Acute Cerebral Infraction Research Articles

Understanding the mechanism of acupuncture in acute cerebral infraction through a proteomic analysis: protocol for a prospective randomized controlled trial.

Acute cerebral infarction (ACI), being the predominant form of stroke, presents challenges in terms of the limited effectiveness of various treatments in improving the neurological function. Although acupuncture shows promise in addressing ACI, the availability of high-quality evidence regarding its efficacy, safety, and underlying mechanism remains insufficient. In this study, we design a multicenter, prospective, single-blind, randomized controlled trial with the aim of evaluating the efficacy and safety of acupuncture for ACI, making an attempt to unveil the molecular mechanisms by proteomic. A total of 132 patients involving four hospitals will be randomized at a 1:1:1 ratio in the acupuncture group, control group, and sham acupuncture group. All the patients will receive basic treatment, and the patients in the acupuncture and sham acupuncture groups will also receive either acupuncture or sham acupuncture treatment, respectively, at six sessions each week for a 2 weeks period, followed by 3 months of follow-up. The primary outcome will be the change in the National Institute of Health Stroke Scale (NIHSS) scores after treatment. The secondary outcomes will include the Fugl-Meyer Assessment (FMA) scale scores and the Barthel Index (BI). Adverse events that occur during the trial will be documented. To discover differentially expressed proteins (DEPs) and their roles between the ACI subjects and healthy controls, we will also perform 4D-DIA quantitative proteomics analysis, and the DEPs will be confirmed by enzyme-linked immunosorbent assay (ELISA). This study was approved by the institutional review board of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine (TYLL2023043). Written informed consent from patients is required. This trial is registered in the Chinese Clinical Trial Registry (ChiCTR2300079204). Trial results will be published in a peer-reviewed academic journal. The results of this study will determine the preliminary efficacy and safety of acupuncture in ACI patients and whether the mechanism of this form of non-pharmacologic stimulation is mediated by a novel therapeutic target for neurorehabilitation through our proteomic analysis. https://www.chictr.org.cn, identifier ChiCTR2300079204.

A cross-sectional study of early-onset epilepsy of intracerebral hemorrhage and construction of a risk prediction model

To study the early-onset epilepsy of intracerebral hemorrhage and build a prediction model to evaluate its prediction efficiency. A cross-sectional investigation was conducted to construct a specialized optimized prediction model. The prediction model was converted into a visual optimized scoring scale, so as to quantify the probability of secondary epilepsy after intracerebral hemorrhage. Based on the current prediction model of acute cerebral infraction and post-stroke seizure (AIS-PSS), the evaluation efficacy of optimized score for secondary epilepsy after hemorrhagic stroke was explored. (1) After sample size calculation and sufficient inclusion and exclusion, 159 patients with cerebral hemorrhage were continuously selected as the model group of this cross-sectional study. A total of 29 patients with early-onset epilepsy and 130 patients without secondary epilepsy were enrolled. The time span was from January 2021 to August 2021. In addition, 77 patients with acute cerebral hemorrhage from August 2021 to February 2022 were selected as the verification group, among which 12 patients had early-onset epilepsy and 65 patients had not any secondary epilepsy. (2) There were significant differences in demographic characteristics such as diabetes history, cerebral infarction history, smoking history, National Institutes of Health Stroke Scale (NIHSS) score, intracerebral hemorrhage hematoma volume, serum creatinine (SCr), neuron-specific enolase (NSE), S-100 protein and intracerebral hemorrhage site between the two model groups with different prognosis (all P < 0.05). (3) The above indexes were included in univariate and multivariate Poisson regression analysis, and the results showed that the duration of diabetes [relative risk (RR) = 1.229, 95% confidence interval (95%CI) was 1.065-1.896, P = 0.036], smoking history (RR = 1.419, 95%CI was 1.133-2.160, P = 0.030), history of cerebral infarction (RR = 1.634, 95%CI was 1.128-2.548, P = 0.041), hematoma volume of cerebral hemorrhage (RR = 1.222, 95%CI was 1.024-2.052, P = 0.041), NES content (RR = 1.146, 95%CI was 1.041-1.704, P = 0.032), were independent influencing factors to constitute the prediction model. The prediction model was converted into a visual optimized scoring scale in the form of a line diagram to obtain the prediction probability corresponding to the corresponding score. (4) Receiver operator characteristic curve (ROC curve) was used to test the evaluation efficiency of optimized score and AIS-PSS score for early-onset cerebral hemorrhage epilepsy. Relevant data of patients in the verification group were extracted according to the information of two scores, and the final score of each patient in the verification group was obtained. The score and prognosis were put into the ROC curve to evaluate the predictive ability of different prediction models. The results showed that the cut-off value of the optimized score and the AIS-PSS score were 144 points and 7 points, respectively, and the area under the ROC curve (AUC) and the Yoden index of the optimized score were slightly lower than the AIS-PSS score. However, compared with AIS-PSS score, there was no significant difference in the evaluation efficiency of optimized score for early-onset epilepsy (Z = 1.874, P > 0.05). This study constructed a specific early-onset epilepsy prediction model for patients with hemorrhagic stroke, and transformed it into an optimized score that is easy for clinical use, and its evaluation efficiency is reliable.

