Sesquiterpenoid-Chromone Heterohybrids from Agarwood of Aquilaria sinensis as Potent Specific Smad3 Phosphorylation Inhibitors.

Aquilarines A (1) and B (2), two unprecedented sesquiterpenoid-chromone heterohybrids, were isolated from Aquilaria sinensis agarwood. 1 is an alkaloid featuring an unusual pyridine nucleus, and 2 possesses a rare sesquiterpenoid-chromone skeleton via a C-C bond. A plausible biosynthetic pathway for 1 and 2 was proposed. Both 1 and 2 could significantly inhibit the expression of extracellular matrix components, and α-SMA at low concentrations in TGF-ß1 induced two types of kidney cells (NRK 52E and NRK 49F) featuring selective inhibition of Smad3 instead of Smad2 phosphorylation, showing their potential in renal fibrosis.

COVID-19-Associated Acute Brain Dysfunction Related to Sepsis.

In global term, as of November 30, 2020, over 30 million people has been infected by a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and more than 10,000,000 of them died of acute organ failure. Our reviews have shown that coronavirus disease 2019 (COVID-19) patients with pneumonia and acute respiratory distress syndrome (ARDS) have life-threatening acute brain dysfunction (ABD), ranging from altered mental status/delirium to stupor/coma. Altered mental status/delirium was the most common manifestation of ABD caused by severe COVID-19. The prevalence of altered mental status and/or delirium was up to 66-79.5%, and prevalence of coma was 10%. The most common clinical type of COVID-19-associated ABD was COVID-19-associated acute stroke including ischemic and hemorrhagic stroke (n > 350 cases), followed by COVID-19-associated encephalopathy (n > 200 cases), and COVID-19-associated central nervous system (CNS) infection (n > 70 cases). According to the Sepsis-3 criteria, we confess that severe COVID-19-associated ABD with ARDS and altered mental status is related to sepsis. Moreover, we also review the diagnosis and treatment of COVID-19-associated ABD with sepsis. In view of the fact that COVID-19 is at the peak of epidemic worldwide, we hope that this review will provide evidence of COVID-19 sepsis threating to the brain dysunction. Thus, recognizing the COVID-19-associated ABD related to sepsis is very important for early empirical combination therapy to survive severe COVID-19.

Acute spontaneous intracerebral hemorrhage and traumatic brain injury are the most common causes of critical illness in the ICU and have high early mortality.

BACKGROUND: Critical care covers multiple disciplines. However, the causes of critical illness in the ICU, particularly the most common causes, remain unclear. We aimed to investigate the incidence and the most common causes of critical illness and the corresponding early mortality rates in ICU patients. METHODS: A retrospective cohort study was performed to examine critically ill patients (aged over 15 years) in the general ICU in Shuyang County in northern China (1/2014-12/2015). The incidences and causes of critical illnesses and their corresponding early mortality rates in the ICU were determined by an expert panel. RESULTS: During the 2-year study period, 1,211,138 person-years (PY) and 1645 critically ill patients (mean age, 61.8 years) were documented. The median Glasgow Coma Scale (GCS) score was 6 (range, 3-15). The mean acute physiology and chronic health evaluation II (APACHE II) score was 21.2 ± 6.8. The median length of the ICU stay was 4 days (range, 1-29 days). The most common causes of critical illness in the ICU were spontaneous intracerebral hemorrhage (SICH) (26%, 17.6/100,000 PY) and traumatic brain injury (TBI) (16.8%, 11.4/100,000 PY). During the first 7 days in the ICU, SICH was the most common cause of death (42.2%, 7.4/10,000 PY), followed by TBI (36.6%, 4.2/100,000 PY). Based on a logistic analysis, older patients had a significantly higher risk of death from TBI (risk ratio [RR], 1.7; 95% CI, 1.034-2.635), heart failure/cardiovascular crisis (RR, 0.2; 95% CI, 0.083-0.484), cerebral infarction (RR, 0.15; 95% CI, 0.050-0.486), or respiratory failure (RR, 0.35; 95% CI, 0.185-0.784) than younger patients. However, the risk of death from SICH in the two groups was similar. CONCLUSIONS: The most common causes of critical illness in the ICU were SICH and TBI, and both critical illnesses showed a higher risk of death during the first 7 days in the ICU.

