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Lipoprotein-associated phospholipase A2 and carotid atherosclerosis

International Journal of Cerebrovascular Diseases.2009;17(6):459-462. doi:10.3760/cma.j.issn.1673-4165.2009.06.011

Lipoprotein-associated phospholipase A2(Lp-PLA2) is a novel biomarker for cardiovascular disease. Its expression in symptomatic carotid plaques is higher than that in asymptomatic ones, and its product lysophosphatidylcholine is associated with tissue oxidative stress and inflammation. In addition, Lp-PLA2 plays a more unique role in the unstable difference of carotid atherosclerotic plaques.

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A correlative study of tumor necrosis factor-α in ischemic brain tissue and brain edema after cerebral ischemia-reperfusion in rats

Lihua SHEN ; Min YE ; Xinsheng DING ; Qiu HAN ; Erbing WU

International Journal of Cerebrovascular Diseases.2009;17(11):840-843. doi:10.3760/cma.j.issn.1673-4165.2009.11.004

Objective To investigate the relationship between tumor necrosis factor-α (TNF-α) in ischemic brain tissue and bran edema after cerebral ischemia-reperfusion in rats.Methods Eighty four male SD rats were randomly assigned to either a cerebral ischemia reperfusion group (n =44) or a sham-operation group (n =40). A model of middle cerebral artery occlusion for 120 minutes followed by reperfusion was induced in rats using the suture method. The infarct size was determined by 2, 3, 5-triphenyi terazoloride (TTC) staining at 6 h,24 h, 3 d, and 7 d respectively after the reperfusion. Dry-wet weight method was used to measure brain water content and evaluate the extent of brain edema. The enzyme-linked immunosorbent assay (ELISA) was used to detect the concentration of TNF-α in ischemic brain tissue. Results TNF-α level in ischemic brain tissue was increased at 6 h (445.8 ±91.7 pg/ml) after the reperfusion, and reached the peak at day 3 (715.5 ±121.3 pg/ml). There were significant differences compared to the sham-operation group and other time points (all P＜0.001). After that, it was decreased gradually, but it was still higher than that in the shamoperation group at day 7 (478.1 ± 145.5 pg/ml vs. 148.5 ± 101.7 pg/ml, P＜0.005). The initial change of the water content in brain tissue lagged behind the increased TNF-α. It did not increase significantly until 24 h after cerebral ischemia-reperfusion (P ＜0.001). It reached the peak at day 3 (P ＜0.001), and it was still higher than that in the control group at day 7 (P ＜0.05). The evolution of cerebral infarct volume was in accordance with the changes of TNF-α level. Conclusions TNF-α is associated with the changes of brain edema and infarct volume,and it is harmful to brain tissue.

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Advances in thrombolytic therapy of acute ischemic stroke

Cong LIU ; Xiaoxin TONG

International Journal of Cerebrovascular Diseases.2009;17(11):866-870. doi:10.3760/cma.j.issn.1673-4165.2009.11.010

Acute ischemic stroke is characterized by high morbidity,high mortality,and high disability.At present,thrombolytic therapy is the only treatment that can improve the prognosis of patients in acute phase.This article reviews the choice of time window,the primary means of thrombolytic therapy and medications,and the complications of recanalization after thrombolytic therapy.

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Is intraarterial thrombolysis within 3 hours for selected acute ischemic stroke patients?

Kejiang SU

International Journal of Cerebrovascular Diseases.2009;17(11):876-880. doi:10.3760/cma.j.issn.1673-4165.2009.11.012

There has been controversies on whether using intravenous or intraarterial thrombolytic therapy around the onset of acute ischemic stroke within 3 hours.This article summarizes the main arguments of different neurologists.

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Effects of memantine hydrochloride on the expressions of cAMP responsive element binding protein and cytochrome c in vascular dementia in rats

Shulong LIU ; Heyu LIU

International Journal of Cerebrovascular Diseases.2009;17(11):849-853. doi:10.3760/cma.j.issn.1673-4165.2009.11.006

Objective To investigate the effects of memantine hydrochloride on the learning and memory function in vascular dementia (VaD) in rats and its possible mechanism.Methods A rat VaD model was induced by using permanent bilateral common carotid artery ligatioa A total of 36 SD rats were randomly divided into sham-operation group, VaD group,and memantine group (memantine hydrochloride was given by intragastric administration, once a day, for eight weeks) (n = 12 in each group). Y maze test was used to observe their behavioral changes. Immunohistochemistry technique was used to detect the changes of the expressions of cAMP responsive element binding protein (CREB) and cytochrome c (CytC) in hippocampal CA1 region and cortex; and TUNEL method was used to detect neuronal apoptosis. Results The learning and memory abilities in memantine group were 50.17 ± 5.56 and 7.08 ± 0.90 respectively, and they were significantly better than 66.36 ± 5.41 and 4.64 ± 1.03 in the VaD group (all P＜0.01); the mean absorbencies of CREB in hippocampal CA1 region and cortex were 147.51 ± 7.11 and 155.37 ± 4.52, respectively, and they were significantly higher than 135.11 ± 8.52 and 142.39 ± 5.24 in the VaD group (all P＜0.01); and the mean absorbencies of CytC in hippocampal CA1 region and cortex were 116.53 ± 4.91 and 113.51 ± 6.05, and they wre significantly lower than 136.65 ±7.43 and 138.09 ±4.88 in the VaD group (all P ＜ 0.01); the extent of apoptosis in the memantine group was also improved significantly compared to the VaD group. Conclusions Memantine hydrochloride may improve the learning and memory function in VaD rats by upregulating the expression of CREB and inhibiting the release of CytC and neuronal apoptosis.

