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1.
Neural Regen Res ; 18(3): 634-642, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36018188

RESUMO

Chronic spinal cord compression (CSCC) is induced by disc herniation and other reasons, leading to movement and sensation dysfunction, with a serious impact on quality of life. Spontaneous disc herniation rarely occurs in rodents, and therefore establishing a chronic spinal cord compression (CSCC) animal model is of crucial importance to explore the pathogenesis and treatment of CSCC. The absence of secreted protein, acidic, and rich in cysteine (SPARC) leads to spontaneous intervertebral disc degeneration in mice, which resembles human disc degeneration. In this study, we evaluated whether SPARC-null mice may serve as an animal model for CSCC. We performed rod rotation test, pain threshold test, gait analysis, and Basso Mouse Scale score. Our results showed that the motor function of SPARC-null mice was weakened, and magnetic resonance images revealed compression at different spinal cord levels, particularly in the lumbar segments. Immunofluorescence staining and western blot assay showed that the absence of SPARC induced apoptosis of neurons and oligodendrocytes, activation of microglia/macrophages with M1/M2 phenotype and astrocytes with A1/A2 phenotype; it also activated the expression of the NOD-like receptor protein 3 inflammasome and inhibited brain-derived neurotrophic factor/tyrosine kinase B signaling pathway. Notably, these findings are characteristics of CSCC. Therefore, we propose that SPARC-null mice may be an animal model for studying CSCC caused by disc herniation.

2.
Nat Sci Sleep ; 14: 1977-1988, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36349065

RESUMO

Background: Although sleep disorders significantly increase the risk of cognitive impairment, literature is relatively scarce regarding the impact of sleep status on cognitive function in patients with acute ischemic stroke (AIS). We seek to study the association between pre-stroke subjective sleep status and cognitive function at 3 months after stroke. Patients and methods: Data were analyzed for 1,759 AIS patients from the Impairment of Cognition and Sleep after Acute Ischemic Stroke or Transient Ischemic Attack in Chinese Patients Study (ICONS). Pre-stroke subjective sleep status was assessed by the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Greater sleep fragmentation was defined as waking up in the middle of the night or early morning ≥3 times a week. Cognitive function was evaluated using the Montreal Cognitive Assessment (MoCA) at 3 months after stroke. Primary endpoint was the incidence of post-stroke cognitive impairment (PSCI) at 3 months after stroke. The association between subjective sleep status and PSCI was evaluated using multivariable logistic regression. Results: PSCI occurred in 52.1% at 3 months after stroke. Patients with very bad sleep quality before stroke were at increased risk of PSCI (OR, 2.11; 95% CI, 1.11-4.03; P=0.03). Subgroup analysis found that the association between very bad sleep quality and PSCI was more evident among patients with high school education or above (OR, 5.73; 95% CI, 1.92-17.10; P for interaction=0.02). In addition, patients with greater sleep fragmentation before stroke were also at higher risk of PSCI (OR, 1.55; 95% CI, 1.20-2.01; P<0.01). Similarly, subgroup analysis showed that the risk of PSCI was more pronounced among patients without employment (OR, 2.45; 95% CI, 1.59-3.77; P for interaction=0.01). Conclusion: Very bad sleep quality and greater sleep fragmentation before stroke were identified as independent risk factors for PSCI at 3 months after stroke.

