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Liu Z, Zhong F, Xie Y, Lu X, Hou B, Ouyang K, Fang J, Liao M, Liu Y. A Predictive Model for the Risk of Posterior Circulation Stroke in Patients with Intracranial Atherosclerosis Based on High Resolution MRI. Diagnostics (Basel) 2022; 12:812. [PMID: 35453860 PMCID: PMC9031625 DOI: 10.3390/diagnostics12040812] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/06/2022] [Accepted: 03/07/2022] [Indexed: 02/05/2023] Open
Abstract
Intracranial vertebrobasilar atherosclerosis is the main cause of posterior circulation ischemic stroke. We aimed to construct a predictive model for the risk of posterior circulation ischemic stroke in patients with posterior circulation atherosclerosis based on high-resolution MRI (HR-MRI). A total of 208 consecutive patients with posterior circulation atherosclerosis confirmed by HR-MRI, from January 2020 to July 2021, were retrospectively assessed. They were assigned to the posterior circulation stroke (49 patients) and non-posterior circulation stroke group (159 patients) based on clinical presentation and diffusion-weighted imaging (DWI). Demographic data, risk factors of atherosclerosis, laboratory findings, and imaging characteristics were extracted from electronic health records. Plaque features were investigated by HR-MRI. Fifty-three clinical or imaging features were used to derive the model. Multivariable logistic regression analysis was employed to construct the prediction model. The nomogram was evaluated for calibration, differentiation, and clinical usefulness. Plaque enhancement, plaque irregular surface morphology, artery location of plaque, and dorsal quadrant of plaque location were significant predictors for posterior circulation stroke in patients with intracranial atherosclerosis. Subsequently, these variables were selected to establish a nomogram. The model showed good distinction (C-index 0.830, 95% CI 0.766-0.895). The calibration curve also showed excellent consistency between the prediction of the nomogram and the observed curve. Decision curve analysis further demonstrated that the nomogram conferred significantly high clinical net benefit. The nomogram calculated from plaque characteristics in HR-MRI may accurately predict the posterior circulation stroke occurrence and be of great help for stratification of stroke decision making.
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Ouyang K, Kang Z, Liu Z, Hou B, Fang J, Xie Y, Liu Y. Posterior Circulation ASPECTS on CT Angiography Predicts Futile Recanalization of Endovascular Thrombectomy for Acute Basilar Artery Occlusion. Front Neurol 2022; 13:831386. [PMID: 35370881 PMCID: PMC8966670 DOI: 10.3389/fneur.2022.831386] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 02/11/2022] [Indexed: 02/05/2023] Open
Abstract
Background Acute basilar artery occlusion (BAO) is the most potentially disastrous outcome and has a high risk of recurrence stroke in posterior circulation infarction (PCI). However, the rate of futile recanalization remains high despite successful recanalization. The objective of this study was to investigate 90 days functional outcomes among patients with BAO who underwent endovascular thrombectomy (EVT) and to identify the risk factors associated with futile recanalization. Methods We retrospectively analyzed 72 patients with acute BAO who received EVT from January 2018 to June 2021. CT angiography source images posterior circulation Acute Stroke Prognosis Early CT Score (CTA-SI pc-ASPECTS) evaluated the extensive hypoattenuation in patients with BAO. Futile recanalization defined an modified Rankin Scale (mRS) of 3-6 at 90 days despite a successful recanalization. Logistic regression analysis was performed to investigate the predictors of futile recanalization. Results Our sample included a total of 55 eligible patients. Patients with poor outcomes showed that the pc-ASPECTS score was lower in patients with poor outcomes than that in patients with good outcomes (P = 0.017). Longer time from symptoms onset-to-the puncture (P = 0.014) and elevation of leucocytes (P = 0.012) were associated with poor outcomes. The multivariable logistic analysis showed that pc-ASPECTS and onset-to-puncture time (OPT) were independent predictors of futile recanalization. Conclusions This study suggested that pc-ASPECTS and OPT are independent predictors of futile recanalization after EVT in patients with BAO. The lower pc-ASPECTS score and longer puncture time will have a poor clinical outcome.
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Zeng ML, Cheng JJ, Kong S, Yang XL, Jia XL, Cheng XL, Chen L, He FG, Liu YM, Fan YT, Gongga L, Chen TX, Liu WH, He XH, Peng BW. Inhibition of Transient Receptor Potential Vanilloid 4 (TRPV4) Mitigates Seizures. Neurotherapeutics 2022; 19:660-681. [PMID: 35182379 PMCID: PMC9226259 DOI: 10.1007/s13311-022-01198-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2022] [Indexed: 02/08/2023] Open
Abstract
Astrocytes are critical regulators of the immune/inflammatory response in several human central nervous system (CNS) diseases. Emerging evidence suggests that dysfunctional astrocytes are crucial players in seizures. The objective of this study was to investigate the role of transient receptor potential vanilloid 4 (TRPV4) in 4-aminopyridine (4-AP)-induced seizures and the underlying mechanism. We also provide evidence for the role of Yes-associated protein (YAP) in seizures. 4-AP was administered to mice or primary cultured astrocytes. YAP-specific small interfering RNA (siRNA) was administered to primary cultured astrocytes. Mouse brain tissue and surgical specimens from epileptic patient brains were examined, and the results showed that TRPV4 was upregulated, while astrocytes were activated and polarized to the A1 phenotype. The levels of glial fibrillary acidic protein (GFAP), cytokine production, YAP, signal transducer activator of transcription 3 (STAT3), intracellular Ca2+([Ca2+]i) and the third component of complement (C3) were increased in 4-AP-induced mice and astrocytes. Perturbations in the immune microenvironment in the brain were balanced by TRPV4 inhibition or the manipulation of [Ca2+]i in astrocytes. Knocking down YAP with siRNA significantly inhibited 4-AP-induced pathological changes in astrocytes. Our study demonstrated that astrocytic TRPV4 activation promoted neuroinflammation through the TRPV4/Ca2+/YAP/STAT3 signaling pathway in mice with seizures. Astrocyte TRPV4 inhibition attenuated neuroinflammation, reduced neuronal injury, and improved neurobehavioral function. Targeting astrocytic TRPV4 activation may provide a promising therapeutic approach for managing epilepsy.
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Affiliation(s)
- Meng-liu Zeng
- Department of Physiology, Hubei Provincial Key Laboratory of Developmentally Originated Disease, School of Basic Medical Sciences, Wuhan University, Donghu Rd185#, 430071 Wuhan, Hubei China
| | - Jing-jing Cheng
- Department of Physiology, Hubei Provincial Key Laboratory of Developmentally Originated Disease, School of Basic Medical Sciences, Wuhan University, Donghu Rd185#, 430071 Wuhan, Hubei China
| | - Shuo Kong
- Department of Physiology, Hubei Provincial Key Laboratory of Developmentally Originated Disease, School of Basic Medical Sciences, Wuhan University, Donghu Rd185#, 430071 Wuhan, Hubei China
| | - Xing-liang Yang
- Department of Physiology, Hubei Provincial Key Laboratory of Developmentally Originated Disease, School of Basic Medical Sciences, Wuhan University, Donghu Rd185#, 430071 Wuhan, Hubei China
| | - Xiang-lei Jia
- Department of Physiology, Hubei Provincial Key Laboratory of Developmentally Originated Disease, School of Basic Medical Sciences, Wuhan University, Donghu Rd185#, 430071 Wuhan, Hubei China
| | - Xue-lei Cheng
- Department of Physiology, Hubei Provincial Key Laboratory of Developmentally Originated Disease, School of Basic Medical Sciences, Wuhan University, Donghu Rd185#, 430071 Wuhan, Hubei China
| | - Ling Chen
- Institute of Forensic Medicine, School of Basic Medical Sciences, Wuhan University, 430071 Wuhan, Hubei China
| | - Fang-gang He
- Institute of Forensic Medicine, School of Basic Medical Sciences, Wuhan University, 430071 Wuhan, Hubei China
| | - Yu-min Liu
- Department of Neurology, Zhongnan Hospital, Wuhan University, Donghu Road 169#, 430071 Wuhan, Hubei China
| | - Yuan-teng Fan
- Department of Neurology, Zhongnan Hospital, Wuhan University, Donghu Road 169#, 430071 Wuhan, Hubei China
| | - Lanzi Gongga
- Tibet University Medical College, 850000 Lhasa, Tibet China
| | - Tao-xiang Chen
- Department of Physiology, Hubei Provincial Key Laboratory of Developmentally Originated Disease, School of Basic Medical Sciences, Wuhan University, Donghu Rd185#, 430071 Wuhan, Hubei China
| | - Wan-hong Liu
- Department of Immunology, School of Basic Medical Sciences, Wuhan University, 430071 Wuhan, Hubei China
| | - Xiao-hua He
- Department of Pathophysiology, School of Basic Medical Sciences, Wuhan University, 430071 Wuhan, Hubei China
| | - Bi-wen Peng
- Department of Physiology, Hubei Provincial Key Laboratory of Developmentally Originated Disease, School of Basic Medical Sciences, Wuhan University, Donghu Rd185#, 430071 Wuhan, Hubei China
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Bai J, Yang J, Song W, Liu Y, Xu H, Liu Y. Intelligent Prediction of Cryptogenic Stroke Using Patent Foramen Ovale from TEE Imaging Data and Machine Learning Methods. INT J COMPUT INT SYS 2022; 15. [DOI: 10.1007/s44196-022-00067-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
AbstractIn spite of the popularity of random forests (RF) as an efficient machine learning algorithm, methods for constructing the potential association for between patent foramen ovale (PFO) and cryptogenic stroke (CS) using this technique are still barely. For the vital regional study areas (atrial septum), RF was used to predict CS in patients with PFO using partial clinical data of patients and remotely sensed imaging examination data obtained from Tee imaging. We validated our method on a dataset of 151 consecutive patients with detected PFO at a large grade A hospital in China from November 2018 to December 2020, we obtained an area under the relative operating characteristic curve of 0.816, with 65% specificity at 73% sensitivity. The RF models accurately represented the relationship between the CS and remotely sensed predictor variables. Therein, maximum mobility, large right-to-left shunt during Valsalva maneuver, size of PFO in diastole and systole, and diastolic length of the tunnel present higher predictive value in CS. Our findings suggest that multi-Doppler sensor data by transesophageal echocardiography (TEE)-detected morphologic and functional characteristics of PFO may play important roles in the occurrence of CS. These results indicate that the established random forest model has the potential to predict CS in patients with PFO and great promise for application to clinical practice.
