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Objective:To investigate the predictive value of plasma lipocalin-2 (LCN2) for the clinical outcome of patients with acute minor ischemic stroke (MIS).Methods:Consecutive patients with acute MIS admitted to the Department of Neurology, Shengze Hospital Affiliated to Nanjing Medical University from October 9, 2017 to August 17, 2018 were selected prospectively. On the day of admission, the National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the degree of neurological impairment. The modified Rankin Scale was used to evaluate the clinical outcome at 90 d after the onset, and 0-1 was defined as a good outcome. Multivariate logistic regression model was used to analyze the correlation between plasma LCN2 and clinical outcome. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of plasma LCN2 for the clinical outcome of patients. Results:A total of 71 patients (68.99±11.24 years old) were enrolled in the study. Forty-six patients were male (64.8%). The median plasma LCN2 was 117.7 μg/L (interquartile range, 61.2-738.4 μg/L). Fifty-six patients (78.9%) had good outcomes, and 15 (21.1%) had poor outcomes. The age, baseline NIHSS score, plasma C-reactive protein and LCN2 of the good outcome group were significantly lower than those of the poor outcome group (all P<0.05). Multivariate logistic regression analysis showed that plasma LCN2 ≤117.7 μg/L (odds ratio 8.574, 95% confidence interval 1.755-41.874; P=0.008) and lower baseline NIHSS scores (for increasing by 1 point: odds ratio 0.396, 95% confidence interval 0.214-0.732; P=0.003) were independently related to good outcome. ROC curve analysis showed that the area under the curve for plasma LCN2 to predict a good outcome was 0.814 (95% confidence interval 0.709-0.918); the best cut-off value was 128.55 μg/L, and the corresponding sensitivity and specificity were 69.6% and 80.0%, respectively. Conclusions:Plasma LCN2 had a good predictive value for the clinical outcome of patients with acute MIS at 90 d after the onset.
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Objective To investigate the correlation between CYP2C19 gene polymorphism and clopidogrel resistance(CR)in patients with ischemic stroke in the north of China.Methods The patients with ischemic stroke were selected as the research object from the First Hospital of Hohhot during September 2015 to No-vember 2016.The polymorphism of CYP2C19 gene was detected by Taqman probe method.Results The clo-pidogrel resistance ratio of the study population is 59%.There is a strong correlation between the CYP2C19* 2 mutant strains with clopidogrel resistance(P=0.006),and we foundd that the increased glutamic oxala-cetic transaminase was associated with clopidogrel resistance.Conclusion Patients with the CYP2C19*2 al-lele were at greater risk of clopidogrel resistance during antithrombotic therapy.
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Objective To investigate the correlation between subclinical hypothyroidism (SCH) and carotid atherosclerosis in patients with acute ischemic stroke.Methods Patients with acute ischemic stroke admitted to Nanjing Shengze Hospital Affiliated to Nanjing Medical University from July 2014 to July 2017 were enrolled retrospectively.SCH was defined as elevated levels of serum thyroid stimulating-hormone (TSH),but the free thyroxine (FT4) and free-triiodothyronine (FT3) levels were normal.Carotid plaque and carotid stenosis were assessed using carotid ultrasound.Multivariate logistic regression analysis was used to determine the correlation between SCH and carotid atherosclerosis.Resuts A total of 176 patients with acute ischemic stroke were enrolled,including 81 females and 95 males;36 complicated with SCH,126 complicated with carotid atherosclerotic plaques,and 9 had carotid stenosis.High-density lipoprotein cholesterol (1.36±0.48 mmol/L vs.1.18 ± 0.30 mmol/L;t =2.090,P =0.039) and TSH (6.29[5.44-7.01]mU/L vs.1.87[1.31-2.67] mU/L;Z =9.243,P =0.001) levels in the SCH group were significantly higher than those in the non-SCH group.There were significant differences in age (73.5[65.0-80.0]years vs.68.0[56.0-75.0]years;Z =2.707,P=0.007),stroke etiology classification (x2 =9.270,P=0.038),TSH level (2.19[1.47-3.72]mU/L vs.2.18[1.24-2.62]mU/L;Z=3.230,P=0.001),and the proportion of patients with SCH (26.98％ vs.4.00％;x2 =11.622,P =0.001) between the plaque group and the non-plaque group.There was no statistical difference in demographic and clinical data between the stenosis group and the non-stenosis group (all P ＞0.05).Multivariatelogistic regression analysis showed that advanced age (odds ratio 1.050,95％ confidence interval 1.014-1.088;P =0.006) and SCH (odds ratio 5.328,95％ confidence interval 1.322-21.468;P =0.019) were the independent risk factors for carotid atherosclerotic plaques.Conclusion Advanced age and SCH were the independent risk factors for carotid plaque in patients with acute ischemic stroke.
