The Effect of Different Hyperbaric Oxygen Treatment Time Windows on Neurological Function and Prognosis in Acute Cerebral Infarction

Objective:To observe the effects of different hyperbaric oxygen treatment time windows on the prognosis and neurological function of acute cerebral infarction.Method:160 patients with acute cerebral infarction admitted to Xiangyang Central Hospital in Hubei Province were randomly divided into four groups,each with 40 cases,using a random number table method.According to the 2017 guidelines for the treatment of cerebral infarction,the control group received routine treatment for acute cerebral infarction;On the basis of the control group,patients in Group A received hyperbaric oxygen therapy within 48 hours of onset;Group B patients receive hyperbaric oxygen therapy within 3-6 days of onset;Group C patients receive hyperbaric oxygen therapy within 7-12 days of onset.Observe the efficacy,recurrence,and neurological function recovery of four groups of patients after treatment.Result:There was no statistically significant difference in the National Institutes of Health Stroke Scale(NIHSS)and Barthel Index(BI)scores among the four groups before treatment(P>0.05).There were statistically significant differences in NIHSS and BI scores between 14 and 30 days after treatment and before treatment(F=16.352,27.261,11.899,28.326,P<0.05).At 14 and 30 days after treatment,the NIHSS score in Group A decreased compared to the control group,Group B,and Group C,while the BI score increased compared to the control group,Group B,and Group C,with statistical significance(P<0.05).There was no statistically significant difference in NIHSS and BI scores between Group C and the control group after treatment(P>0.05).After 30 days of treatment,the total effective rate of Group A was higher than that of the control group and Group C,and the difference was statistically significant(X2=6.135,P<0.05).The one-year recurrence rate of Group A and Group B is lower than that of Group C and the control group,and the difference is statistically significant(X2=8.331,P<0.05).There was no statistically significant difference in adverse reactions among the four groups(P>0.05).Conclusion:Patients with acute cerebral infarction who receive hyperbaric oxygen therapy within 48 hours can improve neurological function and reduce the recurrence rate.The efficacy of receiving hyperbaric oxygen therapy within 7-12 days of onset is equivalent to that of not receiving hyperbaric oxygen therapy.

Effects of acupuncture therapy on plasma neuropeptide Y levels and resuscitation in patients with very early stage acute cerebral infarction A randomized controlled study

BACKGROUND： It is known that acupuncture therapy can decrease plasma neuropeptide Y （NPY） levels in patients with cerebral infarction, but different types of acupuncture therapy used in various stages of cerebral infarction have not been evaluated. OBJECTIVE： To explore the effect of acupuncture therapy on resuscitation （Xingnao Kaiqiao） and plasma NPY levels in patients with very early stage acute cerebral infarction. DESIGN, TIME AND SETTING： This case-controlled study was performed at the Affiliated Hospital of the Medical College of the Chinese People＇s Armed Police Force between September 2004 and October 2005. PARTICIPANTS： Sixty patients with acute cerebral infarction of ≤ 6 hours were used in this study. Patients were randomly divided into an acupuncture therapy group （n = 30） and a routine treatment group （n = 30）. Another 30 healthy subjects were used as the control group. METHODS： The acupuncture therapy of Xingnao Kaiqiao used in the acupuncture therapy group was based on routine western medical treatment and was performed at bilateral Neiguan （PCG） using the twirling, reinforcing-reducing method, Renzhong （DU26） using heavy bird-pecking needling, Sanyinjiao （SPG） using reinforcing and reducing by lifting and thrusting the needle, Jiquan （HT1）, Weizhong （BL40） and Chize （LU5） using reinforcing and reducing by lifting and thrusting the needle. The acupuncture lasted for 14 days. Patients in the routine treatment group underwent routine medical treatment and no intervention was given to subjects in the control group. MAIN OUTCOME MEASURES： A 4 mL venous blood sample was obtained at different time points, i.e., immediately after hospitalization, the next morning, 7 and 14 days after treatment, to measure plasma NPY levels pre- and post-treatment using the radio-immunity method. RESULTS： The plasma NPY levels were significantly higher in both the routine treatment group and the acupuncture therapy group than in the control group pre- and post-treatment （P 〈 0.01）. In particular, the plasma NPY levels in both the acupuncture therapy group and the routine treatment group were increased 7 days post-treatment but decreased from 7-14 days post-treatment. In addition, the plasma NPY levels were significantly lower in the acupuncture therapy group than in the routine treatment group on day 7 and 14 post-treatment （P 〈 0.01）. CONCLUSION： Acupuncture therapy of Xingnao Kaiqiao can decrease plasma NPY levels in patients with very early stage acute cerebral infarction. In addition, the therapeutic effect of acupuncture with a prolonged therapy time is superior to routine treatment.