The "bad" cholesterol can predict abnormal apolipoprotein B levels in a large unselected outpatient cohort.

BACKGROUND: The significant association between total cholesterol (TC), non-high-density lipoprotein cholesterol (non-HDL), and low-density lipoprotein cholesterol (LDL) has been shown to be associated with Apolipoprotein B (Apo B). The objective of this study was to assess whether abnormal levels of TC, non-HDL and LDL can be used as predictors of abnormal serum Apo B levels. RESULTS: TC (r = 0.752), non-HDL (r = 0.799), and LDL(r = 0.817) were significantly positively correlated with Apo B. Areas under the curve of TC, non-HDL, and LDL for predicting abnormal Apo B (>1.10 g/L) were 0.906, 0.918, and 0.928, respectively. The optimal thresholds of prediction of abnormal Apo B were 5.13 mmol/L for TC, 4.23 mmol/L for non-HDL, and 3.34 mmol/L for LDL. At these optimal thresholds of TC, non-HDL and LDL, less than 1.13%, 1.67%, and 0.62% of tests with abnormal Apo B results would have been missed, but approximately 69.4%, 79.7%, and 73.2% of the performed Apo B tests could have been eliminated, respectively. CONCLUSIONS: Apo B levels of unselected outpatients need be not tested (especially when LDL < 3.34 mmol/L, non-HDL < 4.23 mmol/L, and/or TC < 5.13 mmol/L). It will result in 69% reduction in number of ordered Apo B tests. LDL was significantly better than the TC and non-HDL for predicting abnormal Apo B indicating that Apo B needn't tested when LDL level is normal. METHODS: We retrospectively analyzed results of TC, HDL, LDL, and Apo B in a large cohort of unselected outpatients (n = 5486) in Shuyang People's Hospital, Shuyang, China. Non-HDL was calculated by deducting HDL from TC. Correlations between TC, non-HDL, LDL, and Apo B were analyzed by using Spearman's rho approach. Receiver operating characteristics curve analysis was used to evaluate the predictive value of TC, non-HDL, and LDL for abnormal Apo B.

No Awakening in Supratentorial Intracerebral Hemorrhage Is Potentially Caused by Sepsis-Associated Encephalopathy.

BACKGROUND Acute supratentorial intracerebral hemorrhage (sICH) with secondary sepsis is increasing in frequency. We investigated whether no awakening (NA) after sICH with coma is potentially caused by sepsis-associated encephalopathy (SAE). MATERIAL AND METHODS A case-control study of 147 recruited sICH cases with NA and 198 sICH controls with subsequent awakening (SA) was performed at 2 centers in China. All patients underwent brain computed tomography (CT) scans on admission. The odds ratio (OR) of NA was calculated using logistic regression. RESULTS During the study period, 56.5% (83/147) of the patients with sICH with coma and NA had SAE, and 10% (20/198) with sICH with coma and SA had SAE; this difference between the 2 groups was significant (p<0.000). The sICH patients with coma and NA exhibited a longer median time from onset to coma (2.0 days vs. 0.5 days), more frequent confirmed infection (98.0% vs. 24.2%), and a higher Sequential Organ Failure Assessment (SOFA) score (6.3±1.5 vs. 3.4±0.8). These patients also exhibited lower hematoma volume (28.0±18.8 vs. 38.3±24), a lower initial National Institutes of Health Stroke Scale score (19.5±6.6 vs. 30.3±6.8), more frequent brain midline shift (59.2% vs. 27.8%), more frequent diffuse cerebral swelling (64.6% vs. 16.0%), and higher 30-day mortality (54.4% vs. 0.0%) than the patients who did awaken. Logistic multivariable regression analyses revealed that only a higher SOFA score (OR, 1.4; 95% CI, 1.079-1.767; p=0.010) and SAE (OR, 4.0; 95% CI, 1.359-6.775; p=0.001) were associated with NA events in patients with sICH. CONCLUSIONS NA in sICH patients with coma is potentially caused by secondary SAE.