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Lu X, Xie Y, Feng H, Liu Z, Ouyang K, Hou B, Wang M, Kong Z, Zhu Z, Dao W, Zhou Y, Cao J, Long J, Xu Y, Liu Y, Yin X. Psychological impact on COVID-19 patients during the outbreak in China: A case-control study. Psychiatry Res 2021; 305:114180. [PMID: 34461357 DOI: 10.1016/j.psychres.2021.114180] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 08/16/2021] [Accepted: 08/19/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) has caused widespread panic due to its highly infectious and pandemic transmission. We aimed to evaluate the psychological impact of the COVID-19 outbreak on infected subjects in China. METHODS This case-control, survey-based study assessed the psychological status of COVID-19 patients and non-infected controls from February 10 to March 18, 2020, in China. Sex, age, education years, marital status, jobs, annual household income, living status, and geographic origin were matched between the two groups. The main outcome measures included anxiety, depression, insomnia, help-seeking behaviors, and treatment for mental problems. RESULTS A total of 326 patients and 1304 (1:4 ratio) matched non-infected controls were enrolled. Compared with controls, patients had higher scores on the Beck Anxiety Inventory (BAI), Patient Health Questionnaire-9 (PHQ-9), and Insomnia Severity Index (ISI) (all p<0.01). Patients had higher rate of any mental problems (62.6% vs 42.5%, p<0.01), anxiety (27.3% vs 12.2%, p<0.01), depression (26.7% vs 14.6%, p<0.01), suicidal ideation (16.0% vs 10.7%, p<0.01), and insomnia (57.7% vs 36.7%, p<0.01). Among the subjects with mental problems, the proportion of seeking help (15.2% vs 6.9%, p<0.01) and receiving treatment (11.3% vs 4.3%, p<0.01) was higher in patients than controls. CONCLUSIONS Our study showed a higher prevalence of mental problems in COVID-19 patients compared to controls, suggesting a great psychological impact of COVID-19 infection. Our findings highlighted the urgent need for psychological assistance for COVID-19 patients.
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Jiang GT, Shao L, Kong S, Zeng ML, Cheng JJ, Chen TX, Han S, Yin J, Liu WH, He XH, Liu YM, Gongga L, Peng BW. Complement C3 Aggravates Post-epileptic Neuronal Injury Via Activation of TRPV1. Neurosci Bull 2021; 37:1427-1440. [PMID: 34309810 DOI: 10.1007/s12264-021-00750-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 04/07/2021] [Indexed: 02/05/2023] Open
Abstract
Epilepsy is a brain condition characterized by the recurrence of unprovoked seizures. Recent studies have shown that complement component 3 (C3) aggravate the neuronal injury in epilepsy. And our previous studies revealed that TRPV1 (transient receptor potential vanilloid type 1) is involved in epilepsy. Whether complement C3 regulation of neuronal injury is related to the activation of TRPV1 during epilepsy is not fully understood. We found that in a mouse model of status epilepticus (SE), complement C3 derived from astrocytes was increased and aggravated neuronal injury, and that TRPV1-knockout rescued neurons from the injury induced by complement C3. Circular RNAs are abundant in the brain, and the reduction of circRad52 caused by complement C3 promoted the expression of TRPV1 and exacerbated neuronal injury. Mechanistically, disorders of neuron-glia interaction mediated by the C3-TRPV1 signaling pathway may be important for the induction of neuronal injury. This study provides support for the hypothesis that the C3-TRPV1 pathway is involved in the prevention and treatment of neuronal injury and cognitive disorders.
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Affiliation(s)
- Guang-Tong Jiang
- Department of Physiology, Hubei Provincial Key Laboratory of Developmentally Originated Disease, School of Basic Medical Sciences, Wuhan University, Wuhan, 430071, China
| | - Lin Shao
- Department of Physiology, Hubei Provincial Key Laboratory of Developmentally Originated Disease, School of Basic Medical Sciences, Wuhan University, Wuhan, 430071, China
| | - Shuo Kong
- Department of Physiology, Hubei Provincial Key Laboratory of Developmentally Originated Disease, School of Basic Medical Sciences, Wuhan University, Wuhan, 430071, China
| | - Meng-Liu Zeng
- Department of Physiology, Hubei Provincial Key Laboratory of Developmentally Originated Disease, School of Basic Medical Sciences, Wuhan University, Wuhan, 430071, China
| | - Jing-Jing Cheng
- Department of Physiology, Hubei Provincial Key Laboratory of Developmentally Originated Disease, School of Basic Medical Sciences, Wuhan University, Wuhan, 430071, China
| | - Tao-Xiang Chen
- Department of Physiology, Hubei Provincial Key Laboratory of Developmentally Originated Disease, School of Basic Medical Sciences, Wuhan University, Wuhan, 430071, China
| | - Song Han
- Department of Pathophysiology, School of Basic Medical Sciences, Wuhan University, Wuhan, 430071, China
| | - Jun Yin
- Department of Pathophysiology, School of Basic Medical Sciences, Wuhan University, Wuhan, 430071, China
| | - Wan-Hong Liu
- Department of Immunology, School of Basic Medical Sciences, Wuhan University, Wuhan, 430071, China
| | - Xiao-Hua He
- Department of Pathophysiology, School of Basic Medical Sciences, Wuhan University, Wuhan, 430071, China
| | - Yu-Min Liu
- Department of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, 430071, China
| | - Lanzi Gongga
- Medical College, Tibet University, Lhasa, 850013, China
| | - Bi-Wen Peng
- Department of Physiology, Hubei Provincial Key Laboratory of Developmentally Originated Disease, School of Basic Medical Sciences, Wuhan University, Wuhan, 430071, China.
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Wang Q, Feng H, Wang M, Xie Y, Hou B, Lu X, Liu Z, Ouyang K, Zhang R, Cai Q, Xu Z, Li H, Chao H, Yang X, Hong Y, Hu X, Liu Z, Liu Y. Mental Health and Psychological Responses During the Coronavirus Disease 2019 Epidemic: A Comparison Between Wuhan and Other Areas in China. Psychosom Med 2021; 83:322-327. [PMID: 33284256 DOI: 10.1097/psy.0000000000000892] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE This study aimed to compare the mental health and psychological responses in Wuhan, a severely affected area, and other areas of China during the coronavirus disease 2019 (COVID-19) epidemic. METHODS This cross-sectional study was conducted on February 10-20, 2020. A set of online questionnaires was used to measure mental health and responses. A total of 1397 participants from Wuhan (age, 36.4 ± 10.7 years; male, 36.1%) and 2794 age- and sex-matched participants from other areas of China (age, 35.9 ± 9.9 years; male, 39.0%) were recruited. RESULTS Compared with their counterparts, participants from Wuhan had a significantly higher prevalence of any mental health problems (46.6% versus 32.2%; adjusted odds ratio [OR] = 1.89, 95% confidence interval [CI] = 1.65-2.17), anxiety (15.2% versus 6.2%; adjusted OR = 2.65, 95% CI = 2.14-3.29), depression (18.3% versus 9.7%; adjusted OR = 2.11, 95% CI = 1.74-2.54), suicidal ideation (10.5% versus 7.1%; adjusted OR = 1.60, 95% CI = 1.28-2.02), and insomnia (38.6% versus 27.6%; adjusted OR = 1.70, 95% CI = 1.48-1.96). Participants from Wuhan had a slightly higher rate of help-seeking behavior (7.1% versus 4.2%; adjusted OR = 1.76, 95% CI = 1.12-2.77) but similar rate of treatment (3.5% versus 2.7%; adjusted OR = 1.23, 95% CI = 0.68-2.24) for mental problems than did their counterparts. In addition, compared with their counterparts, participants from Wuhan gave higher proportions of responses regarding "fearful" (52% versus 36%, p < .001), "discrimination against COVID-19 cases" (64% versus 58%, p = .006), "strictly comply with preventive behaviors" (98.7% versus 96%, p = .003), and "fewer living and medical supplies" (<2 weeks: 62% versus 57%, p = .015). CONCLUSIONS The COVID-19 epidemic has raised enormous challenges regarding public mental health and psychological responses, especially in the highly affected Wuhan area. The present findings provide important information for developing appropriate strategies for the prevention and management of mental health problems during COVID-19 and other epidemics.
