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Table of Content

    20 April 2015, Volume 10 Issue 04
    Out From Under
    WANG Yong-Jun
    2015, 10(04):  273-278. 
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    Animal Models of Vascular Dementia in Rodents
    WANG Qun, WANG Yong-Jun
    2015, 10(04):  279-283. 
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    Ultrasound and Microbubbles Mediated shRNA Transfection Silences Toll-like Receptor 4 Gene Expression
    ZHENG Xuan*, LIANG Yan-Ling, CHEN Jia, CHEN Zhi-Yi, LI Si-Ying,LUO Jian-Hua, FANG Xiao-Bo.
    2015, 10(04):  284-290. 
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    Objective To determine the effect of the association of ultrasound and microbubble with short hairpin RNA ( shRNA) silencing Wistar rat brain Toll-like receptor 4 (TLR4). Methods Wistar rats were divided into 4 groups:normal sodium (NS) group, naked plasmid group (P), plasmid plus ultrasound (US) irradiation group (P+ultrasound-targeted microbubble destruction [UTMD]), plasmid plus US irradiation and SonoVue group (P+S+UTMD). Lateral ventricle injection of plasmid and SonoVue microbubble into rats' brain was performed and the brains were exposed to extracranial US, the brain TLR4 gene expression efficiency was evaluated 4 days after treatment. Results Western blot result shows that there is not statistical difference between NS group and naked plasmid group (NS:0.351±0.030, P:0.339±0.034, t 1, 2=0.590; P >0.05), but plasmid plus US irradiation group (P+UTMD) and plasmid plus US irradiation and SonoVue group (P+S+UTMD) shows statistical differences between NS group and naked plasmid group (P+S+UTMD:0.223±0.009, P+UTMD:0.277±0.013, t 1, 3=4.900, P <0.01; t 1, 4=8.779, P <0.01). Immunohistochemical analysis also shows statistical differences between Ultrasound Group (P+UTMD group and P+S+UTMD group) and non-Ultrasound group (NS and P) (P+S+UTMD:0.026±0.0013, P+UTMD:0.058±0.0014, t 1, 3=8.334, P <0.01; t 1, 4=21.027, P <0.01). There is not statistical difference between NS group and naked plasmid group (NS:0.079±0.0048, P:0.077±0.0012, t 1, 2=0.797; P >0.05) and P+S+UTMD group has better inhibition effects compared with P+UTMD group (P+S+UTMD:0.026±0.0013, P+UTMD:0.058±0.0014, t 3, 4=33.254; P <0.05). Conclusion The present study shows that this method of UTMD combined mediated shRNA can be used to deliver plasmid deoxyribonucleic acid (DNA) to the brain selectively and effectively. This noninvasive technique is a promising method for cerebral therapy and could be applied in the rapidly developing gene therapy for cerebral diseases.

    Cattle Encephalon Glycoside and Ignotin Ameliorates the Injury of Neurons Through
    Increasing the Level of GDNF of Astrocytes
    GUO An-Chen*, ZHAO Yi-Long, SU Fang,LI Wei-Wei, WANG Yong-Jun, WANG Qun.
    2015, 10(04):  291-297. 
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    【Abstract】 Objective To study the possible mechanism of cattle encephalon glycoside and ignotin (CEGI) to protect the neuron from damage. At the same time, the neuroprotective function of the astrocytes in brain injury was detected. Methods Ten pregnant Sprague Dawley (SD) rats and 10 neonatal SD rats were used to culture primarily neurons and astrocytes in the present study. To mimic the ischemic stroke, we added 40 mmol/L 2, 2'-Azobis (2-methylpropionamidine)dihydrochloride (AAPH) into the culture system to induce the cell injury. And the cell viabilities were detected with spectrophotometer. The protective functions of 0.025 μg/ml, 0.05 μg/ml and 0.1 μg/ml of CEGI were tested in the astrocyte culture system. At the same time, 0.1 μg/ml of CEGI-astrocyte conditional media were made to protect the neurons from AAPH induced injury. And the protective mechanism of CEGI was also detected. Results 40 mmol/L AAPH can be used to induce astrocyte injury. CEGI can ameliorate the AAPH induced astrocyte injury. 0.1 μg/ml of CEGI-astrocyte conditional media can increase the cell viability of neurons, and also CEGI-astrocyte conditional media can inhibit the apoptosis of neurons induced by AAPH. Western blot experiments demonstrated that CEGI-astrocyte conditional media could increase the level of glial cell-derived neurotrophic factor (GDNF) released from astrocytes to protect against neuronal damage induced by AAPH. Conclusion CEGI protects the neuron from injury by stimulating astrocyte secreting GDNF. And astrocytes are the target for neuroprotective drug screening.

