Pub Date : 2010-10-08DOI: 10.3760/CMA.J.ISSN.1006-7876.2010.10.008
Chen Bin, W. Zhaoxia, Luan Xing-hua, Hong Dao-jun, Zhang Wei, Y. Yun
Objective To explore phenotypes and genotypes in 6 Chinese Han families with oculopharyngeal muscular dystrophy (OPMD).Methods There were 28 OPMD patients in 6 Chinese Han families, aged between 32 and 70 years old.The initial symptom was dysphagia in 13 patients, ptosis in 4 patients,lower limb weakness in 1 patient.Most OPMD patients displayed dysphagia and ptosis in 3-20 years after the initial symptom appeared.Biceps brachii biopsies were made in the 6 OPMD probands.The specimens were examined with histological, histochemical stainings and ultrastructural examination.The exon 1 of PABPN1 gene was sequenced in all probands of OPMD and some of their family members.Haplotype analysis was executed in the 6OPMD probands.Results Mild hypertrophy and hypotrophy of fibers and rimmed vacuoles were found in each probands of OPMD muscle biopsies.Intranuclear palisading filamentous inclusions only appeared in 4OPMD probands.Gene analysis identified (GCG)9 in exon 1 of PA BPN 1 gene was detected in 3OPMD families, while (GCG) 6 (GCA) 1 (GCG) 3, (GCG) 10 and (GCG) 8were in one family respectively.Two families with (GCG) 9 expansion shared a common rs2239579 (C) -(GCG) 9-SNP2622 (C) haplotype.Conclusions Dysphagia and ptosis may be the common initial symptoms in Chinese Han OPMD patients.Rimmed vacuoles and intranuclear inclusions may be the common pathological feature in the muscle fibers.Both (GCG) expansions and (GCA) insertion of PABPN1 gene could be detected in Chinese patients.The genetic heterogeneity and the haplotype of three (GCG)9 families in our patients indicate that OPMD arises from different origin within the Han population.Some families with the same (GCG)9 expansions probably come from a common ancestor. Key words: Muscular dystrophy, oculopharyngeal; Poly(A)-binding protein Ⅱ; Pedigree; Haplotypes
{"title":"Phenotypic and genotypic studies in 6 Chinese Han families with oculopharyngeal muscular dystrophy","authors":"Chen Bin, W. Zhaoxia, Luan Xing-hua, Hong Dao-jun, Zhang Wei, Y. Yun","doi":"10.3760/CMA.J.ISSN.1006-7876.2010.10.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1006-7876.2010.10.008","url":null,"abstract":"Objective To explore phenotypes and genotypes in 6 Chinese Han families with oculopharyngeal muscular dystrophy (OPMD).Methods There were 28 OPMD patients in 6 Chinese Han families, aged between 32 and 70 years old.The initial symptom was dysphagia in 13 patients, ptosis in 4 patients,lower limb weakness in 1 patient.Most OPMD patients displayed dysphagia and ptosis in 3-20 years after the initial symptom appeared.Biceps brachii biopsies were made in the 6 OPMD probands.The specimens were examined with histological, histochemical stainings and ultrastructural examination.The exon 1 of PABPN1 gene was sequenced in all probands of OPMD and some of their family members.Haplotype analysis was executed in the 6OPMD probands.Results Mild hypertrophy and hypotrophy of fibers and rimmed vacuoles were found in each probands of OPMD muscle biopsies.Intranuclear palisading filamentous inclusions only appeared in 4OPMD probands.Gene analysis identified (GCG)9 in exon 1 of PA BPN 1 gene was detected in 3OPMD families, while (GCG) 6 (GCA) 1 (GCG) 3, (GCG) 10 and (GCG) 8were in one family respectively.Two families with (GCG) 9 expansion shared a common rs2239579 (C) -(GCG) 9-SNP2622 (C) haplotype.Conclusions Dysphagia and ptosis may be the common initial symptoms in Chinese Han OPMD patients.Rimmed vacuoles and intranuclear inclusions may be the common pathological feature in the muscle fibers.Both (GCG) expansions and (GCA) insertion of PABPN1 gene could be detected in Chinese patients.The genetic heterogeneity and the haplotype of three (GCG)9 families in our patients indicate that OPMD arises from different origin within the Han population.Some families with the same (GCG)9 expansions probably come from a common ancestor. \u0000 \u0000Key words: \u0000Muscular dystrophy, oculopharyngeal; Poly(A)-binding protein Ⅱ; Pedigree; Haplotypes","PeriodicalId":10143,"journal":{"name":"中华神经科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84287024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-09-01DOI: 10.3760/CMA.J.ISSN.1006-7876.2010.09.004
