Critical illness polyneuropathy and critical illness myopathy are frequent complications of severe illness that involve sensorimotor axons and skeletal muscles,respectively.Clinically,they manifest as limb and respira...Critical illness polyneuropathy and critical illness myopathy are frequent complications of severe illness that involve sensorimotor axons and skeletal muscles,respectively.Clinically,they manifest as limb and respiratory muscle weakness.Critical illness polyneuropathy/myopathy in isolation or combination increases intensive care unit morbidity via the inability or difficulty in weaning these patients off mechanical ventilation.Many patients continue to suffer from decreased exercise capacity and compromised quality of life for months to years after the acute event.Substantial progress has been made lately in the understanding of the pathophysiology of critical illness polyneuropathy and myopathy.Clinical and ancillary test results should be carefully interpreted to differentiate critical illness polyneuropathy/myopathy from similar weaknesses in this patient population.The present review is aimed at providing the latest knowledge concerning the pathophysiology of critical illness polyneuropathy/myopathy along with relevant clinical,diagnostic,differentiating,and treatment information for this debilitating neurological disease.展开更多
Cerebral white matter is vulnerable to oxidative stress:Oxidative stress is one of the major harmful conditions for the central nervous system(CNS).Oxidative stress is a state from an imbalance between free radical pr...Cerebral white matter is vulnerable to oxidative stress:Oxidative stress is one of the major harmful conditions for the central nervous system(CNS).Oxidative stress is a state from an imbalance between free radical production and their removal by antioxidants,resulting in an excessive amount of reactive oxygen species(ROS)in cells and tissues.ROS causes cell damage due to oxidation of cellular components,including DNAs,proteins,and lipids.展开更多
Exercise and brain health:Physical activity helps promote and maintain our brain health,including memory and cognitive performance.Research has shown that exercise is a safe behavioral intervention that reduces the ri...Exercise and brain health:Physical activity helps promote and maintain our brain health,including memory and cognitive performance.Research has shown that exercise is a safe behavioral intervention that reduces the risk of hypokinetic diseases,such as hypertension,diabetes,and lipid metabolic disorders.In addition.展开更多
Microglia are responsible for phagocytosis in the brain:Phagocytosis,one of the major mechanisms of innate immune defense,is the process by which several types of cells in the immune system recognize,engulf,and digest...Microglia are responsible for phagocytosis in the brain:Phagocytosis,one of the major mechanisms of innate immune defense,is the process by which several types of cells in the immune system recognize,engulf,and digest large particles,such as pathogens and cell debris.In the brain,microglia play phagocytotic roles to regulate the micro-environment of brains under both physiological and pathological conditions.展开更多
We have recently established a mouse model of focal stroke under dual antiplatelet therapy(DAPT)to study tissue plasminogen activator(tPA)-associated hemorrhagic transformation.The purpose of this short perspective is...We have recently established a mouse model of focal stroke under dual antiplatelet therapy(DAPT)to study tissue plasminogen activator(tPA)-associated hemorrhagic transformation.The purpose of this short perspective is to discuss the rationale for establishing the model,highlighting its relevance for addressing unresolved clinical questions.Hemorrhagic conversion of the ischemic stroke remains one of the major liabilities of thrombolytic therapy with tPA,contributing to unfavorable outcomes and failed regeneration.This was recognized early on,and the resulting restrictions on tPA usage have led to only a minor percentage of stroke patients receiving any kind of drug treatment to limit ischemic injury.展开更多
