Activating blood circulation to remove stasis treatment of hypertensive intracerebral hemorrhage: A multi-center prospective randomized open-label blinded-endpoint trial / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the efficacy and safety of the Chinese herbal therapeutic regimen of activating blood circulation (TRABC) in treatment of hypertensive intracerebral hemorrhage (HICH).</p><p><b>METHODS</b>This was a multi-center prospective randomized open-label blinded-endpoint (PROBE) trial with HICH admitted to 12 hospitals. Totally 240 participants were randomized to the treatment group treated with TRABC in addition to conventional Western treatment or the control group with conventional Western treatment equally for 3 months. Primary outcome was degree of disability as measured by modified Rankin Scale (mRS). Secondary outcomes were the absorption of hematoma and edema, National Institutes of Health Stroke Scale (NIHSS) scores and patient-reported outcome measures for stroke and Barthel activities of daily living index. Adverse events and mortality were also recorded.</p><p><b>RESULTS</b>After 3 months of treatment, the rate of mRS 0-1 and mRS 0-2 in the treatment group was 72.5% and 80.4%, respectively, and in the control group 48.1% and 63.9%, respectively, with a significant difference between groups (P<0.01). Hematoma volume decreased significantly at day 7 of treatment in the treatment group than the control group (P=0.038). Average Barthel scores in the treatment group after treatment was 89.11±19.93, and in the control group 82.18±24.02 (P=0.003). NIHSS scores of the two groups after treatment decreased significantly compared with before treatment (P=0.001). Patient-reported outcomes in the treatment group were lower than the control group at day 21 and 3 months of treatment (P<0.05). There were 4 deaths, 2 in each group, and 11 adverse events, 6 in the treatment group and 5 in the control group.</p><p><b>CONCLUSION</b>The integrative therapy combined TRABC with conventional Western treatment for HICH could promote hematoma absorption thus minimize neurologic impairment, without increasing intracerebral hematoma expansion and re-bleeding.</p>

Effect of blood activating stasis removing method on prognosis of intracerebral hemorrhage patients / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the clinical effect and safety of blood activating stasis removing method (BASRM) on intracerebral hemorrhage patients.</p><p><b>METHODS</b>A multi-center, prospective, randomized, open, controlled and blinded endpoint design was adopted. Totally 228 intracerebral hemorrhage patients were assigned to the treatment group and the control group, 114 in each group by center randomized method. All patients received basic treatment of Western internal medicine. Patients in the treatment group received intravenous infusion with Xingnaojing Injection (XI) from the 1st day of grouping, 20 mL per day for 14 days. Then they took or were nasally fed with Chinese medical granules (by syndrome typing as complicated with wind syndrome, fire syndrome, and phlegm syndrome) for 21 days. Finally they took Naoxueshu Oral Liquid (NOL), 10 mL each time, 3 times per day till the 3rd month of incidence. Patients' disability degree, activities of daily living, neurological impairment, the effective rate, physiologic functions, mental status, social relationship, and degree of treatment satisfaction were assessed using Modified Rankin Scale (MRS), Barthel index (BI), National Institute of Health Stroke Scale (NIHSS), and patient reported outcome (PRO). Head CT was performed to evaluate the absorption of hematoma at the 1st and 7th day of grouping. The safety was also assessed.</p><p><b>RESULTS</b>Totally 108 patients in the treatment group and 112 patients in the control group completed the trial. There was no statistical difference in the total effective rate between the two groups after 3 months of treatment (P>0.05). The MRS score was obviously lower in the treatment group than in the control group (P<0.01) at month 3 after attack (P<0.01). There was statistical difference in the difference between pre-post hematoma volume between the two groups after 7-day treatment (P<0.05). The NIHSS score of two groups at the 7th, 14th, 21st day, and 3rd month decreased significantly (P<0.05). Compared with the control group, the decremenit of NIHSS score decreased more obviously in the treatment group at day 7, 21, and 3rd month (P<0.05). Compared with the control group, the BI increased (P<0.01); physiologic fupctions, social relationship, treatment satisfaction and total score in PRO scale were all lower in the treatment group than in the control group (P<0.05, P<0.01). The incidence of adverse events occurred in 7 cases (6.14%) in the treatment group and 5 cases (4.39%) in the control group, with no statistical difference (P>0.05).</p><p><b>CONCLUSION</b>BASRM could lower the deformity rate of intracerebral hemorrhage patients at month 3, effectively promote hematoma absorption within 7 days, improve neurologic impairment, and elevate living abilities at month 3 of onset.</p>

Use of the SmartPrep technique with concentration of contrast medium control in CT angiography of vertebral and carotid artery / 中华放射学杂志

Objective To study the optimal enhancement phase and exact triggering scan time on spiral CT angiography of vertebral and carotid artery,and to improve the rate of 3D-CT display in vertebral and carotid artery.Methods One hundred and thirty-three cases of CT angiography of vertebral and carotid artery(87 vertebral and 46 carotid artery)were examined with SmartPrep software,which controled the scan at real time after 100 ml contrast medium(350 mg I/ml Omnipaque)were quickly injected through foot back vein.One hundred and thirteen cases of control group were examined by triggeing off the scanning with a delay time of 18—22 s after blous injection through foot back vein.The vertebral and carotid arteries were demonstrated with 3 dimensional reconstruction.Results The successful rate in SmartPrep group was 100% with the enhancement situated in best(n=130)or good(n=3)scanning phase.The threshold concentration values of target vessel were kept on 100 HU in the whole scan period[(18?4)s].However, the triggering time of enhancement scanning was not equal(15—43s)and the deviation was up to 28 s.The average concentration of target vessel was obviously higher in SmartPrep group[(161.4?2.0)HU]than in the control group[(133.3?2.2)HU](t=-9.456,P