MRI characteristics and evaluation of cryptococcus meningoencephalitis in HIV-negative patients / 实用放射学杂志

Objective To search MRI features of patients with HIV-negative cryptococcus meningoencephalitis (CM)and evaluate the value in judging the prognosis of CM.Methods The findings of cranial MRI and prognosis were retrospectively analyzed in 19 cases with India-ink capsule staining-proved HIV-negative CM in our department.The prognosis was evaluated by Glasgow Outcome Scale:score 1=death,score 2=persistent vegetative state,score 3=severe disability,score 4=moderate disability,score 5=good recovery. The patients with score 1-3 were classified as the group of poor prognosis,while those with score 4,5 as good prognosis.Results Abnormal manifestations on cranial MRI were observed in 84.2%(1 6/1 9)cases,meninges enhanced in 84.2% (1 6/1 9),brain edema in 31.6%(6/1 9),brain parenchyma lesion in 47.4% (9/1 9 ),vasculitis in 5.2% (1/1 9 ).The mean duration of follow-up was 3.5 years,The prognosis of 5/9(44.4%)cases with brain parenchyma lesion confirmed by cranial MR was poor.Conclusion The MRI manifestation of HIV-negative CM is diverse,and brain parenchyma lesion confirmed by cranial MRI may associated with poor prognosis.

Study on the relationship between plasma homocysteine and ischemic stroke in young and middle-aged adults / 中国基层医药

Objective To observe the relationship between plasma level of homocysteine(HCY) and ischemic stroke in young and middle-aged adults,explore the clinical signficance concerning the occurrence and development of ischemic stroke in young and middle-aged adults.Methods The plasma homocysteine level of 132 young and middle-aged adults patients with ischemic and 86 control peoples were measured by means of enzymatic cycling assay.Results The plasma homocysteine level in ischemic stroke was higher than that in control group( P ＜ 0.01 ).The higher the plasma homocysteine level,the larger infarcted focus in acute ischemic stroke group of young and middleaged adults.The plasma homocysteine level and the infarcted focus was positively linearly correlated.Conclusion Hyperhomocysteinemia is a risk factor of ischemic stroke among young and middle-aged adults.The higher the plasma homocysteine level,the larger infarcted focus in acute ischemic stroke group.The plasma homocysteine level can reflect the size of the infarcted focus and the degree of disease,and the plasma homocysteine level should serve as a kind of regular examination or as an index intervention can be taken,all of which are great importance to prevent ischemic stroke and reduce its morbilily.