BACKGROUND Intracerebral hemorrhage mainly occurs in middle-aged and elderly patients with hypertension,and surgery is currently the main treatment for hypertensive cerebral hemorrhage,but the bleeding caused by surge...BACKGROUND Intracerebral hemorrhage mainly occurs in middle-aged and elderly patients with hypertension,and surgery is currently the main treatment for hypertensive cerebral hemorrhage,but the bleeding caused by surgery will cause damage to the patient's nerve cells,resulting in cognitive and motor dysfunction,resulting in a decline in the patient's quality of life.AIM To investigate associations between cerebral arterial blood flow and executive and cognitive functions in depressed patients after acute hypertensive cerebral hemorrhage.METHODS Eighty-nine patients with depression after acute hypertensive cerebral hemorrhage who were admitted to our hospital between January 2019 and July 2021 were selected as the observation group,while 100 patients without depression who had acute hypertensive cerebral hemorrhage were selected as the control group.The attention span of the patients was assessed using the Paddle Pin Test while executive function was assessed using the Wisconsin Card Sorting Test(WCST)and cognitive function was assessed using the Montreal Cognitive Assessment Scale(MoCA).The Hamilton Depression Rating Scale(HAMD-24)was used to evaluate the severity of depression of involved patients.Cerebral arterial blood flow was measured in both groups.RESULTS The MoCA score,net scores I,II,III,IV,and the total net score of the scratch test in the observation group were significantly lower than those in the control group(P<0.05).Concurrently,the total number of responses,number of incorrect responses,number of persistent errors,and number of completed responses of the first classification in the WCST test were significantly higher in the observation group than those in the control group(P<0.05).Blood flow in the basilar artery,left middle cerebral artery,right middle cerebral artery,left anterior cerebral artery,and right anterior cerebral artery was significantly lower in the observation group than in the control group(P<0.05).The basilar artery,left middle cerebral artery,right middle cerebral artery,left anterior cerebral artery,and right anterior cerebral artery were positively correlated with the net and total net scores of each part of the Paddle Pin test and the MoCA score(P<0.05),and negatively correlated with each part of the WCST test(P<0.05).In the observation group,the post-treatment improvement was more prominent in the Paddle Pin test,WCST test,HAMD-24 score,and MoCA score compared with those in the pre-treatment period(P<0.05).Blood flow in the basilar artery,left middle cerebral artery,right middle cerebral artery,left anterior cerebral artery,and right anterior cerebral artery significantly improved in the observation group after treatment(P<0.05).CONCLUSION Impaired attention,and executive and cognitive functions are correlated with cerebral artery blood flow in patients with depression after acute hypertensive cerebral hemorrhage and warrant further study.展开更多
Focal ischemia due to reduction of cerebral blood flow(CBF),creates 2 zones of damage:the core area,which suffers severe damage,and penumbra area,which surrounds the core and suffers intermediate levels of injury.Obje...Focal ischemia due to reduction of cerebral blood flow(CBF),creates 2 zones of damage:the core area,which suffers severe damage,and penumbra area,which surrounds the core and suffers intermediate levels of injury.Objectives:A novel method is introduced,which evaluates mitochondrial function in the core and in the penumbra,during focal cerebral ischemia.Methods:Wistar rats underwent focal cerebral ischemia by middle cerebral artery occlusion(MCAO)for 60 minutes,followed by 60 minutes of reperfusion.Mitochondrial function was assessed by a unique Multi-Site—Multi-Parametric(MSMP)monitoring system,which measures mitochondrial NADH using fluorometric technique,and CBF using Laser Doppler Flowmetry(LDF).Results:At the onset of occlusion,CBF dropped and NADH increased significantly only in the right hemisphere.CBF levels were significantly lower and NADH significantly higher in the core than in the penumbra.After reperfusion,CBF and NADH recovered correspondingly to the intensity of ischemia.Conclusion:Application of the MSMP system can add significant information for the understanding of the cerebral metabolic state under ischemic conditions,with an emphasis on mitochondrial function.展开更多