Abstract TMP34: The Role Of Nondiabetic Hyperglycemia In Patients With Acute Cerebral Infarction

Background/Objective: We aims to investigate the incidence of hyperglycemia (HG) and the association between HG and mortality of nondiabetic patients with acute cerebral infraction (ACI) in intensive care units. Hypothesis: We hypothesize that hyperglycemia might increase the mortality rate among nondiabetic patients with ACI. Methods: We enrolled the nondiabetic patients with ACI in the Medical Information Mart for Intensive Care IV database from 2008 to 2019. HG was defined as &gt; 140 mg/dL. Propensity score matching (PSM) was performed to balance the group of HG and non-HG patients with confounders including age, sex, Charlson Comorbidity Index (CCI), Acute Physiology Score (APS) III. We conducted a Cox proportional hazards model to determine the nonlinear association between HG and in-hospital mortality among nondiabetic patients with ACI. Results: Of the 734 patients, 218 patients (29.7%) had HG. Patients with HG were older (71.4±13.3 v.s. 66.6±15.6; P &lt; 0.001) and had higher CCI (6.9±2.5 v.s. 5.9±2.4; P &lt; 0.001), and APS III (39.2±20.6 v.s. 31.0±14.0; P &lt; 0.001) than those without HG. After 1:1 PSM, there remained 207 pairs. The cohorts were well-balanced based on four covariates between the HG and non-HG groups. HG associated with in-hospital mortality (22.5% v.s. 8.9%; P &lt; 0.001), even after PSM (20.3% v.s. 10.6%; P &lt; 0.001). There was a positive non-linear trend between HG and in-hospital mortality and patients might had twofold hazards ratio when serum glucose more than 160 gm/dL. Conclusions: Hyperglycemia is related to poor clinical characteristics, as well as it is an independent short-term risk factor of in-hospital mortality among nondiabetic patients with ACI.

1H-magnetic resonance spectroscopy screening for animals with acute cerebral infraction suitable for thrombolytic therapy***

