RESUMO
Early neurological deterioration (END) is an unfavorable outcome of acute ischemic stroke and is associated with poor prognosis. Blood pressure variability has been suggested to be involved in the development of END. Therefore, the present study investigated the association between blood pressure variability and the development of END. In the present prospective observational study, 286 patients who developed acute ischemic stroke and then hospitalized within 24 h of stroke onset were recruited. Blood pressure parameters (systolic blood pressure, diastolic blood pressure and pulse pressure) were monitored using a 24 h ambulatory sphygmomanometer within 72 h of ischemic onset. Clinical characteristics were also recorded. Multivariate logistic regression analysis was used to analyze the possible relationship between blood pressure parameters and END after adjustment for confounders. Of the 286 patients in the present study, 64 (22.3%) developed END. Pulse pressure variables, including the mean of 24-h pulse pressure (24-h PPMEAN) and the mean of daytime pulse pressure (Day PPMEAN), were found to be higher in the END group compared with those in the non-END group (P<0.05). Multivariate logistic regression analysis revealed that the blood pressure parameters 24-h PPMEAN [odds ratio (OR), 1.08; 95% CI, 1.01-1.16; P=0.02) and Day PPMEAN (OR, 1.20; 95% CI, 1.011-1.45; P=0.04) were significantly associated with END. These findings suggest that the pulse pressure level fluctuations during the acute stage of ischemic stroke can serve important roles in the development of END, which worsens outcomes after stroke.
RESUMO
The paper introduces professor LU Yonghui 's academic thought and clinical experience in treating benign prostatic hyperplasia (BPH). It is believed that the pathogenesis of BPH includes retarded qi movement of triple energizers and dysfunction of the bladder in qi activity, resulting in impairment of water metabolism, and difficulty in micturition occurs. In treatment, acupuncture is delivered at the muscle region (membrane) of the body to promote qi circulation. The needles are inserted at the acupoints of conception vessel to different depths. The shallow insertion is operated at Qihai (CV 6) and Guanyuan (CV 4) to benefit qi movement of triple energizers, the moderate insertion is at Zhongji (CV 3), the front-mu point of the bladder, to benefit the intersections (membranes) of triple energizers, and the deep insertion is at Qugu (CV 2) to work at the internal organ, regulate qi, remove obstruction. As a result, the qi movement of triple energizers is improved, the function of the bladder in qi activity recovered, urination ameliorated and the retention of urine cured.