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Objective To investigate the distribution of glycoprotein (GP) Ⅱ b HPA-3 polymorphism in Chinese Han population in Tianjin and its correlation with ischemic stroke.Methods The patients in this study were divided into either a ischemic stroke group (n =150) or a control group (n =135).Genotyping was conducted by using polymerase chain reaction-restriction fragment length polymorphism and was verified by sampling sequencing Each genotype and allele frequency distribution and its correlation with ischemic stroke were compared.Results The ab genotype,bb genotype and b allele frequency in the patient group were significantly higher than those in the control group (P =0.000),while aa genotype and a allele frequency were significantly lower than those in the control group (P =0.000).There were no significant differences in the frequencies of GPⅡ b genotype and b allele between the different gender and the age groups in the patient group.Although there were no significant differences in genotype frequencies between all etiologic subtypes,b allele frequency in the large artery atherosclerotic stroke subgroup was significantly higher than that in the small vascular occlusive stroke subgroup and that in the cardioembolism subgroup (61.8％ vs.46.7％ vs.47.5％ ;x2 =6.573,P =0.037).Multivariate logistic regression analysis showed that hypertension (odds ratio [OR] 7.475,95％ confidence interval [CI]3.700-15.003; P =0.000) and b allele (OR 3.678,95％ CI 1.245-10.863; P =0.018) were the independent risk factors for ischemic stroke.Conclusions GP Ⅱ b HPA-3 polymorphism may be associated with the risk of ischemic stroke onset.Carrying b allele may be an independent risk factor for ischemic stroke,especially large artery atherosclerotic stroke.
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Objective To observe the levels of serum lipid, blood pressure, waist circumference and blood glucose and to investigate the clinical features of metabolic syndrome in patients with acute cerebral infarction. Methods Serum lipid, blood pressure (systolic/diastolic blood pressure), waist circumference, and blood glucose in 2030 patients with acute cerebral infarction were analyzed retrospectively. Results The prevalence of metabolic syndrome of 2030 inpatients with acute cerebral infarction was 67.73%, and the men and women were 71.80% and 62.00% respectively. The proportions of hypertension, abnormal waist circumference, lipid abnormalities, and impaired fasting glucose in the men were significantly higher than those in the women (all P ＜ 0.05 ). The proportions of metabolic syndrome,hypertension, abnormal waist circumference, and impaired fasting glucose increase with the age (all P ＜ 0.05 ). Conclusions The prevalence of metabolic syndrome in patients with acute cerebral infarction is high. It is very important to evaluate metabolic syndrome in patients with acute cerebral infarction. Controlling dyslipidemia, hypertension, hyperglycosemia, and obesity in the primary and secondary prevention of ischemic stroke can not be ignored.
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Objective To study the reliability and validity of the clinical neurologic deficit scale in evaluating stroke patients. Methods A total of 222 inpatients with acute stroke onset were included in the study. They were assessed when admitted, at the 14th and 90th day of hospitalization by different physicians using the clinical neurologic deficit scale. Intrarater and interrater reliability were determined using Kappa correlation. The split-half rehability and internal consistency were evaluated using Cranbach's a coefficient. Concurrent validity and the predictive validity were determined by spearman rank correlation coefficients. Construct validity was assessed by the factor analysis and the construct validity of the scale was measured according to the classifications of the Oxfordshire Community Stroke Project ischemic stroke subtypes in the patients with cerebral infarction. Results The scores of intrarater reliability in all items were higher than 0.6, the score of interrater reliability in the item "walking" was 0.542, the split-half reliability and the internal consistency were good as demonstrated by the score of 0.911 and 0.886 respectively, and assessment of reliability of different methods showed that "strength in upper limb" and "strength in hand", were poor as shown by the score of 0.393 and 0.386 respectively. The scale is highly correlated with the NIHSS ( both P=0.000) in both total and subtypes of stroke patients according to the classifications of the Oxfordshire Community Stroke Project by concurrent validity analysis. There was a high correlation between the scores of the scale and Barthel Index and the modified Rankin scales at the 90th day of hospitalization (both P=0.000). Conclusions The clinical neurologic deficit scale has a good internal consistency. There is concurrent validity between the scale and the NIHSS and could predict stroke outcome. Factor analysis of the scale displays the best construct validity in the patients with partial anterior circulation infarction, and could be used to evaluate the focus of vertebrobasilar artery despite its insensitivity.
