Recent studies have proposed three lymphatic drainage systems in the brain,that is,the glymphatic system,the intramural periarterial drainage pathway,and meningeal lymphatic vessels,whose roles in various neurological...Recent studies have proposed three lymphatic drainage systems in the brain,that is,the glymphatic system,the intramural periarterial drainage pathway,and meningeal lymphatic vessels,whose roles in various neurological diseases have been widely explored.The glymphatic system is a fluid drainage and waste clearance pathway that utilizes perivascular space and aquaporin-4 protein located in the astrocyte endfeet to provide a space for exchange of cerebrospinal fluid and interstitial fluid.The intramural periarterial drainage pathway drives the flow of interstitial fluid through the capillary basement membrane and the arterial tunica media.Meningeal lymphatic vessels within the dura mater are involved in the removal of cerebral macromolecules and immune responses.After ischemic stroke,impairment of these systems could lead to cerebral edema,accumulation of toxic factors,and activation of neuroinflammation,while restoration of their normal functions can improve neurological outcomes.In this review,we summarize the basic concepts of these drainage systems,including drainage routes,physiological functions,regulatory mechanisms,and detection technologies.We also focus on the roles of lymphatic drainage systems in brain injury after ischemic stroke,as well as recent advances in therapeutic strategies targeting these drainage systems.These findings provide information for potential novel strategies for treatment of stroke.展开更多
Sickle cell disease is a hereditary disease that remains a public health problem in Mali. Our objective was to study strokes in children with sickle cell disease aged from 6 months to 15 years in the pediatrics depart...Sickle cell disease is a hereditary disease that remains a public health problem in Mali. Our objective was to study strokes in children with sickle cell disease aged from 6 months to 15 years in the pediatrics department of the Gabriel Toure university hospital center. This was a retrospective descriptive study from April 1, 2019 to March 31, 2021 and prospective from April 1, 2021 to April 30, 2022, i.e. 3 years, which took place in the Pediatrics department of the Gabriel Toure university hospital center. During this study, we identified 22 cases of stroke among 714 children with sickle cell disease. The frequency of stroke in this population is 3.08%. The age group from1 to 5 years was the most affected with 40.9%. The average age of the patients was 7 years with extremes ranging from 1 year to 15 years and a median of 5 years. The male gender was predominant with 54.5%, for a sex ratio of 1.2. Headaches were the most common neurological antecedents (63.5%). Half of the patients were diagnosed with sickle cell disease after the onset of the stroke. The installation of the deficit was progressive in 54.5% of cases. Consciousness disorders were the most frequent reason of consultation (27.2%), followed by convulsions (18.1%). The most common neurological signs were impaired consciousness and hemiparesis with 45.5% each. The stroke was ischemic in 100% of cases. There were 95.5% of SS forms and 4.5% of Sβ<sup>0</sup>thalassemia forms. Our patients had a hemoglobin level less than 7 g/dl in 57.1% of cases and between 7 and 9 g/dl in 42.8% of cases and hyperleukocytosis (leukocytes > 10,000/mm<sup>3</sup>) in 95.4% of cases. The Sylvian artery was the most affected (45.5%). The fatality rate was 22.7%.展开更多
