Research advances in transcranial Doppler ultrasonography for cerebral hemodynamic assessment after endovascular treatment in acute anterior circulation large artery occlusion / 中风与神经疾病杂志

@#Endovascular therapy （EVT） can significantly improve the prognosis of patients with acute large artery occlusion （LAO）， but still half of the patients cannot achieve functional independence. Transcranial Doppler ultrasonography （TCD） is a non-invasive， convenient， and highly reproducible means of cerebral hemodynamic examination. Recent studies have shown that TCD monitoring of hemodynamics is of value in predicting the occurrence of cerebral hyperperfusion syndrome in patients with acute anterior circulationLAO， monitoring vascular recanalization， vasospasm，cerebral autoregulation，and collateral circulation， and assessing long-term prognosis to improve clinical therapeutic strategies. This review focuses on the application of TCD in cerebral hemodynamic monitoring after EVT in patients with LAO.

Expression pattern of MMP-12 in long-term optic nerve regeneration induced by lens injury / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the expression changes of MMP-12 during the long-term axon regeneration induced by the lens injury after the optic nerve clamp trauma in sprague-dawley(SD)rats.METHODS: The optic nerve injury model and lens injury model of SD rats were established, and the 24 experimental animals were divided into control group; lens injury group; optic nerve injury group; lens injury combined with optic nerve injury group, with 6 rats in each group. Reference transcriptome sequencing was used to analyze the expression changes of differentially expressed genes in the injured optic nerve region, and relevant differentially expressed genes with high expression were screened. Quantitative real-time polymerase chain reaction(qRT-PCR)and enzyme-linked immunosorbent assay(ELISA)were used to quantify the expression changes of matrix metalloproteinase-12(MMP-12)in the injured optic nerve region.RESULTS: The Principal Component Analysis of transcriptome sequencing indicated that lens injury combined with optic nerve injury was the principal component of gene expression change. Analysis of gene expression differences showed that the expression of MMP-12 gene was up-regulated in the lens injury combined with optic nerve injury group. The mRNA expression level of MMP-12 in the lens injury combined optic nerve injury group was up-regulated compared with the control group, the optic nerve injury group and the lens injury group at 14d and 21d after successful modeling(P<0.05). At 7, 28d, there was no difference in expression among all groups. The protein expression level of MMP-12 in the lens injury combined with optic nerve injury group was up-regulated compared with the control group and optic nerve injury group at 7, 14 and 21d after successful modeling(P<0.05), and it was up-regulated in the lens injury group combined with optic nerve injury group compared with optic nerve injury group at 21d(P<0.05). At 28d, there was no difference in expression among all groups.CONCLUSION: The up-regulated expression of MMP-12 may be involved in the long-term regeneration of the optic nerve after lens injury.

Influence of collateral circulation evaluated by CT perfusion imaging in infarction progression and prognoses of patients with acute ischemic stroke before and after thrombectomy / 中华神经医学杂志