BACKGROUNDAs a non-invasive technique which can provide comprehensive biological information, 1H-magnetic resonance spectroscopy (1H-MRS) may provide valuable reference data for irreversible recovery or reversible changes in ischemic tissue after stroke. OBJECTIVETo monitor and evaluate the effect of the urokinase thrombolytic therapy after experimental acute cerebral ischemia by 1H-MRS technology and investigate its adaptability. DESIGNRandomly controlled animal study. SETTINGSShenzhen Hospital of Peking University and National Key Laboratory of Pattern and Atom & Molecular Physics, Wuhan Physics and Mathematics Institute, Chinese Academy of Science. MATERIALSEleven healthy adult Sprague-Dawley (SD) rats, weighing 260 – 300 g and of both genders, were supplied by Experimental Animal Center of Tongji Medical Collage, Huazhong University of Science and Technology [SCXK (e) 2004–007]. 4.7T superconducting nuclear magnetic resonance meter was provided by Brucker Company. METHODSThe experiment was carried out in Shenzhen Hospital of Peking University and National Key Laboratory of Pattern and Atom & Molecular Physics, Wuhan Physics and Mathematics Institute, Chinese Academy of Science from August 2003 to December 2005. (1) The rats were randomly divided into 30-minute self-thrombo-embolism group (n = 6) and 60-minute self-thrombo-embolism group (n = 5). Six rats in 30-minute self-thrombo-embolism group were occluded with clot embolus for 30 minutes and 5 rats in 60-minute self-thrombo-embolism group were occluded for 60 minutes. 10 000 U/kg urokinase was dissolved in 2 mL saline and the operation lasted for 5 minutes. (2) 1H-MRS was performed before thrombolysis and at 3 hours and 24 hours after successful embolization. The metabolic changes of N-acetyl-L-aspartic acid (NAA)/phosphocreatine (PCr) + creatine (Cr), choline phosphate (Cho)/PCr+Cr and lactic acid (Lac)/PCr+Cr in the region of interests were analyzed. (3) The T2W image was conducted 24 hours after the thrombolytic therapy with TR=500 ms and TE=25 ms. (4) The subjects were sacrificed immediately after 1H-MRS and the brain tissues were cut into pieces and stained with HE method; in addition, pathological changes were observed under optic microscope. MAIN OUTCOME MEASURES(1) Metabolic changes of NAA/PCr+Cr, Cho/PCr+Cr and Lac/PCr+Cr in the region of interests; (2) T2W image at 24 hours after the thrombolysis; (3) pathological observation of brain tissue. RESULTSEleven rats were all involved in the final analysis. (1) Metabolic changes in the region of interests: In 30-minute self-thrombo-embolism group, the Lac peak emerged immediately after the embolism, but the ischemic zone decreased 3 hours after the thrombolytic therapy (0.252±0.01, 0.603±0.01, P < 0.01). Lac/(PCr+Cr) ratio was 0.290±0.01 at 24 hours after thrombolysis, which was higher than that at 3 hours after thrombolysis (P < 0.01). The NAA/ (PCr+Cr) ratio decreased significantly at 3 hours after the thrombolysis as compared with that before thrombolysis (0.922±0.16. 1.196±0.01, P < 0.05). In 60-minute self-thrombo-embolism group, the Lac/(PCr+Cr) ratio was higher at 3 hours after thrombolysis than that before thrombolysis (0.846±0.12, 0.601±0.11, P < 0.05) and the NAA/(PCr+Cr) decreased at 3 hours after the embolism. Fluctuation of NAA/ (PCr+Cr) ranged from 0.68 to 0.75 before thrombolysis and from 0.71 to 0.75 at 3 hours after thrombolysis. (2) T2W image: T2W image showed that 2 subjects in 30-minute self-thrombo-embolism group whose Lac/NAA was higher than 0.7 suffered from intracranial hemorrhage. This meant that the subjects with Lac/NAA > 0.7 were more likely to suffer from intracranial hemorrhage. (3) Histological and morphological examinations: Optic microscope demonstrated that interspace surrounding nerve cells was widened at ischemic center; neurons were swelling; nucleus was stained lightly; pyknosis and mesenchymal edema were mainly observed in lateral cortex of brow and vertex and in lateral part of corpus striatum. CONCLUSION(1) Compound parameters in ischemic area before thrombolysis should be regarded as an important predicting marker for thrombolytic therapy, effect evaluation and termination. (2) 1H-MRS combining with other imaging technique is a detecting way for screening cases who are suitable for thrombolytic therapy.

Acute Cerebral Infarction in a Patient with Persistent Trigeminal Artery and Homolateral Hypoplasia of Internal Carotid Artery Distal Anastomosis: A Case Report and a Mini Review of the Literature

BackgroundPersistent primitive trigeminal artery (PPTA) is a rare remnant between the internal carotid artery (ICA) and the basilar artery into adulthood. PPTA generally lacks specific clinical manifestations and occasionally accompanies with other cerebrovascular diseases. Case presentationWe reported a 48-year-old Chinese woman who had repeated episodes of transient ischemic attack presented to our hospital. She had no related risk factors of ischemic cerebrovascular diseases. Magnetic resonance image findings demonstrated acute cerebral infraction in centrum semiovale. Magnetic resonance angiography findings indicated right PPTA and ipsilateral hypoplasia of ICA distal anastomosis. ConclusionsTo the best of our knowledge, this is the first report that acute cerebral infarction in a patient with the right PPTA and ipsilateral hypoplasia of ICA distal anastomosis. According to the literature, congenital factor may play an important role in the formation of these vascular anomalies.

