Platelet-to-neutrophil ratio predicts the outcomes after intravenous thrombolysis in patients with acute ischemic stroke / 国际脑血管病杂志

Objective:To investigate the predictive value of platelet-to-neutrophil ratio (PNR) on hemorrhagic transformation (HT) and poor outcomes at 90 d after intravenous thrombolysis (IVT) in patients with acute ischemic stroke (AIS).Methods:Patients with AIS received IVT in Hefei Second People's Hospital from July 2019 to June 2021 were retrospectively enrolled. HT was defined as intracerebral hemorrhage found by CT reexamination within 24 h after IVT, and the poor outcome was defined as the modified Rankin Scale score ≥3 at 90 d after onset. Multivariate logistic regression analysis was used to determine the independent predictors of HT and poor outcomes at 90 d, and the predictive value of PNR on HT and poor outcomes at 90 d was analyzed by receiver operating characteristic (ROC) curve. Results:A total of 202 patients with AIS treated with IVT were included, of which 32 had HT and 50 had poor outcomes at 90 d after onset. Multivariate logistic regression analysis showed that PNR at 24 h after IVT was significantly and independently negatively correlated with the poor outcomes (odds ratio [ OR] 0.959, 95% confidence interval [ CI] 0.928-0.991; P=0.012); PNR at admission ( OR 0.886, 95% CI 0.827-0.948; P<0.001) and PNR at 24 h after IVT ( OR 0.923, 95% CI 0.879-0.969; P=0.001) were significantly independently and negatively correlated with HT. ROC curve analysis showed that the area under the curve of PNR at 24 h after IVT for predicting poor outcomes was 0.733 (95% CI 0.659-0.807; P=0.012), the best cutoff value was 35.03, and the predictive sensitivity and specificity were 70.4% and 74%, respectively. The area under the curve of PNR at admission for predicting HT was 0.830 (95% CI 0.774-0.886; P<0.001), the best cutoff value was 34.81, and the predictive sensitivity and specificity were 70% and 93.7%, respectively. The area under the curve of PNR at 24 h after IVT for predicting HT was 0.770 (95% CI 0.702-0.839; P=0.001), the best cutoff value was 41.73, and the predictive sensitivity and specificity were 53.5% and 96.9%, respectively. Conclusion:For patients with AIS treated with IVT, lower PNR at 24 h after IVT is an independent predictor of the poor outcomes at 90 d, while PNR at admission and 24 h after IVT are the independent predictors of HT.

Gut microbiome and ischemic stroke / 国际脑血管病杂志

In recent years, the concept of " microbiome-gut-brain axis" has been proposed to reveal the wide connection between gut microbiome and nervous system diseases. As a common and frequently occurring disease of nervous system, the occurrence and outcome of ischemic stroke are closely related to gut microbiome. This article reviews the relationship between gut microbiome and risk factors of ischemic stroke and immune inflammation after stroke.

Effect of high rosuvastatin dose on outcome in patients with large artery atherosclerotic stroke / 中华老年心脑血管病杂志

Objective To study the effect of high rosuvastatin dose on outcome in patients with large artery atherosclerotic stroke (LAAS).Methods Eighty-two LAAS patients were randomly divided into high rosuvastatin dose group (n=39) and routine rosuvastatin dose group (n=43).Their serum blood lipid level and inflammatory indexes were measured and their clinical outcome was assessed.Results No significant difference was found in mortality,recurrence and hemorrhagic transformation between the two groups (P＞0.05).The rate of improved outcome was significantly higher in high rosuvastatin dose group than in routine rosuvastatin dose group (84.62％ vs 65.12％,P=0.04).The serum hs-CRP level was significantly lower in routine rosuvastatin dose group and high rosuvastatin dose group after treatment than before treatment (0.56±0.60 mg/L vs 0.70±0.68 mg/L,P=0.01;0.22±0.29 mg/L vs 0.69±0.58mg/L,P=0.00) and in high rosuvastatin dose group than in routine rosuvastatin dose group after treatment than before treatment (0.22±0.29 mg/L vs 0.56±0.60 mg/L,P=0.00).The rate of LDL C＜1.8 mmol/L and non HDL-C＜2.6 mmol/L was significantly higher in high rosuvastatin dose group than in rosuvastatin dose group after treatment (69.23％ vs 46.51％,P=0.04;66.67％ vs 41.86％,P=0.03).No significant adverse reactions occurred in both groups.Conclusion High rosuvastatin dose can effectively increase the blood lipid level,reduce the serum hs-CRP level,and improve the clinical outcome in LAAS patients.

Gut microbiota and stroke-associated pneumonia / 国际脑血管病杂志

Recent studies have shown that there is a mutual influence between gut microbiota and stroke. Stroke-associated pneumonia (SAP) is a common complication of stroke, which is closely associated with death and poor prognosis of patients. Gut microbiota translocation may be the source of infection of SAP, but the specific mechanism of gut microbiota and SAP remains unclear. This article reviews the relationship between gut microbiota and SAP in order to provide reference for the prevention and treatment of SAP.

β2-Microglobulin and ischemic stroke / 国际脑血管病杂志

β2-Microglobulin is a small molecule protein, consisting of a polypeptide chain.Previous studies have confirmed that serum β2-microglobulin is a biomarker that reflects early renal function injury, and renal function injury is closely correlated with ischemic stroke.Studies in recent years have shown that the level of serum β2-microglobulin increases significantly in patients with ischemic stroke.Thus, it can be used as a biomarker for the risk of ischemic stroke.

Imp aired risk decision in patients with cerebral microbleeds / 国际脑血管病杂志

Objective To investigate whether the decision-making ability was impaired under the condition of clear risk probability in patients with cerebral miceobleeds (CMBs).Methods The Game of Dice Test (GDT) with the clear risk probability was used to conduct the risk decision ability study in 45 patients with CMBs and 45 without CMBs.Results GDT showed that patients in the CMBs group was more like to choose the risky option compared with the non-CMB group (9.64 ± 3.22 vs.6.51 ± 4.48;t =3.809,P ＜0.001).Among the 4 options,the most frequent choice in the CMBs group was the option of the highest risk,i.e.2 numbers (6.91 ±3.02 vs.4.71 ±2.95;t =3.494,P =0.001);and the most frequent choice in the non-CMBs was 3 numbers (4.87 ±2.17 vs.7.71 ±2.71;t =-5.496,P＜0.001).The GDT was divided into 3 stages.The number of security options selected by patients in the CMBs group was significantly less than that by patients in the non-CMBs group in all stages (stage 1:-0.27 ± 3.00 vs.0.93 ±3.09;t =-1.867,P =0.065;stage 2:-0.62 ± 2.55 vs.2.27 ± 2.65;t =-5.268,P ＜ 0.001;stage 3:-0.53 ± 2.57 vs.2.89 ± 3.12;t =-5.677,P＜ 0.001),and with the increase of the number of tests,selecting security options increased gradually in the non-CMB group (F =4.780,P =0.010),while the CMBs group was not (F =0.209,P =0.812).Conclusions The patients with CMBs have significant impairment in decision making ability under the condition of specific risk probability.