Lung imaging characteristics in a patient infected with Elizabethkingia miricola following cerebral hemorrhage surgery: A case report

BACKGROUND Elizabethkingia miricola is a non-fermenting gram-negative bacterium,which was first isolated from the condensate of the Russian peace space station in 2003.Most studies on this bacterium have been carried out in the laboratory,and clinical case studies are rare.To date,a total of 6 clinical cases have been reported worldwide.CASE SUMMARY We present the first case of postoperative pulmonary infection in a patient with intracerebral hemorrhage due to Elizabethkingia miricola.The imaging character-istics of pulmonary infection were identified and the formulation and selection of the clinical treatment plan for this patient are discussed.CONCLUSION Elizabethkingia miricola infection is rare.When pulmonary infection occurs,computed tomography imaging may show diffuse distribution of a ground glass density shadow in both lungs,the air containing bronchial sign in local areas,thickening of bronchial vascular bundle,and pleural effusion.

Optimization of nursing interventions for postoperative mental status recovery in patients with cerebral hemorrhage

BACKGROUND Hypertensive cerebral hemorrhage(HCH),the most common chronic diseases,has become a topic of global public health discussions.AIM To investigate the role of rehabilitative nursing interventions in optimizing the postoperative mental status recovery phase and to provide clinical value for future rehabilitation of patients with HCH.METHODS This randomized controlled study included 120 patients with cerebral HCH who were contained to our neurosurgery department between May 2021–May 2023 as the participants.The participants have randomly sampled and grouped into the observation and control groups.The observation group received the rehabilitation nursing model,whereas the control group have given conventional nursing.The conscious state of the patients was assessed at 7,14,21,and 30 d postoperatively.After one month of care,sleep quality,anxiety,and depression were compared between the two groups.Patient and family satisfaction were assessed using a nursing care model.RESULTS The results showed that the state of consciousness scores of the patients in both groups significantly increased(P<0.05)after surgical treatment.From the 14th day onwards,differences in the state of consciousness scores between the two groups of patients began to appear(P<0.05).After one month of care,the sleep quality,anxiety state,and depression state of patients were significantly better in the observation group than in the control group(P<0.05).Satisfaction with nursing care was higher in the observation group than in the control group(P<0.05).CONCLUSION The rehabilitation nursing model has a more complete system compared to conventional nursing,which can effectively improve the postoperative quality of life of patients with cerebral hemorrhage and improve the efficiency of mental state recovery;however,further analysis and research are needed to provide more scientific evidence.

Postoperative Care for Patients with Hypertensive Intracerebral Hemorrhage

This article summarizes the postoperative care plan for patients with hypertensive intracerebral hemorrhage(HICH).Nursing strategies are analyzed in terms of the level of consciousness,pupil care,vital sign care,temperature care,complication care,and early rehabilitation care,with the goal of providing reference for follow-up care of HICH patients.

Human-induced pluripotent stem cell-derived neural stem cell exosomes improve blood-brain barrier function after intracerebral hemorrhage by activating astrocytes via PI3K/AKT/MCP-1 axis

Cerebral edema caused by blood-brain barrier injury after intracerebral hemorrhage is an important factor leading to poor prognosis.Human-induced pluripotent stem cell-derived neural stem cell exosomes(hiPSC-NSC-Exos)have shown potential for brain injury repair in central nervous system diseases.In this study,we explored the impact of hiPSC-NSC-Exos on blood-brain barrier preservation and the underlying mechanism.Our results indicated that intranasal delivery of hiPSC-NSC-Exos mitigated neurological deficits,enhanced blood-brain barrier integrity,and reduced leukocyte infiltration in a mouse model of intracerebral hemorrhage.Additionally,hiPSC-NSC-Exos decreased immune cell infiltration,activated astrocytes,and decreased the secretion of inflammatory cytokines like monocyte chemoattractant protein-1,macrophage inflammatory protein-1α,and tumor necrosis factor-αpost-intracerebral hemorrhage,thereby improving the inflammatory microenvironment.RNA sequencing indicated that hiPSC-NSC-Exo activated the PI3K/AKT signaling pathway in astrocytes and decreased monocyte chemoattractant protein-1 secretion,thereby improving blood-brain barrier integrity.Treatment with the PI3K/AKT inhibitor LY294002 or the monocyte chemoattractant protein-1 neutralizing agent C1142 abolished these effects.In summary,our findings suggest that hiPSC-NSC-Exos maintains blood-brain barrier integrity,in part by downregulating monocyte chemoattractant protein-1 secretion through activation of the PI3K/AKT signaling pathway in astrocytes.

