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In recent years, for patients with acute ischemic stroke due to large vessel occlusion, intravascular mechanical thrombectomy has become the most recommended treatment method. Determining whether there is ischemic penumbra or not is very important for the selection of patients who are suitable for endovascular mechanical thrombectomy. In addition, the ischemic penumbra also provides guidance for extending the time window of traditional intravenous thrombolytic therapy. This article reviews the imaging evaluation methods of ischemic penumbra.
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Injured neurons will send "help-me" signals to nearby cells after focal injuries. These neurons will be protected by proliferation of neural progenitors, transformation of microglia, and proliferation of endothelial cells. This article provides an in-depth review of the latest research on endogenous " helpme" signals after neuronal injury, especially after cerebral ischemia injury was made, suggesting findings of endogenous "help-me" signals after neuronal injury and its usage as a novel target for intervention may provide new ideas and methods for neuroprotection researches.
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Objective To investigate the neuroprotective effect and its mechanism of local hypothermia combined with nicotinamide phosphoribosyltransferase (NAMPT) on cerebral ischemia-reperfusion injury in rats.Methods Fifty-four Sprague-Dawley rats were randomly divided into sham operation group,model group,NAMPT group,local hypothermia group,and combined treatment group (NAMPT + local hypothermia).A rat model of local cerebral ischemia-reperfusion was induced by suture method.Infarct volume and cerebral edema volume were assessed by 2,3,5-triphenyltetrazolium chloride staining after 2 h cerebral ischemia and 24 h reperfusion in rats.Evans blue staining was used to assess the extent of blood-brain barrier damage,and a 12-point scale was used to assess neurological deficits.Results The infarct volume in the local hypothermia group,NAMPT group,and combination treatment group was significantly lower than that in the model group (all P ＜0.05).The infarct volume in the combination treatment group was significantly lower than that in the NAMPT group (P ＜0.05).The infarct volume in the combination treatment group was lower than that in the local hypothermia group,but it did not reach statistical significance.The neurological function scores of the local hypothermia group,NAMPT group,and combination treatment group were significantly lower than those of the model group (all P ＜0.05).The score of the combined treatment group was significantly lower than that of the NAMPT group and the local hypothermia group (all P＜0.05).Evans blue leakage in the local hypothermia group,NAMPT group,and combination treatment group was lower than that in the model group (all P ＜0.05),but the differences between each treatment group were not statistically significant.Conclusion NAMPT and local hypothermia combination therapy showed better neuroprotective effects on cerebral ischemia-reperfusion injury,suggesting that the combination therapy had clinical transformation prospects.
ABSTRACT
At present,there is still no effective drug treatment for acute ischemic stroke except intravenous thrombolysis.Recently,nicotinamide phosphonbosyltransferase (NAMPT) has been found to reduce neurological deficit after cerebral ischemia and reperfusion.This article reviews the neuroprotective effect of NAMPT in ischemic stroke and its potential mechanisms.
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Objective To compare the clinical characteristics of heart failure patients with preserved ejection fraction (HFPEF) and reduced ejection fraction (HFREF).Methods A total of 171 patients with heart failure from September 2015 to November 2017 in the Second Hospital of Shanxi Medical University were retrospectively analyzed . According to left ventricular ejection fraction (EF),the patients were divided into two groups : HEPEF [EF≥45%, 84 cases,mean age (64.8 ±2.2)years old,33 males and 51 females] and HFREF (EF＜45%,87 cases,mean age (74.6 ±1.5) years old,including 61 males and 26 females).The clinical data of the two groups including general information,underlying etiology,biochemical indicators,echocardiography results,medication in detail were recorded. Results Among the 171 patients, there were 69 patients with coronary heart disease , 44 patients with dilated cardiomyopathy,21 patients with hypertensive heart disease ,10 patients with pulmonary heart disease ,15 patients with rheumatic heart disease,7 patients with degenerative valvular disease ,2 patients with congenital heart disease ,2 cases of heart failure caused by atrial fibrillation ,1 case of viral myocarditis .The patients in the HFPEF group were older [(74.6 ±1.5)years old vs.(64.8 ±2.2) years old,t＝3.598,P＝0.015],more women(60.7%vs.29.9%,χ2＝16.410,P＝0.000),lower body weight [(62.7 ±13.4) kg vs.(68.6 ±14.9) kg,t ＝－2.395,P＝0.018],less likely to have renal insufficiency(36.7%vs.53.6%,χ2＝4.670,P＝0.041),and more likely to have hypertension (54.8%vs.37.9%,χ2＝4.871,P＝0.032) and atrial fibrillation(47.6% vs.13.8%,χ2＝23.107,P＝0.000). The HFPEF group had higher admission systolic blood pressure than the HFREF group [(131.2 ±22.2)mmHg vs. (124.1 ±24.9)mmHg,t＝2.058,P＝0.041].The BNP value[(874.2 ±912.3) pg/mL vs.(835.2 ±1 490.4)pg/mL,t＝－5.011,P＝0.000],hemoglobin value[(125.5 ±24.3)g/L vs.(134.7 ±23.9)g/L,t＝－2.460,P＝0.015] in the HFPEF group were lower than those in the HFREF group .The ESR in the HFPEF group was faster than that in HFREF group[(28.0 ±25.6)mm/h vs.(16.9 ±14.9)mm/h,t＝2.486,P＝0.017].The HFPEF group had smaller left ventricular size than the HFREF group [(50.9 ±6.4)mm vs.(67.3 ±8.5)mm,t＝－11.303,P＝0.000].RAS blockers (52.4% vs.86.2%,χ2＝23.107,P ＝0.000),spironolactone (72.6% vs.88.5%,χ2＝6.926,P ＝0.011),β－blockers (57.1% vs.75.9%,χ2＝6.739,P ＝0.015),statin (38.1% vs.54%,χ2＝4.362,P＝0.046) were used more in the HFREF group,while calcium channel blockers (38.1%vs.13.8%,χ2＝13.208,P＝0.000) and warfarin (16.7%vs.5.7%,χ2＝5.159,P＝0.129) were used more in the HFPEF group.Conclusion Different clinical characteristics were found in patients with HFPEF and HFREF ..Different types of heart failure need different treatment and prevention programs .