Ischemic stroke is one of the most common causes of mortality and disability worldwide.However,treatment efficacy and the progress of research remain unsatisfactory.As the critical support system and essential compone...Ischemic stroke is one of the most common causes of mortality and disability worldwide.However,treatment efficacy and the progress of research remain unsatisfactory.As the critical support system and essential components in neurovascular units,glial cells and blood vessels(including the bloodbrain barrier)together maintain an optimal microenvironment for neuronal function.They provide nutrients,regulate neuronal excitability,and prevent harmful substances from entering brain tissue.The highly dynamic networks of this support system play an essential role in ischemic stroke through processes including brain homeostasis,supporting neuronal function,and reacting to injuries.However,most studies have focused on postmortem animals,which inevitably lack critical information about the dynamic changes that occur after ischemic stroke.Therefore,a high-precision technique for research in living animals is urgently needed.Two-photon fluorescence laser-scanning microscopy is a powerful imaging technique that can facilitate live imaging at high spatiotemporal resolutions.Twophoton fluorescence laser-scanning microscopy can provide images of the whole-cortex vascular 3D structure,information on multicellular component interactions,and provide images of structure and function in the cranial window.This technique shifts the existing research paradigm from static to dynamic,from flat to stereoscopic,and from single-cell function to multicellular intercommunication,thus providing direct and reliable evidence to identify the pathophysiological mechanisms following ischemic stroke in an intact brain.In this review,we discuss exciting findings from research on the support system after ischemic stroke using two-photon fluorescence laser-scanning microscopy,highlighting the importance of dynamic observations of cellular behavior and interactions in the networks of the brain’s support systems.We show the excellent application prospects and advantages of two-photon fluorescence laser-scanning microscopy and predict future research deve展开更多
In this paper,we proposed a contrast-enhanced homemade spectral domain optical coherence tomography(SD-OCT)method for monitoring of brain microcirculation.We used the polyethylene glycol(PEG)-ylated gold nanorods(GNRs...In this paper,we proposed a contrast-enhanced homemade spectral domain optical coherence tomography(SD-OCT)method for monitoring of brain microcirculation.We used the polyethylene glycol(PEG)-ylated gold nanorods(GNRs)as a contrast-enhanced agent,obtained clearly 2D and 3D OCT images of blood vessels and dynamic changes of probes in mouse blood vessels.Owing to high scattering of the PEG-GNRs,more tiny blood vessels can be imaged and the OCT signal can be enhanced by 5.87 dB after injection of PEG-GNRs for 20 min,the enhancement then declined gradually for 60 min.Our results demonstrate an effective technique for the enhanced imaging of blood vessels in vivo,especially for studies of the brain microcirculation,which could be serviced for disease mechanism research and therapeutic drug monitoring.展开更多
目的探讨人脑梗死灶周围组织星形胶质细胞和微血管的变化。方法应用9例因脑梗死而死亡尸检全脑标本,常规 HE 和免疫组织化学染色(SP)标记星形胶质细胞中的胶质纤维酸性蛋白(GFAP)和微血管标记物(CD31),观察星形胶质细胞和微血管的变化...目的探讨人脑梗死灶周围组织星形胶质细胞和微血管的变化。方法应用9例因脑梗死而死亡尸检全脑标本,常规 HE 和免疫组织化学染色(SP)标记星形胶质细胞中的胶质纤维酸性蛋白(GFAP)和微血管标记物(CD31),观察星形胶质细胞和微血管的变化规律。结果以梗死灶为中心,由内到外可分4个区(0～3区);GFAP 在0区和1区表达很少,在2区和3区随缺血时间延长表达持续升高;CD31在0区无表达,在1区可见少量表达,在2区和3区随缺血时间延长表达持续升高。结论脑梗死后星形胶质细胞和微血管反应性增生,在缺血后期 GFAP、CD31广泛表达,两者在组织损伤修复重建过程中起重要作用。展开更多
目的探讨CT一站式检查在脑血肿中的诊断价值。方法选取2015年1~12月在该院行CT平扫并诊断为脑血肿患者50例,均行CT一站式检查,测量血肿体积、血肿边缘区及血肿外层区脑CT灌注成像（CTP）参数,即达峰时间（TTP）、平均通过时间（MTT）、...目的探讨CT一站式检查在脑血肿中的诊断价值。方法选取2015年1~12月在该院行CT平扫并诊断为脑血肿患者50例,均行CT一站式检查,测量血肿体积、血肿边缘区及血肿外层区脑CT灌注成像（CTP）参数,即达峰时间（TTP）、平均通过时间（MTT）、脑血流量（CBF）、脑血容量（CBV）,比较血肿边缘区和外层区的灌注参数差异,并通过四维CT血管造影（4D-CTA）分析血肿的责任血管。结果血肿平均体积为（18.83±11.91）m L,其中40例小于30 m L,6例为30~60 m L,4例大于60 m L。CTP显示,血肿边缘区TTP、MTT较外层区延长,CBF、CBV明显降低,差异有统计学意义（P〈0.05）。4D-CTA显示,23例责任血管,其中8例动脉瘤,4例烟雾病,6例动静脉畸形,5例动脉粥样硬化,血管阴性27例。结论 CT一站式检查能三维立体显示血肿周围血流动力学改变及责任血管,具有重要的临床诊断价值。展开更多
基金supported by the Natural Science Foundation of Beijing(Key Program)No.Z200025(to JHY)+1 种基金the National Natural Science Foundation of China,No.81873818(to LHQ)Supporting Platform Construction Project of Peking University Health Science Center,No.BMU2021ZC011(to JHY).
