Polysomnography and Neuropsychological Analysis of Patients With Post-Traumatic Stress Disorder Two Years After the COVID-19 Pandemic in Wuhan.

OBJECTIVE: We used polysomnography (PSG) monitoring and neuropsychological scales to explore the characteristics of coronavirus disease-2019 (COVID-19) patients diagnosed with post-traumatic stress disorder (PTSD) in Wuhan, two years after the onset of the COVID-19 pandemic. METHODS: A total of 42 patients in the Sleep Medicine Center were diagnosed with insomnia between December 2021 and May 2022; they were divided into the PTSD group (patients with PTSD diagnosed with insomnia after COVID-19 infection) and the non-PTSD group (patients with insomnia without PTSD). A healthy control group was simultaneously included. RESULTS: The PTSD group was more significant than the non-PTSD group in partial manifestations of sleep disorders, neuropsychological clinical symptoms, and partial PSG data. Patients with different COVID-19 subtypes showed significant differences in the course of disease, sleep disorders, neuropsychological clinical symptoms, relevant scale scores, and PSG data analysis. CONCLUSION: The emotional anxiety and depression of COVID-19 patients diagnosed with PTSD two years after the COVID-19 pandemic in Wuhan are more significant, and will not be self-alleviated with the passage of time. It is necessary to continue to pay attention to the PTSD symptoms and sleep psychology of COVID-19 infected patients, and take appropriate measures. Patients with severe and critical COVID-19 have more severe sleep and mental disorders, and there is a significant correlation between the duration of the disease and the severity of mental and mental disorders and sleep disorders after recovery.

Psychological impact on COVID-19 patients during the outbreak in China: A case-control study.

BACKGROUND: The coronavirus disease 2019 (COVID-19) has caused widespread panic due to its highly infectious and pandemic transmission. We aimed to evaluate the psychological impact of the COVID-19 outbreak on infected subjects in China. METHODS: This case-control, survey-based study assessed the psychological status of COVID-19 patients and non-infected controls from February 10 to March 18, 2020, in China. Sex, age, education years, marital status, jobs, annual household income, living status, and geographic origin were matched between the two groups. The main outcome measures included anxiety, depression, insomnia, help-seeking behaviors, and treatment for mental problems. RESULTS: A total of 326 patients and 1304 (1:4 ratio) matched non-infected controls were enrolled. Compared with controls, patients had higher scores on the Beck Anxiety Inventory (BAI), Patient Health Questionnaire-9 (PHQ-9), and Insomnia Severity Index (ISI) (all p<0.01). Patients had higher rate of any mental problems (62.6% vs 42.5%, p<0.01), anxiety (27.3% vs 12.2%, p<0.01), depression (26.7% vs 14.6%, p<0.01), suicidal ideation (16.0% vs 10.7%, p<0.01), and insomnia (57.7% vs 36.7%, p<0.01). Among the subjects with mental problems, the proportion of seeking help (15.2% vs 6.9%, p<0.01) and receiving treatment (11.3% vs 4.3%, p<0.01) was higher in patients than controls. CONCLUSIONS: Our study showed a higher prevalence of mental problems in COVID-19 patients compared to controls, suggesting a great psychological impact of COVID-19 infection. Our findings highlighted the urgent need for psychological assistance for COVID-19 patients.

Clinical characteristics and endovascular treatment in patients with intracranial giant serpentine aneurysms.

BACKGROUND: Giant serpentine aneurysms (GSAs) are a rare subtype of intracranial aneurysm. Recently, GSAs have been successfully treated with endovascular parent artery occlusion with or without distal bypass. The present study retrospectively analyzed the clinical outcomes of endovascular parent artery occlusion for intracranial GSAs. METHODS: Medical records and cerebral angiograms from our endovascular center were retrospectively analyzed. Twenty-two patients with serpentine aneurysms were treated with endovascular occlusion of the parent artery at the site of the aneurysm. These patients had selective treatment. Clinical and angiographic outcomes of the patients were assessed between the 3-month to 3-year stage. RESULTS: The clinical manifestations of GSA included headache, hemiparesis, SAH, epilepsy, memory loss, right oculomotor palsy, and intracerebral hemorrhage. No cerebral infarction occurred. The average Glasgow Outcome Scale (GOS) score was 5. There were no clinical complications and none of the patients had recurrence after selective embolization. All of the patients recovered well, and no recurrence or rebleeding was noted at the follow-up. CONCLUSIONS: Endovascular parent artery occlusion may be a safe and effective way to treat intracranial GSAs.

