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Altered Protein Profiling in Tears from Patients in a Traumatic Vegetative State

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Neuroscience Bulletin 2018年第4期34卷 713-714页

作者： Hai ZOU Wangxiao Bao benyan luo Department of Neurology First Affiliated HospitalCollaborative Innovation Center for Brain ScienceZhejiang University School of MedicineHangzhou 310003China Department of Cardiology Zhejiang Province People's HospitalHangzhou 310003China People's Hospital of Hangzhou Medical College Hangzhou 310003 China

Following severe traumatic brain injury .（sTBI）, patients may remain in a coma, vegetative state （VS）, or minimally conscious state （MCS）, all of which are also clinically termed disorders of consciousness. Patients in a coma show complete disability in the arousal system and fail to achieve awareness spontaneously; yet true coma represents a transient state and rarely lasts longer than a month [1]. The VS （also known as unresponsive wakefulness syndrome）, characterized as a state with spontaneous or stimulus-induced eye-opening but the patient appears totally unaware of self and environment, may persist for months or years [2]. In contrast, the MCS is evidenced by preserved and reproducible signs of awareness as well as sleep-wake cycles, suggesting better recovery than coma and VS. Considering that no signs of consciousness are detectable, patients in a VS suffer from a high rate of misdiagnosis [3].

关键词： TBI VS Altered Protein Profiling in Tears from Patients in a Traumatic Vegetative State

Ambulatory blood pressure profile and stroke recurrence

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Stroke & Vascular Neurology 2021年第3期6卷 352-358,I0006-I0008页

作者： Jie Xu Fei Jiang Anxin Wang Hui Zhi Yuan Gao Junping Tian Jinglin Mo Zimo Chen An-Ding Xu benyan luo Bo Hu Yuqing Zhang Xingquan Zhao Yilong Wang Hao Li Haipeng Shen Yongjun Wang Department of Neurology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina China National Clinical Research Center for Neurological Diseases(NCRCND) Beijing Tiantan HospitalCapital Medical UniversityBeijingChina Department of Statistics and Actuarial Sciences University of Hong KongHong KongChina Biostatistics and Clinical Research Methodology Unit Faculty of MedicineUniversity of Hong KongHong KongChina Department of Neurology The First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenanChina Department of Cardiology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina Department of Neurology and Stroke Center The First Affiliated Hospital of Jinan UniversityGuangzhouGuangdongChina Department of Neurology and Brain Medical Centre The First Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouZhejiangChina Department of Neurology Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina Division of Hypertension National Center for Cardiovascular Disease ChinaFuwai HospitalBeijingChina Faculty of Business and Economics University of Hong KongHong KongChina

Objectives To establish a new ambulatory blood pressure(ABP)parameter(24-hour ABP profile)and evaluated its performance on stroke outcome in ischaemic stroke(IS)or transient ischaemic attack(TIA)patients.Methods The prospective cohort consisted of 1996 IS/TIA patients enrolled for ABP monitoring and a 3-month follow-up for stroke recurrence as outcome.Profile groups of systolic blood pressure(SBP)were identified via an advanced functional clustering method,and the associations of the profile groups and conventional ABP parameters with stroke recurrence were examined in a Cox proportional hazards model.Results Three discrete profile groups(n=604,781 and 611 in profiles 1,2 and 3,respectively)in 24-hour ambulatory SBP were identified.Profile 1 resembled most to the normal diurnal blood pressure pattern;profile 2 also dropped at night,but climbed earlier and with higher morning surge;while profile 3 had sustained higher nocturnal SBP without significant nocturnal SBP decline.The incidence of stroke recurrence was 2.9%,3.9%and 5.5%in profiles 1,2 and 3,respectively.After adjustment for covariates,profile 3 was significantly associated with higher risk of stroke recurrence with profile 1 as reference(HR 1.76,95%CI:1.00 to 3.09),while no significant difference was observed between profiles 2 and 1(HR 1.22,95%CI:0.66 to 2.25).None of conventional ABP parameters showed significant associations with the outcome.Conclusions Ambulatory 24-hour SBP profile is associated with short-term stroke recurrence.Profiles of ABP may help improve identification of stroke recurrence by capturing the additive effects of individual ABP parameters.

