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Background: Progressive encephalomyelitis with rigidity and myoclonus (PERM) is an acute, potentially life-threatening, yet curable neuro-immunological disease characterized by spasms, muscular rigidity, and brainstem and autonomic dysfunction. The clinical features of glycine receptor (GlyR) antibody-positive PERM may be overlooked, particularly with some unusual symptoms., Case Presentation: A 52-year-old man was admitted to the hospital for evaluation of tension headache for 20 days and mild dysarthria. These symptoms were followed by panic, profuse sweating, severe dysarthria, dizziness, unsteady gait, and paroxysmal muscle spasms. Brain magnetic resonance imaging and cerebrospinal fluid analysis were normal. The patient's condition steadily deteriorated. He repeatedly presented with rigidity, panic attacks, severe anxiety, paroxysmal inspiratory laryngeal stridor, cyanosis of the lips, and intractable epilepsy. Electromyography showed multiple myoclonic seizures, a single generalized tonic-clonic seizure, and a single generalized tonic seizure. Screening for autoimmune encephalitis antibodies revealed anti-GlyR antibodies in his cerebrospinal fluid. Immunomodulatory pulse therapy with steroids and immunoglobulin resulted in expeditious improvement of the symptoms within 2 weeks, and a follow-up at 5 weeks showed consistent clinical improvement., Conclusion: Our case highlights that inspiratory laryngeal stridor is an important symptom of PERM. Our observation widens the spectrum of the clinical presentation of anti-GlyR antibody-positive PERM, where early identification is a key to improving prognosis., (© 2022. The Author(s).)

Purpose: To investigate characteristics of intra- and extracranial arterial culprit plaques between patients with single infarct and multiple-infarcts by a head-neck combined high resolution magnetic resonance vessel wall imaging (HR-MRVWI)., Materials and Methods: Forty-three patients with recent ischemic stroke due to large artery atherosclerosis were enrolled. The head-neck combined HR-MRVWI was performed in all patients both pre- and post-contrast administration. Based on diffusion weighted imaging findings, patients were divided into single-infarction and multiple-infarction groups. For patients with anterior circulation ischemic stroke, they were also divided into perforating artery infarction (PAI) and non-PAI groups. Patient demographics, number and location of culprit plaques, artery stenosis percentage, intraplaque hemorrhage, and plaque enhancement were evaluated and compared between single-infarction and multiple-infarction groups, as well as between PAI and non-PAI groups., Results: A total of 83 culprit plaques were identified. The artery stenosis degree was more severe and plaque enhancement more prominent in multiple-infarction group than in single-infarction group. Patients with multiple infarcts also had more culprit plaques per patient than those with single infarct, which contributed to the occurrence of multiple infarcts. For comparison of PAI and non-PAI groups, a higher artery stenosis percentage was observed in non-PAI group, and patients with non-PAI had more culprit plaques per patient, which contributed to a variety of infarct manifestations., Conclusion: A higher stenosis grade and higher number of culprit plaques seem to be associated with a higher number of cerebral infarcts in patients with large artery atherosclerosis., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Acute ischemic stroke has become the major cause of mortality and disability worldwide. Following ischemic stroke, the reperfusion injury is mainly mediated by the burst of reactive oxygen and nitrogen species (RONS). Therefore, blocking the excessive production or removing RONS holds great promise as a potential therapeutic strategy. Herein, we developed a Co-doped Fe 3 O 4 nanozyme that is capable of scavenging H 2 O 2 , O 2 •- , • NO, and ONOO- in vitro and in vivo and provides neuroprotection against ischemic stroke. In vitro experiments showed that pre-incubation with the Co-Fe 3 O 4 nanozyme could prevent neurotoxicity and neuroinflammation induced by H 2 O 2 or lipopolysaccharide, respectively, in HT22 cells. After intravenous administration, the Co-Fe 3 O 4 nanozyme showed no signs of toxicity in peripheral organs of C57BL/6J mice, even after prolonged delivery for 4 weeks. In permanent photothrombotic stroke model and transient middle cerebral artery occlusion stroke model, the Co-Fe 3 O 4 nanozyme specifically accumulated in the infarct rim at 72 h post-stroke and was endocytosed by neurons, astrocytes, microglia, and endothelial cells. Importantly, the Co-Fe 3 O 4 nanozyme delivery reduced the infarct volume in both stroke models. The observation that the Co-Fe 3 O 4 nanozyme was efficacious in two well-characterized ischemic stroke models provides strong evidence that it represents a powerful tool for targeting oxidative and nitrosative stress in the ischemic brain.

