Incidence and survival of lacunar infarction in a southern Chinese population: A 7-year prospective study.

OBJECTIVE: Little attention has been paid to the epidemiological characteristics of lacunar infarction (LAC) in China before. This study aimed to examine the incidence and survival of LAC in a southern Chinese population. METHODS: From 2004-2010 in Changsha, two communities with a registered population of ∼100 000 were selected and data from first-ever ischaemic stroke (IS) cases were prospectively collected. Then the epidemiological characteristics of LAC and non-LAC were evaluated. RESULTS: During the study period, the age-standardized incidence increased at an annual rate of 0.7% (p < 0.001) for LAC and 2.0% (p < 0.001) for non-LAC. The mean annual age-standardized incidence of LAC and non-LAC was 28.2/100 000 and 45.0/100 000, respectively. Compared with non-LAC patients, the prevalence of hypertension, diabetes and hyperlipidemia was significantly higher in patients with LAC (p < 0.05). Although the 30-day fatality rate was significantly lower in patients with LAC than non-LAC (0.5% vs. 14.9%, p < 0.001), there was no significant difference in survival between the two groups (96.7% vs. 95.2%, p = 0.203) after excluding the patients who died within 1 year of stroke onset. CONCLUSION: LAC is a common stroke sub-type in southern China and the long-term prognosis is not benign.

TIMP-1 polymorphisms in a Chinese Han population with intracerebral hemorrhage.

Remodeling of extracellular matrix (ECM) and breakdown of blood-brain barrier (BBB) are crucial events in the pathogenesis of intracerebral hemorrhage (ICH). Matrix metalloproteinases (MMPs), particularly MMP-9 and MMP-2, are the most important degrading enzymes in the ECM and BBB. These proteolytic effects are controlled predominantly by tissue inhibitors of metalloproteinases (TIMPs). TIMP-1 is the main endogenous inhibitor of MMP-9. Two polymorphisms in the TIMP-1 gene (rs4898 and rs2070584) were selected through a literature review and successfully genotyped in a study sample of 410 ICH patients and 305 controls. Differences in genotype and allele frequencies of identified polymorphisms were determined. Furthermore, the serum levels of TIMP-1 were measured in a subgroup of 96 ICH patients on days 1 after ICH onset and 76 controls. Analyses showed that C allele of rs2070584 was significantly associated with the development of ICH in male subjects (p = 0.037, OR = 1.535, 95%CI 1.025-2.300). Multiple logistic regression analysis under three genetic models demonstrated both rs4898 and rs2070584 were not risk factors for ICH in female subjects. Furthermore, serum levels of TIMP-1 were significantly higher in ICH patients than those in normal controls. However, the serum levels of TIMP-1 showed a nonsignificant decrease, depending on the alleles and genotypes of rs2070584 both in male and female cases. In conclusion, this is the first association study of the TIMP-1 gene variants with ICH. Our data suggest that C allele of rs2070584 is a risk factor for ICH development in the Chinese male population. However, the precise function of this variant needs further investigation.

TNFSF4 gene polymorphism rs3861950 but not rs3850641 is associated with the risk of cerebral infarction in a Chinese population.

Tumor necrosis factor superfamily member 4 (TNFSF4) plays a key role in the process of atherosclerosis, a common risk factor for both myocardial and cerebral infarctions. Recent studies indicate that the single nucleotide polymorphism (SNP) rs3850641 in TNFSF4 is associated with higher risk of myocardial infarction, but little is known about the association between TNFSF4 variation and cerebral infarction (CI). A case-control study involving 385 CI patients and 385 age-matched, sex-matched non-CI controls was conducted in a Chinese population, only the most common subtype, atherosclerosis CI, was recruited. Two SNPs of TNFSF4, rs3850641 and rs3861950, were genotyped by the TaqMan SNP genotyping method, and verified partly by genomic DNA sequencing. The results revealed a significant allelic association between rs3861950 and CI (Odds ration = 1.733, 95 % confidence interval = 1.333-2.254, P = 0.000). Genotypic association analysis demonstrated that the CC genotype of rs3861950 confers susceptibility to CI (Odds ration = 2.896, 95 % confidence interval = 1.368-6.132), and it was associated with a significantly higher risk of ischemic stroke (Odds ration = 3.520, 95 % confidence interval = 1.546-8.015, P = 0.003) after adjusting for the other confirmed risk factors such as the history of hypertension, diabetes, CAD, smoking and alcohol drinking. While the odds ratio of the T allele to the C allele was 1.733 (95 % confidence interval: 1.333-2.254). However, there was no significant association between rs3850641 and CI (Odds ration = 1.288, 95 % confidence interval = 0.993-1.670, P = 0.056). TNFSF4 gene polymorphism rs3861950, but not rs3850641, is associated with the risk of atherosclerosis CI in a Chinese population.

