Analysis of The Preventive Effect of Nursing Intervention on Complications After Whole Cerebral Angiography

Objective: To analyze the effect of nursing intervention in preventing complications after whole-brain angiography and reducing the risk of neurological dysfunction, infection, and vascular complications. Methods: One hundred patients who underwent whole-brain angiography in our hospital from December 2022 to December 2023 were selected and randomly divided into control and observation groups of 50 cases each. The control group received routine care, and the observation group received systematic care. The psychological status, complication rate, nursing quality, blood pressure, and nursing satisfaction of the two groups of patients were compared. Results: Before the intervention, there was no significant difference in psychological state between the two groups (P > 0.05). After the intervention, the positive effect (PA) and negative effect (NA) exhibited a significant correlation between the two groups (P < 0.05). The observation group had a lower incidence of postoperative complications as compared to the control group (P < 0.05). The nursing quality and satisfaction of the observation group were significantly higher than those of the control group (P < 0.05). There was no significant difference in blood pressure levels between the two groups before surgery (P > 0.05), while during and after surgery, the blood pressure levels of the two groups of patients showed a highly significant correlation (P < 0.05). Conclusion: Nursing intervention exhibited a significant preventive effect after whole-brain angiography. Scientific and reasonable nursing measures can effectively reduce the incidence of complications and improve the surgical safety and recovery of patients.

Pathogenesis of diabetic cerebral vascular disease complication

Diabetes mellitus is one of the most potent independent risk factors for the development of diabetic cerebral vascular disease(CVD). Many evidences suggested that hyperglycemia caused excess free fatty acids, the loss of endothelium-derived nitric oxide, insulin resistance, the prothrombotic state, endothelial dysfunction, the abnormal release of endothelial vasoactivators,vascular smooth muscle dysfunction, oxidative stress, and the downregulation of mi Rs participated in vessel generation and recovery as well as the balance of endotheliocytes. In turn, these abnormalities, mainly via phosphatidylinositol 3 kinase, mitogen-activated protein kinase, polyol, hexosamine, protein kinase C activation, and increased generation of advanced glycosylation end products pathway, play an important role in inducing diabetic CVD complication. A deeper comprehension of pathogenesis producing diabetic CVD could offer base for developing new therapeutic ways preventing diabetic CVD complications, therefore, in the paper we mainly reviewed present information about the possible pathogenesis of diabetic CVD complication.

Effects of endoscopic surgery via different approaches on neurological function and complications in patients with hypertensive cerebral hemorrhage

Objective:To study the effects of different approaches of neuroendoscopic treatment on neurological function and complications of patients with hypertensive cerebral hemorrhage.Methods:72 patients with hypertensive cerebral hemorrhage diagnosed and treated in our hospital were selected as research objects.They were divided into the study group(n=37)and the control group(n=35)according to different approaches.The study group was the lateral fissure approach,and the control group was the anterior coronary suture approach.The curative effect,hematoma clearance,postoperative wake time,postoperative cerebral edema,daily living ability,neurological function,and complications in the two groups were observed.Results:The efficacy of the study group was higher than that of the control group,and the differences were statistically significant(P<0.05).The postoperative cerebral edema,postoperative wake time,and postoperative intracranial pressure in the study group were lower than those in the control group,and the hematoma clearance rate in the study group was higher than that in the control group,the differences were statistically significant(P<0.05);At 3 and 6 months after treatment,the daily living ability of the study group was higher than that of the control group,and neurological dysfunction of the study group was lower than that of the control group(P<0.05);The complication rate of the study group was lower than that of the control group(P<0.05);There was no significant difference in mortality rate between the two groups(P>0.05).Conclusion:Different approaches have different effects on patients with hypertensive intracerebral hemorrhage.Compared with the anterior coronary suture approach,the lateral fissure approach has less damage to nerve function,and has less postoperative complications.

