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Objective:To investigate the relationship between triglyceride-glucose(TyG) index and vascular cognitive impairment(VCI) in elderly patients with cerebral small vessel disease (CSVD).Methods:A total of 275 patients with CSVD aged 60 years or above admitted in the Department of Neurology of the Second Affiliated Hospital of Nantong University from August 2019 to March 2021 were enrolled in this retrospective study. According to the cognitive function assessed with Montreal Cognitive Assessment (MoCA), patients were divided into VCI group (187 cases) and non-VCI group (88 cases). Receiver operating characteristic (ROC) curve analysis was conducted to assess the value of TyG index in predicting VCI. Binary logistic regression analysis was employed to analyze the correlation between TyG index and VCI.Results:TyG index was higher in the VCI group than that in non-VCI group (9.07±0.54 vs. 8.70±0.55, t = 5.24, P<0.01). The area of ROC curve (AUC) of TyG index for predicting VCI was 0.70 (95% CI:0.64-0.77, P<0.01); taking 8.78 as the optimal cut-off point, the sensitivity and specificity were 0.754 (141/187) and 0.614(54/88), respectively. The proportion of VCI patients in high TyG index group (≥8.78) was higher than that in low TyG index group (<8.78) [141 (80.6%) vs. 46 (46.0%), χ2=34.95, P<0.01]. The binary logistic regression analysis showed that after adjusting for age, level of education, low-density lipoprotein cholesterol (LDL-C), homocysteine (Hcy), uric acid (UA) and total CSVD burden, TyG index was an independent risk factor of VCI ( OR=2.42, 95% CI: 1.37-4.29, P<0.01); and compared to patients with low TyG index (<8.78) the risk of VCI was increased for patients with high TyG index (≥8.78) ( OR=4.09, 95% CI: 2.18-7.68, P<0.01). Conclusion:TyG index is associated with VCI in elderly patients with CSVD, which may be used as a predictor of VCI for those patients.
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Objective:To systematically analyze the clinical features of severe fever with thrombocytopenia syndrome (SFTS) and to provide evidence for the prevention and treatment of SFTS.Methods:Relevant studies of SFTS from six databases, including China National Knowledge Infrastructure, Wanfang Database, Chongqing VIP, PubMed, Cochrane Library and Embase from January 2009 to May 2019 were systematically searched and identified. The literatures were screened and the data of patients′ epidemiology, clinical manifestations, laboratory examinations and prognosis were obtained. Revman 5.2 software was used for meta analysis.Results:Sixty-eight Chinese literatures and fourteen English literatures encompassing 6 780 patients with SFTS were included in the final analysis. Of these patients, 845 cases (12.46%) died. SFTS mostly occurred in mountainous and hilly areas, and farmers (3 637 cases) were the usual victims. The onset season was mostly in summer and the peak was from May to August each year. There were 1 434 patients had a clear history of tick bites, and 21 cases were human-to-human transmitted.There were 6 071 cases (89.54%) presented with fever, 5 407 cases (79.75%) presented with fatigue, 3 140 cases (46.31%) presented with muscle soreness, and 2 300 cases (33.92%) presented with chills.Using random effects model for meta analysis, the levels of creatine kinase (CK) (mean difference ( MD)=500.40, 95% confidence interval ( CI) 380.51-620.28, P<0.01) and lactic acid dehydrogenase (LDH)( MD=442.81, 95% CI 152.85-732.78, P=0.003) in severe patients were both higher than those in mild patients, and the difference were both statistically significant. The risk of death increased in patients aged>60 years( MD=8.19, 95% CI 4.03-12.36, P<0.01). The levels of CK( MD=530.92, 95% CI 29.27-1 032.56, P=0.040), LDH( MD=609.28, 95% CI 80.25-1 138.31, P=0.020), urea nitrogen ( MD=4.67, 95% CI 3.05-6.30, P<0.01) and creatinine ( MD=43.05, 95% CI 23.49-62.62, P<0.01) of patients in the death group were all higher than those in the survival group. The differences were all statistically significant. Conclusions:During the course of SFTS, the patients may show impaired blood system, heart, liver and kidney functions with high mortality. Clinicians should timely monitor the changes of blood routine, myocardial enzyme spectrum, liver and kidney functions and other indicators, so as to find cardiovascular and other system complications as early as possible. Timely treatment could not only reduce liver, heart and other organ injuries, but also reduce mortality.
