Thalamic hemorrhage can lead to the development of central post-stroke pain.Changes in histone acetylation levels,which are regulated by histone deacetylases,affect the excitability of neurons surrounding the hemorrha...Thalamic hemorrhage can lead to the development of central post-stroke pain.Changes in histone acetylation levels,which are regulated by histone deacetylases,affect the excitability of neurons surrounding the hemorrhagic area.However,the regulato ry mechanism of histone deacetylases in central post-stroke pain remains unclea r.Here,we show that iron overload leads to an increase in histone deacetylase 2expression in damaged ventral posterolateral nucleus neurons.Inhibiting this increase restored histone H3 acetylation in the Kcna2 promoter region of the voltage-dependent potassium(Kv)channel subunit gene in a rat model of central post-stroke pain,thereby increasing Kcna2expression and relieving central pain.However,in the absence of nerve injury,increasing histone deacetylase 2 expression decreased Kcna2expression,decreased Kv current,increased the excitability of neurons in the ventral posterolateral nucleus area,and led to neuropathic pain symptoms.Moreover,treatment with the iron chelator deferiprone effectively reduced iron overload in the ventral posterolateral nucleus after intracerebral hemorrhage,reversed histone deacetylase 2 upregulation and Kv1.2 downregulation,and alleviated mechanical hypersensitivity in central post-stroke pain rats.These results suggest that histone deacetylase 2 upregulation and Kv1.2 downregulation,mediated by iron overload,are important factors in central post-stroke pain pathogenesis and co uld se rve as new to rgets for central poststroke pain treatment.展开更多
Objective:This study aims to explore the role of multidisciplinary collaborative interventions in the early rehabilitation of patients with hemorrhagic stroke and kinesiophobia.Methods:Using a convenience sampling met...Objective:This study aims to explore the role of multidisciplinary collaborative interventions in the early rehabilitation of patients with hemorrhagic stroke and kinesiophobia.Methods:Using a convenience sampling method,100 patients with hemorrhagic stroke and kinesiophobia admitted to the Department of Neurology at Nantong First People’s Hospital between January 2022 and December 2023 were selected as subjects.Fifty patients admitted between January 2022 and January 2023 were assigned to the control group,while 50 patients admitted between February 2023 and December 2023 were assigned to the experimental group.The control group received conventional care,while the experimental group received multidisciplinary collaborative interventions provided by a team consisting of neurologists,rehabilitation therapists,psychological counselors,and nurses.The study evaluated the differences in emotional state(using the Hospital Anxiety and Depression Scale,HAD),kinesiophobia level(using the Tampa Scale for Kinesiophobia,TSK),functional recovery(using the modified Rankin Scale,mRS),and daily living abilities(using the Barthel Index,BI)before and after intervention.Results:After the intervention,the HAD scores in the experimental group were significantly lower than those in the control group(P<0.05).The TSK scores in the experimental group were also significantly lower than in the control group(P<0.05),while mRS and BI scores showed significant improvement compared to the control group(P<0.05).Conclusion:Multidisciplinary collaborative interventions have significant effects in reducing kinesiophobia,promoting functional recovery,and improving the quality of life in patients with hemorrhagic stroke.展开更多
Serum prealbumin is a recognized marker of malnutrition,but its prognostic role in patients with hemorrhagic stroke remains unclear.In this study,we retrospectively reviewed the records of 105 patients with hemorrhagi...Serum prealbumin is a recognized marker of malnutrition,but its prognostic role in patients with hemorrhagic stroke remains unclear.In this study,we retrospectively reviewed the records of 105 patients with hemorrhagic stroke admitted to Renmin Hospital of Wuhan University,China,from January to December 2015.We collected demographic and radiological data,and recorded serum prealbumin levels at admission and on days 1,3,6,9,and 14-21.The existence of infections and gastrointestinal hemorrhage,and clinical condition at discharge were also recorded.Serum prealbumin levels during hospitalization were significantly lower in patients with infections compared with those without infections,and also significantly lower in patients with gastrointestinal hemorrhage compared with those without.Serum prealbumin levels at discharge were significantly higher in patients with good recovery than in those with poor recovery.We conclude that regular serum prealbumin measurements in patients with hemorrhagic stroke may be a useful indicator for determining clinical status and prognosis,which may therefore help to guide clinical decision-making.展开更多
BACKGROUND： Conventional neuroimaging diagnosis does not assist with the monitoring or evaluation of basal nuclei ischemic and hemorrhagic stroke, or motor functional recovery. Magnetic resonance, diffusion tensor im...BACKGROUND： Conventional neuroimaging diagnosis does not assist with the monitoring or evaluation of basal nuclei ischemic and hemorrhagic stroke, or motor functional recovery. Magnetic resonance, diffusion tensor imaging, and diffusion tensor tractography have all been used to observe features of cerebral white matter fibrous structures. In addition, diffusion tensor tractography is the only non-invasive imaging method to display the corticospinal tract in vivo. OBJECTIVE： To evaluate the impairment degree of corticospinal tract induced by basal nuclei ischemic and hemorrhagic stroke through the use of magnetic resonance, diffusion tensor imaging, and diffusion tensor tractography, and to analyze the correlation to muscular strength. DESIGN, TIME AND SETTING： A retrospective case analysis was performed at the Department of Medical Imaging, Neurology and Neurosurgery, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA between November 2002 and June 2008. PARTICIPANTS： A total of 15 patients with acute or subacute cerebral ischemic stroke and nine with hemorrhagic stroke in the basal nuclei were selected. METHODS： Magnetic resonance, diffusion tensor imaging, and diffusion tensor tractography results and data were analyzed. Fractional anisotropy and directionally encoded color maps were obtained. Three-dimensional tractography of bilateral corticospinal tract was created, and corticospinal tract integrity was graded. Fractional anisotropy of infarct region and corresponding contralateral normal regions were measured, and hematoma volume in hemorrhagic stroke patients was determined. Hand motor function ability was evaluated using Brunstorm criteria. MAIN OUTCOME MEASURES： Fractional anisotropy of infarct region and corresponding contralateral normal regions; hematoma volume in hemorrhagic stroke patients; correlation between muscular strength and corticospinal tract impairment degree in ischemic stroke and hemorrhagic stroke patients before and after treatment. RESULTS： In ischemic stroke patients, the fractional anisotropy value was significantly lower in the infarct area of white matter than in the normal hemisphere （P 〈 0.01）. The impairment degree of corticospinal tract negatively correlated with muscular strength of the corresponding hand （r = -0.97 P 〈 0.01）. The hematoma volume of hemorrhagic stroke patients significantly negatively correlated with Spearman test results for muscular strength of the corresponding hand （r = -0.88, P 〈 0.01）. CONCLUSION： Corticospinal tract impairment severity negatively correlated with muscular strength and motor functional recovery, which suggested that diffusion tensor imaging and diffusion tensor tractography could be used to evaluate corticospinal tract motor function.展开更多
