Overweight and Obesity in Young Adulthood and the Risk of Stroke: a Meta-analysis.

BACKGROUND: A systematic review assessing the association between overweight and obesity in young adulthood and stroke risk is lacking. Therefore, we conducted a meta-analysis to evaluate the association between overweight and obesity in young adulthood and stroke risk. METHODS: We systematically searched PubMed and Embase databases for related studies of human subjects in the English language. Two investigators independently selected original studies in a 2-step process. Fixed- and random-effects models were used to calculate pooled relative risks (RRs) and 95% confidence intervals (CIs). Subgroup analyses were also performed. RESULTS: Eight studies met the inclusion criteria. The pooled adjusted RR of stroke was 1.36 (95% CI: 1.28-1.44) for overweight in young adulthood and 1.81 (95% CI: 1.45-2.25) for obesity in young adulthood. In subgroup analyses, overweight and obesity in young adulthood increased the risk of stroke in most groups, except for the group of stroke subtype. For ischemic stroke, the adjusted RR was 1.40 (95% CI: 1.24-1.58) for overweight in young adulthood and 1.78 (95% CI: 1.003-3.16) for obesity in young adulthood, whereas adjusted RR for hemorrhagic stroke was 1.25 (95% CI: .83-1.90) for overweight in young adulthood and 1.80 (95% CI: .97-3.35) for obesity in young adulthood. CONCLUSIONS: Overweight and obesity in young adulthood are associated with an increased risk of stroke, probably, independent of other cardiovascular risk factors. The risk effect gradually increases with increasing body weight.

Effect of Urinary Kallidinogenase on Transforming Growth Factor-ß1 and High-Sensitivity C-Reactive Protein Expression in Rat Focal Cerebral Ischemic Injury.

BACKGROUND In this study we investigated the effect of urinary kallidinogenase (UK) on transforming growth factor beta 1 (TGF-ß1) expression in brain tissue. We also explored the neuroprotective mechanism of UK against ischemic injury by measuring serum high-sensitivity C-reactive protein (hs-CRP) level changes after rat cerebral ischemic injury. MATERIAL AND METHODS The rat middle cerebral artery ischemia/reperfusion model was established using the suture method. Sprague-Dawley rats were randomly divided into 3 groups: treatment, Gegen control, and blank control. Each group was subsequently divided into 5 subgroups according to time (6, 12, 24, 48, and 72 h). Rats in the treatment group were administered UK as treatment. TGF-ß1 expression was observed at each time point using SABC and immunohistochemical staining methods to estimate cerebral infarct volume percentage. Serum hs-CRP levels were also measured. RESULTS TGF-ß1 protein expression in ischemic brain tissues of the treatment group significantly increased at each time point (P<0.01) compared with both control groups. Treatment group serum hs-CRP levels significantly decreased at each time point (P<0.05) compared with both control groups. CONCLUSIONS UK exerts a neuroprotective effect by upregulating TGF-ß1 expression and inhibiting excessive inflammatory responses.

FGB gene - 148C>T polymorphism is associated with increased risk of ischemic stroke in a Chinese population: a meta-analysis based on 18 case-control studies.

BACKGROUND: Several published articles investigated the relationship between a polymorphism -148C>T in the ß-fibrinogen gene (FGB) and risk of ischemic stroke, and did not reach the same conclusion. To shed light on these inconclusive findings, we performed a meta-analysis of studies relating the FGB genetic polymorphism (-148C>T) to the risk of ischemic stroke. METHODS: We identified articles by searching PubMed, EMBASE, Chinese National Knowledge Infrastructure databases (CNKI), and Wanfang database in China and by reviewing the references of retrieved articles. We included studies that reported odds ratio (OR) with 95% confidence interval (CI) for the association between the FGB -148C>T polymorphism and stroke risk. Data from eligible studies were extracted for meta-analysis. Stroke risk associated with FGB -148C>T polymorphism was estimated by pooled ORs and 95% CIs. The software Review Manager (version 5.2) was utilized for meta-analysis. Publication bias was tested by funnel plot. RESULTS: Eighteen independent case-control studies containing 2159 ischemic stroke patients and 3222 control subjects were included. Our results showed that -148C>T polymorphism in the FBG gene was associated with increased risk of ischemic stroke ([TT+CT] vs. CC: OR=1.40, 95% CI [1.20-1.45], p<0.0001; T vs. C: OR=1.35, 95% CI [1.18-1.56], p<0.0001, respectively] by a meta-analysis. CONCLUSION: The results of our meta-analysis suggested that the-148C>T polymorphism in the FGB gene is a susceptibility marker of ischemic stroke.

Improvement of the suture-occluded method in rat models of focal cerebral ischemia-reperfusion.

