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1.
Echocardiography ; 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31786807

RESUMO

OBJECTIVES: To evaluate whether inferior vena cava compression (IVCC) can be an alternative for valsalva maneuver (VM) in contrast-enhanced transcranial doppler (c-TCD). METHODS: Patients diagnosed with ischemic stroke, transient ischemic attack, and migraine were enrolled in this study. C-TCD was conducted at resting state, after VM and IVCC to detect right to left shunt (RLS). Then, the RLS was compared to examine whether IVCC could be an alternative for VM in c-TCD. RESULTS: A total of 246 patients were enrolled in this study. Via Wilcoxon signed-rank test of paired data, the detection for RLS of c-TCD conducted after IVCC was superior to at resting state, but inferior to after VM (P ï¼œ .001, P = .01, respectively); the detection for RLS of c-TCD conducted after IVCC was inferior to after VM for patients with good cooperation of VM, but was superior for patients with poor cooperation of VM (P ï¼œ .001, P ï¼œ .001, respectively); the detection for RLS of c-TCD conducted after IVCC and after VM showed no significant difference for patients with good cooperation of VM and without abdominal obesity, or with poor cooperation of VM and with abdominal obesity (P = .201, P = .157, respectively); the detection for RLS of c-TCD conducted after IVCC was superior to at resting state for patients with abdominal obesity (P ï¼œ .001). CONCLUSIONS: For patients with poor cooperation of VM, IVCC could be used as an effective supplement to increase the detection of RLS in c-TCD.

2.
Sleep Med ; 63: 82-87, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31606653

RESUMO

OBJECTIVE: To evaluate the effect of insomnia after acute ischemic stroke on cerebrovascular reactivity (CVR). METHODS: A total of 158 eligible patients with acute ischemic stroke were enrolled prospectively. Of these, six patients were lost to follow-up, and 152 were included in the final analysis. The patients were divided into the insomnia (N = 24) and non-insomnia (N = 128) groups based on the Athens Insomnia Scale. The insomnia group was further divided into benzodiazepine (BDZ) and non-BDZ treatment groups according to BDZ use status after ischemic stroke. The transcranial doppler ultrasound (TCD) breath-holding test was performed to calculate the breath-holding index (BHI) of the responsible cerebral middle artery, which was used to evaluate CVR. Then, univariate and multivariate linear regression analyses were carried out to determine the effect of insomnia after acute ischemic stroke on CVR. RESULTS: At one month after the onset of acute ischemic stroke, TCD-BHI was significantly higher in the non-insomnia group compared with the insomnia group (p = 0.027). In patients with insomnia, TCD-BHI was significantly higher in the BDZ treatment group compared with non-BDZ treatment group (p = 0.039). With age, hypertension, diabetes, hyperlipidemia, long-term smoking, blood homocysteine, and Athens Insomnia Scale score as independent variables, and TCD-BHI at one month after onset as a dependent variable, univariate and multivariate linear regression analyses indicated that the Athens Insomnia Scale score was an independent factor affecting TCD-BHI (regression coefficient, -0.013; 95% confidence interval (CI) -0.024 to -0.003). CONCLUSION: Insomnia after acute ischemic stroke is an independent risk factor for CVR.

3.
Clin Neurol Neurosurg ; 184: 105420, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31310922

RESUMO

OBJECTIVE: To prospectively evaluate the effect of morning blood pressure peak (MBPP) on early progressive ischemic stroke (EPIS). PATIENTS AND METHODS: A total of 135 patients with acute ischemic stroke were enrolled and completed all assessments. The patients were divided into EPIS group and non-EPIS group, with 22 and 113 cases in each group, respectively, according to the assessment of Scandinavian stroke scale within three days after onset. All cases received conventional treatment for stroke and its risk factors. 24 -h dynamic blood pressure monitoring was performed within 24 h after admission. Based on the 24 -h mean blood pressure, MBPP, morning blood pressure, and other risk factors for EPIS, we conducted a logistic regression analysis to evaluate whether MBPP was an independent risk factor for EPIS. RESULTS: Mean systolic blood pressure, systolic and diastolic MBPP, morning systolic and diastolic blood pressure were all significantly higher in EPIS group than in non-EPIS group (p = 0.037, p = 0.001, p = 0.035, p = 0.003, p = 0.042, respectively). Logistic regression analysis showed that MBPP was an independent risk factor for EPIS (OR = 1.057, 95% CI 1.014-1.102, p = 0.009). Further stratified analysis showed that incidences of EPIS in patients with elevated MBPP combined with large artery atherosclerosis or small artery occlusion were comparable (41.2% vs. 25.0%, p = 0.367), and the systolic MBPP was significantly higher in morning EPIS group than in non-morning EPIS group (p = 0.041). CONCLUSION: Elevated systolic MBPP might be an independent risk factor for EPIS, and play a more obvious effect on EPIS manifesting in the morning especially.

