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Stroke prevention: an update

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《医学前沿（英文）》 2012年 第6卷 第1期   页码 22-34 doi: 10.1007/s11684-012-0178-6

摘要：

Stroke is a personal, familial, and social disaster. It is the third cause of death worldwide, the first cause of acquired disability, the second cause of dementia, and its cost is astronomic. The burden of stroke is likely to increase given the aging of the population and the growing incidence of many vascular risk factors. Prevention of stroke includes—as for all other diseases—a “mass approach” aiming at decreasing the risk at the society level and an individual approach, aiming at reducing the risk in a given subject. The mass approach is primarily based on the identification and treatment of vascular risk factors and, if possible, in the implementation of protective factors. These measures are the basis of primary prevention but most of them have now been shown to be also effective in secondary prevention. The individual approach combines a vascular risk factor modification and various treatments addressing the specific subtypes of stroke, such as antiplatelet drugs for the prevention of cerebral infarction in large and small artery diseases of the brain, carotid endarterectomy or stenting for tight carotid artery stenosis, and oral anticoagulants for the prevention of cardiac emboli. There is a growing awareness of the huge evidence-to-practice gap that exists in stroke prevention largely due to socio-economic factors. Recent approaches include low cost intervention packages to reduce blood pressure and cheap “polypills” combining in a single tablet aspirin and several drugs to lower blood pressure and cholesterol. Polypill intake should however not lead to abandon the healthy life-style measures which remain the mainstay of stroke prevention.

关键词： stroke     prevention     vascular risk factors     cerebral infarction     cerebral hemorrhage     anti-thrombotic drugs     carotid endarterectomy    

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Predictive values of plasma TNFα and IL-8 for intracranial hemorrhage in patients with acute promyelocytic

《医学前沿（英文）》 2022年 第16卷 第6期   页码 909-918 doi: 10.1007/s11684-021-0890-1

摘要： In patients with acute promyelocytic leukemia (APL), intracranial hemorrhage (ICH), if not identified promptly, could be fatal. It is the leading cause of failure of induction and early death. Thus, biomarkers that could promptly predict severe complications are critical. Here, cytokine differences between patients with APL with and without ICH were investigated to develop predictive models for this complication. The initial cytokine profiling using plasma samples from 39 patients and 18 healthy donors found a series of cytokines that were remarkedly different between patients with APL and healthy controls. The APL patients were subsequently divided into high and low white blood cell count groups. Results showed that tumor necrosis factor α and interleukin 8 (IL-8) were vital in distinguishing patients with APL who did or did not develop ICH. In addition, verification in 81 patients with APL demonstrated that the two cytokines were positively correlated with the cumulative incidence of ICH. Finally, in-vitro and in-vivo experimental evidence were provided to show that IL-8 influenced the migration of APL-derived NB4 cells and impaired the blood–brain barrier in PML/RARα positive blast-transplanted FVB/NJ mice. These assessments may facilitate the early warning of ICH and reduce future mortality levels in APL.

关键词： acute promyelocytic leukemia     intracranial hemorrhage     cytokines     biomarker    

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Loss of monocarboxylate transporter 1 aggravates white matter injury after experimental subarachnoid hemorrhage

《医学前沿（英文）》 2021年 第15卷 第6期   页码 887-902 doi: 10.1007/s11684-021-0879-9

摘要： Monocarboxylic acid transporter 1 (MCT1) maintains axonal function by transferring lactic acid from oligodendrocytes to axons. Subarachnoid hemorrhage (SAH) induces white matter injury, but the involvement of MCT1 is unclear. In this study, the SAH model of adult male Sprague-Dawley rats was used to explore the role of MCT1 in white matter injury after SAH. At 48 h after SAH, oligodendrocyte MCT1 was significantly reduced, and the exogenous overexpression of MCT1 significantly improved white matter integrity and long-term cognitive function. Motor training after SAH significantly increased the number of ITPR2+SOX10+ oligodendrocytes and upregulated the level of MCT1, which was positively correlated with the behavioral ability of rats. In addition, miR-29b and miR-124 levels were significantly increased in SAH rats compared with non-SAH rats. Further intervention experiments showed that miR-29b and miR-124 could negatively regulate the level of MCT1. This study confirmed that the loss of MCT1 may be one of the mechanisms of white matter damage after SAH and may be caused by the negative regulation of miR-29b and miR-124. MCT1 may be involved in the neurological improvement of rehabilitation training after SAH.

