中国云南纳西族脑血管病患者载脂蛋白E基因的多态性

Currently it is not well known whether apolipoprotein E(ApoE) is a genetic susceptibility factor for cerebrovascular diseases in the Chinese Naxi population.The present study detected and sequenced ApoE polymorphisms of 90 patients with cerebrovascular diseases(58 cases of cerebral infarction and 32 cases of intracerebral hemorrhage),and 50 normal people of Naxi nationality from Yunnan province,China.The populations were used to analyze the relationship of ApoE polymorphisms with cerebral infarction and intracerebral hemorrhage.Results showed an association between ApoE gene polymorphism and the onset of cerebral infarction,and a possibility that the ε4 allele is a susceptibility locus for the risk of cerebral infarction.However,there was no evidence of a relationship between the ApoE gene polymorphism and cerebral hemorrhage.     

趋化因子受体CCR2b基因G190A多态性与脑梗死关系的研究

目的 探讨趋化因子受体CCR2b基因G190A多态性与中国福建地区汉族人群脑梗死(cerebral infarction,CI)的关系.方法 采用聚合酶链反应-限制性片段长度多态性(polymerase chain reaction-restriction fragment length polymorphism,PCR-RFLP)和DNA序列测定法检测200例CI及200名健康对照者趋化因子受体CCR2b基因G190A多态性分布,对两组之间的基因型频率和等位基因频率进行比较.结果 CI组趋化因子受体CCR2b基因G190A多态位点的基因型和等位基因频率分布与对照组比较差异有统计学意义(P<0.05).脑梗死组GG、GA、AA基因型频率分别为83.5%、15.0%、1.5%;G、A等位基因频率分别为91.0%、9.0%.正常对照组GG、GA、AA基因型频率分别为73.0%、22.5%、4.5%;G、A等位基因频率分别为84.3%、15.7%.脑梗死组GG基因型和G等位基因频率高于对照组(P<0.05).结论 趋化因子受体CCR2b基因G190A多态性与脑梗死的发病具有相关性,G等位基因可能是中国福建地区汉族人群脑梗死发病的遗传易感基因.

Abstract：

Objective To investigate the relationship between chemokine receptor CCR2b gene G190A polymorphism and cerebral infarction(CI)of Han population in Chinese Fujian district.Methods The G190A polymorphism in ccr2b gene was detected by polymerase chain reaction-restriction fragment length polymorphism analysis(PCR-RFLP)and DNA sequencing in 200 patients with CI(CI group)and 200 normal controls(NC group).Results There were significant differences in frequencies of allele and genotype of CCR2b G190A gene polymorphism between CI and control groups(P<0.05).In CI group,genotypic frequency of GG Was 83.5%,GA wag 15.0%,AA Was 1.5%.The allele frequency of G Was 91.0%and A was 9.0%.In NC group,genotypic frequency of GG WaS 73.0%,GA was 22.5%,AA was 4.5%.The allele frequency of G was 84.3%and A was 15.7%.The frequencies of CCR2b 190GG genetype and G allele in CI group were siginificantly higher than that in NC group(P<0.05).Conclusions There was association between CCR2b gene G190A polymorphism and cerebral infarction(CI)in Chinese Fujian district Han populations.The CCR2b G190 allele may be a genetic risk factor for cerebral infarction of Hart populations in Chinese Fujian district.     

Why do stroke patients with negative motor evoked potential show poor limb motor function recovery？

Negative motor evoked potentials after cerebral infarction, indicative of poor recovery of limb motor function, tend to be accompanied by changes in fractional anisotropy values and the cerebral pe-duncle area on the affected side, but the characteristics of these changes have not been reported. This study included 57 cases of cerebral infarction whose motor evoked potentials were tested in the 24 hours after the first inspection for diffusion tensor imaging, in which 29 cases were in the negative group and 28 cases in the positive group. Twenty-nine patients with negative motor evoked potentials were divided into two groups according to fractional anisotropy on the affected side of the cerebral peduncle： a fractional anisotropy 〈 0.36 group and a fractional anisotropy 〉 0.36 group. All patients underwent a regular magnetic resonance imaging and a diffusion tensor imaging examina- tion at 1 week, 1, 3, 6 and 12 months after cerebral infarction. The FugI-Meyer scores of their hemiplegic limbs were tested before the magnetic resonance and diffusion tensor imaging exami-nations. In the negative motor evoked potential group, fractional anisotropy in the affected cerebral peduncle declined progressively, which was most obvious in the first 1-3 months after the onset of cerebral infarction. The areas and area asymmetries of the cerebral peduncle on the affected side were significantly decreased at 6 and 12 months after onset. At 12 months after onset, the area asymmetries of the cerebral peduncle on the affected side were lower than the normal lower limit value of 0.83. FugI-Meyer scores in the fractional anisotropy ≥0.36 group were significantly higher than in the fractional anisotropy 〈 0.36 group at 3-12 months after onset. The fractional anisotropy of the cerebral peduncle in the positive motor evoked potential group decreased in the first 1 month after onset, and stayed unchanged from 3-12 months; there was no change in the area of the cerebral peduncle in the first 1-12 months after cerebral infarction. These findings confirmed that if the fractional anisotropy of the cerebral peduncle on the affected side is 〈 0.36 and the area asym-metries 〈 0.83 in patients with negative motor evoked potential after cerebral infarction, then poor hemiplegic limb motor function recovery may occur.     