文摘Recent studies have proposed three lymphatic drainage systems in the brain,that is,the glymphatic system,the intramural periarterial drainage pathway,and meningeal lymphatic vessels,whose roles in various neurological diseases have been widely explored.The glymphatic system is a fluid drainage and waste clearance pathway that utilizes perivascular space and aquaporin-4 protein located in the astrocyte endfeet to provide a space for exchange of cerebrospinal fluid and interstitial fluid.The intramural periarterial drainage pathway drives the flow of interstitial fluid through the capillary basement membrane and the arterial tunica media.Meningeal lymphatic vessels within the dura mater are involved in the removal of cerebral macromolecules and immune responses.After ischemic stroke,impairment of these systems could lead to cerebral edema,accumulation of toxic factors,and activation of neuroinflammation,while restoration of their normal functions can improve neurological outcomes.In this review,we summarize the basic concepts of these drainage systems,including drainage routes,physiological functions,regulatory mechanisms,and detection technologies.We also focus on the roles of lymphatic drainage systems in brain injury after ischemic stroke,as well as recent advances in therapeutic strategies targeting these drainage systems.These findings provide information for potential novel strategies for treatment of stroke.
文摘Sickle cell disease is a hereditary disease that remains a public health problem in Mali. Our objective was to study strokes in children with sickle cell disease aged from 6 months to 15 years in the pediatrics department of the Gabriel Toure university hospital center. This was a retrospective descriptive study from April 1, 2019 to March 31, 2021 and prospective from April 1, 2021 to April 30, 2022, i.e. 3 years, which took place in the Pediatrics department of the Gabriel Toure university hospital center. During this study, we identified 22 cases of stroke among 714 children with sickle cell disease. The frequency of stroke in this population is 3.08%. The age group from1 to 5 years was the most affected with 40.9%. The average age of the patients was 7 years with extremes ranging from 1 year to 15 years and a median of 5 years. The male gender was predominant with 54.5%, for a sex ratio of 1.2. Headaches were the most common neurological antecedents (63.5%). Half of the patients were diagnosed with sickle cell disease after the onset of the stroke. The installation of the deficit was progressive in 54.5% of cases. Consciousness disorders were the most frequent reason of consultation (27.2%), followed by convulsions (18.1%). The most common neurological signs were impaired consciousness and hemiparesis with 45.5% each. The stroke was ischemic in 100% of cases. There were 95.5% of SS forms and 4.5% of Sβ<sup>0</sup>thalassemia forms. Our patients had a hemoglobin level less than 7 g/dl in 57.1% of cases and between 7 and 9 g/dl in 42.8% of cases and hyperleukocytosis (leukocytes > 10,000/mm<sup>3</sup>) in 95.4% of cases. The Sylvian artery was the most affected (45.5%). The fatality rate was 22.7%.
