Bei Shao

Neutrophil-to-Lymphocyte Ratio Is a Prognostic Marker in Acute Ischemic Stroke

BACKGROUNDnNeutrophil-to-lymphocyte ratio is an independent predictor of mortality in patients with acute ischemic stroke. However, it is uncertain whether neutrophil-to-lymphocyte ratio is related with functional outcome and recurrent ischemic stroke. In this study, we aimed to investigate the relationship of neutrophil-to-lymphocyte ratio with stroke severity, functional outcome, and recurrent ischemic stroke after acute ischemic stroke.nnnMETHODSnA total of 280 patients with acute ischemic stroke were included in the study. Patients were divided into 3 groups according to the neutrophil-to-lymphocyte ratio value (<2, 2-3, >3). Demographic, clinical, and laboratory data were collected for all patients. We evaluated the association between neutrophil-to-lymphocyte ratio and (1) stroke severity on admission, (2) functional outcome at 3 months, and (3) recurrent ischemic stroke. Regression analyses were performed, adjusting for confounders.nnnRESULTSnAfter adjustment for potential confounders, neutrophil-to-lymphocyte ratio was associated with an increased risk of stroke severity on admission (odds ratio [OR] 1.364, 95% confidence interval [CI] 1.101-1.690, Pu2009=u2009.005) and primary unfavorable outcome (OR 1.455, 95% CI 1.083-1.956, Pu2009=u2009.013). After a median of 1.13 years (interquartile range.91-1.42) of follow-up, neutrophil-to-lymphocyte ratio was associated with recurrent ischemic stroke after adjustment (hazard ratio 1.499, 95% CI 1.161-1.935, Pu2009=u2009.002).nnnCONCLUSIONSnOur study suggests that neutrophil-to-lymphocyte ratio is associated with stroke severity on admission, primary unfavorable functional outcome, and recurrent ischemic stroke in patients with acute ischemic stroke.

Association Between Serum Levels of Vitamin D and the Risk of Post-Stroke Anxiety

AbstractLow levels of serum vitamin D are common in patients with mood disorders and stroke. It has been shown that low levels of serum vitamin D indicate a risk of depression in post-stroke subjects. Our aim was to determine the relationship between vitamin D and post-stroke anxiety (PSA).A consecutive series of 226 first acute ischemic stroke patients were recruited and followed up for 1 month. Serum levels of vitamin D were measured within 24u200ahours of admission. Patients with significant clinical symptoms of anxiety and a Hamilton anxiety scale score >7 were diagnosed as having PSA. In addition, 100 healthy subjects were recruited as controls and underwent measurements of serum vitamin D.A total of 60 patients (26.55%) showed anxiety at 1 month. Both PSA patients and non-PSA patients had lower serum levels of vitamin D than healthy subjects. A significant relationship was found between PSA and serum levels of vitamin D. Low serum levels of vitamin D (⩽38.48u200anmol/L) were independently associated with the development of PSA (OR: 2.49, 95% CI: 1.21–5.13, Pu200a=u200a0.01).Serum vitamin D status is related to the occurrence of anxiety in post-stroke patients and may be an independent risk factor of PSA after 1 month.

Serum brain-derived neurotrophic factor levels and psychotic symptoms in heroin dependence

OBJECTIVESnPsychotic symptoms are commonly observed among heroin users. Low serum brain-derived neurotrophic factor (BDNF) levels have been reported in schizophrenia and psychosis; however, studies assessing the relationship between serum BDNF levels and psychotic symptoms in heroin dependence are lacking.nnnMETHODnA total of 31 heroin-dependent patients who had never experienced psychotic symptoms during heroin consumption and 21 patients with a history of psychotic symptoms were consecutively recruited. We measured by enzyme-linked immunosorbent assay (ELISA) serum BDNF levels during early abstinence. A gender- and age-matched sample of healthy controls was also recruited and underwent measurement of BDNF.nnnRESULTSnBDNF levels were significantly lower in patients with psychotic symptoms than in those without psychotic symptoms (P<0.001). BDNF levels were not found to be correlated with sex, age, age of onset, duration of heroin use, average daily dose of heroin use, frequency of heroin use, SDS scores, BAI scores and BDI scores in the psychotic subsamples (all P>0.05).nnnCONCLUSIONSnOur findings suggest that heroin-dependent patients with psychotic symptoms share some of the neurotrophic insult that characterizes schizophrenia and psychosis.

