Aim: To explore what is the relationship of the types of post-stroke aphasia with sex, age and stroke types. Methods: Retrospective analysis was administrated on data of 421 patients with acute stroke. Western battery...Aim: To explore what is the relationship of the types of post-stroke aphasia with sex, age and stroke types. Methods: Retrospective analysis was administrated on data of 421 patients with acute stroke. Western battery aphasia was used to measure aphasiac type and aphasia quotient (AQ) score. The patients were divided into three age groups: young, middle-aged and elderly. The stroke types were classified into cerebral infraction (CI) and intracerebral hemorrhage (ICH). Results: All subjects were right-handed, which males and females accounted for 69.60% and 30.40%, respectively. There were 116 cases of Broca’s aphasia (85 males), 35 cases of Wernicke’s aphasia (20 males), 15 cases of conductive aphasia (10 males), 63 cases of transcortical motor aphasia (50 males), 11 cases of transcortical sensory aphasia (8 males), 27 cases of transcortical combined aphasia (13 males), 73 cases of anomic aphasia (47 males) and 81 cases of global aphasia (60 males). Male patients (69.60%) have a significantly higher morbidity of aphasia than that of females (30.40%) after stroke (χ2 = 11.57, P = 0.003), especially those under 65 years old (73.38%). For people 65 years and older, the morbidity of female (42.97%) tends to increase with age. Sex has no significant influence on the types of aphasia (χ2 = 13.84, P = 0.054). Broca’s aphasia is the most common type inboth male and female (29.01%, 24.22%, respectively). The distribution of aphasic types has no obvious difference among three age groups (χ2 = 14.94, P= 0.382). Aphasia induced by CI (306 cases) is more common than that by ICH (115 cases), but there was no difference in distribution of types of aphasia (χ2 = 13.23, P = 0.067). Conclusions: Male patients have a significantly higher level of morbidity of aphasia than females after stroke and a lower average age of onset than females. Broca’s aphasia is the most common one in both male and female. Broca’s aphasia, global and anomic aphasia are the most common aphasic types in both CI and ICH patients, except the female with ICH.展开更多
The incidence of ischemic stroke in patients with diabetes is increasing. While brachial-ankle pulse wave velocity （BaPWV） and ankle-bra- chial index （ABI） are known to be associated with ischemic cardiovascular a...The incidence of ischemic stroke in patients with diabetes is increasing. While brachial-ankle pulse wave velocity （BaPWV） and ankle-bra- chial index （ABI） are known to be associated with ischemic cardiovascular and cerebrovascular diseases, whether these measures predict the risk of ischemic cerebrovascular disease in diabetic patients remains unclear. 117 patients with type 2 diabetes were enrolled in this study. According to the results of head magnetic resonance imaging, the patients were divided into a diabetes-only group （n = 55） and a diabetes and ischemic stroke group （n = 62）. We then performed ABI and BaPWV examinations for all patients. Compared with the diabe- tes-only group, we found decreased ABI and increased BaPWV in the diabetes and ischemic stroke group. Multivariate logistic regression analyses revealed that BaPWV and ABI were risk factors for ischemic stroke in patients with type 2 diabetes. Our findings indicate that decreased ABI and increased BaPWV are objective indicators of increased risk of ischemic stroke in patients with type 2 diabetes.展开更多
Objective To explore the influence of NO and serum endothelins change on prognosis of mixed type stroke patients. Method To test amount of ET and NO,to analysis the influence of NO and ET on prognosis using high effec...Objective To explore the influence of NO and serum endothelins change on prognosis of mixed type stroke patients. Method To test amount of ET and NO,to analysis the influence of NO and ET on prognosis using high effective liquid chromatography and radio immunology method and compared with the control group,then treat with t test. Result Concentrations of serum ET and NO of observe groups were apparently larger than that of control group (P<0.01, P<0.05). Conclusion Serum ET and NO increase apparently in mixed type stroke patients,the higher concentration, the severer disease and deformity of mobility.展开更多
BACKGROUND Human-derived mesenchymal stromal cells have been shown to improve cognitive function following experimental stroke.The activity of exosomes has been verified to be comparable to the therapeutic effects of ...BACKGROUND Human-derived mesenchymal stromal cells have been shown to improve cognitive function following experimental stroke.The activity of exosomes has been verified to be comparable to the therapeutic effects of mesenchymal stromal cells.However,the effects of exosomes derived from human umbilical cord mesenchymal stem cells(HUC-MSCs)(ExoCtrl)on post-stroke cognitive impairment(PSCI)have rarely been reported.Moreover,whether exosomes derived from C-C chemokine receptor type 2(CCR2)-overexpressing HUC-MSCs(ExoCCR2)can enhance the therapeutic effects on PSCI and the possible underlying mechanisms have not been studied.AIM To investigate the effects of ExoCtrl on PSCI and whether ExoCCR2 can enhance therapeutic effects on PSCI.METHODS Transmission electron microscopy,qNano®particles analyzer,and Western blotting were employed to determine the morphology and CCR2 expression of ExoCtrl or ExoCCR2.ELISA was used to study the binding capacity of exosomes to CC chemokine ligand 2(CCL2)in vivo.After the intravenous injection of ExoCtrl or ExoCCR2 into experimental rats,the effect of ExoCtrl and ExoCCR2 on PSCI was assessed by Morris water maze.Remyelination and oligodendrogenesis were analyzed by Western blotting and immunofluorescence microscopy.QRT-PCR and immunofluorescence microscopy were conducted to compare the microglia/macrophage polarization.The infiltration and activation of hematogenous macrophages were analyzed by Western blotting and transwell migration analysis.RESULTS CCR2-overexpressing HUC-MSCs loaded the CCR2 receptor into their exosomes.The morphology and diameter distribution between ExoCtrl and ExoCCR2 showed no significant difference.ExoCCR2 bound significantly to CCL2 but ExoCtrl showed little CCL2 binding.Although both ExoCCR2 and ExoCtrl showed beneficial effects on PSCI,oligodendrogenesis,remyelination,and microglia/macrophage polarization,ExoCCR2 exhibited a significantly superior beneficial effect.We also found that ExoCCR2 could suppress the CCL2-induced macrophage migration and activation in vivo and in vitro,compared with ExoCtrl treated group.CONCLUSION CCR2 over-expression enhanced the therapeutic effects of exosomes on the experimental PSCI by promoting M2 microglia/macrophage polarization,enhancing oligodendrogenesis and remyelination.These therapeutic effects are likely through suppressing the CCL2-induced hematogenous macrophage migration and activation.Key words:Cognitive impairment;Stroke;Exosomes;C-C chemokine receptor type 2;Microglia/macrophage polarization;Remyelination.展开更多
