Smoking and stroke / 医学研究生学报

In the 1970s, the Framingham study found that smoking increased the risk of stroke. Subsequent laboratory and clinical studies have demonstrated that a variety of harmful components in tobacco can damage the vascular endothelium and interfere with the clotting mechanism, giving rise to atherosclerosis and hypercoagulability, which eventually leads to stroke. Furthermore, the harmful ingredients in tobacco may induce hypertension, diabetes, atrial fibrillation and other diseases, which indirectly increase the risk of stroke. However, there are still a lot of questions about the relationship between smoking and stroke. This paper will analyze the correlation between them and its mechanism, and discuss the influence of smoking cessation on the prognosis of stroke, so as to provide reference for the prevention and treatment of related diseases.

Identification and sequencial analysis on rabies virus isolated from a donkey / 中华流行病学杂志

Objective To identify and analyze the genetic characteristics of nucleoprotein (N) and glycoprotein (G) genes of rabies virus (RABV) isolated from a donkey in Wuhan.N gene and G gene of the virus were compared with other representative street strains isolated around Hubei areas as well as the vaccine strains used in China and abroad.Methods RABV in brain tissue of a donkey was detected by direct immunofluorescent method and then inoculated in suckling mice to observe the incidence of rabies.Brain samples of the donkey and infected suckling mice were detected by ELISA.The N gene and G gene fragment of the isolated RABV were amplified by RT-PCR and cloned into pMD18-T vector for sequencing and genetic analysis.Results RABVs were detected in both donkey brain and suckling mice brain samples.The N gene and G gene nueleotide homology of RABV isolated from the donkey with other representative street strains found around Hubei areas as well as vaccine strains used in China and abroad were 85.7％-99.1％ and 82.2％-99.7％,and the deduced amino acid identity were 95.6％-99.8％ and 87.8％-99.4％,respectively.Conclusion Novel RABV was successfully identified and isolated from a donkey and showed close relationship to the representative street strains found around Hubei areas as well as vaccine strains used in China through genetic analysis.

Temporal and spatial population dynamics of rabies virus isolates in China / 病毒学报

In order to study phylogeography, population dynamics and molecular evolution of rabies viruses (RABVs) isolates from China, especially spatio-temporal dynamics, the timescale of RABVs evolution and its pattern of migration, we performed an extensive comparative analysis of RABV N gene sequence data, representing 167 isolates sampled from 20 provinces in a 78-year period (from 1931 through 2009). The available Chinese isolates could be divided into two distinct clades:Phylogroup clades I comprised Chinese group 1-4; Phylogroup clades II contained Chinese group 5-8. We found no evidence for positive selection (dN/dS>1) acting at any codon and found strong selective constraints for N gene. Bayesian Markov Chain Monte Carlo (MCMC) analysis suggested that the Chinese rabies viruses originated within the last 2000 years and the mean rates of nucleotide substitution for the N gene were approximately 4 x 10(-4) substitutions per site per year. The analyses of the spatial and spatio-temporal evolution indicated that RABV isolates from China migrated among different Provinces.

Dynamic observation of cerebral vasoreactivity after carotid angioplasty and stenting / 中华神经医学杂志

Objective To explore the changes and influencing factors of cerebral vasoreactivity (CVR) in patients after carotid angioplasty and stenting (CAS). Methods Thirty-seven patients performed CAS, admitted to our hospital from July 2008 to September 2009, were finished the follow-up and chosen in our study; the breath-holding index (BHI) of the bilateral middle cerebral artery was measured using transcranial Doppler combined with breath holding test before thc operation, and 1 d and 3-10 months after the operation. Repeated measures design analysis of variance was employed to detect the BHI changes before and after the stenting; multiple regression was employed to analyze the influencing factors of BHI. Results BHI values after stenting were significantly higher than those before stenting on the stenotic side (P＜0.05). The follow-up BHI values were negatively correlated with those of tandem stenoses (β=-0.016, P=0.002) and positively correlated with the postoperative BHI values (β=1.030, P=0.000). Conclusion CAS can immediately improve CVR on the ipsilateral side and make it close to normalization gradually. Tandem stenoses are the independent risk factors of CVR.

