[Prevalence of asymptomatic intracranial artery stenosis in middle-aged and elderly population in the community of Foshan city, Guangdong province: a cross-sectional study].

OBJECTIVE: To investigate the prevalence and risk factors of asymptomatic intracranial artery stenosis in middle-aged and elderly population in the community of Foshan city, Guangdong province. METHODS: Subjects from residential communities were chosen through Cluster sampling method. Physical data and history were collected. Serum fasting glucose, total cholesterol and triglycerides concentrations were tested with venous blood samples. Intracranial artery stenosis was diagnosed by transcranial Doppler (TCD). Data was analyzed by the software SPSS 18.0. RESULTS: 1405 subjects met the inclusive criteria, among which 163 (11.6%) were found one (7.4%) or more (4.2%) stenotic arteries, and the standardized rate was 10.3%. 9.89% of the SICA, and 3.05%, 2.29%, 1.59%, 1.38%, 0.89% of basilar artery, middle cerebral artery, anterior cerebral artery, vertebral artery, posterior cerebral artery were found stenotic respectively. Data from the age-stratified analysis showed that the prevalence in these above 70 (27.8%) was significantly higher than that under age 70 (7.5%) (P = 0.000). Single factor and logistic regression analysis demonstrated the history of diabetes mellitus and elevated systolic pressure present were significantly different between stenotic group and the non-stenotic group (P = 0.000, P = 0.000), which were the independent risk factors of asymptomatic stenosis of intracranial arteries (OR = 2.362, 95%CI: 1.194 - 4.674;OR = 1.024, 95%CI: 1.016 - 1.031). CONCLUSION: Comparatively high prevalence of asymptomatic intracranial artery stenosis in middle-aged and aged community population was found in the Southern part of China, especially among the age group above 70. History of diabetes and elevated systolic pressure seemed to be the independent risk factors of asymptomatic stenosis of intracranial arteries.

[Role of abdominal obesity in asymptomatic intracranial arterial stenosis: a community-based study].

OBJECTIVE: To investigate the relationship between abdominal obesity and intracranial artery stenosis and the underlying mechanism. METHODS: By cluster sampling, 1405 adult Han people were selected from the residential communities. Among them, 1035 people conformed to the inclusion criteria. Medical history was documented and body height, body weight, waist circumference, hip circumference and blood pressure were measured. Venous blood samples were collected to detect the serum concentrations of fasting glucose, total cholesterol and triglycerides. Serum nitric oxide (NO) level was determined by cadmium reduction method. Middle cerebral artery stenosis (MCAS) was diagnosed by transcranial Doppler. The SPSS 11.0 software package was used for data analysis. RESULTS: MCA stenosis was found in 66 subjects (6.4%). Univariate analysis showed history of hypertension, history of ischemic heart disease, systolic blood pressure and diastolic blood pressure were the risk factors for MCAS and waist-to-hip ratio (WHR) was a risk factor only in males. Logistic regression demonstrated history of hypertension was an independent risk factor for MCAS both in males and females (P = 0.011, P = 0.009) and WHR for MCAS only in males (P = 0.030). Among males and females over 55 years old, the NO levels were higher in people with a higher WHR and the difference was statistically significant (P = 0.042, P = 0.016); however the NO levels for people with a varying WHR showed statistically insignificant difference among females under 55 years old (P = 0.228). CONCLUSION: Hypertension and abdominal obesity are important risk factors for MCAS. Endothelial cell dysfunction and an elevated level of oxidative stress may be involved in the atherogenetic mechanism of abdominal obesity while estrogen may play a protective role in it.

Patient with pontine warning syndrome and bilateral posterior internuclear ophthalmoplegia: case report.