Does Prior Antiplatelet Treatment Increase the Risk of Hemorrhagic Transformation and Unfavorable Outcome on Day 90 after Intravenous Thrombolysis in Acute Ischemic Stroke Patients

BACKGROUNDnThe effect of prior antiplatelet (AP) therapy on the risk of hemorrhagic transformation (HT), and on functional outcomes of acute ischemic stroke (AIS) after intravenous thrombolysis (IVT), is not known. We performed a retrospective analysis to determine whether history of AP therapy is associated with post-thrombolysis HT and poor prognosis in AIS patients.nnnMETHODSnData pertaining to 145 patients with AIS, who underwent IVT between October 2008 and January 2015, were analyzed. The patients were divided into 2 groups based on whether or not they had received prior AP therapy. Neurological outcomes at 24u2009hours and 3 months after IVT therapy were assessed. Intergroup difference in cost of treatment was also evaluated. A multivariate logistic regression model was used to identify independent predictors of post-thrombolysis HT.nnnRESULTSnAmong 145 patients, 23 (15.8%) had received prior AP therapy. On multivariate analyses, older age (odds ratio [OR]: 1.084; confidence interval [CI], 1.028-1.144) and prior AP therapy (OR: 3.318; CI, 1.172-9.398) were found to be independent predictors of HT.nnnCONCLUSIONnIn this study, prior AP therapy was independently associated with post-thrombolysis HT in AIS.

Three-year prognosis of first-ever primary pontine hemorrhage in a hospital-based registry

Our aim was to evaluate the mortality rate of primary pontine hemorrhage (PPH) and to determine the factors related to the prognosis. Limited data exist on the long-term prognosis and determinants of death in patients with PPH in China. Our study analyzed consecutive cases of first-ever PPH from April 2007 to March 2011 in a hospital-based stroke registry. Mortality rates during 30 day and 3 year follow-ups were analyzed. We used the Kaplan-Meier method to estimate the event rates and binary logistic regression analysis, and Cox proportional hazard regression analysis to identify predictors of short-term and long-term prognosis, respectively. A total of 76 patients were identified, 44 (57.89%) were men. Both 30 day and 3 year overall mortalities in men were higher than women but this different was not statistically significant. Coma on admission, hematoma ⩾ 4 mL and a massive hemorrhage were significantly related to 30 day mortality of PPH. Multivariate Cox proportional hazard regression revealed that coma on admission (hazard ratio [HR] 2.18; 95% confidence interval [CI] 1.16-4.13; p = 0.02) and hematoma ⩾ 4 mL (HR 2.23; 95% CI 1.25-3.96; p = 0.01) were independent predictors of 3 year mortality. In conclusion, the short-term mortality rate and factors related to the prognosis of Chinese patients with PPH are similar to those reported for other populations. A low Glasgow coma scale score on admission and a large hematoma volume may be related to poor 3 year prognosis after PPH.

Leukoaraiosis is Associated with Worse Short-Term Functional and Cognitive Recovery after Minor Stroke

Whether leukoaraiosis burden retards short-term recovery after minor stroke is unclear. We investigated the association between leukoaraiosis and early recovery of neurological function after a first minor ischemic stroke in 217 acute stroke patients (National Institutes of Health Stroke Scale (NIHSS) score ≤5). Leukoaraiosis severity was graded according to the Fazekas scale and categorized into none to mild (0–2; n = 143) or severe (3–6; n = 74) groups. NIHSS and Minimum Mental State Examination (MMSE) were assessed at baseline and at 30 days. Univariate analysis revealed that the severe leukoaraiosis group was older in age (P < 0.001) and had fewer low MMSE patients than non-mild group at baseline (39.1% vs 55.9%, P = 0.003). However, the MMSE improved in none to mild group but not in the severe group at 30-day (15.4% vs 36.5%, P < 0.001). At 30-day, the severe leukoaraiosis group had higher NIHSS scores than the none-mild group (P = 0.04). Multiple linear regression analyses demonstrated that leukoaraiosis severity and admission NIHSS were independently associated with the NIHSS score on day 30 (P = 0.034, 95% CI 0.004–0.091 and P = 0.001, 95% CI 0.011–0.04). Binary regression analyses showed that leukoaraiosis severity and admission MMSE were significantly associated with MMSE (dichotomized) at 30-day (OR 2.1, P < 0.01, 95% CI 1.7–2.6 and OR 5.1, P < 0.01, 95% CI 2.1–12.8). Leukoaraiosis burden is an independent predictor of worse short-term functional and cognitive recovery after a minor ischemic stroke.