Public and professional education on urgent therapy for acute ischemic stroke: a community-based intervention in Changsha.

Excessive delay of presentation for stroke in China is reported. In this study, an intervention trial was conducted to promote urgent therapy for acute ischemic stroke. Two communities in Changsha were selected as either intervention or control community from November 2007 to December 2011. Public and professional education was regularly implemented in the intervention community. Publics' knowledge about early identification and urgent therapy of ischemic stroke was surveyed before and after intervention in the two communities. During the intervention period, first-ever ischemic stroke cases occurring in the intervention community (intervention group) and that in the control community (control group) were collected and followed for 90 days. After intervention, the publics' knowledge levels in the intervention community improved significantly. Intervention group' average presentation time was shorter than control group (8.3 ± 5.8 vs. 10.5 ± 6.5 h, P = 0.018). Percentage of presentation time within 3 h (48.0 %), the rate of ambulance use (59.0 %), and thrombolytic therapy (9.3 %) in the intervention group was all obviously higher than that in the control group (21.5, 41.3, and 4.5, respectively). When admitted, the intervention group had lower mean systolic blood pressure (160.8 ± 26.7 vs. 164.7 ± 26.8 mmHg, P = 0.000) than control group. Survivors in the intervention group were more likely to be in higher Barthel index scoring groups than that in the control group at day 90 [(75, 50-100) vs. (65, 35-90), P = 0.035]. Public and professional education may promote prompt presentation and urgent therapy for ischemic stroke, which may be helpful for patients' prognosis.

Salvianolic acid B protects SH-SY5Y neuroblastoma cells from 1-methyl-4-phenylpyridinium-induced apoptosis.

Parkinson's disease (PD) is associated with mitochondrial dysfunction, oxidative stress, and activation of the apoptotic cascade. In the study, we investigated the effects of salvianolic acid B (Sal B) on 1-methyl-4-phenylpyridinium (MPP(+))-treated SH-SY5Y cells, a classic in vitro model for PD. We found Sal B inhibited the loss of cell viability by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The underlying mechanisms of Sal B action were further studied. Treatment of SH-SY5Y cells with MPP(+) caused a loss of cell viability and mitochondrial membrane potential, condensation of nuclei, elevation in the level of reactive oxygen species (which was associated with cytochrome c release), an increase in the Bax/Bcl-2 mRNA ratio, and activation of caspase-3. Sal B ameliorated the MPP(+)-altered phenotypes. These results indicate that the Sal B protected SH-SY5Y cells against MPP(+)-induced apoptosis by relieving oxidative stress and modulating the apoptotic process. Our findings suggest that salvianolic acid B may be a promising agent to prevent PD.

[Negative association of FGA gene 128C/G polymorphism with cerebral infarction and its effect on plasma fibrinogen in Hunan Hans].

OBJECTIVE: To investigate the relationship of FGA gene 128C/G polymorphism and cerebral infarction (CI) and evaluate the effect of FGA-128C/G polymorphism on plasma fibrinogen in Hunan Hans. METHODS: FGA-128C/G polymorphism was detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and DNA sequencing in 194 CI patients and 114 healthy controls. RESULTS: There were CG and CC genotypes in the FGA-128C/G locus. No GG genotype was observed in Hunan Hans. There was no significant difference in genotype and allele frequencies between the controls and CI group (P> 0.05), and statistically significant difference was not found in fibrinogen (Fg) level between the CG and CC genotypes (P>0.05). After analyzing blood plasma Fg using the influencing factor multiple regression analysis, it was shown that the Fg level had no relationship with the FGA-128C/G genotype, but it increased with age. And the Fg level in males was higher than that in females. CONCLUSION: There was FGA gene 128C/G polymorphism in the Hunan Han population. There was no association of this polymorphism with the increased Fg level of CI patient in the population. FGA-128C/G might not be the predisposing gene of CI in Hunan Han population. The age and sex were the major factors affecting the plasma Fg level in this population.

