Objective To observe the efficacy of breviscapine in the treatment of patients with acute cerebral infarction and its effect on serum neuron specific enolase(NSE), angiotensin-2(Ang-2) and interleukin-6(IL-6) levels.Methods 60 cases of acute cerebral infarction(ACI) patients from January 2014 to January 2015 in Sichuan Provincial People's Hospital were selected and randomly divided into two groups, 30 cases in each group.All patients were given conventional western medicine treatment , and the observation group were also treated with breviscapine.After 2 weeks, the degree of neural function defect scores and efficacy were compared and the serum levels of NSE , Ang-2 and IL-6 were detected by enzyme linked immunosorbent assay(ELISA) and compared pre-and post-treatment between two groups.Results The degree of neural function defect score post-treatment in observation group was significantly lower than that in control group ( P<0.05 ).The overall response in observation group was 27 cases (90.00%), which was significantly higher than 20 cases(66.67%) in control group(χ2 =4.81,P<0.05).The serum levels of Ang-2, IL-6 and NSE post-treatment in observation group were significantly lower than those in control group ( P<0.05 ) .Conclusion The curative effect of breviscapine in treatment of acute cerebral infarction is significantly, which could improve the cerebral microcirculation, protect the brain tissue, and its mechanism may be through reducing the serum levels of NSE, IL-6 and Ang-2.

Objective:To investigate the changes of serum heme oxygenase 1 (HO-1) level and its correlation with clinical characteristics in patients with acute cerebral infarction (ACI) before and after successful recanalization.Methods:Twenty-nine ACI patients accepted mechanical thrombectomy and enjoyed successful vascular recanalization (Thrombolysis in Cerebral Infarction (mTICI) grading≥2B) in our hospital from November 2018 to September 2019 were enrolled as observation group; 22 patients suspected for carotid artery stenosis or cerebral aneurysm underwent DSA (DSA ruled out the intracranial and carotid artery lesions) were chosen as control group. The level of HO-1 was measured by ELISA before and one, three and 7 d after surgery in the observation group, and before and after DSA in the control group. Besides, the correlation of HO-1 expression level with clinical characteristics of patients in the observation group was analyzed.Results:(1) As compared with the control group before DSA, the serum HO-1 level in the observation group before surgery was significantly higher ( P<0.05); and the serum HO-1 level in the observation group 7 d after surgery was significantly higher than that before and one d after surgery ( P<0.05). (2) Preoperative serum HO-1 level in patients with preoperative scores of diffusion weighted imaging (DWI)-Alberta stroke program early CT (ASPECT)≤7 was significantly higher than that in patients with DWI-ASPECT scores>7 from the observation group ( P<0.05). Preoperative serum HO-1 level in patients with baseline National Institutes of Health stroke scale (NIHSS) score≤12 was significantly lower than that in patients with NIHSS scores>12 from the observation group ( P<0.05). The preoperative serum HO-1 level was negatively correlated with DWI-ASPECTS scores ( r=-0.560, P=0.002) and positively correlated with baseline NIHSS scores ( r=0.685, P=0.001). (3) There was no difference in serum HO-1 level between mTICI grading 2B patients and mTICI grading 3 patients from the observation group ( P>0.05); but for patients with mTICI grading 3, the serum HO-1 level 7 d after surgery was significantly higher than that one d after surgery ( P<0.05). (4) The serum HO-1 level in patients with hemorrhagic transformation 3 and 7 d after surgery was significantly higher than that in patients without hemorrhagic transformation from the observation group ( P<0.05); the serum HO-1 level in patients with hemorrhagic transformation 7 d after surgery was significantly higher than that one d after surgery ( P<0.05). Conclusion:The serum HO-1 level is increased in patients with ACI, and it will further increase after successful recanalization; the serum HO-1 level is related with early infarction degree and neurological deficit degree before surgery, recanalization level and hemorrhagic transformation after surgery.