4.
Clin Neurol Neurosurg ; 168: 1-6, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29494855

RESUMO

OBJECTIVE: To evaluate the effect of fluoxetine on three-year recurrence rate of acute ischemic stroke. PATIENTS AND METHODS: 404 enrolled patients with acute ischemic stroke were randomly divided into control and treatment groups, and underwent conventional secondary preventive therapy for ischemic stroke. In addition, the treatment group was administered fluoxetine (20 mg daily for 90 days). A three-year follow-up was performed, and indicators related to risk factors of stroke were assessed at day 90 of follow-up. The effect of fluoxetine on the three-year recurrence rate of acute ischemic stroke was evaluated by survival analysis, as well as multifactor Cox regression analysis. RESULTS: The values of systolic blood pressure, blood total cholesterol, blood low density lipoprotein and glycosylated hemoglobin at day 90 of follow-up were significantly lower in treatment group than control group (P = 0.002, P = 0.002, P = 0.018, P = 0.011, respectively). The occurrence rates of epilepsy, gastrointestinal bleeding, syncope, allergic reactions, hemorrhagic infarction, and death were not significantly different between the two groups during the follow-up (P > 0.05). The recurrence-free survival rate of ischemic stroke was significantly lower in the treatment group than control group as assessed by the Kaplan-Meier test (85.1% Vs 75.7%, P = 0.016), as well as the recurrence-free survival rate after day 90 in the three-year follow-up (87.0% Vs 79.3%, P = 0.043). Multifactor Cox regression analysis demonstrated treatment with fluoxetine was an independent factor reducing three-year recurrence in acute ischemic stroke (HR = 0.594, 95% CI: 0.376-0.938). CONCLUSION: Treatment with fluoxetine for 90 days after acute ischemic stroke significantly reduces the three-year recurrence rate of ischemic stroke.


Assuntos
Isquemia Encefálica/tratamento farmacológico , Fluoxetina/uso terapêutico , Prevenção Secundária , Acidente Vascular Cerebral/tratamento farmacológico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Pressão Sanguínea/efeitos dos fármacos , Isquemia Encefálica/complicações , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Recidiva , Fatores de Risco , Fatores de Tempo , Adulto Jovem
5.
Restor Neurol Neurosci ; 34(2): 177-87, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26923613

RESUMO

PURPOSE: To evaluate the effect of using fluoxetine at different time intervals after ischemic stroke on neurological functional prognosis in China. METHODS: The patients enrolled were randomly allocated to three groups. Group A received fluoxetine 20 mg/day immediately; group B received fluoxetine 20 mg/day 7 days after enrollment; and group C did not receive fluoxetine. The therapeutic duration of fluoxetine was 90 days and the follow-up period was 180 days. RESULTS: The mean NIHSS score at day 90 was significantly lower in group A than group C (P = 0.005), while at day 180, the mean score in group A was significantly lower than groups B and C (P = 0.035, P = 0.000), respectively. The mean BI score at day 90 was significantly higher in group A than group C (P = 0.001), while at day 180, the mean score in group A was significantly higher than groups B and C (P = 0.036, P = 0.000), respectively. Regression analysis indicated that lower NIHSS score and higher BI score at day 180 were attributed to the early administration of fluoxetine. CONCLUSIONS: In patients with ischemic stroke, early administration of fluoxetine may improve the neurological functional prognosis.


Assuntos
Fluoxetina/uso terapêutico , Doenças do Sistema Nervoso/tratamento farmacológico , Doenças do Sistema Nervoso/etiologia , Inibidores de Captação de Serotonina/uso terapêutico , Acidente Vascular Cerebral/complicações , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Pressão Sanguínea/efeitos dos fármacos , Isquemia Encefálica/complicações , China , Método Duplo-Cego , Feminino , Frequência Cardíaca/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/diagnóstico por imagem , Neuroimagem , Exame Neurológico , Cooperação do Paciente , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Acidente Vascular Cerebral/etiologia , Fatores de Tempo , Adulto Jovem
6.
J Stroke Cerebrovasc Dis ; 25(4): 761-70, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26823037