Apolipoprotein E polymorphisms increase the risk of post-stroke depression

Recent reports have shown that apolipoprotein E (APOE) polymorphisms are involved in neurodegenerative disease. However, it is unclear whetherAPOE affects post-stroke depression. Accordingly, we hypothesized thatAPOE polymorphisms modify the risk of post-stroke depression. Here, we performed a hospital-based case-control study (including 76 cerebral infarction cases with post-stroke depression, 88 cerebral infarction cases without post-stroke depression, and 109 controls without any evidence of post-stroke depression or cerebral infarction) to determine possible association betweenAPOE rs429358 and rs7412 polymorphisms and risk of post-stroke depression. Our ifndings show no difference among the groups with regards genotype distribution of the rs7412 polymorphism. In contrast,APOE genotypes with rs429358-C alleles increased the risk of post-stroke depression. Further, the rs429358 polymorphism was associated with significantly decreased regional cerebral blood flow values in the left temporal lobe of post-stroke depression cases. Additionally, the rs429358 polymorphism was not only associated with depression severity, but with increasing serum levels of total cholesterol. These re-sults suggest that theAPOE rs429358 polymorphism is associated with increased risk of developing post-stroke depression, and thatAPOE rs429358-C allele genotypes may be detrimental to recovery of nerve function atfer stoke. Indeed, these ifndings provide clinical data for future post-stroke depression gene interventions.     

PPARγ基因多态性与动脉粥样硬化性脑梗死的相关性研究

目的 探讨PPARγ基因多态性与动脉粥样硬化性脑梗死的关系.方法 本研究共纳入227例动脉粥样硬化性脑梗死患者和404例健康对照人群.以rs1875796为遗传标记,应用多聚酶链-限制性片段长度多态性(PCR-RFLP)技术检测PPARγ基因rs1875796的个体基因型.结果 女性动脉粥样硬化性脑梗死组rs1875796的C等位基因频率较对照组明显增高(χ~2=9.113,P=0.003,OR=2.211,95%CI 1.321～3.700),女性动脉粥样硬化性脑梗死rsl875796位点的CC+CT基因型频率较对照组明显增高(χ=8.032,P=0.005,OR=2.404,95%CI 1.310～4.411),经过多因素回归分析调整了传统危险因素的影响,两组间仍有显著性差异(P=0.006).而男性动脉粥样硬化性脑梗死组与对照组rs1875796的等位基因、基因型频率差异无显著意义.结论 PPARγ基因可能与女性动脉粥样硬化性脑梗死相关.

Abstract：

Objective To investigate the genetic association between the PPARγ gene and atherosclerotic cerebral infarction. Methods 227 patients with atherosclerotic cerebral infarction were recruited into this study, and 404 healthy people were as controls. SNP rs1875796,a C to T base change located in intron 4 of the gene,was used as a genetic marker. PCR-based restriction fragment length polymorphism analysis was applied to genotype rs 1875796 ( Hha I site). Results The frequcncy of allele C was significantly higher in female patients than controls(χ~2 =9. 113,P =0. 003,OR =2.211,95% CI 1. 321～3.700). And the frequcncy of genotype CC + CT was also significantly higher in female patients than controls(χ~2 = 8.032,P = 0.005,OR =2.404, 95% CI 1.310～4.411). Multiple factor regression analysis showed that the differences was still significant after adjusting the traditional risk factors of atherosclerotic cerebral infarction. The frequency of allele C,and genotype CC + CT showed no significance between male patients and controls. Conclusions The present study suggests that the PPARγ gene is likely to contribute to the etiology of atherosclerotic cerebral infarction in female Chinese.     

