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@#Ischemic stroke is the most common cerebrovascular disease with high morbidity and mortality. Neuroimaging examination has important clinical value in the diagnosis, differential diagnosis of stroke and the selection of treatment options, but it has certain limitations in monitoring the progress of post-stroke cerebral ischemia and evaluating prognosis. Both transcranial Doppler (TCD) and quantitative electroencephalogram (QEEG) have the characteristics of non-invasive, easy bedside and dynamic monitoring, and have high application value in clinical evaluation of cerebrovascular diseases and brain function status of patients. This article reviews the application value of TCD and QEEG in the prognosis evaluation of ischemic stroke, in order to provide some references for the effective evaluation of clinical prognosis of patients with acute ischemic stroke and for future research directions.
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Acute ischemic stroke (AIS) is one of the main causes of death and disability in adults, which has brought a heavy burden to society and families. The intertwined process of thrombosis and thrombus inflammation plays a key role in the pathogenesis of AIS. The latest studies find that C-type lectin-like receptor 2 (CLEC-2) may play an important role in cerebral ischemia/reperfusion injury in mice by promoting thrombus inflammation, and its level is related to the progression of AIS and prognoses of patients with AIS. The author reviews the physiological and pathological effects of CLEC-2 and its related research progress in AIS, with a view to provide new research evidences for the occurrence and development of AIS and related treatments.
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@#Objective By observing the changes of angiogenesis related factors and cerebral perfusion before and after treatment in patients with large area cerebral infarction,the formation of collateral circulation of Salvia miltiorrhiza polyphenolic acid injection and its effect on the improvement of nerve function were discussed.Methods Forty-four patients with large area cerebral infarction were selected,and all subjects were randomly divided into the salvia miltiorrhiza polyphenolic acid treatment group and the conventional treatment group (control group) according to the ratio of 1:1,with sample content of 22 patients in each group. Both groups were treated with cerebral infarction dehydration,cranial pressure reduction and brain protection,and the salvia miltiorrhiza polyphenolic acid treatment group was treated with Salvia miltiorrhiza polyphenolic acid injection on the basis of the above medication. The course of treatment in both groups was 14 days. The changes of VEGF,bFGF,Ang and quasi-continuous arterial spin labeling were observed in the two groups before and 14 days after treatment. Changes in the ratio of cerebral blood flow (CBF) to CBF in the region of interest (ROI) and contralateral image region (CBF lesions/CBFnormal),as well as changes in NIHSS score and mRS score.Results Serum levels of VEGF,bFGF and Ang in the two groups increased after treatment compared with those before treatment,and the difference was statistically significant (P<0.05).Fourteen days after treatment,serum levels of VEGF,bFGF and Ang in the salvia miltiorrhiza polyphenolic acid treatment group were significantly higher than those in the control group,with statistically significant differences(P<0.05).After treatment,CBF lesions/CBFnormal in the two groups were increased compared with those before treatment,and the difference was statistically significant(P<0.05).Fourteen days after treatment,CBF lesions/CBFnormal in the salvia miltiorrhiza polyphenolic acid treatment group were significantly higher than those in the control group,with statistically significant differences(P<0.05).The NIHSS and mRS scores of the two groups decreased after treatment compared with before treatment,with statistically significant differences(P<0.05),and the salvianolic acid treatment group decreased significantly compared with the control group (P<0.05).Conclusion Salvia miltiorrhiza polyphenolic acid for injection can promote angiogenesis in patients with large area cerebral infarction,and can significantly improve cerebral blood flow in diseased brain tissue,improve cerebral perfusion,and then effectively improve the symptoms of neurological impairment
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Objective To investigate the epidemiology of viral encephalitis&meningoencephalitis and its clinical characteristics during influenza epidemics in Taiyuan city (between November 2017 and February 2018). Methods A total of 112 patients of viral encephalitis & meningoencephalitis from Shanxi Provincial People's Hospital between October 2016 to March 2018 were recruited. Patients were divided into influenza season (n=46)and non-influenza season (n=66). The clinical characteristics of 46 patients with viral meningititis in the influenza season (IS group) were compared with those in the control group of 66 cases in the non-influenza season (NI group). The Logistic regression analysis was used to study the difference between the clinical features of the IS group and the NI group. Results The incidence of hospitalized patients with viral meningititis was significantly higher in epidemic season than in the non-epidemic season. The regression analysis demonstrated that in the IS group the adolescents were 3.879 times older than other age groups, and the symptoms of mental disorder were 2.843 times that of the symptoms without mental disorder, and the duration less than 2 weeks was 3.001 times the duration greater than 2 weeks. Conclusion Although the incidence of hospitalization in patients with viral encephalitis&meningoencephalitis is increased during the influenza season, there is no outbreak of viral meningititis. In this influenza season, adolescents are susceptible to the viral encephalitis &meningoencephalitis and more prone to mental disorder. However, the prognosis of the disease is relatively good.
