Diagnosis Of Acute Cerebral Infarction Research Articles

Diagnostic value and clinical significance of lncRNA LINC01123 combined with fibrinogen in acute cerebral infarction

ObjectiveTo explore the diagnostic value and clinical significance of lncRNA LINC01123 (LINC01123) binding fibrinogen in acute cerebral infarction (ACI) by evaluating the expression and potential molecular mechanism of LINC01123 in patients with acute cerebral infarction. MethodsThe clinical data of all the volunteers were collected. The level of serum LINC01123 in ACI patients was detected by RT-qPCR. The relationship between LINC01123 and fibrinogen was studied via Pearson’s correlation analysis. ROC curve was used to evaluate the diagnostic value of LINC01123 and fibrinogen for ACI. The risk factors of ACI were investigated by Binary Logistic regression analysis. And the targeting relationship between LINC01123 and downstream miR-361–3p was verified through luciferase activity assay. ResultsSerum LINC01123 and fibrinogen levels were upregulated in ACI patients compared with healthy controls (P < 0.001), and there was a positive correlation between them (r = 0.6537, P < 0.001). In predicting the occurrence of ACI, LINC01123 and fibrinogen have high diagnostic value, and the AUC of combined diagnosis was 0.961, and the sensitivity and specificity (92.54%, 85.82%) were more significant. Meanwhile, LINC01123 and fibrinogen were confirmed to be independent risk factors for ACI (P < 0.0001). Mechanistically, miR-361–3p is the target of LINC01123. The expression of miR-361–3p was low in the serum of ACI patients, which was negatively correlated with the LINC01123 expression (r = −0.6885, P < 0.0001). ConclusionLINC01123 combined with fibrinogen may have important reference value in the diagnosis of ACI as serum markers, which may become clinical indicators to predict the occurrence of ACI.

Bilateral anterior thalamic symmetrical infarction: a case study

BackgroundBilateral anterior thalamic symmetrical infarction is very rarely observed in clinical practice and has rarely been reported in the literature. In this paper we introduce a patient with bilateral anterior thalamic symmetrical infarction and discuss his symptoms, treatment process, and follow-up visit results, as well as the potential pathological mechanisms of the disease.Case presentation: A 71-year-old male had a sudden cognitive decline four days prior to medical consultation. The patient’s brain MRI showed symmetrical high signals in the anterior part of both sides of the thalamus. The patient’s head MRV and immunological tests were normal, and we considered that this patient had a rare case of bilateral anterior thalamic infarction. After 10 days of anti-platelet aggregation that lowered blood lipids and improved circulation, the patient’s symptoms significantly abated. Two years later, we found through telephone follow-up that the patient’s symptoms had not relapsed substantially and that he was able to perform self-care, having only continued to suffer a slight decline in short-term memory.ConclusionFor patients with bilateral prethalamic lesions who have only acute cognitive impairment, if the lesions conform to the blood supply area of both thalamic nodular arteries and DWI shows a high signal, the diagnosis of acute cerebral infarction should be considered, and the standard treatment plan for cerebral infarction should be given as soon as possible.

Effect of VEGF on neurological impairment and prognosis of acute cerebral infarction patients: A retrospective case-control study.

Due to the complex pathological mechanism of acute cerebral infarction, the role of vascular endothelial growth factor (VEGF) on the disease is not clear. Therefore, a retrospective case-control study was performed to explore the effect of VEGF on neurological impairment and prognosis of acute cerebral infarction patients. A total of 100 patients with acute cerebral infarction admitted to our hospital from April 2021 to April 2022 were selected. Blood samples from all patients would be routinely collected to detect the expression of serum VEGF. Pearson chi-square, Spearman correlation and univariate Logistic regression were used to analyze the clinical data to explore the relationship between VEGF expression and basic information, stroke degree, quality of life, and prognosis of patients. To determine whether VEGF can provide relevant basis for the early prevention and prognostic treatment of acute cerebral infarction. And multivariate logistic regression was used to calculate the odds ratio between each variable and VEGF expression. Pearson chi-square test and Spearman correlation coefficient showed that sex, degree of stroke, limb convulsions, loss of consciousness, hemiplegia, aphasia, mental functioning score, overall quality of life score, and short-term prognosis were significantly correlated with VEGF expression in 100 patients. Univariate logistic regression was used to describe the ORs and 95% confidence interval of subjects at the univariate level, and the degree of stroke (OR = 83.333, P < 0.001), tic of limbs (OR = 26.316, P < 0.001), loss of consciousness (OR = 23.256, P < 0.001), hemiplegia (OR = 62.500, P < 0.001), aphasia (OR = 76.923, P < 0.001), mental functioning score (OR = 7.937, P < 0.001), overall quality of life score (OR = 5.464, P < 0.001), short-term prognosis (OR = 37.037, P < 0.001) was significantly correlated with the high expression of VEGF. The level of serum VEGF was positively correlated with neurological impairment degree and prognosis in patients with acute cerebral infarction, the more severe the degree of stroke and the worse the prognosis.

