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Objective:To analyze the risk factors for early neurological deterioration(END)in elderly patients with acute ischemic stroke(AIS)after intravenous thrombolysis.Methods:Clinical data of 118 patients with AIS who had received thrombolysis were collected retrospectively.According to the occurrence of END, cases were divided into the END group(n=28)and the non-END group(n=90). Univariate analysis was used to compare general characteristics, clinical data, laboratory test results, TOAST classification, infarct location, and degree of culprit vessel stenosis between the two groups.Multivariate Logistic regression analysis was used to analyze the related factors for END.Results:Univariate analysis showed that the proportion of patients with diabetes mellitus and previous cerebral infarction was higher in the END group than in the non-END group( χ2=4.000 and 8.056, P=0.046 and 0.005). There were significant differences in National Institutes of Health Stroke Scale(NIHSS)score, time from onset to thrombolysis, thrombolysis time, swallowing dysfunction, albumin, leukocyte count, neutrophil count, lymphocyte count, glycosylated hemoglobin(HbA1c), creatinine, total cholesterol(TC), low density lipoprotein cholesterol(LDL-C), high density lipoprotein cholesterol(HDL-C)and lipoprotein(a)levels between the two groups(all P<0.05). There were also significant differences between the two groups in TOAST classification, infarct location and degree of culprit vessel stenosis( χ2=13.109 and 9.509, Z=2.912, P=0.004, 0.023 and 0.004). Multivariate Logistic regression analysis showed that NIHSS score, HbA1c, cardiogenic stroke, degree of culprit vessel stenosis and leukocyte count on admission were independent risk factors for END( OR=1.122, 2.131, 1.965, 1.876 and 1.563, P=0.036, 0.024, 0.028, 0.030 and 0.041). Conclusions:NIHSS score, HbA1c, cardiogenic stroke, degree of culprit vascular stenosis and leukocyte count on admission are independent risk factors for END, which should be closely monitored and managed with well formulated preventive measures in order to improve the prognosis of AIS patients.
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Objective To explore glycogen synthase kinase -3β( GSK-3β) activity and Toll-like receptor 4 ( TLR4 ) proteins expression of microglia were tested in vitro experiments, and the possible mechanism of postoperative cognitive dysfunction(POCD).Methods The cell morphology of primary culture microglia was observed by inverted microscope;microglia were identified by glial fibrillary acidic protein ( GFAP ) immunofluorescence;the best POCD modeling conditions of microglia injury induced by lipopolysaccharides( LPS) were screened ; microglia vigor was assayed by MTT ; the proteins expressions of GSK-3βand TLR4 of microglia were detected by Western blot.Results GFAP immunofluorescence showed a positive result that primary culture of rat microglia was successful;MTT result showed that the best PODC modeling conditions of microglia injury induced by LPS (100 ng/mL) was 7h; Western blot results showed that the preotein expressions of GSK-3βand TLR4 of microglial cells were up-regulated by LPS compared with the control group,and there were significantly differences (P<0.01).Conclusion PODC pathogenesis may be associated with LPS that could up-regulat the protein expression of GSK-3βand TLR4 in microglial cells.
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<p><b>OBJECTIVE</b>To study the impact of gonadotropin-releasing hormone analogs (GnRHa) on body mass index (BMI) in girls with idiopathic central precocious puberty (ICPP).</p><p><b>METHODS</b>One hundred and thirty-four girls with ICPP were enrolled. Fifty-seven out of the 134 girls were treated with GnRHa for 1.69±0.43 years. The height, weight, bone age and BMI were measured before treatment, at the end of the treatment and after reaching near adult height and compared with those in the untreated 77 girls.</p><p><b>RESULTS</b>The adult predicted height standard deviation score (SDS) at the end of treatment was significantly higher than that before treatment (P<0.01) and was similar to the target height SDS in the GnRHa treatment group (P>0.05). With GnRHa treatment, the near-adult height SDS was higher than the target height SDS (P<0.01). At the end of treatment, the BMI SDS slightly increased compared with pretreatment level (P>0.05). A significant reduction in the BMI was observed when reaching the near-adult height in the GnRHa treatment group compared to the level of pretreatment and the untreated group (P<0.01). However, the BMI in the GnRHa treatment group before treatment, at the end of the treatment and after reaching near adult height remained in the normal range (±1 SD).</p><p><b>CONCLUSIONS</b>GnRHa may improve the final height in girls with ICPP. The alterations of BMI after GnRHa therapy fluctuate in a normal range.</p>