Clinical effects and safety of electroacupuncture for the treatment of post-stroke depression: a systematic review and meta-analysis of randomised controlled trials.

OBJECTIVE: The aim of this systematic review was to assess the efficacy/effectiveness and safety of electroacupuncture (EA) in the treatment of post-stroke depression (PSD). METHODS: A comprehensive literature search in the Pubmed, Embase, CENTRAL, ISI Web of Science, CNKI and Wanfang databases was conducted, and all relevant randomised controlled trials (RCTs) were screened for eligibility by two independent reviewers. The Cochrane Collaboration's tool and Jadad score were used to assess the risk of bias of included studies, and only RCTs scoring ≥3 were included in a meta-analysis. RESULTS: 18 RCTs involving a total of 813 participants (mean age 61.6 years) in the EA groups and 723 participants (mean age 61.9 years) in the control groups were included. The included studies had an average 3 point Jadad score. PSD was diagnosed according to the Chinese Classification of Cerebrovascular Disease (CCCD) and the Chinese Classification of Mental Disease (CCMD) criteria. There was no significant difference between EA and antidepressants (fluoxetine 10-40 mg/day, citalopram 20 mg/day, sertraline 50 mg/day) in terms of the Hamilton Depression Rating Scale (HAMD) scores at week 4 after treatment (standardised mean difference (SMD) -0.11, 95% CI -0.31 to 0.10), at week 6 after treatment (SMD 0.04, 95% CI -0.43 to 0.51) or at week 8 after treatment (SMD -0.01, 95% CI -0.23 to 0.22). However, the combined incidence of adverse events in the EA groups was significantly lower than in the antidepressant groups (RR 0.21, 95% CI 0.14 to 0.33). CONCLUSION: There was no significant difference between EA and antidepressants in the severity of depression, however EA caused fewer adverse events than antidepressants. Additional larger scale RCTs with rigorous study design are required.

Apolipoprotein E polymorphisms increase the risk of post-stroke depression.

Recent reports have shown that apolipoprotein E (APOE) polymorphisms are involved in neurodegenerative disease. However, it is unclear whether APOE affects post-stroke depression. Accordingly, we hypothesized that APOE polymorphisms modify the risk of post-stroke depression. Here, we performed a hospital-based case-control study (including 76 cerebral infarction cases with post-stroke depression, 88 cerebral infarction cases without post-stroke depression, and 109 controls without any evidence of post-stroke depression or cerebral infarction) to determine possible association between APOE rs429358 and rs7412 polymorphisms and risk of post-stroke depression. Our findings show no difference among the groups with regards genotype distribution of the rs7412 polymorphism. In contrast, APOE genotypes with rs429358-C alleles increased the risk of post-stroke depression. Further, the rs429358 polymorphism was associated with significantly decreased regional cerebral blood flow values in the left temporal lobe of post-stroke depression cases. Additionally, the rs429358 polymorphism was not only associated with depression severity, but with increasing serum levels of total cholesterol. These results suggest that the APOE rs429358 polymorphism is associated with increased risk of developing post-stroke depression, and that APOE rs429358-C allele genotypes may be detrimental to recovery of nerve function after stoke. Indeed, these findings provide clinical data for future post-stroke depression gene interventions.

SNCA rs3822086 C>T Polymorphism Increases the Susceptibility to Parkinson's Disease in a Chinese Han Population.