Background: As a common and high incidence of disease, the minor ischemic stroke (MIS) has become an important public health problem. The aim of this study was to address whether patients with MIS have different types...Background: As a common and high incidence of disease, the minor ischemic stroke (MIS) has become an important public health problem. The aim of this study was to address whether patients with MIS have different types and outcome in the elderly in northern China. Methods: A retrospective cohort of consecutive patients was selected for study;all registered neurologic outpatients of the tertiary teaching hospital in northern Jiangsu, China between February, 2011 and February, 2012. A total of 433 outpatients, clinically only having had an initial visit and a MRI study of the brain, were enrolled. Results: Of 433 outpatients, 247 (57.0%) patients with MIS were diagnosed. The clinical types of MIS included stable MIS in 58.3%, acute progressive MIS in 5.3%, and chronic progressive MIS in 36.4% of patients. After adjusted Odd ratio (OR), only aged (OR, 1.0;95% confidence interval [CI], 1.007 - 1.087, p = 0.021), episode duration (OR, 1.8;95% CI, 1.011 - 1.024, p = 0.001), initial number of MIS (OR, 1.1;95% CI, 1.047 - 1.207, p = 0.001), and infarcts volume (OR, 1.8;95% CI, 1.253 - 2.681, p = 0.002) were independently associated with stable MIS and progressive MIS. Total survival was favorable among groups (p = 0.094), but the followed mRS score was significantly higher among those progressive MIS than those stable MIS (2.3 ± 1.0 vs 0.1 ± 0.3, p Conclusion: MIS had a very high prevalence and different clinical types. Stable MIS is a benign stroke, whereas those progressive MIS may have long-term instability or acute and chronic progressive trend. This information is important in prospectively determining outcome of MIS and in patient treatment.展开更多
Background: The cardiovascular risk factors including type 2 diabetes mellitus (T2DM) are a public health problem in sub-Saharan Africa. The aim of this study is to determine the prevalence and factors associated with...Background: The cardiovascular risk factors including type 2 diabetes mellitus (T2DM) are a public health problem in sub-Saharan Africa. The aim of this study is to determine the prevalence and factors associated with stroke in T2DM patients admitted to the emergency Unit in Brazzaville. Patients and Methods: This is the preliminary findings of a cross-sectional study including patients with T2DM, admitted in Emergency Unit of University Hospital of Brazzaville from January to April 2011. One hundred and seven patients were included. Sex ratio was 1.5. Results: The mean age was 60.3 ± 10.2 years (range 40 - 80 years). Stroke story was noted in 5 cases (4.6%). The main pathologies were metabolic complications (n = 51;47.6%) and cardiovascular diseases (n = 36;33.6%), dominated by stroke (17 cases). Epidemiological factors associated with stroke were high standard living (OR = 3, 95% CI: 1.02 - 8.9, p = 0.03), polypharmacy (OR = 3.7, 95% CI: 1.27 - 10.8, p = 0.01), previous hospitalization (OR = 3.1, 95% CI: 1.07 - 8.9, p = 0.03), and the absence of antiplatelet therapy (OR = 4.2, 95% CI 1.2 to 15, p = 0.03). Clinical associated factors were coma (OR = 3.3, 95% CI 1.14 to 9.6, p = 0.02) and the presence of severe hypertension (OR = 4, 95% CI: 1.2 - 12, p = 0.02). Finally, prognostic factors were the transfer in intensive care unit (OR = 9.8, 95% CI: 2.7 - 34, p 0.001). Conclusion: The first cardiovascular complication in patients with T2DM admitted in emergency at University Hospital of Brazzaville is stroke. Primary prevention in high-risk patients is still inadequate.展开更多
Objective: to analyze the nursing measures and effect of type 2 diabetes associated with ischemic stroke. Methods: 60 patients with type 2 diabetes and ischemic stroke in December 2020, and all patients were divided i...Objective: to analyze the nursing measures and effect of type 2 diabetes associated with ischemic stroke. Methods: 60 patients with type 2 diabetes and ischemic stroke in December 2020, and all patients were divided into 2 groups according to the nursing method to compare the nursing effect of each group. Results: the nursing effect was better than the control group with P <0.05. After nursing intervention, blood glucose control was significantly better than in control groups, with statistical significance (P <0.05). Conclusion: applying comprehensive nursing measures to patients with type 2 diabetes and ischemic stroke can further improve the nursing effect, blood sugar level and quality of life.展开更多
Aim: To determine the relationship of carotid plaque, intima media thickness (IMT), resistivity index (RI) and pulsatility index (PI) and prevalence of different risk factors with acute ischemic stroke and stroke subt...Aim: To determine the relationship of carotid plaque, intima media thickness (IMT), resistivity index (RI) and pulsatility index (PI) and prevalence of different risk factors with acute ischemic stroke and stroke subtypes in both diabetic and non-diabetic subjects. Materials and methods: 80 cases of acute ischemic strokes and 40 healthy controls were included in the study. The plaque, IMT, RI and PI were measured by carotid duplex ultrasound. Results: 31 subjects were Type 2 diabetic, 54 hypertensive while 25 were both diabetic and hypertensive. 23 cases (28.75%) had lacunar stroke (LACI), 32 (40%) stroke involving partial anterior circulation(PACI), 10(12.5%) stroke in posterior circulation (PACI) and 15(18.75%) stroke involving total anterior circulation(TACI) respectively. The mean IMT (0.88 ± 0.19mm), RI(0.76 ± 0.05) and PI(1.71 ± 0.19) of patients and mean IMT (0.6±0.09mm), RI (0.61 ± 0.06) and PI (1.53 ± 0.11) of controls were statistically significant (p-0.000). The mean values of IMT, PI and RI were significantly higher in diabetics (IMT-0.90 ± 0.16 VS 0.64 ± 0.11, p-0.013;PI-1.76 ± 0.20 VS 1.49 ± 0.09, P-0.000 and RI-0.76 ± 0.04 VS 0.59 ± 0.06, P-0.000) and similarly the mean values for IMT, PI and RI in hypertensives as compared to controls (IMT-0.88 ± 0.16 vs 0.65 ± 0.10, P-0.006;PI1.69 ± 0.18 vs 1.49 ± 0.09, P-0.000 and RI 0.76 ± 0.04 vs 0.59 ± 0.06, P-0.000). The mean IMT, PI and RI were increased significantly in smokers compared to controls (IMT-0.93 ± 0.20 vs 0.63 ± 0.06, P-0.000;PI-1.82 ± 0.22 vs 1.49 ± 0.09, P-0.000 and RI-0.77 ± 0.04 vs 0.59 ± 0.06, P-0.000). Type 3 plaque accounted for 27 (56.2%) cases and Type 2 plaque 12 (25%) cases. The total number of plaques in patients as compared to controls were significantly more (P-0.0034) and the mean plaque area was 46 mm2 for cases and 20 mm2 for control (P-0.0001). TACI was the most common type of ischemic stroke seen in DM (60%), HTN (66.6%) and smokers (66.7%). Plaques (73.3%), IMT (0.90 ± 0.12), PI(1.72 ± 0.14) and RI (0.76 ± 0.13) were more commonly associated with TACI subtype. On multivariate analysis using ANOVA, the mean PI was highly significant (0.000) in relation to types of plaque. Summary and Conclusions: IMT, RI, PI and plaque type are useful diagnostic parameters for acute ischemic stroke and its subtypes. They can be used as noninvasive tools for predicting and preventing ischemic stroke in smokers as well as subjects with DM and hypertension.展开更多
