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Objective To investigate the predictive values of Kwon's score,Chumbler's score,Age,Atrial Fibrillation,Dysphagia,Sex,Stroke Severity (A2DS2) score,the Preventive ANtibacterial THERapy in Acute Ischemic Stroke (PANTHERIS) score,Acute Ischemic Stroke-Associated Pneumonia Score (AIS-APS),and prestroke Independence,Sex,Age,NIHSS (ISAN) score for stroke-associated pneumonia (SAP) in patients with acute ischemic stroke.Methods The patients with acute ischemic stroke were enrolled retrospectively.They were grouped according to whether to be complicated with SAP or not.The demography and baseline characteristics were compared between the SAP group and the non-SAP group.Multivariate logistic regression analysis was used to identify the independent risk factors for SAP.Receiver operating characteristic (ROC) curves were used to compare the predictive values of the 6 kinds of scores for SAP.Results A total of 1 427 patients with acute ischemic stroke were enrolled.Three hundred ninety-five patients (27.7％) complicated with SAP within 7 d after onset.There were significant differences in age,gender,past history (pneumonia,atrial fibrillation,smoking),laboratory tests (white blood cell count ＞11 × 109/L,baseline blood glucose ≥ 11.1 mmol/L),Oxfordshire Community Stroke Project (OCSP) classification,falling at the time of onset,dysphagia,mechanical ventilation and the modifiel Rankin Scale (mRS) score before onset,baseline Glasgow Coma Scale (GCS) score,baseline National Institutes of Health Stroke Scale (NIHSS) score and 6 scores between the SAP group and the non-SAP group (all P ＜ 0.05).Multivariate logistic regression analysis showed that age (odds ratio [OR] 1.034,95％ confidence interval [CI] 1.019-1.049;P=0.001),white cell count ＞ 11 × 109/L (OR 4.386,95％CI 2.763-6.905;P=0.001),baseline blood glucose ≥ 11.1 mmol/L (OR 1.933,95 ％ CI 1.305-2.864;P =0.001),dysphagia (OR 7.839,95％ CI 4.892-12.563;P =0.001),baseline NIHSS (OR 1.120,95％ CI 1.077-1.165;P =0.001),and baseline GCS score (OR 1.132,95％ CI 1.019-1.257;P =0.021) were the independent risk factors for SAP.The areas under the ROC curves of SAP predicted by the Chumbler's,AIS-APS,A2DS2,ISAN,Kwon's and PANTHERIS scores were 0.830 (95％ CI 0.805-0.855),0.827 (95％ CI 0.802-0.852),0.818 (95％ CI 0.792-0.845),0.788 (95％ CI 0.762-0.814),0.774 (95％CI 0.774-0.803),and 0.727 (95％ CI 0.695-0.758),respectively.There were no significant differences in the area under ROC curves of Chumbler's,A2DS2 and AIS-APS scores between the pairwise comparisons.There were significant differences in the area under ROC curves of the Chumbler's,A2DS2,AIS-APS and ISAN scores between the pairwise comparisons (AIS-APS compared with ISAN:P =0.001;the rests P ＜ 0.001).Conclusions The accuracies of predicting SAP with the Chumbler's,AIS-APS and A2DS2 scores are superior to the ISAN,Known's and PANTHERIS scores,and have higher clinical application value.
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Objective To explore the influence of smoking on olfactory disorder in Parkinson's disease (PD). Methods According to smoking or not, 167 PD patients ( PD group) and 100 normal controls ( normal control group) were divided into smoking subgroups and non-smoking subgroups.The olfactory identification threshold was tested by T&T olfactory assessment.Results Compared with normal control group, the scores of MMSE and montreal cognitive assessment in PD group were significantly decreased ( all P0.05 ) .The olfactory identification threshold in PD group was significantly higher than normal control group (t=6.785, P=0.000).Compared with PD smoking subgroup, the olfactory identification threshold in non-smoking subgroup was significantly higher (t=-3.000, P=0.003).The olfactory identification threshold in normal control smoking subgroup was significantly lower (t=0.784, P=0.435). The olfactory identification threshold of PD smokers had no correlation with smoking pack-years or duration ( r=-0.104, P=0.441;r=-0.156, P=0.246) .Conclusion Smoking may protect olfactory disorder in PD patients, and it has no correlation with smoking pack-years or duration.