High expression of serum GST-π/CypA aids the diagnosis of acute cerebral infarction and predicts short-term poor prognosis

ObjectiveThe study examined the diagnostic and prognostic value of GST-π combined with CypA in acute cerebral infarction (ACI). MethodsThe study included 115 ACI patients and 85 healthy people. Expression patterns of serum GST-π and CypA were detected using ELISA. The diagnostic efficiency of GST-π, CypA, and GST-π combined with CypA on ACI was assessed by ROC curves. Pathological parameters were further analyzed using the Fisher test, t test, and one-way ANOVA. ACI patients were subsequently assigned into severe, moderate, and mild groups under the National Institutes of Health Stroke Scale (NIHSS), followed by Pearson analysis of the correlation between GST-π and CypA and NIHSS scores. The prognosis was evaluated by follow-up using modified Rankin Scale. Correlation between GST-π/CypA expression and ACI prognosis was predicted using a survival curve, and the predictive value of GST-π/CypA on ACI prognosis was assessed with a ROC curve. Lastly, the independent correlation of GST-π and CypA with poor ACI prognosis was analyzed with Logistics multivariate regression analysis. ResultsGST-π and CypA were both highly-expressed in ACI patients. GST-π combined with CypA could better aid ACI diagnosis. Expressions of GST-π and CypA were positively correlated with NIHSS scores of ACI patients. High expressions of GST-π and CypA were correlated with poor short-term prognosis of ACI patients. ConclusionSerum GST-π combined with CypA aids diagnosis and predicts poor short-term prognoses of ACI. Data AvailabilityThe data that support the findings of this study are available from the corresponding author upon reasonable request.

Optimized Deconvolutional Algorithm-based CT Perfusion Imaging in Diagnosis of Acute Cerebral Infarction.

To apply deconvolution algorithm in computer tomography (CT) perfusion imaging of acute cerebral infarction (ACI), a convolutional neural network (CNN) algorithm was optimized first. RIU-Net was applied to segment CT image, and then equipped with SE module to enhance the feature extraction ability. Next, the BM3D algorithm, Dn CNN, and Cascaded CNN were compared for denoising effects. 80 patients with ACI were recruited and grouped for a retrospective analysis. The control group utilized the ordinary method, and the observation group utilized the algorithm proposed. The optimized model was utilized to extract the feature information of the patient's CT images. The results showed that after the SE module pooling was added to the RIU-Net network, the utilization rate of the key features was raised. The specificity of patients in observation group was 98.7%, the accuracy was 93.7%, and the detected number was (1.6 ± 0.2). The specificity of patients in the control group was 93.2%, the accuracy was 87.6%, and the detected number was (1.3 ± 0.4). Obviously, the observation group was superior to the control group in all respects (P < 0.05). In conclusion, the optimized model demonstrates superb capabilities in image denoising and image segmentation. It can accurately extract the information to diagnose ACI, which is suggested clinically.

Study on Model Iterative Reconstruction Algorithm vs. Filter Back Projection Algorithm for Diagnosis of Acute Cerebral Infarction Using CT Images.