关键词： sustained Profiles recurrence

The efficacy and safety of nimodipine in acute ischemic stroke patients with mild cognitive impairment: a double-blind, randomized,placebo-controlled trial

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Science Bulletin 2019年第2期64卷 101-107页

作者： Huaguang Zheng Yilong Wang Anxin Wang Hao Li David Wang Xingquan Zhao Penglian Wang Haipeng Shen Lijun Zuo Yuesong Pan Zixiao Li Xia Meng Xianwei Wang Weixiong Shi Yi Ju Liping Liu Kehui Dong Chunxue Wang Rubo Sui Rong Xue Xiaoping Pan Xiaoyua Niu benyan luo Yi Sui Huali Wang Tao Feng Yongjun Wang Beijing Tiantan Hospital Capital Medical University China National Clinical Research Center for Neurological Diseases OSF Saint Francis Medical Center Peoria Faculty of Business and Economics University of Hong Kong The First Hospital Liao Ning Medical College The General Hospital Tianjin Medical University Guangzhou First People’s Hospital School of Medicine South China University of Technology The First Hospital of Shanxi Medical University The First Hospital Zhejiang Medical University Shenyang First People’s Hospital Shenyang Medical College Dementia Care & Research Center Peking University Institute of Mental Health

Nimodipine might be effective in subcortical vascular dementia(VaD). Its benefit in preventing further cognitive decline in patients with acute ischemic stroke(AIS) and vascular mild cognitive impairment(VaMCI) remains to be established. In this multicenter, double-blind trial, we randomly assigned 654 eligible patients to nimodipine 30 mg three times a day or placebo. The primary outcome was any cognitive decline defined by the changes on the Mini-Mental State Examination(DMMSE à3) or vascular AD assessment scale cognitive subscale(DADAS-cog ! 4) at 6 months. Secondary outcomes included any distribution shift of DADAS-cog, DMMSE or cognitive improvement defined by DADAS-cog à2, or DMMSE ! 0. The primary outcome in the nimodipine group and placebo group were similar for DMMSE à3(4.18% and 7.22%, respectively, P = 0.15) and DADAS-cog ! 4(8.36% and 8.93% respectively,P = 0.88). The distribution shift of DADAS-cog and DMMSE differed significantly between the two groups(P = 0.03 and P = 0.05 respectively). Cognitive improvement occurred in 55.4% in the nimodipine group and 43.6% in the placebo group measured by DADAS-cog à2(Odds Ratio, 1.54; 95% confidence interval[CI] 1.10–2.14, P < 0.01) or 84.0% and 74.6% respectively by DMMSE ! 0(Odds Ratio, 1.79; 95% CI 1.18–2.70, P < 0.01). Nimodipine was associated with better cognitive function in the memory domain. The adverse events rate was similar in two groups. This study is registered with ClinicalTrials.gov,NCT01220622. Nimodipine did not show benefit to prevent cognitive decline in AIS patients with VaMCI, but improved cognition moderately, especially measured in the memory domain.

关键词： Nimodipine Acute ischemic stroke Mild cognitive impairment Cognitive decline Prevention

Jitter analysis with concentric needle electrodes in the extensor digitorum communis for the diagnosis of myasthenia gravis：a pilot study

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Chinese Medical Journal 2014年第18期127卷 3209-3212页

作者： Wang Jianwen Ji Fang luo benyan Department of Neurology First Affiliated Hospital Zhejiang University School of Medicine Hangzhou Zhejiang 310003 China

Background Single-fiber electromyography is the most sensitive neurophysiological test for the diagnosis of myasthenia gravis （MG）,but its use is limited by the potential risk of transmission of infections.Jitter analysis with disposable concentric needle electrodes （CNEs） is therefore being investigated.This pilot study aimed to evaluate jitter analysis with CNEs for the diagnosis of MG.Methods Forty-two healthy Chinese volunteers and 44 MG patients were prospectively enrolled.MG patients were classified according to the Osserman classification,and acetylcholine receptor antibody titer was measured.Jitter analysis with CNEs in the extensor digitorum communis and repetitive nerve stimulation （RNS） testing were performed.Jitter was expressed as the mean consecutive difference （MCD）,and 20 action potential pairs were analyzed in each subject.The mean MCD in each subject and the mean individual MCD of all action potential pairs were compared between groups.Results The mean MCD and mean individual MCD were higher in MG patients （（42.3±20.0） μs and （42.2±26.0） μs） than in healthy volunteers （（23.0±3.1） μs and （22.8±7.5） μs）.The area under the receiver operating characteristic curve for the mean MCD of MG patients and healthy volunteers combined was 0.85.The mean MCD and mean individual MCDwere higher in generalized MG patients （（64.1±18.5） μs and （63.6±30.0） μs） than in ocular MG patients （（33.1±12.0） μs and （33.2±17.6） μs）,and were higher in MG patients with abnormal RNS results （（57.2±18.3） μs and （57.3±29.2） μs） than in MG patients with normal RNS results （（32.9±14.8） μs and （32.7±18.3） μs）.Abnormal RNS results were observed in 38.60% （17/44） of MG patients and abnormal jitter were observed in 72.70% （32/44） of MG patients.Conclusion Jitter analysis with CNEs is feasible for the diagnosis of MG.

