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Role of nuclear factor-κB in brain ischemic preconditioning

International Journal of Cerebrovascular Diseases.2010;18(11):865-871. doi:10.3760/cma.j.issn.1673-4165.2010.11.014

Brain ischemic conditioning (BIP) can improve the tolerance to ischemic injury in the brain. Nuclear factor-κB (NF-κB) is an important transcriptional regulatory factor.It presents in all types of cells in the nerous system. Studies have suggested that BIP may exert neuroprotective effects by mediating NF-κB through a series of cascade reactions. This may provide a new therapeutic strategy for BIP in the prevention and treatment of ischemic cerebrovascular disease in clinical practice.

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Induced pluripotent stem cells and their application in research and treatment of cerebrovascular disease

Wei LIAO ; Yang WANG ; Zhifeng DENG

International Journal of Cerebrovascular Diseases.2010;18(11):860-864. doi:10.3760/cma.j.issn.1673-4165.2010.11.013

Induced pluripotent stem (iPS) cells are reprogrammed by the differentiated adult cells, ard in terms of biological characteristics they are remarkably similar to embryonic stem cells. Compared to the embryonic stem cells, the iPS cells are unrestricted by cell resources, immune rejection and ethics, They maintain the advantages such as specific individual genes, and provide potential cell resources for the fields of regenerative medicine and tissue engineering, This article mainly introduces the iPS cells and their application in the research and treatment of cerebrovascular diseases.

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Relationship between serum CXCL16 levels and stroke subtypes in patients with acute cerebral infarction

Jingjing ZHANG ; Xudong PAN ; Aijun MA ; Xia WANG ; Kun WANG

International Journal of Cerebrovascular Diseases.2010;18(11):818-822. doi:10.3760/cma.j.issn.1673-4165.2010.11.004

Objective To investigate the changes of serum CXCL16 levels in patients with acute cerebral infarction and their relationship with the Trial of Org10172 in Acute Stroke Treatment (TOAST) etiological types of cerebral infarction. Methods The serum CXCL16 levels in 113 patients with acute cerebral infarction were measured by enzyme-linked immunosorbent assay (ELISA), and they were grouped according to TOAST types. The patients between all the subgroups and/or 32 healthy controls were compared. Results The serum CXCL16 levels in patient group were significantly higher than those in control group (2.29 ± 0.21 ng/mlvs.1.75±0.21 ng/ml, t= 12.863, P= 0.000); The serum CXCL16 levels in large artery atherosclerotic (LAA) stroke group were significantly higher than those in small artery occlusive (SAO) stroke group (2.38 ±0.23 ng/mL vs. 2.21 ±0.11 ng/ml, 1 =5. 743, P =0. 000), and both were significantly higher than those in the control group (q = 20. 501, P = 0. 000; q =13. 527, P= 0. 000). In the LAA group, there were no significant differences between the serum CXCL16 levels in ≥2 artery stenosis group and those in only 1 artery stenosis group (2.34 ±0.24 ng/ml vs. 2.46 ± 0. 19 ng/ml, t = - 1.969, P = 0. 054). Multivariate logistic regression analysis showed that CXCL16 (OR =0.972, 95% CI0.956-0. 978, P =0.001)and hyperlipidemia (OR =3.547, 95%CI 1.160-10. 848, P=0. 020) were the independent risk factors for cerebral infarction. Conclusions The serum CXCL16 levels increased in acute cerebral infarction, it closely related with the occurrence of cerebral infarction, and the LAA stroke group was significantly higher than the SAO stroke group.

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Preliminary study of imaging infarct patterns and pathogenesis in patients with anterior circulation infarction

Guoqing ZHOU ; Yongjun CAO ; Guodong XIAO ; Chunyuan ZHANG ; Heqing ZHAO ; Chunfeng LIU

International Journal of Cerebrovascular Diseases.2010;18(11):813-817. doi:10.3760/cma.j.issn.1673-4165.2010.11.003

Objective To analyze imaging infarct patterns and features in patients with severe stenosis or occlusion of internal carotid artery (ICA) and middle cerebral artery (MCA)from the point of view of diffusion-weighted imaging (DWI) and to investigate the infarction related mechanism. Methods Eighty-eight patients with acute ischemic stroke who had moderate to severe ICA or MCA stenosis or occlusion confirmed by cerebral angiography were analyzed retrospectively. They were divided into ICA lesion and MCA lesion groups. The infarct patterns were classified as single and multiple according to DWI. The former were reclassified as perforating artery infarct (PAI), pial infarct (PI), watershed infarct, and large infarct. Results There were 11 types of infarct patterns in MCA territories. The DWI multi-infarct pattern accounted for 62.5% of all patients (55/88). PI with watershed infarction appeared more often in the ICA lesion group (11/45, P=0. 040), and PI with PAI appeared more often in the MCA lesion group (10/43, P = 0. 037). Conclusions In patients with cerebral infarction associated with ICA or MCA severe stenosis or occlusion, most of them showed multi-infarct pattern,which suggested the mixed mechanisms such as embolization, hypoperfusion/impaired clearance of emboli, and local perforating branch occlusion were the main mechanisms of the occurrence of cerebral infarction. The main mechanism of cerebral infarction in the ICA lesion group was embolization combined with hypoperfusion/impaired clearance of emboli, while in the MCA lesion group was embolization combined with local perforating branch occlusion.

