Objective To study the protective effect of different doses of rosiglitazone (RSG)against focal cerebral ischemia-reperfusion injury in rats．Methods Forty male sprague Dawley rats were randomly divided into the following groups：sham-operation，control，lowdose RSG(1 mg/kg·d)，moderate-dose(2 mg/kg·d)，high-dose(4 mg/kg·d)goups(n=8 in each grow)．A rat model of middle cerebral artery occlusion for 2 hours and reperfusion for 22 hours were induced by the intraluminal suture method．An automatie biochemical analyzer was used to detect the blood glucose and lipid levels．A solid phase sandwich enzyme-linked immunosorbent assay was used to determine serum insulin levels，and the insulin sensitivity indexes were calculated．The effect of rosiglitazone on infarct volume and behavioristics was observed．Results Compared with the control group，the infarct volume was significantly reduced，and the neurological function scores were improved significantly in each RSG group(P<0．05 or P<0．01)．The insulin sensitivity was significantly increased(P<0．05 or P<0．01)，and hyperglycemia was reduced significantly after cerebral ischemia(P<0．05)and showed a dose-dependent manner.Conclusions RSG has obvious neuroprotective effect against cerebral ischemia／repeffusion injury in rats．Its mechanism may be associated with the increase of insulin sensitivity．

Smoking is one of the major risk factors for stroke. Both active and passive smoking may increase the risks of stroke, and the risks of stroke may decrease after smoking cessation, even no significant difference with non-smokers. Because of the different age, sex, smoking quantity, years of smoking, and regions of the smoking popuation, their strokes and the risks of all stroke subtypes are also different.

Moyamoya disease is a chronic progressive cerebrovascular disease. Its disability rate and lethality rate are higher. The direct and indirect revascularization can increase cerebral blood flow and reduce the occurrence of cerebral ischemia and cerebral hemorrhage. This article reviews the pathophysiological basis of its surgical treatment, surgical timing, indications, surgical treatment methods and efficacy.

The imbalance in the fibrinolytic system participates in the pathophysic-logical processes of ischemic stroke. Most researchers consider that the fibrinolytic activity decreases in patients with ischemic stroke, while others believe that it increases. Mild hypothermia is a therapeutic approach with great potential and plays the neuroprotective effect through a variety of mechanisms. Animal experiments have demonstrated that the treatment with mild hypothermia may increase the plasma fibrinolytic activity and decrease the expression of local plasminogen activator in ischemic area. Howere, the related clinical research studies are few, and most of them are limited in the safty and collaborative research of mild hypothermia combined with other treatment therapies.

Objective To investigate the effect of the side of cerebral lesion on the outcome in patients with ischemic stroke.Methods A total of 407 consecutive anterior circulation ischemic stroke patients within 14 days after symptom onset were recruited prospectively.The basic data ofthe e,~ISes were collected,such as the National Institutes ofHealth Stroke Scale (NU-ISS)and the side ofcerebral lesion.The modified Rankin Scale(mRS)was used to evaluate the prognosis of the patients at 6 raomhs.Results Of the 407 patients recruited,230 patients (56.5%)Were left hemisphere stroke,177(43.5%)were fight hemisphere stroke.After multivariable logistic recession analysis,the age(odds ratio[OR]1.022,95% confidence interval[CI]1.001-1.043,P=0.040),the side of lesion(OR 1.999.95%CI1.179.3.389.P=0.010),the time from onset to admission(OR1.006,95%(7/1.002-1.010,P=0.007),the outcome of the anterior circulation ischcmic stroke at 6 months aftel"onset.The outcome of the right hemisphere stroke Was significantly worse than that of the left hemisphere stroke.The onset-admission time in patients with right hemisphere stroke(median 12 h,median 39.61 h)was significantly delayed compared to the patients with left hemisphere stroke(median 12 h,median 22.72 h;Z=-2.962,P=0.003).Condusions The outcome of the left hemisphere stroke at 6 months after onset is superior to the right hemisphere stroke,and it mau be associated with the delayed admission.