Objective:To investigate the influence of collateral circulation evaluated by CT perfusion (CTP) imaging in infarction progression and clinical prognoses of patients with acute large-artery occlusion of the anterior circulation before and after thrombectomy.Methods:One hundred and ten patients with acute large-artery occlusion of the anterior circulation within 24 h of onset, admitted to our hospital from May 2018 to September 2019, were chosen in our study; all patients completed thrombectomy; their clinical data were analyzed retrospectively. Regional leptomeningeal collateral-temporally fused maximum intensity projection (rLMC-tMIP) was used to evaluate the collateral circulation based on 4D-CT angiography (4D-CTA). According to the core infarct volume in CTP imaging and the diffusion weighted imaging (DWI) results of MR within one week of surgery, the progressive infarct volume was calculated. Modified Rankin scale (mRS) was used to evaluate the prognoses of these patients 3 months after surgery.Results:(1) There were 56 patients with good collateral circulation and 54 patients with poor collateral circulation. Age ( OR=0.951, 95%CI: 0.910-0.993, P=0.023), cardiac dysfunction ( OR=0.116, 95%CI: 0.018-0.731, P=0.022), baseline fasting blood glucose ( OR=0.788, 95%CI: 0.646-0.961, P=0.019), wakefulness stroke ( OR=0.093, 95%CI: 0.023-0.380, P=0.001), and site of vascular occlusion ( OR=7.604, 95%CI: 2.650-21.821, P=0.000) were independent influencing factors for collateral circulation. (2) Scores of rLMC-tMIP ( 95%CI: -2.947- -1.474, P=0.000), volume of ischemic penumbra ( 95%CI: 0.065-0.126, P=0.000), scores of edema in the brain tissues ( 95%CI: 2.952-7.600, P=0.000), hemorrhage transformation ( 95%CI: 8.966-23.114, P=0.000), and 24 h NIHSS scores ( 95%CI: 0.606-1.248, P=0.000) were independent influencing factors for volume of progressive infarction. (3) There were 59 patients having good prognosis and 51 patients having poor prognosis. Hemorrhage transformation ( OR=0.019, 95%CI: 0.001-0.275, P=0.004) and progressive infarction volume ( OR=0.824, 95%CI: 0.756-0.897, P=0.000) were independent influencing factors for prognoses of patients with acute large-artery occlusion of the anterior circulation after thrombectomy. Conclusion:The scores of rLMC-tMIP based on 4D-CTA can well predict the infarction volume in patients with acute large-artery occlusion of the anterior circulation within 24 h of onset, which can effctively evaluate the clinical prognoses of the patients.

Efficacy and safety of dual antiplatelet therapy guided by thromboelastography / 中华神经医学杂志

Objective:To analyze the efficacy and safety of dual antiplatelet therapy guided by thromboelastography (TEG).Methods:One hundred and nine patients with ischemic cerebrovascular diseases, admitted to and accepted dual antiplatelet therapy in our hospital from August 2020 to April 2021, were enrolled in this study. TEG test was completed 3-5 d after treatment, and clopidogrel gene test was completed during hospitalization. According to the results of adenosine diphosphate (ADP) inhibition rate in TEG, they were divided into high-efficiency group, moderate efficiency group and low efficiency group. No medication change was recommended for patients in the high-efficiency group, but medication changes were recommended for patients in the moderate efficiency group and low efficiency group; differences of National Institutes of Health Stroke Scale (NIHSS) scores, efficacies and safety were recorded in these 3 groups after drug adjustment.Results:The proportion of patients with coronary heart disease in moderate efficiency group was statistically higher than that in high-efficiency group and low efficiency group ( P<0.05). Six patients in the high-efficiency group switched to use aspirin and cilostazol; 28 in the moderate efficiency group and 14 patients in the low efficiency group were disinclined to change their medications and continued to use aspirin+clopidogrel. In patients from the high-efficiency group, the overall incidence of new stroke and in-stent restenosis in patients without changing medications (1/39) was lower than that in patients with changing medications (1/6); in patients from the moderate efficiency group, that in patients without changing medications (6/28) was higher than that in patients with changing medications (1/9); in patients from the low efficiency group, that in patients without changing medications (3/14) was higher than that in patients with changing medications (0/13). In patients with slow metabolism from high-efficiency group, the overall incidence of new stroke and in-stent restenosis in patients without changing medications (2/3) was higher than that in patients with changing medications (1/2). Conclusions:Dual antiplatelet therapy guided by TEG can reduce clinical adverse events without increasing the risk of bleeding. For patients with ADP inhibition rate>70% and clopidogrel genotype (slow metabolism), clopidogrel replacement can further improve efficacy.

Profiling of HAT1-mediated Lysine Acetylation Modification in Liver Cancer / 中国生物化学与分子生物学报