BACKGROUND：Stroke is one of the leading causes of mortality and morbidity of vascular diseases, and its incidence maintains at a high level around the world. In China, stroke has been a major public health problem. B...BACKGROUND：Stroke is one of the leading causes of mortality and morbidity of vascular diseases, and its incidence maintains at a high level around the world. In China, stroke has been a major public health problem. Because the pathogenesis of ischemic stroke is different from that of hemorrhagic stroke, their clinical factors would not be the same. Therefore to investigate the different effects of various effect factors on ischemic versus hemorrhagic stroke and then to enhance the prevention are crucial to decrease the incidence.METHODS：A total of 692 patients, consisting of 540 ischemic stroke patients and 152 hemorrhagic stroke patients from East China, were included in this study. The related factors of stroke subtypes were collected and analyzed.RESULTS：The factors significantly associated with ischemic stroke as opposed to hemorrhagic stroke were family history of stroke, obesity, atherosclerotic plaque of the common carotid artery, atrial fibrillation, hyperfibrinogenemia, transient ischemic attack （TIA）, atherosclerotic plaque of the internal carotid artery, coronary heart, lower high-density lipoproteins （lower HDL）, increasing age, diabetes mellitus, and gender （male） （P〈0.05）. Leukocytosis, hypertension and family history of hypertension were the significant factors associated with hemorrhagic stroke versus ischemic stroke. Smoking, drinking, kidney diseases and lower HDL-C were the significant factors contributing to ischemic stroke in man. Obesity, family history of hypertension, family history of stroke, hypercholesteremia and myocardial ischemia were the significant factors for females with ischemic stroke.CONCLUSIONS：The most prominent factors for overall stroke in East China were hypertension, followed by higher pulse pressure and hypercholesteremia. The factors for ischemic and hemorrhagic stroke are not the same. Different effects of risk factors on stroke are found in male and female patients.展开更多
Proper medical treatment of a stroke victim relies on accurate and rapid differentiation between ischemic and hemorrhagic stroke,which in current practice is performed by computerized tomography（CT） or magnetic reso...Proper medical treatment of a stroke victim relies on accurate and rapid differentiation between ischemic and hemorrhagic stroke,which in current practice is performed by computerized tomography（CT） or magnetic resonance imaging（MRI） scans.A panel of micro RNAs could be an extremely useful clinical tool for distinguishing between hemorrhagic and ischemic stroke.This review has shown that blood miRNA profile can distinguish hemorrhagic from ischemic stroke in patients and in experimental animal models.It also seems likely they can differentiate between intracerebral and subarachnoid hemorrhage stroke.The miRNA profile in cerebrospinal fluid could be a useful diagnostic tool for subarachnoid hemorrhagic stroke.Decreased or increased miRNA levels may be needed either as prevention or treatment of stroke.Administration in vivo of miR-130 a inhibitor or miRNA mimic（miR-367,miR-223） in an intracerebral hemorrhage animal model improved neurological outcomes.展开更多
BACKGROUND： Predicting the outcome of stroke during the acute phase is difficult. Accurate methods for predicting outcomes could assist clinicians and families to make correct decisions in resource-poor environments....BACKGROUND： Predicting the outcome of stroke during the acute phase is difficult. Accurate methods for predicting outcomes could assist clinicians and families to make correct decisions in resource-poor environments. OBJECTIVE： To determine thyroid hormone levels in patients with ischemic or hemorrhagic stroke at the early stage, and to investigate its correlation with stroke prognosis. DESIGN, TIME AND SETTING： A comparative, observational study was performed at the Department of Emergency, Tertiary-care University Affiliated Hospital from January 2004 to January 2006. PARTICIPANTS： A total of 113 patients presenting to the Emergency Department within 3 hours of stroke symptom onset were approached for enrollment in the study. The patients were diagnosed by computer tomography examination, and comprised 87 ischemic stroke and 26 hemorrhagic stroke patients. METHODS： Following a thorough history and examination by emergency physicians, venous blood samples were collected from each patient. Thyroid-stimulating hormone （TSH）, free triiodothyronine （free T3）, and free thyroxine （free T4） levels were measured using a chemiluminescence method. The nerve function of patients was evaluated with Glasgow Coma Scale （GCS） score, and the patients were accordingly assigned to two subgroups-mild stroke （GCS ≥ 9） and severe stroke （GCS ≤ 8）. MAIN OUTCOME MEASURES： Blood levels of TSH, free T3 and free T4; mortality at 7 days. RESULTS： Mean TSH values in hemorrhagic stroke patients with GCS ≤ 8 were significantly greater than those in ischemic stroke patients with GCS ≤ 8 and GCS ≥ 9 （P 〈 0.05）. Compared with patients who survived, the highest TSH levels were detected in patients that had died within 7 days. Correlation analysis results revealed a significant negative relationship between GCS values and TSH levels in patients with hemorrhagic stroke （r= 0.552, P〈 0.01）, and no correlation was determined between GCS values and TSH levels in patients with ischemic stroke （r = 0.239, P 〉 0.05）. CONCLUSION： In patients with hemorrhagic stroke, high TSH levels were observed within the first 3 hours of stroke onset, which could be considered an indicator of poor prognosis.展开更多
In this study, we reported on a patient who showed a new neural tract between the injured anterior cingu- lums and the basal forebrain, as shown by diffusion tensor tractography （DTT）.
