Correlation between risk factors of cognitive dysfunction and blood pressure variability after acute ischemic stroke in northwest Shanghai.

Abstract：Objective: To explore the relationship between risk factors of cognitive dysfunction and blood pressure variability after acute ischemic stroke in northwest Shanghai to establish a model for early identification of high-risk groups of cognitive dysfunction and formulation of more targeted prevention and treatment measures. Methods: Spearman test was used to evaluate the correlation between blood pressure variability and Montreal Cognitive Assessment (MoCA) score in patients with acute ischemic stroke and the partial regression coefficient model was constructed based on the above independent risk factors, and the receiver operating characteristic (ROC) curve was described to analyze the relevant independent risk factors. Results: ROC curve analysis results showed that the clinical prediction model was significantly more effective than a single factor in predicting the risk of cognitive impairment after acute ischemic stroke in northwest Shanghai（P < 0.05）. Conclusion: Cognitive dysfunction after acute ischemic stroke was closely related to high Homocysteine (Hcy) levels, high standard deviation of systolic blood pressure, previous infarction history and infarction of cognitive function area in northwest Shanghai. The prediction model based on the above factors showed satisfactory value in predicting of cognitive dysfunction risk after acute ischemic stroke and there was also the correlation between cognitive function and blood pressure variability.

Enhanced Thermoelectric Properties of Nb-Doped Ti(FeCoNi)Sb Pseudo-Ternary Half-Heusler Alloys Prepared Using the Microwave Method.

Pseudo-ternary half-Heusler thermoelectric materials, which are formed by filling the B sites of traditional ternary half-Heusler thermoelectric materials of ABX with equal atomic proportions of various elements, have attracted more and more attention due to their lower intrinsic lattice thermal conductivity. High-purity and relatively dense Ti1-xNbx(FeCoNi)Sb (x = 0, 0.01, 0.03, 0.05, 0.07 and 0.1) alloys were prepared via microwave synthesis combined with rapid hot-pressing sintering, and their thermoelectric properties are investigated in this work. The Seebeck coefficient was markedly increased via Nb substitution at Ti sites, which resulted in the optimized power factor of 1.45 µWcm-1K-2 for n-type Ti0.93Nb0.07(FeCoNi)Sb at 750 K. In addition, the lattice thermal conductivity was largely decreased due to the increase in phonon scattering caused by point defects, mass fluctuation and strain fluctuation introduced by Nb-doping. At 750 K, the lattice thermal conductivity of Ti0.97Nb0.03(FeCoNi)Sb is 2.37 Wm-1K-1, which is 55% and 23% lower than that of TiCoSb and Ti(FeCoNi)Sb, respectively. Compared with TiCoSb, the ZT of the Ti1-xNbx(FeCoNi)Sb samples were significantly increased. The average ZT values of the Nb-doped pseudo-ternary half-Heusler samples were dozens of times that of the TiCoSb prepared using the same process.

Analysis of risk factors for the efficacy of tirofiban in the treatment of acute ischemic stroke.

OBJECTIVE: To analyse the risk factors for tirofiban efficacy in the early treatment of acute ischemic stroke. METHODS: The clinical data of 204 patients with acute ischemic stroke treated with tirofiban were retrospectively analysed. The early efficacy of tirofiban was assessed by a ≥ 4-point decline in the National Institutes of Health Stroke Scale (NIHSS) score or via the complete disappearance of neurological deficits at the end of ischemic stroke treatment, and patients were divided into an effective groupand an ineffective group. Univariate and multivariate logistic regression analyses were used to compare the differences in clinical data between the two groups. RESULTS: Multivariate logistic regression analysis showed that heavy drinking (OR 0.477, 95% CI 0.249-0.899, P = 0.023), elevated total cholesterol (OR 0.331, 95% CI 0.141-0.734, P = 0.008), NIHSS score at initiation of treatment (OR 1.130, 95% CI 1.026-1.253, P = 0.016) and time from onset to treatment (OR 0.839, 95% CI 0.700-0.979, P = 0.038) were independent risk factors affecting the early efficacy of tirofiban. CONCLUSION: The early curative effect of tirofiban in acute ischemic stroke patients with a heavy drinking history and elevated total cholesterol was poor. In patients with acute ischemic stroke, the higher the NIHSS score was within a certain range (8 < NIHSS ≤15 and the Org 10,172 Trial in the Treatment of Acute Stroke (TOAST) belongs to small-artery occlusion lacunar) at the initiation of treatment and the shorter the time from onset to treatment, the better the early curative effect was.