Status of emotional-social loneliness in patients with acute cerebral infarction and the related factors analysis

Objective To explore the status of emotional-social loneliness including emotional isolation, social isolation, emotional and social loneliness in patients with acute cerebral infraction, and to analyze the related factors. Methods A total of 122 patients with acute cerebral infraction admitted to the neurology department of 5 third-grade class-A hospitals from Jan.2017 to Oct.2017 were enrolled.Data was collected by self-reported questionnaires including patients' general data and the emotional-social loneliness questionnaire data. Results Among 122 patients with acute cerebral infraction, emotional isolation, social isolation, emotional loneliness and social loneliness were found in 48 cases(39.3%), 60 cases(49.2%), 40 cases(32.8%)and 36 cases(29.5%), respectively.The total average score for emotional isolation, social isolation, emotional loneliness and social loneliness were 8.3±5.2, 8.6±5.1, 7.5±6.1, and 7.4±5.5, respectively.The scores for emotional-social loneliness were associated with education level, monthly family income, occupations and the emotion state before disease, and were not associated with gender, marriage status and stroke history. Conclusions The prevalence of emotional-social loneliness is high in patients with acute cerebral infraction.Especially careful attention should be paid to patients with higher education level and retired with monthly family income ≥5 000 RMB. Key words: Brain infraction; Mood disorders; Social isolation; Loneliness

Cystatin C as an index of acute cerebral infraction recurrence: one-year follow-up study

Background and purpose: Cystatin C is associated with acute cerebral infarction (ACI). However, the correlation of serum cystatin C level with recurrence of ACI and different subtypes of ACI had not been fully clarified. The aim of this study was to detect the relationship between serum cystatin C level and recurrent ACI in one-year follow-up and different subtypes of ACI.Methods: A total of 532 consecutive patients with ACI and 339 healthy controls were included. All ACI patients were followed up for one year, the clinical and biochemical characteristics of ACI and ACI recurrent patients were documented and analyzed.Results: A total of 477 (89.7%) patients completed one-year follow-up study, 64 (13.4%) patients suffered ACI recurrence. The results showed serum cystatin C was 1.04 ± 0.19 mg/L and 1.14 ± 0.49 mg/L in control and ACI, respectively (p< .001). The significant risk factors for ACI recurrence were presence of hypertension (p = .009, OR =3.32), diabetes (p =.03, OR =1.87), coronary heart disease (p = .01, OR =2.46), and cystatin C (p = .003, OR =2.87). The risk of ACI recurrence increased with serum cystatin C level. Additionally, cystatin C level was associated with different subtypes of ACI; large-artery atherosclerosis (LAA) subtype had the highest level of cystatin C in ACI and recurrent ACI group.Conclusions: Serum cystatin C level is an independent prediction biomarker for ACI recurrence. LAA subtype of ACI and ACI recurrence was more closely related to elevated cystatin C level.

The effect of interventional thrombolytic therapy for central retinal artery occlusion with ipsilateral internal carotid artery occlusion via supratrochlear artery retrogradely or external carotid artery anterogradely