Ce Huang, Lin-xin Li, Xue Han, Liang Wang, Q. Dong
Objective To investigate the relationship between white matter lesions (WML) within the cholinergic pathway and vascular cognitive impairment.Method Middle-aged and elderly stroke patients underwent brain MRI examination and Montreal Cognitive Assessment (MoCA).Cholinergic Pathways Hyperintensities Scale (CHIPS) scores and the overall WML burden by Schelten on fluidattenuated inversion recovery MRI images were determined and compared with MoCA scores.Spearman partial rank correlation coefficients and standardized regression coefficients were calculated.Results Thirty four patients were included ( mean age ( 62.2 ± 8.8 ) years, 45-82 years).MoCA scores negatively correlated with WML burdens by Schelten scores ( β = - 0.357, P = 0.042) and CHIPS scores ( β =-0.382,P=0.026).CHIPS scores were negatively associated with visuospatial and executive function (r = - 0.290, P = 0.048 ), naming function ( r = - 0.486, P = 0.002 ), attention ( r = - 0.311, P =0.037) and abstraction ( r = - 0.344, P = 0.023).Schelten scores were negatively associated with naming function (r = - 0.492, P = 0.002), attention ( r = - 0.364, P = 0.017) and abstraction ( r = - 0.390,P=0.011).Conclusion WML lesions within the cholinergic pathyway play a possible role in vascular cognitive impairment especially in visuospatial and executive function. Key words: Cholinergic fibers; Neurol pathways; Brain ischemia; Stroke; Congnitive disorders; Severity of illness index
{"title":"The role of cholinergic pathway lesions in vascular cognitive impairment","authors":"Ce Huang, Lin-xin Li, Xue Han, Liang Wang, Q. Dong","doi":"10.3760/CMA.J.ISSN.1006-7876.2010.09.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1006-7876.2010.09.004","url":null,"abstract":"Objective To investigate the relationship between white matter lesions (WML) within the cholinergic pathway and vascular cognitive impairment.Method Middle-aged and elderly stroke patients underwent brain MRI examination and Montreal Cognitive Assessment (MoCA).Cholinergic Pathways Hyperintensities Scale (CHIPS) scores and the overall WML burden by Schelten on fluidattenuated inversion recovery MRI images were determined and compared with MoCA scores.Spearman partial rank correlation coefficients and standardized regression coefficients were calculated.Results Thirty four patients were included ( mean age ( 62.2 ± 8.8 ) years, 45-82 years).MoCA scores negatively correlated with WML burdens by Schelten scores ( β = - 0.357, P = 0.042) and CHIPS scores ( β =-0.382,P=0.026).CHIPS scores were negatively associated with visuospatial and executive function (r = - 0.290, P = 0.048 ), naming function ( r = - 0.486, P = 0.002 ), attention ( r = - 0.311, P =0.037) and abstraction ( r = - 0.344, P = 0.023).Schelten scores were negatively associated with naming function (r = - 0.492, P = 0.002), attention ( r = - 0.364, P = 0.017) and abstraction ( r = - 0.390,P=0.011).Conclusion WML lesions within the cholinergic pathyway play a possible role in vascular cognitive impairment especially in visuospatial and executive function. \u0000 \u0000Key words: \u0000Cholinergic fibers; Neurol pathways; Brain ischemia; Stroke; Congnitive disorders; Severity of illness index","PeriodicalId":10143,"journal":{"name":"中华神经科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86176619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-08-08DOI: 10.3760/CMA.J.ISSN.1006-7876.2009.08.002
Wang Xue-jing, Shen Ruo-wu, Huang Liang, Li Xiao-hui, Tang Bei-sha