Lysine acetylation has emerged as one of the most important post-translational modifications that participates in various biological and pathological processes. Histone acetyltransferase 1 (HAT1) as the first identified protein ε-amino lysine acetyltransferase is able to regulate the acetylation of histones and non-histone proteins. However‚ the acetylation substrates and sites mediated by HAT1 in liver cancer are poorly understood. In this study‚ we demonstrated that HAT1 was highly expressed in the liver cancer tissues‚ which was negatively associated with the prognosis of patients. Based on the establishment of the HAT1-knockout HepG2 cell line‚ we employed a quantitative proteomics approach to study the profiling of acetylation mediated by HAT1 in HepG2 cells. Interestingly‚ we identified a total of 858 Kac sites on 547 proteins in the HepG2 cell line‚ in which HAT1 mediated the levels of Kac of 74 sites on 68 proteins. The pathways and metabolic processes that were affected by HAT1-dependent acetylation modification were analyzed by bioinformatics. The results show that Kac regulates disease development‚ RNA biology‚ spliceosome and nucleosome assembly‚ oxidative stress‚ various signaling pathways and metabolic pathways‚ etc.. Moreover‚ we verified that the HAT1-mediated acetylation modification could promote abnormal lipid metabolism. CCK8 assays‚ clone formation and Edu assays revealed that HAT1 could remarkably enhance the cell proliferation of liver cancer in vitro. Thus‚ our finding explored the profiling of HAT1-mediated protein acetylation in HepG2 cells‚ which provides new insights into the underlying mechanism by which HAT1 mediates the development of liver cancer. Clinically‚ the HAT1-mediated acetylation sites could be used for the precise targets of drug development.

Clinical outcomes of vocal fold immobility after tracheal intubation / 北京大学学报(医学版)

OBJECTIVE@#To assess the incidence of postoperative vocal cord immobility in patients following endotracheal intubation underwent general anesthesia.@*METHODS@#We retrospectively enrolled patients who underwent surgical procedures with endotracheal intubation under general anesthesia from January 2014 to December 2018 in Peking University First Hospital. Demographic and treatment data were obtained for patients with hoarseness and vocal cord fixation. The incidence of postoperative hoarseness and vocal cord fixation were presented and clinical outcomes were further analyzed.@*RESULTS@#A total of 85 998 patients following tracheal intubation and general anesthesia were enrolled in this study. Hoarseness was observed in 222 (0.26%) patients postoperatively. Sixteen patients (73%) were accomplished with symptoms of choking on water, dysphonia and sore throat. Twenty-nine patients with persistent hoarseness on the third postoperative day needed further treatment by otolaryngologists. Among them, seven patients had pharyngolaryngitis and twenty-two patients (0.026%) were demonstrated postoperative vocal cord immobility. There were seventeen patients (77%) with left-side vocal cord fixation and five patients (23%) with right-side vocal cord fixation. Nine patients were identified with arytenoid dislocation. Seven patients had left vocal cord fixation and two patients had right-side vocal cord fixation. Seven patients were intubated under the guidance of visual laryngoscope. One patient was confirmed difficult airway and intubated with light wand. One patient was inserted with laryngeal mask airway. One patient was suspected to have hoarseness caused by gastric tube before anesthesia. One patient showed simultaneously left recurrent laryngeal nerve abnormality on laryngeal electromyography result. The symptom of hoarseness ranged between 6 and 31 days. Three patients underwent closed reduction under local anesthesia and one patient demonstrated spontaneous recovery. Among the remaining thirteen patients with vocal cord immobility, two patients were demonstrated vocal cord paralysis. Eleven patients underwent neck surgery, thyroid surgery and cardiothoracic surgery and further examinations including laryn-geal electromyography and computed tomography help to determine the diagnosis were not performed. All patients were treated with inhaled corticosteroid conservatively. Five patients had significant improvement of symptom and almost regained normal voice. One patient had slight improvement and sixteen patients were not relieved before discharge.@*CONCLUSION@#Patients with hoarseness and vocal fold immobility after endotracheal intubation should be treated properly and immediately.

Efficacy and safety of endovascular recanalization 6-24 h after onset in patients with acute basilar artery occlusion / 中华神经医学杂志