The aim was to explore the application value of computed tomography (CT) perfusion (CTP) imaging based on the iterative model reconstruction (IMR) in the diagnosis of acute cerebral infarction (ACI). 80 patients with ACI, admitted to hospital, were selected as the research objects and divided randomly into a routine treatment group (group A) and a low-dose group (group B) (each group with 40 patients). Patients in group A were scanned at 80 kV–150 mAs, and the traditional filtered back projection (FBP) algorithm was employed to reconstruct the images; besides, 80 kV–30 mAs was adopted to scan the patients in group B, and the images were reconstructed by IMR1, IMR2, IMR3, iDose4 (a kind of hybrid iterative reconstruction technology), and FBP, respectively. The application values of different algorithms were evaluated by CTP based on the collected CTP images of patients and detecting indicators. The results showed that the gray and white matter CT value, SD value, SNR, CNR, and subjective image scores of patients in group B were basically consistent with those of group A (p > 0.05) after the IMR1 reconstruction, and the CT and SD of gray and white matter in patients from group B reduced steeply (p < 0.05), while SNR and CNR increased dramatically after IMR2 and IMR3 reconstruction in contrast to group A (p < 0.05). Furthermore, the cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT) of contrast agent, and time to peak (TTP) of contrast agent in patients from group B after iDose4 and IMR reconstruction were basically the same as those of group A (p > 0.05). Therefore, IMR combined with low-dose CTP could obtain high-quality CTP images of the brain with stable perfusion indicators and low radiation dose, which could be clinically applied in the diagnosis of ACI.

High-Resolution MRI to Evaluate Benefit of Middle Cerebral Artery Stenosis in Secondary Prevention in Patients with Acute Cerebral Infarction

High-resolution magnetic resonance (HRMRI) combined with magnetic resonance angiography (MRA) was used to analyze the correlation between the degree of infarction and the degree of cerebral vascular stenosis, and these patients are all have the trend to contain acute infarction. All patients were examined by CT cerebral angiography, which was analysed by conventional magnetic resonance imaging (MRI), high-Resolution (HRMRI) imaging, and cerebral vascular (MRA) imaging. The infarct size of each patient with cerebral infarction was calculated. The degree of middle cerebral artery stenosis was evaluated. Moreover, agnosis of acute cerebral infarction in middle cerebral artery region was calculated, and the correlation between acute cerebral infarction in middle cerebral artery region and the degree of cerebral vascular stenosis was analyzed. The specificity, sensitivity, and accuracy of magnetic resonance angiography (MRA) in the diagnosis of acute cerebral infarction in the blood supply area of the middle cerebral artery were 90.48%, 94.87%, and 93.94%. The coincidence rates for the degree of middle cerebral artery stenosis were 90.91% for mild stenosis, 92.31% for moderate stenosis, 93.75% for severe stenosis, and 85.71% for vascular occlusion, respectively. The K value was in good agreement with the results of CTA diagnosis (≥0.75). In conclusion, HRMRI can clearly indicated that the location of lesions with acute cerebral infarction, and MRA can show the degree of vascular stenosis, there is a close relationship between them.

内因性脳梗塞が先行した外傷症例に対し急性期再灌流療法を施行した1例(A case of revascularization therapy for acute ischemic stroke with a chief complaint of traumatic injury)

要旨 標準的な外傷診療では生理学的機能の管理および安定化を重視しており，神経学的所見は見逃されやすい。内因性脳梗塞が先行した外傷症例の診療について検討した。症例は78歳の男性，階段2階の踊り場から転落した。右共同偏視，右片麻痺，Glasgow coma scale（GCS）12の意識障害を認めた。外傷全身computed tomography（CT）で頭蓋内に占拠性病変は認めず，動脈優位相で左中大脳動脈の造影欠損を認めた。急性期脳梗塞と診断し，機械的血栓回収療法を行った。外傷機転を介在する内因性脳梗塞では，見逃しや治療介入に時間を要する可能性がある。病院前脳卒中スケールが症状検出に役立つ可能性があり，頭頂部の動脈優位相を含む造影CT検査で主幹動脈閉塞の検索が可能である。画像評価には熟練を要するため，3次元画像処理を行うとともに，適切に専門医へコンサルトし早期診断治療へつなげることが重要である。

Expression of miR-210, miR-137, and miR-153 in Patients with Acute Cerebral Infarction.

