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Table of Content

    20 January 2014, Volume 9 Issue 01
    Guide to Success
    WANG Yong-Jun
    2014, 9(01):  1. 
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    The Pathogenesis,Diagnosis and Treatment of Post-stroke Depression
    ZHANG Zhi-Jun,YUAN Yong-Gui
    2014, 9(01):  5. 
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    Creating a New Era for ASCVD Control
    WANG Yong-Jun
    2014, 9(01):  9. 
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    Cytokines Proteomic Study in Post-Stroke Depression: A Preliminary Study
    GENG Lei-Yu, TANG Hao, LI Wen-Ping, QIAN Fang-Yuan, QIAN Jun-Feng, LI Ling-Jiang, ZHANG Zhi-Jun
    2014, 9(01):  13. 
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    Objective To investigate the association between post-stroke depression (PSD) and the level of cytokines in plasma. Methods Plasma spot signal intensity (SIs) of 120 cytokines were measured by Human Cytokine Antibody Array G-Series 1000 in 12 patients with PSD and 12 non-PSD controls who admitted to the hospital within the first 3 days after stroke onset. The diagnoses of PSD were made in accordance with DSM-IV criteria. The 17-item Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Scale (HAMA) were used to screen for depressive and anxiety symptoms on days 14 after admission. Results Plasma SIs of 4 cytokines (insulin-like growth factor 1 receptor [IGF-I SR], macrophage inflammatory protein-3 beta [MIP-3 beta], placental growth factor [PIGF], vascular endothelial growth factor [VEGF]) were significantly lower in PSD patients than in non-PSD patients, although these findings were not significant after the false discovery rate (FDR) correction for multiple testing to be applied. No cytokine was independently associated with incidence of PSD at the acute stage of stroke. Plasma SIs of IGF-I SR showed a negative correlation with the Barthel index (r =- 0.641, P =0.025) 1 day after admission and showed positive correlations with the HAMD (r =0.478, P =0.005) and HAMA scores (r =0.674, P =0.016) 14 days after admission. Conclusion Plasma levels of cytokines after ischemic stroke can't serve as a biological marker to predict the incidence of PSD. Dysfunction of synaptic plasticity and neurogenesis may play a causative role in PSD.

    Protective Effect of Tanshinone IIA during the Acute Stage of Focal Cerebral Ischemia in Rats
    LIU Ling-Ling*, LIU Hong, YIN Jun-Ling, CHEN Hui-Ying, LIU Xiao-Lei, JIAO Qing-Hai, WU Yi-Ping.
    2014, 9(01):  20. 
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    Objective To investigate the effect of tanshinone IIA (TSA) on the protein expression of phosphorylated cyclic adenosine monophosphate response element binding protein (p-CREB) and transducers of regulated CREB1 (TORC1) and volume of cerebral infarction in rats' parietal cortex during focal cerebral ischemia. Methods Male Sprague-Dawley rats were randomly divided into sham group, control group, TSA low dose group and TSA high dose group, twelve in each group. Focal cerebral ischemia model was induced by occlusion of the right middle cerebral artery using the intraluminal suture method. The rats were scored after waking up. 2, 3, 4 or 5 scores were brought into this study. TSA solution (10 mg/kg, TSA-L; or 20 mg/kg, TSA-H) was injected intraperitoneally immediately after the rats waked up. The rats were scored and sacrified at 24 h after waking up. Infarct size was analyzed with 2, 3, 5-triphenyltetrazolium chloride (TTC). Western blotting was used to analyze the protein expression of TORC1 and p-CREB of each group in the nerve cell, and the positive products were analyzed by image analysis system. Results Compared with control group, the infarct size of TSA-H group was significantly decreased (P =0.004). And nuclear accumulation of TORC1 was only significantly increased in TSA-H group (P <0.001). Compared with control group, the decrease of the infarct size in TSA-L group and the increase of nuclear protein expression of TORC1 have no remarkable differences (P =0.148, P =0.083, respectively), the expression of TORC1 (Total) and p-CREB (Nucleus) protein level in TSA-H (P <0.001) and TSA-L ((P =0.002, P =0.001) group was significantly increased, the enhanced TORC1 is localized in the nucleus and cytoplasm of neurons. Conclusion TSA could protect rat brain from ischemic damage and upregulate the expression of TORC1-CREB pathway in rats' parietal cortex during focal cerebral ischemia.