Objective To investigate the efficacy and safety of endovascular recanalization 6-24 h after onset in patients with acute basilar artery occlusion,and explore the related factors for their prognoses.Methods Clinical data of 37 patients with acute basilar artery occlusion,received endovascular recanalization in our hospital from January 2016 to July 2019,were retrospectively collected;23 patients were into group of onset-to-puncture time (OPT)＞6 h (6-24 h),and 14 patients were into group of OPT ≤ 6 h (0-6 h).Statistical methods were used to compare the postoperative symptomatic intracranial hemorrhage rate,good prognosis rate (modified Rankin scale [mRS] scores ≤ 3) and mortality 3 months after onset between the two groups;clinical data between the subgroups with good and poor prognoses in patients of group of OPT＞6 h were compared.Results The postoperative symptomatic intracranial hemorrhage rate,and good prognosis rate and mortality of patients from group of OPT＞6 h were 30.4％,47.8％ and 43.5％,respectively;and there were no statistically significant differences as compared with those in patients from group of OPT≤6 h (35.7％,35.7％,and 42.9％,P＞0.05).Scores of scales based on preoperative CTA images (posterior circulation-Alberta stroke program early CT scale [pc-ASPECTS],scale of posterior circulation on CTA [pc-CTA],and scale of basilar artery on CTA [BATMAN]) showed significant differences between the good prognosis subgroup and poor prognosis subgroup in patients fiom group of OPT＞6 h (P＜0.05).Conclusion Endovascular recanalization 6-24 h after onset is effective in patients with acute basilar artery occlusion,and the safety does not obviously decrease;scores of pc-ASPECTS,pc-CTA and BATMAN may be related to the clinical prognoses.

An improved association analysis pipeline for tumor susceptibility variant in haplotype amplification area / 南方医科大学学报

OBJECTIVE@#Haplotype amplification on germline variants is suggested to imply potential selective advantages and clonal expansion susceptibility and has become an important signature for seeking cancer susceptibility gene.Here we propose an improved association method that fully considers the haplotype amplification status.@*METHODS@#The haplotype amplification status was estimated by the variant allelic frequencies.We adopted a permutation test on variant allelic frequencies to divide the candidate variants into multiple groups.A likelihood clustering method was then applied to establish the neighborhood system of the hidden Markov random field framework.A filtering pipeline was introduced into the proposed method to further refine the candidate variants, including a Wilson's interval filter and a false discovery rate controller.The final candidate set along with the haplotype amplification status was collapsed into the weighted virtual sites for association tests.@*RESULTS@#Through simulated tests on a series of datasets, we compared the type Ⅰ error rates of different minor allele frequencies, which stably fell within 2%, suggesting good robustness of the algorithm.In addition, we compared another 5 published association approaches for Type-Ⅰ and Type-Ⅱ error rates with the proposed method, which resulted in the error rates all within 2%, demonstrating significant advantages and a good statistical ability of the proposed method.@*CONCLUSIONS@#The proposed method can accurately identify tumor susceptibility variants in haplotype amplification area with good robustness and stability.

Association of degrees of leukoaraiosis severity with prognoses of patients with acute anterior circulation large-artery occlusive stroke after mechanical thrombectomy / 中华神经医学杂志

Objective To assess whether degrees of leukoaraiosis (LA) severity is associated with prognoses of patients with acute anterior circulation large-artery occlusive stroke after mechanical thrombectomy.Methods Clinical data of patients with acute anterior circulation large-artery occlusive stroke who underwent mechanical thrombectomy in our hospital from January 2016 to August 2017 were collected. The subjects were divided into non-to-moderate LA group and severe LA group according to preoperative degrees of LA severity; the baseline data, successful reperfusion rate, and symptomatic intracranial hemorrhage rate within 24 h of surgery, good prognosis rate 90 d after surgery (modified Rankin scale [mRS] scores≤2) and mortality 90 d after surgery were analyzed. According to the prognoses, the patients were divided into good prognosis group and poor prognosis group; univariate regression analysis and multivariate Logistic regression analysis were used to evaluate the relations of degrees of LA severity with prognoses 90 d after surgery.Results In these 146 patients, 100 patients were into the non-to-moderate LA group and 46 patients were into the severe LA group. As compared with patients in the non-to-moderate LA group, patients in the severe LA group had significantly older age (70.50 [59.75, 79.75] yearsvs. 79 [73, 82] years), significantly higher baseline NIHSS scores (20 [16, 25])vs. 22 [18, 28]), significantly higher rate of symptomatic intracranial hemorrhage 24 h after surgery (11.0％ [11/100])vs. 26.1％ [12/46]), statistically higher mortality rate 90 d after surgery (14.0％[14/100]) vs. 14.0％ [14/46]), significantly lower successful reperfusion rate (97.0％ [97/100]vs. 84.8％ [39/46]), and statistically lower good prognosis rate (54.0％ [54/100]vs. 21.7％ [10/46],P<0.05). Among the 146 patients, 64 had good prognosis and 82 had poor prognosis; univariate analysis showed that as compared with than those from the good prognosis group, patients from the poor prognosis group had significantly older age (70.50 [59.75, 79.75] years oldvs. 79 [73, 82] years old) and statistically higher baseline NIHSS scores (20 [16, 25]vs. 22 [18, 28]), and significantly higher proportion of central source embolism by TOAST etiology classification (68.8％ [44/64]vs. 76.8％[63/82]) and proportion of severe LA (15.6％ [10/64]vs. 43.9％ [36/82],P<0.05); multivariate Logistic regression analysis showed that severe LA (OR=3.109, 95％CI: 1.241-7.788,P=0.015), age, baseline NIHSS scores, and TOAST etiology classification were all independent risk factors for poor prognosis 90 d after surgery (P<0.05). ConclusionSevere LA may be associated with poor prognosis of patients with acute anterior circulation large-artery occlusive stroke after mechanical thrombectomy.