Hypothermia is an important protective strategy against global cerebral ischemia following cardiac arrest.However,the mechanisms of hypothermia underlying the changes in different regions and connections of the brain ...Hypothermia is an important protective strategy against global cerebral ischemia following cardiac arrest.However,the mechanisms of hypothermia underlying the changes in different regions and connections of the brain have not been fully elucidated.This study aims to identify the metabolic nodes and connection integrity of specific brain regions in rats with global cerebral ischemia that are most affected by hypothermia treatment.18F-fluorodeoxyglucose positron emission tomography was used to quantitatively determine glucose metabolism in different brain regions in a rat model of global cerebral ischemia established at 31–33℃.Diffusion tensor imaging was also used to reconstruct and explore the brain connections involved.The results showed that,compared with the model rats established at 37–37.5℃,the rat models of global cerebral ischemia established at 31–33℃had smaller hypometabolic regions in the thalamus and primary sensory areas and sustained no obvious thalamic injury.Hypothermia selectively preserved the integrity of the anterior forebrain mesocircuit,exhibiting protective effects on the brain during the global cerebral ischemia.The study was approved by the Institutional Animal Care and Use Committee at Capital Medical University(approval No.XW-AD318-97-019)on December 15,2019.展开更多
A recent study published in Molecular Psychiatry proposes a cellular mechanism that may contribute to decreased insulin production in individuals with type 2 diabetes mellitus(T2DM).1 Using a combination of cell cultu...A recent study published in Molecular Psychiatry proposes a cellular mechanism that may contribute to decreased insulin production in individuals with type 2 diabetes mellitus(T2DM).1 Using a combination of cell culture experiments,animal models and studies in T2DM patients,the authors show that an up-regulation of tau inβ-islet cells can inhibit pancreatic insulin secretion through changes in microtubule assembly.展开更多
Roles of oligodendrocyte precursor cells in the central nervous system:Oligodendrocyte precursor cells(OPCs)have long been recognized for their critical role as precursors to oligodendrocytes,the primary myelin-produc...Roles of oligodendrocyte precursor cells in the central nervous system:Oligodendrocyte precursor cells(OPCs)have long been recognized for their critical role as precursors to oligodendrocytes,the primary myelin-producing cells.As precursors,OPCs mature and differentiate into oligodendrocytes,which contribute significantly to the formation of myelin sheaths around axons.This myelination,which is critical for the conduction of salutatory nerve impulses in the cerebral white matter,underscores the classical role of oligodendrocytes in central nervous system(CNS)functionality.Importantly,because oligodendrocytes are differentiated cells that cannot proliferate.展开更多
Infections occur commonly after stroke and are strongly associated with an unfavourable functional outcome of these patients.Approaches for effective management of poststroke infection remain scarce,presenting an urge...Infections occur commonly after stroke and are strongly associated with an unfavourable functional outcome of these patients.Approaches for effective management of poststroke infection remain scarce,presenting an urgent need for preventive anti-infection strategies for patients who have suffered a stroke.Emerging evidence indicates that stroke impairs systemic immune responses and increases the susceptibility to infections,suggesting that the modification of impaired immune defence could be beneficial.In this review,we summarised previous attempts to prevent poststroke infections using prophylactic antibiotics and the current understanding of stroke-induced immunosuppression.Further elucidation of the immune mechanisms of stroke will pave the way to tailored design of new treatment to combat poststroke infection via modifying the immune system.展开更多