    Endovascular Recanalization of Symptomatic Subclavian Artery Occlusion via Dual Femoral and Radial Access
    LI Zhi-Yong*, ZHANG Meng-Cai, LIU Lian, GAO Feng MIAO Zhong-Rong.
    2014, 9(01):  26. 
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    Objective To investigate the effectiveness of symptomatic subclavian artery occlusion treated with interventional revascularization via femoral artery and radial artery approach. Methods From October 2012 to May 2013, 10 patients with symptomatic subclavian artery occlusion were treated via transluminal balloon expanding and stent implantation in our institution. The clinical results of these patients were analyzed retrospectively. Results The procedures were technically successful in all of the 10 cases. There were no recent complications occurring. There was no in-stent restenosis of those patients verified by vessel ultrasound and computed tomography angiography during the follow-up period from 15 days to 6 months after the procedures. Conclusion The main advantages of interventional revascularization of subclavian artery occlusion through radial artery and femoral artery are minimally invasive, safe, effective and easy accessible, which should be considered to be the optional method for treating subclavian artery occlusion.

    Clinical Characteristics and Imaging Analysis of Moyamoya Disease and Moyamoya
    Syndrome in Children
    WANG Gui-Fen*, ZHANG Dong, GAO Bao-Qin, YANG Wei-Li,WANG Yong-Jun.
    2014, 9(01):  31. 
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    Objective To analyze initial symptoms, clinical characteristics and radiological findings of moyamoya disease (MMD) in children and the association between cerebral infarction and stenoocclusive lesions of advanced Suzuki stage. Methods The clinical and imaging data of 78 children with MMD who were successively hospitalized in Beijing Tiantan Hospital from Jan. 2002 to Mar. 2009 were analyzed retrospectively. The ischemic MMD was divided into transient ischemic attack (TIA) group and cerebral infarction (CI) group. Evaluate two groups' Suzuki stages in digital subtraction angiography (DSA). Results There were 36 boys and 42 girls; mean onset age of MMD was (8.55±3.80) years (range from 1 year 6 months to 17 years). Ages at onset between 5 years and 10 years in children were 47 cases (60.3%). There were 72 of cerebral ischemic and 6 of cerebral hemorrhage. The most frequent initial symptoms of ischemic MMD were weakness of limbs (46, 63.9%), TIA (31, 43.1%) and hemiplegia (15, 20.8%), headache (22, 30.6%), sensory impairment (11, 15.3%), seizure (8, 11.1%), speech disturbance (6, 8.3%). The initial symptoms of hemorrhagic MMD were frequent headache, disturbance of consciousness. The bleeding parts were mainly located at the ventricular system. The frontal/temporal parietal lobe infarctions were involved and the internal carotid artery system was mainly impaired in MMD. There were no statistically significant differences between TIA group and CI group in Suzuki stages (χ 2=1.034, P =0.596). Conclusion The peak onset of MMD in children is 5~10 years old. There were different early clinical characteristics in different developmental stages. It seems that the occurrence of CI in MMD does not associate with the occlusion severity of the internal carotid artery.

    Speical Reviews: Post-Stroke Depression
    ZHANG Zhi-Jun
    2014, 9(01):  37. 
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    Glutamate Dysfunctional Etiology Hypothesis of Post-stroke Depression
    YUE Ying-Ying,YUAN Yong-Gui, ZHANG Zhi-Jun
    2014, 9(01):  38. 
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    Post-stroke depression (PSD) is one of the most common neuropsychiatric complications after stroke that is characterized by depressed mood and loss interest. It can not only affect the neurological rehabilitation, but also significantly increase the mortality of patients. However, the pathogenesis is not clear. Glutamate system plays an important role in depression and PSD and brings new opportunities for treatment along with the appearance of rapid antidepressant ketamine which is the antagonist of an ionotropic glutamate receptor.

    Successful Medical Management of a Patient with Post-stroke Depression
    MOU Xiao-Dong,YUAN Yong-Gui
    2014, 9(01):  43. 
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    2013 ESH/ESC Guidelines for the Management of Arterial Hypertension (Part 1)
    2014, 9(01):  46. 
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    Current Research Progress of Unilateral Moyamoya Disease
    ZHANG Ya-Nan, GAO Pei-Yi, XUE Jing.
    2014, 9(01):  67. 
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    Unilateral moyamoya disease is a chronic vasculopathy characterized by progressive stenosis or occlusion of terminal and main branches of unilateral internal carotid artery, with the formation of moyamoya vessels at the base of brain. The incidence of unilateral moyamoya disease is up to 17.8% and familial forms account for about 6.7% of patients with the disease. Two peaks of age distribution and two first symptoms of children and adults are basically consistent with typical moyamoya disease, but the incidence of hemorrhage is higher in adults with unilateral moyamoya disease, especially ventricular hemorrhage. For the most part, 58.8% of the unilateral cases developed into definite type. Surgical revascularization procedures can help prevent ischemic attacks effectively and improve prognosis, but operation indications need further study. In this review, we summarize current research progress of epidemiology, aetiology, clinical features, imaging features, treatment, and prognosis in unilateral moyamoya disease for profound understanding, clarified diagnosis and effective treatment.

    Cultivation of Neurology Chief Resident
    YANG Hong-Bin, ZHAI Jing, WANG Zhong
    2014, 9(01):  72. 
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