Objective To investigate the change of serum and uric acid of ty pe 2diabetic patient s concomitant with stroke.Methods We selected 202patien ts randomly,and divided them into 3groups:diabetic concomitant with stroke ...Objective To investigate the change of serum and uric acid of ty pe 2diabetic patient s concomitant with stroke.Methods We selected 202patien ts randomly,and divided them into 3groups:diabetic concomitant with stroke gr oup,simp le stroke and simple diabetes group.We tested serum uric acid(UA)an d serum fat of all patients and anal ysis its relationship with type 2dia betes and stroke.Results There was apparent difference in serum UA a nd HDL level be tween type 2diabetic with stroke group and simple diabetic group.Conclusion De crease of HDL is one important risk factor fo r type 2diabetic patients concomi ta nt with stroke,and hypercuricemia i s another important risk factor for male type 2diabetic patients concom itant with stroke.展开更多
Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a member of the proprotein convertase (PCs) family, which facilitates the degradation of low-density lipoprotein receptors (LDL-R) via intracellular and cell su...Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a member of the proprotein convertase (PCs) family, which facilitates the degradation of low-density lipoprotein receptors (LDL-R) via intracellular and cell surface pathways, consequently elevating serum LDL-C levels. PCSK9 is implicated in various processes such as lipid metabolism, atherosclerosis, oxidative stress, inflammatory responses, thrombosis, and apoptosis. It is closely linked to ischemic stroke through its role in inducing and advancing atherosclerosis. PCSK9 inhibitors play a useful role in both acute and secondary prevention of ischemic stroke and can reduce the risk of ischemic stroke. This review examines the influence of PCSK9 on the risk factors associated with ischemic stroke and explores its potential mechanisms, and briefly describes the application of PCSK9 inhibitors in ischemic stroke.展开更多
Neurofibromatosis type I（NF1） is a hereditary,autosomal dominant,neurocutaneous syndrome that is attributed to NF1 gene mutation.NF1 has been associated with scoliosis,macrocephaly,pseudoarthrosis,short stature,ment...Neurofibromatosis type I（NF1） is a hereditary,autosomal dominant,neurocutaneous syndrome that is attributed to NF1 gene mutation.NF1 has been associated with scoliosis,macrocephaly,pseudoarthrosis,short stature,mental retardation,and malignancies.NF1-associated vasculopathy is an uncommon and easily-overlooked presentation.Examination of a Chinese family affected by NF1 combined with cerebral vessel stenosis and/ or abnormality suggested a possible relationship between NF1 and vessel stenosis.To determine which NF1 gene mutation is associated with vascular lesions,particularly cerebral vessel stenosis,we examined one rare family with combined cerebral vessel lesions or maldevelopment.Vascular lesions were detected using transcranial Doppler sonography and digital subtraction angiography in family members.Next,denaturing high-performance liquid chromatography and sequencing were used to screen for NF1 gene mutations.The results revealed a nonsense mutation,c.541C＆gt;T,in the NF1 gene.This mutation truncated the NF1 protein by 2659 aminoacid residues at the C-terminus and co-segregated with all of the patients,but was not present in unaffected individuals in the family.Exceptionally,three novel mutations were identified in unaffected family members,but these did not affect the product of the NF1 gene.Thus the nonsense mutation,c.541C＆gt;T,located in the NF1 gene could constitute one genetic factor for cerebral vessel lesions.展开更多
No recommended guidelines currently exist for the therapeutic concentration or dose of botulinum toxin type A （BTXA） injected into the muscle to treat limb spasticity. Therefore, in this randomized controlled trial,...No recommended guidelines currently exist for the therapeutic concentration or dose of botulinum toxin type A （BTXA） injected into the muscle to treat limb spasticity. Therefore, in this randomized controlled trial, we explored the safety and efficacy of two concentrations and two doses of BTXA in the treatment of spastic toot after stroke to optimize this treatment in these patients. Eligible patients （n = 104） were randomized into four groups. The triceps surae and tibialis posterior on the affected side were injected with BTXA at one of two doses （200 U or 400 U） and two concentrations （50 U/mL or 100 U/mL）. 2he following assessments were conducted before as well as 4 days and 1, 2, 4, and 12 weeks after treatment： spasticity, assessed using the modified Ashworth scale; basic functional mobility, assessed using a timed up and go test; pace, assessed using a 10-meter timed walking test; and the ability to walk, assessed using Holden＇s graded scale and a visual analog scale. The reported results are based on the 89 patients that completed the study. We found significant differences for the two doses and concentrations of BTXA to improve the ability of patients to walk independently, with the high-dose/low-concentration combination providing the best effect. Onset and duration of the ameliorating effects of BTXA were 4-7 days and 12 weeks, respectively. Thus, BTXA effectively treated foot spasms after stroke at an optimal dose of 400 U and concentration of 50 U/mL.展开更多
