Objective:To investigate water exercise therapy's effect on lower limb function rehabilitation in patients with the first stroke.Method:160 patients with the first stroke and lower limb dysfunction who received rehabilitation treatment in the Geriatric Hospital of Hainan, China, from May 2020 to June 2021 were randomly divided into two groups, the control group, and the hydrotherapy group. Each group comprises 80 cases in each group. The control group received conventional drug therapy and traditional rehabilitation training, while the hydrotherapy group received underwater exercise training in combination with the routine group treatment plan. The National Health Center Stroke Scale (NIHSS), the modified Rankin scale (MRS), the limb motor function score table (Fugl-Meyer assessment, FMA), Functional Walking Scale (functional ambulation category scale, FAC), Berg Balance Scale (BBS) and the modified Barthel index (MBI) were respectively used to evaluate the neurological function, lower limb motor function, walking function, balance function and daily living ability before and after treatment.Result:There was no significant difference in NIHSS, MRS, FMA, FAC, BBS, and MBI scores between the two groups before treatment (P > .05). However, after 8 weeks of treatment, there was a significant difference in FMA, FAC, BBS, and MBI scores between the two groups (P = .00035). The FMA scores in control group was 16.60 ± 4.49, while 21.45 ± 2.96 after treatment. The FAC scores in control group was 1.45 ± 0.68, while 1.95 ± 0.783 after treatment.Conclusion:Early water exercise training in hemiplegic patients with the first stroke can significantly enhance the balance ability, walking ability as well as limb coordination of patients.

目的 分析并研究高压氧联合尤瑞克林在治疗老年急性缺血性脑卒中的临床效果.方法 78例老年急性缺血性脑卒中患者(非溶栓患者),随机分配至治疗组(n=38)和对照组(n=40),对照组仅接受高压氧及缺血性脑卒中常规药物治疗,治疗组在对照组基础上加用尤瑞克林0.15肽核酸(PNA)U/d加入100 ml生理盐水中静脉滴注,每天1次0.5 h,连续应用2 w并比较联合治疗1个月后两组临床效果.观察治疗后患者的美国国立卫生研究院脑卒中量表(NIHSS)评分,日常生活活动能力(ADL)评分,脑卒中专用生活质量量表(SS-QOL)及改良Rankin量表(mRS)等指标进行比对疗效,并观察与治疗相关的不良反应.结果 治疗组mRS评分、NIHSS评分、ADL评分及SS-QOL评分等指标均显著优于对照组(P<0.05).高压氧联合尤瑞克林不良反应主要为面部潮红,球结膜充血及血压轻度下降,多可自行恢复.结论 高压氧联合尤瑞克林治疗老年急性脑卒中疗效确切,能有效改善患者神经功能.

目的 探讨血清血管生成素样蛋白2(ANGPTL2)和外周血单核细胞NF-κB mRNA表达预测急性脑梗死(ACI)患者脑水肿的价值.方法 选取本院收治的ACI患者240例,根据头颅CT检查分为脑水肿组58例和对照组182例.ELISA法测血清ANGPTL2水平,RT-PCR法测NF-κB mRNA表达.采用多因素logistic回归分析脑水肿的影响因素,绘制ROC曲线分析两者预测脑水肿的价值.结果 脑水肿组血清ANGPTL2和NF-κB mRNA表达高于对照组(P=0.000).多因素logistic回归分析显示,血清ANGPTL2和NF-κB mRNA表达是脑水肿影响因素(P＜0.05).血清ANGPTL2和NF-κB mRNA表达预测脑水肿的ROC曲线下面积0.887、0.823,均有预测价值.结论 血清ANGPTL2及单核细胞NF-κB mRNA表达是ACI患者脑水肿影响因素,可早期预测脑水肿.

Objective This study was designed to analyze the relationship between tumor metastasis and acute ischemic stroke (AIS) in Chinese cancer patients. Methods This retrospective study included 119 cancer patients with AIS and 152 cancer patients without AIS. Basic information was collected and tumor metastasis status was determined for all patients. Results The whole cohort had a median age of 59 (49–69) years with 150 men (55.4%). There were 98 patients (36.2%) with tumor metastasis. Patients with AIS had significantly more males, tumor metastasis, lung cancer, hypertension, diabetes mellitus, higher age, D-dimer, international normalized ratio, prothrombin time, prothrombin activity, and thrombin time, while they had significantly lower levels of hemoglobin, red blood cells, and hematocrit. In multivariate logistic regression analysis, AIS was significantly and positively associated with age, tumor metastasis, D-dimer, and thrombin time. In multivariate Cox regression analysis, tumor metastasis, AIS, D-dimer, thrombin time, and fibrinogen were significantly and positively associated with worse prognosis. Conclusions This study demonstrates that tumor metastasis was positively and independently associated with AIS in Chinese cancer patients, suggesting that tumor metastasis has a significant relationship with the development of AIS. Additionally, tumor metastasis and AIS had negative independent effects on the prognosis of patients.

