Neutrophil to lymphocyte ratio predicts early stroke risk after transient ischemic attack / 国际脑血管病杂志

Objective To investigate the predictive value of peripheral blood neutrophil to lymphocyte ratio (NLR) for early stroke risk after transient ischemic attack (TIA).Methods Patients with TIA admitted to the Department of Neurology,the Second Hospital of Tianjin Medical University from August 2015 to July 2017 were enrolled retrospectively.According to whether or not ischemic stroke occurred within 90 d after the onset of TIA,they were divided into stroke group and non-stroke group.Multivariate logistic regression analysis was used to determine the independent risk factors for early stroke after TIA,and the receiver operating characteristic curve was used to evaluate the predictive value of baseline NLR for early stroke risk after TIA.Results A total of 131 patients with TIA were enrolled.Among them,23 (17.5％) had a stroke within 90 d,mainly within 7 d after the onset of TIA (n =13,56.5％).Univariate analysis showed that the differences between the two groups were statistically significant in terms of age,ABCD2 score,hypertension,duration of symptoms ≥60 min,diabetes,triglyceride,baseline NLR level,intracranial artery stenosis,use of antiplatelet drugs and dual antiplatelet drugs (all P ＜ 0.05).Multivariate logistic regression analysis showed that after adjusting for the confounding factors,the baseline NLR level (odds ratio [OR]2.631,95％ confidence interval [CI] 1.372-5.046;P =0.004) and ABCD2 score (OR 3.049,95％ CI 1.130-8.226;P =0.028) were the independent risk factors for early stroke after TIA,and use of dual antiplatelet agents (OR 0.195,95％ CI 0.046-0.826;P =0.026) were the independent protective factor.The receiver operating characteristic curve analysis showed that when the NLR cut-off value was 2.84,the area under the curve was 0.803 (95％ CI 0.716-0.889),and the sensitivity and specificity of predicting early stroke risk after TIA were 80.8％ and 69.5％,respectively.Conclusion Higher baseline NLR has certain predictive value for early stroke risk after TIA.

Neutrophil to lymphocyte ratio predicts long-term recurrence risk of acute ischemic stroke / 国际脑血管病杂志

Objective To investigate the predictive value of early neutrophil to lymphocyte ratio(NLR) in peripheral blood for long-term recurrence of ischemic stroke. Methods Patients w ith first-ever acute ischemic stroke w ere enrolled prospectively. The demographics and baseline clinical data of the patients at admission w ere documented and NLR w as calculated. According to the results of 2-year follow-up, they w ere divided into the recurrence group and the non-recurrence group. Multivariate Cox regression analysis w as used to identify the independent risk factors for stroke recurrence and receiver operator characteristic (ROC) curve w as used to evaluate the predictive value of baseline NLR level for recurrent risk of ischemic stroke. Results A total of 395 patients w ith acute ischemic stroke w ere enrolled, 76 patients had recurrence (19.2%) during the follow-up period. Univariate analysis show ed that there w ere significant differences in age,smoking,hyperlipidemia, atrial fibrillation, baseline National Institutes of Health Stroke Scale (NIHSS) score, total cholesterol, low-density lipoprotein cholesterol, fasting blood glucose, homocysteine, NLR, and discontinuation of statins betw een the recurrence group and the non-recurrence group (all P<0.05). Multivariate Cox regression analysis show ed that the baseline NLR level w as an independent risk factor for the recurrence of ischemic stroke (hazard ratio 1.087,95% confidence interval 1.025-1.363; P=0.021). ROC curve analysis show ed that w hen the baseline NLR cutoff value w as 3.61,the area under ROC curve w as 0.756 (95%confidence interval 0.692-0.821).The sensitivity and specificity of predicting recurrence in patients w ith ischemic stroke w ere 73.7% and 73.0%, respectively. Conclusion The higher baseline NLR has a certain predictive value for recurrence of ischemic stroke.

Correlation between anaplastic lymphoma kinase and pediatric malignancies / 中国肿瘤临床

In recent years, the incidence of pediatric malignancies has gradually increased. High-risk patients have poor prognosis, and the main effect of treatments such as surgery and radio-chemotherapy has reached a plateau phase. Targeted therapy, with its reliable efficacy and mild toxicity, has become one of the most promising approaches. Anaplastic lymphoma kinase (ALK) is a receptor tyrosine kinase, and its abnormal forms include gene fusion, gene mutation, gene amplification, and protein overexpression. These aberrations play important roles in the development of childhood cancer. With the application of ALK inhibitors in clinical anti-tumor therapy, targeted ALK treatment has received increased attention. This article aims to review various studies on the relationship between ALK aberrations and pediatric malignancies.

Short term curative effect of NB09 protocol on high-risk and ultra-high-risk neuroblastoma / 天津医药

Objective To evaluate the clinical outcome of NB09 (China Pediatric Neuroblastoma cooperative group 09) protocol on children with high-risk and ultra-high risk neuroblastoma. Methods The clinical and follow-up data of pa?tients who suffered from high-risk (n=7) and ultra-high risk (n=31) neuroblastomas and admitted in Tumor hospital of Tian?jin Medical University between January 2009 to January 2013 were retrospectively reviewed (27 boys and 11 girls). The age at diagnosis was 19-160 months (median age was 36.5 months). In the high risk group, patients were evaluated and operated after 4 to 6 circles of neoadjuvant chemotherapy. In ultra-high risk group, patient received chemotherapy before and after op?eration, then autologous stem cell transplantation and tumor bed radiotherapy. After chemotherapy, retinoic acid treatment was given to patients in ultra high risk group as in high risk group. Results At the end of treatment, 25 patients achieved complete remission; 5 patients achieved partial remission; 3 patients were in stable disease;5 patients were deteriorating in their conditions which lead to 2 deaths. In total, the response rate reaches upto 86.8%. By the end of follow up, 15 patients had a disease-free-survival, 9 patients survived with tumor, 7 died from recurrence and 7 died from deteriorating conditions. Survival time ranged from 6 to 52 months (median survival 25.5 months). The 1-, 2- and 3-year overall survival were 91.7%, 64.5%and 57.3%respectively. Kaplan-Meier curve and Log-rank test showed no statistical significance between high risk and ultra-high risk neuroblastomas. Conclusion The outcome of NB09 protocol for high risk and ultra-high risk neuroblastoma was preliminary affirmed. It is worthy of further clinical verification.