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Hyperhomocysteinemia (HHcy) is one of the independent risk factors for youth cerebral infarction. Gene mutation of key enzymes in homocysteine metabolism is the main cause of HHcy. Few cases of cystathionine beta-synthase (CBS) compound heterozygous mutation complicated with pulmonary embolism and lower extremity artery embolism have been reported. This article reported a young cerebral infarction patient complicated with pulmonary embolism and lower extremity artery embolism, who was subsequently detected with significantly elevated blood Hcy, and finally etiologically diagnosed with CBS 833 T>C/1082C>T compound heterozygous mutation. With the treatment of folic acid, methyl cobalt amine, vitamin B 6 and anticoagulant, the blood Hcy has been gradually declined, and no new thrombotic events occurred during the follow-up period of a year.
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Objective To analyze the related influencing factors of progressive ischemic stroke, and to investigate the value of serum markers for prediction of progressive ischemic stroke. Methods Three hundred and six patients with acute cerebral infarction were divided into progressive ischemic stroke (PIS) group (n=91) and non-progressive ischemic stroke (NPIS) group (n=215). Data of gender, age, past medical history, personal history and serum markers were collected and compared in two groups. Binary Logistic regression was used to analyze the influencing factors of PIS. The receiver operating characteristic (ROC) curves of neutrophils to lymphocytes ratio (NLR), fibrinogen and fasting blood glucose were analyzed in two groups. Results Positive rates of hypertension history, diabetes history, hypercholesterolemia history, incidence of large artery atherosclerotic (LAA) stroke were significantly higher in PIS group than those in NPIS group ( P<0.05). The levels of neutrophils, NLR, fibrinogen and fasting blood glucose were significantly higher, but the level of lymphocytes was significantly lower in patients with PIS than those in patients with NPIS (P<0.05). Logistic regression analysis confirmed that diabetes, LAA stroke, NLR, fibrinogen and fasting blood glucose were independent risk factors for the PIS ( P<0.05). The areas under ROC curve by NLR, fibrinogen and fasting blood glucose were 0.777, 0.560 and 0.574, respectively. The sensitivities of NLR, fibrinogen and fasting blood glucose were 72.5%, 59.8%and 47.3%, respectively;and the specificities were 76.7%, 51.2% and 69.8%, respectively. Conclusion The occurrence of PIS is related with blood pressure, blood lipids, inflammatory cells in peripheral bolld, fibrinogen and fasting blood glucose. The level of NLR in peripheral blood can predict the occurrence of PIS, which can be used as an important reference index for early diagnosis of PIS.
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Objective To study the relationship between serum uric acid (UA) level and cerebrovascular stenosis in acute ischemic stroke (AIS) patients.Methods Five hundred and thirteen patients with AIS or old IS admitted to our hospital from April 2014 to April 2016 were divided into primary IS group (n=236),recurrent IS group (n=136),and old IS group (n=141).Venous blood samples were taken on admission for biochemical testing.The patients were further divided into serum UA≤255 μmol/L group (n=128),serum UA=256-312μmol/L group (n=129),serum UA=313-371 μmol/L group (n=129),and serum UA＞371 μmol/L group (n=127).Their cerebrovascular stenosis was assessed by CT angiography or magnetic resonance angiography after admission.Results The severity of cerebrovascular stenosis,hypertension,diabetes and hyperlipidemia was significantly different in primary IS group,recurrent IS group and old IS group (27.5％ vs 33.8％ vs 12.8％、24.2％ vs 28.7％ vs 46.8％、61.9％ vs 49.3％ vs 40.4％、71.6％ vs 61.8％ vs 46.8％,P=0.000).Logistic regression analysis showed that serum UA≤ 255 μmol/L was an independent risk factor for cerebrovascular stenosis (OR =2.787,95 ％CI:2.209-3.365,P=0.001).The risk of cerebrovascular stenosis decreased gradually with the elevated serum UA level.Conclusion Serum UA level is not directly related with recurrent IS.Low serum UA level is a risk factor for cerebrovascular stenosis in AIS.
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Objective To study the risk factors related to early neurological deterioration (END) in patients with recurrent cerebral infarction (RCI). Methods Three hundreds and twenty-six RCI patients admitted to our hospital from January 2014 to March 2015 were divided into END group (n = 66) and non-END group (n =260). The clinical and laboratory data were collected, and their cerebrovascular lesions were accessed according to the angiographic findings. Results (1) Single factor analysis showed the level of cholesterol was significantly higher in the END group than that of the non-END group (P < 0.05). The proportion of patients suffering from smoking, arterial occlusions, early onset stroke associated pneumonia (SAP) and hyponatremia was also higher in the END group (all P < 0.05). (2) Logistic regression analysis showed that arterial occlusions (OR = 2.137, 95%CI 1.093~4.181), SAP (OR=2.001, 95%CI 1.023~3.912) and hyponetremia (OR=2.467, 95%CI 1.217~ 5.000) were independent risk factors for END of RCI patients (all P < 0.05). Conclusion Arterial occlusions, SAP and hyponatremia may be used as predictors of the early development of RCI patients.
