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Objective:To observe the effects of sacubitril/valsartan (LCZ696) on viral replication and cardiomyocyte apoptosis in mice with coxsackievirus B3 (CVB3)-induced viral myocarditis (VMC) and to analyze the underlying mechanisms.Methods:Forty BALB/c mice were randomly divided into four groups with 10 in each group: Sham, Sham+ LCZ696, VMC, and VMC+ LCZ696 groups. VMC model was established by intraperitoneal injection of 0.1 ml of CVB3 with a concentration of 10 6 TCID 50/ml into BALB/c mice, while the sham intervention was an equal volume of saline. The day of virus injection was defined as day 0. LCZ696 was administered by gavage at a dose of 60 mg/kg every day for seven consecutive days starting from day 1. Mouse survival rates were calculated. Echocardiography was used to evaluate the cardiac function of mice. The level of creatine kinase-MB (CK-MB) was detected by ELISA. Western blot was used to detect the levels of inflammatory cytokines (IL-6, TNF-α), apoptosis-related proteins (caspase-3, cleaved-caspase-3, Bax, Bcl-2), CVB3 surface protein (VP-1) and p-AKT/AKT in the hearts of mice. CVB3 mRNA in mouse hearts was measured by PCR. Inflammatory cell infiltration and cell apoptosis in mouse hearts were observed by HE staining and TUNEL staining, respectively. Results:Compared with the Sham group, the mice in the VMC group had a decreased survival rate and impaired cardiac function ( P<0.05). The levels of CK-MB, IL-6, TNF-α, cleaved-caspase-3/caspase-3, Bax/Bcl-2, VP-1, and CVB3 mRNA in the hearts of VMC mice increased significantly ( P<0.05), accompanied by increased expression of AKT, decreased phosphorylation of AKT ( P<0.05) and increased cell apoptosis. LCZ696 reversed the above changes. It could increase the survival rate, improve the cardiac function ( P<0.05), decrease cardiac inflammation, cell apoptosis and viral replication ( P<0.05), and increase the phosphorylation of AKT ( P<0.05). LCZ696 had no significant effects on the survival rate, cardiac function, myocardial injury, cardiac inflammation, cell apoptosis, viral replication or the expression of PI3K/AKT signaling pathway-related proteins in normal mice. Conclusions:LCZ696 could significantly inhibit cardiomyocyte apoptosis and reduce CVB3 replication in the hearts of VMC mice by regulating the PI3K/AKT pathway, thereby improving mouse cardiac function and survival rate.
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Objective:To clarify the anti-inflammatory effects and anti-endoplasmic reticulum stress effects of resolvin D2 (RvD2) in viral myocarditis mice and to explore its possible mechanism.Methods:Fifty male BALB/c mice were collected and assigned corresponding numbers. Then 40 male BALB/c mice were selected randomly with 10 mice in each group. They were set as normal control group, RvD2 control group, viral myocarditis group and RvD2 treatment group. Afterwards, mice in the RvD2 control group received continuous intraperitoneal injection of RvD2 for 7 days, while mice in the viral myocarditis group received intraperitoneal injection of Coxsackievirus B3 virus (CVB3) in the purpose of constructing an animal model of viral myocarditis. Then, mice in the RvD2 treatment group were given continuous intraperitoneal injection of RvD2 for 7 days. After these 7 days, the mice of each group were sacrificed and their cardiac tissue and serum samples were taken. The expression levels of serum inflammatory factors including IL-1β and TNF-α were detected by ELISA in each group of mice, and HE staining were used to detect the inflammatory cell infiltration in myocardial tissue of each group. Meanwhile, the expression levels of inflammation-related proteins IL-1β, TNF-α as well as endoplasmic reticulum stress-related proteins like GRP78 and Chop in the myocardial tissue in each group of mice were detected by Western blot experiment. The remaining 10 BALB/c mice were treated with intraperitoneal injection of RvD2 as well as GPR18 protein inhibitors after constructing the animal model of viral myocarditis mentioned above. In the end, the expression levels of GPR18 protein, inflammation-related proteins including IL-1β and TNF-α as well as endoplasmic reticulum stress-related proteins like GRP78 and Chop in the myocardial tissue of each group were detected