Adiponectin-Transfected Endothelial Progenitor Cells Have Protective Effects After 2-Hour Middle-Cerebral Artery Occlusion in Rats With Type 2 Diabetes Mellitus.

Objectives: This present study aimed to examine the effects of adiponectin-transfected endothelial progenitor cells (LV-APN-EPCs) on cerebral ischemia-reperfusion injury in rats with type 2 diabetes mellitus (T2DM) and to explore the underlying mechanisms. Methods: Seventy male Sprague-Dawley rats with T2DM were randomly divided into sham, phosphate-buffered saline (PBS), LV-APN-EPCs, LV-EPCs, and EPCs groups. Transient middle cerebral artery occlusion (MCAO) was induced by the intraluminal suture method. After 1 h of reperfusion, the five interventions were performed by tail-vein injections. The modified neurological severity score (mNSS) was used to assess neurological function before and on days 1, 7, and 14 after MCAO. After 14 days, magnetic resonance imaging scanning, hematoxylin and eosin staining, terminal dUTP nick-end labeling staining, Western blotting analysis, cluster of differentiation (CD) 31 immunofluorescence, and enzyme-linked immunosorbent assay were used to evaluate infarct rate, morphological damage, cell apoptosis, and microvessel density. Results: Compared with PBS, LV-EPCs, and EPCs groups, the LV-APN-EPCs group showed significantly lower mNSS score, lower infarct rate, and less morphological damage (all P < 0.05). In addition, compared with other groups, the LV-APN-EPCs group had significantly increased levels of B cell lymphoma/leukemia-2 (Bcl-2) protein, CD31+ microvessels, endothelial nitric oxide synthase, and vascular endothelial growth factor, and decreased levels of Bcl-2-associated X protein and neuronal apoptosis in the peri-infarct cortex (all P < 0.05). Conclusion: These results suggest that LV-APN-EPCs exert protective effects against cerebral ischemia-reperfusion injury in T2DM rats by increasing angiogenesis.

Application of microlecture teaching methods in standardized residency training during COVID-19 in Wuhan: a randomized, controlled study.

BACKGROUND: Providing high-quality training to residency students during the coronavirus 2019 (COVID-19) pandemic has been a goal of our institution. Since 2108, we began to take microlectures to students teaching. Microlectures are online presentations, and the microlecture teaching method has many advantages, such as a short teaching time, situational resource composition, diverse communication, strong pertinence and can attend microlectures from home. The aim of the present study was to evaluate the advantages of the microlecture teaching method on students in standardized residency training. METHODS: Students from our department were randomly divided into the traditional teaching group (control group) and the microlecture teaching group (observation group). The teaching duration for both groups was 3 months. All students were assessed on basic knowledge of the neurology before enrollment. After the teaching session, the students were assessed on teaching effect, theoretical operation, and clinical practice satisfaction. The students also evaluated the teachers, and the teachers evaluated the students. RESULTS: A total of 84 students participated in the study and were divided equally into the observation group (42 students) and the control group (42 students). The results showed that the rate of reaching the standard of teaching effect, achievement of theory and operation, satisfaction with clinical practice, the student's grades by teachers, and student satisfaction with teachers were significantly higher in the observation group than in the control group (all P<0.05). CONCLUSIONS: The microlecture teaching method can effectively improve the clinical teaching effect for neurology students and should be adopted in clinical teaching, especially during the COVID-19 pandemic.

Neurocognitive improvement after angioplasty in patients with chronic middle cerebral artery stenosis and cerebral ischemia.

