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Objective To explore the dynamic changes of inflammatory cytokines and C-reactive protein(CRP)in patients with acute cerebral hemorrhage and its prognostic value.Methods TNF-α, IL-1β, IL-6, IL-8 and CRP were measured in 120 healthy persons and 120 patients after the onset of acute cerebral hemorrhage at 24 h, 3, 7 and 14 d.Correlation analyzes were performed respectively between bleeding quantity or serious degree in patients with acute cerebral hemorrhage and the above indicators.Receiver operating characteristic curve was emploied to analysis its clinical prediction significance to the deterioration of acute cerebral hemorrhage.Results Different periods of serum TNF-α,IL-1β, IL-6, IL-8, and CRP in patients with acute cerebral hemorrhage were higher than those in healthy controls(P<0.05).There was a positive correlation between brain bleeding quantity or severity and the contents of TNF-α, IL-1β, IL-6, IL-8, and CRP in patients with acute cerebral hemorrhage(P<0.05).The inflammatory cytokines and CRP in the patients had its clinical prediction significance to the deterioration of acute cerebral hemorrhage.Conclusion The serum levels of inflammatory cytokines and CRP is involved in cerebral hemorrhage in the pathophysiological process,and these indicators have important predictive value for patients.
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Objective To study the correlation of the level of high-sensitivity C-reactive protein (Hs-CRP) in the acute phase of ischemic stroke and progressive stroke. Methods 101 patients with acute ischemic stroke were collected. Serum Hs-CRP of all patients were measured at 24 hours after admission , the onset of 48 hours, the onset of 72 hours by latex enhanced immune turbidity method. According to their serum Hs-CRP lev-els, the patients were divided into the group of Hs-CRP sustained growth (n = 35) and the group of non Hs-CRP sustained growth (n = 66). The NIHSS scores were assessed on two groups of patients , Logistic regression analysis was made to screen the related factors of Hs-CRP increase and the possible risky factors for progressive ischemic stroke. Results There was a significant difference of serum Hs-CRP level between the two groups (P <0.001). The incidence of progressive stroke in the group of Hs-CRP sustained growth was significantly higher than that in the group of non Hs-CRP sustained growth (χ2 = 32.710, P < 0.001). Logistic regression analysis showed blood glucose , white blood cell count , triglyceride level and NIHSS scores at admission were associated with sustained growth of Hs-CRP and the factors that they included Hs-CRP sustained growth , admission NIHSS scores, diabetes mellitus and pulmonary infection were regarded as independent risk factors. Conclusion The sustained growth of Hs-CRP in the acute phase of ischemic stroke is an independent predictor of progressive stroke.
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Objective The predictive indexes which affect early neurological deterioration ( END) of patients with acute la-cunar stroke still remain unclear .The purpose of the article was to investigate the correlation between the location and numbers of cere -bral microbleeds (CMBs) and END in patients with first-onset lacunar stroke. Methods 217 patients with acute lacunar stroke hos-pitalized in Anhui Provincial Hospital within 24 hours after occurrence from Mar 2009 to May 2012 were prospectively enrolled .All pa-tients underwent susceptibility-weighted imaging MRI right after admission , followed by the investigation on the relationship of the loca-tion and numbers of CMBs and END . Results END occurred in 76 (35.0%) patients.Among these patients, there were 33 positive cases with CMBs (43.3%).There were no significant difference in END incidence between positive group and negative group (P=0.173).In the comparison of the numbers of CMBs foci , patients with more than 5 foci were more prone to END (P=0.005).Logistic regression analysis showed there was relation between CMBs foci numbers>5 and END (OR=3.14, 95% CI: 1.22 ~8.13), and there was no relation between CMBs foci numbers≤5 and END ( OR=1.12, 95%CI:0.53~2.37)as to CMBs negative patients.No signifi-cant relationship was found in CMBs location and END occurrence ( P>0.05). Conclusion The distribution of CMBs foci has nothing to do with early neurological fluctuation .However , more than 5 CMBs foci might be the independent prediction cause of END .