关键词： microRNAs     monocarboxylate transporter 1     motor training     subarachnoid hemorrhage     white matter injury    

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Overexpression of netrin-1 improves neurological outcomes in mice following transient middle cerebral

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《医学前沿（英文）》 2011年 第5卷 第1期   页码 86-93 doi: 10.1007/s11684-011-0118-x

摘要：

Netrin-1 (NT-1) is one of the axon-guiding molecules that are critical for neuronal development. Because of its structural homology to the endothelial mitogens, NT-1 may have similar effects on vascular network formation. NT-1 was shown to be able to stimulate the proliferation and migration of human cerebral endothelial cells in vitro and also promote focal neovascularization in adult brain in vivo. In the present study, we reported the delivery of NT-1 using an adeno-associated virus (AAV) vector (AAV-NT-1) into mouse brain followed by transient middle cerebral artery occlusion (tMCAO). We found that AAV vectors did not elicit a detectable inflammatory response, cell loss or neuronal damage after brain transduction. The level of NT-1 was increased in the AAV-NT-1-transduced tMCAO mice compared with the control mice. Furthermore, the neurobehavioral outcomes were significantly improved in AAV-NT-1-transduced mice compared with the control animals (P<0.05) 7 days after tMCAO. Our data suggests that NT-1 plays a neuronal function recovery role in ischemic brain and that NT-1 gene transfer might present a valuable approach to treat brain ischemic disorders.

关键词： adeno-associated virus     angiogenesis     gene transfer     ischemia     middle cerebral artery occlusion     netrin-1    

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survival and neuronal differentiation of hypoxia-conditioned neuronal progenitor cells in rats with cerebral

Yao Yao, Rui Zhou, Rui Bai, Jing Wang, Mengjiao Tu, Jingjing Shi, Xiao He, Jinyun Zhou, Liu Feng, Yuanxue Gao, Fahuan Song, Feng Lan, Xingguo Liu, Mei Tian, Hong Zhang

《医学前沿（英文）》 2021年 第15卷 第3期   页码 472-485 doi: 10.1007/s11684-021-0832-y

摘要： Hypoxia conditioning could increase the survival of transplanted neuronal progenitor cells (NPCs) in rats with cerebral ischemia but could also hinder neuronal differentiation partly by suppressing mitochondrial metabolism. In this work, the mitochondrial metabolism of hypoxia-conditioned NPCs (hcNPCs) was upregulated via the additional administration of resveratrol, an herbal compound, to resolve the limitation of hypoxia conditioning on neuronal differentiation. Resveratrol was first applied during the neuronal differentiation of hcNPCs and concurrently promoted the differentiation, synaptogenesis, and functional development of neurons derived from hcNPCs and restored the mitochondrial metabolism. Furthermore, this herbal compound was used as an adjuvant during hcNPC transplantation in a photothrombotic stroke rat model. Resveratrol promoted neuronal differentiation and increased the long-term survival of transplanted hcNPCs. 18-fluorine fluorodeoxyglucose positron emission tomography and rotarod test showed that resveratrol and hcNPC transplantation synergistically improved the neurological and metabolic recovery of stroke rats. In conclusion, resveratrol promoted the neuronal differentiation and therapeutic efficiency of hcNPCs in stroke rats via restoring mitochondrial metabolism. This work suggested a novel approach to promote the clinical translation of NPC transplantation therapy.

关键词： neuronal progenitor cells     resveratrol     cerebral ischemia     neuronal differentiation     mitochondrial metabolism     positron emission tomography    

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Comparison of CT-guided aspiration to key hole craniotomy in the surgical treatment of spontaneous putaminal hemorrhage

ZHAO Jizong, WANG Dejiang, WANG Shuo, YUAN Ge, KANG Shuai, JI Nan, ZHAO Yuanli, YE Xun, ZHOU Liangfu, ZHOU Dingbiao, WANG Renzhi, WANG Mei

