Analysis of the Relationship Between the Changes of Serum SAA, LP-PLA2, sCD40L and Carotid Atherosclerosis Plaque in Patients with Acute Cerebral Infarction.

Objective: To explore the relationship between Serum amyloid protein A(SAA), lipoprotein-associated Phospholipase A2 (Lp-PLA2) and soluble CD40 ligand (sCD40L) in detecting the stability of carotid Atherosclerosis plaque. Methods: We examined 90 patients admitted to our hospital with acute cerebral infarction from July 2020 to December 2022. Carotid artery ultrasounds were performed for all of them. These patients were then divided into two groups: the stable plaque group (45 cases) and the unstable plaque group (45 cases), based on the ultrasound results. Additionally, we included a control group of 30 healthy individuals from our hospital. We collected fasting blood samples from the patients upon admission and used enzyme-linked immunosorbent assays to measure the mass concentrations of sCD40L, Lp-PLA2, and SAA in their serum. The results of these biomarkers were compared and analyzed to assess potential associations with plaque stability in patients with cerebral infarction. Results: Comparison of general clinical data and laboratory data: except for High-density lipoprotein, there was a statistical difference between the control group and the cerebral infarction group (P < .05), there was no statistical difference in gender, smoking history, drinking history and age (P > .05). Compared with the control group, the mass concentrations of sCD40L, Lp-PLA2, and SAA in patients with stable and unstable plaques increased significantly (P < .05); Compared with the stable plaque group, the mass concentrations of sCD40L, Lp-PLA2, and SAA in unstable plaque patients increased with statistical significance (P < .05). Correlation analysis shows that the mass concentrations of sCD40L, Lp-PLA2, and SAA are positively correlated with the stability of carotid artery plaques. SCD40L, Lp-PLA2 and SAA have certain diagnostic significance in the subject's working characteristic curve (Receiver operating characteristic) as a marker molecule for the diagnosis of unstable plaque. sCD40L (AUC=0.883) has more diagnostic value than SAA (AUC=0.756) and Lp-PLA2 (AUC=0.826). A binary logistic regression analysis was conducted using the stability of carotid artery plaques as the dependent variable and sCD40L, Lp-PLA2, and SAA as independent variables. The results showed that elevated serum sCD40L, Lp-PLA2, and SAA were independent risk factors for unstable carotid artery plaques (P < .05). Conclusion: The concentrations of sCD40L, Lp-PLA2 and SAA are closely related to the formation and type of carotid Atherosclerosis plaque in patients with acute cerebral infarction. This has potentially important clinical implications for the management and prevention of cardiovascular disease.

Therapeutic effect of Danhong injection on diabetic patients with cerebral infarction and its influence on vascular endothelial function and hemodynamics.

To investigate the therapeutic effect of Danhong injection on diabetic patients with cerebral infarction and its influence on vascular endothelial function and hemodynamic level. A total of 100 diabetic patients with cerebral infarction admitted to our hospital from November 2019 to November 2020 were identified as the research subjects and randomly divided into a control group given routine treatment and a study group treated with Danhong injection, with 50 cases in each group. The efficiency of the two groups on vascular endothelial function, blood glucose level, National Institute of Health Stroke Scale (NIHSS) score, the incidence of adverse reactions, and hemodynamic indicators were compared. Most (98%) of patients in the study group displayed effective outcomes, which was significantly better than that in the control group. The study group outperformed the control study group in the vascular endothelial function, blood glucose level, NIHSS score and hemodynamic indicators (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Danhong injection obtains a promising therapeutic effect on diabetic patients with cerebral infarction, as it significantly improves the vascular endothelial function and hemodynamic level.

A Single-Center Clinical Study to Evaluate Shenxiong Glucose Injection Combined with Edaravone in the Treatment of Acute Large-Area Cerebral Infarction.

