Protective effect of tetrahydroxy stilbene glucoside on learning and memory by regulating synaptic plasticity

Damage to synaptic plasticity induced by neurotoxicity of amyloid-beta is regarded to be one of the pathological mechanisms of learning and memory disabilities in Alzheimer＇s disease patients. This study assumed that the damage of amyloid-beta to learning and memory abilities was strongly associated with the changes in the Fyn/N-methyl-D-aspartate receptor 2B （NR2B） expression. An APP695V7171 transgenic mouse model of Alzheimer＇s disease was used and treatment with tetrahydroxy-stilbene glucoside was administered intragas- trically. Results showed that intragastric administration of tetrahydroxy-stilbene glucoside improved the learning and memory abilities of the transgenic mice through increasing NR2B receptors and Fyn expression. It also reversed parameters for synaptic interface structure of gray type I. These findings indicate that tetrahydroxy stilbene glucoside has protective effects on the brain, and has prospects for its clinical application to improve the learning and memory abilities and treat Alzheimer＇s disease.

Analysis of risk factors and establishment of predictive model for elevated ALT in adult patients with nonalcoholic fatty liver disease

Objective:To explore the risk factors of elevated alanine aminotransferase(ALT)in patients with nonalcoholic fatty liver disease(NAFLD),and to establish a risk prediction model of elevated ALT in patients with NAFLD.Methods:A total of 200 NAFLD subjects were enrolled in Health Examination Center of China-Japan Friendship Hospital in Beijing. The relevant clinical indexes and TCM tongue picture data were collected standardizedly. According to the elevation of ALT,the patients were divided into ALT elevation group and ALT normal group. The independent risk factors of ALT elevation were obtained by logistic regression analysis. Based on this,the logistic regression prediction model of ALT elevation in NAFLD patients was established,and the calibration of the model was evaluated by Hosmer-Lemshow goodness-of-fit test. The area under the subject’s working characteristic curve(AUROC)was used to test the discrimination of the model. Results:The multivariate logistic regression analysis showed that the OR value of male,obesity,elevated total cholesterol(TC),elevated triglyceride(TG)and prickly tongue were 6.059,2.216,2.649,2.106,3.646,respectively,and the P-values were all < 0.05. The AUROC of logistic regression prediction Model 1(without prickly tongue)and Model 2(including prickly tongue)were 0.771(95%CI:0.703-0.840)and 0.801(95%CI:0.736-0.866),respectively,and the maximum Youden index,sensitivity and specificity were 0.414,0.829,0.585 and 0.478,0.686,0.792,respectively. Conclusion:Male,obesity,elevated TC,elevated TG and prickly tongue were independent risk factors for elevated ALT in NAFLD patients. This study established an integrated traditional Chinese and Western medicine model that includes the tongue characteristics,which have certain clinical value in predicting the risk of elevated ALT in patients with NAFLD,and are worth popularizing and applying.

igh-resolution Magnetic Resonance Vessel Wall Imaging for Intracranial Arterial Stenosis

Objective： To discuss the feasibility and clinical value of high-resolution magnetic resonance vessel wall imaging （HRMR VWI） for intracranial arterial stenosis. Date Sources： We retrieved information from PubMed database up to December 2015, using various search terms including vessel wall imaging （VWI）, high-resolution magnetic resonance imaging, intracranial arterial stenosis, black blood, and intracranial atherosclerosis. Study Selection： We reviewed peer-reviewed articles printed in English on imaging technique of VWI and characteristic findings of various intracranial vasculopathies on VWI. We organized this data to explain the value of VWI in clinical application. Results： VWI with black blood technique could provide high-quality images with submillimeter voxel size, and display both the vessel wall and lumen of intracranial artery simultaneously. Various intracranial vasculopathies （atherosclerotic or nonatherosclerotic） had differentiating features including pattern of wall thickening, enhancement, and vessel remodeling on VWI. This technique could be used for determining causes of stenosis, identification of stroke mechanism, risk-stratifying patients, and directing therapeutic management in clinical practice. In addition, a new morphological classification based on VWI could be established for predicting the efficacy of endovascular therapy. Conclusions： This review highlights the value of HRMR VWI for discrimination of different intracranial vasculopathies and directing therapeutic management.