Recent advance in correlation between imaging evaluation before endovascular treatment of acute basilar artery occlusion and clinical prognoses / 中华神经医学杂志

Acute basilar artery occlusion (ABAO) has a high rate of disability and mortality, and the key to its treatment is to start reperfusion therapy as early as possible. A number of retrospective studies have found that the good prognosis rate of endovascular treatment of ABAO is related to number of infarction locus, extent of ABAO, vascular occlusion and collateral circulation. Screening patients through imaging evaluation before endovascular treatment may further improve the rate of favorable outcome. This article reviews research progress on the correlation between imaging evaluation before endovascular treatment of ABAO and clinical prognoses.

Mechanistic advancement in chemotherapeutic agents modulated antitumor immune response / 药学学报

Chemotherapeutic agents, also known as cytotoxic anticancer agents, inhibit the cancer cell proliferation via interrupting DNA replication, transcription and microtubule stability etc. Chemotherapeutic agents have been used in clinical cancer treatment for decades. Recently, with the tremendous advancement in immuno-oncology, chemotherapeutic agents have aroused renewed interest for their great potential to sensitize tumor cells to immunotherapy. Meanwhile, it is worth noting that the effects of chemotherapeutic agents on the immune system involve multiple aspects with complex mechanisms. Currently, there still lacks guidance for the combined use of chemotherapy and immunotherapy, and the clinical benefits remain obscure, impelling a better understanding of the impact of chemotherapeutic agents on the antitumor immunity. This article reviews the mechanistic insights into chemotherapy-modulated antitumor immune responses, with major focus on the direct effect on immune cells and the immunogenic remodeling of tumor cells. The review is particularly interested in the chemotherapy-trigged signaling that contributes to the immunogenic cell death. This review may provide useful insights into the immunomodulatory effects of chemotherapeutic agents and the implications in exploring therapeutic opportunities of chemotherapy in cancer immunotherapy.

Efficacy and safety of endovascular mechanical thrombectomy for acute basilar artery occlusions / 中华神经医学杂志

Objective To evaluate the efficacy and safety of endovascular thrombectomy for acute ischemic stroke due to basilar artery occlusion,and analyze the correlation between baseline clinical features and prognoses.Methods The clinical data of 27 patients with acute stroke due to basilar artery occlusion,admitted to and underwent emergency endovascular thrombectomy in our hospital from February 2016 to March 2017,were analyzed retrospectively.The re-canalization rate and complications were determined and the clinical outcomes were assessed.The correlation between clinical features and prognoses were analyzed.Results Successful re-canalization was achieved in 24 out of 27 patients (88.9 ％),and the mean time from onset to re-canalization was (418.92±223.96) min.Symptomatic intracerebral hemorrhage (SICH) was observed in 2 patients (7.4 ％) and mortality in the first 3 months was 29.6％ (8/27).At 3-month follow up,14 patients (51.8 ％) showed good prognosis (modified Rankin scale [mRS] scores≤＜2) and 13 had poor prognosis.Baseline NIHSS scores (23[12.5,33.8] vs.35[23,39]) and posterior circulation-Alberta Stroke Program Early CT Scale scores (9 [8,10] vs.7 [4,9]) between patients with good prognosis and poor prognosis were significantly different (Z=-2.043,P=0.041;Z=-2.387,P=0.017).Conclusions Endovascular thrombectomy can contribute to a high re-canalization rate and safety.Baseline clinical severity and collateral circulation compensation are associated with clinical prognosis.