《医学前沿（英文）》 2007年 第1卷 第2期   页码 142-146 doi: 10.1007/s11684-007-0027-1

摘要： This study was designed to compare the approaches and efficacies of two different ways of neurosurgical management for spontaneous putaminal hemorrhage (SPH): computed tomographic-guided aspiration (CTGA) and the key-hole approach (KHA). The indications of the two approaches are also explored. From September 2001 to 2003, a total of 1077 cases of SPH distributed in 135 hospitals all over the mainland of China were included for analysis. All cases had three-month follow-up data. The study was designed in a single-blinded manner to compare the efficacies of the different approaches. There were 563 cases in the CTGA group, 165 in the KHA group, and 217 cases in the conventional open craniotomy (COC) group. In the CTGA and KHA groups, the mortalities at one month after operation (M1m) were 17.9% and 18.3%, respectively, while the mortalities at three months after operation (M3m) were 19.4% and 19.4%, respectively (>0.05). The postoperative complications due to CTGA (23.7%) were not significantly different from those due to KHA (25.7%) ( = 0.420). The M3m of patients with Glasgow coma scale (GCS) "d8 was 3.45 and 4.0 times as much as those with GCS>8, respectively. The M3m of patients with complications was 3.92 times as much as those without complications. The M3m of patients with hemorrhage volume "e70 mL was 2.67 times as much as those <70 mL. The CTGA is not better than KHA in the treatment of SPH in terms of a more favorable outcome or less mor tality and morbidity, but CTGA could be the first choice for those with bleeding volumes "d50mL, while KHA is the first choice for those with bleeding volumes >50 mL.

关键词： tomographic-guided aspiration     single-blinded manner     favorable outcome     operation     Glasgow    

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Epidemiology, pathogenesis, and management of coronavirus disease 2019-associated stroke

《医学前沿（英文）》 doi: 10.1007/s11684-023-1041-7

摘要： The coronavirus disease 2019 (COVID-19) epidemic has triggered a huge impact on healthcare, socioeconomics, and other aspects of the world over the past three years. An increasing number of studies have identified a complex relationship between COVID-19 and stroke, although active measures are being implemented to prevent disease transmission. Severe COVID-19 may be associated with an increased risk of stroke and increase the rates of disability and mortality, posing a serious challenge to acute stroke diagnosis, treatment, and care. This review aims to provide an update on the influence of COVID-19 itself or vaccines on stroke, including arterial stroke (ischemic stroke and hemorrhagic stroke) and venous stroke (cerebral venous thrombosis). Additionally, the neurovascular mechanisms involved in SARS-CoV-2 infection and the clinical characteristics of stroke in the COVID-19 setting are presented. Evidence on vaccinations, potential therapeutic approaches, and effective strategies for stroke management has been highlighted.

关键词： SARS-CoV-2     ischemic stroke     stroke     hemorrhagic stroke     cerebral venous thrombosis     vaccination    

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Implications of astrocytes in neurovascular coupling

You ZHOU MD, Chang-Kai SUN MD,

《医学前沿（英文）》 2010年 第4卷 第1期   页码 43-45 doi: 10.1007/s11684-010-0019-4

摘要： Normal brain function requires continuous supply of oxygen and glucose in a strict manner. The close spatial and temporal relationship between neural activity and cerebral blood flow (CBF) is termed as neurovascular coupling, which is dependent or not dependent on astrocytes. The increase in flow evoked by brain activity is mediated by the concerted action of multiple mediators that originate from different cells and act at different levels of the cerebral vasculature. More studies are needed for further understanding the precise mechanisms underlying neurovascular coupling, especially the implications of astrocytes.

关键词： cerebral blood flow     neurovascular coupling     astrocyte    

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Giant renal angiomyolipoma with tuberous sclerosis complex