[Association of single nucleotide polymorphisms of kallikrein 1 gene with cerebral hemorrhage in Changsha Han Chinese].

OBJECTIVE: To explore the association between single nucleotide polymorphisms (SNPs) of KLK1 gene and cerebral hemorrhage in Changsha Han Chinese. METHODS: Two hundred and seventy-three cerebral hemorrhage (CH) patients and 140 healthy controls were collected. The SNPs of rs5516 and rs5517 loci of KLK1 gene were analyzed by SNaPshot methods and direct sequencing. RESULTS: (1)Genotype and allele frequencies in rs5516 locus had no difference between the CH patients and controls (P> 0.05). However, the A allele frequency of the rs5517 locus in CH patients was higher than that in the control group (0.419, 0.321 respectively, P< 0.05). (2)In the control group,the levels of diastolic blood pressure (DBP) of the GA and AA genotype carriers of the rs5517 locus were significantly higher than those of the GG genotype (P< 0.05), while the levels of blood pressure were not significantly different among different genotypes of the rs5516 polymorphism in both CH patients and the control group(P> 0.05). CONCLUSION: Author's preliminary results suggested that the rs5517 polymorphism was associated with cerebral hemorrhage, while the rs5516 polymorphism was not in Changsha Han Chinese.

[Prospective study on associations between levels of total cholesterol, triglyceride and risk of ischemic and hemorrhagic strokes].

OBJECTIVE: To explore associations between levels of total cholesterol (TC), triglyceride (TG) and incidence of ischemic and hemorrhagic strokes in populations. METHODS: Baseline investigations on stroke-related risk factors and physical examinations were performed in 10 093 (> 35 years) stroke-free urban community residents from 5 cities in China during May to July in 1987, follow-up investigations on stroke events were made during 1998 to 2000. The hazard ratios and 95% confidence intervals (CI) of ischemic and hemorrhagic strokes in middle, high tertiles of baseline TC or TG levels were compared with low baseline tertile residents using the Cox regression model. RESULTS: There were 491 first strokes during the 8-years cohort follow-up. Compared with the low tertile, risk of ischemic stroke in the middle and high tertiles of TC level was increased by 61% (HR: 1.61, 95%CI: 1.14-2.27) and 58% (HR: 1.58, 95%CI: 1.12-2.22) after adjustments for DBP, age, sex and other variables in the Cox proportional hazards model. Compared with the low tertile, risk of ischemic stroke in the high tertile of TG level was increased by 43% (HR: 1.43, 95%CI: 1.02-2.00). However, risk of hemorrhagic stroke in the middle and high tertiles of TC level decreased by 12% (HR: 0.88, 95%CI: 0.64-1.22) and 33% (HR: 0.67, 95%CI: 0.48-0.95) compared with the low tertile. CONCLUSIONS: Elevated serum TC and TG are independent risk factors for risk of ischemic stroke. However, low TC was related with increased risk of hemorrhagic stroke.

[Effects of tetrahydroxystilbene glucoside on nerve growth factor and growth associated protein in rats after cerebral ischemia-reperfusion].

OBJECTIVE: To investigate the effects of terahydroxy stilbene glucoside (TSG) on neurological deficits, the expressions of nerve growth factor (NGF) and growth associated protein43 (GAP43) in rats after Cerebral Ischemia-reperfusion. METHODS: 96 Sprague-Dawley male rats were divided into four groups (n = 24): control group, ischemia-reperfusion (I/R) model group, low dose TSG (60 mg/kg) group and high dose TSG (120 mg/kg) group. After 6 days' administration of TSG or natural saline (model group), reversible middle cerebral artery occlusion (MCAO) model was established by intraluminal suture technique. Rats in control group were operated while middle cerebral artery were not blocked. At 6, 24, 48 h and 7 d after reperfusion, behavior test was used to evaluate the neurological deficiency of each group. The expressions of NGF and GAP-43 in the cortex were measured by immunohistochemical method. RESULTS: Compared with model group, both dose of TSG could decrease the grade of the rat neurological defects except at 6 h of ter reperfusion and increase the protein expressions of NGF and GAP-43 after reperfusion. CONCLUSION: TSG can improve the neurological function through increasing the expressions of NGF and GAP-43 of cerebral ischemia-reperfusion rats.

Association between Val/Leu(247) polymorphism of apolipoprotein H and cerebral infarction in a Chinese population.