Comparative study of efficacy and safety of direct thrombectomy and bridging therapy for acute large-vessel occlusion in anterior circulation stroke / 中华神经医学杂志

Objective To compare the efficacy and safety of direct thrombectomy and bridging therapy for acute large-vessel occlusion in anterior circulation stroke.Methods A retrospective study was performed on clinical data of 146 patients with anterior circulation large-vessel occlusion stroke who accepted direct thrombectomy in our hospital from March 2016 to July 2017;85 patients were in direct thrombectomy group and 61 patients were in bridging therapy group.The clinical characteristics,procedural complications and clinical outcomes between the two groups were compared.Results There were no significant differences between the two groups in age,gender,baseline National Institutes of Health Stroke Scale (NIHSS) scores,percentages of patients with hypertension,diabetes and atrial fibrillation,baseline blood glucose,platelet count,creatinine level,baseline systolic blood pressure,stroke etiology,occlusion site,and anesthesia methods (P＞0.05).There were no significant differences between the two groups in admission-to-CT time,admission-to-puncture time,puncture-to-re-canalization time,and admission-to-re-canalization time (P＞0.05).The successful reperfusion rate (91.8％ vs.95.1％),incidence of symptomatic intracranial hemorrhage (11.8％ vs.21.3％),favorable outcome rate 90 d after treatment (41.2％ vs.47.5％),and mortality (20.0％ vs.18.0％) were not significantly different between the two groups (P＞0.05).Conclusion The efficacy and safety of direct thrombectomy and bridging therapy are similar for acute large-vessel occlusion in anterior circulation stroke.

Effect of anesthesia selection on endovascular treatment for anterior circulation major vessel occlusion stroke / 中华神经科杂志

Objective To evaluate the effect of anesthesia selection on endovascular treatment for anterior circulation major vessel occlusion stroke. Methods The clinical data of patients undergoing endovascular treatment in our hospital from January 2016 to August 2016 were retrospectively reviewed. The patients were divided into general anesthesia group and conscious sedation group. Comparison of the differences in time, symptomatic intracranial hemorrhage, and 90-day functional outcome between the two groups was made. Results A total of 73 patients were included in the analysis, 34 (46.6％) in the general anesthesia group, and 39 (53.4％) in the conscious sedation group. The baseline clinical data were balanced in both groups. There was no statistically significant difference in door-to-puncture time, puncture-to-recanalization time and onset-to-recanalization time between the two groups. The postoperative systolic blood pressure was significantly decreased in the general anesthesia group ((126.29 ± 20.07) vs (139.95 ± 21.22) mmHg (1 mmHg=0.133 kPa), t=2.81, P=0.01), whereas the rate of successful reperfusion (modified thrombolysis in cerebral infarction ≥ 2b) (94.1％(32/34) vs 87.2％(34/39), χ2=0.33, P=0.57), symptomatic intracranial hemorrhage rate (17.6％(6/34) vs 10.3％(4/39), χ2=0.33, P=0.57) and good outcome (modified Rankin Scale (mRS) score≤2) at 90 days (41.2％(14/34) vs 53.8％(21/39),χ2=1.17, P=0.28) did not show statistically significant difference between the two groups. Conclusions The selection of general anesthesia or conscious sedation had no significant effect on the outcome of endovascular treatment for anterior circulation major vascular occlusion stroke. The results of the study still need to be verified by large-scale randomized controlled trial.

