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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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An increasing number of studies have demonstrated that exosomes are closely associated with liver fibrosis and mediate the process of liver fibrosis by participating in cytokine secretion, macrophage activation, extracellular matrix remodeling, and hepatic stellate cell activation. This article summarizes that the resolution of liver fibrosis requires the reduction of pro-inflammatory and fibrotic cytokines, the reduction of extracellular matrix protein production, the increase of collagenase activity, and finally the loss of activated myofibroblasts. It is believed that exosomes play an important role in the treatment of liver fibrosis and are potential markers for diagnosis and treatment, and in future studies, it is necessary to improve exosome extraction techniques and standardization of treatment quantification.
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Objective To investigate the correlation between enlarged perivascular space (EPVS) and post-stroke depression (PSD) in patients with ischemic stroke. Methods Consecutive patients with acute cerebral infarction admitted to hospital from March 2010 to March 2014 were enroled prospectively. The patients completed head MRI examination after admission and performed EPVS grading. At 3 months after symptom onset, they performed PSD assessment according to Hamilton Depression Scale (HAMD) and Classification and Diagnostic Criteria of Mental Disorders in China, 3rd edition (CCMD-3). The relationship between EPVS and PSD was analyzed. Results A total of 249 patients were enroled; including 62 patients (4. 9% ) experienced PSD at 3 months. There were significant differences in the proportions of the EPVS classification patients of the baseline National Institutes of Health Stroke Scale score ( the median [interquartile range]; 4 [3 - 6] vs. 3 [2 - 5]; Z = - 2. 950, P = 0. 003), centrum semiovale (χ2 = 14. 370, P = 0. 001), and periventricular (χ2 = 11. 590, P = 0. 003)between the PSD group and the non-PSD group. Multivariable logistic regression analysis showed that centrum semiovale EPVS grade 2 (odds ratio [OR] 3. 89, 95% confidence interval [ CI] 1. 59 - 9. 56) and grade 3 (OR 3. 28, 95% CI 1. 04 - 10. 33) were significantly correlated with PSD; periventricular EPVS grade 2 (OR 0. 72, 95% CI 0. 27 - 1. 91) and grade 3 (OR 2. 24, 95% CI 0. 68 - 7. 37) were not correlated with PSD. Conclusions Centrum semiovale EPVS is independently associated with PSD, and periventricular EPVS is not.
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The endemic situation of schistosomiasis in Tangyin Village of Duchang County from 2000 to 2007 showed the infection rates of residents between 2003 and 2007 were all around 10%.In 2000.2002 and 2007,the infection rates of snails were 0.32%,O.45%and 0.38%,respectively,and the densities of infected snails were 0.016,0.004 No./0.1 m~2.and 0.004 No./0.1 m~2,respectively.It is suggested that the snail control and health education should be strengthened and the self-protection awareness of residents should improve for schistosomiasis control.