Background Lymphocyte to monocyte ratio(LMR)is associated with functional outcome in patients with stroke.But the relationship between the LMR value and the prognosis of cerebral venous sinus thrombosis(CVST)has not b...Background Lymphocyte to monocyte ratio(LMR)is associated with functional outcome in patients with stroke.But the relationship between the LMR value and the prognosis of cerebral venous sinus thrombosis(CVST)has not been investigated.Methods CVST patients,admitted to the First Affiliated Hospital of Zhengzhou University,were retrospectively identified from November 2010 to January 2017.Functional outcomes of patients were evaluated with the modified Rankin Scale(mRS).Patients were divided into good(mRS 0-2)and poor(mRS 3-6)outcomes groups.Univariate and multivariate Cox regression analyses were used to assess the relationship between LMR and the poor survival outcome.Results A total of 228 patients were included of which 41 had poor outcomes(18.0%).The duration of follow-up was 22 months(6-66 months).LMR(2.3±1.2 vs 3.2±1.8,p<0.01)was significantly lower in the poor outcome group.Multivariate Cox regression analysis showed that LMR(HR 0.726,95%CI 0.546 to 0.964,p=0.027)was a independent predictor of poor prognosis.Conclusions LMR may be a predictor of poor prognosis in CVST patients.展开更多
基金supported by grants from China Scholarship Council,No.2008102056the National Natural Science Foundation of China,No.81241147
文摘Critical illness polyneuropathy and critical illness myopathy are frequent complications of severe illness that involve sensorimotor axons and skeletal muscles,respectively.Clinically,they manifest as limb and respiratory muscle weakness.Critical illness polyneuropathy/myopathy in isolation or combination increases intensive care unit morbidity via the inability or difficulty in weaning these patients off mechanical ventilation.Many patients continue to suffer from decreased exercise capacity and compromised quality of life for months to years after the acute event.Substantial progress has been made lately in the understanding of the pathophysiology of critical illness polyneuropathy and myopathy.Clinical and ancillary test results should be carefully interpreted to differentiate critical illness polyneuropathy/myopathy from similar weaknesses in this patient population.The present review is aimed at providing the latest knowledge concerning the pathophysiology of critical illness polyneuropathy/myopathy along with relevant clinical,diagnostic,differentiating,and treatment information for this debilitating neurological disease.
基金Supported in part by National Institutes of Health and the Rotary Foundation Global Scholarship Grants(GG1759314)
文摘Cerebral white matter is vulnerable to oxidative stress:Oxidative stress is one of the major harmful conditions for the central nervous system(CNS).Oxidative stress is a state from an imbalance between free radical production and their removal by antioxidants,resulting in an excessive amount of reactive oxygen species(ROS)in cells and tissues.ROS causes cell damage due to oxidation of cellular components,including DNAs,proteins,and lipids.
文摘Exercise and brain health:Physical activity helps promote and maintain our brain health,including memory and cognitive performance.Research has shown that exercise is a safe behavioral intervention that reduces the risk of hypokinetic diseases,such as hypertension,diabetes,and lipid metabolic disorders.In addition.
文摘Microglia are responsible for phagocytosis in the brain:Phagocytosis,one of the major mechanisms of innate immune defense,is the process by which several types of cells in the immune system recognize,engulf,and digest large particles,such as pathogens and cell debris.In the brain,microglia play phagocytotic roles to regulate the micro-environment of brains under both physiological and pathological conditions.
基金This work was supported by American Heart Association(17GRNT33460100 to KL)Faculty of Medicine,Goethe University Frankfurt(FPF doctoral scholarship to FL).
文摘We have recently established a mouse model of focal stroke under dual antiplatelet therapy(DAPT)to study tissue plasminogen activator(tPA)-associated hemorrhagic transformation.The purpose of this short perspective is to discuss the rationale for establishing the model,highlighting its relevance for addressing unresolved clinical questions.Hemorrhagic conversion of the ischemic stroke remains one of the major liabilities of thrombolytic therapy with tPA,contributing to unfavorable outcomes and failed regeneration.This was recognized early on,and the resulting restrictions on tPA usage have led to only a minor percentage of stroke patients receiving any kind of drug treatment to limit ischemic injury.