Stroke is a rare but serious condition with high mortality and morbidity. We report the case of a 10-year-old child with no known pathological history who was transferred to the pediatric department for hemorrhagic st...Stroke is a rare but serious condition with high mortality and morbidity. We report the case of a 10-year-old child with no known pathological history who was transferred to the pediatric department for hemorrhagic stroke. He had <span style="font-family:Verdana;">been hospitalized 6 days earlier in a peripheral center for a tonic-clonic</span><span style="font-family:Verdana;"> seizure accompanied by loss of consciousness and fever. Clinical examination revealed meningeal syndrome, facial paralysis, right hemiparesis, ataxia with disturbed balance, aphasia, and a peripapillary hemorrhage on the fundus. A cerebral computed tomography (CT) scan showed a hemorrhagic stroke with ventricular flooding. A lumbar puncture was performed and a hematic cerebrospinal fluid (CSF) with 12 leukocytes and 8000 red blood cells was obtained. The evolution was marked by the extinction of the infectious and meningeal syndromes, the regression of the pyramidal syndrome and the persistence of the dysarthria justifying a neuropsychological and speech therapy follow-up. Several challenges (diagnostic, therapeutic) exist in the management of children with stroke. Prospective studies with a larger sample are needed to fill the observed gaps.</span>展开更多
Objective:To investigate the clinical effect of Xingnaojing injection combined with craniocerebral hypothermia apparatus in the treatment of acute hemorrhagic stroke.Methods:Seventy-two patients with acute hemorrhagic...Objective:To investigate the clinical effect of Xingnaojing injection combined with craniocerebral hypothermia apparatus in the treatment of acute hemorrhagic stroke.Methods:Seventy-two patients with acute hemorrhagic stroke admitted to our hospital from March 2018 to September 2019 were randomly divided into two groups,with 36 cases in each group.The control group(n=36)was treated with craniocerebral hypothermia apparatus,and the observation group(n=36)was treated with Xingnaojing injection combined with craniocerebral hypothermia apparatus.The clinical efficacy,the National Institutes of Health Stroke Scale(NIHSS)score and the activity of daily living(MBI score)after 1 month of treatment were compared.Results:The effective rate of treatment in the observation group was higher than that in the control group(P<0.05);NIHSS score was decreased in both groups(P<0.05);MBI score was increased in both groups,and the change range of the observation group was greater than that of the control group,showing statistically significant differences(P<0.05).Conclusion:Xingnaojing injection combined with craniocerebral hypothermia apparatus can improve the clinical efficacy,the neurological impairment and activity of daily living in the treatment of acute hemorrhagic stroke,which is worthy of clinical application.展开更多
Some studies have confirmed the neuroprotective effect of remote ischemic conditioning against stroke. Although numerous animal researches have shown that the neuroprotective effect of remote ischemic conditioning may...Some studies have confirmed the neuroprotective effect of remote ischemic conditioning against stroke. Although numerous animal researches have shown that the neuroprotective effect of remote ischemic conditioning may be related to neuroinflammation, cellular immunity, apoptosis, and autophagy, the exact underlying molecular mechanisms are unclear. This review summarizes the current status of different types of remote ischemic conditioning methods in animal and clinical studies and analyzes their commonalities and differences in neuroprotective mechanisms and signaling pathways. Remote ischemic conditioning has emerged as a potential therapeutic approach for improving stroke-induced brain injury owing to its simplicity, non-invasiveness, safety, and patient tolerability. Different forms of remote ischemic conditioning exhibit distinct intervention patterns, timing, and application range. Mechanistically, remote ischemic conditioning can exert neuroprotective effects by activating the Notch1/phosphatidylinositol 3-kinase/Akt signaling pathway, improving cerebral perfusion, suppressing neuroinflammation, inhibiting cell apoptosis, activating autophagy, and promoting neural regeneration. While remote ischemic conditioning has shown potential in improving stroke outcomes, its full clinical translation has not yet been achieved.展开更多
Stroke, including cerebral ischemia, intracerebral hemorrhage, and subarachnoid hemorrhage, is the leading cause of long-term disability and death worldwide. Animal models have greatly contributed to our understanding...Stroke, including cerebral ischemia, intracerebral hemorrhage, and subarachnoid hemorrhage, is the leading cause of long-term disability and death worldwide. Animal models have greatly contributed to our understanding of the risk factors and the pathophysiology of stroke, as well as the development of therapeutic strategies for its treatment. Further development and investigation of experimental models, however, are needed to elucidate the pathogenesis of stroke and to enhance and expand novel therapeutic targets. In this article, we provide an overview of the characteristics of commonly-used animal models of stroke and focus on the inflammatory responses to cerebral stroke, which may provide insights into a framework for developing effective therapies for stroke in humans.展开更多
Despite overwhelming evidence from large randomized clinical trials supporting a clear benefit of low-density lipoprotein cholesterol(LDL-C)lowering therapy on the primary and secondary prevention of atherosclerotic c...Despite overwhelming evidence from large randomized clinical trials supporting a clear benefit of low-density lipoprotein cholesterol(LDL-C)lowering therapy on the primary and secondary prevention of atherosclerotic cardiovascular disease,data from epidemiological and clinical observations demonstrated an increased incidence of hemorrhagic stroke in patients with low LDL-C exposure(<70 mg/dL),especially among East Asians.Meanwhile,emerging studies have reported a paradoxical phenomenon in which hypercholesterolemia is associated with better short-term outcomes in acute coronary syndrome patients,the"lipid paradox."The underlying mechanism for these two closely connected clinical observations is not clear.This review aimed to summarize the evolution and clinical implications of these two low LDL-C related concepts,and proposed a"double-hit"hypothesis that may help explain these phenomena.It is worth noting that in the era of increasing use of high-intensity LDL-C lowering and dual antiplatelet strategies in atherosclerotic cardiovascular disease in patients receiving percutaneous coronary intervention,balancing the risk of thrombosis with bleeding complication should be a priority in clinical practice.Our hypothesis may raise clinicians’awareness to identify potential high risk patients with low LDL-C(<70 mg/dL),especially among East Asians.展开更多
Stroke is a major cause of adult death and disability worldwide.Epidemiological and animal studies have provided strong evidence that the pathogenesis of stroke is multi-factorial and induced by a combination of envir...Stroke is a major cause of adult death and disability worldwide.Epidemiological and animal studies have provided strong evidence that the pathogenesis of stroke is multi-factorial and induced by a combination of environmental and genetic risk factors,but the identifica-tion of individual causative variants remains little known.Genetic influences are likely to be polygenic with small effect sizes,and stroke itself consists of a number of different subtypes which may each have different genetic profiles.In addition,various ethnic populations may have different stroke risk,such as Asian race.The reasons for high risk of stroke among the Chinese,especially hemorrhagic stroke,remain unknown.Most human studies have taken a candidate gene approach using case-control methodology.To be reliably detected,small relative risks require large sample sizes,probably 1000 patients or more.Genome-wide association(GWA)study is an unbiased and comprehensive approach to identify common risk alleles for complex diseases.Recently,a multistage GWA study has identified three loci on chromosomes 2q,8q and 9p to be associated with intracranial aneurysm in European and Japanese populations.Another GWAfinding is the identification of risk variants for cardioembolic stroke on chromosome 4q25 in European populations.In this review,we mainly focus on the results from case-control association studies on genetic factors that play a role in the risk of ischemic and hemorrhagic stroke in Chinese population.The combined effects of multiple susceptibility genes for stroke risk are also summarized.展开更多
