Cerebral Hemodynamic Indices Research Articles

Cerebral Protection of Intraoperative Infusion of Dexmedetomidine in Patients with Chronic Cerebrovascular Stenosis Undergoing Endovascular Interventional Therapies: A Prospective Randomized Controlled Trial

To investigate the cerebral protective effect of intraoperative dexmedetomidine infusion on patients with chronic cerebral vascular stenosis receiving endovascular interventional therapy. Sixty patients with carotid artery or cerebral artery stenosis or occlusion stenting under elective general anesthesia were divided into dexmedetomidine group (group D) and normal saline group (group N). Group D was given dexmedetomidine loading dose 1.0μg/kg after peripheral vein opening for 10min, and then adjusted infusion rate to 0.5μg/kg/h until stopped 30min before end. At 7days after operation, the contents of S100β, neuron-specific enolase (NSE) and interleukin-6 (IL-6) in group D were apparently lower than those in group N (P<0.05), while the contents of IL-1β and tumor necrosis factor-α in 2 groups showed no statistical significance (P>0.05). Additionally, at 4days and 7days after operation, the scores of Mini-Mental State Scale (MMSE) and Wechsler Memory Scale (WMS) in group D were significantly higher than those in group N (P<0.05). Thirtydays after surgery, the cerebral hemodynamic indexes (relative mean transit time, relative time to peak) in group D were significantly improved, and obviously better than those in group N (P<0.05). The S-100β, NSE, and inflammatory mediator IL-6 in group D were significantly decreased compared with group N, the MMSE and WMS cognitive function scores, and the cerebral blood perfusion were apparently improved in group D, clarifying dexmedetomidine has protective effect on nerve tissue injury by inhibiting inflammation.

Effects of increased intracranial pressure on cerebrospinal fluid influx, cerebral vascular hemodynamic indexes, and cerebrospinal fluid lymphatic efflux

The glymphatic-lymphatic fluid transport system (GLFTS) consists of glymphatic pathway and cerebrospinal fluid (CSF) lymphatic outflow routes, allowing biological liquids from the brain parenchyma to access the CSF along with perivascular space and to be cleaned out of the skull through lymphatic vessels. It is known that increased local pressure due to physical compression of tissue improves lymphatic transport in peripheral organs, but little is known about the exact relationship between increased intracranial pressure (IICP) and GLFTS. In this study, we verify our hypothesis that IICP significantly impacts GLFTS, and this effect depends on severity of the IICP. Using a previously developed inflating balloon model to induce IICP and inject fluorescent tracers into the cisterna magna, we found significant impairment of the glymphatic circulation after IICP. We further found that cerebrovascular occlusion occurred, and cerebrovascular pulsation decreased after IICP. IICP also interrupted the drainage of deep cervical lymph nodes and dorsal meningeal lymphatic function, enhancing spinal lymphatic outflow to the sacral lymph nodes. Notably, these effects were associated with the severity of IICP. Thus, our findings proved that the intensity of IICP significantly impacts GLFTS. This may have translational applications for preventing and treating related neurological disorders.

Effects of Early Acupuncture Combined with Rehabilitation Training on Limb Function and Nerve Injury Rehabilitation in Elderly Patients with Stroke: Based on a Retrospective Cohort Study