Aim To explore the expression levels of miR-210, miR-137, and miR-153 in patients with acute cerebral infarction. Material and Methods. 76 patients with acute cerebral infarction treated in our hospital from April 2016 to October 2017 were enrolled as the observation group. Another 64 normal patients were selected as the control group. The patients were divided into the death and survival groups based on 1-year mortality of patients. qRT-PCR was used to detect the expression of miR-210, miR-137, and miR-153 in the serum of each group. Receiver operating characteristic (ROC) curve was employed to analyze the diagnostic value and predictive value of miR-210, miR-137 and miR-153 death in patients. The correlation between miR-210, miR-137, and miR-153 in the serum of the observation group was analyzed by Pearson's test. Results Levels of miR-210 and miR-137 in the observation group were significantly lower than those in the control group, while levels of miR-153 in the observation group were significantly higher than those in the control group (all P < 0.05). The ROC curve of diagnosis of acute cerebral infarction showed that the area under curve of miR-210 was 0.836, that of miR-137 was 0.843, and that of miR-153 was 0.842. The 1-year survival rate was 71.05%. The 1-year survival of the low-expression group of miR-210 and miR-137 was significantly lower than that of the high-expression group, while the 1-year survival of the low-expression group of miR-153 was significantly higher than that of the high-expression group (all P < 0.05). The ROC curve for predicting death showed that the area under curve of miR-210 was 0.786, that of miR-137 was 0.824, and that of miR-153 was 0.858. Pearson's correlation analysis showed that the expression of miR-210 was positively correlated with that of miR-137, while miR-137 was negatively correlated with that of miR-153 and miR-210 was negatively correlated with that of miR-153. Conclusion miR-210, miR-137, and miR-153 have a certain value in the diagnosis and prediction of 1-year death of acute cerebral infarction and may be potential diagnostic and predictive indicators.

Influencing Factors of Recanalization after Intravenous Thrombolysis with Urokinase in Acute Cerebral Infarction Patients

Background: Intravenous thrombolysis (IVT) with urokinase is the standard reperfusion therapy for acute cerebral infarction (ACI) in China. Only about 30% patients who use urokinase for IVT can recanalize. Therefore, this study aimed to analyze the influencing factors of recanalization after IVT using urokinase in ACI patients. Methods: A total of 391 consecutive patients with a diagnosis of ACI from January 2013 to October 2019 were enrolled and divided into 2 groups: patients without recanalization and patients with recanalization. Related data were collected and analyzed. Results: Univariate analysis showed that there were significant differences in gender, atrial fibrillation, erythrocyte mean corpuscular volume, platelet large cell ratio (P-LCR), glucose (GLU), and severity of ICAS between patients without recanalization and patients with recanalization (p < 0.05). Multivariate logistic regression analysis indicated that P-LCR (odds ratio [OR] = 0.17, 95% confidence interval [CI] = 0.03–0.89, p = 0.04), GLU (OR = 0.28, 95% CI = 0.11–0.67, p = 0.004), and ICAS severity (OR = 0.48, 95% CI = 0.32–0.76, p = 0.001) were the influencing factors of recanalization. Conclusion: For patients with higher levels of P-LCR, GLU, or ICAS severity, the recanalization rate might decrease after ACI.

Plasma level of miR-99b may serve as potential diagnostic and short-term prognostic markers in patients with acute cerebral infarction.