Objective:To investigate the effect of Shuxuetong injection on platelet function, hemorheology and cerebral blood flow in patients with ischemic stroke.Methods: One hundred cases of ischemic stroke admitted in our hos...Objective:To investigate the effect of Shuxuetong injection on platelet function, hemorheology and cerebral blood flow in patients with ischemic stroke.Methods: One hundred cases of ischemic stroke admitted in our hospital from February 2015 to January 2017 were randomly divided into control group and observation group. The control group was given routine treatment. The observation group was given Shuxuetong injection on the basis of the control group. The changes of platelet function, hemorheology and cerebral blood flow before and after treatment were detected in both groups.Results: After treatment, the whole blood viscosity, plasma viscosity and fibrinogen level in both groups were significantly lower than those before treatment. The whole blood viscosity, plasma viscosity and fibrinogen level in the observation group were (4.18±0.05) mPa?s, (1.66±0.12) mPa?s and (3.45±0.08) g/L, respectively, which were significantly lower than the control group;After treatment, the levels of MCA, ACA and PCA in both groups were significantly increased. MCA, ACA and PCA levels in the observation group were (70.82±4.13) cm/s, (60.62±3.55) cm/s and (54.11±2.36) cm/s, which were significantly higher than those in the control group;After treatment, the maximum platelet aggregation rate, PLT, MPV and PDW levels in the two groups significantly decreased. The maximum platelet aggregation rate, PLT, MPV and PDW levels in the observation group were (27.93±1.44)% and (155.32±13.46)×109/L, (9.42±0.32) fL and (9.12±0.24) fL, respectively, which were significantly lower than those in the control group. Conclusions: Shuxuetong injection can effectively improve the patient's hemorheology and platelet function, improve the level of cerebral blood flow in patients with significant effect, it is worth further clinical application.展开更多
OBJECTIVE: To explore the curative effects of warming needle moxibustion combined with manipulation massage on cervical spondylotic vertebral arteriopathy and its influence on the cerebral blood flow and cervical vert...OBJECTIVE: To explore the curative effects of warming needle moxibustion combined with manipulation massage on cervical spondylotic vertebral arteriopathy and its influence on the cerebral blood flow and cervical vertebra function. METHODS: A total of 84 patients with cervical spondylotic vertebral arteriopathy admitted to our hospital from February 2016 to June 2017 were selected, and all patients were divided into an observation group (n=42) and a control group (n=42) according to the random number table method. The patients in the control group were given conventional western treatment, and the patients in the observation group were treated with warming needle moxibustion combined with manipulation massage on the basis of the control group. After 4 weeks of treatment, the changes of main clinical symptoms (vertigo, headache, neck and shoulder pain, tinnitus), cervical function (clinical symptoms, clinical examination, daily life action) and cerebral blood flow parameters (average blood flow velocity of left vertebral artery, right vertebral artery and basilar artery) of the 2 groups were observed, and the clinical efficacy of the 2 groups were statistically analyzed. RESULTS: The scores of vertigo, headache, neck and shoulder pain and tinnitus in the 2 groups were all significantly lower than before treatment (P < 0.05), and the clinical symptom scores in the observation group were significantly lower after treatment (P < 0.05);After treatment, the scores of clinical symptoms, clinical examination and daily life action in the 2 groups were significantly higher than those before treatment (P < 0.05), and the increase of cervical vertebral function score in the observation group was better than that in the control group (P < 0.05);The mean blood flow velocity of the left vertebral artery, right vertebral artery and the basilar artery in the 2 groups after treatment were significantly higher than before treatment (P < 0.05), and the increase of the above cerebral blood flow parameters in the observation group were higher than the control group (P < 0.05). The total effective rate was 92.9% in the observation group and 76.2% in the control group after treatment, and the difference between the 2 groups was statistically significant (P < 0.05). CONCLUSION: Warming needle moxibustion combined with manipulation massage can quickly relieve the clinical symptoms of patients with cervical spondylotic vertebral arteriopathy, improve the cervical function and cerebral blood flow parameters, increase the vertebrobasilar artery blood flow, and promote the recovery of the disease.展开更多
