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Interactions between remote ischemic conditioning and post-stroke sleep regulation

《医学前沿（英文）》 2021年 第15卷 第6期   页码 867-876 doi: 10.1007/s11684-021-0887-9

摘要： Sleep disturbances are common in patients with stroke, and sleep quality has a critical role in the onset and outcome of stroke. Poor sleep exacerbates neurological injury, impedes nerve regeneration, and elicits serious complications. Thus, exploring a therapy suitable for patients with stroke and sleep disturbances is imperative. As a multi-targeted nonpharmacological intervention, remote ischemic conditioning can reduce the ischemic size of the brain, improve the functional outcome of stroke, and increase sleep duration. Preclinical/clinical evidence showed that this method can inhibit the inflammatory response, mediate the signal transductions of adenosine, activate the efferents of the vagal nerve, and reset the circadian clocks, all of which are involved in sleep regulation. In particular, cytokines tumor necrosis factor α (TNFα) and adenosine are sleep factors, and electrical vagal nerve stimulation can improve insomnia. On the basis of the common mechanisms of remote ischemic conditioning and sleep regulation, a causal relationship was proposed between remote ischemic conditioning and post-stroke sleep quality.

关键词： remote ischemic conditioning     sleep regulation     stroke    

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Genetics of ischemic and hemorrhagic stroke in Chinese population

Wei-Li ZHANG MD, PhD, Ru-Tai HUI MD, PhD,

《医学前沿（英文）》 2010年 第4卷 第1期   页码 21-28 doi: 10.1007/s11684-010-0013-x

摘要： Stroke is a major cause of adult death and disability worldwide. Epidemiological and animal studies have provided strong evidence that the pathogenesis of stroke is multi-factorial and induced by a combination of environmental and genetic risk factors, but the identification of individual causative variants remains little known. Genetic influences are likely to be polygenic with small effect sizes, and stroke itself consists of a number of different subtypes which may each have different genetic profiles. In addition, various ethnic populations may have different stroke risk, such as Asian race. The reasons for high risk of stroke among the Chinese, especially hemorrhagic stroke, remain unknown. Most human studies have taken a candidate gene approach using case-control methodology. To be reliably detected, small relative risks require large sample sizes, probably 1000 patients or more. Genome-wide association (GWA) study is an unbiased and comprehensive approach to identify common risk alleles for complex diseases. Recently, a multistage GWA study has identified three loci on chromosomes 2q, 8q and 9p to be associated with intracranial aneurysm in European and Japanese populations. Another GWA finding is the identification of risk variants for cardioembolic stroke on chromosome 4q25 in European populations. In this review, we mainly focus on the results from case-control association studies on genetic factors that play a role in the risk of ischemic and hemorrhagic stroke in Chinese population. The combined effects of multiple susceptibility genes for stroke risk are also summarized.

关键词： genetics     ischemic stroke     hemorrhagic stroke     association study    

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EEG-controlled functional electrical stimulation rehabilitation for chronic stroke: system design and

《医学前沿（英文）》 2021年 第15卷 第5期   页码 740-749 doi: 10.1007/s11684-020-0794-5

摘要： Stroke is one of the most serious diseases that threaten human life and health. It is a major cause of death and disability in the clinic. New strategies for motor rehabilitation after stroke are undergoing exploration. We aimed to develop a novel artificial neural rehabilitation system, which integrates brain--computer interface (BCI) and functional electrical stimulation (FES) technologies, for limb motor function recovery after stroke. We conducted clinical trials (including controlled trials) in 32 patients with chronic stroke. Patients were randomly divided into the BCI-FES group and the neuromuscular electrical stimulation (NMES) group. The changes in outcome measures during intervention were compared between groups, and the trends of ERD values based on EEG were analyzed for BCI-FES group. Results showed that the increase in Fugl Meyer Assessment of the Upper Extremity (FMA-UE) and Kendall Manual Muscle Testing (Kendall MMT) scores of the BCI-FES group was significantly higher than that in the sham group, which indicated the practicality and superiority of the BCI-FES system in clinical practice. The change in the laterality coefficient (LC) values based on μ-ERD (ΔLCm-ERD) had high significant positive correlation with the change in FMA-UE(r= 0.6093, P=0.012), which provides theoretical basis for exploring novel objective evaluation methods.

