Helicobacter pylori(H. pylori) infection is very common and affects approximately half of the world population. It causes gastric diseases, but some authors have reported an association of H. pylori infection with oth...Helicobacter pylori(H. pylori) infection is very common and affects approximately half of the world population. It causes gastric diseases, but some authors have reported an association of H. pylori infection with other systemic manifestations beginning in 1994. The list of potential effects of H. pylori outside the stomach includes a number of extragastric manifestations and we focused on neurological, dermatological, hematologic, ocular, cardiovascular, metabolic, allergic, and hepatobiliary diseases. This review discusses these important reported manifestations that are not related to the gastrointestinal tract.展开更多
Electroacupuncture has been widely used to treat cognitive impairment after cerebral ischemia,but the underlying mechanism has not yet been fully elucidated.Studies have shown that autophagy plays an important role in...Electroacupuncture has been widely used to treat cognitive impairment after cerebral ischemia,but the underlying mechanism has not yet been fully elucidated.Studies have shown that autophagy plays an important role in the formation and development of cognitive impairment,and the phosphoinositide 3-kinase(PI3K)/Akt signaling pathway plays an important role in autophagy regulation.To investigate the role played by the PI3K/Akt signaling pathway in the electroacupuncture treatment of cerebral ischemia/reperfusion rat models,we first established a rat model of cerebral ischemia/reperfusion through the occlusion of the middle cerebral artery using the suture method.Starting at 2 hours after modeling,electroacupuncture was delivered at the Shenting(GV24)and Baihui(GV20)acupoints,with a dilatational wave(1-20 Hz frequency,2 mA intensity,6 V peak voltage),for 30 minutes/day over 8 consecutive days.Our results showed that electroacupuncture reduced the infarct volume in a rat model of cerebral ischemia/reperfusion injury,increased the mRNA expression levels of the PI3K/Akt signaling pathwayrelated factors Beclin-1,mammalian target of rapamycin(mTOR),and PI3K,increased the protein expression levels of phosphorylated Akt,Beclin-1,PI3K,and mTOR in the ischemic cerebral cortex,and simultaneously reduced p53 mRNA and protein expression levels.In the Morris water maze test,the latency to find the hidden platform was significantly shortened among rats subjected to electroacupuncture stimulation compared with rats without electroacupuncture stimulation.In the spatial probe test,the number of times that a rat crossed the target quadrant was increased in rats subjected to electroacupuncture stimulation compared with rats without electroacupuncture stimulation.Electroacupuncture stimulation applied to the Shenting(GV24)and Baihui(GV20)acupoints activated the PI3K/Akt signaling pathway and improved rat learning and memory impairment.This study was approved by the Animal Ethics Committee of the First Affiliated Hospital of Henan Unive展开更多
Helicobacter pylori(H.pylori)is a bacterium that infects more than a half of world’s population.Although it is mainly related to the development of gastroduodenal diseases,several studies have shown that such infecti...Helicobacter pylori(H.pylori)is a bacterium that infects more than a half of world’s population.Although it is mainly related to the development of gastroduodenal diseases,several studies have shown that such infection may also influence the development and severity of various extragastric diseases.According to the current evidence,whereas this bacterium is a risk factor for some of these manifestations,it might play a protective role in other pathological conditions.In that context,when considered the gastrointestinal tract,H.pylori positivity have been related to Inflammatory Bowel Disease,Gastroesophageal Reflux Disease,Non-Alcoholic Fatty Liver Disease,Hepatic Carcinoma,Cholelithiasis,and Cholecystitis.Moreover,lower serum levels of iron and vitamin B12 have been found in patients with H.pylori infection,leading to the emergence of anemias in a portion of them.With regards to neurological manifestations,a growing number of studies have associated that bacterium with multiple sclerosis,Alzheimer’s disease,Parkinson’s disease,and Guillain-Barrésyndrome.Interestingly,the risk of developing cardiovascular disorders,such as atherosclerosis,is also influenced by the infection.Besides that,the H.pylori-associated inflammation may also lead to increased insulin resistance,leading to a higher risk of diabetes mellitus among infected individuals.Finally,the occurrence of dermatological and ophthalmic disorders have also been related to that microorganism.In this sense,this minireview aims to gather the main studies associating H.pylori infection with extragastric conditions,and also to explore the main mechanisms that may explain the role of H.pylori in those diseases.展开更多
目的 研究亚低温联合依达拉奉治疗急性脑梗死的疗效及对血清超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、神经元特异性烯醇化酶(Neuron-specific enolase ,NSE)、S100钙结合蛋白β(S100 calcium binding protein β,S1...目的 研究亚低温联合依达拉奉治疗急性脑梗死的疗效及对血清超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、神经元特异性烯醇化酶(Neuron-specific enolase ,NSE)、S100钙结合蛋白β(S100 calcium binding protein β,S100-β)水平的影响。方法 选取郑州大学附属郑州中心医院收治的急性脑梗死病人96例,随机分为对照组和研究组,各48例。对照组单纯予以依达拉奉治疗,研究组在此基础上施加亚低温治疗。比较两组治疗总有效率、不良反应情况等。记录治疗前后两组神经功能缺损(National Lnstitute of Health Stroke Scale, NHISS)评分和日常生活活动能力(Ability of Daily Life, ADL)评分。采集病人治疗前后血液样本,检测血清hs-CRP、NSE、S100-β蛋白水平及血浆超氧化物歧化酶(su-peroxidedismutase, SOD)和丙二醛(malondialdehyde,MDA)水平。结果 研究组治疗总有效率(91.67%)明显高于对照组(75.00%,χ2=4.80, P =0.03);治疗后,研究组血清学指标hs-CRP、S100-β、NSE均明显低于对照组(均 P <0.01);研究组SOD水平高于对照组( P <0.01),而MDA低于对照组( P <0.01);研究组ADL评分高于对照组( P <0.01),而NHISS评分低于对照组( P <0.01);两组不良反应发生率比较差异无统计学意义( P >0.05)。结论 亚低温联合依达拉奉治疗急性脑梗死疗效显著,可有效改善相关血清学指标,减轻体内氧化应激反应,改善病人神经功能及预后,且较安全可靠。展开更多