Background: Qualitative research can reflect the actual thoughts and experience of research subjects and can be used to explore the experiences of women presenting with twin-to-twin transfusion syndrome (TTTS) to facilitate the provision of targeted psychological support., Methods: A semi-structured interview method was used to assess the pregnancy and parenting experiences of women with TTTS. Colaizzi method was used for data analysis., Results: Eighteen women participated in the study. We found that women with TTTS during pregnancy experienced persistent worry about their children's health from the disease diagnosis to the subsequent parenting processes, even in case of minor changes in their children's health. The lack of an efficient referral process and health information increased their uncertainty about their children's health., Conclusion: In addition to the children's health, other difficulties encountered during pregnancy and parenting may aggravate the pressure. Clinicians in the first-visit hospital and foetal medicine centre should improve the referral process and establish a follow-up system to provide women with health information and psychological support., (© 2021. The Author(s).)

Disturbed blood flow (d-flow) has been known to induce changes of the cells in the arterial wall, increasing the risk of atherosclerosis. However, the heterogeneity of the vascular cell populations under d-flow remains less understood. To generate d-flow in vivo, partial carotid artery ligation (PCL) was performed. Seven days after ligation, single-cell RNA sequencing of nine left carotid arteries (LCA) from the PCL group (10,262 cells) or control group (14,580 cells) was applied and a single-cell atlas of gene expression was constructed. The integrated analysis identified 15 distinct carotid cell clusters, including 10 d-flow-relevant subpopulations. Among endothelial cells, at least four subpopulations were identified, including Klk8 hi ECs, Lrp1 hi ECs, Dkk2 hi ECs, and Cd36 hi ECs. Analysis of GSVA and single-cell trajectories indicated that the previously undescribed Dkk2 hi ECs subpopulation was mechanosensitive and potentially transformed from Klk8 hi ECs under d-flow. D-flow-induced Spp1 hi VSMCs subpopulation that appeared to be endowed with osteoblast differentiation, suggesting a role in arterial stiffness. Among the infiltrating cell subpopulations, Trem2 hi Mφ, Birc5 hi Mφ, DCs, CD4 + T cells, CXCR6 + T cells, NK cells, and granulocytes were identified under d-flow. Of note, the novel Birc5 hi Mφ was identified as a potential contributor to the accumulation of macrophages in atherosclerosis. Finally, Dkk2 hi ECs, and Cd36 hi ECs were also found in the proatherosclerotic area of the aorta where the d-flow occurs. In conclusion, we presented a comprehensive single-cell atlas of all cells in the carotid artery under d-flow, identified previously unrecognized cell subpopulations and their gene expression signatures, and suggested their specialized functions., (© 2021. The Author(s).)

