BackgroundStudies investigating the association between the apolipoprotein E (APOE) gene polymorphism and the risk of intracerebral hemorrhage (ICH) have reported conflicting results. We here performed a meta-analysis based on the evidence currently available from the literature to make a more precise estimation of this relationship.MethodsPublished literature from the National Library of Medline and Embase databases were retrieved. Odds ratio (OR) and 95% confidence interval (CI) were calculated in fixed- or random-effects models when appropriate. Subgroup analyses were performed by race.ResultsThis meta-analysis included 11 case–control studies, which included 1,238 ICH cases and 3,575 controls. The combined results based on all studies showed that ICH cases had a significantly higher frequency of APOE ϵ4 allele (OR= 1.42, 95% CI= 1.21,1.67, P<0.001). In the subgroup analysis by race, we also found that ICH cases had a significantly higher frequency of APOE ϵ4 allele in Asians (OR= 1.52, 95% CI= 1.20,1.93, P<0.001) and in Caucasians (OR= 1.34, 95% CI= 1.07,1.66, P=0.009). There was no significant relationship between APOE ϵ2 allele and the risk of ICH.ConclusionOur meta-analysis suggested that APOE ϵ4 allele was associated with a higher risk of ICH.

Prior studies investigating the association between apolipoprotein E (APOE) gene polymorphism and the risk of intracerebral hemorrhage (ICH) have been inconsistent and limited to small sample sizes. The aim of this study was to test the hypothesis that APOE gene polymorphisms are associated with the risk of ICH in Chinese Han patients. We enrolled 180 ICH patients and 180 controls. APOE genotype was determined by using a polymerase chain reaction-restriction fragment length polymorphism assay. ICH patients had a significantly lower frequency ɛ3/ɛ3 [odds ratio (OR)=0.45, 95% confidence interval (CI)=0.28, 0.71; p=0.001] and ɛ3 allele (OR=0.51, 95% CI=0.35, 0.76; p=0.001) than healthy controls. ICH patients also had a significantly higher frequency ɛ3/ɛ4 (OR=3.61, 95% CI=1.89, 6.88; p<0.001) and ɛ4 allele (OR=3.00, 95% CI=1.76, 5.13; p<0.001) than healthy controls. This study suggests that the APOE genotype is associated with the risk of ICH in Chinese Han patients.

AIm:To investigate clinical factors that may influence the decision to preserve or remove the bone flap during the craniectomy surgery for patients of traumatic brain injury. mATERIAL and mETHods: Clinical data from 2256 TBI patients were quantitatively analyzed and scored based on multiple clinical factors, including preoperative Glasgow Coma Scale (GCS) score, changes in pupil size, hematoma volume, time interval between injury and surgery, midline shift on CT scan, hematoma location and type, cortical collapse and the lateral ventricular shift deformation. REsuLTs:We identified several independent factors in the decision to preserve the bone flap: GCS score and pupil changes before the operation, cortical collapse, injury/surgery time interval and hematoma location. The results suggested that for patients with a combined score of ≥55, their bone flap was generally retained. For cases with a score of 50-55, the surgical decision was based on the patient level of preconscious status, changes in pupil size and the extent of postoperative cortical collapse, and for patients with a score <50, the bone flap was generally removed. CoNCLusIoN:Our scoring scheme is to identify factors that may be helpful when determining whether to remove or retain bone flap of TBI patients.

Traumatic brain injury (TBI) is a severe condition that leads to brain damage and affects brain function. Importantly, TBI incurs public health costs due to its high mortality, and effective treatment for TBI is still lacking. Docosahexaenoic acid (DHA) has a neuroprotective effect that can reduce oxidative, apoptosis, and inflammatory processes. Administration of DHA after TBI attenuates oxidative stress and protein accumulation and is regarded as a potential therapeutic. Iduna is a regulator of parthanatos, and upregulation of Iduna reduces cellular damage and mitochondrial dysfunction. Thus, we speculated that overexpression of Iduna might promote DHA therapy in the treatment of TBI. Here, we found that after combination overexpression of Iduna and DHA in a mouse model of TBI, the expression of inflammatory factors was reduced, while the secretion of neuroprotective factors was increased. In addition, we found that these effects might be mediated by the Wnt/MDM2 pathway, and Iduna might be a therapeutic target for TBI.

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