by Western blot experiments.Results:Compared with the normal control group, the expression levels of inflammatory factors IL-1β and TNF-α in the serum of mice with viral myocarditis were significantly increased, and the degree of infiltration of inflammatory cells in myocardial tissue was also significantly increased. Besides, the expression levels of the inflammation-related proteins IL-1β, TNF-α as well as endoplasmic reticulum stress-related proteins including GRP78 and Chop increased largely. While compared with the viral myocarditis group, the expression levels of serum inflammatory factors IL-1β and TNF-α in the mice of the RvD2 treatment group were significantly reduced and the degree of infiltration of inflammatory cells in the cardiac tissue was significantly reduced. Also, the expression levels of inflammation-related proteins IL-1β and TNF-α as well as endoplasmic reticulum stress-related proteins GRP78 and Chop were significantly reduced. After intraperitoneal injection of RvD2 and GPR18 inhibitor, in the mice treated with viral myocarditis, the expression levels of IL-1β, TNF-α and endoplasmic reticulum stress-related proteins like GRP78 and Chop in myocardial tissue of these mice significantly increased when it came to compare with the RvD2 treatment group, while the expression levels of GPR18 protein were significantly reduced.Conclusions:RvD2 can inhibit the inflammatory response and endoplasmic reticulum stress injury in mice with viral myocarditis by binding to the membrane protein receptor GPR18, thus exerting a protective effect on heart.
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Objective:To investigate the neuroprotective effect of long-term prophylactic use of buphthalein on mice with permanent distal middle cerebral artery occlusion and its relationship with the nuclear factor erysid 2 related factor 2 (Nrf2) pathway.Methods:Nrf2 + /+ wild-type and Nrf2 -/- knockout mice were randomly divided into control group (equal volume vegetable oil), low-dose butylphthalide group (20 mg/kg) and high-dose butylphthalide group (60 mg/kg), with 6 mice in each group. The drug was administered once a day by gavage for 1 month, and then a permanent middle cerebral artery occlusion model was induced by electrocoagulation. After the model was made, the drug was continued and the mice were sacrificed on the 10 th day. The modified Longa grading scale and the rotating rod test were used to evaluate neurological deficits on the 3 rd and 10 th day after the model was made. After the mice were sacrificed, the cerebral infarct volume was measured by triphenyltetrazolium chloride staining. The brain water content was measured by dry and wet weight method. The expression of Nrf2 pathway related factors, including Nrf2, heme oxygenase 1 (HO-1) and NAD(P)H quinone oxidoreductase 1 (NQO1) were measured by quantitative real-time PCR and Western blotting. Results:On the 10 th day after modeling, compared with the Nrf2 -/- control group, the neurological deficit was significantly milder, the volume of cerebral infarction and brain water content were significantly smaller, and the mRNA and protein levels of Nrf2, HO-1 and NQO1 were significantly higher in the Nrf2 + /+ control group, and the differences were statistically significant ( P<0.05). For Nrf2 + /+ mice, compared with the control group, the cerebral infarct volume was significantly reduced ( P<0.05), the brain water content was significantly reduced ( P<0.05), and the neurological function recovery was significantly better ( P<0.05), and the levels of Nrf2, HO-1, and NQO1 mRNA and protein were significantly higher in the high-dose butylphthalide group (all P<0.05). For Nrf2 -/- mice, there were no significant differences in neurological function, cerebral infarction group volume, brain water content, Nrf2, HO-1, NQO1 mRNA and protein levels among the groups. Conclusion:Long-term butylphthalide pretreatment can significantly improve the neurological function, reduce cerebral infarction volume, reduce brain water content, and increase Nrf2, HO-1, NQO1 mRNA and protein expression levels in mice with permanent distal middle cerebral artery occlusion, suggesting butylphthalide may play a neuroprotective effect by up-regulating the expression of Nrf2 gene and its downstream antioxidant stress factors HO-1 and NQO1.