Background: T 2 -weighted (T 2 w) intracranial vessel wall imaging (IVWI) provides good contrast to differentiate intracranial vasculopathies and discriminate various important plaque components. However, the strong cerebrospinal fluid (CSF) signal in T 2 w images interferes with depicting the intracranial vessel wall. In this study, we propose a T 2 -prepared sequence for whole-brain IVWI at 3T with CSF suppression., Methods: A preparation module that combines T 2 preparation and inversion recovery (T 2 IR) was used to suppress the CSF signal and was incorporated into the commercial three-dimensional (3D) turbo spin echo sequence-Sampling Perfection with Application optimized Contrast using different flip angle Evolution (SPACE). This new technique (hereafter called T 2 IR-SPACE) was evaluated on nine healthy volunteers and compared with two other commonly used 3D T 2 -weighted sequences: T 2 w-SPACE and FLAIR-SPACE (FLAIR: fluid-attenuated inversion recovery). The signal-to-noise ratios (SNRs) of the vessel wall (VW) and CSF and contrast-to-noise ratios (CNRs) between them were measured and compared among these three T 2 -weighted sequences. Subjective wall visualization of the three T 2 -weighted sequences was scored blindly and independently by two radiologists using a four-point scale followed by inter-rater reproducibility analysis. A pilot study of four stroke patients was performed to preliminarily evaluate the diagnostic value of this new sequence, which was compared with two conventional T 2 -weighted sequences., Results: T 2 IR-SPACE had the highest CNR (11.01 ± 6.75) compared with FLAIR-SPACE (4.49 ± 3.15; p < 0.001) and T 2 w-SPACE (-56.16 ± 18.58; p < 0.001). The subjective wall visualization score of T 2 IR-SPACE was higher than those of FLAIR-SPACE and T 2 w-SPACE (T 2 IR-SPACE: 2.35 ± 0.59; FLAIR-SPACE: 0.52 ± 0.54; T 2 w-SPACE: 1.67 ± 0.58); the two radiologists' scores showed excellent agreement (ICC = 0.883)., Conclusion: The T 2 IR preparation module markedly suppressed the CSF signal without much SNR loss of the other tissues (i.e., vessel wall, white matter, and gray matter) compared with the IR pulse. Our results suggest that T 2 IR-SPACE is a potential alternative T 2 -weighted sequence for assessing intracranial vascular diseases., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Zhang, Zhu, Qi, Wan, Ren, Zhu, Zhang, Liang, Li, Zheng and Liu.)

Objective: This study aimed to develop a predictive model of early neurological deterioration (END) in patients with acute ischemic stroke (AIS)., Methods: The present retrospective cohort study considered patients with AIS who were admitted to a tertiary hospital in Shenzhen, China between January 2014 and December 2018. An increase of 2 points or more on the National Institute of Health Stroke Scale (NIHSS) within 7 days indicated END. We selected baseline clinical, laboratory, and neuroimaging variables to construct predictive models through multivariate logistic regression. The receiver operating characteristic curve and calibration plots were calculated., Results: A total of 391 patients with AIS were enrolled in the study. END was observed in 64 (16.4%) cases. A prediction model developed from the initial NIHSS score, middle cerebral artery stenosis, and carotid stenosis of≥ 50% showed good discriminative ability: area under the receiver operating characteristic curve, 0.870 (95%CI, 0.813-0.911); threshold, -1.570; specificity, 84.40%; sensitivity, 75.00%; positive predictive value, 48.48%; and a negative predictive value, 94.52%., Conclusion: Our predictive model developed from the initial NIHSS score, middle cerebral artery stenosis, and carotid stenosis of ≥ 50% could identify patients with AIS who were at risk of developing END. The model requires validation by larger studies performed at other institutions., (Copyright © 2020. Published by Elsevier Inc.)

Background: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis (AE) is a common cause of nonviral infectious encephalitis, which can be triggered by herpes simplex virus infection. Previous studies have shown that approximately 27% of herpes simplex encephalitis (HSE) patients produce anti-NMDAR antibodies within 3 months. Immunotherapy is recommended in this situation, but some symptoms usually remain in the 1-year follow-up., Case Presentation: A previously healthy 23-year-old Chinese young woman developed epileptic attack followed by psychiatric symptoms of confusion and irritation as well as cognitive deficits. Brain MRI showed hyperintense lesions of the right temporal lobe on DWI and T2 without contrast enhancement effects. Twenty-one days of acyclovir was administered based on the primary diagnosis of HSE. The anti-NMDAR antibody (IgG) was detected positively on day 11 after disease onset. She had improved cognitive function but suffered another grand mal epilepsy after the first course of intravenous immunoglobulin (IVIG) therapy combined with 1000 mg intravenous methylprednisolone. After discussion, another course of IVIG was started for 5 days. Her symptoms were well controlled with only mild cognitive deficits at the 1-year follow-up (mRS = 1)., Conclusions: Our case indicated that anti-NMDAR antibodies could develop earlier after HSE compared with previous data from adults. We suggested detecting AE antibodies simultaneously with each CSF analysis. Meanwhile, the second course of IVIG therapy was reasonable when symptoms were not controlled after the first course of IVIG combined with IV steroid treatment.