Plaques of Nonstenotic Basilar Arteries with Isolated Pontine Infarction on Three-dimensional High Isotropic Resolution Magnetic Resonance Imaging

Background： There are few studies for evaluating plaque characteristics of nonstenotic basilar arteries （BA）. Our aim was to determine entire BA plaques with a three-dimensional volumetric isotropic turbo spin-echo acquisition （VISTA） and investigate the differences between the patients with and without isolated pontine infarction （IPI）. Methods： Twenty-four consecutive symptomatic patients with nonstenotic BA on time of flight magnetic resonance angiography （TOF MRA） were enrolled from China-Japan Friendship Hospital between January 2014 and December 2014. BA was classified as ＂normal＂ or ＂irregular＂ based on TOF MRA, and ＂normal wall＂, ＂slight wall-thickening＂, and ＂plaque＂ based on three-dimensional VISTA images. Outcomes from MRA and VISTA were compared. Patients were categorized as IPI and non-lPl groups based on the diffusion-weighted imaging. Clinical and plaque characteristics were compared between the two groups. Results： A total of 1024 image slices including 311 （30.37%） plaque slices, 427 （41.70%） slight wall-thickening slices, and 286 （27.93%） normal wall slices for the entire BA from 23 patients were finally included for analysis. VISTA images detected plaques in all the 9 （100%） irregular MRA patients and 7 of 14 （50%） normal MRA patients. IPl was found in 11 （47.83%） patients. Compared to non-IPI group, the IPI group had a higher percentage of plaque slices （P = 0.001 ） and lower percentage of normal wall slices （P = 0.014） than non-IPl group. Conclusions： Three-dimensional V1STA images enable detection of BA plaques not visualized by MRA. BA plaques could be found in both the IPl and non-IPl group. However, IPI group showed plaques more extensively in BA than the non-IPI group.

Clinical and Radiological Features of Wallerian Degeneration of the Middle Cerebellar Peduncles Secondary to Pontine Infarction

Background： Wallerian degeneration （WD） of bilateral middle cerebellar its characteristics have not yet been clarified because of the low incidence peduncles （MCPs） can occur following pontine infarction, but Thus, the present study discussed the clinical and radiological features to improve the awareness of this disease. Methods： Clinical and radiological information from consecutive individuals diagnosed with WD of bilateral MCPs following pontine infarction in three hospitals over the past 4 years between October 2012 and October 2016 were retrospectively investigated and compared with a control group （patients with pontine infarction had no secondary WD）. Results： This study involved 30 patients with WD of MCPs, with a detection rate of only 4.9%. The primary infarctions （χ2 -24.791, P = 0.001, vs. control group） were located in the paramedian pons in 21 cases （70.0%）, and ventrolateral pons in nine cases （30.0%）. WD of the MCPs was detected 8-24 weeks after pons infarction using conventional magnetic resonance imaging （M RI）; all secondary WDs were asymptomatic and detected incidentally. All WD lesions exhibited bilateral, symmetrical, and boundary blurring on MRI. The signal features were hypointense on Tl-weighted imaging, hyperintense on T2-weighted imaging and fluid-attenuated inversion recovery, and slightly hyperintense or isointense on diffusion-weighted imaging and apparent diffusion coefficient maps. Secondary brainstem atrophy was found in six （20.0%） cases. A Modified Rankin Scale score 0-2 was found in 10 （33.3%） cases and score 〉2 in 20 （66.7%） cases at 90 days after discharge, and the short-term prognosis was worse than that in control group （χ2 =12.814, P - 0.001 ）. Conclusions： Despite the rarity of bilateral and symmetrical lesions of MCPs, secondary WD should be highly suspected if these lesions occur within 6 months after pontine infarction, particularly parainedian ports. Conventional MRI appears to be a relatively sensitive method for detecting WD of MCPs, which might affect the short-term prognosis.

Wall Imaging for Unilateral Intracranial Vertebral Artery Hypoplasia with Three-dimensional High-isotropic Resolution Magnetic Resonance Images

Background：There are few studies for evaluating wall characteristics of intracranial vertebral artery hypoplasia （VAH）.The aim of this study was to determine wall characteristics of VAH with three-dimensional volumetric isotropic turbo spin echo acquisition （3D VISTA） images and differentiate between acquired atherosclerotic stenosis and VAH.Methods：Thirty patients with suspicious VAH by luminograms were retrospectively enrolled between January 2014 and February 2015.The patients were classified as ＂acquired atherosclerotic stenosis＂ or ＂VAH＂ based on 3D VISTA images.The wall characteristics of VAH were assessed to determine the presence of atherosclerotic lesions,and the patients were classified into two subgroups （VAH with atherosclerosis and VAH with normal wall）.Wall characteristics of basilar arteries and vertebral arteries were also assessed.The clinical and wall characteristics were compared between the two groups.Results：Five of 30 patients with suspicious VAH were finally diagnosed as acquired atherosclerotic stenosis by 3D VISTA images.25 patients were finally diagnosed as VAH including 16 （64.00%） patients with atherosclerosis and 9 （36.00%） patients with normal wall.In the 16 patients with atherosclerosis,plaque was found in 9 patients,slight wall thickening in 6 patients,and thrombus and wall thickening in 1 patient.Compared with VAH patients with normal wall,VAH patients with atherosclerosis showed atherosclerotic basilar arteries and dominant vertebral arteries more frequently （P =0.000）.Conclusions：Three-dimensional VISTA images enable differentiation between the acquired atherosclerotic stenosis and VAH.VAH was also prone to atherosclerotic processes.