Relationship between the -455G/A and -148C/T polymorphisms in the beta-fibrinogen gene and cerebral infarction in the Xinjiang Uygur and Han Chinese populations

We sought to investigate the correlation between the -455G/A and -148C/T polymorphisms of the β-fibrinogen gene and plasma fibrinogen levels in patients with cerebral infarction and in healthy subjects among the Xinjiang Uygur and Han Chinese populations, by using polymerase chain reaction-restriction enzyme digestion analysis. Results showed that there were no statistically significant differences in the distributions of the -455G/A genotype and allele frequency between the Uygurs and the Han. Plasma fibrinogen levels in cerebral infarction patients among the Uygurs and the Han were higher than those among healthy subjects. In particular, the frequencies of the -455G/A AA and -148C/T TT genotypes were significantly higher than in healthy subjects. Individuals carrying the A or T allele had a higher incidence of cerebral infarction compared with those carrying the G or C allele. Our experimental findings indicate that the -148C/T and -455G/A polymorphisms are associated with cerebral infarction in Xinjiang Uygur and Han Chinese subjects. The susceptibility- conferring alleles are -148T and -455A, and the susceptibility-conferring genotype is -455G/A + AA.     

Therapeutic time window of picroside on cerebral ischemia reperfusion injury in rats

BACKGROUNG: Cerebral schemia may result in cerebral edema and neuronal injury by activating some endogenous mechanisms. It has been confirmed that picrosideⅡ could protect neuronal damage in vitro an ex vitro. OBJECTIVE: The aim of the present study is to explore the neuroprotective effects and the perfect treatment window of picrosideⅡ on brain insult in rats following middle cerebral artery occlusion and reperfusion (MCAO/R). DESIGN, TIME AND SETTING: A randomized, controlled animal experiment was performed at Institute of Cerebrovascular Diseases, Qingdao University Medical College from September 2008 to May 2009. MATERIALS AND METHODS: One hundred and sixty-five adult healthy male Wistar rats were randomly divided into a sham-operation group (n=15), a control group (n=75) and a treatment group (n=75). Rats in the control group and the treatment group were experimented surgery operation of MCAO/R with an intraluminal monofilament suture from left external-internal carotid artery. Those in the treatment group were injected 1.0％ picrosideⅡat a single dosage of 10mg/kg from the tail vein. We evaluated neurological function score by Longa’s method, cerebral infarction volume with tetrazolium chloride (TTC) stain. Then we compared cell apoptosis by terminal deoxynucleotidyl transference-mediated biotinylated deoxyuridine triphosphate nick end labeling technique (TUNEL), and determined the expression alternation of aquaporin-4 (AQP-4) via fluorescence labeling analysis and RT-PCR technique. RESULTS: After MCAO/R, neurological function scores were decreased, and a small infarction focus could be detected in ischemic cortex in the control group at ischemic 0.5h, along with the increased number of positive-apotosis cells and the elevated expression of AQP-4 mRNA and its protein. With the duration of ischemia, neurological scores and infarction sizes obviously increased in the control group during ischemic 1.0h-2.0h. A great deal of positive-apoptotic cells were widespread in the cortex and the striatum in the ischemic ipsilateral. Simultaneously, the expression of AQP-4 mRNA and its protein increased to some extent. PicrosideⅡ treatment significantly improved the loss of neurological function, decreased the infarction volume, and elevated the expression levels of AQP-4 mRNA and its protein compared with those in the control group. The therapeutic effect of picrosideⅡ was notable, especially in the ischemic 1.0h subsection. CONCLUSION: These results demonstrate that picrosideⅡ played a neuroprotective effect on cerebral ischemic reperfusion by inhibiting apoptosis and regulating the expression of AQP-4 mRNA and its protein. The best therapeutic window is at ischemic 1h after MCAO.     