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Affiliation(s)
- Qunfeng Wang
- From the Department of Neurology (Wang, Xie, Hou, Lu, Z.Liu, Ouyang, Zhang, Cai, Xu, Li, Y.Liu), Zhongnan Hospital of Wuhan University, Wuhan, Hubei; Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine (Wang, Feng), The Chinese University of Hong Kong, Shatin, Hong Kong SAR; Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences (Feng), Guangzhou, Guangdong; Department of Ultrasonography (Wang), Zhongnan Hospital of Wuhan University; Department of Neurology (Chao), Hanyang Hospital of Wuhan; Department of Neurology (Yang), No. 1 People's Hospital of Tianmen City, Hubei; Department of Pediatrics (Hong), Zhongnan Hospital of Wuhan University; Department of Psychiatry, Affiliated Wuhan Mental Health Center (Hu), Tongji Medical College of Huazhong University of Science and Technology, Wuhan; and Department of Neurology (Z.Liu), Hubei Jianghan Oil-field General Hospital, Qianjiang, Hubei, PR China. Q.W. and H.F. contributed equally to this work
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Wang M, Li Y, Zhang R, Zhang S, Feng H, Kong Z, Aiziretiaili N, Luo Z, Cai Q, Hong Y, Liu Y. Adiponectin-Transfected Endothelial Progenitor Cells Have Protective Effects After 2-Hour Middle-Cerebral Artery Occlusion in Rats With Type 2 Diabetes Mellitus. Front Neurol 2021; 12:630681. [PMID: 33746885 PMCID: PMC7966523 DOI: 10.3389/fneur.2021.630681] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/28/2021] [Indexed: 02/05/2023] Open
Abstract
Objectives: This present study aimed to examine the effects of adiponectin-transfected endothelial progenitor cells (LV-APN-EPCs) on cerebral ischemia–reperfusion injury in rats with type 2 diabetes mellitus (T2DM) and to explore the underlying mechanisms. Methods: Seventy male Sprague–Dawley rats with T2DM were randomly divided into sham, phosphate-buffered saline (PBS), LV-APN-EPCs, LV-EPCs, and EPCs groups. Transient middle cerebral artery occlusion (MCAO) was induced by the intraluminal suture method. After 1 h of reperfusion, the five interventions were performed by tail-vein injections. The modified neurological severity score (mNSS) was used to assess neurological function before and on days 1, 7, and 14 after MCAO. After 14 days, magnetic resonance imaging scanning, hematoxylin and eosin staining, terminal dUTP nick-end labeling staining, Western blotting analysis, cluster of differentiation (CD) 31 immunofluorescence, and enzyme-linked immunosorbent assay were used to evaluate infarct rate, morphological damage, cell apoptosis, and microvessel density. Results: Compared with PBS, LV-EPCs, and EPCs groups, the LV-APN-EPCs group showed significantly lower mNSS score, lower infarct rate, and less morphological damage (all P < 0.05). In addition, compared with other groups, the LV-APN-EPCs group had significantly increased levels of B cell lymphoma/leukemia-2 (Bcl-2) protein, CD31+ microvessels, endothelial nitric oxide synthase, and vascular endothelial growth factor, and decreased levels of Bcl-2-associated X protein and neuronal apoptosis in the peri-infarct cortex (all P < 0.05). Conclusion: These results suggest that LV-APN-EPCs exert protective effects against cerebral ischemia–reperfusion injury in T2DM rats by increasing angiogenesis.
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Affiliation(s)
- Meiyao Wang
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yan Li
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Renwei Zhang
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Shuaimei Zhang
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Hongliang Feng
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zhaohong Kong
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Nadire Aiziretiaili
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Zhengjin Luo
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Qi Cai
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yan Hong
- Department of Pediatrics, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yumin Liu
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
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Lu X, Li C, Qu C, Huang J, Wang Q, Qiu B, Wang C, Li S, Xu H, Liu Y. A High Resolution MRI Study of the Relationship Between Plaque Enhancement and Perforator Stroke after Stenting for Symptomatic Vertebrobasilar Artery Stenosis. J Stroke Cerebrovasc Dis 2021; 30:105558. [PMID: 33348247 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 12/11/2020] [Accepted: 12/13/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND AND PURPOSE Perforator stroke is one of the most common complications of vertebrobasilar arterial stenting. We investigated whether perforator stroke after vertebrobasilar arterial stenting is associated with plaque enhancement in patients with severe vertebrobasilar artery stenosis. METHODS We studied patients with symptomatic vertebrobasilar arterial stenosis who underwent stenting from January 2017 to July 2020. Patients who underwent high resolution magnetic resonance imaging were recruited among them. Demographic data, risk factors of atherosclerosis, procedure details, and characteristics of imaging were extracted from electronic health records and imaging data. Plaque features were investigated by high resolution magnetic resonance imaging. RESULTS 136 patients were enrolled in this study, 39 of whom fulfilled the inclusion criteria. 18 patients (46.2%) had obvious plaque enhancement among the 39 patients, and 21 (53.8%) had plaque non-enhancement. 21 patients (53.8%) had diffuse distribution, and 22 patients (56.4%) had irregular plaques surface. Patients were divided into plaque enhanced and plaque non-enhanced groups according to the degree of plaque enhancement. Clinical characteristics and other plaque features were similar between two groups. Procedure-related perforator stroke was identified in 4 patients (10.3%). Patients with plaque enhancement were more likely to have perforator stroke after stenting compared with those with plaque non-enhancement (22.2% versus 0%, P = 0.037). CONCLUSIONS Plaque enhancement in high resolution magnetic resonance imaging may be associated with perforator stroke after vertebrobasilar artery stenting.
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Abstract
Background Endothelial progenitor cells (EPCs) play an important role in the re-endothelialization of ischemic cerebrovascular disease. However, the current acquisition method has some deficiencies. This study aimed to design a new and practical method for obtaining EPCs. Methods Bone marrow was obtained autologously from the right tibia of living rats. Briefly, the right tibia bone was carefully exposed and two holes (1 mm in diameter) were made in the tuberosity and lower one-third of the tibia, respectively. A PE-50 catheter and syringe (5 mL) were inserted through the holes to aspirate the bone marrow. Bone marrow mononuclear cells (BMMCs) were isolated by density-gradient centrifugation with Ficoll and counted. Adherent cell culture continued for 2 weeks, and the medium was replaced every 3 days. Results During the first days of culture, adherent cells formed a monolayer, consisting predominantly of small-sized cells. Single large cells with endothelial morphology were observed. On day 4, the nonadherent cells were removed, and the adherent cells were left for further culture. On day 6-7, a proliferating population of round cells formed clusters in the culture chamber, and morphological analysis revealed a homogeneous population of colony-forming units (CFUs). Large, flat cells with endothelial morphology sprouted from the CFUs, which had nearly disappeared by day 14 of culture. The adherent cells were positive for CD133 and vascular endothelial growth factor receptor 2 (VEGFR2), internalized acetylated low-density lipoprotein, and bound ulex europaeus-agglutinin-I, but were negative for CD45, which correlated with the endothelial morphology and ability to form capillaries of EPCs. Conclusions Our results are direct evidence that mononuclear cells (MCS) from living rat bone marrow can be used to culture EPCs in vitro under certain culture conditions, providing a new method for the further study of autologous EPC transplantation.