BACKGROUND: Antiphospholipid antibodies (aPL) are considered to be a cause of an acquired hypercoagulable state leading to cerebral infarction (CI). Apolipoprtein H (apoH) is an important target antigen for aPL and thus apoH polymorphisms may influence aPL production and the development of CI. The purpose of this study was to identify associations between the Val/Leu(247) polymorphism of apoH gene and CI in a Chinese cohort. METHODS: This study comprised 130 CI patients and 100 healthy control subjects. Polymorphism assignment was determined by polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) technique and DNA sequencing. The presence of aPL was detected by ELISA utilizing irradiated ELISA plates. RESULTS: Our results demonstrated an association between the Val/Leu(247) polymorphism of apoH gene and aPL in CI patients. The frequency of V allele was significantly higher in aPL-positive CI patients compared with control group (chi(2) = 6.864, P < 0.05). VL genotype frequency was also significantly higher in aPL-positive CI group compared with control group (chi(2) = 13.879, P < 0.05) and aPL-negative CI group (chi(2) = 5.567, P < 0.05). CONCLUSIONS: The Val(247) allele of apoH gene is significantly associated with the presence of aPL in Chinese patients with CI.

Palmitic and linoleic acids impair endothelial progenitor cells by inhibition of Akt/eNOS pathway.

BACKGROUND: Endothelial progenitor cells (EPCs) are involved in adult neovasculogenesis and maintenance of vascular integrity. Scarce data have been provided for the individual effect of elevated free fatty acids (FFAs) on EPCs. This study was designed to investigate the association between Akt/eNOS signal pathway changes and the proliferation/function of EPCs in the presence of palmitic and linoleic acids. METHODS: After 14-day culture, EPCs were stimulated with different concentrations of palmitic and linoleic acids, with or without SNP, L-NAME, or LY294002. The proliferation and ability of adhesion, migration and tube structure formation of EPCs were observed and the level of phosphorylated Akt protein expression and eNOS protein expression were assayed. RESULTS: Incubation with palmitic and linoleic acids at concentrations of 0.2 muM or higher inhibited EPCs proliferation, significantly reduced migratory rate, reduced adhesion to fibronectin and impaired ability of EPCs to form tube structure in a dose-dependent manner. A simultaneous dose-dependent NO generation and Akt phosphorylation decrease as well as eNOS expression reduction at protein levels were also observed. However, all of the detrimental effects were attenuated by pretreating EPCs with SNP, NO donor. AKT and eNOS inhibitor, LY294002 and L-NAME, respectively, augmented palmitic and linoleic acids inhibitory effects on EPCs. CONCLUSIONS: These findings suggest that palmitic and linoleic acids downregulated AKT/eNOS signal pathway, which contributed to overall poor function and decrease proliferation of EPCs. These changes induced by palmitic and linoleic acids in signaling offer a novel explanation for the overall poor function of EPCs in diabetes mellitus.

[Positive association of apolipoprotein B gene C7673T polymorphism with cerebral hemorrhage with family history].

OBJECTIVE: To investigate the relationship between C7673T polymorphism of apolipoprotein B (apoB) and cerebral hemorrhage with family history (CHFH) in Chinese Han in Changsha, Hunan province. METHODS: Fifteen families of CHFH and 93 sporadic cerebral hemorrhage patients and 100 normal controls were collected. The C7673T polymorphism of apoB was analyzed by PCR-restriction fragment length polymorphism and direct DNA sequencing. The triglyceride(TG), total cholesterol(TC), high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol(LDL-C) levels were examined by oxidase method. The serum level of lipoprotein (a) was determined by immune method. RESULTS: (1)The allele T frequencies of apoB C7673T polymorphism in cerebral hemorrhage patients with family history, first-degree relatives, second-degree relatives, third-degree relatives, the sporadic cerebral hemorrhage patients and the control group were 0.176, 0.136, 0.058, 0.048, 0.081 and 0.040, respectively. (2) The allele T frequencies of apoB C7673T polymorphism in CHFH patients and their first-degree relatives were significantly higher than that of the control group (P< 0.01, P< 0.01), while there was no significant difference among second-degree relatives, third-degree relatives and control group (P> 0.05). And the allele T frequency of apoB C7673T in CHFH patients was significantly higher than that of sporadic cerebral hemorrhage patients (P< 0.05). (3)In CHFH patients and sporadic cerebral hemorrhage group, the levels of TC and LDL-C of the TC genotype were significantly higher than those of the CC genotype, while the level of HDL-C in the TC genotype was significantly lower than that of the CC geneotype (P< 0.05). CONCLUSION: (1)The allele T of apoB C7673T polymorphism may be related to cerebral hemorrhage with family history. (2) The allele T of apoB C7673T polymorphism may increase the susceptibility of cerebral hemorrhage by changing blood lipid levels.