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Objective: To detect the serum levels of D-dimer and N-terminal pro B-type natriuretic peptide [NT-pro BNP] in patients with Acute Ischemic Stroke [AIS], and to explore the risk factors of AIS
Methods: A total of 246 AIS patients treated in our hospital from January 2015 to January 2017 were selected. Meanwhile, 240 healthy subjects were selected as a control group. The D-dimer and NT-pro BNP levels of the two groups were compared. Correlations of such levels with age, gender, blood lipid, Intima- Media Thickness [IMT], fibrinogen and degree of neurological deficits were analyzed
Results: The AIS group had significantly higher levels of Triglyceride [TG], Low-Density Lipoprotein [LDL], D-dimer, NT-pro BNP and fibrinogen as well as IMT than those of the control group, but the High-Density Lipoprotein [HDL] level of the AIS group was significantly lower [P<0.05]. The patients with different genders and ages had significantly different D-dimer and NT-pro BNP levels [P<0.05]. The D-dimer and NT-pro BNP levels were correlated with gender and age. Such levels of females were significantly higher than those of males [P<0.05]. The D-dimer and NT-pro BNP levels of the >/= 60 years old group significantly exceeded those of the <60 years old group [P<0.05]. The levels of D-dimer and NT-pro BNP were negatively correlated with that of HDL [P<0.05], but positively correlated with TG, LDL and fibrinogen levels, IMT, and National Institutes of Health Stroke Scale score [P<0.05]. Multivariate Logistic regression analysis showed that the OR values of D-dimer and NT-pro BNP were 3.65 and 6.96 respectively
Conclusion: Serum D-dimer and NT-pro BNP levels usually increased in AIS patients, and the levels were significantly correlated with AIS onset
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Objective@#To investigate the role of enolase 1 (ENO1) in hepatocellular carcinoma (HCC) and possible mechanism.@*Methods@#Real-time PCR and Western blot were used to measure the expression of ENO1 in HCC tissue, adjacent tissue, hepatoma cells, and normal hepatocytes. The siRNA interference technique was used for ENO1 knockout in HepG2 cells, and then CCK-8, colony formation assay, and transwell assay were used to measure the proliferation, migration, and invasion abilities of HepG2 cells. Real-time PCR and Western blot were used to measure the expression of proteins and genes involved in the activation of the Notch signaling pathway. The two-independent-samples t test and a one-way analysis of variance were used for comparison.@*Results@#HCC tissue and HepG2 cells had significantly higher expression of ENO1 than adjacent tissue and normal hepatocytes (P < 0.05). There were significant reductions in the proliferation, migration, and invasion abilities of HepG2 cells after siRNA interference (P < 0.05). There were also significant reductions in the expression of N1ICD, snail, slug, HEY1, HES1, and HES5 (P < 0.05).@*Conclusion@#ENO1 may promote the development of HCC, possibly by participating in the regulation of the Notch signaling pathway.
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Objective To investigate the positive rate of microembolic signal (MES) and the related factors,as well as the correlation between MES and outcomes in patients with cardiogenic cerebral embolism.Methods Patients with cardiogenic cerebral embolism were enrolled.The baseline data of the patients were collected and the MES monitor was conducted.The baseline data of the MES positive group and MES negative group were compared.Multivariatelogistic regression analysis was used to identify the related factors of the positive MES.The patients were followed up regularly.The outcomes of stroke at 6 months and recurrent stroke within 2 years in the MES positive group and MES negative group were compared.Results A total of 165 patients with cardiogenic cerebral embolism were enrolled,including positive MES in 68 patients (41.2％).There were significant difference in the levels of brain natriuretic peptide (BNP),cardiac troponin-I (cTn-I),and D-dimer between the MES positive group and negative group.Multivariate logistic regression analysis showed that the increased levels of baseline BNP (odds ratio [OR] 1.001,95％ confidence interval CI 1.001-1.002;P＜0.001),cTn-I (OR 36.975,95％ CI 1.516-902.0;P=0.027),and D-dimer (OR 1.001,95％ CI 1.000-1.001;P=0.017) were independently associated with the positive MES in cerebral embolism within 48 h after onset.There was no significant difference in the proportion of patients in good outcome (modified Rankin scale score 0-2) and poor outcome (modified Rankin scale score ＞2) after 6 months between the MES positive group and MES negative group.When the average follow-up time was 20.8 months (range,7-24 months),there were 23 patients (33.8％) and 19 (19.6％) had recurrence in the MES positive group and MES negative group,respectively.Kaplan-Meier analysis showed that the recurrence rate of stroke in the MES positive group was significantly higher than that in the MES negative group (log-rank test:P=0.031).COX regression analysis showed that the positive MES was still an independent risk factor for stroke recurrence after adjusting for other confounding factors (OR 0.328,95％ CI 0.142-0.761;P=0.009).Conclusions The positive MES was associated with the increased BNP,cTn-I,and D-dimer levds.The positive MES was not associated with clinical outcomes at 6 month after the onset,but it was associated with the recurrence of stroke within 2 years.