Objective To observe the effect of interventional thrombolytic therapy for central retinal artery occlusion (CRAO) with ipsilateral internal carotid artery occlusion via supratrochlear artery retrogradely or external carotid artery anterogradely. Methods Nine CRAO patients (9 eyes) were enrolled in this study, including 5 males and 4 females. The mean age was (45.2±18.1) years. The mean onset duration was 24 hours. There were 4 eyes with vision of no light perception, 3 eyes with light perception and 2 eyes with hand movement. Fundus fluorescein angiography (FFA) examination showed that the retinal artery was filled with delayed fluorescence. The peak of fluorescence was seen in the anterior part of the artery, and some of the eyes showed retrograde filling. The arm-retinal circulation time (A-Rct) was ≥35 s in 4 eyes, ≥35 s - <25 s in 5 eyes. The filling time of retinal artery and its branches (FT) was ≥ 15 s in 2 eyes, ≥12 s - <15 s in 3 eyes, ≥9 s -<12 s in 4 eyes. All the patients received the treatment of interventional thrombolytic therapy via supratrochlear artery retrogradely (8 eyes) or external carotid artery anterogradely (1 eye) according to the indications and contraindications of thrombolytic therapy in acute cerebral infraction patients. Urokinase (0.4 million U in total) was intermittently injected into the arteries. After artery thrombolysis, the changes of digital subtraction angiography (DSA), filling time of retinal artery and its branches on FFA within 24 hours and the visual acuity were observed. According to the A-Rct and FT on FFA, the therapeutic effects on retinal circulation were defined as effective markedly (A-Rct≤15 s, FT≤2 s) , effective (A-Rct was improved but in the range of 16 - 20 s, FT was in 3 - 8 s) and no effect (A-Rct was improved but ≥21 s, FT≥9 s). The related local or systemic complications were recorded. Results After the injection of urokinase into the catheter, the ophthalmic artery and its branches were increased in 6 eyes (66.7%), and the development of the eye ring was significantly more than that of the eyes before thrombolysis. The circulation time in ophthalmic artery was speeded up for 2 s before thrombolysis in 3 eyes, 3 s in 3 eyes, and 4 s in 2 eyes. Within 24 hours after thrombolysis treatment, the A-Rct was significantly decreased than that of before interventional therapy. The retinal circulation was effective markedly in 4 eyes (44.4%), effective in 4 eyes (44.4%) and no effect in 1 eyes (11.2%) . The vision was improved 3 lines in 4 eyes (44.4%), 2 lines in 3 eyes (33.3%), 1 line in 1 eye (11.2%) and no change in 1 eye (11.2%). There were no abnormal eye movements, vitreous hemorrhage and incision hematoma, intracranial hemorrhage, cerebral embolism, and other local and systemic adverse effectives during the follow-up. Conclusions The interventional thrombolytic therapy via supratrochlear artery retrogradely or external carotid artery anterogradely for CRAO with the ipsilateral internal carotid artery occlusion can improve retinal circulation and vision. There are no related local or systemic complications. Key words: Retinal artery occlusion/drug therapy; Carotid stenosis/drug therapy; Thrombolytic therapy; Radiography, interventional; Angiography, digital subtraction; Fluorescein angiography

Tissue plasminogen activator; identifying major barriers related to intravenous injection in ischemic acute cerebral infraction.

Background:According to previous publications, in patients with acute ischemic cerebral infarction, thrombolytic therapy using intravenous tissue plasminogen activator (IV-tPA) necessitates precise documentation of symptoms’ onset. The aim of this study was to identify major barriers related to the IV-tPA injection in such patients.Materials and Methods:Between the year 2014-2015, patients with definitive diagnosis of acute cerebral infarction (n = 180) who attended the neurology ward located at the Isfahan Alzahra Hospital were studied. To investigate barriers related to door to IV-tPA needle time, personal reasons, and criteria for inclusion or exclusion of patients, three questionnaire forms were designed based on the Food and Drug Administration-approved indications or contraindications.Results:The mean age of males versus females was 60 versus 77.5 years (ranged 23–93 vs. 29–70 years), respectively. Out of total population, only 10.7% transferred to hospital in <4.5 h after the onset of symptoms. Regarding to eligibility for IV-tPA, 68.9% of total population have had criteria for such treatment. Concerning to both items such as transferring to hospital in <4.5 h after the onset of symptoms and eligibility for IV-tPA, only 6.6% of total population met the criteria for such management. There was ignorance or inattention to symptoms in 75% of population studied. There was a mean of 195.92 ± 6.65 min (182.8–209.04 min) for door to IV-tPA needle time.Conclusion:Despite the international guidelines for IV-tPA injection within 3–4.5 h of ischemic stroke symptoms’ onset, the results of this study revealed that falling time due to ignorance of symptoms, literacy, and living alone might need further attention. As a result, to decrease death and disability, educational programs related to the symptoms’ onset by consultant neurologist in Isfahan/Iran seem to be advantageous.

Effects of occupational therapy on the cognitive function and event-related potentials of patients with acute cerebral infraction

Objective To explore the effect of occupational therapy on the cognitive function and P300 event-related potentials (ERPs) of patients with acute cerebral infraction.Methods Ninety-eight acute cerebral infarction patients with cognitive impairment were selected using the mini-mental state examination (MMSE).They were randomly divided into an observation group (n =49) who received occupational therapy plus routine rehabilitation treatment and a control group (n =49) who received only the routine rehabilitation treatment.Before and after 8 weeks of treatment,the patients' cognitive function and their ability in the activities of daily living(ADL) were evaluated using the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) and the modified Barthel index (MBI),respectively.P300 ERPs were also detected.Results There was no significant difference between the two groups with regard to various scores before the treatment (P ＞ 0.05).After 8 weeks of treatment,the LOTCA and MBI scores and the latency and amplitude of ERPs were significantly better than those before treatment in both groups (P ＜ 0.05).In the observation group,the scores of LOTCA (99.4 ± 8.4),MBI (80.7 ± 5.9) and the latency and amplitude of ERPs [(373.45 ± 52.13) ms and (5.87 ± 2.63) μV,respectively] were significantly better than those in the control group(P ＜ 0.05).Conclusion Occupational therapy program based on conventional rehabilitation training can promote the ADL ability and cognitive function of patients with acute cerebral infraction.It is worth applying in clinical practice. Key words: Occupational therapy; Cerebral infraction; Cognitive impairment; Event-related potential