Ouyan SHI PhD, Guodong XU BM, Chunxiang WANG BM,

《医学前沿（英文）》 2009年 第3卷 第4期   页码 495-498 doi: 10.1007/s11684-009-0068-8

摘要： Though rare, angiomyolipomas (AMLs) are the most common mesenchymal tumors of kidney. In general, AMLs can always be associated with two conditions affecting other organ systems: tuberous sclerosis complex (TSC) and sporadic lymphangioleiomyomatosis. This article presents a case of renal AML occurring in a 14-year-old girl with a definite diagnosis of TSC. She had been diagnosed with TSC at the age of three, and a schedule for close observation was disobeyed. At this time, she underwent a series of examinations: physical examination, ultrasonography, angiography, computed tomography (CT), and magnetic resonance imaging (MRI) scans. The physical examination showed adenoma sebaceum in a butterfly paranasal distribution, and a mass was palpated in the left upper quadrant. There were no neurological deficits. Imaging studies (including ultrasonography, angiography, CT, and MRI) of the abdomen showed a large heterogeneous mass arising from the left kidney. Partial nephrectomy was performed. The pathological diagnosis was hemorrhagic renal AML. No recurrence was found in the three-year follow-up. We concluded that schedule of close observation on patients with TSC should be strictly abided by for the high morbidity of AMLs. The specific risks of renal AMLs are spontaneous hemorrhage and rupture. Treatment options for AMLs include conservative and interventional (total/partial nephrectomy, cryoptherapy, and embolization) treatments.

关键词： renal angiomyolipoma     tuberous sclerosis complex     hemorrhage    

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电刺激小脑顶核与中枢神经源性神经保护

董为伟

《中国工程科学》 2001年 第3卷 第11期   页码 32-38

摘要：

电刺激小脑顶核为一种重要的条件性中枢神经源性神经保护途径，文章介绍了中枢神经源性神经保护及其机制，神经保护特点及所涉及的解剖部位；重点讨论电刺激小脑顶核对缺血性脑损伤的神经保护机理，并展望其临床应用及研究前景。

关键词： 神经保护     条件性     小脑顶核     电刺激     脑缺血    

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Leonurine protects ischemia-induced brain injury via modulating SOD, MDA and GABA levels

Shilei ZHENG, Jingru ZHU, Jiao LI, Shuang ZHANG, Yunfei MA

《农业科学与工程前沿（英文）》 2019年 第6卷 第2期   页码 197-205 doi: 10.15302/J-FASE-2018245

摘要：

The present study was designed to investigate the protective effects of leonurine, a compound purified from that is active on ischemic rat behavior and cortical neurons, and explore the underlying mechanism. The general rat activity, cortical neuron morphology, superoxide dismutase (SOD), malondialdehyde (MDA), -aminobutyric acid (GABA) and glutamate decarboxylase 67 (GAD67) levels were measured. We found leonurine significantly improve the general activity of rats in an open-field test, which was associated with attenuated neuronal damage induced by ischemia. Moreover, serum SOD activity was significantly greater, MDA level lower in the leonurine group as compared with ischemia group. In addition, GABA content in the cerebral cortex was significantly greater in high-dose leonurine group. Correspondingly, GAD67 protein level coincided with the GABA level. Taken together, our results demonstrated that leonurine attenuated brain injury during ischemia via antioxidative and anti-excitotoxicity effects by targeting GABA and leonurine might become a useful adjuvant neuroprotective agent.

关键词： cerebral ischemia     GABA     neuroprotection     leonurine     SOD    

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Cerebral regional and network characteristics in asthma patients: a resting-state fMRI study

Siyi Li, Peilin Lv, Min He, Wenjing Zhang, Jieke Liu, Yao Gong, Ting Wang, Qiyong Gong, Yulin Ji, Su Lui

《医学前沿（英文）》 2020年 第14卷 第6期   页码 792-801 doi: 10.1007/s11684-020-0745-1

摘要： Asthma is a serious health problem that involves not only the respiratory system but also the central nervous system. Previous studies identified either regional or network alterations in patients with asthma, but inconsistent results were obtained. A key question remains unclear: are the regional and neural network deficits related or are they two independent characteristics in asthma? Answering this question is the aim of this study. By collecting resting-state functional magnetic resonance imaging from 39 patients with asthma and 40 matched health controls, brain functional measures including regional activity (amplitude of low-frequency fluctuations) and neural network function (degree centrality (DC) and functional connectivity) were calculated to systematically characterize the functional alterations. Patients exhibited regional abnormities in the left angular gyrus, right precuneus, and inferior temporal gyrus within the default mode network. Network abnormalities involved both the sensorimotor network and visual network with key regions including the superior frontal gyrus and occipital lobes. Altered DC in the lingual gyrus was correlated with the degree of airway obstruction. This study elucidated different patterns of regional and network changes, thereby suggesting that the two parameters reflect different brain characteristics of asthma. These findings provide evidence for further understanding the potential cerebral alterations in the pathophysiology of asthma.

