Plasma miR-126 and miR-143 as Potential Novel Biomarkers for Cerebral Atherosclerosis

Background

Cerebral atherosclerosis is the most important mechanism for ischemic stroke. However, specific plasma biomarkers to assess atherosclerosis susceptibility are still lacking. Circulating miRNAs have been shown to be promising biomarkers for various pathologic conditions. We investigated whether plasma miR-126 and miR-143 could be used as biomarkers for identifying and evaluating cerebral atherosclerosis. Results showed that miR-143 and miR-126 might participate in the process of atherosclerosis and were minimally affected by cerebral infarction. Using Pearson correlation analysis, we showed that miR-126 and miR-143 were correlated with the presence and severity of cerebral atherosclerosis. The ability of miR-126 and miR-143 to differentiate atherosclerosis patients from healthy controls was demonstrated via a receiving operating characteristic curve with high specificity and sensitivity. Our data thus indicate that miR-126 and miR-143 may be potential specific biomarkers for atherosclerosis.     

脑梗死患者急性期血清C反应蛋白的动态变化及临床意义

目的 探讨急性脑梗死(ACI)患者血清C反应蛋白(CRP)的含量变化及其临床意义.方法 随机选择80例急性脑梗死患者,采用液相免疫沉淀散射比浊法对患者检测血清CRP水平,按梗死灶大小分组观察,并对其神经功能缺损进行标准评分.结果 急性脑梗死不同梗死灶组比较,大小梗死组卒中后5 ～ 7 d水平最高,随后逐渐下降,两组均较腔梗组为高(P<0.01);不同临床分型组间比较,重型组明显高于中型、轻型组、(均P<0.01).结论 血清CRP水平增高与急性脑梗死发生、梗死灶大小和严重程度关系密切,CRP可考虑作为急性脑梗死患者评估病情的指标之一.     

脑梗死患者急性期血清高敏C-反应蛋白的动态变化及临床意义

目的　探讨急性脑梗死(ACI)患者高敏C-反应蛋白(hsCRP)的含量变化及其临床意义。方法　随机选择60例急性脑梗死患者,利用Dade-Behring ProSpec全自动特定蛋白分析系统,采用散射免疫比浊法检测各组患者hsCRP血清水平,观察ACI不同病程含量变化。并对其神经功能缺损进行标准评分。并选取30例健康体检者作为对照组。结果　急性脑梗死组不同时期血清hsCRP含量均高于对照组(P <0.05),卒中后第7天水平最高,随后逐渐下降;血清hsCRP含量与神经功能缺损程度呈正相关(r =0.53,P <0.01),重型患者hsCRP浓度明显高于轻、中型患者。结论　急性脑梗死患者血清hsCRP明显升高,且与神经功能缺损程度呈正相关,可作为急性脑梗死患者病变稳定程度的敏感指标之一。     

以多流域脑梗死为特征的肺癌继发特鲁索综合征1例并文献复习

1 病例介绍 患者女性,63岁,以主诉"咳嗽、咳痰1月余,双下肢无力1天"于2020年10月30日入住胸外科,于2020年11月7日转入神经内科.患者1个月余前无明显诱因出现咳嗽、咳痰,为少量白色泡沫样痰,痰中无带血,行胸部CT见右肺上叶后段软组织团块影,边界不规则,可见毛刺及分叶,增强扫描见双期不均匀渐进性强化(图1...     

