Table of Content

20 February 2012, Volume 7 Issue 02

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主编手记

Nature or Nurture

WANG Yong-Jun

2012, 7(02):  81-82. 

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述评

Genetic Causes of Stroke

FAN Dong-Sheng

2012, 7(02):  83-85. 

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论著

Association of rs2383206 Single Nucleotide Polymorphism on Chromosome 9p21 and Cerebral Infarction in Chinese Han

LI Shu-Juan;ZHANG Yu-Jie;LIU Dong-Tao;et al

2012, 7(02):  86-90. 

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Objective To investigate the association of rs2383206 single nucleotide polymorphism(SNP) on chromosome 9p21 and cerebral infarction in northern Chinese Han population.Methods Three hundred and fifty-five cases of patients with early cerebral infarction(CI group) and 430 cases of surgical patients hospitalized over the same period as controls. PCR-SNP Stream technology was used to genotype rs2383206 polymorphism, and genotyping results were statistically analyzed.Results The frequency of genotype AG of rs2383206 was increased in CI group, compared with control group, P=0.007). G allele frequency of rs2383206 was also higher in CI group than control group. After adjusting for confounding factors, we found that, compared with AA homozygotes of the rs2383206, GG/GA genotype has significant effect to increase the risk of cerebral infarction(adjusted OR 1.23, 95%CI 1.11-2.05, P=0.009). rs2383206 G-allele increased the risk of large artery atherosclerotic stroke by 2.09 times.Conclusion Rs2383206 is the susceptible locus to CI in Chinese Hans.

Association between Chemokine CXC Ligand 16 Gene A181V Polymorphism and TOAST Classification

SONG Shuang;PAN Xu-Dong;MA Ai-Jun;et al

2012, 7(02):  91-97. 

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Objective To investigate the relationship between chemokine CXC ligand 16(CXCL16) gene A181V polymorphism, serum CXCL16 levels and cerebral infarction subtypes according to the trial of ORG 10172 in acute stroke treatment (TOAST) classification.Methods The polymorphisms of CXCL16 gene A181V were analyzed by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP). The serum CXCL16 levels in 74 healthy controls and 177 patients with acute cerebral infarction were measured by Enzyme linked immunosorbent assay(ELISA).Results The serum CXCL16 levels of patients were significant higher than those of healthy controls(P<0.001). According to TOAST classification, the patient controls were divided into three groups. Then we found that serum CXCL16 levels were significant different among large artery atherosclerotic stroke(LAA) group, small artery occlusion stroke(SAO) group and healthy controls(P<0.001). Logistic regression revealed that serum CXCL16 levels were an independent risk factor for cerebral infarction(P<0.001). The CXCL16 gene A181V genotype distribution and allele frequencies showed no differences between patient controls and healthy controls(P>0.05). However, among LAA group, SAO group and healthy controls the AAhomozygotes had significantly higher cerebral infarction risk compared with the G allele carriers (GA+GG)(P<0.001). CXCL16 gene A181V polymorphism was associated to serum CXCL16 levels(P=0.009).Conclusions Serum CXCL16 level correspond well with CXCL16 gene A181V polymorphism. An allele may be useful to identify patients at increased risk of Large artery atherosclerotic stroke.

Protection of Taurine against Transient Forebrain Ischemia in Gerbils

ZHAO Yu-Mei;SUN Ming;XU Chao

2012, 7(02):  98-102. 

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Objective To investigate the protection of taurine against transient forebrain ischemia in gerbils.Methods The model of transient forebrain ischemia in gerbil was induced through ligating bilateral carotid arteries for 5 min. The dose of 2.5, 5, 15 or 50 mg/kg of taurine was administrated intravenously 1 h after ischemia. The behavior and the neuronal death in hippocampal CA1 region were evaluated 7 days after induction of ischemia.Results Treatment with 2.5 mg/kg of taurine improved gerbil behavior and reduced the neuronal death in hippocampal CA1 region, although it did not reach statistical significance. Taurine at dose of 5, 15 or 50 mg/kg improved gerbil behavior(P=0.001, 0.006, and 0.037, respectively), and reduced the neuronal death in hippocampal CA1 region significantly(all P=0.0001). Moreover, the efficacies of 5, 15, and 50 mg/kg of taurine were better than that of 2.5 mg/kg of taurine(P=0.001, 0.001, and 0.005, respectively).Conclusions Taurine attenuates the brain damage due to transient forebrain ischemia in a dose-dependent manner, suggesting that taurine is an efficacious neuroprotectant.

Effects of Subhypothermia on Hemorrhagic Transformation and Ultramicrostructure after Middle Cerebral Ischemia-Reperfusion

KONG Wei;WU Shuo-Lin;MAO Shu-Jing;et al

2012, 7(02):  103-108. 

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Objective To investigate the effect of sub-hypothermia on hemorrhagic transformation and ultra-structure of the rats with cerebral ischemia-reperfusion within or beyond 3 hours-the therapeutic time window, and to study the neuroprotective effect of subhypothermia on cerebral ischemia in rats.Methods Using the intra-luminal suture method, we subjected Sprague-Dawley rats to middle cerebral artery occlusion(MCAO) model and reperfusion 3 hours, 6 hours or 9 hours later, and then the rats were divided into normal temperature group, subhypothermia for 3 hours group and subhypothermia 5 hours group. A group of sham-operated animals without ischemic was used as control. At the 24th hour after ischemia, all rats were killed. Six rats were selected in each group for measuring the amount of bleeding according to the method described by Sumii T et al. Two or 3 rats were selected in each group for observing morphologic changes of endothelial cell, gliacyte, neuron and neuropile in retrochiasmatic cortex ischemic boundary zones by electron microscopy.Results The cerebral injury and hemorrhagic transformation aggravated as the time prolonging after ischemia-reperfusion,subhypothermia should prevent the development of the injury and hemorrhagic transformation. Observation under transmission electron microscopes showed that cerebral ultrastructure of retrochiasmatic cortex ischemic boundary zones was damaged in different degrees in MCAOR groups, and the cerebral ultrastructure injury increased in cortex ischemic boundary zones as the ischemic time prolonging. Subhypothermia could alleviate the nerve cell damage. It showed the most effective in MCAO3hR+HT3h group.Conclusion Subhypothermia has protective effect on brain ultrastructure of rats with cerebralischemia reperfusion injury. It provides ultrastructural foundation for brain functional reconstruction.