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

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

Effects of emergency hyperbaric oxygen therapy on nerve injury, angiogenesis and cerebral blood perfusion in patients with acute cerebral infarction

Objective:To explore the effects of emergency hyperbaric oxygen therapy on nerve injury, angiogenesis and cerebral blood perfusion in patients with acute cerebral infarction.Methods:A total of118 patients with acute cerebral infarction who were treated in the hospital between April 2015 and October 2017 were selected as study subjects and divided into hyperbaric oxygen group (n=59) and control group (n=59) by random number table method. Control group received conventional therapy, hyperbaric oxygen group received conventional therapy combined with hyperbaric oxygen therapy, and both groups were treated for 2 weeks. The differences in nerve injury, angiogenesis and cerebral blood perfusion were compared between the two groups before and after treatment.Results: Differences in nerve injury, angiogenesis and cerebral perfusion were not significant between the two groups immediately after diagnosis. After 2 weeks of treatment, serum nerve injury indexes IGF-1, Copeptin, PAO, AQP4 and H-FABP contents of hyperbaric oxygen group were lower than those of control group;serum angiogenesis indexes PEDF, Ang-1 and VEGF contents were higher than those of control group whereas ES content was lower than that of control group;stenotic-side cerebral blood perfusion parameters CBF and CBV levels were higher than those of control group whereas TTP level was lower than that of control group.Conclusion: Emergency hyperbaric oxygen therapy can effectively reduce nerve injury, promote cerebral angiogenesis and increase cerebral blood perfusion in patients with acute cerebral infarction.

Effects of adjuvant danhong injection therapy on nerve injury and platelet activation markers in patients with acute cerebral infarction

Objective:To investigate the effects of adjuvant danhong injection therapy on nerve injury and platelet activation markers in patients with acute cerebral infarction.Methods: A total of 102 patients with acute cerebral infarction who were treated in our hospital between January 2016 and September 2017 were reviewed and divided into the routine group (n=54) who received conventional therapy and the danhong injection group who received adjuvant danhong injection therapy. The differences in the contents of nerve injury indexes in serum and platelet activation markers in peripheral blood were compared between the two groups before treatment, after 3 d of treatment and after 7 d of treatment.Results: There was no statistically significant difference in the contents of nerve injury indexes in serum and platelet activation markers in peripheral blood between the two groups before treatment. After 3 d of treatment and after 7 d of treatment, copeptin, H-FABP and NSE contents in serum of danhong injection group were lower than those of routine group whereas BDNF and bFGF contents were higher than those of routine group;CD62p, CD42b, PAC-1 and PMA contents in peripheral blood were lower than those of routine group.Conclusion: Conventional therapy combined with adjuvant danhong injection therapy can effectively reduce the degree of nerve injury and inhibit the platelet activation in patients with acute cerebral infarction.