IMM-H004 therapy for permanent focal ischemic cerebral injury and cardiopulmonary complications via CKLF1/CCR4-mediated inflammation pathway

OBJECTIVE To investigate the effects of IMM-H004 on permanent focal cerebral ischemia injury and associated cardiopulmonary complications,further elucidating the molecular mechanisms.METHODS The effects of IMM-H004 were investigated in wild-type(WT) and CKLF1-/-rats.The effects of IMM-H004 on ischemic stroke injury and its cardiopulmonary complications were determined using 2,3,5-triphenyltetrazolium chloride(TTC) staining,behavior tests,magnetic resonance imaging(MRI)scans,enzyme-linked immunosorbent assay(ELISA),Nissl staining,and histo-pathological examination.Multiple molecular experiments including immunohistological staining,immunofluorescence staining,quantitative RT-PCR,Western blotting,and co-immunoprecipitation assays were used to elucidate the underlying mechanisms.RESULTS IMM-H004 treatment provided significant protection against ischemic stroke-induced brain injury and associated cardiopulmonary complications,through CKLF1-depedent-anti-inflammation pathway in rats.IMM-H004 downregulated the amount of CKLF1 and disturbed the combination between CKLF1 and C-C chemokine receptor type 4,suppressing the inflammatory response and protecting the damaged organs in ischemic setting.CONCLUSION This preclinical study established efficacy of IMM-H004 as a potential therapeutic medicine for ischemic stroke and associated cardiopulmonary complications.The protective effects of IMM-H004 may due to its specific mechanism through CKLF1.These results support further efforts to develop IMM-H004 for human clinical trials in acute cerebral ischemia,especially for patients who are not suitable for reperfusion therapy.

Effects of Progressive Muscle Relaxation Training Combined with Emotion Nursing of Traditional Chinese Medicine on Motor Function and Quality of Life in Patients with Cerebral Stroke Complicated with Hemiplegia

OBJECTIVE: To explore the effects of progressive muscle relaxation training combined with emotion nursing of traditional Chinese medicine(TCM) on the motor function and quality of life in patients with cerebral stroke complicated with hemiplegia. METHODS: A total of 100 cases of patients with cerebral stroke complicated with hemiplegia who were admitted to Rehabilitation Medicine Department of Suzhou Municipal Hospital from May 2016 to May 2017 were selected and randomly divided into study group(50 cases) and control group(50 cases), and they were nursed for 1 month. Control group was given routine nursing, and study group was given progressive muscle relaxation training combined with TCM emotion nursing on the basis of routine nursing. The scores of all items were obtained by nurses through questionnaires, and the motor function and quality of life were analyzed and compared between the 2 groups. RESULTS: After nursing, the scores of muscle strength, Barthel index(BI) and Fugl-Meyer motor function scales in study group were higher than those in control group(P < 0.05). The facing scores of coping style in study group were higher than those in control group, and the avoidance score and yielding score were lower than those in control group(P < 0.05). The scores of depression and anxiety in study group were lower than those in control group(P < 0.05). The scores of items in SF-36 life scale in study group were higher than those in control group(P < 0.05). CONCLUSION: Progressive muscle relaxation training combined with TCM emotion nursing is conducive to the recovery of motor function and improvement of quality of life in patients with cerebral stroke complicated with hemiplegia.

CLINICAL OBSERVATION ON TREATMENT OF CEREBRAL APOPLEXY-INDUCED APHASIA BY ACUPUNCTURE

Acupuncture therapy was adopted in the present study to treat aphasia caused by cerebral apoplexy. Among the 24 patients in treatment group, 13 cases were cured, 6 were markedly improved, 4 improved and 1 ineffective. The total effective rate of this group was 95. 8%. Of the patients in the control group, 6 cases were cured, 5 markedly improved, 10 improved and 3 ineffective.The overall curative rate was 87. 5%. The therapeutic results of these two groups were statistically significantly different (P<0.05), the result of the treatment group superior to that of the control group. The obtained results indicate that the acupuncture therapy is an effective way for this illness.