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Is there a role for revascularisation in asymptomatic carotid stenosis?

Kejiang SU ; Jiahong GENG

International Journal of Cerebrovascular Diseases.2010;18(11):875-880. doi:10.3760/cma.j.issn.1673-4165.2010.11.016

There has been controversy over what method should be used to treat patients with asymptomatic carotid stenosis, especially the optimal medical therapy has been able to reduce the risk of stroke significantly in these patients and its efficacy is equal to or even exceed today's carotid endarterectomy or stenting. However, the treatment value of revascularization in patients with asymptomatic carotid stenosis does not completely disappear, and with the improved technologies and the prolonged follow-up time, their effects may be more apparent in reducing the risk of stroke. The optimal medical treatment can indeed significantly reduce the risk of stroke in patients with asymptomatic carotid stenosis, but it may not be able to solve all the problems. This article expounds the opinions of different authors in the treatment of asymptomatic carotid stenosis with revascularization according to the data available.

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Early intensive blood pressure reduction in acute cerebral hemorrhage

Chunhua YAN ; Jindan SI ; Lie WU

International Journal of Cerebrovascular Diseases.2010;18(11):827-830. doi:10.3760/cma.j.issn.1673-4165.2010.11.006

There are more prognostic factors affecting the patients with cerebral hemorrhage, including bleeding volume, bleeding site, cause of bleeding, and blood pressure regulation during acute phase. Among them, the regulation of blood pressure during acute phase is a man-controlled important factor. However, the ideal blood pressure level has not yet to he determined at present. Therefore, more clinical trials are needed to determine the exact time window of blood pressure management in patients with intracerebral hemorrhage during acute phase and the range of blood pressure control.

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Copeptin: a novel prognostic marker for cerebrovascular disease

Jun LI ; Aimei ZHANG ; Xianzhang LI ; Qiujie Lü

International Journal of Cerebrovascular Diseases.2010;18(11):850-853. doi:10.3760/cma.j.issn.1673-4165.2010.11.011

Copeptin is a part of the C-terminal pro-arginine vasopressin. It is correlated with the prognosis of various diseases. Recent studies have found that copeptin is a novel,independent prognostic marker for stroke, and it may improve the existing risk stratification scheme of stroke.

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Risk factors for post-stroke depression

Chunyan CAO ; Zhaoyun HUANG

International Journal of Cerebrovascular Diseases.2010;18(11):845-849. doi:10.3760/cma.j.issn.1673-4165.2010.11.010

Post-stroke depression (PSD) is a common complication of stroke. Its prevalence range was from 23% to 60%. This article reviews the risk factors for PSD,including gender, age, premorbid personality, education, history of stroke and depression, stroke type, stroke location, neurological dysfunction, cognitive impairment, aphasia, and social support.

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Vascular cognitive impairment no dementia

Mufeng ZHU ; Liying DENG ; Hao LIU

International Journal of Cerebrovascular Diseases.2010;18(11):839-844. doi:10.3760/cma.j.issn.1673-4165.2010.11.009

As the early stage of dementia, vascular cognitive impairment no dementia (VCI-ND) has become a hot research topic in recent years. The effective identification of VCI-ND has important clinical significance for prevention and decreasing of dementia. This article reviews the advances in research on neuropsychology, neuroimaging, biological markers, as well as the prevention and treatment of VCI-ND.

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The levels of serum sFas and sFasL in patients with acute cerebral infarction: an observational study

Peng SHI ; Wenjing WANG ; Zhaoping WANG

International Journal of Cerebrovascular Diseases.2010;18(11):823-826. doi:10.3760/cma.j.issn.1673-4165.2010.11.005

Objective To investigate the changes of serum soluble Fas (sFas) and soluble Fas-ligand (sFasL), and the relationship betweenthe level of serum sFas or sFasL and the infarct volume in patients with acute cerebral infarction (ACI). Methods Sixty patients with ACI (female 28, male 32) served as study group and 30 healthy subjects (female 18, male 12) served as control group. An enzyme-linked immunosorbent assay was used to detect the levels of serum sFas and sFasL in both groups, and the differences of the sFas and sFasL concentration were compared between the two groups. Results The levels of serum sFas at 48 hours, at day 7 and 14 in the ACl group were 6. 27 ± 1.48 ng/L, 4. 99 ± 1.15 ng/L, and 3.74 ± 0.58 ng/L,respectively, and they were all significantly higher than 3.00 ± 0. 38 ng/L in the control group (P <0. 05). The levels of serum sFasL at 48 hours, at day 7 and 14 in the ACI group were 4.40 ± 1.32 ng/L, 3. 19 ± 0.94 ng/L, and 1.91±0.45 ng/L, respectively. They were significantly higher than 1.15 ±0.21 ng/L in the control group (P<0.01). The levels of sFas (1.91 ± 0.45) ng/L, respectively, and they were all significantly higher than (4.98 ±0.91) ng/L(t = 12.12 ,P <0. 01)and (3.58 ±0. 87) ng/L(t =5.35 ,P <0.01) in the small infarction group. The levels of serum sFas and sFasL in patients with ACI showed positive correlation (r =0. 748, P =0. 01). Conclusions High serum sFas and sFasL may indicate larger infarct volume in patients with ACI.

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