Influence on Neural Function of Acute Cerebral Infarction with Dl-3-budylphthalinde and Cinepazidemaleate Combination Therapy

ZHAO Liu-Zhuang;WANG Li-Juan

2012, 7(02):  109-113. 

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Objective To study the curative effect and safety of dl-3-budylphthalinde and cinepazidemaleate on acute cerebral infarction.Methods One hundred and sixty patients with acute cerebral infarction were divided into four groups continuously and randomly:combination therapy group(40cases), budylphthalinde group(40cases), dl-3-budylphthalinde group(40cases) and conventional treatment group(40cases). Neural function defect and activity of daily living were tested by National Institutes of Health Stroke Scale(NIHSS) and Barthel Index(BI) before therapy and after two weeks and six month treatment. Adverse events were statistically analyzed.Results NIHSS total score after two weeks treatment, Compared with conventional treatment group, budylphthalinde group or dl-3-budylphthalinde used alone has no statistical significance(P>0.05), but there was synergy between the two drugs(P<0.01). BI after two weeks treatment, budylphthalinde group or dl-3-budylphthalinde used alone has statistical significance (P=0.029, P=0.002), but combination therapy group has better effect(P=0.001). NIHSS total score and BI after six month treatment, budylphthalinde group or dl-3-budylphthalinde used alone or combination therapy has significant curative effect(P<0.01), and combination therapy group has better effect. The 1 case in therapy group, 2 cases in dl-3-budylphthalinde group, 1 case in conventional treatment group appeared upset stomach. Symptoms improved after symptomatic treatment.Conclusion There was synergy between l-3-budylphthalinde combined with cinepazidemaleate. Itis an effective and safe method to treat acute cerebral infarction by the two drugs.

专题论坛

Fabry Disease and Stroke

LU Ming;FAN Dong-Sheng

2012, 7(02):  115-119. 

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Genes Research of Hemorrhagic Cerebrovascular Disease

LUO Di;BI Qi

2012, 7(02):  120-124. 

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病例讨论

A Case of Cerebral Autosomal Recessive Arteriopathy with Subcortical Infarcts and Leukoen- Cephalopathy

SUN A-Ping;FAN Dong-Sheng

2012, 7(02):  125-128. 

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指南与规范

2011 Singapore Ministry of Health: Clinical Practice Guidelines of Stroke and Transient Cerebral Ischemic Attack

ZHEN Zhi-Gang;HOU Xiao-Fang;WANG Chun-Yu;et al

2012, 7(02):  129-135. 

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综述

Symptoms, Neuroimaging and Notch3 Mutations of CADASIL and Its Features in Chinese Patients

SUN Yi-Min;WU Zhi-Ying

2012, 7(02):  136-140. 

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Cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy(CADASIL) is a rare hereditary disease of small cerebral arteries caused by mutations within Notch3. The symptoms in Chinese patients are characterized by subcortical infarctions, cognitive impairment while the migraine with aura is rare. Multiple subcortical lacunar infarcts and white matter lesions around lateral ventricles were the features in neuroimaging. Lesions in the anterior part of the temporal lobes, external capsula and callosum are specific for CADASIL. The mutations within Notch3 were predominantly located in exon 11, 4 and 3 and some hot spots might exist.

Original Grading Scales of Intracerebral Hemorrhage and Its Modifications

LU Jing-Jing;ZHAO Xing-Quan

2012, 7(02):  141-145. 

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Intracerebral hemorrhage(ICH) is the most serious stroke type and carries higher risk of mortality and disability. Grading scales of ICH are essential for selecting standard treatment regiments and comparison of patient selection and treatment efficacy for clinical trials. Since the first grading scale was introduced by Hemphill in 2001, its efficiency has been confirmed by external validations, and a number of modified grading scales and prognostic models based on the original ICH score have been developed for clinicians. We extensively reviewed the academic and social backgrounds, study methodologies, scale definitions and external validations of classical ICH grading scales in this article. Our purpose is to elucidate range of application and validating intensity of different grading scales of ICH.

Metabolic Syndrome and Stroke

MI Dong-Hua;WANG Chun-Xue;ZHANG Ning;et al

2012, 7(02):  146-150. 

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Metabolic syndrome(MS) is a clinical syndrome of central obesity, impaired diabetes or glucose regulation, hypertention, dyslipidemia ,as the main content, and insulin resistance is a common pathophysiological basis. Recently, there emerged many research about metabolic syndrome on stroke development and outcome. In order to evaluate stroke risks more accurately, and so as to promote the individualized management and treatment of stroke patients, we reviewed the research development of metabolic syndrome on stroke incidence, recurrence and prognosis in the past a few years.

教学园地

Teaching of Clinical Practice Lessons about Cerebrovascular Disease for Neurosurgery Graduate Students

QI Wei;ZHAO Yuan-Li

2012, 7(02):  151-153. 

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