Neuroanatomical circuitry between kidney and rostral elements of brain: a virally mediated transsynaptic tracing study in mice.

The identity of higher-order neurons and circuits playing an associative role to control renal function is not well understood. We identified specific neural populations of rostral elements of brain regions that project multisynaptically to the kidneys in 3-6 days after injecting a retrograde tracer pseudorabies virus (PRV)-614 into kidney of 13 adult male C57BL/6J strain mice. PRV-614 infected neurons were detected in a number of mesencephalic (e.g. central amygdala nucleus), telencephalic regions and motor cortex. These divisions included the preoptic area (POA), dorsomedial hypothalamus (DMH), lateral hypothalamus, arcuate nucleus (Arc), suprachiasmatic nucleus (SCN), periventricular hypothalamus (PeH), and rostral and caudal subdivision of the paraventricular nucleus of the hypothalamus (PVN). PRV-614/Tyrosine hydroxylase (TH) double-labeled cells were found within DMH, Arc, SCN, PeH, PVN, the anterodorsal and medial POA. A subset of neurons in PVN that participated in regulating sympathetic outflow to kidney was catecholaminergic or serotonergic. PRV-614 infected neurons within the PVN also contained arginine vasopressin or oxytocin. These data demonstrate the rostral elements of brain innervate the kidney by the neuroanatomical circuitry.

Neuroanatomical Circuitry between Kidney and Rostral Elements of Brain: a Virally Mediated Transsynaptic Tracing Study in Mice / 华中科技大学学报（医学）（英德文版）

The identity of higher-order neurons and circuits playing an associative role to control renal function is notwell understood.We identified specific neural populations of rostral elements of brain regions that project multisynaptically to the kidneys in 3~ days after injecting a retrograde tracer pseudorabies virus (PRV)-614 into kidney of 13 adult male C57BL/6J strain mice.PRV-614 infected neurons were detected in a number of mesencephalic (e.g.central amygdala nucleus),telencephalic regions and motor cortex.These divisions included the preoptic area (POA),dorsomedial hypothalamus (DMH),lateral hypothalamus,arcuate nucleus (Arc),suprachiasmatic nucleus (SCN),periventricular hypothalamus (PeH),and rostral and caudal subdivision of the paraventricular nucleus of the hypothalamus (PVN).PRV-614/Tyrosine hydroxylase (TH) double-labeled cells were found within DMH,Arc,SCN,PeH,PVN,the anterodorsal and medial POA.A subset of neurons in PVN that participated in regulating sympathetic outflow to kidney was catecholaminergic or serotonergic.PRV-614 infected neurons within the PVN also contained arginine vasopressin or oxytocin.These data demonstrate the rostral elements of brain innervate the kidney by the neuroanatomical circuitry.

Risk factors for nosocomial nontraumatic coma: sepsis and respiratory failure.

BACKGROUND: Coma's are a major cause of clinical deterioration or death. Identification of risks that predispose to coma are important in managing patients; however, the risk factors for nosocomial nontraumatic coma (NNC) are not well known. Our aim was to investigate the risk factors in patients with NNC. METHODS: A retrospective case-control design was used to compare patients with NNC and a control group of patients without coma in a population-based cohort of 263 participants from the neurological intensive care unit in Shuyang County People's Hospital of Northern China. Coma was diagnosed by a Glasgow Coma Scale score ≤8. Adjusted odds ratios for patients with NNC were derived from multivariate logistic regression analyses. RESULTS: A total of 96 subjects had NNC. The prevalence of NNC was 36.5% among the subjects. Among these, 82% had acute cerebrovascular etiology. Most of the NNC usually occurred at day 3 after admission to the neurological intensive care unit. Patients with NNC had higher hospital mortality rates (67.7% vs 3%, P<0.0001) and were more likely to have a central herniation (47.9% vs 0%, P<0.001) or uncal herniation (11.5% vs 0%, P<0.001) than those without NNC. Multiple logistic regression showed that systemic inflammatory response syndrome-positive sepsis (odds ratio =4, 95% confidence interval =1.875-8.567, P<0.001) and acute respiratory failure (odds ratio =3.275, 95% confidence interval =1.014-10.573, P<0.05) were the factors independently associated with a higher risk of NNC. CONCLUSION: Systemic inflammatory response syndrome-positive sepsis and acute respiratory failure are independently associated with an increased risk of NNC. This information may be important for patients with NNC.

