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Objective To investigate the correlation between apolipoprotein and homocysteine levels with the stability of carotid plaque and the degree of stenosis??Methods One hundred elderly patients with acute cerebral infarction from January 2017 to December 2017 were collected continuously in Harbin Fourth Hospital,All patients underwent color Doppler ultrasound examination of carotid artery??They were divided into stable plaque group and unstable plaque group according to the results of color Doppler ultrasound,then according to the degree of stenosis they were divided into intimal thickening group with 23 cases, mild stenosis (stenosis degree＜50%) with 26 cases,moderate stenosis group (50%≤stenosis degree＜70%) with 28 cases,severe stenosis group (70%≤stenosis degree) with 23 cases??All the patients were selected to collect the blood of the elbow in the early morning to detect the level of apolipoprotein B and Hcy??Results Compared with unstable plaque group, smoking, drinking, hemoglobin A1c ( HbA1c), ApoB and Hcy had significant differences (all P＜0??05)??Gender,history of diabetes mellitus,history of hypertension,systolic pressure,diastolic pressure,low density lipoprotein cholesterol (LDL?C),triglyceride (TG) There was no significant difference in total cholesterol ( TC) and total cholesterol ( all P＞0??05)??Multivariate logistic regression was performed after correcting the related risk factors excluding blood lipids??The results showed that alcohol ( OR＝ 1??247 ( 95%CI: 0??626－1??958), P＝ 0??043), Hcy ( OR＝ 3??163 ( 95%CI: 1??824 －4??772),P＝0??045), bloodpressure ( OR＝1??286 ( 95%CI: 0??688－2??005), P＝0??027), HbA1c ( OR＝3??671(95%CI: 1??904－6??630),P＝0??011),ApoB (OR＝1??717(95%CI: 1??005－2??634),P＝0??036), LDL?C(OR＝1??516(95%CI: 0??968－2??489),P＝0??024),TC( OR＝1??403( 95%CI: 0??801－2??343),P＝0??030) and TG ( OR＝1??342 ( 95%CI: 0??712－2??198), P＝0??019) are independent risk factors for unstablecarotid plaque and severe carotid stenosis??Conclusion Apolipoprotein and homocysteine may be independent predictors of unstable carotid plaque and severity of carotid stenosis??
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Objective To investigate the effects of Dihuang Yinzi (DY) on the receptor for advanced glycation end-products(RAGE)/reactive oxygen species(ROS)/apoptosis pathway in SH-SY5Y cells induced by amyloid-beta1-42 (Aβ1-42) oligomer. Methods Firstly, we adopted methyl thiazolyl tetrazolium(MTT) method to detect the cell vitality in fetal bovine serum (FBS) group, blank serum group, and low-, middle- and high- dose DY-containing serum groups, so as to confirm the optimal concentration and treatment time of DY-containing serum. Secondly, we applied MTT method to detect cell vitality and applied Annexin V/propidium iodide (PI) staining method to observe the apoptosis of SH-SY5Y cells treated with 0~20 μmol/L Aβ1-42 for 24 and 48 h, so as toconfirm the optimal concentration and treatment time of Aβ1-42 for establishing Alzheimer's disease (AD) model in vitro. Thirdly, MTT method was used for the detection of cell vitality, and Annexin V/PI staining method was used for detection of the apoptosis of SH-SY5Y cells in blank serum group, model group, western medicine control group and low-, middle-and high-dose DY-containing serum groups, and Dihydroethidium (DHE) method was used for the assay of ROS contents, so as to observe the effect of DY on the recovery of injured SH-SY5Y cells induced by Aβ1-42. Finally, we applied Western blot method to detect the expression level of RAGE in SH-SY5Y cells of blank group, model group and DY-containing serum group; after Aβ1-42-induced SH-SY5Y cells were transfected with RAGE gene, we adopted DHE staining method and Annexin V/PI staining method to detect ROS content and cell apoptotic rate in all of the above groups, so as to observe the effect of DY on SH-SY5Y cell apoptosis and RAGE expression. Results The cell vitalities were increased in low- and middle-dose DY-containing serum groups at 24 h (P < 0.05 or P < 0.01 compared with that in the blank serum group). The conditions for the establishment of AD model in vitro were as follows: the optimal concentration of Aβ1-42 was 5μmol/L, and the treatment time was 24 h. The cell vitalities were significantly enhanced, the cell apoptotic rate and ROS content were significantly lowered in Aβ1-42-induced SH-SY5Y cells of the medication groups(P <0.05 or P < 0.01 compared with those in the model group) , and the cell vitality was the highest and the cell apoptotic rate was the lowest in the middle-dose DY-containing serum group. The RAGE expression level was decreased in Aβ1-42-induced SH-SY5Y cells of the middle-dose DY-containing serum group(P < 0.05 compared with that in the model group) . ROS content and cell apoptotic rate were decreased in Aβ1-42-induced SH-SY5Y cells transfected with RAGE gene in the middle-dose DY-containing serum group (P<0.01). Conclusion DY may play an anti-oxidative role through inhibiting the production of ROS and cell apoptosis, thus to suppress RAGE protein and to achieve the preventive and therapeutic effect for AD.
