[Paroxysmal kinesigenic dyskinesia: 2 case reports].

Paroxysmal kinesigenic dyskinesia (PKD) is a rare neurological condition in which brief and frequent dyskinetic attacks are provoked by sudden movement. PKD is more common in men and can be idiopathic (commonly familial) or due to a variety of causes. The pathophysiology of PKD is uncertain but it could be an ion-channel disorder. Genetic linkage studies have isolated several loci on chromosome 16, and proline-rich transmembrane protein 2 (PRRT2) has been identified as a causative gene of PKD by using a combination of exome sequencing and linkage analysis. Antiepileptic drugs, particularly, carbamazepine are very helpful in a large proportion of cases. Sometimes it can be difficult to distinguish this syndrome from epilepsy. We reported 2 patients who presented abnormal involuntary attack. Evaluations included general physical examinations, endocrinologic and metabolic studies, video electroencephalograms and brain MRI imaging. All of these studies were normal. All of symptoms showed excellent response to carbamazepine.

Investigation of canopy interception characteristics in slope protection grasses: A laboratory experiment.

Canopy interception significantly affects hydrological processes such as infiltration, runoff and evapotranspiration. Research on grass canopy interception remains limited, and the experimental methods employed differ substantially. To thoroughly investigate the canopy interception characteristics of grass and clarify the methodological differences, five commonly utilized slope protection grass species in temperate regions were cultivated in a laboratory setting, and their canopy interception characteristics were experimentally investigated using the water-balance method (WBM), the water-wiping method (WWM) and the water-immersion method (WIM), respectively. The results showed that the WBM is more accurate for measuring canopy interception in grass, whereas both the WWM and the WIM underestimate grass canopy interception capacity. The canopy interception capacity measured by the WBM was 1.61-2.09 times higher than that of the WWM and 1.93-3.47 times higher than that of the WIM. Grey correlation analysis of the eight evaluated factors indicated that leaf area is the most influential factor affecting canopy interception in grass, followed by rainfall amount, dry mass, rainfall intensity, canopy projection area, leaf contact angle, fresh weight, and average height. There is a negative power function relationship between the interception ratio and the rainfall amount. With increasing rainfall intensity, the canopy interception capacity initially increases and then decreases, peaking at rainfall intensities of 15 to 20 mm/h. Leaf contact angle is a key quantifiable parameter that explains the differences in canopy interception among different grass species, and the canopy interception per unit leaf area decreases as the leaf contact angle increases. This study demonstrates that the WBM provides the most accurate measurements of grass canopy interception compared to the WWM and WIM, and highlights the leaf contact angle as a key factor in explaining interspecies differences. These findings could enhance the understanding of grass canopy interception and guide the selection of experimental methods.

A triple-source CT system for micro-scale investigation of geological materials: A simulation study.

A triple-source CT system is proposed for micro-scale testing of geological materials. This study aims at reducing the projection acquisition time by two-thirds compared to a conventional single-source CT system. The proposed system with different positioning errors in the source-to-object distance (SOD) was simulated and tested using the Shepp-Logan phantom model, as well as slices of sand, glass beads, and concrete samples. Furthermore, the imaging quality of a single-source and the triple-source CT system with different dead detector pixels was compared. The results showed that within the maximum allowable positioning error, the pixel differences between the simulated and the original images are close to zero, and the structural similarities are greater than 0.96. In the presence of dead detector pixels, the quality of the simulated images in the triple-source CT system is superior to that of a single-source CT system. The presented triple-source CT system performs well in high-quality image reconstruction.

[Atherosclerotic stenosis of intracranial and extracranial cerebral arteries in patients with cerebral infarction and the correlative factors].