The apoptosis repressor with caspase recruitment domain(ARC)plays a critical role in extrinsic apoptosis initiation via death receptor ligands,physiological stress,infection response in a tissue-dependent manner,endop...The apoptosis repressor with caspase recruitment domain(ARC)plays a critical role in extrinsic apoptosis initiation via death receptor ligands,physiological stress,infection response in a tissue-dependent manner,endoplasmic reticulum(ER)stress,genotoxic drugs,ionizing radiation,oxidative stress,and hypoxia.Recent studies have suggested that regulating apoptosis-related pathways can improve outcomes for patients with neurological diseases,such as hemorrhagic stroke.ARC expression is significantly correlated with acute cerebral hemorrhage.However,the mechanism by which it mediates the anti-apoptosis pathway remains poorly known.Here,we discuss the function of ARC in hemorrhagic stroke and argue that it could serve as an effective target for the treatment of hemorrhagic stroke.展开更多
Cerebrovascular diseases,including ischemic and hemorrhagic strokes,affect more than 6 million US adults annually.Strokes cause high rates of morbidity and mortality due to the central nervous system’s sensitivity to...Cerebrovascular diseases,including ischemic and hemorrhagic strokes,affect more than 6 million US adults annually.Strokes cause high rates of morbidity and mortality due to the central nervous system’s sensitivity to disruptions in blood flow,and are refractory to traditional surgical interventions.A variety of minimally invasive surgical and endovascular approaches have recently been developed to improve patient outcomes following stroke.展开更多
BACKGROUND Hematoma expansion(HE)typically portends a poor prognosis in spontaneous intracerebral hemorrhage(ICH).Several radiographic and laboratory values have been proposed as predictive markers of HE.AIM To perfor...BACKGROUND Hematoma expansion(HE)typically portends a poor prognosis in spontaneous intracerebral hemorrhage(ICH).Several radiographic and laboratory values have been proposed as predictive markers of HE.AIM To perform a systematic review and meta-analysis on the association of neu-trophil-to-lymphocyte ratio(NLR)and HE in ICH.A secondary outcome exa-mined was the association of NLR and perihematomal(PHE)growth.METHODS Three databases were searched(PubMed,EMBASE,and Cochrane)for studies evaluating the effect of NLR on HE and PHE growth.The inverse variance me-thod was applied to estimate an overall effect for each specific outcome by combining weighted averages of the individual studies’estimates of the logarithm odds ratio(OR).Given heterogeneity of the studies,a random effect was applied.Risk of bias was analyzed using the Newcastle-Ottawa Scale.The study was conducted following the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines.The protocol was registered in PROSPERO(No.CRD42024549924).RESULTS Eleven retrospective cohort studies involving 2953 patients were included in the meta-analysis.Among those,HE was investigated in eight studies,whereas PHE growth was evaluated in three.Blood sample was obtained on admission in ten studies,and at 24 hours in one study.There was no consensus on cut-off value among the studies.NLR was found to be significantly associated with higher odds of HE(OR=1.09,95%CI:1.04-1.15,I2=86%,P<0.01),and PHE growth(OR=1.28,95%CI:1.19-1.38,I2=0%,P<0.01).Qualitative analysis of each outcome revealed overall moderate risk of bias mainly due to lack of control for systemic confounders.CONCLUSION The available literature suggests that a possible association may exist between NLR on admission and HE,and PHE growth.Future studies controlled for systemic confounders should be designed to consolidate this finding.If confirmed,NLR could be added as a readily available and inexpensive biomarker to identify a subgroup of patients at higher risk of developing HE.展开更多
We have developed a new three dimensional (3-D) conductivity imaging approach and have used it to detect human brain conductivity changes corresponding to acute cerebral stroke. The proposed Magnetic Resonance Electri...We have developed a new three dimensional (3-D) conductivity imaging approach and have used it to detect human brain conductivity changes corresponding to acute cerebral stroke. The proposed Magnetic Resonance Electrical Impedance Tomography (MREIT) approach is based on the J-Substitution algorithm and is expanded to imaging 3-D subject conductivity distribution changes. Computer simulation studies have been conducted to evaluate the present MREIT imaging approach. Simulations of both types of cerebral stroke, hemorrhagic stroke and ischemic stroke, were performed on a four-sphere head model. Simulation results showed that the correlation coefficient (CC) and relative error (RE) between target and estimated conductivity distributions were 0.9245±0.0068 and 8.9997%±0.0084%, for hemorrhagic stroke, and 0.6748±0.0197 and 8.8986%±0.0089%, for ischemic stroke, when the SNR (signal-to-noise radio) of added GWN (Gaussian White Noise) was 40. The convergence characteristic was also evaluated according to the changes of CC and RE with different iteration numbers. The CC increases and RE decreases monotonously with the increasing number of iterations. The present simulation results show the feasibility of the proposed 3-D MREIT approach in hemorrhagic and ischemic stroke detection and suggest that the method may become a useful alternative in clinical diagnosis of acute cerebral stroke in humans.展开更多
Myeloperoxidase is an important inflammatory factor in the myeloid system,primarily expressed in neutrophils and microglia.Myeloperoxidase and its active products participate in the occurrence and development of hemor...Myeloperoxidase is an important inflammatory factor in the myeloid system,primarily expressed in neutrophils and microglia.Myeloperoxidase and its active products participate in the occurrence and development of hemorrhagic and ischemic stroke,including damage to the blood-brain barrier and brain.As a specific inflammatory marker,myeloperoxidase can be used in the evaluation of vascular disease occurrence and development in stroke,and a large amount of experimental and clinical data has indicated that the inhibition or lack of myeloperoxidase has positive impacts on stroke prognosis.Many studies have also shown that there is a correlation between the overexpression of myeloperoxidase and the risk of stroke.The occurrence of stroke not only refers to the first occurrence but also includes recurrence.Therefore,myeloperoxidase is significant for the clinical evaluation and prognosis of stroke.This paper reviews the potential role played by myeloperoxidase in the development of vascular injury and secondary brain injury after stroke and explores the effects of inhibiting myeloperoxidase on stroke prognosis.This paper also analyzes the significance of myeloperoxidase etiology in the occurrence and development of stroke and discusses whether myeloperoxidase can be used as a target for the treatment and prediction of stroke.展开更多
Background: Recent literature reported a recurrent increase in hemorrhagic stroke (HS) rates in low- and middle-income countries. However, the causes and mechanisms of the rising HS rates are unknown. To address these...Background: Recent literature reported a recurrent increase in hemorrhagic stroke (HS) rates in low- and middle-income countries. However, the causes and mechanisms of the rising HS rates are unknown. To address these issues, the present epidemiological study was carried out in the neurovascular unit of the neurology department at the Centre Hospitalier Universitaire (CHU) de Cocody in Abidjan (Africa). Methods: The study included 60 patients hospitalized from January 1 to December 31, 2016, who underwent brain CT (computerized tomography) scans. We examined the medical records and survey forms in these patients with acute stroke (within 7 days) admitted to the Neurovascular Unit receiving only stroke patients. In these patients, we explored stroke distribution according to socio-demographic variables: age, gender and socio-professional categories. In addition, common risk factors were assessed. Results: In Côte d’Ivoire, our studies showed an ischemic stroke (IS) rate of 66.67% and a hemorrhagic stroke (HS) rate of 33.33%. Our studies indicated that stroke particularly affects the 40 - 60 age group. Then, stroke frequency has fallen in the 30 - 40 and 60 - 70 age groups, becoming rare in relatively young (70 years) subjects. In the sample analyzed, stroke occurred in women (56.67%) compared with men (43.33%). However, there was no gender-specific predilection for stroke. In addition, 90% of strokes occur in the working population and 10% in the non-working population. Arterial hypertension was the highest medical risk factor among patients (66.13%), compared with the other risk factors i.e. alcohol (17.42%), smoking (12.90%), previous stroke (9.67%), diabetes (6.65%), heart disease (6.65%) and dyslipidemia (3.23%). Specifically, hypertension was the main risk factor causing HS (45%) and IS (21.66%) in patients. Conclusion: Stroke particularly affected socio-economically active subjects (aged 40 - 60) in Africa, which were subjected to high prevalence of hemorrhagic stroke (HS). Chronic stress related to working life and unfavorable socioeconomic conditions would be a triggering event for hemorrhagic stroke.展开更多
