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Objective:To investigate the correlation between the Type D personality and the severity of white matter hyperintensities (WMHs) in patients with cerebral small vessel disease (CSVD).Methods:Consecutive patients with CSVD admitted to the Changzhou First People's Hospital between November 2020 and June 2021 were enrolled prospectively. The patients were scored on the Type D Personality Scale at admission; the scores of negative affectivity (NA) and social inhibition (SI) dimension were calculated respectively. The general data, laboratory examination data and imaging data of the patients were collected. Periventricular and deep WMHs were scored using the Fazekas visual scoring method. The total score 0-2 was defined as low-WMHs (L-WMHs), and 3-6 was defined as high-WMHs (H-WMHs). Multivariate logistic regression analysis was used to determine the independent influencing factor of WMHs. Results:A total of 100 patients with CSVD were enrolled, including 51 males (51%), aged 67.21±9.38 years, 29 (29%) had Type D personality; 56 (56%) were in the L-WMHs group and 44 (44%) were in the H-WMHs group. Univariate analysis showed that the proportion of Type D personality, NA dimension score, the proportion of hypertension, diastolic blood pressure, triglyceride and homocysteine in the H-WMHs group were significantly higher than those in the L-WMHs group (all P<0.05). Multivariate logistic regression analysis showed that NA dimension score (odds ratio [ OR] 18.351, 95% confidence interval [ CI] 2.780-121.135; P=0.003), age ( OR 1.134, 95% CI 1.039-1.238; P=0.005) and hypertension ( OR 7.771, 95% CI 1.525-39.607; P=0.014) were significantly positively correlated with the severity of WMHs, while triglycerides were significantly negatively correlated with the severity of WMHs ( OR 0.306, 95% CI 0.130-0.722; P=0.007). Conclusion:Type D personality is closely associated with the severity of WMHs in patients with CSVD.
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Objective To investigate the association between heme oxygenase-1 (HO-1) gene rs2071746 polymorphism and long-term clinical outcome in patients with ischemic stroke.Methods Between July 2015 and June 2017,consecutive patients with acute ischemic stroke admitted to the Department of Neurology,the Third Affiliated Hospital of Soochow University were enrolled prospectively.TOAST classification was performed for all patients.Genotyping of the HO-1 gene rs2071746 polymorphism was performed using a modified multiplex ligase detection reaction technique.The patients were followed up.The primary endpoint events included ischemic stroke,vascular death,and myocardial infarction.Multivariate Cox proportional hazard regression model was used to analyze the independent influencing factors for primary endpoint events.Results A total of 1 698 patients with successful genotyping and follow-up information were enrolled.Genotyping showed that the frequency of rs2071746 A allelewas 44.91％.They were followed up for 15.21 ± 7.39 months,and 168 patients (9.89％) had primary endpoint events.The incidence of primary endpoint events in A allele carriers was significantly lower than that in non-A allele carriers (8.80％ vs.12.40％;P =0.018).Multivariate Cox proportional risk regression model showed that after adjusting for age,gender,hypertension,diabetes mellitus,smoking,alcohol consumption,and genotype,A allele was an independent protective factor for primary endpoint events in patients with acute ischemic stroke (hazard risk [HR] 0.693,95％ confidence interval [CI]0.506-0.949;P=0.022).Subgroup analysis showed that carrying the A allele was an independent protective factor for primary endpoint events in patients with large atherosclerotic stroke (HR 0.651,95％ CI 0.425-0.997;P=0.048),while rs2071746 polymorphism was not associated with long-term outcome in other etiological subtypes.Conclusion The HO-1 gene rs2071746 A allele may be a protective factor for the long-term outcome in patients with acute ischemic stroke and large atherosclerotic stroke.
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It has been previously thought that calcification is a feature of the stability of atherosclerotic plaques. However, recent studies have shown that microcalcification in atherosclerotic plaques is significantly associated with plaque vulnerability. The relationship between atherosclerotic plaques and calcification is unclear, and the specific role of calcification in atherosclerotic plaques remains controversial.
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Objective To investigate the effect of butylphthalide on cerebrovascular reactivity (CVR) in patients with severe intracranial internal carotid stenosis.Methods The patients with severe intracranial internal carotid stenosis diagnosed by cerebral angiography in Nanjing Stroke Registry Program from January 2010 to November 2010 were randomly divided into either the butylphthalide group or the control group.All patients received the oral drugs for ischemic cerebrovascular disease that met the guideline criteria,and butylphthalide 20 mg,3 times a day orally was added in the butylphthalide group.The CVR was evaluated by transcranial Doppler and CO2 inhalation challenge test,and reexamined 3 months after treatment.Results A total of 81 patients met the inclusion criteria,11 (13.6％) were lost to follow-up,and finally 70 (n =35 in each group) were included in the analysis.The mean age of the patients was 55.2 ± 9.0 years,47 of them were male and 23 were female.The degree of vascular stenosis was 72％ to 99％ (mean 79.4％ ± 9.5％).The CVR was improved significantly after 3 months of treatment in the butylphthalide group than that in the control group (P =0.007),but it was not improvedsignificantly in the control group (P =0.330).All the patients did not have ischemic stroke events during the medication.No serious adverse reactions occurred in the butylphthalide group.Conclusions Butylphthalide may improve the CVR in patients with severe intracranial internal carotid stenosis.