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Objective:To investigate the independent predictors of the long-term clinical outcomes in patients with branch atheromatous disease (BAD) in lenticulostriate artery (LSA) territory.Methods:Patients with LSA-BAD admitted to the Department of Neurology, Zhongnan Hospital of Wuhan University from January 1, 2016 to June 1, 2019 were enrolled retrospectively. Their demography, vascular risk factor, and baseline clinical data were collected. The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the severity of stroke. The clinical outcomes were evaluated by the modified Rankin Scale at 6 months. 0-2 was defined as good outcome, and >2 was defined as poor outcome. Multivariate logistic regression analysis was used to determine the independent influencing factors of clinical outcomes in patients with LSA-BAD. Results:A total of 81 patients with LSA-BAD were enrolled. Their age 59.20±11.75 years (range, 39-81 years), 53 were male (65.4%), and median baseline NIHSS score was 1.0 (interquartile range, 0-4.0). Forty-one patients (50.6%) received intravenous thrombolysis. At 6-month follow-up after the onset, 63 patients (77.8%) had a good outcome, and 18 (22.2%) had a poor outcome. The baseline NIHSS score of the poor outcome group was significantly higher than that of the good outcome group (6.5 [0-9.0] vs. 1.0 [0-3.0]; Z=2.395, P=0.017), while the proportion of mild stroke (61.6% vs. 98.4%; χ2=17.595, P<0.001) and patients receiving intravenous thrombolysis (38.9% vs. 54.0%; χ2=4.450, P=0.035) were significantly lower than those of the good outcome group. Multivariate logistic regression analysis showed that after adjusting for other confounding factors, venous thrombolysis was independently correlated with the good outcome (odds ratio 0.099, 95% confidence interval 0.011-0.924; P=0.042), while the high baseline NIHSS score was independently associated with the poor outcome (odds ratio 1.736, 95% confidence interval 1.262-2.388; P=0.001). Conclusion:Intravenous thrombolysis is helpful to improve the outcomes of patients with LSA-BAD, and a higher baseline NIHSS score is an independent predictor of the poor outcome.
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Objective To explore the effect of uric acid in cerebral small vessel disease and its cognitive impairment.Methods 102 patients with cerebral small vessel disease(CSVD)and 56 patients with NCSVD (non-CSVD) were enrolled.The CSVD imaging manifestations was assessed by brain MRI.Neuropsychological test was used to evaluate the cognitive function and serum uric acid concentration was detected.The uric acid levels was compared in CSVD and NCSVD groups and Logistic regression was used to assess the risk factor of CSVD.In patients with CSVD,the cognitive function was compared between the patients with and without hyperuricemia and partial correlation analysis was used to assess the relationship between uric acid and cognitive function.Results The serum uric acid level of patients with CSVD was higher than that of patients with NCSVD ((360.31 ±78.31) μmol /L,(301.79±49.37) μmol/L,P＜0.05).Uric acid was risk factor for patients with CSVD (OR=1.014,95％CI=1.007-1.021,P＜0.05).In patients with CSVD,there were significant differences in MMSE,VFT,DSST and TMT-A scores between patients with and without hyperuricemia (MMSE (23.76± 3.09) vs (22.27 ± 3.87);VIT (34.29 ± 8.01) vs (31.85 ± 6.16);DSST (34.39 ± 7.84) vs (31.15±7.47);TMT-A(59.10±17.52) vs (65.98±15.97),all P＜0.05).Uric acid was negatively correlated with MoCA,DST and VFT scores (r=-0.178,P=0.039;r=-0.202,P=0.018;r=-0.250,P=0.004),and positively correlated with TMT-B time cost (r=0.241,P=0.005).Conclusion Uric acid is a risk factor for CSVD and may damages the overall cognitive function,attention,language and executive function of patients with CSVD.
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Objective To investigate the expression and significances of DPP-4 and IL-6 in febrile seizures(FS).Methods FS were induced in Sprague-Dawley(SD) rats at P14 in a hot water bath by using classical model of hyperthermia-induced seizures.A genome-wide microarray experiment was generated in the rats.The relationship between the differentially expressed genes were analyzed by the method of bioinformatics, and the gene and protein levels of DPP-4 and IL-6 were detected by QPCR,WB and ELISA.Selected 50 children with FS(FS group) and 25 healthy children(control group), and to compare the gene and protein levels of DPP-4 and IL-6 between the two groups.Results Interaction network diagram of differential gene expression showed that there may be interactions between DPP-4 and IL-6.Animal and clinical experiments showed that the DPP-4 and IL-6 gene and protein levels were significantly higher in FS group compared with control group(P<0.05).Conclusion There were high gene and protein expressions of DPP-4 and IL-6 in the FS group compared with the control group.These results indicated that immune and inflammations may play an important role in the FS, and it has provided an attractive pharmacological target for the treatment of FS in clinic.