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Cerebral infarction, with high incidence, high mortality, high disability and high recurrence rates, can impose a serious burden on families and society. After cerebral infarction occurrence, neurons, as the fundamental structures of the central nervous system, are unable to renew or multiply after death; hence, full recovery from neurological impairments following cerebral infarction is challenging. With stem cell and genetic recombination advancements, cellular replacement therapy after cerebral infarction progresses, which helps clinical transformation and application. In this paper, the basic researches of cellular replacement therapy after cerebral infarction are reviewed from 3 aspects: endogenous nerve regeneration, exogenous stem cell transplantation, and in situ somatic cell trans-differentiation into neurons, in order to provide references for cerebral infarction treatment
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Objective:To evaluate the efficacy and safety of reperfusion therapy in patients with wake-up stroke (WUS) under the guidance of "tissue-window" by comparing with patients with non-WUS who received reperfusion therapy within "time-window".Methods:Two hundred and thirty-five acute ischemic stroke patients admitted to our hospital from January 2018 to December 2019 were enrolled in our study. Patients with non-WUS received reperfusion therapy within "time-window"; patients with WUS accepted multimodal CT examination at Emergency right after admission, Mistar software was used to reconstruct CT perfusion imaging (CTP) images, and reperfusion therapy was given to these patients after the judgement of "tissue-window". The differences of clinical data, prognoses, and safety indexes were compared between patients with WUS and non-WUS.Results:In these 235 patients, 45 patients were with WUS and 190 were with non-WUS. As compared with patients with non-WUS, those with WUS had significantly lower percentages of patients with hypertension history and patients accepted intravenous thrombolysis ( P<0.05). In 153 patients accepted intravenous thrombolysis, 23 patients were with WUS and 130 were with non-WUS; the time from admission to intravenous thrombolysis in WUS patients was significantly longer than that in non-WUS patients ( P<0.05); the clinical data, prognoses, and safety indexes showed no significant differences between these patients with WUS and non-WUS ( P>0.05). In 82 patients accepted bridging thrombectomy and direct thrombectomy, 22 patients were with WUS and 60 were with non-WUS; the clinical data, prognoses, and safety indexes showed no significant differences between these patients with WUS and non-WUS ( P>0.05). Conclusion:By comparing with patients with non-WUS who received reperfusion therapy within "time-window", reperfusion therapy is effective and safe for WUS patients under the guidance of multimodal CT "tissue-window".
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Objective@#Symptomatic intracranial hemorrhage (sICH) is one of the severe complications of ischemic stroke thrombolysis. Several prognostic scales have been developed to predict the risk of sICH. The performance of seven scales was compared in a single center cohort.@*Methods@#Data of patients with consecutive ischemic stroke who received 0.9 mg/kg intravenous recombinant tissue plasminogen activator (rt-PA) thrombolysis within 4.5 h time window from stroke onset were collected. Seven scales that can provide an estimate of risk of sICH were identified and evaluated: Hemorrhage After Thrombolysis (HAT), blood Sugar, Early infarct signs, (hyper) Dense cerebral artery sign, Age, National Institutes of Health (NIH) Stroke Scale (SEDAN), Stroke Prognostication using Age and NIH Stroke Scale (SPAN)-100, Safe Implementation of Thrombolysis in Stroke (SITS), Total Health Risks In Vascular Events (THRIVE), Glucose at presentation, Race (Asia), Age, Sex (male), systolic blood Pressure at presentation, and Severity of stroke at presentation (NIH Stroke Scale; GRASPS) and Multicenter Stroke Survey (MSS). The area under the receiver operating characteristic curve (AUROC) was calculated and Logistic regression and the Hosmer-Lemeshow test were also performed.@*Results@#The current study included 293 patients, of whom 7.85% (23/293) had sICH by National Institute of Neurological Disorders and Stroke (SICHNINDS), 5.46% (16/293) by Europe Cooperative Acute Stroke Study Ⅱ (SICHECASSⅡ) and 4.44% (13/293) by Safe Implementation of Thrombolysis in Stroke (SICHSITS) criteria. SEDAN had the highest AUROC for predicting sICH: sICHNINDS: AUROC=0.843, OR=3.167, 95%CI 2.106-4.762, P<0.01; sICHECASSⅡ: AUROC=0.797, OR=2.509, 95%CI 1.652-3.812, P<0.01; sICHSITS: AUROC=0.784, OR=2.172, 95%CI 1.405-3.357, P<0.01. And SPAN-100 had the lowest AUROC among all the seven scales and was only associated with risk of SICHNINDS in regression analysis. Furthermore, when sub-grouped the cohort into anterior circulation infarction and posterior circulation infarction, regression analysis suggested that all the seven scales were however not associated with sICH risk in patients with posterior circulation infarction.@*Conclusions@#SEDAN constantly had the highest predictive power, SPAN-100 had the worst. The seven scales studied could not predict sICH in posterior circulation infarction.
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Ischemic stroke has the characteristics of high disability,high mortality,and high recurrence rate,and the abundant collateral circulation is an independent predictor of good outcomes in stroke.This article mainly elaborates the cytological and molecular mechanisms of vascular remodeling process after ischemic stroke in order to provide new ideas and targets for the treatment of ischemic stroke.
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Homocysteine is a risk factor for ischemic stroke.The association between homocysteine and ischemic stroke has been becoming a hot spot of research all over the world,but has not yet got a consistent result up to now.In this article,we reviewed the pathogenic mechanism,intervention,new treatment strategies,and summarized the current progress of the association of homocysteine with ischemic stroke.