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Affiliation(s)
- Zhaohong Kong
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Meixin Chen
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jian Jiang
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jiang Zhu
- Department of Neurology, The First Hospital of Yulin, Yulin, China
| | - Yumin Liu
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
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Cai Q, Feng H, Huang J, Wang M, Wang Q, Lu X, Xie Y, Wang X, Liu Z, Hou B, Ouyang K, Pan J, Li Q, Fu B, Deng Y, Liu Y. The mental health of frontline and non-frontline medical workers during the coronavirus disease 2019 (COVID-19) outbreak in China: A case-control study. J Affect Disord 2020; 275:210-5. [PMID: 32734910 DOI: 10.1016/j.jad.2020.06.031] [Citation(s) in RCA: 157] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 06/14/2020] [Accepted: 06/23/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND OBJECTIVE Coronavirus disease 2019 (COVID-19) is a new infectious disease with high transmissibility and morbidity. It has caused substantial mental distress to medical professionals. We aimed to compare the psychological impact of the COVID-19 outbreak between frontline and non-frontline medical workers in China. METHODS This case-control study recruited 1173 frontline and 1173 age- and sex-matched non-frontline medical workers during the COVID-19 outbreak (February 11 to 26, 2020). A set of online questionnaires were used to measure mental problems (i.e., anxiety, insomnia, and depressive symptoms), and help-seeking behavior and treatment for these mental problems. RESULTS Frontline medical workers had higher rates of any mental problem (52.6% vs. 34.0%, adjusted OR=1.88, 95% CI=1.57-2.25), anxiety symptoms (15.7% vs. 7.4%, adjusted OR=1.95, 95% CI=1.46-2.61), depressed mood (marginally insignificant; 14.3% vs. 10.1%, adjusted OR=1.32, 95% CI=0.99-1.76) and insomnia (47.8% vs. 29.1%, adjusted OR=1.96, 95% CI=1.63-2.36) than non-frontline medical workers. No significant difference was observed in terms of suicidal ideation (12.0% vs. 9.0%, adjusted OR=1.25, 95% CI=0.92-1.71), help-seeking (4.5% vs. 4.5%, adjusted OR=1.00, 95% CI=0.53-1.87) or treatment (3.4% vs. 2.3%, adjusted OR=1.38, 95% CI=0.54-3.52) for mental problems. LIMITATIONS The case-control nature of the data precludes causal inferences, and there is a possibility of bias related to self-reports. CONCLUSIONS Frontline medical workers had more mental problems but comparable help-seeking behaviors and treatment for these problems than non-frontline medical workers. These findings highlight the timely mental support and intervention for medical workers, especially for those on the frontline.
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Wang M, Feng H, Zhang S, Luo Z, Liang Y, Xu Y, Mei B, Kong Z, Liu Y. Association between red blood cell distribution width and white matter hyperintensities: A large-scale cross-sectional study. Brain Behav 2020; 10:e01739. [PMID: 32683781 PMCID: PMC7503097 DOI: 10.1002/brb3.1739] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 05/07/2020] [Accepted: 06/06/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Red blood cell distribution width (RDW) is a strong prognostic marker for various medical conditions, such as ischemic strokes. However, the relationships between higher RDW and the subtypes of white matter hyperintensities (WMHs) remain unclear. Hence, this study aimed to thoroughly evaluate the relationships between RDW and the subtypes of WMHs. PATIENTS AND METHODS This cross-sectional study was a retrospective analysis of hospital database (Dongguan Medical System, from April 2015 to February 2017). The presence and subtypes of WMHs were evaluated using Fazekas score with the T2WI-FLAIR brain images from a 1.5-T MRI system. The overall sample was randomly split in half. One of the two split-half samples was used for determining the optimal cutoff value of higher RDW and another for further statistical analyses. RESULTS A total of 555 subjects with WMHs and 642 controls were recruited. The optimal cutoff value of higher RDW was 13.25%. Logistic regression revealed that higher RDW (≥13.25%) was positively associated with periventricular WMHs (adjusted OR = 1.81, 95% CI: 1.16-2.82, p = .009). However, higher RDW was not associated with total WMHs (adjusted OR = 1.52, 95% CI: 0.99-2.33, p = .057) and deep WMHs (adjusted OR = 1.21, 95% CI: 0.76-1.94, p = .426). CONCLUSION Our findings suggested that higher RDW may be independently associated with periventricular WMHs, but not with total WMHs and deep WMHs.
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Affiliation(s)
- Meiyao Wang
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Department of Ultrasonography, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Hongliang Feng
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., China
| | - Shuaimei Zhang
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Zhengjin Luo
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yan Liang
- Department of Neurology, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Yan Xu
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Bin Mei
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Zhaohong Kong
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yumin Liu
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
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Hong Y, Yu Q, Kong Z, Wang M, Zhang R, Li Y, Liu Y. Exogenous endothelial progenitor cells reached the deficient region of acute cerebral ischemia rats to improve functional recovery via Bcl-2. Cardiovasc Diagn Ther 2020; 10:695-704. [PMID: 32968626 DOI: 10.21037/cdt-20-329] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background As discovered in our previous study, autologous endothelial progenitor cells (EPCs) protect against acute focal ischemia rat via the promotion of angiogenesis. However, it is unknown whether the EPCs that reached the deficient region were transplanted ones or the products of other auto-conversion cells they had promoted. This study aimed to gather direct evidence for determining if exogenous transplanted EPCs directly participate in angiogenesis in ischemic areas and attempted to clarify the related mechanism. Methods First, EPCs were extracted in vitro from male rats, which were characterized by uptake of fluorescently labeled acetylated low-density lipoprotein (ac-LDL) intake and Ulex europaeus agglutinin (UEA-1) and subsequently introduced to middle cerebral artery occlusion (MCAO) female rats for 7 days after ischemia surgery. The EPC-treated animals received approximately 1×106 cells, while the control animals received phosphate buffered saline (PBS). The animals behavior function recovery were by a rotarod (TOR) test, while infarct volume was assessed by brain magnetic resonance imaging (MRI). CD31 antibody was used to determine the presence of EPCs in the ischemic zone, and sex-determining region Y (SRY) gene in-situ hybridization (ISH) traced the EPC process. In addition, immunohistochemistry and Western blot were used to assess B-cell lymphoma 2 (Bcl-2) expression in the ischemic brain. Results Behavior tests and MRI of all ischemic stroke groups on postoperative day 14 indicated that EPCs were more effective in behavior function recovery and reducing infarct volume and gliosis status than the control group. Cluster of differentiation (CD31) immunofluorescent staining and SRY gene ISH demonstrated that EPCs yielded a better outcome in both angiogenesis and exogenous cell homing status. We also observed increased Bcl-2 distribution and higher plasma Bcl-2 levels in the EPC-treated group compared to the control group. Conclusions Our results provide direct evidence that exogenous EPCs can participate in angiogenesis to improve neurological outcome and revascularization directly after stroke, with Bcl-2 playing an important role in this process.
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Affiliation(s)
- Yan Hong
- Department of Pediatrics, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Qing Yu
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Zhaohong Kong
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Meiyao Wang
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Renwei Zhang
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yan Li
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yumin Liu
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
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Wu X, Liu Y, Nie C, Kang Z, Wang Q, Sun D, Li H, Liu Y, Mei B. Efficacy and Safety of Intravenous Thrombolysis on Acute Branch Atheromatous Disease: A Retrospective Case-Control Study. Front Neurol 2020; 11:581. [PMID: 32733357 PMCID: PMC7358343 DOI: 10.3389/fneur.2020.00581] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 05/20/2020] [Indexed: 02/05/2023] Open
Abstract
Background and Objective: Branch atheromatous disease (BAD) is distinctive from large-artery atherosclerosis and small-vessel disease, which is single subcortical infarction caused by the occlusion of perforator's orifice. This study aimed to indicate whether intravenous thrombolysis (IVT) with alteplase could prevent early neurological deterioration (END) and improve functional outcome for patients with BAD within 4.5 h after symptom onset. Methods: We retrospectively analyzed data collected from patients with BAD who were admitted to our hospital from January 2015 to August 2019. To investigate the efficacy and safety of IVT, subjects were classified into alteplase and control groups. A propensity score matching analysis was performed to control substantial heterogeneity of subgroup. The coprimary outcomes were END that is defined as an increase of ≥2 points in the National Institutes of Health Stroke Scale (NIHSS) score within 7 days after stroke, and favorable outcome at 3 months after stroke that defined by a score of 0-1 point on the modified Rankin scale (mRS). Results: A total of 135 patients were eventually enrolled in this study (n = 51 for the alteplase group and n = 84 for the control group). Additionally, 42 pairs of subjects were successfully matched by propensity score matching. Intravenous alteplase within 4.5 h after stroke onset reduced the incidence of END [unadjusted odds ratio (OR), 3.32; 95% confidence interval (CI), 1.06-10.37] and improved the clinical outcome at 3 months after stroke, with more patients achieving favorable functional prognosis (mRS, 0-1 point; unadjusted OR, 0.25; 95% CI, 0.10-0.62). Patients in the alteplase group were more likely to be independent (mRS, 0-2 points) at 3 months after stroke (unadjusted OR, 0.33; 95% CI, 0.12-0.90). The rate of death or dependence (mRS, ≥4 points) in the alteplase group was also markedly lower than that in the control group (unadjusted OR, 4.06; 95% CI, 1.03-16.02). Conclusion: Our findings indicated that intravenous thrombolysis may be a safe and effective therapy for patients with BAD.