Data mining has the potential to provide information for improving clinical acupuncture strategies by uncovering hidden rules between acupuncture manipulation and therapeutic effects in a data set. In this study, we p...Data mining has the potential to provide information for improving clinical acupuncture strategies by uncovering hidden rules between acupuncture manipulation and therapeutic effects in a data set. In this study, we performed acupuncture on 30 patients with hemiplegia due to acute ischemic stroke. All participants were pre-screened to ensure that they exhibited immediate responses to acupuncture. We used a twirling reinforcing acupuncture manipulation at the specific lines between the bilateral Baihui（GV20） and Taiyang（EX-HN5）. We collected neurologic deficit score, simplified Fugl-Meyer assessment score, muscle strength of the proximal and distal hemiplegic limbs, ratio of the maximal H-reflex to the maximal M-wave（Hmax/Mmax）, muscle tension at baseline and immediately after treatment, and the syndromes of traditional Chinese medicine at baseline. We then conducted data mining using an association algorithm and an artificial neural network backpropagation algorithm. We found that the twirling reinforcing manipulation had no obvious therapeutic difference in traditional Chinese medicine syndromes of ＂Deficiency and Excess＂. The change in the muscle strength of the upper distal and lower proximal limbs was one of the main factors affecting the immediate change in Fugl-Meyer scores. Additionally, we found a positive correlation between the muscle tension change of the upper limb and Hmax/Mmax immediate change, and both positive and negative correlations existed between the muscle tension change of the lower limb and immediate Hmax/Mmax change. Additionally, when the difference value of muscle tension for the upper and lower limbs was 〉 0 or 〈 0, the difference value of Hmax/Mmax was correspondingly positive or negative, indicating the scalp acupuncture has a bidirectional effect on muscle tension in hemiplegic limbs. Therefore, acupuncture with twirling reinforcing manipulation has distinct effects on acute ischemic stroke patients with different symptoms or stages of disease. Improved muscle te展开更多
Background： Early neurological deterioration （END） is a prominent issue after recanalization treatment. However. few studies have reported the characteristics of END after endovascular treatment （EVT） as so far. ...Background： Early neurological deterioration （END） is a prominent issue after recanalization treatment. However. few studies have reported the characteristics of END after endovascular treatment （EVT） as so far. This study investigated the incidence, composition, and outcomes of END after intravenous recombinant tissue plasminogen activator （IV rt-PA） and EVT of acute ischemic stroke, and identified risk factors for END. Methods： Medical records of patients who received recanalization treatment between January l, 2014, and December 31, 2015 were reviewed. Patients were classified into IV rt-PA or EVT group according to the methods ofrecanalization treatment. The END was defined as an increase in the National Institutes of Health Stroke Scale （N1HSS） ≥4 or an increase in la of NIHSS ≥I within 72 h after recanalization treatment. Clinical data were compared between the END and non-END subgroups within each recanalization group. Results： Of the 278 patients included in the study, the incidence of END was 34.2%. The incidence rates of END were 29.8% in the IV rt-PA group and 40.2% in the EVT group, lschemia progression （68.4%） was the main contributor to END followed by vasogenic cerebral edema （21. 1%） and symptomatic intracranial hemorrhage （10.5%）. Multivariate logistic regression showed that admission systolic blood pressure （SBP） ≥160 mmHg （odds ratio [OR]： 2.312, 95% confidence interval [CI]： 1.105-4.837） and large artery occlusion after IV rt-PA （OR： 3.628.95% （7： 1.482-8.881 ） independently predicted END after IV rt-PA; and admission SBP 〉 140 mmHg （OR： 5.183, 95% CI：1.967 13.661 ）, partial recanalization （OR： 4.791,95% CI： 1.749-13.121 ）, and nonrecanalization （OR： 5.952, 95% CI： 1.841-19.243） independently predicted END alter EVT. The mortality rate and grave outcome rate at discharge of all the END patients （26.3% and 55.8%） were higher than those of all the non-END patients （1.1% and 18.6%： P 〈 0.01）. Concl展开更多
Purpose To evaluate the efficacy and safety of Ginkgo biloba extract(GBE)in acute ischaemic stroke and its impact on the recurrence of vascular events.Methods We conducted a multicentre,prospective,randomised,open lab...Purpose To evaluate the efficacy and safety of Ginkgo biloba extract(GBE)in acute ischaemic stroke and its impact on the recurrence of vascular events.Methods We conducted a multicentre,prospective,randomised,open label,blinded,controlled clinical trial enrollingpatients with an onset of acute stroke within 7 days from five hospitals in China Jiangsu Province.Participants were assigned to the GBE group(450 mg GBE with 100 mg aspirin daily)or the control group(100 mg aspirin daily)for 6 months.The primary outcome was the decline in the Montreal Cognitive Assessment score at 6 months.Secondary outcomes were other neuropsychological tests of cognitive and neurological function,the the incidence of adverse events and vascular events.results 348 patients were enrolled:179 in the GBE group and 169 in the control group.With 18 patients lost to follow-up,the dropout rate was 5.17%.Admission data between two groups were similar,but in the GBE group there was a marked slow down in the decline in the Montreal Cognitive Assessment scores(−2.77±0.21 vs−1.99±0.23,P=0.0116(30 days);−3.34±0.24 vs−2.48±0.26,P=0.0165(90 days);−4.00±0.26 vs−2.71±0.26,P=0.0004(180 days))compared with controls.The National Institutes of Health Stroke Scale scores at 12 and 30 days,the modified Rankin Scale scores for independent rate at 30,90 and 180 days,and the Barthel Index scores at 30,90 and 180 days in the GBE group were significantly improved compared with controls.Improvements were also observedin GBE groups for Mini-Metal State Examination scores of 30,90 and 180 days,Webster's digit symbol test scores at 30 days and Executive Dysfunction Index scores at 30 and 180 days.No significant differences were seen in the incidence of adverse events or vascular events.conclusions We conclude that GBE in combination with aspirin treatment alleviated cognitive and neurological deficits after acute ischaemic stroke without increasing the incidence of vascular events.展开更多