Influencing factors of kinking of extracranial internal carotid artery in patients with transient ischemic attack / 中华神经医学杂志

Objective To investigate the influencing factors of kinking of extracranial internal carotid artery (EICA) in patients with transient ischemic attack. Methods Three hundred and thirty-four patients with ischemic cerebrovascular disease performed digital subtraction angiography (DSA) were chosen; they were divided into 2 groups according to vascular morphology through DSA detection: kinking group (angulation smaller than 90°, n=110) and non-kinking group (angulation larger than 90°, n=224). According to the age, the patients were divided into youth group (18-45 years old),middle age group (46-64 years old) and elderly group (older than 65 years old). The influencing factors which may be related to the kinking of EICA, including gender, age, height and stenosis degree, and the risk factors for cerebrovascular diseases were statistically analyzed. Results Univariate analysis found that the kinking group and non-kinking group on the ratio of age, gender, height, and histories of hypertension, smoking and drinking were significantly different (P＜0.05). Multiple logistic regression analysis showed that the kinking of EICA was obviously correlated to the history of hypertension (OR=2.546, 95% CI: 1.376-4.712, P=0.003) and age (taking youth group as reference group, middle age group:OR=2.610, 95% CI: 1.056-6.452, P=0.038, elderly group: OR=2.929, 95% CI: 1.159-7.401, P=0.023).Conclusion The history of hypertension and age are identified as independent predictors for kinking of EICA in patients with ischemic cerebrovascular diseases.

Influencing factors of diagnostic time in adult Moyamoya disease / 中华神经医学杂志

Objective To investigate the influencing factors of diagnostic time in adult moyamoya disease (MMD) and provide evidence for its early diagnosis. Methods The clinical data of 65 consecutive patients, admitted to our hopspital from August 2008 to December 2009, were retrospectively analyzed. Logistic regression nalysis was employed to confirm the relevant factors of diagnostic time. Results The 65 patients with early diagnosis and late diagnosis were 41 (63.1%) and 24 (36.9%), respectively. The percentage of patients firstly visiting a hospital with the third grade, patients with high education and high income, and patients having initial hemorrhage of the early diagnosis group was significantly higher than that in those of late diagnosis group (P<0.05). Through a logistic regression analysis, the grade of initial hospital, the level of education, initial symptom and economic level were significantly associated with the early diagnosis, and the patients having initial hemorrhage and firstly visiting a hospital with higher grade were diagnosed earlier (OR=3.401, 95%CI 1.301-8.892, P=0.013;OR=26.351, 95%CI 4.953-140.193, P=0.000). Conclusion Patients with MMD having initial hemorrhage and firstly visiting a hospital with the third grade can be early diagnosed.

Clinical interference and follow-up studies in patients with symptomatic carotid artery totalocclusion / 中华神经医学杂志

Objective To evaluate the effects of artery-interventional therapy and drug treatment on patients with symptomatic carotid artery total occlusion,and observe the follow-up results of cerebrovascular events after clinical interference.Methods According to patient′s intention,62patients with symptomatic carotid artery total occlusion,admitted to our hospitals from February 2004 to January 2009,were divided into artery-interventional therapy group(n=21)and drug treatment group (n=41).In the artery-interventional therapy group,patients were given revascularization of internal carotid by endovascular intervention.In the drug treatment group,patients were given aspirin,clopidogrel and statins.The major end-point outcome of follow-up survey was the 2-year functional prognosis evaluated by modified Rankin Scale(mRS),and Rank sum test was employed to compare the differences of mean rank of the 2 groups; the minor end-point outcome was the cardiovascular events,and Kaplan-Meier method and multivariate Cox regression were employed to analyze the median time and independent risk factors.Results During the 3,6 and 9 months,1 and 2 years of follow-up,mRS average ranks in the artery-interventional therapy group were statistically lower than those in the drug treatment group(P＜0.05).The median times of recurrence of cardio-cerebrovascular events in the artery-interventional therapy group and drug treatment group were(17.42±1.20)months(95％CI:15.07-19.76)and(19.43±1.51)months(95％CI:16.48-22.38),respectively,and Kaplan-Meier analysis showed no significant difference(P＞0.05).Survival Cox regression analysis showed that independent factors of cardio-cerebrovascular events were smoking(RR=3.189,95％CI:1.020-9.968,P=0.046),diabetes(RR=2.717,95％CI:1.113-6.631,P=0.028),and baseline NIHSS scores(RR=2.984,95％CI:1.049-8.485,P=0.040),but treatment methods(artery-interventional therapy and drug treatment)were not independent factors(RR=1.191,95％CI:0.430-3.296,P=0.737).Conclusion Artery-interventional therapy is superior to drug therapy in achieving better functional prognosis; however,the 2-year-follow-up shows that the artery-interventional therapy can not reduce the occurrence of cardio-eerebrovascular events.Smoking,diabetes and baseline NIHSS scores are independent factors of recurrence of cardio-cerebrovascular events.