BACKGROUND AND PURPOSE: There are only a few cognitive screening tests for the Chinese-speaking population, and so this study aimed to validate the Chinese version of Addenbrooke's Cognitive Examination III (ACE-III) for detecting mild cognitive impairment (MCI) and mild dementia. Its diagnostic accuracy was compared with the Chinese versions of the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). METHODS: The 176 included individuals were divided into 3 groups: mild dementia group, MCI group, and normal control group. MMSE, MoCA, and ACE-III were administered to all participants by researchers who were blinded to the clinical grouping. The receiver operating characteristic (ROC) curves were analyzed. RESULTS: ACE-III exhibited good internal consistency and convergent validity. Age and education level significantly influenced the total ACE-III scores. When screening MCI, the area under the ROC curve (AUC) was significantly larger for ACE-III than for MMSE (0.88 vs. 0.72, p<0.05) and MoCA (0.88 vs. 0.76, p<0.05). ACE-III showed higher sensitivity (0.75) and specificity (0.89) than MMSE (0.64 and 0.63, respectively) and MoCA (0.67 and 0.77) at the optimal cutoff score of 88/89. For detecting mild dementia, ACE-III yielded satisfactory sensitivity (0.94) and specificity (0.83) at the optimal cutoff score of 74/75. The AUC of ACE-III was 0.95, which was comparable to those of MMSE (0.95) and MoCA (0.91). In participants with ≥12 years of education, the AUC was significantly larger for ACE-III than for MMSE when detecting MCI (0.90 vs. 0.68, p<0.05) and mild dementia (0.97 vs. 0.90, p<0.05). CONCLUSIONS: The present study has verified that ACE-III is a reliable and accurate tool for screening MCI and mild dementia in the Chinese-speaking population, and is significantly superior to MMSE and MoCA for detecting MCI.
Area Under Curve ; Asian Continental Ancestry Group ; Dementia ; Education ; Humans ; Mass Screening ; Methylenebis(chloroaniline) ; Mild Cognitive Impairment ; ROC Curve ; Sensitivity and Specificity

Background::The effect of bariatric surgery on type 2 diabetes mellitus (T2DM) control can be assessed based on predictive models of T2DM remission. Various models have been externally verified internationally. However, long-term validated results after laparoscopic sleeve gastrectomy (LSG) surgery are lacking. The best model for the Chinese population is also unknown.Methods::We retrospectively analyzed Chinese population data 5 years after LSG at Beijing Shijitan Hospital in China between March 2009 and December 2016. The independent t-test, Mann–Whitney U test, and chi-squared test were used to compare characteristics between T2DM remission and non-remission groups. We evaluated the predictive efficacy of each model for longterm T2DM remission after LSG by calculating the area under the curve (AUC), sensitivity, specificity, Youden index, positive predictive value (PPV), negative predictive value (NPV), and predicted-to-observed ratio, and performed calibration using Hosmer–Lemeshow test for 11 prediction models. Results::We enrolled 108 patients, including 44 (40.7%) men, with a mean age of 35.5 years. The mean body mass index was 40.3 ± 9.1 kg/m 2, the percentage of excess weight loss (%EWL) was (75.9 ± 30.4)%, and the percentage of total weight loss (% TWL) was (29.1 ± 10.6)%. The mean glycated hemoglobin A1c (HbA1c) level was (7.3 ± 1.8)% preoperatively and decreased to (5.9 ± 1.0)% 5 years after LSG. The 5-year postoperative complete and partial remission rates of T2DM were 50.9% [55/108] and 27.8% [30/108], respectively. Six models, i.e., "ABCD", individualized metabolic surgery (IMS), advanced-DiaRem, DiaBetter, Dixon et al’s regression model, and Panunzi et al’s regression model, showed a good discrimination ability (all AUC >0.8). The "ABCD" (sensitivity, 74%; specificity, 80%; AUC, 0.82 [95% confidence interval [CI]: 0.74–0.89]), IMS (sensitivity, 78%; specificity, 84%; AUC, 0.82 [95% CI: 0.73–0.89]), and Panunzi et al’s regression models (sensitivity, 78%; specificity, 91%; AUC, 0.86 [95% CI: 0.78–0.92]) showed good discernibility. In the Hosmer–Lemeshow goodness-of-fit test, except for DiaRem ( P <0.01), DiaBetter ( P <0.01), Hayes et al ( P = 0.03), Park et al ( P = 0.02), and Ramos-Levi et al’s ( P <0.01) models, all models had a satifactory fit results ( P >0.05). The P values of calibration results of the "ABCD" and IMS were 0.07 and 0.14, respectively. The predicted-to-observed ratios of the "ABCD" and IMS were 0.87 and 0.89, respectively. Conclusion::The prediction model IMS was recommended for clinical use because of excellent predictive performance, good statistical test results, and simple and practical design features.