Objective To investigate the relationship between the carotid intima-media thickness(IMT),the characterization of atherosclerotic plaque as well as the degree of carotid stenosis and ischemic stroke.Methods Tbe patients with first-ever acute ischemic stroke (ischemic stroke group)detected by color Doppler ultrasonogaphy and the outpatients and hospitalized patients without ischemic stroke in the same period(control groupl were collected retrospectively.The demogaphic data,vascular risk factors,and characterization of atherosclerotic plaque were compared between the two groups.Ischemic stroke group was divided into stroke subtype groups according to the TOAST classification.Their characteristics of carotid atherosclerosis were corapared.Restdt,A total of 200 patients with first-ever acute ischemic stroke and 200 patients without ischemic stroke were included in the study.The carotid IMT in the ischemic stroke group WaS sigaificantlv thicker than that in the control group(left side:1.04±0.22 mm vs.0.69±0.13 mm,t=7.34,P<0.01;right side:1.05 ±0.21 mm vs.0.71±0.16 mm,t=7.43,P<0.01).The proportions of the patients with moderate and severe stenosis were significantly higher(moderate stenosis:38% vs.14%,x1=7.64,P<0.01:SCVele stenosis:27% vs,6%,x2=7.93,P<0.01),and the proportion of patients with mild stenosis was no significant difference.The detection rate of carotid plaque in the ischemic stroke group was significantly higher than that in the control group(87.0% vs.31.5%,X2=7.01,P<0.01).The numbers of unstable plaque(tipid soft plaque,flat plaque,and mixed plaque)in the ischemic stroke group were 301(65.3%),and significantly mole than 65(31.7%)in the control group(x2=6.30,P<0.01).There was no significant difference in the distribution of carotid plaque between the two groups.The plaques were most common at the carotid artery bifurcation.Compared with those in other stroke subtypes.such as cardioembolism,small-vessel occlusion.stroke of other determined etiology,and stroke of undetermined etiology,the cm'otid IMT(left side:F=22.34,P<0.01;right side:F=21.41,P<0.01),and the proportion of Upid soft plaque(x2=7.93,P<0.01),carotid severe stenosis(x2=6.83,P<0.01),carotid occlusion(x2=14.00,P<0.01)in stroke patients with large-artery atherosclerosis were significantly incleased.Condusiom Carotid IMT,the numlbers of unstable Plaque as well as the degree of carotid stenosis were associated with the occurrence of isehemic stroke.

Objective To preliminarily study on the values of microembolic signal(MES)monitoring in the evaluation of anti-Platelet agent or anti-Platelet agent+statins in patients with acute ischemic cerebrovascular disease.Methods Among the patients with acute ischemic cerebrovascular disease in the cm'otid system who performed MES monitoring the MES-positive patients were ramaomly allocated into dual antiplatelet group(aspirin 100 mg/d+clopidogrel 75 mg/d)and dual antiplatelet + atorvastatin goup (aspirin 100 mg/d + clopidogrel 75 mg/d +atorvastatin 20 me4d).MEss were monitored by transcranial Doppler ultrasound.Results Among the 60 patients with acute cerebrovascular disease in the carotid system,13(21.7%)were MES positive.in which,6 and 7 were randomly divided into dual antiplatelet group and dual antiplatelet + atorvastatin group respectively.There were no significant differences in the constituent ratios of sex hypertmsion,diabetes,coronary heart disease,smoking,alcohol consumption,and history of previous stroke as well as the age,time from onset to microembolic monitoring,and time from onset to drug intervention between the 2 groups.There were no significant differences in the numbers of microemboli(8.83±1.17/h vs.9.00±1.83/h)before treatment between the dual alltiplatelet group and dual antiplatdet + atorvastatin group (P=0.851);2 and 7 days after treatment,the numbers of micromixfli were 4.17±1.47 and 2.17±0.75/h respevtively in the dutral antiplatelet group,and they were significantly higher than 1.43±0.976 and 0.71±0.488/h)respevtively in the dual antiplatelet + atorvastatin group (P=0.002 and P=0.003).They were followed up for 8 days;and there were 110 ischemic events in both groups.Conclusions The dual antiplatelet agents or those in combination with statins might reduce the number of MES,but when they were used in combination with statins,the number Of MES reduced more significant.However.because there are only a few patients in the study,this conclusion still needs to be further validatod in a large-scale multicenter randomized controlled trial.The MES monitoring has a certain value in the evaluation of anti-platelet drugs or those in combination with statins