[Deficient mRNA expression of specific protein 3 gene in peripheral blood mononuclear cells from patients with multiple sclerosis].

OBJECTIVE: To characterize the deficiency of the mRNA expression of specific protein (SP3) gene in peripheral blood mononuclear cells (PBMCs) from Chinese patients with multiple sclerosis (MS) and study its correlation with the disease phenotypes. METHODS: Fifty-six patients with definite MS were collected and total RNA was extracted from their PBMCs. Specific primers corresponding to SP3 gene were designed and the mRNA expression of SP3 gene was detected by reverse transcriptase-PCR (RT-PCR) method. The deficiency of SP3 expression was compared among MS patients, irrelevant disease group and normal controls. RESULTS: Of the 56 MS cases, 23 (41.1%) were SP3-deficient. In contrast, the frequency of SP3-deficiency in normal subjects and irrelevant disease controls was 8.6% (5/35) and 14.3% (4/27), respectively. The frequency of the SP3-expression deficiency in MS patients was significantly higher than that in both control groups (P< 0.01). Within the MS cases, the scores of expanded disability status scale (EDSS) in the SP3-expressing subjects were significantly different from that in the SP3-deficient ones in the stable, but not in the active, phase of MS (P< 0.05). CONCLUSION: Author's observation suggested that deficient expression of SP3 gene occurs in Chinese MS patients, and that the SP3 expression may correlate with the clinical manifestations of MS and play roles in its immunological pathogenesis.

[The association of apolipoprotein B gene polymorphism with cerebral infarction with positive family history and its effect on plasma lipid levels].

OBJECTIVE: To explore the relationship between apolipoprotein B (apoB) gene G12669A polymorphism and cerebral infarction with family history, and to evaluate the effect of G12669A polymorphism on plasma lipid levels. METHODS: Peripheral blood samples were collected from 147 members of 15 cerebral infarction families, including 47 cerebral infarction patients with positive family history (CIFH-P), 43 first-degree relatives (CIFH-I), 28 second-degree relatives (CIFH-II), and 29 third-degree relatives (CIFH-III), 83 sporadic cerebral infarction (SCI) patients, and 100 healthy controls. Polymerase chain reaction- restriction fragment length polymorphism was used to detect the apoB gene G12669A polymorphism. Oxidase method was used to detect the levels of triglyceride (TG), total cholesterol (TC), high-density lipoprotein (HDL), and low-density lipoprotein (LDL). The serum levels of lipoprotein (a) [LP (a)], apoB-100, and apoAI were determined by immune method. RESULTS: (1) The frequencies of A allele in the CIFH-P, CIFH-I, CIFH-II, CIFH-III, and SCI groups patients and control group were 0.106, 0.081, 0.036, 0.034, 0.090, and 0.045 respectively, that of the CIFH-P group being significantly higher than that of the control group (P < 0.05), and those of the CIFH-I, CIFH-II, CIFH-III, and SCI groups not being significantly different from that of the control group. (2) In both CIFH-P and SCI groups, the TC and LDL-C levels of the patients with G/A gene type were significantly higher than those of the G/G gene type, while the HDL-C level of the patients with G/A gene type was significantly lower than that of the G/G gene type (all P < 0.05). CONCLUSION: A allele in G12669A polymorphism may be one of the genetic factors influencing the susceptibility to CI in the individuals with a positive family history, and it may play its role through its influence on the blood lipid levels.

[Effect of apoB polymorphism on plasma lipid levels and cerebral hemorrhage in Changsha Han Chinese].