    Incidence and Influencing Factors of the Symptomatic Seizure after Spontaneous Supratentorial Intracerebral Hemorrhage
    LI Zi-Xiao*, WANG Chun-Xue, WANG Yi-Long,LI Lin-Zi, ZHAO Xing-Quan, SHAO Xiao-Qiu, WANG Chun-Juan, PAN Yue-Song, WANG Yong-Jun.
    2015, 10(04):  298-305. 
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    Objective To investigate the incidence of the symptomatic seizure after spontaneous supratentorial intracerebral hemorrhage and its relative risk factors. Methods This prospective cohort from the China National Stroke Registry included consecutive patients between September 2007 and August 2008. This study included patients with spontaneous supratentorial intracerebral hemorrhage within 14 days after symptom onset and without history of epilepsy. The symptomatic seizure that occurred at intracerebral hemorrhage symptom onset and during hospitalization was recorded. The baseline clinical characteristics were compared between patients with or without seizures. The multivariable Logistic model was used to identify the relationship between patients’ demographic characteristics, medical histories, Glasgow Coma Scale (GCS) scores on admission, hemorrhagic locations and hematoma volume, in-hospital complications, and the occurrence of the symptomatic seizure. Results This study included 2862 patients with spontaneous supratentorial intracerebral hemorrhage. In this cohort, their median age was 62.0 (interquartile range 53.0~72.0), 1115 (39.0%) of them were female, 1921 (67.1%) had the history of hypertension disease. Compared with those without seizures,patients with seizures more likely have low GCS score (9.5 vs 12.5, P =0.006), high rate of in-hospital complications including hydrocephalus (5.3% vs 1.5%, P =0.050) and pneumonia (30.1% vs 17.0%, P <0.001). In the multiple logistic analysis, the following factors were independently associated with the occurrence of the symptomatic seizure: GCS on admission (per decreasing 2 scores, odds ratio [OR] 1.32, 95% confidence interval [CI] 1.21~1.45), hematoma involving cortical locations (OR 5.82, 95%CI 3.88~8.72), and the in-hospital complications including hydrocephalus (OR 2.73, 95%CI 1.14~6.56) and pneumonia (OR 1.65, 95%CI 1.09~2.52). Conclusion The symptomatic seizure after spontaneous supratentorial intracerebral hemorrhage is common. Level of consciousness, hematoma involving the cortex, and complications of hydrocephalus and pneumonia are independent relative factors.

    Survey on Knowledge of Traditional Stroke Risk Factors and Perceived Risk for Developing Stroke in Women
    YANG Juan*, WANG Jian, OU Shu, ZHANG Jie, WANG Ni,YANG Na, GAO Pan, HE Lan-Ying, PANG Rui-Juan.
    2015, 10(04):  306-312. 
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    Objective To investigate the knowledge level of traditional stroke risk factors and perceived risk for developing stroke in women. Methods A cross-sectional study was conducted from January to December in 2011. Multistage sampling was used and 1000 households were selected in Yuzhong district, each household determined one female member to join the survey. A trained interviewer conducted a face-to-face investigation of knowledge about traditional stroke risk factors, including smoking, hypertension, diabetes mellitus, hyperlipidemia, heart disease and previous stroke, and perceived risk for developing stroke. Results A total of 682 participants completed the survey. The respondents' awareness rate of traditional stroke risk factors ranged from 53.8% to 88.0%. Only 17.2% of respondents perceived themselves to be at risk for developing stroke. In the multivariate analyses, educational level, a history of hypertension, hyperlipidemia, heart disease and previous stroke were independent predictors of perceived risk for stroke (P <0.05). Patients with more risk factors had a higher awareness of perceived risk for stroke (P <0.05). Conclusion Female residents of Chongqing do not perceive themselves to be at risk for stroke. The awareness of the risk for stroke has yet to be enhanced in women, especially those women with stroke risk factors.

