BACKGROUND:Tenecteplase improves reperfusion and functional outcomes compared with alteplase in patients with large vessel occlusion. We assessed whether this superiority varies with thrombolysis-to-puncture time (TTP). METHODS:This retrospective analysis of a prospective multicenter cohort included patients with large vessel occlusion who received bridging therapy with either tenecteplase or alteplase between January 2022 and September 2025. Patients were stratified by TTP (<60 versus ≥60 minutes). We subsequently assessed the association of TTP with efficacy and safety outcomes between the alteplase and tenecteplase groups using multivariable logistic regression adjusted for age, baseline National Institutes of Health Stroke Scale score, and time from stroke onset to arterial puncture. Functional independence was defined as a modified Rankin Scale score of 0 to 2 at 3 months. RESULTS:Of 1106 patients who received bridging therapy, 1003 were included in the primary analysis (tenecteplase, 488; alteplase, 515). The median age was 68 (interquartile range, 58-75) years in both groups, with men comprising 64.3% and 66.0%, respectively. Tenecteplase was associated with superior 3-month functional independence compared with alteplase (53.6% versus 48.1%; adjusted odds ratio, 1.37 [95% CI, 1.03-1.82]). This benefit was concentrated in patients with a TTP <60 minutes, where tenecteplase yielded higher rates of both early recanalization (19.0% versus 9.1%; adjusted odds ratio, 2.36 [95% CI, 1.32-4.23]; Pinteraction=0.047) and functional independence (61.0% versus 49.0%; adjusted odds ratio, 1.77 [95% CI, 1.13-2.77]; Pinteraction=0.111). No between-agent differences were significant with TTP ≥60 minutes. Safety outcomes were comparable, but each 30-minute TTP increase independently elevated hemorrhagic risks for both agents. CONCLUSIONS:The recanalization superiority of tenecteplase over alteplase is time-dependent, evident only within a TTP <60 minutes. Although the translation of this advantage into functional outcome was not statistically modified by time, optimizing workflow to achieve this rapid window maximizes the potential benefit of tenecteplase, which should be prioritized in capable settings.

Background and Purpose In patients with large vessel occlusion (LVO), intravenous thrombolysis (IVT) frequently alters thrombus location; however, the clinical impact of this phenomenon remains unclear. We aimed to compare post-IVT thrombus dynamics between tenecteplase and alteplase and to evaluate the association between thrombus dynamics and 3-month outcomes. Methods This retrospective study analyzed prospectively collected, multicenter data from consecutive patients with LVO who underwent bridging therapy between January 2022 and December 2024. Thrombus dynamics were classified as resolution, migration, or stability. Analyses incorporated propensity score matching with weighting to balance baseline characteristics. Results Of the 806 initially included patients, 746 were included after matching (373 treated with tenecteplase and 373 treated with alteplase). The incidence of thrombus migration was significantly higher in the tenecteplase group than in the alteplase group (19.3% vs. 11.3%; odds ratio [OR]: 1.92; 95% confidence interval [CI] 1.27–2.91). The advantage of tenecteplase over alteplase was restricted to patients with an IVT-to-puncture time of <60 minutes (18.6% vs. 6.2%; P=0.001) and was no longer significant when the interval ≥60 minutes (19.7% vs. 15.0%; P=0.204; Pinteraction=0.043). Additionally, thrombus migration was associated with a better functional outcome (OR: 1.62; 95% CI 1.04–2.53). Finally, tenecteplase was associated with improved functional independence compared with alteplase (OR: 1.43; 95% CI 1.04–1.95). Conclusions Tenecteplase demonstrated superior efficacy in inducing thrombus migration compared with alteplase, particularly within 60 minutes of IVT administration. Thrombus migration independently predicted improved functional independence. These findings support the preferential use of tenecteplase for bridging therapy in patients with LVO.