Cerebral and pulmonary embolisms after transcatheter arterial chemoembolization for hepatocellular carcinoma

A cerebral lipiodol embolism is an extremely rare complication of transcatheter arterial chemoembolization for hepatocellular carcinoma. We present a case of cerebral lipiodol embolism that occurred after the third arterial chemoembolization, report the clinical and radiological findings, and review the medical literature.

Pulmonary and cerebral lipiodol embolism after transcatheter arterial hemoembolization in hepatocellular carcinoma

Pulmonary and cerebral lipiodol embolism after transcatheter arterial chemoembolization (TACE) of hepatocellular carcinoma is rare. To our knowledge, only 7 cases have been reported in the literature. We present a case of pulmonary and cerebral lipiodol embolism, and analyzed retrospectively the imaging and clinical data of the patient and conclude the most probable mechanism of pulmonary and cerebral lipiodol embolism, which is different from that of the cases reported previously.

A Preliminary Study on the Effect Evaluation of Electroacupuncture Combined with Balloon Dilation in the Treatment of Dysphagia after Cerebral Infarction

Objective: Dysphagia is a frequent symptom caused by cerebral infarction. This study investigated the effect evaluation and safety of electroacupuncture combined with balloon dilatation on dysphagia after cerebral infarction. Methods: Totally 100 patients with dysphagia after cerebral infarction were enrolled as study subjects and assigned into the control group (treated with balloon dilatation) and the observation group (treated with electroacupuncture and balloon dilatation), with 50 cases in each group. The general data of participants were recorded. Before or after treatment, swallowing function was assessed by water swallow test, standardized swallowing function assessment (SSA), videofluoroscopic swallow study (VFSS), and functional oral intake scale (FOIS). The cerebral hemodynamics, serological indicators, neurological impairment, quality of life (QOL) score were analyzed. Additionally, the occurrence of complications and adverse reactions after treatment was assessed. Results: There was no significant difference in gender, age, BMI, course of disease, and grade of dysphagia between the two groups. Balloon dilatation alone and electroacupuncture combined with balloon dilatation decreased the water swallow test, SSA, and VFSS scores, increased FOIS score, and improved the swallowing function, cerebral hemodynamic parameters, serological indicators, neurological function and QOL, with the better efficacy in the combined therapy. Moreover, combined therapy had lower incidences of complications and adverse reactions than balloon dilatation therapy alone. Conclusion: Electroacupuncture intervention combined with balloon dilatation therapy ameliorates swallowing function, cerebral hemodynamics, serological indicators, neurological function and QOL, and reduces complications and adverse reactions in dysphagia after cerebral infarction.

Cerebral Infarction after Spine Surgery: Report of Two Cases

There has been an increase in spinal surgery for the elderly, with a corresponding potential increase in perioperative complications. In our department, 1833 patients underwent spinal surgery under general anesthesia from April 2001 to October 2012, and 2 of 260 patients aged ≥75 years old had postoperative cerebral infarction. An analysis of the pathogenic mechanism and potential risk factors showed that a history of cerebral infarction was a significant risk factor. Blood pressure rapidly increased on arousal from anesthesia, and particularly on extubation. The change in blood pressure was examined as a potential risk factor for cerebral infarction, but no significant relationship was observed. This result requires further examination in more patients with cerebral infarction after spinal surgery.