Objective A case-control study was conducted to explore the effect of acupuncture combined with rehabilitation training on limb function and nerve injury rehabilitation in elderly patients with stroke. Methods A total of 72 elderly patients with stroke treated from March 2019 to June 2021 in our hospital were enrolled as the object of study. The clinical data were collected and divided into two groups according to their different treatment methods. The patients cured with routine treatment combined with rehabilitation training were taken as the control group and the patients cured with acupuncture combined with rehabilitation training as the study group. The clinical efficacy was recorded, and the cognition and activities of daily living were evaluated by Terrell Cognitive Assessment scale, limb motor function score, and activities of daily living scale. The National Institutes of Health Stroke Scale (NIHSS) and Glasgow Coma Scale (GCS) were employed to compare the neurological function before and after treatment. Glasgow Outcome Scale (GOS) and Disability Rating Scale (DRS) were adopted to evaluate the functional prognosis. The simplified Fugl-Meyer assessment of motor recovery score was employed to evaluate the limb function of the patients. The Wolf Motor Function Test (WMFT) score was adopted to evaluate the functional rehabilitation effect of the patients. Enzyme-linked immunosorbent assay (ELISA) was adopted to determine the serum neurological function indexes such as nerve growth factor, Smur100B protein, and glial fibrillary acidic protein. The cerebral blood flow (CBF), peak time, average transit time, and cerebral blood volume were measured by CT perfusion imaging, and the incidence of side effects during treatment was recorded. Results Regarding the recovery of cognitive function and daily function after treatment, after treatment, the MoCA and ADL scores were increased, and the comparison indicated that the MoCA and ADL scores of the study group were remarkably higher compared to the control group (P < 0.05). With regard to the FMA-UE scores after treatment, the Fugl-Meyer scores were gradually increased, and the Fugl-Meyer scores in the study group were remarkably higher compared to the control group (P < 0.05) in the next two months. After 2 weeks, 4 weeks, 6 weeks, and 6 weeks of treatment, the WMFT scores gradually increased, and the WMFT score of the study group was remarkably higher compared to the control group. After treatment, the levels of nerve growth factor and S-100B protein were decreased, and the level of glial fibrillary acidic protein was increased. Comparison between the two groups, it indicated the improvement degree of each neurological function index in the study group was remarkably better (P < 0.05). With regard to cerebral hemodynamic indexes after treatment, 1 week after treatment, the CBF and average transit time of the observation group were remarkably higher compared to the control group, and the levels of cerebral blood volume and peak time were remarkably lower compared to the control group (P < 0.05). After 4 weeks of treatment, the cerebral hemodynamic indexes of the observation group did not change remarkably, and they were all lower than 1 week after the treatment. In the terms of side effects, 1 case of limb dysfunction, 1 case of swallowing dysfunction, 1 case of electrolyte disturbance, and none of infection in the study group, the incidence of adverse reactions was 8.33%. In the control group, there were 3 cases of limb dysfunction, 2 cases of swallowing dysfunction, 2 cases of electrolyte disturbance, and 3 cases of infection, and the incidence of adverse reactions was 27.78%. Compared between groups, the incidence of adverse reactions in the study group was lower (P < 0.05). Conclusion Early use of acupuncture combined with rehabilitation training has a remarkable therapeutic effect on elderly stroke patients. It can remarkably promote the recovery of the patient's condition, remarkably enhance their neurological function, cognitive function, motor function, and daily life function, and effectively strengthen the patient's prognosis score. It has important clinical application value to reduce the incidence of adverse reactions.

Investigation of the Effects of Large Bone Flap Craniotomy on Cerebral Hemodynamics, Intracranial Infection Rate, and Nerve Function in Patients with Severe Craniocerebral Trauma.

In order to explore the clinical value of large bone flap craniotomy, the effects of standard large bone flap craniotomy on cerebral hemodynamic indexes, incidence of postoperative intracranial infection, and neurological function in patients with severe craniocerebral trauma are investigated. 89 patients with severe craniocerebral trauma admitted from January 2020 to June 2021 are analyzed retrospectively. All patients are divided into a large craniotomy group (n = 45) and control group (n = 44) according to different surgical methods. The large craniotomy group is treated with large craniotomy decompression, and the control group is treated with traditional craniotomy decompression. The incidence of intracranial infection in each group is recorded, and NIHSS is applied to observe the neurological function recovery of 2 groups before and 1 month after operation. Besides, the patients are followed up after surgery and the Kaplan–Meier survival curve is obtained to compare the survival rate of patients in the two groups. It is clearly evident that the two surgical methods have certain clinical efficacy in the treatment of patients with severe craniocerebral trauma. Comparatively, the large craniotomy can further improve brain blood supply and improve neurological function recovery. Also, it can obtain low incidence of postoperative adverse reactions and intracranial infection.

