Research progress of endogenous neural stem cells in injury repair strategies after ischemic stroke

Ischemic stroke is characterized by high incidence,high mortality,and high disability and is the primary cause of death and disability among adults in China.Endogenous neural stem cells(NSCs)are a group of cells that have the potential to self-renew and differentiate into functional nerve cells.Under normal circumstances,NSCs are in a quiet state.When the body is subjected to specific stimulation or injury,NSCs can be activated,proliferate,migrate to the damaged site,and differentiate into functional nerve cells to repair the injured tissue.NSCs induced by ischemic stimulation have limited regenerative capacity and cannot completely restore damaged tissues.Exogenous NSC transplantation has some effect.However,it is limited by the low survival rate of transplanted NSCs,immune rejection,ethics,and risk of tumor formation.Therefore,it is necessary to study further the strategies and mechanisms of endogenous NSC activation to promote nerve function repair after stroke.This article reviews recent advancements in drug therapy,hypoxic/ischemic conditioning,Chinese medicine,and rehabilitation strategies for NSC treatment.Furthermore,it explores new strategies and mechanisms developed recently,offering innovative plans and ideas to enhance clinical stroke treatment.

A prediction model for large vessel occlusion in suspected stroke patients based on available prehospital information

Objective:Early and accurate identification of large vessel occlusion(LVO)acute ischemic stroke(AIS)patients is critically important for stroke management.Practicable scales with simple items can facilitate prehospital paramedics distinguishing LVO-AIS patients with high efficiency and help to avoid unnecessary and costly delays.The current study aims to develop a screening tool to predict AIS-LVO patients based on prehospital available data.Method:A total of 251 suspected stroke patients who were transported to the emergency department of our hospital via emergency medical services were consecutively enrolled from August,2020 to January,2022.Data including demographic information,medical history,clinical manifestations,and vital signs were collected.A multivariate logistic regression model was developed based on statistically significant variables selected from univariate analysis.Result:Forty-two patients(16.7%)were diagnosed as LVO-AIS based on imaging validation at admission.A comprehensive model was developed with past medical history factors such as atrial fibrillation and coronary heart disease,vital signs such as systolic blood pressure,and prominent symptoms and signs such as gaze palsy,facial paralysis,and dysarthria.The model showed better diagnostic performance in terms of area under the receiver operating characteristic curves(0.884,95%CI,0.830-0.939),which was higher than other common prehospital prediction scales such as the Face,Arm,Speech,Time test(FAST),the Field Assessment Stroke Triage for Emergency Destination(FAST-ED)scale,and the Gaze-Face-Arm-Speech-Time test(G-FAST).Calibration curve analysis,decision curve analysis,and clinical impact curve analysis further validated the reliability,net benefit,and potential clinical impact of the prediction model,respectively.Conclusion:We conducted a prediction model based on prehospital accessible factors including past history of atrial fibrillation and coronary heart disease,systolic blood pressure,and signs such as gaze palsy,facial palsy,and dysarthria.The prediction model showed good diagnostic power and accuracy for identification of the high-risk patients with LVO and may become an effective tool for the LVO recognition in prehospital settings.Future studies are warranted to refine and validate the model further in order to enhance the accuracy and objectivity of clinical judgments.

Dysfunction of blood-brain barrier in cerebral amyloid angiopathy

Increasing evidence demonstrated that the blood-brain barrier(BBB)was involved in developing cerebral amyloid angiopathy(CAA).The BBB participates in the neurovascular coupling and regulates the transport of substances,which is closely related to neurodegenerative diseases.In CAA,the deposition of amyloid beta(Aβ)in arteries,capillaries,and arterioles of meninges and cerebral cortex results in the destruction of the BBB,chronic inflammatory response,chronic cerebral hypoperfusion,and dysfunction of the neurovascular unit,which eventually leads to neurodegeneration.At the same time,CAA is an age-related disease.Patients with CAA often have some risk factors for cerebrovascular diseases,such as hypertension and diabetes,which can further aggravate the damage to the BBB.Thus,it is of great significance to pay attention to the BBB in the pathogenesis and future intervention targets of CAA.Therefore,this manuscript reviewed the dysfunction of the BBB in CAA.

The effects of hypoxia on major blood components:a brief review

The prevalence of stroke displays obvious geographical variation and is higher on plateaus.Similarly,prolonged stay at high altitude is associated with higher incidence of stroke.High-altitude hypoxia can elicit various physiological dysfunctions,and hypoxia is suggested to be the principal contributing factor of stroke.In this brief review,the effects of hypoxia on the properties of the blood components such as erythrocytes,leukocytes and thrombocytes are presented,in an effort to inform the prevention and treatment of stroke in high-altitude areas.

Direct Ischemic Postconditioning Following Stroke Thrombectomy:A Promising Therapy for Reperfusion Injury

Recanalization of occluded vessels and timely reperfusion are the primary therapies for acute ischemic stroke(AIS),with endovascular thrombectomy proven as the most effective therapy for large-vessel recanalization and improved outcomes of AIS patients.However,despite a high recanalization rate of 90% or even higher,the rate of 3-month functional independence is approximately 50%,while mortality remains around 15%[1].

An overview of graphene-based hydroxyapatite composites for orthopedic applications

Hydroxyapatite(HA)is an attractive bioceramic for hard tissue repair and regeneration due to its physicochemical similarities to natural apatite.However,its low fracture toughness,poor tensile strength and weak wear resistance become major obstacles for potential clinical applications.One promising method to tackle with these problems is exploiting graphene and its derivatives(graphene oxide and reduced graphene oxide)as nanoscale reinforcement fillers to fabricate graphene-based hydroxyapatite composites in the form of powders,coatings and scaffolds.The last few years witnessed increasing numbers of studies on the preparation,mechanical and biological evaluations of these novel materials.Herein,various preparation techniques,mechanical behaviors and toughen mechanism,the in vitro/in vivo biocompatible analysis,antibacterial properties of the graphene-based HA composites are presented in this review.