Delayed massive cerebral infarction after perioperative period of anterior cervical discectomy and fusion:A case report

BACKGROUND Cerebral infarction is an extremely rare postoperative complication of anterior cervical discectomy and fusion(ACDF),particularly in the delayed setting.We present a case who had a sudden stroke on day 18 after surgery.By sharing our experience with this case,we hope to provide new information about stroke after anterior cervical surgery.CASE SUMMARY We present the case of a 61-year-old man with more than 20 years of hypertension and 14 years of coronary heart disease who had suffered a stroke 11 years ago.The patient was admitted for a multiple ACDF due to symptoms of cervical spondylotic myelopathy and had a sudden stroke on day 18 after surgery.Imaging findings showed a large-area infarct of his left cerebral hemisphere and thrombosis in his left common carotid artery.With the consent of his family,the thrombus was removed and a vascular stent was implanted through an interventional operation.Forty days later,the patient was transferred to a rehabilitation hospital for further treatment.He had normal consciousness but slurred speech at the 1-year follow-up evaluation.The motor and sensory functions of his hemiplegic limbs partially recovered.CONCLUSION This case illustrated that a postoperative stroke related to anterior cervical surgery may be attributed to prolonged carotid retraction and might have a long silent period.Preventive measures include careful preoperative and postoperative examination for high-risk patients as well as gentle and intermittent retraction of carotid artery sheath during operation.

OBSERVATION ON THE THERAPEUTIC EFFECT OF ENCLOSING NEEDLING UNDER CT ORIENTATION FOR TREATMENT OF ISCHEMIC CEREBRAL STROKE AND ITS INFLUENCE ON PLASMA NO

In the present paper, 61 cases of ischemic cerebral apoplexy were randomly divided into enclosing needling group (n=31) and scalpacupuncture group (n=30). After 30 sessions of treatment, there was a significant difference between the two groups in the therapeutic effect (P<0.05), indicating enclosing needling being superior to scalpacupuncture. Both enclosing needling and scalpacupuncture could lower plasma NO content while the former was more apparent in lowering plasma NO level.

Fracture of a cerebral protection device wire in carotid artery stenting： an unexpected complication

There are very few reports concerning the failure of devices used in carotid artery stenting. Here we report a fracture of the distal part of the guiding wire of a cerebral protection device during carotid artery stenting for management of a restenotic lesion after carotid endarterectomy.

ELONGATED-NEEDLE TREATMENT OF URINARY INCONTINENCE CAUSED BY APOPLEXY

In the present paper, the effect of deep insertion of elongated needle onto pelvic nerve(pelvic plexus) for treatment of 32 cases of urinary incontinence caused by apoplexy was observed andcompared to that of filiform needle group (25 cases). Results showed that the total effective rates ofthe elongated needle group and the filiform needle group were 96. 88 % and 68 % respectively, display-ing a significant difference (P【0.05) between the two groups. In addition, mechanisms of elongatedneedle in treatment of incontinence of urine were analyzed preliminarily.

Risk factors for thepostoperative cerebral complicationin patients with acute type A aortic dissection

Background Patients with acute type A aortic dissection have a high incidence of postoperative cerebral complication. Better understanding of the risk factors could help to optimize prevention and treatment strategies. Method A total of 298 patients of acute type A aortic dissection operated in Guangdong Cardiac Institution from 2010.10 to 2014.12 were included, 253 of them were male and the other 45 were female. Their average age was 45.8__. 12.2y. All the patients were divided into cerebral complication and no cerebral complication groups. Data collectedfrom both groups were analyzed by univariate and multivariate analyses to identify the indepen- dent risk factors of postoperative cerebral complication. Result The incidence of postoperative cerebral compli- cation was 37.9% （113/298）. Among 113 patients, temporary nerve damage （TND） group and permanent nerve damage （PND） accounted for 93 cases（31.2%） and 20 cases （6.7%） respectively. Logistic Regress multivariate analysis showed that history of hypertension （OR=2.560, 95%CI, 1.397-4.692, P〈0.01）, total arch replacement （OR=2.315, 95%CI, 1.386-3.869, P〈0.01）, time of aortic arrest （OR=1.008, 95%CI, 1.004-1.012, P〈0.01） and postoperative hypoxemia （OR=1.858, 95%CI, 1.122-3.078, P〈0.05） were the independent risk factors of the post- operative cerebral complication in patients with acute type A aortic dissection. Conclusion Incidence of postop- erative cerebral complication is high in the acute type A aortic dissection patients itsmajor risk factors are hypertension history, total arch replacement, and long duration of aortic arrest or hypoxemia.

