Background and purpose Atherosclerosis is a very complex process influenced by various systemic and local factors.Therefore,in patients with bilateral carotid plaques(BCPs),there may be differences in carotid plaque v...Background and purpose Atherosclerosis is a very complex process influenced by various systemic and local factors.Therefore,in patients with bilateral carotid plaques(BCPs),there may be differences in carotid plaque vulnerability between the sides.We aimed to investigate the differences in BCP characteristics in patients with BCPs using magnetic resonance vessel wall imaging(MR-VWI).Methods Participants with BCPs were selected for subanalysis from a multicentre study of Chinese Atherosclerosis Risk Evaluation II.We measured carotid plaque burden,identified each plaque component and measured their volume or area bilaterally on MR-VWI.Paired comparisons of the burden and components of BCPs were performed.Results In all,540 patients with BCPs were eligible for analysis.Compared with the right carotid artery(CA),larger mean lumen area(p<0.001),larger mean wall area(p=0.025),larger mean total vessel area(p<0.001)and smaller normalised wall index(p=0.006)were found in the left CA.Regarding plaque components,only the prevalence of lipid-rich necrotic core(LRNC)in the left CA was higher(p=0.026).For patients with a vulnerable plaque component coexisting on both sides,only the intraplaque haemorrhage(IPH)volume(p=0.011)was significantly greater in the left CA than in the right CA.Conclusions There were asymmetries in plaque growth and evolution between BCPs.The left carotid plaques were more likely to have larger plaque burden,higher prevalence of LRNC and greater IPH volume,which may contribute to the lateralisation of ischaemic stroke in the cerebral hemispheres.展开更多
Introduction The safety outcomes of endovascular therapy for intracranial artery stenosis in a real-world stetting are largely unknown.The Clinical Registration Trial of Intracranial Stenting for Patients with Symptom...Introduction The safety outcomes of endovascular therapy for intracranial artery stenosis in a real-world stetting are largely unknown.The Clinical Registration Trial of Intracranial Stenting for Patients with Symptomatic Intracranial Artery Stenosis(CRTICAS)was a prospective,multicentre,real-world registry designed to assess these outcomes and the impact of centre experience.Methods 1140 severe,symptomatic intracranial arterial stenosis(ICAS)patients treated with endovascular therapy were included from 26 centres,further divided into three groups according to the annual centre volume of intracranial angioplasty and stent placement procedures over 2 years:(1)high volume for≥25 cases/year;(2)moderate volume for 10–25 cases/year and(3)low volume for<10 cases/year.Results The rate of 30-day stroke,transient ischaemic attack or death was 9.7%(111),with 5.4%,21.1%and 9.7%in high-volume,moderate-volume and low-volume centres,respectively(p<0.05).Multivariable logistic regression confirmed high-volume centres had a significantly lower primary endpoint compared with moderate-volume centres(OR=0.187,95%CI:0.056 to 0.627;p≤0.0001),while moderate-volume and low-volume centres showed no significant difference(p=0.8456).Conclusion Compared with the preceding randomised controlled trials,this real-world,prospective,multicentre registry shows a lower complication rate of endovascular treatment for symptomatic ICAS.Non-uniform utilisation in endovascular technology,institutional experience and patient selection in different volumes of centres may have an impact on overall safety of this treatment.展开更多
Objective: To discuss the correlation among intracranial arterial stenosis and its risk factors. Methods: A total of 486 patients with transient ischemic attack(TIA) or ischemic cerebral infarction were examined using...Objective: To discuss the correlation among intracranial arterial stenosis and its risk factors. Methods: A total of 486 patients with transient ischemic attack(TIA) or ischemic cerebral infarction were examined using color doppler flow imaging(CDFI) and transcranial doppler ultrosonography(TCD). According to the degrees of extracranial arterial stenosis, patients with mild-to-moderate extracranial stenosis were classified into group A(435 cases) while those with constant severe stenosis or occlusion were classified into group B(51 cases). The differences between the two groups of risk factors were compared, and the multi-factor logistic regression analysis of risk factors associated with moderately severe intracranial arterial stenosis was performed. Results:(1) The risk factors that were significantly associated with intracranial arterial stenosis included age(P = 0.034) and gender(P = 0.044).