OBJECTIVES: To investigate the clinical efficacy and safety of Shenxiong glucose injection combined with edaravone in the treatment of acute large-area cerebral infarction. METHODS: 156 patients with acute large-area cerebral infarction admitted to our hospital from July 2015 to January 2017 were included in the analysis. The patients were randomly divided into experimental (78 cases) and control (78 cases) groups. Patients in the experimental group were given a 30 mg injection of edaravone in 100 ml of 0.9% sodium chloride solution by intravenous drip, twice a day within 30 minutes and a daily 200 ml injection of Shenxiong glucose by intravenous drip. Patients in the control group were given a 30 mg edaravone injection in 100 ml of 0.9% sodium chloride solution by intravenous drip, twice a day, and the drip was completed within 30 minutes. Patients in both groups were treated for 2 weeks. The levels of fibrinogen (FIB), D-dimer, interleukin 6 (IL-6), P-selectin (CD62P), and hypersensitive C-reactive protein (hs-CRP) were evaluated in the two groups of patients. Neurological disability was evaluated using the modified Rankin scale (mRS) and the neurological deficit score (National Institute of Health Stroke Scale, NIHSS). Adverse reactions to the treatments were also recorded. RESULTS: No significant differences in age, gender, medical histories, and blood biochemical indices were observed between the two groups before treatment (P > 0.05). After treatment, the levels of FIB, D-dimer, IL-6, CD62P, and hs-CRP were significantly lower following treatment and compared to the control group (P < 0.05). Also, the mRS and NIHSS scores were significantly lower after treatment and compared with the control group (P < 0.05). The total effective rate of the treatment in the experimental group was significantly higher compared to the control group (P < 0.05). During the treatment period, no obvious adverse reactions were observed in the two groups of patients. CONCLUSIONS: In addition to the routine basic treatment of acute large-area cerebral infarction, the addition of Shenxiong glucose injection combined with edaravone injection can improve platelet aggregation and reduce inflammation by affecting P-selectin, D-dimer, and FIB. This treatment approach promotes the recovery of nerve defect function without obvious adverse reactions in patients with acute large-area cerebral infarction.

Salvianolate injection in the treatment of acute cerebral infarction: A systematic review and a meta-analysis.

To evaluate the effectiveness and safety of Salvianolate injection (SI) in the treatment of acute cerebral infarction (ACI).We electronically searched databases including PubMed, The Cochrane Library, EMBASE, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure, and WanFang Data to collect randomized controlled trials (RCTs) focused on SI treating ACI up to August 2017. Two reviewers independently screened literatures, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software.A total of 39 RCTs involving 4516 patients were included. The results of meta-analysis showed that compared with the Western medicine (WM) therapies group [experimental group (EG)], the total effective rate of SI + WM [control group (CG)] was higher (relative risk = 1.29, 95% CI: 1.24-1.35, P < .00001) in 21 RCTs; SI could improve movement function evaluation scores, including National Institute of Health Stroke Scale, Barthel Index, activities of daily living (P < .00001). There was no significant difference in modified Rankin Scale scores between the 2 groups (P = .008) EG was better than CG in improving Montreal Cognitive Assessment scores (P = .001) and Mini-Mental State Examination scores (P < .00001). SI could improved not only the hemorheology indexes, including plasma viscosity, whole blood high-shear viscosity, whole blood low-shear viscosity, fibrinogen (P < .00001), but also high-sensitivity C-reactive protein and C-reactive protein. EG could achieve a better effect on improving the neural deficit scores (P < .00001). There was no significant difference about adverse drug reactions/adverse drug events between the EG and CG (P = .73).Salvianolate can promote recovery of the motor and cognitive function of patients with ACI. However, due to the limited quality and quantity of included studies, more high-quality studies are needed to verify the above conclusion.

Effects of Kudiezi Injection on Serum Inflammatory Biomarkers in Patients with Acute Cerebral Infarction.

BACKGROUND: Kudiezi injection is a traditional Chinese medicine for acute cerebral infarction, but the exact mechanisms are poorly understood. OBJECTIVE: To investigate the mechanisms of Kudiezi injection on the inflammatory response in the treatment of acute cerebral infarction. METHODS: This was a prospective study of patients with acute cerebral infarction within 48 h of onset and treated between July 2012 and July 2016 at three hospitals in China. The patients were randomized to routine treatments (control group) versus routine treatments and Kudiezi injection (Kudiezi group). The National Institutes of Health Stroke Score was assessed on days 1, 3, 5, 7, and 14. The patients were tested for serum levels of pro- and anti-inflammatory cytokines (S100 calcium-binding protein B, neuron-specific enolase, interleukin-6, interleukin-10, interleukin-18, and matrix metaloproteinase-9; by enzyme-linked immunosorbent assay) immediately after admission and on days 3, 5, and 14. RESULTS: Stroke scores were improved in both groups from days 1 to 14. On days 5 and 7, stroke scores in the Kudiezi group were lower than in the control group (P < 0.05). Compared with controls, the Kudiezi group had lower serum S100 calcium-binding protein B on day 14; higher interleukin-6 and interleukin-10 on day 3; lower interleukin-6 and interleukin-18 on day 5; and lower interleukin-18 and matrix metaloproteinase-9 on day 14. CONCLUSION: Kudiezi injection could lead to early reduction of interleukin-6, interleukin-18, matrix metaloproteinase-9, neuron-specific enolase, and S100 calcium-binding protein B levels and increases of interleukin-10 levels in patients with acute ischemic stroke. This trial is registered with ClinicalTrials.gov NCT01636154.

