简介：A57-year-oldmanreportedexperiencingdyspneaafterwalking100feetthathasbeenprogressingdespitemedicaltherapy.Hehastwo-pilloworthopneaandoccasionalnighttimedyspneabutnoangina.Hehadananteriormyocardialinfarction5yearspreviouslybutdidnotseekmedicalcareuntil2daysaftertheevent.Viabilitystudiesdemonstratedonlylimitedanteriorwallviability.–Electrocardiogram:sinusrhythmwithleftbundlebranchblock.–Medications:furosemide,120mgtwicedaily;metolazone,5mgeveryotherday;carvedilol,25mgtwicedaily;lisinopril,40mgdaily;spironolactone,25mgdaily.

简介：瞄准：观察效果是在老鼠肝细胞的cyclinD1表示上的化学家preconditioning在期间早是化学家灌注。方法：54只SD老鼠随机被划分成是preconditioning组(IP)，ischemia/reperfusion组(红外)和假冒的操作组织的化学家(那么)。IP和红外组进一步被划分成四亚群(n=6)。假冒的操作组(那么)担任了控制组(n=6)。部分肝ischemia/reperfusion的一个模型被使用，在哪个老鼠在灌注以前为60min受到肝局部缺血。在IP组的动物经历了在ischemia/reperfusion挑战以前每次为5min是化学家preconditioning两次。在灌注的0，1，2，和4h以后，在每个组的浆液和肝织物被收集检测浆液中高音，肝组织病理学说和cyclinD1mRNA和蛋白质的表示的水平。流动血细胞计数被用来作为房间新生的数量指示物检测房间周期。结果：与红外组相比，IP组在1h显示出显著地更低的中高音水平到4h亚群(P<0.05)。增长索引(PI)由S阶段和G2/M-phase比率显示了[(S+G2/M)/(G0/G1+S+G2/M)]显著地在0和1h在IP组被增加(26.44+/-7.60%对18.56+/-6.40%，41.87+/-7.27%对20.25+/-6.70%，P<0.05)。同时，cyclinD1蛋白质表示能在IP组被检测。但是在红外组，，cyclinD1蛋白质表示发生了在灌注以后的2h。在IP显著地增加的cyclinD1mRNA的表示在0和1h组织(0.568+/-0.112对0.274+/-0.069，0.762+/-0.164对0.348+/-0.093，P<0.05)。结论：局部缺血preconditioning能保护肝细胞免于ischemia/reperfusion损害，它可能早与房间增长和cyclinD1的表示有关在期间是化学家灌注。

简介：AIMTo探索在网膜的血容器的氧浸透怎么在ischemic和non-ischemic分支被改变网膜的静脉吸藏(BRVO).METHODSFiftyBRVO眼睛被划分成ischemic(n=26)和non-ischemic(n=24)组，基于宫底荧光黄angiography。健康个人(n=52和n=48，分别地)也为二个组作为控制被招募。堵塞容器和中央容器的吝啬的氧浸透被oximetry在BRVO和控制groups.RESULTSIn测量ischemicBRVO组，堵塞小动脉氧浸透(SaO2-一，106.0%±；14.3%)，而不是堵塞小静脉氧浸透(SaO2-V,60.8%±；9.4%)，看了增加什么时候与那些相比在一样的象限容器(SaO2-A,86.1%±；16.5%)在contralateral眼睛(P<；0.05)。中央容器的氧浸透堵塞容器与那些显示出类似的趋势。在non-ischemicBRVO组，堵塞，中央SaO2-V和SaO2-A没显示出重要变化。在ischemic和non-ischemicBRVO，当时，中央SaO2-A显著地被增加与健康individuals.CONCLUSIONObvious变化在相比堵塞，中央SaO2-A在ischemicBRVO组被发现，显示在小动脉的氧新陈代谢的混乱可以参予ischemicBRVO的致病。