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Relationship between homocysteine and the levels of plasma folic acid, vitamin B_(12) and lipid in patients with acute cerebral infarction

Xu LIU ; Yu MA ; Xin WANG

International Journal of Cerebrovascular Diseases.2009;17(11):836-839. doi:10.3760/cma.j.issn.1673-4165.2009.11.003

Objective To investigate the differences of the plasma homocysteine (Hcy) between the patients with acute cerebral infarction and the normal controls, and the relationship between the levels of plasma Hcy and folic acid, vitamin B_(12) and lipids, and the relationship between clinical symptoms in patients with acute cerebral infarction. Methods A total of 91 patients with first-ever acute cerebral infarction and 100 controls without cerebrovascular accident were included. Their ratio factors such as age, sex, hypertension and diabetes did not have significant differences. Enzymatic cycling was used to detect plasma Hcy levels. Chemiluminescence was use to detect folic acid and vitamin B_(12) levels. Biochemical analyzer was used to measure lipid levels. The patients with acute cerebral infarction were evaluated by the National Institutes of Health Stroke Scale (NIHSS). Results The plasma Hcy level was significant higher in the acute cerebral infarction group than that in the control group (21.22 ±7.29 μmol/L vs. 13.19 ± 2.13 μmol/L) (P ＜ 0.05); the plasma Hcy level in the acute cerebral infarction group was significantly negatively correlated with folic acid (r = - 0.307,P ＜0.05) and vitamin B_(12) (r = - 0.270, P ＜0.05). It was significantly positively correlated with low-density lipoprotein (r =0.282, P ＜0.05), and it was significantly negatively correlated with high-density lipoprotein (r = -0.219, P ＜0.05). The mean value of the plasma Hcy in acute cerebral infarction group increased with the increase of NIHSS scores. Conclusions Hyperhomocysteinemia is an independent risk factor for acute cerebral infarction. The levels of folic acid and vitamin B_(12) decreased with the increase of Hcy levels. The higher the Hcy levels,the more serious the clinical symptoms are. Hcy may increase the risk of ischemic cerebrovascular disease by influencing the lipid metabolism.

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Thrombolytic strategies for acute ischemic stroke

Meijuan ZHANG ; Yun XU

International Journal of Cerebrovascular Diseases.2009;17(11):871-875. doi:10.3760/cma.j.issn.1673-4165.2009.11.011

Thrombolytic therapy is a main treatment method for ischemic stroke.Intravenous recombinant tissue-type plasminogen activator (rtPA) is the only FDA-approved therapy for acute stroke; however,its clinical application has been limited because the narrow therapeutic time window and the presence of the risk of hemorrhagic complication.In order solve these problems,a large number of clinical trials have started to focus on the studies of intra-arterial thrombolysis,mechanical thrombolysis and sonothrombolysis.

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Mechanisms of hemoglobin and its degradation products in brain edema formation after intracerebral hemorrhage

Xiumin GE ; Chenghan WU ; Lili GAO

International Journal of Cerebrovascular Diseases.2009;17(11):863-865. doi:10.3760/cma.j.issn.1673-4165.2009.11.009

The peak of the brain edema after intracerebral hemorrhage usually begins after 3 to 4 days.A large quantity of hemoglobin releases and degrades during this process,and its degradation products iron ion,bilirubin and carbon monoxide,etc play important roles in the process of cerebral edema.They all involve in the formation Of delayed brain edema after intracerebral hemorrhage.The research of hemoglobin and its degradation products is expected to find out a new way for the treatment of intracerebral hemorrhage.

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Early brain injury after subarachnoid hemorrhage

Linyan TONG ; Changlin HU

International Journal of Cerebrovascular Diseases.2009;17(11):859-862. doi:10.3760/cma.j.issn.1673-4165.2009.11.008

Subarachnoid hemorrhage (SAH) is a disease with high disability and mortality rate.It is still lack of effective treatment means in clinical practice.Studies in recent years have found that early brain injury may be the primary causes that result in higher mortality and poor prognosis in patients with SAH.This article mainly reviews the animal models and pathogenesis of early brain injury after SAH.

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Impact of deferoxamine intervention on perihematoma tissue in rats with intracerebral hemorrhage

Shengshan LIU ; Changqing LI ; Guodong CAI ; Yang GU

International Journal of Cerebrovascular Diseases.2009;17(11):854-858. doi:10.3760/cma.j.issn.1673-4165.2009.11.007

Objective To investigate the effect of the abnormally accumulated iron ions in the perihematoma tissue lesions and the impact of deferoxamine intervention. Methods A total of 135 SD rats were randomly assigned to sham-operation (n = 15), intracerebral hemorrhage (n =60) and deferoxamine (n =60) groups. A rat model of intracerebral hemorrhage was induced by the infusion of autologous blood. The neurological deficit score, brain water content (dry/wet weight method), blood-brain barrier permeability (Evans blue extravasation method), DNA fragmentation (TUNEL staining), and the impact of deferoxamine intervention were observed at different time points in all groups.Results One to seven days after intracerebral hemorrhage, the neurological deficit score, perihematomal water content, the blood-brain barrier permeability, and the numbers of TUNEL positive cells in the intracerebral hemorrhage group were significantly higher than those in the sham-operation group (P ＜0.01, P ＜0.05, P ＜0.01, and P ＜0.05). All the observation indexes in the deferoxamine and intracerebral hemorrhage groups showed the same trend, however, the neurological score, perihematomal water content, the blood brain barrier permeability, and the numbers of TUNEL positive cells were significantly lower than those in the intracerebral hemorrhage group (P ＜ 0.05, P ＜ 0.05, P ＜ 0.05, and P ＜ 0.05). Conclusions The abnormal accumulation of iron ions involves in the pathological injury of perihematoma tissue after intracerebral hemorrhage, and deferoxamine may reduce this injury.

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