Transplantation of umbilical cord-derived mesenchymal stem cells（UC-MSCs） for repair of traumatic brain injury has been used in the clinic. Hyperbaric oxygen（HBO） treatment has long been widely used as an adjuncti...Transplantation of umbilical cord-derived mesenchymal stem cells（UC-MSCs） for repair of traumatic brain injury has been used in the clinic. Hyperbaric oxygen（HBO） treatment has long been widely used as an adjunctive therapy for treating traumatic brain injury. UC-MSC transplantation combined with HBO treatment is expected to yield better therapeutic effects on traumatic brain injury. In this study, we established rat models of severe traumatic brain injury by pressurized fluid（2.5–3.0 atm impact force）. The injured rats were then administered UC-MSC transplantation via the tail vein in combination with HBO treatment. Compared with monotherapy, aquaporin 4 expression decreased in the injured rat brain, but growth-associated protein-43 expression, calaxon-like structures, and CM-Dil-positive cell number increased. Following combination therapy, however, rat cognitive and neurological function significantly improved. UC-MSC transplantation combined with HBO therapyfor repair of traumatic brain injury shows better therapeutic effects than monotherapy and significantly promotes recovery of neurological functions.展开更多
Animal and clinical studies have confirmed the therapeutic effect of bone marrow mesenchymal stem cells on cerebral ischemia, but their mechanisms of action remain poorly understood. Here, we summarize the transplanta...Animal and clinical studies have confirmed the therapeutic effect of bone marrow mesenchymal stem cells on cerebral ischemia, but their mechanisms of action remain poorly understood. Here, we summarize the transplantation approaches, directional migration, differentiation, replacement, neural circuit reconstruction,angiogenesis, neurotrophic factor secretion, apoptosis, immunomodulation, multiple mechanisms of action,and optimization strategies for bone marrow mesenchymal stem cells in the treatment of ischemic stroke.We also explore the safety of bone marrow mesenchymal stem cell transplantation and conclude that bone marrow mesenchymal stem cell transplantation is an important direction for future treatment of cerebral ischemia. Determining the optimal timing and dose for the transplantation are important directions for future research.展开更多
Tongguan Liqiao acupuncture therapy has been shown to effectively treat dysphagia after stroke-based pseudobulbar paralysis. We presumed that this therapy would be effective for dysphagia after bulbar paralysis in pat...Tongguan Liqiao acupuncture therapy has been shown to effectively treat dysphagia after stroke-based pseudobulbar paralysis. We presumed that this therapy would be effective for dysphagia after bulbar paralysis in patients with brainstem infarction. Sixty-four patients with dysphagia following brainstem infarction were recruited and divided into a medulla oblongata infarction group（n = 22）, a midbrain and pons infarction group（n = 16）, and a multiple cerebral infarction group（n = 26） according to their magnetic resonance imaging results. All patients received Tongguan Liqiao acupuncture for 28 days. The main acupoints were Neiguan（PC6）, Renzhong（DU26）, Sanyinjiao（SP6）, Fengchi（GB20）, Wangu（GB12）, and Yifeng（SJ17）. Furthermore, the posterior pharyngeal wall was pricked. Before and after treatment, patient swallowing functions were evaluated with the Kubota Water Test, Fujishima Ichiro Rating Scale, and the Standard Swallowing Assessment. The Barthel Index was also used to evaluate their quality of life. Results showed that after 28 days of treatment, scores on the Kubota Water Test and Standard Swallowing Assessment had decreased, but scores on the Fujishima Ichiro Rating Scale and Barthel Index had increased in each group. The total efficacy rate was 92.2% after treatment, and was most obvious in patients with medulla oblongata infarction（95.9%）. These findings suggest that Tongguan Liqiao acupuncture therapy can repair the connection of upper motor neurons to the medulla oblongata motor nucleus, promote the recovery of brainstem infarction, and improve patient＇s swallowing ability and quality of life.展开更多
Neural stem cells have great potential for the development of novel therapies for nervous system diseases.However,the proliferation of endogenous neural stem cells following brain ischemia is insufficient for central ...Neural stem cells have great potential for the development of novel therapies for nervous system diseases.However,the proliferation of endogenous neural stem cells following brain ischemia is insufficient for central nervous system self-repair.Ginkgolide B has a robust neuroprotective effect.In this study,we investigated the cell and molecular mechanisms underlying the neuroprotective effect of ginkgolide B on focal cerebral ischemia/reperfusion injury in vitro and in vivo.Neural stem cells were treated with 20,40 and 60 mg/L ginkgolide B in vitro.Immunofluorescence staining was used to assess cellular expression of neuron-specific enolase,glial fibrillary acid protein and suppressor of cytokine signaling 2.After treatment with 40 and 60 mg/L ginkgolide B,cells were large,with long processes.Moreover,the proportions of neuron-specific enolase-,glial fibrillary acid protein-and suppressor of cytokine signaling 2-positive cells increased.A rat model of cerebral ischemia/reperfusion injury was established by middle cerebral artery occlusion.Six hours after ischemia,ginkgolide B（20 mg/kg） was intraperitoneally injected,once a day.Zea Longa＇s method was used to assess neurological function.Immunohistochemistry was performed to evaluate the proportion of nestin-,neuron-specific enolase-and glial fibrillary acid protein-positive cells.Real-time quantitative polymerase chain reaction was used to measure m RNA expression of brain-derived neurotrophic factor and epidermal growth factor.Western blot assay was used to analyze the expression levels of brain-derived neurotrophic factor and suppressor of cytokine signaling 2.Ginkgolide B decreased the neurological deficit score,increased the proportion of nestin-,neuron-specific enolase-and glial fibrillary acid protein-positive cells,increased the m RNA expression of brain-derived neurotrophic factor and epidermal growth factor,and increased the expression levels of brain-derived neurotrophic factor and suppressor of cytokine signaling 2 in the ischemic penumbra.Together展开更多