Serum vascular endothelial growth factor and cortisol expression to predict prognosis of patients with hypertensive cerebral hemorrhage

BACKGROUND Cerebral hemorrhage is a common and severe complication of hypertension in middle-aged and elderly men.AIM To investigate the correlation between vascular endothelial growth factor(VEGF)and cortisol(Cor)and the prognosis of patients with hypertensive cerebral hemorrhage.METHODS A hundred patients with hypertensive intracerebral hemorrhage were enrolled from January 2020 to December 2022 and assigned to the hypertensive intracerebral hemorrhage group.Another 100 healthy people who were examined at our hospital during the same period were selected and assigned to the healthy group.Peripheral venous blood was collected,and serum Cor and VGEF levels were measured through enzyme linked immunosorbent assay.RESULTS A statistically significant difference in serum Cor and VGEF levels was observed among patients with varying degrees of neurological impairment(P<0.05).Serum Cor and VGEF levels were significantly higher in the severe group than in the mild-to-moderate group.Cor and VEGF levels were significantly higher in patients with poor prognoses than in those with good prognoses.Multiple logistic regression analysis revealed that serum Cor and VGEF levels were independent factors affecting hypertensive intracerebral hemorrhage(P<0.05).CONCLUSION Cor and VGEF are associated with the occurrence and development of hypertensive cerebral hemorrhage and are significantly associated with neurological impairment and prognosis of patients.

Whole-brain CT Perfusion at Admission and During Delayed Time-window Detects the Delayed Cerebral Ischemia in Patients with Aneurysmal Subarachnoid Hemorrhage

Objective To evaluate the utility of computed tomography perfusion(CTP)both at admission and during delayed cerebral ischemia time-window(DCITW)in the detection of delayed cerebral ischemia(DCI)and the change in CTP parameters from admission to DCITW following aneurysmal subarachnoid hemorrhage.Methods Eighty patients underwent CTP at admission and during DCITW.The mean and extreme values of all CTP parameters at admission and during DCITW were compared between the DCI group and non-DCI group,and comparisons were also made between admission and DCITW within each group.The qualitative color-coded perfusion maps were recorded.Finally,the relationship between CTP parameters and DCI was assessed by receiver operating characteristic(ROC)analyses.Results With the exception of cerebral blood volume(P=0.295,admission;P=0.682,DCITW),there were significant differences in the mean quantitative CTP parameters between DCI and non-DCI patients both at admission and during DCITW.In the DCI group,the extreme parameters were significantly different between admission and DCITW.The DCI group also showed a deteriorative trend in the qualitative color-coded perfusion maps.For the detection of DCI,mean transit time to the center of the impulse response function(Tmax)at admission and mean time to start(TTS)during DCITW had the largest area under curve(AUC),0.698 and 0.789,respectively.Conclusion Whole-brain CTP can predict the occurrence of DCI at admission and diagnose DCI during DCITW.The extreme quantitative parameters and qualitative color-coded perfusion maps can better reflect the perfusion changes of patients with DCI from admission to DCITW.