Relationship Between Cerebral Hemodynamics, Tissue Oxygen Saturation, and Delirium in Patients With Septic Shock: A Pilot Observational Cohort Study.

Background: Septic shock patients have tendencies toward impairment in cerebral autoregulation and imbalanced cerebral oxygen metabolism. Tissue Oxygen Saturation (StO2) and Transcranial Doppler (TCD) monitoring were undertaken to observe the variations of cerebral hemodynamic indices and cerebral/peripheral StO2 to find risk factors that increase the sepsis-associated delirium (SAD).Materials and Methods: The research cohort was chosen from septic shock patients received in the Department of Critical Care Medicine, Xiangya Hospital, Central South University between May 2018 and March 2019. These patients were separated into two groups, SAD and non-SAD as assessed by using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Comparisons were made between the two groups in terms of peripheral StO2, fluctuations in regional cerebral oxygen saturation (rSO2), cerebral vascular automatic regulation function [Transient Hyperemic Response Ratio (THRR) index], cerebral hemodynamic index, organ function indicators, blood gas analysis indices, and patient characteristics.Results: About 39% of the patients (20/51) suffered from SAD. Nearly 43% of the patients died within 28 days of admission (22/51). Individuals in the SAD cohort needed a longer period of mechanical ventilation [5 (95% CI 2, 6) vs. 1 days (95% CI 1, 4), p = 0.015] and more time in ICU [9 (95% CI 5, 20) vs. 5 days (95% CI 3, 9), p = 0.042]; they also experienced more deaths over the 28-day period (65 vs. 29%, p = 0.011). The multivariate regression analysis indicated that independent variables associated with SAD were THRR index [odds ratio (OR) = 5.770, 95% CI: 1.222–27.255; p = 0.027] and the mean value for rSO2 was < 55% (OR = 3.864, 95% CI: 1.026–14.550; p = 0.046).Conclusion: Independent risk factors for SAD were mean cerebral oxygen saturation below 55% and cerebrovascular dysregulation (THRR < 1.09).

Edaravone Combined with Clopidogrel Is Beneficial to Improve Efficacy, Neurological Impairment, and Life Function in Acute Cerebral Infarction Patients.

Objective This research aimed at investigating the efficacy of edaravone combined with clopidogrel on acute cerebral infarction (ACI) and its influence on the neurological deficit and life function. Methods Totally, 154 ACI cases were included and then divided into the control group (CG) (n = 71) and research group (RG) (n = 83) according to the treatment methods. Patients in the CG were treated with clopidogrel alone, and those in the RG were under edaravone-clopidogrel combination therapy. The efficacy, adverse reactions, NIHSS score, cerebral hemodynamic indexes, and Fugl-Meyer scale (FMA) and Barthel index (BI) of activities of daily living (ADL) scores were observed. Results Compared with before treatment, the symptoms of both groups were improved after treatment: the NIHSS scores decreased, FMA and ADL scores increased, and cerebral hemodynamic indexes were improved. Compared with the CG, the efficacy and cerebral hemodynamic indexes of the RG were better, the adverse reactions were equivalent, the NIHSS score was lower, and the ADL and FMA scores were higher. Conclusion Edaravone combined with clopidogrel can effectively treat ACI and improve the neurological deficit and life function of patients.

Evaluation of the Clinical Efficacy of Acupuncture and Moxibustion Combined with Repetitive Transcranial Magnetic Stimulation on Cognitive Function and Sleep Disorders in Patients with Mild Vascular Dementia