Background: The rate of intravenous thrombolysis for acute ischaemic stroke remains low in China. We investigated whether the implementation of a citywide Acute Stroke Care Map (ASCaM) is associated with an improvement of acute stroke care quality in a Chinese urban area., Methods: The ASCaM comprises 10 improvement strategies and has been implemented through a network consisting of 20 tertiary hospitals. We identified 7827 patients with ischaemic stroke admitted from April to October 2017, and 506 patients underwent thrombolysis were finally included for analysis., Results: Compared with 'pre-ASCaM period', we observed an increased rate of administration of tissue plasminogen activator within 4.5 hours (65.4% vs 54.5%; adjusted OR, 1.724; 95% CI 1.21 to 2.45; p=0.003) during 'ASCaM period'. In multivariate analysis models, 'ASCaM period' was associated with a significant reduction in onset-to-door time (114.1±55.7 vs 135.7±58.4 min, p=0.0002) and onset-to-needle time (ONT) (169.2±58.1 vs 195.6±59.3 min, p<0.0001). Yet no change was found in door-to-needle time. Clinical outcomes such as symptomatic intracranial haemorrhage, favourable functional outcome (modified Rankin Scale ≤2) and in-hospital mortality remained unchanged., Conclusion: The implementation of ASCaM was significantly associated with increased rates of intravenous thrombolysis and shorter ONT. The ASCaM may, in proof-of-principle, serve as a model to reduce treatment delay and increase thrombolysis rates in Chinese urban areas and possibly other highly populated Asian regions., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: During medical imaging, cystic radiation encephalopathy and brain metastasis are difficult to differentiate, and hence they are easily misdiagnosed. To our knowledge, a nasopharyngeal carcinoma recurrence after more than seven years with cerebral metastasis that mimicked cystic radiation encephalopathy has not been reported., Case Presentation: A 52-year-old man was admitted to the hospital owing to weakness of the right limb for one month, which increased in intensity for three days. He had been diagnosed with nasopharyngeal carcinoma in 2011, which was treated by radiotherapy. The patient successively developed cystic radiation encephalopathy and brain metastasis from the nasopharyngeal carcinoma, which mimicked cystic radiation encephalopathy relapse. Left frontotemporal craniotomy, surgical resection of brain metastasis, and repair of the skull base and dura were performed. Postoperative computed tomography showed that midline deviation recovered, and brain edema was reduced., Conclusions: This report is significant because brain metastasis from nasopharyngeal carcinoma can masquerade as a benign entity and cause fatal consequences. In patients presenting with cystic radiation encephalopathy, brain metastasis should be considered as a differential diagnosis.