BACKGROUND: The use of middle cerebral artery (MCA) angioplasty compared with drug therapy has been controversial. Few studies have reported the correlations between cognitive function improvement and MCA angioplasty. This study aimed to explore neurocognitive function after angioplasty in patients with middle cerebral artery stenosis (MCAS) and objective cerebral ischemia. METHODS: We identified 14 patients diagnosed with MCAS aged 45-65 years. Neurocognitive function evaluation was performed by 2 independent clinical psychologists using the Mini-Mental State Examination (MMSE), Montreal cognitive assessment scale (MoCA), and Multi-Dimensional Psychology. All patients received general anesthesia, underwent diagnostic cerebral angiography (DSA) via the femoral route and angioplasty, and then were sent to the neurologic intensive care unit (NICU) for overnight hemodynamic and neurologic monitoring. Aspirin and clopidogrel treatments were continued for 3 months after successful intervention. Complete neurologic examinations, including assessment with the National Institutes of Health Stroke (NIHSS), and modulate RANK score (MRS) were conducted by 2 independent neurologists. The patients received a family follow-up at 1 week, 1 month, and 3 months after the interventional procedure. Neurologic sequelae, intracranial hemorrhages, and deaths were recorded as an endpoint. Follow-up clinical and imageological examinations were scheduled at 6 months after the intervention. Follow-up brain computed tomography (CT) perfusion or magnetic resonance angiography (MRA) perfusion scans performed by 2 imageological scanners were scheduled 6 months after the procedure. RESULTS: Angioplasty technical success was achieved in 14 parents (100%). We found that 10 patients did not have recurrent MCAS in the angioplasty site and had significant improvements in the associated brain perfusion situation and cognitive founction as compared before and after angioplasty. Also, 4 patients had evident restenosis in the angioplasty site. In the nonstenosis group, we found significant improvements in the MMSE, 3-dimensional (3D) mental rotation, simple calculation, and spatial working memory. In the recurrent stenosis group, we found no statistically significant changes in cognitive function compared with the baseline and after a 6-month follow up. There were high correlations between the changes in perfusion and the changes in word and picture memory. There was a significant correlation between the change in perfusion with MMSE (-0.522), spatial working memory (0.655), and Raven's progressive matrices test (0.637); a moderate correlation with 3D rotation (0.413), and simple calculation (-0.359); and weak correlation with visual tracking (0.026) and MoCA (0.279). CONCLUSIONS: Angioplasty surgery significantly improves neurocognitive function in patients with middle cerebral artery stenosis (MCAS) and objective cerebral ischemia.

Pain characteristics in amyotrophic lateral sclerosis patients and its impact on quality of life: a prospective observational study in a northern city of China.

BACKGROUND: Pain in amyotrophic lateral sclerosis (ALS) has a considerable impact on the quality of life of both patients and their caregivers, and thus the identification and evaluation of pain characteristics in ALS should be addressed. However, due to the scarcity of research data, pain in ALS is still frequently underestimated and insufficiently treated. The aim of this study was to investigate the characteristics of pain in patients with ALS using standardized pain questionnaires. METHODS: Eighty-nine patients diagnosed with ALS were interviewed. Consecutive patients with peripheral neuropathy were used as control subjects and were matched to the ALS subjects by age and sex. Patient data including gender, age, the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) score, and the pain severity index (PSI) were collected. The characteristics between ALS and peripheral neuropathy, and between ALS patients with and without pain were compared. RESULTS: In all, 89 patients with ALS and 89 control subjects with peripheral neuropathy were included. There were no significant differences in sex ratio and age between the two groups. There were significantly more patients with pain symptoms in the ALS group (35/89, 39%) than in the peripheral neuropathy group (20/89, 22%). Quality of life was significantly affected in the ALS patients with pain (using ALS patients without pain as control subjects). CONCLUSIONS: The results suggested that pain was a significant symptom in patients with ALS and had a considerable impact on quality of life.

A new method of culturing rat bone marrow endothelial progenitor cells in vitro.