4.
Front Neurol ; 13: 930500, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36388194

RESUMO

Background and purpose: Studies showed that patients with hemorrhagic stroke are at a higher risk of developing deep vein thrombosis (DVT) than those with ischemic stroke. We aimed to develop a risk score (intracerebral hemorrhage-associated deep vein thrombosis score, ICH-DVT) for predicting in-hospital DVT after ICH. Methods: The ICH-DVT was developed based on the Beijing Registration of Intracerebral Hemorrhage, in which eligible patients were randomly divided into derivation (60%) and internal validation cohorts (40%). External validation was performed using the iMCAS study (In-hospital Medical Complication after Acute Stroke). Independent predictors of in-hospital DVT after ICH were obtained using multivariable logistic regression, and ß-coefficients were used to generate a scoring system of the ICH-DVT. The area under the receiver operating characteristic curve (AUROC) and the Hosmer-Lemeshow goodness-of-fit test were used to assess model discrimination and calibration, respectively. Results: The overall in-hospital DVT after ICH was 6.3%, 6.0%, and 5.7% in the derivation (n = 1,309), internal validation (n = 655), and external validation (n = 314) cohorts, respectively. A 31-point ICH-DVT was developed from the set of independent predictors including age, hematoma volume, subarachnoid extension, pneumonia, gastrointestinal bleeding, and length of hospitalization. The ICH-DVT showed good discrimination (AUROC) in the derivation (0.81; 95%CI = 0.79-0.83), internal validation (0.83, 95%CI = 0.80-0.86), and external validation (0.88; 95%CI = 0.84-0.92) cohorts. The ICH-DVT was well calibrated (Hosmer-Lemeshow test) in the derivation (P = 0.53), internal validation (P = 0.38), and external validation (P = 0.06) cohorts. Conclusion: The ICH-DVT is a valid grading scale for predicting in-hospital DVT after ICH. Further studies on the effect of the ICH-DVT on clinical outcomes after ICH are warranted.

5.
CNS Neurosci Ther ; 2022 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-36415111

RESUMO

AIM: The association between magnesium and outcomes after stroke is uncertain. We aimed to investigate the association of serum magnesium with all-cause mortality and poor functional outcome. METHODS: We included patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA) from the China National Stroke Registry III. We used Cox proportional hazards model for all-cause mortality and logistic regression model for poor functional outcome (modified Rankin Scale [mRS] 2-6/3-6) to examine the relationships. RESULTS: Among the 6483 patients, the median (interquartile range) magnesium was 0.87 (0.80-0.93) mmol/L. Patients in the first quartile had a higher risk of mRS score 3-6/2-6 at 3 months (adjusted odds ratio [OR]: 1.30; 95% confidence interval [CI]: 1.02, 1.64; adjusted OR: 1.29; 95% CI: 1.04-1.59) compared with those in the fourth quartile. Similar results were found for mRS score 26 at 1 year. The age- and sex-adjusted hazard ratio (HR) with 95% CI in first quartile magnesium was 1.40 (1.02-1.93) for all-cause mortality within 1 year, but became insignificant (HR: 1.03; 95% CI: 0.71-1.50) after adjusting for potential variables. CONCLUSIONS: Low serum magnesium was associated with a high risk of poor functional outcome in patients with AIS or TIA.

6.
JAMA Netw Open ; 5(11): e2242596, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36394871

RESUMO

Importance: Although researchers have devoted substantial efforts, money, and time to studying the causes of dementia and the means to prevent it, no effective treatment exists yet. Identifying preclinical risk factors of dementia could help prevent or delay its progression. Objective: To develop a point risk score prediction model of dementia. Design, Setting, and Participants: This study used a large UK population-based prospective cohort study conducted between March 13, 2006, and October 1, 2010. Data analysis was performed from June 7 to September 15, 2021. Individual analyses of time end points were concluded at the first dementia diagnosis during the follow-up period. The data were split into training and testing data sets to separately establish and validate a prediction model. Main Outcomes and Measures: Outcomes of interest included 5-, 9-, and 13-year dementia risk. Least absolute shrinkage and selection operator and multivariate Cox proportional hazards regression models were used to identify available and practical dementia predictors. A point risk score model was developed for the individual prediction of 5-, 9-, and 13-year dementia risk. Results: A total of 502 505 participants were selected; the population after exclusions for missing data and dementia diagnosis at baseline was 444 695 (205 187 men; mean [SD] age, 56.74 [8.18] years; 239 508 women; mean [SD] age, 56.20 [8.01] years). Dementia occurrence during the 13 years of follow-up was 0.7% for men and 0.5% for women. The C statistic of the final multivariate Cox proportional hazards regression model was 0.86 for men and 0.85 for women in the training data set, and 0.85 for men and 0.87 for women in the testing data set. Men and women shared some modifiable risk and protective factors, but they also presented independent risk factors that accounted for 31.7% of men developing dementia and 53.35% of women developing dementia according to the weighted population-attributable fraction. The total point score of the risk score model ranged from -18 to 30 in men and -17 to 30 in women. The risk score model yielded nearly 100% prediction accuracy of 13-year dementia risk both in men and women. Conclusions and Relevance: In this diagnostic study, a practical risk score tool was developed for individual prediction of dementia risk, which may help individuals identify their potential risk profile and provide guidance on precise and timely actions to promote dementia delay or prevention.