Rationale: Myelin oligodendrocyte glycoprotein (MOG) antibody (MOG-Ab) disease (MOG-AD) is a type of demyelinating disease of the central nervous system characterized by a high frequency of optic neuritis (ON) attacks. anti-Nmethyl-D-aspartate receptor (NMDAR) encephalitis (anti-NMDARe) is an autoimmune disorder characterized by memory deficits, conscious disturbance, and seizures. Cases of simultaneous occurrence of MOG-Ab and anti-NMDARe antibody (anti-NMDARe-Ab) are rarely reported and could be mistaken for overlapping MOG-antibody disease (MOG-AD) and NMDARe. The diagnosis of such patients is challenging., Patient Concerns: We report the case of a 37-year-old man who presented with recurrent headaches for 3 months and worsening symptoms over 2 weeks. He had a history of ON. He had a generalized seizure after 7 days in the hospital., Diagnosis: Brain magnetic resonance imaging (MRI) and cerebrospinal fluid tests showed no apparent abnormalities. Repeat MRI showed slight lesions 7 days later, and cerebrospinal fluid tests showed the simultaneous occurrence of MOG-Ab and anti-NMDARe-Ab., Interventions: He completely recovered after treatment with low doses of oral corticosteroids., Outcomes: Two months and 2 years follow-up showed that his condition was stable., Lessons: The co-occurrence of MOG-Ab and anti-NMDAR-Ab does not indicate the co-occurrence of MOG-AD and anti-NMDARe. Laboratory findings should be combined with the clinical features to achieve an accurate and suitable diagnosis., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Baseline systolic blood pressure (SBP) is an important parameter that can significantly influence the outcome in ischemic stroke patients who received intravenous thrombolysis, but the target baseline SBP for optimal outcome is uncertain. This study aimed to assess the relationship between baseline SBP and outcome., Materials and Methods: Studies that evaluated the association between the baseline SBP and the outcome of patients undergoing thrombolytic therapy were sought. Data were extracted according to a predefined data extraction form and then analyzed by STATA 12.0 software. The primary endpoint was the occurrence of good outcomes measured by a modified Rankin Scale score at 3 months, while the secondary endpoint was the occurrence of intracranial hemorrhage and death., Results: Eleven studies involving a total of 33,263 patients were included. Pooled data suggested that the odds of good outcome was decreased by 7% per 10 mm Hg increase in baseline SBP (odds ratio=0.93; 95% confidence interval: 0.91-0.94; P<0.001). Patients with higher baseline SBP were more likely to have intracranial hemorrhage (odds ratio=1.12 per 10 mm Hg increase; 95% confidence interval: 1.08-1.16, P<0.001)., Conclusions: This study suggested that lower baseline SBP may be positively associated with a greater chance of good outcome and less chance of intracranial hemorrhage. However, this effect was reliable only when the baseline SBP was within a certain range, which has not been explicitly stated. Therefore, more well-designed studies are needed to define the optimal baseline SBP.

Objectives: To compare visualization of joint intracranial and carotid vessel walls between 5× compressed sensing accelerated three-dimensional DANTE-SPACE sequence (CS VWI) acquired in 5 min and the same sequence accelerated by 2.7× parallel imaging (PI VWI) which takes 9-10 min currently., Methods: Following institutional review board approval and informed consent, 28 subjects including 20 stroke patients underwent PI and CS VWI examinations with an acquired spatial resolution of isotropic 0.55 mm and joint coverage of intracranial and carotid arteries. Quantitative wall thickness measurements of CS VWI and PI VWI were compared on healthy volunteers and patients with wall thickening respectively. Subjective wall visualizations of the two VWI methods on patients were scored by two radiologists blindly and independently using a 4-point scale followed by inter-rater reproducibility analysis., Results: Linear regression analysis of wall thickness measurements showed excellent agreement between CS VWI and PI VWI in both healthy volunteers (r = 0.99) and stroke patients with wall thickening (r = 0.99). Subjective wall visualization score of CS VWI was slightly lower than PI VWI (3.13 ± 0.41 vs. 3.31 ± 0.79) but still had good diagnostic quality (> 3 based on a 4-point scale). The two radiologists' scores agreed excellently, evidenced by the intraclass correlation coefficient (ICC) values being higher than 0.75 (p < 0.001)., Conclusions: Compressed sensing expedients joint intracranial and carotid VWI acquired at an isotropic resolution of 0.55 mm in 5 min without compromising quantitative vessel wall thickness measurement or diagnostic wall visualization., Key Points: • CS VWI facilitates comprehensive visualization of intracranial and carotid vessel walls at an acquired isotropic resolution of 0.55 mm in a single 5-min scan. • CS VWI affords comparable vessel wall visualization and morphology measurement as PI VWI with a shortened acquisition time by 45%. • CS VWI alleviates the intensive trade-off between imaging resolution and scan time, and benefits the scan efficiency, motion robustness, and patient tolerance of high-resolution joint intracranial and carotid VWI.