OBJECTIVE: To investigate the distribution of atherosclerotic stenosis of cerebral arteries in Chinese patients suffered from cerebral infarction, and to determine if there are any factors correlating with intracranial and extracranial atherosclerosis. METHODS: For this study, we enrolled 428 consecutive in-patients with cerebral infarction, All patients were examined with transcranial Doppler ultrasonography (TCD) and carotid duplex ultrasound to detect atherosclerotic lesions in intracranial and extracranial cerebral arteries, some also were examined by magnetic resonance angiography (MRA) and/or digital subtraction angiography (DSA), they were all diagnosed as atherosclerotic cerebral artery stenosis. The patients were divided into three groups according to the different location of lesions, the frequency of risk factors of atherosclerosis and the demographic parameters were compared among these groups. RESULTS: 199 cases (46.5%) had only intracranial artery stenosis, 129 cases (30.1%) had only extracranial artery stenosis, 100 cases (23.4%) had both intracranial and extracranial stenosis (combine group). Compared with the other two groups, the levels of total cholesterol and low density lipoprotein-cholesterol of the intracranial artery group are both significantly higher (TC: P(1) = 0.001, P(2) = 0.000; LDL-C: P(1) = 0.004, P(2) = 0.039), the combine group had a significant higher ratio of male than that of the intracranial artery group(P = 0.003), there were no any other atherosclerosis risk factors had association with the location of cerebral artery stenosis. CONCLUSION: The occurrence of stenosis in intracranial arteries is more frequent than that in extracranial arteries in Chinese patients with cerebral infarction, and the lipid level is higher in the intracranial artery group, most risk factors of atherosclerosis may not be major determinants of location for cerebral atherosclerosis.

[Expressions of PDCD5 and other apoptosis-related proteins in muscle of patients with mitochondrial cytopathy].

OBJECTIVE: To investigate the expression of PDCDS, Caspase-3, Bcl-2 and Bax in skeletal muscle of patients with mitochondrial encephalomyopathies with lactate acidosis and stroke like episodes (MELAS), limb-girdle type mitochondrial myopathy (LGMM) and chronic progressive external ophthalmoplegia (CPEO), and to explore the correlation between apoptosis and the pathogenesis of mitochondrial cytopathy. METHODS: Three patients with MELAS, 2 patients with LGMM and 6 patients with CPEO were enrolled, including eight males and three females, the diagnosis of MELAS, LGMM or CPEO was made on the basis of clinical manifestations, muscle biopsy specimen findings and a point mutation or a large-scale mitochondrial DNA deletion. Controls consisted of 11 muscle biopsy samples from subjects with no diagnostic findings (age and gender matched with patients'). Muscle biopsy was performed after obtaining the informed consent. The specimens were quickly frozen and transverse sections stained for hematoxylineosin, periodic acid Schiff reaction, oil red "0", modified Gomori trichrome, ATPase, NADH-TR, succinate dehydrogenase, cytochrome c oxidase, and nonspecific esterase. The expression of PDCD5, Caspase-3, Bcl-2 and Bax were detected by immunohistochemistry. The authors used the tissue slices of prostate or tonsil containing the target protein as positive control and PBS in place of these primary antibodies as negative control. RESULTS: PDCDS was highly expressed in some ragged red fibers in 2 patients with LGMM and 3 patients with CPEO. And it was also expressed in some capillary of patients with MELAS and LGMM. Caspase-3 was expressed in a few ragged red fibers in 1 patients with MELAS, 2 patients with LGMM and 1 patient with CPEO. And there was also expression in some capillary of both MELAS and LGMM. Bcl-2 staining showed a high expression in sarcoplasm of some ragged red fibers and atrophic fibers in 4 patients with MELAS, 2 patients with LGMM and 5 patients with CPEO, at the same time, it was weakly expressed in sarcoplasm of all type 2 muscle fibers and some small vessels of both patients and controls. There was no Bax immunoreactive fiber or vessel in MELAS, LGMM and CPEO patients. All of the above-mentioned proteins except Bcl-2 were negative in muscle fibers and vessels of controls. CONCLUSION: Abnormal regulation of apoptosis is involved in the pathophysiology of mitochondrial cytopathy. And PDCDS, Bcl-2 and Caspase-3 take part in regulation.