Metabolic Syndrome Is a Strong Risk Factor for Minor Ischemic Stroke and Subsequent Vascular Events.

BACKGROUND: Minor ischemic stroke (MIS) represents a major global public health problem worldwide due to high incidence. The aim of this study was to investigate whether metabolic syndrome (MetS) is a strong risk for MIS and subsequent vascular events (SVE). METHODS: A retrospective cohort study was performed examining symptomatic MIS in a Chinese neurologic outpatient population aged over 25 years without history of stroke. MetS was defined using the International Diabetes Federation criteria. MIS was diagnosed by magnetic resonance imaging-diffusion weighted images or fluid-attenuated inversion recovery. RESULTS: Of 1361 outpatients, a total of 753 (55.3%) patients were diagnosed with MIS; of them, 80% had a score of 0 using the MIS had a 0 score on the National Institutes of Health Stroke Scale. Among these, 303 (40.2%) individuals with MIS were diagnosed with MetS. Diagnosed of MIS with MetS significantly correlated with abdominal obesity (30.7% v.s 18.0%), hypertension (91.1% v.s 81.6%), increased blood glucose (6.9±2.4 v.s 5.0±0.4), dyslipidemia (78.2% v.s 48.2%), and SVE (50.5% v.s 11.3%) when compared with the controls group. On adjusted analysis, the risk of SVE was also significantly associated with three additional MetS criterion (RR,9.0; 95% CI, 5.677-14.46). Using Cox proportional analysis, risk of SVE in patient with MIS was significantly associated with MetS (RR, 3.3; 95% CI, 1.799-6.210), older age (RR, 1.0; 95% CI, 1.001-1.048), and high blood glucose (RR,1.1; 95%CI, 1.007-1.187). CONCLUSIONS: The MetS is a strong risk factor for MIS, and patients presenting with MIS and MetS are at a high risk of SVE. Further studies are required to determine the improvement of Mets prevention in the reduction of MIS and SVE.

Establishing Reference Intervals of Aspartate Aminotransferase-to-Platelet Ratio Index for Apparently Healthy Elderly.

BACKGROUND: Aspartate aminotransferase (AST) to platelet ratio index (APRI) serves as a parameter in evaluating liver fibrosis in current clinical practice. However, reference standard (reference intervals, RIs) or baseline levels of APRI have not been previously reported. The purpose of this paper is to establish the reference intervals of APRI in apparently healthy elderly people from the region of Shuyang, China. METHODS: Blood specimens were collected from local elderly residents (selected 51,263 elderly Han Shuyang Chinese from 65 to 97 years old, 32.97% males and 67.03% females) by standard procedures. Complete blood counts were determined by Sysmex XE-2100 analyzer and the AST values were measured by a TBA2000FR automatic biochemical analyzer (Toshiba Co., Ltd., Japan). The 95% reference intervals were calculated by using the non-parametric method according to the document: Defining, Establishing, and Verifying Reference Intervals in the Clinical Laboratory; Approved Guideline-Third Edition (C28-A3) of CLSI. RESULTS: RIs established for healthy elderly include: 0.1398-0.6266 for males and 0.1282-0.5798 for females (0.1284-0.5086 for 65-74 years old; 0.1209-0.5704 for > or = 75 years old). Ris of APRI for elderly males were higher than those of females, and values of APRI increased with increasing age for females. CONCLUSIONS: We established scientific and reasonable RIs of APRI for the healthy elderly in our region.