Objective: Emerging evidence shows that perivascular adipose tissue (PVAT) is crucially involved in inflammation and cardiovascular diseases. However, controversial results have been reported regarding the effect of PVAT in atherosclerosis. This study aimed to determine the role of PVAT in disturbed blood flow (d-flow)-induced carotid plaque formation., Methods: ApoE -/- male mice underwent partial carotid ligation (PCL) to induce d-flow in the left carotid artery (LCA) and were fed a high-fat diet for 2 weeks. Oil Red O and hematoxylin and eosin stains were used to determine adipose tissue. Thoracic PVAT from ApoE -/- or wild-type female mice were transplanted to the LCA of PCL-treated ApoE -/- mice. Carotid arteries were stained with Sudan IV to detect atherosclerotic lesions. Quantitative real-time reverse transcription polymerase chain reaction and immunofluorescence staining were performed to assess macrophage infiltration., Results: By 2 weeks of the high-fat diet after PCL surgery, de novo adipose tissue was formed around the ligated LCA, where atherosclerotic plaques were also observed. Quantitative real-time reverse transcription polymerase chain reaction analysis of the newly formed PVAT revealed a similar transcription profile to native PVAT. Treatment with bisphenol A diglycidyl ether, a peroxisome proliferator-activated receptor γ inhibitor, diminished PVAT formation but increased plaque size and macrophage infiltration. Transplantation of thoracic PVAT from wild-type mice (PVAT-T WT ) rather than from ApoE -/- mice (PVAT-T ApoE-/- ) nearly abrogated LCA plaque macrophage content without affecting plaque size. Mechanistically, PVAT-T ApoE-/- showed higher messenger RNA levels of inflammatory cytokines compared with PVAT-T WT ., Conclusions: Our findings suggest that regulated PVAT formation may confer protection against atherosclerosis-prone shear stress, probably through attenuation of focal inflammation., (Copyright © 2018 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)

The efficacy of neurofeedback is a point of great controversy, because a certain proportion of users cannot properly regulate their brain activities and thereby fail to benefit from neurofeedback. To address the neurofeedback inefficacy problem, the present study is aimed to design and implement a new neurofeedback system that can more effectively and consistently regulate users' brain activities than the conventional way of training users to voluntarily regulate brain activities. The new neurofeedback system delivers external visual stimuli continuously at a specific alpha phase, which is real-time decoded from ongoing alpha wave, to regulate the alpha wave. Experimental results show that the proposed training-free externally-regulated neurofeedback (ER-NF) system can achieve consistent (effective in almost all sessions for almost all users), flexible (either increasing or decreasing peak alpha frequency and alpha power), and immediate (taking or losing effect immediately after stimulation is on or off) modulation effects on alpha wave. Therefore, the ER-NF system holds great potential to be able to more reliably and flexibly modulate cognition and behavior., (Copyright © 2019. Published by Elsevier Inc.)

Introduction: Lipoprotein-associated phospholipase A 2 (Lp-PLA 2 ) is a well-known risk factor of atherosclerotic vascular diseases. Nevertheless, its role in the acute phase of ischemic stroke is still unclear. The aim of this study is to identify the relationship between Lp-PLA 2 levels and early neurological deterioration (END) in acute ischemic stroke patients with Trial of Org 10 172 in Acute Stroke Treatment (TOAST) subtype of large arterial atherosclerosis (LAA). Methods: We enrolled Chinese patients with first ever acute ischemic stroke admitted to Neurology Department of Shenzhen Second People's Hospital within 48 h from onset of symptoms during January - November 2015. Demographic and laboratory information were collected while END was defined as an increase in the National Institute of Health Stroke Scale score by ≥ 1 point in motor power, or ≥ 2 points in the total score within 10 days after admission. Results: Overall 181 patients were involved; END was diagnosed in 30 patients within 10 days after admission. The odds ratio for END increased with increasing levels of Lp-PLA 2 (intermediate level, OR = 1.96, 95%CI 1.02-4.27, p  = 0.041; high level, OR = 2.99, 95%CI 1.26-5.73, p  = 0.023). Conclution: Intermediate and high level of Lp-PLA 2 was identified as independent predictor of END in multivariate analysis. Lp-PLA 2 could be valued as a risk factor of END in patients with acute ischemic stroke with TOAST subtype of LAA.

