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Objective:To explore the relationship between the vitamin D receptor ApaⅠ and BsmⅠ gene polymorphisms and the risk of benign paroxysmal positional vertigo(BPPV).Methods:The 98 patients with BPPV admitted to the Neurology Clinic of our hospital from March 2020 to March 2021 were selected as vertigo group, and 100 healthy individuals were selected as a healthy control group.The gene polymorphism of ApaⅠ(rs7975232)and Bsm Ⅰ(rs1544410)were detected by polymerase chain reaction-based restriction fragment length polymorphism(PCR-RFLP). Binary Logistic regression was used to analyze the influencing factors of benign paroxysmal positional vertigo.Results:The serum levels of total cholesterol and uric acid were significantly higher in the BPPV group than in a healthy control group( P<0.05). The actual and predicted values of the ApaⅠ and BsmⅠ gene distribution were compared between the BPPV group and a healthy control group, and the difference was not statistically significant( P>0.05). The ApaⅠ and BsmⅠ genotypes of the BPPV group and the control group were stable and consistent with the Hardy-Weinberg equilibrium law.The ApaⅠ gene rs7975232 and the BsmⅠ gene rs1544410 genotype and allele frequency distribution[n(%)]showed statistically significant difference(all P<0.05)between control vs BPPV groups.The locus genotype and allele frequency distribution[n(%)]showed statistically significant difference between control vs BPPV group( P<0.05). The total cholesterol, blood uric acid, rs7975232CC, rs7975232AA, rs1544410 CC, and rs1544410 CT were risk factors for the occurrence of benign paroxysmal positional vertigo. Conclusions:Gentic polymorphisms at the cleavage sites of restriction endonuclease of vitamin D gene ApaⅠ rs7975232 and BsmⅠ gene rs1544410 have certain correlation with the occurrence of(BPPV)disease.Population with type CC and AA in ApaI rs7975232 and type CC and CT in BsmⅠ rs1544410 are more prone to BPPV.
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Objective:To investigate the correlation between fluid-attenuated inversion recovery vascular hyperintensities(FVH) and prognosis and cognitive dysfunction in patients with internal watershed cerebral infarction(IWI).Methods:Totally106 patients with IWI were selected.According to FVH diagnostic criteria, there were 59 cases in FVH (+ ) group and 47 cases in FVH (-) group.Demographic data and risk factors of cerebrovascular disease were collected to assess the clinical neurological function of the patients at admission and discharge, and the short-term outcome was assessed by modified RANKIN scale (mRS) score at 90 days after discharge.The cognitive function of patients was assessed by MMSE scale.Results:There was no significant difference in NIHSS score between the two groups on admission ( P>0.05). The NIHSS score of FVH (+ ) group((3.37±2.33))at discharge was significantly lower than that of the FVH (-) group ((4.43±2.72))( P<0.05). The rate of neural function improvement and mRS score after discharge 90 days in FVH (+ ) group((42.16±12.20)%, (1.75±1.12)) was significantly higher than that in FVH (-) group((37.58±13.64)%, (2.19±1.38))(both P<0.05). The scores of orientation, recall and language ability of MMSE in FVH (+ ) group ((9.26±0.21), (1.66±0.27), (7.69±0.44) respectively)were significantly lower than those of FVH (-) group((9.43±0.36), (1.83±0.34), (7.85±0.28) respectively)(all P<0.05). There was no significant difference in memory, attention and calculation between the two groups ( P>0.05). Conclusion:FVH has no correlation with the severity of IWI patients when they are admitted to hospital.FVH may be used as an imaging sign for prognosis evaluation of patients with IWI .However, IWI patients with FVH may have more severe cognitive impairment.
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Objective To investigate the correlation of microembolic signals (MES) and outcome in patients with acute ischemic stroke.Methods The patients with acute ischemic stroke were enrolled in the study.The MES of middle cerebral artery was monitored dynamically using transcranial color Doppler ultrasound.The early lesions of ischemic stroke were evaluated by MRI.The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate neurological deficits.The modified Rankin scale was used to evaluate the outcome,and the stroke recurrence was recorded.Results A total of 135 patients with acute ischemic stroke were enrolled,in which,33 were cardiogenic cerebral embolism,49 were large artery atherosclerotic stroke,24 were small arterial occlusive stroke,and 29 were other clear causes or cryptogenic stroke.Multivariate logistic regression analysis showed that coronary heart disease (odds ratio [OR],5.862,95％ confidence interval [CI] 2.008-17.114; P =0.000) was the independent risk factor for positive MES within 48 hours after stroke onset,while the history of antithrombotic treatment (OR 0.376,95％ CI 0.141-0.998; P =0.045) was its independent protective factor.In addition,coronary heart disease (OR 4.879,95％ CI 1.257-18.939; P =0.033),hypertension (OR 4.958,95％ CI 1.029-23.882; P =0.030),and diabetes (OR 3.659,95％ CI 1.027-13.034; P =0.050) were the independent risk factors for positive MES within 1 week after stroke onset.The NIHSS scores of the patients of the positive MES at baseline and 1 week and the clinical outcome at 3 months had no significant differences with the patients of negative MES,however,stroke recurrence and deaths increased significantly (P =0.019).Conclusions MES within 48 hours of onset was not associated with the outcome in patients with acute ischemic stroke at 3 months,however,the incidence of endpoint events such as recurrence and death was significantly higher in patients of positive MES within 3 months.
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Objective Investigate the effect on blood pressure(BP)control to prevent hypertensive cerebral hemorrhage with hematoma enlargement.Methods 96 patients with hypertensive brain hemorrhage in course of disease less than 3 hours and mean arterial pressure(MAP)more than 130 mmHg(1 mmHg=0.133 kPa)were divided into randomly treatment group(48 cases)and control group(48 cases).The patients in treatment group were administered 12.5～25 mg Captopril sublingually per 3～4 h to control MPA≤130 mmHg and keep 24 hours since disease onset.However,the patients in control group were disused any hypotensive drug.Two groups were compared with the incidence rate of enlarged hematoma.Results Captopril sublingually had its effect after 15 minutes administered,and MPA was controlled≤130 mmHg during 60 minutes administered and keep well.The difference between two groups was statistically significant.The enlarged hematoma incidence rate of treatment group was 8.3% and that of the control group was 22.9%.The difference between two groups was significant(P
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Objective To study the relationship between hyperhomocysteinemia and intracranial and extracranial vascular stenosis in patients with ischemic cerebrovascular disease.Methods 405 patients with ischemic cerebrovascular disease were chosen to detect their serum homocysteine(Hcy) concentrations using automatic biochemical analyzer by enzymatic cycle detection,and the levels of serum folate and Vitamin B12 were detected .The intracranial vascular were detected by Transcranial Doppler, and the extracranial vascular were detected by Color Doppler. The internal carotid arteries(ICA) were classified as normal, mild stenosis(95%). Results Mean serum Hcy concentrations were significantly higher in patients with stenosis of intracranial or (and) extracranial vascular than that in the patients with no arterial stenosis (P0.05). The serum Hcy concentrations were different significantly in patients with different severities of the ICA stenosis and the MCA stenosis (all P0.05). The serum Hcy concentrations were positive correlation with severities of the ICA stenosis and the MCA stenosis(r=0.356, P