Use of various CT imaging methods for diagnosis of acute ischemic cerebrovascular disease

Thirty-four patients with cerebral infarction and 18 patients with transient ischemic attack were examined by multi-slice spiral CT scan, CT perfusion imaging, and CT angiography within 6 hours after onset. By CT perfusion imaging, 29 cases in the cerebral infarction group and 10 cases in the transient ischemic attack group presented with abnormal blood flow perfusion, which corresponded to the clinical symptoms. By CT angiography, various degrees of vascular stenosis could be detected in 41 patients, including 33 in the cerebral infarction group and eight in the transient ischemic attack group. The incidence of intracranial artery stenosis was higher than that of extracranial artery stenosis. The intracranial artery stenosis was located predominantly in the middle cerebral artery and carotid artery siphon, while the extracranial artery stenosis occurred mainly in the bifurcation of the common carotid artery and the opening of the vertebral artery. There were 34 cases (83%) with convict vascular stenosis and perfusion abnormalities, and five cases (45%) with perfusion abnormalities but without convict vascular stenosis. The incidence of cerebral infarction in patients with National Institutes of Health Stroke Scale scores ≥ 5 points during onset was significantly higher than that in patients with National Institutes of Health Stroke Scale scores < 5 points. These experimental findings indicate that the combined application of various CT imaging methods allows early diagnosis of acute ischemic cerebrovascular disease, which can comprehensively analyze the pathogenesis and severity of acute ischemic cerebrovascular disease at the morphological and functional levels.     

Xueshuantong improves cerebral blood perfusion in elderly patients with lacunar infarction

A total of 64 patients with acute lacunar infarction were enrolled within 24 hours of onset. The patients received conventional therapy (antiplatelet drugs and hypolipidemic drugs) alone or conventional therapy plus 450 mg Xueshuantong once a day. The main ingredient of the Xueshuantong lyophilized powder used for injection was Panax notoginseng saponins. Assessments were made at admission and at discharge using the National Institutes of Health Stroke Scale, the Activity of Daily Living and the Mini-Mental State Examination. Additionally, the relative cerebral blood flow, relative cerebral blood volume and relative mean transit time in the region of interest were calculated within 24 hours after the onset of lacunar infarction, using dynamic susceptibility contrast magnetic resonance perfusion imaging technology. Patients underwent a follow-up MRI scan after 4 weeks of treatment. There was an improvement in the Activity of Daily Living scores and a greater reduction in the scores on the National Institutes of Health Stroke Scale in the treatment group than in the control group. However, the Mini-Mental State Examination scores showed no significant differences after 4 weeks of treatment. Compared with the control group, the relative cerebral blood flow at discharge had increased and showed a greater improvement in the treatment group. Furthermore, there was a reduction in the relative mean transit time at discharge and the value was lower in the treatment group than in the control group. The experimental findings indicate that Xueshuantong treatment improves neurological deficits in elderly patients with lacunar infarction, and the mechanism may be related to increased cerebral perfusion.     

The Change of Mobility and Deformability of Red Cell Membrane in the Patients with Cerebral Infarction

To study the blood cell hemoyheology,the mobility and deformability of red cell membrane,the activity and assembly of platelets ,the content of cholesterol crvstals and thrombus in circulation in cerebral infarction patientrs. Observing the cell hemorheologi cal condition of the red clee, platelet,cholesterol cryitals, and active thrombus in active blood analysis with Bradford's microscope(15,000 times). The study indicates that in the ceredral infarction patients,the red cell appeared rowleax and its deformbility was poor and its membrane mobility reduvde(P＜0.05). In this group blood viscosity was higher, the platelet assembling rate rose and the thrombus in circulation increases more signifi cantly than the nomal group (P＜0.01). The change of membrane mobility,the rsising of platelet assemble rate, the in creasing of plasma viscosity and flowing embolism are the important pathological basis of cerebral infarction. It may provide important material and practical meaning for precluding,diagnosing,curing and prognosising ischmia cerebralvas cular diseases.     

脑梗死患者记忆障碍与情感障碍的研究

目的 本文通过对脑梗死所致记忆障碍与情感障碍进行研究,明确记忆障碍及情感障碍与脑损害部位是否有必然联系,探索记忆障碍和情感障碍的相互影响.方法 收集神经内科住院的初次脑梗死患者80例,正常对照组40例.分别进行记忆功能测定、情感测定以及MRI各项指标的测量,然后进行统计分析.结果 正常组和脑梗死组记忆功能障碍有显著性差异(P<0.001).脑梗死体积、数量和部位不同,其记忆障碍和情感障碍均有显著性差异(P<0.05).左侧半球病变引起的记忆损害及情感障碍较右侧半球病变严重.结论 脑梗死后记忆障碍和情感障碍发生率很高,且与梗死部位、容积、数量等显著相关,严重降低脑卒中患者的治疗效果和生活质量.

