Endogenous FGF21 attenuates blood-brain barrier disruption in penumbra after delayed recanalization in MCAO rats through FGFR1/PI3K/Akt pathway / 中南大学学报(医学版)

OBJECTIVES@#Restoration of blood circulation within "time window" is the principal treating goal for treating acute ischemic stroke. Previous studies revealed that delayed recanalization might cause serious ischemia/reperfusion injury. However, plenty of evidences showed delayed recanalization improved neurological outcomes in acute ischemic stroke. This study aims to explore the role of delayed recanalization on blood-brain barrier (BBB) in the penumbra (surrounding ischemic core) and neurological outcomes after middle cerebral artery occlusion (MCAO).@*METHODS@#Recanalization was performed on the 3rd day after MCAO. BBB disruption was tested by Western blotting, Evans blue dye, and immunofluorescence staining. Infarct volume and neurological outcomes were evaluated on the 7th day after MCAO. The expression of fibroblast growth factor 21 (FGF21), fibroblast growth factor receptor 1 (FGFR1), phosphatidylinositol-3-kinase (PI3K), and serine/threonine kinase (Akt) in the penumbra were observed by immunofluorescence staining and/or Western blotting.@*RESULTS@#The extraversion of Evans blue, IgG, and albumin increased surrounding ischemic core after MCAO, but significantly decreased after recanalization. The expression of Claudin-5, Occludin, and zona occludens 1 (ZO-1) decreased surrounding ischemic core after MCAO, but significantly increased after recanalization. Infarct volume reduced and neurological outcomes improved following recanalization (on the 7th day after MCAO). The expressions of Claudin-5, Occludin, and ZO-1 decreased surrounding ischemic core following MCAO, which were up-regulated corresponding to the increases of FGF21, p-FGFR1, PI3K, and p-Akt after recanalization. Intra-cerebroventricular injection of FGFR1 inhibitor SU5402 down-regulated the expression of PI3K, p-Akt, Occludin, Claudin-5, and ZO-1 in the penumbra, which weakened the beneficial effects of recanalization on neurological outcomes after MCAO.@*CONCLUSIONS@#Delayed recanalization on the 3rd day after MCAO increases endogenous FGF21 in the penumbra and activates FGFR1/PI3K/Akt pathway, which attenuates BBB disruption in the penumbra and improves neurobehavior in MCAO rats.

Prediction scale of cerebrovascular disease subtypes for high-risk population / 中南大学学报(医学版)

Objective: Cerebrovascular disease can be roughly divided into 2 subtypes: Cerebral ischemia (CI) and cerebral hemorrhage (CH). No scale currently exist that can predict the subtypes of cerebrovascular diseases. This study aims to establish a prediction scale for the subtypes of cerebrovascular diseases. Methods:A total of 1200 cerebrovascular disease patients were included in this study, data from 1081 (90％) patients were used to establish the CI-CH risk scale, and data from 119 (10％) patients were used to test it. Risk factors for the CI-CH risk scale were identified by 2 screens, with two-tailed student ' s t-test and two-tailed Fisher ' s exact test preliminarily and with logistic regression analysis further. The scores of each risk factor for CI-CH risk scale were determined according to the odds rate, and the cut-off point was determined by Youden index. Results: Nine risk factors were ultimately selected for score system, including age (≥75 years old was ?1, <75 years old was 0), BMI (<24 kg/m2 was 0, 24?28 kg/m2 was ?1,>28 kg/m2 was?2), hypertension grade (grade 1 was 1, grade 2 was 2, and grade 3 was 3), diabetes status (no was 0, yes was?1), antihypertensive drug use (no was 0, yes was?2), alcohol consumption (<60 g/d was 1, ≥60 g/d was 2), uric acid (less than normal was 0, normal was?1, high than normal was?2), LDL cholesterol (<2 mmol/L was 0, 2?4 mmol/L was?1, and>4 mmol/L was?2), and HDL cholesterol (<1.55 mmol/L was 0,≥1.55 mmol/L was 2). Patients with a score more than 0 were classified as the CH group, Conversely, they were assigned to the CI group;its sensitivity, specificity, and accuracy were 74.5％, 77.9％, and 76.4％, respectively. Conclusion: The CI-CH risk scale can help the clinician predict the subtypes of cerebrovascular diseases.