Assuntos
Demência , Masculino , Humanos , Feminino , Pessoa de Meia-Idade , Demência/diagnóstico , Demência/epidemiologia , Demência/etiologia , Estudos Prospectivos , Fatores de Risco , Modelos de Riscos Proporcionais , Causalidade
7.
J Bone Miner Metab ; 2022 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-36399257

RESUMO

INTRODUCTION: Osteosarcoma is the most common malignancy in children, with high morbidity worldwide. Researches indicated that long non-coding RNAs (lncRNAs) played crucial roles in various cancers. Nevertheless, study investigating lncRNA long intergenic non-protein coding RNA 1089 (LINC01089) in osteosarcoma is extremely rare. Thus, the research of LINC01089 is of great significance. MATERIALS AND METHODS: qRT-PCR and western blot were done to test the expression of RNAs and proteins in osteosarcoma cells. Functional assays were carried out to evaluate biological behaviors of hFOB1.19 and osteosarcoma cells with or without LINC01089 knockdown and overexpression. In vitro and in vivo experiments in a rescue manner were performed to reveal the influences of LINC01089 and Hippo pathway on osteosarcoma cell phenotype and tumor growth. RESULTS: LINC01089 was down-regulated in osteosarcoma cells and overexpressing LINC01089 was validated to restrain cell growth in vitro and tumor growth in vivo. Additionally, silencing LINC01089 could exacerbate cell malignant behaviors. Correlation of LINC01089 and Hippo pathway was proved. Overexpressing LINC01089 could activate Hippo pathway to exert antitumor effects. CONCLUSION: LINC01089 could restrain the progression of osteosarcoma through activating Hippo pathway.

8.
Front Public Health ; 10: 1021200, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36438223

RESUMO

We report a severe COVID-19 complicated with MIS-C in a girl treated by the author in China, and discuss the current research status and progress in the diagnosis and therapy of MIS-C in children. The patient was a 4-year-old child previously healthy who was referred to the hospital with a complaint of fever, finally, Multisystem inflammatory syndrome was diagnosed with COVID-19.


Assuntos
COVID-19 , SARS-CoV-2 , Feminino , Humanos , Pré-Escolar , China
9.
J Vis Exp ; (189)2022 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-36408984

RESUMO

As the most common male malignancy, prostate cancer (PC) ranks second in mortality, primarily due to a 65%-75% bone metastasis rate. Therefore, it is essential to understand the process and related mechanisms of prostate cancer bone metastasis for developing new therapeutics. For this, an animal model of bone metastasis is an essential tool. Here, we report detailed procedures to generate a bone metastasis mouse model via intra-cardiac injection of prostate cancer cells. A bioluminescence imaging system can determine whether prostate cancer cells have been accurately injected into the heart and monitor cancer cell metastasis since it has great advantages in monitoring metastatic lesion development. This model replicates the natural development of disseminated cancer cells to form micro-metastases in the bone and imitates the pathological process of prostate cancer bone metastasis. It provides an effective tool for further exploration of the molecular mechanisms and the in vivo therapeutic effects of this disease.


Assuntos
Neoplasias Ósseas , Neoplasias da Próstata , Humanos , Camundongos , Masculino , Animais , Xenoenxertos , Neoplasias Ósseas/secundário , Neoplasias da Próstata/patologia , Transplante Heterólogo , Modelos Animais de Doenças
10.
Ann Transl Med ; 10(19): 1050, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36330395

