Objectives: Inflammation is associated with the occurrence and prognosis of ischemic stroke. The aim of this study was to evaluate the association between inflammatory biomarkers and the short-term clinical outcomes of acute ischemic stroke (AIS) patients after intravenous thrombolysis (IVT). Materials and Methods: A total of 208 AIS patients treated with IVT were enrolled in this retrospective study. Blood tests of inflammatory biomarkers, including the leukocyte count, neutrophil count, lymphocyte count, neutrophil-to-lymphocyte ratio and high-sensitivity C-reactive protein level, were conducted within 24 h after IVT. The primary outcome was decent functional recovery (DFR) [modified Rankin Scale score (mRS) of 0-2] at 3 months. The secondary outcomes included symptomatic intracranial hemorrhage and 3-month mortality. A multivariate analysis was performed to evaluate the associations between inflammatory biomarkers and 3-month clinical outcomes. Results: At 3 months follow-up, 113 (62.2%) patients achieved DFR. As compared to patients with DFR, patients without DFR had higher leukocyte counts (8.5 +/- 2.4 x 109/L versus 6.9 +/- 1.7 pound 10(9)/L, P=0.000), neutrophil counts (6.1 +/- 2.3 x 10(9)/L versus 4.6 +/- 1.7 x 10(9)/L, P=0.000) and neutrophil-to-lymphocyte ratio (4.6 +/- 2.4 versus 3.3 +/- 1.9, P=0.000). After adjusting for the stroke subtype, severity of stroke, and medical history, the leukocyte count and neutrophil count remained significantly correlated with non-DFR (adjusted odds ratio [OR] 1.488; 95% confidence interval [CI], 1.247-1.776; P=0.000 and adjusted OR 1.522; 95% CI, 1.269-1.826; P=0.000, respectively). Conclusions: This study demonstrates that increased levels of inflammatory biomarkers are independently associated with poor outcomes at 3 months in AIS patients treated with IVT.

目的 用计算机网络药理学技术分析柴胡疏肝散治疗卒中后抑郁的有效成分,并预测其作用机制.方法 从中药系统药理学分析平台(TCMSP)中获取柴胡疏肝散的化学成分和靶点,同时利用OMIM、TTD和PharmGkb数据库获取治疗卒中和抑郁的共有靶标.采用Excel筛选分子和靶标,Cytoscape软件建立柴胡疏肝散的中药成分-靶点网络图,通过生物学信息注释数据库(DAVID)对基因功能及代谢通路进行分析.结果 从数据库筛选出柴胡疏肝散122个中药成分与卒中后抑郁的42个靶蛋白相互作用,其中雌激素受体(ESR1)、前列素内环氧化物合成酶2(PTGS2)、糖原合成酶激酶3β(GSK3β)、SLC6A4和白三烯A4水解酶(LTA4H)为柴胡疏肝散治疗卒中后抑郁的作用靶点,主要涉及花生四烯酸代谢通路、5-羟色胺能突触通路、催乳素信号通路和甲状腺激素信号通路,通过调节炎症应答、突触合成、雌激素应答、记忆、生物合成、药物反应和昼夜节律从而治疗卒中后抑郁.结论 通过网络药理学研究揭示了柴胡疏肝散治疗卒中后抑郁的可能机制,为进一步阐明其作用靶点奠定了基础.

Objective The abnormal ankle-brachial index ( ABI) is associated with the incidence of cardiocerebral vascular diseases, but little is known about its relationship with cerebral microbleeds (CMB).This study aimed to investigate the correlation be-tween ABI≤0.9 and different distribution patterns of CMB . Methods We enrolled 187 patients with acute lacunar infarction , inclu-ding 115 non-CMB cases and 72 CMB cases (20 strictly lobar, 24 strictly deep, and 28 lobar and deep).We analyzed the differences between the two groups and the association of abnormal ABI with the occurrence and distribution of CMB by logistic regression analysis . Results ABI≤0.9 was found in 57 (30.5%) of the patients, with a significantly higher incidence rate in the CMB group than in the non-CMB group (43.1%vs 22.6%, P=0.003).The level of ABI was negatively correlated with the number of CMBs (r=-0.211, P=0.006).Multivariate logistic regression analysis after adjusted for confounders indicated that ABI ≤0.9 was significantly associated with the presence of CMB (OR=2.363;95%CI:1.181-4.729), deep CMB (OR=3.434;95%CI:1.283-9.187), and lobar and deep CMB ( OR=2.837;95%CI:1.098-7.333) in patients with ischemic cerebrovascular disease . Conclusion Decreased ABI is a risk factor of CMB, particularly deep CMB, in patients with ischemic stroke.