关键词： brain–computer interface     functional electrical stimulation     electroencephalogram     laterality coefficient     chronic stroke    

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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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Implantation of human umbilical cord mesenchymal stem cells for ischemic stroke: perspectives and challenges

null

《医学前沿（英文）》 2015年 第9卷 第1期   页码 20-29 doi: 10.1007/s11684-014-0371-x

摘要：

Ischemic stroke is a focal cerebral insult that often leads to many adverse neurological complications severely affecting the quality of life. The prevalence of stroke is increasing throughout the world, while the efficacy of current pharmacological therapies remains unclear. As a neuroregenerative therapy, the implantation of human umbilical cord mesenchymal stem cells (hUC-MSCs) has shown great possibility to restore function after stroke. This review article provides an update role of hUC-MSCs implantation in the treatment of ischemic stroke. With the unique “immunosuppressive and immunoprivilege” property, hUC-MSCs are advised to be an important candidate for allogeneic cell treatment. Nevertheless, most of the treatments are still at primary stage and not clinically feasible at the current time. Several uncertain problems, such as culture conditions, allograft rejection, and potential tumorigenicity, are the choke points in this cellular therapy. More preclinical researches and clinical studies are needed before hUC-MSCs implantation can be used as a routinely applied clinical therapy.

关键词： cellular therapy     transplantation     human umbilical cord     mesenchymal stem cells     ischemic stroke    

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Stroke prevention: an update

null

《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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A novel classification method for aid decision of traditional Chinese patent medicines for stroke treatment

null

《医学前沿（英文）》 2017年 第11卷 第3期   页码 432-439 doi: 10.1007/s11684-017-0511-1

摘要：

Traditional Chinese patent medicines are widely used to treat stroke because it has good efficacy in the clinical environment. However, because of the lack of knowledge on traditional Chinese patent medicines, many Western physicians, who are accountable for the majority of clinical prescriptions for such medicine, are confused with the use of traditional Chinese patent medicines. Therefore, the aid-decision method is critical and necessary to help Western physicians rationally use traditional Chinese patent medicines. In this paper, Manifold Ranking is employed to develop the aid-decision model of traditional Chinese patent medicines for stroke treatment. First, 115 stroke patients from three hospitals are recruited in the cross-sectional survey. Simultaneously, traditional Chinese physicians determine the traditional Chinese patent medicines appropriate for each patient. Second, particular indicators are explored to characterize the population feature of traditional Chinese patent medicines for stroke treatment. Moreover, these particular indicators can be easily obtained by Western physicians and are feasible for widespread clinical application in the future. Third, the aid-decision model of traditional Chinese patent medicines for stroke treatment is constructed based on Manifold Ranking. Experimental results reveal that traditional Chinese patent medicines can be differentiated. Moreover, the proposed model can obtain high accuracy of aid decision.

关键词： traditional Chinese patent medicines     stroke     aid decision     data mining     manifold ranking    

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EEG controlled neuromuscular electrical stimulation of the upper limb for stroke patients

Hock Guan TAN, Cheng Yap SHEE, Keng He KONG, Cuntai GUAN, Wei Tech ANG

《机械工程前沿（英文）》 2011年 第6卷 第1期   页码 71-81 doi: 10.1007/s11465-011-0207-1

摘要：

This paper describes the Brain Computer Interface (BCI) system and the experiments to allow post-acute (<3 months) stroke patients to use electroencephalogram (EEG) to trigger neuromuscular electrical stimulation (NMES)-assisted extension of the wrist/fingers, which are essential pre-requisites for useful hand function. EEG was recorded while subjects performed motor imagery of their paretic limb, and then analyzed to determine the optimal frequency range within the -rhythm, with the greatest attenuation. Aided by visual feedback, subjects then trained to regulate their -rhythm EEG to operate the BCI to trigger NMES of the wrist/finger. 6 post-acute stroke patients successfully completed the training, with 4 able to learn to control and use the BCI to initiate NMES. This result is consistent with the reported BCI literacy rate of healthy subjects. Thereafter, without the loss of generality, the controller of the NMES is developed and is based on a model of the upper limb muscle (biceps/triceps) groups to determine the intensity of NMES required to flex or extend the forearm by a specific angle. The muscle model is based on a phenomenological approach, with parameters that are easily measured and conveniently implemented.

