Li-Xin Zhou
Peking Union Medical College Hospital
Network
Latest external collaboration on country level. Dive into details by clicking on the dots.
Publication
Featured researches published by Li-Xin Zhou.
Atherosclerosis | 2010
Wei-Hai Xu; Ming-Li Li; Shan Gao; Jun Ni; Li-Xin Zhou; Ming Yao; Bin Peng; Feng Feng; Jin Zy; Liying Cui
OBJECTIVE Recently, the technique of high-resolution magnetic resonance imaging (HR-MRI) has been developed to depict intracranial artery wall. We aimed to compare the vessel wall properties between symptomatic and asymptomatic atherosclerotic middle cerebral arteries (MCA) using HR-MRI. METHODS We studied 26 patients with symptomatic and 35 patients with asymptomatic MCA stenosis. Routine cranial MRI, magnetic resonance angiography and HR-MRI were performed on each patient. The cross-sectional images of MCA wall on HR-MRI were compared between the two groups. RESULTS The degree of MCA stenosis was similar between the two groups (67.9% vs 63.9%, P=0.327). On HR-MRI, eccentric plaques were observed in 26 (100%) symptomatic and 28 (80%) asymptomatic stenosis. In the remaining seven (20%) asymptomatic stenosis, only constrictive remodeling (vessel shrinkage) was observed. Compared with the asymptomatic group, symptomatic MCA stenosis had a larger wall area (P<0.001), greater remodeling ratio (P<0.001), higher prevalence of expansive remodeling (outward expansion of the vessel wall) (P=0.003) and lower prevalence of constrictive remodeling (P=0.008). CONCLUSIONS Different vessel wall properties on HR-MRI were observed between symptomatic and asymptomatic MCA stenosis. Further prospective studies are required to investigate whether HR-MRI is a helpful tool in stratifying stroke risk in patients with MCA atherosclerotic disease.
Journal of Neuroimaging | 2011
Jun Ni; Li-Xin Zhou; Hong‐lin Hao; Qing Liu; Ming Yao; Ming-Li Li; Bin Peng; Liying Cui
Some patients with posterior reversible encephalopathy syndrome (PRES) present with atypical clinical and neuroimaging findings. The purpose of this study is to review the clinical and neuroimaging findings in patients diagnosed with PRES.
Stroke | 2011
Wei-Hai Xu; Ming-Li Li; Shan Gao; Jun Ni; Li-Xin Zhou; Ming Yao; Bin Peng; Feng Feng; Jin Zy; Liying Cui
Background and Purpose— Microanatomy studies reveal that most penetrating branches of middle cerebral artery (MCA) arise from the dorsal–superior surface of the trunk. Using high-resolution MRI, we sought to explore the plaque distribution of MCA atherosclerosis and its clinical relevance in relation to the orifices of penetrating arteries. Methods— We retrospectively analyzed the imaging and clinical data of 86 patients with atherosclerotic MCA stenosis. On high-resolution MRI, plaques were categorized based on the involvement of the superior, inferior, ventral, or dorsal MCA wall. The relationship of plaque distribution and clinical presentation was analyzed. Results— A total of 92 stenotic MCAs (40 symptomatic and 52 asymptomatic) on 828 image slices were studied. Overall, of the 251 slices with identified plaques, plaques were more frequently located at the ventral (44.8%) and inferior (31.7%) wall as compared with the superior (14.3%) and dorsal wall (9.0%; P<0.001). Symptomatic MCA stenosis had more superior (P=0.016) and less inferior (P=0.023) wall plaques than asymptomatic stenosis. Within the group of symptomatic MCA stenosis, vessels with penetrating artery infarctions had more superior (P=0.001) but less ventral (P=0.038) and inferior (P=0.024) plaques than without penetrating artery infarctions. Conclusions— MCA plaques tend to locate opposite to the orifices of penetrating arterial branches. Further studies are required to investigate whether MCA plaque distribution is an independent determinant of stroke occurrence and its subtypes.