Abstract：

Objective Based on the memory impairment caused by cerebral infarction,to study affective disorder,a clear memory disorder and affective disorder and brain damage have a causal link,and explore barriers tO memory impairment and emotional interaction.Methods The collection of the initial hospitalization in patients of Department of NeurologY with cerebral infarction was 80 cases and 40 case8 of normal control group.Memory and emotional function were meantured,as well as MRI measurement were recorded for the purpose of statistical analysis.Results Normal group and memory dysfunction in cerebral infarction group were significantly different(P<0.001).Infarct vdume,quantity and location is different from its memory impairment and affective disorder were significantly different(P<0.05).Lesions of left hemisphere caused more serious memory impairment and emotional obstacles than those of the right hemisphere.Conclusions Memory impairment after cerebral infarction and the high incidence of affective disorder showes correlation with the infarct location, vdume and the number significantly,and are related to a serious decline in the effect of treatment and quality of life of stroke patients.     

Electrocardiogram cerebral infarction changes in acute patients

BACKGROUND: Comparison of different stroke locations had been focused in past researches in electrocardiogram (ECG) changes of cerebral stroke patients. Some researches neglected the heart disease in the illness history. OBJECTIVE: To discuss ECG changes in different infarction locations and size of acute cerebral infarction and compare with healthy people. DESIGN: Contrast observation. SETTING: Shanghai Ninth People's Hospital. PARTICIPANTS: A total of 57 patients with cerebral infarction were selected from the Neurological Department of Ninth People's Hospital of Shanghai from March 2003 to September 2005. They were diagnosed according to the criteria revised in the 4th National Cerebral Disease Conference and brain images. Patients who had heart disease were excluded. There were 32 males and 25 females, who were 65-84 years old. Among them, 23 cases were involved in right hemisphere, 34 cases in left one, 23 in base ganglion, 11 in brain stem, 9 in frontal lobe and 14 in other parts. According to their infarction size (plus size in every different scan), they were divided into three different groups: large-size group (n = 10) with size larger than 3.5 cm3, medium-size group (n = 13) with size between 1.5-3.5 cm3, and small-size group (n = 34) with size smaller than 1.5 cm3. Another 50 healthy subjects were regarded as control group. There were 29 males and 21 females aged 40-82 years. All these cases knew and agreed of the examination. METHODS: Patients received 12-lead ECG examinations within the first 6-24 hours of onset while control group received it at the same time. The HR, PR, QTc, QRS, T wave and ST changes were compared between the two groups. MAIN OUTCOME MEASURES: The ECG changes and differences in two hemispheres, in different infarction locations and sizes. RESULTS: All 57 patients and 50 healthy subjects were involved in the final analysis. ① ECG changes in infarction group and control group. There were no differences in HR, QRS time and cases with opposite T wave of infarction group compared with control group (P > 0.05). PR and QTc [(0.167±0.010), (0.383±0.029) s] in infarction group were longer than those in control group [(0.159±0.008), (0.361±0.022) s, t = 1.982, 2.363, P < 0.05, 0.01]. ST changes cases were 77% (44/57), which was more than those in control group [46% (23/50), χ2 = 11.072, P < 0.01]. ② Comparison of infarction in two hemispheres. HR, PR interval, QRS time, cases with opposite T wave and ST changes showed no differences (P > 0.05), and QTc interval in right hemisphere infarction was longer than left one [(0.391±0.054), (0.380±0.034) s, t =1.673, P < 0.05]. ③ ECG changes in different infarction locations. HR, PR interval, QTc interval, QRS time, cases with opposite T wave and ST changes showed no statistically significantly differences (P > 0.05). ④ ECG changes in different infarction sizes. HR, PR interval, QRS time showed no differences (P > 0.05). QTc interval in large size group was longer than the others [(0.399±0.044), (0.388±0.073), (0.378±0.124) s, F = 3.19, P < 0.05]. Cases with opposite T wave and ST changes in large size group were 80% (8/10), 100% (10/10), which were higher than those in medium size group [46% (6/13), 69% (9/13)] and small size group [44% (15/34), 35% (12/34), χ２ = 8.495, 10.538, P < 0.05, 0.01]. CONCLUSION: ① PR interval and QTc interval prolonged in cerebral infarction patients. Furthermore, QTc interval was more obvious in large size infarction group and right hemisphere infarction group. ② Infarction location did not affect the changes of ECG.     