简介：Theconnexin43(Cx43)proteins,whichisthepredominantproteinthatcanformgapjunctionsandnon-junctionalhemichannelsinventricularmyocardium,arecentraltothecardioprotectionaffordedbyischemicpreconditioning(IP)andmaybeischemicpostconditioning(PC)too.RecentstudiesshowedthatrecruitmentofCx43tothemitochondriainIPmightplayaroleintheproductionofreactiveoxygenspecies(ROS)thatmediatesIP.ThelocalizationofCx43atmitochondriaappearstobeimportantfortheachievedcardioprotectionandopensanewdoorforustorevealtheexactmechanismsofischemia/reperfusion(I/R)injuryandcardioprotection,anditmightbenewtargetsofpharmacologicalmodulatortoachievedcardioprotection.

简介：目的将在更低的手足讨论ischemic挛缩的功能的重建的方法并且基于它的严厉和预后在更低的手足为ischemic挛缩建议一个分类协议。有在更低的手足的ischemic挛缩的42个病人全部的方法A在这研究被包括。根据骚乱的不同类型和严厉，由神经解压缩组成的外科的重建，腱变长或转移的度，内在的脚肌肉版本和小腿腹胫骨的神经吻合在每个病人被执行。手术后地结果，所有病人能走在扁平的地面上。落下脚在10个病人被改正，并且5个病人仍然在楼梯活动期间感到了一些困难。到屈肌hallucislongus腱的裂口跟腱转移在12个病人被执行，并且他们的走的稳定性被改进。七个病人接受了在5个病人在2个病人和S3到达到S2的ipsilateralsuraltibial神经吻合，和敏感恢复。在更低的手足的结论Ischemic挛缩是在更低的手足损伤以后的破坏复杂并发症。挛缩的预防比确定的挛缩的治疗更重要。到屈肌hallucislongus腱和小腿腹胫骨的神经吻合的裂口跟腱转移，被我们开始实现，能在更低的手足改进ischemic挛缩的功能的恢复，并且因此在更低的手足为ischemic挛缩的功能的重建提供一种新选择。

简介：Onehundredandseventeenacutecerebralinfarctionpatientswererandomlydivid-edintotwogroups:Scalpacupuncturegroup(GroupA)andpuremedicationgroup(GroupB).Thefunctionofthenervoussystem,brainelectricalactivitymappingandsomatosensoryevokedpotentialswereobservedbeforeandafterthetreatment.Itwasfoundthattheindexesinthetwogroupschangedsignificantly(P<0.05).ThecurativeeffectsinGroupAwerebetterthanthatinGroupB(P<0.001).Thecurativeeffectsofscalpacupunctureonacutecerebralinfarctionwereobjectivelyconfirmedbymeansofelectrophysiologicalstudies.

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简介：ObjectivesPlasmauricacid(UA)concentrationwassuspectedtoelevateinelderlywithischemiccardiomyopathy(ICM).MethodsWeanalyzedthedataof235elderlyaged60yearsandolderwithcoronaryheartdisease:silentmyocardialischemiaoranginapectorisconfirmedbyangiography.Amongthesepatients,154hadICMdefinedasleftventricularend-diastolicdiameter(LVDd)male>55mm,female>50mm(mean:63.51±7.70mm)measuredbyechocardiography.DifferenceinUAwasanalyzedbetweenpatientswithandwithoutICM.ResultsTherewassignificantincreaseofUAinICMcomparedwithnon-ICM(432.82±143.05umol/Lvs361.06±137.35umol/L,P<0.05);andUAwaspositivelyrelatedtoLVDd(r=0.25,P<0.05).ConclusionsTherewassignificantincreaseofUAinelderlywithICMduetolongtermsilentmyocardialischemiaandanginapectoris.Moreover,UAwaspositivelyrelatedtoLVDd.