Transient and persistent symptoms in patients with lacunar infarction: results from a prospective cohort study.

BACKGROUND: The transient symptoms with lacunar infarction (TSI) and persistent symptoms with lacunar infarction (PSI) are the most common forms of symptomatic lacunar infarction (LI). The aim of this study was to compare the differences in TSI and PSI of symptomatic LI. METHODS: A prospective cohort study was conducted in the neurologic outpatients of the tertiary teaching hospital in Northern China between February 2011 and February 2012. The TSI and PSI in participants aged 35 years or over were assessed. Patients were followed up and their outcomes were compared. RESULTS: Of the 453 symptomatic outpatients, 251 patients with LI were diagnosed by magnetic resonance imaging. Approximately 77.3% (194/251) of the patients with LI at this time had TSI. and the remaining 23.7% had PSI. After the adjusted odds ratios, only middle age (risk ratio [RR], 1.1; 95% confidence interval [CI], 1.157-1.189), lower National Institutes of Health Stroke Scale score (RR, 20.6; 95% CI, 6.705-13.31), smaller lacunae on brain images (RR, 2.9; 95% CI, 1.960-4.245), and LI frequently in the anterior circulation territory (RR, 0.2; 95% CI, 0.079-0.721) were independently associated with TSI. During a mean follow-up of 6 months, survival rate was significantly higher among patients with TSI than among those with PSI (log rank, 6.9; P=0.010); estimated unadjusted incidence of vascular subsequent events (30.9% vs 54.4%, P=0.001) was significantly lower in TSI than in PSI. CONCLUSION: The TSI has a higher prevalence and is associated with a lower risk of vascular subsequent events and death than PSI. The implications of these findings for TSI and PSI may require different interventions.

Early prediction and outcome of septic encephalopathy in acute stroke patients with nosocomial coma.

BACKGROUND: Septic encephalopathy (SE) is the most common acute encephalopathy in ICU; however, little attention has been focused on risk of SE in the course of acute stroke. Our aim is to investigate the early prediction and outcome of SE in stroke patients with nosocomial coma (NC). METHODS: A retrospective cohort study was conducted in an ICU of the tertiary teaching hospital in China from January 2006 to December 2009. Ninety-four acute stroke patients with NC were grouped according to with or without SE. Risk factors for patients with SE were compared with those without SE by univariate and multivariate analysis. RESULTS: Of 94 stroke patients with NC, 46 (49%) had NC with SE and 48 (51%) had NC without SE. The onset-to-NC time was significant later in stroke patients with SE than those without SE (P < 0.01). There was a significant difference in body temperature, heart rate, respiratory rate, white blood cell (WBC), systolic blood pressure (SBP), diastolic blood pressure (DBP), systemic inflammatory response syndrome (SIRS), acute respiratory failure, septic shock, hypernatremia, and sequential organ failure assessment (SOFA) score between the SE and non-SE group (P < 0.05). On a repeat head imaging, vasogenic edema (P = 0.023) and subcortical white matter lesions (P = 0.011) were significantly higher in patients with SE than those without SE, while hematoma growth (P = 0.000), infarction progress (P = 0.003), and recurrent subarachnoid hemorrhage (SAH) (P = 0.011) were significantly lower in patients with SE than those without SE. Patients with SE had higher adjusted rates of fever ≥ 39 °C (odds ratio (OR): 2.753; 95% confidence interval (CI): 1.116 - 6.794; P = 0.028) and SIRS ≥ 3 items (OR: 6.459; 95% CI: 2.050 - 20.351; P = 0.001). The 30-day mortality in stroke patients with SE was higher than those without SE (76.1% vs. 45.8%, P = 0.003). CONCLUSION: High fever and severe SIRS are two early predictors of stroke patients with SE, and survival rates were worse in stroke patients with SE than those without SE.