BACKGROUND: Endothelial progenitor cells (EPCs) play an important role in the re-endothelialization of ischemic cerebrovascular disease. However, the current acquisition method has some deficiencies. This study aimed to design a new and practical method for obtaining EPCs. METHODS: Bone marrow was obtained autologously from the right tibia of living rats. Briefly, the right tibia bone was carefully exposed and two holes (1 mm in diameter) were made in the tuberosity and lower one-third of the tibia, respectively. A PE-50 catheter and syringe (5 mL) were inserted through the holes to aspirate the bone marrow. Bone marrow mononuclear cells (BMMCs) were isolated by density-gradient centrifugation with Ficoll and counted. Adherent cell culture continued for 2 weeks, and the medium was replaced every 3 days. RESULTS: During the first days of culture, adherent cells formed a monolayer, consisting predominantly of small-sized cells. Single large cells with endothelial morphology were observed. On day 4, the nonadherent cells were removed, and the adherent cells were left for further culture. On day 6-7, a proliferating population of round cells formed clusters in the culture chamber, and morphological analysis revealed a homogeneous population of colony-forming units (CFUs). Large, flat cells with endothelial morphology sprouted from the CFUs, which had nearly disappeared by day 14 of culture. The adherent cells were positive for CD133 and vascular endothelial growth factor receptor 2 (VEGFR2), internalized acetylated low-density lipoprotein, and bound ulex europaeus-agglutinin-I, but were negative for CD45, which correlated with the endothelial morphology and ability to form capillaries of EPCs. CONCLUSIONS: Our results are direct evidence that mononuclear cells (MCS) from living rat bone marrow can be used to culture EPCs in vitro under certain culture conditions, providing a new method for the further study of autologous EPC transplantation.

Exogenous endothelial progenitor cells reached the deficient region of acute cerebral ischemia rats to improve functional recovery via Bcl-2.

BACKGROUND: As discovered in our previous study, autologous endothelial progenitor cells (EPCs) protect against acute focal ischemia rat via the promotion of angiogenesis. However, it is unknown whether the EPCs that reached the deficient region were transplanted ones or the products of other auto-conversion cells they had promoted. This study aimed to gather direct evidence for determining if exogenous transplanted EPCs directly participate in angiogenesis in ischemic areas and attempted to clarify the related mechanism. METHODS: First, EPCs were extracted in vitro from male rats, which were characterized by uptake of fluorescently labeled acetylated low-density lipoprotein (ac-LDL) intake and Ulex europaeus agglutinin (UEA-1) and subsequently introduced to middle cerebral artery occlusion (MCAO) female rats for 7 days after ischemia surgery. The EPC-treated animals received approximately 1×106 cells, while the control animals received phosphate buffered saline (PBS). The animals behavior function recovery were by a rotarod (TOR) test, while infarct volume was assessed by brain magnetic resonance imaging (MRI). CD31 antibody was used to determine the presence of EPCs in the ischemic zone, and sex-determining region Y (SRY) gene in-situ hybridization (ISH) traced the EPC process. In addition, immunohistochemistry and Western blot were used to assess B-cell lymphoma 2 (Bcl-2) expression in the ischemic brain. RESULTS: Behavior tests and MRI of all ischemic stroke groups on postoperative day 14 indicated that EPCs were more effective in behavior function recovery and reducing infarct volume and gliosis status than the control group. Cluster of differentiation (CD31) immunofluorescent staining and SRY gene ISH demonstrated that EPCs yielded a better outcome in both angiogenesis and exogenous cell homing status. We also observed increased Bcl-2 distribution and higher plasma Bcl-2 levels in the EPC-treated group compared to the control group. CONCLUSIONS: Our results provide direct evidence that exogenous EPCs can participate in angiogenesis to improve neurological outcome and revascularization directly after stroke, with Bcl-2 playing an important role in this process.

MicroRNA-126 promotes endothelial progenitor cell proliferation and migration ability via the Notch pathway.