Effects of Shaoyao-Gancao Decoction on Infarcted Cerebral Cortical Neurons: Suppression of the Inflammatory Response following Cerebral Ischemia-Reperfusion in a Rat Model.

The mechanisms by which Shaoyao-Gancao decoction (SGD) inhibits the production of inflammatory cytokines in serum and brain tissue after cerebral ischemia-reperfusion (CI-RP) in rats were investigated. A right middle cerebral artery occlusion was used to induce CI-RP after which the rats were divided into model (n = 39), SGD (n = 28), clopidogrel (n = 25) and sham operated (n = 34) groups. The Bederson scale was used to evaluate changes in behavioral indices. The levels of IL-1ß, TNF-α, MCP-1, IL-10, RANTES, VEGF, and TGF-ß1 in the serum and infarcted brain tissues were measured. Nissl body and immunohistochemical staining methods were used to detect biochemical changes in neurons, microglial cells, and astrocytes. Serum levels of VEGF, TNF-α, MCP-1, IL-1ß, and IL-10 increased significantly 24 h after CI-RP. In brain tissue, levels of TNF-α and IL-1ß significantly increased 24 h after CI-RP, whereas levels of TGF-ß1 and MCP-1 were significantly higher 96 h after CI-RP (P < 0.05). SGD or clopidogrel after CI-RP reduced TNF-α and IL-1ß levels in brain tissue and serum levels of MCP-1, IL-1ß, and IL-10. SGD increased the number of NeuN-positive cells in infarcted brain tissue and reduced the number of IBA1-positive and GFAP-positive cells. The efficacy of SGD was significantly higher than that of clopidogrel.

[Effect of Scalp-acupuncture Treatment on Levels of Serum High-sensitivity C-reactive Protein, and Pro-inflammatory Cytokines in Patients with Acute Cerebral Infarction].

OBJECTIVE: To observe the influence of scalp acupuncture on levels of high-sensitivity C-reactive protein (hs-CRP), TNF-α, IL-6, and IL-1ß levels in patients with acute cerebral infarction (ACl), so as to investigate its mechanism underlying improvement of ACI. METHODS: A total of 61 patients with ACI were randomly allocated to scalp acupuncture group (n = 31) and control (medication) group (n = 30). The patients of the control group were routinely treated by administration of Aspirin, Danhong injection, Cytidine Diphosphate for neurotrophy, blood pressure-control and blood-fat lowering medicines, etc., while those of the scalp acupuncture group were treated by routine treatment with the medicines mentioned above plus daily scalp acupuncture stimulation of bilateral Dingnieqianxiexian [MS 6, penetrative needling from Qianding (GV 21) to Xuanli (GB 6)] and Dingniehouxiexian [MS 7, from Baihui (GV 20) to Qubin (GB 7)]. The treatment was conducted once daily for 7 days. Serum hs-CRP, TNF-α, IL-6, and IL-1ß contents were assayed by using enzyme linked immunosorbnent assay (ELISA). The therapeutic effects of scalp acupuncture were evaluated by using clinical neurological disfunction scale (NDS, 0-45 points for consciousness, gazing, facial palsy, speech, myodynamia, walking-ability). RESULTS: (1) Of the 30 and 31 cases in the control and scalp acupuncture groups, 5 (16.7%) and 8 (25.8%) were basically controlled, 9 (30.0%) and 16 (51.6%) experienced remarkable improvement in their symptoms, 12 (40.0%) and 6 (19.4%) were improved, 4 (13.3%) and 1(3.2%) failed, with the effective rates being 86.7% and 96.8%, respectively. The increased levels of serum hs-CRP, TNF-α, IL-6 and IL-1ß in ACl patients were reversed on the 3rd and 7th day after scalp acupuncture treatment (P < 0.05, P < 0.01). (2) A positive correlation existed between the NDS score and the serum levels of hs-CRP (r = 0.497, P < 0.01). (3) NDS scores were obviously decreased in both groups on the 7th day after the treatment compared with their baseline data (P < 0.05, P < 0.01). CONCLUSION: Scalp acupuncture treatment can improve the ACI patients' clinical symptoms, probably by reducing ACl induced inflammatory reactions.