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Objective To investigate the effect of high frequency (10 Hz),low frequency (1 Hz) and theta burst stimulation (TBS) mode of repetitive transcranial magnetic stimulation (rTMS) on the recovery of motor function in hemiplegic patients following acute ischemic stroke.Methods Seventy-two patients with hemiplegia after acute ischemic stroke were randomly grouped with the random number table.They were treated with low frequency (n=18),high frequency (n=18),and TBS (n=18) rTMS or sham stimulation (control group,n=18),once a day,for 2 weeks.Fugl-Meyer Assessment (FMA) and National Institutes of Health Stroke Scale (NIHSS) were used to evaluate neurological function in all patients before rTMS treatment (on the day before the first treatment) and after treatment (on the day after the last treatment).Results After treatment,the FMA and NIHSS scores in the 4 groups were significantly improved compared with before treatment (all P<0.05).After rTMS treatment,the FMA and NIHSS scores were improved significantly in the high frequency group,low frequency group and TBS group compare with the control group (all P<0.05).There were no significant differences among all the treatment groups.Conclusion sHigh frequency,low frequency and TBS rTMS can improve the recovery of motor function in hemiplegic patients following acute ischemic stroke.There were no significant differences among all the treatment modes.
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Objective To investigate the correlation between plasma cathepsin L (CatL) levels and establishment of cerebral collateral circulation in acute ischemic stroke patients with cerebral artery stenosis.Methods The patients with acute ischemic stroke with at least one cerebral large artery (including internal carotid artery,middle cerebral artery,vertebral artery,and basilar artery) stenosis ＞ 70％ diagnosed by whole cerebral angiography were enrolled.ASITN/SIR blood flow classification system was used to systematically evaluate the establishment of cerebral collateral circulation.Grade 0-2 was defined as poor collateral branch and 3-4 was defined as good collateral branch,Enzyme linked immunosorbent assay was used to detect the plasma CatL level.Results A total of 79 acute ischemic stroke patients with cerebral artery stenosis were enrolled,including 63 male and 16 female.Their mean age was 58.76 ± 12.24 years old.There were 51 patients (64.56％) in the poor collateral branch group and 28 (35.44％) in the good collateral branch group.There was no significant difference in plasma CatL levels between the good collateral circulation group and the poor collateral circulation group (7.09± 2.27 mg/L vs.8.79±3.53 mg/L;t =2.751,P =0.069).Multivariable logistic regression analysis showed that only the high National Institutes of Health Stroke Scale score was the independent risk factor for poor collateral circulation (odds ratio 0.935,95％ confidence interval 0.823-0.963;P=0.046),and there was no significant independent correlation between plasma CatL levels and collateral circulation (odds ratio 0.910,95％ confidence interval 0.766-1.081;P =0.285).Conclusion There was no significant correlation between plasma CatL levels and cerebral collateral development in acute ischemic stroke patients with cerebral artery stenosis.
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Objective To determine collateral circulation in patients with acute ischemic stroke using capillary index score (CIS)in order to evaluate the prognosis of endovascular treatment. Methods From January 2013 to December 2015,46 consecutive patients with acute ischemic stroke treated with endovascular treatment at the Department of Neurology,Central Hospital of Baotou were enrolled retrospectively. Angiography was performed before endovascular treatment in order to complete CIS score. The patients were divided into a good prognosis group (n = 21)and a poor prognosis group (n = 25)according to the modified Rankin scale (mRS)scores. Univariate analysis was used to compare the baseline data and the clinical data of the two groups,including age,sex,history of diabetes,pretreatment systolic blood pressure,conducting intravenous thrombolysis or not,time from ictus to intravenous thrombolysis,National Institutes of Health Stroke Scale (NIHSS)score,Alberta stroke program early CT score (ASPECTS),vascular filling,time from onset to revascularization,and postoperative vascular recanalization (the modified Thrombolysis in Cerebral Infarction [mTICI]). Multivariate analysis was used to analyze the effect of CIS score on good prognosis. Results There were no significant differences in age,sex,history of diabetes,pretreatment systolic blood pressure,conducting intravenous thrombolysis or not,time from ictus to thrombolysis,and number of mechanical thrombectomy between the good prognosis group and the poor prognosis group (all P > 0. 05). There were significant differences in the NIHSS score (15 ± 3 vs. 19 ± 4),ASPECTS score (8 [7,10]vs. 6 [5,8]),filling well 85. 7% (18 / 21)vs. 44. 0% [11 / 25]),time from ictus to recanalization (363 ± 42 min vs. 398 ± 53 min),and postoperative vascular recanalization (mTICI≥Ⅱb)(100. 0% [21 / 21]vs. 68. 0%[17 / 25];all P < 0. 05). CIS (OR,8. 600,95% CI 2. 670 -33. 800)and mTICI grade (OR,5. 720, 95%CI 12. 170-22. 300)were significantly associated with the prognosis. Conclusion The CIS score can be used to evaluate brain perfusion. fCIS is closely associated with the good clinical prognosis. When screening the suitable patients for endovascular therapy,increasing the CIS score to evaluate the salvageable brain tissue is effective and feasible.