RESUMO

Background: Little is known about the impact of prevalent dementia on in-hospital outcomes of patients with incident stroke in China. Using data from the Chinese Stroke Center Alliance (CSCA), we aim to quantify the prevalence of pre-stroke dementia and whether this group is at higher risk of adverse in-hospital outcomes compared to those without pre-stroke dementia. Methods: We used multivariable logistic regression models to assess the associations between pre-stroke dementia and ambulation by day 2, in-hospital mortality, in-hospital complications, and being discharged home. Covariates included age, sex, comorbidities [dyslipidemia, atrial fibrillation, peripheral vascular disease (PVD), smoking, and alcohol use], medication history (antiplatelet drugs or lipid-lowering drugs), stroke severity [measured by the National Institute of Health Stroke Scale (NIHSS)], administration of intravenous tissue plasminogen activator (IV tPA) within 4.5 hours of stroke onset, and receipt of deep vein thrombosis (DVT) prophylaxis if indicated. Results: In the final analytic sample of 559,070 ischemic stroke patients with no prior stroke history enrolled across 1,476 hospitals, those with pre-stroke dementia (n=1,511; 0.3%) were older and more likely to be female. Despite having received similar treatment, patients with pre-stroke dementia had lower odds of ambulating by day 2 [odds ratio (OR) =0.69; 95% confidence interval (CI): 0.62-0.78], higher odds of in-hospital mortality (OR =2.01; 95% CI: 1.35-2.99) or complications (OR =2.17; 95% CI: 1.93-2.44), and lower odds of being discharged home compared to those without pre-stroke dementia (OR =0.71; 95% CI: 0.62-0.83). Conclusions: Worse in-hospital outcomes among patients with pre-stroke dementia may be explained by pre-existing cognitive impairment that limited their ability to advocate for care needs. Further research is needed to determine whether a different care pathway or additional attention from clinicians is necessary for patients with pre-stroke dementia.

11.
Molecules ; 27(22)2022 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-36432067

RESUMO

A series of novel paclitaxel derivatives modified by boronic acid according to the characteristics of the interaction between RB(OH)2 and different strapping agents of intraliposomal aqueous phase were designed and synthesized, which were then used to develop remote poorly water-soluble drugs loading into liposomes. Meanwhile, we screened nineteen paclitaxel boronic acid derivatives for their cytotoxic activities against three cancer cell lines (A549, HCT-116 and 4T1) and one normal cell line (LO2), and performed liposome formulation screening of active compounds. Among all the compounds, the liposome of 4d, with excellent drug-encapsulated efficiency (>95% for drug-to-lipid ratio of 0.1 w/w), was the most stable. Furthermore, the liposomes of compound 4d (8 mg/kg, 4 times) and higher dose of compound 4d (24 mg/kg, 4 times) showed better therapeutic effect than paclitaxel (8 mg/kg, 4 times) in the 4T1 tumor model in vivo, and the rates of tumor inhibition were 74.3%, 81.9% and 58.5%, respectively. This study provided a reasonable design strategy for the insoluble drugs to improve their drug loading into liposomes and anti-tumor effect in vivo.


Assuntos
Lipossomos , Paclitaxel , Paclitaxel/farmacologia , Paclitaxel/uso terapêutico , Estabilidade de Medicamentos , Ácidos Borônicos
12.
Front Neurol ; 13: 1014244, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36324378

RESUMO

Objective: The aim of this study was to investigate the pattern of volume changes in neurofunctional hippocampal subfields in patients with insomnia and their associations with risk of development of insomnia. Methods: A total of 120 patients with insomnia (78 females, 42 males; mean age ± standard deviation, 43.74 ± 13.02 years) and 120 good sleepers (67 females, 53 males; mean age, 42.69 ± 12.24 years) were recruited. The left hippocampus was segmented into anterior (L1), middle (L2), and posterior (L3) subregions. The right hippocampus was segmented into top anterior (R1), second top anterior (R2), middle (R3), posterior (R4), and last posterior (R5) subregions. Multivariate logistic regression was used to evaluate the associations of hippocampal volume (HV) of each subfield with the risk of the development of insomnia. Mediation analyses were performed to evaluate mediated associations among post-insomnia negative emotion, insomnia severity, and HV atrophy. A visual easy-to-deploy risk nomogram was used for individual prediction of risk of development of insomnia. Results: Hippocampal volume atrophy was identified in the L1, R1, and R2 subregions. L1 and R2 volume atrophy each predisposed to an ~3-fold higher risk of insomnia (L1, odds ratio: 2.90, 95% confidence intervals: [1.24, 6.76], p = 0.014; R2, 2.72 [1.19, 6.20], p = 0.018). Anxiety fully mediates the causal path of insomnia severity leading to R1 volume atrophy with a positive effect. We developed a practical and visual competing risk-nomogram tool for individual prediction of insomnia risk, which stratifies individuals into different levels of insomnia risk with the highest prediction accuracy of 97.4% and an average C-statistic of 0.83. Conclusion: Hippocampal atrophy in specific neurofunctional subfields was not only found to be associated with insomnia but also a significant risk factor predicting development of insomnia.