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Objective To investigate clinical features and the early recurrence factors of watershed infarction(WSI).Methods Two hundred and eighty-three patients with acute anterior circulation vascular infraction confirmed by CT or MRI were collected in Heilongjiang Province Hospital from January 2010 to December 2012.Patients' information including gender,sex,risk factors for stroke and vascular stenosis was colleced.Patients were divided into the lacunar infarction group (n =83),large infarction group(n =60) and the WSI group (n =140).All patients were followed up for 6 months to observe cerebral infarction recurrence status.The national institutes of health stroke scale(NIHSS) test of all patients was performed.Meanwhile the information including disease stage was collected and analysed.Results (1) The recurrent rate in WSI group,large infarction group and lacunar infarction group were 40.0％ (56/140),30.0％ (18/60),9.6％ (8/83)respectively.The difference between recurrent rate and lacunar infarction group was statistically significant(x2 =23.5,x2 =9.7,P ＜ 0.05),and the recurrent rate of WSI was highest.(2)The symptoms of patients with WSI were relatively mild in most patients after the initial stroke.75.7％ (106/140)WSI patients were 0-4 points regarding of NIHSS score,22.9％ (32/140) for 5-9 points and only 1.4％ (2/140) for more than 10 points.The clinical symptoms aggravated obviously in recurrent WSI patients.Of recurrent patients,28.6％ (16/56) were with high NIHSS score (score ≥ 10 points).(3)The difference between recurrent group and unrecurrent group in terms of unstable plaque,baseline systolic blood pressure,degree of stenosis ≥ 70％ was statistically significant(P ＜ 0.05).Conclusion The recurrent rate is higher in WSI group than other infarction type.The clinical symptoms are relatively mild in most of the WSI patients after the initial stroke,but the symptoms turn serious when stoke recurrent and the prognosis is poor.The unstable plaque,baseline systolic blood pressure,degree of stenosis ≥ 70％ may be the risk factors of stroke recurrence.
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Objective To investigate the changes of the electrocardiograms (ECG) and the cardiac markers in patients with acute insular infarction,and analyze the relationship between them and the prognosis.Methods A total of 202 patients with acute middle cerebral artery territory infarction (patients group) and 150 control subjects (control group) was selected in this study.Patients included insular infarction (insular infarction group,136 cases),non-insular infarction (non-insular infarction group,66 cases),left-side insular infarction(71 cases) and right-side insular infarction(65 cases).ECG recordings and plasma cardiac troponin I (cTnI),creatine kinase-MB (CK-MB) were measured and compared.Death in 6 months was followed-up.Results There was significant difference in the incidence of abnormal changes of ECG and plasma cTnI,CK-MB increasing between patients group and control group (P ＜0.01).The incidence of abnormal changes of ECG and fatality rate were higher in insular infarction group than those in non-insular infarction group [80.88％(110/136) vs.46.97％(31/66) and 11.76％ (16/136) vs.3.03％ (2/66),P ＜ 0.05 or ＜ 0.01].The incidences of ectopy and prolonged QT were higher in right-side insular infarction patients than those in left-side insular infarction patients [44.62％(29/65) vs.11.27％ (8/71),P ＜0.01 ; 55.38％ (36/65) vs.35.21％ (25/71),P ＜ 0.05].The incidences of sinus bradycardia and ST segment deviation were higher in left-side insular infarction patients than those in right-side insular infarction patients [22.54％(16/71) vs.7.69％(5/65),P ＜ 0.05 ;47.89％(34/71) vs.13.85％ (9/65),P ＜ 0.05].The increased rates plasma cTnI and CK-MB level were mainly seen in insular infarction [insular infarction group:47.79％ (65/136),34.56％ (47/136); non-insular infarction group:4.55％ (3/66),1.52％ (1/66),P ＜ 0.01].The incidence of plasma cTnI increasing in right-side insular infarction patients was higher than that in left-side insular infarction patients [67.69％(44/65) vs.29.58％(21/71),P＜ 0.05].There was no significant difference in the incidence of plasma CK-MB increasing between left-side insular infarction patients and right-side insular infarction patients(P ＞ 0.05).The fatality rates in plasma cTnI,CK-MB increasing patients were higher than those in normal plasma cTnI,CK-MB patients [16.18％ (11/68) vs.5.22％ (7/134),P ＜0.05;29.17％ (14/48) vs.2.60％ (4/154),P ＜0.01].Conclusions The effects of acute hemispheric cerebral infarction on heart are mainly associated with destruction of insula.Patients with insular infarction have more abnormal changes of cardiac markers and ECG,which is correlated with poor prognosis.