RESUMO

OBJECTIVE: We investigated the effects of fluoxetine on the short-term and long-term neural functional prognoses after ischemic stroke. METHODS: In this prospective randomized controlled single-blind clinical study in China, eligible patients afflicted with ischemic stroke were randomized into control and treatment groups. Patients in the treatment group received fluoxetine in addition to the basic therapies in the control group over a period of 90 days. The follow-up period was 180 days. We evaluated the effects of fluoxetine on the National Institutes of Health Stroke Scale (NIHSS) score and Barthel Index (BI) score after ischemic stroke through single- and multiple-factor analysis. RESULTS: The mean NIHSS score on day 180 after treatment was significantly lower in the treatment group than in the control group (P = .009). The mean BI scores on days 90 and 180 were significantly higher in the treatment group (P = .026) than in the control group (P = .011). The improvements in the NIHSS and BI scores on days 90 and 180 compared with baseline in the treatment group were all significantly greater than that in the control group (P = .033, P = .013, P = .013, P = .019, respectively). Treatment with fluoxetine was an independent factor affecting the NIHSS and BI scores on day 180 after treatment. CONCLUSION: Treatment with fluoxetine for 90 days after ischemic stroke can improve the long-term neural functional outcomes.


Assuntos
Fluoxetina/uso terapêutico , Inibidores de Captação de Serotonina/uso terapêutico , Acidente Vascular Cerebral/tratamento farmacológico , Resultado do Tratamento , Isquemia Encefálica/complicações , China , Feminino , Seguimentos , Humanos , Masculino , Prognóstico , Índice de Gravidade de Doença , Método Simples-Cego , Acidente Vascular Cerebral/etiologia , Fatores de Tempo
7.
Chem Commun (Camb) ; 51(90): 16229-32, 2015 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-26401528

RESUMO

By using the simple but effective method-air plasma to treat the precursor Zn(OH)2, the hydrogen-related defects in ZnO, which lead to increased charge carrier recombination, have been reduced. Successfully, a photoelectric conversion efficiency of 8.03% for pure ZnO-based DSSCs has been achieved, which is the highest one up to now.

8.
PLoS One ; 8(7): e68254, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23861874

RESUMO

AIMS: Interindividual variability in telomere length is highly heritable. Leukocyte telomere length (LTL) shortening has been shown to be associated with the process of atherosclerosis. But whether the inheritance of LTL is related to stroke is still unclear. The aim of this study was to test if telomere shortening was associated with stroke and whether this association was mainly due to inheritance or acquired cardiovascular risk factors. METHODS: Our study was focused on stroke in patients and their siblings. 450 subjects were recruited into this study: 150 patients with ischemic stroke as case group, 150 siblings of patients free of stroke (sibling group) and 150 healthy people as normal control. LTL was measured by real-time Polymerase Chain Reactions. The association between LTL and the cardiovascular risk factors was also determined. RESULTS: A significant decrease of LTL was found in case group when comparing with sibling (0.92±0.77 vs 1.68±1.24, p<0.001) and normal groups (0.92±0.77 vs 1.95±1.07, p<0.001), but no significant difference was found between sibling group and healthy control (p = 0.330). Shorter telomere length was independently associated with hypertension (p = 0.029, OR = 2.189, 95%CI:1.084-4.421), recent social pressure (p = 0.001, OR = 3.121, 95%CI:1.597-6.101), age (p = 0.004, OR = 1.055, 95%CI:1.017-1.093), HDL (p = 0.022, OR = 0.227, 95%CI:0.064-0.810) and diabetes (p = 0.018, OR = 3.174, 95%CI:1.221-8.252). Additionally, shortened length of telomere (p = 0.017, OR = 3.996, 95%CI:1.283-12.774) was an independent risk biomarker for stroke among case and sibling groups. CONCLUSION: The present study has demonstrated that decreased LTL might be associated with ischemic stroke but unlikely to be causative.


Assuntos
Leucócitos/metabolismo , Acidente Vascular Cerebral/genética , Encurtamento do Telômero , Adulto , Biomarcadores , Doenças Cardiovasculares , Feminino , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Irmãos
9.
Neural Regen Res ; 7(14): 1088-94, 2012 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-25722699

RESUMO

Cerebral ischemia was induced using photothrombosis 1 hour after intraperitoneal injection of the p38 mitogen-activated protein kinase (MAPK) inhibitor SB239063 into Swedish mutant amyloid precursor protein (APP/SWE) transgenic and non-transgenic mice. The number of surviving neurons in the penumbra was quantified using Nissl staining, and the activity of p38 MAPKs was measured by western blotting. The number of surviving neurons in the penumbra was significantly reduced in APP/SWE transgenic mice compared with non-transgenic controls 7 days after cerebral ischemia, but the activity of p38 MAPKs was significantly elevated compared with the non-ischemic hemisphere in the APP/SWE transgenic mice. SB239063 prevented these changes. The APP/SWE mutation exacerbated ischemic brain injury, and this could be alleviated by inhibiting p38 MAPK activity.

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