Table of Content

20 February 2015, Volume 10 Issue 02

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Curiosity

WANG Yong-Jun

2015, 10(02):  99-100. 

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Model Choice of Ischemic Stroke and Experimental Design in Preclinical Study

WANG Qun,WANG Yong-Jun

2015, 10(02):  101-106. 

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In Vivo Morphological Observation of Cortical Vessel in Mice after Chronic Cerebral Hypoperfusion

NAN Di, GUO Huai-Lian, HE Qi-Hua, SONG Jiang-Man.

2015, 10(02):  107-112. 

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Objective To dynamically observe the morphological changes of the cortical vessel in mice after chronic cerebral hypoperfusion through a cranial window. Methods The left common carotid artery ligation and transient right common carotid artery ligation operations were performed on 7 Tie2-GFP transgenic mice. The cortical vessels were observed using confocol microscopy through a cranial window before brain ischemia (D0) and 7 days after brain ischemia (D7). The diameter and density of capillaries, along with the diameter and morphological change of arterioles and venules, were analyzed. Results ①The diameters of capillary before and 7 days after the brain ischemia were (6.62±0.75) μm and (12.50±3.29)μm, which increased significantly after brain ischemia (P <0.001). ②The capillary densities before and 7 days after the brain ischemia were (11.67±1.72) segments per region of interest (ROI) and (11.08±2.06) segments per ROI. The difference was not significant (P =0.0583). ③The diameters of the precapillary arteriole, post capillary venule, true capillary and thoroughfare channel before and 7 days after the brain ischemia were (6.33±0.94)μm vs (12.36±3.20) μm, (6.87±1.10)μm vs (12.37±2.78)μm, (6.37±0.52)μm vs (11.41±3.10)μm and (6.35±0.92)μm vs (13.91±6.17)μm, respectively, all increased significantly after brain ischemia (P <0.01, <0.01, <0.01, and <0.05, respectively). The most significant dilation was observed in thoroughfare channel.④The diameters of venules on D0 and D7 were (19.59±8.74)μm and (24.81±6.25)μm, which increased significantly after brain ischemia (P =0.0054). However, the diameters of arterioles on D0 and D7 were (12.71±2.10)μm and (13.20±3.09)μm, the difference was not significant (P =0.2947); ⑤Capillary remodeling, tortuosity and new anastomosis between venules were observed after brain ischemia. Conclusion The dilation of capillaries and venules were observed after brain ischemia. These changes may contribute to the regulation of cerebral blood flow after chronic cerebral hypoperfusion.

Association between SNP83 Polymorphism in Phosphodiesterase 4D Gene and Prognosis of Ischemic Stroke

SONG Yan-Li, WANG Chun-Juan,WANG Peng-Lian, LIN Jin-Xi,MA Yue-Tao, LIU Li, DU Wan-Liang, LIU Gai-Fen.

2015, 10(02):  113-119. 

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Objective To investigate the association between single nucleotide polymorphism 83 (SNP83 ) polymorphism in phosphodiesterase 4D (PDE4D) gene and prognosis of ischemic stroke. Methods We consecutively enrolled 736 ischemic stroke patients who admitted to Beijing Tiantan Hospital from October 2009 to July 2011, and SNP83 was genotyped by the Sequenom Massyarray technique. Logistic regression analysis was used to investigate the association between SNP83 and three months' prognosis of ischemic stroke under different genetic models. Combined endpoint event was defined as recurrence of stroke, death of all causes and other cerebro-cardiovascular events. Results A total of 736 ischemic stroke patients were enrolled into the study, and 677 patients had information of follow-up after three months of stroke. Compared with the patients without combined endpoint event, the patients with combined endpoint event were older ([67.02±0.70] vs [59.98±3.35], P <0.001), had higher proportion of history of atrial fibrillation (9.3% vs 3.7%, P =0.048), and had higher National Institutes of Health Stroke Scale (NIHSS) score[11(5~16) vs 5(2~9), P <0.001]. When analyzing the gene polymorphism, we found that the proportion of AG+GG genotype was significantly higher in the patients with combined endpoint event than those without combined endpoint event (50.0% vs 36.7%, P =0.007), and in the multivariable analyzing adjusted for age, NIHSS score and history of atrial fibrillation, the AG/GG genotype was significantly associated with combined endpoint event (adjusted odds ratio [OR] 1.84, 95% confidence interval [CI] 1.04~3.26). However, no significant association was found with poor outcome after ischemic stroke. Conclusion AG/GG genotype of SNP83 in PDE4D gene was associated with combined endpoint event after ischemic stroke.