Spinocerebellar ataxia type 3 (SCA3) is an inherited neurodegenerative disorder. Some of its clinical features resemble those of primary Parkinson’s disease (PD), which can easily lead to misdiagnosis. There is currently no disease-modifying therapy available for SCA3, treatment is mainly symptomatic. Herein, we report a case of a young female patient with SCA3 who presented with Parkinsonian as the main manifestation and underwent globus pallidus internus (GPi) deep brain stimulation (DBS). This is a 36-year-old female patient. Her first symptoms occurred at the age of 28 in 2009, manifesting as gait abnormalities in the right lower limb. She was misdiagnosed with early-onset PD in 2011. Genetic testing showed abnormal numbers of CAG repeats (15/70) within the coding region of the ATXN3 genes. She was diagnosed with SCA3. The patient initially responded well to levodopa-based medication, but the treatment effects gradually attenuated over time, with the development of severe symptom fluctuations and dyskinesia in 2018. The patient underwent GPi-DBS surgery in the absence of cerebellar signs, cognitive, and mood disorders. Six-year postoperative follow-up results suggest that long-term GPi-DBS is effective for the control of dyskinesia, but the residual motor symptoms (parkinsonism and ataxia) had progressively worsened in the patient. Various targets have been reported to be selected for DBS treatment of SCA3, with substantial individual differences in treatment outcomes. This case emphasizes the importance of genetic testing for the diagnosis of SCA3 and provides a basis for personalized treatment of patients with SCA3.

Background:Parkinson's disease (PD) affects both sexes, but there are notable differences in its clinical manifestations and management in women. Objective:This study aimed to compare variations in sex and thyroid hormone levels and menstrual factors between postmenopausal women with and without motor complications (PWP-MC and PWP-nMC, respectively) and analyze their correlations with motor complications. Methods:Ninety-five Postmenopausal Women with Parkinson's Disease (PWP) provided data on age at menarche, age at menopause, menstrual cycle duration (interval between cycle starts (days)), total years of menstruation (menopausal age - age at menarche), thyroid disease history, and gynecological surgical history. Six sex hormones and seven thyroid function indicators were measured, followed by an analysis of the relationships among sex hormone levels, thyroid function, menstrual factors, clinical characteristics, and disease severity in PWP. The effects of sex hormones and menstrual factors on motor complications in PWP were also investigated. Results:The results revealed several key findings: (1) PWP-MC exhibited lower serum prolactin levels than PWP-nMC (p < 0.05). (2) In PWP, serum estradiol levels were negatively correlated with Hamilton Anxiety Rating Scale (HAMA) scores (r = -0.208, p = 0.043). (3) There were no statistically significant differences in age at menarche, age at menopause, menstrual cycle duration, menstruation duration (Days of active bleeding per cycle), or total years of menstruation between PWP-MC and PWP-nMC (p > 0.05). (4) In PWP, age at menarche was negatively correlated with Mini-Mental State Examination (MMSE) scale scores (r = -0.264, p = 0.01) and Montreal Cognitive Assessment (MoCA) scale scores (r = -0.297, p = 0.004); total years of menstruation were positively correlated with MoCA scale scores (r = 0.278, p = 0.006); menstrual cycle duration was negatively correlated with Unified Parkinson's Disease Rating Scale, Part III (UPDRS-III) scores (r = -0.246, p = 0.016) and Hoehn-Yahr (H-Y) stages (r = -0.236, p = 0.021); and menstruation duration was positively correlated with HAMA (r = 0.215, p = 0.036) and Non-Motor Symptoms Scale (NMSS) scores (r = 0.214, p = 0.037). (5) In PWP-MC, age at menopause and total years of menstruation were positively correlated with Hamilton Depression Rating Scale (HAMD) scores (r = 0.335, p = 0.043; r = 0.352, p = 0.033, respectively); menstruation duration was negatively correlated with UPDRS-III scores (r = -0.362, p = 0.028) and positively correlated with HAMD (r = 0.329, p = 0.047) and HAMA (r = 0.451, p = 0.005) scores; and menstruation duration was positively correlated with NMSS (r = 0.325, p = 0.050) scores. (6) In PWP-nMC, age at menarche was negatively correlated with MMSE (r = -0.332, p = 0.011) and MoCA (r = -0.296, p = 0.024) scores; total years of menstruation were negatively correlated with UPDRS-III (r = -0.287, p = 0.029) scores and positively correlated with MMSE (r = 0.316, p = 0.016) and MoCA (r = 0.337, p = 0.010) scores. (7) Compared with PWP-nMC, PWP-MC had lower serum triiodothyronine levels (p < 0.05) and higher serum thyroid-stimulating hormone levels (p < 0.05). (8) In PWP-MC, triiodothyronine levels were negatively correlated with UPDRS-III scores (r = -0.344, p = 0.037) and H-Y stages (r = -0.445, p = 0.005); free triiodothyronine (FT3) levels were negatively correlated with H-Y stages (r = -0.476, p = 0.003); and free thyroxine (FT4) levels were negatively correlated with UPDRS-III scores (r = -0.422, p = 0.009) and H-Y stages (r = -0.365, p = 0.026). Conclusion:These findings suggest that the occurrence of motor complications in PWP may be correlated with prolactin, T3, and FT3 levels. Additionally, attention should be given to thyroid function and serum T3, T4, FT3, and FT4 levels in PWP, as lower levels may be associated with more severe motor symptoms, higher H-Y stages, and poorer cognitive function. Furthermore, older age at onset was inversely associated with motor complications in PWP, whereas a longer disease duration and higher NMSS score are risk factors.