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Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social interaction and communication, along with repetitive and restrictive patterns of behaviors or interests. Normal brain development is crucial to behavior and cognition in adulthood. Abnormal brain development, such as synaptic and myelin dysfunction, is involved in the pathogenesis of ASD. Microtubules and microtubule-associated proteins (MAPs) are important in regulating the processes of brain development, including neuron production and synaptic formation, as well as myelination. Increasing evidence suggests that the level of MAPs are changed in autistic patients and mouse models of ASD. Here, we discuss the roles of MAPs.
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Animals , Humans , Autism Spectrum Disorder , Metabolism , Autistic Disorder , Metabolism , Disease Models, Animal , Microtubule-Associated Proteins , Metabolism , Neurons , Metabolism , Social BehaviorABSTRACT
Several of the genetic models and environmental risk factor models were used in the animal model study in autism.The BTBR T+ Itpr3tf(BTBR) mice are an inbred strain and have emerged as strong candidates to serve as models of a range of autism-relevant behaviors, showing deficiencies in social behaviors and reduced or unusual ultrasonic vocalizations as well as increased repetitive self-grooming.There are increasing investigations targeted to ameliorating the behavioral phenotypes of autism in BTBR mice.This review briefly summarizes the advance in the research on the BTBR mice model of autism.
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Objective To analyze the possible risk factors for Parkinson's disease (PD),and to provide clues to its etiology and prevention.Methods A matched case-control study,including 91 cases of PD and 364 controls,was carried out in Shanxi Provincial People's Hospital.Subjects completed an interviewer administered questionnaire about some putative risk factors.Multivariable conditional Logistic regression model was used to analyze the associated factors for PD.SAS 8.0 was used to analyze the data.Results 6 risk factors were found significantly associated with PD.The odds ratio (OR) of Parkinson's disease was 5.421 (95%CI:1.272-23.103) for family history,3.330 (95%CI:1.268-8.741) for rural living more than 10 years,2.495 (95%CI:1.044-5.961) for maternal smoking during pregnancy,1.607 (95% CI:1.224-2.112) for maternal age more than 37 years,3.673 (95%CI:1.766 7.643) for history of drinking alcohol,2.147 (95%CI:1.279 3.602) for less physical exercising.Conclusions PD is a disease affected by the interaction of genetic and environmental factors,and the risk factors should be intervened selectively.
