Pinellia ternata attenuates carotid artery intimal hyperplasia and increases endothelial progenitor cell activity via the PI3K/Akt signalling pathway in wire-injured rats.

CONTEXT: Clinically, Pinellia ternata (Thunb.) Breit. (Araceae) (PT) has been widely used in the treatment of atherosclerosis and hyperlipidaemia, but the underlying mechanisms are still not clearly understood. OBJECTIVE: This research was conducted to confirm the mechanism by which PT affects carotid artery intimal hyperplasia. MATERIALS AND METHODS: An intestinal hyperplasia Sprague-Dawley rat model was established by carotid artery injury. The rats were randomly divided into five groups (n = 8): sham, model, PT (with daily intragastric administration of 10 g/mL/kg PT tubers water extract), PT+LY294002 (with intraperitoneal injection of 50 mg/kg LY294002 + 10 g/mL/kg PT) and endothelial progenitor cells (EPCs) (with injection of 5 × 105/cells), and treated for 4 or 8 weeks. RESULTS: HE staining showed that PT attenuated intimal hyperplasia. RT-PCR, Western blotting and immunohistochemistry showed that PT increased the expression of vascular endothelial growth factor (VEGF) and eNOS in the atherosclerotic carotid artery. PT increased the Dil-acLDL+/FITC-UEA-1+ population (from 0.41 ± 0.085% to 0.60 ± 0.092%) in the blood, decreased TCHO, TG, LDL-C, IL-6 and TNF-α levels, and increased HDL-C and IL-10 levels in the blood. However, these changes were reversed by the PI3K/Akt pathway inhibitor LY294002. DISCUSSION AND CONCLUSIONS: PT can be developed as an atherosclerosis and carotid intimal hyperplasia treatment drug. Therefore, further study will focus on the effects of PT on intimal hyperplasia in wire-injured atherosclerosis patients and explore in depth some other relevant molecular mechanisms.

Lifestyles correlate with stroke recurrence in Chinese inpatients with first-ever acute ischemic stroke.

OBJECTIVES: The previous studies have shown that recurrent stroke (RS) adversely affects the life of survivors of ischemic stroke (IS). However, lifestyle associated with RS has received a little systematic study in Chinese Han patients. We aimed to perform a comprehensive assessment of lifestyle and the potential risk factors associated with RS in Chinese Han inpatients with first-ever acute ischemic stroke by conducting a long-term follow-up. METHODS: Using a prospective and longitudinal design, we recruited 421 patients with first-ever acute ischemic stroke who were consecutively admitted to the Acute Stroke Unit between November 2012 and January 2014. Demographic data, vascular risk factors, previous Rankin scale score, and etiology were collected at study intake. Multivariable Cox regression model was used to investigate the influencing factors for RS. RESULTS: Fifty-seven (13.5%) patients experienced RS during the 1-year follow-up period. Multivariable Cox regression analysis revealed that smoking [hazard ratio (HR), 2.153; 95% confidence interval (CI), 1.263-3.671], high-density lipoprotein cholesterol (HDL) (HR 0.438; 95% CI 0.211-0.911), housework (HR 0.488; 95% CI 0.256-0.933), ischemic heart disease (IHD) (HR 2.998; 95% CI 1.281-7.020), daily consumption of fresh fruits (HR 0.477; 95% CI 0.278-0.819), and good sleep quality (HR 0.375; 95% CI 0.216-0.650) were associated with RS among stroke patients. CONCLUSIONS: Our results suggest that healthy lifestyle (high fruit intake, smoking cessation, housework, and good sleep quality), higher HDL levels, and lack of IHD may be associated with a lower risk of RS in patients with first-onset IS.

Early neurological deterioration in acute ischemic stroke: A propensity score analysis.