Risk factors for female pelvic organ prolapse and urinary incontinence / 中南大学学报(医学版)

To explore the risk factors for and the pathogenic mechanisms of pelvic organ prolapse and urinary incontinence.
 Methods: A total of 2 668 females who completed pelvic floor functional detection from July 2014 to October 2015 in the Physical Examination Center of the Third Xiangya Hospital of Central South University. The patients were divide into 4 groups: an urinary incontinence group, an organ prolapse group, an organ prolapse with urinary incontinence group, and a normal group. We compared the age, BMI, menopause, gravidity and parity, delivery pattern, the coordination of pelvic floor and abdominal muscles among the 4 groups.
 Results: There were statistical differences in age and BMI values among the 4 groups (P0.05). In the mode of delivery, there were statistical difference among the normal group and the other 3 groups (P0.05). Among the 4 groups, the normal group was the best one in coordination between pelvic floor and abdominal muscles, following by the organ prolapse group, the pelvic organ prolapse group and the urinary incontinence group.
 Conclusion: Aging, menopause, number of pregnancies and delivery, BMI, and mode of delivery all affect the occurrence of pelvic organ prolapse and urinary incontinence. Females with urinary incontinence or organ prolapse are not good in coordination between the pelvic floor and abdominal muscles.

Efficacy of physical therapy for female sexual dysfunction / 中南大学学报(医学版)

To investigate the efficacy of manipulation combined with electrical stimulation and biofeedback on the treatment of female sexual dysfunction. 
 Methods: Seventy-two female patients with sexual dysfunction were recruited from the Third Xiangya Hospital of Central South University from January 2014 to December 2015. Subjects were randomly divided into three groups (A, B, and C). Patients in group A and group B received manipulation therapy and electrical stimulation biofeedback therapy, respectively, while patients in group C received manipulation combined with biofeedback electrical stimulation treatment for 30 days. The strength and fatigue degree of the type I and the type II muscle fiber of the pelvic muscles in all groups were evaluated before and one month after the treatment for further comparison. Questionnaire survey was used to investigate the frequency of sexual life and orgasm before and after treatment.
 Results: The strength and fatigue degree of patients in group C was significantly better than those of the other two groups (P<0.05).
 Conclusion: Manipulation therapy combined with electrical stimulation and biofeedback can effectively enhance the recovery of sexual dysfunction in postpartum women and improve the quality of sexual life for patients with postpartum sexual dysfunction. It therefore can be spread in clinical practice.

Expression profile of long non-coding RNA in non-alcoholic fatty liver disease / 中南大学学报(医学版)

Objective:To analyze the characteristics of long non-coding RNA (lncRNA) expression in nonalcoholic fatty liver disease (NAFLD).Methods:lncRNA-mRNA microarray was conducted on the liver tissue samples from 10 patients with simple gallbladder stone (5 NAFLD liver samples and 5 normal liver samples),and the differentially expressed lncRNA was analyzed by bioinformatics technology.Results:Compared with the normal liver samples,there were abnormal expression of 1 735 lncRNAs and 1 485 mRNAs in NAFLD liver samples.Among them,535 lncRNAs and 760 mRNAs were up-regulated,1 200 lncRNAs and 725 mRNAs were down-regulated.Conclusion:Compared with normal liver,the expression oflncRNA in NAFLD tissues is obviously abnormal.These lncRNAs may play an important role in the occurrence and development of NAFLD.

