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 detect the expressions of circulating microRNAs (miRNAs) of peripheral whole blood in Alzheimer's disease (AD) and investigate the potential roles of the miRNAs as diagnostic bi omarkers for Alzheimer's disease.Methods Peripheral blood samples were obtained from 110 AD patients and 150 age-and gender-matched normal controls.The concentrations of seven candidate miRNAs,including miR-9,miR-29a,miR-29b,miR-101,miR-181c,miR-137and miR-126,were measured with a real-time quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) method.The data of two groups were collected and analyzed by SPSS 19.0 software.Results It was found that miR-29a (P=1.12×10-5) and miR-101 (P=6.24× 10-7) were markedly down-regulated in peripheral blood of AD patients compared with normal controls.In addition,logistic regression analysis revealed peripheral whole blood miR-29a/101 combination could be a potential biomarker of AD with better specificity (82％) and sensitivity (75％).Conclusions miR-29a/101 combination in peripheral whole blood may serve as a useful noninvasive diagnostic biomarker for AD.

Objective To determine and compare the levels of serum matrix metalloproteinase (MMP)-2 and MMP-9 in acute stage of cerebral infarction and the relationship and prognosis between them and the classification of TOAST. Methods The levels of MMP-2 and MMP-9 were detected by ELISA in 60 cerebral infarction patients(CI group)while 30 healthy donors were served as control group (NC group).Results The level of MMP-2 in CI group was significantly lower than that in NC group (P＜0.01) and the level of MMP-9 was significantly higher than that in NC group (P＜0.01).Compared with lacunar infarction (LI) group,the level of MMP-9 was significantly higher in cardiogenic cerebral embolism group(CCE group) and large artery arteriosclerosis cerebral infarction group (LAA group);The serum level of MMP-9 was related to NIHSS.The serum level of MMP-9 in good prognosis patients was significantly lower than that in poor prognosis patients (P＜0.01).Conclusions The serum level of MMP-9 is increased after cerebral infarction.The serum level of MMP-9 in the CCE group and LAA group is significantly higher than that in LI group.The level of MMP-9 is a reliable parameter in evaluating the disabilities in cerebral infarction.The level of serum MMP-9 within 24 hours of onset can predict the prognosis of cerebral infarction independently.

Objective To investigate the effects of serum levels of leptin, IGF-1, BDNF and inflammatory markers in patients with post-stroke depression(PSD). Methods By using Hamilton rating scale for depression (HAMD) ,46 patients with post-stroke depression were recruited and 50 patients without depression as the control group. Two weeks after the onset of stroke, serum levels of leptin, insulin growth factor(IGF-1), hs-CRP, intracellular adhesion molecule (ICAM-1) and brain-derived neurotrophic factors (BDNF) were measured by enzymelinked immunosorbent assay(ELISA). Results The levels of leptin and IGF-1 in patients with PSD were significantly higher than that of the control group (( 57.4 ± 14.32) ng/ml vs (17.53 ± 11.62) ng/ml, P = 0. 002;(120.86 ±28.66) ng/ml vs (66.5 ± 17.51) ng/ml, P=0. 004 respectively). The serum levels of leptin and IGFI were positively correlated with the HAMD score(r=0. 724, P＜0. 01; r=0. 641, P＜0. 01 respectively). There was no significant differences in the levels of hs-CRP((2.3 ±0.42) mg/dl vs (2.2 ± 0.28) mg/dl, P= 0. 767),ICAM-1 (( 182.6 ± 50.27) ng/ml vs (178.7 ± 51.14) ng/ml, P = 0. 812) and BDNF(( 25.8 ± 8.35) ng/ml vs (24.2 ±7.48)ng/ml, P = 0.580)in the two groups. Conclusion The serum levels of leptin and IGF-1 may be associated with post-stroke depression and may be the markers of PSD in the old stroke patients.

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 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.

ObjectiveTo investigate the effects of acupuncture on the serum leptin and IGF-1 in patients with post-stroke depression (PSD).MethodsBy using Hamilton rating scale for depression (HAMD),94 patients with PSD were recruited and randomly divided into 2 groups:acupuncture group and control group.All patients were given routine clinical treatments and second level medical prevention.Patients in the acupuncture group received Linggui Ba fa acupuncture treatment and oral administration of Sertraline and patients in the control group were treated with oral administration of Sertraline only.Serum levels of letpin and insulin growth factor (IGF-1) were measured by enzyme linked immunosorbent assay (ELISA) before and after treatments in all patients.ResultsThe levels of leptin and IGF-1 in patients of acupuncture group were significantly lower than that of the control group after treatment[(17.06 ± 12.38) ng/ml vs (32.27 ± 15.09)ng/ml,P＜0.01; (52.61±24.74)ng/ml vs (77.15±20.83)ng/ml,P＜0.01 respectively].The scores of HAMD in acupuncture group were significantly lower than that of control group after the treatment[(8.06±3.32)、(13.67±8.05)]and 6 month later[(6.52±2.08)、(10.26±6.16)].ConclusionThe serum levels ofleptin and IGF-1 were significantly lower and depression symptoms were improved after acupuncture in elderly patients with post-strok depressin.

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.