Objective:To explore the clinical application value of limb remote ischemic postconditioning (LRIPC) in patients with acute cerebral infarction after recanalization.Methods:A total of 78 patients with acute cerebral infarction admitted to the First Affiliated Hospital of Shantou University Medical College from June 2017 to March 2019 were selected. According to the random number table method, they were divided into the observation group with 39 cases (LRIPC + conventional medical treatment) and the control group with 39 cases (conventional medical treatment). The National Institutes of Health Stroke Scale (NIHSS) and Montreal Cognitive Assessment scale (MoCA) scores, the changes of cerebral blood perfusion, cerebral infarction volume and the levels of nerve function indexes before and after the treatment were compared and analyzed.Results:After the treatment, the NIHSS scores in the observation group were lower than thosein the control group, and the MoCA scores were higher than those in the control group, the differences were statistically significant ( P<0.05). After the treatment, the mean transit time of cerebral blood flow in the observation group was shorter than that in the control group, while the regional cerebral blood flow and regional cerebral blood volume were higher than those in the control group, the differences were statistically significant ( P<0.05). After the treatment, the volume of cerebral infarction in the observation group was lower than that in the control group ( P<0.05). After the treatment, the levels of matrix metalloproteinase 9 and S-100B protein in the observation group were lower than those in the control group: (142.45 ± 36.23) mg/L vs. (176.89 ± 42.63) mg/L, (2.52 ± 0.46) μg/L vs. (3.61 ± 0.75) μg/L; and the level of nerve growth factor was higher than that in the control group: (143.49 ± 10.58) μg/L vs. (124.96 ± 13.62) μg/L, the differences were statistically significant ( P<0.05). Conclusions:LRIPC can improve the nerve functions, cognitive functions andreduce the volume of cerebral infarction by improving cerebral blood flow. It also has a good effect on alleviating the neurological functional impairment after vascular recanalization.

Carotid atherosclerosis is closely related to cognitive impairment. Different degrees of atherosclerosis can affect cognitive impairment, including overall cognitive and multiple cognitive domain impairments. This article reviews the research progress on the relationship between carotid atherosclerosis and cognitive impairment in recent years.

Thalamic ischemic stroke may yield deficits in several cognitive domains,including memory,attention,language and executive function,which are often neglected.This article reviews the advances in cognitive impairment in patients with thalamic ischernic stroke in recent years.

Objective To investigate the correlation between serum lipoprotein (a) (Lp(a)) level andischemic stroke and its etiological subtypes. Methods The consecutive inpatients with acute ischemic stroke (case group) and age-and sex-matched healthy subjects (control group) over the same period were enrolled retrospectively. The demographic and baseline clinical data, as well as fasting blood glucose, fibrinogen,homocysteine, total cholesterol, triacylglycerol, high-densitylipoprotein cholesterol, low -density lipoprotein cholesterol, and Lp(a) concentration of the case group and the control group were collected. According to TOAST classification criteria, the patients in the case group were divided into large artery atherosclerosis (LAA), small artery occlusion (SAO) and cardioembolism (CE), and the patients with other determined etiology and undetermined etiology were excluded. Multivariate logistic regression analysis was used to make clear the correlation between serum Lp(a) and acute ischemic stroke and its etiological subtypes. Results A total of 214 patients with ischemic stroke were enrolled. Ninety-seven had LAA (45.33%), 64 (29.91%) had SAO, and 53 (24.77%) had CE. There were 118 subjects in the control group. There were significant differences in the proportions of hypertension, diabetes, hyperlipidemia, atrial fibrillation and alcohol consumption, as well as systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, low -density lipoprotein cholesterol, Lp(a), fibrinogen, and homocysteine between the case group and the control group (all P <0.001). Multivariate logistic regression analysis showed that after adjustment for age and sex, Lp(a) is an independent risk factor for ischemic stroke (odds ratio [OR] 2.014, 95% confidence interval [CI ] 1.273-3.092, P = 0.036). The independent risk factors for LAA included hypertension (OR 3.353, 95% CI 1.714-6.558, P = 0.001), systolic blood pressure ( OR 2.786, 95% CI 1.136-5.538, P =0.016), homocysteine ( OR 1.108, 95% CI 1.031-2.191, P = 0.005), total cholesterol (OR 2.169, 95% CI 1.599-4.943, P = 0.001), low -density lipoprotein cholesterol ( OR2.782, 95% CI 1.093-5.238, P =0.024), and Lp(a) (OR 3.072, 95% CI 1.907-8.064, P =0.001). Theindependent risk factors for SAO included hypertension ( OR 7.042, 95% CI 3.189-25.55, P =0.001), diabetes mellitus (OR 5.162, 95% CI 2.372-11.23, P =0.001), fibrinogen (OR 1.667, 95% CI 1.434-2.025, P = 0.045), and homocysteine (OR 1.967, 95% CI 1.859-1.995, P =0.036). The independent risk factors for CE included atrial fibrillation (OR 13.340, 95% CI 4.637-39.20, P = 0.001), fibrinogen (OR 2.365, 95% CI 1.147- 4.904, P =0.029), and Lp(a) (OR 1.656, 95% CI 1.996-3.001, P = 0.035). Conclusions Lp(a) is an independent risk factor for ischemic stroke, and can be used as a serum biomarker for predicting the risk of the onset of ischemic stroke. There are differences in independent risk factors between the different stroke etiological subtypes. Lp(a) is independently associated with LAA and CE; however, it has no independent correlation with SAO.