Management of cerebral amyloid angiopathy and atrial fibrillation:We are still far from precision medicine

The use of anticoagulation therapy could prove to be controversial when trying to balance ischemic stroke and intracranial bleeding risks in patients with concurrent cerebral amyloid angiopathy(CAA)and atrial fibrillation(AF).In fact,CAA is an age-related cerebral vasculopathy that predisposes patients to intracerebral hemorrhage.Nevertheless,many AF patients require oral systemic dose-adjusted warfarin,direct oral anticoagulants(such as factor Xa inhibitors)or direct thrombin inhibitors to control often associated with cardioembolic stroke risk.The prevalence of both CAA and AF is expected to rise,due to the aging of the population.This clinical dilemma is becoming increasingly common.In patients with coexisting AF and CAA,the risks/benefits profile of anticoagulant therapy must be assessed for each patient individually due to the lack of a clear-cut consensus with regard to its risks in scientific literature.This review aims to provide an overview of the management of patients with concomitant AF and CAA and proposes the implementation of a risk-based decision-making algorithm.

Nimodipine for treatment of perifocal edema following aspiration and drainage in patients with cerebral hemorrhage

BACKGROUND： After cephalophyma removal, perifocal edema does not disappear subsequently, but progresses occasionally. Nimodipine can improve cerebral blood flow, so it maybe reduce cerebral edema area, and speed up the absorption of edematous fluid. OBJECTIVE： To observe the effect of nimodipine on perifocal edema area and neurologic function in patients with hypertensive intracerebral hemorrhage （HICH） following stereotaxic aspiration. DESIGN： Clinical controlled observation. SETTING： Department of Neurology, Third Hospital Affiliated to Liaoning Medical University. PARTICIPANTS： Totally 116 HICH inpatients admitted to the Department of Neurology, Third Hospital Affiliated to Liaoning Medical University from January 2003 to January 2005 were involved in this experiment. They all met the classification and diagnosis of cerebrovascular disease proposed in 1995 4th National Conference on Cerebrovascular Disease. The bleeding volume ≥ 35 mL was confirmed by skull CT. The involved patients, 64 male and 52 femlae, averaged 63 years old, ranging from 40 to 70 years. All the patients suffered from unilateral cerebral hemisphere hemorrhage, and muscle strength of paralyzed limb was less than degree Ⅲ. Informed consents of therapeutic items were obtained from all the patients and relatives. METHODS： ① According to different wills, the patients were assigned into treatment group （n =60） and control group （n =56）. In the treatment group, the involved patients, 32 male, 28 female, averaged 63 years. They underwent operation and administration of nimodipine. In the control group, the involved patients, 30 male and 26 female, averaged 62 years old. They all underwent operation simply. Patients in the two groups all received stereotaxic aspiration, drainage, dehydration, haemostasis, antiinflammation, blood pressure controlling and other treatments. Patients in the treatment group were also intravenously injected with 0.2 g/L nimodipine（Bayer Medicine Health Care Co., Ltd., Lot No. 021127） at 10 mg/d. One course of treatment was 15 days. ② According to the clinical neurologic function deficit score of stroke proposed in the 4th National Conference on Cerebrovascular Disease （mild： 0-15 points; moderate： 16-30 points; severe： 31-45 points）, neurologic function deficit score and the largest perifocal edema area of patients in two groups were recorded on the 1st, 7th and 15th days after operation. The differences in perifocal edema area and neurologic deficit score between on the 1st and 7th days and between on the 7th and 15th days were calculated. MAIN OUTCOME MEASURES： Changes in the neurologic function deficit score and the largest perifocal edema area. RESULTS： Two of treatment group and 16 of control group died. Finally, 98 patients participated in the final analysis. ①In the treatment group, the difference in the largest perifocal edema area on the postoperative 7th and 15th days and on the 1st day was （1.02±0.07） and （1.86±0.10） cm2, respectively, which changed more significantly as compared with control group, respectively [（0.02±0.04）,（0.61±0.09） cm2,P 〈 0.01]. ② The difference in neurologic function deficit score between on the postoperative 15th and 1st days in the treatment group was larger than that in the control group [（7.23±0.22）,（2.68±0.32） points,P 〈 0.01]. CONCLUSION： Nimodipine obviously reduces perifocal edema area of patients with cerebral hemorrhage following aspiration and drainage, and promotes the recovery of neurologic function.

