Combined therapy of intensive statin plus intravenous rt-PA in acute ischemic stroke: the INSPIRE randomized clinical trial.

OBJECTIVE: To investigate the safety and efficacy of intensive statin in the acute phase of ischemic stroke after intravenous thrombolysis therapy. METHODS: A total of 310 stroke patients treated with rt-PA were randomly scheduled into the intensive statin group (rosuvastatin 20 mg daily × 14 days) and the control group (rosuvastatin 5 mg daily × 14 days). The primary clinical endpoint was excellent functional outcome (mRS ≤ 1) at 3 months, and the primary safety endpoint was symptomatic intracranial hemorrhage (sICH) in 90 days. RESULTS: The intensive statin users did not achieve a favorable outcome in excellent functional outcome (mRS ≤ 1) at 3 months compared with controls (70.3% vs. 66.5%, p = 0.464). Intensive statin also not significantly improved the overall distribution of scores on the modified Rankin scale, as compared with controls (p = 0.82 by the Cochran-Mantel-Haenszel test). The incidence of primary safety endpoint events (sICH) in 90 days did not significantly differ between the intensive statin group and control group (0.6% vs. 1.3%, p > 0.999). CONCLUSION: The INSPIRE study indicated that intensive statin therapy may not improve clinical outcomes compared with the low dose of statin therapy in AIS patients undergoing intravenous thrombolysis, and the two groups had similar safety profile. CLINICAL TRIAL REGISTRATION: URL: http://www.chictr.org . Unique identifier: ChiCTR-IPR-16008642.

Task relevance effect on number/shape conflict detection in the number-matching task: An ERP study.

It is debatable whether the task relevance effect on a conflict occurs in the detection or in the inhibition underlying sequential matching. To explore this issue, three types of number pairs, identical (e.g., 12, 12), conserved (e.g., 12, ), and non-conserved (e.g., 12, 15) pairs, were displayed to be judged as perceptually (identical shape condition) or quantitatively (identical value condition) the same. Both error rates and RTs for the three types of number pairs showed different patterns to detect perceptual mismatch in the identical shape condition and number inequivalence in the identical value conditions. The event-related potential (ERP) results showed that increased N200 and N400 as well as decreased P300 were triggered by the conserved and non-conserved pairs in contrast to identical pairs in the identical shape condition and by the non-conserved pairs relative to the conserved and identical pairs in the identical value condition. These results showed that task-relevant mismatches were attended to and detected in both conditions. Therefore, for the task-relevance effect on a conflict, attention is selectively directed to task-relevant features rather than inhibiting task-irrelevant conflict.

Stress-Induced Hyperglycemia and Remote Diffusion-Weighted Imaging Lesions in Primary Intracerebral Hemorrhage.

BACKGROUND AND PURPOSE: Stress-induced hyperglycemia (SIH) is the relative transient increase in glucose during a critical illness such as intracerebral hemorrhage (ICH) and is likely to play an important role in the pathogenesis of remote diffusion-weighted imaging (DWI) lesion (R-DWIL) in primary ICH. We sought to determine the association between SIH and the occurrence of R-DWILs. METHODS: We prospectively enrolled primary ICH patients within 14 days after onset from November 2016 to May 2018. In these patients, cerebral magnetic resonance imaging was performed within 14 days after ICH onset. R-DWIL was defined as a hyperintensity signal in DWI with corresponding hypointensity in apparent diffusion coefficient, and at least 20 mm apart from the hematoma. SIH was measured by stress-induced hyperglycemia ratio (SHR). SHR was calculated by fasting blood glucose (FBG) divided by estimated average glucose derived from glycosylated hemoglobin. The included patients were dichotomized into two groups by the 50th percentile of SHR, and named as SHR (-P50) group and SHR (P50+) group, respectively. We evaluated the association between SHR and R-DWIL occurrence using multivariable logistic regression modeling adjusted for potential confounders. RESULTS: Among the 288 patients enrolled, forty-six (16.0%) of them had one or more R-DWILs. Compared with the patients in the lower 50% of SHR (SHR [-P50]), the odds ratio (OR) [95% confidence interval (CI)] for the higher 50% of SHR (SHR [P50+]) group for R-DWIL occurrence was 3.13 (1.39-7.07) in the total population and 6.33 (2.19-18.30) in population absent of background hyperglycemia after adjusting for potential covariates. Similar results were observed after further adjusted for FBG. CONCLUSIONS: Our study demonstrated that SIH was associated with the occurrence of R-DWILs in patients with primary ICH within 14 days of symptom onset.

