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    20 November 2012, Volume 7 Issue 11
    The Eternal Monument
    WANG Yong-Jun
    2012, 7(11):  833-834. 
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    Magnetic Resonance Imaging:Essential Imaging Technique for Assessment of Atherosclerotic Plaques
    LOU Xin
    2012, 7(11):  835-838. 
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    Feasibility of Three-Dimentional Flow-Dephasing Magnetic Resonance Imaging in Detecting Atherosclerosis of Intracranial Arteries
    LIU Meng-Qi*, MA Ning, JIANG Wei-Jian, MA Lin, LOU Xin.
    2012, 7(11):  839-844. 
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    【Abstract】 Objective To explore the feasibility of three dimensional flow-dephasing-prepared fast spoiled gradient recalled echo(3D FDP-FSPGR) in detecting the  laque of intracranial artery using 3.0T MR scanner.

    Methods Ten patients with intracranial artery stenosis >70% confirmed by digital subtraction angiography were enrolled in this study. 3D FDP-FSPGR and two dimensional double inversion recovery(2D DIR) were performed in all patients. The contrast-noise-ratio, the lumen area and plaque area which the two sequences were measured and compared.

    Results The contrast-noise-ratio of 3D FDP-FSPGR was 10.16±4.28 and 2D DIR was 14.81±5.26, there were no statistically significant differences etween the two sequences(t =2.03, P <0.05). Lumen area and plaque area from 3D FDP-FSPGR and 2D DIR techniques highly correlated(ICCs of 0.96 and 0.95, respectively). The results measured of two sequences were 2.2±1.2 mm2 and 2.2±1.3 mm2 for lumen area, 18.8±1.4 mm2 and 18.5±0.9 mm2 for plaque area, respectively. The scan ranges of two sequences were 48 mm and 8 mm, respectively, and the scan time were 3.7 minutes and 4.8 minutes, spectively.

    Conclusions 3D FDP-FSPGR is able to acquire the three dimensional wall images of main intracranial arterial trunk with larger coverage in shorter scan time compared with 2D DIR. It may provide more comprehensive accurate  information for clinical therapeutic because of the satisfying image quality and reliable technology.

    Study on High Level Expression of Activated MMP-9 may Increase Hemorrhagic Risk of Cerebral Arteriovenous Malformation
    LI Xiong*, WANG Rong, LIU Ling, WU Jun,PENG Lei, LI Yu, WANG Shuo.
    2012, 7(11):  845-849. 
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    【Abstract】 Objective To investigate the role of MMP-9 in the hemorrhagic mechanism of cerebral arteriovenous malformation(AVM).

    Methods Thirty-one patients with AVMs and 25 patients with epilepsy were admitted in our hospital during October 2010 to March 2011. The AVM tissue samples were divided into a ruptured group, non-ruptured group and control group. Tissue samples were obtained from the AVM nidus during surgery or from the temporal lobectomy of patients undergoing surgical treatment of epilepsy. Western blot analysis was used to measure MMP-9 in the tissues. Immunofluorescence was used to measure tissue MMP-9 expression in each group. Gelatin zymography showed the expression of activated MMP-2 and MMP-9 in the tissue.

    Results MMP-9 protein expression in the non-ruptured group was greater than that in the normal group and the ruptured group. (1.21±0.34 vs 0.35±0.06, P =0.0014; 1.21±0.34 vs 0.32±0.08,P =0.047), but no difference between the ruptured and the control group(0.32±0.08 vs 0.35±0.06,P =0.7456). Gelatin zymography showed that the activity of MMP-9 was significantly higher in the ruptured than the non-ruptured and control groups(0.97±0.08 vs 0.40±0.09, P =0.009; 0.97±0.08 vs 0.30±0.07, P =0.0034). In the ruptured group, active MMP-2 expression was significantly higher than that in the unruptured and control group(1.36±0.17 vs 0.55±0.12, P =0.019; 1.36±0.17 vs 0.36±0.09, P =0.006).

    Conclusion MMP-9 had higher expression in the AVM tissues and more MMP-9 transformed to activated form in ruptured AVM tissues; this may lead to increase in hemorrhage risk due to AVM.

    Dynamic Observation of Clopidogrel Resistance in Patients with Cerebral Infarction
    SHI Hong-Ting*, ZHOU Bo-Rong, WANG Rong, DENG Yan-Hua, GUAN Hai-Tao, LIU Zi-Fan.
    2012, 7(11):  852-857. 
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    Objective To investigate the dynamic changes in patients with cerebral infarction(CI) of clopidogrel resistance(CR), and to observe the change of rate of platelet aggregation(△RPA) and the incidence rate of CR in patients with ischemic stroke and high risk(high risk factors of stroke).