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Affiliation(s)
- Xiangbo Wu
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Yang Liu
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Chuang Nie
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Zhiming Kang
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Qunfeng Wang
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Dong Sun
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Huagang Li
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Yumin Liu
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Bin Mei
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
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Huang J, Hou B, Zhang S, Wang M, Lu X, Wang Q, Liu Y. The Protective Effect of Adiponectin-Transfected Endothelial Progenitor Cells on Cognitive Function in D-Galactose-Induced Aging Rats. Neural Plast 2020; 2020:1273198. [PMID: 32273888 DOI: 10.1155/2020/1273198] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 03/03/2020] [Accepted: 03/10/2020] [Indexed: 02/05/2023] Open
Abstract
Aging is a multifactorial process involving the cumulative effects of inflammation, oxidative stress, and mitochondrial dynamics, which can produce complex structural and biochemical alterations to the nervous system and lead to dysfunction of microcirculation, blood-brain barrier (BBB), and other problems in the brain. Long-term injection of D-galactose (D-gal) can induce chronic inflammation and oxidative stress, accelerating aging. The model of accelerated aging with long-term administration of D-gal have been widely used in anti-aging studies, due to the increase of chronic inflammation and decline of cognition that similarity with natural aging in animals. However, despite extensive researches in the D-gal-induced aging rats, studies on their microvasculature remain limited. Endothelial progenitor cells (EPCs), which are precursors to endothelial cells (ECs), play a significant role in the repair and regeneration process of endogenous blood vessel, and adiponectin (APN), a protein derived from adipocyte, has many effects on protective vascular endothelium and anti-inflammatory. Recently, many studies have shown that APN can promote improvements in cognitive function. Under these circumstances, we investigated the neuroprotective effect of the APN-transfected EPC (APN-EPC) treatment on rats after administration with D-gal and explored the likely underlying mechanisms. Compared to model group for D-gal administration, better cognitive function and denser microvessels were significantly found in the APN-EPC treatment group, and indicated APN-EPC treatment in aging rats could improve the cognitive dysfunction and microvessel density. The level of proinflammatory cytokines IL-1β, IL-6, and TNF-α, activated astrocytes and apoptosis rate were significantly reduced in the APN-EPC group compared with the model group, showed that APN-EPCs alleviated the neuroinflammation in aging rats. In addition, the APN-EPC group inhibited the decrease of BBB-related proteins claudin-5, occludin, and Zo-1 in aging rats and attenuated BBB dysfunction significantly. These results of our study indicated that APN-EPC treatment in D-gal-induced aging rats have a positive effect on improving cognitive and BBB dysfunction, increasing angiogenesis, and reducing neuroinflammation and apoptosis rate. This research suggests that cell therapy via gene modification may provide a safe and effective approach for the treatment of age-related neurogenerative diseases.
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Xi C, Li S, Liu Y, Mei B. Disappearance of long-term right-sided essential tremor after stroke in the left corona radiata. Neurol Clin Pract 2020; 9:487-489. [PMID: 32042486 DOI: 10.1212/cpj.0000000000000650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 02/19/2019] [Indexed: 02/05/2023]
Affiliation(s)
- Chunhua Xi
- Department of Neurology (CX), The Third Affiliated Hospital of Anhui Medical University, HeFei; Department of Radiology (SL); and Department of Neurology (CX, YL, BM), Zhongnan Hospital of Wuhan University, HuBei Province, China
| | - Sirui Li
- Department of Neurology (CX), The Third Affiliated Hospital of Anhui Medical University, HeFei; Department of Radiology (SL); and Department of Neurology (CX, YL, BM), Zhongnan Hospital of Wuhan University, HuBei Province, China
| | - Yumin Liu
- Department of Neurology (CX), The Third Affiliated Hospital of Anhui Medical University, HeFei; Department of Radiology (SL); and Department of Neurology (CX, YL, BM), Zhongnan Hospital of Wuhan University, HuBei Province, China
| | - Bin Mei
- Department of Neurology (CX), The Third Affiliated Hospital of Anhui Medical University, HeFei; Department of Radiology (SL); and Department of Neurology (CX, YL, BM), Zhongnan Hospital of Wuhan University, HuBei Province, China
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Liu X, Dai Q, Ye R, Zi W, Liu Y, Wang H, Zhu W, Ma M, Yin Q, Li M, Fan X, Sun W, Han Y, Lv Q, Liu R, Yang D, Shi Z, Zheng D, Deng X, Wan Y, Wang Z, Geng Y, Chen X, Zhou Z, Liao G, Jin P, Liu Y, Liu X, Zhang M, Zhou F, Shi H, Zhang Y, Guo F, Yin C, Niu G, Zhang M, Cai X, Zhu Q, Chen Z, Liang Y, Li B, Lin M, Wang W, Xu H, Fu X, Liu W, Tian X, Gong Z, Shi H, Wang C, Lv P, Tao Z, Zhu L, Yang S, Hu W, Jiang P, Liebeskind DS, Pereira VM, Leung T, Yan B, Davis S, Xu G, Nogueira RG. Endovascular treatment versus standard medical treatment for vertebrobasilar artery occlusion (BEST): an open-label, randomised controlled trial. Lancet Neurol 2019; 19:115-122. [PMID: 31831388 DOI: 10.1016/s1474-4422(19)30395-3] [Citation(s) in RCA: 328] [Impact Index Per Article: 65.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/18/2019] [Accepted: 09/06/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Previous randomised trials have shown an overwhelming benefit of mechanical thrombectomy for treating patients with stroke caused by large vessel occlusion of the anterior circulation. Whether endovascular treatment is beneficial for vertebrobasilar artery occlusion remains unknown. In this study, we aimed to investigate the safety and efficacy of endovascular treatment of acute strokes due to vertebrobasilar artery occlusion. METHODS We did a multicentre, randomised, open-label trial, with blinded outcome assessment of thrombectomy in patients presenting within 8 h of vertebrobasilar occlusion at 28 centres in China. Patients were randomly assigned (1:1) to endovascular therapy plus standard medical therapy (intervention group) or standard medical therapy alone (control group). The randomisation sequence was computer-generated and stratified by participating centres. Allocation concealment was implemented by use of sealed envelopes. The primary outcome was a modified Rankin scale (mRS) score of 3 or lower (indicating ability to walk unassisted) at 90 days, assessed on an intention-to-treat basis. The primary safety outcome was mortality at 90 days. Secondary safety endpoints included the rates of symptomatic intracranial haemorrhage, device-related complications, and other severe adverse events. The BEST trial is registered with ClinicalTrials.gov, NCT02441556. FINDINGS Between April 27, 2015, and Sept 27, 2017, we assessed 288 patients for eligibility. The trial was terminated early after 131 patients had been randomly assigned (66 patients to the intervention group and 65 to the control group) because of high crossover rate and poor recruitment. In the intention-to-treat analysis, there was no evidence of a difference in the proportion of participants with mRS 0-3 at 90 days according to treatment (28 [42%] of 66 patients in the intervention group vs 21 [32%] of 65 in the control group; adjusted odds ratio [OR] 1·74, 95% CI 0·81-3·74). Secondary prespecified analyses of the primary outcome, done to assess the effect of crossovers, showed higher rates of mRS 0-3 at 90 days in patients who actually received the intervention compared with those who received standard medical therapy alone in both per-protocol (28 [44%] of 63 patients with intervention vs 13 [25%] of 51 with standard therapy; adjusted OR 2·90, 95% CI 1·20-7·03) and as-treated (36 [47%] of 77 patients with intervention vs 13 [24%] of 54 with standard therapy; 3·02, 1·31-7·00) populations. The 90-day mortality was similar between groups (22 [33%] of 66 patients in the intervention vs 25 [38%] of 65 in the control group; p=0·54) despite a numerically higher prevalence of symptomatic intracranial haemorrhage in the intervention group. INTERPRETATION There was no evidence of a difference in favourable outcomes of patients receiving endovascular therapy compared with those receiving standard medical therapy alone. Results might have been confounded by loss of equipoise over the course of the trial, resulting in poor adherence to the assigned study treatment and a reduced sample size due to the early termination of the study. FUNDING Jiangsu Provincial Special Program of Medical Science.