基金supported by the National Natural Science Foundation of China,Nos.U2004106 (to WY),81971061 (to JC)the Key Scientific Research Project of Colleges and Universities in Henan Province,No.21A320039 (to WY)。
文摘Thalamic hemorrhage can lead to the development of central post-stroke pain.Changes in histone acetylation levels,which are regulated by histone deacetylases,affect the excitability of neurons surrounding the hemorrhagic area.However,the regulato ry mechanism of histone deacetylases in central post-stroke pain remains unclea r.Here,we show that iron overload leads to an increase in histone deacetylase 2expression in damaged ventral posterolateral nucleus neurons.Inhibiting this increase restored histone H3 acetylation in the Kcna2 promoter region of the voltage-dependent potassium(Kv)channel subunit gene in a rat model of central post-stroke pain,thereby increasing Kcna2expression and relieving central pain.However,in the absence of nerve injury,increasing histone deacetylase 2 expression decreased Kcna2expression,decreased Kv current,increased the excitability of neurons in the ventral posterolateral nucleus area,and led to neuropathic pain symptoms.Moreover,treatment with the iron chelator deferiprone effectively reduced iron overload in the ventral posterolateral nucleus after intracerebral hemorrhage,reversed histone deacetylase 2 upregulation and Kv1.2 downregulation,and alleviated mechanical hypersensitivity in central post-stroke pain rats.These results suggest that histone deacetylase 2 upregulation and Kv1.2 downregulation,mediated by iron overload,are important factors in central post-stroke pain pathogenesis and co uld se rve as new to rgets for central poststroke pain treatment.
基金Nantong First People’s Hospital“Care for Love”Fund Nursing Innovation Support Project-Nursing Research Topic“Development and Evaluation of an Internet-Based Continuing Care Program Incorporating Self-Management Guided by the Theory of Planned Behavior for Elderly Stroke Patients”(Project No.HLCXKT-20240104)。
文摘Objective:This study aims to explore the role of multidisciplinary collaborative interventions in the early rehabilitation of patients with hemorrhagic stroke and kinesiophobia.Methods:Using a convenience sampling method,100 patients with hemorrhagic stroke and kinesiophobia admitted to the Department of Neurology at Nantong First People’s Hospital between January 2022 and December 2023 were selected as subjects.Fifty patients admitted between January 2022 and January 2023 were assigned to the control group,while 50 patients admitted between February 2023 and December 2023 were assigned to the experimental group.The control group received conventional care,while the experimental group received multidisciplinary collaborative interventions provided by a team consisting of neurologists,rehabilitation therapists,psychological counselors,and nurses.The study evaluated the differences in emotional state(using the Hospital Anxiety and Depression Scale,HAD),kinesiophobia level(using the Tampa Scale for Kinesiophobia,TSK),functional recovery(using the modified Rankin Scale,mRS),and daily living abilities(using the Barthel Index,BI)before and after intervention.Results:After the intervention,the HAD scores in the experimental group were significantly lower than those in the control group(P<0.05).The TSK scores in the experimental group were also significantly lower than in the control group(P<0.05),while mRS and BI scores showed significant improvement compared to the control group(P<0.05).Conclusion:Multidisciplinary collaborative interventions have significant effects in reducing kinesiophobia,promoting functional recovery,and improving the quality of life in patients with hemorrhagic stroke.
基金supported by the National Natural Science Foundation of China,No.81571147an American Heart Association Award,No.14FTF19970029
文摘Serum prealbumin is a recognized marker of malnutrition,but its prognostic role in patients with hemorrhagic stroke remains unclear.In this study,we retrospectively reviewed the records of 105 patients with hemorrhagic stroke admitted to Renmin Hospital of Wuhan University,China,from January to December 2015.We collected demographic and radiological data,and recorded serum prealbumin levels at admission and on days 1,3,6,9,and 14-21.The existence of infections and gastrointestinal hemorrhage,and clinical condition at discharge were also recorded.Serum prealbumin levels during hospitalization were significantly lower in patients with infections compared with those without infections,and also significantly lower in patients with gastrointestinal hemorrhage compared with those without.Serum prealbumin levels at discharge were significantly higher in patients with good recovery than in those with poor recovery.We conclude that regular serum prealbumin measurements in patients with hemorrhagic stroke may be a useful indicator for determining clinical status and prognosis,which may therefore help to guide clinical decision-making.
基金a Grant from the Science and Technology Department of Fujian Province,No.2006J0192
文摘BACKGROUND： Conventional neuroimaging diagnosis does not assist with the monitoring or evaluation of basal nuclei ischemic and hemorrhagic stroke, or motor functional recovery. Magnetic resonance, diffusion tensor imaging, and diffusion tensor tractography have all been used to observe features of cerebral white matter fibrous structures. In addition, diffusion tensor tractography is the only non-invasive imaging method to display the corticospinal tract in vivo. OBJECTIVE： To evaluate the impairment degree of corticospinal tract induced by basal nuclei ischemic and hemorrhagic stroke through the use of magnetic resonance, diffusion tensor imaging, and diffusion tensor tractography, and to analyze the correlation to muscular strength. DESIGN, TIME AND SETTING： A retrospective case analysis was performed at the Department of Medical Imaging, Neurology and Neurosurgery, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA between November 2002 and June 2008. PARTICIPANTS： A total of 15 patients with acute or subacute cerebral ischemic stroke and nine with hemorrhagic stroke in the basal nuclei were selected. METHODS： Magnetic resonance, diffusion tensor imaging, and diffusion tensor tractography results and data were analyzed. Fractional anisotropy and directionally encoded color maps were obtained. Three-dimensional tractography of bilateral corticospinal tract was created, and corticospinal tract integrity was graded. Fractional anisotropy of infarct region and corresponding contralateral normal regions were measured, and hematoma volume in hemorrhagic stroke patients was determined. Hand motor function ability was evaluated using Brunstorm criteria. MAIN OUTCOME MEASURES： Fractional anisotropy of infarct region and corresponding contralateral normal regions; hematoma volume in hemorrhagic stroke patients; correlation between muscular strength and corticospinal tract impairment degree in ischemic stroke and hemorrhagic stroke patients before and after treatment. RESULTS： In ischemic stroke patients, the fractional anisotropy value was significantly lower in the infarct area of white matter than in the normal hemisphere （P 〈 0.01）. The impairment degree of corticospinal tract negatively correlated with muscular strength of the corresponding hand （r = -0.97 P 〈 0.01）. The hematoma volume of hemorrhagic stroke patients significantly negatively correlated with Spearman test results for muscular strength of the corresponding hand （r = -0.88, P 〈 0.01）. CONCLUSION： Corticospinal tract impairment severity negatively correlated with muscular strength and motor functional recovery, which suggested that diffusion tensor imaging and diffusion tensor tractography could be used to evaluate corticospinal tract motor function.
