Prognostic value of the platelet-to-lymphocyte ratio for outcomes of stroke: a systematic review and meta-analysis.

OBJECTIVE: The current study aimed to conduct a systematic literature search and pool data from individual studies to assess the relationship between platelet-lymphocyte ratio (PLR) and functional outcomes and mortality in stroke patients. MATERIALS AND METHODS: The databases of PubMed, Embase and Google Scholar were searched for relevant studies up to 21st August 2021. Odds ratios (OR) with 95% confidence intervals (CI) were calculated for the association between PLR and poor functional outcomes and mortality. RESULTS: Sixteen studies were included in the systematic review and nine in the meta-analysis. On analysis of eight studies, we noted no statistically significant relationship between PLR and poor functional outcomes in patients with stroke (OR: 1.00 95% CI: 1.00, 1.00 I2=80% p=0.30). Data on mortality was reported by just two studies. Pooled analysis indicated no statistical relationship between PLR and mortality in patients with stroke (OR: 1.49 95% CI: 0.56, 3.98 I2=76% p=0.43). Descriptive analysis of the remaining studies demonstrated conflicting results for the relationship between PLR and early neurological deterioration (END) and functional outcomes. CONCLUSIONS: Our results indicate that PLR may not be a useful prognostic marker to predict functional outcomes after AIS. Evidence on the predictive power of PLR for mortality and END after stroke is scarce and contrasting. There is a need for further studies assessing the role of PLR in predicting outcomes of stroke patients while taking into account important confounders like baseline stroke severity and treatment modality.

[Association between hyperuricemia and incidence risk for cardiometabolic abnormity in children].

Objective: To investigate the relationships between hyperuricemia and the incidence risk for cardiometabolic abnormity in children. Methods: Data were obtained from School-based Cardiovascular and Bone Health Promotion Program. In 2017, a total of 15 391 children aged 6-16 years in Beijing were selected through stratified cluster sampling at baseline survey. Follow-up investigation was conducted in 2019. Logistic regression model was used to analyze the relationships of uric acid quartiles and change in uric acid levels with incidence risks for cardiometabolic abnormity (hypertension, hyperglycemia and dyslipidemia). Results: A total of 8 807 children (4 376 boys, 4 431 girls) were included in the analysis, the average age of the children was (11.1±3.3) years at baseline survey. The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of incidence risk for hypertension in the third and fourth quartiles of the UA were 1.39 (1.11-1.75) and 1.56 (1.19-1.81), respectively. The ORs and 95% CIs of risk for high LDL-C in the second, third and fourth quartiles were 1.88 (1.16-3.05),1.98 (1.23-3.17) and 2.25 (1.42-3.57). The uric acid level increased by one standard deviation, the risk increased by 17% for hypertension and 27% for high LDL-C. The uric acid level increased by 10 µmol/L, the risk increased by 2.1% for hypertension and 2.9% for high LDL-C. The gender-stratified analysis showed that the similar results. The ORs and 95% CIs were 1.32 (1.09-1.60) and 1.50 (1.05-2.16) for hypertension, 1.90 (1.38-2.60) and 2.96 (1.58-5.52) for high TC, 1.78 (1.26-2.51) and 2.84 (1.60-5.03) for high LDL-C in the groups of newly diagnosed hyperuricemia and persistent hyperuricemia. Conclusions: Higher uric acid level was associated with increased incidence risks for hypertension, abnormal TC and LDL-C. Maintaining optimal uric acid level by children might contribute to the early prevention of cardiovascular diseases.

[Influence of change in blood pressure status from childhood to adulthood on renal dysfunction: a cohort study].