Factors associated with cerebral microbleeds in patients with ischemic stroke / 中华神经医学杂志

Objective To investigate the clinical and neuroimaging features of cerebral microbleeds(CMBs)in patients with ischemic stroke. Methods MRI,including gradient-echo T2~*-weighted MRI,was performed in 85 patients with acute ischemic stroke.Their clinical information and imaging characteristics were analyzed. Results One hundred and twenty-four CMBs were noted in 26 patients(30.6%)with the number of CMBs ranged from 1 to 16 per patient.CMBs were more frequently presentcd in the cortical-subcortical region and thalamus-basal ganglia than in the cerebellum and brain stem legions.Some CMBs in the brain stem had related neurological symptoms and signs.CMBs,the age of the patient,the number of lacunar infarcts and the white matter changes were correlative(r=0.243,P=0.025;r=0.337,P=0.025;r=0.438,P=0.000).CMBs could be well demonstrated in the gradient-echo T2~*-weighted MRI and some larger ones could be demonstrated in the apin-echo T2~*-weighted MRI and DWI. Conclusion CMBs are the sighs for microangiopathy in the brain with advanced age,mutiple lacunar infartion and leukoaraiosis as its main prognosis factors.

Effects of montelukast on atherosclerosis and monocyte chemoattractant protein-1 expression in ahypercholesterolemic rabbit model / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the effects of montelukast on atherosclerosis and monocyte chemoattractant protein-1 expression in a hypercholesterolemic rabbit model.</p><p><b>METHODS</b>Thirty four male New Zealand white rabbits were randomized into four groups including normal control group (n = 6), placebo group (n = 8), atorvastatin group (1.5 mgxkg(-1)xd(-1), beginning at 8(th) weeks for 4 weeks, n = 10) and montelukast group (1 mgxkg(-1)xd(-1), beginning at 8(th) weeks for 4 weeks, n = 10). Rabbits except those in normal control group were fed a high cholesterol diet for 12 weeks. Serum lipids were measured at 0, 8 and 12 weeks after intervention. The intima/media ratio, percentages of macrophages or smooth muscle cells in intima and the expression of MCP-1 mRNA were examined.</p><p><b>RESULTS</b>Atherosclerosis was evidenced in placebo group and atorvastatin or montelukast treatment significantly reduced neointima (0.32 +/- 0.12 and 0.34 +/- 0.10 vs. 1.12 +/- 0.36, P < 0.05) and macrophage content [(9.8 +/- 4.6)% and (11.2 +/- 3.7)% vs. (34.6 +/- 8.8)%, P < 0.05], increased SMC content [(18.6 +/- 6.9)% and (19.2 +/- 8.6)% vs. (5.2 +/- 2.3)%, P < 0.05] and inhibited expression of MCP-1 mRNA (0.42 +/- 0.08 and 0.40 +/- 0.06 vs. 2.36 +/- 0.48, P < 0.01). Montelukast had similar anti-atherogenetic effects as atorvastatin but had no influence on plasma lipids.</p><p><b>CONCLUSIONS</b>Montelukast could attenuate atherosclerosis in this hypercholesterolemic rabbit model which might be attributed to its anti-inflammatory effects.</p>

