ABSTRACT
Objective To investigate the predictive value of neutrophil to lymphocyte ratio (NLR) at admission for large vessel occlusion (LVO) in patients with acute ischemic stroke. Methods The clinical data of patients with acute ischemic stroke admitted to Guangzhou First People's Hospital from January 2016 to November 2017 were enrolled retrospectively. NLR was calculated according to results of blood routine examination within 6 h after admission. Multivariate logistic regression analysis was used to determine the independent correlation between NLR and LVO. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of NLR for LVO. Results A total of 109 patients with acute ischemic stroke were enrolled, including 42 females (38. 5％) and 67 males (61. 5％). Their mean age was 63. 6 years. Forty-six patients (42. 2％) had LVO. The proportions of patients with atrial fibrillation, previous stroke or transient ischemic attack, and the National Institutes of Health Stroke Scale score, white cell count, NLR, neutrophil count, and fasting blood glucose in the LVO group were significantly higher than those in the non- LVO group, while lymphocyte count was significantly lower than that in the non-LVO group (all P < 0. 05). Multivariate logistic regression analysis showed that NLR was an independent risk factor for LVO after adjusting for the confounding factors (odds ratio 2. 768, 95％ confidence interval, 2. 272-4. 984; P = 0. 001). The ROC curve analysis of NLR predicting LVO showed that the area under the curve was 0. 712 (95％ confidence interval 0. 638-0. 793), and the sensitivity and specificity were 79. 3％ and 73. 6％ respectively as the optimal cut-off value was 4. 18. Conclusions Increased NLR in early peripheral blood may effectively predict LVO in acute ischemic stroke.
ABSTRACT
Objective To observe the effects of early rehabilitation training on endothelial progenitor cells (EPCs),stromal cell-derived factor alpha 1 (SDF-lα) and motor function recovery in hemiplegic patients with acute cerebral infarction.Methods Fifty hemiplegic patients after a first acute cerebral infarction were randomly divided into a control group (n =25) and an experimental group (n =25).Both groups of patients were given routine drug therapy,while the experimental group also received early rehabilitation (within 48 hours of onset).EPCs and SDF-1α levels in peripheral blood were measured before and after one week of treatment,and Fugl-Meyer assessments and modified Barthel index scoring were conducted at admission and after three months of treatment.Results There was no difference between the 2 groups before the treatment.After a week of treatment,however,the EPC and SDF-1α values of both groups had increased,with those of the experimental group increasing significantly more than in the control group.Spearman rank correlation analysis showed that the increase in EPCs was positively correlated with the SDF-1α increment in the first week.After 3 months of treatment,the average FMA and MBI results of the experimental group were significantly better than those of the control group.Conclusion Early rehabilitation training can help to further improve the recovery of motor function for hemiplegic patients after acute cerebral infarction.This may be related to its effect in upregulating the expression of SDF-1α,thus contributing to the mobilization of EPCs in the bone marrow.
ABSTRACT
Objective To explore the effect of electroacupuncture on CD 34 +VEGFR2 +endothelial progenitor cell (EPC)-derived vessels and stromal cell-derived factor-1α(SDF-1α)/CXCR4, and study its mechanism of promoting an-giogenesis in hippocampus after focal cerebral ischemia /reperfusion .Methods A total of 180 healthy male adult Sprague Dawley (SD) rats were randomly divided into sham operation (sham) group, model (I/R) group, electroacupuncture (I/RE) group, I/RE plus AMD3100 (A specific antagonist of CXCR4) group (I/REA) and AMD3100 (I/RA) group. The rats received filament occlusion of the right middle cerebral artery for 2 hours followed by reperfusion .Electroacupunc-ture was applied to “Baihui” (GV20)/“Siguan” (Hegu LI 4/Taichong LR 3) acupoints for 30 min, once a day.The mR-NA expression of SDF-1αand CXCR4 were detected by reverse transcription-polymerase chain reaction ( RT-PCR) .Double immunofluorescence was used to stain CD 34 +VEGFR2 +EPC-derived vessels.Results Compared with the sham group, the mRNA expressions of SDF-1αand CXCR4 were significantly upregulated in I/R and I/RE group ( P<0.05 ) , but that in I/RE group was more significantly increased than I/R group(P<0.05).In addition, the mRNA expression of SDF-1αand CXCR4 were highly increased on day 1 in the I/REA group than that of I/RE group, but decreased than that of I/RE group on day 7 after reperfusion (P<0.01).CD34 +VEGFR2 +EPCs-derived vessels were obviously increased on 3d and 7d in the I/RE group compared with that of the I/R group, and significantly decreased on 7d in the I/REA group compared with that of the I/RE group ( P<0.01) .Conclusions Electroacupuncture can effectively promote an-giogenesis through upregulating the expression of SDF-1αand CXCR4 in rat ischemic hippocampus after focal cerebral is-chemia/reperfusion.