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Affiliation(s)
- Xinfeng Liu
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China; Stroke Center and Department of Neurology, First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
| | - Qiliang Dai
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Ruidong Ye
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Wenjie Zi
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China; Department of Neurology, Xinqiao Hospital, Third Military Medical University, Chongqing, China
| | - Yuxiu Liu
- Department of Medical Statistics, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Huaiming Wang
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Wusheng Zhu
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Minmin Ma
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Qin Yin
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Min Li
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Xinying Fan
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Wen Sun
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yunfei Han
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Qiushi Lv
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Rui Liu
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Dong Yang
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Zhonghua Shi
- Department of Neurosurgery, 101th Hospital of the People's Liberation Army, Wuxi, China
| | - Dequan Zheng
- Department of Neurology, 175th hospital of the People's Liberation Army, Affiliated Southeast Hospital of Xiamen University, Zhangzhou, China
| | - Xiaorong Deng
- Department of Neurology, Hubei Zhongshan Hospital, Hubei, China
| | - Yue Wan
- Department of Neurology, Hubei Zhongshan Hospital, Hubei, China
| | - Zhen Wang
- Department of Neurology, Changsha Central Hospital, Changsha, China
| | - Yu Geng
- Department of Neurology, Zhejiang Provincial People's Hospital, Hangzhou, China
| | - Xingyu Chen
- Department of Neurology, Affiliated Zhongshan Hospital, Xiamen University, Xiamen, China
| | - Zhiming Zhou
- Department of Neurology, Yijishan Hospital of Wannan Medical College, Wuhu, China
| | - Geng Liao
- Department of Neurology, Maoming People's Hospital, Maoming, China
| | - Ping Jin
- Department of Neurology, Lu'an Affiliated Hospital of Anhui Medical University, Lu'an, China
| | - Yumin Liu
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xintong Liu
- Department of Neurology, Guangdong No 2 Provincial People's Hospital, Guangzhou, China
| | - Meng Zhang
- Department of Neurology, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Feng Zhou
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Hongchao Shi
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yunfeng Zhang
- Department of Neurology, Affiliated Hospital of Nantong University, Nantong, China
| | - Fuqiang Guo
- Department of Neurology, Sichuan People's Hospital, Chengdu, China
| | - Congguo Yin
- Department of Neurology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Guozhong Niu
- Department of Neurology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Mei Zhang
- Department of Neurology, First People's Hospital of Huainan, Huainan, China
| | - Xueli Cai
- Department of Neurology, Lishui Hospital of Zhejiang University, Lishui, China
| | - Qiyi Zhu
- Department of Neurology, Linyi People's Hospital, Linyi, China
| | - Zhonglun Chen
- Department of Neurology, Mianyang Central Hospital, Mianyang, China
| | - Yingchun Liang
- Department of Neurology, Taian City Central Hospital, Taian, China
| | - Bing Li
- Department of Neurology, Yantai Yuhuangding Hospital, Yantai, China
| | - Min Lin
- Department of Neurology, Fuzhou General Hospital of Nanjing Military Region, Fuzhou, China
| | - Wei Wang
- Department of Radiology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Haowen Xu
- Department of Intervention Neuroradiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xinmin Fu
- Department of Neurology, Xuzhou Central Hospital, Xuzhou, China
| | - Wenhua Liu
- Department of Neurology, Wuhan No 1 Hospital, Wuhan, China
| | - Xiguang Tian
- Department of Neurology, Chinese Armed Police Force Guangdong Armed Police Corps hospital, Guangzhou, China
| | - Zili Gong
- Department of Neurology, Xinqiao Hospital, Third Military Medical University, Chongqing, China
| | - Haicun Shi
- Department of Neurology, Third People's Hospital of Yancheng, Yancheng, China
| | - Chuanming Wang
- Department of Neurology, Shenzhen Nanshan People's Hospital and 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China
| | - Penghua Lv
- Department of Interventional Radiology, Northern Jiangsu People's Hospital, Yangzhou, China
| | - Zhonghai Tao
- Department of Neurology, Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Liangfu Zhu
- Cerebrovascular Center, Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China
| | - Shiquan Yang
- Department of Neurology, 123rd Hospital of the People's Liberation Army, Bengbu, China
| | - Wei Hu
- Stroke Center and Department of Neurology, First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Pingzhou Jiang
- Department of Neurology, Yangzhou Hongquan Hospital, Yangzhou, China
| | - David S Liebeskind
- Neurovascular Imaging Research Core and University of California Los Angeles Stroke Center, Department of Neurology, University of California, Los Angeles, CA, USA
| | - Vitor M Pereira
- Department of Medical Imaging and Surgery, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada
| | - Thomas Leung
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China
| | - Bernard Yan
- Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Stephen Davis
- Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Gelin Xu
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Raul G Nogueira
- Department of Neurology, Neurosurgery and Radiology, Emory University School of Medicine, Atlanta, GA, USA.
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Kong Z, Hong Y, Zhu J, Cheng X, Liu Y. Endothelial progenitor cells improve functional recovery in focal cerebral ischemia of rat by promoting angiogenesis via VEGF. J Clin Neurosci 2018; 55:116-121. [PMID: 30041898 DOI: 10.1016/j.jocn.2018.07.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 05/13/2018] [Accepted: 07/08/2018] [Indexed: 02/05/2023]
Affiliation(s)
- Zhaohong Kong
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Yan Hong
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Jiang Zhu
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Xin Cheng
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Yumin Liu
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
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Xu ZP, Gan GS, Liu YM, Xiao JS, Liu HX, Mei B, Zhang JJ. Adiponectin Attenuates Streptozotocin-Induced Tau Hyperphosphorylation and Cognitive Deficits by Rescuing PI3K/Akt/GSK-3β Pathway. Neurochem Res 2017; 43:316-323. [PMID: 29098530 DOI: 10.1007/s11064-017-2426-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 09/30/2017] [Accepted: 10/21/2017] [Indexed: 02/05/2023]
Abstract
Clinical studies have demonstrated that decreased adiponectin is associated with the development of Type 2 diabetes mellitus (T2DM) and Alzheimer's disease (AD). We focused on determining the neuroprotective effect offered by adiponectin against streptozotocin-induced brain damage in ICV-STZ rat model. We found that adiponectin supplements significantly restored the cognitive deficits in ICV-STZ rat model including shorter escape latency, more crossing times and increased time spent in the target quadrant. Adiponectin supplements also increased number of dendritic branches and mushroom percentage. In addition, adiponectin supplements attenuated tau hyperphosphorylation at multiple AD-related sites through activation of protein Ser9-phosphorylated glycogen synthase kinase-3β (Ser9-GSK-3β) with increased the Akt and PI3K activity. Our data suggest that adiponectin supplements have neuroprotective effects on the ICV-STZ rat model, which may be mediated by the activation of the PI3K/Akt/GSK-3β signaling pathway.
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Affiliation(s)
- Zhi-Peng Xu
- Department of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, 430071, China.,Department of Anesthesiology, Wuhan General Hospital of PLA, Wuhan, 430070, China
| | - Guo-Sheng Gan
- Department of Anesthesiology, Wuhan General Hospital of PLA, Wuhan, 430070, China
| | - Yu-Min Liu
- Department of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, 430071, China
| | - Jin-Song Xiao
- Department of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, 430071, China
| | - Han-Xing Liu
- Department of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, 430071, China
| | - Bin Mei
- Department of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, 430071, China
| | - Jun-Jian Zhang
- Department of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, 430071, China.
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Zhang R, Xie X, Yu Q, Feng H, Wang M, Li Y, Liu Y. Constitutive Expression of Adiponectin in Endothelial Progenitor Cells Protects a Rat Model of Cerebral Ischemia. Neural Plast 2017; 2017:6809745. [PMID: 29201467 DOI: 10.1155/2017/6809745] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 08/15/2017] [Indexed: 02/05/2023] Open
Abstract
Endothelial progenitor cells (EPCs), as precursors to endothelial cells, play a significant part in the process of endogenous blood vessel repair and maintenance of endothelial integrity. Adiponectin (APN) is an adipocyte-specific adipocytokine. In this study, we aim to test whether we transplant a combined graft of EPCs transfected with the adiponectin gene into a rat model of cerebral ischemia could improve functional recovery after middle cerebral artery occlusion (MCAO). Sprague-Dawley (SD) rats were randomly divided into a MCAO control group, a MCAO EPC treatment group, and a MCAO LV-APN-EPC treatment group. A focal cerebral ischemia and reperfusion model was induced by the intraluminal suture method. After 2 h of reperfusion, EPCs were transplanted by injection through the tail vein. A rotarod test was conducted to assess behavioral function before MCAO and on days 1, 7, and 14 after MCAO. After 14 d, TTC staining, CD31 immunofluorescence, and TUNEL staining were used to evaluate infarct volume, microvessel density, and cell apoptosis. Results revealed that behavioral function, infarct area percentage, microvessel density, and cell apoptosis rates were more favorable in the LV-APN-EPC treatment group than in the EPC treatment group. These data suggested that gene-modified cell therapy may be a useful approach for the treatment of ischemic stroke.
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Wang T, Sun D, Liu Y, Mei B, Li H, Zhang S, Zhang J. The Impact of Carotid Artery Stenting on Cerebral Perfusion, Functional Connectivity, and Cognition in Severe Asymptomatic Carotid Stenosis Patients. Front Neurol 2017; 8:403. [PMID: 28848495 PMCID: PMC5552726 DOI: 10.3389/fneur.2017.00403] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 07/26/2017] [Indexed: 02/05/2023] Open
Abstract
Background and purpose Asymptomatic carotid artery stenosis can lead to not only stroke but also cognition impairment. Although it has been proven that carotid artery stenting (CAS) can reduce the risk of future strokes, the effect of CAS on cognition is conflicting. In recent years, pulsed arterial spin labeling (pASL) MRI and resting-state functional MRI (R-fMRI) have been employed in cognitive impairment studies. For the present study, cognition is evaluated in severe asymptomatic carotid artery stenosis patients undergoing CAS, and the mechanisms underlying the cognitive change are explored by pASL MRI and R-fMRI. Materials and methods We prospectively enrolled 24 asymptomatic, severe (≥70%), unilateral internal carotid artery stenosis patients, who were expecting the intervention of CAS. Cognition assessment (including the Montreal Cognitive Assessment Beijing Version, the Minimum Mental State Examination, the Digit Symbol Test, the Rey Auditory Verbal Learning Test, and the Verbal Memory Test) and an integrated MRI program (pASL MRI, and R-fMRI) were administered 7 days before and 3 months after CAS. Results 16 subjects completed the follow-up study. After stenting, significant improvement in the scores of the MMSE, the Verbal Memory test, and the delayed recall was found. No significant difference was found in the scores of the Montreal Cognitive Assessment Beijing Version, the Digit Symbol Test, and the immediate recall. After CAS treatment, asymptomatic carotid artery stenosis patients showed increased perfusion in the left frontal gyrus, increased amplitude of low-frequency fluctuation (ALFF) in the right precentral gyrus, and increased connectivity to the posterior cingulate cortex (PCC) in the right supra frontal gyrus. However, no significant correlations were found between these imaging changes and cognition assessments. Conclusion Successful CAS can partly improve cognition in asymptomatic carotid artery stenosis patients. The cognition improvement may be partly attributed to the increased perfusion in the left frontal gyrus, increased ALFF in the right precentral gyrus, and increased connectivity to the PCC in the right supra frontal gyrus.