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Objective@#To explore the electrocardiographic characteristics of patients with idiopathic ventricular arrhythmias (VAs) originating from different portions of distal great cardiac veins (DGCV).@*Methods@#The study included 49 patients underwent successful RFCA of premature ventricular complex(PVCs)/ventricular tachycardia(VT) from different portions of the DGCV in our department from July 2009 to March 2016. The surface 12-lead electrocardiogram (ECG) and intraventricular ablation mapping features were analyzed. Patients were divided into four groups according to the mapping and ablation results: DGCV1(10 patients), DGCV2 (13 patients), proximalanterior interventricular vein (PAIV, 17 patients)and extend distal great cardiac vein (EDGCV, 9 patients). We analyzed the similarities and differences between surface 12-lead ECG of patients with PVCs/VT from different portions of DGCV, and compared with random chosen 290 patients with PVCs/VT from ventricular outflow tract and adjacent structure.@*Results@#A positive R wave in inferior leads, a negative QS morphology in lead aVL and aVR were found among all groups. The different characteristics of surface 12-lead ECG of VAs originating from DGCV were as follows: (1)EDGCV patients demonstrated a positive R or r wave on lead Ⅰ(6/9) while a negative rS or qr wave was evidenced in other three groups (39/40). (2)A positive R pattern on lead V1, V5-V6 (11/13) was presented in patients of DGCV2 group; R (without S or s) wave on V1 (9/10), RS or Rs wave on V5-V6 were found in DGCV1 group; RS or rS wave was seen on lead V1, R(without S)wave in lead V5-V6 (25/26) were found in EDGCV and PAIV group and the amplification of R wave in EDGCV was higher than V1 of PAIV group.(3)Precordial lead transition zone was in front of V1 for DGCV1 and DGCV2 groups (23/23), within V1-V3 for EDGCV group, but on V2 or within V2-V3 for PAIV group.(4)Patients of DGCV1 and DGCV2 demonstrated a longer Pseudo delta wave time(PdW), intrinsicoid deflection time (IDT), significantly larger maximum deflection index (MDI) than those in PAIV and EDGCV groups (P<0.001). (5)The different characteristics of surface 12-lead ECG between VAs originating from DGCV and those from ventricular outflow tract and adjacent structure were as follows: ① The ECG features were similar between PVIA and LCC group, both demonstrated a rs wave on the lead Ⅰ, rS wave on V1-V2 and R wave on V5-V6; ②The ECG features were similar betweenEDGCV and RCC group, both presented with R or r wave on the lead Ⅰ, the QRS wave of precordial leads was similar as PAIV and LCC groups; ③A R wave on the lead V1, V5-V6 was found in group DGCV2, and ILCC; ④Similar to the group Endo-MAA, patients in DGCV1 group also demonstrated a R wave on the lead V1 and a Rs wave on V5-V6.@*Conclusion@#A positive R wave in inferior leads, a negative QS morphology in lead aVL and aVR are seen in all patients, but different electrocardiographic characteristics of PVC/VT originating from the different portions of the DGCV are presented on lead Ⅰ and V1-V6.