Effects of electroacupuncture on endothelial function and circulating endothelial progenitor cells in patients with cerebral infarction.

This study evaluated the effects of electroacupuncture (EA) on endothelial function and endothelial progenitor cells (EPC) in patients with cerebral infarction. In a randomized, placebo-controlled, crossover study, 20 patients with cerebral infarction were randomized into two treatment groups: EA or placebo. Before and after each intervention, pulse amplitude tonometry (PAT) was used to assess endothelial function and peripheral blood was analyzed for the number of EPCs. Circulating EPCs were quantified by flow cytometry as CD45(low) CD34(+) KDR2(+) cells. Plasma vascular endothelial growth factor (VEGF) and interleukin (IL)-10 levels were measured. Seven days later, crossover was performed on each group, with each group receiving the other treatment using the same protocol. The PAT hyperemia ratio ranged from 1.57 ± 0.41 to 2.04 ± 0.51 after EA, representing a significant improvement (P = 0.002); however, there was no improvement in the placebo group (P = 0.48). Circulating EPCs, as measured by flow cytometry, increased to 110.6 ± 74.3/100 µL in the EA group (P = 0.001) but did not change in the placebo group (45.9 ± 35.3/100 µL, P = 0.08). The increases in the number of EPCs and the PAT ratio after treatment were correlated (r = 0.78, P < 0.001). Plasma VEGF levels increased with EA compared to baseline (261.2 ± 34.0 vs 334.9 ± 80.5 pg/mL, P = 0.003). The number of circulating EPCs was positively correlated with plasma levels of VEGF (r = 0.50, P = 0.02). In conclusion, EA induced improvement of EPC levels and the PAT ratio in patients with cerebral infarction.

Low levels of plasma omega 3-polyunsaturated fatty acids are associated with cerebral small vessel diseases in acute ischemic stroke patients.

Cerebral small vessel diseases (SVDs) are related to stroke or cognitive dysfunction. n-3-polyunsaturated fatty acids (PUFAs) such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) represent possible disease-modifying factors for cardiovascular disease or dementia. Our hypothesis was that a low proportion of plasma FAs would be associated with cerebral SVDs. We prospectively enrolled 220 patients with a first-episode cerebral infarction within 7 days after symptom onset. The composition of plasma FAs was analyzed by gas chromatography methods. The presence and burden of cerebral microbleeds (CMBs), high-grade white matter changes (HWCs), high-grade perivascular spaces (HPVSs), and asymptomatic lacunar infarctions (ALIs) were investigated. The mean proportion (± SD) was 2.0 ± 0.7 for EPA, 8.9 ± 1.5 for DHA, and 12.0 ± 2.1 for ∑ n-3-PUFAs. In total, 46 (20.9%) patients had CMBs, 64 (29.1 %) had HWCs, 57 (25.9%) had HPVSs, and 65 (29.5%) had ALIs. In univariate analyses, CMBs, HWCs, and HPVSs were each negatively correlated with the proportion of EPA, DHA, and ∑ n-3-PUFAs. In the multivariate analysis, a lower proportion of EPA, DHA and ∑ n-3-PUFAs was associated with the presence of CMBs, HWCs and HPVS, but not ALIs. Total SVDs score was inversely correlated with the proportion of EPA, DHA and ∑ n-3-PUFAs. Overall, we found an association between low proportions of plasma n-3-PUFAs and cerebral SVDs pathologies. Further studies are needed to explore the association and potential therapeutic role of FAs in cerebral SVDs.

[Research about formulas for activating blood and resolving stasis Xuesaitong capsule regulate CD117+ hemopoietic stem cell to produce new blood].