Effects of Intravenous Thrombolytic Therapy with Alteplase on Neurological Function,Coagulation Function and Serum Inflammatory Factors in Patients with Acute Cerebral Infarction

Objective:To investigate the effects of intravenous thrombolysis therapy with alteplase on neurological function,coagulation function and serum inflammatory factors in patients with acute cerebral infarction.Methods:A total of 96 patients with acute cerebral infarction admitted to our hospital from September 2017 to October 2019 were randomly divided into two groups,with 48 patients in each group.The control group(n=48)received routine treatment,and the observation group received intravenous thrombolysis therapy with alteplase on the basis of routine treatment.The neurological deficit score,prothrombin time(PT),activated partial thromboplastin time(APTT),tumor necrosis factor-a level(TNF-α),and high-sensitivity C-reactive protein(hs-CRP)were compared between the two groups after 15 days of treatment.Results:After treatment,NIHSS scores in both groups were lower than those before treatment;PT levels were increased,while APTT,TNF-αand hs-CRP levels were all decreased in both groups,and the changes in the observation group were greater than those in the control group,with statistically significant difference(P<0.05).Conclusions:Intravenous thrombolysis therapy with alteplase can improve the neurological function,coagulation function and serum levels of inflammatory factors in patients with acute cerebral infarction,which is worthy of clinical application.

Differences in the effect of intravenous alteplase thrombolysis and non-thrombolytic therapy on the neurological function in patients with acute cerebral infarction

Objective:To study the differences in the effect of intravenous alteplase thrombolysis and non-thrombolytic therapy on the neurological function in patients with acute cerebral infarction as well as the specific molecular mechanism.Methods:Patients with acute cerebral infarction who were treated in our hospital between April 2013 and May 2016 were selected and randomly divided into two groups, thrombolysis group received intravenous alteplase thrombolysis and non-thrombolysis group received conventional treatment. After treatment, transcranial color Doppler ultrasound was used to assess intracranial blood flow, and serum was collected to detect blood coagulation function indexes, nerve injury indexes and inflammatory stress response indexes.Results:1 week and 2 weeks after treatment, middle cerebral artery Vs, Vd and Vm levels of thrombolysis group were significantly higher than those of non-thrombolysis group;2 weeks after treatment, serum FVIII, VWF, S100β, NSE, GFAP, MBP, UCH-L1, TNF-α, IL-1β, MDA, AOPP and 8-OHdG content of thrombolysis group were significantly lower than those of control group while PT, TT and APTT were significantly higher than those of control group.Conclusion: Intravenous alteplase thrombolysis can improve cerebral blood perfusion and alleviate nerve injury in patients with acute cerebral infarction, and inhibiting blood coagulation process as well as oxidizing and inflammatory reaction is the molecular mechanism for alteplase to achieve therapeutic action.

Effect of adjuvant therapy with ginkgo-damole on apoptosis, nerve injury and platelet aggregation of patients with acute cerebral infarction

Objective:To investigate the effect of adjuvant therapy with ginkgo-damole on apoptosis, nerve injury and platelet aggregation of patients with acute cerebral infarction. Methods:A total of 74 patients with acute cerebral infarction treated in our hospital from March 2014 to December 2015 were retrospectively analyzed, and they were divided into ginkgo-damole group and conventional treatment group according to a therapeutic schedule that whether ginkgo-diyidamolum were included. At Week 2 and Week 4 after treatment, contents of apoptosis molecule, nerve injury molecule and index of platelet aggregation in serum were detected. Results:At Week 2 after treatment, contents of soluble Fas, soluble Fas ligand, soluble tumor necrosis factor related apoptosis inducing ligand, S100β, neuron specific enolase, glial fibrillary acidic protein, myelin basic protein, malonaldehyde, endothelin-1, fibrinogen and D-dimer in patients' sera of ginkgo-damole group were significantly lower than those of conventional treatment group. Contents of nitric oxide in sera were obviously higher than that of conventional treatment group. At Week 4 after treatment, contents of soluble Fas, soluble Fas ligand, soluble tumor necrosis factor related apoptosis inducing ligand, S100β, neuron specific enolase, glial fibrillary acidic protein, myelin basic protein, malonaldehyde, endothelin-1, fibrinogen and D-dimer in patients' sera of ginkgo-damole group were significantly lower than those of conventional treatment group. Contents of nitric oxide in sera were obviously higher than that of conventional treatment group. Conclusions:Adjuvant therapy with ginkgo-damole can inhibit the apoptosis of neuron cells and neurogliocyte and reduce the neural function injury and the situation of platelet aggregation.