BACKGROUND: Presently, clinic memory scale is used to evaluate learning memory ability in most studies, and the influence of difference in measurement condition of individuals exists. OBJECTIVE: To study the correla...BACKGROUND: Presently, clinic memory scale is used to evaluate learning memory ability in most studies, and the influence of difference in measurement condition of individuals exists. OBJECTIVE: To study the correlation between regional cerebral blood flow (rCBF) perfusion and learning memory function in special brain regions of patients with cerebral infarction at convalescent period, and to try to find out a method which can quantitatively evaluate learning ability. DESIGN: Case observation, and correlation analysis. SETTINGS: Shandong Institute for Behavioral Medicine; the Affiliated Hospital of Jining Medical College. PARTICIPANTS: Totally 70 patients with cerebral infarction admitted to Department of Neurology, Jining Medical College between January 2004 and December 2005 were involved. The involved patients, 58 male and 12 female, were averaged (52±3) years, and they were all right handed. They all met the diagnosis criteria instituted by the Fourth National Conference on Cerebrovascular Disease, and were confirmed as cerebral infarction by skull CT or MRI. Informed consents of detected items were obtained from all the patients and relatives. METHODS: When the patients were at convalescent period, their learning and memory ability were measured with “ clinic memory scale (set A)”. The 18 patients whose total mark over 100 were regarded as good learning memory function group; The 23 cases whose total mark less than 70 were regarded as poor learning memory function group. RCBF of hippocampus, nucleus amygdalae, temporal cortex and prefrontal lobe of patients between two groups were measured and compared by single photon emission computed tomography (SPECT). The total scores of the 18 good learning memory patients and 23 poor learning memory patients were taken as dependent variable Y, and their rCBFs of hippocampus, nucleus amygdale, temporal cortex and prefrontal lobe respectively as independent variable X for linear correlation analysis. MAIN OUTCOME MEASURES: Correlation of rCBF in different brain regions and learning memory ability in patients with cerebral infarction. RESULTS: ①The rCBF of hippocampus, nucleus amygdale, temportal cortex and prefrontal cortex of good learning memory function group were significantly higher than those of poor learning memory function group (P 〈 0.05). ②In the good learning memory function group, rCBF of hippocampus, nucleus amygdale, temportal cortex and prefrontal cortex were significantly positively correlated with memory scale scores ( r = 0.961, 0.926, 0.954, 0.907, P 〈 0.05 ) , and also in the poor learning memory function group (r = 0.979, 0.976, 0.991, 0.953, P 〈 0.05 ) . CONCLUSION: The rCBF of hippocampus, nucleus amygdale, temportal cortex and prefrontal cortex of patients with cerebral infarction are significantly positively correlated with memory scale scores. Predicting learning memory ability of patients by quantitative determination of rCBF provides a quantitative and objective method for evaluating learning memory ability.展开更多
In comparison to a carbohydrate-rich breakfast, a nutritionally balanced breakfast reportedly leads to a higher core body temperature because of diet-induced thermogenesis (DIT) and also results in higher task perform...In comparison to a carbohydrate-rich breakfast, a nutritionally balanced breakfast reportedly leads to a higher core body temperature because of diet-induced thermogenesis (DIT) and also results in higher task performance. This study aimed to examine the relationships among the core body temperature, blood glucose level, cerebral blood flow, and cognitive performance when the core body temperature is raised to a similar extent as in DIT in the morning. This crossover study included 18 male participants who performed four sets of cognitive tests in the morning with four different foot baths and glucose intake conditions. In elevated body temperature (EBT) conditions, the core body temperature was increased by a foot bath at 42˚C or 39˚C, while in low body temperature (LBT) conditions, it was maintained at 35˚C by a foot bath;the participants received no glucose or two intakes of 20-g glucose for each thermal condition. In addition to the core body temperature measurement, the cerebral blood flow in the dorsolateral prefrontal cortex (DLPFC) was measured using near-infrared spectroscopy. Three blood collections were performed to measure the changes in blood glucose levels. The results revealed that in the EBT conditions, the core body temperature remained 0.3˚C - 0.5˚C higher than that at wake-up time, while the glucose intake conditions increased blood glucose levels which remained higher than those during fasting. No significant between-treatment difference was observed in the results of cognitive tests. However, the blood flow in the DLPFC increased during the second test period in the EBT/glucose and LBT/glucose conditions, whereas during the fourth test period, it increased solely in the EBT/glucose condition. Thus, in addition to the blood glucose level, an elevated core body temperature within the physiological range may be needed for long-term maintenance of the cerebral blood flow response.展开更多