Objective: To investigate the influence of change in blood pressure status from childhood to adulthood on renal damage. Methods: Data were obtained from Beijing Blood Pressure Cohort initiated from 1987. 3 198 children and adolescents aged 6-18 years from 6 primary and 6 middle schools in Chaoyang, Xicheng and Haidian Districts of Beijing were enrolled at baseline by using a cluster random sampling method, and 1 222 participants were followed up during 2010-2012. The measurements included weight, height, and blood pressure at baseline and microalbumin, serum creatinine, cystatin C and blood pressure at follow-up. Based on blood pressure status in childhood and adulthood, the participants were divided into four groups: participants with normal blood pressure in both childhood and adulthood, participants with elevated blood pressure in childhood but normal blood pressure in adulthood, participants with normal blood pressure in childhood but elevated blood pressure in adulthood, and participants with elevated blood pressure in both childhood and adulthood. Multivariate linear regression model was used to investigate the association of change in blood pressure from childhood to adulthood on renal dysfunction. Results: The prevalence of elevated blood pressure in childhood and adulthood was 17.9% and 39.9%, respectively. The P(50) (P(25)-P(75)) of microalbumin was 5.7(3.0-12.0) mg/L, and the concentration of eGFR and cystatin C were (118.0±19.8)% and (0.734±0.184)mg/L, respectively. With adjustment for sex, baseline age and follow-up years, compared with participants with persistently normal blood pressure from childhood to adulthood, participants with normal blood pressure in childhood but elevated blood pressure in adulthood had significantly higher levels of microalbumin (ß=0.502, 95%CI: 0.320-0.684) and cystatin C (ß=0.049, 95%CI: 0.025-0.073). After adjustment for sex, baseline age, follow-up duration, and adult BMI, smoking and drinking, participants with normal blood pressure in childhood and elevated blood pressure in adulthood had higher levels of adult urine microalbumin (ß=0.322, 95%CI: 0.128-0.516) and cystatin C (ß=0.032, 95%CI:0.007-0.057). Conclusion: An increase in blood pressure during childhood and adulthood has an adverse impact on renal functional damage in adulthood. These findings underscore the importance of maintaining normal blood pressure during life course to prevent the development of chronic kidney disease.

[Effect of genetic polymorphisms on change in body mass index and obesity status during childhood].

Objective: The present study aimed to prospectively validate whether the single nucleotide polymorphisms (SNPs) in obesity-related genes were associated with change in body mass index (BMI) and obesity status during childhood. Methods: Based on the Beijing Child and Adolescent Metabolic Syndrome study (BCAMS), which was initiated between April and October in 2004, we conducted a follow-up study among 1 624 children aged 6 to 11 years old with genetic data in December 2010. A total of 777 children (246 obese and 531 non-obese) were reassessed for BMI. Z-score of BMI was used to standardize for age and sex. The changes in BMI Z-score during follow up were calcnlated SNPs were genotyped by quantitative Real-time PCR (rs9939609, rs6499640, rs7138803, rs1805081, rs17782313, rs6265, rs10938397, rs6235, rs29941, rs2844479, rs10913469 and rs4788102). Overweight and obesity were diagnosed by the age-and sex-specific BMI cutoffs recommended by the International Obesity Task Force. A multilocus genetic risk score for BMI was calculated as the simple sum of alleles of all the SNPs associated with BMI. Linear regression models and logistic regression models were performed to assess the associations of change in BMI Z-score and obese status with genotypes (assuming an additive model), respectively. Results: During 6 years of follow-up, 158 previously obese children remained obese as they aged into adolescence, and 88 transiently obese children were not obese during the second survey, 58 children were newly identified obese, and the other 473 children remained their non-obese state. BMI Z-score increased from 1.41±0.05 at baseline to 1.57±0.06 at follow up.The genotypes of the SNPs except rs6499640(P=0.033) and rs6265(P=0.041) were in Hardy-Weinberg equilibrium in each group (P>0.05). Each additional copy of the rs9939609 A allele was significantly associated with an increase in BMI Z-score (ß=0.205, P=0.014) during follow up. Per C allele of rs17782313 was associated with an increase in BMI Z-score at baseline (ß=0.268, P=0.003). As the non-obese reference, a significantly relative risk of obesity at follow up was observed for children carrying rs9939609 A-allele versus the T-allele carriers (OR=2.37, 95%CI: 1.45-3.88, P=0.001). Rs17782313 C-allele was significantly increase the risk of obesity only at baseline (OR=1.79, 95%CI: 1.24-2.60, P=0.002). Rs1805081 A-allele was significantly associated with durative of obesity (OR=1.45, 95%CI: 1.04-2.03, P=0.028). Each unit higher genetic risk score was associated with increases risk of 0.18 times (OR=1.18, 95%CI: 1.05-1.33) in childhood transient obesity, and 0.22 times (OR=1.22, 95% CI: 1.06-1.42) in incident obesity at follow-up. But it was not significantly associated with persisted obesity during 6 years of follow-up (OR=1.09, 95% CI: 0.99-1.20). Conclusion: We confirmed that the change of BMI and obesity status in children was affected by different genetic factors. Individual who carries more risk alleles in obesity-related genes may increase the susceptibility to obesity.