The comparative efficacy of tenecteplase versus alteplase in achieving early recanalization (ER) before mechanical thrombectomy (MT) for large-vessel occlusion (LVO) remains uncertain. This study was a retrospective analysis of prospectively collected data of consecutive patients with LVO underwent intravenous thrombolysis (IVT) and brain angiography between January 2022 and December 2023. ER was defined as ≥ 50

Acute vestibular syndrome (AVS) is characterized by the sudden onset of dizziness or vertigo, accompanied by nausea, vomiting, gait instability, and nystagmus, lasting for more than 24 hours and often persisting for several days to weeks. Central AVS primarily involves central vestibular structures, such as the brainstem and cerebellum, and is most commonly caused by ischemic stroke in the posterior circulation. When acute posterior circulation infarction presents solely with isolated dizziness or vertigo, without other symptoms of central nervous system damage, it is often misdiagnosed as a peripheral vestibular disorder, this can lead to serious consequences. Therefore, distinguishing between central AVS and peripheral AVS in clinical practice is crucial, as the treatment strategies and prognosis differ significantly. Early identification of central AVS helps in adopting specific diagnostic and therapeutic measures. With advancements in vestibular and oculomotor theories, as well as neuroimaging, it is now possible to rapidly identify and diagnose central AVS of a vascular cause. This article summarizes recent diagnostic strategies, and discusses the progress in clinical and laboratory examinations for central AVS of a vascular cause presenting as isolated vertigo.

Objective:Characteristic ocular symptoms are expected to serve as potential biomarkers for early diagnosis of Parkinson's disease (PD). However, possible ocular impairments in PD patients are rarely studied. The study aimed to investigate eye movement characteristics and pupil diameter changes in early-stage PD patients using virtual reality (VR)-based system and explore their contribution in the diagnosis of early-stage PD. Methods:Forty-three early-stage PD patients and 25 healthy controls were included. Eye movements and pupillary response of all subjects were recorded and evaluated by wearing VR glasses. All subjects completed pro-saccade and anti-saccade tasks. Saccadic eye movement and pupillary response parameters were analyzed. Random Forests method was used for classification task, the performance of the classification model in differentiating early-stage PD patients from healthy controls were evaluated. Results:PD patients exhibited reduced pro-saccade velocity and accuracy, longer average time to complete the pro-saccade, and lower anti-saccade error correction rate than healthy controls (all p < 0.05). Significant differences were found in the trajectories of changes in pupil diameter between the two groups. After extraction of frequency-amplitude features of pupil constriction from the spectra of the eye movement signals of PD patients, it can be seen that the amplitudes of movement signals of both the left and right eyes at different frequencies during pro-saccade and anti-saccade tasks were significant. The number of significant amplitude frequencies in both eyes at low (0-6 Hz), medium (7-12 Hz) and high frequencies (13-19 Hz) was 23, 9, and 16, respectively, during pro-saccade task, which was 10, 29, and 43, respectively, during anti-saccade task. The model with all features achieved an accuracy of up to 79%. Conclusion:This study presents a non-invasive approach toward the diagnosis of early-stage PD with VR technology. Eye movement and pupillary response abnormalities measured using VR may be used as effective biomarkers for the diagnosis of early-stage PD.

