BACKGROUNDA recent study demonstrated that the inflammatory response accompanying necrotic brain injury played an important role in stroke. Thus, inhibition of this response may help to stop the expansion of infarcts. It has been also shown that the spleen, a major peripheral immune organ, plays a role in stroke-induced immune responses. This study aimed to establish rat models of middle cerebral artery occlusion (MCAO) and to investigate the effect of splenectomy and possible mechanisms in that rat models.

METHODSInfarct size in a stroke model was measured with the Nissl body staining method, numbers of inflammatory cells in ischemic regions were detected by immunofluorescence staining, and inflammatory factors were assayed by enzyme-linked immunosorbent assay and real-time polymerase chain reaction (PCR) in brain homogenates and sera. The significance of differences was determined by one-way analysis of variance (ANOVA) followed by the least significant difference post hoc test.

RESULTSInfarct size in the brain of rats that underwent splenectomies 2 weeks before permanent MCAO ((34.93 ± 3.23)%) was over 50% smaller than that of rats subjected to the stroke surgery alone ((74.33 ± 2.36)%, P < 0.001; (77.30 ± 2.62)%, P < 0.001). Lower numbers of T cells, neutrophils, and macrophages in brain tissue and lower levels of pro-inflammatory cytokines, such as interleukin (IL)-1β and tumor necrosis factor (TNF)-α, were observed in rats that underwent splenectomies, compared with the two other groups, but splenectomized rats showed higher levels of the anti-inflammatory factor IL-10 in the brain.

CONCLUSIONThe mechanism(s) by which splenectomy protects brain from damage induced by stroke may correlate with the decreased numbers of inflammatory cells and changes in inflammatory cytokines.

Animals ; Cerebral Infarction ; prevention & control ; Cytokines ; secretion ; Inflammation ; prevention & control ; Male ; Rats ; Rats, Sprague-Dawley ; Splenectomy ; Stroke ; complications ; T-Lymphocytes ; immunology

Adult ; Azoospermia/parasitology* ; Hormones/blood* ; Humans ; Infertility, Male/parasitology* ; Male ; Polymerase Chain Reaction ; Testicular Diseases/parasitology* ; Trichomonas Infections/parasitology* ; Trichomonas vaginalis

Objective To investigate the relationships between the risk factors (the levels of blood glucose and blood fat) and the severity of leukoaraiosis (LA) in patients with type 2 diabetes.Methods The risk factors (including levels of plasma HbA1c,fasting blood glucose,2 hours blood glucose after meals,triglyceride,total cholesterol,high density lipoprotein,and low density lipoprotein) were measured and the head magnetic resonance were used in the selected patients who were diagnosed as having subcortical vascular dementia and type 2 diabetes (n=106).According to the Fazekas's classification of signals of deep white matter hyperintense (DWMH) and periventricular hyperintense (PVH),the severity of LA was graded as grade 1,2 and 3 by its appearance under MRI.LA scores were obtained by its appearance under MRI according to the semiquantitative way; the influencing factors of LA scores were analyzed using multiple linear regression.The clinical features of patients with different plasma HbAlc levels were compared; the relations of signals of DWMH and PVH with other risk factors were compared; and the clinical features of patients with different signals of DWMH and PVH were compared too.Results LA scores were positively related to HbAlc level and age (r=0.457,P=0.000;r=0.400,P=0.000).The signals of DWMH and PVH were positively related to the HbA1c level and age (r=0.385,P=0.000; r=0.361,P=0.000; r=0.458,P=0.000; r=0.364,P=0.000).Statistical significance of stroke history in different signals of DWMH and PVH was noted (P＜0.05).After adjusting the age,signals of DWMH and PVH were positively correlated to the HbA1c level (r=0.253,P=0.009; r=0.318,P=0.001).Conclusion In the patients with type 2 diabetes,the plasma level of HbA 1 c is an important biochemical indicator which reflects the severity of LA (including DWMH and PVH); age and stroke history are relative with the severity of LA,while blood fat level is not correlated to the severity of LA.