简介：AbstractBackground:Intravenous thrombolysis (IVT) is an effective way for treating acute ischemic stroke (AIS). However, its effects have not been established among AIS patients with unclear stroke symptoms or with stroke onset for >4.5 h.Methods:We searched PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials and Google Scholar databases for randomized controlled trials that compared IVT (IVT group) and placebo or usual care (control group [CG]) in AIS patients with disease onset for >4.5 h. The outcomes of interest included the favorable functional outcome (defined as modified Rankin Scale [mRS] scores 0-1) at 90 days, the functional independence (defined as mRS scores 0-2) at 90 days, proportion of patients with symptomatic intracerebral hemorrhage (sICH) and death at 90 days. We assessed the risk of bias using the Cochrane tool. Pre-specified subgroup analyses were performed by age (≤70 years or >70 years), National Institute of Health Stroke Scale (NIHSS, ≤10 or >10) and time window (4.5-9.0 h or >9.0 h).Results:Four trials involving 848 patients were eligible. The risk of bias of included trials was low. Patients in the IVT group were more likely to achieve favorable functional outcomes (45.8% vs. 36.7%; OR 1.48, 95% CI 1.12-1.96) and functional independence (63.8% vs. 55.7%; OR 1.43, 95% CI 1.08-1.90) at 90 days, but had higher risk of sICH (3.0% vs. 0.5%; OR 5.28, 95% CI 1.35-20.68) at 90 days than those in the CG. No significant difference in death at 90 days was found between the two groups (7.0% vs. 4.1%; OR 1.80; 95% CI 0.97-3.34).Conclusions:Use of IVT in patients with extended time window may improve their functional outcomes at 90 days, although IVT may induce increased risk of sICH. Care of these patients should well balance the potential benefits and harms of IVT.

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简介：Fortheestablishmentofdirectrevascularicationoftheischemicmyocardium,aNd:YAGlaserwithawavelengthof1060nmandanopiticfiberdiameterof500umwasusedtocreate20to25transmuralchannelsinthecentralischemicregionoftheleftventricleafterthecoronarywasligatured.Thechannelswerecreatedfromtheepicard1alsurfacetotheendocardiumandeachchannelreceivedabout64joulesofthe

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简介：Strokeisaleadingcauseofdisabilityanddeath,yeteffectivetreatmentsforacutestrokehasbeenverylimited.Thusfar,tissueplasminogenactivatorhasbeentheonlyFDA-approveddrugforthrombolytictreatmentofischemicstrokepatients,yetitsapplicationisonlyapplicabletolessthan4–5%ofstrokepatientsduetothenarrowtherapeuticwindow(<4.5hoursaftertheonsetofstroke)andthehighriskofhemorrhagictransformation.Emergingevidencefrombasicandclinicalstudieshasshownthattherapeutichypothermia,alsoknownastargetedtemperaturemanagement,canbeapromisingtherapyforpatientswithdifferenttypesofstroke.Moreover,thesuccessinanimalmodelsusingpharmacologicallyinducedhypothermia(PIH)hasgainedincreasingmomentumforclinicaltranslationofhypothermictherapy.Thisreviewprovidesanupdatedoverviewofthemechanismsandprotectiveeffectsoftherapeutichypothermia,aswellastherecentdevelopmentandfindingsbehindPIHtreatment.ItisexpectedthatasafeandeffectivehypothermictherapyhasahightranslationalpotentialforclinicaltreatmentofpatientswithstrokeandotherCNSinjuries.

简介：Strokeremainsthethirdleadingcauseofdeathandofadultdisabilityworldwide.Vascularocclusion,followedbyischemiccascade,leadstoirreversibletissueinjury.RecombinanttissueplasminogenactivatoristheonlyFDAapproveddrugforthecurrenttreatmentofacuteischemicstroke.However,traditionalChinesemedicinehasalonghistoryandrichclinicalexperienceinthetreatmentandrehabilitationofischemicstroke.Usingaclassicalmiddlecerebralarteryocclusion(MCAO)strokemodel,wetestedtheeffectivenessofYiqihuoxuecalmwind(YCW)capsuleonneurologicalfunction,grosspathologyandoxidativestressstatusinMCAOrats.YCWcapsule(3.36and6.72g·kg~(-1)ofcrudedrug)couldsignificantlylowerLonga'sscoreandsuperoxidedismutase(SOD)level,togetherwithlessnecroticcellsandinfarctedarea.InadditiontoelevatedMDAanddownregulatediNOSexpression,YCWcapsuleexhibiteditsneuroprotectiveeffectsviafreeradicalscavengingandNOinhibition.