急性脑梗死患者上气道形态变化

Objective To investigate the feature of the morphology changes in the upper airway in patients with acute cerebral infarction and to find a new method to prevent and cure cerebral infarction.Methods Sixty-six patients with cerebral infarction confirmed by brain MRI or CT scan(within 3 weeks of onset) were recruited.The patients were examined by upper airway MRI scan and polysomnography (PSG).Then the patients were divided into obstructive sleep apnea hypopnca syndrome(OSAHS)group and non-OSAHS group.In addition.16 patients showing OSAHS but without stroke history(OSAHS nonstroke group)were included in the study.The sagittal and horizontal lengths of the nasopharynx,palatopharynx,glossopharynx and hypopharynx were measured and their closs-sectional areas were calculated.The length,thickness and cross-sectional area of the palate were also measured.Statistic analysis of each data among the groups was performed using SPSS software.Results Among 66 cases with acute cerebral infarction,75.8 % (50/66)were diagnosed with OSAHS.The anteropesterior diameer,left and right diameters and smallest section area in upper airway were all smaller in the OSAHS group with acute cerebral infaretion than those in the non-OSAHS group and OSAHS non-stroke group.The narrowest segments in upper airway were nasopharynx and ompharynx.which are caused by shortened left and right diameters.The area of the soft palate in the OSAHS-stroke group was significant bigger((452.2±99.6)mm2)than that in non-OSAHS group((350.0±69.4)mm2,t:4.575,P<0.05).The lowest SO2 in OSAHS-stroke group(68.9 % ±10.5 % )was the lowest among three groups.The more severe the airway constriction was.the higher the apnea-hypopnea index(AHI)was and the lower the lowest SO2 was.Conclusion Patients withl stroke show higher incidence of OSAHS and present more severe multilevel upper airway constriction.Upper airway constriction may be the new target of early treatment for better prognosis of cerebral infarction.     

Low frequency repetitive transcranial magnetic stimulation improves motor dysfunction after cerebral infarction

Low frequency(≤ 1 Hz) repetitive transcranial magnetic stimulation(r TMS) can affect the excitability of the cerebral cortex and synaptic plasticity. Although this is a common method for clinical treatment of cerebral infarction, whether it promotes the recovery of motor function remains controversial. Twenty patients with cerebral infarction combined with hemiparalysis were equally and randomly divided into a low frequency r TMS group and a control group. The patients in the low frequency r TMS group were given 1-Hz r TMS to the contralateral primary motor cortex with a stimulus intensity of 90% motor threshold, 30 minutes/day. The patients in the control group were given sham stimulation. After 14 days of treatment, clinical function scores(National Institute of Health Stroke Scale, Barthel Index, and Fugl-Meyer Assessment) improved significantly in the low frequency r TMS group, and the effects were better than that in the control group. We conclude that low frequency(1 Hz) r TMS for 14 days can help improve motor function after cerebral infarction.     

Effect of extracranial electric stimulation at cerebellar fastiglal nucleus on serum C-reactive protein of patients with acute cerebral infarction

BACKGROUND: Some reports indicate that electric and/or chemical stimulation at various brain sites of experimental animals can raise regional cerebral blood flow and improve cerebral circulation; however, its mechanism is still unclear. OBJECTIVE: To observe the effects of electric stimulation at cerebellar fastigial nucleus on serum C-reactive protein of patients with acute cerebral infarction. DESIGN: Non-randomized synchronized contrast study. SETTING: The Second People's Hospital of Xinxiang City. PARTICIPANTS: A total of 54 patients with acute cerebral infarction were selected from the Department of Neurology, the Second People's Hospital of Xinxiang from December 2005 to December 2006. There were 31 males and 23 females, and their ages ranged from 56 to 80 years. All patients met the diagnostic criteria of the Fourth National Cerebrovascular Academic Meeting, were finally diagnosed by using CT examination, and provided the confirmed consent. Based on therapeutic demands, patients were divided into electric stimulation group and routine treatment group with 27 cases in each group. In addition, 21 healthy subjects, including 11 males and 10 females and aging 53–78 years, were selected as the control group. All the subjects in the control group did not have any histories of cerebrovascular diseases and severe body diseases. METHODS: Based on routine drug therapy, patients in the electric stimulation group were also treated by using CVFT-010M cerebral circulation function therapeutic device (made in Shanghai). Electrode was fixed at bilateral mastoid in the first group and at extensible sides of upper limbs in the second group. Electric stimulation was given twice a day and lasted for 30 minutes each time. Ten days were regarded as a course. Parameters of device: mode Ⅲ, frequency 198%, and intensity 90%–110% (bionic current). Patients in the routine treatment group received the routine drug treatment. Content of serum C-reactive protein was measured in both electric stimulation group and routine treatment group before treatment and at 20 days after treatment, while in the control group on the exact day of health examination by using immunization. MAIN OUTCOME MEASURES: Level of serum C-reactive protein in the three groups. RESULTS: All 54 patients with acute cerebral infarction and 21 healthy subjects were involved in the final analysis. Level of serum C-reactive protein was higher in both electric stimulation group and routine treatment group than that in the control group before treatment (P < 0.01). While, level of serum C-reactive protein was lower in the electric stimulation group than that in the routine treatment group after electric stimulation at cerebellar fastigial nucleus (P < 0.01). CONCLUSION: Electric stimulation at cerebellar fastigial nucleus can decrease level of serum C-reactive protein in patients with acute cerebral infarction, and this may be one of the therapeutic mechanisms for curing acute cerebral infarction.     