Curative effect of surgery combined with nerve growth factor preparation treatment of acute cerebral hemorrhage

Objective: To study the effect of surgery combined with nerve growth factor preparation treatment of acute cerebral hemorrhage on nerve cytokines and nerve injury. Methods: 68 patients with acute cerebral hemorrhage who received emergency minimally invasive evacuation of hematoma in Zigong No. 4 People's Hospital between August 2014 and September 2016 were selected and randomly divided into mNGF group and control group, mNGF group received postoperative mouse nerve growth factor preparation combined with conventional therapy, and control group accepted routine postoperative treatment. 10d, 20d and 30d after treatment, the serum was collected to determine the levels of nerve cytokines and nerve injury molecules. Results: 10d, 20d and 30d after treatment, serum BDNF (5.29±0.88 vs. 3.58±0.61, 6.94±0.93 vs. 3.78±0.55, 9.28±1.13 vs. 4.57±0.62 ng/ml), NTF-α (2.94±0.52 vs. 1.35±0.18, 3.88±0.58 vs. 1.51±0.20, 5.21±0.72 vs. 2.95±0.46 ng/ml), NGF (0.89±0.11 vs. 0.62±0.08, 1.02±0.15 vs. 0.78±0.09, 1.45±0.18 vs. 0.92±0.12 ng/ml) and VEGF (147.53±19.52 vs. 110.38±14.28, 184.95±22.51 vs. 121.29±17.85, 237.49±31.28 vs. 145.38±18.31 pg/ml) levels of mNGF group were significantly higher than those of control group while S100β (1.27±0.20 vs. 2.19±0.33, 0.94±0.14 vs. 1.76±0.25, 0.71±0.09 vs. 1.32±0.17 ng/ml), GFAP (2.08±0.36 vs. 4.42±0.55, 1.65±0.25 vs. 3.57±0.51, 1.31±0.17 vs. 2.93±0.42 pg/ml), NSE (34.21±5.82 vs. 73.19±9.35, 27.58±4.12 vs. 58.76±8.28, 22.12±3.25 vs. 39.52±5.28 ng/ml), MBP (5.28±0.93 vs. 11.28±1.86, 3.89±0.51 vs. 9.12±1.14, 3.12±0.41 vs. 6.79±0.94 ng/ml), MDA (6.97±0.93 vs. 14.21±1.87, 5.02±0.78 vs. 11.75±1.76, 3.57±0.62 vs. 8.12±0.99 μmol/L), AOPP(65.19±9.68 vs. 155.62±19.63, 48.59±7.21 vs. 118.75±16.85, 37.83±5.28 vs. 82.11±10.18 μmol/L) and 8-OHdG (4.77±0.67 vs. 10.28±1.52, 3.52±0.51 vs. 9.38±1.15, 2.33±0.41 vs. 6.52±0.92 ng/ml) levels were significantly lower than those of control group. Conclusion: Surgery combined with nerve growth factor preparation treatment of acute cerebral hemorrhage can improve neural nutritional status and reduce nerve injury degree, and it is beneficial to the recovery of neural function.

EFFECT OF ACUPUNCTURE ON NEUROLOGICAL DEFECTS AND DAILY LIFE ABILITY IN PATIENTS WITH ACUTE CEREBRAL HEMORRHAGE

Objective: To observe the effect of acupuncture of Shuigou (GV 26), Neiguan (PC 6), Zusanli (ST 36), etc. on neurological defects and daily life ability in patients with acute cerebral hemorrhage. Methods: Fifty eight cases of acute cerebral hemorrhage patients were randomized into control group (n=28) and treatment group (n=30). Patients of two groups were both treated with intravenous infusion of Mannitol and other expectant medicines. In addition, patients of treatment group were also treated with acupuncture therapy, once daily and continuously for one month. Before and after treatment, the scores of neurological defects and daily life ability (Barthel Index) were given for assessing the therapeutic effect. Results: Following treatment, both scores of neurological defects of two groups decreased significantly (P<0.05), and the score of treatment group was strikingly lower than that of control group (P<0.05). After treatment, values of Barthel Index (BI) of two groups increased considerably in comparison with pre treatment (P<0.01), and the value of BI of treatment group was bigger than that of control group (P<0.05). Conclusion: Acupuncture can improve acute cerebral hemorrhage patients’ nervous function and daily life ability.