Objective: To explore the clinical effects of acupuncture and repeated transcranial magnetic stimulation in patients with mild vascular dementia. Method: From May 2020 to May 2021, 40 patients with mild vascular dementia in Harbin Fourth Hospital (our hospital) were divided into the experimental group (20 cases, using conventional drugs + acupuncture + repeated transcranial magnetic stimulation) and the control group (20 cases, for example, the application of conventional medication). The improvement of cognitive function score, sleep quality score, quality of life score, and cerebral hemodynamics before and after treatment were compared between the two groups. Result: Before treatment, the difference in cognitive function score, sleep quality score, quality of life score, and cerebral hemodynamic index between the two groups of patients did not form, that is, p&gt;0.05; after treatment, the experimental group’s cognitive function score was (19.45±2.47) points , Sleep quality score (12.18±2.09), quality of life score (33.29±4.08), left cerebral blood flow velocity (65.76±3.32) cm/s, right cerebral blood flow velocity (64.32±3.25) cm/s, more For the control group, P&lt;0.05. Conclusion: In the clinical treatment of patients with mild vascular dementia, based on conventional drugs, combined with acupuncture and repetitive transcranial magnetic stimulation, the patients’ cognitive function can be improved, and the quality of sleep and quality of life can be improved. Comprehensive clinical promotion.

Effects of intravenous thrombolysis with alteplase combined with edaravone on cerebral hemodynamics and T lymphocyte level in patients with acute cerebral infarction.

Our study aimed to investigate the effect of intravenous thrombolysis with alteplase and edaravone on cerebral hemodynamics and T lymphocyte level in patients harboring acute cerebral infarction.There involved a total of 118 patients with acute cerebral infarction from November 2017 to May 2019 in our hospital were randomly divided into 2 groups: the observation group (59 patients were treated with intravenous thrombolysis with alteplase combined with edaravone) and the control group (59 patients were treated with intravenous thrombolysis of alteplase). The clinical effect, neurological function, cerebral hemodynamic index, T lymphocyte level, oxygen free radical scavenging level and oxidative stress index of the 2 groups were observed and compared.Before the treatment, there were no significant differences in neurological function, cerebral hemodynamic indexes, T-lymphocyte level, oxygen free radical scavenging level and oxidative stress indexes between the 2 groups (P > .05). After the treatment, the neurological function, cerebral hemodynamic indexes, T-lymphocyte level, oxygen free radical scavenging level and oxidative stress indexes of the 2 groups were significantly improved. In addition, the observation group exerted greater beneficial effect in terms of the clinical effect, neurologic function, cerebral hemodynamic index, T lymphocyte level, oxygen free radical scavenging level and oxidative stress index than those of the control group (P < .05).The intravenous thrombolysis with alteplase and edaravone is effective in the treatment of acute cerebral infarction, which also provides better results in terms of improving the clinical efficacy and prognosis of patients and might be an alternative option for clinical practice.

Influence of different qualitative composition of infusion solutions on cerebral hemodynamics in patients with acute ischemic stroke

The aim: Investigate the effect of 0.9% NaCl, HES 130, HAES-LX-5% and mannitol 15% on cerebral hemodynamics in patients with AIS. Materials and methods: The study included 100 patients with AIS. As the investigated solutions were used: isosmolar 0.9% NaCl, hyperosmolar mannitol 15%, colloid-isoosmolar HES 130, colloid-hyperosmolar HAES-LX-5%. The control group received only 0.9% NaCl compared: 0.9% NaCl+HES 130, 0.9% NaCl+HAES-LX-5%, 0.9% NaCl+mannitol 15%. Evaluation of cerebral hemodynamic (indexes of cerebral blood flow) was performed using doppler ultrasound of cerebral arteries. Results: The dynamics of specific volume velocity of blood flow per 100 grams of brain substance indicates that in the group of 0.9% NaCl and 0.9% NaCl+mannitol is the tendency to decrease the blood flow of the brain during 7 days of treatment, respectively: 2.8% and 7.5%. In patients with HES 130 solution cerebral blood flow increases by 14.2%, whereas when applied HAES-LX-5% during 7 days, it increases by 43.2% (p=0.004). Conclusions: The analysis of the data of treatment the patients with AIS showed the best effect (p=0.004) of improvement of the cerebral circulation in the use of the polyfunctional infusion solution HAES-LX-5% unlike the 0.9% NaCl group and group of 0.9% NaCl+mannitol where was a decrease of the dynamics of cerebral blood flow, which could lead to hypoperfusion of the brain.