Objective To investigate the real type of the first earlier onset spinocerebellar ataxia family in China. Methods Two family members were subjected to autopsy, whose genetypings were confirmed by polymerase chain reaction (PCR) and direct sequencing technique. Golgi staining, immunohistochemistry and electron microscopy methods were used to detect the neurodegeneration in central nervous system of 2 patients. Results The light microscopic and electron microscopic showed synaptic degeneration of Purkinje cell in the cerebellar cortex, which was accompanied by deterioration of Purkinje cell, and both inferior olivary complex, dentate nucleus and anterior central gyrus. Conclusions There is severer neurodegeneration in the central nervous system of earlier onset spiuocerebellar ataxia 6 patient, especially in cerebellar cortex, inferior olivary complex and dentate nucleus, and the neurodegeneration may depend on disease duration. Key words: Spinocerebellar ataxias; Pedigree; Purkinje cells; Cerebellar nuclei
{"title":"A family with earlier onset spinocerebellar ataxia 6 in China","authors":"Wang Xue-jing, Shen Ruo-wu, Huang Liang, Li Xiao-hui, Tang Bei-sha","doi":"10.3760/CMA.J.ISSN.1006-7876.2009.08.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1006-7876.2009.08.002","url":null,"abstract":"Objective To investigate the real type of the first earlier onset spinocerebellar ataxia family in China. Methods Two family members were subjected to autopsy, whose genetypings were confirmed by polymerase chain reaction (PCR) and direct sequencing technique. Golgi staining, immunohistochemistry and electron microscopy methods were used to detect the neurodegeneration in central nervous system of 2 patients. Results The light microscopic and electron microscopic showed synaptic degeneration of Purkinje cell in the cerebellar cortex, which was accompanied by deterioration of Purkinje cell, and both inferior olivary complex, dentate nucleus and anterior central gyrus. Conclusions There is severer neurodegeneration in the central nervous system of earlier onset spiuocerebellar ataxia 6 patient, especially in cerebellar cortex, inferior olivary complex and dentate nucleus, and the neurodegeneration may depend on disease duration. \u0000 \u0000Key words: \u0000Spinocerebellar ataxias; Pedigree; Purkinje cells; Cerebellar nuclei","PeriodicalId":10143,"journal":{"name":"中华神经科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88062848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-01-08DOI: 10.3760/CMA.J.ISSN.1006-7876.2009.01.010
Guo Shou-gang, Du Yi-feng, Q. Chuan-qiang, Wang Minzhong, Tang Zhouping, Zhang Suming
Objective To explore the repair mechanism of olfactory ensheathing cells (OECs)-neurotrophin-3 (NT-3) gene engineering cell on neuron myeline and axon of experimental allergic encephalomyelitis (EAE).Methods OECs-NT-3 gene engineering cell, constructed by ueurotrophin-3 transinfecting OECs inducted by retrovirus, was transplanted into lateral ventricle.The migration and distribution were observed and compared with control group and OECs transplantation group.Then myeline repair and axon regeneration were evaluated in the aspects of function score, morphological structure, SYN grey level Results (1) OECs-NT-3 could survive, diffuse, migrate with axons, spread in the focus diffusely on the 28th day after transplantation.(2) OECs-NT-3 survived and migrated to the transcription level of NT-3 mRNA in transgene group, being (212.3±16.1)×10-2, significantly higher than OECs group ((1.98±0.19)×10-2) and the contrast group ((1.23±0.13)×10-2, t = - 31.161, -31.928, P < 0.01).(3) The myeline of transgene group was kept complete and the number of inflamatory focus was lower than those of other groups (t = 11.388-22.728, P <0.01).(4) The SYN grey level of transgene group was obviously higher (P < 0.01).Conclusion OECs-NT-3 cell expresses NT-3 in EAE stably and effectively, which contributes to the repair of myeline and the regeneration of axon. Key words: Encephalomyelitis, autoimmune, experimental; Gene therapy; Neurotrophic 3; Gene transfer techniques
