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2019 Vol. 15, No. 4
Published: 2019-12-25

Review
Original Research
Case Report
 
       Original Research
141 Correlation between peripheral blood leukocyte count and classification ratio and prognosis of patients with acute non-cardiogenic ischemic stroke Hot!
DONG Yanhua, ZHANG Caixiao, DU Lu, LIU Yuchen, ZHAO Liang
DOI: 10.12022/jnnr.2019-0054
Objective: The purpose of this study is to investigate the prognostic value of peripheral blood leukocyte count, neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) in patients with acute non-cardiogenic ischemic stroke.

Methods: From June 1, 2017 to June 1, 2018, 323 patients with acute non-cardiogenic ischemic stroke who were hospitalized in the Department of Neurology, Affiliated Hospital of Chengde Medical College, met the criteria of case selection. The data of demography, vascular risk factors, drug use history, blood routine test, National Institutes of Health Stroke Scale (NIHSS) score at admission, modified Rankin Scale (MRS) score at discharge and duration of hospitalization were collected for retrospective analysis. According to the peripheral blood leukocyte count, the groups were divided as follows: ≤10.0×109/L, (10.1-11.0)×109/L,(11.1-12.0)×109/L and ≥12.1×109/L; according to NLR, the groups were divided as follows: <3.6, 3.6-6.5 and >6.5; according to LMR, the groups were divided as follows: <2.97, 2.97-4.83 and >4.83. Multivariate logistic regression was used to analyze the independent risk factors of prognosis in patients with acute non-cardiogenic ischemic stroke. The receiver operator characteristic (ROC) curve was used to evaluate the predictive ability of peripheral blood leukocyte count, NLR and LMR on prognosis, and calculate the sensitivity and specificity.

Results: According to MRS score, the patients were divided into two groups: good prognosis group (213 cases, MRS score ≤ 2) and poor prognosis group (110 cases, MRS score is 3-6). The neutrophil count, NLR, hypersensitive C-reactive protein, homocysteine and baseline NHISS score in the poor prognosis group were significantly higher than those in the good prognosis group (P<0.05), and the duration of hospitalization was significantly longer (P<0.05), while the lymphocyte count and LMR in the poor prognosis group were significantly lower than those in the good prognosis group (P<0.05). The results of multivariate logistic regression analysis showed that the peripheral blood leukocyte count [≤10.0×109·L-1 vs (10.1-11.0)×109·L-1: odds ratio: 1.788 (95% confidence interval: 1.119-2.854), P=0.015], NLR [odds ratio: 1.275 (95% confidence interval: 1.031-1.576), P=0.025], LMR [<2.97 vs 2.97-4.83: odds ratio: 0.277 (95% confidence interval: 0.072-0.814), P=0.013], the level of hypersensitive C-reactive protein [odds ratio: 2.389 (95% confidence interval: 1.194-4.799), P=0.014], and the baseline NHISS score [odds ratio: 12.630 (95% confidence interval: 6.115-27.741), P<0.001] were independent risk factors for prognosis of patients with acute non-cardiogenic ischemic stroke. The results of ROC curve showed that leukocyte count, NLR and LMR were not ideal predictors for the prognosis of acute non-cardiogenic ischemic stroke, and the combined detection might have a higher predictive value.

Conclusion: Peripheral blood leukocyte count, NLR, LMR, high-sensitivity C-reactive protein level and baseline NIHSS score were independent risk factors of prognosis (MRS score) in patients with acute non-cardiogenic ischemic stroke. Due to the convenience and low cost of peripheral blood leukocyte count, NLR and LMR detection, it is suitable for clinical application. It is necessary to carry out multi-center prospective studies with a larger sample to further verify.

2019 Vol. 15 (4): 141-148 [Abstract] ( 103 ) PDF (1293 KB)  ( 114 )
       Review
149 Progress in music therapy for stroke and research prospect Hot!
KONG Lingyu1, GAO Hanyi1, 2, GAO Qiang1, WANG Xiangqian1, WANG Ying1, ZHANG Qi1
DOI: 10.12022/jnnr.2019-0070

Music therapy is one of the treatment methods for stroke, which is performed by listening, singing, playing or cooperating with music rhythm. With music stimulation, music therapy can accelerate the nerve repair in patients with stroke, improve the blood flow of brain, the cognitive level and the motor function, and help to alleviate the dysfunction caused by stroke. Compared with the conventional drug therapy, music therapy can also prevent the potential mental disorders and treat the existing mental disorders in patients with stroke, so as to improve the patients’ psychology, effectively supplement the deficiency of psychological intervention, and help the patients to recover better. This paper reviews the latest progress in music therapy for stroke, and looks forward to the future development of music therapy.