The prediction of recurrent cerebral infarction by the neovascularization grade of carotid plaque using contrast enhanced ultrasonography: a Logistic regression model analysis / 中华医学超声杂志（电子版）

Objective To evaluate the utility of neovascularization grade of carotid plaque using contrast enhanced ultrasonography in the prediction of recurrent cerebral infarction by Logistic regression model analysis. Methods Eight-nine patients with first cerebral infarction were studied by conventional and contrast enhanced ultrasonography, then the two-dimensional echoic grade and neovascularization grade of carotid plaque was assessed. The condition of recurrent cerebral infarction in next year was followed up. The independent risk and predictive factors of recurrent cerebral infarction were analyzed by Logistic regression model and the utility of the independent risk and predictive factors in the prediction of recurrent cerebral infarction was evaluated by ROC curve. Results Both two-dimensional echoic grade of carotid plaque (P=0.028) and neovascularization grade of carotid plaque (P=0.006) were the risk and predictive factors of recurrent cerebral infarction in single-factor Logistic regression model. However, only the neovascularization grade of carotid plaque was the independent risk and predictive factor in multiple-factor Logistic regression model (P=0.043) with an OR value of 1.916. The sensitivity and specificity of the neovascularization grade of carotid plaque in prediction of recurrent cerebral infarction (cut-off value>Ⅱ) were 67.74% and 70.69% respectively and the area under ROC curve was 0.684(95%CI:0.577~0.779,P=0.0017).Conclusion The neovascularization grade of carotid plaques on contrast enhanced ultrasonography is the independent risk and predictive factor in prediction of recurrent cerebral infarction.

The Predictive Value of Carotid Plaque Score for Evaluating the Severity of Coronary Artery Lesions / 中国循环杂志

Objective:To study the predictive value of carotid plaque score for evaluating the severity of coronary artery lesions.Methods:A total of 152 patients with coronary angiography diagnosed coronary artery disease (CAD) in our hospital from 2016-01 to 2016-05 were selected.According to coronary branch involvement,the patients were divided into 3 groups:Single branch lesion group,n=72,Double branch lesion group,n=38 and Multi branch lesion group,n=42.The basic conditions as plaque detection rate,high-density lipoprotein cholesterol (HDL-C),body mass index (BMI) were collected and carotid ultrasound examination was conducted in all patients.Carotid plaque condition and coronary lesion degree were calculated by semi-quantitative score and Gensini score methods;the relationship between semi-quantitative score and Gensini score was compared.Results:Total cholesterol (TC),HDL-C,LDL-C and BMI were similar among different groups,P＞0.05.Compared with Single branch lesion group,Double branch lesion group and Multi branch lesion group had more smokers and the higher plaque detection rate,P＜0.05.Semi-quantitative score and Gensini score were elevating as coronary lesion branch increasing accordingly.Conclusion:The severity of coronary lesions could be evaluated and predicted by semi-quantitative calculation of carotid integral.

The Predictive Value of Carotid Plaque Score for Evaluating the Severity of Coronary Artery Lesions / 中国循环杂志

Objective:To study the predictive value of carotid plaque score for evaluating the severity of coronary artery lesions.Methods:A total of 152 patients with coronary angiography diagnosed coronary artery disease (CAD) in our hospital from 2016-01 to 2016-05 were selected.According to coronary branch involvement,the patients were divided into 3 groups:Single branch lesion group,n=72,Double branch lesion group,n=38 and Multi branch lesion group,n=42.The basic conditions as plaque detection rate,high-density lipoprotein cholesterol (HDL-C),body mass index (BMI) were collected and carotid ultrasound examination was conducted in all patients.Carotid plaque condition and coronary lesion degree were calculated by semi-quantitative score and Gensini score methods;the relationship between semi-quantitative score and Gensini score was compared.Results:Total cholesterol (TC),HDL-C,LDL-C and BMI were similar among different groups,P＞0.05.Compared with Single branch lesion group,Double branch lesion group and Multi branch lesion group had more smokers and the higher plaque detection rate,P＜0.05.Semi-quantitative score and Gensini score were elevating as coronary lesion branch increasing accordingly.Conclusion:The severity of coronary lesions could be evaluated and predicted by semi-quantitative calculation of carotid integral.

