[A prospective cohort study on blood pressure control and risk of ischemic stroke in patients with hypertension].

Objective: To explore the association between blood pressure control and risk of ischemic stroke (IS) in patients with hypertension. Methods: A total of 5 488 patients with hypertension from 60 communities were randomly selected from 101 communities in 8 streets of Nanshan District in Shenzhen City by using two-stage sampling method. The social demographic characteristics, behavior and life style, coronary heart disease and diabetes were collected and the physical condition, blood pressure and blood biochemical indexes were measured. From April 1, 2010 to August 31, 2017 as the follow-up period, the incidence of IS was annually collected by using telephone survey. Cox proportional hazard regression model was used to analyze the relationship between blood pressure control, systolic blood pressure (SBP), diastolic blood pressure (DBP) and the risk of IS. Results: The age of all patients was (58.50±12.14) years old, including 2 712 males (49.42%) and 3 112 patients with well-controlled blood pressure (56.71%). During the follow-up period, 358 new cases of IS were confirmed, and the incidence density was 1 346.27/100 000 person-years. Cox proportional hazard regression model analysis showed after adjusting for confounding factors, unstable blood pressure control, SBP≥150 mmHg (1 mmHg=0.133 kPa; compared with SBP<120 mmHg), and DBP≥95 mmHg (compared with DBP<80 mmHg) were associated with risk of IS. The HR (95%CI) was 1.29 (1.04, 1.59), 2.00 (1.26, 3.17) and 1.52 (1.01, 2.64), respectively. Subgroup analyses showed these associations only existed in female patients with hypertension. The HR (95%CI) was 1.39 (1.05, 1.85), 2.53 (1.41, 4.56) and 1.73 (1.00, 3.36), respectively. Conclusion: Unstable blood pressure control increases the risk of IS in female patients with hypertension.

Apoptosis, proliferation, and morphology during vein graft remodeling in rabbits.

Neo-intima development and atherosclerosis limit the long-term use of vein grafts for revascularization of ischemic tissues. Recently, studies have confirmed that proliferating cell nuclear antigen (PCNA) plays an important role in cell proliferation. Our research confirmed that 28 days after vein transplantation, PCNA expression increases significantly. Using rabbits, rather than rodents, for a more representative model of human vein grafts, we aimed to establish a time course of changes in cell proliferation and apoptosis using morphometric and immunohistochemical analyses, western blot, terminal deoxynucleotidyl transferase dUTP nick end labeling, and transmission electron microscopy (TEM). The external jugular veins of 42 healthy purebred male New Zealand white rabbits were grafted onto their common carotid arteries. The rabbits were divided into seven groups, with vein grafts being harvested before surgery, and at 1, 3, 7, 14, 28, and 90 days afterwards. The extent of stenosis and apoptosis, PCNA protein levels, and TEM morphology were subsequently examined. Intimal thickness was slightly decreased 1 day following surgery, but then increased continuously until the 90th day. Western blot and immunohistochemistry both indicated lowered PCNA expression on day 1, although levels subsequently increased, peaking at 7 days post-surgery. After surgery, apoptosis was lowest on day 7, and remained low thereafter. TEM revealed signs of apoptosis as vein graft restenosis progressed. Proliferation and apoptosis co-occurred following grafting, indicating that both processes were involved in vein graft remodeling. Apoptosis levels were highest between days 1 and 3 after surgery, whereas proliferation culminated on the 7th day.

Intracranial ganglioglioma: clinicopathological and MRI findings in 16 patients.

AIM: To record the clinical findings and magnetic resonance imaging (MRI) characteristics of intracranial gangliogliomas in 16 patients. MATERIALS AND METHODS: Sixteen patients were imaged using unenhanced and contrast-enhanced MRI. Eight patients underwent unenhanced CT and of these, three underwent contrast-enhanced CT. Two radiologists read the images retrospectively. The images were studied with regard to location, size, margin, signal intensity, enhancement characteristics, cystic changes, and presence of calcifications. Clinical data, such as presenting signs and symptoms, physical findings, and medical histories, were collected. Histopathological and immunohistochemical studies were performed and analysed by two pathologists. RESULTS: In 12 cases the tumours were located in one of the cerebral hemispheres; in the other cases they were located in the brainstem, cerebellum, suprasellar area or the thalamus. The tumour dimension varied from 1-7 cm, with a mean of 3.6 cm+/-1.8 cm. The MRI features of ganglioglioma in the present cohort can be divided into three patterns: cystic (n=2), cystic-solid (n=6), and solid (n=8). Solid lesions had a predilection for the temporal lobe; cystic and cystic-solid tumours had a wide anatomical distribution. Cystic lesions were significantly smaller than both cystic-solid and solid lesions (F=4.28, P<0.05). Cystic changes in the cystic-solid tumours showed one of the following patterns: those with walls showing contrast enhancement, those containing an enhancing nodule, or cysts without an obvious wall. The solid portion of cystic-solid gangliogliomas and the entire tumour in solid tumours showed homogeneous enhancement of variable degrees on T1-weighted (T1W) spin-echo (SE) images. Five tumours had mild or moderate oedema. In one patient two separate gangliogliomas were found, each lesion exhibiting different MRI features: solid and cystic-solid. One case of cortical ganglioglioma was found, causing bone erosion due to pressure. One tumour with chronic haemorrhage was found in the study. CONCLUSION: MRI features of gangliogliomas are non-specific. A ganglioglioma should be suspected when a tumour shows the following features: (1) a solid lesion located in the temporal lobes with mild or no oedema and homogeneous enhancement on SE T1W images; or (2) a small cystic lesion or cystic-solid mixed mass with a wall enhancement or a markedly enhanced nodule. We report a patient with two separate gangliogliomas and a case with bone erosion.

Age-related changes in pumping mechanical behavior of rat ventricle in terms of systolic elastance and resistance.

Both the maximal systolic elastance (Emax) and the theoretical maximal flow (Qmax) can quantify the systolic mechanical behavior of the ventricular pump. Physically, Emax can reflect the intrinsic contractility of the myocardium as an intact heart. The quantity in (Qmax is inversely related to the internal resistance of the left ventricle. How great the effects of age are on these Emax and Qmax has never been examined, however. This study was to determine the ventricular pumping mechanics in terms of the systolic elastance and resistance in male Fischer rats at 6, 12, 18, and 24 months of age. We measured left ventricular (LV) pressure and ascending aortic flow waves using a high-fidelity pressure sensor and an electromagnetic flow probe, respectively. Those two parameters that characterize the systolic pumping mechanics of the left ventricle are obtained by making use of an elastance-resistance model. The basic hemodynamic condition in those animals with different ages is characterized by (i) no significant change in cardiac output and (ii) a decrease in basal heart rate, LV end-systolic pressure, as well as effective arterial volume elastance. Changes that take place in the left ventricle with age include a decline in Emax and an increase in Qmax especially at 24 months. These results demonstrate that the impaired intrinsic contractility of an aging heart may be compensated to some extent by the diminished ventricular internal resistance. Such compensation in aging rats may maintain normal blood flow essential for the metabolic needs of tissues and/or organs before heart dysfunction and failure occur.