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| 1 | Clopidogrel loading dose versus maintenance dose to treat patients with acute ischaemic stroke in China(CLASS-China):results from a prospective double-blind randomised clinical trial显示文摘Aim The role of clopidogrel in treating patients with acute ischaemic stroke is unclear.We have conducted the clinical trial in order to evaluate the efficacy and safety of clopidogrel with a loading dose in treating patients with non-cardiogenic acute ischaemic stroke.Method Clopidogrel loading dose versus maintenance dose to treat patients with acute ischaemic stroke in China(CLASS-China)was a prospective,randomised,double-blind and placebo-controlled clinical trial in China.Patients with acute ischaemic stroke of non-cardiogenic origin within 48 hours of onset were enrolled and those received thrombolysis were excluded.Enrolled patients were divided into two treatment groups:loading dose and routine dose.The primary outcome was the incidence of stroke recurrence or progression within 7 days.Primary safety outcome was measured by life-threatening haemorrhage.An intent-to-treat analysis was used for the statistical analysis.results From March 2008 to March 2010,a total of 303 patients from 16 centres were recruited into this study;six were excluded because of lack of basic information.Since the enrolment was slow and the study drug expired in March 2010,this clinical trial was stopped earlier than planned.No significant baseline and demographic differences were seen between the two groups.There was no difference in primary outcome between the loading dosage group 16.1%(24/149)and control group 14.9%(22/148),respectively(p=0.782).The mortality and disability rate within 90 days in loading dose group(19.6%)was slightly lower than that in controlled group(23.4%),p=0.444.Loading dose group had two(1.3%)cases of fatal haemorrhage and control group had four(2.7%)within 90 days,p=0.674.No significant difference was detected in other adverse events between the groups.conclusion In our study stopped early due to slow enrolment,loading dose of clopidogrel does not reduce the risk of recurrent stroke.Future trials with sufficient number of patients enrolled are needed to re-examine this hypothesis. | Ying Zhao Wanyong Yang Zefeng Tan Wenmin Wang Weimin Xiao Jinsheng Zeng Anding Xu | 2017 | Stroke & Vascular Neurology2017，2，3： | 7 |
| 2 | Chinese Stroke Association guidelines for clinical management of cerebrovascular disorders:executive summary and 2019 update on organizational stroke management显示文摘Aim Stroke is characterised by high morbidity,mortality and disability,which seriously affects the health and safety of the people.Stroke has become a serious public health problem in China.Organisational stroke management can significantly reduce the mortality and disability rates of patients with stroke.We provide this evidence-based guideline to present current and comprehensive recommendations for organisational stroke management.Methods A formal literature search of MEDLINE(1 January 1997 through 30 September 2019)was performed.Data were synthesised with the use of evidence tables.Writing group members met by teleconference to discuss data-derived recommendations.The Chinese Stroke Association’s Levels of Evidence grading algorithm was used to grade each recommendation.results Evidence-based guidelines are presented for the organisational management of patients presenting with stroke.The focus of the guideline was subdivided into prehospital first aid system of stroke,rapid diagnosis and treatment of emergency in stroke centre,organisational management of stroke unit and stroke clinic,construction of regional collaborative network among stroke centres and evaluation and continuous improvement of stroke medical quality.Conclusions The guidelines offer an organisational stroke management model for patients with stroke which might help dramatically. | Min Lou Jing Ding Bo Hu Yusheng Zhang Hao Li ZeFeng Tan Yan Wan An-Ding Xu Chinese Stroke Association Stroke Council Guideline Writing Committee | 2020 | Stroke & Vascular Neurology2020，5，3： | 7 |
| 3 | COVID-19 induces new-onset insulin resistance and lipid metabolic dysregulation via regulation of secreted metabolic factors显示文摘Abnormal glucose and lipid metabolism in COVID-19 patients were recently reported with unclear mechanism.In this study,we retrospectively investigated a cohort of COVID-19 patients without pre-existing metabolic-related diseases,and found new-onset in suli n resista nee,hyperglycemia,and decreased HDL-C in these patie nts.Mecha nistically,SARS-CoV-2 infecti on in creased the expression of RE1-silencing transcription factor(REST),which modulated the expression of secreted metabolic factors including myeloperoxidase,apelin,and myostatin at the transcriptional level,resulting in the perturbation of glucose and lipid metabolism.Furthermore,several lipids,including(±)5-HETE,(±)12-HETE,propionic acid,and isobutyric acid were identified as the potential biomarkers of COVID-19-induced metabolic dysregulation,especially in insulin resistance.Taken together,our study revealed insulin resistance as the direct cause of hyperglycemia upon COVID-19,and further illustrated the underlying mechanisms,providing potential therapeutic targets for COVID-19-induced metabolic complications. | Xi He Chenshu Liu Jiangyun Peng Zilun Li Fang Li Jian Wang Ao Hu Meixiu Peng Kan Huang Dongxiao Fan Na Li Fuchun Zhang Weiping Cai Xinghua Tan Zhongwei Hu Xilong Deng Yueping Li Xiaoneng Mo Linghua Li Yaling Shi Li Yang Yuanyuan Zhu Yanrong Wu Huichao Liang Baolin Liao Wenxin Hong Ruiying He Jiaojiao Li Pengle Guo Youguang Zhuo Lingzhai Zhao Fengyu Hu Wenxue Li Wei Zhu Zefeng Zhang Zeling Guo Wei Zhang Xiqiang Hong Wei kang Cai Lei Gu Ziming Du Yang Zhang Jin Xu Tao Zuo Kai Deng Li Yan Xinwen Chen Sifan Chen Chunliang Lei | 2022 | Signal Transduction and Targeted Therapy2022，7，1： | 0 |