Evaluation on the safety and efficacy of lyophilized purified human rabies vaccine (CTN-Vero-RV) / 中华流行病学杂志

<p><b>OBJECTIVE</b>To observe the safety and efficacy of lyophilized purified human rabies vaccine CTN-Vero RV, CTN strain produced in Vero cells.</p><p><b>METHODS</b>450 healthy volunteers were divided into two groups, with 300 of them receiving CTN-Vero-RV (rabies vaccine for human use made in Vero cells with CTN strain) while 150 of them receiving PVRV to serve as control group. All the subjects were immunized on days 0, 3, 7, 14 and 28 at deltoid muscle respectively. Local and systemic reactions were observed and sera were collected for neutralizing antibody testing using RFFIT. 365 and 730 days after the first dose, sera from the 212 and 176 subjects of the studied group while 97 and 80 subjects from the control group were collected to test for neutralizing antibody.</p><p><b>RESULTS</b>No severe local or systemic reactions were observed after immunization was performed in the two groups. On days 3, 7, 14, 28 and 365 after the first dose, the antibody positive rates appeared to be 2.35%, 80.78%, 100.00%, 100.00%, 98.58% and 73.30% in the study group and 4.00%, 87.20%, 100.00%, 100.00%, 97.94% and 76.25% in the controls respectively. On day 0, 3, 7, 14, 28, 365 and 730, GMT of the neutralizing antibody level were 0.12, 1.01, 9.83, 12.61, 3.68 and 2.81 IU/ml in the study group while 0.13, 1.18, 10.24, 11.61, 4.18 and 1.92 IU/ml were seen in the control group respectively. There were no significant differences in both antibody positive rates and GMT between the two groups on days 3, 7, 14, 28, 365 or 730 (P > 0.05).</p><p><b>CONCLUSION</b>CTN-Vero-RV was safe and effective as well as could generate a persistent immune response.</p>

Study on the feasibility of a cell-culture inoculation test in the detection and isolation of street rabies virus / 中华流行病学杂志

Objective Feasibility of using MNA cell-culture inoculation test to detect and isolate the street rabies virus. Methods Using MNA cell-culture inoculation test, fluorescent antibody test (FAT) and sandwich ELISA with double-antibodies to detect 33 specimens of street rabies virus, 20 specimens of negative canine brains and 4 specimens of healthy mice brains. Results 33 specimens of street rabies virus were positive to the cell-culture inoculation test but the others were negative. The concordances of MNA cell-cultured inoculation test with FAT and sandwich ELISA with double-antibodies were both 100%. Conclusion MNA cell-culture inoculation test appeared to be both highly sensitive and specific in detecting the street rabies virus, and could be used in detection and isolation of the virus.

Effect of organophosphate-induced acute neuronal damage in rats / 中华神经医学杂志

Objective To evaluate the neuronal injury induced by organophosphorus(OP) compound exposurein rats andinvestigate andthepossible mechanisms. Methods Eighteen SD rats were randomly divided into OP groups(n=12)and the control group(n=6).SD rats were given intramuscular sarin inection followed 1 min later by intraperitoneal injection of atropine sulphate and pralidoxime,and the rats with typical toxic reactions were used for subsequent experiment.The rats in the control group received normal saline injections in identical manners.Twenty-four hours later,the brain tissue of the rats were taken for HE staining and neuronal nuclei antigen(NeuN)immunohistochemistry to quantitatively assess the neuronal damages in the pyriform cortex,hippocampus CAl and striatum.Results HE staining showed massive degeneration of the neurons in the pyriform cortex,hippocampus CAland striatum of rats with satin injection.Compared to the rats with saline injections,the rats exposed to satin presented with significantly decreased number of NeuN-positive neurons(P<0.05).Conclusion OP Can induce acute neuronal death in rat brain and cause a series of symptoms in the central nervous system,probably by such noncholinergic mechanisms as glutamic acid-induced eytotoxieity and oxidative stress.

