Pinellia ternata attenuates carotid artery intimal hyperplasia and increases endothelial progenitor cell activity via the PI3K/Akt signalling pathway in wire-injured rats.

CONTEXT: Clinically, Pinellia ternata (Thunb.) Breit. (Araceae) (PT) has been widely used in the treatment of atherosclerosis and hyperlipidaemia, but the underlying mechanisms are still not clearly understood. OBJECTIVE: This research was conducted to confirm the mechanism by which PT affects carotid artery intimal hyperplasia. MATERIALS AND METHODS: An intestinal hyperplasia Sprague-Dawley rat model was established by carotid artery injury. The rats were randomly divided into five groups (n = 8): sham, model, PT (with daily intragastric administration of 10 g/mL/kg PT tubers water extract), PT+LY294002 (with intraperitoneal injection of 50 mg/kg LY294002 + 10 g/mL/kg PT) and endothelial progenitor cells (EPCs) (with injection of 5 × 105/cells), and treated for 4 or 8 weeks. RESULTS: HE staining showed that PT attenuated intimal hyperplasia. RT-PCR, Western blotting and immunohistochemistry showed that PT increased the expression of vascular endothelial growth factor (VEGF) and eNOS in the atherosclerotic carotid artery. PT increased the Dil-acLDL+/FITC-UEA-1+ population (from 0.41 ± 0.085% to 0.60 ± 0.092%) in the blood, decreased TCHO, TG, LDL-C, IL-6 and TNF-α levels, and increased HDL-C and IL-10 levels in the blood. However, these changes were reversed by the PI3K/Akt pathway inhibitor LY294002. DISCUSSION AND CONCLUSIONS: PT can be developed as an atherosclerosis and carotid intimal hyperplasia treatment drug. Therefore, further study will focus on the effects of PT on intimal hyperplasia in wire-injured atherosclerosis patients and explore in depth some other relevant molecular mechanisms.

Effect of Huoxiang Zhengqi Pill on Early Neurological Deterioration in Patients with Acute Ischemic Stroke Undergoing Recanalization Therapy and Predictive Effect of Essen Score.

Early neurologic deterioration (END) in the acute phase of ischemic stroke is a serious clinical event, which is closely related to poor prognosis. Therefore, it is important to identify presentation features that predict END and take relevant treatment measures, as they could help to prevent the deterioration of high-risk patients. The prospective intervention study was carried out from January 2018 to December 2019. We included consecutive patients hospitalized for acute ischemic stroke (AIS) within 6 hours of onset. Patients were randomly assigned (1 : 1) to recanalization therapy plus Huoxiang Zhengqi Pill (HXZQ) (intervention group) or standard recanalization therapy alone (control group). The primary outcome was the development of END according to predefined criteria within the first 1 week of stroke onset. Poisson regression was used to identify predictors for END. Of the 155 patients enrolled in the study (age, 63 ± 11 years; 28.4% female), 20 (12.9%) developed END. Univariate analysis showed that the use of HXZQ and Essen stroke risk score (ESRS) (low risk group) were protective factors for END, while advanced age was a risk factor for END. However, in multivariate analysis, only ESRS (OR, 0.232; 95%CI, 0.058-0.928; P=0.039) and the use of HXZQ (OR, 0.297; 95%CI, 0.096-0.917; P=0.035) were statistically significant. ESRS can be used as the prediction factor of END. HXZQ has small side effects and wide indication. It could be used in the treatment of AIS.

Early neurological deterioration in acute ischemic stroke: A propensity score analysis.

BACKGROUND: To investigate whether endovascular therapy (EVT) was one of the factors influencing the incidence of early neurological deterioration (END) in patients with acute ischemic stroke (AIS) as compared with intravenous thrombolysis alone. METHODS: This study was based on our single-center's database that included information on stroke patients hospitalised between January 2012 and September 2015. A total of 220 patients who underwent EVT after IV rt-PA, EVT or IV rt-PA alone. To reduce the lack of randomization, we conducted a propensity score analysis using the SPSS custom dialog. After matching was completed, the 2 groups (with END versus non-END) were compared between matched groups. Variables with a p value ≤ 0.1 by univariate analysis were candidates for inclusion in logistic regression analysis. RESULTS: Of 220 acute ischemic strokes attended, 213 patients were included (62.0%, 23.0% and 15.0% with circulation occlusion in the anterior, posterior and both branches, respectively). END was detected in 68 patients (31.9%). Multivariable analysis showed that END was positively associated with glucose level (OR, 1.40; 95%CI, 1.10-1.79; p = 0.007), uric acid level (OR, 1.01; 95% CI, 1.00-1.02; p = 0.026) and treatment methods (EVT: OR, 3.87; 95% CI, 1.32-11.35; p = 0.014). However, there was significant difference in baseline data (NIHSS and INR) between EVT group and non-EVT group. CONCLUSION: Our findings suggest that hyperglycemia, hyperuricemia and EVT may be independently associated with END in AIS, even after controlling for possible confound factors. Further studies are warranted to confirm these results.

[Risk factors for recurrence of large atherosclerotic cerebral infarction].

OBJECTIVE: To explore the risk factors for recurrence of large atherosclerotic cerebral infarction in first?episode patients. METHODS: The consecutive patients with acute cerebral infarction diagnosed in the Department of Neurology were screened for large atherosclerotic cerebral infarction by CTA/MRA examination, and all the confirmed patients were followed up for 1 year. The patients were divided into recurrent ischemic stroke group and non?recurrent group according to occurrence of cerebrovascular events during the follow?up. RESULTS: A total of 256 eligible patients were included in this study, and all of them completed the follow?up. During the 1?year follow?up, 30 (11.7%) patients had ischemic cerebrovascular stroke events. Univariate analysis showed significant differences in alcohol drinking (P=0.028), smoking (P=0.007), high?density lipoprotein cholesterol (HDL; P=0.045), ischemic heart disease (P=0.002), antihypertensive agents (P=0.036) and statin use (P=0.016) between the recurrent group and non?recurrent group. Cox regression analysis showed that irregular use of statins (RR=0.410, P=0.043), smoking (RR=2.253, P=0.043), HDL (RR=0.327, P=0.029), and ischemic heart disease (RR=8.566, P<0.001) were correlated with recurrent ischemic stroke. CONCLUSION: The first?episode patients with irregular use of statins, low HDL levels, smoking and ischemic heart disease are at higher risks for having ischemic stroke recurrence.

[Relationship between masseter muscle electromyographic activities and the position of the mandible].

OBJECTIVE: To investigate the changes in electromyographic activities of the temporal and masseter muscles at different positions of the mandible. METHODS: Twenty orthodontic patients with Angle Class II malocclusion and mandibular retrusion (ANB<6°) aged 10-14 years were enrolled in this study. All the patients were treated with Forsus fixed functional appliance combined with MBT straight-wire appliance. The electromyographic activities of the temporal (T) and masseter (M) muscles before, during and after functional treatment were evaluated by assessing the average integrated electromyogram (EMG) and T/M ratio at clenching status in different mandibular positions. RESULTS: After functional forward positioning of the mandible, the electromyographic activities of the temporal and masseter muscles decreased and T/M ratio increased significance at the clenching status (P<0.05). CONCLUSION: The appliance insertion and activation is associated with a decreased EMG activity of the temporal and masseter muscles, and the T/M ratio is correlated to the position of the mandible.