BACKGROUND: To investigate whether endovascular therapy (EVT) was one of the factors influencing the incidence of early neurological deterioration (END) in patients with acute ischemic stroke (AIS) as compared with intravenous thrombolysis alone. METHODS: This study was based on our single-center's database that included information on stroke patients hospitalised between January 2012 and September 2015. A total of 220 patients who underwent EVT after IV rt-PA, EVT or IV rt-PA alone. To reduce the lack of randomization, we conducted a propensity score analysis using the SPSS custom dialog. After matching was completed, the 2 groups (with END versus non-END) were compared between matched groups. Variables with a p value ≤ 0.1 by univariate analysis were candidates for inclusion in logistic regression analysis. RESULTS: Of 220 acute ischemic strokes attended, 213 patients were included (62.0%, 23.0% and 15.0% with circulation occlusion in the anterior, posterior and both branches, respectively). END was detected in 68 patients (31.9%). Multivariable analysis showed that END was positively associated with glucose level (OR, 1.40; 95%CI, 1.10-1.79; p = 0.007), uric acid level (OR, 1.01; 95% CI, 1.00-1.02; p = 0.026) and treatment methods (EVT: OR, 3.87; 95% CI, 1.32-11.35; p = 0.014). However, there was significant difference in baseline data (NIHSS and INR) between EVT group and non-EVT group. CONCLUSION: Our findings suggest that hyperglycemia, hyperuricemia and EVT may be independently associated with END in AIS, even after controlling for possible confound factors. Further studies are warranted to confirm these results.

Basilar artery atherosclerotic plaques distribution in symptomatic patients: a 3.0T high-resolution MRI study.

PURPOSE: To investigate basilar artery atherosclerotic plaque distribution characteristics in symptomatic patients using 3.0T high-resolution MRI. MATERIALS AND METHODS: Thirty-eight patients with recent ischemic strokes or transient ischemic attacks were included. Conventional angiographic luminal imaging of these patients showed at least 30% basilar artery stenosis. Patients then underwent basilar artery high-resolution MRI examinations (T2WI, T1WI and post-contrast enhanced T1WI in short axial and long axial views). The narrowest lumen plaque distribution was evaluated by cross-section division into four equal arcs (right, ventral, left and dorsal arcs) on the short axial T2-weighted images. The percent plaque fraction was calculated as arc plaque area/luminal area×100, with each compared by analysis. RESULTS: The basilar artery lumens and walls were clearly shown in all 38 patients. The median plaque area sizes were 2.73mm(2) (range: 1.04-5.29mm(2)) on the ventral wall, 0.59mm(2) (range: 0-1.50mm(2)) on the left wall, 0.87mm(2) (range: 0-2.68mm(2)) on the dorsal wall, and 0.36mm(2) (range: 0-1.80mm(2)) on the right wall. The mean plaque fraction percentages were 21.6% (range: 7.9-34.0%) on the ventral wall, 4.6% (range: 0-10.0%) on the left wall, 6.3% (range: 0-16.3%) on the dorsal wall, and 2.6% (range: 0-12.9%) on the right wall. On the ventral wall, the plaque fraction percentage was significantly greater than the remaining three arcs (P=.000). CONCLUSIONS: Basilar artery atherosclerotic plaques were mainly distributed at the ventral site of the artery. High-resolution MR examination may provide helpful information to minimize endovascular therapy risk complications in basilar artery atherosclerotic disease.

[Correlation of collateral circulation and prognosis in patients with acute cerebral infarction].

OBJECTIVE: To evaluate the correlation of collateral circulation with prognosis in patients with acute cerebral infarction. METHODS: A total of 260 patients with acute ischemic stroke within 1 week of symptom onset underwent digital subtraction angiogram (DSA). The National Institutes of Health Stroke Scale (NIHSS) scores were obtained at admission. And the Modified Rankin scores (mRS) were assessed at a 3-month follow-up. The follow-up data were acquired through clinic visits or telephone interviews. RESULTS: Among them, 86 were found to have intra- or extra-cranial culprit artery severe stenosis or occlusion. And 36 (75.00%) in 48 patients had collateral arterial circulation while 11 (28.64%) in 38 patients posterior circulation. There were statistical differences in the NIHSS scores at admission and favorite clinical outcome (mRS ≤ 2) at 3-month follow-up for patients with and without collateral circulation. CONCLUSION: DSA is the golden standard for the assessment of collateral circulation in patients with severe cerebral artery stenosis or occlusion. The prognosis is better in stroke patients with collateral circulation.