Ischemic stroke is a leading cause of mortality and long-term disability worldwide. Given the detrimental effects of acute stroke, several neuroprotective agents have been evaluated in these patients. However, the ben...Ischemic stroke is a leading cause of mortality and long-term disability worldwide. Given the detrimental effects of acute stroke, several neuroprotective agents have been evaluated in these patients. However, the benefits of the evaluated agents appear to be limited and none is currently recommended for clinical use. On the other hand, prior treatment with agents that are used for the primary and secondary prevention of stroke, including statins and antiplatelets, has been associated with better outcome in patients who experience an acute stroke. In contrast, there are limited data as to whether prior treatment with antidiabetic agents is beneficial in diabetic patients who suffer a stroke. In this context, the findings of a recent study that showed reduced stroke size following pretreatment with linagliptin, a dipeptidyl peptidase-4(DDP-4) inhibitor, compared with glimepiride, in both diabetic and non-diabetic mice, appear promising. Despite these preclinical findings suggesting neuroprotective effects of DPP-4 inhibitors in acute stroke, it is still unclear whether these actions will also be observed in humans. Of note, two recent large randomized, placebo-controlled studies did not show any effect of DPP-4 inhibitors on cardiovascular events, including stroke. Several other ongoing trials are evaluating the effects of DPP-4 inhibitors on cardiovascular morbidity and mortality. These studies also provide a major opportunity to assess whether patients treated with this class of antidiabetic agents will suffer from less severe strokes and whether their outcome after stroke will be more favorable.展开更多
The scavenger receptor class B type I gene can protect against atherosclerosis; a mononucleotide polymorphism is associated with differences in blood lipid metabolism, postprandial serum lipid levels, insulin resistan...The scavenger receptor class B type I gene can protect against atherosclerosis; a mononucleotide polymorphism is associated with differences in blood lipid metabolism, postprandial serum lipid levels, insulin resistance, coronary artery disease and familial hyperlipidemia. In this study, the scavenger receptor class B type I gene exon 1 G4A gene polymorphism in atherosclerotic cerebral infarction patients, cerebral hemorrhage patients and normal controls was detected using the polymerase chain reaction-restriction fragment length polymorphism method. The results showed that the GA ＋ AA genotype frequency of scavenger receptor class B type I gene G4A in atherosclerotic cerebral infarction patients was similar to that in cerebral hemorrhage patients and normal controls; however, the A allele frequency was significantly lower than that in normal controls. The serum level of high-density lipoprotein cholesterol in patients with the scavenger receptor class B type I gene G4A GA ＋ AA genotype was significantly higher, while the serum level of low-density lipoprotein cholesterol was significantly lower than that in patients with the GG genotype, in both the atherosclerotic cerebral infarction and cerebral hemorrhage groups. The serum level of high-density lipoprotein cholesterol in patients with the scavenger receptor class B type I gene G4A GA ＋ AA genotype was significantly higher, while the serum levels of low-density lipoprotein cholesterol and total cholesterol were significantly lower than those in normal controls with the GG genotype. Our experimental results suggest that the G4A polymorphism of the scavenger receptor class B type I gene is a possible predisposing risk factor for atherosclerotic cerebral infarction, and that it has no association with cerebral hemorrhage in the Hart population in Hunan province of China. The A allele is possibly associated with the metabolism of high-density and low-density lipoprotein cholesterol.展开更多
In this paper based on investigation on the structural types of sea embankments in the southeast coastal area of China, as well as the related tidal stages, waves and strength of marine soils, the finite element metho...In this paper based on investigation on the structural types of sea embankments in the southeast coastal area of China, as well as the related tidal stages, waves and strength of marine soils, the finite element method (FEM) calculations for seepage flow stability, including the overall stability against sliding and local stability of sloping surface under the action of tidal stage and waves are carried out. A comparison of the computational results of FEM for single circular slip, composite circular slip and geogrid reinforcement against sliding shows that for calculation of stability against sliding of marine soft soil foundation it is even more reasonable to use the composite circular slip. The stability of sloping type sea embankment against sliding is slightly better than that of the vertical face type; for the combination of three defences (wave, scour and seepage defences) the sea embankment structural type of a composite cross section with a platform should be a good one, but it still should be suitable to local conditions. For the local stability of riprap slope blocks and wall face loose masonry blocks, according to the analyses of wave-induced seepage flow fields, calculating formulas are given and they are verified by model test on block stability of breakwaters.展开更多
AIM:To evaluate the association of nonalcoholic fatty liver disease(NAFLD)with acute ischemic stroke severity and in-hospital outcome.METHODS:We prospectively studied all patients who were admitted in our Department w...AIM:To evaluate the association of nonalcoholic fatty liver disease(NAFLD)with acute ischemic stroke severity and in-hospital outcome.METHODS:We prospectively studied all patients who were admitted in our Department with acute ischemic stroke between September 2010 and August 2012(n=415;39.5%males,mean age 78.8±6.6 years).The severity of stroke was assessed with the National Institutes of Health Stroke Scale(NIHSS)score at admission.NALFD was defined as serum alanine aminotransferase and/or aspartate aminotransferase levels above the upper limit of normal in the absence of other causes of elevated aminotransferases levels[chronic hepatitis B or C,drug toxicity,increased alcohol consumption(】21 and】14 drinks per week in men and women,respectively),cholestatic diseases or rhabdomyolysis].The outcome was assessed with the modified Rankin scale(mRS)score at discharge and in-hospital mortality.Adverse outcome was defined as mRS score at discharge≥2.Dependency at discharge was defined as mRS score between 2 to 5.RESULTS:NAFLD was present in 7.7%of the study population.Patients with NAFLD had lower serum high-density lipoprotein cholesterol and higher triglyceride levels than patients without NAFLD(P【0.05 for both comparisons).Demographic data,the prevalence of other cardiovascular risk factors and the prevalence of established CVD did not differ between the two groups.At admission,the NIHSS score did not differ between patients with and without NAFLD(6.3±6.4and 8.8±9.6,respectively;P=NS).At discharge,the mRS score did not differ between the two groups(1.9±2.2 and 2.6±2.2 in patients with and without NAFLD,respectively;P=NS).Rates of dependency at discharge were also similar in patients with and without NAFLD(36.8%and 55.0%,respectively;P=NS)as were the rates of adverse outcome(42.9%and58.6%,respectively;P=NS).In-hospital mortality rates also did not differ between the 2 groups(8.0%and 7.0%in patients with and without NAFLD,respectively;P=NS).CONCLUSION:The presence of NAFLD in patients admitted for acute ischemic stroke does not appear to be associated with more severe stroke or with worse in-hospital outcome.展开更多