不同病因和发病机制首次急性缺血性卒中患者超敏C反应蛋白的变化

目的 观察首发急性缺血性卒中不同病因和发病机制患者发病早期血清超敏C反应蛋白（high sensitivity C-reactive protein,hs-CRP）水平变化,探讨其在缺血性卒中患者中的临床意义。 方法 采用免疫比浊法对423例首发住院缺血性卒中患者发病7 d内血清hs-CRP水平进行测定,按照中国缺血性卒中亚型（Chinese Ischemic Stroke Subclassification,CISS）标准对患者进行病因及发病机制分型,并进行对照分析。 结果 在不同病因中,心源性卒中组hs-CRP水平最高［（8.09±4.47）mg/L］,其次依次为大动脉粥样硬化组［（5.89±4.02）mg/L］、其他病因组［（5.21±4.64）mg/L］、穿支动脉疾病组［（3.67±3.47）mg/L］、病因不明确组［（2.83±4.40）mg/L］,组间比较差异有显著性（F=7.905,P=0.015）;大动脉粥样硬化病因中发病机制不同,hs-CRP水平亦不相同,由高到低依次为：动脉-动脉栓塞组［（7.88±3.35）mg/L］、混合机制组［（5.88±3.50）mg/L］、低灌注/栓子清除下降组［（5.15±4.36）mg/L］、载体动脉（斑块或血栓）阻塞穿支动脉组［（4.47±3.88）mg/L］,组间比较差异有显著性（F=15.821,P=0.013）。 结论 首发急性缺血性卒中患者不同CISS亚型hs-CRP水平差异具有显著性     

Association of Metabolic Syndrome and C-reactive Protein Levels with Intracranial Atherosclerotic Stroke

Background

The risk factors for intracranial atherosclerosis are unclear but may differ from those for other stroke subtypes. Here, we investigated whether metabolic syndrome, an emerging risk factor for cardiovascular disease, is associated with intracranial atherosclerotic stroke.

Methods

Using the Adults Treatment Panel III criteria, we evaluated the components of metabolic syndrome in 439 patients with ischemic stroke or transient ischemic attacks. The prevalence of metabolic syndrome within each stroke subtype was determined, and the association between intracranial atherosclerosis and metabolic syndrome was evaluated.

Results

Metabolic syndrome was observed more frequently in patients with intracranial atherosclerosis than in those with other types of stroke (P=0.003). In a multiple regression analysis, metabolic syndrome, but not conventional risk factors, was independently associated with intracranial atherosclerosis (P=0.016). By contrast, the serum level of C-reactive protein was correlated negatively with the presence of intracranial atherosclerosis. Intracranial atherosclerosis was most prevalent in patients with metabolic syndrome and low levels of C-reactive protein (P=0.024).

Conclusions

Our results indicate that metabolic syndrome is a strong independent risk factor for intracranial atherosclerotic stroke. Therefore, treatment of metabolic abnormalities may be an important prevention strategy for intracranial atherosclerotic stroke.     

The Value of Diffusion-Weighted MRI in the Diagnosis of Cerebral Fat Embolism

Fat embolism syndrome complicates open fractures involving long bones, although it occasionally follows nontraumatic conditions. Incomplete forms of the syndrome (ie, cerebral fat embolism) represent a challenge to diagnosis, and brain MRI represents a valuable diagnostic tool. We describe a patient who had a fat embolism to the brain after an isolated traumatic open fracture of the tibia. MRI with T2 and diffusion-weighted images revealed multiple, reversible brain lesions, suggesting vasogenic edema and consistent with this entity. At present, MR imaging is the most sensitive technique to evaluate cerebral fat embolism.     

Amino Acid Levels as Potential Biomarkers of Multiple Sclerosis in Elderly Patients: Preliminary Report

Background and PurposeAging in multiple sclerosis is associated with both disease- and age-dependent neurodegeneration. Serum metabolomic profiling of amino acids seems to be a promising method for searching for biomarkers of neurodegenerative disorders. The aim of this study was to determine the profile of nonessential amino acids in the serum of elderly patients with secondary progressive multiple sclerosis (SPMS).MethodsWe used high-performance liquid chromatography to evaluate the serum concentrations of nonessential amino acids in subjects aged >65 years: six patients with SPMS and 20 control subjects (CS).ResultsThe serine and alanine levels were significantly higher in SPMS patients than in CS, whereas the concentrations of aspartic acid, arginine, and cysteine were significantly lower in SPMS patients. These observations indicate that amino acids may be involved in SPMS neurodegeneration mechanisms. There were no significant differences in the serum concentrations of the other four amino acids investigated (glutamic acid, glycine, proline, and tyrosine) between patients with SPMS and CS.ConclusionsThe preliminary results obtained in the study suggest that the metabolism of some amino acids is altered in patient with SPMS. We also conclude that amino acid profiling might be helpful in searching for putative biomarkers of central nervous system diseases. However, considering the multifactorial, heterogeneous, and complex nature of SPMS, further validation research involving larger study samples is required before applying these biomarkers in diagnostic practice.     