Effects of butyphthalide combined with routine anticoagulant and antioxidant therapy on nerve function, angiogenesis and free radical generation in patients with acute cerebral infarction

Objective: To investigate the effects of butyphthalide combined with routine anticoagulant and antioxidant therapy on the nerve function, angiogenesis and free radical generation in patients with acute cerebral infarction. Methods: A total of 142 patients with acute cerebral infarction who were treated in this hospital between August 2014 and January 2017 were collected as research subjects and divided into control group (n=71) and butyphthalide group (n=71) by random number table method. Control group received routine anticoagulant and antioxidant therapy, and butyphthalide group received butyphthalide combined with routine anticoagulant and antioxidant therapy. The differences in serum nerve function indexes, angiogenesis indexes and free radical generation-related indexes were compared between the two groups before and after treatment. Results: Before treatment, there was no statistically significant difference in serum levels of nerve function indexes, angiogenesis indexes and free radical generation-related indexes between the two groups of patients. After treatment, serum nerve function index IGF-1 level of butyphthalide group was higher than that of control group whereas copeptin, PAO and H-FABP contents were lower than those of control group;serum angiogenesis indexes VEGF, MMP-2 and MMP-9 contents were higher than those of control group;serum contents of free radical generation-related indexes ROS and MDA were lower than those of control group. Conclusions: Butyphthalide combined with routine anticoagulant and antioxidant therapy can effectively optimize the nerve function, promote the cerebral angiogenesis and inhibit the free radical generation in patients with acute cerebral infarction.

Effects of Xuefu Zhuyu Decoction combined with conventional therapy on inflammatory response, oxidative stress, endothelium and related factors in patients with acute cerebral infarction

Objective: To explore the effects of Xuefu Zhuyu Decoction combined with conventional therapy on inflammatory response, oxidative stress, endothelium and related factors in patients with acute cerebral infarction. Methods: A total of 162 patients with acute cerebral infarction admitted to our hospital from November 2016 to January 1818 were selected as subjects. According to the random sampling method, the subjects were divided into 81 cases in the control group and 81 cases in the observation group. The control group was treated with conventional intracranial pressure, anticoagulation, anti-oxidation and lipid-lowering treatment. The observation group was treated with Xuefu Zhuyu Decoction on the basis of the control group. The changes of inflammatory response, oxidative stress, endothelium and related factors were compared and analyzed. Results:Before treatment, the levels of TNF-α, CRP, SOD, MDA, AOPPS, NO, ET-1, MMP-9, PAF and IGF-1 in the two groups were not significantly different, and there was no statistical significance. After treatment, the levels of TNF-α and CRP in the two groups were significantly lower than those before treatment, and the levels of TNF-α and CRP in the observation group were significantly lower than control group;the levels of MDA and AOPPS in the two groups were significantly lower than those before treatment, while the level of SOD was significantly higher than before treatment, and the levels of MDA and AOPPS in the observation group were significantly lower than control group, while the level of SOD was significantly higher. In the control group;the level of ET-1 in the two groups was significantly lower than that before treatment, while the level of NO was significantly higher than that before the treatment, and in the observation group the level of ET-1 was significantly lower than the control group, while the level of NO was significantly higher. In the control group;the levels of MMP-9 and PAF in the two groups were significantly lower than those before treatment, while the level of IGF-1 was significantly higher than before treatment, and the levels of MMP-9 and PAF in the observation group were significantly lower than control group, while the level of IGF-1 was significantly higher than control group. Conclusions: Xuefu Zhuyu Decoction combined with conventional treatment of acute cerebral infarction can effectively reduce inflammation and oxidative stress, improve vascular endothelial function and nerve function, and significantly reduce the degree of brain injury, which has clinical significance.