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Objective To study the prevalence of FⅤ Leiden mutation and its relationship to anticardiolipin antibodies (aCL) and ischemic cerebrovascular disease (ICVD). Methods The factor Ⅴ Leiden mutation was analyzed in 75 healthy and 118 ICVD patients using PCR-RFLP analysis.The anticardiolipin antibodies level was also measured by enzyme-linked immunosorbent assay along with international standards in 86 patients with ICVD.The resistance to activated protein C(APC-R )was measured in 27 patients. Results The mutation, in heterozygous form, was found in 6 cases out of 118 ICVD patients, with a prevalence of 5.1%.None of the 75 healthy were found to carry the FⅤ Leiden mutation.The patients who carried the FⅤ Leiden mutation were young, whose average age was 50 years old.In 27 patients whose APC-R was measured , 8 patients were positive.In 86 patients whose aCL level was also measured simultaneously, an elevated aCL level was found in 26 cases, of whom 3 cases were found carrying the FⅤ Leiden mutation as well, making the group of patient possess a prevalence of 11.5 %, showing no strongly statistical significance in contrast to the patients without elevated aCL 5.0%.However, within the total of 6 cases with FⅤ Leiden mutation found in this group, 3 cases were patients with elevated aCL.Conclusions It was suggested that although FⅤ Leiden mutation was accounted for a small proportion of patients with ICVD, it might play a crucial role in thrombosis. The prevalence of young patients who carried FⅤ Leiden mutation should be higher.The final combined analysis revealed FⅤ Leiden mutation which is of highly significant relation to aCL in this group of Chinese patients with ICVD.It's detection should be of greatly clinical significance in finding cause, predicting the progress, prevention and treatment.
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Objective To investigate the effects of GMl on inducing adult rat MSCs to the neural progenitor cells and their descendants. Methods Purified MSCs were induced by basic fibroblast growth factor (bFGF) alone, GMl alone or by combination of bFGF and GMl. After 3 days of incubation, fibronectin and collagen I were detected by immunocytochemistry, and nestin by immunofluorescence. Neuron-specific enolase ( NSE) , glial fibrillary acidic protein ( GFAP) and galactose cerebroside ( GalC) were detected by immunocytochemistry after 7 days of incubation. Results After induction by bFGF alone or combination of bFGF and GM1, some MSCs exhibited the phenotypes of neural progenitor cells in 3 days, and then exhibited neurons and astrocytes in 7 days. In these two groups, cells positive for fibronectin and collagen I were decreased markedly after 3 days of induction. At the same time, cells positive for nestin were increased markedly. After 7 days of induction, NSE and GFAP-positive cells were increased significantly (22. 28% ?2. 97% and 26. 65%?3. 17% ). Furthermore, the combination of bFGF and GMl showed a maximal increase (30. 35%?3. 51% and 32. 22%?2. 68% ). But the GMl alone had shown no inductive effects. Conclusion Combination of bFGF and GMl might synergistically improve the neural induction of MSCs, showing a promising route for the application of MSCs.
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Objective To study the therapeutic efficacy of dopaminergic agonists,? dihydroergocriptin(Cripar) by multiple center opened trial Methods Sixty cases of Parkinson's disease were divided into two groups: monotherapy group(27 cases) and combined therapy group(33 cases) The improvement in both groups after therapy was observed Results Patients undergone monotherapy were treated with ? dihydroergocriptin and those undergone combined therapy were treated with combined use of ? dihydroergocriptin and L doparmine All patients after treatment showed improvement of clinical symptoms There were 7 patients (28 0%) in the monotherapy group and 13 patients (39 4%) in the combined therapy group markedly improved Evaluation of therapeutic improvement by modified UPDRS revealed that the average scores was 5 01 in monotherapy group and was 6 39( P