Stroke | 2014
Bin Peng; Jun Ni; Craig S. Anderson; Yi-Cheng Zhu; Wang Y; Chuanqiang Pu; Jiang Wu; Jianming Wang; Li-Xin Zhou; Ming Yao; Jia He; Guangliang Shan; Shan Gao; Wei-Hai Xu; Liying Cui
Background and Purpose— High rates of ischemic stroke and poor adherence to secondary prevention measures are observed in the Chinese population. Methods— We used a national, multicenter, cluster-randomized controlled trial in which 47 hospitals were randomized to either a structured care program group (n=23) or a usual care group (n=24). The structured care program consisted of a specialist-administered, guideline-recommended pharmaceutical treatment and a lifestyle modification algorithm associated with written and Internet-accessed educational material for patients for the secondary prevention of ischemic stroke. The primary efficacy outcome was the proportion of patients who adhered to the recommended measures at 12-month postdischarge. This trial is registered with ClinicalTrial.gov (NCT00664846). Results— At 12 months, 1287 (72.1%) patients in the Standard Medical Management in Secondary Prevention of Ischemic Stroke in China (SMART) group and 1430 (72%) patients in the usual care group had completed the 12-month follow-up (P=0.342). Compared with the usual care group, those in the SMART group showed higher adherence to statins (56% versus 33%; P=0.006) but no difference in adherence to antiplatelet (81% versus 75%; P=0.088), antihypertensive (67% versus 69%; P=0.661), or diabetes mellitus drugs (73% versus 67%; P=0.297). No significant difference in the composite end point (new-onset ischemic stroke, hemorrhagic stroke, acute coronary syndrome, and all-cause death) was observed (3.56% versus 3.59%; P=0.921). Conclusions— The implementation of a program to improve adherence to secondary ischemic stroke prevention efforts in China is feasible, but these programs had only a limited impact on adherence and no impact on 1-year outcomes. Further development of a structured program to reduce vascular events after stroke is needed. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00664846.
PLOS ONE | 2016
Ming Yao; Jun Ni; Li-Xin Zhou; Bin Peng; Yi-Cheng Zhu; Liying Cui; Smart investigators
Background Although increasing evidence suggests that hyperglycemia following acute stroke adversely affects clinical outcome, whether the association between glycaemia and functional outcome varies between stroke patients with\without pre-diagnosed diabetes remains controversial. We aimed to investigate the relationship between the fasting blood glucose (FBG) and the 6-month functional outcome in a subgroup of SMART cohort and further to assess whether this association varied based on the status of pre-diagnosed diabetes. Methods Data of 2862 patients with acute ischemic stroke (629 with pre-diagnosed diabetics) enrolled from SMART cohort were analyzed. Functional outcome at 6-month post-stroke was measured by modified Rankin Scale (mRS) and categorized as favorable (mRS:0–2) or poor (mRS:3–5). Binary logistic regression model, adjusting for age, gender, educational level, history of hypertension and stroke, baseline NIHSS and treatment group, was used in the whole cohort to evaluate the association between admission FBG and functional outcome. Stratified logistic regression analyses were further performed based on the presence/absence of pre-diabetes history. Results In the whole cohort, multivariable logistical regression showed that poor functional outcome was associated with elevated FBG (OR1.21 (95%CI 1.07–1.37), p = 0.002), older age (OR1.64 (95% CI1.38–1.94), p<0.001), higher NIHSS (OR2.90 (95%CI 2.52–3.33), p<0.001) and hypertension (OR1.42 (95%CI 1.13–1.98), p = 0.04). Stratified logistical regression analysis showed that the association between FBG and functional outcome remained significant only in patients without pre-diagnosed diabetes (OR1.26 (95%CI 1.03–1.55), p = 0.023), but not in those with premorbid diagnosis of diabetes (p = 0.885). Conclusion The present results demonstrate a significant association between elevated FBG after stroke and poor functional outcome in patients without pre-diagnosed diabetes, but not in diabetics. This finding confirms the importance of glycemic control during acute phase of ischemic stroke especially in patients without pre-diagnosed diabetes. Further investigation for developing optimal strategies to control blood glucose level in hyperglycemic setting is therefore of great importance. Trial Registration ClinicalTrials.gov NCT00664846
Chinese Medical Sciences Journal | 2011
Li-Xin Zhou; Jun Ni; Shan Gao; Bin Peng; Liying Cui
Objective To investigate the clinical neurological manifestations of Takayasu arteritis (TA). Methods A retrospective study was conducted with 63 consecutive TA cases admitted to Peking Union Medical College Hospital from January 2009 to May 2010. All the patients fulfilled the diagnostic criteria of TA by the American College of Rheumatology. Among the 63 TA patients, 27 with neurological manifestations were included in the present study. All the patients were evaluated using standardized neurological examination, sonography, computed tomography (CT) angiography, and cerebral CT or magnetic resonance imaging. Results Dizziness and visual disturbance were the most common symptoms, which occurred in 20 (74.1%) and 16 (59.3%) patients respectively. Another common symptom was headache, observed in 15 (55.6%) patients. Six (22.2%) patients had suffered from ischemic stroke; 7 (25.9%) patients had epileptic seizures. Two (7.4%) patients were diagnosed as reversible posterior encephalopathy syndrome (RPES) based on typical clinical and imaging manifestations. Conclusions Neurological manifestations are common symptoms in TA patients in the chronic phase, including dizziness, visual disturbance, headache, ischemic stroke, seizures, and some unusual ones such as RPES. We suggested RPES be included into the differential diagnosis of acute neurological changes in TA.