{"title":"The treatment of olfactory ensheathing cells-neurotrophin-3 gene engineering cell transplantation on experimental allergic encephalomyelitis","authors":"Guo Shou-gang, Du Yi-feng, Q. Chuan-qiang, Wang Minzhong, Tang Zhouping, Zhang Suming","doi":"10.3760/CMA.J.ISSN.1006-7876.2009.01.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1006-7876.2009.01.010","url":null,"abstract":"Objective To explore the repair mechanism of olfactory ensheathing cells (OECs)-neurotrophin-3 (NT-3) gene engineering cell on neuron myeline and axon of experimental allergic encephalomyelitis (EAE).Methods OECs-NT-3 gene engineering cell, constructed by ueurotrophin-3 transinfecting OECs inducted by retrovirus, was transplanted into lateral ventricle.The migration and distribution were observed and compared with control group and OECs transplantation group.Then myeline repair and axon regeneration were evaluated in the aspects of function score, morphological structure, SYN grey level Results (1) OECs-NT-3 could survive, diffuse, migrate with axons, spread in the focus diffusely on the 28th day after transplantation.(2) OECs-NT-3 survived and migrated to the transcription level of NT-3 mRNA in transgene group, being (212.3±16.1)×10-2, significantly higher than OECs group ((1.98±0.19)×10-2) and the contrast group ((1.23±0.13)×10-2, t = - 31.161, -31.928, P < 0.01).(3) The myeline of transgene group was kept complete and the number of inflamatory focus was lower than those of other groups (t = 11.388-22.728, P <0.01).(4) The SYN grey level of transgene group was obviously higher (P < 0.01).Conclusion OECs-NT-3 cell expresses NT-3 in EAE stably and effectively, which contributes to the repair of myeline and the regeneration of axon. \u0000 \u0000Key words: \u0000Encephalomyelitis, autoimmune, experimental; Gene therapy; Neurotrophic 3; Gene transfer techniques","PeriodicalId":10143,"journal":{"name":"中华神经科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80565448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-11-08DOI: 10.3321/J.ISSN:1006-7876.2008.11.003
C. Liying, Li Shun-wei, Zhan Wei-wei, Peng Guo-guang, He Li, Fan Dong-sheng, Shenjia Yang, Wan Yong-jun, Gao Xu-guang, Jia Jian-ping, Zeng Jin-sheng, X. En, Li Cheng-yan, H. Jia
Objective To assess the efficacy and safety of dl-3-butylphthalide on the treatment of acute ischemic stroke. Methods A total of 197 patients who were in the period of 72 hours of first attack of ischemic stroke of internal carotid artery with NIHSS from 5 to 25 scores were enrolled in this multi-center, randomized, double-blind and aspirin-control study. Compound " Dan Shen" was used as a baseline therapy. Results Basical recovery plus significant improvement was seen in 74.7% of the patients in dl-3-butylphthalide group and 60.9% in aspirin group (CMH value 4.0,P=0.047);There was a significant improvement for dl-3-butylphthalide group regarding NIHSS total score, total score difference value and Barthel index on the day 11th and 21st after treatment compared with control group. The main adverse reaction of dl-3-butylphthalide was increased aminotransferase and mainly the slight increase of aspartate aminotransferase, by 4.34% and 0 respectively. Conclusion dl-3-butyiphthalide should be regarded as an effective and safe treatment for ischemic stroke and a treatment without severe side effects. Key words: Cerebrovascular accident; Brain iachemia; Benzofurans; Randomized controlled trials
{"title":"Effects of dl-3-butylphthalide soft capsules on treatment of acute ischemlC stroke: multi-center, randomized, double-blind, double-dummy and aspirin-control study","authors":"C. Liying, Li Shun-wei, Zhan Wei-wei, Peng Guo-guang, He Li, Fan Dong-sheng, Shenjia Yang, Wan Yong-jun, Gao Xu-guang, Jia Jian-ping, Zeng Jin-sheng, X. En, Li Cheng-yan, H. Jia","doi":"10.3321/J.ISSN:1006-7876.2008.11.003","DOIUrl":"https://doi.org/10.3321/J.ISSN:1006-7876.2008.11.003","url":null,"abstract":"Objective To assess the efficacy and safety of dl-3-butylphthalide on the treatment of acute ischemic stroke. Methods A total of 197 patients who were in the period of 72 hours of first attack of ischemic stroke of internal carotid artery with NIHSS from 5 to 25 scores were enrolled in this multi-center, randomized, double-blind and aspirin-control study. Compound \" Dan Shen\" was used as a baseline therapy. Results Basical recovery plus significant improvement was seen in 74.7% of the patients in dl-3-butylphthalide group and 60.9% in aspirin group (CMH value 4.0,P=0.047);There was a significant improvement for dl-3-butylphthalide group regarding NIHSS total score, total score difference