<strong>Objective</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"><strong>: </strong>To evaluate the clinical value of...<strong>Objective</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"><strong>: </strong>To evaluate the clinical value of transcranial color Doppler ultrasound (TCCD) in assessing cerebral function after cardiopulmonary resuscitation (CPR). </span><b><span style="font-family:Verdana;">Methods</span></b><span style="font-family:Verdana;">: A prospective study was conducted in 52 patients with cardiac arrest treated by CPR from January 2018 to January 2020, and its clinical data were analyzed</span></span><span style="font-family:Verdana;">. </span><span style="font-family:;" "=""><span style="font-family:Verdana;">According to classification of cerebral performance category (CPC), 31 cases (CPC grade 1 - 2) were selected in the good prognosis group and 21 cases (CPC grade 3 - 5) in the poor prognosis group. The cerebral blood flow was measured by transcranial Doppler ultrasound (TCCD) 24 h after CPR, and the differences were compared between the two groups in stroke index, diastolic blood flow velocity (Vd), systolic peak blood flow velocity (Vs) and mean peak blood flow velocity (Vm). The ROC curve of cerebral blood flow after CPR was drawn to predict the prognosis of brain function. </span><b><span style="font-family:Verdana;">Results</span></b><span style="font-family:Verdana;">: The data showed that the pulsatility index of middle cerebral artery of the poor prognosis group decreased within 24 h</span></span><span style="font-family:Verdana;">;</span><span style="font-family:Verdana;">the difference between the two groups was statistically significant (p < 0.05);the Vd, Vs, Vm increased in the good prognosis group</span><span style="font-family:Verdana;">;</span><span style="font-family:;" "=""><span style="font-family:Verdana;">the difference between the two groups was statistically significant (p < 0.05). The ROC curve of cerebral blood flow after CPR was drawn to predict the prognosis of brain function, and the results showed that the area under the curve and the optimal critical value of cerebral blood flow were 0.731 and 5.69. The sensitivity and specificity were 67.3% and 79.1% respectively. </span><b><span style="font-family:Verdana;">Conclusion</span></b><span style="font-family:Verdana;">: The cerebral blood flow increase in the early stage of successful CPR is positively correlated with the prognosis of cerebral functional resuscitation. Monitoring intracranial blood flow after CPR by TCCD has clinical value to evaluate prognosis of brain function.</span></span>展开更多
目的观察不同针灸介入时机对大脑中动脉供血区急性脑梗死神经功能预后的影响。方法回顾性选取2020年1月—2022年8月收治的116例大脑中动脉供血区急性脑梗死患者的临床资料进行分析,根据针灸介入时机分为两组。两组均进行静脉溶栓及常规...目的观察不同针灸介入时机对大脑中动脉供血区急性脑梗死神经功能预后的影响。方法回顾性选取2020年1月—2022年8月收治的116例大脑中动脉供血区急性脑梗死患者的临床资料进行分析,根据针灸介入时机分为两组。两组均进行静脉溶栓及常规药物治疗,观察组61例患者于发病72 h内给予针灸治疗,对照组55例患者于发病2周时给予针灸治疗。检测两组不同时间点侧支循环代偿情况、脑损伤标志物的水平,评估两组不同时间点简易精神状态检查(Mini-mental state examination,MMSE)评分、神经功能评分、Barthel指数(Barthel index,BI)评分、肢体运动功能评分、中医症状评分的差异,统计两组疗效。结果治疗前,两组侧支循环代偿情况比较,差异无统计学意义(P>0.05)。治疗4周和随访时,两组患侧大脑前动脉平均血流速度与对侧大脑中动脉平均血流速度的比值(Ratio of the average flow ve⁃locity of the affected anterior cerebral artery to the average flow velocity of the contralateral middle cerebral artery,iVACA/cVM⁃CA)较治疗前升高,观察组同时间点较对照组更高(P<0.05);两组患侧大脑后动脉平均血流速度与对侧大脑中动脉平均血流速度的比值(Ratio of the average flow velocity of the affected posterior cerebral artery to the average flow velocity of the contralateral middle cerebral artery,iVPCA/cVMCA)与治疗前比较,差异无统计学意义(P>0.05)。治疗前,两组脑损伤标志物比较,差异无统计学意义(P>0.05)。治疗4周和随访时,两组脑源性神经营养因子(Brain-derived neurotrophic factor,BDNF)较治疗前升高,观察组同时间点较对照组更高(P<0.05);两组钙结合蛋白β(Calcium binding proteinβ,S100β)、神经胶质纤维酸性蛋白(Glial fibrillary acid protein,GFAP)较治疗前下降,观察组同时间点较对照组更低(P<0.05)。治疗前,两组Fugl-Meyer评分、中医症状评分等相关评分比较,差异无统计学意义(P>0.05)。治疗4周和随访时,两组MMSE评分、BI评分及上肢和下肢Fugl-Meyer评分较治疗前升高,观察组同时间点较对照组更高(P<0.05);两组美国国立卫生院神经功能缺损(National institutes of health stroke scale,NIHSS)评分、中医症状评分较治疗前下降,观察组同时间点较对照组更低(P<0.05)。观察组总有效率为88.52%(54/61)高于对照组的72.73%(40/55),差异有统计学意义(P<0.05)。结论发病72h内采用针灸治疗可改善大脑中动脉供血区急性脑梗死脑损伤标志物的表达,改善脑血流,促进神经功能的恢复,有利于疾病的康复。展开更多
