ABSTRACT
Objective To investigate the correlations of high mobility group protein box-1 (HMGB1) level with severity and prognoses of acute cerebral infarction.MethodsBetween April 2018 and October 2018, 300 patients with acute cerebral infarction and 122 healthy control subjects were enrolled. According to National Institute of Health stroke scale (NIHSS) scores, patients with acute cerebral infarction were divided into group A (NIHSS scores<5), group B (5≤NIHSS scores≤15) and group C (NIHSS scores≥16). According to modified Rankin Scale (mRS) scores, patients were divided into good prognosis group (mRS scores≤2) and poor prognosis group (mRS scores>2) after 3 months of follow up. The serum levels of HMGB1, low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) in different groups were detected and compared. Pearson correlation analysis and receiver operating characteristic curve were used to analyze the correlations of serum HMGB1 level with other indicators and evaluate their predictive values in poor prognosis.Results The serum HMGB1 level in the acute cerebral infarction patients was significantly higher than that in the controls ([7.98±3.99]μg/Lvs. [4.61±1.02]μg/L,P<0.05); the serum HMGB1 level in the group C was significantly higher than that in group B ([12.86±1.91]μg/Lvs. [7.30±1.07]μg/L,P<0.05), and that in group B was statistically higher than that in group A ([7.30±1.07]μg/Lvs. [3.78±0.95]μg/L,P<0.05). Serum HMGB1 level was positively correlated with LDL-C level and NIHSS scores (r=0.521,P=0.000;r=0.931,P=0.000), and negatively correlated with HDL-C level (r=-0.114,P=0.001). The serum HMGB1 level in good prognosis group was significantly lower than that in poor prognosis group ([6.52± 3.29]μg/Lvs. [9.88±4.03]μg/L,P<0.05), and the serum HMGB1 level was positively correlated with mRS scores (r=0.160,P=0.000). The area under the curve of HMGB1 predicting poor prognosis of acute cerebral infarction (0.736[95％CI: 0.677-0.795]) was larger than that under the curve of LDL-C predicting poor prognosis of acute cerebral infarction (0.634[95％CI: 0.570-0.698]).ConclusionSerum HMGB1 level in patients with acute cerebral infarction is significantly increased, which is related to severity of disease, and has certain predictive value in prognoses of acute cerebral infarction.
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Objective To investigate the relationship between the cerebral microbleeds (CMBs) and changes of cognitive function,and the possible mechanism of cognitive impairment caused by CMBs.Methods Sixty-eight micro-hemorrhage patients on susceptibility weighted imagine (SWI) sequences composed positive group,and sixty-eight patients selected without micro-hemorrhage in the SWI sequence and meeting the selection criteria as control group.At the same time,both two groups were assessed by MoCA and CDT scale inspection.Results CDT scores of CMBs group (2.00±0.88) were significantly lower than those of control group (3.76±0.53),and there was significantly different in the two groups (t=-3.27,P=0.00).At the same time,MoCA total scores and executive functions,naming,calculation,language,abstraction,recall scores of CMBs group were significantly lower than those of control group,and all of the groups were significantly different (t=-5.48,P=0.00; t=-4.36,P=0.00; t=-2.35,P=0.01 ; t=-2.49,P=0.02; t=-4.09,P=0.00; t=-4.63,P=0.00).CDT scores,MoCA total scores,executive functions,language,abstraction,memory scores between CMBs groups and control group were significantly different at all levels (P＜0.05).Executive functions,languages and calculated inter-group of mild CMBs,moderate CMBs,severe CMBs were significantly different (P＜0.05).The number of CMBs was negative correlation with total scores,executive function,language,and abstract (r=-0.675,P=0.000; r=-0.689,P=0.000; r=-0.536,P=0.000; r=-0.636,P=0.000).Conclusion The existence of CMBs and the number of CMBs are closely related to cognitive dysfunction.The more of CMBs,the more of obvious cognitive impairment.
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Objective To investigate the detection rate of malnutrition among post-stroke patients in community hospitals and unravel the relevant factors that precipitate malnutrition after stroke. Methods Based on 438 post-stroke patients who were admitted in community hospitals, we examined the demographic characteristics, the nutritional indices and the possible malnutrition related factors through a cross-sectional study.Results The detection rate of malnutrition among post-stroke patients was 52.7%. Group comparison through multivariate logistic regression analysis showed that there was a higher malnutrition detection rate in the post-stroke patients with multiple stroke attacks (three stroke attackes and above, OR = 11.00,95%CI 1. 14-106.34), higher NIHSS scores (group with NIHSS≥15, OR=7.09, 95% CI 2.90-17.36) , higher modified Rankin scales (group mRS 4-5, OR = 15. 77,95% CI 6.61-37.59) (trend test P<0.0001) .The risk of malnutrition was also correlated with the post-stroke depression, poorer family care, no early-stage rehabilitation, history of malignant tumors and severe alcoholism. Conclusions There is a high detection rate of malnutrition among post-stroke patients in community hospitals. There are many factors related to malnutrition among post-stroke patients in the community. More attention to controllable influencing factors would improve the prognosis of post-stroke patients.