ObjectiveThe aim of the present study is to explore the potential diagnostic and prognostic value of plasma levels of miR‐99 family for patients with acute cerebral infarction (ACI).MethodsA total of 112 patients who have been diagnosed with ACI were enrolled in this study, and 112 healthy volunteers were served as the controls. The plasma of the patients and controls were collected, and total RNAs were isolated, and the expression levels of miR‐99a, miR‐99b, and miR‐100 in the plasma of patients and controls were compared determined by RT‐qPCR methods; moreover, the receiver operating characteristic (ROC) curve has been drawn to determine whether the plasma levels of miR‐99b can distinguish patients with ACI from the controls; furthermore, the short‐term prognosis of the patients was evaluated by glasgow outcome scale (GOS), and the correlation between the plasma levels of miR‐99b and the GOS of the patients was evaluated. Finally, the correlation between the plasma level of miR‐99 and VEGF of ACI patients was analyzed.ResultsIt was observed that miR‐99b was significantly decreased in the plasma of ACI patients compared with the healthy controls (P < .01), while the plasma levels of miR‐99a and miR‐100 showed no significant differences between the patients with ACI and the healthy controls; moreover, the area under the curve (AUC) of miR‐99b for the diagnosis of ACI was 0.8882 (95% confidence interval (CI), 0.8451‐0.9313), suggesting that plasma level of miR‐99b is a sensitive marker to distinguish patients with ACI from the healthy volunteers; furthermore, the serum level of miR‐99b was negatively correlated with GOS score of the patients (r = −.56, P < .001); finally, the plasma level of miR‐99b was negatively correlated with the levels of VEGF (r = −.3013, P = .0012).ConclusionmiR‐99b was down‐regulated in plasma of patients with ACI, and plasma level of miR‐99b may be a potential diagnostic and prognostic marker for the diagnosis and treatment of ACI.

Diagnostic Value of Serum MIF and CCL23 in the Patients with Acute Cerebral Infarction.

The current study aims to investigate the clinical significance of serum macrophage migration inhib-itory factor (MIF) and C-C motif chemokine living 23 (CCL23) in patients with acute cerebral infarction (ACI). Seventy-nine patients with ACI were selected and divided into three types, including large-area atherosclerosis (LAA), cardiovascular central embolism (CCE), and small-area occlusion (SAO) according to the Trial of Org 10172 in Acute Stroke Treatment or TOAST. At the same time, 79 healthy people were selected as the control group. The concentrations of MIF and CCL23 were measured by ELISA. Pearson's correlation assay was carried out to explore the correlation between MIF, CCL23, and clinical index. The diagnostic value of MIF and CCL23 was evaluated using ROC analysis. Our data showed that both of MIF and CCL23 levels were significantly enhanced in the serum of ACI patients compared to controls. Pearson's correlation assay indicated that serum MIF and CCL23 levels were positively correlated with NIHSS score, but negatively correlated with Barthel index. Moreover, the concentrations of MIF and CCL23 in CCE and LAA subgroups were significantly higher than those in SAO subgroups, while there was no statistical significance between CCE and LAA subgroups. ROC curve showed that combined use of MIF and CCL-23 demonstrated a better AUC of 0.903 (95% CI: 0.840 - 0.966), with the sensitivity and specificity of 0.91 and 0.87, respectively. In summary, both MIF and CCL23 were significantly increased in ACI patients. Combined use of MIF and CCL23 may be helpful in the diagnosis of ACI.

Evaluation of lipoprotein-associated phospholipase A2, serum amyloid A, and fibrinogen as diagnostic biomarkers for patients with acute cerebral infarction.

ObjectiveThe aim of this study was to explore the clinical values of combined detection of lipoprotein‐associated phospholipase A2 (Lp‐PLA2), serum amyloid A (SAA), and plasma fibrinogen (FIB) in the diagnosis of acute cerebral infarction (ACI).MethodsA case‐control study including 100 hospitalized patients with ACI and 47 healthy controls was carried out. The level of Lp‐PLA2, SAA, and FIB was detected, respectively, and their clinical values were analyzed. Carotid lesions and neurological impairment were also analyzed in each patient.ResultsThe level of Lp‐PLA2, SAA, and FIB in the ACI group was significantly higher than that of the controls, and the three biomarkers showed a significant positive correlation and were considered as risk factors for ACI. The area under the curve (AUC) for Lp‐PLA2, SAA, and FIB was 0.858, 0.743, and 0.672, respectively. When three biomarkers were used in combination, the AUC was 0.879. Compared with the other groups, the levels of three biomarkers in bilateral carotid plaque ACI group were all significantly higher. In addition, the level of Lp‐PLA2 and SAA in ACI patients with severe neurological impairment was also significantly higher than that of the mild‐to‐moderate group.ConclusionLp‐PLA2 combined with SAA and FIB had a high clinical value for rapid diagnosis and prediction of ACI. These biomarkers were also significantly associated with the formation of bilateral carotid atherosclerotic plaques and the severe neurological impairment in ACI patients.