目的探讨化瘀解痉方联合尼莫地平治疗动脉瘤性蛛网膜下腔出血(Subarachnoid hemorrhage,SAH)后脑血管痉挛患者的疗效及对其血管内皮功能的影响。方法选取2022年1月-2023年1月期间保定市第一中心医院收治的SAH后脑血管痉挛患者90例,按随...目的探讨化瘀解痉方联合尼莫地平治疗动脉瘤性蛛网膜下腔出血(Subarachnoid hemorrhage,SAH)后脑血管痉挛患者的疗效及对其血管内皮功能的影响。方法选取2022年1月-2023年1月期间保定市第一中心医院收治的SAH后脑血管痉挛患者90例,按随机数字表法分为对照组和观察组,每组各45例。对照组给予尼莫地平治疗,观察组在对照组基础上联合化瘀解痉方治疗,均连续治疗15 d。观察两组患者治疗前后神经功能缺损评分(National institute of health stroke scale,NIHSS)、Hunt-Hess分级评分、意识障碍程度评分(Glasgow coma scale,GCS)、血管内皮功能指标[内皮素-1(Endothelin-1,ET-1)、血管内皮生长因子(Vascular endothelial growth factor,VEGF)]、脑血流指标[大脑中动脉平均流速(Mean flow velocity of middle cerebral artery,MCA-Vm)、颈内动脉颅外段平均流速(Mean extracranial velocity of internal carotid artery,VICA-Vm)、脑血管痉挛(Cerebral vasospasm,CAS)指数]改善情况,临床总有效率及不良反应情况。结果治疗后两组患者NIHSS、Hunt-Hess评分均较治疗前降低,GCS评分均较治疗前升高,差异有统计学意义(P<0.05);且观察组NIHSS、Hunt-Hess评分均明显低于对照组,GCS评分明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者ET-1、VEGF水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组ET-1、VEGF水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者MCA-Vm、VICA-Vm及CAS指数均较治疗前降低,差异有统计学意义(P<0.05);且观察组MCA-Vm、VICA-Vm及CAS指数均明显低于对照组,差异有统计学意义(P<0.05)。治疗后观察组临床总有效率91.11%(41/45)明显高于对照组73.33%(33/45),差异有统计学意义(P<0.05)。治疗期间,两组患者均未发生不良反应,也未出现死亡病例。结论化瘀解痉方联合尼莫地平能够改善SAH后脑血管痉挛患者的血管内皮功能,增加脑血流灌注,减轻神经功能损伤,控制病情发展,疗效显著,安全性高。展开更多
文摘BACKGROUND Intracerebral hemorrhage mainly occurs in middle-aged and elderly patients with hypertension,and surgery is currently the main treatment for hypertensive cerebral hemorrhage,but the bleeding caused by surgery will cause damage to the patient's nerve cells,resulting in cognitive and motor dysfunction,resulting in a decline in the patient's quality of life.AIM To investigate associations between cerebral arterial blood flow and executive and cognitive functions in depressed patients after acute hypertensive cerebral hemorrhage.METHODS Eighty-nine patients with depression after acute hypertensive cerebral hemorrhage who were admitted to our hospital between January 2019 and July 2021 were selected as the observation group,while 100 patients without depression who had acute hypertensive cerebral hemorrhage were selected as the control group.The attention span of the patients was assessed using the Paddle Pin Test while executive function was assessed using the Wisconsin Card Sorting Test(WCST)and cognitive function was assessed using the Montreal Cognitive Assessment Scale(MoCA).The Hamilton Depression Rating Scale(HAMD-24)was used to evaluate the severity of depression of involved patients.Cerebral arterial blood flow was measured in both groups.RESULTS The MoCA score,net scores I,II,III,IV,and the total net score of the scratch test in the observation group were significantly lower than those in the control group(P<0.05).Concurrently,the total number of responses,number of incorrect responses,number of persistent errors,and number of completed responses of the first classification in the WCST test were significantly higher in the observation group than those in the control group(P<0.05).Blood flow in the basilar artery,left middle cerebral artery,right middle cerebral artery,left anterior cerebral artery,and right anterior cerebral artery was significantly lower in the observation group than in the control group(P<0.05).The basilar artery,left middle cerebral artery,right middle cerebral artery,left anterior cerebral artery,and right anterior cerebral artery were positively correlated with the net and total net scores of each part of the Paddle Pin test and the MoCA score(P<0.05),and negatively correlated with each part of the WCST test(P<0.05).In the observation group,the post-treatment improvement was more prominent in the Paddle Pin test,WCST test,HAMD-24 score,and MoCA score compared with those in the pre-treatment period(P<0.05).Blood flow in the basilar artery,left middle cerebral artery,right middle cerebral artery,left anterior cerebral artery,and right anterior cerebral artery significantly improved in the observation group after treatment(P<0.05).CONCLUSION Impaired attention,and executive and cognitive functions are correlated with cerebral artery blood flow in patients with depression after acute hypertensive cerebral hemorrhage and warrant further study.
文摘Focal ischemia due to reduction of cerebral blood flow(CBF),creates 2 zones of damage:the core area,which suffers severe damage,and penumbra area,which surrounds the core and suffers intermediate levels of injury.Objectives:A novel method is introduced,which evaluates mitochondrial function in the core and in the penumbra,during focal cerebral ischemia.Methods:Wistar rats underwent focal cerebral ischemia by middle cerebral artery occlusion(MCAO)for 60 minutes,followed by 60 minutes of reperfusion.Mitochondrial function was assessed by a unique Multi-Site—Multi-Parametric(MSMP)monitoring system,which measures mitochondrial NADH using fluorometric technique,and CBF using Laser Doppler Flowmetry(LDF).Results:At the onset of occlusion,CBF dropped and NADH increased significantly only in the right hemisphere.CBF levels were significantly lower and NADH significantly higher in the core than in the penumbra.After reperfusion,CBF and NADH recovered correspondingly to the intensity of ischemia.Conclusion:Application of the MSMP system can add significant information for the understanding of the cerebral metabolic state under ischemic conditions,with an emphasis on mitochondrial function.