value and Barthel index on the day 11th and 21st after treatment compared with control group. The main adverse reaction of dl-3-butylphthalide was increased aminotransferase and mainly the slight increase of aspartate aminotransferase, by 4.34% and 0 respectively. Conclusion dl-3-butyiphthalide should be regarded as an effective and safe treatment for ischemic stroke and a treatment without severe side effects. \u0000 \u0000Key words: \u0000Cerebrovascular accident; Brain iachemia; Benzofurans; Randomized controlled trials","PeriodicalId":10143,"journal":{"name":"中华神经科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85706899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-03-08DOI: 10.3321/J.ISSN:1006-7876.2008.03.015
Chen Biao, F. Xianghua, Wu Yong-hao, Jin Song-ling, Liu Hong-jun, Li Shu-ting
Objective To evaluate the effects of Deng Zhan Sheng Mai (DZSM) capsule, a compound made of Chinese herbs, on secondary and tertiary prevention of ischemic stroke. Methods A hospital-based randomized open-blinded clinical trial was conducted among people with a prior history of ischemic stroke. Hospitals were assigned to treatment group, in which all of the participants took DZSM capsules for 3 months, or control group, in which no DZSM capsules was administrated. The primary endpoint was the reduction of levels of blood lipids, fasting blood glucose (FBG) and fibrinogen in the 3rd month. The secondary endpoints were recurrence of stroke, incidence of cardiovascular event (CVD) and all-cause mortality in the 18th month. Results 495 people were enrolled in the treatment group and 504 in the control group, respectively. In the 3rd month, the levels of total cholesterol(TC),FBG and fibrinogen were significantly reduced by 1.7%,4.3 and 8.2%(t values were 4.13,6.65 and 8.50 respectively),and the levels of HDL-C and HDL-C/TC were increased by 7.6%and 1 1.6%(t values were 2.15 and 3.67)in the treatment group, respectively(all P＜0.05＝.The levels of TC,HDL-C and HDL-C/TC decreased significantly in the eontrol group(all P＜0.05＝.The incidence of recurrent stroke and CVD events were lower in the treatment group than those in the control group, but the differences did not reach the significant levels. The prevalence of post-stroke depression (PSD) was also decreased in the 3rd mouth while it remained stable in the controls (P for trend equals to 0.0027). The mortality was significantly lower in the treatment group (P=0.008). Conclusion The levels of TC,FBG and fibrinogen as well as the prevalence of PSD and all-cause mortality have decreased significantly in treatment group treated with DZSM capsule for 3 months as compared with the control group. Key words: Brain ischemia; Cerebrovascular accident; Erigeron breviscapua; Randomized controlled trials
{"title":"The effects of Deng Zhan Sheng Mai capsule on secondary and tertiary prevention of ischemic stroke","authors":"Chen Biao, F. Xianghua, Wu Yong-hao, Jin Song-ling, Liu Hong-jun, Li Shu-ting","doi":"10.3321/J.ISSN:1006-7876.2008.03.015","DOIUrl":"https://doi.org/10.3321/J.ISSN:1006-7876.2008.03.015","url":null,"abstract":"Objective To evaluate the effects of Deng Zhan Sheng Mai (DZSM) capsule, a compound made of Chinese herbs, on secondary and tertiary prevention of ischemic stroke. Methods A hospital-based randomized open-blinded clinical trial was conducted among people with a prior history of ischemic stroke. Hospitals were assigned to treatment group, in which all of the participants took DZSM capsules for 3 months, or control group, in which no DZSM capsules was administrated. The primary endpoint was the reduction of levels of blood lipids, fasting blood glucose (FBG) and fibrinogen in the 3rd month. The secondary endpoints were recurrence of stroke, incidence of cardiovascular event (CVD) and all-cause mortality in the 18th month. Results 495 people were enrolled in the treatment group and 504 in the control group, respectively. In the 3rd month, the levels of total cholesterol(TC),FBG and fibrinogen were significantly reduced by 1.7%,4.3 and 8.2%(t values were 4.13,6.65 and 8.50 respectively),and the levels of HDL-C and HDL-C/TC were increased by 7.6%and 