关键词： brain computer interface     neuromuscular electrical stimulation     stroke     musculoskeletal modeling    

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Status of hyperhomocysteinemia in China: results from the China Stroke High-risk Population Screening

《医学前沿（英文）》 2021年 第15卷 第6期   页码 903-912 doi: 10.1007/s11684-021-0871-4

摘要： A nationwide survey was conducted from October 2018 to September 2019 to assess the prevalence of hyperhomocysteinemia (Hhcy) and its influencing factors in China. A standardized questionnaire was used to collect information. Hhcy was defined as the level of serum homocysteine (HCY) ≥15.0 µmol/L. The H-type hypertension (HHYP) was defined as hypertension with an elevated serum HCY (≥15.0 µmol/L). Finally, 110 551 residents ≥40 years of age from 31 provinces in the mainland of China were included. Overall, the median serum HCY level was 10.9 µmol/L (interquartile range 7.9–15.1). A total of 28 633 participants (25.9%) were defined as Hhcy. The Hhcy prevalence ranged from 7.9% in Shanghai to 56.8% in Tianjin. The data showed that serum HCY levels were associated with age, male gender, cigarette smoking, hypertension, diabetes, ethnicity, endurance in exercise (inverse), and fruit and vegetable intake (inverse). In addition, 15 486 participants were defined as HHYP, and the rate was 14.0%. HHYP was an independent predictor of stroke with an adjusted odds ratio of 1.752 (95% CI 1.338–2.105). The geographical distribution pattern of the Hhcy epidemic reflects dynamic differences, and national strategies should be carried out to further improve the care of patients with Hhcy across China.

关键词： homocysteine     hyperhomocysteinemia     H-type hypertension     Chinese    

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proteomics revealed extensive microenvironmental changes after stem cell transplantation in ischemic stroke

《医学前沿（英文）》 2022年 第16卷 第3期   页码 429-441 doi: 10.1007/s11684-021-0842-9

摘要： The local microenvironment is essential to stem cell-based therapy for ischemic stroke, and spatiotemporal changes of the microenvironment in the pathological process provide vital clues for understanding the therapeutic mechanisms. However, relevant studies on microenvironmental changes were mainly confined in the acute phase of stroke, and long-term changes remain unclear. This study aimed to investigate the microenvironmental changes in the subacute and chronic phases of ischemic stroke after stem cell transplantation. Herein, induced pluripotent stem cells (iPSCs) and neural stem cells (NSCs) were transplanted into the ischemic brain established by middle cerebral artery occlusion surgery. Positron emission tomography imaging and neurological tests were applied to evaluate the metabolic and neurofunctional alterations of rats transplanted with stem cells. Quantitative proteomics was employed to investigate the protein expression profiles in iPSCs-transplanted brain in the subacute and chronic phases of stroke. Compared with NSCs-transplanted rats, significantly increased glucose metabolism and neurofunctional scores were observed in iPSCs-transplanted rats. Subsequent proteomic data of iPSCs-transplanted rats identified a total of 39 differentially expressed proteins in the subacute and chronic phases, which are involved in various ischemic stroke-related biological processes, including neuronal survival, axonal remodeling, antioxidative stress, and mitochondrial function restoration. Taken together, our study indicated that iPSCs have a positive therapeutic effect in ischemic stroke and emphasized the wide-ranging microenvironmental changes in the subacute and chronic phases.

关键词： ischemic stroke     microenvironment     induced pluripotent stem cells (iPSCs)     positron emission tomography (PET)     quantitative proteomics    

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Autoimmunity in acute ischemic stroke and the role of blood—brain barrier: the dark side or the light

Nikolay V. Tsygan, Alexandr P. Trashkov, Igor V. Litvinenko, Viktoriya A. Yakovleva, Alexandr V. Ryabtsev, Andrey G. Vasiliev, Leonid P. Churilov

《医学前沿（英文）》 2019年 第13卷 第4期   页码 420-426 doi: 10.1007/s11684-019-0688-6

摘要： This article presents a synopsis of the current data on the mechanisms of blood—brain barrier (BBB) alteration and autoimmune response in acute ischemic stroke. Most researchers confirm the relationship between the severity of immunobiochemical changes and clinical outcome of acute ischemic stroke. Ischemic stroke is accompanied by aseptic inflammation, which alters the brain tissue and exposes the co-stimulatory molecules of the immune system and the neuronal antigens. To date, BBB is not considered the border between the immune system and central nervous system, and the local immune subsystems are found within and behind the BBB. BBB disruption contributes to the leakage of brain autoantigens and induction of secondary autoimmune response to neuronal antigens and long-term inflammation. Glymphatic system function is altered and jeopardized both in hemorrhagic and ischemic stroke types. The receptors of innate immunity (toll-like receptor-2 and toll-like receptor-4) are also involved in acute ischemia—reperfusion injury. Immune response is related to the key processes of blood clotting and fibrinolysis. At the same time, the stroke-induced immune activation may promote reparation phenomena in the brain. Subsequent research on the reduction of the acute ischemic brain injury through the target regulation of the immune response is promising.