| 4 | Increased retinal venule diameter as a prognostic indicator for recurrent cerebrovascular events:a prospective observational study显示文摘Microvasculature of the retina is considered an alternative marker of cerebral vascular risk in healthy populations.However,the ability of retinal vasculature changes,specifically focusing on retinal vessel diameter,to predict the recurrence of cerebrovascular events in patients with ischemic stroke has not been determined comprehensively.While previous studies have shown a link between retinal vessel diameter and recurrent cerebrovascular events,they have not incorporated this information into a predictive model.Therefore,this study aimed to investigate the relationship between retinal vessel diameter and subsequent cerebrovascular events in patients with acute ischemic stroke.Additionally,we sought to establish a predictive model by combining retinal veessel diameter with traditional risk factors.We performed a prospective observational study of 141 patients with acute ischemic stroke who were admitted to the First Affiliated Hospital of Jinan University.All of these patients underwent digital retinal imaging within 72 hours of admission and were followed up for 3 years.We found that,after adjusting for related risk factors,patients with acute ischemic stroke with mean arteriolar diameter within 0.5-1.0 disc diameters of the disc margin(MAD_(0.5-1.0DD))of≥74.14μm and mean venular diameter within 0.5-1.0 disc diameters of the disc margin(MVD_(0.5-1.0DD))of≥83.91μm tended to experience recurrent cerebrovascular events.We established three multivariate Cox proportional hazard regression models:model 1 included traditional risk factors,model 2 added MAD_(0.5-1.0DD)to model 1,and model 3 added MVD0.5-1.0DD to model 1.Model 3 had the greatest potential to predict subsequent cerebrovascular events,followed by model 2,and finally model 1.These findings indicate that combining retinal venular or arteriolar diameter with traditional risk factors could improve the prediction of recurrent cerebrovascular events in patients with acute ischemic stroke,and that retinal imaging could be a useful and non-invasive method for identifying high-risk patients who require closer monitoring and more aggressive management. | Ying Zhao Dawei Dong Ding Yan Bing Yang Weirong Gui Man Ke Anding Xu Zefeng Tan | 2024 | Neural Regeneration Research2024，19，5： | 0 |
| 5 | FUS-mediated HypEVs: Neuroprotective effects against ischemic stroke显示文摘Few studies have investigated the properties and protein composition of small extracellular vesicles (sEVs) derived from neurons under hypoxic conditions. Presently, the extent of the involvement of these plentiful sEVs in the onset and progression of ischemic stroke remains an unresolved question. Our study systematically identified the characteristics of sEVs derived from neurons under hypoxic conditions (HypEVs) by physical characterization, sEV absorption, proteomics and transcriptomics analysis. The effects of HypEVs on neurites, cell survival, and neuron structure were assessed in vitro and in vivo by neural complexity tests, magnetic resonance imaging (MRI), Golgi staining, and Western blotting of synaptic plasticity-related proteins and apoptotic proteins. Knockdown of Fused in Sarcoma (FUS) small interfering RNA (siRNA) was used to validate FUS-mediated HypEV neuroprotection and mitochondrial mRNA release. Hypoxia promoted the secretion of sEVs, and HypEVs were more easily taken up and utilized by recipient cells. The MRI results illustrated that the cerebral infarction volume was reduced by 45% with the application of HypEVs, in comparison to the non- HypEV treatment group. Mechanistically, the FUS protein is necessary for the uptake and neuroprotection of HypEVs against ischemic stroke as well as carrying a large amount of mitochondrial mRNA in HypEVs. However, FUS knockdown attenuated the neuroprotective rescue capabilities of HypEVs. Our comprehensive dataset clearly illustrates that FUS-mediated HypEVs deliver exceptional neuroprotective effects against ischemic stroke, primarily through the maintenance of neurite integrity and the reduction of mitochondria-associated apoptosis. | Yousheng Wu Xiaoxiong Huang Zefeng Tan Jiankun Zang Min Peng Niu He Tao Zhang Hongcheng Mai Anding Xu Dan Lu | 2023 | Bioactive Materials2023，，11： | 0 |
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