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Objective To study the phosphorylation of AKT2 protein and autophagy activation in cardiac tissues of mice infected with coxsackievirus B3 (CVB3) for further analyzing the regulatory mecha-nism of PI3K/AKT2/mTOR signaling pathway on autophagy activation in viral myocarditis. Methods Thir-ty BALB/c mice were randomly divided into three groups (n=10): control group, myocarditis group and AKT activator-treated group. Those in the latter two groups were intraperitoneally injected with CVB3 to es-tablish the mouse model of acute viral myocarditis. Daily intraperitoneal injection of 0.04 mg/g of Akt acti-vator (SC79) was given to each mouse in the AKT activator-treated group 24 hours after CVB3 infection for 7 consecutive days,while the mice in the other two groups were given the same dose of normal saline. HE staining was used to observe the infiltration of inflammatory cells and tissue necrosis. Expression of CVB3 and inflammatory cytokines such as IL-1β and IL-6 in cardiac tissues at mRNA level was detected by q-PCR. Brain natriuretic peptide(BNP) and cardiac troponin I(cTnI) were measured by ELISA to evaluate myocardial injury. Changes in the expression of autophagy-related protein LC3 and Beclin1 at protein level as well as PI3K/AKT2/mTOR pathway were analyzed by Western blot assay. Results Compared with the con-trol group,massive inflammatory cell infiltration was observed in cardiac specimens of mice with myocarditis, but no obvious tissue necrosis was detected. Moreover,expression of CVB3 and inflammatory factors in car-diac tissues at mRNA level,levels of BNP and cTnI in blood,LC3Ⅱto LC3Ⅰratio as well as Beclin1 pro-tein level in cardiac tissues were significantly increased after CVB3 infection(P<0.05),whereas the activi-ty of PI3K/AKT2/mTOR signaling pathway was decreased. AKT activator not only down-regulated the LC3Ⅱ to LC3Ⅰratio and the expression of Beclin1 protein, but also enhanced the activation of PI3K/AKT2/mTOR signaling pathway in cardiac tissues of mice with myocarditis (P<0.05). Conclusion Enhanced autophagy and suppressed PI3K/AKT2/mTOR signaling pathway are observed in cardiac tissues of mice with myocarditis,indicating that the activation of autophagy may be regulated by PI3K/AKT2/mTOR signaling pathway.
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Objective: To evaluate the clinical effect of pereutaneous vertbroplasty (PVP) combined with implantation of iodine-125 (125 I)radioactive particle in the treatment of vertebral metastasis,and to provide basis for the treatment of vertebral metastasis.Methods:A total of 69 patients with vertebral metastasis were divided into test group (n=32)and control group (n=37);the patients in test group were treated with PVP comined with implantation 125 I radioactive particle and the patients in control group were treated with PVP only.The heights of anterior and posterior vertebral bodies of the patients before and after treatment were detected by X-ray.The numerical rating scale (NRS)scores,pain relief rate and the incidence of surgical complications of the patients were recorded before operation and 1 d,1 week,1 month,3 months,and 6 months after operation.Results:The operation was successfully performed in all the patients without local bleeding;there were no movement dysfunction and nerve compression phenomenon.There was no leakage of bone cement.All the 125 I radioactive particles located well and there was no particle obscission.The heights of vertebral bodies of the patients in two groups after operation were increased compared with before operation (P <0.05).The NRS scores of the patients in two groups s at 1 d,1 week,1 month,3 months,6 months after operation were significantly decreased compared with before operation (P <0.05);compared with control group,the NRS scores of the patients in test group at 1 d,1 week, 1 month,3 months,6 months after operation were decreased (P <0.05).The incidence of pulmonary embolism or radiation myelitis complications was about 4.3% in 69 patients.Compared with control group,the difference in the incidence of complications of the patients in test group was not significant (P < 0.05 ).Conclusion:PVP combined with 125 I radioactive particle implantation is a safe and effective method in the treatment of vertebral metastasis,which can relieve the pain of the patients obviously compared with PVP.
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Objective To explore whether fluid-attenuated inversion recovery can be used to estimate the onset time of acute ischemic stroke (ALS) based on the analysis of signal strength through the fluid-attenuated inversion-recov?ery (FLAIR)and volume of interest (ROI) in ALS patients with known time of onset. Method Forty-seven AIS patients who met the inclusion criteria were recruited from Baotou Central Hospital, Department of Neurology from January 2011 to December 2012. The patients had stroke onset within 12 hours and completed MRI scan including diffusion-weighted imaging DWI, apparent diffusion and coefficient ADC FLAIR. Based on MRI findings, patients were divided into, three groups:0~180 min, 180~360 min and 360~720 min groups. Signal strength values of the DWI、FLAIR and ADC in ipsi?lateral and contralateral sides were measured. Result There was a significant difference in the FLAIR signal strength among these three groups.The FLAIR signal strength was significantly lower in 0~180 min and 180~360 min groups than in 360-720 min. FLAIR positive rate was 16.7%, 62.5%, and 70.6% in 0~180 min, 180~360 min and 360~729 min groups, respectively. Conclusion FLAIR positive rate gradually increases as the onset prolongs. Thus, lower FLAIR posi?tive rate indicates shorter onset time of AIS, which can be used to assist acute intravenous thrombolytic therapy.