OBJECTIVE:Subclinical hypothyroidism (SCH) has been associated with atherosclerosis and increased risk of ischaemic stroke. However, whether SCH is associated with cerebral small vessel disease (cSVD) remains largely unexplored. This study aimed to investigate the relationship between SCH and total cSVD burden, a composite measurement detected with magnetic resonance imaging (MRI), in patients with minor ischaemic stroke or transient ischaemic attack (TIA).DESIGN:This was a prospective observational cohort study conducted in a tertiary referral hospital.METHODS:Subclinical hypothyroidism (SCH) was defined as with mildly or moderately increased thyroid-stimulating hormone levels (TSH, 4.5-10.0 mIU/L), but with normal free thyroxine levels. Brain MRI presence of silent lacunar infarcts (LIs), white matter lesions (WMLs), cerebral microbleeds (CMBs) and enlarged perivascular spaces (EPVs) were summed to a validated scales ranging from 0 to 4 to represent the load of cSVD. The associations between SCH and cSVD were analysed by logistic regression analyses.RESULTS:Subclinical hypothyroidism (SCH) was identified in 43 of 229 (18.8%) patients with minor stroke or TIA. Compared with patients without SCH, those with SCH had higher risks of WMLs, CMBs and total cSVD burden. Adjustment of potential confounders did not change these associations.CONCLUSIONS:These findings showed that SCH might be associated with the presence of WMLs, CMBs, as well as cSVD burden in patients with minor stroke or TIA.

Background and Aims. Metabolic syndrome (MetS) has been associated with occurrence and prognosis of ischemic stroke. This study aimed to evaluate whether an association exists between MetS and early neurological deterioration (END) following acute ischemic stroke and the possible role inflammatory biomarkers play. Methods and Results. We conducted a prospective cohort investigation that involved 208 stroke patients within 48 hours from symptom onset. MetS was determined by the modified National Cholesterol Education Program/Adult Treatment Panel III criteria. END was defined as an increase of ⩾1 point in motor power or ⩾2 points in the total National Institutes of Health Stroke Scale (NIHSS) score within 7 days. Univariate logistic regression analysis showed that patients with MetS had a 125% increased risk of END (OR 2.25; 95% CI 1.71–4.86, P = 0.005). After adjustment for fibrinogen and high-sensitivity C-reactive protein, MetS remained significantly correlated to END (OR 2.20; 95% CI 1.10–4.04, P = 0.026) with a 77% elevated risk per additional MetS trait (OR 1.77; 95% CI 1.23–2.58, P = 0.002). Conclusions. This study demonstrated that MetS may be a potential predictor for END after ischemic stroke, which was independent of raised inflammatory mediators.

Objective To investigate the correlation of the level of circulating endothelial progenitor cells (EPCs) and cerebral atherosclerosis burden (CAB) in patients with large artery atherosclerotic stroke (LAAS) and its predictive effect for LAAS.Metlods Consecutive patients with LAAS and healthy controls were enrolled.Flow cytometry wad used to detect EPC level in peripheral blood.CAB was assessed according to the results of CT angiography or magnetic resonance angiography.Univariate analysis was used to compare the demographic and clinical data in both groups.Multivariate logistic regression analysis was used to identify the correlation of circulating EPC level and LAAS.Results A total of 141 patients with LAAS and 100 controls were enrolled.The constituent ratios of hypertension (65.9％ vs.51.0％;x2 =5.443,P =0.020) and diabetes (27.0％ vs.16.0％;x2 =4.035,P=0.045) of the patents,as well as systolic blood pressure (139.1 ± 1 1.1 mmHg vs.131.6 ± 15.7 mmHg;t =3.549,P =0.003;1 mmHg =0.133 kPa) and fasting blood glucose (5.8 ±2.1 mmol/L vs.5.2 ±2.0 mmol/L;t =2.344,P=0.020) in the patient group were significantly higher than those in the control group,while the circulating EPC level (median,interquartile range) (13[3-32] /ml vs.31 [7-59]/ml;Z=3.913,P=0.001) was significantly lower than the control group.Multivariate logistic regression analysis showed that the decreased circulating EPC level (odd ratio 2.632,95％ confidence interval 1.412-4.907,P=0.002) was an independent risk factor for LAAS after adjusting the confounders.The EPC level in the CAB ＞ 3 group was significantly lower than that in the CAB 1 group (5 [2-19]/ml vs.22 [9-43]/ml;Z =3.338,P =0.011).Spearman rank correlation analysis showed that the EPC level was significantly negatively correlated with CAB (r=-0.257,P=0.002).Conclusions The decreased circulating EPC level was an indenpendent risk factor for the onset of LAAS,and the EPC level was negatively correlated with CAB.