13.
Clin Exp Med ; 2022 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-36329220

RESUMO

Crohn's disease (CD) is well characterized by chronic inflammation of the gastrointestinal tract. The diagnose of CD relays on the comprehensive evaluation of patient symptoms, laboratory examination, radiology, and endoscopy. There is lack of biomarkers or simple test for CD detection. Serum samples from healthy subjects (n = 16) and CD patients (n = 16) were collected and prepared for untargeted metabolomics analysis using the ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS) method. The alterations of serum metabolites and the potential biomarkers were profiled by statistical analysis. And the associated metabolic pathway was analyzed based on Kyoto Encyclopedia of Genes and Genomes (KEGG) database. The performance of potential biomarkers was assessed by receiver operating characteristic (ROC) analysis. A complete separation between HS and CD groups was seen in OPLS-DA. A total of 108 and 131 significantly altered metabolites in positive and negative ion mode, respectively, were identified, and most of them belong to several pathways ranging from lipid metabolism to amino acid metabolism and energy homeostasis. KEGG analysis revealed that lipid metabolism enriched most significantly. Further, ceramide, phosphatidylethanolamine (PE), and taurochenodeoxycholic acid (TCDCA) presented the highest predictive accuracy of the patients with CD as analyzed by ROC. The current study demonstrated that lipid metabolism is mostly related to CD pathogenesis. Further investigations are indicated to examine the use of lipid-related metabolites of ceramide, PE, and TCDCA as potential biomarkers for CD diagnosis.

14.
Neurochem Res ; 2022 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-36327016

RESUMO

Stroke is one of the leading causes of death and long-term serious disability. Current therapeutic strategy is limited to thrombolytic agents, consequently, boosting endogenous neuroprotective mechanisms of the brain to protect itself against harmful stimuli and restore from damages are widely studied. Preconditioned brain to tolerate cerebral ischemia/reperfusion injury could be initiated by several different pharmacological and mechanical strategies, such as ischemic preconditioning, ethanol pharmacological preconditioning and other pre- and post-conditions, such as remote ischemic preconditioning and exercise preconditioning. In this article, we will discuss the major mechanism of ischemia/reperfusion injury and provide an overview of preconditioning in all its various forms, describe the underlying mechanisms and review the recent clinical application of this emerging neuroprotective strategy.

15.
Nutrients ; 14(21)2022 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-36364800

RESUMO

Ying Yang Bao (YYB) is conventionally prescribed as a nutritional supplement to infants and young children (IYC) in less developed areas of China. However, whether 18-month YYB consumption is reasonable needs assessment. This study examined the influence of the duration of YYB consumption on hemoglobin (Hb) levels and anemia prevalence. Data from the Nutrition Improvement Project on Children in Poor Areas of China in 2018-2019 were used. Questionnaires were used to collect information on basic characteristics, dietary status, and YYB consumption. Propensity score matching (PSM) was used to balance confounders. Hb levels and anemia prevalence in IYC with different durations of YYB consumption were compared. After PSM, all covariates were well-balanced, and 1151 pairs of IYC were included in subsequent analyses. During the 1st-9th months of intervention, YYB effectively increased Hb levels and reduced anemia prevalence in the intervention group. During the 10th-18th months of intervention, Hb levels in the control group increased and anemia prevalence decreased, while Hb levels and anemia prevalence fluctuated in the intervention group. In conclusion, YYB was effective in improving nutritional status of infants, but had a limited effect in young children. Nutritional supplements with different quantities or nutrients should be considered for young children.