OBJECTIVE: To explore the effect of apoB polymorphism on plasma lipid levels and cerebral hemorrhage in (CH) Changsha Han Chinese. METHODS: One hundred thirty CH patients and 100 normal people were involved. C7673T polymorphism of apoprotein B was analyzed by PCR-restriction fragment length polymorphism (PCR-PFLP); and the triglyceride(TG), total cholesterol (TC), high density lipoprotein-cholesterol (HDL), and low density lipoprotein-cholesterol(LDL) levels were examined by oxidase method. The serum level of lipoprotein(a) was determined by immunology method. RESULTS: (1) Allele T frequencies of apoB C7673T in CH patients and the control group were 0.108 and 0.040, respectively. Allele T frequencies of apoB C7673T in the CH patients were significantly higher than those in the control group (P< 0.01). (2) In the CH patients, the levels of TC and LDLjC of the T/C gene type were significantly higher than those of the C/C gene type, while the levels of HDLjC of the T/C gene type were significantly lower than those of the C/C gene type (P< 0.05). CONCLUSION: ApoB C7673T polymorphism may be related to cerebral hemorrhage, and the changing blood lipid level may increase the susceptibility of CH.

Effect of polygonum multiflorum on the fluidity of the mitochondria membrane and activity of COX in the hippocampus of rats with Abeta 1-40-induced Alzheimer's disease.

OBJECTIVE: To explore the effect of polygonum multiflorum on the fluidity of mitochondria membrane and activity of cytochrome oxidase (COX) in Alzheimer's disease (AD) model rats. METHODS: Forty-five SD rats were randomly divided into 3 groups: an AD model group, a control group, and a treatment group (n=15). AD model was established by injecting beta-amyloid protein (Abeta) 1-40 into the hippocampus of rats. The learning and memory abilities of rats were tested with the Y-electrical maze. The coefficient of viscosity of the hippocampal mitochondria membrane was determined by a spectrofluorometer, and the activity of COX was measured by an ultraviolet spectrophotometer. RESULTS: Compared with the control group, the learning and memory ability of the AD model group was significantly lower (P<0.01), while the coefficient of viscosity of the hippocampal mitochondria membrane of the AD model group rats was significantly higher (P<0.01), and COX activity was lower (P<0.01). Compared with the AD model group rats, the coefficient of viscosity of the hippocampal mitochondria membrane of the treatment group was significantly lower (P<0.05), and COX activity was significantly improved (P<0.05). CONCLUSION: Polygonum multiflorum could improve the fluidity of mitochondria membrane and the activity of mitochondrial COX in the model of Alzheimer's disease.

Effect of willed movement training on neurorehabilitation after focal cerebral ischemia and on the neural plasticity-associated signaling pathway.

Neurorehabilitation training is a therapeutic intervention for the loss of neural function induced by focal cerebral ischemia, however, the effect varies depending on the neurorehabilitation exercises. Willed movement (WM) training is defined as task­oriented training, which increases enthusiasm of patients to accomplish a specific task. The current study was performed to the evaluate effect of WM training on neurorehabilitation following focal cerebral ischemia, and further investigate the influence on neural plasticity­associated signaling pathway. Sprague­Dawley rats following temporary middle cerebral artery occlusion (tMCAO) were randomly divided into four groups: tMCAO (no rehabilitation training), CR (control rehabilitation), EM (environmental modification) and WM groups. Rats in the CR group were forced to exercise (running) in a rotating wheel. In the WM group, food was used to entice rats to climb on a herringbone ladder. Herringbone ladders were also put into the cages of the rats in the CR and EM groups, however without the food attraction. WM group exhibited an improvement in neurobehavioral performance compared with other groups. TTC staining indicated an evident reduction in brain damage in the WM group. There were increased synaptic junctions following WM training, based on the observations of transmission election microscopy. Investigation of the molecular mechanism suggested that WM training conferred the greatest effect on stimulating the extracellular signal­related kinase (ERK)/cyclic adenosine monophosphate response element­binding protein 1 (CREB) pathway and glutamate receptor 2 (GluR2)/glutamate receptor interacting protein 1­associated protein 1 (GRASP­1)/protein interacting with C­kinase 1 (PICK1) cascades among groups. Collectively, the improvement of neurobehavioral performance by WM training following tMCAO is suggested to involve the ERK/CREB pathway and GluR2/GRASP­1/PICK1 cascades. The present study provided a preliminary foundation for future research on the therapeutic effect of WM training against stroke­induced neuron damage.

Change in stroke incidence from a population-based intervention trial in three urban communities in China.