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Objectives To screen the high-risk population of stroke in China using color Doppler flow imaging (CDFI)and to establish a stroke risk prediction model in Chinese population in order to prevent and treat stroke early. Methods Forty-one base hospitals and 715 286 people in the project areas of the first 6 provinces of China conducted routine physical examinations and investigated the related risk factors for cardiocerebrovascular diseases from July 2011 to April 2012 using a cross-sectional study,among them 61 860 patients underwent carotid CDFI screening,and 49 386 of them were high-risk population (exposed to≥3 risk factors). The bilateral common carotid interma-media thickness (IMT),the number of plaques and the degree of carotid stenosis were screened and documented. And whether carotid IMT thickening or not,with or without carotid plaques,and degree of carotid artery stenotic rate 0-49% and≥50% were performed by multivariate logistic regression analysis with the risk factors for stroke,respectively. Results (1)Logistic regression analysis showed that hypertension,atrial fibrillation,smoking,and lack of physical exercise were the independent risk factors for carotid IMT thickening (hypertension:OR,1. 17;95%CI 1. 12-1. 22;atrial fibrillation:OR,1. 15;95%CI 1. 09-1. 21;smoking:OR,1. 13;95%CI 1. 08-1. 17;and lack of physical exercise:OR,1. 12;95%CI 1.08-1. 16). (2)Hypertension,atrial fibrillation, smoking,and diabetes were the independent risk factors for carotid plaque and carotid artery stenosis rate≥50%(carotid plaque,hypertension:OR,1. 55;95%CI 1. 47-1. 62;atrial fibrillation:OR,1. 13;95%CI 1.06-1. 21;smoking:OR,1. 16;95%CI 1. 11-1. 22;and diabetes:OR,1. 30;95%CI 1. 24-1. 37). Carotid stenosis rate≥50%,hypertension:OR,1. 78;95%CI 1.55-2. 03;atrial fibrillation:OR,1. 59;95%CI 1. 39-1. 81;smoking:OR,1. 33;95%CI 1. 20-1. 48;and diabetes:OR,1. 30;95%CI 1. 17-1. 45. Simple obesity did not increase the incidences of carotid atherosclerotic plaque and carotid artery stenosis ≥50%(OR,0. 78, 0.83;95%CI 0. 75-0. 82 ,0. 75-0. 92,respectively). Conclusions Neck vascular ultrasound can be used as a valuable means for screening high-risk population and detecting risk factors of stroke. It has an important clinical significance for the early diagnosis and treatment of carotid atherosclerosis disease.
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Objective To investigate the risk factors of restless leg syndrome (RLS) among male elders.Methods A case-control study between 148 old male RLS patients (case group) and 155 non-RLS male elders (control group) was conducted to investigate the risk factors of RLS.The general demographic data (age,education level,marital status,etc.),lifestyle (including physical exercise,smoking and alcohol) and past medical history were compared between two groups.Univariate analysis and non-conditional multivariate Logistic regression analysis was conducted by SPSS 13.0 software.Results In univariate analysis:there was significant difference in history of Parkinson disease between two groups [8.8% (13/148)vs.3.2% (5/155)] (P <0.05),but there was no significant difference in smoking,alcohol,physical exercise,history of diabetes mellitus and history of peripheral nerve disease between two groups (P > 0.05).The serum creatinine in case group was higher than that in control group [(103.92 ± 32.07) μ mol/L vs.(85.35 ± 36.14) μ tmol/L] (P =0.000),and there was no significant difference in systolic blood pressure,diastolic blood pressure,hemoglobin,fasting blood glucose between two groups (P > 0.05).Multivariate analysis showed that after adjusting for potential confounders,history of Parkinson disease and peripheral nerve disease,and serum creatinine was the independent risk factors of RLS among male elders.The values of OR(95% CI) were 5.68(1.046-30.846),4.13(1.109-15.368),1.02(1.014-1.036),respectively.Conclusion Histories of Parkinson disease and peripheral nerve disease and serum creatinine are the independent risk factors of RLS among male elders.
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Objectives To investigate the clinical feature of Parkinson's disease (PD) with restless leg syndrome (RLS) and the pathogenesis of RLS. Methods We conducted a cross-sectional and control study. The case group concluded 31 PD with RLS patients, meanwhile 39 PD patients were selected as the control group. Clinical history, clinical manifestations, complications and laboratory examinations were compared respectively between the two groups. Results All the RLS symptoms did not appear in RLS patients until the PD symptoms came out. Significant differences were found in complications such as swallow disturbance, constipation and illusion, when we compared the two PD groups (P < 0.05 ). Compared with the PD or healthy group, the level of serum ferritin and the H-reflex latency of tibial nerve were significantly decreased in PD with RLS group ( P<0.05). Conclusions Secondary RLS is a complication of PD.Deficiency of iron and decreased inhibition function of spinal cord may lead to the occurrence of RLS in PD patients. When their motor symptoms are serious and complications are more common, PD patients are more possible to have RLS symptoms.