Efficacy and Safety of Chinese Herbs for the Prevention of the Risk of Renal Damage in Henoch-Schonlein Purpura in Children: Meta-Analysis of Randomized Controlled Trials and GRADE Evaluation.

Objective. To evaluate the efficacy and safety of traditional Chinese medicine in preventing kidney damage caused by Henoch-Schonlein Purpura (HSP) in Children by meta-analysis. Methods. We systematically searched the main Chinese and English electronic databases and collected randomized controlled trials of Chinese herbs in children with HSP until July 2018. Then we used the bias risk assessment tool in Cochrane Handbook 5. 1. 0 to complete the risk assessment of the included studies. We utilized STATA12.0 and RevMan 5.3 for meta-analysis and GRADE pro. for quality evaluation of evidence. Result. (1) Meta-analysis: data from 39 studies, representing 3643 individuals, were included in the analysis. Thirty-seven studies were treated with traditional Chinese medicine for clearing away heat and cooling blood, which were combined. On this basis, subgroup analysis was conducted according to the bias risk of the original study. It showed that Chinese herbs can significantly improve the treatment effect (OR: 4.31, 95% CI [3.34, 5.57], P < 0.01) and reduce the risk of renal damage (RR: 0.36; 95% CI [0.21, 0.61], P < 0.01) and the risk of recurrence (RR: 0.43, 95% CI [0.34, 0.54], P<0.01). (2) Side effect: a total of 7 studies described adverse reactions, and 12 of 319 patients in therapy group had adverse events and 20 of 263 patients in control group. (3) Publication bias: the bias risk Egger's test for the incidence of kidney injury was P=0.572, the relapse rate Egger's test was P=0.175, the efficiency was combined with the low-risk original study, and the bias risk Egger's test was P=0.175. There was not any significant publication bias based on the funnel plot and Egger's test. (4) GRADE evaluation: GRADE evaluation showed that the quality of evidence in the risk of renal damage and recurrence rate was moderate. Conclusion. Chinese medicine treatment can prevent the occurrence of renal damage in children with HSP and can reduce the recurrence rate, the incidence of adverse reactions, and the effect in terms of efficiency. However, the quality of the included studies in the meta-analysis and the quality of the evidence of outcomes were not high; the clinical use of the evidence needs to be cautious.

Distinctive functional deficiencies in axonal conduction associated with two forms of cerebral white matter injury.

AIMS: This study determines whether assessment with compound action potentials (CAPs) can distinguish two different forms of cerebral white matter injury at the functional levels. METHODS: A pure demyelination model was induced in C57/BL6 adult mice by dietary supplementation of cuprizone (0.2%) for 6 weeks. Callosal L-N5-(1-Iminoethyl) ornithine (L-NIO) hydrochloride (27 mg/mL) was injected into the corpus callosum (CC) to induce a focal white matter stroke (WMS), resulting in both demyelination and axonal injury. White matter integrity was assessed by performing CAP recording, electron microscopy, and immunohistological and luxol fast blue (LFB) staining. RESULTS: Immunohistological and electron microscopic analyses confirmed the induction of robust demyelination in CC with cuprizone, and mixed demyelination and axonal damage with L-NIO. Electrophysiologically, cuprizone-induced demyelination significantly reduced the amplitude of negative peak 1 (N1), but increased the amplitude of negative peak 2 (N2), of the CAPs compared to the sham controls. However, cuprizone did not affect the axonal conduction velocity. In contrast, the amplitude and area of both N1 and N2 along with N1 axonal conduction velocity were dramatically decreased in L-NIO-induced WMS. CONCLUSIONS: Concertedly, parameters of the CAPs offer a novel functional assessment strategy for cerebral white matter injury in rodent models.

Increased Soluble CD137 Levels and CD4+ T-Cell-Associated Expression of CD137 in Acute Atherothrombotic Stroke.