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Objective:To investigate the effect of growth hormone on osteopontin expression during orthodontic tooth movement in rats.Methods:Forty male Wistar rats (2 weeks,average weight 200 g) were randomly divided into a control group and an experimental group (n=20 per group).The experimental group received subcutaneous injections of growth hormone at a dose of 0.15 U/(kg·d),and the control group received equivalent volumes of saline.A nickel-titanium spring was fixed between the maxillary incisors and the left upper first molar with a force of 0.49 N to move the molar mesially.All rats were sacrificed on day 3,7,10 or 14 with cardiac perfusion.And the left side of upper jaw was removed.The longitudinal section of the first molar was prepared from sagittal direction to observe osteopontin expression in the pressure area between the mesial buccal root and distal buccal root by immunohistochemical staining and semi-quantitative analysis.Results:The positive expression of osteopontin in the 2 groups showed similar trend,which was increased firstly and then was decreased.The expression of osteopontin on day 7 in the experimental group showed strong positive expression but it was decreased significantly on day 10 compared with the control group (P＜0.05).Conclusion:Systemic application of growth hormone could affect the expression of osteopontin and probably plays an important role in regulating bone resorption in the compression area during orthodontic tooth movement in rats.
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@#Recurrent cerebral infarction (RCI) is very common in clinical practice. Intracranial and extracranial vessels diseases closely associate with the recurrence of cerebral infarction. Hypertension, diabetes, high homocysteine, etc., result in vascular stenosis and more in-farction recurrence by atherosclerosis and arterial plaque formation. Study of the etiology of RCI is important for the secondary prevention of cerebral infarction.
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@#Objective To investigate the reliability and validity of Simple Facial Grading System (SFGS) in patients with idiopathic facial palsy. Methods 80 patients with idiopathic facial palsy were evaluated with the House-Brackmann (H-B) scale and SFGS before and every 2 weeks after treatment until 12 weeks or recovery. They were assessed by 2 testers before and 2 weeks after treatment. The results were analyzed and compared. Results The Cronbach's α coefficient was 0.93 of SFGS, and 0.74 of H-B scale. The intraclass correlation coefficient (ICC) between testers was 0.84 or higher of SFGS, and 0.77 or higher of H-B scale. The Spearman's rank correlation coefficient between SFGS and H-B scale was 0.73, Kappa coefficients was 0.81 for grade II, 0.74 for grade III, 0.49 for grade IV, 0.66 for grade V, and 0.92 for grade VI. The scores of SFGS and H-B scale positively correlated with the recovery time. Conclusion SFGS is a kind of evaluation for peripheral facial paralysis with satisified reliability and validity, which can be applied to evaluate the severity and outcome during acute stage.
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Objective To investigate the reliability and validity of Simple Facial Grading System (SFGS) in patients with idiopathic fa-cial palsy. Methods 80 patients with idiopathic facial palsy were evaluated with the House-Brackmann (H-B) scale and SFGS before and ev-ery 2 weeks after treatment until 12 weeks or recovery. They were assessed by 2 testers before and 2 weeks after treatment. The results were analyzed and compared. Results The Cronbach'sαcoefficient was 0.93 of SFGS, and 0.74 of H-B scale. The intraclass correlation coeffi-cient (ICC) between testers was 0.84 or higher of SFGS, and 0.77 or higher of H-B scale. The Spearman's rank correlation coefficient be-tween SFGS and H-B scale was 0.73, Kappa coefficients was 0.81 for grade II, 0.74 for grade III, 0.49 for grade IV, 0.66 for grade V, and 0.92 for grade VI. The scores of SFGS and H-B scale positively correlated with the recovery time. Conclusion SFGS is a kind of evaluation for peripheral facial paralysis with satisified reliability and validity, which can be applied to evaluate the severity and outcome during acute stage.
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@#Objective To investigate the reliability and validity of Simple Facial Grading System (SFGS) in patients with idiopathic facial palsy. Methods 80 patients with idiopathic facial palsy were evaluated with the House-Brackmann (H-B) scale and SFGS before and every 2 weeks after treatment until 12 weeks or recovery. They were assessed by 2 testers before and 2 weeks after treatment. The results were analyzed and compared. Results The Cronbach's α coefficient was 0.93 of SFGS, and 0.74 of H-B scale. The intraclass correlation coefficient (ICC) between testers was 0.84 or higher of SFGS, and 0.77 or higher of H-B scale. The Spearman's rank correlation coefficient between SFGS and H-B scale was 0.73, Kappa coefficients was 0.81 for grade II, 0.74 for grade III, 0.49 for grade IV, 0.66 for grade V, and 0.92 for grade VI. The scores of SFGS and H-B scale positively correlated with the recovery time. Conclusion SFGS is a kind of evaluation for peripheral facial paralysis with satisified reliability and validity, which can be applied to evaluate the severity and outcome during acute stage.
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AIM To study the effects of PDB on blood glucose. METHODS 3 groups of health mice and 3 groups of model mice were administered with high, mean and low doses of PDB compatibility groups (combined with glibenclamide 0.66 mg?kg -1) respectively for 15 days. The blood goucose variation of health and model mice was observed. RESULTS A low dose of PDB compatibility group decreased obviously blood glucose in the health mice. Its mean value was(3.10?0.14), while control group's blood glucose was 4.46?0.12, P