The temporal dynamics of neuronal autophagy and apoptosis in the ischemic penumbra following stroke remains unclear.Therefore,in this study,we investigated the dynamic changes in autophagy and apoptosis in the penumbr...The temporal dynamics of neuronal autophagy and apoptosis in the ischemic penumbra following stroke remains unclear.Therefore,in this study,we investigated the dynamic changes in autophagy and apoptosis in the penumbra to provide insight into potential therapeutic targets for stroke.An adult Sprague-Dawley rat model of permanent ischemic stroke was prepared by middle cerebral artery occlusion.Neuronal autophagy and apoptosis in the penumbra post-ischemia were evaluated by western blot assay and immunofluorescence staining with antibodies against LC3-Ⅱ and cleaved caspase-3,respectively.Levels of both LC3-Ⅱ and cleaved caspase-3 in the penumbra gradually increased within 5 hours post-ischemia.Thereafter,levels of both proteins declined,especially LC3-Ⅱ.The cerebral infarct volume increased slowly 1–4 hours after ischemia,but subsequently increased rapidly until 5 hours after ischemia.The severity of the neurological deficit was positively correlated with infarct volume.LC3-Ⅱ and cleaved caspase-3 levels were high in the penumbra within 5 hours after ischemia,and after that,levels of these proteins decreased at different rates.LC3-Ⅱ levels were reduced to a very low level,but cleaved caspase-3 levels remained high 72 hours after ischemia.These results indicate that there are temporal differences in the activation status of the autophagic and apoptotic pathways.This suggests that therapeutic targeting of these pathways should take into consideration their unique temporal dynamics.展开更多
Thirty-four patients with cerebral infarction and 18 patients with transient ischemic attack were examined by multi-slice spiral CT scan, CT perfusion imaging, and CT angiography within 6 hours after onset. By CT perf...Thirty-four patients with cerebral infarction and 18 patients with transient ischemic attack were examined by multi-slice spiral CT scan, CT perfusion imaging, and CT angiography within 6 hours after onset. By CT perfusion imaging, 29 cases in the cerebral infarction group and 10 cases in the transient ischemic attack group presented with abnormal blood flow perfusion, which corresponded to the clinical symptoms. By CT angiography, various degrees of vascular stenosis could be detected in 41 patients, including 33 in the cerebral infarction group and eight in the transient ischemic attack group. The incidence of intracranial artery stenosis was higher than that of extracranial artery stenosis. The intracranial artery stenosis was located predominantly in the middle cerebral artery and carotid artery siphon, while the extracranial artery stenosis occurred mainly in the bifurcation of the common carotid artery and the opening of the vertebral artery. There were 34 cases （83%） with convict vascular stenosis and perfusion abnormalities, and five cases （45%） with perfusion abnormalities but without convict vascular stenosis. The incidence of cerebral infarction in patients with National Institutes of Health Stroke Scale scores 〉 5 points during onset was significantly higher than that in patients with National Institutes of Health Stroke Scale scores 〈 5 points. These experimental findings indicate that the combined application of various CT imaging methods allows early diagnosis of acute ischemic cerebrovascular disease, which can comprehensively analyze the pathogenesis and severity of acute ischemic cerebrovascular disease at the morphological and functional levels.展开更多
目的探讨Infant Neurological International Battery(Infanib)对新生儿重症监护病房出院的高危早产儿后期运动发育异常的预测效度。方法纳入对象为2008年6月至2010年3月入住新生儿重症监护病房治疗出院的早产儿,在纠正年龄3～4月、6～...目的探讨Infant Neurological International Battery(Infanib)对新生儿重症监护病房出院的高危早产儿后期运动发育异常的预测效度。方法纳入对象为2008年6月至2010年3月入住新生儿重症监护病房治疗出院的早产儿,在纠正年龄3～4月、6～7月龄时采用Infanib进行运动发育评估;在纠正年龄12月龄或12月龄以上采用Peabody运动发育量表或临床神经学体检评估运动结局。通过计算Infanib对后期运动发育结局评估的敏感性、特异性、阳性预测值以及阴性预测值等进行预测效度评价。结果共147例早产儿参与临床随访,在纠正年龄3～4月、6～7月龄时进行Infanib评估的患儿分别为147例、117例;纠正年龄12月龄或12月龄以上129例。最终运动发育正常90例(69.8%),运动发育落后28例(21.7%),脑瘫11例(8.5%)。纠正年龄3～4月龄和6～7月龄Infanib评估对运动发育异常的敏感性分别为84.6%、100%;特异性75.6%、91.7%;阳性预测值60.0%、82.5%;阴性预测值91.9%、100%。结论 Infanib可以用于早产儿运动发育的早期评估,并具有较好的预测效度。展开更多
Orientin is a flavonoid monomer.In recent years,its importance as a source of pharmacological active substance is growing rapidly due to its properties such as anti-myocardial ischemia,anti-apoptosis,anti-radiation,an...Orientin is a flavonoid monomer.In recent years,its importance as a source of pharmacological active substance is growing rapidly due to its properties such as anti-myocardial ischemia,anti-apoptosis,anti-radiation,anti-tumor,and anti-aging.However,the neuroprotective effects of Orientin on stroke injury have not been comprehensively evaluated.The aim of the present study was thus to investigate the neuroprotective capacity and the potential mechanisms of Cyperus esculentus L.orientin(CLO)from Cyperus esculentus L.leaves against ischemia/reperfusion(I/R)injury using standard orientin as control.For in vitro studies,we treated HT22 cells with CoCl2 as an in vitro ischemic injury model.HT22 cells in the control group were treated with CoCl2.For in vivo studies,we used rat models of middle cerebral artery occlusion,and animals that received sham surgery were used as controls.We found that CLO protected CoCl2-induced HT22 cells against ischemia/reperfusion injury by lowering lipid peroxidation and reactive oxygen species formation as well as decreasing protein oxidation.However,CLO did not reduce the release of lactate dehydrogenase nor increase the activity of superoxide dismutase.Results showed that CLO could decrease neurological deficit score,attenuate brain water content,and reduce cerebral infarct volume,leading to neuroprotection during cerebral ischemia-reperfusion injury.Our studies indicate that CLO flavonoids can be taken as a natural antioxidant and bacteriostastic substance in food and pharmaceutical industry.The molecular mechanisms of CLO could be at least partially attributed to the antioxidant properties and subsequently inhibiting activation of casepase-3.All experimental procedures and protocols were approved on May 16,2016 by the Experimental Animal Ethics Committee of Xinjiang Medical University of China(approval No.IACUC20160516-57).展开更多
文摘Helicobacter pylori(H. pylori) infection is very common and affects approximately half of the world population. It causes gastric diseases, but some authors have reported an association of H. pylori infection with other systemic manifestations beginning in 1994. The list of potential effects of H. pylori outside the stomach includes a number of extragastric manifestations and we focused on neurological, dermatological, hematologic, ocular, cardiovascular, metabolic, allergic, and hepatobiliary diseases. This review discusses these important reported manifestations that are not related to the gastrointestinal tract.