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Objective To evaluate the detection of membrane neutrophil alkaline phosphatase (NAP)in diagnosis of infection in patients with acute cerebral hemorrhage.Methods A total of 208 patients with acute cerebral hemorrhage,including 1 52 cases without infection (uninfected group)and 56 cases with infection (infected group),admitted in the Second Affiliated Hospital of Nantong University during January 201 0 to July 201 6 were enrolled,30 healthy subjects were also enrolled in the study as control group.The peripheral blood from all subjects were collected,and the counts of white blood cell (WBC), percentage of neutrophil,serum procalcitonin (PCT)and NAP were measured.The value of above 4 indicators in diagnosing infection was determined by receiver operating characteristic (ROC ) curves. ANOVA and t test were used to analyze the data,Pearson correlation was performed to analyze the correlation between NAP and PCT in infected group.Results The levels of WBC,percentage of neutrophil and NAP in both infected and uninfected group were higher than those in healthy control group at admission(F =1 1 7.64, 1 00.69 and 425.09,all P <0.01 ),and the levels of WBC,PCT and NAP were also higher when infection occurred compared with those at admission in infected group (t =3.1 4,34.30 and 36.39,all P <0.01 ). The expression of NAP was positively correlated with PCT in infected group (r =0.762,P <0.05).ROC curve analysis showed that the areas under the curves of NAP and PCT in diagnosis of infection were 0.875 and 0.884,respectively.When 1 0655.28 AB/c and 5.01 mg/L were taken as cut-off values,the sensitivities of NAP and PCT in diagnosis of infection were 85.50% and 87.66%;the specificities were 90.50%和 90.31 %,respectively.The level of NAP in infected patients with gram-positive bacterial infections was higher than that in patients with gram-negative bacterial infections (t =6.29,P <0.01 ). Conclusion The expression of NAP in patients with acute cerebral hemorrhage increases when infection occurs,which may be helpful to the clinical diagnosis of bacterial infection.
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Objective To study general law of typing according to syndrome differentiation of Chronic Obstructive Pulmonary Disease (COPD). Method Based on large sample prospective Clinical Epidemiology investigation, symptoms, conditions of tongue, pulse according to TCM and pulmonary function, quality of life in 616 patients of COPD were collected. By means of Frequencies procedure, factor analysis, cluster analysis and analysis of variance in SPSS11.5, analyze the investigated data and lay difficient types of syndrome of COPD according to TCM. Meanwhile, explored distinct distribution and the relation between types of syndrome and pulmonary function, quality of life in patient5 with COPD. Result There were six types according to syndrome differentiation of COPD, deficiency of lung-qi, pathogenic wind-cold attacking lung, deficiency of pulmonosplenic both vital energy and yin, yin-deficiency of the lung and kidney, stagnation of phlegm and pathogenic fluid-reteneion in lung following splenic asthenia and stagnation of liver-qi, blood stasis-phlegm following deficiency of heart-yang and kidney-yang. There were multiple types of syndrome in COPD patients, the relation was detected between each type of syndrome and lung function, quality of life. Conclusion To draw assistance from clinical epidemiology and mathematical statistics method, the initial standard of differentiation of symptoms and signs to COPD was layed. The regularity of types of syndrome to COPD was detected. The result could be used in diagnosis of COPD, and the method could be communicated in the standardization research of syndrome differentiation.