As a proinflammatory cytokine, CD137 (4-1BB, TNFRSF9) is present in membrane-bound and soluble forms. Increased expression of CD137 was recently found in T cells in human atherosclerotic plaques. However, the exact role of CD137 in ischemic stroke is not clear. In this study we analyzed the protein levels of soluble CD137 (sCD137) and the expression of CD137 on CD4+ T cells in the peripheral blood of patients with acute atherothrombotic stroke by using the cytometry beads array (CBA) and flow cytometry. Within 24 hours of onset, the stroke patients showed elevated levels of sCD137 (2.7 pg/ml) and CD137 expression on CD4+ T cells (4.9 ± 3.2%) compared with normal controls (1.1 pg/ml, P < 0.01; 1.3 ± 1.0%, P < 0.01). Alterations in CD137 expression may enhance ischemia-induced inflammatory responses via bidirectional signaling and, consequently, aggravate brain injury in early stages of this disorder.

Treatment of late lithium-pilocarpine-induced status epilepticus with diazepam.

PURPOSE: It is well known that status epilepticus (SE) becomes increasingly difficult to control over time. Previous studies have indicated that the electroencephalographic pattern at the time of intervention is predictive of the probability of successful treatment. However, these findings are based on studies limited to the first 2h of SE onset. Little data is available on the efficacy of treating SE at later time points. METHODS: The aim of the present study was to investigate the efficacy of diazepam (DZP) treatment given at two different phases of SE in a lithium-pilocarpine rat model: during continuous ictal discharges (CIDs, phase 3), and during late periodic epileptiform discharges (late PEDs, phase 5). Changes in cortical and hippocampal electroencephalographs (EEGs) were observed continuously during the phases of SE, as well as at 24, 36, 48, and 72h after SE onset. The effects of DZP treatment during CIDs or during late PEDs were compared to control DZP-untreated rats. RESULTS: In all three groups, hippocampal and cortical EEGs displayed five distinct phases of SE. There were no statistical differences in the duration of phases 1 and 2 among the three groups. Although DZP administration during CIDs did not terminate CIDs in most rats, it did significantly shorten the duration of phases 3 and 4 of SE. Importantly, DZP given during phase 5 successfully ended behavioral and electrographic seizures in most rats. CONCLUSIONS: Hippocampal and cortical EEGs displayed five distinct phases of SE that were similarly responsive to DZP treatment. Termination of electrographic seizures with DZP treatment was more effective in the last phase of SE (late PEDs) than in phase 3 (CIDs). These findings suggest that previous reports of DZPs decrease in efficacy over time may not be applicable to DZP treatment at 4h-post onset.

Characteristics of hippocampal volumes in healthy Chinese from MRI.

BACKGROUND/OBJECTIVES: The volume of hippocampus has been associated with a number of disorders and would be helpful in clinical and research practice. This study provided the normal data of hippocampal volumes in a healthy Chinese sample and assessed the possible effects of age, gender and side on it. METHODS: Sixty-one normal participants with a broad age span from 6 to 82 years were enrolled in the study. The hippocampal volumes of them were obtained from oblique coronal MR images using inversion recovery (IR) sequence and normalized to adjust intersubject variation in head size. RESULTS: The corrected volume in the right side of hippocampus was 2.204-2.944 cm(3), and 2.068-2.700 cm(3) in the left. There were no statistically significant differences among different age and gender groups (p>0.05). The volume of right hippocampus was larger than that of the left side (p<0.001). CONCLUSIONS: We presented the volume range of hippocampus in healthy Chinese on MRI in this study. No age and gender effects were found on hippocampal volumes. Side-to-side asymmetry was obtained by statistical analysis.

[Memory T cell subsets in peripheral blood of patients with multiple sclerosis].