    Methods Sixty-eight cases in normal people and 59 cases in patients with high risk(HR) and 121 cases in patients with CI were enrolled. The rate of platelet aggregation(RPA) was examined on baseline and two weeks after medication(clopidogrel 75 mg/d). The patients who had CR were used or combined with other antiplatelet drug to investigate the △RPA after two weeks. Patients who had non-CR continued to be given clopidogrel 75 mg/d to investigate △RPA after three months and six months.

    Results Before overdosed, CI group([65.75±13.11]%) respectively compared with normal group([50.49±12.42]%) and HR group([56.71±11.33]%), which the RPA had a significant difference(t =4.534, P =0.000 vs t =7.829, P =0.000); The incidence of CR in patients with HR was 13.6%(8 cases), the incidence of CR in patients with CI was 29.75%(36 cases). Three months after overdosed the incidence of new CR in patients with CI was not detected, six months after overdosed the incidence of new CR in patients with CI was 17.65%; When other antiplatelet drug were used, RPA decreased by >10% in 70% CR patients.

    Conclusion The incidence of CR in patients with CI was higher. Dynamic changes of CR may occur in patients with CI

    Association between Lp-PLA2 Gene A379V Polymorphism and TOAST Classification
    LI Cui-Ling, MA Ai-Jun, WANG Kun, WANG Yuan, JIANG Xue-Song, YI PENG, FAN Ling-Yan, HAN Ying, PAN Xu-Dong.
    2012, 7(11):  858-863. 
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    【Abstract】 Objective To explore the relationship between the serum lipoprotein phospholipase A2(Lp-PLA2) level and its gene A379V polymorphism and the trial of Org 10172 in acute stroke treatment(TOAST) subtypes of cerebral infarction.

    Methods The serum Lp-PLA2 level in 200 patients with acute cerebral infarction and 172 healthy controls were measured by Enzyme linked immunosorbent assay(ELISA). Polymerase chain reaction(PCR) and direct sequencing assay were used to detect gene polymorphism.

    Results The serum Lp-PLA2 level of the patients (24.39±6.63)ng/ml was higher than that in healthy controls (15.78±4.32)ng/ml, there was a significant difference(P <0.01). According to TOAST classification, we found that serum Lp-PLA2 level was significant different among large artery atherosclerotic stroke(LAA) group (25.60±6.71)ng/ml, small artery occlusion stroke(SAO) group (21.43±5.47)ng/ml and healthy controls (15.78±4.32)ng/ml(P <0.01). Among the patients,the CC genotype frequency was 68%,the C allele frequency was 83%,compared with the healthy controls(CC genotype frequency was 68%,C was 83%), there was no difference(P ﹥0.05). However,the serum Lp-PLA2 level of the CC homozygote (26.27±6.25)ng/ml had significantly higher stroke risk compared with the T allele carriers(CT+TT) (20.39±5.64)ng/ml(P <0.01).

    Conclusion The serum Lp-PLA2 level in the cerebral infarction increased, LAA group was the most obvious; Maybe A379V polymorphism CC genotype had relationship with stroke.

    Determining the Etiology and Individualized Treatment Protocols in Patients with Ischemic Stroke: the Role of Intracranial Artery High Resolution Magnetic Resonance Imaging
    TIAN Cheng-Lin
    2012, 7(11):  870-873. 
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    Plaques, Stenosis and Stroke
    2012, 7(11):  874-876. 
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    Radiological Analyses of Dolichoectatic Basilar Dissecting Aneurysm: a Case Report
    WANG Yan-Min, LOU Xin, YANG Xin-Jian, Li Tao
    2012, 7(11):  877-881. 
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    A Case Report of Intraranial Venous Sinus Thrombosis with Newly Diagnosed Churg-Strauss Syndrome
    QI Dong,ZHAO Ying-Ying,WANG Rui-Jin,
    2012, 7(11):  882-885. 
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    Advances of Research on Neuronal Plasticity after Cerebral Ischemia-Reperfusion
    LIU Cheng-Yong*, XU Ming-Shu, GE Lin-Bao.
    2012, 7(11):  902-906. 
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    【Abstract】 The brain has a capacity of repairing ischemia reperfusion injury. Through various mechanisms, the brain develops a plastically change. The plastically substances of the internal brain which is related to ischemia reperfusion injury are mainly the followings: synaptophysin(Syn),growth-associated protein-43(GAP-43) and microtubule-associated protein-2(MAP-2), etc. By kinds of means, they infect the plastically change of ischemia reperfusion injury respectively. But the change is also influenced by factors such as the living surroundings, rehabilitation training and pharmacotherapy, etc.

    Application of Evidence-Based Medicine Teaching in Neurointervention Training
    YUE Xuan-Ye, ZHANG Zun-Sheng, CUI Gui-Yun, et al
    2012, 7(11):  907-909. 
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