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@#Objective To establish a nomogram model based on cystatin C (Cys-C) to predict the risk of large-artery atherosclerosis (LAA) by analyzing the risk factors of LAA and to evaluate its effectiveness. Methods A retrospective observational study performed on clinical data of 800 patients with acute ischemic stroke (AIS) in the Department of Neurology,Affiliated Hospital of Xuzhou Medical University,from January 2019 to January 2022.Patients were randomly assigned (2∶1 ratio) to the training set (n=546) and the validation set (n=254). The independent risk factors of LAA were determined by logistic regression analysis. A nomogram model of the risk of LAA was established and the model was verified internally and externally. The nomogram was evaluated based on discrimination,calibration,and clinical efficacy using the concordance statistic (C-statistic),calibration plot and decision curve analysis (DCA),respectively. Results Univariate and multifactor logistic regression analysis screening showed hypertension,diabetes,cystatin c,low-density lipoprotein (LDL),homocysteine (HCY),and hypersensitive C-reactive protein (hs-CRP) as independent correlated predictors of LAA,and the prediction model constructed from this,and the ROC curve was plotted with an area under the training set curve of 0.800 (0.762-0.838),with a diagnostic threshold of 0.6224,corresponding to a sensitivity of 68.3% and a specificity of 79.2%,and a validation set curve with an area under the curve of 0.838 (0.786-0.890) and a diagnostic threshold of 0.5901,corresponding to a sensitivity of 79.5% and a specificity of 78.5%,with a well-fitted calibration curve. Conclusion The nomogram model established has a good degree of differentiation and accuracy. It has a good performance in predictive ability,which is simple,intuitive and individualized to screen high-risk groups and has a certain predictive value for the occurrence of LAA patients,and can improve their prognosis through various preventive measures at an early stage.
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Objective:To investigate the diagnostic value of cerebrospinal fluid interleukin-6 (IL-6), neuron-specific enolase (NSE) and S100B protein in patients with central nervous system infection.Methods:The clinical data of 78 patients with central nervous system infection (infected group) from October 2015 to February 2019 in the Department of Neurology, Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed. Among the patients, viral meningitis was in 41 cases, tuberculous meningitis was in 23 cases, and purulent meningitis was in 14 cases. Another 100 patients who were admitted to the hospital during the same period for cerebrospinal fluid and other related examinations and excluded central nervous system infection (control group) were selected. Enzyme-linked immunosorbent assay was used to detect the levels of IL-6, NSE and S100B protein.Results:The cerebrospinal fluid levels of IL-6, NSE and S100B protein in infected group were significantly higher than those in control group: 16.70 (8.54, 228.18) ng/L vs. 6.64 (4.96, 8.21) ng/L, 13.62 (11.50, 19.01) μg/L vs. 9.95 (7.54, 12.39) μg/L and 3.07 (0.24, 11.57) μg/L vs. 0.16 (0.12, 0.21) μg/L, and there were statistical differences ( P<0.05). The cerebrospinal fluid levels of IL-6, NSE and S100B protein in patients with tuberculous meningitis were significantly higher than those in patients with viral meningitis and patients with purulent meningitis: 173.30 (13.74, 503.80) ng/L vs. 9.37 (4.80, 113.55) and 89.96 (14.02, 239.60) ng/L, (30.82 ± 14.09) μg/L vs. (12.00 ± 2.33) and (17.62 ± 5.63) μg/L, (18.29 ± 16.05) μg/L vs. (2.12 ± 1.24) and (5.79 ± 4.82) μg/L; the indexes in patients with purulent meningitis were significantly higher than those in patients with viral meningitis, and there were statistical differences ( P<0.05). Conclusions:Cerebrospinal fluid IL-6, NSE and S100B proteins have different expressions in patients with different types of central nervous system infection, and have certain clinical application value for the diagnosis of central nervous system infection.