目的:观察中西医结合治疗脑梗死恢复期的临床疗效。方法:选取68例患者,随机分为2组。对照组34例,按照缺血性卒中二级预防指南常规治疗;治疗组34例,在对照组治疗基础上加用益气养阴活血方。2组疗程均为4周。比较2组临床疗效、NIHSS评分及血流动力学参数。结果:治疗组总有效率82.4%,明显高于对照组的61.8%;治疗组较对照组更能显著降低NIHSS评分,增加平均血流速度及平均血流量,降低外周血管阻力。结论:中西医结合治疗期脑梗死恢复期,可显著提高疗效,减少神经功能缺损症状、体征,改善血流动力学。

帕金森病(PD)是一种好发于中老年人群以中脑黑质和纹状体通路变性为主的慢性神经系统变性疾病,临床上以静止性震颤、运动迟缓进行性加重、肌强直、姿势步态异常为特征。对北京、上海、西安三地29454位年龄大于55岁受访者的调查表明,65岁以上PD患病率男性为1.7%、女性为1.6%[1]。目前,临床上多采用左旋多巴及其复合制剂治疗PD,但长期服药后会出现疗效减退、异动症、运动波动(开关现象、剂末现象)和幻觉,以及精神障碍等不良反应,仍缺乏持久有效的治疗方案。近年来,笔者在西医常规药物治疗基础上,应用自拟补肾活血通络中药辅助治疗PD患者34例,取得显著疗效,现报道如下。

Objeetive To investigate the clinical and imaging features in patients with corpus callosum infarction.Methods The patients with corpus callosum infarction confirmed by MRI were collected retrospectively.Their clinical manifestations and imaging data were analyzed.Results The corpus callosum infarction accounted for 1.04％ of all patients with cerebral infarction.Its major risk factors were hypertension,coronary heart disease,and diabetes.Its typical clinical manifestations included ideomotor apraxia (42.9％),frontal gait (28.6％) and alien hand syndrome (14.3％) accompanied with limb paralysis,disturbance of consciousness,cognitive impairment and other symptoms.MRI detected 8 corpus callosum lesions.Most were involved in the body of corpus callosum (62.5％),followed by splenium (25.0％) and genu (1/8,12.5％).The frontal lobe (57.1％),basal ganglia (42.9％) and occipital lobe (42.9％) were frequently involved.Diffusion tensor imaging revealed that the fiber connections of the body and genu of corpus callosum were broken in one case.Angiography showed that 6 patients had vascular stenosis or occlusion,and the most common was vertebral artery stenosis (66.7％),followed by anterior cerebral artery (50.0％),and common carotid arery,internal carotid artery and middle cerebral artery stenoses were rare (all 33.3％).Conclusions The incidence of corpus callosum infarction is low.Atherosclerosis is the pathogenic key.Its clinical manifestations are diverse,and they are associated with the sites of infarction.

<正>2011年7月至2013年3月期间,笔者运用中医综合疗法治疗腰椎间盘突出症患者50例,并与采用西药结合功能锻炼治疗的48例作对照,取得较好疗效,现报告如下。1临床资料1.1一般资料我院门诊腰椎间盘突出症患者98例,随机分为2组。治疗组50例:男32例,女18例;

目的:评价脑心疏方对脑梗死急性期患者的疗效及对FIB和血液流变学的影响。方法:选取临床患者80例,随机分为治疗组和对照组各40例。2组患者均按照急性缺血性卒中常规治疗方案给予基本治疗,对照组给予口服拜阿司匹林100mg,每晚1次;治疗组在对照组用药的基础上给予脑心疏方治疗。结果:治疗组总有效率95.00%,显著高于对照组的80.00%;治疗组较对照组更能显著降低中医症候积分及血黏度。结论:脑心疏方治疗急性期脑梗死,可显著提高疗效,减少神经功能缺损症状、体征,改善中医症候,改善血液流变学高凝状态。

本文是国家"十一五"科技攻关课题--周仲瑛学术思想及临症研究的一部分.论文从辨证要点、治疗原则、组方用药三方面,介绍周老诊治慢性肾小球肾炎蛋白尿临床经验,旨在传承国医大师的学术思想,弘扬先大中医.

Theoretical Origin of Traditional Chinese Medicine,Chinese medicine prescriptions discussed, three aspects of modern pharmacological research to explore the body's aging and renal medicine is intrinsically intrinsically linked.Chinese medicine theory as guidance,rely on modern science and technology,further develop the body and TCM kidneys of aging research,to expand scientific research,well - being of human society.

目的:评价曲美他嗪对急性脑血管病患者心脏功能的作用。方法:选择脑卒中后心肌缺血患者320例。随机分为常规治疗组和曲美他嗪治疗组。2组均给予传统抗心绞痛药物(β受体阻滞剂、钙离子拮抗剂、血管紧张素转化酶抑制剂、硝酸盐制剂以及抗血小板药物等)治疗,曲美他嗪治疗组在此基础上加以曲美他嗪;共治疗8周。观察2组患者治疗前后的临床情况以及心脏超声的指标变化。结果:与常规治疗组比较,曲美他嗪组能明显减少心绞痛的发作次数和硝酸甘油的消耗量(P<0.01),提高患者左室射血分数(P<0.01),改善左室舒张功能(P<0.01)。但2组的血压、心率,以及血压心率乘积差异无统计学意义。结论:曲美他嗪能减轻急性脑血管病患者心肌缺血及心绞痛的症状,提高和改善其收缩和舒张功能。