Analysis on the Plasma miRNAs of Patients with Asymptomatic Cerebral Atherosclerotic and Large Artery Atherosclerotic Ischemic Stroke

YANG Shu-Na*, MA Ai-Jun, PAN Xu-Dong, ZHONG Qian-Wei, WANG Lan, ZHANG Zhang, PANG Meng.

2015, 10(02):  120-127. 

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Objective To establish the plasma miRNAs expression profile change of patients with asymptomatic cerebral atherosclerotic (AS) and large artery atherosclerotic (LAA) ischemic stroke. Methods Retrospective study is adopted, and our study included eight asymptomatic cerebral atherosclerotic patients (AS group), eight LAA ischemic stroke patients (LAA group), and eight controls (control group). All participants were selected from the Affiliated Hospital of Medical College Qingdao University from January 1 to Februry 28 in 2013. The Solexa sequencing technology was employed to detect the expression profile of miRNAs in the specimens, we found out the differentially expressed miRNAs. At last, we made an initial prediction and functional analysis of target genes regulated by the differentially expressed miRNAs. The results of the Solexa sequencing technology were verified by real-time polymerase chain reaction (PCR). Results Twenty six miRNAs including miR-let-7a-5p, miR-146b-5p, miR-26a-5p, miR-23a-3p were found differentially expressed among the 3 groups. Compared with control group, 41 miRNAs including miR-10b-5p, miR-126-5p, miR-143-3p, miR-192-5p were found differentially expressed in AS group and LAA group. The bioinformatics analysis indicated that the target genes of these differentially expressed miRNAs participated in cell adhesion, differentiation, and proliferation. The results of real-time PCR indicated that there was a good consistency between PCR verified results and Solexa sequencing data. Conclusion miRNA expression profile of patients with AS and LAA ischemic stroke has some similarities, also has some differences.

Growth Associated Protein-43 Influences the Orientation of Cell Division in the Brain

HUANG Rui*, WEN Yu-Jun, JU Li-Li.

2015, 10(02):  128-134. 

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Objective To study the mechanism of growth associated protein-43 (GAP-43) involved in neurogenesis, in order to verify the hypothesis that GAP-43 may influence the orientation of cell division through interacting with G proteins. Methods The experiment was divided into two groups, the experimental and control groups. Six C57BL/6J GAP-43 transgenic pregnant mice (24 fetuses of E13.5 and E17.5 days) were as the experimental group, and six wild-type pregnant mice (24 fetuses of E13.5 and E17.5 days) were as the control group. The localization of GAP-43 was determined by immunofluorescence and Western blot, while the interaction of GAP-43 and Gαi were detected by co-immunoprecipitation (co-IP). Furthermore, in order to compare the orientation of cell division in fetal brains of the transgenic mice with that in wild type mous , we measured the exact angle of the dividing chromatics in regard to the ventricular zone during neurogenesis. Results Respectively selected 24 embryonic mice of embryonic period of 13.5 and 17.5 in each group (transgenic and wild type groups). The Western blot and immunofluorescence results showed that the expression of GAP-43 was higher in transgenic groups than those in wild type groups and was on the membrane in both two groups (P <0.05). The co-IP result showed that GAP-43 interacted with Gαi. The analysis of the exact angle of the dividing chromatics revealed a signi?cant difference in dividing cells in the transgenic group compared with the wild type group of E13.5 (P <0.05). Conclusion The GAP-43 is involved in the orientation of cell division through Gαi and this may be an important mechanism for neurogenesis in the mammalian brain. This study provides the foundation of the mechanism of GAP-43 in neurogenesis and stroke for further study.

The Progress of Cerebral Preconditioning

ZHAO Yi-Long*, GUO An-Chen, WANG Yong-Jun, WANG Qun.

2015, 10(02):  135-140. 