New features of the cerebral hemodynamics of brain arteries in patients with HIV-infection in Uzbekistan

We aim to study the cerebral hemodynamic indices of the brain arteries in HIV-infected patients. 56 HIV-infected patients were examined, with verified serological and clinical diagnosis, whose average age was 35.7 ± 1.3 years, among which there were 31 (55.4%) men and 25 (44.6%) women. The state of cerebral hemodynamics and vascular reactivity of the cerebral arteries was studied using standard techniques using sensors of 2, 4, 8 MHz on the Spectromed-300 device (Russia). Cerebral hemodynamic disorders in patients according to the Doppler study showed a decrease in blood flow velocity in the ICA by 24.5 and 33.9%, in the MCA by 25.4 and 34.5%, in the PA - by 24.3 and 44.7%, in OA - by 21.7 and 32.6% (groups 1 and 4, respectively) in relation to the indicators in the control group. There were also signs of an increase in vascular tone in all investigated vessels, according to an increase in the pulsation index (Pi) and circulatory resistance (Ri), on average, 1.5 and 2.3 times in group 1; 1.8 and 2.75 times in 4 groups. An increase in vascular tone suggests the inadequate functioning of dilatatory mechanisms at the capillary bed level, which indicates stress in the mechanisms of adaptation of cerebral vessels, which, if not corrected, can lead to their breakdown and development of dyscirculatory processes in the CNS in HIV-infected patients already at the preclinical stages of the disease.

Using computerized tomography perfusion to measure cerebral hemodynamics following treatment of traumatic brain injury in rabbits.

The present study aimed to investigate the use of computerized tomography (CT) perfusion for evaluating cerebral hemodynamics following traumatic brain injury (TBI) in rabbits. The animals were randomly assigned into four groups (n=10 animals/group): i) Control, ii) TBI, iii) TBI + common decompression and iv) TBI + controlled decompression groups. A TBI model was established in rabbits using epidural balloon inflation. In the groups receiving intervention, animals were provided common decompression or controlled decompression treatments. Conventional CT and CT perfusion scanning were performed, with cerebral hemodynamic indices, including regional cerebral blood flow (rCBF), regional cerebral blood volume (rCBV) and mean transit time (MTT) being measured. Blood-brain barrier (BBB) permeability was evaluated using Evans blue staining. Compared with those in the control group, rCBF and rCBV values of the bilateral temporal lobes and basal ganglion in the TBI, TBI + common decompression and TBI + controlled decompression groups were significantly lower, whereas the MTT values were markedly prolonged and Evans blue dye content was greatly increased (P<0.01). Controlled decompression was demonstrated to be more potent than common decompression for preventing TBI-induced decline in rCBF and rCBV values in the bilateral temporal lobes and basal ganglion, as well as reversing TBI-induced extension of MTT in the bilateral temporal lobes (P<0.01 vs. TBI group). However, neither common nor controlled decompression could reduce TBI-induced increase in BBB permeability. In conclusion, these findings indicate that CT perfusion may be used to monitor cerebral hemodynamics following TBI in rabbits. Controlled decompression was deduced to be more potent than common decompression for preventing abnormalities in cerebral hemodynamics after TBI.

Study on the Cerebral Blood Flow Regulatory Features of Acupuncture at Acupoints of the Governor Vessel.

Background: Many studies to clarify the influences of acupuncture at different acupoints of various meridians on cerebral blood flow (CBF) were conducted in the past. However, the influences of acupuncture at the points of the Governor Vessel on CBF have not yet been studied tangibly. Objective: The purpose of this study was to investigate the influences of acupuncture at individual acupoints of the Governor Vessel on cerebral hemodynamic indices. Materials and Methods: Two hundred and seventy-nine patients with chronic cerebral circulation insufficiency (CCCI) were observed, using a cerebrovascular disease diagnosis system (CVD 3000, KCC, Pyongyang, Democratic People's Republic of Korea). Various hemodynamic indices-such as vascular compliance, hemodynamic resistance, and blood flow quantity-were compared before and after acupuncture at individual acupoints of the Governor Vessel. Results: The influences of the points of Governor Vessel on CBF were different from each other, and systemic specificity of the Governor Vessel did not emerge. The largest number of indices showed significant changes when GV 16 was punctured, and the effects of GV 16, GV 20, and GV 14 on the head and the neck were relatively better than those of the points on the trunk. Conclusions: The points on the head and the neck of the Governor Vessel improve CBF biphasic regulation relatively better than the points on the trunk.