基金supported by the National Natural Science Foundation of China,No.81574042the Traditional Chinese Medicine Special Research Projects of Henan Province of China,No.2018JDZX011(both to XDF).
文摘Electroacupuncture has been widely used to treat cognitive impairment after cerebral ischemia,but the underlying mechanism has not yet been fully elucidated.Studies have shown that autophagy plays an important role in the formation and development of cognitive impairment,and the phosphoinositide 3-kinase(PI3K)/Akt signaling pathway plays an important role in autophagy regulation.To investigate the role played by the PI3K/Akt signaling pathway in the electroacupuncture treatment of cerebral ischemia/reperfusion rat models,we first established a rat model of cerebral ischemia/reperfusion through the occlusion of the middle cerebral artery using the suture method.Starting at 2 hours after modeling,electroacupuncture was delivered at the Shenting(GV24)and Baihui(GV20)acupoints,with a dilatational wave(1-20 Hz frequency,2 mA intensity,6 V peak voltage),for 30 minutes/day over 8 consecutive days.Our results showed that electroacupuncture reduced the infarct volume in a rat model of cerebral ischemia/reperfusion injury,increased the mRNA expression levels of the PI3K/Akt signaling pathwayrelated factors Beclin-1,mammalian target of rapamycin(mTOR),and PI3K,increased the protein expression levels of phosphorylated Akt,Beclin-1,PI3K,and mTOR in the ischemic cerebral cortex,and simultaneously reduced p53 mRNA and protein expression levels.In the Morris water maze test,the latency to find the hidden platform was significantly shortened among rats subjected to electroacupuncture stimulation compared with rats without electroacupuncture stimulation.In the spatial probe test,the number of times that a rat crossed the target quadrant was increased in rats subjected to electroacupuncture stimulation compared with rats without electroacupuncture stimulation.Electroacupuncture stimulation applied to the Shenting(GV24)and Baihui(GV20)acupoints activated the PI3K/Akt signaling pathway and improved rat learning and memory impairment.This study was approved by the Animal Ethics Committee of the First Affiliated Hospital of Henan Unive
文摘Helicobacter pylori(H.pylori)is a bacterium that infects more than a half of world’s population.Although it is mainly related to the development of gastroduodenal diseases,several studies have shown that such infection may also influence the development and severity of various extragastric diseases.According to the current evidence,whereas this bacterium is a risk factor for some of these manifestations,it might play a protective role in other pathological conditions.In that context,when considered the gastrointestinal tract,H.pylori positivity have been related to Inflammatory Bowel Disease,Gastroesophageal Reflux Disease,Non-Alcoholic Fatty Liver Disease,Hepatic Carcinoma,Cholelithiasis,and Cholecystitis.Moreover,lower serum levels of iron and vitamin B12 have been found in patients with H.pylori infection,leading to the emergence of anemias in a portion of them.With regards to neurological manifestations,a growing number of studies have associated that bacterium with multiple sclerosis,Alzheimer’s disease,Parkinson’s disease,and Guillain-Barrésyndrome.Interestingly,the risk of developing cardiovascular disorders,such as atherosclerosis,is also influenced by the infection.Besides that,the H.pylori-associated inflammation may also lead to increased insulin resistance,leading to a higher risk of diabetes mellitus among infected individuals.Finally,the occurrence of dermatological and ophthalmic disorders have also been related to that microorganism.In this sense,this minireview aims to gather the main studies associating H.pylori infection with extragastric conditions,and also to explore the main mechanisms that may explain the role of H.pylori in those diseases.