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Objective To investigate MRI appearances of aquaporin(AQP) and its effect in different brain regions of patients with Parkinson's disease(PD).Methods A prospective study was carried out in 33 PD patients(PD group) and 23 gender-and age-matched healthy controls (control group).Clinical data of PD patients were collected.The aquaporin imaging of diffusion-weighted magnetic resonance imaging (MRDWI) with multiple b-values in different brain regions were performed to detect the apparent diffusion coefficient(AQP-ADC) values of aquaporin.The PD patients were assessed and graded by modified Hoehn-Yahr grading,then the AQP-ADC values of control group,mild PD group,moderate and severe PD group were analyzed using one-way analysis of variance.The correlation analysis was carried out to detect the relationship between AQP-ADC values in different brain regions and Hoehn-Yahr grading of PD patients.Results Compared with control group,mild PD group had significantly higher AQP-ADC values in red nucleus(RN) and globus pallidus(GP) ((0.24±0.04) vs (0.21±0.04),(0.21±0.04) vs (0.16±0.04);both P＜0.05);while the AQP-ADC values in RN and GP of moderate and severe PD group were significantly lower than that of mild PD group((0.21±0.02) vs (0.24±0.04),(0.18±0.03) vs (0.21±0.04);both P＜0.05);but there was no significant difference between moderate and severe PD group and control group(P＞0.05);and there was also no significant difference in substantianigra (SN),putamen (Pu) and thalamus (THA) among control group,mild PD group and moderate and severe PD group(P＞0.05).The correlation analysis showed that there were negative correlations between the AQP-ADC values in RN and GP and Hoehn-Yahr grading(r=-0.479 and-0.395,P＜ 0.05),while there was no correlation in SN,Pu and THA (P＞ 0.05).Conclusion The AQPADC values are increased in RN and GP of mild PD patients,and decreased in moderate and severe PD patients,while there is no significant change in SN,Pu and THA of the two groups,suggesting that the expression of AQP in different brain regions may be related to the severity and pathological stage of PD.
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Translational medicine emerging as a new concept in medical field, concentrates on the integration of theory and practice , and the conjunction of basic medical science and clinical medicine. Barriers between the basic medicine and clinical medicine existing in medical education in China make students possess limited intelligence, narrow perspectives and low creativity etc., causing the medical teaching unable to conform to the demand of translational medicine. The article introduces the basic conception of translational medicine and the necessity of medical teaching reform, the meth-ods of promoting teaching reform by integrating the curriculum systems, bettering experimental teach-ing systems, strengthening humanities education, improving faculty construction and optimizing eval-uation system for students.
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Objective To summarize the features of multiple sclerosis (MS) in China. Methods The clinical manifestations and inducements of 413 MS patients are comprehensively analyzed using clinical statistical method. Other parameters are also analyzed by electromyography and brainstem auditory evoked potential. Results MS in China mainly invades young and middle-aged people, with a higher ratio in female than in male. MS was found mostly acute or subacute in onset and usually due to an inducement mainly consisting of common cold, fever, cyesis and fatigue. The first seen symptoms were various and complicated, but mainly showed different types of visual disturbance such as the acuity of vision decrease, constriction of visual field and diplopia. Limb paralysis, sensory abnormality and visual disturbance were found the commonest symptoms. Lhermitte’s sign was common. Paroxysmal symptoms as algospasm and seizure were relatively common. Electromyography and brainstem evoked potential showed that peripheral nervous system damage might occur in MS. Spinal cord and visual nerve were found the mostly invaded according to the clinical data. Conclusion The features of MS in China should be different from those in the western countries.
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Objective TO explore the etiology and pathogenesis of multiple sclerosis. Methods The information of pa-tients from 413 MS was analyzed comprehensively by the clinical statistical methods. Results Common cold was the com-monest factor causing MS, and fever,fatigue and childbirth were also the common causes. Immunological disturbance exis-ted in MS. CD~+_4 cell decreased in most of MS patients, but the distribution of CD~+_8 cell was not regular. The level of sexhormones was abnormal in MS,but it was not the same in male and female. There were three patients having family histo-ry of MS. Conclusion Virus infection,sex hormones and heredity factors are all related to MS through facilitating immu-nological disturbance.