Assuntos
Anemia , População Rural , Lactente , Criança , Humanos , Pré-Escolar , China/epidemiologia , Anemia/epidemiologia , Anemia/prevenção & controle , Suplementos Nutricionais , Prevalência , Hemoglobinas/análise
16.
Opt Express ; 30(18): 32895-32907, 2022 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-36242342

RESUMO

Linear optical sampling (LOS) is one of the most promising techniques for optical modulation analyzers. The LOS system generally adopts a mode-locked fiber laser (MFL) to generate an ultra-stable optical pulse to realize under-sampling for signal under test (SUT). However, it is challenging for MFL to produce a high-repetition-frequency pulse, making more measurement errors of conventional LOS technology, especially for high-speed signals. This paper proposes a dual-pulse mixing (DPM) based LOS system to increase the repetition frequency using fiber delay lines with the multiplied optical pulse. We propose the pulse location and peak extraction algorithms to compensate the time bias and amplitude bias in the DPM-based LOS system, which significantly improves the measurement speed and range. The experiment results show that the DPM-based LOS system can increase the number of sampling points twice compared with the conventional LOS within the same sampling time window. Furthermore, the proposed DPM-based LOS system can achieve less error vector magnitude with a reduction of 9.1% compared with the conventional LOS. Hence, the proposed DPM-based LOS system has great potential for high-speed signal processing.

17.
Stroke Vasc Neurol ; 2022 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-36219569

RESUMO

BACKGROUND: Although vascular dementia (VaD) is not uncommon in the hospital, most studies on VaD are community based. This study on VaD is the first to use a national hospital information system (HIS) in China. METHODS: This study was a hospital population-based cohort study, and data were acquired from the Hospital Quality Monitoring System, a Chinese national database that covers 1531 tertiary hospitals in China. The medical records in the HIS included demographic information, diagnoses, procedures, expenses, etc. VaD was diagnosed by hospital attending physicians and identified by the International Classification of Diseases (ICD) 10 code (F01.0-F01.9). RESULTS: 1259 (82.23%) tertiary hospitals were included in this study, and 274 230 hospitalisation records of 123 700 VaD patients from 2016 to 2018 were identified for analysis. VaD (51.27%) was the most common type of dementia in hospitalised patients. The age-adjusted and sex-adjusted hospital incidence of VaD was estimated to be 2.97 per 100 000 person-years (95% CI 2.92 to 3.02). The mean age of VaD patients admitted to hospitals was 74.13±10.88, with more male (61.0%) patients. The main comorbidities were hypertension (67.2%), heart disease (63.6%) and cerebral infarction (55.5%). The mortality rate of VaD in hospital was 28.91‰ (95% CI 28.0 to 29.9) between 2016 and 2018. The top 1 cause of death due to VaD was pneumonia and other respiratory disorders. CONCLUSIONS: VaD is the most common form of dementia in hospitalised patients. It casts huge burdens on affected patients and their caregivers. Vascular risk factors are prevalent in VaD patients. Reducing these factors is essential to improve patient care. The leading causes of death by VaD are pneumonia and other respiratory disorders. Hospital care and the management of respiratory illness are critical for VaD care in the hospital.

18.
J Hum Hypertens ; 2022 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-36220910

RESUMO

This study aims to assess the associations of functional outcomes following acute ischemic stroke (IS) with ambulatory pulse rate (PR) and characterize the time-variant properties of the associations. The prospective cohort consisted of 1831 patients who had ambulatory blood pressure (BP) and PR monitoring following acute IS, and neurologic status evaluated at discharge and 3-month follow-up. The neurologic disability was defined as modified Rankin Scale ≥3. Logistic regression and generalized penalized functional regression models were used to examine the associations of ambulatory BP and PR with neurologic disability. Adjusting for covariates, the neurologic disability at discharge and 3-month was associated with high average 24-h, daytime, and nocturnal PR (odds ratio, OR = 1.20-1.34; p < 0.05 for all), high standard derivation of nocturnal PR (OR = 1.19 and 1.32; p < 0.05 for both), and low nocturnal PR decline (OR = 0.76 and 0.76; p < 0.05 for both). The OR functions of ambulatory PR on neurologic disability were "W-shaped" from 0 a.m. to 12 p.m., with ORs >1 in the wee hours and at noon, and ORs <1 before dawn and at night. The ambulatory BP profiles were not associated with neurologic disability at discharge or 3-month. The ambulatory PR is associated with the risk of short-term neurologic disability of stroke patients, with four different phases in a 24-h cycle. Ambulatory PR monitoring, especially nocturnal PR monitoring, has significant clinical implications for the prevention of short-term neurologic disability in stroke inpatients.