Susceptibility gene for stroke or cerebral infarction in the Han population in Hunan Province of China

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 Han population in Hunan province of China. The A allele is possibly associated with the metabolism of high-density and low-density lipoprotein cholesterol.     

急性脑梗死患者上气道形态变化

Objective To investigate the feature of the morphology changes in the upper airway in patients with acute cerebral infarction and to find a new method to prevent and cure cerebral infarction.Methods Sixty-six patients with cerebral infarction confirmed by brain MRI or CT scan(within 3 weeks of onset) were recruited.The patients were examined by upper airway MRI scan and polysomnography (PSG).Then the patients were divided into obstructive sleep apnea hypopnca syndrome(OSAHS)group and non-OSAHS group.In addition.16 patients showing OSAHS but without stroke history(OSAHS nonstroke group)were included in the study.The sagittal and horizontal lengths of the nasopharynx,palatopharynx,glossopharynx and hypopharynx were measured and their closs-sectional areas were calculated.The length,thickness and cross-sectional area of the palate were also measured.Statistic analysis of each data among the groups was performed using SPSS software.Results Among 66 cases with acute cerebral infarction,75.8 % (50/66)were diagnosed with OSAHS.The anteropesterior diameer,left and right diameters and smallest section area in upper airway were all smaller in the OSAHS group with acute cerebral infaretion than those in the non-OSAHS group and OSAHS non-stroke group.The narrowest segments in upper airway were nasopharynx and ompharynx.which are caused by shortened left and right diameters.The area of the soft palate in the OSAHS-stroke group was significant bigger((452.2±99.6)mm2)than that in non-OSAHS group((350.0±69.4)mm2,t:4.575,P<0.05).The lowest SO2 in OSAHS-stroke group(68.9 % ±10.5 % )was the lowest among three groups.The more severe the airway constriction was.the higher the apnea-hypopnea index(AHI)was and the lower the lowest SO2 was.Conclusion Patients withl stroke show higher incidence of OSAHS and present more severe multilevel upper airway constriction.Upper airway constriction may be the new target of early treatment for better prognosis of cerebral infarction.     

急性脑梗死患者上气道形态变化

Objective To investigate the feature of the morphology changes in the upper airway in patients with acute cerebral infarction and to find a new method to prevent and cure cerebral infarction.Methods Sixty-six patients with cerebral infarction confirmed by brain MRI or CT scan(within 3 weeks of onset) were recruited.The patients were examined by upper airway MRI scan and polysomnography (PSG).Then the patients were divided into obstructive sleep apnea hypopnca syndrome(OSAHS)group and non-OSAHS group.In addition.16 patients showing OSAHS but without stroke history(OSAHS nonstroke group)were included in the study.The sagittal and horizontal lengths of the nasopharynx,palatopharynx,glossopharynx and hypopharynx were measured and their closs-sectional areas were calculated.The length,thickness and cross-sectional area of the palate were also measured.Statistic analysis of each data among the groups was performed using SPSS software.Results Among 66 cases with acute cerebral infarction,75.8 % (50/66)were diagnosed with OSAHS.The anteropesterior diameer,left and right diameters and smallest section area in upper airway were all smaller in the OSAHS group with acute cerebral infaretion than those in the non-OSAHS group and OSAHS non-stroke group.The narrowest segments in upper airway were nasopharynx and ompharynx.which are caused by shortened left and right diameters.The area of the soft palate in the OSAHS-stroke group was significant bigger((452.2±99.6)mm2)than that in non-OSAHS group((350.0±69.4)mm2,t:4.575,P<0.05).The lowest SO2 in OSAHS-stroke group(68.9 % ±10.5 % )was the lowest among three groups.The more severe the airway constriction was.the higher the apnea-hypopnea index(AHI)was and the lower the lowest SO2 was.Conclusion Patients withl stroke show higher incidence of OSAHS and present more severe multilevel upper airway constriction.Upper airway constriction may be the new target of early treatment for better prognosis of cerebral infarction.     