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Objective To investigate the expression of CD4 +CD25 +CD127 low regulatory T cells in peripheral blood mononuclear cells( PBMNCs) in order to explore the influence on the immune status and disease progression in the different period of acute ischemic stroke. Methods 60 patients with acute cerebral infarction were selected as the stroke group,and divided them into the 24~48 h group (n=16), 3~7 d group (n=22) and 8~14 d group (n=22);22 healthy human were set as the control group. To analyze the percentage of CD4 +CD25 +CD127low regu-latory T cells in the peripheral blood of acute cerebral infarction patients and healthy human with flow cytometry. Results The percentages of CD4 +CD25 +CD127 low and CD4 +CD25 high regulatory T cells in the peripheral blood of the stroke group were significantly decreased at 24 ~48 h,3 ~7 d ( P 0.05);the percentage of CD4 + regula-tory T cells in the peripheral blood of the stroke group was significantly higher than control group ( P <0.05 ) . Conclusion Imbalance of regulatory T cells is very likely to play an important role in the immunological injury of acute ischemic stroke. Regulatory T cells may be involved in the pathogenesis of acute ischemic stroke,and early detection may provide a basis for treatment.
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Microglia can be activated immediately after acute cerebral ischemia and play a role of double-edged sword of nerve repair and neurotoxicity.Studies in recent years have suggested that this dual role of microglia can be achieved by a Toll-like receptor 2 (TLR2) signal transduction pathway.Therefore,reasonable regulation of TLR2 expression of microglia may improve the therapeutic effect of cerebral ischemia to a certain extent.This article reviews the mechanisms of TLR2 in cerebral ischemia and the possible interventions.
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Objective To assess the ability of ABCD3-Ⅰ score in evaluating the early risk of cerebral infarction after transient ischemic attack ( TIA ).Methods A total of 107 TIA patients were evaluated according to ABCD2,ABCD3 and ABCD3-Ⅰ criteria.The occurrences of cerebral infarction within 2 days and 7 days were observed.Results The AUCRoc of ABCD2,ABCD3 and ABCD3-Ⅰ were 0.61,0.66 and 0.71 in predicting the risk of cerebral infarction within 2 days,and were 0.62,0.68 and 0.74 in predicting within 7 days,respectively.Among 107 patients with TIA,13 evolved into cerebral infarction within 2 days,accounting for 12.1％,and 24 within 7 days,accounting for 22.4％.According to ABCD3-Ⅰ criteria,17 patients were of low risk scored 0-3 ; 54 patients were of medium risk scored 4-7 ; and 36 patients were of high risk scored 8-13.The different incidence of cerebral infarction after TIA was related to ABCD3-Ⅰ score:the higher the score was,the higher incidence was.Except for age factor,every score item of ABCD3-Ⅰ display obvious influence to the occurrence of cerebral infarction within 2 days and 7 days after TIA (P ＜ 0.05 ).Conclusion ABCD3-Ⅰ criteria could more effectively predict the occurrence of early risk of cerebral infarction after TIA,which could be used in regular clinical practice for assistance in TIA risk stratification and treatment.