This study assessed the effects of tenecteplase (rh-TNK-TPA) in ischemic stroke treatment, focusing on neurological function, cerebral blood flow, inflammation, and quality of life. Fifty-three patients received rh-TNK-TPA and 47 received alteplase. The rh-TNK-TPA formulation showed a single-chain content of 73.47% and molecular weight of 58,778.23 Da. Baseline data were comparable between groups (p > 0.05). Clinical efficacy was significantly higher in the rh-TNK-TPA group (96.23%) than in the alteplase group (87.23%) (p < 0.05). Neurological biomarkers (NSE, UCH-L1, MBP, GFAP, S-100(3) decreased in both groups post-treatment, with more significant reductions in the experimental group. Cerebral blood flow improved, with increased MCA values and decreased ACA/PCA values, more favourable in the rh-TNK-TPA group (p < 0.05). Inflammatory markers, TLR-4, and NF-kappa B levels declined after treatment, significantly more in the rh-TNK-TPA group (p < 0.05). Quality of life improved in both groups, but more markedly in the experimental group (p < 0.05). Adverse reactions and mortality showed no significant differences (p > 0.05). Overall, rh-TNK-TPA thrombolysis improves clinical outcomes and quality of life by reducing inflammation and neurological injury via TLR-4/NF-kappa B pathway modulation, supporting its clinical use.

Objective This paper was performed to unravel the predictive value of serum cystatin C (Cys C) and matrix metalloproteinase 9 (MMP-9) levels before vascular stent implantation for in-stent restenosis (ISR) 6-12 months after stent implantation for intracranial and extracranial arterial stenosis. Methods One hundred and ninety-eight patients who underwent dilatation stenting for intracranial and extracranial arterial stenosis and completed Digital Subtraction Angiography or head and neck CT- Angiography review were selected for the study and were divided into ISR group (n = 33) and no ISR (NISR) group (n = 165) according to the presence or absence of ISR. Serum levels of Cys C, MMP-9, triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), uric acid (UA), creatinine (Cr), homocysteine (Hcy), fibrinogen (FIB), total bilirubin (TBIL), endothelin-1 (ET-1), nitric oxide (NO), angiotensin II (Ang II), interleukin-6 (IL-6), tumor necrosis factor (TNF-α), and C-reactive protein (CRP) levels before vascular stent implantation were examined and compared between groups. ROC curves were employed for analyzing the predictive value of serum Cys C and MMP-9 alone or in combination for ISR. Pearson test was utilized for analyzing the serum Cys C and MMP-9 with vasoactive substances and inflammatory cytokines in patients in the ISR group. Logistic regression analysis was implemented to analyze the factors influencing ISR 6-12 months after stent implantation for intracranial and extracranial arterial stenosis. Results Cys C, MMP-9, LDL, UA, Cr, Hcy, FIB, ET-1, NO, Ang II, IL-6, TNF-α, and CRP were higher in the ISR group than in the NISR group, and TBIL was lower than in the NISR group (P < 0.05). The AUC of the combined serum Cys C and MMP-9 (AUC = 0.900) was greater than that of Cys C (AUC = 0.685) or MMP-9 (AUC = 0.870) alone (P < 0.05). Cys C and MMP-9 levels were positively correlated with ET-1, NO, Ang II, IL-6, TNF-α, and CRP (r > 0, P < 0.05). Increased levels of Cys C, MMP-9, LDL-C, UA, Cr, Hcy, FIB, ET-1, NO, Ang II, IL-6, TNF-α, and CRP, and diabetes were risk factors for the development of ISR (OR > 1, P < 0.05), and TBil was protective factor (OR < 1, P < 0.05). Conclusion Serum Cys C combined with MMP-9 levels are effective in predicting ISR.

