Pregnancy-associated plasma protein-A (PAPP-A),a high-molecular-weight zinc-binding metrix metalloproteinase,is expressed abundantly in the ruptured atherosclerostic plaque. PAPP-A can be used as a novel biological marker of plaque instability and cardiovascular events in patients with acute coronary syndrome. However,the role of PAPP-A in iscbemic stroke remains unclear. This article reviews the value of VAPP-A in predicting the risks of ischemic stroke events.

Objective To investigate the correlation between interleukin 18 (IL-18) gene promoter -137 G/C polymorphism and plasma levels of IL-18 and cerebral infraction.Methods A total of 218 Han patients with acute cerebral infarction in northern China were recruited and 218 sex- and age-matched health subjects were used as control group. Enzyme-linked irnmunosorbent assay was used to detcet the level of IL-18. Sequence specific primer-polymerase chain reaction was used to detect IL-18 gene promoter - 137 G/C polymorphism. Results The plasma IL-18 levels (1 47. 47 ±29. 79 ng/L vs. 78. 78 ± 16. 42 ng/L; t =29. 816, P ＜0. 01)and the frequency of - 137 GG genotype (79. 8％ vs. 67. 0％;x2 =8. 563, P =0. 032) in the acute cerebral infarction group were significantly higher than those in the control group. The risk of cerebral infarction in individuals with - 137GG genotype was 1.95 times higher than that in individuals without - 137GG genotype (odds ratio 1.95, 95％ confidence interval 1. 263-3. 012,P =0. 002); plasma IL-18 levels in patients with CG genotype were significantly higher than those in patients with CG +CC genotype (150. 00 ±27. 26 ng/L vs. 118. 47 ±21.62 ng/L, t =8. 222, P ＜0. 01). Conclusions The IL-18 gene promoter - 137 G/C polymorphism correlates with cerebral infarction in Han population in north China. The risk of cerebral infarction in individuals with GG genotype is significantly higher, and it may be associated with its influence on plasma level of IL-18.

Cervical artery dissection (CeAD) is characterized by an intramural hematoma of the internal carotid artery or the vertebral artery.CeAD is the major cause of ischemic stroke in young adults.Carotid artery dissection is a major cause of stroke.Early recognition and treatment of CeAD is important for the prevention of ischemic stroke.

Objective To explore the clinical effect of microendoscopic discectomy through posterior approach in old patients with multilevel lumber spinal stenosis and analyze the influence factors that related to clinical effect .Methods 64 old patients with multilevel lumber spinal stenosis were selected and divided into microendoscopic group and open group based on different operation method ,each group contained 32 patients .Comparison was made between two groups in respects of operation time ,amount of bleed-ing ,hospital time post-operation and Nakai scores .Analyzed the influence factors that related to clinical effect .Results The opera-tion time ,amount of bleeding ,hospital time post-operation in microendoscopic group were lower than open group ,the differences had statistical significance .Based on the Nakei score ,the curative effect in microendoscopic group was slightly lower than open group ,but the differences had no statistical significance .The JOA score pre-operation ,walking distances and complication were rela-tive factors that could influence the clinical effect of microendoscopic discectomy through posterior approach method .Conclusion Microendoscopic discectomy through posterior approach in old patients with multilevel lumber spinal stenosis had quicker postoper-ative recovery than conventional operation ,and the JOA score pre-operation ,walking distances and complication were relative fac-tors that could influence the clinical effect of microendoscopic discectomy through posterior approach method .

Adenosine monophosphate-activated protein kinase (AMPK) is a serine/threonine protein kinase,which is a energy regulation switch in the cells of the body.In the case of nutritional deficiencies and ischemia,AMPK system is activated as the metabolism and stress signal transduction component to regulate the expression of downstream target proteins.After acute ischemic stroke,AMPK is activated and aggravates neuronal apoptosis,and giving AMPK inhibitor may reduce cerebral ischemic injury.The activation of AMPK after stroke may result in the upregulation of brain-derived neurotrophic factor expression and the activation of endothelial nitric oxide synthase,and they play the protective roles for neuronal regeneration and repair.This article reviews the advances in research on the roles of AMPK in experimental cerebral ischemia.