文摘BACKGROUND：Stroke is one of the leading causes of mortality and morbidity of vascular diseases, and its incidence maintains at a high level around the world. In China, stroke has been a major public health problem. Because the pathogenesis of ischemic stroke is different from that of hemorrhagic stroke, their clinical factors would not be the same. Therefore to investigate the different effects of various effect factors on ischemic versus hemorrhagic stroke and then to enhance the prevention are crucial to decrease the incidence.METHODS：A total of 692 patients, consisting of 540 ischemic stroke patients and 152 hemorrhagic stroke patients from East China, were included in this study. The related factors of stroke subtypes were collected and analyzed.RESULTS：The factors significantly associated with ischemic stroke as opposed to hemorrhagic stroke were family history of stroke, obesity, atherosclerotic plaque of the common carotid artery, atrial fibrillation, hyperfibrinogenemia, transient ischemic attack （TIA）, atherosclerotic plaque of the internal carotid artery, coronary heart, lower high-density lipoproteins （lower HDL）, increasing age, diabetes mellitus, and gender （male） （P〈0.05）. Leukocytosis, hypertension and family history of hypertension were the significant factors associated with hemorrhagic stroke versus ischemic stroke. Smoking, drinking, kidney diseases and lower HDL-C were the significant factors contributing to ischemic stroke in man. Obesity, family history of hypertension, family history of stroke, hypercholesteremia and myocardial ischemia were the significant factors for females with ischemic stroke.CONCLUSIONS：The most prominent factors for overall stroke in East China were hypertension, followed by higher pulse pressure and hypercholesteremia. The factors for ischemic and hemorrhagic stroke are not the same. Different effects of risk factors on stroke are found in male and female patients.
文摘Proper medical treatment of a stroke victim relies on accurate and rapid differentiation between ischemic and hemorrhagic stroke,which in current practice is performed by computerized tomography（CT） or magnetic resonance imaging（MRI） scans.A panel of micro RNAs could be an extremely useful clinical tool for distinguishing between hemorrhagic and ischemic stroke.This review has shown that blood miRNA profile can distinguish hemorrhagic from ischemic stroke in patients and in experimental animal models.It also seems likely they can differentiate between intracerebral and subarachnoid hemorrhage stroke.The miRNA profile in cerebrospinal fluid could be a useful diagnostic tool for subarachnoid hemorrhagic stroke.Decreased or increased miRNA levels may be needed either as prevention or treatment of stroke.Administration in vivo of miR-130 a inhibitor or miRNA mimic（miR-367,miR-223） in an intracerebral hemorrhage animal model improved neurological outcomes.
文摘BACKGROUND： Predicting the outcome of stroke during the acute phase is difficult. Accurate methods for predicting outcomes could assist clinicians and families to make correct decisions in resource-poor environments. OBJECTIVE： To determine thyroid hormone levels in patients with ischemic or hemorrhagic stroke at the early stage, and to investigate its correlation with stroke prognosis. DESIGN, TIME AND SETTING： A comparative, observational study was performed at the Department of Emergency, Tertiary-care University Affiliated Hospital from January 2004 to January 2006. PARTICIPANTS： A total of 113 patients presenting to the Emergency Department within 3 hours of stroke symptom onset were approached for enrollment in the study. The patients were diagnosed by computer tomography examination, and comprised 87 ischemic stroke and 26 hemorrhagic stroke patients. METHODS： Following a thorough history and examination by emergency physicians, venous blood samples were collected from each patient. Thyroid-stimulating hormone （TSH）, free triiodothyronine （free T3）, and free thyroxine （free T4） levels were measured using a chemiluminescence method. The nerve function of patients was evaluated with Glasgow Coma Scale （GCS） score, and the patients were accordingly assigned to two subgroups-mild stroke （GCS ≥ 9） and severe stroke （GCS ≤ 8）. MAIN OUTCOME MEASURES： Blood levels of TSH, free T3 and free T4; mortality at 7 days. RESULTS： Mean TSH values in hemorrhagic stroke patients with GCS ≤ 8 were significantly greater than those in ischemic stroke patients with GCS ≤ 8 and GCS ≥ 9 （P 〈 0.05）. Compared with patients who survived, the highest TSH levels were detected in patients that had died within 7 days. Correlation analysis results revealed a significant negative relationship between GCS values and TSH levels in patients with hemorrhagic stroke （r= 0.552, P〈 0.01）, and no correlation was determined between GCS values and TSH levels in patients with ischemic stroke （r = 0.239, P 〉 0.05）. CONCLUSION： In patients with hemorrhagic stroke, high TSH levels were observed within the first 3 hours of stroke onset, which could be considered an indicator of poor prognosis.
基金supported by the National Research Foundation(NRF)of Korea Grant funded by the Korean Government(MSIP)(2015R1A2A2A01004073)
文摘In this study, we reported on a patient who showed a new neural tract between the injured anterior cingu- lums and the basal forebrain, as shown by diffusion tensor tractography （DTT）.
文摘Stroke is a rare but serious condition with high mortality and morbidity. We report the case of a 10-year-old child with no known pathological history who was transferred to the pediatric department for hemorrhagic stroke. He had <span style="font-family:Verdana;">been hospitalized 6 days earlier in a peripheral center for a tonic-clonic</span><span style="font-family:Verdana;"> seizure accompanied by loss of consciousness and fever. Clinical examination revealed meningeal syndrome, facial paralysis, right hemiparesis, ataxia with disturbed balance, aphasia, and a peripapillary hemorrhage on the fundus. A cerebral computed tomography (CT) scan showed a hemorrhagic stroke with ventricular flooding. A lumbar puncture was performed and a hematic cerebrospinal fluid (CSF) with 12 leukocytes and 8000 red blood cells was obtained. The evolution was marked by the extinction of the infectious and meningeal syndromes, the regression of the pyramidal syndrome and the persistence of the dysarthria justifying a neuropsychological and speech therapy follow-up. Several challenges (diagnostic, therapeutic) exist in the management of children with stroke. Prospective studies with a larger sample are needed to fill the observed gaps.</span>
文摘Objective:To investigate the clinical effect of Xingnaojing injection combined with craniocerebral hypothermia apparatus in the treatment of acute hemorrhagic stroke.Methods:Seventy-two patients with acute hemorrhagic stroke admitted to our hospital from March 2018 to September 2019 were randomly divided into two groups,with 36 cases in each group.The control group(n=36)was treated with craniocerebral hypothermia apparatus,and the observation group(n=36)was treated with Xingnaojing injection combined with craniocerebral hypothermia apparatus.The clinical efficacy,the National Institutes of Health Stroke Scale(NIHSS)score and the activity of daily living(MBI score)after 1 month of treatment were compared.Results:The effective rate of treatment in the observation group was higher than that in the control group(P<0.05);NIHSS score was decreased in both groups(P<0.05);MBI score was increased in both groups,and the change range of the observation group was greater than that of the control group,showing statistically significant differences(P<0.05).Conclusion:Xingnaojing injection combined with craniocerebral hypothermia apparatus can improve the clinical efficacy,the neurological impairment and activity of daily living in the treatment of acute hemorrhagic stroke,which is worthy of clinical application.
