Stress-Induced Hyperglycemia and Remote Diffusion-Weighted Imaging Lesions in Primary Intracerebral Hemorrhage.

BACKGROUND AND PURPOSE: Stress-induced hyperglycemia (SIH) is the relative transient increase in glucose during a critical illness such as intracerebral hemorrhage (ICH) and is likely to play an important role in the pathogenesis of remote diffusion-weighted imaging (DWI) lesion (R-DWIL) in primary ICH. We sought to determine the association between SIH and the occurrence of R-DWILs. METHODS: We prospectively enrolled primary ICH patients within 14 days after onset from November 2016 to May 2018. In these patients, cerebral magnetic resonance imaging was performed within 14 days after ICH onset. R-DWIL was defined as a hyperintensity signal in DWI with corresponding hypointensity in apparent diffusion coefficient, and at least 20 mm apart from the hematoma. SIH was measured by stress-induced hyperglycemia ratio (SHR). SHR was calculated by fasting blood glucose (FBG) divided by estimated average glucose derived from glycosylated hemoglobin. The included patients were dichotomized into two groups by the 50th percentile of SHR, and named as SHR (-P50) group and SHR (P50+) group, respectively. We evaluated the association between SHR and R-DWIL occurrence using multivariable logistic regression modeling adjusted for potential confounders. RESULTS: Among the 288 patients enrolled, forty-six (16.0%) of them had one or more R-DWILs. Compared with the patients in the lower 50% of SHR (SHR [-P50]), the odds ratio (OR) [95% confidence interval (CI)] for the higher 50% of SHR (SHR [P50+]) group for R-DWIL occurrence was 3.13 (1.39-7.07) in the total population and 6.33 (2.19-18.30) in population absent of background hyperglycemia after adjusting for potential covariates. Similar results were observed after further adjusted for FBG. CONCLUSIONS: Our study demonstrated that SIH was associated with the occurrence of R-DWILs in patients with primary ICH within 14 days of symptom onset.

[Research progress of NADPH oxidases and their inhibitors].

NADPH oxidases (NOXs) are the key enzymes of redox signaling in vivo and also the main source of reactive oxygen species (ROS) in the body. ROS plays a role of double-edged sword. On the one hand, ROS, at the level of physiological amount, has the effect of immune defense and also acts as a second messenger involved in the regulation of cellular signaling pathways. On the other hand, excessive ROS can cause oxidative stress, leading to the disorder of cellular functions. Recently, studies showed that ROS plays an important role in acceleration of some pathological reactions such as inflammation, fibrosis and tumor formation. As a major source of ROS, NOX has become a popular target in treating oxidative stress, inflammation, fibrosis and tumor. Herein, the role of NOX in these pathological processes and the research progress of NOX inhibitors are reviewed.

[Clinical analysis of immune function and intestinal flora changes in patients with oral squamous carcinoma before and after treatment].

PURPOSE: To characterize the alterations of intestinal bacteria and immunological function in patients with oral squamous cell carcinoma(OSCC) before and after treatment. METHODS: From September 2020 to September 2021, 28 patients suffering OSCC and 10 healthy volunteers undergoing treatment at our hospital were enrolled in the study. Conventional treatment regimens were administered to OSCC patients and the changes in immune function, intestinal bacteria composition and short-chain fatty acids were measured 1 week before and 6 months after therapy. GraphPad Prism 9.0 software package was used for data analysis. RESULTS: Immunological function measurements indicated significantly lower levels of lymphocyte subsets (including CD3+, CD4+, NK, CD4+/CD8+) and immunoglobulins (including IgG, IgA, IgM) in the peripheral blood of OSCC patients before treatment compared to healthy volunteers (P<0.05), as well as remarkably lower levels of serum cytokines (including TNF-α、IL-4、IL-6) (P<0.05). Following 6 months of conventional treatment, there was an improvement in immune function in OSCC patients compared to all patients before treatment(P<0.05). Compared to healthy volunteers, the diversity of intestinal bacteria was decreased in OSCC patients before treatment, whereas the diversity of intestinal bacteria recovered in OSCC patients after conventional treatment. At the phylum, the distribution of Epsilonbacteraeota, Proteobacteria and Patescibacteria were significantly elevated and the concentration of Verrucomicrobia was decreased in OSCC patients before treatment compared to healthy volunteers(P<0.05). Intriguingly, convention therapy reversed the disturbance of intestinal bacteria, including downgrading levels of Epsilonbacteraeota, Proteobacteria and Patescibacteria and increasing levels of Verrucomicrobia(P<0.05). Short-chain fatty acids (including acetic acid, propionic acid and butyric acid) were present at a lower level in the intestine of OSCC patients before treatment and were elevated after conventional treatment. CONCLUSIONS: Conventional treatment remarkably enhances immune function, revitalizes the distribution of intestinal microflora, elevates the content of short-chain fatty acids in the intestine of OSCC patients, thereby improving the patients' health.

Early elevated neutrophil-to-lymphocyte ratio associated with remote diffusion-weighted imaging lesions in acute intracerebral hemorrhage.

AIMS: To explore the relationship between the circulating neutrophil-to-lymphocyte ratio (NLR) and the remote diffusion-weighted imaging lesions (R-DWILs) after spontaneous intracerebral hemorrhage (ICH). METHODS: Consecutive patients with spontaneous ICH were prospectively collected from November 2016 to May 2018 and retrospectively analyzed. We included subjects who presented within 24 hours after symptom onset and were free of detectable infections on admission or in hospital. Blood samples were obtained at 24-48 hours after ICH ictus, while all complete MRI scans were performed at 5-8 days. R-DWILs were defined as focal hyperintensities remote from the site of the ICH or the peri-hematoma regions. NLR was calculated by dividing the absolute neutrophil counts by the absolute lymphocyte counts. Multivariate binary logistic regression models were generated to evaluate the relationship between NLR and R-DWILs. RESULTS: One hundred sixty-three subjects met eligibility criteria (age 62.3 ± 13.6 years, 60.7% males), of whom 31(19.0%) experienced R-DWILs. Higher circulating NLR was documented in patients with R-DWILs. With the best cutoff value of 6.01, elevated NLR was independently associated with the presence of R-DWILs (OR = 3.170, 95% CI 1.306-7.697, P = .011) in the bivariate logistic regression analysis with adjustment for age, sex, atrial fibrillation, previous ischemic stroke/TIA, SBP on admission, hematoma volume, and IVH. CONCLUSIONS: This study provides significant evidence of the association between circulating NLR and R-DWILs in spontaneous ICH patients. Patients with NLR > 6.01 at 24-48 hours after ICH ictus should be paid more attention to when evaluating R-DWILs.