关键词： stroke     blood–brain barrier     autoimmunity     innate immunity     inflammation     cell death    

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Evaluation of the relative risk of stroke in patients with hypertension using cerebrovascular hemodynamic

HUANG Jiuyi, WANG Guiqing, GUO Jiping, CAO Yifeng, WANG Yan, YANG Yongju, YU Xuehai

《医学前沿（英文）》 2007年 第1卷 第3期   页码 274-278 doi: 10.1007/s11684-007-0052-0

摘要： The relative risk (RR) of stroke in patients with hypertension was evaluated by using synthetic index of cerebrovascular hemodynamics. A total of 7,371 patients with hypertension with ages ≥40 years were selected from a population-based cohort study of the risk factors for stroke. The data on the baseline investigation of risk factors, the determination of cerebrovascular hemodynamic parameters (CVHP), and stroke follow-up were analyzed. The RR of stroke in patients with hypertension was evaluated by CVHP scores. Univariate analysis indicated that hypertension, complicated by other risk factors, had significant statistical association with the onset of stroke. RRs for stroke when hypertension complicated with decrease of hemodynamic scores, heart disease, cigarette smoking and alcohol consumption were 4.93 (95%CI, 3.26–7.45), 1.90 (95%CI, 1.36–2.66), 1.99 (95%CI, 1.42–2.79) and 1.73 (95%CI, 1.19–2.53) respectively. In multivariate analysis, hemodynamic score, age, sex, cigarette smoking, family history of stroke and systolic blood pressure were selected by the Cox regression for inclusion in the final analysis. Among them, the RR of hemodynamic score was highest. The analysis of doseresponse relationships indicated that when the hemodynamic scores in patients with hypertension were lower than 75 points, the RR of stroke at 75, 60, 45, 30 and 15 points were 2.85, 4.43, 4.54, 5.40 and 9.88, respectively. The risk of stroke in patients with hypertension is closely asso ciated with hemodynamic impairment and the hemodynamic score may be used for quantitative evaluation of relative risks of stroke.

关键词： inclusion     quantitative evaluation     cerebrovascular     relative     decrease    

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一种高效的二冲程发动机概念——结合空气混合动力系统的增压 直流扫气式直喷汽油（BUSDIG）发动机 Review

王新颜, 赵华

《工程（英文）》 2019年 第5卷 第3期   页码 535-547 doi: 10.1016/j.eng.2019.03.008

摘要：

本研究提出并设计了一种新颖的二冲程增压直流扫气式直喷汽油（BUSDIG）发动机，以实现发动机小型化和低速化，进而提升发动机的性能和效率。本文综述了BUSDIG 发动机的设计和开发过程，并总结了主要的研究成果。为了最大限度地提高发动机的扫气性能，并实现合理的缸内流动以促进燃油/ 空气的混合过程，本研究采用三维（3D）计算流体动力学（CFD）模拟手段系统分析了发动机缸径/ 冲程比（B/S）、扫气道角度和进气道的设计。此外，本研究还系统分析了扫气口和排气门开启型线对扫气过程的影响。为实现最佳的缸内燃油分层，采用经过实验标定的Reize-Diwakar模型开展了缸内喷雾的CFD 模拟，系统分析了不同喷油策略对缸内混合气形成过程的影响。基于优化后的BUSDIG 发动机设计方案，在Ricardo WAVE 软件中构建了对应的一维（1D）发动机计算模型。计算结果表明，采用稀薄燃烧和喷水策略，二冲程BUSDIG发动机的最高有效热效率可达47.2%。在化学计量燃空当量比条件下，BUSDIG 发动机在1600 r∙min–1 的转速下可实现379 N∙m 的扭矩，在4000 r∙min–1 的转速下可达到112 kW∙L–1 的功率密度。

关键词： 二冲程发动机     直流扫气     发动机设计     发动机模拟     扫气性能     热效率    

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Elevated C-reactive protein levels predict worsening prognosis in Chinese patients with first-onset stroke