Analysis of the Effect of Limb Rehabilitation Therapy Combined with Transcranial Magnetic Stimulation Therapy on Muscle Activity in Patients with Upper Limb Dysfunction After Cerebral Infarction

Objective:To analyze the effect of limb rehabilitation therapy combined with transcranial magnetic stimulation therapy on muscle activity in patients with upper limb dysfunction after cerebral infarction(CI).Methods:320 patients with upper limb dysfunction after CI were selected,all of whom were treated in our hospital between June 2021 and June 2023.They were randomly grouped according to the lottery method into the control group(limb rehabilitation therapy,160 cases)and the intervention group(transcranial magnetic stimulation therapy+limb rehabilitation therapy,160 cases).The upper limb function scores,neuro-electrophysiological indicators,daily living ability scores,and quality of life scores of the two groups were compared.Results:Compared with the control group,upper limb function scores and daily living ability scores in the intervention group were higher after treatment,and the neuro-electrophysiological indicators of the intervention group were lower after treatment(P<0.05).Conclusion:Transcranial magnetic stimulation therapy combined with limb rehabilitation therapy has significant effects in patients with upper limb dysfunction after CI and is worthy of promotion and application.

The Effect of Predictive Nursing Intervention on Cardiac Function and Clinical Outcomes in CCU Patients with Acute Myocardial Infarction After Interventional Therapy

Objective:To evaluate the impact of predictive nursing on the care of acute myocardial infarction(AMI)patients in the Coronary Care Unit(CCU)after interventional therapy.Methods:From September 2021 to September 2023,84 AMI patients admitted to the CCU were randomly divided into two groups:the experimental group(42 patients)received predictive nursing,and the reference group(42 patients)received conventional nursing.Cardiac function and clinical outcomes were compared between the groups.Results:Before nursing,there was no difference in cardiac function between the two groups(P>0.05).After nursing,the cardiac function of the experimental group was better than that of the reference group(P<0.05).The clinical outcomes of the experimental group were better than those of the reference group(P<0.05).Before nursing,there was no difference in psychological scores between the two groups(P>0.05).After nursing,the psychological scores of the experimental group were lower than those of the reference group(P<0.05).Conclusion:Predictive nursing can improve the cardiac function and clinical outcomes of AMI patients after interventional therapy and can also regulate patients’negative psychological states.

Effect of fasudil combined with conventional therapy on nerve and blood coagulation function as well as Hcy metabolism in patients with acute cerebral infarction

Objective:To analyze the effect of fasudil combined with conventional therapy on nerve and blood coagulation function as well as Hcy metabolism in patients with acute cerebral infarction. Methods:80 patients with acute cerebral infarction treated in our hospital between January 2013 and January 2013 were selected as the research subjects and divided into observation group (n = 40) and control group (n = 40) according to the random number table. Control group received conventional therapy and observation group received fasudil combined with conventional therapy. After 14 d of treatment, the levels of cerebral blood perfusion parameters, nerve function indexes, platelet function indexes and homocysteine (Hcy) of two groups of patients were determined.Results:After 14 d of treatment, middle cerebral artery and basilar artery peak systolic flow velocity (Vs), low diastolic flow velocity (Vd) and mean flow velocity (Vm) levels of observation group were higher than those of control group (P<0.05);serum nerve function indexes brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) content were higher than those of control group (P<0.05) while phosphatidic acid (PA), neuron-specific enolase (NSE), S100β protein (S100β), and substantia nigra divalent metal transporter 1 (DMT1) content were lower than those of control group (P<0.05);serum platelet function indexes platelet activation-dependent granule membrane protein-140 (GMP-140), fibrinogen receptor-1 (PAC-1), platelet activating factor (PAF) and platelet-derived growth factor BB (PDGF-BB) content were lower than those of control group (P<0.05);serum Hcy content was lower than that of control group (P<0.05).Conclusions:Fasudil combined with conventional therapy can optimize the nerve function and blood coagulation function in patients with acute cerebral infarction, and also plays a positive role in reducing Hcy levels.