Effect of lumbrokinase on patients with acute and moderate risk pulmonary thromboembolism / 中南大学学报(医学版)

Objective:To explore the clinical efficacy and safety oflumbrokinase in the treatment of acute and moderate risk pulmonary thromboembolism.Methods:The clinical data of 60 patients with acute and moderate risk pulmonary thromboembolism,who were collected from January 2010 to October 2015 in Hunan Provincial People's Hospital,were retrospectively analyzed.According to the different treatments,60 patients were randomly divided into a lumbrokinase group (lumbrokinase in combination with low molecular heparin and sequential warfarin,n=30) and a control group (low molecular heparin and sequential warfarin,n=30).The clinical efficacy and safety were compared between the two groups.Results:Compared with the control group,maximum short axis,ratio of right and left ventricles,systolic pulmonary artery pressure,and the main pulmonary artery diameter in the lumbrokinase group were significant changed after the treatment for 10,20 and 30 d.NT-proBNP level in the lumbrokinase group after the treatment for 10,20 and 30 d was significantly reduced than that in the the control group (P＜0.05).However,the value of PO2 significantly increased after 10,20 and 30 d,and there was no significant difference between 20 d and 30 d (P＞0.05).D-dimer in the two groups was obviously increased after treatment for 10 d,but it was significantly reduced after treatment for 20 d or 30 d (P＜0.05).The clinical efficacy of the lumbrokinase group was better than that in the control group,with significant difference (P＜0.05).Conclusion:Combination of lumbrokinase with low molecular heparin and sequential warfarin is a safe and efficient strategy in treating the patients with acute and moderate risk pulmonary thromboembolism.It is worthy of clinical popularization and application.

Factors related to the length of hospital stay for cerebrovascular accident / 中南大学学报(医学版)

OBJECTIVE@#To explore the factors related to the length of hospital stay for cerebrovascular accident and to provide the basis for health administrative department to formulate measures, and for clinical department to develop treatment guidelines.@*METHODS@#We collected the medical record of the hospitalized cerebrovascular accident patients from 2008 to 2013 in the Third Xiangya Hospital, Central South University. The collected data included demographic information, disease characteristics, treatment information and health economics information. Then we analyzed the factors related to the length of hospital stay for cerebrovascular accident. SPSS 13.0 was used for statistical analysis and logistic regression and nonparametric rank sum test was performed.@*RESULTS@#The length of stay in hospital was from one day to 513 days, with a median of 10 days. The length of stay for women was shorter than that of men (OR=0.869). The length of stay for the older patients was longer than that of younger patients (OR=1.158). The length of stay for patients who implemented a surgery was 1.686 times longer than those who were not implemented a surgery (OR=1.686). The length of stay for ischemic cerebrovascular patients was shorter than that of the hemorrhagic cerebrovascular patients (OR=0.275). The patients with new rural cooperative medical insurance or without health insurance usually stayed a short time in hospital.@*CONCLUSION@#Sex, age, surgery, type of cerebrovascular accident and medicare type are the factors that affect the length of hospital stay for cerebrovascular accident.

Therapeutic effect of extracorporeal shock wave combined with orthopaedic insole on plantar fasciitis / 中南大学学报(医学版)

Objective: To observe the therapeutic effect of extracorporeal shock wave combined with orthopaedic insole on plantar fasciitis. Methods: A total of 153 plantar with plantar fasciitis were randomly divided into a combined group (n=51), an extracorporeal shock wave group (n=53) and an orthopaedic group (n=49). The combined group received treatment of both extracorporeal shock wave and orthopaedic insole while the extracorporeal shock wave or the orthopaedic group only received the treatment of extracorporeal shock wave or orthopaedic insole. The therapeutic parameters such as visual analogue scale (VAS) scores, continued walking time and thickness of the plantar fascia were monitored before and atf er the treatment for 2 weeks, 1 month and 3 months, respectively. Results: The VAS scores in the 3 groups were all reduced after the treatment compared with the corresponding scores before the therapy (P<0.05). hTe VAS score in the extracorporeal shock wave group was greater than that in the orthopedic group atfer the treatment for 2 weeks. hTe VAS score in the combined group was smaller than that in the orthopedic group atfer the treatment for 2 weeks and 3 months (P<0.05). hTe VAS scores in the orthopedic group and the combined group were smaller than those in the extracorporeal shock wave group after the treatment for 1 month or 3 months (P<0.05). The continued walking time and thickness of the plantar fascia was improved after the treatment (P<0.05). hTe cure rate and total effective rate in the combination group were obviously greater than those in the two other groups. hTe cure rate in the orthopedic group was greater than that in the extracorporeal shock wave group (P<0.05). Conclusion: Extracorporeal shock wave combined with orthopaedic insole therapy is an effective method to treat plantar fasciitis. It is recommended to spread in clinic.