Abnormal autonomic nervous regulation has an important role in the development of hypertension. As to whether blood pressure (BP) or BP variability represents the proper characteristics for predisposition to hypertension in Chinese young adults remains controversial. We studied the properties of the indices extracted from beat-to-beat BP during a 13 min cold pressor test (CPT). In this study, 69 Chinese young adults including 34 offspring of hypertensive parents (OHPs; 25.6±2.5 years) and 35 offspring of normotensive parents (ONPs; 25.3±2.3 years) were analyzed. We assessed the differences between the two groups regarding mean beat-to-beat BP and variability indices. Beat-to-beat BP variability indices included time-domain indices and frequency-domain indices. Our results showed that the differences in beat-to-beat systolic BP and mean BP levels between the OHPs and the ONPs were statistically significant (P<0.05). Furthermore, more BP variability indices in the frequency domain were significantly different between the two groups. We concluded that BP variability was superior to BP as an index to evaluate the cardiovascular and sympathetic reactivity to the CPT. Moreover, compared with time-domain BP variability, we found more differences in frequency-domain BP variability between the two groups, thus indicating that frequency-domain BP variability may be a potential index of predisposition to hypertension.

The hemodynamic alteration in the cerebral circulation caused by the geometric variations in the cerebral circulation arterial network of the circle of Wills (CoW) can lead to fatal ischemic attacks in the brain. The geometric variations due to impairment in the arterial network result in incomplete cerebral arterial structure of CoW and inadequate blood supply to the brain. Therefore, it is of great importance to understand the hemodynamics of the CoW, for efficiently and precisely evaluating the status of blood supply to the brain. In this paper, three-dimensional computational fluid dynamics of the main CoW vasculature coupled with zero-dimensional lumped parameter model boundary condition for the CoW outflow boundaries is developed for analysis of the blood flow distribution in the incomplete CoW cerebral arterial structures. The geometric models in our study cover the arterial segments from the aorta to the cerebral arteries, which can allow us to take into account the innate patient-specific resistance of the arterial trees. Numerical simulations of the governing fluid mechanics are performed to determine the CoW arterial structural hemodynamics, for illustrating the redistribution of the blood flow in CoW due to the structural variations. We have evaluated our coupling methodology in five patient-specific cases that were diagnosed with the absence of efferent vessels or impairment in the connective arteries in their CoWs. The velocity profiles calculated by our approach in the segments of the patient-specific arterial structures are found to be very close to the Doppler ultrasound measurements. The accuracy and consistency of our hemodynamic results have been improved (to [Formula: see text] %) compared to that of the pure-resistance boundary conditions (of 43.5 [Formula: see text] 28 %). Based on our grouping of the five cases according to the occurrence of unilateral occlusion in vertebral arteries, the inter-comparison has shown that (i) the flow reduction in posterior cerebral arteries is the consequence of the unilateral vertebral arterial occlusion, and (ii) the flow rate in the anterior cerebral arteries is correlated with the posterior structural variations. This study shows that our coupling approach is capable of providing comprehensive information of the hemodynamic alterations in the pathological CoW arterial structures. The information generated by our methodology can enable evaluation of both the functional and structural status of the clinically significant symptoms, for assisting the treatment decision-making.

The functional assessment of a hemodynamic significant stenosis base on blood pressure variation has been applied for evaluation of the myocardial ischemic event. This functional assessment shows great potential for improving the accuracy of the classification of the severity of carotid stenosis. To explore the value of grading the stenosis using a pressure gradient (PG)-we had reconstructed patient-specific carotid geometries based on MRI images-computational fluid dynamics were performed to analyze the PG in their stenotic arteries. Doppler ultrasound image data and the corresponding MRI image data of 19 patients with carotid stenosis were collected. Based on these, 31 stenotic carotid arterial geometries were reconstructed. A combinatorial boundary condition method was implemented for steady-state computer fluid dynamics simulations. Anatomic parameters, including tortuosity (T), the angle of bifurcation, and the cross-sectional area of the remaining lumen, were collected to investigate the effect on the pressure distribution. The PG is highly correlated with the severe stenosis (r = 0.902), whereas generally, the T and the angle of the bifurcation negatively correlate to the pressure drop of the internal carotid artery stenosis. The calculation required <10 min/case, which made it prepared for the fast diagnosis of the severe stenosis. According to the results, we had proposed a potential threshold value for distinguishing severe stenosis from mild-moderate stenosis (PG = 0.88). In conclusion, the PG could serve as the additional factor for improving the accuracy of grading the severity of the stenosis., (Copyright © 2016 the American Physiological Society.)