Role of sLOX-1 in intracranial artery stenosis and in predicting long-term prognosis of acute ischemic stroke

The role of sLOX‐1 in acute ischemic stroke still remains unclear. This study aims to demonstrate the value of sLOX‐1 in evaluating degrees of intracranial artery stenosis and to predict prognosis in stroke.

The value of the bulbocavernosus reflex and pudendal nerve somatosensory evoked potentials in distinguishing between multiple system atrophy and Parkinson's disease at an early stage

This study was designed to investigate the clinical value of the bulbocavernosus reflex (BCR) and pudendal nerve somatosensory evoked potentials (PSEPs) in the differential diagnosis between multiple system atrophy (MSA) and Parkinsons disease (PD) in early stage.

Correlation of Changes in Leukocytes Levels 24 Hours after Intravenous Thrombolysis With Prognosis in Patients With Acute Ischemic Stroke

OBJECTIVEnLeukocytes play a crucial role in inflammation and immune response. This study aims to demonstrate the value of changes in leukocytes levels 24 hours after intravenous thrombolysis to predict prognosis in acute ischemic stroke (AIS).nnnMETHODSnFrom Jan 2016 to Oct 2017, the patients who suffered AIS to our center within 4.5 hours of symptom onset were all treated with recombinant tissue-type plasminogen activator. Data from 213 AIS patients were analyzed. Patients were divided into 4 groups: persistent leukocytosis (PL), transient leukocytosis (TL), leukocytosis 24 hours (L24H) and no leukocytosis (NL). By comparison, the factors with statistically significant were selected in pairwise multiple comparisons. Good clinical outcome was defined as the Modified Rankin Scale score of 2 or lower. Multivariate logistic regression was used to assess the association of the indicators with clinical outcome.nnnRESULTSnBy pairwise multiple comparisons, PL and L24H had higher baseline National Institutes of Health Stroke Scale (NIHSS) score than NL and were likely to lead poor clinical outcomes. TL had a better prognosis than L24H. As the results of multivariable analyses shown, PL and L24H were risk factors to poor functional outcomes (odds ratio [OR] = 2.668, 95% confidence interval [CI] = 1.139-6.249, P = .024; ORu202f=u202f6.648, 95%CIu202f=u202f2.048-21.584, P = .002).nnnCONCLUSIONnPersistent leukocytosis and leukocytosis 24 hours both had higher baseline NIHSS scores, more serious stroke and were more likely to lead to unfavorable outcome. Therefore, changes in leukocytes levels 24 hours after intravenous thrombolysis could be predicted the short-term functional outcome of AIS patients.

Modulation of CaMKIIa-GluN2B interaction in levodopa-induced dyskinesia in 6-OHDA-lesioned Parkinson’s rats

Long-term treatment with L-dopa leads to involuntary aimless movements called L-dopa-induced dyskinesia (LID) has hindered its use in Parkinsons disease (PD) patients. Emerging evidence suggests a possible role of CaMKIIa and its interacting partners in the development of LID. In this study, we found that CaMKIIa was found to form complexes with GluN2B after chronic administration of L-dopa in adult rat striatal neurons. Intrastriatal injection of KN-93 significantly reduced the level of GluN2B in CaMKIIa precipitates with a dose dependent response, as well as reduced the Global ALO AIM score without ablation of the therapeutic response to L-dopa. In parallel, intrastriatal injection of MK-801 significantly alleviated the level of CaMKIIa in GluN2B precipitates compared to LID group (pu2009<u20090.01), and this is accompanied by realizing improvement of the Global ALO AIM score also without affect the efficacy of L-dopa. In summary, the present study indicated that CaMKIIa-GluN2B interaction had an important role in the development of LID. Disrupt of this link by intrastriatal infusion of KN-93 or MK-801 ameliorated dyskinesia in 6-OHDA-lesioned PD rats.