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Affiliation(s)
- Tao Wang
- Department of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, China
| | - Dong Sun
- Department of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, China
| | - Yumin Liu
- Department of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, China
| | - Bin Mei
- Department of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, China
| | - Huagang Li
- Department of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, China
| | - Shengming Zhang
- Department of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, China
| | - Junjian Zhang
- Department of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, China
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Liu Y, Fan Y, Liu Y, Wang T, Feng H, Liu G, Mei B. A retrospective study of branch atheromatous disease: Analyses of risk factors and prognosis. ACTA ACUST UNITED AC 2017; 37:93-9. [PMID: 28224419 DOI: 10.1007/s11596-017-1700-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 12/20/2016] [Indexed: 02/08/2023]
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Feng H, Xie Y, Mei B, Liu Y, Li B, Yin C, Wang T, Liu Y. Endovascular vs. medical therapy in symptomatic vertebral artery stenosis: a meta-analysis. J Neurol 2016; 264:829-838. [PMID: 27544500 DOI: 10.1007/s00415-016-8267-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 08/10/2016] [Accepted: 08/10/2016] [Indexed: 02/05/2023]
Affiliation(s)
- Hongliang Feng
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Yi Xie
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Bin Mei
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Yang Liu
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Benlei Li
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Changqing Yin
- Department of Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Tao Wang
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Yumin Liu
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.
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Wu W, Huo X, Zhao X, Liao X, Wang C, Pan Y, Wang Y, Wang Y. Relationship between Blood Pressure and Outcomes in Acute Ischemic Stroke Patients Administered Lytic Medication in the TIMS-China Study. PLoS One 2016; 11:e0144260. [PMID: 26828609 PMCID: PMC4735460 DOI: 10.1371/journal.pone.0144260] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 11/16/2015] [Indexed: 02/05/2023] Open
Abstract
Objective Increased blood pressure (BP) management following acute ischemic stroke (AIS) remains controversial. This study aimed to identify the association between BP and clinical outcomes in AIS patients administered lytic medication in the TIMS-China (thrombolysis implementation and monitor of acute ischemic stroke in China) database. Methods The sample comprised 1128 patients hospitalized within 4.5 hours (h) of AIS for intravenous recombinant tissue plasminogen activator (i.v. rt-PA) thrombolysis. Systolic BP (SBP) and diastolic BP (DBP) at baseline, 2 h and 24 h after treatment, and changes from baseline were analyzed. The study outcomes comprised a favorable outcome (modified Rankin Scale 0–1 at 90 days) and symptomatic intracerebral hemorrhage (SICH), analyzed using logistic regression, with low BP as the reference group. Results Lower BP (baseline, 2 h, and 24 h) was beneficial in AIS patients and significantly related to a favorable outcome (P<0.05). A substantial BP decrease at 24 h after rt-PA thrombolysis was significantly associated with a favorable outcome compared with a moderate BP decrease (P = 0.0298). A SBP >160 mmHg 2 h after rt-PA thrombolysis was significantly associated with SICH compared with a SBP <140 mmHg (P = 0.0238). An increase or no change (>25 mmHg) in SBP was significantly associated with SICH (P = 0.002) compared with a small SBP decrease (1–9 mmHg). Conclusions This study provides novel evidence that lower BP within the first 24 h is associated with a more favorable outcome and less frequent SICH in AIS patients administered lytic medication. Routine BP-lowering treatment should be considered in AIS patients following lytic medication.
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Affiliation(s)
- Wei Wu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of neurology, Qilu Hospital of Shandong University, Jinan China & Braian Science Research Institute, Shandong University, Jinan, China
| | - Xiaochuan Huo
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaoling Liao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Chunjuan Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yuesong Pan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- * E-mail: (YW); (YW)
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- * E-mail: (YW); (YW)
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Mei B, Liu GZ, Yang Y, Liu YM, Cao JH, Zhang JJ. Comparative analysis of general characteristics of ischemic stroke of BAD and non-BAD CISS subtypes. ACTA ACUST UNITED AC 2015; 35:885-90. [PMID: 26670441 DOI: 10.1007/s11596-015-1523-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 10/25/2015] [Indexed: 02/05/2023]
Abstract
Based on the recently proposed Chinese ischemic stroke subclassification (CISS) system, intracranial branch atheromatous disease (BAD) is divided into large artery atherosclerosis (LAA) and penetrating artery disease (PAD). In the current retrospective analysis, we compared the general characteristics of BAD-LAA with BAD-PAD, BAD-LAA with non-BAD-LAA and BAD-PAD with non-BAD-PAD. The study included a total of 80 cases, including 45 cases of BAD and 35 cases of non-BAD. Subjects were classified using CISS system: BAD-LAA, BAD-PAD, non-BAD-LAA and non-BAD-PAD. In addition to analysis of general characteristics, the correlation between the factors and the two subtypes of BAD was evaluated. The number of cases included in the analysis was: 32 cases of BAD-LAA, 13 cases of BAD-PAD, 21 cases of non-BAD-LAA, and 14 cases of non-BAD-PAD. Diabetes mellitus affected more non-BAD-LAA patients than BAD-LAA patients (P=0.035). In comparison with non-BAD-PAD, patients with BAD-PAD were younger (P=0.040), had higher initial NIHSS score (P<0.001) and morbidity of ischemic heart disease (P=0.033). Within patients with BAD, the PAD subtype was associated with smoking (OR=0.043; P=0.011), higher low-density lipoprotein (OR=5.339; P=0.029), ischemic heart disease (OR=9.383; P=0.047) and diabetes mellitus (OR=12.59; P=0.020). It was concluded that large artery atherosclerosis was the primary mechanism of BAD. The general characteristics showed no significant differences between the CISS subtypes of LAA and PAD within BAD, as well as between the BAD and non-BAD within LAA subtype. Several differences between PAD subtypes of BAD and non-BAD were revealed.
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Kong Z, Liu Y, Jiang J, Fu B, Cheng X. [The clinical characteristics of patients with vertebrobasilar dolichoectasia]. Zhonghua Nei Ke Za Zhi 2014; 53:23-6. [PMID: 24674723 DOI: pmid/24674723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To explore the clinical features of patients with vertebrobasilar dolichoectasia (VBD). METHODS Patients diagnosed with posterior circulation ischemia in our hospital from October 2008 to January 2012 were consecutively collected and were divided into the VBD group and the non-VBD (NVBD) group. Clinical manifestations, risk factors, hemodynamic parameters and neuroimaging features were collected. RESULTS (1) Statistical difference was observed in dyslipidemia, hypertension and the history of diabetes in the two groups (P < 0.05). (2) The cerebral hemodynamic features of the VBD patients were as the following: decreased peak systolic velocity of vertebral artery and basilar artery and decreased systolic/diastolic ratio. Statistical difference was showed in the average peak flow velocity (Vm), pulsatility index (PI) and resistance index (RI) (P = 0.036, 0.032, 0.032, respectively). (3) The main clinical manifestations of VBD were ischemic cerebrovascular disease, hemorrhagic cerebrovascular disease, oppression, brain damage symptoms and hydrocephalus. (4) The diagnosis in most of the VBD patients was confirmed by neural imaging and MRI was the first choice. CONCLUSION The VBD patients have relative unique clinical features. MRI should be the first choice for neuroimaging.