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简介：Conventionalrecommendationsfordiagnostictestingfortheevaluationofstableischemicheartdiseaseinwomenhavelargelyparalleledthoseinmen.Althoughtheyaredesignedprimarilyfortheidentificationofobstructivecoronaryarterydisease(CAD),traditionalapproachescanleadtoovertestinginwomenwithoutdifferentiatingwhoistrulyatrisk.Severaluniquefactorsrelatedtothepresentation,diagnosis,andunderlyingpathophysiologyofstableischemicheartdiseaseinwomennecessitateamorespecificapproachtotheassessmentoftheirrisk,completewithseparateguidelineswhenappropriate.Thisoverviewhighlightshowadvancednoninvasiveimagingtools,includingcardiaccomputedtomographyangiography,positronemissiontomography,andcardiacmagneticresonanceimaging,areenablingverysensitiveassessmentsofanatomicatheroscleroticplaqueburden,macrovessel-andmicrovessel-relatedischemia,andmyocardialfibrosis,respectively.Movingforward,effectivediagnostictestingwillneedtoidentifywomenathighriskofadversecardiovascularevents(notanatomicallyobstructiveCADperse)withoutovertestingthoseatlowrisk.JudiciousapplicationofnovelimagingapproacheswillbecriticaltobroadeningthedefinitionsofCADandischemiatobetterreflectthewholespectrumofpathologicalphenotypesinwomen,includingnonobstructiveCADandcoronarymicrovasculardysfunction,andaidinthedevelopmentofneededevidence-basedstrategiesfortheirmanagement.

简介：ＴＨＥＨＥＭＯＲＨＥＯＬＯＧＹＣＨＡＮＧＥＩＮＩＳＣＨＥＭＩＣＲＥＧＩＯＮＢＹＣＯＲＯＮＡＲＹＳＴＥＮＯＳＩＳＡＦＴＥＲＬＡＳＥＲＩＲＲＡＤＩＡＴＩＯＮＯＮＢＬＯＯＤＴＨＥＨＥＭＯＲＨＥＯＬＯＧＹＣＨＡＮＧＥＩＮＩＳＣＨＥＭＩＣＲＥＧＩＯＮＢＹＣＯＲ...

简介：AbstractBackground:The aim of this study was to comprehensively evaluate the risk factors of periprocedural ischemic stroke associated with endovascular treatment of intracranial aneurysms using a real-world database.Methods:From August 2016 to March 2017, 167 patients were enrolled. Univariate analysis and multivariate logistic regression analysis were used to examine the risk factors for periprocedural ischemic stroke.Results:Among the 167 cases, periprocedural ischemic stroke occurred in 20 cases (11.98%). After univariate analysis, the ischemic group had a higher proportion of large (≥ 10 mm) aneurysms than the control group (45.0% vs. 23.1%, p= 0.036). The incidence of periprocedural ischemic stroke was higher in cases treated by flow diverter (21.6%) or stent-assisted coiling (11.8%) than in cases treated by coiling only (2.7%), and the differences were statistically significant (p = 0.043). After multivariate logistic regression analysis, treatment modality was the independent risk factor for periprocedural ischemic stroke. Compared with the coiling-only procedure, flow diverter therapy was associated with a significantly higher rate of periprocedural ischemic stroke (OR 9.931; 95% CI 1.174-84.038; p = 0.035).Conclusions:Aneurysm size and treatment modality were associated with periprocedural ischemic stroke. Larger aneurysms were associated with increased risk of periprocedural ischemic stroke. Flow diverter therapy was associated with significantly more periprocedural ischemic stroke than the coiling procedure alone.