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Stroke is the third most common cause of death after heart attack and cancer and has profound negative social and economic effects. Treatments for stroke are more concentrated in the acute period of stroke, and there is no effective method in the recovery period of stroke. Pharmacological treatments are either ineffective or confounded by adverse effects, and neuroprotection and brain repair in patients after acute brain damage are still major unfulfilled medical needs. Recently, endogenous mechanisms by which the brain protects itself against noxious stimuli and recovers from damage are being studied. Research on preconditioning, also known as induced tolerance, has resulted in various promising strategies for the treatment of patients with acute brain injury. On the one hand, preconditioning can identify endogenous protective or regenerative mechanisms that can be therapeutically induced. On the other hand, preconditioning could be used as a therapeutic technique by inducing tolerance in individuals in whom ischemic events are anticipated, such as high-risk surgical cohorts or patients with subarachnoid hemorrhage or transient ischemic attack.

Neuroprotection of Plant Polyphenols in Cerebral Ischemia

LI Wei-Wei*, LI Jun-Fa,GUO An-Chen, WANG Yong-Jun, WANG Qun.

2015, 10(02):  141-146. 

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Plant polyphenols are dietary components that exert a variety of biochemical and pharmacological effects. Recently, considerable interest has been focused on polyphenols because of their antioxidant, anti-inflammatory, and anti-proliferative activities. Reactive oxygen species can damage lipids, proteins, and nucleic acids, thereby inducing apoptosis or necrosis. There is increasing evidence supporting the hypothesis that plant polyphenols can provide protection against neurodegenerative changes associated with cerebral ischemia. This article reviews the neuroprotective effects of plant extracts and their constituents that have been used in animal models of cerebral ischemia. The use of polyphenols as therapeutic agents in stroke has been suggested.

Biomarkers for Cerebral Ischemic Preconditioning

SU Fang*, ZHU Yu-Lan, GUO An-Chen, WANG Yong-Jun, WANG Qun.

2015, 10(02):  147-152. 

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Ischemic preconditioning (IPC) is an intrinsic neuroprotective mechanism whereby a brief, sublethal ischemic insult protects against a subsequent lethal ischemic attack. Its basic premise is that brief durations of ischemia induce innate defense systems leading to tolerance of subsequent, more severe ischemia. Preconditioning has been observed in multiple organs and species, among which cerebral ischemic preconditioning had gained much more attention. Finding suitable biomarkers to show the ischemic tolerance induced by ischemic preconditioning is a translational research priority. The ideal biomarker should be easily obtained, with high sensitivity and specificity. In this article, we will review the probable serum and imaging biomarkers for cerebral ischemic tolerance induced by ischemic preconditioning.

Vertebral Artery Dissection in a Patient with Acute Infarction in the Right Cerebellum and Thalamus

JI Wen-Juan, LIU Nan

2015, 10(02):  153-156. 

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Guidelines for the Primary Prevention of Stroke:A Statement for Healthcare Professionals from the American Heart Association/American Stroke Association (Part 1)

XU Bao-Lei，MA Cui，ZHAO Ming-Lei, et al.

2015, 10(02):  157-164. 

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Advance of Perfusion Imaging in Predicting Hemorrhagic Transformation after
Thrombolytic Therapy for Acute Ischemic Stroke

CHEN Ke-Nan, GUO Shun-Yuan,GENG Yu.

2015, 10(02):  165-169. 

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Hemorrhagic transformation (HT) is a serious complication of ischemic stroke. The mechanism of HT is thought to be endothelial injury and blood-brain barrier disruption due to severe ischemia. Recent studies have demonstrated that perfusing imaging is useful in the pretreatment prediction of HT, and is more strongly associated and may allow better prediction of HT when compared with CT or diffusion imaging. This article reviews the studies that evaluated different perfusion imaging parameters as predictors of HT in acute ischemic stroke with the aim to facilitate obtaining the reliable therapy strategies for acute ischemic stroke and improving patient selection for acute reperfusion therapy.

Research Progess in Hyperthyroidism and Moyamoya Syndrome

XIAO Fu-Long*, GAO Pei-Yi.

2015, 10(02):  170-174. 