基金supported partly by the National Natural Science Foundation of China,No.82071332the Chongqing Natural Science Foundation Joint Fund for Innovation and Development,No.CSTB2023NSCQ-LZX0041 (both to ZG)。
文摘Some studies have confirmed the neuroprotective effect of remote ischemic conditioning against stroke. Although numerous animal researches have shown that the neuroprotective effect of remote ischemic conditioning may be related to neuroinflammation, cellular immunity, apoptosis, and autophagy, the exact underlying molecular mechanisms are unclear. This review summarizes the current status of different types of remote ischemic conditioning methods in animal and clinical studies and analyzes their commonalities and differences in neuroprotective mechanisms and signaling pathways. Remote ischemic conditioning has emerged as a potential therapeutic approach for improving stroke-induced brain injury owing to its simplicity, non-invasiveness, safety, and patient tolerability. Different forms of remote ischemic conditioning exhibit distinct intervention patterns, timing, and application range. Mechanistically, remote ischemic conditioning can exert neuroprotective effects by activating the Notch1/phosphatidylinositol 3-kinase/Akt signaling pathway, improving cerebral perfusion, suppressing neuroinflammation, inhibiting cell apoptosis, activating autophagy, and promoting neural regeneration. While remote ischemic conditioning has shown potential in improving stroke outcomes, its full clinical translation has not yet been achieved.
基金supported by grants from National Institute on Aging (R01 AG031811, R01 AG037506)National Institute of Neurological Disorders and Stroke (R01 NS083078-01A1, R41 NS080329-01A1)+1 种基金American Heart Association grant (14GRNT20460026)the National Natural Science Foundation of China (81300993, 81571145)
文摘Stroke, including cerebral ischemia, intracerebral hemorrhage, and subarachnoid hemorrhage, is the leading cause of long-term disability and death worldwide. Animal models have greatly contributed to our understanding of the risk factors and the pathophysiology of stroke, as well as the development of therapeutic strategies for its treatment. Further development and investigation of experimental models, however, are needed to elucidate the pathogenesis of stroke and to enhance and expand novel therapeutic targets. In this article, we provide an overview of the characteristics of commonly-used animal models of stroke and focus on the inflammatory responses to cerebral stroke, which may provide insights into a framework for developing effective therapies for stroke in humans.
基金supported by the National Natural Science Foundation of China(Nos.81570335,81970304)a grant from Tianjin Municipal Science and Technology Commission,China(No.18ZXZNSY00290)
文摘Despite overwhelming evidence from large randomized clinical trials supporting a clear benefit of low-density lipoprotein cholesterol(LDL-C)lowering therapy on the primary and secondary prevention of atherosclerotic cardiovascular disease,data from epidemiological and clinical observations demonstrated an increased incidence of hemorrhagic stroke in patients with low LDL-C exposure(<70 mg/dL),especially among East Asians.Meanwhile,emerging studies have reported a paradoxical phenomenon in which hypercholesterolemia is associated with better short-term outcomes in acute coronary syndrome patients,the"lipid paradox."The underlying mechanism for these two closely connected clinical observations is not clear.This review aimed to summarize the evolution and clinical implications of these two low LDL-C related concepts,and proposed a"double-hit"hypothesis that may help explain these phenomena.It is worth noting that in the era of increasing use of high-intensity LDL-C lowering and dual antiplatelet strategies in atherosclerotic cardiovascular disease in patients receiving percutaneous coronary intervention,balancing the risk of thrombosis with bleeding complication should be a priority in clinical practice.Our hypothesis may raise clinicians’awareness to identify potential high risk patients with low LDL-C(<70 mg/dL),especially among East Asians.
基金supported by the Ministry of Science and Technology of China(Nos.2006CB503805,2009DFB30050,and G200056901).
文摘Stroke is a major cause of adult death and disability worldwide.Epidemiological and animal studies have provided strong evidence that the pathogenesis of stroke is multi-factorial and induced by a combination of environmental and genetic risk factors,but the identifica-tion of individual causative variants remains little known.Genetic influences are likely to be polygenic with small effect sizes,and stroke itself consists of a number of different subtypes which may each have different genetic profiles.In addition,various ethnic populations may have different stroke risk,such as Asian race.The reasons for high risk of stroke among the Chinese,especially hemorrhagic stroke,remain unknown.Most human studies have taken a candidate gene approach using case-control methodology.To be reliably detected,small relative risks require large sample sizes,probably 1000 patients or more.Genome-wide association(GWA)study is an unbiased and comprehensive approach to identify common risk alleles for complex diseases.Recently,a multistage GWA study has identified three loci on chromosomes 2q,8q and 9p to be associated with intracranial aneurysm in European and Japanese populations.Another GWAfinding is the identification of risk variants for cardioembolic stroke on chromosome 4q25 in European populations.In this review,we mainly focus on the results from case-control association studies on genetic factors that play a role in the risk of ischemic and hemorrhagic stroke in Chinese population.The combined effects of multiple susceptibility genes for stroke risk are also summarized.
基金supported by the Shanghai Hospital Development Center(grant number:SHDC2020CR3021A,to YG)the National Natural Science Foundation of China(grant number:82072788,to YG).
文摘The apoptosis repressor with caspase recruitment domain(ARC)plays a critical role in extrinsic apoptosis initiation via death receptor ligands,physiological stress,infection response in a tissue-dependent manner,endoplasmic reticulum(ER)stress,genotoxic drugs,ionizing radiation,oxidative stress,and hypoxia.Recent studies have suggested that regulating apoptosis-related pathways can improve outcomes for patients with neurological diseases,such as hemorrhagic stroke.ARC expression is significantly correlated with acute cerebral hemorrhage.However,the mechanism by which it mediates the anti-apoptosis pathway remains poorly known.Here,we discuss the function of ARC in hemorrhagic stroke and argue that it could serve as an effective target for the treatment of hemorrhagic stroke.
文摘Cerebrovascular diseases,including ischemic and hemorrhagic strokes,affect more than 6 million US adults annually.Strokes cause high rates of morbidity and mortality due to the central nervous system’s sensitivity to disruptions in blood flow,and are refractory to traditional surgical interventions.A variety of minimally invasive surgical and endovascular approaches have recently been developed to improve patient outcomes following stroke.