Objective: To investigate the effects of bone marrow mesenchymal stem cells (BMSCs) transplantation for treating spinal cord injury (SCI) in rat and the cytokine expression changes in the local injury tissues., Methods: BMSCs were separated from Sprague Dawley (SD) rat and cultured with the whole bone marrow culture method. rAd-EGFP was used to transfect the 5th generation BMSCs for green fluorescent protein (GFP) label. Twelve SD rats were randomly divided into experimental group (n = 6) and control group (n = 6). After the T10 SCI model was established with Allen's impact device in 2 groups, 1 x 1096) GFP-labeled BMSCs and PBS were administered by subarachnoid injection in situ in experimental group and control group, respectively. Basso-Beattie-Bresnahan (BBB) score was used to detect the motor function at immediat, 1, 2, 3, 4, and 5 weeks after SCI. At 5 weeks, the spinal cord tissues were harvested for the histological and immunofluorescent staining examinations to measure the expressions of neural marker molecules, including Nestin, glial fibrillary acidic protein (GFAP), and neuron-specific nuclear protein (NeuN). Cytokine was analyzed with antibody array., Results: At 5 weeks, 2 rats died of urinary tract infection in 2 groups respectively, the other rats survived to the end of experiment. BBB score of experimental group was significantly higher than that of control group at 1, 2, 3, 4, and 5 weeks (P < 0.05). At 5 weeks, histological results showed that there were many cells with regular arrangement in the experimental group; there were less cells with irregular arrangement in the control group. Compared with the control group, Nestin and NeuN expressions significantly increased (P < 0.05), and GFAP expression significantly decreased (P < 0.05) in the experimental group. Leptin and ciliary neurotrophic factor levels were higher in the experimental group than the control group, but granulocyte-macrophage colony-stimulating factor, tumor necrosis factor β, interleukin 1 β, and tissue inhibitor of metalloproteinases 1 levels were lower in the experimental group than the control group., Conclusion: BMSCs transplantation can improve survival and regeneration of nerve cells and enhances the recovery of nerve function by regulating secretion of cytokines from grafted BMSCs.

In this paper, time courses of discrete cortical current sources evoked by target and distractor stimulus are presented in a visual three-stimulus oddball paradigm. 64-channel electroencephalogram (EEG) signals were recorded in healthy subjects in the paradigm where the P3b component of the P300 is evoked in the detection of rare events (target and distractor) and the P3a component is mainly produced by distractor events. A regional source model with constraints of spatial coordinates from fMRI was then applied to event-related potentials (ERPs) data in the target and distractor conditions. Activities of regional sources indicated bilateral inferior parietal lobe, posterior parietal cortex and inferior temporal cortex mainly contribute to the P3b, while the P3a was mainly produced by bilateral insula, bilateral precentral sulcus and cingulate gyrus. Target processing involved parietal lobe, inferior temporal cortex and left insula engaged in stimulus-driven attention process, goal-directed attention process, categorization of visual stimuli and memory retrieval, while distractor processing involved right insula and cingulate gyrus engaged in attention switching and reengagement of attention resource.

The cDNA encoding stathmin is identified from the brain and spinal cord cDNA library of Gekko japonicus. It contains a 450 bp open-reading-frame, corresponding to a deduced protein of 149 amino acids. At amino acid level. gecko stathmin shares more than 76.4% identities with vertebrate stathmins, and especially, it shares 100% identity with human stathmin, suggesting that the selective pressure must have been extremely high for the conservation of stathmin during the vertebrates including reptile evolution. Reverse transcriptase polymerase chain reaction (RT-PCR) shows that gecko stathmin is ubiquitously expressed in all tissues examined. In situ hybridization reveals that stathmin transcript mainly appear in the gray matter of spinal cord. The change of stathmin expression in spinal cord after tail amputation is examined by semiquantitative RT-PCR. Stathmin expression increases at 1 day and 3 day after amputation and decreases to the control level at I week. However, the expression level increases again at 2 weeks. These suggest that stathmin may be associated with the immune protection of the injury, as well as in the regeneration of spinal cord.