ABSTRACT
AIM: The role of uric acid as a risk factor for cardio-cerebrovascular diseases is controversial. In this study, we aimed to investigate the relationship between serum uric acid level and the risk of cardio-cerebrovascular events in middle-aged and non-obese Chinese men. METHODS: We included 3152 participants from the health examination center of Tongji Hospital from June 2007 to June 2010. Clinical examination and medical records were collected at the annual health examination. The hazard ratios (HRs) of uric acid for cardio-cerebrovascular events were calculated by Cox proportional hazards models. Generalized additive model and threshold effect analysis were used to explore the non-linear relationship between serum uric acid level and the incidence of cardio-cerebrovascular event. RESULT: The mean follow-up time was 52 months. When the participants were classified into four groups by the serum acid quarter (Q1-Q4), the HRs (95% CI) of Q2-Q4 for cardio-cerebrovascular events were 1.26 (0.83, 1.92), 1.97 (1.33, 2.91) and 2.05 (1.40, 3.01), respectively, compared with the reference (Q1). The actual incidence and conditional incidence of cardio-cerebrovascular events in the high serum acid group were higher than those in the low serum acid group, which were stratified by the turning point (sUA = 372 µmol/L). We also showed a strong prognostic accuracy of the multiple variable-based score in 3 years and 5 years, with area under the receiver operating characteristic (ROC) curve of 0.790 (0.756-0.823) and 0.777 (0.749-0.804), respectively. CONCLUSION: Serum uric acid level is a strong risk factor for cardio-cerebrovascular events.
Subject(s)
Asian People , Cardiovascular Diseases/blood , Cardiovascular Diseases/epidemiology , Cerebrovascular Disorders/blood , Cerebrovascular Disorders/epidemiology , Uric Acid/blood , Adult , Age Factors , Biomarkers , Cardiovascular Diseases/mortality , Cerebrovascular Disorders/mortality , China/epidemiology , Comorbidity , Follow-Up Studies , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Prevalence , Proportional Hazards Models , ROC Curve , Risk FactorsABSTRACT
OBJECTIVE: To compare the efficacy of istradefylline (20 mg/day, 40 mg/day) and repetitive transcranial magnetic stimulation (rTMS) (1 Hz, 10 Hz) as an adjunct therapy to levodopa in the treatment of Parkinson's disease (PD). METHODS: A total of 132 PD patients from China were randomly assigned to receive 20 mg/day istradefylline plus sham-rTMS (Group I), 40 mg/day istradefylline plus sham-rTMS (Group II), placebo plus 1 Hz rTMS (Group III) and placebo plus 10 Hz rTMS (Group IV) for 12 weeks. Unified Parkinson's Disease Rating Scale (UPDRS) part III score was the primary outcome. Clinical Global Impression-Global Improvement (CGI-I) was the secondary outcome. The change in daily off time in Groups I and II was also recorded. RESULTS: After 12 weeks of treatment, the changes in UPDRS part III score were -6.05, -6.39, -5.91 and -6.46 for Groups I, II, III and IV, respectively, and the difference was not significant. The difference in CGI-I among the four groups was not significant. The daily off time was reduced by -1.43 hours in Group I and -1.62 hours in Group II. No severe adverse events occurred among the four groups. CONCLUSION: These results indicate that, as augmentation agents to levodopa in the treatment of PD, istradefylline and rTMS had comparable efficacy and tolerability.
Subject(s)
Levodopa/therapeutic use , Parkinson Disease/therapy , Purines/therapeutic use , Transcranial Magnetic Stimulation/methods , Aged , China , Female , Humans , Levodopa/administration & dosage , Male , Middle Aged , Parkinson Disease/drug therapy , Purines/administration & dosage , Treatment OutcomeABSTRACT
The aim of this study was to investigate the temporal and spatial relationship between phospho-Rb (ser 795) and neuronal apoptotic death in rats subjected to transient focal cerebral ischemia. We found increased phosphorylation of Rb and translocation from neuronal nucleus to cytoplasm in the penumbra zone at 12 h, 1 day, 3 days and 7 days after middle cerebral artery occlusion (MCAO)/reperfusion, compared with sham-operated controls. At 12 h and 1 day, phospho-Rb appeared to be colocalizated with TUNEL staining in neurons, but staining was not colocalizated at 3 days and 7 days. These results demonstrated that cytoplasmic translocation of phospho-Rb from nucleus of neurons occurs in potential apoptotic neurons in the early stages of ischemia/reperfusion, suggesting that the Rb pathway may only be involved in early neuronal apoptosis and may be not an apoptotic signal in the late stages of transient cerebral ischemia.
