目的 探讨磁共振扩散加权成像（DWI）、动脉自旋标记技术（ASL）、磁共振血管成像（MRA）联合应用在缺血性脑血管病诊断中的价值。 方法 对2010年3月－2012年5月经临床和影像学诊断的104例缺血性脑血管病患者，行常规MRI、液体衰减反转恢复序列、DWI及ASL、MRA序列检查，分析DWI、ASL、MRA多种技术显示病变的信号特征、面积大小及与血管关系。 结果 DWI对急性及亚急性脑梗死的检出率为100%，对大、小面积梗死病灶检出率无明显差异；ASL对大、小面积的急性及亚急性脑梗死的检出率有差异，对大面积梗死检出率为100%，对小面积梗死的检出率为70%；DWI和ASL对短暂性脑缺血发作的检出率分别为0%、70%，液体衰减反转恢复序列对短暂性脑缺血发作患者大脑皮层下斑状缺血灶检出最敏感。 结论 DWI和ASL均可用于急性脑梗死的早期诊断，ASL对大、小面积的急性及亚急性脑梗死的检出率有差异，DWI、ASL及MRA联合应用可准确评估缺血半暗区及侧支血管情况，在缺血性脑血管病诊断中有重要价值。
Purpose To examine the change of optic disc blood flow in primary open angle glaucoma(POAG) patients after cold provocation test and nifedipine administration． Methods Using Heidelberg retinal flowmetry (HRF),the blood flow of optic disc of glaucoma patients and normal control subjects were measured under basal condition, after cold provocation test,and after nifedipine administration. Results The mean optic disc blood volume and flow of POAG patients reduced from 27.1 and 545.4 to 22.3 and 452.4 after cold provocation test (Plt;0.05),and increased to 29.0 and 579.5 after nifedipine adminstration(Plt;0.05).The changes of mean optic disc blood flow of patients with a history of cold extremities show statistic significance compared with whom without such history (Plt;0.05)). Conclusion The changes of blood flow of optic disc in POAG patients may be influenced by cold stimuli and administration of nifedipine,and the history of cold extremities might be connected with the change of optic disc blood flow in POAG patients. (Chin J Ocul Fundus Dis,2000,16:85-87)
ObjectiveTo explore the correlation between -765G/C polymorphism of cyclooxygenase-2 (COX-2) gene and the risk of ischemic stroke (IS). MethodsPubMed, CBM, The Cochrane Library (Issue 3, 2015), CNKI, CBM, VIP and WanFang Data were searched from inception to March 2015 to collect case-control or nested case-control studies about -765G/C polymorphism of COX-2 gene and the risk of IS. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.1 software and Stata 12.0 software. ResultsA total of 10 studies involving 2611 cases and 18589 controls were included. The results of meta-analysis showed that, there was no correlation between -765G/C polymorphism and the risk of IS (GC+CC vs. GG: OR=1.05, 95%CI 0.88 to 1.25, P=0.620; CC vs. GG+GC: OR=1.04, 95%CI 0.83 to 1.30, P=0.730; GC vs. GG: OR=1.04, 95%CI 0.87 to 1.25, P=0.630; CC vs. GG: OR=1.09, 95%CI 0.86 to 1.36, P=0.480; C vs. G: OR=1.03, 95%CI 0.89 to 1.20, P=0.700). Subgroup analysis results showed that, the COX-2 gene -765G/C polymorphism was a risk factor for IS in African-Americans (GC+CC vs. GG: OR=1.42, 95%CI 1.12 to 1.78, P=0.003; GC vs. GG: OR=1.39, 95%CI 1.09 to 1.78, P=0.008; CC vs. GG: OR=1.51, 95%CI 1.04 to 2.18, P=0.030; C vs. G: OR=1.27, 95%CI 1.08 to 1.51, P=0.004), but not in Asians and Caucasians. ConclusionCurrent evidence shows that -765G/C polymorphism of COX-2 gene may be a genetic risk factor for IS in African-Americans, but not in Asians and Caucasians. Due to the limited quantity and quality of the included studies, more high quality studies are needed to verify the above conclusion.
Objective To systematically evaluate the influence of alcohol intervention on the outcome of rats and mice with ischemic stroke. Methods Databases including PubMed, EMbase, BIOSIS and CNKI were electronically searched from establishment dates of databases to June 2012 to retrieve animal experiments on the influence of alcohol intervention on the outcome of rats and mice with ischemic stroke. The relevant studies were identified according to the predefined inclusion and exclusion criteria, the data were extracted, and the quality was evaluated. Then meta-analysis was performed using RevMan 5.1 software. Results Eight studies were included. The results of meta-analysis showed that no significant difference was found between the alcohol intervention group and the control group (MD=−6.98%, 95%CI −20.38% to 6.43%, P=0.31). However, compared with the control group, low dose of acute alcohol intervention (less than 2 g/kg) improved the prognosis of ischemic stroke with a significant difference (MD=−22.83%, 95%CI −38.77% to −6.89%, P=0.005), and highly-concentrated of chronic alcohol intervention worsened the cerebral ischemic damage of rats and mice with a significant difference (MD=24.06%, 95%CI 10.54% to 37.58%, P=0.000 5). Conclusion Low dose of acute alcohol intervention (less than 2 g/kg) could improve the prognosis of rats and mice with ischemic stroke which has the potential neuro-protective effects. However, highly-concentrated chronic alcohol intervention could worsen the cerebral ischemic damage. Due to the limitations of the included studies such as publication bias, the influence of alcohol intervention on the outcome of rats and mice with ischemic stroke could be overestimated.
As a risk factor for vascular diseases and inflammatory diseases, fibrinogen has received more and more attention. Hyperfibrinogenemia is associated with the occurrence, development, and poor outcome of artery-venous ischemic stroke (acute ischemic stroke, transient ischemic attack and cerebral venous thrombosis). Therefore, fibrinogen may be a potential therapeutic target for the prevention and management of artery-venous ischemic stroke. However, there has been controversy regarding the defibrinogen therapy in artery-venous ischemic stroke. Therefore, this paper introduces the efficacy and safety of defibrinogen therapy alone, combined with antiplatelet or combined with anticoagulant in prevention and management of artery-venous ischemic stroke in detail, in order to re-understand the role of defibrinogen therapy in the prevention and management of artery-venous ischemic stroke.
ObjectiveTo research on the effect of nursing intervention on CT scanning success rate and image quality in head CT perfusion imaging for cerebral ischemia patients. MethodBetween June 2013 and July 2014, we retrospectively analyzed the clinical data of 203 patients who underwent CT perfusion imaging for cerebral ischemia. All the patients received nursing intervention including the following aspects:body position, psychology, sedation, leakage of contrast medium, allergic reaction, etc. ResultsA total of 199 patients successfully underwent the examination, among whom there were 190 (93.6%) satisfactory and 9 (4.5%) qualified results. The other four patients (1.9%) stopped examination because of motion artifacts. So the success rate came to 98.1%, and the failure rate was 1.9%. ConclusionsWith nursing intervention before, during and after CT scanning, patients with acute cerebral ischemia can accept higher success rate in examining and satisfactory image quality. At the same time, the nursing service was also improved.