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International Journal of Cerebrovascular Diseases.2015;(5):359-364. doi:10.3760/cma.j.issn.1673-4165.2015.05.007

As a pattern of manifestation of cerebral small vessel disease,cerebral microinfarct(CMI) is a very common neuropathological change in old people. It is significantly correlated w ith cognitive decline and dementia. This article review s the meuropathology, neuroimaging and clinical significance of CMI.

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Expression changes of miRNAs in cerebral ischemia-reperfusion injury after deep hypothermic low flow in mice

Changfeng FAN ; Peicheng DING ; Weiyan ZHANG ; Zhongyuan WEN ; Di YU ; Song WANG ; Xuming MO

International Journal of Cerebrovascular Diseases.2015;(5):354-358. doi:10.3760/cma.j.issn.1673-4165.2015.05.006

Objective To observe the expression changes of 12 ischemia-related microRNAs (miRNA) in cerebral ischemia-reperfusion injury after deep hypothermic low flow (DHLF) in mice.Methods A total of 80 3-w eek-old healthy and clean grade C57BL/6 male mice w ere randomly divided into either a DHLF model group or a sham operation group. Each group w as redivided into 4 subgroups according to the time points of 2, 6, 12, and 24 h (10 in each group). The bilateral carotid arteries of the DHLF model group w ere clipped and a DHLF model w as established, w hile the carotid arteries of the sham operation group w ere not clipped. The mice w ere sacrified at each time point and the brain tissue w as removed. The total RNA w as extracted. Quantitative reverse transcriptase polymerase chain reaction w as used to detect miRNA expression. Results Compared w ith the sham operation group, the expression levels of 9 miRNAs w ere upregulated, 2 w ere dow n-regulated, and 1 did not have any significant change in the DHLF model group. Conclusions The expression levels of 11 miRNAs changed significantly after DHLF. It might have a regulatory role in cerebral ischemia-reperfusion injury after DHLF.

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Blood oxygen level dependent functional magnetic resonance imaging for the diagnosis of vascular cognitive impairment

Zhenjie TENG ; Peiyuan LYU

International Journal of Cerebrovascular Diseases.2015;(5):392-395. doi:10.3760/cma.j.issn.1673-4165.2015.05.014

The significance of the diagnosis of vascular cognitive impairment(VCI)is able to do early intervention and delay or even prevent its progress. How ever, due to the limitations of diagnostic methods and standards, the patients w ith mild VCI often can not get timely and accurate diagnosis. Recent studies have show n that blood oxygen level dependent functional magnetic resonance imaging (BOLD-fMRI) may provide objective indicators for the diagnosis of VCI. This article review s the application of BOLD-fMRI in the diagnosis of VCI.

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Application of thrombelastography in antithrombotic therapy of ischemic cerebrovascular disease

Chengjie ZHU ; Rui ZHAO

International Journal of Cerebrovascular Diseases.2015;(5):388-391. doi:10.3760/cma.j.issn.1673-4165.2015.05.013

The condition and prognosis of ischemic cerebrovascular disease(ICVD)are closely associated w ith the w hole blood coagulation status and the reactivity of antiplatelet agents of patients. Thromboelastography ( TEG ) is a reliable means to detect the w hole blood coagulation and fibrinolytic capacity. Its overal results of the evaluation can be used in the coagulation monitoring, efficacy of antiplatelet therapy, and prognostic evaluation in patients w ith ischemic cerebrovascular disease. In recent years, the detection methods of TEG have been improved continuously. The research reports for its clinical application are gradual y increasing. This article review s the clinical application of TEG in the diagnosis, treatment, and prognostic evaluation in ischemic cerebrovascular disease.