Reference intervals for total bilirubin, ALT, AST and creatinine in healthy Chinese elderly.

BACKGROUND: The aim of this study was to establish the reference intervals (RIs) of total bilirubin (TBIL), alanine aminotransferase (ALT), aspartate transaminase (AST), and creatinine (CREA) for apparently healthy elderly (Han ethnicity) in Shuyang, China. MATERIAL AND METHODS: A total of 54 912 blood specimens from elderly residents age 65-104 years were collected by standard procedures in Shuyang county of Jiangsu province. TBIL, ALT, AST, and CREA for each participant were determined by automatic biochemical analyzer. Distribution and differences of TBIL, ALT, AST, and CREA were analyzed and compared between the elderly of the same age of different sexes and different ages of the same sex. RIs of TBIL, ALT, AST, and CREA were compared with the current RIs. The RIs and 95% confidence intervals were calculated using nonparametric method (2.5th-97.5th percentiles) according to the guideline of the Clinical and Laboratory Standards Institute. RESULTS: RIs established for the healthy elderly include: TBIL 7.8~30.6 µmol/L for males and 7.3~26.1 µmol/L for females; ALT 8.7~47.3 U/L for males and 8.4~45.2 U/L for females; AST 15.7~46.9 U/L for males and 15.1~46.2 U/L for females; and CREA 45.1~100.9 µmol/L for males and 38.7~85.0 µmol/L for females. Reference intervals of TBIL, ALT, AST, and CREA for male elderly were higher than those of females, and values of CREA increased with increasing age. CONCLUSIONS: We have established a panel of locally relevant RIs. It is necessary to establish scientific and reasonable RIs of TBIL, ALT, AST, and CREA for the healthy elderly in our region, which will provide a reference for clinicians and inspection officers.

Remote ischemic postconditioning protects against gastric mucosal lesions in rats.

AIM: To investigate the protective effects of remote ischemic postconditioning (RIP) against limb ischemia-reperfusion (IR)-induced gastric mucosal injury. METHODS: Gastric IR was established in male Wistar rats by placing an elastic rubber band under a pressure of 290-310 mmHg on the proximal part of both lower limbs for 3 h followed by reperfusion for 0, 1, 3, 6, 12 or 24 h. RIP was performed using three cycles of 30 s of reperfusion and 30 s of reocclusion of the femoral aortic immediately after IR and before reperfusion for up to 24 h. Rats were randomly assigned to receive IR (n = 36), IR followed by RIP (n = 36), or sham treatment (n = 36). Gastric tissue samples were collected from six animals in each group at each timepoint and processed to determine levels of malondialdehyde (MDA), superoxide dismutase (SOD), xanthine oxidase (XOD) and myeloperoxidase (MPO). Additional samples were processed for histologic analysis by hematoxylin and eosin staining. Blood samples were similarly collected to determine serum levels of lactate dehydrogenase (LDH), creatine kinase (CK), tumor necrosis factor (TNF)-α and interleukin (IL)-10. RESULTS: The pathologic changes in gastric tissue induced by IR were observed by light microscopy. Administration of RIP dramatically reduced the gastric damage score after 6 h of reperfusion (5.85 ± 0.22 vs 7.72 ± 0.43; P < 0.01). In addition, RIP treatment decreased the serum activities of LDH (3.31 ± 0.32 vs 6.46 ± 0.03; P < 0.01), CK (1.94 ± 0.20 vs 4.54 ± 0.19; P < 0.01) and the concentration of TNF-α (53.82 ± 0.85 vs 88.50 ± 3.08; P < 0.01), and elevated the concentration of IL-10 (101.46 ± 5.08 vs 99.77 ± 4.32; P < 0.01) induced by IR at 6 h. Furthermore, RIP treatment prevented the marked elevation in MDA (3.79 ± 0.29 vs 6.39 ± 0.81) content, XOD (7.81 ± 0.75 vs 10.37 ± 2.47) and MPO (0.47 ± 0.05 vs 0.82 ± 0.03) activities, and decrease in SOD (4.95 ± 0.32 vs 3.41 ± 0.38; P < 0.01) activity in the gastric tissue as measured at 6 h. CONCLUSION: RIP provides effective functional protection and prevents cell injury to gastric tissue induced by limb IR via anti-inflammatory and antioxidant actions.