OBJECTIVE: To investigate the phenotypes of memory T cell subsets in the patients with multiple sclerosis (MS) and further explore the mechanisms that lead to the changes of the memory T cell subsets. METHODS: Peripheral blood samples were collected from 20 MS patients, 9 with relapsing-remitting MS (RRMS) and 11 with secondary progressive multiple sclerosis (SPMS), 20 patients with cerebral infarction (disease control group), and 22 healthy persons (healthy control group). Flow cytometry and ELISA were used to detect the phenotypes of the memory T cell subsets and plasma concentration of interleukin-15 (IL-15). RESULTS: The level of CD8+ TCM of the MS group was 20% +/- 11%%, significantly higher than that of the healthy control group (13% +/- 6%, P < 0.05). The level of the CD8+ terminal effector memory T cells of the MS group was 24% +/- 15%, significantly lower than that of the healthy control group (39% +/- 19%, P < 0.05). The plasma IL-15 level of the MS group was 36.01 pg/m, significantly higher than that of the healthy control group (9.53 pg/ml, P < 0.05). CONCLUSION: The upregulation of CD8+ TCM in the MS patients may reflect a persistent chronic inflammatory response that may have been induced during early stages of the disease, while IL-15 may participate in the immunoregulatory process of promoting TCM differentiation.

Characteristics of elevated cardiac troponin I in patients with acute ischemic stroke.

OBJECTIVE: To study prognostic characteristics of cardiac troponin I (cTnI) elevation in acute ischemic stroke. METHODS: We retrospectively studied patients (n = 248) with acute ischemic stroke, acute ST-segment elevation myocardial infarction, and acute non-ST-elevation myocardial infarction who were treated between January 2013 and October 2015. Baseline demographic data and changes in cTnI levels among these three groups were compared. Patients with acute ischemic stroke were assigned to either the cTnI elevation group (cTnI > 0.034 ng/mL) or the no cTnI elevation group (cTnI ≤ 0.034 ng/mL). Logistic regression analysis was used to identify risk factors associated with elevated serum cTnI in patients with acute ischemic stroke. Moreover, the duration of hospital stay and incidence of major cardiovascular outcomes were compared in patients with acute ischemic stroke, with or without elevated cTnI. RESULTS: In this study population of patients with acute ischemic stroke (n = 178), acute ST-segment elevation myocardial infarction (n = 35), and acute non-ST-elevation myocardial infarction (n = 35), patients with acute ischemic stroke with elevated cTnI comprised 18.5% of subjects. Patients with elevated cTnI were older and more likely to have a history of hypertension. In addition, these patients had higher levels of inflammatory markers, reduced renal functions, increased D-dimer levels, higher NIH stroke scores, and lower left ventricular ejection fractions. Logistic regression analysis showed that both percentage of neutrophil and NIH stroke scores were elevated; estimated glomerular filtration rate and left ventricular ejection fraction were decreased in patients with acute ischemic stroke who had elevated cTnI, and they had more frequent major cardiovascular events during hospital stay. CONCLUSION: Elevated cTnI detected in patients with acute ischemic stroke, indicated a greater likelihood of poor short-term prognosis during hospital stay.

[Cognitive function and psychological characteristics of patients with chronic fatigue syndrome].

