الملخص
Ischemic stroke （IS） is a serious cerebrovascular disease common in clinical practice. Targeting the pathogenesis of IS， intravenous thrombolysis for restoring blood flow is still the most effective therapy. However， intravenous thrombolysis has shortcomings such as increased bleeding risk， narrow therapeutic window， and contraindications， which limited its clinical application. Protection of the ischemic brain tissue before full recovery of blood flow is associated with the prognosis of IS. Studies have identified multiple pathways in the alleviation of the brain injury caused by IS， such as the mammalian target of rapamycin （mTOR） signaling pathway. Traditional Chinese medicine （TCM） has abundant therapies and unique advantages in the treatment of IS， especially in alleviating symptoms and improving the quality of life of patients. After the onset of IS， TCM can be integrated with Western medicine to play a role in the whole process of treatment， rehabilitation， and recurrence prevention as soon as possible， thus maximizing patient benefits. TCM has clinical significance for the recovery of neurological and motor functions after IS. Studies have shown that TCM can reduce the cerebral injury caused by IS by regulating and activating the mTOR signaling pathway， thereby regulating autophagy， inhibiting apoptosis of nerve cells， and reducing oxidative stress and inflammation. TCM exerts a positive effect for achieving cerebral protection and improving the prognosis of IS and provides new ideas for the prevention and treatment of IS. This article introduces the role of the mTOR signaling pathway in the pathogenesis of IS and reviews the research progress in the TCM regulation of this pathway in the treatment of IS， aiming to provide new therapeutic ideas and systematic scientific reference for the treatment of IS with TCM.
الملخص
Objective To investigate the value of blend sign and/or black hole sign with CT scanning for predicting early hematoma enlargement in patients with primary intracerebral hemorrhage.Methods From July 2011 to July 2016,244 consecutive patients with primary intracerebral hemorrhage in the First Affiliated Hospital of Chongqing Medical University were enrolled prospectively.From the onset to the first CT time were all ≤ 6 h.They were randomly divided into either an early hematoma enlargement group (n =82) or a non-hematoma enlargement group (n =162) according to whether they had early hematoma enlargement or not.The general data of patients were collected and compared between the groups,including previous history,clinical features,Glasgow coma scale (GCS) at admission,imaging features (black hole sign,blend sign and black hole sign and/or blend sign),etc.Multivariate logistic regression analysis was performed on the factors influencing early hematoma enlargement.The predictive value of imaging signs of early hematoma enlargement was analyzed.Results (1) In patients with early hematoma enlargement,there were 27 (32.9％) patients had black hole sign,33 (40.2％) had blend sign,and 50(61.0％) had blend sign and/or black hole sign.(2) The volume of hematoma according to 1 ml,the first CT time from onset to admission according to 1 h,and GCS on admission according to 1,the black hole sign and blend sign were included in the multivariate logistic regression analysis.The results showed that both the blend sign (OR,14.04,95％ CI 5.16-38.18) and the black hole sign (OR,5.69,95％ CI 2.12-15.30) were the independent risk factors for early hematoma enlargement (all P ＜ 0.01).After further adjustment,it showed that the blend sign and/or black hole sign were also the independent risk factors for early hematoma enlargement (OR,14.08,95％ CI 5.99-33.08,P ＜0.01).(3) After the analysis of the receiver operating characteristic curve,the sensitivity,specificity,positive predictive value,negative predictive value,and Youden Index of the blend sign and/or black hole sign of predicting early hematoma enlargement were 61.0％,90.1％,76.0％,82.0％,and 0.511,respectively.Its Youden Index was closer to 1 than the black hole sign (Youden Index:0.280) and the blend sign (Youden Index:0.346).Conclusion Compared with the single sign,the blend sign combined with black hole sign has better predictive ability for early hematoma enlargement after intracerebral hemorrhage.
الملخص
Objective To observe the effect of the self-made traditional Chinese medicine combined with brufen in treatment of cervical spondylosis. Methods 170 cases were divided into the treatment group(85 cases) and the control group(85 cases) randomly. The control group was treated with brufen. Patients in treatment group received routine treatment plus the self-made traditional Chinese medicine. After the treatment, the curative effect, aches and coma were analyzed. Results The total effective rate was 94. 1% in treatment group but 84. 7% in control group.Difference between the two groups had statistical significance( x2 = 3.997,P ＜ 0. 05). The integrate of 1 ahes and coma were ( 7. 8 ± 2. 4), (9. 4 ± 2. 1 ) marks and ( 2. 5 ± 0. 6), (3. 1 ± 0. 9) respectively, it was lower than before treatment(11.9 ±2.3) ,(12.3 ±2.9) marks and (5.6 ± 1.4) ,(5.3 ± 1.2) marks. Aches and coma showed a great difference after treatment from those before treatment( t = 34. 641、6. 159、6. 173、6. 080,all P ＜0. 05 ). Aches and coma were lower then those of control group(t =9. 283、3. 464,all P ＜0. 05). No severe adverse reaction occurred in two groups. Conclusion The self-made traditional Chinese medicine combined with brufen is effective to treat aches and coma in cervical spondylosis. The method was feasible for treat aches and coma in cervical spondylosis.
الملخص
Twenty six uncontrolled patients with Graves′ disease were treated with thyroid artery embolism. Twenty two cases were followed for 24 60 months. The long term effect was observed after thyroid artery embolism. The results showed that the long term cure rate is 81.4% (18/22).