Objective To investigate the relationship between the interleukin-17 (IL-17),interleukin23 (IL-23) and carotid artery sclerosis in patients with cerebral infarction.Methods One hundred and twentyfive cerebral infarction patients in the first affiliated hospital of Shantou University medical college from June 2010 to June 2012 were recruited.All the subjects were examined with carotid ultrasonography.According to the results of carotid ultrasonography,all patients were divided into carotid atherosclerosis group(86 cases) and non carotid atherosclerosis group(39 cases).Patients with carotid atherosclerosis were divided into soft plaque group (35 cases),hard plaque group (21 cases),mixed plaque group (30 cases) based on plaque feature.Carotid atherosclerosis patients with cerebral infarction plaque determined by semi-quantitative method were grouped into Ⅰ grade(29 cases),Ⅱ grade (43 cases),Ⅲ grade (14 cases) according to the severity atherosclerosis.Serum levels of IL-17 and IL-23 were measured.Results The levels of IL-17 and IL-23 in patients with carotid atherosclerosis group were (31.42 ± 8.73) μg/L and(21.79 ± 9.34) μg/L,higher than that of non-carotid atherosclerosis group((22.81 ±6.52) μg/L,t =5.15,P ＜0.01 ; (14.33 ±6.21) μg/L,t =4.99,P ＜0.01).The IL-17 and IL-23 levels in patients with soft plaque,hard plaque and mixed plaque group were significant different (F =10.181,3.835,P ＜0.05).Serum IL-17 in soft plaque and mixed plaque expression group was higher than that of hard plaque group (P =0.001,P=0.007).IL-23 level in soft plaque group was higher than mixed plaque and hard plaque groups(P =0.017;P =0.045).The IL-17 and IL-23 levels in Ⅰ,Ⅱ,Ⅲ level group were markedly different (F =41.046,3.739 ; P ＜ 0.05),and there was significant difference between Ⅱ,Ⅲ and Ⅰ group(P ＜0.01,P ＜0.05).The correlation between IL-17 and IL-23 levels in Ⅰ,Ⅱ,Ⅲ level group were 0.892 and 0.420 (P =0.000 ; P =0.041).Conclusion IL-17 and IL-23 play important roles in the pathologic progress of artery sclerosis and are helpful for early diagnosis of the disease.

Objective To investigate the imbalance of T helper 17 (Th17) / CD4 + CD25 + regulatory cell (Treg) in HAM/TSP patients.Methods Enzyme linked immunosorbent assay (ELISA) was performed to measure the levels of interleukin (IL-17) and IL-10 in CSF,and flow cytometry to determine the percentage of Th17 and Treg cells in peripheral blood of patients with HAM/TSP.Results There was a significant increase in the level of IL-17 [(4.58 ± 0.70)pg/ml vs (0.76 ± 0.17)pg/ml,P ＜ 0.01] in CSF and the percentage of Th17 cells [(2.00 ± 0.64) ％ vs (0.41 ± 0.24) ％,P ＜ 0.01],but a decrease in the level of IL-10 in CSF and the percentage of Treg cells in peripheral blood of patients with HAM/TSP compared with the control group.The ratio of Th17/Treg cell (0.55 ±0.10 vs 0.06 ±0.03) in the peripheral blood of patients with HAM/TSP increased significantly compared with control group (t =12.11,P ＜0.01).Conclusions The imbalance between Thl7 and Treg cells may play an important role in the pathogenesis of the disease.

Dyslipidemia is a recognized risk factor for ischemic stroke. As an important component of lipids, lipoprotein(a) (Lp [a] ) was first found within the atherosclerotic plaques which is similar to the lipid body of the low-density lipoprotein cholesterol? Studies have showed that Lp (a) is involved in the formation of atherosclerosis and thrombosis through a variety of mechanisms, and then triggers cardio-cerebrovascular diseases. Identifying its relation with ischemic stroke and other risk factors may provide references for early prevention and treatment of ischemic stroke.

Caspases are a group of enzymes mainly for the execution of apoptosis.In recent years,studies have shown that caspases participate in the occurrence and development of many diseases,especially tumors and nervous system diseases.Of those,caspase-9 is one of the most important initiating molecules.This article reviews the structural characteristics,activation and regulation of caspase-9,its regulation mechanism of apoptosis,and briefly describes its relation with ischemic cerebrovascular disease.

Objective To evaluate the predicting value of the marker of endothelial injury: plasma matrix metalloproteinase-9( MMP-9) and high sensitivity C-reactive protein( hsCRP) level on the progression of acute anterior circulating territory infarction progressing to malignant middle cerebral artery infarction (m-MCAI). Methods 90 patients with acute anterior circulating territory infarction, in which 46 patients progressed to m-MCAI, were collected and sampled consecutively. The plasma MMP-9 and hsCRP of all patients were determined by ELISA and immunotur-bidimetry,respectively,at admission. And the clinical characters and cranial CT features of the patients were analyzed. Results At admission,the plasma MMP-9 level in the patients with m-MCAI(242.0 ±58.0)ng/ml was significantly higher than that in the patients with non m-MCAI( 169.0 ± 50.0) ng/ml( P < 0. 01) ,the plasma hsCRP level in the patients with m-MCAI(6.25 ±1.2) ng/ml was significantly higher than that in the patients with non m-MCAI( 1.55 ± 0.9) mg/ml( P <0. 01).Conclusion The increased level of plasma MMP-9 and hsCRP could be predictors for the m-MCAI proceeding.

Aphasia is the loss or impairment of language caused by brain damage. Stroke is the most common cause of aphasia. The language function in most patients with aphasia will get recovery with different degrees no matter whether they have performed language training or not. In recent years, functional magnetic resonance imaging (fMRI) technology has been widely used in neuro-linguistic research, This article reviews the advances in research on investigating the recovery mechanisms of poststroke aphasia with fMRI.