Resveratrol is a polyphenolic compounds in many plants.It has many effects inchuding antioxidation,anti-inflammation,inhibiting apoptosis,and scavenging free radicals.Resveratrol preconditioning has neuroprotective effect in ischemia-reperfusion in rats by activating silent information regulator 2 homolog 1.This effect is similar to brain ischemic preconditioning.In addition,resveratrol can also attenuate the brain infraction volume of cerebral ischemia/reperfusion in mice and improve neurological function.This article reviews the neuroprotective effect of resveratrol and its mechanisms in cerebral ischemia.

Oxytocinreceptor(OTR)isamemberofG -proteincoupledreceptor ,whichhasbeen foundinmanytumorsandcancercelllines .Manystudiesrevealedoxytocin(OT)mayinhibitthetumorand cancercellgrowthandproliferation ,butthemechanismofthisinhibitionisnotwellknown .Someexperiments indicatedcAMP -PKAsystemparticipatesinthesignaltransductionthatoxytocininhibitsthecancercellpro liferation .However ,otherexperimentsshowedthesignaltransductionforoxytocinintheHs5 78Tcarcinosaco macellisthesameasthatinthenormalcells .Inthisreview ,therelationshipbetweenOTRandtumorsare summarized . [

Objective To investigate the effects of Polysaccharide Sulfate (PSS) on plasma von Willebrand factor (vWF) and thrombomodulin (TM) in patients with acute cerebral infarction.Methods 64 patients with acute cerebral infarction were randomly assigned to receive intravenous drip of PSS (150 mg/d for 14 days, 32 cases, PSS group) or Troxerutin (600 mg/d for 14 days, 32 cases, control group). All of the patients were tested for plasmatic levels of vWF and TM prior to and at 7 d, 14 d after treatment.Results The levels of vWF in PSS group at 7 d, 14 d after treatment were obviously decreased compared with control group (all P

Objective To investigate the effects of resveratrol on the first and double oxygen-glucose deprivation (OGD) primary cortical neuron silent information regulator 1 (SIRT1), AMP-activated protein kinase (AMPK) activity and ATP content, and its possible neuroprotective mechanism. Methods Cortical neurons were taken from the embryos of 18-day Wistar rats. An in vitro repeated ischemia model was induced by the double OGD after the success of primary culture. Trypan blue stalning was used to detect the cel survival rate. Western blot was used to detect the SIRT1 and phospho-AMPK expression. Deacetylase fluorescence assay was used to detect the SIRT1 activity. Bioluminescence assay was used to detect the ATP content. Results Compared with the control group, resveratrol (0. 5 μmol/L) preconditioning significantly increased the survival rates after the single and double OGD (al P < 0. 001), ATP content (al P = 0. 004), SIRT1 activity (single: P = 0. 001; double: P = 0. 002), and the expression levels of SIRT1 (single: P = 0. 029; double: P = 0. 023) and phospho-AMPK (al P = 0. 001). Conclusions Resveratrol has the neuroprotective effect for the first and double OGD cortical neurons. Its mechanism may be associated with upregulating the SIRT1/AMPK signaling pathways and decreasing the energy requirements.