Hypertension outcomes in metabolically unhealthy normal-weight and metabolically healthy obese children and adolescents.

Metabolically healthy obesity (MHO) begins in childhood and continues into adulthood. However, the association between MHO and the risk of developing hypertension remains controversial. A prospective cohort study was conducted to investigate the risk of hypertension in MHO and metabolically unhealthy normal-weight (MUNW) Chinese children and adolescents. A total of 1183 participants, 6-18 years old at baseline with normal blood pressure values, were studied using follow-up data from the cohort of the Beijing Child and Adolescent Metabolic Syndrome (BCAMS) study. The participants were classified according to the body mass index and the presence/absence of metabolic abnormality, which was defined by metabolic syndrome (MetS) or insulin resistance (IR). During the 6-year follow-up period, 239 (20.2%) participants developed incident hypertension. After adjusting for age, sex, physical activity, pubertal stage, dietary habits and family history of hypertension, an increased risk for hypertension was observed in the MHO individuals (risk ratio, RRMetS 5.42; 95% confidence interval (CI) 3.19-9.22 and RRIR 7.59; 95% CI 1.64-35.20) compared with their metabolically healthy normal-weight counterparts. Independent of the definition of metabolic abnormality, the MUNW subjects did not have an elevated incidence of hypertension. These results suggest that the risk of developing hypertension is increased in the MHO but not in the MUNW individuals.

Increase in body mass index, waist circumference and waist-to-height ratio is associated with high blood pressure in children and adolescents in China.

This study compared the association between blood pressure (BP) and obesity in 1145 Chinese children and adolescents (608 males, 537 females) using data from the 2006 China Health and Nutrition Survey. Obesity was diagnosed by body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR). Analysis of variance was used to analyse the difference in BP among different subgroups. Odds ratios (OR) were calculated and multivariate logistic regression analysis was carried out. The prevalence of high systolic and diastolic BP increased directly with corresponding increments in BMI, WC and WHtR, although the prevalence and OR of high BP were higher when increased BMI was combined with WC (OR 3.39; 95% confidence interval [CI] 1.79, 6.41) or WHtR (OR 3.28; 95% CI 1.71, 6.30). In conclusion, increased BMI, WC and WHtR were directly associated with high BP in Chinese children and adolescents.

Toxicity assessment of polycyclic aromatic hydrocarbons using an air-tight algal toxicity test.

The existing toxicity data on the effects of polycyclic aromatic hydrocarbons (PAHs) on Pseudokirchneriella subcapitata (green alga) are quite insufficient. These data were derived using different test techniques (e.g. conventional batch test, closed-system test, semi-static test). The relative toxicity relationship for various PAHs is thus difficult to interpret. Consequently, the current toxicity database is insufficient and also inadequate for analyses of the effects of PAHs on P. subcapitata. This study evaluated the toxicity of eleven PAHs using an air-tight test technique. The relative toxicity relationship was determined on a uniform basis, and was different from the relationship based on current available data. P. subcapitata. was found to be more susceptible to PAHs than Daphnia magna, fathead minnow, and Scenedesmus subspicatus. Quantitative structure-activity relationship (QSAR) was established based on the chemical's hydrophobicity with R(2) equal to 0.88. Photo-induced toxicity for various PAHs was also explored by exposing PAHs under UV-photoactivation. Toxicity of anthracene, benzanthrone, and benzo[a]anthracene was found to increase 3.5 to 25 times after UV exposure. Phototoxicity was observed when the HOMO-LUMO gap varied between 6.8 and 8.0 eV.

Cytotoxicity of rhenium(I) alkoxo and hydroxo carbonyl complexes in murine and human tumor cells.