文摘Aim: To explore what is the relationship of the types of post-stroke aphasia with sex, age and stroke types. Methods: Retrospective analysis was administrated on data of 421 patients with acute stroke. Western battery aphasia was used to measure aphasiac type and aphasia quotient (AQ) score. The patients were divided into three age groups: young, middle-aged and elderly. The stroke types were classified into cerebral infraction (CI) and intracerebral hemorrhage (ICH). Results: All subjects were right-handed, which males and females accounted for 69.60% and 30.40%, respectively. There were 116 cases of Broca’s aphasia (85 males), 35 cases of Wernicke’s aphasia (20 males), 15 cases of conductive aphasia (10 males), 63 cases of transcortical motor aphasia (50 males), 11 cases of transcortical sensory aphasia (8 males), 27 cases of transcortical combined aphasia (13 males), 73 cases of anomic aphasia (47 males) and 81 cases of global aphasia (60 males). Male patients (69.60%) have a significantly higher morbidity of aphasia than that of females (30.40%) after stroke (χ2 = 11.57, P = 0.003), especially those under 65 years old (73.38%). For people 65 years and older, the morbidity of female (42.97%) tends to increase with age. Sex has no significant influence on the types of aphasia (χ2 = 13.84, P = 0.054). Broca’s aphasia is the most common type inboth male and female (29.01%, 24.22%, respectively). The distribution of aphasic types has no obvious difference among three age groups (χ2 = 14.94, P= 0.382). Aphasia induced by CI (306 cases) is more common than that by ICH (115 cases), but there was no difference in distribution of types of aphasia (χ2 = 13.23, P = 0.067). Conclusions: Male patients have a significantly higher level of morbidity of aphasia than females after stroke and a lower average age of onset than females. Broca’s aphasia is the most common one in both male and female. Broca’s aphasia, global and anomic aphasia are the most common aphasic types in both CI and ICH patients, except the female with ICH.
文摘The incidence of ischemic stroke in patients with diabetes is increasing. While brachial-ankle pulse wave velocity （BaPWV） and ankle-bra- chial index （ABI） are known to be associated with ischemic cardiovascular and cerebrovascular diseases, whether these measures predict the risk of ischemic cerebrovascular disease in diabetic patients remains unclear. 117 patients with type 2 diabetes were enrolled in this study. According to the results of head magnetic resonance imaging, the patients were divided into a diabetes-only group （n = 55） and a diabetes and ischemic stroke group （n = 62）. We then performed ABI and BaPWV examinations for all patients. Compared with the diabe- tes-only group, we found decreased ABI and increased BaPWV in the diabetes and ischemic stroke group. Multivariate logistic regression analyses revealed that BaPWV and ABI were risk factors for ischemic stroke in patients with type 2 diabetes. Our findings indicate that decreased ABI and increased BaPWV are objective indicators of increased risk of ischemic stroke in patients with type 2 diabetes.
文摘Objective To explore the influence of NO and serum endothelins change on prognosis of mixed type stroke patients. Method To test amount of ET and NO,to analysis the influence of NO and ET on prognosis using high effective liquid chromatography and radio immunology method and compared with the control group,then treat with t test. Result Concentrations of serum ET and NO of observe groups were apparently larger than that of control group (P<0.01, P<0.05). Conclusion Serum ET and NO increase apparently in mixed type stroke patients,the higher concentration, the severer disease and deformity of mobility.
基金the National Natural Science Foundation of China,No.81871847 and No.81672261
文摘BACKGROUND Human-derived mesenchymal stromal cells have been shown to improve cognitive function following experimental stroke.The activity of exosomes has been verified to be comparable to the therapeutic effects of mesenchymal stromal cells.However,the effects of exosomes derived from human umbilical cord mesenchymal stem cells(HUC-MSCs)(ExoCtrl)on post-stroke cognitive impairment(PSCI)have rarely been reported.Moreover,whether exosomes derived from C-C chemokine receptor type 2(CCR2)-overexpressing HUC-MSCs(ExoCCR2)can enhance the therapeutic effects on PSCI and the possible underlying mechanisms have not been studied.AIM To investigate the effects of ExoCtrl on PSCI and whether ExoCCR2 can enhance therapeutic effects on PSCI.METHODS Transmission electron microscopy,qNano®particles analyzer,and Western blotting were employed to determine the morphology and CCR2 expression of ExoCtrl or ExoCCR2.ELISA was used to study the binding capacity of exosomes to CC chemokine ligand 2(CCL2)in vivo.After the intravenous injection of ExoCtrl or ExoCCR2 into experimental rats,the effect of ExoCtrl and ExoCCR2 on PSCI was assessed by Morris water maze.Remyelination and oligodendrogenesis were analyzed by Western blotting and immunofluorescence microscopy.QRT-PCR and immunofluorescence microscopy were conducted to compare the microglia/macrophage polarization.The infiltration and activation of hematogenous macrophages were analyzed by Western blotting and transwell migration analysis.RESULTS CCR2-overexpressing HUC-MSCs loaded the CCR2 receptor into their exosomes.The morphology and diameter distribution between ExoCtrl and ExoCCR2 showed no significant difference.ExoCCR2 bound significantly to CCL2 but ExoCtrl showed little CCL2 binding.Although both ExoCCR2 and ExoCtrl showed beneficial effects on PSCI,oligodendrogenesis,remyelination,and microglia/macrophage polarization,ExoCCR2 exhibited a significantly superior beneficial effect.We also found that ExoCCR2 could suppress the CCL2-induced macrophage migration and activation in vivo and in vitro,compared with ExoCtrl treated group.CONCLUSION CCR2 over-expression enhanced the therapeutic effects of exosomes on the experimental PSCI by promoting M2 microglia/macrophage polarization,enhancing oligodendrogenesis and remyelination.These therapeutic effects are likely through suppressing the CCL2-induced hematogenous macrophage migration and activation.Key words:Cognitive impairment;Stroke;Exosomes;C-C chemokine receptor type 2;Microglia/macrophage polarization;Remyelination.