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Objective To investigate the correlation between carotid intraplaque neovascularization and acute ischemic cerebrovascular disease. Methods The patients examined with contrast-enhanced ultrasound were enroled and divided into either a symptomatic group or an asymptomatic group according to their cerebral ischemic symptoms. The patients were also divided into a low-echo group, an equal-echo group, and an heterogeneous echo group according to the plaque echo characteristics on conventional ultrasound. The carotid intraplaque neovascularization was evaluated with contrast-enhanced ultrasound. Multivariate logistic regression analysis was used to identify the correlation between carotid intraplaque neovascularization and acute ischemic cerebrovascular disease. Results A total of 73 patients with acute ischemic cerebrovascular disease were enroled, 32 patients in the symptoms group (19 ischemic stroke, 13 transient ischemic attack), 41 patients in the asymptomatic group. Plaque echo characteristics: low-echo 15, equal-echo 41, and heterogeneous echo 17. The proportions of the patients with plaque enhancement (84. 4% vs. 61. 0% ; χ2 = 4. 802, P = 0. 028) and enhanced intensity (21. 78 ± 8. 50 dB vs. 15. 93 ± 8. 82 dB; t = 2. 440, P = 0. 018) in the symptomatic group were significantly higher than those in the asymptomatic group. The proportions of the patients with enhanced plaque in the low-echo, equal-echo and heterogeneous echo group were 93. 3% , 58. 5% , and 82. 4% , respectively (χ2 = 7. 826, P = 0. 020 ). The low-echo group and heterogeneous echo group were significantly higher than the equal-echo group (al P 0. 05). The intraplaque enhanced intensities in the low-echo group, equal-echo group, and heterogeneous echo group were 22. 62 ± 9. 33 dB, 14. 38 ± 8. 02 dB, and 18. 15 ± 9. 64 dB, respectively (F = 3. 877, P = 0. 027). The low-echo group was significantly higher than the equal-echo group (P = 0. 024 ). Multivariate logistic regression analysis showed that carotid intraplaque neovascularization (odds ratio 3. 456, 95% confidence interval 1. 103 - 10. 828; P = 0. 033) was independently associated with acute ischemic cerebrovascular disease. Conclusions Carotid intraplaque neovascularization is closely associated with acute ischemic cerebrovascular disease.
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The fluid-attenuated inversion recovery (FLAIR) sequence technique is widely used in each system organ examination in clinical practice.It has an important value for the diagnosis of various diseases,especially for central nervous system examination.This article reviews the applications and related research of FLAIR technique in patients with acute ischemic stroke.
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in mice with coxsackievirus B3 (CVB3)-induced viral myocarditis through a comparative study with Carve-dilol.Methods 150 BALB/c male mice were divided into four groups including control group (n=30), myocarditis group (n=40), Ivabradine treatment group (n=40) and Carvedilol treatment group (n=40). Viral myocarditis was induced by intraperitoneal injection of CVB 3 in experimental mice , while mice in the control group were injected with PBS accordingly .The mice in four groups were respectively administered with PBS, PBS, Ivabradine and Carvedilol after 24 h of infection for 14 consecutive days .Heart specimens were collected from 8 mice of each group on days 4, 7 and 14 after measuring their heart rates .The patho-logical changes in heart tissues were observed through hematoxylin e-osin staining .Semi-quantitative RT-PCR and ELISA were performed to detect the expressions of MCP -1, IL-6 and TNF-αat mRNA and protein lev-els.CVB3 RNA was quantified by semi-quantitative RT -PCR as well .Results Compared with myocarditis group, the histopathological damages in myocardium were significantly alleviated in both Ivabradine group and Carvedilol group on days 7 and 14.The expressions of MCP-1,IL-6 and TNF -αat mRNA level were up-regulated in mice treated with Ivabradine and Carvedilol as compared with those in control group .Compared with myocarditis group , the expressions of TNF-αon day4 and IL-6 on day 7 at mRNA level were reduced in Ivabradine and Carvedilol treatment groups .MCP-1 expression at mRNA level was only down-regulated in Iv-abradine group on day 7.Concluison Ivabradine treatment could alleviate histopathological damages in my -ocardium of mice with CVB3-induced viral myocarditis , which was similar to the effects of carvedilol treat-ment.The treatment effects might be associated with the down-regulation of expressions of IL-6, TNF-αand MCP-1 at mRNA and protein levels .