CLINICAL REPORT ON IMPROVEMENT OF MOBILITY OF AFFECTED SHOULDER JOINT CAUSED BY ACUTE CEREBRAL INFARCTION TREAT-ED WITH ACUPUNCTURE AND MASSAGE

Objective To observe the effects of acupuncture and massage to improve the mobility of affected shoulder joint caused by acute cerebral infarction. Methods 120 cases of acute cerebral infarction were randomized into two groups, named treatment group with acupuncture and massage and control group with western medicine. Acupoint selection of treatment group with acupuncture and massage： Yōngquán （涌泉 KI1）, Láogōng （劳宫 PC8）, Hòuxī （后溪SI3）, Gōngsūn （公孙 SP4）, Fēngchī （风池 GB20）, Jiānyú （肩髃 LI15）, Qūchí （曲池 LI11）, Hégǔ （合谷 LI4）, Huántiào （环跳 GB30）, Zúsānlǐ （足三里 ST36）, Tàichōng （太冲 LR3）, Anterior Oblique Line of Vertex-Temporal and Posterior Oblique Line of Vertex-Temporal. Massage techniques： roll for relax, hold and press, flick and fiddle, and shake. Control group with western medicine was treated with mannitol ＋ low molecular weight dextran ＋ CDP-choline. Results Compared with control group, treatment group could apparently improve the mobility of shoulder joint and lower the injury percentage （P〈0. 01） ; and the therapeutic effect of treatment group is better than that of control group （P〈0. 05） for treating acute cerebral infarction. Conclusion The therapy of acupuncture combined with massage could improve the function of the affected shoulder joint caused by acute cerebral infarction, and enhance therapeutic effect.

Influences of blood lipids on the occurrence and prognosis of hemorrhagic transformation after acute cerebral infarction: a case-control study of 732 patients

Background: To study the influence of blood lipid levels on hemorrhagic transformation(HT) and prognosis after acute cerebral infarction(ACI).Methods: Patients with ACI within 72 h of symptoms onset between January 1 st, 2015, and December 31 st, 2016, were retrospectively analyzed. Patients were divided into group A(without HT) and group B(HT). The outcomes were assessed after 3 months of disease onset using the modified Rankin Scale(m RS). An m RS score of 0–2 points indicated excellent prognosis, and an m RS score of 3–6 points indicated poor prognosis.Results: A total of 732 patients conformed to the inclusion criteria, including 628 in group A and 104 in group B. The incidence of HT was 14.2%, and the median onset time was 2 d(interquartile range, 1–7 d). The percentages of patients with large infarct size and cortex involvement in group B were 80.8% and 79.8%, respectively, which were both significantly higher than those in group A(28.7 and 33.4%, respectively). The incidence rate of atrial fibrillation(AF) in group B was significantly higher than that in group A(39.4% vs. 13.9%, P<0.001). The adjusted multivariate analysis results showed that large infarct size, cortex involvement and AF were independent risk factors of HT, while total cholesterol(TC) was a protective factor of HT(OR=0.359, 95% CI 0.136–0.944, P=0.038). With every 1 mmol/L reduction in normal TC levels, the risk of HT increased by 64.1%. The mortality and morbidity at 3 months in group B(21.2% and 76.7%, respectively) were both significantly higher than those in group A(8.0% and 42.8%, respectively). The adjusted multivariate analysis results showed that large infarct size(OR=12.178, 95% CI 5.390–27.516, P<0.001) was an independent risk factor of long-term unfavorable outcomes, whereas low-density lipoprotein cholesterol(LDL-C) was a protective factor(OR=0.538, 95% CI 0.300–0.964, P=0.037). With every 1 mmol/L reduction in normal LDL-C levels, the risk of an unfavorable outcome increased by 46.2%. Major therapies, including intravenous recombinant human tissue plasminogen activator(r TPA), intensive lipid-lowering statins and anti-platelets, were not significantly related to either HT or long-term, post-ACI poor prognosis.Conclusions: For patients with large infarct sizes, especially those with cortex involvement, AF, or lower levels of TC, the risk of HT might increase after ACI. The risk of a long-term unfavorable outcome in these patients might increase with a reduction in LDL-C.