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Glibenclamide for the prevention of cerebral edema and hemorrhagic transformation in ischemic stroke

Hongyan CHEN ; Hongjun WANG

International Journal of Cerebrovascular Diseases.2015;(5):383-387. doi:10.3760/cma.j.issn.1673-4165.2015.05.012

Cerebral edema and hemorrhagic transformation(HT) are the common complications of ischemic stroke. Ischemic cerebral edema is the primary cause of death in patients w ith large infarction. The sulfonylurea receptor 1 (Sur1) transient receptor potential M4 (Trpm4) channel plays an important role in focal cerebral ischemia. Both animal experiment and clinical studies have show n that the Sur1 selective inhibitor glibenclamide provides neuroprotection for ischemic stroke, including infarct volume reduction and improvement of neurological function, especial y in attenuating cerebral edema and reducing the incidence of HT. This article review s the advances in research on glibenclamide for the prevention of cerebral edema and HT in patients w ith ischemic stroke.

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Neuroprotective effect of glucagon-like peptide-1 receptor activation in cerebral ischemia

Ling HAN ; Guofang XUE ; Dongfang LI

International Journal of Cerebrovascular Diseases.2015;(5):378-382. doi:10.3760/cma.j.issn.1673-4165.2015.05.011

Glucagon-like peptide 1(GLP-1) is an important member of incretin.Takingitoralymay stimulate the terminal ileum and colon L cel s to secrete GLP-1. After GLP-1 biding specific receptor GLP-1 receptor ( GLP-1R), it exerts the roles of promoting glucose-dependent insulin secretion, inhibiting glucagon secretion, and decreasing plasma glucagon level. The molecular mass of GLP-1 is relatively smal er and can directly cross the blood-brain barrier, and both central and peripheral nervous systems have the GLP-1R expression. GLP-1 significantly improves neurological deficits and reduces infarct volume. It may exert neuroprotective effect through the mechanisms of inhibiting the inflammatory response, oxidative stress, and cel apoptosis. This article review s the discovery of GLP-1, its biological characteristics and neuroprotective effect in cerebral ischemia.

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Orexin A and cerebrovascular diseases

Wei HE ; Zhiqiang SU

International Journal of Cerebrovascular Diseases.2015;(5):374-377. doi:10.3760/cma.j.issn.1673-4165.2015.05.010

Orexins are a class of important hypothalamic neuropeptides,including type A and B. Orexins are associated w ith numerous physiological functions, including sleep-aw akening, energy balance, endocrine and visceral functions, and they also have certain relations w ith the pathophysiological changes, such as drow siness and drug abuse. In recent years, the pathophysiological role and mechanism, as w el as the clinical significance of orexins in cerebrovascular diseases are causing concern. This article summarizes the roles of orexins and focuses on the roles of orexin A in cerebrovascular diseases.

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Varicella-zoster virus infection and stroke

Dandan ZHANG ; Bo SONG ; Yuan GAO ; Hui FANG ; Yapeng LI ; Yongli TAO ; Yuming XU ; Shilei SUN

International Journal of Cerebrovascular Diseases.2015;(5):371-373. doi:10.3760/cma.j.issn.1673-4165.2015.05.009

The varicela-zoster virus(VZV) infection causes central vasculopathy,and then leads to stroke onset. This article review s the correlation betw een VZV infection and stroke onset in order to conduct a comprehensive assessment of patients w ith VZV infection, thereby reducing the risk of stroke after VZV infection.

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Diabetes mellitus aggravates cerebral ischemia-reperfusion injury in rats by inflammatory response

Chengling LIU ; Jiangquan HAN ; Yongtao HU

International Journal of Cerebrovascular Diseases.2015;(5):349-353. doi:10.3760/cma.j.issn.1673-4165.2015.05.005