19.
Opt Express ; 30(19): 35014-35028, 2022 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-36242503

RESUMO

Due to many technical difficulties, the study of molecular photoacoustic endoscopic (PAE) imaging in deep tissues is limited. In this work, we have set up a multimodal acoustic-resolution-based PAE (AR-PAE) system to image the rabbit rectum and preliminarily explored the potential of molecular PAE for deep-seated targets in proof-of-concept. We developed an improved back-projection (IBP) algorithm for focused detection over the centimeter-scale imaging depth. We also developed a deep-learning-based algorithm to remove the electrical noise from the step motor to prevent data averaging for reduced scanning time. We injected a dose of indocyanine green (ICG) near the rabbit rectum and compared 2D and 3D photoacoustic/ultrasound (PA/US) images at different wavelengths. We proposed incorporating a small camera to guide the slow PA/US endoscopic scan. Results show that this system has achieved a lateral resolution of about 0.77/0.65 mm for PA/US images with a signal-to-noise ratio (SNR) of 25/38 dB at an imaging depth of 1.4 cm. We found that the rectum wall and the ICG can be well distinguished spectroscopically. Results also show that the PA images at 532 nm have higher signal intensity and reflection artifacts from pelvic tendons and bones than those at longer wavelengths such as 800 nm. The proposed methods and the intuitive findings in this work may guide and promote the development of high-penetration molecular PAE.


Assuntos
Técnicas Fotoacústicas , Acústica , Animais , Endoscopia/métodos , Verde de Indocianina/química , Imagem Molecular , Técnicas Fotoacústicas/métodos , Coelhos
20.
J Am Heart Assoc ; 11(19): e027265, 2022 10 04.
Artigo em Inglês | MEDLINE | ID: mdl-36193936

RESUMO

Background Trimethylamine N-oxide (TMAO) contributes to cardiovascular disease through its prothrombotic, proatherothrombotic, and proinflammatory effects. We aimed to evaluate whether residual risk of recurrent stroke of TMAO and its precursor choline remain among patients who received dual-antiplatelet therapy and intensive lipid-lowering therapy and with a low inflammation level (high-sensitivity C-reactive protein <2 mg/L on admission). Methods and Results Patients with ischemic stroke or transient ischemic attack were enrolled from the CNSR-III (Third China National Stroke Registry) in China. Plasma TMAO and choline concentrations at baseline were measured in 9793 participants using liquid chromatography-mass spectrometry. The primary outcome was a new stroke within 1 year. Multivariable-adjusted hazard ratios were calculated using Cox regression models to investigate the associations of TMAO and choline with stroke recurrence. Among all patients, elevated TMAO and choline levels were associated with an increased risk of recurrent stroke (adjusted hazard ratios, 1.28 [95% CI, 1.12-1.45]; and 1.50 [95% CI, 1.32-1.71], respectively). Moreover, elevated TMAO and choline levels were associated with an increased risk of recurrent stroke among patients who received dual-antiplatelet therapy (1.65 [95% CI, 1.28-2.13]; and 1.70 [95% CI, 1.32-2.19], respectively), intensive lipid-lowering therapy (1.49 [95% CI, 1.15-1.94]; and 1.49 [95% CI, 1.15-1.92], respectively), with high-sensitivity C-reactive protein <2 mg/L (1.39 [95% CI, 1.14-1.69]; and 1.88 [95% CI, 1.53-2.30], respectively), and concurrently received dual-antiplatelet therapy, intensive lipid-lowering therapy and with high-sensitivity C-reactive protein <2 mg/L (3.57 [95% CI, 1.73-7.38]; and 2.19 [95% CI, 1.16-4.16], respectively). Conclusions TMAO and choline were risk factors for recurrent stroke independent of dual-antiplatelet therapy, intensive lipid-lowering therapy at discharge, and low inflammation on admission.


Assuntos
Colina , Acidente Vascular Cerebral , Proteína C-Reativa , Humanos , Inflamação/complicações , Lipídeos , Metilaminas , Óxidos , Inibidores da Agregação Plaquetária/efeitos adversos , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/prevenção & controle
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