OBJECTIVE: To investigate the mechanism that the formulas for activating blood and resolving stasis can regulate hemopoietic stem cell to produce new blood. METHOD: Rats were established animal model of acute cerebral infarction by referencing Olivette' method. They were randomly divided into model group, the group of the high, middle, low dose of the formulas for activating blood and resolving stasis. Each group and then wasrandomly divided into subgroups by 1, 3, 7, 14, 28 d. Xuesaitong capsule was formulated into 20, 40, 60 g x L(-1) with normal saline. The rats were given gavage drugs once a day until the experient ended, and the model group was administrated by intragastrical perfusion of normal saline. ELISA was used to detect the expression of SCF in peripheral blood and bone marrow among different groups at different time points. Flow cytometry was used to observe the changes of CD117 in blood and bone marrow. RESULT: The CD117+ HSC and SCF concentration in peripheral blood and bone marrow of model group were increasing during 1-14 d,there was a peak on the 14th day, then the expression was reducing. CD117+ HSC and SCF concentration rising trend in the group of the high, middle dose of the formulas for activating blood and resolving stasis was preceded model group (P < 0.05). CONCLUSION: Activating blood and resolving stasis can regulate hemopoietic stem cell to produce new blood, and it is through the regulation of CD117+ HSC number to achieve the purpose.

Failure of dabigatran and rivaroxaban to prevent thromboembolism in antiphospholipid syndrome: a case series of three patients.

Direct oral factor inhibitors (DOFIs) are an attractive alternative to vitamin K antagonists (VKA) for the treatment of patients with antiphospholipid syndrome (APS). In the absence of prospective, randomised trial data, reports of therapeutic failures in clinical practice alert clinicians to potential limitations of DOFI therapy for this indication. Data for all cases were collected from a centralised system that contains complete medical records of all patients treated and followed at Mayo Medical Center. We present here three consecutive APS patients who had had no thromboembolism recurrence on warfarin but were switched to DOFIs. The diagnosis of APS was established according to currently recommended criteria. The three cases were as follows: A woman with primary APS developed thrombotic endocarditis with symptomatic cerebral emboli after transition to dabigatran. A second woman with primary APS experienced ischemic arterial strokes and right transverse-sigmoid sinus thrombosis after conversion to rivaroxaban. A man with secondary APS suffered porto-mesenteric venous thrombosis after switching to rivaroxaban. None of these patients had failed warfarin prior to the transition to DOFIs. Based on these three cases, we advocate caution in using DOFIs for APS patients outside of a clinical trial setting, until further data becomes available.

Correlation between tongue manifestations and glucose, total cholesterol, and high-density lipoprotein cholesterol in patients with acute cerebral infarction.

OBJECTIVE: To analyze the association between tongue manifestations and the levels of glucose (GLU), total cholesterol (TCH), and high-density lipoprotein cholesterol (HDL-C) in subjects with acute cerebral infarction. METHODS: Hospitalized patients with first unilateral cerebral infarction in the Neurological Department of Xuanwu Hospital were included and the correlation between tongue fur color, fur nature, and the levels of GLU, TCH, HDL-C were analyzed. RESULTS: HDL level in the thin fur group was higher than that in the thick fur group (P = 0.02). The difference in the levels of GLU, TCH, and HDL-C among the groups was significant (P < 0.05), classified in terms of slippery, moist, and dry fur. Further comparison between the groups by Student-Newman-Keuls test showed that GLU level in the dry fur group was the highest. Moreover, the TCH level in the slippery fur group was higher than the other two groups. CONCLUSION: A correlation between tongue manifestations and GLU, TCH, HDL-C was identified in the patients with acute cerebral infarction.

[Effects of acupuncture and "Tongxinluo" capsule on plasma lysophosphatidic acid level in patients with acute cerebral infarction].