基金supported by Beijing Municipal Health Commission of China,No.Jing2019-2(to TLW)。
文摘Hypothermia is an important protective strategy against global cerebral ischemia following cardiac arrest.However,the mechanisms of hypothermia underlying the changes in different regions and connections of the brain have not been fully elucidated.This study aims to identify the metabolic nodes and connection integrity of specific brain regions in rats with global cerebral ischemia that are most affected by hypothermia treatment.18F-fluorodeoxyglucose positron emission tomography was used to quantitatively determine glucose metabolism in different brain regions in a rat model of global cerebral ischemia established at 31–33℃.Diffusion tensor imaging was also used to reconstruct and explore the brain connections involved.The results showed that,compared with the model rats established at 37–37.5℃,the rat models of global cerebral ischemia established at 31–33℃had smaller hypometabolic regions in the thalamus and primary sensory areas and sustained no obvious thalamic injury.Hypothermia selectively preserved the integrity of the anterior forebrain mesocircuit,exhibiting protective effects on the brain during the global cerebral ischemia.The study was approved by the Institutional Animal Care and Use Committee at Capital Medical University(approval No.XW-AD318-97-019)on December 15,2019.
文摘A recent study published in Molecular Psychiatry proposes a cellular mechanism that may contribute to decreased insulin production in individuals with type 2 diabetes mellitus(T2DM).1 Using a combination of cell culture experiments,animal models and studies in T2DM patients,the authors show that an up-regulation of tau inβ-islet cells can inhibit pancreatic insulin secretion through changes in microtubule assembly.
基金supported in part by National Institutes of Health,Nos.5R01NS113556-05,1R21NS128310-01(to KA).
文摘Roles of oligodendrocyte precursor cells in the central nervous system:Oligodendrocyte precursor cells(OPCs)have long been recognized for their critical role as precursors to oligodendrocytes,the primary myelin-producing cells.As precursors,OPCs mature and differentiate into oligodendrocytes,which contribute significantly to the formation of myelin sheaths around axons.This myelination,which is critical for the conduction of salutatory nerve impulses in the cerebral white matter,underscores the classical role of oligodendrocytes in central nervous system(CNS)functionality.Importantly,because oligodendrocytes are differentiated cells that cannot proliferate.
基金This study was supported in part by the National Basic Research Program of China,grant 2013CB966900National Science Foundation of China,grant 81230028,81301044,81471535+2 种基金American Heart Association,grant 16SDG27250236National Institutes of Health,grant R01NS092713National Multiple Sclerosis Society,grant RG-1507-05318.
文摘Infections occur commonly after stroke and are strongly associated with an unfavourable functional outcome of these patients.Approaches for effective management of poststroke infection remain scarce,presenting an urgent need for preventive anti-infection strategies for patients who have suffered a stroke.Emerging evidence indicates that stroke impairs systemic immune responses and increases the susceptibility to infections,suggesting that the modification of impaired immune defence could be beneficial.In this review,we summarised previous attempts to prevent poststroke infections using prophylactic antibiotics and the current understanding of stroke-induced immunosuppression.Further elucidation of the immune mechanisms of stroke will pave the way to tailored design of new treatment to combat poststroke infection via modifying the immune system.
基金This work was supported by the Science and Technology Department of the Henan Province grant number(No.152102310058)the National Natural Science Foundation of China grant number(No 81530037)the China Scholarship Council(to KL).
文摘Background Lymphocyte to monocyte ratio(LMR)is associated with functional outcome in patients with stroke.But the relationship between the LMR value and the prognosis of cerebral venous sinus thrombosis(CVST)has not been investigated.Methods CVST patients,admitted to the First Affiliated Hospital of Zhengzhou University,were retrospectively identified from November 2010 to January 2017.Functional outcomes of patients were evaluated with the modified Rankin Scale(mRS).Patients were divided into good(mRS 0-2)and poor(mRS 3-6)outcomes groups.Univariate and multivariate Cox regression analyses were used to assess the relationship between LMR and the poor survival outcome.Results A total of 228 patients were included of which 41 had poor outcomes(18.0%).The duration of follow-up was 22 months(6-66 months).LMR(2.3±1.2 vs 3.2±1.8,p<0.01)was significantly lower in the poor outcome group.Multivariate Cox regression analysis showed that LMR(HR 0.726,95%CI 0.546 to 0.964,p=0.027)was a independent predictor of poor prognosis.Conclusions LMR may be a predictor of poor prognosis in CVST patients.