文摘Objective:To investigate the effect of Shuxuetong injection on platelet function, hemorheology and cerebral blood flow in patients with ischemic stroke.Methods: One hundred cases of ischemic stroke admitted in our hospital from February 2015 to January 2017 were randomly divided into control group and observation group. The control group was given routine treatment. The observation group was given Shuxuetong injection on the basis of the control group. The changes of platelet function, hemorheology and cerebral blood flow before and after treatment were detected in both groups.Results: After treatment, the whole blood viscosity, plasma viscosity and fibrinogen level in both groups were significantly lower than those before treatment. The whole blood viscosity, plasma viscosity and fibrinogen level in the observation group were (4.18±0.05) mPa?s, (1.66±0.12) mPa?s and (3.45±0.08) g/L, respectively, which were significantly lower than the control group;After treatment, the levels of MCA, ACA and PCA in both groups were significantly increased. MCA, ACA and PCA levels in the observation group were (70.82±4.13) cm/s, (60.62±3.55) cm/s and (54.11±2.36) cm/s, which were significantly higher than those in the control group;After treatment, the maximum platelet aggregation rate, PLT, MPV and PDW levels in the two groups significantly decreased. The maximum platelet aggregation rate, PLT, MPV and PDW levels in the observation group were (27.93±1.44)% and (155.32±13.46)×109/L, (9.42±0.32) fL and (9.12±0.24) fL, respectively, which were significantly lower than those in the control group. Conclusions: Shuxuetong injection can effectively improve the patient's hemorheology and platelet function, improve the level of cerebral blood flow in patients with significant effect, it is worth further clinical application.
文摘OBJECTIVE: To explore the curative effects of warming needle moxibustion combined with manipulation massage on cervical spondylotic vertebral arteriopathy and its influence on the cerebral blood flow and cervical vertebra function. METHODS: A total of 84 patients with cervical spondylotic vertebral arteriopathy admitted to our hospital from February 2016 to June 2017 were selected, and all patients were divided into an observation group (n=42) and a control group (n=42) according to the random number table method. The patients in the control group were given conventional western treatment, and the patients in the observation group were treated with warming needle moxibustion combined with manipulation massage on the basis of the control group. After 4 weeks of treatment, the changes of main clinical symptoms (vertigo, headache, neck and shoulder pain, tinnitus), cervical function (clinical symptoms, clinical examination, daily life action) and cerebral blood flow parameters (average blood flow velocity of left vertebral artery, right vertebral artery and basilar artery) of the 2 groups were observed, and the clinical efficacy of the 2 groups were statistically analyzed. RESULTS: The scores of vertigo, headache, neck and shoulder pain and tinnitus in the 2 groups were all significantly lower than before treatment (P < 0.05), and the clinical symptom scores in the observation group were significantly lower after treatment (P < 0.05);After treatment, the scores of clinical symptoms, clinical examination and daily life action in the 2 groups were significantly higher than those before treatment (P < 0.05), and the increase of cervical vertebral function score in the observation group was better than that in the control group (P < 0.05);The mean blood flow velocity of the left vertebral artery, right vertebral artery and the basilar artery in the 2 groups after treatment were significantly higher than before treatment (P < 0.05), and the increase of the above cerebral blood flow parameters in the observation group were higher than the control group (P < 0.05). The total effective rate was 92.9% in the observation group and 76.2% in the control group after treatment, and the difference between the 2 groups was statistically significant (P < 0.05). CONCLUSION: Warming needle moxibustion combined with manipulation massage can quickly relieve the clinical symptoms of patients with cervical spondylotic vertebral arteriopathy, improve the cervical function and cerebral blood flow parameters, increase the vertebrobasilar artery blood flow, and promote the recovery of the disease.
基金the Grant from Bureau of Science and Technology of Jining City, No.2004JH006
文摘BACKGROUND: Presently, clinic memory scale is used to evaluate learning memory ability in most studies, and the influence of difference in measurement condition of individuals exists. OBJECTIVE: To study the correlation between regional cerebral blood flow (rCBF) perfusion and learning memory function in special brain regions of patients with cerebral infarction at convalescent period, and to try to find out a method which can quantitatively evaluate learning ability. DESIGN: Case observation, and correlation analysis. SETTINGS: Shandong Institute for Behavioral Medicine; the Affiliated Hospital of Jining Medical College. PARTICIPANTS: Totally 70 patients with cerebral infarction admitted to Department of Neurology, Jining Medical College between January 2004 and December 2005 were involved. The involved patients, 58 male and 12 female, were averaged (52±3) years, and they were all right handed. They all met the diagnosis criteria instituted by the Fourth National Conference on Cerebrovascular Disease, and were confirmed as cerebral infarction by skull CT or MRI. Informed consents of detected items were obtained from all the patients and relatives. METHODS: When the patients were at convalescent period, their learning and memory ability were measured with “ clinic memory scale (set A)”. The 18 patients whose total mark over 100 were regarded as good learning memory function group; The 23 cases whose total mark less than 70 were regarded as poor learning memory function group. RCBF of hippocampus, nucleus amygdalae, temporal cortex and prefrontal lobe of patients between two groups were measured and compared by single photon emission computed tomography (SPECT). The total scores of the 18 good learning memory patients and 23 poor learning memory patients were taken as dependent variable Y, and their rCBFs of hippocampus, nucleus amygdale, temporal cortex and prefrontal lobe respectively as independent variable X for linear correlation analysis. MAIN OUTCOME MEASURES: Correlation of rCBF in different brain regions and learning memory ability in patients with cerebral infarction. RESULTS: ①The rCBF of hippocampus, nucleus amygdale, temportal cortex and prefrontal cortex of good learning memory function group were significantly higher than those of poor learning memory function group (P 〈 0.05). ②In the good learning memory function group, rCBF of hippocampus, nucleus amygdale, temportal cortex and prefrontal cortex were significantly positively correlated with memory scale scores ( r = 0.961, 0.926, 0.954, 0.907, P 〈 0.05 ) , and also in the poor learning memory function group (r = 0.979, 0.976, 0.991, 0.953, P 〈 0.05 ) . CONCLUSION: The rCBF of hippocampus, nucleus amygdale, temportal cortex and prefrontal cortex of patients with cerebral infarction are significantly positively correlated with memory scale scores. Predicting learning memory ability of patients by quantitative determination of rCBF provides a quantitative and objective method for evaluating learning memory ability.
