MMP-9基因多态性与缺血性脑卒中发病及预后的相关性研究

目的:研究基质金属蛋白酶9(MMP-9)基因多态性与缺血性脑卒中(IS)发病及预后的相关性,为IS的防治提供新的理论依据。方法:选取治疗的IS患者100例,根据TOAST分型标准分为大动脉粥样硬化型(LAA)组41例,小动脉阻塞型(SAO)组59例,并选取健康体检者40例作为对照组,采用PCR-RFLP法检测各组MMP-9基因C1562T、R279Q多态性,并对IS患者进行3个月的随访,采用Logistic回归分析C1562T、R279Q多态性与IS患者预后的相关性。结果:LAA组、SAO组MMP-9基因C1562T位点T等位基因、C/T+T/T基因型频数均高于对照组,差异有统计学意义(P0.05),LAA组、SAO组C1562T位点C等位基因、C/C基因型频数及R279Q位点等位基因和基因型频数与对照组比较差异无统计学意义(P0.05);Logistic回归分析显示,MMP-9各型别基因与预后无明显相关性(P0.05)。结论:MMP-9基因C1562T的T等位基因是IS发病的穿易感基因之一,但MMP-9基因多态性与IS患者的预后并无明显相关性。     

影响阿替普酶治疗急性缺血性卒中早期疗效的临床研究

目的:探讨影响阿替普酶静脉溶栓治疗急性缺血性卒中早期疗效的因素。方法:回顾性分析2010年11月至2014年11月我院接受阿替普酶静脉(rt-PA)溶栓治疗的49例急性缺血性卒中患者的临床数据,根据美国国立卫生研究院神经功能缺损评分(NIHSS评分),溶栓后24h评分减少超过3分为溶栓早期有效组(24例),否则为溶栓早期无效组(25例),比较两组各临床数据的差异。结果:两组患者性别、年龄、吸烟史、酗酒史、高血压病史、糖尿病史、溶栓前血糖、血生化、血压等均无差异(P0.05);早期有效组患者房颤发生率、脑白质病变发生率和溶栓前NIHSS评分较早期无效组低,差异均有统计学意义(P0.05);早期有效组患者90天生活自理率较早期无效组高,差异有统计学意义(P0.05)。结论:阿替普酶静脉溶栓后早期疗效好者3个月预后好;溶栓前无房颤、无白质疏松患者溶栓后早期疗效好。     

Serum and Cerebrospinal Fluid Magnesium Levels, Glasgow Coma Scores, and In-Hospital Mortality in Patients with Acute Stroke

The aim of this study was to determine the relationship between serum and cerebrospinal fluid (CSF) magnesium (Mg⁺²) levels, Glasgow Coma Scores (GCS), and 7-day mortality in acute stroke patients. Patients with acute ischemic or hemorrhagic stroke arriving within the first 3 h of symptoms were included in the study. The control group consisted of healthy volunteers. GCS was determined, and blood and CSF samples were taken in order to establish serum and CSF glucose, Mg⁺², sodium, potassium, calcium, and chlorine levels. Mortality was recorded at 7 days after admission. CSF Mg⁺² in the ischemic infarct group was significantly lower than in the control group (p = 0.006). CSF Mg⁺² in the ischemic infarct patients with a GCS ≤ 8 were significantly lower (p = 0.002) than controls and in ischemic infarct patients with a GCS ≥9. In the ischemic stroke patients, CSF Mg⁺² and GCS were significantly correlated (r = 55, p = 0.031). CSF Mg⁺² levels in ischemic stroke patients who died within 7 days were significantly lower than controls, ischemic stroke patients who survived, and hemorrhagic stroke patients who died (p = 0.002, p = 0.042, and p = 0.005, respectively). Low CSF Mg⁺² levels in patients with acute ischemic stoke at admission predicted a higher 1-week mortality.     

Persistent migration of neuroblasts from the subventricular zone to the injured striatum mediated by osteopontin following intracerebral hemorrhage

We investigated intracerebral hemorrhage (ICH)-induced lateral migration of neuroblasts and the mechanism underlying this migration. ICH model was induced by collagenase injection into the striatum of adult wild-type and osteopontin (OPN) knockout mice. In the wild-type mice, the lateral migration of neuroblasts from the ipsislateral subventricular zone (SVZ) towards the hematoma started at day 3 and continued up to day 28 after ICH. In addition to migrating towards the hematoma, neuroblasts also migrated to the area of ipsilateral striatum remote to the hematoma. The migrating neuroblasts were closely associated with activated astrocytes and blood vessels in the injured striatum. Following ICH, the expression of OPN was up-regulated in the ipsilateral striatum from day 1 to day 28. In vitro , OPN treatment did not affect the proliferation of neural progenitors, but enhanced the trans-well and radial migration of neural progenitors. In vivo , OPN deficiency did not affect the proliferation of neural progenitors in the SVZ. However, following ICH a significant decrease in lateral neuroblast migration was observed in the OPN knockout mice compared with the wild-type mice. These results suggest that increased OPN expression in the injured striatum plays a significant role in the lateral migration of neuroblasts following ICH.     