急性脑梗死患者上气道形态变化

Objective To investigate the feature of the morphology changes in the upper airway in patients with acute cerebral infarction and to find a new method to prevent and cure cerebral infarction.Methods Sixty-six patients with cerebral infarction confirmed by brain MRI or CT scan(within 3 weeks of onset) were recruited.The patients were examined by upper airway MRI scan and polysomnography (PSG).Then the patients were divided into obstructive sleep apnea hypopnca syndrome(OSAHS)group and non-OSAHS group.In addition.16 patients showing OSAHS but without stroke history(OSAHS nonstroke group)were included in the study.The sagittal and horizontal lengths of the nasopharynx,palatopharynx,glossopharynx and hypopharynx were measured and their closs-sectional areas were calculated.The length,thickness and cross-sectional area of the palate were also measured.Statistic analysis of each data among the groups was performed using SPSS software.Results Among 66 cases with acute cerebral infarction,75.8 % (50/66)were diagnosed with OSAHS.The anteropesterior diameer,left and right diameters and smallest section area in upper airway were all smaller in the OSAHS group with acute cerebral infaretion than those in the non-OSAHS group and OSAHS non-stroke group.The narrowest segments in upper airway were nasopharynx and ompharynx.which are caused by shortened left and right diameters.The area of the soft palate in the OSAHS-stroke group was significant bigger((452.2±99.6)mm2)than that in non-OSAHS group((350.0±69.4)mm2,t:4.575,P<0.05).The lowest SO2 in OSAHS-stroke group(68.9 % ±10.5 % )was the lowest among three groups.The more severe the airway constriction was.the higher the apnea-hypopnea index(AHI)was and the lower the lowest SO2 was.Conclusion Patients withl stroke show higher incidence of OSAHS and present more severe multilevel upper airway constriction.Upper airway constriction may be the new target of early treatment for better prognosis of cerebral infarction.     

急性脑梗死患者上气道形态变化

Objective To investigate the feature of the morphology changes in the upper airway in patients with acute cerebral infarction and to find a new method to prevent and cure cerebral infarction.Methods Sixty-six patients with cerebral infarction confirmed by brain MRI or CT scan(within 3 weeks of onset) were recruited.The patients were examined by upper airway MRI scan and polysomnography (PSG).Then the patients were divided into obstructive sleep apnea hypopnca syndrome(OSAHS)group and non-OSAHS group.In addition.16 patients showing OSAHS but without stroke history(OSAHS nonstroke group)were included in the study.The sagittal and horizontal lengths of the nasopharynx,palatopharynx,glossopharynx and hypopharynx were measured and their closs-sectional areas were calculated.The length,thickness and cross-sectional area of the palate were also measured.Statistic analysis of each data among the groups was performed using SPSS software.Results Among 66 cases with acute cerebral infarction,75.8 % (50/66)were diagnosed with OSAHS.The anteropesterior diameer,left and right diameters and smallest section area in upper airway were all smaller in the OSAHS group with acute cerebral infaretion than those in the non-OSAHS group and OSAHS non-stroke group.The narrowest segments in upper airway were nasopharynx and ompharynx.which are caused by shortened left and right diameters.The area of the soft palate in the OSAHS-stroke group was significant bigger((452.2±99.6)mm2)than that in non-OSAHS group((350.0±69.4)mm2,t:4.575,P<0.05).The lowest SO2 in OSAHS-stroke group(68.9 % ±10.5 % )was the lowest among three groups.The more severe the airway constriction was.the higher the apnea-hypopnea index(AHI)was and the lower the lowest SO2 was.Conclusion Patients withl stroke show higher incidence of OSAHS and present more severe multilevel upper airway constriction.Upper airway constriction may be the new target of early treatment for better prognosis of cerebral infarction.