Novel Predictors of Stroke-Associated Pneumonia: A Single Center Analysis.

Stroke-associated pneumonia (SAP) is a common cause of disability or death. Although the researches on SAP have been relatively mature, the method that can predict SAP with great accuracy has not yet been determined. It is necessary to discover new predictors to construct a more accurate predictive model for SAP. We continuously collected 2,366 patients with acute ischemic stroke, and then divided them into the SAP group and non-SAP group. Data were recorded at admission. Through univariate analyses and multivariate regression analyses of the data, the new predictive factors and the predictive model of SAP were determined. The receiver operating characteristic (ROC) curve and the corresponding area under the curve (AUC) were used to measure their predictive accuracy. Of the 2,366 patients, 459 were diagnosed with SAP. International normalized ratio (INR) (odds ratio = 37.981; 95% confidence interval, 7.487-192.665; P < 0.001), age and dysphagia were independent risk factors of SAP. However, walking ability within 48 h of admission (WA) (odds ratio = 0.395; 95% confidence interval, 0.287-0.543; P < 0.001) was a protective factor of SAP. Different predictors and the predictive model all could predict SAP (P < 0.001). The predictive power of the model (AUC: 0.851) which included age, homocysteine, INR, history of chronic obstructive pulmonary disease (COPD), dysphagia, and WA was greater than that of age (AUC: 0.738) and INR (AUC: 0.685). Finally, we found that a higher INR and no WA could predict SAP in patients with acute ischemic stroke. In addition, we designed a simple and practical predictive model for SAP, which showed relatively good accuracy. These findings might help identify high-risk patients with SAP and provide a reference for the timely use of preventive antibiotics.

[Effect of electroacupuncture intervention on N-methyl-D-aspartic acid receptor expression in spinal cord in rats with chronic constrictive injury of the sciatic nerve].

UNLABELLED: OBJECTIVE; To observe the changes of N-methyl-D-aspartic acid (NMDA) receptor expression of spinal cord after electroacupuncture (EA) intervention in rats with chronic constrictive injury (CCI) of the sciatic nerve so as to reveal the mechanism underlying improvement of neuropathic pain. METHODS: Sixty male SD rats were randomly divided into sham operation (sham) group, CCI model group and EA group (n = 20). CCI model was established by ligature of the right sciatic nerve with a piece of surgical chromic suture. For rats of the sham group, the right sciatic nerve was just isolated without ligature. The rats of the EA group were given with EA stimulation of "Weizhong" (BL 40) and "Huantiao" (GB 30) on the injured side at a frequency of 2 Hz, electric current of 1-3 mA for 30 min (increasing 1 mA every 10 min). The treatment was conducted once a day from the 11th day to the 20th day after modeling. NMDA receptor 2 B subunit (NR 2 B) protein and mRNA expression levels in the spinal cord were determined by immunohistochemistry, Western blot and reverse transcription (RT)-polymerase chain reaction (PCR), respectively, and spinal NMDA receptor subunit 1 (NR 1) protein and mRNA expression levels were measured by Western blot and RT-PCR, respectively. RESULTS: In comparison with the sham group, NR 1 protein and mRNA expression levels of the model group in the spinal cord were considerably upregulated after CCI (P < 0.01, P < 0.05). In comparison with the model group NR 1 protein and mRNA expression levels of the EA group in the spinal cord were evidently down-regulated (P < 0.05). No significant changes of NR 2 B protein and mRNA expression after CCI and EA stimulation were found after immunohistochemistry, Western blot and RT-PCR measurements (P > 0.05). CONCLUSION: EA intervention is effective in alleviating neuropathic pain in CCI rats, which may be closely related to its effects in lowering functional activity of NR 1 protein and mRNA in the spinal cord.

FoxO1 regulates muscle fiber-type specification and inhibits calcineurin signaling during C2C12 myoblast differentiation.

Adult skeletal muscle fibers can be categorized into slow-oxidative and fast-glycolytic subtypes based on specialized metabolic and contractile properties. The Forkhead box O1 (FoxO1) transcription factor governs muscle growth, metabolism, and cell differentiation, and has been shown to be involved in regulating muscle fiber type specification. However, to date, the mechanism behind FoxO1-mediated fiber type diversity is still unclear. In this article, FoxO1 being expressed preferentially in fast twitch fiber enriched muscles is reported. Moreover, the autors also detected that FoxO1 expression decreased in both fast and slow muscles from mice undergoing endurance exercise which induced a fast-to-slow fiber type transition. Using C2C12 myoblast, constitutively active FoxO1 mutant altered the proportion of muscle fiber type composition toward a fast-glycolytic phenotype and attenuated calcineurin phosphatase activity. In addition, a transcriptionally inactive FoxO1 by resveratrol triggered the expression of genes related to slow-oxidative muscle but not sufficient to induce a complete slow fiber transformation. Taken together, these results suggest that FoxO1 up-regulates fast fiber-type formation and down-regulates muscle oxidative capacity at least in part through inhibition of the calcineurin pathway.

[Effects of heavenly stem-prescription of point selection of needling methods of Ziwu Liuzhu on ischemic cerebrovascular diseases].

OBJECTIVE: To observe effects of heavenly stem-prescription of point selection of the needling methods of midnight-noon ebb-flow on motorial and neurological functional deficit of ischemic cerebrovascular diseases. METHODS: The patients were randomly divided into a Ziwu Liuzhu group and a channel acupoint selection group. In the channel acupoint selection group, Jianyu (LI 15), Quchi (LI 11), Waiguan (TE 5), Zusanli (ST 36) were selected, combined with selected acupoints by syndrome differentiation. In the Ziwu Liuzhu group, on the basis of the channel acupoint selection group, according to the principle "the acupoints of the yang-channel were opened at yang-day-yang-hour and the acupoints of the yin-channel were opened at yin-day-yin-hour", and acupoints were selected by the day-hour acupoint-opening method of the Ziwu Liuzhu Najia method in Zhenjiu Daquan. The patients in the both groups began to be treated at the Chen hour (7:00-9:00) or Si hour (9:00-11:00) in the morning, 10 times constituting one course. They were treated for 3 courses. Improvement of the motor function symptom cumulative score, Fugl-Meyer (FMA) and improvement of neurological functional deficit were investigated. RESULTS: The FMA score (36.13 +/- 21.80) after treatment was significantly lower than (73.50 +/- 21.53) before treatment (P<0.01) in the Ziwu Liuzhu group, and (54.43 +/- 20.89) after treatment was significantly lower than (62.27 +/- 22.91) before treatment (P<0.05) in the channel acupoint selection group; the neurological functional deficit score (15.40 +/- 9.34) after treatment was significantly lower than (27.17 +/- 10.81) before treatment in the Ziwu Liuzhu group, and (23.97 +/- 1.30) was lower than (27.97 +/- 7.72) before treatment in the channel acupoint selection group. After treatment, FMA and the neurological functional scores significantly improved in the Ziwu Liuzhu group as compared with those in the channel acupoint selection group (P<0.05). CONCLUSION: Ziwu Liuzhu Najia point-selection method can effectively improve both nervous function and motor function in the patient of ischemic cerebrovascular disease.