Risk factors associated with retinal vein occlusion / 眼科新进展

Objective To perform a risk factor analysis of central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO),and compare the difference in risk factors between CRVO and BRVO.Methods Retrospective observational casecontrol study included 46 CRVO patients,33 BRVO patients and 79 control subjects with senile cataract or refractive error,the risk factors and blood lipid spectrum analysis were performed and compared.Results Multivariate linear regression analysis showed that higher serum levels of homocysteine (P ＜ 0.000 1),total cholesterol (P =0.003 0),lipoprotein (a) (P =0.027 0),hypertension (P =0.022 0) and shorter axial length (P ＜0.000 1) were significantly correlated with CRVO.BRVO was associated with higher serum levels of homocysteine (P ＜0.000 1),total cholesterol (P =0.008 0),hypertension (P =0.002 0),body mass index (P =0.004 0) and shorter axial length (P =0.001 0).There was no significant difference in risk factors between CRVO and BRVO patients on multivariate analysis.Conclusion Multiple systemic (hyperlipidemia,hypertension and hyperhomocystinemia) and ocular (shorter axial length) risk factors are associated with both CRVO and BRVO,but these risk factors are not different between CRVO and BRVO.

p22phox C242T gene polymorphism and overt diabetic nephropathy: a meta-analysis of 1,452 participants

BACKGROUND/AIMS: The p22phox C242T gene polymorphism (rs4673) may be linked to an increased susceptibility for overt diabetic nephropathy (ODN), but the study results are still inconclusive. METHODS: To explore the relationship between p22phox C242T gene polymorphism and ODN, the current meta-analysis of 707 ODN patients and 745 controls from five individual studies was conducted. The pooled odds ratio (OR) and its corresponding 95% confidence interval (CI) were evaluated by either a random or fixed effect model. RESULTS: In our meta-analysis, a significant relationship between the p22phox C242T gene polymorphism and ODN was found under allelic (OR, 2.760; 95% CI, 1.400 to 5.450; p = 0.004), recessive (OR, 5.080; 95% CI, 1.020 to 25.430; p = 0.05), dominant (OR, 1.700; 95% CI, 1.167 to 2.477; p = 0.006), homozygous (OR, 3.900; 95% CI, 1.022 to 14.889; p = 0.046), heterozygous (OR, 1.523; 95% CI, 1.167 to 1.986; p = 0.002), and additive genetic models (OR, 2.019; 95% CI, 1.232 to 3.309; p = 0.005). CONCLUSIONS: A positive correlation between p22phox C242T gene polymorphism and ODN risk was found. The T allele carriers of p22phox C242T gene polymorphism might be predisposed to ODN.

LPL gene Pvu II polymorphism and hypertriglyceridemia: a meta-analysis involving 1,640 subjects

BACKGROUND/AIMS: Although lipoprotein lipase (LPL) gene Pvu II polymorphism has been associated with an increased risk of hypertriglyceridemia (HT), there is no clear consensus within the scientific community. METHODS: A meta-analysis of 1,640 subjects from six individual studies was conducted to better elucidate the potential relationship between the LPL gene Pvu II polymorphism and HT within the Chinese population. Pooled odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were evaluated by using fixed effect models. RESULTS: Our analysis indicated a significant association between LPL gene Pvu II polymorphism and HT within the Chinese population under allelic (OR, 1.550; 95% CI, 1.320 to 1.830; p = 1.158 × 10-7), recessive (OR, 0.540; 95% CI, 0.390 to 0.750; p = 0.0002), dominant (OR, 1.889; 95% CI, 1.501 to 2.377; p = 5.960 × 10-8), homozygous (OR, 2.167; 95% CI, 1.531 to 3.067; p = 1.242 × 10-5), heterozygous (OR, 1.810; 95% CI, 1.419 to 2.309; p = 1.842 × 10-6), and additive genetic models (OR, 1.553; 95% CI, 1.320 to 1.828; p = 1.158 × 10-7). CONCLUSIONS: Because LPL gene Pvu II restriction fragment length polymorphism polymorphism was associated with an elevated risk of HT, the P+ allele carriers of the LPL gene might be predisposed to HT.