关键词： myasthenia gravis single fiber electromyography,＇jitter concentric needle electrode

尤瑞克林用药时长对急性缺血性脑卒中患者疗效和安全性的影响——RESK研究亚组分析

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中华神经科杂志 2024年第3期57卷 225-232页

作者：倪俊姚明王丽华于明李润辉赵丽宏王佳春汪银洲汪昕宋海庆罗本燕王佳伟黄一宁崔丽英中国医学科学院北京协和医学院北京协和医院神经科、疑难重症及罕见病国家重点实验室北京100730 哈尔滨医科大学附属第二医院神经内科哈尔滨150086 江苏大学附属医院神经内科镇江212002 沈阳医学院附属中心医院神经内科沈阳110024 丹东市人民医院神经内科丹东118016 哈尔滨市第一医院神经内科哈尔滨150028 福建省立医院神经内科福州350013 复旦大学附属中山医院神经内科上海200032 首都医科大学宣武医院神经内科北京100053 浙江大学医学院附属第一医院神经内科杭州310003 首都医科大学附属北京同仁医院神经内科北京100710 北京大学第一医院神经内科北京100034

目的探究尤瑞克林不同用药时长对急性缺血性脑卒中患者疗效和安全性的影响。方法本研究为RESK研究的亚组分析。从2015年8月到2020年6月共纳入65个中心的990例脑卒中患者,根据尤瑞克林用药时间长短分为短时用药组(用药8 d,n=185)和长时... 详细信息

目的探究尤瑞克林不同用药时长对急性缺血性脑卒中患者疗效和安全性的影响。方法本研究为RESK研究的亚组分析。从2015年8月到2020年6月共纳入65个中心的990例脑卒中患者,根据尤瑞克林用药时间长短分为短时用药组(用药8 d,n=185)和长时用药组(用药15 d和21 d,n=805)。分析患者90 d改良Rankin量表(mRS)评分为0分、0~1分和0~2分的患者比例,22 d美国国立卫生研究院卒中量表(NIHSS)评分较基线的变化,90 d Barthel指数≥95分患者比例和不良事件发生率。采用χ2检验、单因素和多因素Logistic回归分析等进行组间比较。结果多因素回归分析结果显示,短时用药组和长时用药组90 d mRS评分0~2分的患者比例[74.1%(137/185)比75.0%(604/805);OR=1.047,95%CI 0.676~1.620,P=0.838]和22 d NIHSS评分较基线的变化[(4.60±2.00)分比(4.26±2.80)分;OR=-0.390,95%CI-1.125~0.344,P=0.297],差异均无统计学意义;90 d mRS评分0~1分的患者比例[48.1%(89/185)比59.1%(476/805);OR=0.674,95%CI 0.463~0.983,P=0.041]和90 d Barthel指数≥95分患者比例[43.6%(79/181)比55.1%(442/802);OR=0.614,95%CI 0.420~0.897,P=0.012],在短时用药组均显著低于长时用药组。两组不良事件的发生率差异无统计学意义。结论对于急性缺血性脑卒中患者,尤瑞克林连续用药8 d即可改善患者近期(22 d NIHSS评分)和远期疗效(90 d mRS评分0~2分),且安全耐受。在条件允许的情况下,增加尤瑞克林用药时长可显著提高患者远期无残疾率(90 d mRS评分0~1分)和生活质量(90 d Barthel指数),且不增加不良事件风险。

关键词：卒中尤瑞克林治疗效果安全性用药时长

Is radical-by-radical reading strategy effective for Chinese pure alexia?

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Is radical-by-radical reading strategy effective for Chinese...

Adult-onset clinically mild encephalitis/encephalopathy with a reversible splenial lesion:a new case report and a systematic review of reported cases

中华医学会第十七次全国神经病学学术会议

作者： Zhongqin Chen Hanyu Shao Mingwei Xu Guoping Peng Xuchu Weng benyan luo Department of Neurology & Brain Medical Center the First Affiliated HospitalZhejiang University School of Medicine Center for Cognition and Brain Disorders Hangzhou Normal University

Objective Currently,it is unclear whether a radical-by-radical(RBR)reading strategy exists in Chinese pure alexia,compared to the letter-by-letter(LBL)reading strategy in alphabetic languages.In this study,we focus on...