Value of inflammatory mediator profiles and procalcitonin in predicting postoperative infection in patients with hypertensive cerebral hemorrhage

BACKGROUND Hypertensive cerebral hemorrhage(HICH)is a common clinical cerebrovascular disease and one of the most serious complications of hypertension.Early warning of the occurrence of infection during treatment and timely anti-infective treatment are of great significance for the early prevention and treatment of postoperative infection in patients with HICH.Changes in the levels of inflammatory mediators,which are closely related to the occurrence and development of postoperative infection,and procalcitonin(PCT),which is a sensitive indicator for diagnosing bacterial infections,are widely used in clinical practice.AIM To explore the application value of inflammatory mediator profiles and PCT in predicting postoperative infection in patients with HICH.METHODS A total of 271 patients who underwent HICH surgery at our hospital between March 2019 and March 2021 were selected and divided into the infection(n=80)and non-infection(n=191)groups according to whether postoperative infection occurred.The postoperative infection status and etiological characteristics of the infective pathogens in the infection group were analyzed.Changes in inflammatory mediator profile indices and PCT levels were compared between the two groups,pre-and postoperatively.RESULTS A total of 109 strains of pathogenic bacteria were detected in the infection group,including 67 strains(61.47%)of gram-negative bacteria,32 strains(29.36%)of gram-positive bacteria,and 10 strains(9.17%)of fungi.The main infection site of the patients in the infection group was the respiratory system(63.75%).Preoperative interleukin(IL)-4,IL-6,IL-10,tumor necrosis factor-α,interferon-γ,and PCT levels were higher in the infection group than in the non-infection group(P<0.05),and there were no significant differences in the IL-2 Levels between the two groups(P>0.05).The inflammatory mediator profile indices and PCT levels were higher in the two groups of patients on the first postoperative day than preoperatively(P<0.05),and were higher than those in the non-infection group(P<0.05).Logistic regression analysis showed that preoperative IL-6 and PCT levels correlated with postoperative infection(P<0.05).Operating characteristic curve analysis results showed that the area under the curve(AUC)values of preoperative IL-6 and PCT levels in predicting postoperative infection in patients with HICH were 0.755 and 0.824,respectively.The AUC value of joint detection was 0.866,which was significantly higher than that of the single index(P<0.05).CONCLUSION Preoperative IL-6 and PCT levels are correlated with postoperative infection in patients with HICH.Their detection is clinically significant for early identification of patients at high risk for postoperative infection.

Inhibitory effects of lidocaine on cerebral vasospasm in a rabbit model of subarachnoid hemorrhage

Following subarachnoid hemorrhage, vasoconstrictor substances, cellular apoptosis, blood coagulation, and vascular cell proliferation affect the onset of cerebral vasospasm. Previous studies from our laboratory have revealed that injection of lidocaine （2 mg） into the cisterna magna reduces cerebral vasospasm and nerve functional impairment in an animal model of subarachnoid hemorrhage. The present study determined the optimal lidocaine dose for vasospasm and brain injury by injecting different doses of lidocaine into the cisterna magna in a rabbit model of subarachnoid hemorrhage. Results showed that endothelin, tumor necrosis factor-a, and interleukin-6 levels significantly increased in plasma, and calcitonin gene-related peptide levels significantly decreased in plasma （P 〈 0.05）. The number of neurons was decreased, the number of cells expressing c-Fos increased in the hippocampus, and cross-sections and diameters of basilar arteries were reduced （P 〈 0.05）. These changes significantly improved following injection of lidocaine （1,2, 4, and 6 mg） into the cisterna magna. A dose of 6 mg lidocaine into the cisterna magna resulted in optimal effects on cerebral vasospasm and brain injury following subarachnoid hemorrhage.