OBJECTIVE: To observe the effect of acupuncture of Neiguan (PC 6), Sanyinjiao (SP 6), etc. on plasma lysophosphatidic acid (LPA) level in patients with acute cerebral infarction (ACI) so as to study its mechanism underlying improvement of ACI. METHODS: A total of 160 patients with ACI were randomly divided into four groups: medication (Aspirin and Panax Notoginseng Saponins for improving blood circulation), acupuncture, Tongxinluo, and acupuncture+ Tongxinluo groups, with 40 cases being in each group. Plasma LPA content was measured using biochemical method, and the therapeutic effects of the 4 groups were assessed by neurologic deficit score which were evaluated using the modified standards of the 4Th Session of Chinese National Cerebrovascular Conference issued in 1995. RESULTS: Following the treatment, plasma LPA levels and neurological deficit scores were significantly decreased in the medication, acupuncture, Tongxinluo and acupuncture+ Tongxinluo groups in com- parison with pre-treatment in each group (P<0.01), and LPA level and neurological deficit score of the acupuncture + Tongxinluo group were significantly lower than those of the other three groups (P<0. 01). Of the four 40 cases in the medication, acupuncture, Tongxinluo and acupuncture+Tongxinluo groups, 6, 7, 7 and 12 patients were basically cured, 9, 8, 9 and 18 experienced marked improvement in their symptoms, 14, 16, 15 and 6 were improved, 6, 5, 4 and 2 were invalid, 5, 4, 5 and 2 got worsened, with the effective rates(basically cured+ improvement) being 37.5%, 37.5%, 40.0% and 75.0%, respectively. The therapeutic effect of the acupuncture+Tongxinluo group was significantly superior to those of the other three groups (P<0. 01). CONCLUSION: Acupuncture can accelerate the recovery of neurological function and ameliorate clinical symptoms in ACI patients, which may be related to its effect in lowering plasma PLA. The therapeutic effect of acupuncture + Tongxinluo is relatively better than simple acupuncture and simple medication.

[Effect of acupoint catgut embedding on motor function and serum high sensitivity C-reactive protein and IL-6 levels in patients with acute cerebral infarction].

OBJECTIVE: To evaluate the effect of acupoint catgut embedding on motor function in patients with acute cerebral infarction (ACI), and to explore its mechanism. METHODS: Sixty-three ACI patients were randomly assigned to acupuncture group (n = 30) and catgut embedding group (n = 33). Patients of the acupuncture group received acupuncture stimulation of Baihui (GV 20), Neiguan (P 6), Sanyinjiao (SP 6), Taichong (LR 3), etc. and scalp-point Motor Area, Sensory Area, Balance Area, once daily, 5 times a week for 20 times. Patients of the catgut embedding group received catgut embedding at the acupoints same to acupuncture group, once every 10 days, 3 times altogether. Additionally, both groups received regular treatment of neurology (controlling blood pressure, blood sugar and blood lipids levels, physical therapy, etc.) and early rehabilitation training (limb otor training). The patients' functional mobility was evaluated by simplified Fugl-Meyer Assessment Scale (FMA) and Modified Bathel Index Scale (MBI). The level of serum high sensitivity C-reactive protein (hs-CRP) was detected using latex agglutination reaction method; and serum in terleukin-6 (IL-6) content measured by enzyme-linked immunosorbent assay. RESULTS: lts After 30 days' treatment, the mean scores of FMA and MBI were significantly increased in both acupuncture group and catgut embedding grou p (P < 0.05), suggesting an improvement of the cerebral infarction patient's functional mobility after the treatment. The therapeutic effect of the catgut embedding was obviously superior to that of the acupuncture grou p (P < 0. 05). The mean contents of serum IL-6 and hs-CRP of the two groups were significantly decreased after the treatmen t (P < 0.05), suggesting a reduction of proinflammatory cytokine and inflammatory mediator levels, respectively. The levels of both serum IL-6 and hs-CRP of the catgut embedding group were markedly lower than those of the acupuncture group ( P < 0.05). CONCLUSION: ion Acupoint catgut embedding therapy is effective in improving cerebral infarction patients' functional mobility, which is related to its action in inhibiting inflammatory reaction in the early stage of cerebral ischemic injury.

Inhibitory effects of Qushuanling Capsule () on thrombus formation and platelet aggregation in rats.

OBJECTIVE: To investigate the effects of Qushuanling Capsule ( QSLC) on thrombus formation and platelet aggregation in rats. METHODS: Arteriovenous bypass, venous thrombosis, and middle cerebral artery thrombosis models were used in rats to investigate the anti-thrombotic effects of QSLC, a compound of nine Chinese herbs. The platelet aggregation induced by adenosine diphosphate (ADP), thrombin or arachidonic acid (AA), as well as the contents of thromboxane B(2) (TXB(2)) and 6-keto-prostaglandin F1α (6-keto-PGF1α) in rat plasma and aortic walls, were determined to investigate the possible mechanisms of the anti-thrombotic effects of QSLC. RESULTS: After oral administration with QSLC for 7 days, arteriovenous bypass thrombosis was obviously suppressed compared with the model group, venous thrombosis was also obviously suppressed, rat behaviors were obviously improved, and brain infarct size as well as water content were also reduced. The platelet aggregation induced by ADP or thrombin was inhibited by QSLC, but the drug had no effect on AA-induced platelet aggregation and content of TXB(2) and 6-keto-PGF1α in plasma and the aortic wall. CONCLUSION: These results suggest that QSLC can be used in the prevention and treatment of thrombotic diseases, and that its mechanism of action may be related to inhibition of platelet aggregation.