1 1.6%(t values were 2.15 and 3.67)in the treatment group, respectively(all P＜0.05＝.The levels of TC,HDL-C and HDL-C/TC decreased significantly in the eontrol group(all P＜0.05＝.The incidence of recurrent stroke and CVD events were lower in the treatment group than those in the control group, but the differences did not reach the significant levels. The prevalence of post-stroke depression (PSD) was also decreased in the 3rd mouth while it remained stable in the controls (P for trend equals to 0.0027). The mortality was significantly lower in the treatment group (P=0.008). Conclusion The levels of TC,FBG and fibrinogen as well as the prevalence of PSD and all-cause mortality have decreased significantly in treatment group treated with DZSM capsule for 3 months as compared with the control group. \u0000 \u0000Key words: \u0000Brain ischemia; Cerebrovascular accident; Erigeron breviscapua; Randomized controlled trials","PeriodicalId":10143,"journal":{"name":"中华神经科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73390324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2007-05-23DOI: 10.3760/J.ISSN:1006-7876.2007.05.006
D. Ding, L. Chuan-zhen, M. Ding, Bing-hua Su, C. Feng
Objective To evaluate the efficacy and safety of a new drug,human urinary kallidinogenase,against acute brain infarction.Method A 15-center,randomized,double-blinded and 3:1 placebo-controlled study was carried out.Acute brain infarction within 48 hours of onset in the territory of the middle cerebral artery were indicated as subjects;kallidinogenase or placebo which was dissolved in 50 ml saline,was slowly injected intraveousely within 30 minutes daily for 3 weeks.The European Stroke Scale and Barthel Index were used to evaluate the neurological deficit and the activities of daily living(ADL),followed by a follow-up at the end of the third month.Results 446 patients were enrolled,who completed ITT analysis,including 330 in kallidinogenase group and 116 in placebo group,meanwhile 421 proceeded with PP analysis(311 and 110 respectively).There were no significant differences of the baseline data between the 2 groups.At the end of treatment,the ESS scores increased by 55.1%±33.0% and 44.7%±32.8% respectively in kallidinogenase group(KG)and placebo group(PG,P=0.0022),the difference being significant.PP analysis had similar results.As for ADL,follow-up 90 days after the treatment showed 374 cases followed,280 in KG and 94 in PG;1 died in PG,while none in KG.In KG,the cases whose BI≥50 were significantly more than those in PG(P=0.0228).Adverse events possibly or definitely attributable to the drug were observed in 27 cases(7.74%),mostly were mild,such as palpitation,flush,dizziness, nausea etc,without special management needed.Only 2 died which was confirmed not correlated to kallidinogenase,and another 2 cases of sudden blood pressure drop were observed.The blood pressure drop, quickly restoring soon after the withdrawal of kallidinogenase and use of hemopiesic drugs,was considered to be caused by the combination use of anti-hypertensive drug ACEI and quick infusion speed.Conclusion Kallidinogenase is efficacious for acute brain infarction in improving the neurological deficits,which is safe in clinical use.
{"title":"A multicenter,randomized,double-blinded and placebo-controlled study of acute brain infarction treated by human urinary kallidinogenase","authors":"D. Ding, L. Chuan-zhen, M. Ding, Bing-hua Su, C. Feng","doi":"10.3760/J.ISSN:1006-7876.2007.05.006","DOIUrl":"https://doi.org/10.3760/J.ISSN:1006-7876.2007.05.006","url":null,"abstract":"Objective To evaluate the efficacy and safety of a new drug,human urinary kallidinogenase,against acute brain infarction.Method A 15-center,randomized,double-blinded and 3:1 placebo-controlled study was carried out.Acute brain infarction within 48 hours of onset in the territory of the middle cerebral artery were indicated as subjects;kallidinogenase or placebo which was dissolved in 50 ml saline,was slowly injected intraveousely within 30 minutes daily for 3 weeks.The European Stroke Scale and Barthel Index were used to evaluate the neurological deficit and the activities of daily