International Journal of Stroke | 2011
Bin Peng; Yi-Cheng Zhu; Liying Cui; Jun Ni; Wei-Hai Xu; Li-Xin Zhou; Ming Yao; Lin Chen; Jianming Wang; Wang Y; Chuanqiang Pu
Background Although guidelines for secondary ischemic stroke have been developed, there is a gap between guidelines and clinic practice. Aims This study will investigate the current status of secondary ischemic stroke prevention in China, and implement a standard medical program in ischemic stroke and/or transient ischemic attack patients, and to examine the feasibility and efficacy of the program. Design This is a multicentre, parallel, randomized, open label, controlled trial to evaluate the feasibility and efficacy of a recommended guideline based program (SMART) in secondary stroke prevention. Forty-eight sites across Mainland China will participate in the trial. The number of enrolled patients in the study will be 4074. Primary outcome includes the proportion of patients adherent to eligible measures recommend by the SMART program, which is derived from current prevention guidelines for ischemic stroke, and the proportion of the patients achieving the treatment target. Secondary outcomes include new onset ischemic stroke, hemorrhagic stroke, acute coronary syndrome and all causes of death. The study has been registered on Clinicaltrials.gov (NCT00664846); to date, 3380 patients have been enrolled.
Frontiers in Aging Neuroscience | 2017
Ning Su; Fei-Fei Zhai; Li-Xin Zhou; Jun Ni; Ming Yao; Ming-Li Li; Zheng-Yu Jin; Gaolang Gong; Shu-Yang Zhang; Li-Ying Cui; Feng Tian; Yi-Cheng Zhu
Objective: To investigate the correlation between cerebral small vessel disease (CSVD) burden and motor performance of lower and upper extremities in community-dwelling populations. Methods: We performed a cross-sectional analysis on 770 participants enrolled in the Shunyi study, which is a population-based cohort study. CSVD burden, including white matter hyperintensities (WMH), lacunes, cerebral microbleeds (CMBs), perivascular spaces (PVS), and brain atrophy were measured using 3T magnetic resonance imaging. All participants underwent quantitative motor assessment of lower and upper extremities, which included 3-m walking speed, 5-repeat chair-stand time, 10-repeat pronation–supination time, and 10-repeat finger-tapping time. Data on demographic characteristics, vascular risk factors, and cognitive functions were collected. General linear model analysis was performed to identify potential correlations between motor performance measures and imaging markers of CSVD after controlling for confounding factors. Results: For motor performance of the lower extremities, WMH was negatively associated with gait speed (standardized β = -0.092, p = 0.022) and positively associated with chair-stand time (standardized β = 0.153, p < 0.0001, surviving FDR correction). For motor performance of the upper extremities, pronation–supination time was positively associated with WMH (standardized β = 0.155, p < 0.0001, surviving FDR correction) and negatively with brain parenchymal fraction (BPF; standardized β = -0.125, p = 0.011, surviving FDR correction). Only BPF was found to be negatively associated with finger-tapping time (standardized β = -0.123, p = 0.012). However, lacunes, CMBs, or PVS were not found to be associated with motor performance of lower or upper extremities in multivariable analysis. Conclusion: Our findings suggest that cerebral microstructural changes related to CSVD may affect motor performance of both lower and upper extremities. WMH and brain atrophy are most strongly associated with motor function deterioration in community-dwelling populations.