Objective To investigate the roles of tumor necrosisfactor-α(TNF-α) and nuclear factor-κB (NF-κB) in cerebral ischemia-reperfusion injury in rats w ith diabetes mel itus. Methods Thirty-six healthy male Sprague-Daw ley rats w ere divided into a euglycemic sham operation group, a euglycemic isc hemia-reperfusion group, and a diabetes ischemia-reperfusion group (n=12 in each group) according to a random number table. A diabetes model w as induced by intraperitoneal injection of streptozotocin, and then a focal cerebral ischemia-reperfusion model w as induced by the suture method. The neurological deficit score was performed at 24 h after reperfusion. 2,3,5 triphenyl tetrazolium staining was used to measure the cerebral infarction area. Western blotting w as used to detect the expression levels of NF-κB and TNF-αon the ischemic sides. Results The neurological function scores w ere 0.00 ±0.00, 2.50 ±1.08, and 3.20 ± 1.03, respectively in the euglycemic sham operation, euglycemic cerebral ischemia-reperfusion and diabetes cerebral ischemia-reperfusion groups, and there w ere significant differences (F=38.015, P<0.001). The neurological deficit scores of the diabetes cerebral ischemia-reperfusion group w ere significantly aggravated compared with the euglycemic cerebral ischemia-reperfusion group (P<0.05). The infarct areas of the euglycemic sham operation, euglycemic cerebral ischemia-reperfusion and diabetes cerebral ischemia-reperfusion groups w ere 0.00% ±0.00%, 33.09% ±5.17%, and 55.45% ±9.29%, respectively, and there w ere significant differences among the groups (F=206.614, P<0.001), in w hich the infarct area in the diabetes cerebral ischemia-reperfusion group w as enlarged significantly compared w ith the euglycemic cerebral ischemia-reperfusion group ( P< 0.05 ). At 24 h after reperfusion, there w ere no significant differences in the expression levels of the cortical NF-κB (F=29.993, P<0.001) and TNF-α(F=28.722, P<0.001) on the ischemic sides in each group, in w hich the expression levels of NF-κB and TNF-αin the diabetes cerebral ischemia-reperfusion group w ere increased significantly compared w ith the euglycemic cerebral ischemia-reperfusion group (al P<0.05). Conclusions Diabetes may aggravate cerebral ischemia reperfusion injury. The upregulated expression of TNF-αand NF-κB may be one of the mechanisms of diabetes aggravating cerebral ischemia-reperfusion injury.

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Recurrent stroke in patients w ith right-to-left shunt and cryptogenic stroke

Fang ZHOU ; Aixia ZHUANG ; Shouqin FENG ; Qinghong ZENG ; Yujuan QI ; Le YIN ; Yuanyuan WANG ; Hongxia NIE ; Yang WANG ; Chuanqi WANG ; Shanhua YU ; Jiandong JIANG

International Journal of Cerebrovascular Diseases.2015;(5):344-348. doi:10.3760/cma.j.issn.1673-4165.2015.05.004

Objective To investigate the relationship between the right-to-left shunt(RLS)detected with contrast-enhanced transcranial Doppler (c-TCD) and recurrent stroke in patients with cryptogenic stroke.Methods The consecutive patients w ith ischemic stroke w ere enrol ed. The patients w ith cryptogenic stroke w ere screened according to the TOAST criteria. They w ere divided into either a RLS positive group or a RLS negative group according to the c-TCD findings, and then they w ere fol ow ed up for a period of one year. They w ere also divided into a recurrent group and a non-recurrent group according to w hether they had recurrence or not. Results A total of 118 patients w ith cryptogenic ischemic stroke w ere enrol ed, including 46 in the RLS positive group, 72 in the RLS negative group, 10 in the recurrent group, and 108 in the non-recurrent group. There w ere no significant differences in demographic and baseline data betw een the RLS negative group and the RLS positive group. There w ere significant differences in RLS positive rate (7/10 vs.39/108; P=0.046) and proportion of patients with server RLS (2/10 vs.1/108; P=0.019) betw een the recurrent group and the non-recurrent group. Multivariate logistic regression analysis show ed that the positive RLS w as an independent predictor of recurrent stroke (odds ratio 4.896, 95% confidence interval 1.135-21.120;P=0.033). Conclusions The positive RLS may be an independent risk factor for the recurrence in patients w ith cryptogenic ischemic stroke.

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