Endothelial repairing function in patients with symptomatic middle cerebral arterial stenosis after stent implantation / 中华全科医师杂志

Objective To investigate the relation between endothelial repairing function and in-stent restenosis in patients with symptomatic middle cerebral arterial (MCA) stenosis after stent implantation.Method Sixty-six patients with symptomatic MCA stenosis underwent percutaneous stent implantation.Cranial CTA revealed that 23 patients had MCA restenosis (restenosis group) 1 year after stenting,including 14 cases with ＞50％ stenosis and 1 case with MCA occlusion,and 43 patients had no restenosis (non-restenosis group).The number of endothelial progenitor cells (EPC) was examined by flow cytometry,the adhesion function of EPC was tested by adhesion assay,the migration ability of EPC was tested by Transwell method and serum vascular endothelial growth factor (VEGF) levels were measured by ELISA.The relationship of endothelial repairing function with restenosis was analyzed.Results The MCA stent implantations were successfully performed in all patients.The EPC number (33.7 ± 4.6 vs.61.6 ± 6.4),adhesion activities (26.1 ± 7.5 vs.56.3-± 9.6),migration activities (12.0 ± 3.9 vs.21.4 ± 6.5) and serum VEGF level [(56.7 ± 14.6) vs.(89.6 ± 17.32) ng/L] in restenosis group were significantly lower than those in non-restenosis group (t =18.48,13.09,6.34 and 7.73,all P ＜ 0.05).Conclusion For patients with MCA stenosis after percutaneous stent implantation the increased risk of in-stent restenosis is associated with low level of EPCs and their migration ability,and low serum VEGF level.

The dynamic changes and clinical significance of serum P-selectin and C reactive protein in patients with cerebral infarction / 中国医师进修杂志

Objective To evaluate and explore the Patients with acute cerebral infarction P-selectin and C-reactive protein (CRP) clinical significance.Methods According to the degree of neurological deficit scores were divided into light group (38 cases),medium group (35 cases) and severe group (25 cases),30healthy subjects were selected as the control group,measured at different time levels of P-selectin and CRP.Results Light group,medium group,severe group admitted 24 h P-selectin levels were higher,the difference was statistically significant (P ＜ 0.05).Light group,medium group,severe group admission decreased after 3 d P-selectin levels were highest; mild group admitted 24 h,7 d P-selectin levels and medium-sized group and severe group differences were statistically significant (P ＜ 0.05).Light group,medium group,severe group admission 3 d P-selectin levels were statistically significant differences (P ＜ 0.05) among the three groups.Light group,medium group admitted 14 d P-selectin levels and heavy group differences were statistically significant (P ＜ 0.05).Light group,medium group,severe group admitted 24 h CRP levels were higher,the difference was statistically significant (P ＜ 0.05).Light group,medium group,severe group admitted 24 h,3 d,7 d,14 d CRP levels decreased,comparing the differences among the three groups were statistically significant (P ＜ 0.05) at the same time point.Linear correlation analysis showed that P-selectin hormone levels and CRP levels were positively correlated (r =0.493,P ＜ 0.05).Conclusions Serum P-selectin and C reactive protein may be involved in the pathological process of ACI.The changes of serum P-selectin and C reactive protein levels were contributed to judge severity of pathological changes,focus range and prognosis assessment.It is an important biochemical observational indicator,and it's worthy recommending in clinic.

Relationship between high sensitive C-reactive protein and stroke subtype according to Chinese Ischemic Stroke Subclassification criteria in patients with acute cerebral infarction / 中华全科医师杂志

By analyzing the clinical data of 216 cases of acute cerebral infarction (ACI) from 2012 January to 2013 June retrospectively,we found that the serum levels of high sensitive C-reactive protein (hs-CRP) in patients were significantly higher than those in 186 controls (P ＜0.01).The degree of neural function defect in ACI patients was assessed by the National Institutes of Health Stroke Scale (NIHSS) score.The hs-CRP level of the patients with NIHSS score ＞ 8 were higher than that in those with NIHSS score ≤8 (P ＜ 0.05).The hs-CRP level of patients of large artery atherosclerosis were (6.32 ± 4.12) mg/L and the positive rate of hs-CRP was 85.7％ (84/98).All were respectively higher than those in patients of penetrating artery disease [(1.97 ±0.86) mg/L,7/71],cardiogenic stroke [(3.70 ± 2.76) mg/L,14/24],undetermined etiology [(3.43 ± 3.52) mg/L,5/11] and other etiologies [(3.41 ± 3.25) mg/L,5/12] (all P ＜ 0.05).Logistic regression analysis was performed for the risk factors of ACI.The correlative factors of ACI included hypertension,diabetes mellitus,atrial fibrillation,smoking,total cholesterol,homocysteine and high sensitive C-reactive protein (OR =1.56,1.19,1.23,1.17,3.08,1.34,1.25,all P ＜ 0.01).The serum levels of hs-CRP increased significantly in ACI patients and were correlated with the degree of neural function defect.