Intracranial atherosclerotic stenosis (ICAS) is an important cause for the occurrence,development,and recurrence of ischemic stroke.Age,hypertension,diabetes,and smoking etc.are its traditional risk factors.Among them,symptomatic ICAS is the key of clinical intervention.Its treatments include intensive medical therapy,endovascular treatment,extracranial intracranial arterial bypass grafting,encephaloduroarteriosynangiosis,and external counterpulsation,etc.

Objective To investigate the correlation between methylenetetrahydrofolate reductase (MTHFR) gene 3 '-untranslated region rs4846049 G/T polymorphism and risk of ischemic stroke in a Chinese Han population. Methods A total of 396 patients with ischemic stroke and 378 healthy subjects (control group ) were selected using a case-control study design. Large artery atherosclerosis and small artery occlusion in the case group were 268 and 128 cases, respectively. Polymerase chain reaction-restriction fragment length polymorphism and the direct sequencing method were used to detect MTHFR gene rs4846049 G/T polymorphism. Results As compared to the GG genotype, the TT genotype significantly increased the risk of ischemic stroke (odds ratio [OR] 2. 87, 95% confidence interval [CI] 1. 43-5. 76;P=0. 003). Compared with G allele, T allele significantly increased the risk of the disease (OR 1. 62, 95% OR 1. 28-2. 06; P< 0. 001 ). Subgroup analyses showed that the rs4846049 G/T polymorphism could significantly increase the onset risks of LAA and SAO subtype stroke (all P<0.05). Conclusions MTHFR gene rs4846049 G/T polymorphism may be associated with the increased susceptibility to ischemic stroke in the Chinese Han population. The T allele may be a genetic risk factor for ischemic stroke in the Chinese Han population.

Objective To investigate the correlation between MicroRNA-146a (miR-146a) C ＞ G polymorphism and ischemic stroke.Methods The case control studies of the relationship between miR-146a polymorphism and ischemic stroke published before February 2016 were retrieved comprehensively.The Statal2.0 software package was used to conduct the meta-analysis.The odds ratio (OR) and 95％ confidence interval (CI) were used to evaluate the strength of association between the polymorphisms and the risk of ischemic stroke.Results A total of 8 articles were enrolled,including 2 891 patients in the case group and 4 019 in the control group.The selected literature did not have obvious publication bias.In the general population,the dominant model (GG + CG vs.CC:OR 1.011,95％ CI 0.863-1.185;P =0.889),recessive model (GG vs.CG + CC:OR 0.999,95％ CI 0.761-1.311;P=0.994),heterozygous model (CG vs.CC:OR 1.052,95％ CI 0.943-1.173;P =0.368),homozygous model (GG vs.CC:OR 1.114,95％ CI 0.819-1.515;P =0.491),and allele model (G vs.C:OR 1.062,95％ CI0.919-1.227;P=0.413) did not show significant correlation between the miR-146a C ＞ G polymorphism and the risk of ischemic stroke.Subgroup analysis showed that the miR-146a C ＞ G polymorphism was not associated with the onset risks of large artery atherosclerotic and small arterial occlusive stroke.Conclusions According to the literature available,the miR-146a C ＞ G polymorphism may not be significantly associated with the risk of ischemic stroke.