OBJECTIVE: Protofibrils of alpha-synuclein mediate neuronal cell death and propagate Parkinson's disease (PD). In this study, we investigated the relationship between the rs3822086 C>T polymorphism located in the fourth intron of the alpha-synuclein (SNCA) gene and susceptibility to PD in a Chinese Han population. METHODS: 146 PD patients and 144 sex- and age-matched healthy individuals (control group) were selected for this study. The SNCA rs3822086 polymorphism was examined in all 300 study subjects by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. RESULTS: The genotype and allele frequencies of the SNCA rs3822086 polymorphism showed significant differences between the PD group and control group (TT: 25.3% vs. 18.8%, p=0.035; CT+TT: 77.4% vs. 66.0%, p=0.031; T allele: 51.4% vs. 42.4%, p=0.030; respectively). Stratified analyses based on gender indicated that male PD patients exhibited higher genotype and allele frequencies of the SNCA rs3822086 polymorphism compared to healthy male controls (TT: 26.7% vs. 13.2%, p=0.011; CC+CT: 73.3% vs. 86.8%, p=0.024; T allele: 51.2% vs. 37.9%, p=0.012; respectively). Age-stratified analyses indicated that the genotype and allele frequencies of the SNCA rs3822086 polymorphism were significantly higher in PD patients older than 60 years in comparison to healthy controls (TT: 32.2% vs. 20.5%, p=0.014; CT+TT: 77.0% vs. 60.2%, p=0.017; T allele: 54.6% vs. 40.3%, p=0.008; respectively). CONCLUSION: Our findings demonstrate that the SNCA rs3822086 C>T polymorphism correlates with increased susceptibility to PD among the Chinese Han population.

Association of the single-nucleotide polymorphism and haplotype of the P-selectin gene with ischemic stroke.

Inflammation has recently proven to be associated with the pathogenesis of atherosclerosis and inflammatory genes are good candidates for the risk of developing atherosclerosis. The early phase of atherosclerosis involves the recruitment of inflammatory cells from the circulation and their transendothelial migration. This process is mainly mediated by cellular adhesion molecules. The adhesion molecule P-selectin may play a role in the pathogenesis of atherosclerosis. Polymorphism of P-selectin gene, which may affect the production level of the adhesion molecule, has been associated with a number of atherosclerotic disease. To test this hypothesis, we investigated the relationship of P-selectin gene polymorphisms and ischemic stroke in a Chinese population. We analyzed single nucleotide polymorphisms of P-selectin gene -2,123 G/C, -1,969 G/A, -1,817 T/C and Thr715Pro in three hundred and five patients with ischemic stroke and 280 age and sex matched controls, using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and DNA sequencing method. There were no significant differences in the genotype, allele and haplotype frequencies of P-selectin gene polymorphisms between the group of patients with ischemic stroke and the control group. Furthermore, there was no significant association of genotype, allele and haplotype at any of the polymorphism in relation to any subtype of ischemic stroke. We did not observe an association between P-selectin gene polymorphisms and ischemic stroke or any subtype of ischemic stroke. However, further studies are needed to explore the complex interaction between environmental factors and P-selectin gene polymorphisms in the risk of ischemic stroke, particularly in ethnically different populations.

[Effection of observation Xinnaoxin capsules in treatment of chronic cerebral circulatory insufficiency].

OBJECTIVE: To observe the therapeutic effect of Xinnaoxin capsules in patients with chronic cerebral circulatory insufficiency. METHOD: Patients with chronic cerebral circulatory insufficiency were divided randomly into two groups: a Xinnaoxin capsules group (n = 60, treated by Xinnaoxin capsules for four 4 weeks), a control group (n = 58, treated by Nimodiping for four weeks). The transcranial doppler (TCD) was used to determined mean velocity (Vm) and auto-viscometer measured hemorheological indices before and after being treated. RESULT: After 4 weeks treatment, the hemorheological indices and mean velocity were obviously improve in Xinnaoxin capsules group (P <0.05), there is significant difference between the effective rate of two groups (88.3%, 70.7%). CONCLUSION: Our study suggest that Xinnaoxin capsules have therapeutic function on chronic cerebral circulatory insufficiency.

[Effect of Panax notoginseng saponins on serum neuronal specific enolase and rehabilitation in patients with cerebral hemorrhage].