文摘Background: As a common and high incidence of disease, the minor ischemic stroke (MIS) has become an important public health problem. The aim of this study was to address whether patients with MIS have different types and outcome in the elderly in northern China. Methods: A retrospective cohort of consecutive patients was selected for study;all registered neurologic outpatients of the tertiary teaching hospital in northern Jiangsu, China between February, 2011 and February, 2012. A total of 433 outpatients, clinically only having had an initial visit and a MRI study of the brain, were enrolled. Results: Of 433 outpatients, 247 (57.0%) patients with MIS were diagnosed. The clinical types of MIS included stable MIS in 58.3%, acute progressive MIS in 5.3%, and chronic progressive MIS in 36.4% of patients. After adjusted Odd ratio (OR), only aged (OR, 1.0;95% confidence interval [CI], 1.007 - 1.087, p = 0.021), episode duration (OR, 1.8;95% CI, 1.011 - 1.024, p = 0.001), initial number of MIS (OR, 1.1;95% CI, 1.047 - 1.207, p = 0.001), and infarcts volume (OR, 1.8;95% CI, 1.253 - 2.681, p = 0.002) were independently associated with stable MIS and progressive MIS. Total survival was favorable among groups (p = 0.094), but the followed mRS score was significantly higher among those progressive MIS than those stable MIS (2.3 ± 1.0 vs 0.1 ± 0.3, p Conclusion: MIS had a very high prevalence and different clinical types. Stable MIS is a benign stroke, whereas those progressive MIS may have long-term instability or acute and chronic progressive trend. This information is important in prospectively determining outcome of MIS and in patient treatment.
文摘Background: The cardiovascular risk factors including type 2 diabetes mellitus (T2DM) are a public health problem in sub-Saharan Africa. The aim of this study is to determine the prevalence and factors associated with stroke in T2DM patients admitted to the emergency Unit in Brazzaville. Patients and Methods: This is the preliminary findings of a cross-sectional study including patients with T2DM, admitted in Emergency Unit of University Hospital of Brazzaville from January to April 2011. One hundred and seven patients were included. Sex ratio was 1.5. Results: The mean age was 60.3 ± 10.2 years (range 40 - 80 years). Stroke story was noted in 5 cases (4.6%). The main pathologies were metabolic complications (n = 51;47.6%) and cardiovascular diseases (n = 36;33.6%), dominated by stroke (17 cases). Epidemiological factors associated with stroke were high standard living (OR = 3, 95% CI: 1.02 - 8.9, p = 0.03), polypharmacy (OR = 3.7, 95% CI: 1.27 - 10.8, p = 0.01), previous hospitalization (OR = 3.1, 95% CI: 1.07 - 8.9, p = 0.03), and the absence of antiplatelet therapy (OR = 4.2, 95% CI 1.2 to 15, p = 0.03). Clinical associated factors were coma (OR = 3.3, 95% CI 1.14 to 9.6, p = 0.02) and the presence of severe hypertension (OR = 4, 95% CI: 1.2 - 12, p = 0.02). Finally, prognostic factors were the transfer in intensive care unit (OR = 9.8, 95% CI: 2.7 - 34, p 0.001). Conclusion: The first cardiovascular complication in patients with T2DM admitted in emergency at University Hospital of Brazzaville is stroke. Primary prevention in high-risk patients is still inadequate.
文摘Objective: to analyze the nursing measures and effect of type 2 diabetes associated with ischemic stroke. Methods: 60 patients with type 2 diabetes and ischemic stroke in December 2020, and all patients were divided into 2 groups according to the nursing method to compare the nursing effect of each group. Results: the nursing effect was better than the control group with P <0.05. After nursing intervention, blood glucose control was significantly better than in control groups, with statistical significance (P <0.05). Conclusion: applying comprehensive nursing measures to patients with type 2 diabetes and ischemic stroke can further improve the nursing effect, blood sugar level and quality of life.