Morphological Change of Early Spontaneous Recanalization Following Internal Carotid Artery Occlusion due to Possible Dissection

The early period of spontaneous recanalization is commonly described as within hours to weeks after internal carotid artery （ICA） occlusion.Of occlusion due to carotid artery dissection （CAD）,early recanalization is observed in 57-59% of cases.[1] CAD is a highly dynamic process with dramatic morphological changes in the early stage of the disease;however,little is known about the radiographic findings in the initial week.

Myotonic Dystrophy Type 1 Associated with White Matter yperintense Lesions： Clinic, Imaging, and Genetic Analysis

Myotonic dystrophy （DM） is a chronic, slowly progressing, highly variable, inherited multisystemic disease, which includes two main types： DM type 1 （DM1） and DM type 2 （DM2）. Both DM 1 and DM2 are autosomal dominantly inherited disorder. DM1, also called Steinert disease, is characterized by myotonia, muscle weakness, muscular dystrophy, endocrinopathy, cataract, cardiac conduction defect, central nervous system （CNS） dysfunction, and so on.

Dural arteriovenous fistula disguised as cerebral venous sinus thrombosis

Dural arteriovenouscommunications betweenfistulas （DAVFs） are directthe intracranial arterial andvenous systems without an intervening nidus. Clini-cians sometimes fail to give a correct diagnosis ofDAVF. Given the similarity of their clinical andmagnetic resonance imaging （MRI） manifestations,diagnostic confusion may arise between DAVF andcerebral venous sinus thrombosis （CVST） （Simonet al., 2009）.

Medial Rectus Nuclear Palsy as a Sole Feature of Midbrain Infarction Secondary to Stenosis of Posterior Cerebral Artery

To the Editor： Ophthalmoplegia can cause diplopia, with a lot of etiologies including cerebrovascular disease. Nuclear ophthalmoplegia resulted from brainstem infarction is often accompanied by other symptoms of brainstem dysfunction. It is fairly rare that midbrain infarction only manifests as isolated medial rectus nuclear palsy. Here, we provided such an uncommon case and discussed the possible etiology.

STAT3 signal that mediates the neural plasticity is involved in willed-movement training in focal ischemic rats

Willed-movement training has been demonstrated to be a promising approach to increase motor per- formance and neural plasticity in ischemic rats. However, little is known regarding the molecular signals that are in- volved in neural plasticity following willed-movement training. To investigate the potential signals related to neural plasticity following willed-movement training, littermate rats were randomly assigned into three groups： middle cerebral artery occlusion, environmental modification, and willed-movement training. The infarct volume was measured 18 d after occlusion of the right middle cerebral artery. Reverse transcription-polymerase chain reaction （PCR） and im- munofluorescence staining were used to detect the changes in the signal transducer and activator of transcription 3 （STAT3） mRNA and protein, respectively. A chromatin immunoprecipitation was used to investigate whether STAT3 bound to plasticity-related genes, such as brain-derived neurotrophic factor （BDNF）, synaptophysin, and protein in- teracting with C kinase 1 （PICK1）. In this study, we demonstrated that STAT3 mRNA and protein were markedly increased following 15-d willed-movement training in the ischemic hemispheres of the treated rats. STAT3 bound to BDNF, PICK1, and synaptophysin promoters in the neocortical cells of rats. These data suggest that the increased STAT3 levels after willed-movement training might play critical roles in the neural plasticity by directly regulating plasticity-related genes.

Congenital Hypoplasia of Bilateral Internal Carotid Artery with Migraine-Like Headache with Aura

To the Editor： A 36-year-old man with intermittent migraine-like headache with aura for 20 years underwent cerebrovascular computed tomography angiography （CTA） revealing very small calibers of bilateral internal carotid arteries （ICAs） in other hospital. He was admitted to our hospital for further examination several days later. He had no vascular risk factors, and no family history of atherosclerotic or cerebrovascular diseases. On admission, general physical and neurological examinations were normal and vascular systolic murmur was not detected in the neck. Blood tests, including items relevant to diabetes, dyslipidemia, and vasculitis, were unremarkable.

A Rare Case of Persistent Primitive Trigeminal Artery with Multiple Anomalies of Cerebral Vessels

To the Editor： A 38-yearoold man was admitted to our hospital with transient aphasia and weakness of the right extremities. As a habitual smoker, he had been diagnosed with hypertension and hyperlipidemia 3 and 10 years prior, respectively. With regard to family history, he stated that his father had suffered cerebral infarction.