Efficacy of cattle encephalon glycoside and ignotin in patients with acute cerebral infarction: a randomized, double-blind, parallel-group, placebo-controlled study

Cattle encephalon glycoside and ignotin(CEGI)injection is a compound preparation formed by a combination of muscle extract from hea lthy rabbits and brain gangliosides from cattle,and it is generally used as a neuroprotectant in the treatment of central and peripheral nerve injuries.However,there is still a need for high-level clinical evidence from large samples to support the use of CEGI.We therefore carried out a prospective,multicenter,randomized,double-blind,parallel-group,placebo-controlled study in which we recruited 319 patients with acute cerebral infarction from 16 centers in China from October 2013 to May 2016.The patients were randomized at a 3:1 ratio into CEGI(n=239;155 male,84 female;61.2±9.2 years old)and placebo(n=80;46 male,34 female;63.2±8.28 years old)groups.All patients were given standard care once daily for 14 days,including a 200 mg aspirin enteric-coated tablet and 20 mg atorvastatin calcium,both taken orally,and intravenous infusion of 250–500 mL 0.9%sodium chloride containing 40 mg sodium tanshinone IIA sulfonate.Based on conventional treatment,patients in the CEGI and placebo groups were given 12 mL CEGI or 12 mL sterile water,respectively,in an intravenous drip of 250 mL 0.9%sodium chloride(2 mL/min)once daily for 14 days.According to baseline National Institutes of Health Stroke Scale scores,patients in the two groups were divided into mild and moderate subgroups.Based on the modified Rankin Scale results,the rate of patients with good outcomes in the CEGI group was higher than that in the placebo group,and the rate of disability in the CEGI group was lower than that in the placebo group on day 90 after treatment.In the CEGI group,neurological deficits were decreased on days 14 and 90 after treatment,as measured by the National Institutes of Health Stroke Scale and the Barthel Index.Subgroup analysis revealed that CEGI led to more significant improvements in moderate stroke patients.No drug-related adverse events occurred in the CEGI or placebo groups.In conclusion,CEGI may be a safe and effective treatment for acute cerebral infarction patients,especially for moderate stroke patients.This study was approved by the Ethical Committee of Peking University Third Hospital,China(approval No.2013-068-2)on May 20,2013,and registered in the Chinese Clinical Trial Registry(registration No.ChiCTR1800017937).

Hypoxic preconditioning stimulates angiogenesis in ischemic penumbra after acute cerebral infarction

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

The Effect of Electro-Acupuncture on Motor Function Recovery in Patients with Acute Cerebral Infarction:A Randomly Controlled Trial

The aim of this study is to investigate the effect of electro-acupuncture treatment in acute phase of cerebral infarction on the motor functions. In this randomly controlled trial, 86 patients were allocated to two groups, the experimental group given clinical and electro-acupuncture treatments for a period of 4 weeks, and the control group given clinical treatment plus active and/or passive functional exercise. The result showed that the level of impairment and disability in both groups were improvement according to the Chinese Stroke Scale, Brunnstrom-Fugl-Meyer score, and Barthel Index throughout the study and 3 months after. The motor functions and the activities of daily living (ADL) were improved significantly in the electro-acupuncture group as compared with the control group (P