Analysis of CT and MRI Combined Examination for the Diagnosis of Acute Cerebral Infarction.

The aim of this study was to analyse the application value of CT and MRI combined examination for the diagnosis of acute cerebral infarction. It was an observational study carried out from March 2017 to April 2018. All the patients of acute cerebral infarction, diagnosed on the basis of clinical and laboratory findings and underwent brain CT and MRI examination within 6 hours after the onset of the disease, were included in the study. A total of 70 patients were diagnosed, which included 40 (57.14%) males and 30 (42.86%) females. Median age was 64 years. The confirmed diagnosis rate of acute cerebral infarction by CT combined with MRI was higher than that by CT examination alone (p<0.001). The positive rates of the brainstem were statistically different between the two methods (p=0.007). The diameter of infarct lesion in CT combined with MRI was longer than that in CT examination alone (p<0.001). CT combined with MRI can be used as the first choice for early diagnosis of acute cerebral infarction, particularly of brain stem.

Predictive value of serum procalcitonin and hypersensitive C-reactive protein levels in patients with acute cerebral infarction complicated with infection

To analyze the changes of early procalcitonin (PCT) and hypersensitive C-reactive protein (hs-CRP) in patients with acute cerebral infarction, and to explore the predictive value of both for acute cerebral infarction with infection. 206 acute cerebral infarction patients admitted to the department of neurology of Feicheng Mining Center Hospital from May 2014 to May 2019 were enrolled. Clinical data of patients and serum PCT and hs-CRP levels at 24, 48 and 72 hours after onset were collected. Patients were divided into infected group (n = 69) and non-infected group (n = 137) according to whether infection occurred within 5 days after onset. And 60 healthy people in the same period were selected as the healthy control group. The trends of serum PCT and hs-CRP levels in each group were analyzed. The receiver operating characteristic (ROC) curve was used to analyze the values of serum PCT and hs-CRP levels in identifying acute cerebral infarction with infection. The serum level of PCT at 24, 48 and 72 hours in the infected group and the non-infected group were significantly higher than those in the healthy control group, and the serum level of PCT at 48 hours and 72 hours in the infected group were significantly higher than those in the non-infected group (μg/L: 0.28±0.08 vs. 0.19±0.03, 0.31±0.07 vs. 0.15±0.06, both P < 0.05). Compared with 24 hours, the serum PCT level in the infected group at 48 hours and 72 hours were significantly increased, but decreased in the non-infected group. The serum hs-CRP level in the infected group at 24, 48 and 72 hours were significantly higher than those in the non-infected group and the healthy control group (mg/L: 5.86±1.73 vs. 5.45±1.08, 5.25±1.33; 8.01±2.41 vs. 5.67±2.13, 5.25±1.33; 14.25±2.19 vs. 12.30±1.87, 5.25±1.33; all P < 0.05). And the serum hs-CRP level in the non-infected group at 72 hours was significantly higher than that in the healthy control group. Compared with 24 hours, the serum hs-CRP level in the infected group and non-infected group at 48 hours and 72 hours were significantly increased. It was shown by ROC curve analysis that serum PCT and hs-CRP levels at 24 hours had no predictive value for infection in patients with acute cerebral infarction [area under ROC curve (AUC) was 0.440, 0.576 respectively, both P > 0.05]. At 48 hours, the AUC of serum PCT in diagnosis of acute cerebral infarction with infection was 0.850 [95% confidence interval (95%CI) = 0.784-0.916], the sensitivity and specificity were 66.7% and 97.8% when the cut-off of PCT was 0.25 μg/L; the AUC of serum hs-CRP was 0.759 (95%CI = 0.689-0.830), the sensitivity and specificity were 66.7% and 76.6% when the cut-off of hs-CRP was 6.80 mg/L; the AUC of PCT combined with hs-CRP was 0.911 (95%CI = 0.859-0.964), the sensitivity was 90.5%, the specificity was 86.9%. At 72 hours, the AUC of serum PCT in diagnosis of acute cerebral infarction with infection was 0.952 (95%CI = 0.916-0.989), the sensitivity and specificity were 89.9% and 93.4% when the cut-off of PCT was 0.23 μg/L; the AUC of serum hs-CRP was 0.753 (95%CI = 0.678-0.828), the sensitivity and specificity were 60.9% and 83.2% when the cut-off of hs-CRP was 14.01 mg/L; the AUC of PCT combined with hs-CRP was 0.954 (95%CI = 0.918-0.991), the sensitivity was 97.1%, and the specificity was 89.8%. The results showed that the diagnostic value of serum PCT at 48 hours and 72 hours were higher than those of hs-CRP, and the predictive value of PCT combined with hs-CRP was higher than those of single index. Acute cerebral infarction itself has an effect on serum PCT level; serum PCT level above 0.23 μg/L at 72 hours after onset and reference to serum hs-CRP level have a high predictive value for the diagnosis of infection in patients with acute cerebral infarction.