OBJECTIVE: To investigate the cognitive function and psychological characteristics of the patients with chronic fatigue syndrome (CFS) in China and analyze its relation with primary psychological diseases. METHODS: Ninety-one patients with CFS who visited the People's Hospital, Peking University, in Beijing from Beijing, Shanghai, Tianjin, Heilongjiang, Jilin, Hebei, Inner Mongolia, Shanxi, Shandong, Sichuan, Gansu, Fujian, and Guangdong, 42 males and 49 females, aged 37 +/- 7, 43% of which had the record of formal schooling of regular college course or over and 21 of which had the record of formal schooling of college for professional training, and 58% of which showed clear causes, diagnosed by the CDC criteria 1994, underwent case history collection, physical examination, necessary laboratory test, memory test, and SCL-90, Hamilton depression rating scale (HAMD), and Hamilton anxiety rating scale (HAMA) testing. Thirty healthy persons, 14 males and 16 females, aged 37 +/- 7, were used as controls., A table of case file was established based on the CDC criteria 1994 for each patient to record the relevant data. Independent-Samples T Test was used to compare the memory quotient, the total score and general mean score of SCL-90, the score of HAMD and HAMA. Analyzed the impairment of cognitive function and psychological characteristics of patients with CFS. RESULTS: The most common symptoms was descent of remembrance and/or attention (82/91, 90%). The memory quotient of the CFS patients was 85 +/- 14, significantly lower than that of the healthy controls (98 +/- 12, t = 4.627, P = 0.000). The total score of SCL-90 of the CFS patients was 192 +/- 47, significantly higher than that of the healthy controls (140 +/- 46, t = 5.297, P = 0.000). The symptoms with a factor score > or = 2.0 in SCL-90 included obsessive-compulsive symptoms (61/91, 67%), somatization (61/91, 67 %), depression (57/91, 63%), and anxiety (49/91, 54%). The HAMD score of the CFS patients was 9.9 +/- 6.1, significantly higher than that of the healthy controls (6.5 +/- 2.5, t = 2.948, P = 0.004). The HAMA score of the CFS patients was 9.9 +/- 7.0, significantly higher than that of the healthy controls (5.9 +/- 2.9, t = 3.015, P = 0.003). CONCLUSION: The CFS patients in China have an obvious impairment of remembrance and show different psychological abnormalities that are different from those of the patients with primary psychological diseases.

Spontaneous aching pain and peculiar involuntary movements: a case report of painful legs and moving toes and review of the literature.

Painful legs and moving toes (PLMT) is a rare syndrome characterized by spontaneous neuropathic pain and peculiar involuntary movements in the lower limbs, especially the toes and feet. As it is a relatively rare disorder worldwide, the exact pathophysiology still remains a mystery. Until recently, numerous methods of clinical treatments have been tried; however, the success rate of the therapies is still very low. Here, we report a case of PLMT and also summarize the recent clinical and research literatures regarding clinical presentation, electrophysiological features, etiology, treatment methods, and prognosis of this disorder. Doctors should be aware of this rare syndrome in a patient with painful and/or restless legs. On the other hand, multiple clinical treatments should be tried, even those which usually produce a poor outcome.

[In vivo migration of mesenchymal stem cells].

Mesenchymal stem cells (MSC) have the capacities of low immunogenicity, multiple differentiation, hematopoietic supporting and immunoregulation. And due to their relative ease of availability and ex vivo expansion, the applications of MSC in the prevention and treatment of clinical disease have been rapidly expanded in the recent years. However, increasing investigations indicate that intravenously infused MSC widely distribute to various organs of the recipients. The two intended clinical goals of adoptive cellular therapy reached to the greatest efficiency. Therefore, the ideal candidate cells showed to have the capacity of site-specific relocation in vivo. In this review, the distribution characteristics of infused MSC and the recent research advances on the strategies to enhance targeted migration of MSCs are summarized.

Application and performance of two stroke outcome prediction models in a chinese population.

OBJECTIVE: To apply and examine the performance of 2 acute stroke outcome prediction models, the Six Simple Variable Model (SSV model) and the One-Year Mortality Model (OYM model), in patients in China who had either a cerebral infarction or a cerebral hemorrhage. DESIGN: An observational study that used both retrospective and prospective study methods. SETTING: A regional acute care facility in China. PARTICIPANTS: Two hundred and forty-eight consecutive patients who had an acute stroke who were admitted to the hospital between October 2007 and March 2009. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Survival and daily activity independence 6 months after a stroke and 1-year mortality. RESULTS: The study sample had a mean age of 68.6 years (standard deviation, 11.1); 52.8% of the subjects were men, 66.5% had a cerebral infarction, and 33.5% had a cerebral hemorrhage. In the cohort, 107 patients (43.1%) achieved daily activity independence at 6-month follow-up, and 52 patients (21.0%) had died within 1 year. The area under the receiver operating characteristic curve (ROC) was 0.966 (0.935-0.998) for patients who had a cerebral infarction and 0.859 (0.766-0.952) for patients who had a cerebral hemorrhage in the prediction of 6-month survival and daily activity independence with use of the SSV model. The area under the ROC curve was 0.894 (0.846-0.965) for patients who had a cerebral infarction and 0.937 (0.904-0.988) for patients who had a cerebral hemorrhage in the prediction of 1-year mortality when the OYM model was used. CONCLUSIONS: Both the SSV and OYM prognostic models can be used for function and mortality outcome prediction for patients in China who have had a stroke. Variation existed in the precision of prediction between patients who had a cerebral infarction and those who had a cerebral hemorrhage. Other potential factors influencing functional recovery and mortality after stroke must be considered in outcome prediction.