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Objective To investigate the relation of the associated biomarkers and the early clinicaloutcomes in acute cerebral infarction. Methods Three hundred and seventeen patients with cerebral infarctionwere enrolled after the first onset. Coagulation function, liver, kidney function, blood cholesterol, andelectrolytical were tested within 24 hours of onset. Chinese Stroke Scale (CSS) and National Institutes of HealthStroke Scale (NHISS) were scored on admission, and NHISS on the tenth day after admission were scored.Evaluated the severity on admission and early functional recovery on the tenth day after admission with CSS andthe difference of NHISS. According to CSS, patients were divided into three groups: mild, moderate and severegroup. According to scale margin of NHISS between on admission and the tenth day after admission , patients weredivided into three groups: improved group, unchanged group and worsened group. Difference of biomarkers amongdifferent groups were statistical analyzed. Results Serum calcium (SC), TBIL, FIB, HCY, SUA levels amongmild, moderate and severe group were significantly different (P < 0.05). The more severe, the higher TBIL,FIB, HCY, SUA levels and the lower SC level. The SC, FIB, SUA levels were significantly different amongimproved group, unchanged group and worsened group (P < 0.05). SC level were the lowest in worsened group,while FIB, SUA levels were the highest. Conclusions In acute cerebral infarction patients, SC, FIB, SUAlevels are closely related to the severity and early clinical prognosis.
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Objective To explore types and risk factors of recurrent ischemic stroke in ischemic stroke patients using antiplatelet drugs. Methods By retrospective study, 130 recurrent ischemic stroke patients using antiplatelet drugs (antiplatelet therapy group) and 101 recurrent ischemic stroke patients not taking antiplatelet drugs (non antiplatelet therapy group) were collected. Two groups of patients were divided according to the ischemic subtypes, and risk factors between different subtypes were analyzed. Results (1) Single factor analysis showed history of coronary heart disease and smoking are more frequent in antiplatelet therapy group with recurrent lacunar infarction (LI). History of coronary heart disease, diabetes, and high level of low density lipoprotein (LDL) are more frequent in antiplatelet therapy group suffer from recurrent atherosclerotic thrombosis (AT). (2)Logistic regression analysis showed the history of coronary heart disease , smoking are independent risk factors for recurrent LI in antiplatelet therapy group (P = 0.018, P = 0.027); history of coronary heart disease, diabetes, and high level of LDL are independent risk factors for recurrent AT in antiplatelet therapy group (P =0.003, P = 0.010, P = 0.002). Conclusions The history of coronary heart disease and smoking are independent risk factors for the recurrence of LI in patients with antiplatelet therapy. History of coronary heart disease , diabetes , and high level of LDL are independent risk factors for the recurrence of AT in patients with antiplatelet therapy. Combined coronary heart disease would increase both LI and AT recurrence.
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Objective:To identify the novel intronic transcripts containing 11q13.5 HERV-W gag sequence, and explore the modulation of the transcripts on the alternative splicing of host gene PTD015. Methods:Half-nested PCR and touchdown PCR were used to amplify the target transcripts. The transcripts were cloned and sequenced. The plasmids inserted with the target transcripts were transfected into JEG3 cells and the alternative spliced mRNA levels of PTD015 were measured with real time PCR. Results:A 1 739 bp novel intronic transcript containing 755 bp 11q13.5 HERV-W gag sequence, 527 bp 5′ long terminal repeat and 457 bp sequence on the 5′-end of 11q13.5 HERV-W was identified. The intronic antisense transcripts significantly down-regulated the alternative spliced mRNA levels of PTD015. Conclusion:The intronic antisense transcripts originating from the second intron of gene PTD015 could modulate the alternative splicing of the host gene PTD015.
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Objective:To investigate the effects of viral infection and starvation on the transcription of syncytin 1 and glial cell missing 1 (GCM1), and the modulation of GCM1 on the transcription of syncytin 1 in different cells thereof. Methods:The mRNA levels of GCM1 and syncytin 1 were measured with real time RT-PCR. Furthermore, the possible modulation of GCM1 on the transcription of syncytin 1 was explored in astrocytes by RNA interference against GCM1.Results:The transcriptional levels of GCM1 and syncytin 1 were up-regulated in different cells at various levels under the stimulation of both viral infection and starvation. Accompany with the reduction of GCM1 mRNA levels(P ＜ 0.05, as compared to controls) induced by GCM1 RNA interference, the mRNA level of syncytin 1 reduced significantly in JEG-3 cells compared to that of controls (P ＜ 0.01). However, the syncytin 1 mRNA level had no obvious change in CCF-STTG1 cells notwithstanding the significant reduction of GCM1 mRNA level induced by GCM1 RNA interference. Conclusion: This study suggests that viral infection and starvation could up-regulate the transcription of GCM1 and syncytin 1, and GCM1 may not directly modulate the transcription of syncytin 1 in astrocytes.
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Objective To demonstrate anti-proliferative effect and significance of 7?-hydroxycholesterol(7? OHCH) on astrocytes.Methods Ferric chloride were given with a cortical injection rats,then immediatedly infused liposome suspension including 7? OHCH in the injury site.Glial fibrillary acidic protein(GFAP) expression in cortex was detected quantitatively by immunohistochemistry and computerized image analysis.Results The number of GFAP positive astrocytes around the injury site was decreased to baseline.Conclusions 7?-OHCH has anti-proliferative property on astrocytes,and this could facilitate the investigation on the influences of reactive gliosis on functional recovery following brain injury and other kinds of pathogenesis involving glial cell proliferation.
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Objective To demonstrate anti-proliferative property and significance of 7?-hydroxycholesterol(7?OHCH)on astrocytes after brain injury.Methods The rats were given a cortical injection of ferric chloride, then immediately infused liposome suspension with or without 7?OHCH in the injury site. Glial fibrillary acidic protein(GFAP) expression in cortex detected quantitatively with immunohistochemistry and computerized image analysis.Results A mass of inflammatory cells infiltrated and the number of GFAP positive astrocytes increased greatly around the injury site in rats with injection of iron,whereas the structure of cortex and the number of GFAP positive astrocytes around the injury site in the rats with injection of iron and 7?OHCH were as same as normal control.Conclusion 7?OHCH has anti-proliferative property on astrocytes, and this will provide a new way to prevent reactive gliosis and facilitate brain functional recovery following brain injury.