文摘Aim: To determine the relationship of carotid plaque, intima media thickness (IMT), resistivity index (RI) and pulsatility index (PI) and prevalence of different risk factors with acute ischemic stroke and stroke subtypes in both diabetic and non-diabetic subjects. Materials and methods: 80 cases of acute ischemic strokes and 40 healthy controls were included in the study. The plaque, IMT, RI and PI were measured by carotid duplex ultrasound. Results: 31 subjects were Type 2 diabetic, 54 hypertensive while 25 were both diabetic and hypertensive. 23 cases (28.75%) had lacunar stroke (LACI), 32 (40%) stroke involving partial anterior circulation(PACI), 10(12.5%) stroke in posterior circulation (PACI) and 15(18.75%) stroke involving total anterior circulation(TACI) respectively. The mean IMT (0.88 ± 0.19mm), RI(0.76 ± 0.05) and PI(1.71 ± 0.19) of patients and mean IMT (0.6±0.09mm), RI (0.61 ± 0.06) and PI (1.53 ± 0.11) of controls were statistically significant (p-0.000). The mean values of IMT, PI and RI were significantly higher in diabetics (IMT-0.90 ± 0.16 VS 0.64 ± 0.11, p-0.013;PI-1.76 ± 0.20 VS 1.49 ± 0.09, P-0.000 and RI-0.76 ± 0.04 VS 0.59 ± 0.06, P-0.000) and similarly the mean values for IMT, PI and RI in hypertensives as compared to controls (IMT-0.88 ± 0.16 vs 0.65 ± 0.10, P-0.006;PI1.69 ± 0.18 vs 1.49 ± 0.09, P-0.000 and RI 0.76 ± 0.04 vs 0.59 ± 0.06, P-0.000). The mean IMT, PI and RI were increased significantly in smokers compared to controls (IMT-0.93 ± 0.20 vs 0.63 ± 0.06, P-0.000;PI-1.82 ± 0.22 vs 1.49 ± 0.09, P-0.000 and RI-0.77 ± 0.04 vs 0.59 ± 0.06, P-0.000). Type 3 plaque accounted for 27 (56.2%) cases and Type 2 plaque 12 (25%) cases. The total number of plaques in patients as compared to controls were significantly more (P-0.0034) and the mean plaque area was 46 mm2 for cases and 20 mm2 for control (P-0.0001). TACI was the most common type of ischemic stroke seen in DM (60%), HTN (66.6%) and smokers (66.7%). Plaques (73.3%), IMT (0.90 ± 0.12), PI(1.72 ± 0.14) and RI (0.76 ± 0.13) were more commonly associated with TACI subtype. On multivariate analysis using ANOVA, the mean PI was highly significant (0.000) in relation to types of plaque. Summary and Conclusions: IMT, RI, PI and plaque type are useful diagnostic parameters for acute ischemic stroke and its subtypes. They can be used as noninvasive tools for predicting and preventing ischemic stroke in smokers as well as subjects with DM and hypertension.
文摘Objective To investigate the change of serum and uric acid of ty pe 2diabetic patient s concomitant with stroke.Methods We selected 202patien ts randomly,and divided them into 3groups:diabetic concomitant with stroke gr oup,simp le stroke and simple diabetes group.We tested serum uric acid(UA)an d serum fat of all patients and anal ysis its relationship with type 2dia betes and stroke.Results There was apparent difference in serum UA a nd HDL level be tween type 2diabetic with stroke group and simple diabetic group.Conclusion De crease of HDL is one important risk factor fo r type 2diabetic patients concomi ta nt with stroke,and hypercuricemia i s another important risk factor for male type 2diabetic patients concom itant with stroke.
文摘Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a member of the proprotein convertase (PCs) family, which facilitates the degradation of low-density lipoprotein receptors (LDL-R) via intracellular and cell surface pathways, consequently elevating serum LDL-C levels. PCSK9 is implicated in various processes such as lipid metabolism, atherosclerosis, oxidative stress, inflammatory responses, thrombosis, and apoptosis. It is closely linked to ischemic stroke through its role in inducing and advancing atherosclerosis. PCSK9 inhibitors play a useful role in both acute and secondary prevention of ischemic stroke and can reduce the risk of ischemic stroke. This review examines the influence of PCSK9 on the risk factors associated with ischemic stroke and explores its potential mechanisms, and briefly describes the application of PCSK9 inhibitors in ischemic stroke.
基金supported by the National High Technology Development Project(863 Project)of China(2006AA02Z497)the National Basic Research Development Program(973 program)of China(2007CB511902)the National Natural Science Foundation of China(81341036)
文摘Neurofibromatosis type I（NF1） is a hereditary,autosomal dominant,neurocutaneous syndrome that is attributed to NF1 gene mutation.NF1 has been associated with scoliosis,macrocephaly,pseudoarthrosis,short stature,mental retardation,and malignancies.NF1-associated vasculopathy is an uncommon and easily-overlooked presentation.Examination of a Chinese family affected by NF1 combined with cerebral vessel stenosis and/ or abnormality suggested a possible relationship between NF1 and vessel stenosis.To determine which NF1 gene mutation is associated with vascular lesions,particularly cerebral vessel stenosis,we examined one rare family with combined cerebral vessel lesions or maldevelopment.Vascular lesions were detected using transcranial Doppler sonography and digital subtraction angiography in family members.Next,denaturing high-performance liquid chromatography and sequencing were used to screen for NF1 gene mutations.The results revealed a nonsense mutation,c.541C＆gt;T,in the NF1 gene.This mutation truncated the NF1 protein by 2659 aminoacid residues at the C-terminus and co-segregated with all of the patients,but was not present in unaffected individuals in the family.Exceptionally,three novel mutations were identified in unaffected family members,but these did not affect the product of the NF1 gene.Thus the nonsense mutation,c.541C＆gt;T,located in the NF1 gene could constitute one genetic factor for cerebral vessel lesions.
基金supported by a grant from the Shandong Science and Technology Development Plan Project in China,No.2012YD18031
文摘No recommended guidelines currently exist for the therapeutic concentration or dose of botulinum toxin type A （BTXA） injected into the muscle to treat limb spasticity. Therefore, in this randomized controlled trial, we explored the safety and efficacy of two concentrations and two doses of BTXA in the treatment of spastic toot after stroke to optimize this treatment in these patients. Eligible patients （n = 104） were randomized into four groups. The triceps surae and tibialis posterior on the affected side were injected with BTXA at one of two doses （200 U or 400 U） and two concentrations （50 U/mL or 100 U/mL）. 2he following assessments were conducted before as well as 4 days and 1, 2, 4, and 12 weeks after treatment： spasticity, assessed using the modified Ashworth scale; basic functional mobility, assessed using a timed up and go test; pace, assessed using a 10-meter timed walking test; and the ability to walk, assessed using Holden＇s graded scale and a visual analog scale. The reported results are based on the 89 patients that completed the study. We found significant differences for the two doses and concentrations of BTXA to improve the ability of patients to walk independently, with the high-dose/low-concentration combination providing the best effect. Onset and duration of the ameliorating effects of BTXA were 4-7 days and 12 weeks, respectively. Thus, BTXA effectively treated foot spasms after stroke at an optimal dose of 400 U and concentration of 50 U/mL.