文摘BACKGROUND Hematoma expansion(HE)typically portends a poor prognosis in spontaneous intracerebral hemorrhage(ICH).Several radiographic and laboratory values have been proposed as predictive markers of HE.AIM To perform a systematic review and meta-analysis on the association of neu-trophil-to-lymphocyte ratio(NLR)and HE in ICH.A secondary outcome exa-mined was the association of NLR and perihematomal(PHE)growth.METHODS Three databases were searched(PubMed,EMBASE,and Cochrane)for studies evaluating the effect of NLR on HE and PHE growth.The inverse variance me-thod was applied to estimate an overall effect for each specific outcome by combining weighted averages of the individual studies’estimates of the logarithm odds ratio(OR).Given heterogeneity of the studies,a random effect was applied.Risk of bias was analyzed using the Newcastle-Ottawa Scale.The study was conducted following the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines.The protocol was registered in PROSPERO(No.CRD42024549924).RESULTS Eleven retrospective cohort studies involving 2953 patients were included in the meta-analysis.Among those,HE was investigated in eight studies,whereas PHE growth was evaluated in three.Blood sample was obtained on admission in ten studies,and at 24 hours in one study.There was no consensus on cut-off value among the studies.NLR was found to be significantly associated with higher odds of HE(OR=1.09,95%CI:1.04-1.15,I2=86%,P<0.01),and PHE growth(OR=1.28,95%CI:1.19-1.38,I2=0%,P<0.01).Qualitative analysis of each outcome revealed overall moderate risk of bias mainly due to lack of control for systemic confounders.CONCLUSION The available literature suggests that a possible association may exist between NLR on admission and HE,and PHE growth.Future studies controlled for systemic confounders should be designed to consolidate this finding.If confirmed,NLR could be added as a readily available and inexpensive biomarker to identify a subgroup of patients at higher risk of developing HE.
基金Project supported partly by the National Science Foundation (No.BES-0411898) and the National Institues of Health (No. R01EB00178) USA
文摘We have developed a new three dimensional (3-D) conductivity imaging approach and have used it to detect human brain conductivity changes corresponding to acute cerebral stroke. The proposed Magnetic Resonance Electrical Impedance Tomography (MREIT) approach is based on the J-Substitution algorithm and is expanded to imaging 3-D subject conductivity distribution changes. Computer simulation studies have been conducted to evaluate the present MREIT imaging approach. Simulations of both types of cerebral stroke, hemorrhagic stroke and ischemic stroke, were performed on a four-sphere head model. Simulation results showed that the correlation coefficient (CC) and relative error (RE) between target and estimated conductivity distributions were 0.9245±0.0068 and 8.9997%±0.0084%, for hemorrhagic stroke, and 0.6748±0.0197 and 8.8986%±0.0089%, for ischemic stroke, when the SNR (signal-to-noise radio) of added GWN (Gaussian White Noise) was 40. The convergence characteristic was also evaluated according to the changes of CC and RE with different iteration numbers. The CC increases and RE decreases monotonously with the increasing number of iterations. The present simulation results show the feasibility of the proposed 3-D MREIT approach in hemorrhagic and ischemic stroke detection and suggest that the method may become a useful alternative in clinical diagnosis of acute cerebral stroke in humans.
基金supported by the National Natural Science Foundation of China,No.81771297(to YNZ)CuiYing Scientific and Technological Innovation Program of Lanzhou University Second Hospital of China,No.CY2017-MS04(to YNZ)+2 种基金Hui-Chun Chin and Tsung-Dao Lee Chinese Undergraduate Research Endowment of China,No.LZU-JZH2224(to YCW)National Innovation and Entrepreneurship Training Program for Undergraduate of China,No.201910730212(to YCW)CuiYing Scientific Training Program for Undergraduates of Lanzhou University Second Hospital of China,No.CYXZ2019-06(to YCW).
文摘Myeloperoxidase is an important inflammatory factor in the myeloid system,primarily expressed in neutrophils and microglia.Myeloperoxidase and its active products participate in the occurrence and development of hemorrhagic and ischemic stroke,including damage to the blood-brain barrier and brain.As a specific inflammatory marker,myeloperoxidase can be used in the evaluation of vascular disease occurrence and development in stroke,and a large amount of experimental and clinical data has indicated that the inhibition or lack of myeloperoxidase has positive impacts on stroke prognosis.Many studies have also shown that there is a correlation between the overexpression of myeloperoxidase and the risk of stroke.The occurrence of stroke not only refers to the first occurrence but also includes recurrence.Therefore,myeloperoxidase is significant for the clinical evaluation and prognosis of stroke.This paper reviews the potential role played by myeloperoxidase in the development of vascular injury and secondary brain injury after stroke and explores the effects of inhibiting myeloperoxidase on stroke prognosis.This paper also analyzes the significance of myeloperoxidase etiology in the occurrence and development of stroke and discusses whether myeloperoxidase can be used as a target for the treatment and prediction of stroke.
文摘Background: Recent literature reported a recurrent increase in hemorrhagic stroke (HS) rates in low- and middle-income countries. However, the causes and mechanisms of the rising HS rates are unknown. To address these issues, the present epidemiological study was carried out in the neurovascular unit of the neurology department at the Centre Hospitalier Universitaire (CHU) de Cocody in Abidjan (Africa). Methods: The study included 60 patients hospitalized from January 1 to December 31, 2016, who underwent brain CT (computerized tomography) scans. We examined the medical records and survey forms in these patients with acute stroke (within 7 days) admitted to the Neurovascular Unit receiving only stroke patients. In these patients, we explored stroke distribution according to socio-demographic variables: age, gender and socio-professional categories. In addition, common risk factors were assessed. Results: In Côte d’Ivoire, our studies showed an ischemic stroke (IS) rate of 66.67% and a hemorrhagic stroke (HS) rate of 33.33%. Our studies indicated that stroke particularly affects the 40 - 60 age group. Then, stroke frequency has fallen in the 30 - 40 and 60 - 70 age groups, becoming rare in relatively young (70 years) subjects. In the sample analyzed, stroke occurred in women (56.67%) compared with men (43.33%). However, there was no gender-specific predilection for stroke. In addition, 90% of strokes occur in the working population and 10% in the non-working population. Arterial hypertension was the highest medical risk factor among patients (66.13%), compared with the other risk factors i.e. alcohol (17.42%), smoking (12.90%), previous stroke (9.67%), diabetes (6.65%), heart disease (6.65%) and dyslipidemia (3.23%). Specifically, hypertension was the main risk factor causing HS (45%) and IS (21.66%) in patients. Conclusion: Stroke particularly affected socio-economically active subjects (aged 40 - 60) in Africa, which were subjected to high prevalence of hemorrhagic stroke (HS). Chronic stress related to working life and unfavorable socioeconomic conditions would be a triggering event for hemorrhagic stroke.