通络扶正汤对脑卒中后遗症患者血清Wnt3a、Wnt5a表达量及神经功能影响分析

【目的】分析通络扶正汤(由胆南星、法半夏、桃仁、天麻、全蝎、红花、地龙等中药组成)对脑卒中后遗症患者神经功能及血清分泌型糖蛋白(Wnt)3a、Wnt5a表达量的影响。【方法】采用回顾性研究方法,根据治疗方案的不同将146例脑卒中后遗症风痰瘀阻证患者分为观察组和对照组,每组各73例。对照组给予常规西药及康复治疗,观察组在对照组的基础上给予通络扶正汤治疗,疗程为3周。观察2组患者治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、Berg平衡量表(BBS)评分、Fugl-Meyer量表(FMA)评分、Holden步行功能分级(FAC)、躯干屈伸肌群表面肌电均方根值(RMS)及血清Wnt3a、Wnt5a表达量的变化情况,并比较2组患者的临床疗效和不良反应发生率。【结果】(1)治疗3周后,观察组的总有效率为95.89%(70/73),对照组为79.45%(58/73),组间比较,观察组的疗效明显优于对照组(P<0.01)。(2)治疗后,2组患者的NIHSS评分均较治疗前明显降低(P<0.05),BBS、FMA评分均较治疗前明显升高(P<0.05),且观察组对NIHSS评分的降低幅度及对BBS、FMA评分的升高幅度均明显优于对照组(P<0.01)。(3)治疗后,2组患者的FAC分级均较治疗前改善(P<0.05),且观察组对FAC分级的改善作用明显优于对照组(P<0.05)。(4)治疗后,2组患者的竖脊肌、腹直肌表面肌电RMS值均较治疗前明显升高(P<0.05),且观察组对竖脊肌、腹直肌表面肌电RMS值的升高幅度均明显优于对照组(P<0.01)。(5)治疗后,2组患者的血清Wnt3a、Wnt5a表达量均较治疗前明显升高(P<0.05),且观察组对血清Wnt3a、Wnt5a表达量的升高幅度均明显优于对照组(P<0.01)。(6)观察组的不良反应发生率为4.11%(3/73),对照组为6.85%(5/73),组间比较,差异无统计学意义(P>0.05)。【结论】通络扶正汤可有效减轻脑卒中后遗症患者神经功能受损程度及运动障碍,提高平衡能力及治疗效果,增强躯干屈伸肌群肌力,上调血清Wnt3a、Wnt5a表达量,且不良反应发生率低,具有较高的安全性。

龙胆汤联合足浴治疗脑卒中后失眠临床观察

目的研究龙胆汤内服联合足浴在脑卒中后失眠老年患者中的临床疗效。方法选取66例脑卒中后失眠患者,随机分为对照组和观察组,每组33例。对照组采用艾司唑仑片口服治疗,观察组采用龙胆汤内服联合足浴治疗。疗程均为4周,比较2组患者的临床疗效。结果治疗后观察组总有效率为93.94%(31/33),明显高于对照组的66.67%(22/33),差异有统计学意义(P<0.01)。结论采用龙胆汤内服联合足浴治疗脑卒中后失眠,可有效改善患者睡眠质量,且无明显不良反应,值得临床推广。