缺血再灌卒中后抑郁小鼠模型的建立

目的探讨并建立卒中后抑郁小鼠动物模型。方法先利用结扎颈总动脉造成小鼠不完性全脑缺血再灌注病理损伤,利用悬尾和强迫游泳方法诱导小鼠抑郁模型,利用正交试验设计全面考察其影响因素,确定最佳造模条件。结果以缺血5min,再灌10min,再缺血5min所诱导抑郁模型最为明显,且死亡率较低。结论利用此方法所造卒中后抑郁模型具有操作简便、成功率较高且经济的特点,适用于该类药物筛选。     

NeuA O-acetylesterase activity is specific for CMP-activated O-acetyl sialic acid in Streptococcus suis serotype 2

The two ubiquitously expressed sphingosine kinases (SphK) 1 and 2 are key regulators of the sphingolipid signaling pathway. Despite the formation of an identical messenger, i.e. sphingosine 1-phosphate (S1P), they exert strikingly different functions. Particularly, SphK2 is necessary for the phosphorylation of the sphingosine analog fingolimod (FTY720), which is protective in rodent stroke models. Using gene deficient mice lacking either SphK1 or SphK2, we investigated the role of the two lipid kinases in experimental stroke.We performed 2 h transient middle cerebral artery occlusion (tMCAO) and analyzed lesion size and neurological function after 24 h. Treatment groups received 1 mg/kg FTY720. Neutrophil infiltration, microglia activation, mRNA and protein expression of SphK1, SphK2 and the S1P₁ receptor after tMCAO were studied.Genetic deletion of SphK2 but not SphK1 increased ischemic lesion size and worsened neurological function after tMCAO. The protective effect of FTY720 was conserved in SphK1^−/− mice but not in SphK2^−/− mice.This suggests that SphK2 activity is an important endogenous protective mechanism in cerebral ischemia and corroborates that the protective effect of FTY720 is mediated via phospho-FTY720.     

Effects of genetic variants on lipid parameters and dyslipidemia in a Chinese population

A number of recent genome-wide association (GWA) studies have identified several novel genetic determinants of plasma lipid and lipoprotein concentrations in European populations. However, it is still unclear whether these loci identified in Caucasian GWA studies also exert the same effect on lipid and lipoprotein concentrations in a Chinese population. We genotyped 10 single-nucleotide polymorphisms (SNPs) in nine loci in a Chinese Han population sample (n = 4,192) and assessed the associations of these SNPs with metabolic traits, using linear regression adjusted for age, gender, diabetes status, and body mass index. Three variants (rs12654264, P ～ 1.7 × 10(-6); rs3764261, P ～ 7.1 × 10(-7); and rs4420638, P ～ 1.1 × 10(-3)) showed strong evidence for association with total cholesterol; four variants (rs780094, P ～ 1.8 × 10(-11); rs17145738, P ～ 5.0 × 10(-7); rs326, P ～ 2.3 × 10(-6); and rs439401, P ～ 2.2 × 10(-5)) showed strong evidence for association with triglycerides, four variants (rs17145738, P ～ 1.9 × 10(-4); rs326, P ～ 9.7 × 10(-4); rs1800588, P ～ 1.5 × 10(-7); and rs3764261, P ～ 4.3 × 10(-14)) showed strong evidence for association with HDL-cholesterol (HDL-C), two variants (rs12654264, P ～ 2.3 × 10(-5); and rs4420638, P ～ 3.6 × 10(-4)) showed strong evidence for association with LDL-C, and four variants (rs326, P ～ 2.8 × 10(-3); rs1800588, P ～ 6.1 × 10(-4); rs3764261, P ～ 2.0 × 10(-3); and rs4420638, P ～ 9.4 × 10(-5)) showed strong evidence for association with total cholesterol-HDL-C-related ratio. These SNPs generated strong combined effects on lipid traits and dyslipidemia. Our findings indicate that the variants that associated with metabolic traits in Europeans may also play a role in a Chinese Han population.     

急性脑卒中患者腹泻并发症的临床分析

目的:探讨急性脑卒中患者并发腹泻的发生状况及危险因素,以降低脑卒中并发腹泻的发生率。方法:对264例急性脑卒中患者观察腹泻并发症的发生,分析一般临床资料,使用Logistic回归分析腹泻并发症的可能危险因素。结果:不同类型急性脑卒中并发腹泻发生率差异无统计学意义(P0.05),有无糖尿病的并发腹泻发生率差异有统计学意义(P0.05),抗生素使用的并发腹泻发生率差异有统计学意义(P0.05),腹泻并发症的发生与患者年龄、入院时GCS昏迷量表评分、营养状况、糖尿病史、抗生素使用有关(OR=4.36、8.78、4.48、6.26、5.64),腹泻组和非腹泻组病死率差异有统计学意义(P0.05)。结论:急性脑卒中的患者易发生腹泻,合理选择和使用抗生素,合理饮食,尽量减少医疗干预措施的影响,可减少腹泻并发症的发生。