[A study of traditional Chinese medicine syndromes correlated to neurologic function or to coagulation function in patients with acute cerebral infarction].

OBJECTIVE: To investigate the correlations between traditional Chinese medicine (TCM) syndrome elements and neurologic function and between them and coagulation function in patients with acute cerebral infarction (ACI). METHODS: Two hundred and twenty-three patients with ACI were enrolled. The syndromes of this disease were scored according to Stroke Diagnostic Criteria for Differentiation of Syndromes. Neurologic function deficit score (NDS) was scored according to stroke scale of the National Institutes of Health (NIHSS). The prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen (FIB) contents were detected. The correlations between TCM syndrome elements and NDS and between them and coagulation function were investigated. RESULTS: Two hundred and twenty-three patients with ACI were divided into six syndromes: wind syndrome (n=147, 65.92%), fire syndrome ( n=100, 44.84%), tan syndrome (n=123, 55.16%), blood stasis syndrome (n=78, 34.98%), deficiency of qi syndrome (n=31, 13.90%), and yin deficiency causing hyperactivity of yang syndrome (n=25, 11.21%). The wind, tan and fire syndromes were the main syndrome elements related to ACI. The scores of wind, fire, tan and deficiency of qi syndromes were positively related to NDS (r1=0.207, P1=0.002; r2=0.284, P2=0.000; r3=0.245, P3=0.000; r4=0.152, P4=0.023). The score of deficiency of qi syndrome was negatively correlated with PT (r=-0.170, P=0.011); and the scores of tan, blood stasis, and deficiency of qi syndromes were negatively correlated with APTT (r1=-0.182, P1=0.006; r2=-0.148, P2=0.027; r3=-0.211, P3=0.001).Other syndromes were not correlated to NDS or coagulation factors. CONCLUSION: The neurologic function deficiency due to ACI is more likely influenced by wind, tan, and fire syndromes; deficiency of qi syndrome also has some effects. The syndromes of tan, blood stasis, and deficiency of qi are closely correlated with coagulation function, and their scores may reflect the clotting function in patients with ACI.

Therapeutic effect of Korean red ginseng on inflammatory cytokines in rats with focal cerebral ischemia/reperfusion injury.

This study aims to identify the therapeutic effect of Korean red ginseng (KRG) on the expression of inflammatory cytokines in rats with focal cerebral ischemia/reperfusion injury. Adult male Sprague-Dawley rats were subjected to transient middle cerebral artery occlusion (tMCAO) for two hours. They were fed KRG extract (100 mg/kg/day per orally) or saline after reperfusion. Tests for neurological deficits, using the modified neurologic severity score and the corner turn test, were performed before the ischemic event, and one, three, and seven days after tMCAO. Serum levels of cytokines were measured three and seven days after the operation, using enzyme-linked immunosorbent assays. The infarct volume was assessed after seven days by staining brain tissue with 2% 2, 3, 5-triphenyltetrazolium chloride. Oral administration of KRG significantly reduced the infarct volumes and rapidly improved neurological deficits. Serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1ß), and IL-6 were higher in tMCAO-operated rats than in the sham-operated rats. These changes were attenuated by daily KRG intake for seven days. Serum IL-10 levels were significantly increased in KRG-fed rats, as compared to sham-operated and saline-fed rats. Our results suggested that KRG provides neuroprotection for rats with focal cerebral ischemia/reperfusion injury. This neuroprotection may be due to raised IL-10 expression and a reduction in the serum levels of TNF-α, IL-1ß, and IL-6.

[Effect of Shuxuetong injection on neuron-specific enolase of serum and recovery of function in patients with acute cerebral infarction].