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A growing body of evidence demonstrates that vascular factors have involved in the occurrence and development of Alzheimer's disease.This article reviews the research progress of the AD-associated vascular factors from the aspects of AD epidemiology,pathology,clinical research,imaging,and genetics,expecting to investigate the nature of AD from all aspects through vascular factors and finding a new entry point for prevention,diagnosis and treatment of AD.
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Objective To study the clinical significance of diffusion weighted imaging (DWI) positive lesions in transient ischemic attacks (TIA) patients,TIA patients with fully reversible lesions were compared with the other patients for investigating the predictive value of apparent diffusion coefficient(ADC) for distinguishing between TIA and stroke.Methods Fifty-seven patients hospitalized with TIA at Department of Neurology,Central Hospital of Baotou August 2009 to June 2011 were identified.All patients had brain magnetic resonance imaging within 24 h after onset,then they were divided into DWI positive group and negative group.A follow-up MR imaging or CT was available in patients of DWI positive group.According to MRI or CT,patients were divided into TIA group and cerebral infarction (CI) group.Clinical features and DWI Imaging were compared between the two groups.For each lesion,the quantitative parameters on initial DWI (ADC) were recorded,and comparisons between reversible and irreversible lesions were performed.Results The ADC values were (630.4 ±25.9) × 10-3 mm2/s in lesions with TIA and (495.2 ±60.0) x 10-3 mm2/s with brain infaction (t =6.669,P =0.000).The relative ADC ratio values were lower (62.6％ ±7.4％ vs 82.1％ ±5.6％,t =7.013,P =0.000) in lesions with subsequent infarct than in those that were fully reversible.Conclusions ADC values are moderately decreased in DWI lesions from TIA patients,while ADC values are significantly decreased in CI group.It is useful to early distinguish TIA from CI by comparing ADC and rADC values.
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Adiponectin is one of the cytokines secreted by fat cells.It has a variety of physiological functions,including anti-inflammation,anti-atherosclerosis,anti-diabetes,and anti-obesity,etc.Studies in recent years have demonstrated that there are certain correlations of adiponectin with vascular risk factors and cerebrovascular disease.
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Objective To study the best diagnostic imaging procedure after acute stroke.Methods 53 patients with acute stroke were recruited within 72 hours after symptom onset.CT was performed in all patients firstly, then T1 weighted-imaging( T1 WI), T2 weighted-imaging( T2WI ), gradient recalled echo T2 * weighted-imaging( GRE-T2 * WI) and diffusion-weighted imaging(DWI) were examined at 1.5T.Furthermore 15 patients with ischemic stroke received perfusion-weighted imaging(PWI) examination.Results 15 patients with acute cerebral hemorrhage and one patient of hemorrhagic brain tumor appeared clear on GRE-T2 * WI.3 patients with transient ischemic attack(TIA) were normal on T1WI ,T2WI ,GRE-T2* WI and DWI.18 cases with cerebral infarction appeared normal on GRE-T2 * WI within 6 hours after symptom onset, and 7 cases of them underwent PWI examination, the signal intensity of 3 cases were PWI ≥ DWI and of 4 cases were PWI = DWI.14 patients appeared hyperintense on GRE-T2 * WI within 6 ～72 hours after symptom onset.8 patients of them underwent PWI examination,the signal intensity of 6 cases were PWI≥DWI and of 2 cases were PWI = DWI.Of 14 patients,7 patients appeared as 1 ～ 18 dot or patchy hypointense whose diameter was about 2 ～ 5mm on GRE-T2 * WI.Another case of headache with hemiplegia and the side of the limb didnt show abnormalities on the CT, but showed a low signal in ambient cistern on T2 * WI and was proved to be subarachnoid hemorrhage.Conclusion After acute stroke,multi-sequence MRI enables the "one-stop shopping" imaging of cerebral hemorrhage,cerebral infarction and TIA in a shorter time,makes the state of micro-bleeding clear,determines ischemic penumbra,and even guides for thrombolytic treatment.
