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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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Piezoelectric pump with flexible venous valves for active cell transmission

《机械工程前沿（英文）》 2022年 第17卷 第4期 doi: 10.1007/s11465-022-0712-4

摘要： The development of organ-on-a-chip systems demands high requirements for adequate micro-pump performance, which needs excellent performance and effective transport of active cells. In this study, we designed a piezoelectric pump with a flexible venous valve inspired by that of humans. Performance test of the proposed pump with deionized water as the transmission medium shows a maximum output flow rate of 14.95 mL/min when the input voltage is 100 V, and the pump can transfer aqueous solutions of glycerol with a viscosity of 10.8 mPa·s. Cell survival rate can reach 97.22% with a yeast cell culture solution as the transmission medium. A computational model of the electric-solid-liquid multi-physical field coupling of the piezoelectric pump with a flexible venous valve is established, and simulation results are consistent with experimental results. The proposed pump can help to construct the circulating organ-on-a-chip system, and the simple structure and portable application can enrich the design of microfluidic systems. In addition, the multi-physical field coupling computational model established for the proposed piezoelectric pump can provide an in-depth study of the characteristics of the flow field, facilitating the optimal design of the micro-pump and providing a reference for the further study of active cell transport in organ-on-a-chip systems.

关键词： venous valve     flexible venous valve     cell transmission     organ-on-a-chip system     piezoelectric device    

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Classification and treatment of orbital venous malformations: an updated review

Tianyuan Li, Renbing Jia, Xianqun Fan

《医学前沿（英文）》 2019年 第13卷 第5期   页码 547-555 doi: 10.1007/s11684-018-0623-2

摘要： Orbital venous malformation (OVM) is a congenital vascular disease. As a common type of vascular malformation in the orbit, OVM may result in vision deterioration and cosmetic defect. Classification of orbital vascular malformations, especially OVMs, is carried out on the basis of different categories, such as angiogenesis, hemodynamics, and locations. Management of OVM is complicated and challenging. Treatment approaches include sclerotherapy, laser therapy, embolization, surgical resection, and radiotherapy. A satisfactory outcome can be achieved only by selecting the appropriate treatment according to lesion characteristics and following the sequential multi-method treatment strategy. This article summarizes the current classification and treatment advances in OVM.

关键词： orbit     venous malformation     treatment     sclerotherapy     laser     embolization    

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Understanding risk of thrombosis with thrombocytopenia syndrome after Ad26.COV2.S vaccination

《医学前沿（英文）》 2021年 第15卷 第6期   页码 938-941 doi: 10.1007/s11684-021-0895-9

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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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Antithrombin deficiency and decreased protein C activity in a young man with venous thromboembolism:

null

《医学前沿（英文）》 2018年 第12卷 第3期   页码 319-323 doi: 10.1007/s11684-017-0553-4

摘要：

Antithrombin and protein C are two crucial members in the anticoagulant system and play important roles in hemostasis. Mutations in and lead to deficiency or dysfunction of the two proteins, which could result in venous thromboembolism (VTE). Here, we report a Chinese 22-year-old young man who developed recurrent and serious VTE in cerebral veins, visceral veins, and deep veins of the lower extremity. Laboratory tests and direct sequencing of and were conducted for the patient and his family members. Coagulation tests revealed that the patient presented type I antithrombin deficiency combined with decreased protein C activity resulting from a small insertion mutation c.848_849insGATGT in and a short deletion variant c.572_574delAGA in . This combination of the two mutations was absent in 400 healthy subjects each from southern and northern China. Then, we summarized all the mutations of the and gene reported in the Chinese Han population. This study demonstrates that the combination of antithrombin deficiency and decreased protein C activity can result in severe VTE and that the coexistence of different genetic factors may increase the risk of VTE.

关键词： antithrombin deficiency     protein C activity     mutation     variant     venous thromboembolism     anticoagulants    

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Venous thromboembolism in children with acute lymphoblastic leukemia in China: a report from the Chinese