AIMS:This study aimed to investigate the incidence and risk factors of motor complications including wearing-off (WO) and dyskinesia during long-term levodopa (LD) therapy in Chinese patients with Parkinson's disease (PD), and develop corresponding predictive models, thereby providing a basis for personalized treatment strategies. METHODS:This cross-sectional study included 208 consecutive PD patients who were recruited. The presence of WO and dyskinesia was assessed by a 9-item wearing-off questionnaire and the Unified Parkinson's Disease Rating Scale part IV. Univariate and multivariate logistic regression analyses were used to predict the risk factors of WO and dyskinesia. Predictive models for WO and dyskinesia were then constructed, and their diagnostic performance was evaluated using the area under the curve (AUC). RESULTS:The overall prevalence rate of motor complications was 46.2% (96/208), with a prevalence of 45.7% (95/208) for WO, 22.1% (46/208) for dyskinesia, and 21.6% (45/208) for the simultaneous occurrence of WO and dyskinesia. Younger age at onset (OR 0.92, p < 0.001), higher levodopa-equivalent daily dose (LEDD) (OR 1.00, p < 0.001), and higher Hoehn-Yahr stage (OR 3.41, p < 0.001) were independent risk factors for WO. A predictive model for WO constructed using these three variables demonstrated high diagnostic efficacy with an AUC of 0.887 (95% CI 0.842-0.932), a sensitivity of 84%, and a specificity of 83%. The independent risk factors for dyskinesia included younger age at onset (OR 0.94, p < 0.001), akinetic-rigid type (OR 2.42, p = 0.034), and higher LEDD (OR 1.01, p < 0.001). A predictive model for dyskinesia constructed using these three variables yielded an AUC value of 0.829 (95% CI 0.767-0.897), with a sensitivity of 67% and a specificity of 89%. The two models were both well calibrated and had a high net clinical benefit. CONCLUSION:Our findings suggest that the prevalence of motor complications during long-term LD treatment is relatively high among PD patients in China, with WO occurring more commonly than dyskinesia. Younger age at PD onset, higher LEDD, more severe disease, and akinetic-rigid subtype are key predictors of motor complications. The predictive models developed in this study could serve as a potential tool to assist clinicians in identifying patients at higher risk for WO and dyskinesia, and may support personalized treatment optimization.

This purpose of this study is to investigate the effectiveness and safety of utilizing the arterial spin-labeling (ASL) combined with diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) combined with DWI double mismatch in the endovascular treatment of patients diagnosed with wake-up stroke (WUS). In this single-center trial, patients diagnosed with WUS underwent thrombectomy if acute ischemic lesions were observed on DWI indicating large precerebral circulation occlusion. Patients with no significant parenchymal hypersignal on FLAIR and ASL imaging showing a hypoperfusion tissue to infarct core volume ratio of at least 1.2 were included. The participants were divided into groups receiving endovascular thrombectomy plus medical therapy or medical therapy alone, based on their subjective preference. Functional outcomes were assessed using the ordinal score on the modified Rankin scale (mRs) at 90 days, along with the rate of functional independence. In this study, a total of 77 patients were included, comprising 38 patients in the endovascular therapy group and 39 patients in the medical therapy group. The endovascular therapy group exhibited more favorable changes in the distribution of functional prognosis measured by mRs at 90 days, compared to the medical therapy group (adjusted common odds ratio, 3.25; 95

Background:The investigation of mitophagy in Alzheimer's disease (AD) remains relatively underexplored in bibliometric analysis. Objective:To delve into the progress of mitophagy, offering a comprehensive overview of research trends and frontiers for researchers. Methods:Basic bibliometric information, targets, and target-drug-clinical trial-disease extracted from publications identified in the Web of Science Core Collection from 2007 to 2022 were assessed using bibliometric software. Results:The study encompassed 5,146 publications, displaying a consistent 16-year upward trajectory. The United States emerged as the foremost contributor in publications, with the Journal of Alzheimer's Disease being the most prolific journal. P. Hemachandra Reddy, George Perry, and Xiongwei Zhu are the top 3 most prolific authors. PINK1 and Parkin exhibited an upward trend in the last 6 years. Keywords (e.g., insulin, aging, epilepsy, tauopathy, and mitochondrial quality control) have recently emerged as focal points of interest within the past 3 years. "Mitochondrial dysfunction" is among the top terms in disease clustering. The top 10 drugs/molecules (e.g., curcumin, insulin, and melatonin) were summarized, accompanied by their clinical trials and related targets. Conclusions:This study presents a comprehensive overview of the mitophagy research landscape in AD over the past 16 years, underscoring mitophagy as an emerging molecular mechanism and a crucial focal point for potential drug in AD. This study pioneers the inclusion of targets and their correlations with drugs, clinical trials, and diseases in bibliometric analysis, providing valuable insights and inspiration for scholars and readers of JADR interested in understanding the potential mechanisms and clinical trials in AD.