脑卒中康复期患者社会疏离、病耻感及生存质量的相关性研究

目的对脑卒中康复期患者社会疏离、病耻感及生存质量进行现状调查、分析其相关性,并探讨生存质量的影响因素。方法选取2022年1月至2023年6月就诊于本院的110例脑卒中患者为研究对象,采用一般资料问卷、一般疏离感量表、社会影响量表、健康调查简表对入组脑卒中患者进行问卷调查。结果共有110例脑卒中患者进入本研究,其中,缺血性卒中82例,出血性卒中28例,年龄48~79岁,平均(54.53±7.45)岁,男性69例,占比62.73%,女性41例,占比37.27%。量表评估结果显示:社会疏离得分(48.58±5.46)分、病耻感得分(70.64±6.45)分、生存质量得分(50.26±6.42)分。脑卒中康复期患者社会疏离得分与病耻感得分间呈现正相关关系(r=0.425,P=0.013);社会疏离得分与生存质量得分间呈负相关关系(r=-0.326,P=0.009);病耻感得分与生存质量得分间负相关关系(r=-0.315,P=0.022)。影响因素分析结果显示:月收入、受教育程度、社会疏离得分及病耻感得分是脑卒中康复期患者生存质量得分的影响因素(P<0.05)。结论脑卒中康复期患者社会疏离水平较高、病耻感水平一般、生存质量水平一般。提示临床护理人员应根据患者具体疾病情况,不仅需要密切关注患者疾病及康复情况,也需要最大限度的降低患者出现的社会疏离和病耻感水平,改善患者可能出现的社会性衰弱,对提高脑卒中康复期患者的生存质量有积极意义。

Effect of JIN's 3-needle technique and motor function trai-ning on upper extremities motor recovery of cerebral apoplexy induced hemiplegia

Objective To observe the clinical effects on upper extremities function recovery of cerebral apoplexy induced hemiplegia by combination of JIN＇s 3-needle technique and motor function trai- ning. Methods Eight-seven cases of cerebral apoplexy induced hemiplegia were randomized into an observation group （44 cases） and a control group （43 cases）. JIN＇s 3-needle technique and motor function training were both adopted for the observation group. Three temporal acupuncture points on the affected side were selected. Three lower arm points, namely Qfichi （曲池 LI 11 ）, Waiguan （外关 TE 5） and Hegu （ 合谷 LI 4） were adopted for flaccid hemiplegia. While 3 upper arm points for relieving spasm, namely Jiquan （极泉HT 1）, Chize （尺泽 LU 5） and Neiguan （内关 PC 6） were chosen for spastic hemiplegia. Motor function training was applied alone for the control group. Treating courses for both groups were 5 weeks. And scores of Brunnstrom and FugI-Meyer assessments of the affected limbs were analyzed. Results Improvement on scores of FugI-Meyer and Brunnstrom assessments were observed for both groups after the treatment（P〈0. 05, P〈0. 01 ）. The post-treatment scores of the observation group was better than that of the control group after the treatment （ P〈0.05, P〈0.01 ）. Conclusion Treat- ment of combination of JIN＇s 3-needle technique with motor function training can obviously improve the motor function of the upper extremities of patients with cerebral apoplexy induced hemiplegia.

血管栓塞介入治疗脑动脉瘤的临床效果及其对并发症发生率的影响分析

目的:研究分析血管栓塞介入治疗脑动脉瘤的临床效果及对并发症发生率的影响。方法:选取2018年1月—2022年1月样本医院接诊的100例脑动脉瘤患者作为研究对象,按照治疗方法将其分为实验组和对照组,每组各50例,实验组选择血管栓塞介入治疗,对照组选择开颅夹闭的手术治疗形式。对比两组患者住院情况、手术的时间、并发症及预后情况。结果:实验组患者住院时间和手术治疗时间均短于对照组,差异有统计学意义(t=4.939、11.839,P<0.05);实验组患者并发症发生率明显少于对照组,差异有统计学意义(χ^(2)=7.162,P<0.05);使用Glasgow评分评价预后,实验组患者预后优秀率高于对照组,差异有统计学意义(χ^(2)=9.091,P<0.05)。结论:使用血管栓塞介入治疗脑动脉瘤效果较好,可改善患者预后、降低并发症、缩短住院时间和手术时间。