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Adult-onset clinically mild encephalitis/encephalopathy with...

A randomized,6-week,fixed-dose trial for comparison between citalopram and citalopram-paliperidone combination in the treatment of patients with somatoform disorder

华东六省一市第二十三次神经病学学术会议暨2016年浙江...

作者： Jianwen Wang Kang Wang Xuning Zheng Mingwei Xu Jiajia Zhou Hui Liang benyan luo Department of Neurology First Affiliated HospitalZhejiang University School of Medicine

Background:In 2004,Tada H.et al described a new clinical-radiological entity referred as clinically mild encephalitis/encephalopathy with a reversible splenial lesion(MERS).Since then MERS in children has been well investigated in recent years.The occurrence of MERS in adult might be lower than in children.Here we will review the clinical and radiologic characteristics of reported cases with adult-onset MERS in English literature and add a new case.

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A randomized,6-week,fixed-dose trial for comparison between ...

2011年浙江省医学会精神病学分会学术年会暨浙江省医师...

作者： Manli Huang Jianbo Hu Ning Wei Lin Chen Shanshan Wang Weihua Zhou Shaohua Hu Yi Xu benyan luo Department of Psychiatry First Affiliated HospitalCollege of MedicineZhejiang University Department of Neurology First Affiliated HospitalCollege of MedicineZhejiang University

Objectives To evaluate the effectiveness and tolerability of citalopram versus citalopram-paliperidone combination therapy in patients with somatoform disorders(SD).Methods In this 6-week, randomized,fixed-dose study,60 patients with SD(ICD-10 F45.0),undifferentiated SD(F45.1),and somatoform autonomic dysfunction(F45.3),received citalopram 20 mg/day with or without paliperidone 3mg/day.Four scales were used to evaluate efficacy at the end of 2nd,4th,6th week after treatment:Somatoform Disorders Screening Instrument-7(SOMS-7),subscore of Hamilton Anxiety Scale(HAMA-SOM),17-item Hamilton Depression Scale(HAMD17),and Treatment Emergent Symptom Scale(TESS).Results 1)In the intention to treat population(N=51),the overall response ratio(50%reduction in SMOS-7 scores) was significantly higher in the citalopram-paliperidone group compared to the citalopram group after 6-week treatment(71.4%vs 38.10%,χ2=4.71,P=0.03);2)The SOMS-7 and HAMA-SOM total score of citalopram-paliperidone group decreased more significantly than that of citalopram group,and a significant difference could be observed at the end of 4 weeks of the treatment;3)There was no significant difference between the two groups in adverse effects,and no serious adverse event was reported in both groups.Conclusions Our findings indicate that the combination of paliperidone with citalopram exhibits synergic effects for patients with SD.

关键词： somatoform disorders somatoform disorders screening instrument-7,hamilton anxiety scale citalopram paliperidone

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缺血性脑卒中的溶栓治疗

中国实用内科杂志 2006年第14期26卷 1044-1047页

作者：罗本燕浙江大学医学院附属第一医院神经内科浙江杭州310000

急性缺血性脑卒中(AIS)又称脑梗死,是由于局部脑血流突然中断引起局部脑组织缺血坏死而致的相应神经功能缺损.它威胁着上千万人的生命,是工业化国家第3死亡原因,仅次于心肌梗死和癌症,同时它也是造成终身残疾的首要原因[1].在脑卒中发... 详细信息

急性缺血性脑卒中(AIS)又称脑梗死,是由于局部脑血流突然中断引起局部脑组织缺血坏死而致的相应神经功能缺损.它威胁着上千万人的生命,是工业化国家第3死亡原因,仅次于心肌梗死和癌症,同时它也是造成终身残疾的首要原因[1].在脑卒中发生后脑血管造影显示80%病人有动脉闭塞,如抢救不及时,会造成脑组织不可逆性坏死.迄今为止,尚无有效并且十分安全的方法减轻脑组织的受损程度.理论上讲,治疗急性缺血性脑卒中的基本方法有两种,一是改善缺血脑组织的供血;二是保护缺血脑组织,减轻(或避免)各种继发性损害.为了获得理想的疗效,必须设法在缺血脑组织出现不可逆损害之前,尽早消除血栓,使闭塞的血管再通,及时恢复供血.

关键词：溶栓治疗缺血性脑卒中症状性脑出血溶栓药物纤溶酶原