Objective To investigate the clinical differences and the mechanism of ischemic stroke related to intracranial branch atheromatous diseases.Methods All 213 consecutive patients diagnosed with ischemic stroke related to intracranial branch atheromatous diseases by using diffusion-weighted imaging (DWI),admitted to our hospital from January 22,2008 to October 13,2011,were studied.These patients were classified into paramedian pontine arteries group (PPA group,n=56)and lenticulostriate arteries group (LSA group,n=157) according to the DWI findings.The clinical characteristics were compared between the two groups.Results The differences on the mean length of hospital stay and white matter degeneration were statistically significant between PPA group and LSA group (t=-2.044,P=0.045; x2=6.832,P=0.009).In univariate logistic regression analysis,the odds ratio (OR) of concomitant white matter degeneration comparing with the opposite was 11.652,95％CI was (1.483-91.529) and P value was 0.020.Conclusion The ischemic stroke related to intracranial branch atheromatous diseases usually accompanies with concomitant white matter degeneration,and the characteristics are different resulting from different blood supplies.

Objective To find out the different features of deep gray matter lesions on magnetic resonance imaging (MRI) among patients with acute disseminated encephalomyelitis (ADEM),multiple sclerosis (MS),and neuromyelitis optica (NMO) in adults.Methods After searching the database,353 adult patients,admitted to our hospital from August 2004 to October 2012 and diagnosed as ADEM,MS,and NMO,were identified.Among them,95 adult patients with ADEM (n=12),MS (n=60) and NMO (n=23) had deep gray matter lesions on MRI were included in our study.Morphological features of deep gray matter lesions,including diameter,quantity and distribution among these patients,were compared.Results The percentage of lesions involved in the thalamus,caudate nucleus and globus pallidus was not significantly different among the three groups (P＞0.05).Putamen was more frequently involved in patients with ADEM than that in patients with MS and NMO (P=0.002 and 0.013,respectively).Hypothalamus was more frequently involved in patients with NMO than that in patients with ADEM and MS (P=0.033 and 0.001,respectively).The diameter of the thalamus lesion in patients with ADEM was significantly larger than that in patients with NMO (P=0.027),but was not significantly different from that in patients with MS (P=0.116); no significant difference between the lesion diameters of patients with MS and NMO was observed (P=0.209).The diameters of the lesions located in the caudate nucleus,globuspallidus,putmen,and hypothalamus were not significantly different among the three groups (P＞0.05).Furthermore,no significant difference was found among the three groups in respect of the symmetry of lesion distribution (P=0.335).Conclusions Thalamus involvement might not be helpful in differentiating ADEM from MS in adults.Putamen involvement might be helpful in differentiating ADEM from MS and NMO.Hypothalamus involvement is specific for NMO.Lesion size is not useful in the differential diagnosis of ADEM,MS,and NMO.

Objective To investigate the correlation between severity of leukoaraiosis (LA) and plasma levels of homocysteine and fibrinogen in patients with Binswanger disease (BD).Methods All patients with BD,admitted to our hospital from January 2005 to May 2011,were selected consistently with the diagnostic criteria of Bennett.The levels of plasma homocysteine (Hcy),fibrinogen (Hcy),low-density lipoprotein (LDL),apolipoprotein A (Apoa),apolipoprotein B (Apob),and high-density lipoprotein (HDL) were measured.According to the Kinkel's classification of BD,the severity of LA was graded as mild,moderate,or severe by its appearance under MRI.The relation between levels of plasma Hcy and Fib and severity of LA in BD patients were analyzed.Results Single factor analysis indicated that the dispositions of gender,age,hypertensive disease,stroke and hyperlipoidemia in BD patients with different severities of LA were significantly different (P＜0.05).The severity degree of LA was positively correlated with the levels of Hcy and Fib (P＜0.05).Ordered logistic regression analysis showed that female was severer than male in the severity of the LA in BD patients; age,stroke and level of plasma Fib were positively related to the severity of LA in BD patients (P＜0.05).Conclusion The high plasma level of Fib is an important factor for BD deterioration; reducing the level of plasma Fib may delay the aggravation of BD.