Effect of Xuesaitong Soft Capsule (血塞通软胶囊) on Hemorrheology and in Auxiliarily Treating Patients with Acute Cerebral Infarction

Objective: To observe the therapeutic effect of Xuesaitong soft capsule(血塞通软胶囊, XST)and its effect on platelet counts, coagulation factor 1 (CF1) as well as hemorrheologic indexes in treating patients with acute cerebral infarction (ACI). Methods: Two hundred and four patients with ACI were assigned into two groups, the control group (n=96) and the treated group (n=108). They were all treated with conventional Western medicines, including mannitol, troxerutin, citicoline, piracetam and aspirin, while to the treated group, XST was given additionally through oral intake, twice a day, 2 capsules each time for 8 successive weeks. The clinical efficacy was evaluated according to the nerve function deficits scoring and the changes of platelet count. CF1 and hemorrheological indexes were measured before and after treatment.Results: The total effective rate was 87.0% in the treated group, and 87.5% in the control group, respectively, showing insignificant difference between them. But the markedly effective rate in the treated group ( 66.7%) was significantly higher than that in the control group (27.1%, P<0.01). The count of platelet was not changed significantly in both groups after treatment, while CF1 in them evidently lowered at the end of the 4th and 8th weeks of treatment, but showed insignificant difference between the two groups. The hematocrit, whole blood viscosity and plasma viscosity in both groups were all improved significantly after treatment, but also showed insignificant difference in comparison of the two groups. Conclusion: XST has good efficacy in auxiliary treatment of patients with ACI, though its mechanism remains to be further explored.

Efficacy of Solitaire AB stent-release angioplasty in acute middle cerebral artery atherosclerosis obliterative cerebral infarction

BACKGROUND In both national and international studies,the safety and effectiveness of treatment with the Solitaire stent in patients with ischemic stroke caused by acute large vessel occlusion were good,and the disability rate was significantly reduced.However,there are currently only a few reports on the differences in endovascular treatment for different etiological classifications,especially in the anterior cranial circulation,aorta atherosclerotic stenosis,and acute thrombosis.AIM To investigate the efficacy of Solitaire AB stent-release angioplasty in patients with acute middle cerebral artery atherosclerosis obliterative cerebral infarction.METHODS Twenty-five patients with acute middle cerebral atherosclerosis obliterative cerebral infarction were retrospectively enrolled in this study from January 2017 to December 2019.The Solitaire AB stent was used to improve anterior blood flow to maintain modified cerebral infarction thrombolysis[modified thrombolysis in cerebral infarction(mTICI)]at the 2b/3 level or above,the stent was then unfolded and released.RESULTS All 25 patients underwent successful surgery,with an average recanalization time of 23 min.One patient died of cerebral hemorrhage and cerebral herniation after the operation.The National Institutes of Health Stroke Scale(NIHSS)scores immediately after surgery(7.5±5.6),at 24 h(5.5±5.6)and at 1 wk(3.6±6.7)compared with the preoperative NIHSS score(15.9±4.4),were significantly different(P<0.01).One case of restenosis was observed 3 mo after surgery(the stenosis rate was 50%without clinical symptoms),the modified Rankin scale scores were 0 points in 14 cases(56%),1 point in 4 cases(16%),2 points in 2 cases(8%),3 points in 3 cases(12%),4 points in 1 case(4%),and 6 points in 1 case(4%).CONCLUSION In acute middle cerebral artery atherosclerosis obliterative cerebral infarction,when the Solitaire AB stent is unfolded and the forward blood flow is maintained at mTICI level 2b/3 or higher,stent release may be a safe and effective treatment method;however,long-term observation and a larger sample size are required to verify these findings.