Impact of urinary tract and pulmonary infection on mortality after intracerebral hemorrhage in Brazzaville

Objective: To evaluate the impact of urinary tract and pulmonary infection on mortality after cerebral hemorrhage. Method: We conducted at the University Hospital of Brazzaville, a cross-sectional study from January to August2012 inthe emergency department, neurology and intensive care unit. It included patients admitted for cerebral hemorrhage confirmed by CT-scan. A statistical analysis by logistic regression was carried out to evaluate the correlation between infection and death. Result: Among total of 261 patients for stroke, 82 admitted for cerebral hemorrhage (31.4%). The mean age was 55 ± 11 years (range 26 to 83 years). The sex ratio men/women was 1.7. Hypertension was the most important risk factor to 80.5%. The average intake in neurology time was 28 ± 13 hours. The average time for completion of the CT-scan was 2.4 ± 2 days. Thirty-eight (46.3%) patients had a fever linked to an infectious cause from the third day of hospitalization. The most frequent infectious complications were sepsis (n = 16%;42%), pulmonary infection (n = 14%;37%) and urinary tract infection (n = 8%;21%). Specific mortality of infection was 31.7% (n = 26). The multivariate analysis showed a positive correlation between the occurrence of infection and mortality (p = 0.002), specifically between sepsis and mortality (p = 0.0004), and an association between the time of admission late in neurology and the occurrence of infectious complications (p = 0.0001). Conclusion: Infection is one of the dreaded complications of cerebral hemorrhage. It is often associated with delayed care in specialized areas, and is thereby a preventable cause of death.

Risk factors for intracerebral hemorrhage and coronary heart diseases over a 3-year period in patients admitted to some hospitals of Tongliao city of Nei Monggol Autonomous Region Retrospective analysis on case data

BACKGROUND： Intracerebral hemorrhage（ICH） and coronary heart disease （CHD） have the same pathological base, atherosclerosis, and the similar risk factors,such as smoking ,drinking, hypertension, hyperlipemia, diabetes mellitus, etc; but the distributions of two diseases are very different in the populations. This may be related to the exposure of risk factors and different effects of risk factors on two diseases. OBJECTIVE： To analyze the distribution difference of risk factors for ICH and CHD in the populations of Tongliao city of Nei Monggol Autonomous Region. DESIGN： Retrospective analysis. SETTING： School of Radiation Medicine and Public Health, Soochow University; Tongliao Hospital, Nei Monggol Autonomous Region. PARTICIPANTS： Random sampling was used to select 6 hospitals from 10 hospitals affiliated to Tongliao City of Nei Monggol Autonomous Region. Totally 1 672 medical records of patients with ICH and 2 195 medical records of patients with CHD admitted to Department of Neurology and Department of Cardiovascular Internal Medicine of above-mentioned 6 hospitals between January 2003 and December 2005 were collected according to the investigation need. METHODS： The subjects, whose medical records were involved, were performed retrospective analysis with pre-prepared questionnaire ＂Stroke and Coronary Heart Disease Epidemiologic Questionnaire＂. The main contents included： ①Social demography condition： The distributions of gender, age, nationality, etc. ②Previous history of disease： hypertension, diabetes mellitus, etc. ③Related risk factors： systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, smoking, drinking and glucose （GLU）. The database of Epidata was transformed to SPSS database. Single-and multiple-factor non-conditional Logistic regression analysis were performed on the data, and OR value and 95% CI were calculated. The distribution differences of risk factors for two diseases were compared. MAIN OUTCOME MEASURES： Single- and multi-factor non-conditional Logistic regression analysis results of each factor of patients. RESULTS： Single-factor non-conditional Logistic regression analysis showed that statistical significance existed in gender, age, nationality, smoking, drinking, history of hypertension, history of diabetes mellitus, hypertension, triglyceride （TG）, and GLU ten factors（OR =0.199, OR 95% CI 0.142-0.280 to OR =7.484, OR 95% CI 6.186-9.054, P 〈 0.01）. ②The results of multiple-factor non-conditional Logistic regression analysis showed 8 factors including age, gender, smoking, hypertension, history of hypertension, history of diabetes mellitus, GLU and TG（OR =0.203, OR 95% CI 0.114-0.361 to OR =8.262,OR 95% CI 5.466- 12.491, P 〈 0.01）. CONCLUSION： ICH and CHD are the diseases induced by various risk factors. Significant difference exists in gender, age, smoking, hypertension, history of hypertension, GLU, history of diabetes mellitus and TG.