(2) Intracranial artery stenosis was observed in both anterior and posterior cerebral arteries in patients with hypertension, diabetes, and coronary heart disease respectively(P < 0.05).(3) Compared with group A, patients in group B were older(P = 0.000), with a higher proportion of men(P = 0.037), and the intracranial arterial stenosis degrees were significantly higher(P = 0.013).(4) Multi-factor logistic regression analysis showed that diabetes is a risk factor for moderately severe intracranial arterial stenosis(P < 0.05), and hyperlipidemia is a protective factor(P = 0.012). Conclusions: Age, gender, hypertension, diabetes, coronary heart disease, and smoking are risk factors for the distribution of intracranial arterial stenosis. The degrees of intracranial arterial stenosis are related with extracranial arterial stenosis. Diabetes is a risk factor for moderately severe intracranial arterial stenosis while hyperlipidemia is a protective factor.展开更多
Objective: We aimed to provide an alternative cell source for cell therapy in leukoaraiosis(LA). Methods: Olfactory ensheathing cells(OECs) from the olfactory bulb were isolated,cultured, and purified. Next, the lenti...Objective: We aimed to provide an alternative cell source for cell therapy in leukoaraiosis(LA). Methods: Olfactory ensheathing cells(OECs) from the olfactory bulb were isolated,cultured, and purified. Next, the lentivirus carrying human VEGF165 gene was constructed and transfected into OECs. Results: The proliferative capacity of primary OECs was strong. OECs were infected with different multiplicity of infection. The expression level of VEGF was confirmed by real-time PCR with specific primers for GAPDH and VEGF, indicating that the genetically engineered OECs-VEGF produced VEGF with functional activity. Conclusions: Our data showed that these engineered OECs-VEGF highly express functional VEGF and retain the characteristics of astrocytes and Schwann cells,providing an alternative cell source for cell therapy in LA.展开更多
基金funding through grant from the Ministry of Health Commission of Shandong Province(202009010617).
文摘Background and purpose Atherosclerosis is a very complex process influenced by various systemic and local factors.Therefore,in patients with bilateral carotid plaques(BCPs),there may be differences in carotid plaque vulnerability between the sides.We aimed to investigate the differences in BCP characteristics in patients with BCPs using magnetic resonance vessel wall imaging(MR-VWI).Methods Participants with BCPs were selected for subanalysis from a multicentre study of Chinese Atherosclerosis Risk Evaluation II.We measured carotid plaque burden,identified each plaque component and measured their volume or area bilaterally on MR-VWI.Paired comparisons of the burden and components of BCPs were performed.Results In all,540 patients with BCPs were eligible for analysis.Compared with the right carotid artery(CA),larger mean lumen area(p<0.001),larger mean wall area(p=0.025),larger mean total vessel area(p<0.001)and smaller normalised wall index(p=0.006)were found in the left CA.Regarding plaque components,only the prevalence of lipid-rich necrotic core(LRNC)in the left CA was higher(p=0.026).For patients with a vulnerable plaque component coexisting on both sides,only the intraplaque haemorrhage(IPH)volume(p=0.011)was significantly greater in the left CA than in the right CA.Conclusions There were asymmetries in plaque growth and evolution between BCPs.The left carotid plaques were more likely to have larger plaque burden,higher prevalence of LRNC and greater IPH volume,which may contribute to the lateralisation of ischaemic stroke in the cerebral hemispheres.
基金supported by the National Key Research and Development Project(2016YFC1301703)the Beijing Scientific and Technologic Project(D161100003816002).