BACKGROUND: Effective regulation of the biological function of endothelial progenitor cells (EPCs) is of great importance in its clinical application. This study aimed to explore the effect of microRNA-126 (miR-126) on the proliferation and migration of EPCs and the possible mechanism involved. METHODS: EPCs was isolated and cultured in vitro, and differences in the expression of miR-126 in endothelial cells (ECs) and EPCs, respectively, were detected by quantitative real-time PCR (RT-PCR). EPCs proliferation was then observed through CCK8 and colony formation experiments. Flow cytometry was also used to observe changes in the cycle and apoptosis of EPCs, and their migration ability was detected by scratch healing and Transwell assays. RT-PCR and Western blotting were carried out to observe the expression of key mRNA molecules and proteins of the Notch pathway. RESULTS: The relative expression of miR-126 in the EPCs group were 1.91±0.21, which was significantly higher than that in the EC group (1.25±0.06, P<0.05). When si-miR-126 and si-NC were transfected into the EPCs, it was found that the proliferation ability of cells in the si-miR-126 group decreased significantly (P<0.05), the apoptotic rate of the cells transfected with si-miR-126 was significantly increased, and the cell cycle was blocked at G0/G1 phase. RT-PCR and Western blotting demonstrated that the mRNA and protein expressions of Notch 1 and HES were significantly decreased in the si-miR-126 group. CONCLUSIONS: miR-126 can effectively promote the proliferation, invasion, and migration of EPCS, while inhibiting apoptosis, through the Notch1 pathway.

Association between red blood cell distribution width and white matter hyperintensities: A large-scale cross-sectional study.

BACKGROUND: Red blood cell distribution width (RDW) is a strong prognostic marker for various medical conditions, such as ischemic strokes. However, the relationships between higher RDW and the subtypes of white matter hyperintensities (WMHs) remain unclear. Hence, this study aimed to thoroughly evaluate the relationships between RDW and the subtypes of WMHs. PATIENTS AND METHODS: This cross-sectional study was a retrospective analysis of hospital database (Dongguan Medical System, from April 2015 to February 2017). The presence and subtypes of WMHs were evaluated using Fazekas score with the T2WI-FLAIR brain images from a 1.5-T MRI system. The overall sample was randomly split in half. One of the two split-half samples was used for determining the optimal cutoff value of higher RDW and another for further statistical analyses. RESULTS: A total of 555 subjects with WMHs and 642 controls were recruited. The optimal cutoff value of higher RDW was 13.25%. Logistic regression revealed that higher RDW (≥13.25%) was positively associated with periventricular WMHs (adjusted OR = 1.81, 95% CI: 1.16-2.82, p = .009). However, higher RDW was not associated with total WMHs (adjusted OR = 1.52, 95% CI: 0.99-2.33, p = .057) and deep WMHs (adjusted OR = 1.21, 95% CI: 0.76-1.94, p = .426). CONCLUSION: Our findings suggested that higher RDW may be independently associated with periventricular WMHs, but not with total WMHs and deep WMHs.

2019 novel coronavirus pneumonia with onset of dizziness: a case report.

The 2019 novel coronavirus (2019-nCoV) epidemic continues, with the number of infections and deaths increasing. The respiratory tract is the main route of transmission of the virus, and the majority of symptoms are respiratory relative. Until now, there has been no reports concerning the nervous system onset. We present a 2019-nCoV patient with the onset of simple dizziness, accompanied by dry throat, no fever, no cough, no headache, no mental abnormality, and no obvious abnormality in the nuclear magnetic resonance imaging (MRI) of the head. Meanwhile, chest computed tomography (CT) scans showed multiple small spot shadows and interstitial changes in the early stage, especially in the extrapulmonary zone. There was a development of multiple ground-glass shadows and infiltrative shadows in both lungs with mild pleural effusion. The nucleic acid gene detection was positive, and thus the diagnosis of 2019-nCoV was confirmed. At last, the prognosis was good after active treatment. After antiviral and anti-infective treatment, the symptoms recovered. We presume that 2019-nCoV can also manifest in the nervous system alone, and lung CT, which has relative specificity, should be used as a routine screening method.

Edaravone reduces depression severity in patients with symptomatic intracranial stenosis and is associated with the serum expression of sex hormones.

