）, Fengchi（GB20）, Wangu（GB12）, and Yifeng（SJ17）. Furthermore, the posterior pharyngeal wall was pricked. Before and after treatment, patient swallowing functions were evaluated with the Kubota Water Test, Fujishima Ichiro Rating Scale, and the Standard Swallowing Assessment. The Barthel Index was also used to evaluate their quality of life. Results showed that after 28 days of treatment, scores on the Kubota Water Test and Standard Swallowing Assessment had decreased, but scores on the Fujishima Ichiro Rating Scale and Barthel Index had increased in each group. The total efficacy rate was 92.2% after treatment, and was most obvious in patients with medulla oblongata infarction（95.9%）. These findings suggest that Tongguan Liqiao acupuncture therapy can repair the connection of upper motor neurons to the medulla oblongata motor nucleus, promote the recovery of brainstem infarction, and improve patient＇s swallowing ability and quality of life.

Neuroprotective effect of ischemic preconditioning in focal cerebral infarction: relationship with upregulation of vascular endothelial growth factor

Neuroprotection by ischemic preconditioning has been confirmed by many studies, but the precise mechanism remains unclear. In the present study, we performed cerebral ischemic pre- conditioning in rats by simulating a transient ischemic attack twice （each a 20-minute occlusion of the middle cerebral artery） before inducing focal cerebral infarction （2 hour occlusion-reper- fusion in the same artery）. We also explored the mechanism underlying the neuroprotective effect of ischemic preconditioning. Seven days after ocdusion-reperfusion, tetrazolium chloride staining and immunohistochemistry revealed that the infarct volume was significantly smaller in the group that underwent preconditioning than in the model group. Furthermore, vascular endothelial growth factor immunoreactivity was considerably greater in the hippocampal CA3 region of preconditioned rats than model rats. Our results suggest that the protective effects of ischemic preconditioning on focal cerebral infarction are associated with upregulation of vascu- lar endothelial growth factor.

Hypoxic preconditioning stimulates angiogenesis in ischemic penumbra after acute cerebral infarction

Previous studies have demonstrated the protective effect of hypoxic preconditioning on acute cerebral infarction, but the mechanisms underlying this protection remain unclear. To investigate the protective mechanisms of hypoxic preconditioning in relation to its effects on angiogenesis, we in- duced a photochemical model of cerebral infarction in an inbred line of mice （BALB/c）. Mice were then exposed to hypoxic preconditioning 30 minutes prior to model establishment. Results showed significantly increased vascular endothelial growth factor and CD31 expression in the ischemic penumbra at 24 and 72 hours post infarction, mainly in neurons and vascular endothelial cells. Hypoxic preconditioning increased vascular endothelial growth factor and CD31 expression in the ischemic penumbra and the expression of vascular endothelial growth factor was positively related to that of CD31. Moreover, hypoxic preconditioning reduced the infarct volume and improved neu- rological function in mice. These findings indicate that the protective role of hypoxic preconditioning in acute cerebral infarction may possibly be due to an increase in expression of vascular endothelial growth factor and CD31 in the ischemic penumbra, which promoted angiogenesis.