Objective:To investigate the predictive value of plasma exosomal microRNA (miR)-124-3p in the risk of chronic cerebral hypoperfusion (CCH).Methods:A case-control study. Thirty patients who were diagnosed with CCH (CCH group) based on cranial artery spin labeling (ASL) in the neurology outpatient clinic of Sichuan Provincial People′s Hospital from March 2022 to June 2022 and 30 healthy volunteers (control group) were included. Age, gender, smoking history, alcohol consumption history, diabetes history, hypertension, hyperlipidemia history, uric acid, fasting blood glucose, homocysteine and plasma exosomal miR-124-3p expression level were compared between the two groups. Comparisons of categorical variables were analyzed by either χ2 test or Fisher′s exact test. If the data of continuous variables followed a normal distribution, they were expressed as mean±standard deviation (SD) and compared by t-test for two independent samples; otherwise, the data were expressed as M( Q1, Q3), and analyzed by Mann-Whitney U test for comparison between two groups. The correlation between cerebral blood flow and exosomal miR-124-3p levels was analyzed by Pearson′s correlation. Binary multifactorial logistic regression analysis was used to determine the risk factors associated with CCH, and corresponding odds ratios ( OR) and 95% confidence intervals ( CI) were calculated. P<0.05 was considered significant. Results:There was no significant difference in age (64±8 vs. 60±8 years old), gender (33.3% vs. 30.0%), history of smoking (20.0% vs. 3.3%), alcohol consumption (20.0% vs. 6.7%), diabetes mellitus (13.3% vs. 13.3%), hypertension (53.3% vs. 30.0%), history of hyperlipidemia (46.7% vs. 36.7%), uric acid (288±60 vs.319±67 μmol/L), and fasting glucose [4.99(4.63, 5.91) vs. 5.28(5.09, 6.05) mmol/L] and homocysteine [11.35(10.18, 13.08) vs.11.00(9.78, 13.03) μmol/L] between the CCH and control groups ( P>0.05). Plasma exosomal miR-124-3p expression was significantly higher in the CCH group than in the control group [13.08 (8.59, 21.55) vs. 2.85 (1.44, 5.10), respectively; U=169.50, P<0.001]. Pearson′s correlation test showed that the level of exosomal miR-124-3p was negatively correlated with cerebral blood flow in the hypoperfused region in patients with CCH ( r=-0.932, P<0.001). Multi-factor logistic regression analysis showed that plasma exosomal miR-124-3p was independently associated with the risk of CCH ( OR=1.169,95% CI 1.063-1.286, P=0.001). Conclusions:The expression of plasma exosomal miR-124-3p is negatively correlated with cerebral blood flow in areas of low perfusion and is an independent risk factor for CCH. Plasma exosomal miR-124-3p may thus serve as a valid biomarker for CCH risk prediction.

Lipoxin A4 (LXA4) is one of the metabolites of arachidonic acid, and it is an endogenous anti-inflammatory factor that can alleviate the inflammatory reaction through various pathways. Inflammatory response plays an important role in the process of cerebral ischemia. LXA4 can play a protective role on nerve cells by regulating proinflammatory cytokines, protecting blood-brain barrier, inhibiting activation and infiltration of leukocyte, alleviating local microcirculation inflammatory response, regulating inflammatory mediators such as leukotrienes and inflammasome, regulating the metabolism of inflammatory related enzymes, and alleviating oxidative stress injury. This article reviews the anti-inflammatory effects of LXA4 in cerebral ischemia.

Stigmasterol is a plant sterol with anti-apoptotic, anti-oxidative and anti-inflammatory effect through multiple mechanisms. In this study, we further assessed whether it exerts protective effect on human brain microvessel endothelial cells (HBMECs) against ischemia-reperfusion injury and explored the underlying mechanisms. HBMECs were used to establish an in vitro oxygen and glucose deprivation/reperfusion (OGD/R) model, while a middle cerebral artery occlusion (MCAO) model of rats were constructed. The interaction between stigmasterol and EPHA2 was detected by surface plasmon resonance (SPR) and cellular thermal shift assay (CETSA). The results showed that 10 μmol·L^-1 stigmasterol significantly protected cell viability, alleviated the loss of tight junction proteins and attenuated the blood-brain barrier (BBB) damage induced by OGD/R in thein vitro model. Subsequent molecular docking showed that stigmasterol might interact with EPHA2 at multiple sites, including T692, a critical gatekeep residue of this receptor. Exogenous ephrin-A1 (an EPHA2 ligand) exacerbated OGD/R-induced EPHA2 phosphorylation at S897, facilitated ZO-1/claudin-5 loss, and promoted BBB leakage in vitro, which were significantly attenuated after stigmasterol treatment. The rat MCAO model confirmed these protective effects in vivo. In summary, these findings suggest that stigmasterol protects HBMECs against ischemia-reperfusion injury by maintaining cell viability, reducing the loss of tight junction proteins, and attenuating the BBB damage. These protective effects are at least meditated by its interaction with EPHA2 and inhibitory effect on EPHA2 phosphorylation.
Humans ; Animals ; Rats ; Stigmasterol ; Phosphorylation ; Endothelial Cells ; Molecular Docking Simulation ; Reperfusion Injury ; Blood-Brain Barrier ; Glucose ; Microvessels ; Oxygen

Abdomen/diagnostic imaging* ; Artificial Intelligence ; Body Composition ; Magnetic Resonance Imaging ; Practice Guidelines as Topic