Assessment of cerebral hemodynamic parameters using pulsatile versus non-pulsatile cerebral blood outflow models.

Prior methods evaluating the changes in cerebral arterial blood volume (∆CaBV) assumed that brain blood transport distal to big cerebral arteries can be approximated with a non-pulsatile flow (CFF) model. In this study, a modified ∆CaBV calculation that accounts for pulsatile blood flow forward (PFF) from large cerebral arteries to resistive arterioles was investigated. The aim was to assess cerebral hemodynamic indices estimated by both CFF and PFF models while changing arterial blood carbon dioxide concentration (EtCO2) in healthy volunteers. Continuous recordings of non-invasive arterial blood pressure (ABP), transcranial Doppler blood flow velocity (CBFVa), and EtCO2 were performed in 53 young volunteers at baseline and during both hypo- and hypercapnia. The time constant of the cerebral arterial bed (τ) and critical closing pressure (CrCP) were estimated using mathematical transformations of the pulse waveforms of ABP and CBFVa, and with both pulsatile and non-pulsatile models of ∆CaBV estimation. Results are presented as median values ± interquartile range. Both CrCP and τ gave significantly lower values with the PFF model when compared with the CFF model (p ≪ 0.001 for both). In comparison to normocapnia, both CrCP and τ determined with the PFF model increased during hypocapnia [CrCPPFF (mmHg): 5.52 ± 8.78 vs. 14.36 ± 14.47, p = 0.00006; τPFF (ms): 47.4 ± 53.9 vs. 72.8 ± 45.7, p = 0.002] and decreased during hypercapnia [CrCPPFF (mmHg): 5.52 ± 8.78 vs. 2.36 ± 7.05, p = 0.0001; τPFF (ms): 47.4 ± 53.9 vs. 29.0 ± 31.3, p = 0.0003]. When the CFF model was applied, no changes were found for CrCP during hypercapnia or in τ during hypocapnia. Our results suggest that the pulsatile flow forward model better reflects changes in CrCP and in τ induced by controlled alterations in EtCO2.

Assessment of the Agreement between Cerebral Hemodynamic Indices Quantified Using Dynamic Susceptibility Contrast and Dynamic Contrast-enhanced Perfusion Magnetic Resonance Imagings.

Background:Brain tumor is one of the most common tumors. A successful treatment might be achieved with an early identification. Pathological investigation as the gold standard method for tumor identification has some limitations. Noninvasive assessment of tumor specifications may be possible using perfusion-weighted magnetic resonance imaging (MRI). Cerebral blood volume (CBV) and cerebral blood flow (CBF) could be calculated based on dynamic contrast-enhanced MRI (DCE-MRI) in addition to dynamic susceptibility contrast MRI (DSC-MRI) modality. Each category of the cerebral hemodynamic and permeability indices revealed the specific tumor characteristics and their collection could help for better identification of the tumor. Some mathematical methods were developed to determine both cerebral hemodynamic and permeability indices based on a single-dose DCE perfusion MRI. There are only a few studies available on the comparison of DSC- and DCE-derived cerebral hemodynamic indices such as CBF and CBV.Aim:The objective of the study was to validate first-pass perfusion parameters derived from T1-based DCE method in comparison to the routine T2*-based DSC protocol.Materials and Methods:Twenty-nine patients with brain tumor underwent DCE- and DSC-MRIs to evaluate the agreement between DSC- and DCE-derived cerebral hemodynamic parameters. Agreement between DSC- and DCE-derived cerebral hemodynamic indices was determined using the statistical method described by Bland and Altman. The reliability between DSC- and DCE-derived cerebral hemodynamic indices was measured using the intraclass correlation analysis.Results:The achieved magnitudes for DCE-derived CBV (gray matter [GM]: 5.01 ± 1.40 mL/100 g vs. white matter [WM]: 1.84 ± 0.74 mL/100 g) and DCE-derived CBF (GM: 60.53 ± 12.70 mL/100 g/min vs. WM: 32.00 ± 6.00 mL/100 g/min) were in good agreement with other studies. The intraclass correlation coefficients showed that the cerebral hemodynamic indices could accurately be estimated based on the DCE-MRI using a single-compartment model (>0.87), and DCE-derived cerebral hemodynamic indices are significantly similar to the magnitudes achieved based on the DSC-MRI (P < 0.001). Furthermore, an acceptable agreement was observed between DSC- and DCE-derived cerebral hemodynamic indices.Conclusion:Based on the measurement of the cerebral hemodynamic and blood–brain barrier permeability using DCE-MRI, a more comprehensive collection of the physiological parameters cloud be achieved for tumor evaluations.