OBJECTIVE: To investigate the effect of edaravone on depression relief in symptomatic patients with intracranial stenosis and its relationship with the expression of sex hormones. METHODS: We recruited 112 patients with symptomatic intracranial arterial stenosis from Renmin Hospital, Wuhan University, between October 2014 and October 2017. All patients were divided into the traditional or experimental (traditional treatment + intravenous infusion of edaravone 30 mg twice a day for 14 days) treatment groups. The general clinical data were collected, and neurological functional recovery using the Modified Rankin Scale (mRS) and National Institute of Health stroke scale (NIHSS) scores were recorded. Symptom Checklist 90 (SCL-90) was used to assess the general psychological changes of the patient, followed by the 24 Hamilton Depression Scale (HAMD) to examine the incidence of post-stroke depression (PSD). This divided the patients into the mild, moderate, and severe depression groups. Next, we measured the serum protein expression of the sex hormones estradiol (E2), testosterone (T), follicle stimulating hormone (FSH), prolactin (PRL), and luteinizing hormone (LH). RESULTS: The mRS and NIHSS scores were significantly lower in the experimental group than in the control group (P < .05). There was no significant difference in SCL90 score before intervention (P > .05); the scores were significantly lower in the experimental group after intervention (P < .05). There was a significant difference in SCL-90 and HAMD scores between groups before treatment (P < .05), with significantly lower scores in the experimental group post-treatment (P < .05). The incidence of depression was significantly reduced in the experimental group post-treatment. Furthermore, the expression of E2 and FSH was significantly higher (P < .01) and lower (P < .001), respectively, in women than in men in the experimental group post-treatment. Interestingly, the expression of T was significantly lower in men in the experimental group post-treatment (P < .001). CONCLUSION: Edaravone significantly improved the clinical efficacy of stent implantation in intracranial artery stenosis treatment by alleviating depression and reducing the incidence of PSD.

Wogonin improves functional neuroprotection for acute cerebral ischemia in rats by promoting angiogenesis via TGF-ß1.

BACKGROUND: Previous studies showed that wogonin is a potential candidate for more effective treatment of neuronal and inflammatory disease and could offer neuroprotective activity in various models, but all these studies were in vitro. Our research aimed to investigate the neuroprotective effect of wogonin on focal cerebral ischemia in rats and uncover its potential mechanism. METHODS: A total of 80 male SD rats were randomly divided into a sham operation group (Sham group, 20 rats), a normal saline group (NS group, 20 rats), and a wogonin intervention group (W2W group, 20 rats), while the remaining 20 rats were kept as a substitute. The model of focal cerebral ischemia (MCAO) was established by thread embolization. The neurological deficits were evaluated by the modified neurological deficit scale (mNSS). The laser confocal technique was used to observe the diameter, density, and total area of microvessel. Lastly, the expression of transforming growth factor-ß1 (TGF-ß1) was detected by Western blot. RESULTS: The mNSS scores of the NS group and Wn2W group were 6.57±1.13 and 4.39±0.92 respectively, and the difference between NS group and Wn2W group was statistically significant (P<0.05); the vascular diameter of the Wn2W group, Sham group, and NS group were 2.93±0.19, 4.24±0.16, and 3.56±0.22 µm respectively, and the differences among these groups were statistically significant (F=102.142, P<0.01). Furthermore, the differences in the vascular density (F=290.49, P<0.01) and total microvessel area (F=163.08, P<0.01) among these groups were also statistically significant. The expression of TGF-ß1 in ischemic brain tissue of the Sham group, NS group, and Wn2W group were 0.46±0.14, 0.62±0.18, and 0.94±0.21 respectively, and the differences among these groups were statistically significant (F=102.142, P<0.01). CONCLUSIONS: Wogonin can markedly reduce nerve injury and improve nerve function in rats with cerebral ischemia, which may be related to the TGF-ß1 pathway.

Endothelial progenitor cells improve functional recovery in focal cerebral ischemia of rat by promoting angiogenesis via VEGF.