《医学前沿（英文）》 2023年 第17卷 第3期   页码 518-526 doi: 10.1007/s11684-022-0958-6

摘要： Venous thromboembolism (VTE) is a complication in children with acute lymphoblastic leukemia (ALL). The Chinese Children’s Cancer Group-ALL-2015 protocol was carried out in China, and epidemiology, clinical characteristics, and risk factors associated with VTE were analyzed. We collected data on VTE in a multi-institutional clinical study of 7640 patients with ALL diagnosed in 20 hospitals from January 2015 to December 2019. First, VTE occurred in 159 (2.08%) patients, including 90 (56.6%) during induction therapy and 108 (67.92%) in the upper extremities. T-ALL had a 1.74-fold increased risk of VTE (95% CI 1.08–2.8, P = 0.022). Septicemia, as an adverse event of ALL treatment, can significantly promote the occurrence of VTE (P < 0.001). Catheter-related thrombosis (CRT) accounted for 75.47% (n = 120); and, symptomatic VTE, 58.49% (n = 93), which was more common in patients aged 12–18 years (P = 0.023), non-CRT patients (P < 0.001), or patients with cerebral thrombosis (P < 0.001). Of the patients with VTE treated with anticoagulation therapy (n = 147), 4.08% (n = 6) had bleeding. The VTE recurrence rate was 5.03% (n = 8). Patients with VTE treated by non-ultrasound-guided venous cannulation (P = 0.02), with residual thrombus (P = 0.006), or with short anticoagulation period (P = 0.026) had high recurrence rates. Thus, preventing repeated venous puncture and appropriately prolonged anticoagulation time can reduce the risk of VTE recurrence.

关键词： acute lymphoblastic leukemia     child     venous thromboembolism     epidemiology     clinical characteristic     risk factor    

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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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Effects of combined procedure and devascularization alone on hyperdynamics of the portal venous system

HUA Rong, SUN Yongwei, WU Zhiyong

《医学前沿（英文）》 2008年 第2卷 第3期   页码 244-247 doi: 10.1007/s11684-008-0046-6

摘要： Shunts and devascularizations have totally different effects on the hemodynamics of the portal venous system. The actual results of pericardial devascularization (PCDV) alone and conventional splenorenal shunt combined with pericardial devascularization (combined procedure, CP) should be determined by more clinical observations. This study aimed to evaluate effects on hemodynamics in the portal venous system after CP and PCDV only. In 20 patients who received CP and 18 who received PCDV, hemodynamic parameters of the portal venous system were studied by magnetic resonance angiography 1 week before and 2 weeks after operation. Free portal pressure (FPP) was continuously detected by a transducer during the operations. Compared to the preoperative data, a decreased flow in the portal vein (PVF) [(563.12 ± 206.42) mL/min (1080.63 ± 352.85) mL/min, < 0.05], a decreased portal vein diameter (PVD) [(1.20 ± 0.11) cm (1.30 ± 0.16) cm, < 0.01], a decreased FPP [(21.50 ± 2.67) mmHg (29.88 ± 2.30) mmHg, < 0.01] and an increased flow in the superior mesenteric vein (SMVF) [(1105.45 ± 309.03) mL/min (569.13 ± 178.46) mL/min, < 0.05] were found in the CP group after operation; a decreased PVD [(1.27 ± 0.16) cm (1.40 ± 0.23) cm, < 0.05], a decreased PVF [(684.60 ± 165.73) mL/min (1175.64 ± 415.09) mL/min, < 0.05], a decreased FPP [(24.40 ± 3.78) mmHg (28.80 ± 3.56) mmHg, < 0.05] and an increased SMVF [(697.91 ± 121.83) mL/min (521.30 ± 115.82) mL/min, < 0.05] were observed in the PCDV group. After operation, PVF in the CP group [(563.12 ± 206.42) mL/min (684.60 ± 165.73) mL/min, > 0.05] had no significant decrease, while FPP [(21.50 ± 2.67) mmHg (24.40 ± 3.78) mmHg, < 0.01] had a significant decrease as compared with that in the PCDV group. PVF and FPP could be decreased by both surgical procedures, but the effect of decreasing FPP was much better in the combined procedure than in PCDV alone. Further, there was no significant difference in PVF between the two groups. It is suggested that the combined surgical procedure could integrate the advantages of shunting with those of devascularization, as well as maintaining the normal anatomic structure of hepatic portal system, thus it should be one of the best choices for patients with portal hypertension when surgical interventions are considered.
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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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Anti-β2GPI/β2GPI complexes induce platelet activation and promote thrombosis via

Wenjing Zhang, Caijun Zha, Xiumin Lu, Ruichun Jia, Fei Gao, Qi Sun, Meili Jin, Yanhong Liu

《医学前沿（英文）》 2019年 第13卷 第6期   页码 680-689 doi: 10.1007/s11684-018-0673-5

摘要： Anti- glycoprotein I (anti- GPI) antibodies are important contributors to the development of thrombosis. Anti- GPI antibody complexes with GPI are well known to activate monocytes and endothelial cells via the intracellular NF- B pathway with prothrombotic implications. By contrast, the interaction of anti- GPI/ GPI complexes with platelets has not been extensively studied. The p38 mitogen-activated protein kinase (MAPK) pathway has been recognized to be an important intracellular signaling pathway in the coagulation cascade and an integral component of arterial and venous thrombosis. The present study reveals that levels of anti- GPI/ GPI complexes in sera are positively associated with p38MAPK phosphorylation of platelets in thrombotic patients. Furthermore, SB203580 inhibits anti- GPI/ GPI complex-induced platelet activation. Thrombus formation decreased in mice after treatment with anti- GPI/ GPI complexes. In conclusion, p38MAPK may be a treatment target for anti- GPI antibody-associated thrombotic events.