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Objective To investigate the risk factors of cerebral microbleeds (CMBs) in patients with acute isch?emic stroke of large-artery atherosclerosis. Methods One hundred twelve patients with acute ischemic stroke of large-ar?tery atherosclerosis admitted from July 2013 to January 2014 in Nanjing First Hospital affiliated to Nanjing Medical Uni?versity were enrolled. According to the results of MRI magnetic sensitive weighted imaging, the patients were divided into CMBs group or non-CMBs group. The history, general clinical data, serum biochemical results and MRI in both groups were enrolled. All the data were analyzed by the univariate and multivariate analysis. Results The results of univariate analysis showed that there were significant differences in age (61.620±11.479 vs. 70.620±11.185), serum uric acid (UA) level (278.920±69.512 vs. 353.460±111.206), serum creatinine (Cr) level (71.360±19.797 vs. 90.450±44.989), serum ho?mocysteine (Hcy) level (12.587±2.664 vs. 21.715±10.437) between the two groups (P<0.05). There were significant differ?ences in constituent ratio of Fazekas' s grade of periventricular hyperintensities and deep white matter hyperintensities between the two groups (P<0.05). The results of multivariate analysis showed that age (OR=0.963, 95%CI:0.905~1.025, P<0.05) and serum Hcy level (OR=1.487, 95%CI:1.219~1.813, P<0.05) were the independent risk factors for CMBs in patients with acute ischemic stroke of large-artery atherosclerosis. Conclusions Age and serum Hcy level are the inde?pendent risk factors for CMBs in patients with acute ischemic stroke of large-artery atherosclerosis.
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Images corresponded to the right knee of a 27 years old, healthy, male volunteer, weighing 68 Kg, 175 cm height, with no knee joint disease, were selected. The scanning was performed using 1.5T Twinspeed/Excite magnetic resonance tomography. The image was uninterrupted sagittal planes picture, and the scanning way was from the inside to out. The three-dimensional tibia-femoral joint model was established by the MR1 images after they were handled by correlation analysis software (Mimics10.0, Geomagic Studio 8.0). At last, transformed the model format STL file to IGS file, which can be acceptable by analysis software 11.0. On the base of this way, a highly simulation tibia-femoral model was established. It provides a guarantee for the further finite element analysis concerning checking the surface of femoral condyle cartilage to repair interphalangeal joint injuries. The result demonstrated that 3-D computer model established by using 2-D MRI pictures makes up the CT scanning deficiencies on soft tissue, which confirms the model closer to the real anatomical structure.
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To examine the ability of intrastriatal gene transfer of vascular endothelial growth factor 165 mediated by adenoviral vector to rescue dopaminergic neurons in a rat model of Parkinson's disease (PD), we constructed recombinant replication-deficent adenoviral vectors carrying the gene of VEGF165 (Ad-VEGF), and injected Ad-VEGF (or Ad-LacZ and PBS as controls) into the striatum of rats 7 days after the lesion by 6-hydroxydopamine. The rat rotational behavior analysis and tyrosine hydroxylase (TH) immunohistochemistry were performed to assess the change of dopaminergic neurons. Our results showed that the rats receiving Ad-VEGF injection displayed a significant improvement in apomorphine-induced rotational behavior and a significant preservation of TH-positive neurons and fibers compared with control animals. It is concluded that intrastriatal gene transfer by Ad-VEGF may rescue the dopaminergic neurons from degeneration in a rat model of PD.
ABSTRACT
To examine the ability of intrastriatal gene transfer of vascular endothelial growth factor 165 mediated by adenoviral vector to rescue dopaminergic neurons in a rat model of Parkinson's disease (PD), we constructed recombinant replication-deficent adenoviral vectors carrying the gene of VEGF165 (Ad-VEGF), and injected Ad-VEGF (or Ad-LacZ and PBS as controls) into the striatum of rats 7 days after the lesion by 6-hydroxydopamine. The rat rotational behavior analysis and tyrosine hydroxylase (TH) immunohistochemistry were performed to assess the change of dopaminergic neurons. Our results showed that the rats receiving Ad-VEGF injection displayed a significant improvement in apomorphine-induced rotational behavior and a significant preservation of TH-positive neurons and fibers compared with control animals. It is concluded that intrastriatal gene transfer by Ad-VEGF may rescue the dopaminergic neurons from degeneration in a rat model of PD.