Effect of PD-WEBB training on balance impairment and falls in people with Parkinson's disease / 中南大学学报(医学版)

OBJECTIVE@#To determine the effect of Parkinson's disease-weight bearing exercise for better balance (PD-WEBB) exercise on balance impairment and falls in people with Parkinson's disease (PD).@*METHODS@#A single-blind, randomized controlled clinical trial was conducted. The falls efficacy scale score, unified Parkinson disease rating scale (UPDRS) score and Mini-BESTest score were measured and compared between a PD-WEBB group and a control group.@*RESULTS@#The falls efficacy scale score, UPDRS-2 score, UPDRS-3 score and Mini-BESTest score were improved in the PD-WEBB group compared with the control group (P<0.05), with no significant change in UPDRS-1 score between the two groups.@*CONCLUSION@#PD-WEBB training can significantly improve the balance impairment and quality of life to prevent falls. PD-WEBB training is suitable for PD patients in China, and is a reasonable, effective and sustainable training of family and community assessment model.

Roles of periostin in proliferation and migration of vascular smooth muscle cells and the effect of atorvastatin on them / 中南大学学报(医学版)

OBJECTIVE@#To investigate the expression of periostin in in vitro cultured vascular smooth muscle cells (VSMCs) induced by TGF-β1 and the relationship between periostin expression and the migration and proliferation of the VSMCs. Further, to investigate the effects of atorvastatin on the above-mentioned processes and the molecular mechanisms of atorvastatin inhibition of TGF-β1- induced periostin production.@*METHODS@#Rat aorta smooth muscle cells were cultivated by the method of tissue explants adherence. Cells of generation 3 to 6 were used as the experimental system. Primary cultured rat vascular smooth muscle cells were treated by TGF-β1 and different concentrations of atorvastatin,Y-2763 (Rho kinase inhibitor), or atorvastatin plus MVA for 24 hours. The expression of periostin was measured by RT-PCR and Western blot. A Boyden chamber assay was used to measure cell migration, and an MTT test was used to measure cell proliferation.@*RESULTS@#Periostin expression in rat VSMCs stimulated by TGF-β1 increased significantly (4.158 ± 0.515 vs 0.385 ± 0.031), VSMC migration(25 ± 4 vs 8 ± 2) and proliferation (0.85 ± 0.06 vs 0.32 ± 0.03) also increased significantly. Atorvastatin significantly inhibited TGF-β1-induced periostin production in rat VSMCs, as well as VSMC migration and proliferation, in a dose-dependent manner. Rho kinase inhibitor Y-27632 significantly inhibited TGF-β1-induced periostin production in rat VSMCs (2.082 ± 0.245). The inhibitory effect of atorvastatin on periostin upregulation induced by TGF-β1 was reversed by mevalonate (3.838 ± 0.326).@*CONCLUSION@#Periostin can promote rat VSMC migration and proliferation. Atorvastatin inhibition of periostin expression induced by TGF-β1 in VSMCs may be exerted by inhibition of the production of MVA and other isoprene compounds and by blocking the Rho/Rho kinase signaling pathway.

Effect of pregnancy-associated plasma protein-A on the function of endothelial cells / 中南大学学报(医学版)

OBJECTIVE@#To determine the effect of pregnancy-associated plasma protein A (PAPP-A) on the function of vascular endothelial cells (VEC).@*METHODS@#Human umbilical vein endothelial cell (HUVEC) line, derived from human umbilical vein, was cultured in vitro with PAPP-A at 0, 50, 100, and 200 ng/mL for 0, 12, 24, and 48 hours, respectively. Nitric oxide (NO) levels and endothlin-1 (ET-1) levels were determined by spectrophotometer and immunehistory.@*RESULTS@#The NO levels of HUVECs in the PAPP-A groups were significantly lower than those in the control group (P<0.05). The ET-1 levels of HUVECs in the PAPP-A groups were significantly higher than those in the control group (P<0.05). The changes were all dose-dependent.@*CONCLUSION@#PAPP-A may affect the function of vascular endothelial cells by reducing the secretion of NO and increasing the level of ET-1.