文摘Ischemic stroke is a leading cause of mortality and long-term disability worldwide. Given the detrimental effects of acute stroke, several neuroprotective agents have been evaluated in these patients. However, the benefits of the evaluated agents appear to be limited and none is currently recommended for clinical use. On the other hand, prior treatment with agents that are used for the primary and secondary prevention of stroke, including statins and antiplatelets, has been associated with better outcome in patients who experience an acute stroke. In contrast, there are limited data as to whether prior treatment with antidiabetic agents is beneficial in diabetic patients who suffer a stroke. In this context, the findings of a recent study that showed reduced stroke size following pretreatment with linagliptin, a dipeptidyl peptidase-4(DDP-4) inhibitor, compared with glimepiride, in both diabetic and non-diabetic mice, appear promising. Despite these preclinical findings suggesting neuroprotective effects of DPP-4 inhibitors in acute stroke, it is still unclear whether these actions will also be observed in humans. Of note, two recent large randomized, placebo-controlled studies did not show any effect of DPP-4 inhibitors on cardiovascular events, including stroke. Several other ongoing trials are evaluating the effects of DPP-4 inhibitors on cardiovascular morbidity and mortality. These studies also provide a major opportunity to assess whether patients treated with this class of antidiabetic agents will suffer from less severe strokes and whether their outcome after stroke will be more favorable.
文摘The scavenger receptor class B type I gene can protect against atherosclerosis; a mononucleotide polymorphism is associated with differences in blood lipid metabolism, postprandial serum lipid levels, insulin resistance, coronary artery disease and familial hyperlipidemia. In this study, the scavenger receptor class B type I gene exon 1 G4A gene polymorphism in atherosclerotic cerebral infarction patients, cerebral hemorrhage patients and normal controls was detected using the polymerase chain reaction-restriction fragment length polymorphism method. The results showed that the GA ＋ AA genotype frequency of scavenger receptor class B type I gene G4A in atherosclerotic cerebral infarction patients was similar to that in cerebral hemorrhage patients and normal controls; however, the A allele frequency was significantly lower than that in normal controls. The serum level of high-density lipoprotein cholesterol in patients with the scavenger receptor class B type I gene G4A GA ＋ AA genotype was significantly higher, while the serum level of low-density lipoprotein cholesterol was significantly lower than that in patients with the GG genotype, in both the atherosclerotic cerebral infarction and cerebral hemorrhage groups. The serum level of high-density lipoprotein cholesterol in patients with the scavenger receptor class B type I gene G4A GA ＋ AA genotype was significantly higher, while the serum levels of low-density lipoprotein cholesterol and total cholesterol were significantly lower than those in normal controls with the GG genotype. Our experimental results suggest that the G4A polymorphism of the scavenger receptor class B type I gene is a possible predisposing risk factor for atherosclerotic cerebral infarction, and that it has no association with cerebral hemorrhage in the Hart population in Hunan province of China. The A allele is possibly associated with the metabolism of high-density and low-density lipoprotein cholesterol.
文摘In this paper based on investigation on the structural types of sea embankments in the southeast coastal area of China, as well as the related tidal stages, waves and strength of marine soils, the finite element method (FEM) calculations for seepage flow stability, including the overall stability against sliding and local stability of sloping surface under the action of tidal stage and waves are carried out. A comparison of the computational results of FEM for single circular slip, composite circular slip and geogrid reinforcement against sliding shows that for calculation of stability against sliding of marine soft soil foundation it is even more reasonable to use the composite circular slip. The stability of sloping type sea embankment against sliding is slightly better than that of the vertical face type; for the combination of three defences (wave, scour and seepage defences) the sea embankment structural type of a composite cross section with a platform should be a good one, but it still should be suitable to local conditions. For the local stability of riprap slope blocks and wall face loose masonry blocks, according to the analyses of wave-induced seepage flow fields, calculating formulas are given and they are verified by model test on block stability of breakwaters.
文摘AIM:To evaluate the association of nonalcoholic fatty liver disease(NAFLD)with acute ischemic stroke severity and in-hospital outcome.METHODS:We prospectively studied all patients who were admitted in our Department with acute ischemic stroke between September 2010 and August 2012(n=415;39.5%males,mean age 78.8±6.6 years).The severity of stroke was assessed with the National Institutes of Health Stroke Scale(NIHSS)score at admission.NALFD was defined as serum alanine aminotransferase and/or aspartate aminotransferase levels above the upper limit of normal in the absence of other causes of elevated aminotransferases levels[chronic hepatitis B or C,drug toxicity,increased alcohol consumption(】21 and】14 drinks per week in men and women,respectively),cholestatic diseases or rhabdomyolysis].The outcome was assessed with the modified Rankin scale(mRS)score at discharge and in-hospital mortality.Adverse outcome was defined as mRS score at discharge≥2.Dependency at discharge was defined as mRS score between 2 to 5.RESULTS:NAFLD was present in 7.7%of the study population.Patients with NAFLD had lower serum high-density lipoprotein cholesterol and higher triglyceride levels than patients without NAFLD(P【0.05 for both comparisons).Demographic data,the prevalence of other cardiovascular risk factors and the prevalence of established CVD did not differ between the two groups.At admission,the NIHSS score did not differ between patients with and without NAFLD(6.3±6.4and 8.8±9.6,respectively;P=NS).At discharge,the mRS score did not differ between the two groups(1.9±2.2 and 2.6±2.2 in patients with and without NAFLD,respectively;P=NS).Rates of dependency at discharge were also similar in patients with and without NAFLD(36.8%and 55.0%,respectively;P=NS)as were the rates of adverse outcome(42.9%and58.6%,respectively;P=NS).In-hospital mortality rates also did not differ between the 2 groups(8.0%and 7.0%in patients with and without NAFLD,respectively;P=NS).CONCLUSION:The presence of NAFLD in patients admitted for acute ischemic stroke does not appear to be associated with more severe stroke or with worse in-hospital outcome.