BACKGROUND: Capsular warning syndrome was first described in 1993, featured with repetitive episodes of motor and/or sensory dysfunction without cortical signs. Recently, it has been demonstrated that clinically typical capsular warning syndrome can be associated with pontine infarct and the term oepontine warning syndrome was coined. CASE PRESENTATION: A 54-year-old woman with a history of hypertension was seen with profound left-sided hemiplegia. She had had 3 episodes of left-sided weakness before complete hemiplegia. Her speech was slurred. Left central facial palsy and hemiglossoplegia were presented. Her left plantar response was extensor and bilateral posterior internuclear ophthalmoplegia was seen on neurologic examination. Biochemical tests revealed hyperglycemia and dyslipidemia on the next day. MRI demonstrated an acute right paramedian pontine infarct. The patient was commenced on oral clopidogrel, atorvastatin and acarbose. After 23 days of hospitalization, she was discharged with severe left hemiplegia. CONCLUSIONS: 1) Pontine warning syndrome may be underestimated and understudied. 2) Posterior internuclear ophthalmoplegia is a rare clinical sign in cerebrovascular diseases, while it can help to locate a brainstem lesion rather than an internal capsular one. 3) Blood pressure lowering administration may be improper for patients with pontine warning syndrome.

[Study on the correlation between hypertension and the indexes of vascular endothelial function among people living in the community].

OBJECTIVE: To study the features of hypertension and vessel endothelium functional parameter in people living at the community level as well as the risk factors of hypertension. Differences of angiotensin II (Ang II ), prostacyclin (PGI2) and nitric oxide (NO) among normal group and three hypertension groups were also studied. METHODS: By cluster sampling, 1134 adult Han people were selected from the residential communities. Medical history was documented and measurements of body height, body weight, waist circumference, hip circumference and blood pressure were performed. Serum NO levels were determined by cadmium reduction method while plasma Ang II and PGI2 concentration were determined by radioimmunoassay. SPSS 13.0 was used for data analysis. RESULTS: The total ratio of hypertension from people living at the community was 44.5%, with the standardized prevalence of hypertension as 15.3%. With the increase of age, the prevalence of hypertension also increased. Overweight and obesity seemed to be independent risk factors for hypertension. History of smoking and drinking and gender did not enter the logistic equation for hypertension. The amount of plasma Ang II concentration of the three hypertension groups was significantly lower than that in the normal group while the lowest group appeared to from the one that hypertension was under control. The NO and PGI2 levels of the two groups whose hypertension had been known were significantly higher than in the normal group while the difference between the group whose hypertension had not been measured and the normal group was not found. CONCLUSION: The prevalence of hypertension had been increasing. Control of body weight seemed to be a useful way for prevention of hypertension. We assumed that the negative feedback regulation of renin-angiotonin-aldosterone system in hypertension patient still existed which called for the research on the mechanism of hypertension.

[Risk factors of middle cerebral artery stenosis in Foshan community, Guangdong province: a longitudinal study].

OBJECTIVE: To explore the risk factors of middle cerebral artery stenosis (MCAS) in a dynamic manner so as to supply evidence to help prevent cerebral stroke based on the results of epidemiological study. METHODS: 2500 residents were sampled randomly from the residents of Rongqi town and underwent questionnaire survey, physical examination, transcranial Doppler sonography (TCD), and detection of plasma homocysteine (Hcy) in 2002, and 1068 of them that conformed with the criteria: (1) without symptoms of brain ischemia, (2) with temporal window to conduct TCD, and (3) having undergone the questionnaire survey and blood biochemical examination, were enrolled for lone-term study. In 2006 844 of the 1068 residents remained, 277 males and 567 females, aged 60 +/- 10 (12.5 - 88) who still conformed to the criteria. Based on the results of TCD examination of MCA the residents were divided into two groups, MCAS group and non-MCAS group. Logistic regression analysis was used to analyze the data. RESULTS: The morbidity of MCAS of the asymptomatic residents was 2.73% in 2002 and 4.62% in 2006. Logistic regression analysis demonstrated that history of diabetes mellitus (GM) and hyperhomocysteinemia (HHcy) were the risk factors of MCAS based on the data of 2002. But, 4 years later, history of hypertensive disease, coronary heart disease (CHD), diabetes mellitus and HHcy were the risk factors and marriage status was also a factor. The changes of coronary heart disease, DM and BMI were the risk factors of MCAS. CONCLUSION: MCAS exists in the asymptomatic residents. History of hypertensive disease, DM, CHD and HHcy are the risk factors of MCAS Heart attack and changes of body weight contributed to MCAS.