文摘目的 研究亚低温联合依达拉奉治疗急性脑梗死的疗效及对血清超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、神经元特异性烯醇化酶(Neuron-specific enolase ,NSE)、S100钙结合蛋白β(S100 calcium binding protein β,S100-β)水平的影响。方法 选取郑州大学附属郑州中心医院收治的急性脑梗死病人96例,随机分为对照组和研究组,各48例。对照组单纯予以依达拉奉治疗,研究组在此基础上施加亚低温治疗。比较两组治疗总有效率、不良反应情况等。记录治疗前后两组神经功能缺损(National Lnstitute of Health Stroke Scale, NHISS)评分和日常生活活动能力(Ability of Daily Life, ADL)评分。采集病人治疗前后血液样本,检测血清hs-CRP、NSE、S100-β蛋白水平及血浆超氧化物歧化酶(su-peroxidedismutase, SOD)和丙二醛(malondialdehyde,MDA)水平。结果 研究组治疗总有效率(91.67%)明显高于对照组(75.00%,χ2=4.80, P =0.03);治疗后,研究组血清学指标hs-CRP、S100-β、NSE均明显低于对照组(均 P <0.01);研究组SOD水平高于对照组( P <0.01),而MDA低于对照组( P <0.01);研究组ADL评分高于对照组( P <0.01),而NHISS评分低于对照组( P <0.01);两组不良反应发生率比较差异无统计学意义( P >0.05)。结论 亚低温联合依达拉奉治疗急性脑梗死疗效显著,可有效改善相关血清学指标,减轻体内氧化应激反应,改善病人神经功能及预后,且较安全可靠。
基金supported by a grant from the Supporting Program of the"Eleventh Five-year Plan"for Science&Technology Research of China,Ministry of Science and Technology of China,No.2006BAI12B02a grant from the Scientific Research Fund for Talent Introduction in the Gansu University of Chinese Medicine of China,No.2012-11
文摘Data mining has the potential to provide information for improving clinical acupuncture strategies by uncovering hidden rules between acupuncture manipulation and therapeutic effects in a data set. In this study, we performed acupuncture on 30 patients with hemiplegia due to acute ischemic stroke. All participants were pre-screened to ensure that they exhibited immediate responses to acupuncture. We used a twirling reinforcing acupuncture manipulation at the specific lines between the bilateral Baihui（GV20） and Taiyang（EX-HN5）. We collected neurologic deficit score, simplified Fugl-Meyer assessment score, muscle strength of the proximal and distal hemiplegic limbs, ratio of the maximal H-reflex to the maximal M-wave（Hmax/Mmax）, muscle tension at baseline and immediately after treatment, and the syndromes of traditional Chinese medicine at baseline. We then conducted data mining using an association algorithm and an artificial neural network backpropagation algorithm. We found that the twirling reinforcing manipulation had no obvious therapeutic difference in traditional Chinese medicine syndromes of ＂Deficiency and Excess＂. The change in the muscle strength of the upper distal and lower proximal limbs was one of the main factors affecting the immediate change in Fugl-Meyer scores. Additionally, we found a positive correlation between the muscle tension change of the upper limb and Hmax/Mmax immediate change, and both positive and negative correlations existed between the muscle tension change of the lower limb and immediate Hmax/Mmax change. Additionally, when the difference value of muscle tension for the upper and lower limbs was 〉 0 or 〈 0, the difference value of Hmax/Mmax was correspondingly positive or negative, indicating the scalp acupuncture has a bidirectional effect on muscle tension in hemiplegic limbs. Therefore, acupuncture with twirling reinforcing manipulation has distinct effects on acute ischemic stroke patients with different symptoms or stages of disease. Improved muscle te
文摘Background： Early neurological deterioration （END） is a prominent issue after recanalization treatment. However. few studies have reported the characteristics of END after endovascular treatment （EVT） as so far. This study investigated the incidence, composition, and outcomes of END after intravenous recombinant tissue plasminogen activator （IV rt-PA） and EVT of acute ischemic stroke, and identified risk factors for END. Methods： Medical records of patients who received recanalization treatment between January l, 2014, and December 31, 2015 were reviewed. Patients were classified into IV rt-PA or EVT group according to the methods ofrecanalization treatment. The END was defined as an increase in the National Institutes of Health Stroke Scale （N1HSS） ≥4 or an increase in la of NIHSS ≥I within 72 h after recanalization treatment. Clinical data were compared between the END and non-END subgroups within each recanalization group. Results： Of the 278 patients included in the study, the incidence of END was 34.2%. The incidence rates of END were 29.8% in the IV rt-PA group and 40.2% in the EVT group, lschemia progression （68.4%） was the main contributor to END followed by vasogenic cerebral edema （21. 1%） and symptomatic intracranial hemorrhage （10.5%）. Multivariate logistic regression showed that admission systolic blood pressure （SBP） ≥160 mmHg （odds ratio [OR]： 2.312, 95% confidence interval [CI]： 1.105-4.837） and large artery occlusion after IV rt-PA （OR： 3.628.95% （7： 1.482-8.881 ） independently predicted END after IV rt-PA; and admission SBP 〉 140 mmHg （OR： 5.183, 95% CI：1.967 13.661 ）, partial recanalization （OR： 4.791,95% CI： 1.749-13.121 ）, and nonrecanalization （OR： 5.952, 95% CI： 1.841-19.243） independently predicted END alter EVT. The mortality rate and grave outcome rate at discharge of all the END patients （26.3% and 55.8%） were higher than those of all the non-END patients （1.1% and 18.6%： P 〈 0.01）. Concl
基金The work was supported by the National Natural Science Foundation of China(81230026,81630028)the Science and Technology Department of Jiangsu Province(BE2016610)Jiangsu Province Key Medical Discipline(ZDXKA2016020).
文摘Purpose To evaluate the efficacy and safety of Ginkgo biloba extract(GBE)in acute ischaemic stroke and its impact on the recurrence of vascular events.Methods We conducted a multicentre,prospective,randomised,open label,blinded,controlled clinical trial enrollingpatients with an onset of acute stroke within 7 days from five hospitals in China Jiangsu Province.Participants were assigned to the GBE group(450 mg GBE with 100 mg aspirin daily)or the control group(100 mg aspirin daily)for 6 months.The primary outcome was the decline in the Montreal Cognitive Assessment score at 6 months.Secondary outcomes were other neuropsychological tests of cognitive and neurological function,the the incidence of adverse events and vascular events.results 348 patients were enrolled:179 in the GBE group and 169 in the control group.With 18 patients lost to follow-up,the dropout rate was 5.17%.Admission data between two groups were similar,but in the GBE group there was a marked slow down in the decline in the Montreal Cognitive Assessment scores(−2.77±0.21 vs−1.99±0.23,P=0.0116(30 days);−3.34±0.24 vs−2.48±0.26,P=0.0165(90 days);−4.00±0.26 vs−2.71±0.26,P=0.0004(180 days))compared with controls.The National Institutes of Health Stroke Scale scores at 12 and 30 days,the modified Rankin Scale scores for independent rate at 30,90 and 180 days,and the Barthel Index scores at 30,90 and 180 days in the GBE group were significantly improved compared with controls.Improvements were also observedin GBE groups for Mini-Metal State Examination scores of 30,90 and 180 days,Webster's digit symbol test scores at 30 days and Executive Dysfunction Index scores at 30 and 180 days.No significant differences were seen in the incidence of adverse events or vascular events.conclusions We conclude that GBE in combination with aspirin treatment alleviated cognitive and neurological deficits after acute ischaemic stroke without increasing the incidence of vascular events.