文摘Introduction The safety outcomes of endovascular therapy for intracranial artery stenosis in a real-world stetting are largely unknown.The Clinical Registration Trial of Intracranial Stenting for Patients with Symptomatic Intracranial Artery Stenosis(CRTICAS)was a prospective,multicentre,real-world registry designed to assess these outcomes and the impact of centre experience.Methods 1140 severe,symptomatic intracranial arterial stenosis(ICAS)patients treated with endovascular therapy were included from 26 centres,further divided into three groups according to the annual centre volume of intracranial angioplasty and stent placement procedures over 2 years:(1)high volume for≥25 cases/year;(2)moderate volume for 10–25 cases/year and(3)low volume for<10 cases/year.Results The rate of 30-day stroke,transient ischaemic attack or death was 9.7%(111),with 5.4%,21.1%and 9.7%in high-volume,moderate-volume and low-volume centres,respectively(p<0.05).Multivariable logistic regression confirmed high-volume centres had a significantly lower primary endpoint compared with moderate-volume centres(OR=0.187,95%CI:0.056 to 0.627;p≤0.0001),while moderate-volume and low-volume centres showed no significant difference(p=0.8456).Conclusion Compared with the preceding randomised controlled trials,this real-world,prospective,multicentre registry shows a lower complication rate of endovascular treatment for symptomatic ICAS.Non-uniform utilisation in endovascular technology,institutional experience and patient selection in different volumes of centres may have an impact on overall safety of this treatment.
基金Supported by the National Natural Science Foundation of China(Grant No.30970991)Critical R&D Project of Shandong Province,2015(Grant No.2015GSF118069)
文摘Objective: To discuss the correlation among intracranial arterial stenosis and its risk factors. Methods: A total of 486 patients with transient ischemic attack(TIA) or ischemic cerebral infarction were examined using color doppler flow imaging(CDFI) and transcranial doppler ultrosonography(TCD). According to the degrees of extracranial arterial stenosis, patients with mild-to-moderate extracranial stenosis were classified into group A(435 cases) while those with constant severe stenosis or occlusion were classified into group B(51 cases). The differences between the two groups of risk factors were compared, and the multi-factor logistic regression analysis of risk factors associated with moderately severe intracranial arterial stenosis was performed. Results:(1) The risk factors that were significantly associated with intracranial arterial stenosis included age(P = 0.034) and gender(P = 0.044).(2) Intracranial artery stenosis was observed in both anterior and posterior cerebral arteries in patients with hypertension, diabetes, and coronary heart disease respectively(P < 0.05).(3) Compared with group A, patients in group B were older(P = 0.000), with a higher proportion of men(P = 0.037), and the intracranial arterial stenosis degrees were significantly higher(P = 0.013).(4) Multi-factor logistic regression analysis showed that diabetes is a risk factor for moderately severe intracranial arterial stenosis(P < 0.05), and hyperlipidemia is a protective factor(P = 0.012). Conclusions: Age, gender, hypertension, diabetes, coronary heart disease, and smoking are risk factors for the distribution of intracranial arterial stenosis. The degrees of intracranial arterial stenosis are related with extracranial arterial stenosis. Diabetes is a risk factor for moderately severe intracranial arterial stenosis while hyperlipidemia is a protective factor.
基金Supported by the National Natural Science Foundation of China(Grant No.30970991)Critical R&D Project of Shandong Province,2015(Grant No.2015GSF118069)
文摘Objective: We aimed to provide an alternative cell source for cell therapy in leukoaraiosis(LA). Methods: Olfactory ensheathing cells(OECs) from the olfactory bulb were isolated,cultured, and purified. Next, the lentivirus carrying human VEGF165 gene was constructed and transfected into OECs. Results: The proliferative capacity of primary OECs was strong. OECs were infected with different multiplicity of infection. The expression level of VEGF was confirmed by real-time PCR with specific primers for GAPDH and VEGF, indicating that the genetically engineered OECs-VEGF produced VEGF with functional activity. Conclusions: Our data showed that these engineered OECs-VEGF highly express functional VEGF and retain the characteristics of astrocytes and Schwann cells,providing an alternative cell source for cell therapy in LA.