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Objective To study the effect of inhibitors of the multidrug transporters including P-glycoprotein (PGP)and multi-drug resistance-associated protein(MRP)on the regulation of concentration of oxcarbazepine in the extra-cellular fluid of the hippocampus after pilocarpine induced seizures in rats.To investigate whether oxcarbazepine are sub-strate for PGP and MRP and whether brain expressions of PGP and MRP are involved in muhidrug resistance mechanisms of refractory epilepsy.Methods The epileptic rats model were established by repeated peritoneal injection treatment with pi-locarpine.Thirty-two Wistar rats were divided into four groups:control group,pilocarpine epileptic model group,verapamil treated group and probenecid treated group.At 30,60,90,120 and 150 min following systemic injection of oxcarbazepine (80 mg/kg),dialysate was collected and the concentration of oxcarbazepine in the extracellular fluid of hippocampus was determined by microdialysis and high-performance liquid chromatography technique.Results After systemic injection of oxcarbazepine,the concentration of oxcarbazepine in extracellular fluid of the hippocampus during 90~150 min(1.26±0.09、0.93±0.10)were much higher in verapamil treated group than in pilocarpine epileptic model group(0.87±0.06、0.66±O.04)(P<0.05)and the concentration of oxcarbazepine in the hippocampus during 60~150 min(1.07 4±0.11、1.32±O.13、1.02±0.10、0.87±0.08)were higher in probenecid treated group than in pilocarpine epileptic model group (0.81±0.08、0.87±0.06、0.66.4±0.04、0.58±0.06)(P<0.05).Conclusions Oxcarbazepine are substrates for PGP and MRP and,penetration of oxcarbazepine through blood-brain barrier are restricted by PGP and MRP.Increased expres-sions of PGP and MRP in brain maybe involved in the mechanisms of multidrug resistance of refractory epilepsy.
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Objective To investigate the impact of multi-drug transporters including P-glycoprotein (PGP) and multi-drug resistance associated protein (MRP) on concentration of lamotrigine in the extracellular fluid in hippocampus of epilepsy rat models induced by pilocarpine, and to deduce the multi-drug resistance mechanisms in refractory epilepsy. Methods The epilepsy rat models were established by repeated administration (by ip) of pilocarpine. A microdialysis probe was placed into the hippocampus of the epileptic rats and dialysate was collected at five time-points from 30--150 minutes after systemic injections of lamotrigine (10 mg/kg). The concentration of lamotrigine in the extracellular fluid in the hippocampus was determined by high-performance liquid chromatography (HPLC). Then PGP inhibitor verapamil and MRP inhibitor probenecid was added individually through microdialysis probe and the concentration of lamotrigine was detected again. Results Compared with control group (0. 41 ± 0. 10 in 60 minutes, 0. 50 ±0.04 in 90 minutes, 0. 39 ±0. 09 in 120 minutes and 0. 30±0.06 in 150 minutes), verapamil significantly increased the concentration of lamotrigine in extracellular fluid of the hippocampus 60--150 minutes (0. 65 ±0. 11, 0. 84 ± 0. 09, 0. 70± 0. 09 and 0. 58 ± 0. 08 respectively) after injection (F value were 5.01, 8.61, 10. 23 and 7.89, all P < 0. 05) and probenecid also enhanced the concentration of lamotrigine 90--150 minutes (0. 75 ± 0. 09, 0. 58±0. 10 and 0. 49±0. 07) after injection (F = 6. 58, 4. 56, 4. 75, all P < 0. 05). Conclusions Penetration of lamotrigine through blood-brain barrier in pilocarpine induced epilepsy rats is restricted by PGP and MRP, resulting in decreased concentration of lamotrigine in the extracellular fluid of the hippocampus. Therefore, increasing expression of PGP and MRP in brains of epilepsy patients might be an important mechanism involved in multi-drug resistance in refractory epilepsy.