2019 Vol. 15 (4): 149-155 [Abstract] ( 115 ) PDF (1212 KB)  ( 235 )
156

Progress in antidepressant and anxiety treatment to improve motor function and its mechanism in poststroke patients Hot!

Progress in antidepressant and anxiety treatment to improve motor function and its mechanism in poststroke patients[J]. Journal of Neurology and Neurorehabilitation, 2019,15(4): 156-161')" href="#"> ZHENG Xuanlu, SIMA Dandan, GUI Liqin, YUAN Yike, SCHR?DER Joana, PAN Weidong
DOI: 10.12022/jnnr.2019-0096

With in-depth research on motor function recovery after stroke, more and more literatures have reported that antidepressant and anxiety treatment is not only effective for post-stroke depression and anxiety, but also significantly promotes the recovery of motor function after stroke. In recent years, it has been studied whether the traditional Chinese and Western medicine drugs against depression and anxiety can improve the recovery of motor function in post-stroke patients, and its mechanism has been discussed. In this paper, the latest progress in the role and mechanism of Chinese and Western medicine in improving or independently improving the limb motor function in post-stroke patients is reviewed, in order to provide references for the prevention, treatment and rehabilitation of limb motor dysfunction after stroke.

2019 Vol. 15 (4): 156-161 [Abstract] ( 83 ) PDF (1072 KB)  ( 98 )
162 Research progress in rehabilitation of hyperextended knee after stroke Hot!
QUAN Honglei, FENG Wei
DOI: 10.12022/jnnr.2019-0080
Hyperextended knee is one of the common complications in hemiplegia patients after stroke due to muscle weakness or spasm of lower limbs and proprioceptive disorder. So far, its specific pathogenesis is not clear. Patients may have limited functional activities and pathological changes due to over extension of the knee joint, and those who have serious illness may have limited walking, which will affect their ability of daily life and quality of life. Rehabilitation training can help reduce the occurrence of hyperextended knee after stroke and improve the walking function of patients. This paper reviews the progress in rehabilitation and prevention of hyperextended knee in patients after stroke, in order to provide references for clinical prevention and treatment of hyperextended knee.
2019 Vol. 15 (4): 162-166 [Abstract] ( 115 ) PDF (914 KB)  ( 168 )
       Case Report
167 Mitochondrial encephalomyopathy with lactic acidosis and stroke-like episode (MELAS): one case report and literature review Hot!
WANG Kan, PAN Yuanmei, GUAN Yangtai
DOI: 10.12022/jnnr.2019-0086

Objective: To improve the understanding of mitochondrial encephalomyopathy with lactic acidosis and stroke-like episode (MELAS) syndrome in clinical practice.

Methods: The clinical diagnosis and treatment of one patient with MELAS syndrome were reported. The clinical manifestations, diagnosis and possible mechanism of MELAS syndrome were discussed based on literature review.

Results: One patient with MELAS syndrome manifested first-onset stroke attack, and then appeared epileptic seizures. Suspicious antibodies in cerebrospinal fluid and serum were negative. The result of mitochondrial disease gene detection revealed m.3243A>G, and the final diagnosis was MELAS syndrome.

Conclusion: MELAS syndrome is one of the most common type of mitochondrial myopathy, which can influence multiple systems, including brain and muscle tissues. The clinical manifestations of MELAS syndrome are various and lack of a unified diagnostic standard, so it is easy to escape diagnosis or be misdiagnosed, and the prognosis is poor. Therefore, it is very important to recognize MELAS syndrome early, in order to make the diagnosis as soon as possible and give appropriate treatment to improve the prognosis of patients.

2019 Vol. 15 (4): 167-172 [Abstract] ( 98 ) PDF (1982 KB)  ( 95 )
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