文摘Transplantation of umbilical cord-derived mesenchymal stem cells（UC-MSCs） for repair of traumatic brain injury has been used in the clinic. Hyperbaric oxygen（HBO） treatment has long been widely used as an adjunctive therapy for treating traumatic brain injury. UC-MSC transplantation combined with HBO treatment is expected to yield better therapeutic effects on traumatic brain injury. In this study, we established rat models of severe traumatic brain injury by pressurized fluid（2.5–3.0 atm impact force）. The injured rats were then administered UC-MSC transplantation via the tail vein in combination with HBO treatment. Compared with monotherapy, aquaporin 4 expression decreased in the injured rat brain, but growth-associated protein-43 expression, calaxon-like structures, and CM-Dil-positive cell number increased. Following combination therapy, however, rat cognitive and neurological function significantly improved. UC-MSC transplantation combined with HBO therapyfor repair of traumatic brain injury shows better therapeutic effects than monotherapy and significantly promotes recovery of neurological functions.
基金supported by the Natural Science Foundation of Heilongjiang Province of China,No.H2015083a grant from Higher Education Reform Project of Mudanjaing Medical University of China,No.2013016
文摘Animal and clinical studies have confirmed the therapeutic effect of bone marrow mesenchymal stem cells on cerebral ischemia, but their mechanisms of action remain poorly understood. Here, we summarize the transplantation approaches, directional migration, differentiation, replacement, neural circuit reconstruction,angiogenesis, neurotrophic factor secretion, apoptosis, immunomodulation, multiple mechanisms of action,and optimization strategies for bone marrow mesenchymal stem cells in the treatment of ischemic stroke.We also explore the safety of bone marrow mesenchymal stem cell transplantation and conclude that bone marrow mesenchymal stem cell transplantation is an important direction for future treatment of cerebral ischemia. Determining the optimal timing and dose for the transplantation are important directions for future research.
基金supported by a grant from the Construction of Traditional Chinese Medicine Prevention and Treatment of Apoplexy Comprehensive System,No.201007002
文摘Tongguan Liqiao acupuncture therapy has been shown to effectively treat dysphagia after stroke-based pseudobulbar paralysis. We presumed that this therapy would be effective for dysphagia after bulbar paralysis in patients with brainstem infarction. Sixty-four patients with dysphagia following brainstem infarction were recruited and divided into a medulla oblongata infarction group（n = 22）, a midbrain and pons infarction group（n = 16）, and a multiple cerebral infarction group（n = 26） according to their magnetic resonance imaging results. All patients received Tongguan Liqiao acupuncture for 28 days. The main acupoints were Neiguan（PC6）, Renzhong（DU26）, Sanyinjiao（SP6）, Fengchi（GB20）, Wangu（GB12）, and Yifeng（SJ17）. Furthermore, the posterior pharyngeal wall was pricked. Before and after treatment, patient swallowing functions were evaluated with the Kubota Water Test, Fujishima Ichiro Rating Scale, and the Standard Swallowing Assessment. The Barthel Index was also used to evaluate their quality of life. Results showed that after 28 days of treatment, scores on the Kubota Water Test and Standard Swallowing Assessment had decreased, but scores on the Fujishima Ichiro Rating Scale and Barthel Index had increased in each group. The total efficacy rate was 92.2% after treatment, and was most obvious in patients with medulla oblongata infarction（95.9%）. These findings suggest that Tongguan Liqiao acupuncture therapy can repair the connection of upper motor neurons to the medulla oblongata motor nucleus, promote the recovery of brainstem infarction, and improve patient＇s swallowing ability and quality of life.
基金supported by the National Natural Science Foundation of China,No.81073082 to JSZ
文摘Neural stem cells have great potential for the development of novel therapies for nervous system diseases.However,the proliferation of endogenous neural stem cells following brain ischemia is insufficient for central nervous system self-repair.Ginkgolide B has a robust neuroprotective effect.In this study,we investigated the cell and molecular mechanisms underlying the neuroprotective effect of ginkgolide B on focal cerebral ischemia/reperfusion injury in vitro and in vivo.Neural stem cells were treated with 20,40 and 60 mg/L ginkgolide B in vitro.Immunofluorescence staining was used to assess cellular expression of neuron-specific enolase,glial fibrillary acid protein and suppressor of cytokine signaling 2.After treatment with 40 and 60 mg/L ginkgolide B,cells were large,with long processes.Moreover,the proportions of neuron-specific enolase-,glial fibrillary acid protein-and suppressor of cytokine signaling 2-positive cells increased.A rat model of cerebral ischemia/reperfusion injury was established by middle cerebral artery occlusion.Six hours after ischemia,ginkgolide B（20 mg/kg） was intraperitoneally injected,once a day.Zea Longa＇s method was used to assess neurological function.Immunohistochemistry was performed to evaluate the proportion of nestin-,neuron-specific enolase-and glial fibrillary acid protein-positive cells.Real-time quantitative polymerase chain reaction was used to measure m RNA expression of brain-derived neurotrophic factor and epidermal growth factor.Western blot assay was used to analyze the expression levels of brain-derived neurotrophic factor and suppressor of cytokine signaling 2.Ginkgolide B decreased the neurological deficit score,increased the proportion of nestin-,neuron-specific enolase-and glial fibrillary acid protein-positive cells,increased the m RNA expression of brain-derived neurotrophic factor and epidermal growth factor,and increased the expression levels of brain-derived neurotrophic factor and suppressor of cytokine signaling 2 in the ischemic penumbra.Together
基金supported by the National Natural Science Foundation of China,No.81460351the Doctoral Foundation of Kunming University of Science and Technology of China,No.KKSY201360112the Scientific Research Foundation of Yunnan Provincial Department of Education of China,No.2014Y070
文摘The temporal dynamics of neuronal autophagy and apoptosis in the ischemic penumbra following stroke remains unclear.Therefore,in this study,we investigated the dynamic changes in autophagy and apoptosis in the penumbra to provide insight into potential therapeutic targets for stroke.An adult Sprague-Dawley rat model of permanent ischemic stroke was prepared by middle cerebral artery occlusion.Neuronal autophagy and apoptosis in the penumbra post-ischemia were evaluated by western blot assay and immunofluorescence staining with antibodies against LC3-Ⅱ and cleaved caspase-3,respectively.Levels of both LC3-Ⅱ and cleaved caspase-3 in the penumbra gradually increased within 5 hours post-ischemia.Thereafter,levels of both proteins declined,especially LC3-Ⅱ.The cerebral infarct volume increased slowly 1–4 hours after ischemia,but subsequently increased rapidly until 5 hours after ischemia.The severity of the neurological deficit was positively correlated with infarct volume.LC3-Ⅱ and cleaved caspase-3 levels were high in the penumbra within 5 hours after ischemia,and after that,levels of these proteins decreased at different rates.LC3-Ⅱ levels were reduced to a very low level,but cleaved caspase-3 levels remained high 72 hours after ischemia.These results indicate that there are temporal differences in the activation status of the autophagic and apoptotic pathways.This suggests that therapeutic targeting of these pathways should take into consideration their unique temporal dynamics.