Clinical effect of Danhong injection combined with acupuncture in the treatment of vascular parkinson

Objective To study the clinical effect of Danhong injection combined with acupuncture in the treatment of vascular Parkinson syndrome (VP). Methods A total of 98 patients with VP who were treated in the hospital from January 2015 to January 2017 were enrolled in this study. According to the digital random table method, the patients were divided into two groups, the observation group and the control group with each 49 cases. Both groups were given basic treatment, and based on that, the observation group was treated with Danhong injection and acupuncture treatment. Both groups were compared before and after 8 weeks of treatment with the outcome indices of exercise and motor function score, blood rheology index and cerebral hemodynamic indexes, as well as adverse reactions. Results The total effective rate of the observation group was 87.76% (43/49), while the control group was 71.43% (35/49), and the difference was statistically significant (χ2=4.021, P 0.05). Conclusions The Danhong injection combined with acupuncture showed better effect on VP patients, and it could improve the clinical symptoms and blood circulation. Key words: Parkinson disease,secondary; Danhong injection; Acupuncture therapy; Integrated Chinese traditional and western medicine therapy

Association between FSP, CVHI, inflammatory cytokines and the incidence of primary stroke

This case-control study was designed to establish a new risk-prediction model for primary stroke using Framingham stroke profile (FSP), cerebral vascular hemodynamic indexes (CVHI) and plasma inflammatory cytokines including hs-CRP, IL-6, TNF-α and Lp-PLA2. A total of 101 primary stroke patients admitted to Dongguan Houjie Hospital between August 2014 and June 2015 were assigned into the case group, and 156 age- and gender-matched healthy subjects from the Houjie Community were allocated into the control group. The prognostic values of FSP, CVHI and inflammatory cytokines including high sensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and lipoprotein-associated phospholipase A2 (Lp-PLA2) were assessed by multivariate logistic regression analysis. Seven risk-prediction models (FSP, CVHI, inflammatory cytokine, FSP+CVHI, FSP+inflammatory cytokine, CVHI+inflammatory cytokine, CVHI+FSP+inflammatory cytokine) were successfully established and the prognostic values were statistically compared by ROC curve and Z test. For FSP, the stroke risk was significantly elevated by 2.85 times when the FSP score was increased by 1 level (P=0.043), increased by 3.25 times for CVHI (P=0.036), 6.53 times for IL-6 (P=0.003), and 7.75 times for Lp-PLA2 (P=0.000). The sensitivity of FSP+CVHI+inflammatory cytokine and CVHI+inflammatory cytokine models was higher than 90%. For model specificity, the specificity of FSP+CVHI+inflammatory cytokine model alone exceeded 90%. FSP, CVHI, IL-6 and Lp-PLA2 are independent risk factors of stroke. Integrating IL-6 and Lp-PLA2 into the models can significantly enhance the risk prediction accuracy of primary stroke. Combined application of FSP+CVHI+inflammatory cytokine is of potential for risk prediction of primary stroke.