OBJECTIVE: To observe the clinical effect and the influences of Shuxuetong injection on serum neuron-specific enolase (NSE) level, the neurological deficit and activities of daily living in patients with acute cerebral infarction. METHOD: The 80 patients with acute cerebral infarction were randomly divided into Shuxuetong treatment group (40 cases) and routine control group (40 cases), both received routine treatment, while Shuxuetong injection was given additionally to treatment group. The serum NSE level, the National Insitute of Health Stroke Scale (NIHSS) scores and the clinical effect were observed pre-and post-treatment. The Barthel Index (BI) was evaluated after one month. RESULT: The serum NSE level and NIHSS scores in two groups of post-treatment decreased obviously than those of pre-treatment, and after treatment in Shuxuetong treatment group the serum NSE level and NIHSS scores were significantly lower than those in control group, the differences were significant (P<0.05). Effective rate of Shuxuetong treatment group was 87.5%, and control group was 65%, the difference of the clinical effect between the two groups was significance (P<0.05). After one month BI of post-treatment in two groups improved than those of pre-treatment, and Shuxuetong treatment group was significantly better compared with control group (P<0.05). CONCLUSION: Shuxuetong injection has the remarkable neuronal protective effect, can decrease the serum level of NSE after acute cerebral infarction, promote recovery of nerve function, reduce disability rate, and improve quality of life and prognosis of patients with acute cerebral infarction.

[Effect of ultra-micronized Buyang Huanwu decoction on neurological function, quality of life, and serum vascular endothelial growth factor in patients convalescent from cerebral infarction].

OBJECTIVE: To study effect of Buyang Huanwu decoction (BYHWD) on neurological function, quality of life, and serum vascular endothelial growth factor (VEGF) in patients convalescent from cerebral infarction, and to evaluate the effect of ultra-micronized BYHWD. METHODS: Two hundred and fifty-one patients met the inclusion criteria were randomly assigned to traditional BYHWD (TB) group (n=83), ultra-micronized BYHWD (UB) group (n=85) and the control group (n=83) according to time of entrance into the study with 1:1:1. All patients received rehabilitation training, but for patients in the TB and UB groups, traditional BYHWD (15 g, twice a day) or ultra-micronized BYHWD (5 g, twice a day) was given respectively, for a course of 12 weeks. Clinical curative effect and curative effect of syndrome according to traditional Chinese medicine (TCM) were evaluated. Nerve function and quality of life in patients were evaluated, serum VEGF was determined before and after treatment. The level of VEGF in 23 healthy volunteers was also determined to serve as normal control. RESULTS: The total effective rate was 83.5%, 85.5% and 77.1% in UB group, TB group and the control group, respectively, and the total symptomatic effective rate in TCM was 87.0%, 89.2% and 77.1%, respectively. Compared with the control group, there was significant difference in UB or TB group (all P<0.05), but there was no significant difference between UB and TB groups (both P >0.05). Serum VEGF levels (ng/L) were significantly lower before treatment in control group, TB group and UB group than those in normal control group (79.87±2.81, 80.19±3.23, 80.23±3.18 vs. 68.13±3.39, all P<0.05). Neurologic deficit score (NDS), quality of life and serum VEGF were improved after treatment in three groups, but they were better in UB or TB group than the control group [NDS: 11.95±5.03, 12.68±4.67 vs. 15.23±5.12, quality of life score: 64.71±6.73, 63.56±6.53 vs. 59.09±6.81, serum VEGF (ng/L): 76.38±3.02, 76.84±3.18 vs. 70.26±3.15 , all P<0.05], but there was no significant difference between UB and TB groups (all P >0.05). CONCLUSION: BYHWD can improve neurological function and quality of life, and increase serum VEGF in patients convalescent from cerebral infarction, and ultra-micronized BYHWD, the dosage can be decreased.

[Relationship between tongue presentations and serum level of C-reactive protein in patients with acute cerebral infarction].

OBJECTIVE: To investigate the relationship between tongue presentations and the serum level of C-reactive protein (CRP) in patients with acute cerebral infarction (ACI). METHODS: Tongue presentations of 200 incipient unilateral ACI patients were observed, their serum CRP level was determined, and the relationship between the two entries was analyzed. RESULTS: Serum level of CRP in patients with thick tongue coating were significantly more than those with thin coating (117 cases vs. 73 cases); tongue coating was greasy in 149 patients and un-greasy in 51 patients. Spearman correlation analysis showed that the serum level of CRP was positively correlated with the thickness of tongue coating (r = 0.186, P = 0.008); also with the greasy degree. The difference of CRP levels in patients with different color and dryness of tongue was insignificant statistically (P > 0.05). CONCLUSION: Correlation between tongue presentations and serum CRP level is possibly existed in patients with ACI.