living(ADL),followed by a follow-up at the end of the third month.Results 446 patients were enrolled,who completed ITT analysis,including 330 in kallidinogenase group and 116 in placebo group,meanwhile 421 proceeded with PP analysis(311 and 110 respectively).There were no significant differences of the baseline data between the 2 groups.At the end of treatment,the ESS scores increased by 55.1%±33.0% and 44.7%±32.8% respectively in kallidinogenase group(KG)and placebo group(PG,P=0.0022),the difference being significant.PP analysis had similar results.As for ADL,follow-up 90 days after the treatment showed 374 cases followed,280 in KG and 94 in PG;1 died in PG,while none in KG.In KG,the cases whose BI≥50 were significantly more than those in PG(P=0.0228).Adverse events possibly or definitely attributable to the drug were observed in 27 cases(7.74%),mostly were mild,such as palpitation,flush,dizziness, nausea etc,without special management needed.Only 2 died which was confirmed not correlated to kallidinogenase,and another 2 cases of sudden blood pressure drop were observed.The blood pressure drop, quickly restoring soon after the withdrawal of kallidinogenase and use of hemopiesic drugs,was considered to be caused by the combination use of anti-hypertensive drug ACEI and quick infusion speed.Conclusion Kallidinogenase is efficacious for acute brain infarction in improving the neurological deficits,which is safe in clinical use.","PeriodicalId":10143,"journal":{"name":"中华神经科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2007-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87839168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2007-02-01DOI: 10.3760/J.ISSN:1006-7876.2007.02.006
Xiao-dong Yuan, I. Szirmai, D. Robert
Objective To analyze clinical characteristic of static and dynamic cerebral autoregulation(CA)in patients with Parkinson disease(PD),mean cerebral blood flow velocities (MCBFV)in both middle cerebral artery(MCA),mean arterial blood pressure(MABP),end tidal CO_2 (EtCO_2)and some other index are measured simultaneously and continuously during the Valsalva maneuver (VM)and tilt table testing(TTT).Methods Seventeen patients with PD and eight age-matched control subjects were measured continuously and simultaneously of heart rate(HR),CBFV in both MCA by transeranial Doppler,MABP,MABP adjusted to brain level(MABP_(brain))by Finapress 2300 Ohmeda and end-tidal CO_2(EtCO_2).TTT was performed firstly during graded tilt(in the rest supine position as baseline,10°,30°,70°head-up tilt,and supine recovery).Secondly,VM was carried out.Goshng' s pulsatility index of MABP_(brain).and both MCA(PI_(BP),PIMCBFV_L,PIMCBFV_R),ratio of PIMCBFV_L/PI_(BP), PIMCBFV_R/PIB_p(PI_L/PI_(BP),PI_R/PI_(BP))were calculated for all phases.Cerebrovascular resistance (CVR)and static CA(sCA)were also calculated.The autoregulatory indices,as authoregulatory slope indice(ASI),A Ⅰ-Ⅱ and A Ⅰ-Ⅳ,side-to-side differences of indices(SSD),were also calculated during VM.Results The results in TTT showed that MABP_(brain)was decreased significantly in control and patients with Head-up tilt,but there was a significant decrease from baseline only at 70°head-up position (77.1±12.3,59.9±10.2,P=0.03;79.2±11.8,61.8±15.1,P=0.02),but it was not significant between patients and controls at any tilt level(P0.05).MCBFV in MCA in the patients was significantly lower than that in the controls((34.1±7.5)-(44.1±13.8),(61.4±15.9)-(65.4±19.2),P 0.05),and CVR in the patients were significantly higher than that in the controls at all test positions ((2.0±1.1)-(2.3±1.0),(1.0±0.2)-(1.2±0.4),P0.05).sCA_(MCAL)and sCA_(MCAR)were significantly decreased in the patient group(by 15.0%,6.8%)than those in the control group(by 73.4%,75.7%)(P0.01).During VM,MCBFV was significantly lower in the patients than in the controls in all phases((35.7±12.7)-(54.2±16.1),(47.1±11.3)-(80.2±25.5),P0.05). MCBFV in the patients was not different between phase Ⅱ a and Ⅱb(P=0.33).PI_(BP)in the controls was markedly lower in phase Ⅱb than on the baseline(P0.05),and PI_L/PI_(Bp)was markedly higher in phase Ⅱ a,Ⅲb than on the baseline(P0.05).PI_(BP)in patients was markedly decreased in phase Ⅰ,Ⅱ a, Ⅱb,Ⅲ than on the baseline((0.6±0.1)-(0.5±0.2),0.7±0.1,P0.05)respectively,but PI_L/PI_(BP) and PI_R/PI_(BP)rose significantly in phase Ⅱ a to Ⅲ((2.1±1.0)-(2.9±1.5),1.5±0.5,P0.05). Conclusions Patients with PD are in a baseline condition of higher CVR,lower MCBFV.The results in TTT showed that the patients with PD presented a special type of dysfunction of sCA resulting from dysfunction of dilatation of the downstream resistance vessels.Dynamic CA during VM shows characteristic phase-delayed changes in healthy controls.The clinical threshold of CA mark