The relationship between oxidized low-density lipoprotein and related ratio and acute cerebral infarction.

This study aimed to study the value of oxidized low-density lipoprotein (OX-LDL) and related ratio in the diagnosis of acute cerebral infarction and the classification of acute cerebral infarction.Of the 129 patients enrolled in this study, 94 patients with acute cerebral infarction were assigned to the case group, and 35 healthy subjects were enrolled as control group (n = 35). And then the case group were divided into large-artery atherosclerosis (LAA) group (n = 61) and small-artery occlusion (SAO) group (n = 33) according to the TOAST classification standard. Plasma OX-LDL levels were determined by enzyme-linked immunosorbent assay. OX-LDL/total cholesterol (OX-LDL/TC), OX-LDL/high-density lipoprotein (OX-LDL/HDL), OX-LDL/LDL were calculated.There were significant differences in OX-LDL, OX-LDL/TC, OX-LDL/HDL, and OX-LDL/LDL in patients with acute cerebral infarction and those in control group (P < .001). The area under the receiver-operating characteristic curve of OX-LDL and related ratio was >0.7 (P < .001). There was a slight positive correlation between OX-LDL/TC and National Institutes of Health Stroke Scale score at admission (r = 0.265, P = .039) in the LAA group.OX-LDL, OX-LDL/TC, OX-LDL/HDL, and OX-LDL/LDL were closely related to acute cerebral infarction, especially with large atherosclerotic cerebral infarction. OX-LDL/TC can reflect the severity of acute cerebral infarction for LAA, but it cannot predict the short-term prognosis of acute cerebral infarction.

Introduction to the Technical Aspects of Computed Diffusion-weighted Imaging for Radiologists.

Diffusion-weighted (DW) imaging is a magnetic resonance (MR) imaging method. It is an indispensable sequence for the diagnosis of acute cerebral infarction and is recognized as a standard tool in oncologic imaging. Computed DW imaging refers to the synthesizing of arbitrary b-value DW images from a set of measured b-value images by voxelwise fitting. Computed DW imaging is advantageous because it generates DW images with a higher diffusion effect than that achievable by using the MR imaging units in use today. Additionally, computed DW imaging can reduce imaging time while producing images characterized by a higher signal-to-noise ratio than what the acquired DW images would display at the corresponding b values. By fitting input images acquired at a lower b value and correspondingly a shorter echo time, the signal intensity of the resulting computed DW image is closer to the ideal case. Computed DW images are generated by employing mathematical models that use mono-, bi-, or triexponential equations. To generate accurate computed DW images, the appropriate model must be selected, and the image parameters for the input data must be chosen accordingly. In addition, to reduce artifacts on computed DW images, the misalignment of input data must be corrected with the aid of image registration techniques. ©RSNA, 2018.