EXPRESSION OF IL-2 AND SIL-2R AND ALTERATION OF CELL IMMUNITY IN PATIENTS WITH HYPERTENSIVE CEREBRAL HEMORRHAGE

Objective To study the expression of interleukin-2(IL-2), soluble interleukin-2 receptor (sIL-2R), determine the alteration of erythrocytic immunity and T cell subgroup in the blood of outer circulation in patients with hypertensive cerebral hemorrhage so and to probe into the relationship between them, and to explore the clinical significance. Methods Enzyme linked immnunosorbent assay (ELISA) was used to determine the content of IL-2 and sIL-2R. The immunoadsorption was employed to examine the erythrocytic immune activity and its regulating function. Streptavidin-peroxidase(S-P) was used to determine the cell number of CD3 (cluster of differentiation3), CD4 and CD8. Results The content of IL-2 in the group with hypertensive cerebral hemorrhage was significantly lower than that in the control group (P<0.01), and the content of sIL-2R increased. Red blood cell C_ 3b receptor (RBC.C_ 3b R) and RBC immune adherence enhancing factor (RFEB) dropped greatly (P<0.01), while RBC immune complex rosette (RBC.ICR) and RBC immune adherence inhibiting factor (RFIR) increased greatly. The cell number of CD3 and CD4decreased (P<0.01) and there was no obvious change in CD8 (P<0.05). Conclusion The decrease of immune function was observed in patients with hypertensive cerebral hemorrhage. The determination of the content of IL-2, sIL-2R, erythrocytic immunity and the activity of T subgroup has an important clinical significance in the occurrence, development, treatment, and prognosis of hypertensive cerebral hemorrhage.

CT Perfusion Imaging Predicts One-Month Outcome in Patients with Acute Spontaneous Hypertensive Intracerebral Hemorrhage

Purpose: Little is known about the relationship between perihematomal perfusion parameters in acute spontaneous hypertensive intracerebral hemorrhage patients and recent outcome. The purpose of this study was to evaluate the relationship between the perfusion parameters of the perihematomal brain tissue and the recent prognosis of patients with acute spontaneous hypertensive intracerebral hemorrhage (shICH) using CT perfusion (CTP) imaging. Methods: Twenty-six patients with clinical and CT diagnosed supratentorial shICH received CTP scanning within 8 - 19 h after symptom onset. At the maximum levels of the hematoma, cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) of perihematomal area (isodense within 1cm rim of perilesion area on plain CT) and contralateral mirrored hemisphere were measured, and rCBF, rCBV, rMTT were calculated (ipsilateral/contralateral). The one-month follow-up in accordance with daily living table (Barthel index, BI) by telephone was recorded. Results: The CBV, CBF, and MTT values of perihematoma area were (1.61 ± 1.53) ml·100 g-1, (16.48 ± 12.58) ml·100 g-1·min-1, and (9.12 ± 2.57) s, respectively. (For more information,please refer to the PDF)

Common features in patients with intracerebral hemorrhage following superficial temporal artery-middle cerebral artery bypass in steno-occlusive cerebrovascular disease

Five patients treated for intracranial cerebral hemorrhage after superficial temporal artery-middle cerebral artery bypass in Xuwu Hospital, Capital Medical University, Beijing, China, from 2005-2011 were included in this study. Prior to superficial temporal artery-middle cerebral artery bypass, all patients showed diminished cerebrovascular reactivity and an ipsilateral ischemic lesion. Intracranial cerebral hemorrhage developed within 1-4 days following superficial temporal artery-middle cerebral artery bypass. Transcranial Doppler showed increased middle cerebral artery velocity of 50-100% in the operated hemisphere. These findings suggested that focal hyperperfusion, an ipsilateral ischemic lesion and diminished cerebrovascular reactivity are the important characteristics of intracerebral hemorrhage following superficial temporal artery-middle cerebral artery bypass in patients with steno-occlusive cerebrovascular disease.