Stroke has been the main cause of death in most urban residents in China since the 1990s. A community-based intervention trial carried out in China aimed to reduce the incidence and mortality of stroke. In 1991, two well-matched communities each with approximately 50,000 people were selected as intervention or control communities in the urban areas of Beijing, Shanghai and Changsha. Regular health education and health promotion activities were carried out between 1991 and 2000 in the intervention communities but no special action was taken in the control communities. Both fatal and nonfatal stroke cases were meticulously registered during the study in the two communities to assess the effect of long-term intervention. The trend in stroke incidence and the effect of intervention on stroke incidence were analyzed using a Poisson regression model adjusted for age, sex, year and city. Between 1991 and 2000, 2,273 first-ever stroke cases were registered in the intervention communities and 3,015 in the control communities. Geographic variation and changes in the incidence of stroke and its subtypes were found among these 3 cities. Through 10 years of intervention, incidence risks of all, ischemic and hemorrhagic strokes decreased by 11.4% (relative risk 0.8959; 95% confidence interval, CI, 0.8483-0.9460; p < 0.0001), 13.2% (relative risk 0.8676; 95% CI 0.8054-0.9345; p = 0.0002) and 7.2% (relative risk 0.9283; 95% CI 0.8517-1.0117; p = 0.0899), respectively, in the intervention compared with control communities. Accordingly, comprehensive community-based intervention measures could effectively reduce the incidence of stroke in the population.

Cerebral angiogenesis after collagenase-induced intracerebral hemorrhage in rats.

Spontaneous intracerebral hemorrhage (ICH) is one of the most devastating subtypes of stroke. Since angiogenesis is a fundamental process to brain development and repair by new blood vessel formation from pre-existing ones, mediated by numerous angiogenic factors including vascular endothelial growth factor (VEGF), the goal of the present work is to establish whether there is cerebral angiogenesis in rat brains with collagenase-induced ICH. Investigations were also performed to evaluate whether ICH alters expression of VEGF and its receptors Flt-1 and Flk-1. ICH was induced on adult male Sprague-Dawley rats by stereotactic injection of collagenase type VII into right globus pallidus. Angiogenesis was identified by hematoxylin-eosin stain and double immunolabeling method, and expression of VEGF and the receptors was evaluated by immunohistochemistry and quantitative real time reverse transcription-polymerase chain reaction. New vessels appeared around the hematoma and extended into it from 7 days, and 5-Bromo-2-Deoxyuridine-labeled nuclei in cerebral endothelial cells resided around the hematoma and the labeling peaked from 7 to 14 days. Expression of VEGF, Flt-1 and Flk-1 was observed in cerebral endothelial cells at the hemorrhagic basal ganglion, and increases of their mRNA persisted to 28 days. These findings suggest that ICH can induce cerebral angiogenesis and upregulation of VEGF, Flt-1 and Flk-1 and that modulation of angiogenesis via altering expression of VEGF and its receptors may be a potential strategy for promoting ICH repair.

[COX-2 and mPGES-1 expression in carotid atherosclerotic plaques].

OBJECTIVE: To investigate the changes in the expressions of inducible cyclooxygenase type 2 (COX-2) and membrane associated prostaglandin E-1(mPGES-1) in human carotid atherosclerotic plaques and to explore possible mechanisms of inflammatory process involved in plaque stability. METHODS: The mRNA and protein levels of COX-2 and mPGES-1 were compared between minimally and grossly atherosclerotic arterial tissues. COX-2 and mPGES-1 gene expression were established by immunohistochemistry and reverse transcriptase-polymerase chain reaction (RT-PCR) in 10 mesenchymal artery controls and 24 atherosclerotic specimens. Presence of COX-2 and mPGES-1 protein was assessed by Western blotting. RESULTS: Immunohistochemical staining showed that the COX-2 and mPGES-1 immunoreactive substances were present in the cytoplasm of smooth muscle cell. Compared with the control group, immunostaining positive cells increased in carotid atherosclerotic plaque group. COX-2 and mPGES-1 gene expression was significantly elevated in atherosclerotic plaques (P< 0.05, respectively). The increased mRNA and protein levels of COX-2 and mPGES-1 were correlated in atherosclerotic tissue (P< 0.05). The mRNA and protein levels of COX-2 and mPGES-1 related to degree of pathological damage in atherosclerotic tissue (P< 0.05). COX-2 and mPGES-1 were not found in the control group (mesenteric vascular walls). CONCLUSION: COX-2 and mPGES-1 expression in plaques is significantly higher than that in the control group. These findings suggests that COX-2 and mPGES-1 might play a role in pathogenesis of atheroscleros and modulation of inflammatory process involved in plaque stability, and COX-2 may have proinflammatory enzyme properties.