Objective To investigate the value of magnetic resonance imaging (MRI)-based intravenous thrombolysis in patients with wake-up ischemic strokes (WUIS).Methods Patients presenting within 12 hours of acute stroke symptom onset and those with WUIS confirmed by CT,excluding intracranial hemorrhage,were encouraged to perform an emergent brain MRI scan to confirm the diagnosis of hyperacute ischemic stroke (hyper-intense in DWI without hyper-intense change in T2WI or fluid attenuated inversion recovery (FLAIR)).These patients then received intravenous thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA).All patients were divided into either stroke presenting within 12 hours or WUIS.The clinical outcomes were assessed by the modified Rankin scale (mRS) and the Barthal index (BI) at baseline and at 90 days after the thrombolysis therapy.Results Two hundred and sixty-one patients (261/563,56.4％) had confirmed diagnosis of hyperacute ischemic stroke (WUIS,n =73,73/121 =60.3％ vs within 12 hours,n =188,188/342 =55.0％).Altogether,192 patients (139 in within 12 hours group,and 53 in WUIS group) received intravenous thrombolytic therapy with rt-PA.No significant differences were found between the 2 groups at the baseline characteristics and at 90 days outcomes after the thrombolysis therapy(x2 =1.296 and 1.473,P =0.538 and 0.489,respectively).Also no significant differences were found in the incidence rate of secondary hemorrhage (including both of asymptomatic and symptomatic) and mortality rate between the 2 groups.Conclusion MRI-based intravenous thrombolysis is safe and effective in the treatment of patients with hyperacute WUIS.

Objective To investigate the value of MRI in thmmbolytic thempy of hyperacute cerebral arterial thrombosis.Methods One hundred and sixteen patients with acute cerebral arterial thrombosis were recruited.plain CT and multi.modal MRI were performed in all patients.Thirty-three patients with hyperacute cerebral infarction were treated bv recombinant tissue plasminogen activator(rt-PA) and followed-up periodically using MRI.Results The 33 patients with thrombolysis selected by MRI demonstrated clinical improvement.90 d moclified Rankin scale scores(mRs)were less than 2 and life quality Barthal indexes(BI)were from 80 to 100.The complication included one asymptomatic parenchymal hematoma(PH1)one weeks after thrombolytic therapy and 4(12.2%)hemorrhagic infarction(HI)6 to 24 hours after thrombolytic therapy.Condusions MRI has significant clinical value for the screening and follow-up of intravenous thrombolytic therapy of hyperacute ischemic stroke.MRI-based thrombolysis is a safe and effective method for hyperacute ischemic stroke.

Objective To investigate the effect of Puromycin(PAN)and Tacrolimus(FK506)on the expre-ssion of podocin in podocytes,and discuss the mechanism of FK506 in improving proteinuria caused by the damage of glomerular podocytes.Methods Mouse podocyte were cultured and divided into 3 groups,which were control group, PAN group and FK506 group,respectively.The changes of each group after 8 hours,24 hours and 48 hours of treatment were detected by using phase-contrast microscope,and the expression and distribution of protein and mRNA were tested by adopting Western blot,quantitative real-time PCR and immunofluorescence technique.Results Compared with the control group(8.54 ± 0.25,8.27 ± 0.07,7.45 ± 0.13)at each time point(8 hours,24 hours and 48 hours),the soma size of the PAN group(6.41 ± 0.22,4.96 ± 0.09,3.76 ± 0.16)was reduced.But in the FK506 group(7.67 ± 0.06, 6.62 ± 0.04,5.57 ± 0.27),it was increased at each time point(8 hours,24 hours and 48 hours)compared with the PAN group.The podocytic process and the intercellular connection disappeared,and the distribution was significantly scattered.The mRNA(0.87 ± 0.15,0.78 ± 0.15,0.58 ± 0.12)and protein(0.82 ± 0.02,0.62 ± 0.03,0.50 ± 0.02) expressions of podocin increased in FK506 group and mRNA(0.63 ± 0.12,0.56 ± 0.01,0.48 ± 0.02),protein (0.71 ± 0.03,0.46 ± 0.01,0.34 ± 0.02)were observably reduced in PAN group at each time point(8 hours,24 hours and 48 hours)and showed abnormal distribution in PAN group,compared with the control group[podocin mRNA (1.22 ± 0.15,1.18 ± 0.06,0.87 ± 0.30),protein(0.86 ± 0.03,0.87 ± 0.03,0.61 ± 0.07)].Conclusions PAN attenuates the mRNA and protein expression of podocin by damaging podocytes,inversely,while FK506 protects poto-cyte injury by stabilizing the mRNA and protein expression of podocin,which maybe involve inhibition of proteinuria.It can be used as a target for the study and treatment of kidney diseases.