{"title":"Evaluation of cerebral autoregulation by multimodality monitoring during tilt table test and Valsalva maneuver in Parkinson's disease","authors":"Xiao-dong Yuan, I. Szirmai, D. Robert","doi":"10.3760/J.ISSN:1006-7876.2007.02.006","DOIUrl":"https://doi.org/10.3760/J.ISSN:1006-7876.2007.02.006","url":null,"abstract":"Objective To analyze clinical characteristic of static and dynamic cerebral autoregulation(CA)in patients with Parkinson disease(PD),mean cerebral blood flow velocities (MCBFV)in both middle cerebral artery(MCA),mean arterial blood pressure(MABP),end tidal CO_2 (EtCO_2)and some other index are measured simultaneously and continuously during the Valsalva maneuver (VM)and tilt table testing(TTT).Methods Seventeen patients with PD and eight age-matched control subjects were measured continuously and simultaneously of heart rate(HR),CBFV in both MCA by transeranial Doppler,MABP,MABP adjusted to brain level(MABP_(brain))by Finapress 2300 Ohmeda and end-tidal CO_2(EtCO_2).TTT was performed firstly during graded tilt(in the rest supine position as baseline,10°,30°,70°head-up tilt,and supine recovery).Secondly,VM was carried out.Goshng' s pulsatility index of MABP_(brain).and both MCA(PI_(BP),PIMCBFV_L,PIMCBFV_R),ratio of PIMCBFV_L/PI_(BP), PIMCBFV_R/PIB_p(PI_L/PI_(BP),PI_R/PI_(BP))were calculated for all phases.Cerebrovascular resistance (CVR)and static CA(sCA)were also calculated.The autoregulatory indices,as authoregulatory slope indice(ASI),A Ⅰ-Ⅱ and A Ⅰ-Ⅳ,side-to-side differences of indices(SSD),were also calculated during VM.Results The results in TTT showed that MABP_(brain)was decreased significantly in control and patients with Head-up tilt,but there was a significant decrease from baseline only at 70°head-up position (77.1±12.3,59.9±10.2,P=0.03;79.2±11.8,61.8±15.1,P=0.02),but it was not significant between patients and controls at any tilt level(P0.05).MCBFV in MCA in the patients was significantly lower than that in the controls((34.1±7.5)-(44.1±13.8),(61.4±15.9)-(65.4±19.2),P 0.05),and CVR in the patients were significantly higher than that in the controls at all test positions ((2.0±1.1)-(2.3±1.0),(1.0±0.2)-(1.2±0.4),P0.05).sCA_(MCAL)and sCA_(MCAR)were significantly decreased in the patient group(by 15.0%,6.8%)than those in the control group(by 73.4%,75.7%)(P0.01).During VM,MCBFV was significantly lower in the patients than in the controls in all phases((35.7±12.7)-(54.2±16.1),(47.1±11.3)-(80.2±25.5),P0.05). MCBFV in the patients was not different between phase Ⅱ a and Ⅱb(P=0.33).PI_(BP)in the controls was markedly lower in phase Ⅱb than on the baseline(P0.05),and PI_L/PI_(Bp)was markedly higher in phase Ⅱ a,Ⅲb than on the baseline(P0.05).PI_(BP)in patients was markedly decreased in phase Ⅰ,Ⅱ a, Ⅱb,Ⅲ than on the baseline((0.6±0.1)-(0.5±0.2),0.7±0.1,P0.05)respectively,but PI_L/PI_(BP) and PI_R/PI_(BP)rose significantly in phase Ⅱ a to Ⅲ((2.1±1.0)-(2.9±1.5),1.5±0.5,P0.05). Conclusions Patients with PD are in a baseline condition of higher CVR,lower MCBFV.The results in TTT showed that the patients with PD presented a special type of dysfunction of sCA resulting from dysfunction of dilatation of the downstream resistance vessels.Dynamic CA during VM shows characteristic phase-delayed changes in healthy controls.The clinical threshold of CA mark","PeriodicalId":10143,"journal":{"name":"中华神经科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2007-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79647411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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