D-二聚体在颅内静脉窦血栓形成 诊治中的研究进展

D-二聚体是交联纤维蛋白在纤溶酶作用下产生的一种特异性降解产物。既可反映凝血
酶的活性,又可反映纤溶酶的活性。近年来大量研究表明,D-二聚体在颅内静脉窦血栓形成中普遍
升高,有助于早期诊断颅内静脉窦血栓形成,因此D-二聚体异常升高提示颅内静脉窦血栓形成可能,
但D-二聚体正常能否除外颅内静脉窦血栓形成仍存在争议。本文就D-二聚体和颅内静脉窦血栓
形成的关系,D-二聚体在颅内静脉窦血栓形成的早期诊断、治疗及预后判断中的临床意义做一综述,
以期指导临床。     

不同影像技术在表现为孤立性颅内高压的脑静脉窦血栓诊断中的应用

脑静脉窦血栓形成(cerebralvenous sinus thrombosis,CVST)是指由不同病因引起的颅内静脉窦血栓形成,引起窦腔狭窄、闭塞,脑静脉血回流受阻和脑脊液吸收障碍,进而引起颅内高压等一系列病理生理改变以及相应症状的一组疾病[1].     

D-二聚体与纤维蛋白原比值与青年急性脑梗死患者颈动脉粥样硬化斑块的相关性分析

目的 探讨青年急性脑梗死(young acute cerebral infarction,YACI)患者D-二聚体与纤维蛋白原比值(D-dimer to fibrinogen ratio,DFR)与颈动脉粥样硬化斑块的关系.方法 回顾性连续收集2014年2月-2020年9月进行了颈动脉斑块超声造影(contrast-e...     

急性脑梗死血清C反应蛋白水平的临床意义

目的 探讨急性脑梗死（ACI）患者血清C反应蛋白（CRP）水平的意义及其机制。方法 测定129例ACI患者、46名健康对照者血清CRP水平,观察比较ACI患者在不同病情、不同梗死面积时血清CRP水平的变化,对发病后48h病情发展变化进行评定,根据评分结果分为进展型与完全型脑梗死两组进行观察比较。结果 ACI患者血清CRP水平[（0.81&#177;0.48）mg/dL]明显高于健康对照组[（0.27&#177;0.16）mg/dL]（P〈0.01）,且CRP水平随神经功能缺损程度评分增高亦明显升高;进展性脑梗死患者血清CRP水平明显高于非进展性患者（P〈0.01）。结论 CRP一定程度上是预测ACI患者病情严重程度及进展的相关生化指标之一。     

大脑中动脉闭塞或狭窄缺血性卒中患者血液炎性标志物变化

【摘要】
目的 观察大脑中动脉闭塞（middle cerebral artery occlusion,MCAO）或狭窄的缺血性卒中患者的危险
因素及血白细胞（white blood cell,WBC）、红细胞沉降率（erythrocyte sedimentation rate,ESR）和超敏
C反应蛋白（high-sensitivity C-reactive protein,hs-CRP）的变化。
方法 2005年1月～2011年1月期间北京友谊医院神经内科连续入选符合研究标准的262例缺血性卒中
患者,其中98例MCAO（闭塞组）、23例大脑中动脉（middle cerebral artery,MCA）狭窄率70%～99%（重
度狭窄组）、60例MCA狭窄率50%～69%（中度狭窄组）和81例MCA狭窄率<50%（轻度狭窄组）。比较四
组患者的危险因素及入院24 h血WBC、ESR和hs-CRP等指标。
结果 闭塞组、重度狭窄和中度狭窄组糖尿病患病率明显高于轻度狭窄组（P分别为0.008、0.044和
0.018）,其他危险因素在四组间比较差异均无显著性。闭塞组WBC、ESR和hs-CRP水平均高于轻度狭窄
组（P分别为0.005、0.002和0.001）;重度狭窄组ESR亦高于轻度狭窄组（P =0.026）。
结论 MCA闭塞和重度狭窄的缺血性卒中患者血WBC、ESR和hs-CRP水平高于MCA轻度狭窄患者。     