Production and Characterization of Monoclonal Antibodies of Shrimp White Spot Syndrome Virus Envelope Protein VP28 / 中国病毒学

BALB/c mice were immunized with purified White spot syndrome virus (WSSV).Six monoclonal antibody cell lines were selected by ELISA with VP28 protein expressed in E.coll in vitro neutralization experiments showed that 4 of them could inhibit the virus infection in crayfish.Westernblot suggested that all these monoclonal antibodies were against the conformational structure of VP28.The monoclonal antibody 7B4 was labeled with colloidal gold particles and used to locate the VP28 on virus envelope by immunogold labeling.These monoclonal antibodies could be used to develop immunological diagnosis methods for WSSV infection.

Molecular Epidemiology and Sequencing of the G-L Intergenic Region of Rabies Viruses Isolated in China / 中国病毒学

A group of 25 rabies viruses (RABVs),recovered from 24 dogs and one human case,were collected from various areas in China between 2004 and 2006.Genetic and phylogenetic analyses of the G-L intergenic region were carried out in 25 street RABV isolates and CTN vaccine strains of 7 generations.The study was based on the comparison of a 519 bp nucleotide sequence,encompassing the G-L intergenic region.The nucleotide sequence homologies of Chinese street strains were from 95.5% to 100%.The phylogenetic analysis showed that all Chinese isolates clearly supported the placement of all Chinese viruses in Lyssavirus genotype 1 and they were distributed according to their geographical origins.All of the Chinese strains were closely related but they could still be divided into two groups:group of street strains and group of CTN strains.This study presents details about the molecular epidemiology of rabies viruses based on the sequences of the G-L Intergenic region.

Application of immunofluorescence and sandwich ELISA with double-antibodies in detection of human rabies / 法医学杂志

OBJECTIVE@#To explore the application of immunofluorescence and sandwich ELISA with double-antibodies in detection of human rabies.@*METHODS@#The cerebrum, cerebellum, brainstem, and hippocampus of four patients died of rabies identified by clinical diagnosis were collected and kept in freezer at -70 degrees C or in formaldehyde solution separately. The rat brain tissue infected by CVS strain of rabies virus was used as a positive control and the brain tissue of a patient died of acute pancreatitis was used as a negative control.@*RESULTS@#Rabies virus was detected in the tissues kept in freezer at -70 degrees C and the positive control but was not detected in the tissues kept in formaldehyde solution and the negative control.@*CONCLUSION@#Immunofluorescence and Sandwich ELISA with double-antibodies could be used in detection of human rabies. The samples should be kept in deep frozen temperature condition instead of in formaldehyde solution.

An epidemiological study of rabies virus in domestic dogs, cats and wildlife and the immunogenicity study for rabies vaccines derived from different cell cultured virus strains / 病毒学报

For epidemiological investigation of the rabies virus carrier rates of domestic dogs, cats and wild animals like rodent animals and bats,three kinds of regions where rabies had higher incidence (Hunan and Guizhou Provinces), lower incidence (Jiangsu Province, Wuhan City) and provisionally rabies-free (Shenyang City) were selected. Then the antigenic types, the genovariation of the isolaled viruses and the currently vaccine matching of the virus strains were analyzed. The results showed that in China the principal host of rabies is dog,the total virus carrier rate of the captured dogs was 2.56%, and the highest positive isolation rate was 20.0% in some monitoring site. However,there was no evidence about the rabies virus carrier rate in rodent animals,bats or other wild animals. The rabies vaccines which prepared from aG and CTN strains have already been produced successfully in China. The research showed that the nucleotide sequences of the newly isolated viruses were more similar with the glycoprotein gene of CTN strain. In order to evaluate the safety and the efficacy of the vaccines currently used, two groups (50 people each) were injected with vaccine of aG strain and CTN strain respectively in five surveillance points. The neutralizing antibody tested were 0.49 IU/mL-0.52 IU/mL and 6.7 IU/mL-7.53 IU/mL after the 7 and the 14 days of vaccine injection respectively. In addition, the rates of antibody positive seroconversion were 45.1%-47.9% and 100% respectively, and there was no moderate or severe adverse reactions observed. These data showed the vaccines have satisfactory effect on safety and protection.