Objective To investigate the correlation between the glial fibrillary acidic protein(GFAP),neuron-specific enolase(NSE),synaptoghysin (SYN),neurite outgrowth inhibitor-A(Nogo-A)expression and neurological outcome in tissue surrounding the infarct during the recovery after cerebral ischemia-reperfusion injury in rats.Methods A 2-hour middle cerebral artery occlusion(MCAO)and reperfusion model in rats was induced by the intraluminal suture method.The modified neurological severity score(mNSS)was performed at day 28,35,42,and 49.Immunohistochemistry was used to detect the expressions of GFAP,NSE,SYN,and Noga-A in tissue surrounding the infarct.Results The mNSS score decreased gradually over time after cerdnal ischemia-reperfusion injury in rats.Except day 35(5.11±0.737)vs.day 42 (4.54±0.519),and day 42 vs.day 49(4.29±0.488),there were significant differences at all other time points(all P<0.05).The numbers of GFAP positive cells deergased gradually form day 28 to day 49,in which,the numbers of GFAP positive cells at day 42(51.00±13.59)vs.day 49(44.38±11.94) were significantly less than those at day 28(69.00±15.10)(P<0.05).There were no significant differences in the numbers of NSE positive cells at all time points,but their integrated optical density(IOD)increased gradually.There were significant differences between day 28(6 218.57±1 864.25)and day 42(9 414.00±2 491.12) or day 49(12 522.50±3 106.99),and between day 35(7 343.40±1 533.35)and day 49(all P< 0.05).There were no significant differences at all other time points.The SYN express (IOD)increased gradually.and it was significantly lower at day 49(66 503.00±12 834.61)than that at day 28(43 905.14±13 208.59)(P<0.05).The numbers of Nogo-A positive cells decreased gradually,and they were significantly less at day 49(42.13±14.45) than those at day 28(59.57±15.25)(P<0.05).The GFAP expression was positively correlated with the mNSS scores(r=0.993,P=0.007).The NSE(r=-0.954,P=0.044)and SYN(r=-0.992,P=0.008) expression was negatively correlated with the mNSS scores.Conclusion The neurological outcome was associated with the downregulation of GFAP expression and the upregalation of NSE and SYN expression during the recovery after cerebral ischemia-reperfusion injury in rats.

Objective To investigate the neuroprotective effect of sophocarpine against transient focal cerebral ischemia via down-regulation of the acid-sensing ion channel 1(ASICl) in rats.Methods Twenty-five SD rats were randomly allocated into sham operation,cerebral ischemia/reperfusion,and 5,10,and 20 mg/kg sophocarpine pretreatment groups (n=5 in each group).A rat focal ischemia model was induced by the intraluminal suture method.Five,10 and 20 mg/kg sophocarpine were injected intraperitoneally for pretreatrnent.2,3,5-triphenyltetrazolium chloride staining was used to detect cerebral infarct volume.TUNEL staining was used to detect apoptosis.Immunohistochemistry and Western blot were used to detect the expression of ASIC1 and ASIC2.Results The infarct volume after ischemia-reperfusion was(181.21±9.21)mm3,while the 5,10,and 20 mg/kg sophocarpine pretreatment groups were(150.12±6.19),(52.31±4.20),and(32.18±3.82)mm3,respectively;the neurological function scores in the cerebral ischemia/reperfusion group was(3.62±0.36),while the 5,10,and 20 mg/kg sophocarpine pretreatment grows were(3.15±0.36),(1.92±0.18),and(1.85±0.21),respectively;The surviving neurons only accounted for(31.2±2.8)% of the total cell number in the cerebral ischemia-reperfusion group,while they accounted for(51.2±3.7)%,(76.5±2.1)%,and(77.1±4.1)% in the 5,10,and 20 mg/kg sophocarpine pretreatnmat groups.Compared with the cerebral ischemia/reperfusion group,the cerebral infarct volume was decreased significantly in the sophocarpine pretreatrnent groups(all P<0.01),the neurological function scores were decreased significantly(all P<0.01),and the number of apoptotic cells was decreased significantly (all P<0.01).Immunohistochemistry showed that the number of ASIC-1 positive cells in the sham operation,cerebral ischemia-reperfusion,and 5,10,and 20 mg/kg sophocarpine pretreatment groups were(162.5±8.3),(165.1±5.3),(138.3±7.2),(82.1±6.3),and(69.2±5.5)/mm respectively;Western blot showed that the ASIC1 protein expression was decreased sigaificantly in the 10 and 20 mg/ky sophocarpine pretreatment groups (P<0.01),while there WaS no significant difference in the ASIC2 protein expression.Condusions Sophocarpine may play a neuroprotective role for cerebral ischemia-reperfusion injury in rats via down-regulating the expression of ASIC1 protein.

The research of the secondary damage remote from middle cerebral artery territory infarction has made significant progress in recent years.More animal experiments from the cellular,biochemical and molecular levels have been performed for in-depth and detailed research on remote site damage. The injury mechanisms such as oxidative damage and β amyloid deposition have been found.The new imaging detection technologies,such as magnetic resonance diffusion tensor imaging(DTI),have gradually been applied to the diagnosis of remote site damage.