LncRNA SNHG16 Functions as an Oncogene by Sponging MiR-4518 and Up-Regulating PRMT5 Expression in Glioma.

BACKGROUND/AIMS: Long noncoding RNAs (lncRNAs) have recently emerged as novel and potentially promising therapeutic targets in various cancers. However, the expression pattern and biological function of lncRNAs in glioma remain largely elusive. In the present study, we investigated the functional role of an lncRNA, small nucleolar RNA host gene 16 (SNHG16), in glioma. METHODS: The expression levels of SNHG16 and miR-4518 were measured using qRT-PCR. The relationship between the levels of SNHG16 and clinicopathologic features were statically analyzed. The levels of proteins were detected using western blot. Bioinformatics analysis and luciferase reporter assays were applied to the analysis of the relationship between SNHG16, miR-4518 and PRMT5. Cell viability and apoptosis were measured using MTT and apoptosis ELISA assay, respectively. RESULTS: SNHG16 was highly expressed in glioma tissues and cell lines, which was related to poorer clinicopathologic features and shorter survival time. Knockdown of SNHG16 inhibits the viability and induces apoptosis of glioma cells. Further investigation revealed that SNHG16 could up-regulate the expression of miR-4518 targeted gene PRMT5 via acting as an endogenous sponge of miR-4518. Moreover, SNHG16 also affects the expression of Bcl-2 family proteins and the activation of PI3K/Akt signaling pathway. CONCLUSION: Our study revealed a novel SNHG16-miR-4518-PRMT5 pathway regulatory axis in glioma pathogenesis. SNHG16 could be used as a potential therapeutic target in the treatment of glioma.

[Effects of endothelial progenitor cells and endothelial outgrowth cells in repair of injured carotid vessel: a comparative study with rabbits].

OBJECTIVE: To compare the effects of endothelial progenitor cells (EPCs) and endothelial outgrowth cells (EOCs) on the repair of injured vessels. METHODS: Mononuclear cells (MNCs) were isolated from rabbit peripheral blood by density-gradient centrifugation. EPCs and EOCs were obtained from the culture of MNCs and labeled with the cell dye CM-DiI for cells tracking. Eighteen rabbits were made into models of balloon-injured common carotid artery and then divided into 2 equal groups to undergo injection of the suspensions of EPCs or EOCs. Nine rabbits underwent injection of normal saline as control group. Four weeks after transplantation, the rabbits underwent venous injection of Evans blue, and then were killed with the injured vessels taken out. Fluorescence-labeled both types of cells, endothelial regeneration rate and IA/MA ratio were detected. RESULTS: Four weeks after transplantation, fluorescence-labeled EPCs and EOCs were detected within the tunica intima, mostly in the neointima and on the luminal surface of injured vessel. The endothelialization area of denuded vessel of the EPC and EOC groups were 91.6% +/- 3.6% and 89.1% +/- 6.3% respectively, both significantly larger than that of the control group (62.1% +/- 7.5%, both P < 0.01), however, without significant difference between the 2 former groups (P = 0.50). The intima area/media area ratio of the EPC and EOC groups were 0.48 +/- 0.11 and 0.44 +/- 0.06, both significantly lower than that of the control group (0.88 +/- 0.14, both P < 0.01), however, without significant difference between the 2 former groups (P = 0.59). CONCLUSION: Transplantation of both EPCs and EPCs accelerate the reendothelialization and reduce the neointimal formation with similar effects.