    Relationship between Serum Homocysteine and Carotid Atherosclerosis Plaque in Chinese Acute Cerebral Infarction Patients
    LIU Ming-Yong, ZHOU Li-Chun.
    2015, 10(04):  313-318. 
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    Objective To explore the relationship between serum homocysteine and carotid atherosclerosis plaque in Chinese acute cerebral infarction patients. Methods All 196 hospitalized patients with acute cerebral infarction from June 2013 to June 2014, coming from Chaoyang Hospital west campus, were retrospectively analyzed. All patients were received carotid ultrasonography screening. To all patients, maximal thickness of carotid atherosclerosis plaque (MTCAP) and serum homocysteine (HCY) were assessed. Patients were classified into two groups according to the presence or absence of plaque (152 cases and 44 cases, respectively). Results The median of HCY in none plaque group (n=44) and plaque group (n=152) is 11.6 μmol/L and 14.0 μmol/L, respectively, with P value 0.011 (<0.05) in Rank test. Spearman correlation test showed that there was a liner relationship between HCY and MTCAP, r =0.247, P =0.0001 (<0.05). Logistic regression revealed that age (odds ratio [OR] value 1.089, 95%confidence interval [CI] 1.050~1.131, P =0.0001), male (OR value 4.304, 95%CI 1.738~10.660, P =0.002), hypertension history (OR value 3.864, 95%CI 1.750~8.534, P =0.001) were independent risk factors of carotid atherosclerosis plaque, but HCY (OR value 1.026, 95%CI 0.973~1.081, P =0.344) was not. However, the analysis of none cardiac cerebral infarction subgroup (n =183) according to TOAST classification method shows that HCY is an independent risk factor of carotid atherosclerosis plaque (OR value 1.267, 95%CI 1.006~1.430, P =0.003). Conclusion For Chinese acute infarction patients, serum HCY positively correlates to maximal thickness of atherosclerosis plaque. And HCY is an independent risk factor to the presence of carotid atherosclerosis plaque in none cardiac cerebral infarction patients.

    Autophagy:A Double-edged Sword in Cerebral Ischemia
    LI Wei-Wei*, WANG Qun, GUO An-Chen, WANG Yong-Jun, LI Jun-Fa.
    2015, 10(04):  319-325. 
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    Autophagy may be a new therapeutic target for stroke according to recent research, but whether activation of autophagy plays a positive role or negative role in neuronal survival is still controversial. This review summarizes the dual effects of autophagy in ischemia/hypoxiainduced neuronal injury and its possible signaling pathways.

    In Vitro Model for Ischemic Stroke
    GUO An-Chen*, ZHAO Yi-Long, SU Fang, LI Wei-Wei, WANG Yong-Jun, WANG Qun.
    2015, 10(04):  326-330. 
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    Ischemic stroke is one of the leading causes of mortality and evere disability, the incidence of which accounts for 60%~80% of all the stroke patients. The in vitro models of ischemic stroke are important for detecting its mechanisms and therapy. At present, the in vitro models of ischemic stroke from neurons, glial cells, epithelial cells, blood-brain barrier and neurovascular units were established. In this paper, we reviewed the advances for in vitro model of ischemic stroke, which provide the potential selectivity for research in ischemic stroke.