The aim of the present study was to provide a simple method of establishing a rat model for focal cerebral ischemia-reperfusion (FCIR). The suture-occluded method was used to establish FCIR in male Sprague-Dawley rats. An incision was made over the bifurcation of the common carotid artery (CCA), through which a suture was inserted up to the internal carotid artery (ICA). The suture remained in the skin subsequent to model establishment and was withdrawn to the CCA to enable reperfusion. The reliability of the rat model was assessed via analysis of nerve function, tetrazolium (TTC) staining and pathological examination. Following FCIR in rats, the resulting neurological impairments were observed. TTC staining revealed infarcts and pathological examination revealed typical pathological changes. This modified method was simple, reliable and, therefore, may be used to investigate FCIR.

Associations of genetic polymorphisms of SAA1 with cerebral infarction.

BACKGROUND: Serum amyloid A protein (SAA) is both an inflammatory factor and an apolipoprotein. However, the relation between genetic polymorphisms of SAA and cerebral infarction (CI) remains unclear. METHODS AND RESULTS: The previously reported 4 Single Nucleotide Polymorphisms (rs12218, rs4638289, rs7131332, and rs11603089) of SAA1 gene were genotyped by TaqMan method in a case-control study including 287 cerebral infarction patients and 376 control subjects. We found rs12218 CC genotype and rs7131332 AA genotype were more frequent among CI patients than among controls (9.76% versus 3.19%, P = 0.001; 32.75% versus 24.20%; p = 0.017; respectively). After adjustment of confounding factors such as sex, age, smoking, drinking, hypertension, diabetes, and lipids profile, the difference remained significant in rs12218 (P < 0.01, OR = 2.106, 95% CI: 1.811-7.121). CONCLUSION: Genetic polymorphism of SAA1 may be a genetic maker of cerebral infarction in Chinese.

Executive dysfunction in patients with cerebral hypoperfusion after cerebral angiostenosis/occlusion.

Impairment of executive functions (EFs) was investigated in patients with cerebral hypoperfusion after cerebral angiostenosis/occlusion. Several EFs were measured in patients with cerebral angiostenosis/occlusion and healthy subjects. The vascular conditions, regional cerebral blood flow (rCBF), regional cerebral blood volume (rCBV), mean transit time (MTT), time to peak (TTP), and delay time were assessed. The scores of the vascular stenosis/occlusion group were significantly lower than those of the control group. rCBV and rCBF were negatively correlated with the error response times in the Stroop test, and the persistent error responses in the Wisconsin Card Sorting Test (WCST) were positively correlated with the Montreal Cognitive Assessment (MoCA) scores. TTP was positively correlated with the reaction and error reaction times, and the persistent error response in WCST was negatively correlated with the times of sorting in WCST and MoCA scores. MTT was positively correlated with the persistent error response in WCST. In the Stroop test, delay time was positively correlated with response time, and negatively correlated with error response times, and the persistent error response in WCST and MoCA scores. Patients with cerebral hypoperfusion after cerebral angiostenosis/occlusion had executive dysfunctions in working memory, sustained attention, response inhibition, cognitive flexibility, thought organization, planning, and implementation. Moreover, their executive dysfunctions were related with the decline in rCBF and rCBV. The prolonged TTP, MTT, and delay time suggested a slow blood flow and the poor compensation of collateral circulation, resulting in impairment of the EFs.

Study on drug resistance of Pseudomonas aeruginosa plasmid-mediated AmpC ß-lactamase.

The aim of the present study was to investigate the resistance of plasmid-mediated AmpC ß-lactamase in Pseudomonas aeruginosa, to detect and identify the AmpC genotype and to provide evidence for antibiotic applications in the clinic. Resistance phenotype in 108 strains of clinically isolated P. aeruginosa was determined by Kirby-Bauer disk test and cefoxitin three dimensional test in AmpC-positive strains. Plasmids were extracted from AmpC-positive strains using the SDS-alkali splitting technique. The depurated plasmid was used to amplify AmpC ß-lactamase genes by PCR. Positive PCR products were sequenced by the Shanghai Sangon Biological Engineering Technology Company. Gene homology of PCR products with other index sample gene sequences was compared. In the present study, 28 AmpC enzyme-positive P. aeruginosa strains among 108 were identified. Multidrug­resistance to antibiotics was observed in positive AmpC P. aeruginosa strains and a new P. aeruginosa strain of plasmid-mediated CMY-7 type AmpC enzyme was identified. In addition, AmpC type ß-lactamases were revealed to be important in the resistance mechanism to antibiotics in P. aeruginosa. This is the first report of CMY-7 plasmid­mediated AmpC enzyme expression in P. aeruginosa.