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Objective The method transcranial Doppler (TCD)and end-tidal carbon dioxide partial pressure (ETCO2 ) was used to investigate the cerebrovascular reserve capacity in patients with intracranial artery stenosis.Including the cerebral vasodilator reserve,contracted reserve and the overall reserve.Methods The 72 cases were enrolled in this study,include of 42 patients with one or two sides middle cerebral artery (MCA) stenosis,or other intracranial artery stenosis and 30 normal persons. All the patients were routinely examined with TCD,and the TCD QL software was used to evaluate the cerebrovascular reserve. Hypercapnia was induced by inhaling the CO2 who breathed himself,and hypocapnia was induced by voluntary hyperventilation. The changes of velocities were recorded in both side of MCA,and the ETCO2 was recorded by the external measuring device. Results ( 1 ) The cerebral vasodilator reserve of one side of MCA stenosis group ( ( 3.65% ± 2. 62% )/mm Hg),the heavier side of multi-vessel stenosis group ( ( 1.99% ± 2. 78% )/mm Hg ),and normal control group ( left ( 3.54% ± 1.66% )/ mm Hg; right (3. 81% ± 1.63% )/mm Hg) had significant difference( F = 3. 755 ,P ＜ 0. 05 ). The heavier side of multivessel stenosis group' s cerebral vasodilator reserve were significantly lower than normal control group ( t =- 2. 546,P ＜ 0. 05 ). (2) The overall reserve of one side of MCA stenosis group ( ( 3.22% ± 1. 27% )/mm Hg),the heavier side of multi-vessel stenosis group( (2. 30% ± 1.14% )/mm Hg),and normal control group(left (3. 19% ±0. 81% )/mm Hg;right (3. 23% ±0. 70% )/mm Hg)had significant difference(F=5. 894,P ＜0. 01 ). The heavier side of multi-vessel stenosis group' s overall reserve were significantly lower than normal control group( t = - 3. 357,P ＜ 0. 01 ) and they were also significantly lower than one side of MCA stenosis group (t = 2.471,P ＜ 0. 05 ). (3) The extent of vascular disease correlated inveresely to the cerebral vasodilator reserve( r = - 0. 322,P ＜ 0. 05 ) and the overall reserve( r = - 0. 364,P ＜ 0. 05 ) in the heavier side of patients who have vascular disease.Conclusions ( 1 ) TCD with ETCO2 is a simple,economic and effective method for assessing CVR. (2)The capacity of cerebrovascular reserve was reduced in patients with intracranial artery stenosis.
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Oxidative stress is 811 important risk factor for premature athcrosclcrosis.Itis involved in a variety of pathophysiological processes,including mitochondrial damage,freeradical release,lipid peroxidation,phospholipase activation,and infl~niatory modiator release.A growing body of research suggests that oxidative stress,oxidized low density hpoprotein,andlipoprotein-associated phospholipase A2 Play important roles in the occurrence and developmentof athcrosclcrosis.Therefore,investigating their relationship contributes to deepen theunderstanding of athcrosclerosis and take appropriate preventive measures.
ABSTRACT
About 50-70% patients will have secondary cardiac damage after subarachnoid hemorrhage (SAH),and the cardiac damage will aggravate cerebral ischemia and hypoxia,which may also promote the occurrence of delayed hypoxic-ischemic encephalopathy. By means of the detections of electrocardiogram,echocardiography,and serum myocardial enzymes,many researchers observe the clinical features and duration of this change and its relationship with the prognosis. This article reviews the advance in research on the causes of early cardiac damage after SAH,as well as the clinical features of the changes of electrocardiogram,echocardiography,and myocardial enzymes.