International Journal of Stroke | 2016
Jun Ni; Ming Yao; Li-Xin Zhou; Yi-Cheng Zhu; Bin Peng; Liying Cui
Background Education level is considered as an important factor for post-stroke functional outcome. Our previous study confirms the feasibility of SMART program to improve adherence of secondary stroke prevention in China. Aims We aim to investigate whether this program can influence the impact of educational level on post-stroke functional outcome in this sub-group analysis of SMART study. Methods We enrolled 3722 patients with acute ischemic stroke from multicenter (n = 47) SMART cohort. Patient’s educational level was categorized as three: illiterate, 6th grade or lower, and 7th grade or higher. Functional outcome at six-month post-stroke was assessed by Modified Rankin Scale (mRS) and categorized as favorable (mRS: 0–2) or poor (mRS: 3–5). Binary logistic model, adjusting for age, gender, stroke history, hypertension, diabetes, hyperlipidemia, educational level, and NIHSS was performed, respectively, in SMART group and usual care group to evaluate the effect of the SMART program on stroke functional outcome among different educated patients. Results In both groups, logistic regression analysis showed that poor functional outcome was independently associated with older age [OR(95% CI):1.81(1.41–2.33), p < 0.001(SMART); OR (95% CI):1.38 (1.09–1.73), p = 0.007(usual care)], higher baseline NIHSS [OR (95% CI): 2.90 (2.38–3.53), p < 0.001(SMART); OR (95% CI): 2.82 (2.32–3.44), p < 0.001(usual care)], and diabetes [OR(95% CI):1.88 (1.18–3.00), p = 0.008(SMART); OR (95%CI):1.68 (1.03–2.73), p = 0.037(usual care)]. Compared to illiterate, higher educational levels were independently associated with favorable outcome in usual care group [OR (95% CI): 0.43 (0.20–0.93), p = 0.032 (6th grade or lower) and OR (95% CI): 0.40 (0.19–0.84), p = 0.016 (7th Grade or higher)], but not in SMART group (p = 0.806 and p = 0.889, respectively). Conclusions This study demonstrates that implementation of SMART program may improve post-stroke functional outcome among illiterate. This suggests special attention should be paid to illiterate patients with intensive education in order to improve post-stroke disability.
Stroke | 2018
Fei-Fei Zhai; Shuang Yan; Ming-Li Li; Fei Han; Quan Wang; Li-Xin Zhou; Jun Ni; Ming Yao; Shu-Yang Zhang; Liying Cui; Jin Zy; Yi-Cheng Zhu
Background and Purpose— Intracranial arterial dolichoectasia (IADE) is a poorly understood arteriopathy compared with intracranial atherosclerotic stenosis (ICAS). We aimed to investigate the risk factors of IADE and ICAS and their relationship with neuroimaging markers of cerebral small vessel disease in a population-based study. Methods— This study comprised 1237 participants (aged 57.2±9.4 years, 37.6% men) who underwent brain magnetic resonance imaging and magnetic resonance angiography. IADE was assessed based on basilar artery dolichoectasia (diameter, height of bifurcation, and laterality of basilar artery) and dilation of basilar artery and internal carotid artery (intracranial volume-adjusted diameter ≥2 SD). ICAS was defined as any degree of stenosis in at least 1 intracranial artery. The neuroimaging markers of cerebral small vessel disease, including lacunes, white matter hyperintensities, microbleeds, dilated perivascular spaces, and brain atrophy, were evaluated. Results— Basilar arterial dolichoectasia was observed in 3.6% (45/1237); intracranial arterial dilation in 5.9% (67/1142); and ICAS in 15.7% (194/1237). Older age, higher systolic blood pressure, diabetes mellitus, higher LDL-C (low-density lipoprotein cholesterol) and lower HDL-C (high-density lipoprotein cholesterol) were associated with the presence of ICAS (all P<0.001), whereas only older age was associated with IADE. ICAS was associated with lacunes (odds ratio, 2.91; 95% confidence interval, 1.96–4.34; P<0.001), increased white matter hyperintensities volume (&bgr;±SE, 0.54±0.13; P<0.001), and brain atrophy (&bgr;±SE, −1.16±0.21; P<0.001), whereas basilar arterial dolichoectasia was mainly associated with dilated perivascular spaces in basal ganglia (odds ratio, 2.20; 95% confidence interval, 1.20–4.02; P=0.01) and, to a lesser extent, associated with lacunes and microbleeds. Conclusions— IADE and ICAS had different risk factor profiles and associated with different imaging phenotypes of cerebral small vessel disease, suggesting different underlying mechanisms.