基金supported by grants from the National Natural Science Foundation of China,Nos.92148206,82071330(to ZPT)82201745(to HN)the Natural Science Foundation of Hubei Province,China,Nos.2021BCA109(to ZPT)and 2021CFB067(to HN)。
文摘Ischemic stroke is one of the most common causes of mortality and disability worldwide.However,treatment efficacy and the progress of research remain unsatisfactory.As the critical support system and essential components in neurovascular units,glial cells and blood vessels(including the bloodbrain barrier)together maintain an optimal microenvironment for neuronal function.They provide nutrients,regulate neuronal excitability,and prevent harmful substances from entering brain tissue.The highly dynamic networks of this support system play an essential role in ischemic stroke through processes including brain homeostasis,supporting neuronal function,and reacting to injuries.However,most studies have focused on postmortem animals,which inevitably lack critical information about the dynamic changes that occur after ischemic stroke.Therefore,a high-precision technique for research in living animals is urgently needed.Two-photon fluorescence laser-scanning microscopy is a powerful imaging technique that can facilitate live imaging at high spatiotemporal resolutions.Twophoton fluorescence laser-scanning microscopy can provide images of the whole-cortex vascular 3D structure,information on multicellular component interactions,and provide images of structure and function in the cranial window.This technique shifts the existing research paradigm from static to dynamic,from flat to stereoscopic,and from single-cell function to multicellular intercommunication,thus providing direct and reliable evidence to identify the pathophysiological mechanisms following ischemic stroke in an intact brain.In this review,we discuss exciting findings from research on the support system after ischemic stroke using two-photon fluorescence laser-scanning microscopy,highlighting the importance of dynamic observations of cellular behavior and interactions in the networks of the brain’s support systems.We show the excellent application prospects and advantages of two-photon fluorescence laser-scanning microscopy and predict future research deve
基金This work has been partially supported by the National Key R&D Program of China(2017YFA0700402)National Basic Research Program of China(2015CB352005)+3 种基金the National Natural Science Foundation of China(61722508/61525503/61620106016/61835009/81727804)Guangdong Natural Science Foundation Innovation Team(2014A030312008)Shenzhen Basic Research Project(JCYJ20150930104948169/JCYJ20160328-144746940/JCYJ20170412105003520)and Natural Science Foundation of SZU(2017027).
文摘In this paper,we proposed a contrast-enhanced homemade spectral domain optical coherence tomography(SD-OCT)method for monitoring of brain microcirculation.We used the polyethylene glycol(PEG)-ylated gold nanorods(GNRs)as a contrast-enhanced agent,obtained clearly 2D and 3D OCT images of blood vessels and dynamic changes of probes in mouse blood vessels.Owing to high scattering of the PEG-GNRs,more tiny blood vessels can be imaged and the OCT signal can be enhanced by 5.87 dB after injection of PEG-GNRs for 20 min,the enhancement then declined gradually for 60 min.Our results demonstrate an effective technique for the enhanced imaging of blood vessels in vivo,especially for studies of the brain microcirculation,which could be serviced for disease mechanism research and therapeutic drug monitoring.
文摘目的探讨人脑梗死灶周围组织星形胶质细胞和微血管的变化。方法应用9例因脑梗死而死亡尸检全脑标本,常规 HE 和免疫组织化学染色(SP)标记星形胶质细胞中的胶质纤维酸性蛋白(GFAP)和微血管标记物(CD31),观察星形胶质细胞和微血管的变化规律。结果以梗死灶为中心,由内到外可分4个区(0～3区);GFAP 在0区和1区表达很少,在2区和3区随缺血时间延长表达持续升高;CD31在0区无表达,在1区可见少量表达,在2区和3区随缺血时间延长表达持续升高。结论脑梗死后星形胶质细胞和微血管反应性增生,在缺血后期 GFAP、CD31广泛表达,两者在组织损伤修复重建过程中起重要作用。
文摘目的探讨CT一站式检查在脑血肿中的诊断价值。方法选取2015年1~12月在该院行CT平扫并诊断为脑血肿患者50例,均行CT一站式检查,测量血肿体积、血肿边缘区及血肿外层区脑CT灌注成像（CTP）参数,即达峰时间（TTP）、平均通过时间（MTT）、脑血流量（CBF）、脑血容量（CBV）,比较血肿边缘区和外层区的灌注参数差异,并通过四维CT血管造影（4D-CTA）分析血肿的责任血管。结果血肿平均体积为（18.83±11.91）m L,其中40例小于30 m L,6例为30~60 m L,4例大于60 m L。CTP显示,血肿边缘区TTP、MTT较外层区延长,CBF、CBV明显降低,差异有统计学意义（P〈0.05）。4D-CTA显示,23例责任血管,其中8例动脉瘤,4例烟雾病,6例动静脉畸形,5例动脉粥样硬化,血管阴性27例。结论 CT一站式检查能三维立体显示血肿周围血流动力学改变及责任血管,具有重要的临床诊断价值。