After reviewing the diagnosis and treatment process of a patient with active cancer who experienced wake-up stroke, we have summarized the clinical manifestations, laboratory examination results, imaging features, pathological results, and treatment in this report. Patients with active cancer who experience wake-up stroke often have mild neurological deficits at the time of onset. For the patient in this study, laboratory test results were mainly characterized by abnormal coagulation function and elevated tumor markers. The brain magnetic resonance imaging (MRI) images were characterized by involvement of both the arterial and venous systems. Thrombolytic therapy during the window period can improve the symptoms of neurological deficits. Overall, anticoagulation therapy was safe and effective in our patient.

以腹痛为首发表现的Trousseau综合征少有报道。本文报告了1例以腹痛为首发表现且合并脾梗死的Trousseau综合征患者临床资料，并结合文献复习进行分析讨论。Trousseau综合征累及颅脑导致的急性缺血性脑卒中事件可出现进展性神经功能缺损症状，因此临床医师需要提高对该疾病的认识，及时诊治，以免贻误病情。

目的 探讨帕金森病(PD)患者血清脑源性神经营养因子前体蛋白(pro-BDNF)水平,分析其与病情严重程度、认知障碍的关系.方法 选取海南省干部疗养院(海南省老年病医院)自2017年7月至2019年7月收治的110例PD患者为PD组,选取同期于我院体检的89例健康者为健康组.两组均采血检测血清pro-BDNF水平,采用蒙特利尔认知评估量表(MoCA)评估认知功能.根据Hoehn-Yahr(H-Y)分期将PD患者分为1期组(n=38)、2～3期组(n=51)、4～5期组(n=21),比较3组血清pro-BDNF水平及MoCA评分.根据MoCA评分将PD患者分为认知障碍组(n=46)与非障碍组(n=64),比较两组血清pro-BDNF水平、H-Y分期.采用Pearson线性相关分析血清pro-BDNF水平与H-Y分期、MoCA评分的相关性.结果 PD组血清pro-BDNF水平高于健康组,MoCA各维度评分及总分均低于健康组,差异有统计学意义(P<0.05).2～3期组、4～5期组血清pro-BDNF水平高于1期组,且4～5期组高于2～3期组,差异有统计学意义(P<0.05).2～3期组、4～5期组MoCA各维度评分及总分低于1期组,且4～5期组低于2～3期组,差异有统计学意义(P<0.05).认知障碍组血清pro-BDNF水平、H-Y分期高于非障碍组,差异有统计学意义(P<0.05).经Pearson线性相关分析显示,血清pro-BDNF水平与H-Y分期呈正相关,与视空间与执行功能、命名、注意力、语言、延迟回忆、定向力评分及MoCA总分呈负相关(P<0.05);血清pro-BDNF水平与抽象评分无相关性(P>0.05).结论 pro-BDNF在PD患者血清中呈高水平表达,与患者的H-Y分期、MoCA评分均有相关性,可能成为临床评估PD进展的重要指标.

目的 探讨多巴丝肼联合普拉克索治疗老年帕金森病的疗效.方法 选取自2018年1月至2020年9月海南省干部疗养院收治的140例老年帕金森病患者为研究对象.将患者随机分为常规组与观察组,每组各70例.常规组采用单纯多巴丝肼治疗,观察组在常规组基础上加用普拉克索治疗.比较两组的治疗总有效率,治疗前后的统一帕金森病评定量表(UPDRS)评分、实验室指标水平.结果 观察组治疗总有效率显著高于常规组,差异有统计学意义(P<0.05).治疗后,两组患者的UPDRS评分均低于治疗前,且观察组低于常规组,差异均有统计学意义(P<0.05).治疗后,两组患者的5-羟色胺和脑源性神经营养因子水平均高于治疗前,且观察组高于常规组;两组患者的S100β水平低于治疗前,且观察组低于常规组;差异均有统计学意义(P<0.05).结论 多巴丝肼联合普拉克索治疗老年帕金森病可有效提高缓解效果,控制病情进展.