Safety and efficacy of low-dose and long-course tirofiban in large hemispheric infarction.

Background: The clinical efficacy and safety of tirofiban in the treatment of large hemispheric infarction (LHI) remain controversial. Methods: This study prospectively enrolled patients with acute LHI who were admitted to Putuo Hospital affiliated with Shanghai University of Traditional Chinese Medicine from June 2021 to December 2021. The patients were randomly assigned to the tirofiban group [3-4 µg/(kg·h)] or control group (clopidogrel 75 mg/d). Results: A total of 71 patients with acute LHI were selected: 36 in the tirofiban group and 35 in the control group. The reduction of the NIHSS score in the tirofiban group was 2.92 ± 9.31 at discharge, and that of the control group was -3.23 ± 12.06 (p = 0.021, OR, 0.006; 95% CI, 0.004-0.008). Six patients (16.7%) in tirofiban group and 14 patients (40%) in control group died during hospitalization (p = 0.029, OR, 0.300; 95% CI, 0.099-0.908). There was significant difference in Modified Rankin Scale (mRS) 5-6 scores at 90 days between the two groups (p = 0.023, OR, 0.327; 95% CI, 0.124-0.867). However, there was no significant difference in mRS 0-1 (p = 0.321, OR, 0.972; 95% CI, 0.920-1.027), mRS 2 (p = 0.572, OR, 2.00; 95% CI, 0.173-23.109), mRS 3 (p = 0.225, OR, 2.214; 95% CI, 0.601-8.161), or mRS 4(p = 0.284, OR, 1.859; 95% CI, 0.593-5.825) scores between the two groups. There was no difference in symptomatic intracranial hemorrhage (p = 0.29, OR, 0.305; 95% CI, 0.030-3.081), asymptomatic intracranial hemorrhage (p = 0.123, OR, 0.284; 95% CI, 0.053-1.518). There was a significant difference in systemic bleeding events during hospitalization (p = 0.044, OR, 0.309; 95% CI, 0.096-1.000). Conclusions: Low-dose and long-course tirofiban treatment may significantly improve the early neurological function and reduce the in-hospital mortality in LHI patients. Meanwhile, tirofiban does not increase the risk of any type of bleeding events.

Anti-epileptic/pro-epileptic effects of sodium channel modulators from Buthus martensii Karsch.

The East Asian scorpion Buthus martensii Karsch (BmK) is one of the classical traditional Chinese medicines for treating epilepsy for over a thousand years. Neurotoxins purified from BmK venom are considered as the main active ingredients, acting on membrane ion channels. Voltage-gated sodium channels (VGSCs) play a crucial role in the occurrence of epilepsy, which make them become important drug targets for epilepsy. Long chain toxins of BmK, composed of 60-70 amino acid residues, could specifically recognize VGSCs. Among them, α-like neurotoxins, binding to the receptor site-3 of VGSC, induce epilepsy in rodents and can be used to establish seizure models. The ß or ß-like neurotoxins, binding to the receptor site-4 of VGSC, have significant anticonvulsant effects in epileptic models. This review aims to illuminate the anticonvulsant/convulsant effects of BmK polypeptides by acting on VGSCs, and provide potential frameworks for the anti-epileptic drug-design.

Enhanced Thermoelectric Performance of Cu2Se via Nanostructure and Compositional Gradient.

Forming co-alloying solid solutions has long been considered as an effective strategy for improving thermoelectric performance. Herein, the dense Cu2-x(MnFeNi)xSe (x = 0-0.09) with intrinsically low thermal conductivity was prepared by a melting-ball milling-hot pressing process. The influences of nanostructure and compositional gradient on the microstructure and thermoelectric properties of Cu2Se were evaluated. It was found that the thermal conductivity decreased from 1.54 Wm-1K-1 to 0.64 Wm-1K-1 at 300 K via the phonon scattering mechanisms caused by atomic disorder and nano defects. The maximum zT value for the Cu1.91(MnFeNi)0.09Se sample was 1.08 at 750 K, which was about 27% higher than that of a pristine sample.