关键词： asthma     brain     regional activation     functional connectivity     resting-state fMRI    

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Emergency adult living donor right lobe liver transplantation for fulminant hepatic failure

ZHANG Feng, WANG Xuehao, LI Xiangcheng, KONG Lianbao, SUN Beicheng, LI Guoqiang, QIAN Xiaofen, CHEN Feng, WANG Ke, LU Sheng, PU Liyong, LU Ling

《医学前沿（英文）》 2007年 第1卷 第3期   页码 282-286 doi: 10.1007/s11684-007-0054-y

摘要： Fulminant hepatitis is fatal in most cases and timely liver transplantation is the only effective treatment. This study evaluates the survival outcomes of patients who underwent living-donor liver transplantation (LDLT) using right lobe liver grafts for fulminant liver failure due to hepatitis B infection. Nine cases of adult right lobe LDLT were performed in our department from September 2002 to August 2005 and the clinical and following-up data were reviewed. According to the pre-transplant Child-Pugh-Turcotte classification, the nine patients were classified as grade C. The model for end-stage liver disease (MELD) score of these patients ranged from 16 to 42. The principal complications before transplantation included abnormal renal function, hepatic coma of different degrees and alimentary tract hemorrhage. The main complications after transplantation included pulmonary infection in two cases, acute renal failure in three cases and transplantation-related encephalopathy in one case. No primary failure of vascular or biliary complications occurred. The one-year survival rate was 55.6%. There were no serious complications or deaths in donors. In general, it is extremely difficult to treat fulminant hepatitis by conservative regimen, particularly, in cases with rapid progression. Emergency adult living-donor liver transplantation is an effective treatment for fulminant hepatitis patients and is relatively safe for donors.

关键词： alimentary     abnormal     hemorrhage     principal     different    

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标题 作者 时间 类型 操作

Stroke prevention: an update

null

期刊论文

Predictive values of plasma TNFα and IL-8 for intracranial hemorrhage in patients with acute promyelocytic

期刊论文

Loss of monocarboxylate transporter 1 aggravates white matter injury after experimental subarachnoid hemorrhage

期刊论文

Overexpression of netrin-1 improves neurological outcomes in mice following transient middle cerebral

null

期刊论文

survival and neuronal differentiation of hypoxia-conditioned neuronal progenitor cells in rats with cerebral

Yao Yao, Rui Zhou, Rui Bai, Jing Wang, Mengjiao Tu, Jingjing Shi, Xiao He, Jinyun Zhou, Liu Feng, Yuanxue Gao, Fahuan Song, Feng Lan, Xingguo Liu, Mei Tian, Hong Zhang

期刊论文

Comparison of CT-guided aspiration to key hole craniotomy in the surgical treatment of spontaneous putaminal hemorrhage

ZHAO Jizong, WANG Dejiang, WANG Shuo, YUAN Ge, KANG Shuai, JI Nan, ZHAO Yuanli, YE Xun, ZHOU Liangfu, ZHOU Dingbiao, WANG Renzhi, WANG Mei

期刊论文

Epidemiology, pathogenesis, and management of coronavirus disease 2019-associated stroke

期刊论文

Implications of astrocytes in neurovascular coupling

You ZHOU MD, Chang-Kai SUN MD,

期刊论文

Giant renal angiomyolipoma with tuberous sclerosis complex

Ouyan SHI PhD, Guodong XU BM, Chunxiang WANG BM,

期刊论文

电刺激小脑顶核与中枢神经源性神经保护

董为伟

期刊论文

Leonurine protects ischemia-induced brain injury via modulating SOD, MDA and GABA levels

Shilei ZHENG, Jingru ZHU, Jiao LI, Shuang ZHANG, Yunfei MA

期刊论文

Cerebral regional and network characteristics in asthma patients: a resting-state fMRI study

Siyi Li, Peilin Lv, Min He, Wenjing Zhang, Jieke Liu, Yao Gong, Ting Wang, Qiyong Gong, Yulin Ji, Su Lui

期刊论文

Emergency adult living donor right lobe liver transplantation for fulminant hepatic failure

ZHANG Feng, WANG Xuehao, LI Xiangcheng, KONG Lianbao, SUN Beicheng, LI Guoqiang, QIAN Xiaofen, CHEN Feng, WANG Ke, LU Sheng, PU Liyong, LU Ling

期刊论文