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The abnormal vascular network found in moyamoya syndrome is different from that in moyamoya disease. Stenosis in intracranial vessels found in moyamoya syndrome may be a subtype or an early stage of moyamoya disease. The pathophysiology in moyamoya syndrome may have some common ground with moyamoya disease. The pathophysiology in moyamoya syndrome associated with hyperthyroidism includes autoimmune disorder, abnormal hemodynamic, arteriosclerosis and increased sympathetic activation. Changes in thyroxin level should be concerned in clinical practice. In this review, we summarize the pathophysiology of moyamoya syndrome associated with hyperthyroidism and some points in clinical diagnosis and treatment.

Imaging Evaluation of Cerebral Collateral Circulation

LI Qian-Lu, YANG De-Yu, LIU Bo, LI Zhi-Wei.

2015, 10(02):  175-180. 

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Ischemic cerebrovascular disease is a common and frequently-occurring disorder harming human health. With improvement of people's living standard, incidence rate of the disease is increasing. The key to treat the patients with ischemic cerebrovascular disease is to improve and recover cerebral perfusion, and the cerebral collateral circulation plays an important role in this tache. The imaging evaluation of cerebral collateral circulation contribution is the key to choose the best treatment. The golden standard of evaluating the cerebral collateral circulation is digital subtraction angiography (DSA), which can show the distribution of the collateral vessels clearly. Considering the invasiveness of DSA, we also can choose transcranial Doppler (TCD) to measure the blood velocity of collateral circulation vessles, determine the direction of blood, computed tomography angiography (CTA) to observe the intracranial blood vessels dynamically from any angle and magnetic resonance imaging (MRI) to show all the main blood vessels and their branches. Because of the limitation of all these techniques, knowledge of the merits and demerits about these techniques is important for a reasonable choice, we will discuss these aspects in this review.

Research Review on the Damage of Blood-Brain Barrier after Cerebral Hemorrhage

XU Nan, CAO Fei.

2015, 10(02):  181-186. 

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Brain edema is one of the serious complications caused by hemorrhagic stroke, in which the vasogenic brain edema caused by blood-brain barrier damage is the main type of cerebral edema. At present, a number of studies have shown that there are various factors inducing bloodbrain barrier disruption after cerebral hemorrhage. For instance, thrombin, inflammatory mediators, matrix metalloproteinases, complement, hemoglobin breakdown products, aquaporin-4 and the interactions of them all play a significant role in this pathophysiological process.

Study on Improving the Quality of Cerebrovascluar Disease Clinical Teaching Rounds
under the Circumstances of Clinical Medicine Professional Certification

WANG Lei, XU Rong, MENG Shi-Jiao.

2015, 10(02):  187-188. 

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Objective To explore the influence extent on cerebrovascluar disease clinical teaching rounds under the circumstances of clinical medicine professional certification. Methods We selected 2007 grade, 2008 grade, 2009 grade Seventh grade college interns in Beijing Tiantan Hospital affiliated to Capital Medical University, and compared the quality of cerebrovascular disease clinical teaching rounds before and after clinical medicine professional certification (the Fifth year). Results Before (2007, 2008) and after (2009) clinical professional certification, the assessment average score of cerebrovascular disease clinical teaching rounds' quality were 97.4 points, 97.7 points, 99.0 points, there are significant differences (P <0.05). Conclusion Clinical professional certification may have a major impact in improving the quality of clinical teaching rounds.

Improvement of Magnetic Resonance Imaging Diagnosis of Education Mode under the
New Situation

LOU Xin.

2015, 10(02):  189-192. 

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Objective To improve the new teaching methods of magnetic resonance imaging (MRI) which emphasizes on combining clinic research with clinic application in the new situation. Methods From Sep. 2013 to Jan. 2014, 68 visiting doctors accepted teaching classes for MRI diagnosis. According to the number sequence, they were divided into 2 groups (the old teaching group vs the new teaching group). Results Before the teaching process, the scores of the old teaching group had no difference with the new teaching group ([71.3±6.8] vs [72.1±7.1], P =0.830). After the teaching process, the scores of the new teaching group were higher than the old teaching group ([81.2±7.8] vs [86.2±6.7], P =0.005). The doctors who accepted the new teaching mode have more interest in studying than those that accepted the old teaching mode (P =0.036). Conclusion The new teaching mode may be more helpful for the visiting doctors to improve scores and interests in MRI diagnosis than the old teaching mode.