Effects of edaravone, the free radical scavenger, on outcomes in acute cerebral infarction patients treated with ultra-early thrombolysis of recombinant tissue plasminogen activator

ObjectivesEdaravone, a free radical scavenger, alleviates blood-brain barrier disruption in conjunction with suppression of the inflammatory reaction in acute cerebral infarction. Thrombolysis with recombinant tissue plasminogen activator (rtPA) is an established therapy for acute cerebral infarction patients. The purpose of this study was to assess the effects of edaravone on outcomes in acute cerebral infarction patients treated with ultra-early thrombolysis of iv-rt-PA. Patients and MethodsWe conducted a retrospective cohort study using the database of Ningbo First Hospital. We identified patients who were admitted with a primary diagnosis of acute cerebral infarction and treated with intravenous rtPA(iv-rtPA) within 3 h of symptom onset from March 1st in 2014 to October 31st in 2016.Thenceforth,the patients were divided into 2 groups by treatment with(edaravone group) or without edaravone(non-edaravone group). Glasgow Coma Scale (GCS) scores and mRS score at admission were used. Clinical background, risk factors for acute cerebral infarction hemorrhagic transformation, 7-day mortality, recanalization rate, bleeding complications and blood rheology indexes were collected. We also collected the following factors: National Institutes of Health Stroke Scale scores, barthel index. Results136 patients treated without edaravone during hospitalization were selected in non-edaravone group while edaravone group included 132 patients treated with edaravone during hospitalization. The patient baseline distributions were well balanced between non-edaravone group and edaravone group. The rate of hemorrhagic transformation in non-edaravone group was higher than that in edaravone group (P ＜ 0.05). The NIHSS scores 7 days and 14 days after symptom onset were higher in non-edaravone group than in edaravone group (both P ＜ 0.05). Edaravone group showed a higher recanalization rate and a lower bleeding complications rate at discharge than the non-edaravone group (both P ＜ 0.05). The differences of all the blood rheology indexes between the two groups were statistically significant (all P ＜ 0.05). ConclusionsEdaravone may improve outcomes of acute cerebral infarction patients treated with ultra-early thrombolysis of iv-rt-PA.

The Clinical Implications of Thrombelastography in the Diagnosis of Acute Cerebral Infarction.

Thrombelastography (TEG) is an analyzer reflecting the dynamic changes of blood coagulation. It has been used as a diagnosis index in many diseases. The aim of this study was to evaluate the relationship between TEG and acute cerebral infarction. Eighty patients with acute cerebral infarction and 80 healthy controls were enrolled. Each patient's TEG results and routine coagulation indices were recorded. All analyses were conducted with SPSS16.0 software. Patients with acute cerebral infarction showed lower TEG R and K levels but higher TEG MA levels. There was a significantly negative correlation between TEG R and fibrinogen in the patient group. In addition, receiver operator characteristic curve analysis showed that TEG MA (cutoff value 63.9 mm) was a predictor of acute cerebral infarction (AUC value = 0.741, sensitivity 61%, specificity 81%). TEG results have important clinical implications in the early diagnosis of acute cerebral infarction.

The alliance with expanding blood volume and correcting anemia is an effective therapeutic measure for the adult anemia patients of acute cerebral infarction

ABSTRACTPurpose/aim of the study: Various factors are believed to be involved in the etiology of cerebral infarction. Anemia has been shown to deteriorate in association with ischemic stroke. However, the exact clinical association between anemia and ischemic stroke still remains unclear. We evaluated the clinical features of adult anemia patients with acute cerebral infarction and seek a better treatment different from the other causes of cerebral infarction, and to provide a reference for the diagnosis and treatment of these anemia patients with acute cerebral infarction.Methods: Thirty-two adult patients of acute cerebral infarction with anemia were included in this study. A primary discharge diagnosis of acute cerebral infarction with anemia was done, and all subjects were evaluated as retrospective data. The clinical features were analyzed. A chi-square test was used to analyze the associations between different variables. Therapeutic interventions and outcomes were analyzed under t-test, compared between the two groups.Results: The NIHSS score in the patients with the administration of EBV/CA (Expanding blood volume and correcting anemia) more lowed than Non-EBV/CA in 7 days and 14 days after initial hospitalization. The mRS score in the patients with the administration of EBV/CA also more lowed than Non-EBV/CA in 14 days. Moreover, the correlation between Hb-serum-level and NIHSS scores in the time of initial hospitalization is negative significantly.Conclusions: Anemia is associated with increased neuronal damage and deterioration of acute cerebral infarction in the adults. Expanding blood volume and correcting anemia are effective therapeutic measures in the adult patients of acute cerebral infarctions with anemia.