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Objective To investigate the risk factors for acute ischemic stroke in patients with lower extremity atherosclerosis (LEA).Methods The consecutive patients with acute ischemic stroke admitted to hospital within 7 d after onset were enrolled retrospectively.Color Doppler flow imaging was used to detect LEA.The demographic characteristics,vascular risk factors,and laboratory parameters were identified and analyzed.Results A total of 156 patients with acute ischemic stroke were enrolled,including 138 with LEA.Univariate analysis showed that age (69.5± 11.8 years vs.60.4± 11.5 years;t =3.063,P =0.003) and the proportion of patients with hypertension (81.1％ vs,55.6％;x2 =2.467,P =0.014) in the LEA group were significantly higher than those in the non-LEA group.Multivariate logistic regression analysis showed that after adjustment for confounders such as gender,baseline systolic blood pressure,diabetes mellitus,and ischemic heart disease,age (odds ratio [OR] 1.059,95％ confidence interval [CI] 1.016-1.105;P=0.007),and hypertension (OR 3.128,95％ CI 1.084-9.026,P =0.035) were the independent risk factors for acute ischemic stroke complicated with LEA.Conclusions Age and hypertension are associated with acute ischemic stroke complicated with LEA.
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Objective To investigate the relationship between transforming growth factor gene (TGF) single nucleotide poly‐morphism (SNP) and multiple myeloma (MM) .Methods The case control study was performed ,55 patients with MM and 55 healthy controls were selected .The genotype and allele detections were performed by adopting the polymerase chain reaction (PCR) and the ligase detection reaction (LDR) respectively .Then the sequencing based typing was further conducted .Results There were no statistically significant differences in the two loci genotype frequencies ,allele frequencies and genotype frequencies in joint hap‐loid typing between the MM group and the control group(P>0 .05) .Conclusion SNP of TGF gene has no obvious correlation with the occurrence of MM and subtypes.
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Cerebral smal vessel disease (CSVD) accounts for 25 to 30% of al strokes. It is a main cause of vascular cognitive impairment. Because of cerebral smal vessels can not easily be directly observed and studied in vivo and on imaging, so the term CSVD is generaly used to describe a syndrome of clinical, cognitive, neuroimaging, and neuropathological changes, and not focus on the pathological changes of the smal vessel wal itself that caused these syndromes. This article reviews the advances in research on CSVD, particularly its pathological changes of vessel wals.
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Granulocyte macrophage-colony stimulating factor (GM-CSF) is a muhifunctional growth factor. It stimulates the proliferation, differemiation and maturity of hematopoietic progenitor cell (HPC), and transfers from bone marrow to periphery, inducing multiple cell proliferation or differentiation. In recent years, some studies have indicated that GM-CSF plays an important role in anti-apoptosis, inducing neuronal differentiation and angiogenesis, which will he a new supplement to the treatment of ischemic cerebrovascular disease. This article reviews the effects of GM-CSF in the treatment of ischemic cerebrovascular disease.
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Objective To study the mithridatism of VMAT 2 in transgeneic CHO cell.Methods Using technology of transgene from PC 12 to CHO, MTT reduction assay was used to detect the toxic effect on MPP + to wtCHO and cDNACHO,meanwhile the role of reserpine was observed,including the toxic effect to MPP + on specific blocking agent of VMAT 2.Results cDNACHO to the sensitivity of MPP + was much less than that of wtCHO over concentration of 0.5 mmol/L MPP +; cDNACHO had the same sensitive as wtCHO to rotenon;after the reserpine was added,the above role disappeared,but wtCHO reserpine was given alone,it couldn't change its sensitivity to MPP +.Conclusion VMAT 2 has protective effect on cDNACHO by transporting MPP + to vesicles; PC 12 possesses the antitoxic components.