The correlation study of cerebral vascular hemo-dynamic index with blood pressure, body mass index etc.in 28 616 outpatients

Objective To explore the correlation study of cerebral vascular hemo-dynamic index(CVHI) with blood pressure, body mass index (BMI) etc.in outpatients. Methods Participants were outpatients with non-invasive CVHI test, who were selected as study subjects.Height, weight, blood pressure and other general information were investigated and the distribution characteristics of blood pressure, BMI and CVHI were compared in different age and gender groups. Results A total of 28 616 subjects were included in the study.The age range was 11-99 years.Means of CVHI integral score in males and females were (77.78±28.44)points and (79.18±27.8)points(t=4.275, P<0.01), and abnormality rates of the score(<75 points) were 30.1% and 28.1%(χ2=13.444, P<0.01), the differences were statistically significant.CVHI score was decreased and the abnormal rate was increased with aging.Systolic blood pressure was elevated with aging and diastolic blood pressure was higher in middle age subjects(40-65 years). The proportions of over weighted and obesity in male were 37.5% and 15.4%, which in female were 33.2% and 14.9%(χ2=70.661, P<0.01). It was especially higher in middle age subjects. Conclusion Degree of injury of cerebrovascular function and level of systolic blood pressure are along with aging.Means of BMI and diastolic blood pressure is higher in middle age population.The rate of high risk individuals in outpatients is about 30%. Key words: Blood pressure; Body mass index(BMI); Cerebrovascular Trauma; Stroke

Study on Cerebral Blood Flow Regulatory Features of Acupuncture Stimulation at Various Acupoints

Abstract Background: Acupuncture therapy is widely used for treating cerebrovascular diseases, including chronic cerebral artery insufficiency, poststroke, and vertebrobasilar artery insufficiency (VBI). To improve the effect of acupuncture for treating cerebral vascular diseases, it is necessary to clarify the effect of the individual acupoints on the cerebral hemodynamic indices and prescribe the acupoints according to their functional features. Objective: The goal of this research was to observe the influence of acupuncture stimulation at some acupoints of the Gallbladder and Bladder Meridians on cerebral hemodynamic indices. Materials and Methods: For this study, 249 patients with cerebrovascular diseases, including VBI, poststroke, and chronic cerebral artery insufficiency were observed. All participants were outpatients in the Pyongyang Medical College Hospital of Kim Il Sung University, in Pyongyang City, of the Democratic People's Republic of Korea, from January of 2012 to October of 2014. Various...

Change in Cerebrovascular Resistance as Diagnostic Index of Cerebral Hemodynamics in Patients with Severe Combined Traumatic Brain Injury

Change in Cerebrovascular Resistance as Diagnostic Index of Cerebral Hemodynamics in Patients with Severe Combined Traumatic Brain Injury

The Interventional Effect of Remote Ischemic Preconditioning on Cerebral Small Vessel Disease: A Pilot Randomized Clinical Trial

Background: Remote ischemic preconditioning (RIPC) of the limb has been shown to induce ischemic tolerance in basic and clinical studies that focused on sustained large artery occlusion rather than small vessel disease (SVD). This study aimed to evaluate the protective effects of brief repetitive limb RIPC on patients with cerebral SVD. Methods: Seventeen patients with cerebral SVD were enrolled. Patients underwent 5 ischemia-reperfusion cycles of preconditioning/sham preconditioning on both upper limbs twice a day for 1 year. Cerebral hemodynamic indexes, brain lesions, cognitive functions and assessment outcomes of dizziness handicap inventory (DHI) were analyzed. Results: In the RIPC group, the mean flow velocity (MFV) of the left middle cerebral artery (MCA) was accelerated (57.33 (52.33-61.34) vs. 51.33 (48.83-58.33), respectively; p = 0.038), and the post-treatment DHI score was reduced (18 (13-19) vs. 34 (21-45), respectively; p = 0.043). The post-treatment volume of the white matter lesions (WMLs) was also reduced (4.19 (2.96-7.25) vs. 6.06 (4.67-10.95), respectively; p = 0.050). There was no remarkable difference between the 2 groups either before or after treatment. Conclusion: The present study indicates that RIPC has potential beneficial effects on cerebral SVD by increasing the MFV of MCA, decreasing the DHI score as well as the volume of WMLs in patients with SVD.