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Affiliation(s)
- Zhaohong Kong
- Department of Neurology,Zhongnan Hospital, Wuhan University, Wuhan 430071, China
| | - Yumin Liu
- Department of Neurology,Zhongnan Hospital, Wuhan University, Wuhan 430071, China,
| | - Jian Jiang
- Department of Neurology,Zhongnan Hospital, Wuhan University, Wuhan 430071, China
| | - Beibei Fu
- Department of Neurology,Zhongnan Hospital, Wuhan University, Wuhan 430071, China
| | - Xiansong Cheng
- Department of Neurology,Zhongnan Hospital, Wuhan University, Wuhan 430071, China
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Cai Q, Qiu CY, Qiu F, Liu TT, Qu ZW, Liu YM, Hu WP. Morphine inhibits acid-sensing ion channel currents in rat dorsal root ganglion neurons. Brain Res 2014; 1554:12-20. [PMID: 24491633 DOI: 10.1016/j.brainres.2014.01.042] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 01/18/2014] [Accepted: 01/24/2014] [Indexed: 02/08/2023]
Abstract
Extracellular acidosis is a common feature in pain-generating pathological conditions. Acid-sensing ion channels (ASICs), pH sensors, are distributed in peripheral sensory neurons and participate in nociception. Morphine exerts potent analgesic effects through the activation of opioid receptors for various pain conditions. A cross-talk between ASICs and opioid receptors in peripheral sensory neurons has not been shown so far. Here, we have found that morphine inhibits the activity of native ASICs in rat dorsal root ganglion (DRG) neurons. Morphine dose-dependently inhibited proton-gated currents mediated by ASICs in the presence of the TRPV1 inhibitor capsazepine. Morphine shifted the proton concentration-response curve downwards, with a decrease of 51.4±3.8% in the maximum current response but with no significant change in the pH0.5 value. Another μ-opioid receptor agonist DAMGO induced a similar decrease in ASIC currents compared with morphine. The morphine inhibition of ASIC currents was blocked by naloxone, a specific opioid receptor antagonist. Pretreatment of forskolin, an adenylyl cyclase activator, or the addition of cAMP reversed the inhibitory effect of morphine. Moreover, morphine altered acid-evoked excitability of rat DRG neurons and decreased the number of action potentials induced by acid stimuli. Finally, peripheral applied morphine relieved pain evoked by intraplantar of acetic acid in rats. Our results indicate that morphine can inhibit the activity of ASICs via μ-opioid receptor and cAMP dependent signal pathway. These observations demonstrate a cross-talk between ASICs and opioid receptors in peripheral sensory neurons, which was a novel analgesic mechanism of morphine.
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Affiliation(s)
- Qi Cai
- Department of Pharmacology, Hubei University of Science and Technology, 88 Xianning Road, Xianning 437100, Hubei, PR China; Neurology Department, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei, PR China
| | - Chun-Yu Qiu
- Department of Pharmacology, Hubei University of Science and Technology, 88 Xianning Road, Xianning 437100, Hubei, PR China
| | - Fang Qiu
- Department of Pharmacology, Hubei University of Science and Technology, 88 Xianning Road, Xianning 437100, Hubei, PR China
| | - Ting-Ting Liu
- Department of Pharmacology, Hubei University of Science and Technology, 88 Xianning Road, Xianning 437100, Hubei, PR China
| | - Zu-Wei Qu
- Department of Pharmacology, Hubei University of Science and Technology, 88 Xianning Road, Xianning 437100, Hubei, PR China
| | - Yu-Min Liu
- Neurology Department, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei, PR China.
| | - Wang-Ping Hu
- Department of Pharmacology, Hubei University of Science and Technology, 88 Xianning Road, Xianning 437100, Hubei, PR China.
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Liu YM, Wang X, Nawaz A, Kong ZH, Hong Y, Wang CH, Zhang JJ. Wogonin ameliorates lipotoxicity-induced apoptosis of cultured vascular smooth muscle cells via interfering with DAG-PKC pathway. Acta Pharmacol Sin 2011; 32:1475-82. [PMID: 21986573 DOI: 10.1038/aps.2011.120] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
AIM To investigate the effects of wogonin (5,7-dihydroxy-8-methoxyflavone) extracted from Scutellaria baicalensis Georgi (S baicalensis) on lipotoxicity-induced apoptosis of vascular smooth muscle cells (VSMCs) and the underlying mechanisms. METHODS Cultured VSMCs were used. Apoptosis of VSMCs was induced by palmitate (0.75 mmol/L), and detected using TUNEL assay. The expression levels of protein and phosphorylated protein were measured using Western blot analysis. RESULTS Treatment of VSMCs with wogonin (10, 25 and 50 μmol/L) significantly attenuated the apoptosis and endoplasmic reticulum (ER) stress induced by palmitate in concentration- and time-dependent manners. Wogonin (50 μmol/L) decreased palmitate-induced reactive oxygen species (ROS) generation. The ER stress inhibitor 4-phenyl butyric acid (5 mmol/L) significantly decreased palmitate-induced apoptotic cells, and occluded the anti-apoptotic effect of wogonin (25 μmol/L). Wogonin (10, 25 and 50 μmol/L) significantly reduced the intracellular diacylglycerol (DAG) accumulation and expression levels of phosphorylated PKCs in palmitate-treated VSMCs. CONCLUSION Our results suggest that wogonin inhibits lipotoxicity-induced apoptosis of VSMCs via suppressing the intracellular DAG accumulation and subsequent inhibition of PKC phosphorylation. Wogonin has therapeutic potential for the prevention and treatment of atherosclerosis.
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Affiliation(s)
- Yuan Yuan
- Center for Gene Diagnosis, Zhongnan Hospital, Wuhan University, Wuhan 430071, China
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Liang K, Yang L, Yin C, Xiao Z, Zhang J, Liu Y, Huang J. Estrogen stimulates degradation of beta-amyloid peptide by up-regulating neprilysin. J Biol Chem 2009; 285:935-42. [PMID: 19897485 DOI: 10.1074/jbc.m109.051664] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Postmenopausal estrogen depletion is a characterized risk factor for Alzheimer disease (AD), a human disorder linked to high levels of beta-amyloid peptide (Abeta) in brain tissue. Previous studies suggest that estrogen negatively regulates the level of Abeta in the brain, but the molecular mechanism is unknown. Here, we provide evidence that estrogen promotes Abeta degradation mainly through a principal Abeta degrading enzyme, neprilysin, in neuroblastoma SH-SY5Y cells. We also demonstrate that up-regulation of neprilysin by estrogen is dependent on both estrogen receptor alpha and beta (ERalpha and ERbeta), and ligand-activated ER regulates expression of neprilysin through physical interactions between ER and estrogen response elements (EREs) identified in the neprilysin gene. These results were confirmed by in vitro gel shift and in vivo chromatin immunoprecipitation analyses, which demonstrate specific binding of ERalpha and ERbeta to two putative EREs in the neprilysin gene. The EREs also enhance ERalpha- and ERbeta-dependent reporter gene expression in a yeast model system. Therefore, the study described here provides a putative mechanism by which estrogen positively regulates expression of neprilysin to promote degradation of Abeta, reducing risk for AD. These results may lead to novel approaches to prevent or treat AD.
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Affiliation(s)
- Kaiwei Liang
- State Key Lab of Virology, College of Life Sciences, Wuhan University, Wuhan, Hubei 430072, China
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Xiao ZM, Sun L, Liu YM, Zhang JJ, Huang J. Estrogen regulation of the neprilysin gene through a hormone-responsive element. J Mol Neurosci 2009; 39:22-6. [PMID: 19127446 DOI: 10.1007/s12031-008-9168-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2008] [Accepted: 12/10/2008] [Indexed: 02/05/2023]
Abstract
Our previous data showed that neprilysin (NEP), a zinc metalloendopeptidase, which can degrade amyloid-beta peptide (Abeta) whose central nerve system accumulation is the primary cause of Alzheimer's disease (AD), responds to estrogen in the brain. Recently, it has been shown that the transcription of the neprilysin gene can be up regulated by progesterone, androgens, and glucocorticoids through two androgen response elements within the NEP gene--an androgen response region (ARR) and an androgen response element (ARE). Through a yeast report gene system, we now find that the ARR but not the ARE respond to estrogen. However, androgen could efficiently enhance the expression of the report gene mainly through ARE. Our results indicate that the decrease of NEP, caused by the decline of estrogen or androgen with aging, may be an important factor leading to Abeta accumulation and AD.
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Affiliation(s)
- Zhi-Min Xiao
- State Key Laboratory of Virology, College of Life Sciences, Wuhan University, Wuhan, Hubei 430072, China
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Liu YM, Zhang JJ, Jiang J. [Observation on clinical effect of Angelica injection in treating acute cerebral infarction]. Zhongguo Zhong Xi Yi Jie He Za Zhi 2004; 24:205-8. [PMID: 15074085 DOI: pmid/15074085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To study the therapeutic effect of Angelica Injection (AI) in treating acute cerebral infarction (ACI). METHODS One thousand four hundred and four patients, who were treated with AI (692 patients in Group A), compound salvia (390 patients in Group B) and low molecular dextran injection (322 patients in Group C) respectively. Indexes such as CT scanning on infarcted volume, scoring of clinical neuro-function deficit taking on the 1st, 3rd, 7th, 15th and 25th day, clinical therapeutic effectiveness evaluated by the end of the 2nd week and the improvement of Barthel index scores were observed. RESULTS The total effective rate in Group A, B and C was 78.7%, 63.6% and 59.3% respectively, that in Group A was significantly higher than in the other two groups (P < 0.05). The improvement of neuro-function deficit scores and Barthel scores in Group A were better than those in Group B and C (on the 25th day, P < 0.01), and the decrement of infarcted volume in Group A was larger than that in Group C (P < 0.01). CONCLUSION AI has evident therapeutic effect in treating ACI.
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Affiliation(s)
- Yu-min Liu
- Department of Neurology, Zhongnan Hospital, Wuhan University, Wuhan 430071
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