文摘In comparison to a carbohydrate-rich breakfast, a nutritionally balanced breakfast reportedly leads to a higher core body temperature because of diet-induced thermogenesis (DIT) and also results in higher task performance. This study aimed to examine the relationships among the core body temperature, blood glucose level, cerebral blood flow, and cognitive performance when the core body temperature is raised to a similar extent as in DIT in the morning. This crossover study included 18 male participants who performed four sets of cognitive tests in the morning with four different foot baths and glucose intake conditions. In elevated body temperature (EBT) conditions, the core body temperature was increased by a foot bath at 42˚C or 39˚C, while in low body temperature (LBT) conditions, it was maintained at 35˚C by a foot bath;the participants received no glucose or two intakes of 20-g glucose for each thermal condition. In addition to the core body temperature measurement, the cerebral blood flow in the dorsolateral prefrontal cortex (DLPFC) was measured using near-infrared spectroscopy. Three blood collections were performed to measure the changes in blood glucose levels. The results revealed that in the EBT conditions, the core body temperature remained 0.3˚C - 0.5˚C higher than that at wake-up time, while the glucose intake conditions increased blood glucose levels which remained higher than those during fasting. No significant between-treatment difference was observed in the results of cognitive tests. However, the blood flow in the DLPFC increased during the second test period in the EBT/glucose and LBT/glucose conditions, whereas during the fourth test period, it increased solely in the EBT/glucose condition. Thus, in addition to the blood glucose level, an elevated core body temperature within the physiological range may be needed for long-term maintenance of the cerebral blood flow response.
文摘<strong>Objective</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"><strong>: </strong>To evaluate the clinical value of transcranial color Doppler ultrasound (TCCD) in assessing cerebral function after cardiopulmonary resuscitation (CPR). </span><b><span style="font-family:Verdana;">Methods</span></b><span style="font-family:Verdana;">: A prospective study was conducted in 52 patients with cardiac arrest treated by CPR from January 2018 to January 2020, and its clinical data were analyzed</span></span><span style="font-family:Verdana;">. </span><span style="font-family:;" "=""><span style="font-family:Verdana;">According to classification of cerebral performance category (CPC), 31 cases (CPC grade 1 - 2) were selected in the good prognosis group and 21 cases (CPC grade 3 - 5) in the poor prognosis group. The cerebral blood flow was measured by transcranial Doppler ultrasound (TCCD) 24 h after CPR, and the differences were compared between the two groups in stroke index, diastolic blood flow velocity (Vd), systolic peak blood flow velocity (Vs) and mean peak blood flow velocity (Vm). The ROC curve of cerebral blood flow after CPR was drawn to predict the prognosis of brain function. </span><b><span style="font-family:Verdana;">Results</span></b><span style="font-family:Verdana;">: The data showed that the pulsatility index of middle cerebral artery of the poor prognosis group decreased within 24 h</span></span><span style="font-family:Verdana;">;</span><span style="font-family:Verdana;">the difference between the two