To investigate the role of venous infusion of endothelial progenitor cells (EPCs) in the reendothelialization of acute focal cerebral ischemia model in rats. And explore the mechanism of VEGF to promote angiogenesis of functional recovery in focal cerebral ischemia of rat. A model of middle cerebral artery occlusion (MCAo) was used to mimic ischemia following EPCs extraction from the same donor rats. EPCs were characterized by CD34, CD45 and CD133 expressions, and confirmed by uptake of fluorescently labeled Dil-ac-LDL and FITC-UEA-1 and flow cytometry analysis. EPCs were expanded in vitro and injected into the jugular vein of the same donor animals daily for 5 days after ischemia surgery. EPC-treated animals received approximately 1 × 106 cells, while control animals received PBS. Animals were evaluated the functional recovery, endothelial cell proliferation, vascular distribution, and VEGF levels. The EPC-treated group showed lower infarct volume and a significant recovery of neurological function. We also observed increased vascular distribution through bromodeoxyuridine (BrdU) staining and high plasma VEGF levels in the EPC-treated group compared to control groups. Our results provided direct evidence that auto-graft EPCs can improve neurological outcome and revascularization after ischemic stroke and indicated an important role of VEGF in this process. Our study suggested that EPCs may have potential therapeutic applications for the ischemic cerebrovascular disease.

[The clinical characteristics of patients with vertebrobasilar dolichoectasia].

OBJECTIVE: To explore the clinical features of patients with vertebrobasilar dolichoectasia (VBD). METHODS: Patients diagnosed with posterior circulation ischemia in our hospital from October 2008 to January 2012 were consecutively collected and were divided into the VBD group and the non-VBD (NVBD) group. Clinical manifestations, risk factors, hemodynamic parameters and neuroimaging features were collected. RESULTS: (1) Statistical difference was observed in dyslipidemia, hypertension and the history of diabetes in the two groups (P < 0.05). (2) The cerebral hemodynamic features of the VBD patients were as the following: decreased peak systolic velocity of vertebral artery and basilar artery and decreased systolic/diastolic ratio. Statistical difference was showed in the average peak flow velocity (Vm), pulsatility index (PI) and resistance index (RI) (P = 0.036, 0.032, 0.032, respectively). (3) The main clinical manifestations of VBD were ischemic cerebrovascular disease, hemorrhagic cerebrovascular disease, oppression, brain damage symptoms and hydrocephalus. (4) The diagnosis in most of the VBD patients was confirmed by neural imaging and MRI was the first choice. CONCLUSION: The VBD patients have relative unique clinical features. MRI should be the first choice for neuroimaging.

Wogonin ameliorates lipotoxicity-induced apoptosis of cultured vascular smooth muscle cells via interfering with DAG-PKC pathway.

AIM: To investigate the effects of wogonin (5,7-dihydroxy-8-methoxyflavone) extracted from Scutellaria baicalensis Georgi (S baicalensis) on lipotoxicity-induced apoptosis of vascular smooth muscle cells (VSMCs) and the underlying mechanisms. METHODS: Cultured VSMCs were used. Apoptosis of VSMCs was induced by palmitate (0.75 mmol/L), and detected using TUNEL assay. The expression levels of protein and phosphorylated protein were measured using Western blot analysis. RESULTS: Treatment of VSMCs with wogonin (10, 25 and 50 µmol/L) significantly attenuated the apoptosis and endoplasmic reticulum (ER) stress induced by palmitate in concentration- and time-dependent manners. Wogonin (50 µmol/L) decreased palmitate-induced reactive oxygen species (ROS) generation. The ER stress inhibitor 4-phenyl butyric acid (5 mmol/L) significantly decreased palmitate-induced apoptotic cells, and occluded the anti-apoptotic effect of wogonin (25 µmol/L). Wogonin (10, 25 and 50 µmol/L) significantly reduced the intracellular diacylglycerol (DAG) accumulation and expression levels of phosphorylated PKCs in palmitate-treated VSMCs. CONCLUSION: Our results suggest that wogonin inhibits lipotoxicity-induced apoptosis of VSMCs via suppressing the intracellular DAG accumulation and subsequent inhibition of PKC phosphorylation. Wogonin has therapeutic potential for the prevention and treatment of atherosclerosis.