基金supported by the Youth Fund of the First Clinical College of Liaoning Medical University, No. 2010C20
文摘Thirty-four patients with cerebral infarction and 18 patients with transient ischemic attack were examined by multi-slice spiral CT scan, CT perfusion imaging, and CT angiography within 6 hours after onset. By CT perfusion imaging, 29 cases in the cerebral infarction group and 10 cases in the transient ischemic attack group presented with abnormal blood flow perfusion, which corresponded to the clinical symptoms. By CT angiography, various degrees of vascular stenosis could be detected in 41 patients, including 33 in the cerebral infarction group and eight in the transient ischemic attack group. The incidence of intracranial artery stenosis was higher than that of extracranial artery stenosis. The intracranial artery stenosis was located predominantly in the middle cerebral artery and carotid artery siphon, while the extracranial artery stenosis occurred mainly in the bifurcation of the common carotid artery and the opening of the vertebral artery. There were 34 cases （83%） with convict vascular stenosis and perfusion abnormalities, and five cases （45%） with perfusion abnormalities but without convict vascular stenosis. The incidence of cerebral infarction in patients with National Institutes of Health Stroke Scale scores 〉 5 points during onset was significantly higher than that in patients with National Institutes of Health Stroke Scale scores 〈 5 points. These experimental findings indicate that the combined application of various CT imaging methods allows early diagnosis of acute ischemic cerebrovascular disease, which can comprehensively analyze the pathogenesis and severity of acute ischemic cerebrovascular disease at the morphological and functional levels.
文摘目的探讨Infant Neurological International Battery(Infanib)对新生儿重症监护病房出院的高危早产儿后期运动发育异常的预测效度。方法纳入对象为2008年6月至2010年3月入住新生儿重症监护病房治疗出院的早产儿,在纠正年龄3～4月、6～7月龄时采用Infanib进行运动发育评估;在纠正年龄12月龄或12月龄以上采用Peabody运动发育量表或临床神经学体检评估运动结局。通过计算Infanib对后期运动发育结局评估的敏感性、特异性、阳性预测值以及阴性预测值等进行预测效度评价。结果共147例早产儿参与临床随访,在纠正年龄3～4月、6～7月龄时进行Infanib评估的患儿分别为147例、117例;纠正年龄12月龄或12月龄以上129例。最终运动发育正常90例(69.8%),运动发育落后28例(21.7%),脑瘫11例(8.5%)。纠正年龄3～4月龄和6～7月龄Infanib评估对运动发育异常的敏感性分别为84.6%、100%;特异性75.6%、91.7%;阳性预测值60.0%、82.5%;阴性预测值91.9%、100%。结论 Infanib可以用于早产儿运动发育的早期评估,并具有较好的预测效度。
基金supported by the National Natural Science Foundation of China,No.31770385(to SQJ)
文摘Orientin is a flavonoid monomer.In recent years,its importance as a source of pharmacological active substance is growing rapidly due to its properties such as anti-myocardial ischemia,anti-apoptosis,anti-radiation,anti-tumor,and anti-aging.However,the neuroprotective effects of Orientin on stroke injury have not been comprehensively evaluated.The aim of the present study was thus to investigate the neuroprotective capacity and the potential mechanisms of Cyperus esculentus L.orientin(CLO)from Cyperus esculentus L.leaves against ischemia/reperfusion(I/R)injury using standard orientin as control.For in vitro studies,we treated HT22 cells with CoCl2 as an in vitro ischemic injury model.HT22 cells in the control group were treated with CoCl2.For in vivo studies,we used rat models of middle cerebral artery occlusion,and animals that received sham surgery were used as controls.We found that CLO protected CoCl2-induced HT22 cells against ischemia/reperfusion injury by lowering lipid peroxidation and reactive oxygen species formation as well as decreasing protein oxidation.However,CLO did not reduce the release of lactate dehydrogenase nor increase the activity of superoxide dismutase.Results showed that CLO could decrease neurological deficit score,attenuate brain water content,and reduce cerebral infarct volume,leading to neuroprotection during cerebral ischemia-reperfusion injury.Our studies indicate that CLO flavonoids can be taken as a natural antioxidant and bacteriostastic substance in food and pharmaceutical industry.The molecular mechanisms of CLO could be at least partially attributed to the antioxidant properties and subsequently inhibiting activation of casepase-3.All experimental procedures and protocols were approved on May 16,2016 by the Experimental Animal Ethics Committee of Xinjiang Medical University of China(approval No.IACUC20160516-57).