Jiangtao YAN, Rutai HUI, Daowen WANG

《医学前沿（英文）》 2009年 第3卷 第1期   页码 30-35 doi: 10.1007/s11684-009-0005-x

摘要： The role of high sensitivity C-reactive protein (hsCRP) in predicting prognosis after stroke in the Asian population has not been investigated. We hypothesized that elevated levels of hsCRP were associated with worsening prognosis after stroke in Chinese patients. Two hundred and ninety consecutive patients with first-onset stroke and 290 age- and gender-matched control subjects without any cerebrovascular disease were enrolled for study. Plasma hsCRP level was detected and subsequent vascular events and death were recorded in both groups over a 5-year period. Compared to control group, patients presenting with stroke had higher plasma hsCRP level (3.3 ± 3.8 1.3 ± 2.2 mg/L, < 0.01). Furthermore, in the group of patients with stroke, the mean plasma hsCRP level was higher in patients who developed subsequent vascular diseases or died as compared with the patients without further complications (4.4 ± 4.3 2.7 ± 3.3 mg/L, < 0.01). Compared to the lowest tertile of hsCRP level, the relative risk for vascular events or death in stroke patients was 2.91 in the highest tertile of hsCRP (95% CI, 1.54–5.50, = 0.001). This increase in relative risk for vascular events or death in stroke patients continued after adjustment for age, sex and other cardiovascular risk factors such as hypertension and diabetes ( : 2.771, 95% CI: 1.367–5.617, = 0.005). These findings indicate that increased hsCRP level is associated with worsening prognosis after stroke in Chinese patients and suggests that inflammation is correlated with stroke outcome.

关键词： C-reactive protein     inflammation     stroke    

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三峡工程齿轮齿条爬升式升船机设计

钮新强,覃利明,于庆奎

《中国工程科学》 2011年 第13卷 第7期   页码 96-103

摘要：

三峡升船机具有提升重量大、升程高、上下游通航水位变幅大、水位变率快等特点，是目前世界上规模和技术难度最大的升船机。经过方案比选，三峡升船机最终确定采用齿轮齿条爬升式，其设备构造复杂，制造、安装及土建结构施工精度要求很高，并首次采用中德联合设计方式。概要介绍了三峡工程齿轮齿条爬升式升船机的总体布置、以及塔柱结构、重要设备的设计方案与关键技术。

关键词： 升船机     爬升式     安全机构     行程同步    

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标题 作者 时间 类型 操作

Interactions between remote ischemic conditioning and post-stroke sleep regulation

期刊论文

Genetics of ischemic and hemorrhagic stroke in Chinese population

Wei-Li ZHANG MD, PhD, Ru-Tai HUI MD, PhD,

期刊论文

EEG-controlled functional electrical stimulation rehabilitation for chronic stroke: system design and

期刊论文

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

期刊论文

Implantation of human umbilical cord mesenchymal stem cells for ischemic stroke: perspectives and challenges

null

期刊论文

Stroke prevention: an update

null

期刊论文

A novel classification method for aid decision of traditional Chinese patent medicines for stroke treatment

null

期刊论文

EEG controlled neuromuscular electrical stimulation of the upper limb for stroke patients

Hock Guan TAN, Cheng Yap SHEE, Keng He KONG, Cuntai GUAN, Wei Tech ANG

期刊论文

Status of hyperhomocysteinemia in China: results from the China Stroke High-risk Population Screening

期刊论文

proteomics revealed extensive microenvironmental changes after stem cell transplantation in ischemic stroke

期刊论文

Autoimmunity in acute ischemic stroke and the role of blood—brain barrier: the dark side or the light

Nikolay V. Tsygan, Alexandr P. Trashkov, Igor V. Litvinenko, Viktoriya A. Yakovleva, Alexandr V. Ryabtsev, Andrey G. Vasiliev, Leonid P. Churilov

期刊论文

Evaluation of the relative risk of stroke in patients with hypertension using cerebrovascular hemodynamic

HUANG Jiuyi, WANG Guiqing, GUO Jiping, CAO Yifeng, WANG Yan, YANG Yongju, YU Xuehai

期刊论文

一种高效的二冲程发动机概念——结合空气混合动力系统的增压 直流扫气式直喷汽油（BUSDIG）发动机

王新颜, 赵华

期刊论文

Elevated C-reactive protein levels predict worsening prognosis in Chinese patients with first-onset stroke

Jiangtao YAN, Rutai HUI, Daowen WANG

期刊论文

三峡工程齿轮齿条爬升式升船机设计

钮新强,覃利明,于庆奎

期刊论文