关键词： anti-   

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Clinical and genetic risk factors for venous thromboembolism in Chinese population

Chen WANG PhD, MD, Zhen-Guo ZHAI PhD, MD, Ying H. SHEN PhD, MD, Lan ZHAO PhD, MD,

《医学前沿（英文）》 2010年 第4卷 第1期   页码 29-35 doi: 10.1007/s11684-010-0012-y

摘要： Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, carries significant mortality and morbidity. The most important and effective way to reduce VTE incidence is to identify the patients at risk and give necessary prevention. VTE is a multifactorial and complicated disorder. Major risk factors for VTE include surgery and trauma, acute medical illness, active cancer and pregnancy. Genetic factors increase susceptibility to the disease and are useful in predicting the development of VTE. Gene-gene and gene-environment interactions alter and magnify the clinical picture in this disorder. This brief review summarizes some selected clinical and genetic risk factors for VTE based on the current research in China.

关键词： risk factor     stroke     prothrombin     plasminogen activator inhibitor type-1     polymorphism     thrombophilia     biomarker    

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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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Endogenous tissue factor pathway inhibitor in vascular smooth muscle cells inhibits arterial thrombosis

null

《医学前沿（英文）》 2017年 第11卷 第3期   页码 403-409 doi: 10.1007/s11684-017-0522-y

摘要：

Tissue factor pathway inhibitor (TFPI) is the main inhibitor of tissue factor-mediated coagulation. TFPI is expressed by endothelial and smooth muscle cells in the vasculature. Endothelium-derived TFPI has been reported to play a regulatory role in arterial thrombosis. However, the role of endogenous TFPI in vascular smooth muscle cells (VSMCs) in thrombosis and vascular disease development has yet to be elucidated. In this TFPIFlox mice crossbred with Sma–Cre mice were utilized to establish TFPI conditional knockout mice and to examine the effects of VSMC-directed TFPI deletion on development, hemostasis, and thrombosis. The mice with deleted TFPI in VSMCs (TFPISma) reproduced viable offspring. Plasma TFPI concentration was reduced 7.2% in the TFPISma mice compared with TFPIFlox littermate controls. Plasma TFPI concentration was also detected in the TFPITie2 (mice deleted TFPI in endothelial cells and cells of hematopoietic origin) mice. Plasma TFPI concentration of the TFPITie2 mice was 80.4% lower (P<0.001) than that of the TFPIFlox mice. No difference in hemostatic measures (PT, APTT, and tail bleeding) was observed between TFPISma and TFPIFlox mice. However, TFPISma mice had increased ferric chloride–induced arterial thrombosis compared with TFPIFlox littermate controls. Taken together, these data indicated that endogenous TFPI from VSMCs inhibited ferric chloride–induced arterial thrombosis without causing hemostatic effects.

关键词： arterial thrombosis     conditional knockout mice     tissue factor pathway inhibitor     vascular smooth muscle cells    

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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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标题 作者 时间 类型 操作

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

期刊论文

Piezoelectric pump with flexible venous valves for active cell transmission

期刊论文

Classification and treatment of orbital venous malformations: an updated review

Tianyuan Li, Renbing Jia, Xianqun Fan

期刊论文

Understanding risk of thrombosis with thrombocytopenia syndrome after Ad26.COV2.S vaccination

期刊论文

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

null

期刊论文

Antithrombin deficiency and decreased protein C activity in a young man with venous thromboembolism:

null

期刊论文

Venous thromboembolism in children with acute lymphoblastic leukemia in China: a report from the Chinese

期刊论文

Stroke prevention: an update

null

期刊论文

Effects of combined procedure and devascularization alone on hyperdynamics of the portal venous system

HUA Rong, SUN Yongwei, WU Zhiyong

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

Anti-β2GPI/β2GPI complexes induce platelet activation and promote thrombosis via

Wenjing Zhang, Caijun Zha, Xiumin Lu, Ruichun Jia, Fei Gao, Qi Sun, Meili Jin, Yanhong Liu

期刊论文

Clinical and genetic risk factors for venous thromboembolism in Chinese population

Chen WANG PhD, MD, Zhen-Guo ZHAI PhD, MD, Ying H. SHEN PhD, MD, Lan ZHAO PhD, MD,

期刊论文

Implications of astrocytes in neurovascular coupling

You ZHOU MD, Chang-Kai SUN MD,

期刊论文

Endogenous tissue factor pathway inhibitor in vascular smooth muscle cells inhibits arterial thrombosis

null

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