Objective To investigate the relationships between the levels of plasma soluble CD40 ligand (sCD40L),fetuin-A and pregnancy-associated plasma protein A (PAPP-A) and carotid plaque in patients with acute ischemic stroke.Methods The patients with acute ischemic stroke were enrolled in the study.Carotid arteries were assessed by using carotid artery ultrasound.The patients were divided into either a carotid artery plaque group or a non-carotid artery plaque group according to the assessment results.The former were further divided into a stable plaque sub-group and an unstable plaque sub-group according the nature of plaque.Enzyme-linked immunosorbent assay was used to detect the levels of plasma sCD40L,fetuin-A and PAPP-A.The demography,previous history,complications,laboratory tests and plasma inflammatory biomarkers between the carotid artery plaque group and the non-carotid artery plaque group and between the stable plaque subgroup and the unstable plaque subgroup were compared.Multivariate logistic regression analysis was used to investigate the relationship between plasma inflammatory biomarkers and carotid plaques.Results A total of 200 patients with acute ischemic stroke were included.Among them,78 were females and 122 were males (aged 33 to 87 years,mean 60.1 ± 10.3 years); 139 patients were in the carotid artery plaque group and 61 were in the non-plaque group; 43 were in the stable plaque subgroup and 96 were in the unstable plaque subgoup.The mean age of the carotid artery plaque subgroup was significantly greater than that in the non-plaque subgroup (63.2 ± 8.7 years vs.50.3 ± 9.5 years; t ＝ 10.179,P =0.000),the constituent ratios of men (68.3％ vs.44.3％;x2＝ 10.336,P＝ 0.001),hypertension (71.2 vs.54.1％;x2=5.540,P=0.019),diabetes (46.8％ vs.29.5％ ;x2 =5.199,P =0.023),and hyperlipidemia (78.4％ vs.37.7％ ;x2 =31.31,P =0.000)in patients of carotid plaque group were significantly higher than those of the non-carotid plaque group.The levels of total cholesterol (5.7 ± 1.1 mmol/L vs.5.3 ± 1.0 mmol/L; t =2.433,P =0.016),low-density lipoprotein cholesterol (4.5 ± 1.0 mmol/L vs.4.1 ±0.9 mmol/L; t =2.683,P =0.008),fasting glucose (7.5 ±2.5 mmol/Lvs.6.4±2.1 mmol/L; t=3.002,P＝0.003),sCD40L (151.4 ± 55.8 pg/mlvs.102.8 ±65.9 pg/ml; t =5.360,P=0.000),fctuin-A (390.1 ± 80.6 μg/ml v.s.352.9 ± 98.6 μg/ml; t =2.591,P =0.011),and PAPP-A (11.49 ±4.67 mIU/L vs.8.46 ± 3.99 mIU/L; t =4.409,P =0.000) were significantly higher than those of the non-carotid plaque group.Multivariate logistic regression analysis showed that hyperlipidemia (odds ratio [OR] 6.582,95％ confidence interval [CI] 2.321-18.662; P =0.000),sCD40L (OR6.372,95％ CI 2.174-18.670;P=0.010),and fetuin-A (OR 4.101,95％ CI 1.012-16.619; P=0.048) were the independent predictors for carotid artery plaques in patients with acute ischemic stroke.The mean age of the stable plaque subgroup was significantly lower than that of the unstable plaque subgroup (59.6 ± 9.3 years vs.64.1 ± 7.2 years; t =3.231,P =0.002).The constituent ratio in patients with hypertension was significantly lower than that of the unstable plaque subgroup (55.8％ vs.78.1％ ; x2 =7.213,P =0.007).The levels of total cholesterol (5.4 ±0.9 mmol/L vs.6.0 ± 1.1 mmol/L; t =3.136,P =0.002),low-density lipoprotein cholesterol (4.0 ± 1.2 mmol/L vs.5.7 ± 1.0 mmol/L; t =8.696,P =0.000),fasting glucose (7.1 ± 2.3 mmol/L vs,7.9 ± 1.9 mmol/L; t =2.147,P =0.034),sCD40L (135.3 ±74.3 pg/ml vs.176.5 ±64.5 pg/ml; t =3.319,P ＝0.001),and PAPP-A (10.96 ± 5.02 mIU/L vs.13.98 ±4.63 mIU/L; t =3.463,P =0.001) were significantly lower than those of the unstable plaque subgroup,while the level of high-density lipoprotein cholesterol was significantly higher than that of the unstable plaque subgroup (1.2 ± 0.2 mmol/L vs.1.1 ± 0.3 mmol/L; t =2.314,P=0.022).Multivariate logistic regression analysis showed that HDL-C (OR 0.234,95％ CI0.060-0.906; P =0.022) was an independent protective factor for unstable plaques,while sCD40L (OR 5.290,95％ CI 1.613-17.351; P =0.029) and PAPP-A (OR4.125,95％ CI 1.281-13.283; P =0.021) were the independent predictors for unstable plaques.Conclusions The levels of sCD40L,PAPP-A,and fetuin-A were associated with the existence and stability of carotid artery plaque.The increased plasma sCD40L and fetuin-A were the independent predictors for carotid artery plaques in patients with acute ischemic stroke,and the increased levels of plasma sCD40L and PAPP-A were the independent predictors for carotid artery plaque instability in patients with acute ischemic stroke.