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The Montreal Cognitive Assessment (MoCA) scale is a rating scale for rapid screening of mild cognitive impairment.In recent years,with the deepening of clinical research,the application scope of MoCA has been gradually expanded to the assessment of cognitive impairment-related diseases.This article reviews the clinical advances in research on MoCA in early screening of vascular cognitive impairment-no dementia
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Objective To investigate the identification role of plasma high sensitive Creactive protein (hs-CRP) and lipoprotein (a) (Lp [a]) levels in the diagnosis of patients with acute ischemic stroke according to the TOAST classification. Methods The levels of plasma hsCRP and Lp (a) in 82 acute stroke patients ( ＜24 hours) and 60 healthy controls were detected using immune scatter turbidimetry and immune transmission turbidity, and try to make use of Holter, ultrasonography, magnetic resonance imaging, magnetic resonance angiography/CT angiography/dagital subtraction angiography and other tests. Finally, they were classified according to the diagnostic criteria of the TOAST classification of ischemic stroke. Results There were significant differences in plasma hs-CRP and Lp (a) levels between all the subtypes of the acute ischemic sroke group and the control group (all P ＜0. 001). The the level of plasma hsCRP in patients with cardioembolism (CE) was highest. Hs-CRP could be used as a biological marker of CE subtype (odds ratio[OR] = 1. 84,95% confidence interval [CI] 1. 18-2. 85, P ＜ 0. 05). When its concentration was ＞ 3. 48 mg/L, the sensitivity and specificity of predicting CE were 89% and 83% respectively. The plasma level of the AT patients was highest, it could be used as a biological marker of AT subtype (OR = 1. 02, 95% CI 1. 01-1. 03, P＜0. 05); when its concentration was ＞ 183. 5 mg/L, the sensitivity and specificity of predicting AT were 87% and 85% respectively. Conclusions The plasma hs-CRP and Lp (a) levels of patients with acute ischemic stroke may provide some help for timely and accurate etiological typing.
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P-selectin is also known as CD62. It promotes the occurrence of ischemic cerebrovascular disease by mediating the activation of endothelial cells and platelets as well as the processes of the formation and development of atherogenesis. A number of studies have confirmed that P-selectin plays important roles in the occurrence and development of the risk factors (such as hypertension, diabetes, hypercholesterolemia, heart disease, smoking, alcohol abuse and hyperfibrinogenemia) for ischemic cerebrovascular disease. It remains to be confirmed by further studies whether P-selectin can be used as an independent risk factor for predicting the occurrence of ischemic cerebrovascular disease.
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Objective To study effect of nasal tolerance with rat-derived 97-116 peptide of AChR α-subunit(Rα97-116(V108A))on the manifestation of muscle weakness and the immunity function of experimental autoimmune myasthenia gravis(EAMG).Methods Twenty-two EAMG model Lewis rats immunized thrice with Rα97-116(V108A)were divided randomly into tolerance group and control group.They were respectively immunized with Rα97-116(V108A)and PBS buffer solution for 10 days via nasal mucous.Then the body weight and Lennon score of two group Lewis rats were measured.Their serum anti-AChR antibodies were tested by ELISA,the expression levels of CD28,CTLA4,B7-1 and B7-2 were determined by flow cytometry.Results Compared with control group at different time points.the body weight of tolerance group rats(tolerance group(228.1±5.8)g,control group(215.0±16.2)g,t=2.395,P＜0.05)increased,the mean clinical score of rats(tolerance group 1.55±0.44.control group 2.10±0.66,t=-2.20,P＜0.05)decreased and the amount of serum anti-AChR antibody(tolerance group 0.97±0.20,control group 1.27±0.26,t=-2.857,P＜0.05)decreased obviously.the amount of CD28,B7-1,B7-2,CTLA4(%)expressed on the surface of peripheral blood cells(tolerance group:27.35±7.05,4.73±0.58,2.71±0.35,1.72±0.44,control group:40.02±8.81,9.52±1.25,5.88±1.09,2.64±0.47)down-regulated markedly(t=3.479,10.861,8.755,4.403,all P＜0.01).Conclusion Nasal mucous tolerance with Rα97-116(V108A)could ameliorate muscular weakness of EAMG rats while activates T cell and inhibits B cellular immunity.
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The aim of our study was to observe changes of biliary trace elements and hepatolienal ultrasonography in patients with HL D treated synthetically by metal-binding a- gents DMSA and DMPS.Using Aloka SSD2 5 6 ultrasonography and WFX-1 E2 atomic ab- sorption spectrophotometer,we analysed and asseyed the sonograms and biliary trace ele- ments of30 patients with differentultrasonographic typesbefore and six weeksafter DMSA and DMPS treatment.Biliary B juice were obtained by duodenal drainage.The results showed that the biliary copper content of patients with glinting echogenic dots type,rock stratum type and tree-like type increaed markedly after therapy(P