    Advances in Correlation between miRNA and Platelet Activity:a Novel and Potential Biomarker to Evaluate the Efficacy of Anti-platelet Therapy
    LIN Ze-Ming, LIU Xin-Tong.
    2015, 10(04):  331-335. 
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    MicroRNA (miRNA) is a non-coding small RNA molecule, participating in regulating biologic activities, with a large quantity. MiRNAs have their specific expression in different processes related to platelet formation, mRNA regulation, protein synthesis and platelet activation. For instance, miRNA participates in regulating the biogenesis and differentiation of megakaryocytes and the pathway of platelet activation. Scientists pay a lot of efforts to figure out the relationship between miRNA and platelet reactivity, which points out a new possibility to evaluate the efficacy of anti-platelet therapy by using miRNA as a novel biomarker. This article is trying to review the studies about the relevance between miRNA and platelet reactivity.

    Conventional Magnetic Resonance Imaging in the Diagnosis of One Case of Asymptomatic Hemorrhagic Transformation of Cerebral Infarction
    LIU Tong-Tong, CHEN Xin, CHEN Xiao-Hong
    2015, 10(04):  336-339. 
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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 3)
    XU Bao-Lei,ZHAO Ming-Lei, WU Hao, et al.
    2015, 10(04):  340-353. 
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    Early Diagnosis and Analysis of Misdiagnosis of Cerebral Venous and Sinus Thrombosis
    during Pregnancy and the Puerperium
    FANG Xiao-Bo, LIANG Yan-Ling.
    2015, 10(04):  354-358. 
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    The cerebral venous sinus and venous thrombosis is a special type of ischemic cerebrovascular disease, which easily occurs in women during pregnancy and the puerperium. Despite advances in the recognition of cerebral venous and sinus thrombosis (CVST) in recent years, yet the low incidence, complex clinical manifestations, and high mortality and morbidity still puzzle us. Therefore, we should pay more attention to it because good prognosis can be got by the early intervention. This review will focus on early diagnosis and the analysis of misdiagnosis, in order to facilitate clinicians' early identification of hazard warning, so that they can make an early diagnosis, avoid misdiagnosis and get timely intervention for those patients.

    Research Progress of Post-stroke Depression and Cerebral Small Vessel Diseases 
    MING Bao-Hong, GUO Yang.
    2015, 10(04):  359-363. 
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    The post-stroke depression (PSD) is one of the common complications after stroke. It not only affects the recovery of the psychiatric and neurological function in patients, but also increases mortality  and morbidity, resulting in a negative influence for the prognosis in patients with stroke. There is a certain degree of correlation between the PSD and the lesion site, degree of pathological changes. But recent studies demonstrated that the cerebral small vessel diseases (CSVD) are also closely related to the occurrence of PSD. With the increasing of the aging population, the occurrence of the CSVD is raising. The CSVD is not only an important risk factor of PSD, but also increases the severity of PSD. In this article, we made a review of the relationship between CSVD and PSD.

    Teaching Experiences and the Existing Problems of General Practitioners in Neurology Specialty Practice
    XU Chun-Ling, CHEN Kui, LI Ji-Mei.
    2015, 10(04):  364-365. 
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    Application with Technology of CBL-Literature Review-Clinical Practice in Clinical Teaching of Cerebrovascular Disease
    XU Bin, KANG Geng-Jie, SUN Li.
    2015, 10(04):  366-368. 
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    Objective  To analyze the effect of multi-technology combined with CBL-Literature Review-Clinical Practice model in clinical teaching of cerebrovascular disease in postgraduate students of neurology. Methods  Twenty-six students from Fu Xing Hospital who enrolled in 2011-2012 were divided into the multi-technology group (n=14) and the lecture-based learning (LBL) group (n=12). Objective evaluation scores were used to compare the clinical application effects of two groups during rotation and training in Department of Neurology. Results  In summarizing the characteristics of cases, clinical thinking and literature review, the scores in multi-technology combined with CBL-Literature Review-Clinical Practice model group was significantly higher than those in the LBL group (P<0.05) in the case of the same level of basic education. Conclusion  The model of multi-technology can improve the ability of clinical thinking and skills as well as initiative in postgraduate students of neurology, it is also an effective method of graduate teaching.