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Objective To investigate the genetic association between endothelin receptor type A(EDNRA)gene polymor-phism and delayed cerebral vasospasm(DCVS)in patients with aneurysmal subarachnoid hemorrhage(aSAH).Methods 133 aSAH patients from January 2015 to January 2017 were recruited to participate in the study.According to whether com-bined with DCVS,they were divided into the DCVS group(78 cases)and the control group(55 cases).Genotype was deter-mined by polymerase chain reaction-restriction fragment length polymorphism combined with DNA direct sequencing tech-nique for the polymorphism of the EDNRA gene.Results Samples of DCVS group and control group both were consistent with Hardy-Weinberg's law of inheritance(χ2=0.295,P=0.863;χ2=0.652,P=0.722).There were significant differ-ences of EDNRA gene rs5335 polymorphism between DCVS group and control group,under allele model(χ2=4.213,P=0.040)and the dominant model(χ2=4.790,P=0.029).However,there was no difference of EDNRA gene polymorphism between DCVS group and control group under recessive model(χ2=1.299,P=0.254).Multivariate Logistic regression a-nalysis showed that allele C was protective factor of DCVS for aSAH patients(OR=0.572,95%CI 0.401~0.872,P=0.021).Conclusion For aSAH patients,EDNRA gene rs5335 polymorphism may closely related to DCVS.
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Objective To systematically analyze the risk factors for de1ayed cerebral vasospasm after aneurysm subarachnoid hemorrhage in order to provide evidence for prevention and treatment of the disease .Methods Articles of risk factors for de1ayed cerebral vasospasm after aneurysm subarachnoid hemorrhage from VIP ,CBM ,CNKI ,Wangfang and pubmed ,springlink ,highwire database ,and correlated indexes were extracted for Meta‐analysis by using RevMan 5 .1 .Results Thirteen articles were selected . The heterogeneity of all data was equilibrium ,and used fixed effects model .The difference showed statistical significance in the his‐tory of hypertension ,Fisher > Ⅱ ,age>50 years and the posterior circulation aneurysm (P0 .05) .The symmetry of funnel plots prompted no publication bias .Conclusion Patients with history of hypertension ,Fisher > Ⅱ ,age< 50 years and the posterior circulation aneurysm are at higher risk of de1ayed cerebral vasospasm ,strengthen close monitoring and management are crucial in these patients .
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Objective To observe whether piperine has the ability to prevent delayed cerebral vasospasm(DCVS) after subarachnoid hemorrhage(SAH).Methods Thirty-two New Zealand white rabbits were divided into four groups randomly(n=8).Group A(shamed-injecting blood): Puncture was completed without injecting blood into the cisterna magna;Group B(SAH): DCVS model was made with two-hemorrhage of SAH by injecting autologous arterial blood into the cisterna magna;Group C(SAH + piperine): Piperine(piperine(20 mg/kg),solvent(0.5 mL/kg)) was intravenously administrated daily since day 0 after first injection.Group D(SAH+DMSO): The solvent((0.5 mL/kg)) was gave by i.v.for DCVS models.All animals were sacrificed at day 7 after the first injection.The internal diameter and D/T(internal diameter/wall thickness) values of basilar artery(BA) were measured.The expression of ET-1 and eNOS in arterial wall of BA at day 7 was collected via immunohistochemistry method.Results The severe vasospasm of BA,over expression of ET-1 and diminished expression of eNOS in group B were found vs group A.The vasospasm of BA in group C was obviously alleviated in comparison with it in group B and D,respectively(P
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Objective To analyze the accuracy,sensitivity and safety of multidetector CT angiography(MDCTA) and DSA;furthermore to explore the clinical value of MDCTA in studying the delayed cerebral vasospasm(DCVS) .Methods Delayed cerebral vasospasm was induced in 17 rabbits by injection of autologuous blood into the cisterna magna and followed by a second injection 24 hours later.MDCTA and DSA were carried out at the 7th day before and after the procedure in order to obtain the data of vascular diameter changes for comparative study.Results The basilar artery diameters detected by MDCTA were shown preoperatively as(1.55 ? 0.14) mm and postoperatively as(0.95 ? 0.20) mm;and detected by DSA as(1.61 ? 0.19) mm and(1.00 ? 0.17) mm postoperatively;showing statistically equivalence between the two methods.Conclusions MDCTA is recommended as a reliable,rapid,and minimally invasive diagnostic method,providing a new technique for the delayed cerebral vasospasm research.
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Delayed cerebral vasospasm (DCVS) is an important incapacitating or lethal cause after subarachnoid hemorrhage (SAH),but the patho-physiological process was vague. The effective drugs of treating DCVS are particularly important including ion channel blockers or openers,endothelin synthetic inhibitor or receptor antagonist,anti-inflammatory agents,antioxidants,fibrinolytic agents,traditional Chinese herbs,etc. The article reviews the research progress in the preclinical and clinical pharmacotherapy on DCVS after SAH,and explores the applications and effects and debates about these therapeutic drugs at present.
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Objective To discuss the ultrastructural pathological characteristics and dynamic changes of brain vessel after subarachnoid hemorrhage(SAH),and the mechanism of these changes in delayed cerebral vasospasm.Methods SAH model was made by infusing blood twice into the cistern magna of Japanese rabbits.The animals were divided randomly into SAH group,saline group,puncture group and blank group,at 1 h,3 d,5 d,7 d and 10 d after the first infusion the animals were perfused and basilar artery was harvested.Ultrastructural changes were observed under light microscope and electron microscope.Results Under the light microscope,the vessel wall became thick,the vessel cavity became narrow,the endothelia cells became swollen,vacuoles could be found in the chromatin,inner elastic membrane became reductus and broke.Under the electron microscope,the close connection between the endothelial cells disappeared,the membrane of the cells fell off,and the mitochondria became swollen,vacuoles could be seen,the chromatin became concentrated,heterochromatin could be seen,smooth muscle became deformed,chromatin became uneven, myofilament had derangement and fragmentation and dissolved,vacuolus could be seen in the kytoplasm,mitochondrion became swollen.The structural change of basilar artery under the light microscope got similar to that under the electron microscope;slight change was observed right after 1 h of SAH,significant change was observed at 3 d,and most obvious change was observed between 5 d and 7 d.Conclusion Ultrastructural changes were observed in the basilar artery after SAH,and significant dynamic changes were observed in the progress.The damage of endothelia cells may be the important factors which cause delayed cerebral vasospasm.