groups was statistically significant (p < 0.05);the Vd, Vs, Vm increased in the good prognosis group</span><span style="font-family:Verdana;">;</span><span style="font-family:;" "=""><span style="font-family:Verdana;">the difference between the two groups was statistically significant (p < 0.05). The ROC curve of cerebral blood flow after CPR was drawn to predict the prognosis of brain function, and the results showed that the area under the curve and the optimal critical value of cerebral blood flow were 0.731 and 5.69. The sensitivity and specificity were 67.3% and 79.1% respectively. </span><b><span style="font-family:Verdana;">Conclusion</span></b><span style="font-family:Verdana;">: The cerebral blood flow increase in the early stage of successful CPR is positively correlated with the prognosis of cerebral functional resuscitation. Monitoring intracranial blood flow after CPR by TCCD has clinical value to evaluate prognosis of brain function.</span></span>
文摘目的观察不同针灸介入时机对大脑中动脉供血区急性脑梗死神经功能预后的影响。方法回顾性选取2020年1月—2022年8月收治的116例大脑中动脉供血区急性脑梗死患者的临床资料进行分析,根据针灸介入时机分为两组。两组均进行静脉溶栓及常规药物治疗,观察组61例患者于发病72 h内给予针灸治疗,对照组55例患者于发病2周时给予针灸治疗。检测两组不同时间点侧支循环代偿情况、脑损伤标志物的水平,评估两组不同时间点简易精神状态检查(Mini-mental state examination,MMSE)评分、神经功能评分、Barthel指数(Barthel index,BI)评分、肢体运动功能评分、中医症状评分的差异,统计两组疗效。结果治疗前,两组侧支循环代偿情况比较,差异无统计学意义(P>0.05)。治疗4周和随访时,两组患侧大脑前动脉平均血流速度与对侧大脑中动脉平均血流速度的比值(Ratio of the average flow ve⁃locity of the affected anterior cerebral artery to the average flow velocity of the contralateral middle cerebral artery,iVACA/cVM⁃CA)较治疗前升高,观察组同时间点较对照组更高(P<0.05);两组患侧大脑后动脉平均血流速度与对侧大脑中动脉平均血流速度的比值(Ratio of the average flow velocity of the affected posterior cerebral artery to the average flow velocity of the contralateral middle cerebral artery,iVPCA/cVMCA)与治疗前比较,差异无统计学意义(P>0.05)。治疗前,两组脑损伤标志物比较,差异无统计学意义(P>0.05)。治疗4周和随访时,两组脑源性神经营养因子(Brain-derived neurotrophic factor,BDNF)较治疗前升高,观察组同时间点较对照组更高(P<0.05);两组钙结合蛋白β(Calcium binding proteinβ,S100β)、神经胶质纤维酸性蛋白(Glial fibrillary acid protein,GFAP)较治疗前下降,观察组同时间点较对照组更低(P<0.05)。治疗前,两组Fugl-Meyer评分、中医症状评分等相关评分比较,差异无统计学意义(P>0.05)。治疗4周和随访时,两组MMSE评分、BI评分及上肢和下肢Fugl-Meyer评分较治疗前升高,观察组同时间点较对照组更高(P<0.05);两组美国国立卫生院神经功能缺损(National institutes of health stroke scale,NIHSS)评分、中医症状评分较治疗前下降,观察组同时间点较对照组更低(P<0.05)。观察组总有效率为88.52%(54/61)高于对照组的72.73%(40/55),差异有统计学意义(P<0.05)。结论发病72h内采用针灸治疗可改善大脑中动脉供血区急性脑梗死脑损伤标志物的表达,改善脑血流,促进神经功能的恢复,有利于疾病的康复。
文摘目的探讨化瘀解痉方联合尼莫地平治疗动脉瘤性蛛网膜下腔出血(Subarachnoid hemorrhage,SAH)后脑血管痉挛患者的疗效及对其血管内皮功能的影响。方法选取2022年1月-2023年1月期间保定市第一中心医院收治的SAH后脑血管痉挛患者90例,按随机数字表法分为对照组和观察组,每组各45例。对照组给予尼莫地平治疗,观察组在对照组基础上联合化瘀解痉方治疗,均连续治疗15 d。观察两组患者治疗前后神经功能缺损评分(National institute of health stroke scale,NIHSS)、Hunt-Hess分级评分、意识障碍程度评分(Glasgow coma scale,GCS)、血管内皮功能指标[内皮素-1(Endothelin-1,ET-1)、血管内皮生长因子(Vascular endothelial growth factor,VEGF)]、脑血流指标[大脑中动脉平均流速(Mean flow velocity of middle cerebral artery,MCA-Vm)、颈内动脉颅外段平均流速(Mean extracranial velocity of internal carotid artery,VICA-Vm)、脑血管痉挛(Cerebral vasospasm,CAS)指数]改善情况,临床总有效率及不良反应情况。结果治疗后两组患者NIHSS、Hunt-Hess评分均较治疗前降低,GCS评分均较治疗前升高,差异有统计学意义(P<0.05);且观察组NIHSS、Hunt-Hess评分均明显低于对照组,GCS评分明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者ET-1、VEGF水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组ET-1、VEGF水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者MCA-Vm、VICA-Vm及CAS指数均较治疗前降低,差异有统计学意义(P<0.05);且观察组MCA-Vm、VICA-Vm及CAS指数均明显低于对照组,差异有统计学意义(P<0.05)。治疗后观察组临床总有效率91.11%(41/45)明显高于对照组73.33%(33/45),差异有统计学意义(P<0.05)。治疗期间,两组患者均未发生不良反应,也未出现死亡病例。结论化瘀解痉方联合尼莫地平能够改善SAH后脑血管痉挛患者的血管内皮功能,增加脑血流灌注,减轻神经功能损伤,控制病情发展,疗效显著,安全性高。