OBJECTIVE: To observe the effect of Panax notoginseng saponins (PNS) on serum content of neuronal specific enolase (NSE) and function recovery in patients with cerebral hemorrhage (CH) for exploring the therapeutic action of PNS in treating CH. METHODS: Fifty CH patients with their course of disease not more than 5 days were randomly assigned to two groups, 27 in the PNS group and 23 in the control group, all were treated with conventional treatment, while PNS was given additionally to the PNS group. The serum levels of NSE before and after treatment were determined by electrochemiluminescence, and the recovery of patients, including their neuro-function deficit and daily living activity, was assessed according to scoring by the National Institute of Health Stroke Scale (NIHSS) and Barthel Index (BI) respectively. RESULTS: Before treatment, the difference between the two groups in serum NSE content and scores of NIHSS and BI was insignificant (P > 0.05). However, after 3 weeks of treatment, the level of NSE and score of NIHSS were significantly lower, while score of BI was significantly higher in the PNS group than those in the control group respectively (all P < 0.01). In the PNS group, the level of NSE showed a positive correlation with the score of NIHSS (r = 0.757, P < 0.05), and a negative correlation with the score of BI (r = - 0.803, P < 0.05). CONCLUSION: PNS can effectively protect the neuron and promote functional rehabilitation in patients after CH.

[Quality of life of epilepsy patients in Zhuang populations in Guangxi Guixi area].

OBJECTIVE: To investigate the quality of life (QOL) and its influence factors in epilepsy patients in Zhuang population in Guangxi Guixi area. METHODS: Totally 78 epilepsy patients in Zhuang populations and 60 healthy controls were enrolled, and their QOL was assessed with Quality of Life in Epilepsy Inventory-31 (QOLIE-31). The QOLIE-31 scores of patients between different sexes, anti-epileptic drugs (AEDs) usage, duration of seizure, and seizure types were compared. RESULTS: QOL score was significantly lower in epileptic group (53.9 +/- 8.0) compared with control group (77.0 +/- 7.1) (P < 0.01). No difference was found in QOLIE-31 scores of patients between men and women (P > 0.05). Patients with single AED, shorter duration of seizure, and tonic-clonic seizure had higher QOLIE-31 scores than those with multiple AEDs, longer duration of seizure, and other seizure types (P < 0.01, P < 0.05, P < 0.01, respectively). CONCLUSIONS: QOL is lower in epilepsy patients than normal people in Zhuang populations in Guangxi Guixi area. Medication and seizure type affects the QOL in patients with epilepsy.

[Intercellular adhesion molecule-1 gene K469E polymorphism and genetic susceptibility of ischemic stroke in Chinese Zhuang populations].

OBJECTIVE: To examine the relationship between intercellular adhesion molecule-1 (ICAM-1) gene polymorphism and ischemic stroke (IS) in Chinese Zhuang populations. METHODS: The K469E polymorphism in the exon 6 of ICAM-1 gene was detected by polymerase chain reaction-restriction fragment length polymorphism analysis and DNA sequencing in 205 patients with IS of Zhuang nationality and in 210 healthy controls, and the serum level of ICAM-1 was determined by enzyme-linked immunosorbent assay. RESULTS: The IS group showed significantly higher serum levels of ICAM-1 than did the control group (P < 0.01). There was significant difference in frequencies of allele and genotype in K469E polymorphism between IS and control groups, respectively (P < 0.05). The K allele carriers had 1.424 times the risk of suffering from IS as compared with the E allele carriers (OR = 1.424, 95% CI: 1.071 - 1.894); the serum ICAM-1 level of E allele carriers was significantly higher than that of K allele carriers (501.24 +/- 139.56 ng/ml vs 475.17 +/- 118.35 ng/ml, P < 0.01). CONCLUSION: There is an association between ICAM-1 gene K469E polymorphism and IS, and E allele may be a genetic risk factor of IS among Guangxi Zhuangs, in which the ICAM-1 E allele carriers may have up-regulated expression of ICAM-1 and hence are at a higher risk of ischemic stroke.