Analysis of cost-effectiveness for four kinds drugs in the treatment of acute cerebral infraction

Objective To evaluate the treatment of acute cerebral infarction of 4 kinds of drug cost-effective-ness.Methods A retrospective analysis was performed on 207 patients with acute cerebral infarction,according to the drug formulation of patients treatment,they were divided into four groups： group A （alprostadil）,group B（Oza-grel）,group C（Dan red injection）,group D（Xuesaitong）,the curative effects and adverse reactions were observed and analyzed by using pharmacoeconomic cost-effectiveness method.Results The costs of groups A,B,C and D were 5 248.6,4 253.7,4 475.8,3 501.2 yuan,respectively;The effective rates were 92.2%,83.7%,87.5%,76.9%, respectively;The cost effectiveness ratio（C/E） were 56.93,50.82,51.15,45.53,respectively;A,B,C group compared with the incremental cost-D group,the effect of ratio（△C/△E） were 107.2,110.7,91.9;The incidence of adverse reactions were 3.9%,6.1%,12.5%,11.5%.Conclusion Alprostadil group scheme was the best treatment scheme. Key words: Brain Infarction Drug Therapy Costs and Cost Analysis

Clinical Effects of Acupuncture Combined with Herbal Medicine with the Functions of Detoxication and Purging Fu-organ on Patients with Constipation of Phlegm-heat and Bowel-repletion Type in Acute Cerebral Infraction

Objective To probe into the clinical effect of acupuncture combined with herbal medicine with the functions of detoxication and purging fu-organ on patients with constipation of phlegm-heat and bowel-repletion type in acute cerebral infarction.Methods The enrolled cases were randomly assigned to an observation group of 35 cases and a control grouD of 35 cases.Besides both groups were treated with routine neurological treatment and acupuncture with the flinchon of brain activating,the observation group was treated by acupuncture combined with herbal medicine with the functions of detoxication and purging fu-organ and the control group was treated with Dilute Glycerol.Such indexes of patients in both groups were observed 7 days and 21 days before and after the treatment as clinical effect of constipation,scores of related symptoms,and scores of traditional Chinese medical category and clinical effect.Results The effective rates of eonstipation 7 davs and 21 days after treatment were 93.7% and96.9% in the observation group,and 61.8% and79.4% in the control group,with significant differences between the two groups(P＜0.01).After the treatment for 7 days and 21 days,the symptoms of constipation.dark tongue,yellow and greasy fur were improved significantly in the observation group than those in the control group(P＜0.05);The observation group also showed a definite therapeutic effect than the control group on treating the svmptoms of upset minded,constipation,red or dark tongue,yellow and greasy fur(P＜0.01).The scores of traditional Chinese medical category of the observation group were lower than that of the control group(P＜0.01)after treatment for21 days.The total improvement rate was 97.0% in the observation group comparing 55.8%in the control group,showing significant difference(P＜0.01).Conclusion The method of acupuncture combined with herbal medicine with the functions of detoxication and purging fu-organ has a definite therapeutic effect on treating constipation of phlegm-heat and bowel-repletion in acute cerebral infarction.It can also improve clinical effects of these patients,which is worth generalizing in the clinical practice. Key words: Acupuncture combined with herbal medicine; Detoxication and purging fu-organ; Acute cerebral infraction; Phlegm-heat and bowel-repletion

Usefulness of heart rate and blood pressure correlation in evaluating central autonomic network function – A study in amyotrophic lateral sclerosis, acute cerebral infraction, and Guillain-Barré syndrome

Usefulness of heart rate and blood pressure correlation in evaluating central autonomic network function – A study in amyotrophic lateral sclerosis, acute cerebral infraction, and Guillain-Barré syndrome