Increased CD8+ central memory T cells in patients with multiple sclerosis.

A T-cell-mediated autoimmune process against central nervous system myelin is believed to underlie the pathogenesis of multiple sclerosis (MS). Formation of immunological memory is based on the differentiation of naïve T cells to memory T cells after exposure to antigens and specific cytokines. The aim of this study was to analyse peripheral blood mononuclear cells in patients with MS for different T-cell subsets including naïve and memory T cells. Flow cytometry and enzyme-linked immunosorbent assay were used to analyse memory T-cell subsets and plasma concentration of interleukin-15 (IL-15) in peripheral blood of MS patients, patients with other neurological disorders and healthy controls. MS patients had a skewed distribution of T cells with an increased level of CD8+/CCR7+/CD45RA - central memory T cells (TCM) compared to healthy controls. In addition, MS patients showed significantly higher levels of plasma IL-15 than healthy controls did. Upregulated CD8+ TCM in MS patients may reflect a persistent chronic inflammatory response that may have been induced during early stages of the disease. This derangement may be important for maintaining chronic inflammation in MS.

Facile synthetic route to enantiopure unsymmetric cis-2,5-disubstituted pyrrolidines.

The (+/-)-cis-5-arylcarbamoyl-2-ethoxycarbonylpyrrolidines 6a-g were firstly synthesized in 53-64% yields by using meso-diethyl-2,5-dibromoadipate 3 and (S)-(-)-1-phenylethylamine in three steps. The diastereomeric mixture (S;2S,5R)-(-)-7 and (S;2R,5S)-(+)-8 were prepared by the Grignard reaction and separated by a flash column chromatography in 29 and 52% yields. The absolute configurations of (+)-8 was confirmed by X-ray crystallographic analysis and the enantiopure pyrrolidines (2S,5R)-(-)-9/(2R,5S)-(+)-9 and (2S,5R)-(-)-10/(2R,5S)-(+)-10 were obtained in good yields.

Gene polymorphism of platelet glycoprotein I balpha in Chinese patients with large- and small-artery subtypes of ischemic stroke.

The platelet surface glycoprotein (GP) I balpha, an important part of the GP I b-IX-V complex, participates in the formation of thrombosis by initially mediating platelet adhesion under high shear stress. The purpose of present study was to investigate the association between gene polymorphism of GP I balpha (human platelet antigen 2, HPA2) and ischemic stroke in a matched case-control study. One hundred patients and 100 matched controls were enrolled in the study. The cases were divided into large- and small-vessel subtypes of ischemic stroke according to Trial of Org10172 in Acute Stroke Treatment criteria. Genotyping for GP I balpha polymorphism was documented by polymerase chain reaction amplification and restriction enzyme analysis. There were no statistically significant differences in the GP I balpha HPA2 genotype distribution between ischemic stroke group, large-vessel subtype group, small-vessel subtype group and corresponding control groups. The heterozygote genotype of GP I balpha HPA2 was more frequent in the large-vessel subtype group (16.1%) than in the small-vessel subtype group (10.1%), but the difference was not statistically significant. Ourresults suggest that the polymorphism of the GP I balpha HPA2 genotype might not be a genetic risk factor of ischemic stroke.