高血压合并脑梗死患者血浆C-反应蛋白、纤维蛋白原及白细胞变化的研究

目的探讨高血压合并脑梗死患者急性期血浆C-反应蛋白(CRP)、纤维蛋白原(Fib)水平、白细胞(WBC)及分类计数的变化与高血压合并脑梗死的关系。方法将患者分为两组,高血压合并脑梗死组(68例)和单纯高血压组(65例),检测两组患者急性期血浆CRP、Fib和WBC水平。结果高血压合并脑梗死患者急性期CRP、Fib水平、WBC总数、中性粒细胞数均比单纯高血压患者明显增高(P＜0．01)。结论C-反应蛋白、纤维蛋白原和白细胞升高可能与脑梗死的发生和进展相关,抗炎治疗可能是脑梗死治疗的一个选择。     

心房颤动合并脑栓塞患者的抗凝治疗现状和出血转化分析

目的 通过充血性心力衰竭、高血压、年龄≥75岁（双倍）、糖尿病、卒中（双倍）、血管病变、年 龄65～74岁、女性（Congestive heart failure,Hypertension,Age≥75（doubled）,Diabetes Mellitus,Stroke （doubled）,vascular disease,age 65～74 and sex category（female）,CHA2DS2-VASc）评分观察心房颤 动合并脑栓塞患者的抗栓治疗现状,分析高血压、异常的肝肾功能、卒中、出血、国际标准化比 值（international normalized ratio,INR）不稳定、年龄、药物治疗或者饮酒（Hypertension,Abnormal renal and liver function,Stroke,Bleeding,Labile international normalized ratio,Elderly,Drugs and alcohol intake, HAS-BLED）评分及其他相关临床危险因素与心房颤动合并脑栓塞出血转化的关系。 方法 回顾性分析2012年5月至2014年12月在北京博爱医院神经康复科住院的心房颤动合并脑栓塞 患者的临床资料。根据CHA2DS2-VASc评分观察低危组（0分）、中危组（1分）、高危组（≥2分）的抗栓 治疗情况。根据HAS-BLED评分,分析心房颤动脑栓塞出血转化（hemorrhagic transformation,HT）率在 出血转化低危组（0～2分）和出血转化高危组（≥3分）之间的差异,同时对多个临床变量进行多因素 分析,寻找与HT相关的临床危险因素。 结果 研究共入组101例患者,患者在发生脑栓塞之前,根据CHA2DS2 -VASc评分,低危组抗凝率 66.7%（2/3）,无抗血小板治疗;中危组抗凝、抗血小板率均为16.7%（2/12）;高危组抗凝率19.8% （17/86）,抗血小板率14.0%（12/86）。脑栓塞前1个月内停用抗凝治疗而发病的占所有抗凝患者 42.8%（9/21）。发生脑栓塞之后,所有患者均为高危组,抗凝治疗率68.3%（69/101）,抗血小板 治疗率25.7%（26/101）。根据HAS-BLED评分,心房颤动合并脑栓塞后,出血转化高危组HT 58.5% （31/53）,与低危组HT 37.5%（18/48）比较,差异有显著性（χ 2=4.443,P =0.035）。对HT组与非HT 组的多个临床变量分析发现,两组美国国立卫生研究院（National Institutes of Health Stroke Scale, NIHSS）评分差异有显著性（14.860±4.486 vs 11.940±5.648,P =0.006）;HAS-BLED评分差异有显 著性（2.76±0.80 vs 2.21±0.96,P =0.003）;病灶范围大的梗死灶HT为57.9%（44/76）,小的梗 死灶为HT 20%（5/25）,两组有显著差异（P =0.001）。多因素Logistic回归分析发现NIHSS（OR 1.106, 95%CI 1.106～1.216,P =0.036）、病灶范围大小（OR 5.083,95%CI 1.826～14.148,P =0.002）和HASBLED 评分（OR 2.353,95%CI 1.326～4.175,P =0.003）均是心房颤动患者脑栓塞后HT的危险因素。 结论 心房颤动合并脑栓塞的患者抗栓治疗率不理想,HAS-BLED评分能很好地预测心房颤动合并 脑栓塞后的HT风险,另外,神经功能缺损较重、病灶范围大也是心房颤动合并脑栓塞患者发生HT的 危险因素。