The rhenium(I) alkoxo/hydroxo carbonyl complexes were shown to be very potent in suspended tumor cell lines in suppressing growth but were more selective in inhibiting the growth of cultures from solid tumors. Their mode of action in L1210 lymphoid leukemia cells indicated that they were not alkylating agents but interfered with nucleic acid metabolism at multiple enzyme sites, e.g. dihydrofolate reductase, PRPP-amido transferase, thymidine kinase, with DNA strand scission after 60 min incubation. These compounds did not function mechanistically exclusively as cisplatin derivatives causing intrastrand linkages of DNA but rather they mimicked the metal complexes of aminecarboxyboranes, furan oximes, N-substituted thiosemicarbazones, trifluoromethyl borons and ferratricarbadecarbanyl complexes acting as antimetabolites.

Direct identification of serotypes of natural human rotavirus isolates by hybridization using cDNA probes derived from segment 9 of the rotavirus genome.

Under stringent hybridization conditions, cDNA of segment 9 of the rotavirus genome, which codes for the viral protein VP7, permitted differentiation of serotypes of culture-grown rotaviruses and natural isolates of human rotaviruses directly from clinical specimens. This was evident for the following reasons. (i) The cDNA of one serotype selectively hybridized with the RNA of the same serotype of culture-grown rotaviruses. (ii) Natural isolates of the virus thus identified as serotype 2 were also those which gave the short electrophoretic pattern characteristic of the genome of serotype 2, subgroup 1 viruses. Isolates having the long electrophoretic pattern characteristic of the genome of subgroup 2 viruses were identified as serotype 1, 3, or 4 by this method. (iii) For patients who had previously undergone serological analysis, the serotypes being excreted were the same serotypes against which there was the most marked serum neutralizing antibody response. Although the virus population was genetically diverse, the preponderance of the population prevalent in Guangzhou and Foshan in each of the three successive years between 1982 and 1985 comprised a single serotype. The dominant serotype changed from one year to another, but there was minimal cocirculation of different serotypes in this community. All virus isolates belonged to serotype 1,2,3, or 4, and there was no evidence to suggest that the other human rotavirus serotypes were prevalent in this community.

Development of neutralizing antibodies and group A common antibodies against natural infections with human rotavirus.

We determined the levels of group A common and neutralizing antibodies against human rotavirus in paired serum specimens obtained from 38 infants within 12 days of the onset of diarrhea. Thirty of the infants excreted rotavirus in stools, and eight did not. Nine patients (30%) with rotavirus diarrhea and seven patients (88%) with diarrhea due to other causes had detectable levels (greater than or equal to 1: 80) of immunoglobulin (IgG) common antibodies in acute-phase sera. All the patients with rotavirus diarrhea showed at least fourfold rises in titers of IgG or IgM common antibodies or both, while only two control patients showed significant rises in either IgG or IgM common antibodies in their convalescent-phase sera. Of the 19 patients excreting "short" electropherotypes of rotavirus, 18 showed at least fourfold rises in titers of neutralizing antibodies against serotype 2 human rotavirus but not against serotype 1, 3, or 4. Nine of the ten patients excreting "long" electropherotypes showed significant rises in neutralizing antibodies against serotype 3, and the other patient showed a significant rise in neutralizing antibodies against serotype 1. One patient excreted long and short electropherotypes simultaneously, and he also showed a significant rise in neutralizing antibodies against serotype 2 and 3 viruses. The control patients with diarrhea did not show significant changes in titers of antibodies against any of the serotypes. These results demonstrated that the neutralizing antibody response within 2 weeks after clinical onset is specific for the infecting serotype of rotavirus.

Occurrence of rotaviruses in Guangzhou and Hong Kong.

Electropherotypes of human rotavirus (HRV) isolated from Hong Kong and Guangzhou were compared to study the transmission of HRV between the cities. Forty-one electropherotypes were identified from 418 hospitalized patients with HRV infection at the Queen Mary Hospital, and 22 were detected from 66 outpatients in community clinics at a separate area in Hong Kong. Nineteen electropherotypes were detected in 370 hospitalized cases of HRV infection from seven hospitals in Guangzhou. Results showed that HRV electropherotypes appeared to circulate freely within each area, yet the HRV population between the two cities remained different. Six electropherotypes were common to both cities. Three of these were predominant types found in Guangzhou and later detected in Hong Kong. One of these was found to cause an outbreak in Hong Kong. Of the remaining three electropherotypes, two were detected in both cities simultaneously, whereas one was first detected in Hong Kong.