Cerebral Small Vessel Disease / 国际脑血管病杂志

Small vessel disease (SVD) of the cerebral white and central grey matter is an important subtype of vascular dementia (VD).SVD-dementia is characterized by a dysexecutive type of cognitive impairment,neurological deficits including imbalance and voiding dysfunction,and emotional disturbances.SVD is also frequent among clinically healthy subjects and patients with mild cognitive impairment.It is easily visualized by imaging techniques,but difficult to distinguish from mixed SVD/ Alzheimer Disease.This article reviews the recent progress in research on SVD and the problems have to be resolved.

Application of McAbs against rabies nucleocapsid in diagnosis of rabies street virus / 中华流行病学杂志

<p><b>OBJECTIVE</b>McAbs against rabies nucleocapsid were used to detect rabies street viruses in animal brain specimens with indirect immunofluorescent assay to evaluate the sensitivity and specificity of this assay.</p><p><b>METHODS</b>62 specimen from rabid animal brains including genotype 1 to 7 and 271 specimens from different normal animal brains collected in Pasteur Institute in 2003 were tested and compared, using indirect immunofluorescent assay. All these specimens were identified and compared using rapid rabies enzyme immunodiagnosis, fluorescent antibody test and rabies virus isolation assay in neuroblastoma cell culture which were all provided by Pasteur Institute.</p><p><b>RESULTS</b>Both sensitivity and the specificity of the indirect immunofluorescent assay were 100%.</p><p><b>CONCLUSION</b>The results showed a positive of rabies virus detection with these methods.</p>

Effect of noninvasive intranasal delivery of nerve growth factor on pyriform cortex of sarin-poisioned rats / 中华神经科杂志

Objective To study the effect of intranasal(IN)delivery of nerve growth factor(NGF) on pyriform cortex of satin-poisoned rats.Methods Sprague-Dawley rats were treated with satin and atropine sulphate, pralidoxime to establish satin-poisoned rat model.Then NGF or saline was administered via the olfactory pathway.24 hours later, damaged and residual healthy neurons were estimated and quantified on pyriform cortex using hematoxylin-eosin(HE)staining and neuronal nuclei antigen(NeuN) immunohistochemistry.Results A massive quantity of degenerating neurons were seen in the pyriform cortex of rats with intranasal saline.And compared to the normal rats, the number of neurons of rats with intranasal saline was significantly reduced by 39.44% [(404.75?25.17)/mm~2].But the number of neurons in rats with intranasal NGF [(651.94?36.02)/mm~2] didn't change significantly compared to the normal rats.Conclusion Intranasal delivery of NGF, reducing the degenerating neurons on pyriform cortex of satin-exposure rats, is a potential treatment for satin intoxication.

Comparison of Different Methods Used in Detection of Respiratory Syncytial Virus / 实用儿科临床杂志

Objective To select more rapid,sensitive and specific method in detection of respiratory syncytial virus(RSV)directly from clinical specimens.Methods RSV was detected by virus isolation in tissue culture,direct smears and detection by indirect immunofluorecence assay(IFA),rapid culture assay,sandwich enzyme linked immunosorbent assay(ELISA)as well as labbed streptavidin biotin method(LSAB)from 45 specimens(nasopharyngeal aspirates,NPAs) collected from infants and young children with acute lower respiratory tract infection.Results Of 45 NPAs,12 cases(26.7%) were positive by virus isolation,14 cases(31.1%) were positive for RSV by direct detection of RSV antigen by IFA,20 cases(44.4%) were positive with rapid culture assay,4 cases(8.9%)were positive by sandwich ELISA,4 cases(8.9%)were positive by LSAB.Conclusion Rapid culture assay and direct detection of RSV in NPAs direct smears by IFA are rapid,sensitive method in the diagnosis of RSV infections.