Alzheimer’s disease (AD) is a type of neurodegenerative disorder and the most common form of dementia. MicroRNA (miRNA) has been shown to play a role in various diseases, including AD. It also has been reported to regulate autophagy. We extracted miRNA from blood samples and constructed an miRNA-101a lentivirus vector. In this study we found the level of miRNA-101a was significantly reduced in the plasma of patients with AD and APPswe/PS1ΔE9 transgenic mice. The relative expression of miRNA-101a exhibited a relatively high diagnostic performance (area under receiver operating characteristic curve: 0.8725) in the prediction of AD with a sensitivity of 0.913 and a specificity of 0.733 at the threshold of 0.6463. Under electron microscopy, autophagic vacuoles in AD-related cells numbered more than the cells up-regulating miRNA-101a in the in vitro experiments. Dual-luciferase reporter assay and Western blot results proved that the MAPK1 pathway plays a role in the formation of autophagic vacuoles in AD. This study found that the autophagy phenomenon regulated by miRNA-101a via the MAPK pathway might be a new mechanism in AD. This could provide new insights into AD formation and treatment.
Purpose We hypothesize delayed perihematomal edema (DHE) leads to secondary injury after spontaneous intracerebral hemorrhage (sICH) with a poor prognosis. Hence, we need to investigate the risk factors of DHE and identify whether DHE will predict the poor outcome of sICH. Methods We retrospectively recruited 121 patients with sICH admitted to the Department of Neurology from January 2014 to August 2018. After dividing all these patients into DHE group and non‐DHE group, we analyzed the potential risk factors and outcome of DHE using a multivariate logistic regression model. Results We conclude DHE after sICH associates with age, hospitalization time, hematoma shape, blood pressure upon admission, alcohol consumption, blood sodium level, and baseline hematoma volume within 24 hours after symptom onset, among which differences were statistically significant (P < .05). Logistic regression analysis finally identified that age (OR = 0.958, 95% CI = 0.923‐0.995) and the baseline hematoma volume (OR = 1.161, 95% CI = 1.089‐1.238) were the most significant risk factors for DHE, and moreover, the DHE (OR = 3.062, 95% CI = 1.196‐7.839) was also a risk factor for poor prognosis in sICH patients. Conclusion We suggest DHE is a clinical predictor of secondary injury following sICH and poor prognosis. In addition, age and baseline hematoma volume are considered significant high‐risk factors for DHE in patients with sICH.
Hematoma expansion (HE) occurs in approximately one-third of patients with intracerebral hemorrhage and leads to high rates of mortality and morbidity. Currently, contrast extravasation within hematoma, termed the spot sign on computed tomography angiography (CTA), has been identified as a strong independent predictor of early hematoma expansion. Past studies indicate that the spot sign is a dynamic entity and is indicative of active hemorrhage. Furthermore, to enhance the spot sign's accuracy of predicting HE, spot parameters observed on CTA or dynamic CTA were used for its quantification. In addition, spot signs detected on multiphase CTA and dynamic CTA are shown to have higher sensitivity and specificity when compared with simple standardized spot sign detection in recent studies. Based on the spot sign, novel methods such as leakage sign and rate of contrast extravasation were explored to redefine HE prediction in combination with clinical characteristics and spot sign on CTA to assist clinical judgment. The spot sign is an accepted independent predictor of active hemorrhage and is used in both secondary intracerebral hemorrhage and the process of surgical assessment for hemorrhagic risk in patients with ischemic stroke. Spot sign predicts patients at high risk for hematoma expansion.
Carotid intramural hematoma, a type of carotid artery dissection, is hard to detect with traditional imaging examinations including color ultrasonography, computed tomography angiography (CTA), and digital subtraction angiography (DSA) because of the unaffected tunica intima. In this article, we report and discuss two cases of carotid intramural hematoma. In the first case, the patient experienced sudden-onset dysarthria with difficulty chewing and sucking. The diagnosis of ischemic stroke was further supported with the clinical presentation, physical examination, and a head CT scan. Later, the head and neck CTA examination detected the left carotid vessel had an irregular vascular wall and luminal stenosis, which was ultimately confirmed as intramural hematoma after performing neck high-resolution MRI (HR-MRI). Another patient was rapidly diagnosed with acute ischemic stroke using a head MRI scan, but the qualitative nature of the responsible vessel could not be distinguished by CTA and DSA. They could only demonstrate full occlusion of the carotid artery. HR-MRI was needed to identify the intramural hematoma-type ICA dissection. In conclusion, compared with CTA and DSA, HR-MRI is a cost-effective imaging examination with high resolution and easy repeatability. It can more accurately determine the nature of the vascular wall, the relationship of vessels and surrounding tissues, and effectively assists in the clinical judgement for intramural hematoma and other atypical carotid artery dissections.
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