Objective To investigate the correlation between R219K (rs2230806 G/A) polymorphism in the ATP binding cassette transporter (ABC) A1 gene and ischemic stroke in a Chinese Han population. Methods A total of 360 patients with ischemic stroke and 358 healthy subjects were selected using a case-control study design. The patients with ischemic stroke were redivided into either a large artery atherosclerosis (LAA) group or a smal artery occlusion (SAO) group according to the TOAST criteria. Polymerase chain reaction-restriction fragment length polymorphism analysis and direct sequencing method were used to detect R219K (rs2230806 G/A) polymorphism in the ABCA1 gene. Results Using GG genotype as a reference, the AA genotype reduced the risk of ischemic stroke by 65% (odds ratio [OR] 0. 35, 95%confidence interval [CI] 0. 23 - 0. 55; P < 0. 001) and the onset risk of LAA by 77% (OR 0. 23, 95% CI 0. 13 - 0. 40; P < 0. 001), but it did not have significant correlation with SAO. The interaction of rs2230806 G/A polymorphisms with smoking, drinking, hypertension, and diabetes had no significant effect on the on-set risk of ischemic stroke (al P > 0. 05). AA genotype was enable to increase the high-density lipoprotein cholesterol levels of the patient group (OR 0. 35, 95% CI 0. 28 - 0. 42; P < 0. 001) and the control group (OR 0. 19, 95% CI 0. 14 - 0. 23; P < 0. 001) significantly, while it did not have significant correlation with the low-density lipoprotein cholesterol, total cholesterol, and triglyceride. Conclusions R219K (rs2230806 G/A) polymorphism in the ABCA1 gene may be associated with the reduced predisposition of ischemic stroke in a Chinese Han population, especialy LAA. The A alele may be a hereditary protective factor; its mechanism may be associated with the increase of high-density lipoprotein cholesterol levels.

Objective To explore the relationship between lecithin cholesterol acy ltransferase (LCAT) gene 608C/T and 511C/T polymorphisms and stroke in Chinese Han population in Hunan province. Methods One hundred fifty patients with cerebral infarction, 150patients with cerebral hemorrhage, and 122 age- and sex-matched healthy controls were selected.LCAT gene 608C/T and 511C/T polymorphisms were detected by using polyrnerase chain reaction, single strand conformation polymorphism, and restriction fragment length polymorphisms. Results The CT genotype frequency (14. 0% ) and T allele frequency (7. 0% )of the LCAT gene 608C/T in the cerebral infarction group were significantly higher than those in the control group (all P ＜0. 05), while there were no significant differences in the CT genotype frequency (7. 3% ) and T allele frequency (3.7%) between the cerebral hemorrhage group and the control group (P ＞ 0. 05). The CT genotype frequency (10. 0% ) and T allele frequency (5. 0% ) of the LCAT gene 511C/T in the cerebral infarction group were significantly higher than those in the control group (all P ＜0. 01), while there were no significant differences in the CT genotype frequency (3.3%) and T allele frequency (1.7%) between the cerebral hemorrhage group and the control group (P ＞0. 05). Conclusions The 608C/T and 511C/T polymorphisms may be associated with the occurrence of atherosclerotic cerebral infarction in Chinese Han population in Hunan province. They may be the predisposing factors for atherosclerotic cerebral infarction in this population; however, they are not associated with cerebral hemorrhage.

Objective To investigate the correlation between ATP-binding cassette transporter A1 (ABCA1) R219K polymorphism and ischemic stroke in Chinese populations.Methods The case control studies of the correlation between Chinese ABCA1 R219K polymorphism and ischemic stroke published before May 2013 were collected using comprehensive literature search.The Stata 11.0 software was used to conduct metaanalysis.Odds ratio (OR) and its 95％ confidence interval (CI) was used to evaluate the strength of association between the gene polymorphism and ischemic stroke.Results A total of 10 studies met the criteria and were included in the analysis,including 1 619 patients in the patient group and 1907 in the control group.The selected literature had no obvious bias.Meta-analysis showed that the risk of ischemic stroke in patients carrying RK + KK genotype significantly decreased 8％ (OR 0.92,95％ CI 0.88-0.96; P =0.000)compared to those carrying RR genotype.The risk of ischemic stroke in patients carrying KK genotype significantly decreased 36％ compared to those carrying RR genotype (OR 0.64,95％ CI 0.44-0.94; P =0.02).The risk of ischemic stroke in patients carrying RK genotype significantly decreased 19％ compared to those carrying RR genotype (OR 0.81,95％ CI 0.69-0.95; P =0.009).The risk of ischemic stroke in patients carrying K allele significantly decreased 17％ compared to those carrying R allele (0R 0.83,95％ CI 0.69-0.99; P =0.036).Conclusions ABCA1 R219K polymorphism is associated with the susceptibility of ischemic stroke in Chinese.K allele may be a genetic protective factor for ischemic stroke in Chinese populations.