Laboratory reference intervals of complete blood count for apparently healthy elderly people in Shuyang, China.

BACKGROUND: Currently, there are no appropriate RIs of blood cells available for the elderly in most clinical laboratories in China. The aim of this study is to establish the RIs of complete blood cell count for apparently healthy elderly people. METHODS: Blood specimens were collected from elderly residents by standard procedures. Complete blood counts were determined by Sysmex XE-2100 analyzer. The RIs and 95% confidence intervals were calculated by the robust method recommended by CLSI C28-A3 guideline. RESULTS: RIs established for healthy elderly include: total WBC 3.63 - 10.3 x 10(9)/L for males and 3.64 - 10.3 x 10(9)/L for females; RBC 3.74 - 5.49 x 10(12)/L for males and 3.74 - 5.53 x 10(12)/L for females; Hb 109 - 167 g/L for males and 109 - 168 g/L for females; HCT 36.0 - 51.8% for males and 35.7 - 51.8% for females; MCV 86.0 - 105 fL for males and 86.2 - 106 fL for females; MCH 26.4 - 33.6 pg for males and 26.4 - 33.8 pg for females; MCHC 293 - 333 g/L for males and 291 - 335 g/L for females; RDW-SD 39.3 - 53.7 fL for males and 39.6 - 54.5 fL for females; RDW-CV 11.7 - 15.1% for males and 11.7 - 15.2% for females; PLT 122 - 355 x 10(9)/L for males and 122 - 350 x 10(9)/L for females; PCT 14.1 - 37.6 x 10(-1) mL/L for males and 13.9 - 37.9 x 10(-1) mL/L for females; MPV 11.3 - 15.5 fL for males and 11.3 - 15.5 fL for females; PDW 9.74 - 17.0% for males and 9.72 - 17.0% for females; platelet-LCR (P-LCR) 21.3 - 51.2% for males and 21.1 - 51.4% for females. CONCLUSIONS: We established scientific and reasonable RIs of blood cell analysis for the healthy elderly in our region.

Hemorrhagic pure sensory strokes in the thalamus and striatocapsular area: causes, clinical features and long-term outcome.

BACKGROUND: Although there have been sporadic reports of patients with hemorrhagic pure sensory strokes (HPSS) in the thalamus and striatocapsular areas, the causes, clinical featuring and long-term outcome have not been adequately investigated. METHODS: We recruited 7 consecutive patients without hemiparetic stroke who had HPSS in the thalamic and striatocapsular areas. A CT scan was performed to verify brain imaging patterns, and their causes, clinical featuring and long-term outcome were observed. RESULTS: We studied 7 patients who had HPSS in the thalamic and striatocapsular areas as seen in CT scans. The 7 patients had hypertension, and small hemorrhages were found in the thalamus of 2 patients and in the posterior quarter of the posterior limb of the internal capsule in 4 patients; only 1 patient had a microhemorrhage in the thalamus. The volume of the hemorrhages ranged from 0.3 to 6.3 ml, with a mean of 2.3 ± 1.9 ml. Three patients showed a decreased sense of spinothalamic modality, and position and vibration senses were spared. Four patients showed a sensory deficit of both spinothalamic and medial lemniscal type. The outcomes were excellent and without post-stroke pain in all patients. CONCLUSION: HPSS in the thalamus and striatocapsular area are usually small hemorrhages or microhemorrhages from rupturing of the microvessels or the branches of small vessels. HPSS only have an impact on the adjacent sensory nucleus or pathway, and have a good outcome without post-stroke pain.