Traumatic fatal cerebral hemorrhage in an old patient with a history of multiple sclerosis under dabigatran： a case report and review of the literature

直接抗凝剂药的一劣势是一粒解毒药的缺乏，它可以与创伤的大脑损害在病人变得相关。尽管有周期性的下降，有 atrial 纤维性颤动和中略的一个 77 年的老人收到了 dabigatran。由于 ground-level-fall，他与中线移动受不了 subarachnoidal 和 intraparenchymal 出血， subdural hematoma 和大脑浮肿。没有重获知觉，尽管有 osteoclastic 环锯术和 hematoma 撤退，他七天以后仍然保持无知觉、死。最可能，减少了由于增加的年龄，力量贡献了的 dabigatran 清理致命的功课。我们与 unexplained 下降在病人建议抑制抗凝剂治疗。如果抗凝剂治疗被认为必要，有他们为实验室监视和抗凝剂活动的颠倒的潜力的 vitamin-K-antagonists 应该被比较喜欢。

Anticoagulant treatment for pulmonary embolism in patient with cerebral hemorrhage secondary to mechanical thrombectomy: A case report

BACKGROUND Cerebral hemorrhage secondary to cerebral embolism after mechanical thrombectomy is characterized by high morbidity,disability and mortality.If the patient also has severe pulmonary embolism(PE)at the same time,the treatment becomes more complex.This report describes the treatment strategy for a patient with PE and cerebral hemorrhage secondary to cerebral embolism after mechanical thrombectomy.CASE SUMMARY A 70-year-old woman presented to our emergency department with right-sided hemiplegia and mixed aphasia of 2.5 h duration.She was diagnosed with left cerebral embolism,left internal carotid artery occlusion,PE and left calf intramuscular vein thrombosis.Following mechanical thrombectomy,brain magnetic resonance imaging showed cerebral infarction with basal ganglia hemorrhage.We observed changes in cerebral hemorrhage on serial monitoring of brain computed tomography and adjusted the dose of anticoagulant drugs.After 3 wk of treatment,the patient’s neurological and respiratory symptoms significantly improved,and a favorable prognosis was obtained.CONCLUSION Anticoagulation could be a potential option for PE accompanied by hemorrhagic transformation of an ischemic infarct.

Effects of ulinastatin combined with surgery on nerve injury, oxygen free radicals and inflammatory factors production of patients with hypertensive intracerebral hemorrhage

Objective: To study the effects of ulinastatin combined with surgery on nerve injury, oxygen free radicals and inflammatory factors production of patients with hypertensive intracerebral hemorrhage. Methods: The patients with hypertensive intracerebral hemorrhage received surgical treatment in our hospital during February 2015 - December 2017 were selected and divided into two groups by random number table. The observation group received ulinastatin combined surgery and the control group received conventional medicine combined with surgery. Before treatment and 1 weeks after treatment, serum levels of nerve damage markers, neurotrophic indexes, oxygen free radicals production indexes and inflammatory cytokines were measured. Results: After treatment, the contents of NSE, VILIP-1, GFAP, S100B, MDA, AOPP, 8-OHdG, NO, ET-1, TNF-α, sICAM-1, sVCAM-1, sICAM-1 of two groups were all decreased, the contents of BDNF, NGF, VEGF, IGF-I were all increased and the decreasing trend of NSE, VILIP-1, GFAP, S100B, MDA, AOPP, 8-OHdG, NO, ET-1, TNF-α, sICAM-1, sVCAM-1, sICAM-1 of observation group was more obvious than that of the control group, the increasing trend of BDNF, NGF, VEGF, IGF-I content was more obvious than that of the control group. Conclusion: The use of ulinastatin combined with surgery in the treatment of hypertensive intracerebral hemorrhage can significantly reduce the damage of nerve function and reduce the production of oxygen free radicals and inflammatory factors.