Parkinson's disease (PD) is known to impact both sexes, yet women exhibit unique clinical profiles and require tailored disease management strategies. This study sought to delineate the differences in sex and thyroid hormone levels, along with menstrual factors, in postmenopausal women with PD with motor complications and to evaluate their correlation with motoric issues. A cohort of 95 postmenopausal women with PD provided data encompassing menarche and menopause timing, menstrual cycle characteristics, and thyroid and gynecological histories. Hormonal and thyroid function assessments were conducted, correlating with PD patients’ clinical features and disease severity. Key findings include lower serum prolactin in women with PD and motor complications, a negative correlation between estradiol levels and HAMA scores, and no significant differences in menstrual characteristics between those with and without motor complications. Menarche age negatively correlated with cognitive scores, while the menstrual cycle and its duration showed associations with motor symptom severity. Women with motor complications demonstrated specific correlations between menopause timing, menstrual cycle, and psychological scores and presented with lower T3 and higher thyroid-stimulating hormone levels. T3 and FT3 levels were negatively linked to motor symptom severity and H-Y staging in this group. Motor complications in female PD patients are potentially linked to prolactin and T3 levels, underscoring the need for vigilant thyroid function monitoring. Advanced age at PD onset appears protective against motor complications, contrasting with the risks of extended disease duration and elevated NMSS scores.

目的:探讨大动脉粥样硬化(LAA)与心源性栓塞(CE)2种不同机制所致急性大血管闭塞(ALVO)患者的临床特点,并比较血管内治疗(EVT)的疗效及预后.方法:回顾性纳入2018年5月至2022年7月在航天中心医院国家高级卒中中心接受EVT的ALVO患者.根据卒中病因分型将患者分为LAA组和CE组,应用mTICI分级评价血管再通情况、改良Rankin量表评分(mRS)评价患者90d预后,统计术后72h颅内出血转化(HT)发生率及90d死亡率,评价EVT的安全性.比较2组患者的临床特征、手术疗效及预后,并探讨不良预后的独立危险因素.结果:共纳入184例患者,其中LAA组164例(89.1％),CE组20例(10.9％).与CE组相比,LAA组年龄更小(P＜0.001),基线美国国立卫生研究院卒中量表(NIHSS)评分更低(P=0.024),基线格拉斯哥昏迷(GCS)评分更高(P=0.037).2组既往心房颤动(P＜0.001)、饮酒史(P= 0.004)及D-二聚体(P=0.008)及尿酸(P=0.038)水平均存在统计学差异.2组在穿刺至再通时间、术后成功再通、取栓次数及取栓方式等手术相关操作均无统计学差异.LAA组患者90d预后良好的比例显著高于CE组(38.4％vs10％,P=0.012),死亡率较CE组低(13.4％vs35％,P=0.03),差异有统计学意义,但2组颅内HT无统计学差异(P=0.522).多因素Logistic回归分析显示,年龄和基线NIHSS评分是不良预后的独立危险因素.结论:LAA型缺血性卒中患者接受EVT治疗较CE型预后更好、死亡率更低;年龄、基线NIHSS评分与不良预后独立相关.

Purpose Limb remote ischemic conditioning (LRIC) may be an effective method to control hypertension. This study investigated whether LRIC decreases blood pressure by regulating the hypertensive inflammatory response in spontaneously hypertensive rats (SHR). Method The SHR and aged-matched Wistar rats with different ages were randomly assigned to the SHR group, SHR+LRIC group, Wistar group, and Wistar + LRIC group. LRIC was conducted by tightening a tourniquet around the upper thigh and releasing it for three cycles daily (10 mins x3 cycles). Blood pressure, the percentage of monocytes and T lymphocytes, and the concentration of pro-inflammatory cytokines in the blood were analyzed. Results The blood pressure of SHR was significantly higher than that of age-matched Wistar rats. LRIC decreased blood pressure in SHR at different ages (4, 8, and 16 weeks old), but had no effect on the blood pressure in Wistar rats. Flow cytometry analysis showed that blood monocytes and CD8 T cells of SHR were higher than those of Wistar rats. LRIC significantly decreased the percentage of monocytes and CD8 T cells in SHR. Consistent with the changes of immune cells, the levels of plasma IL-6 and TNF-α in SHR were also higher. And LRIC attenuated the plasma IL-6 and TNF-α levels in SHR. Conclusion LRIC may decreased the blood pressure via modulation of the inflammatory response in SHR.

AbstractObjectivesThis study aimed to assess the epidemiological features and explore the potential risk factors for early neurological deterioration (END) in patients with acute single small subcortical infarction (SSSI) who underwent antiplatelet therapy without carotid artery stenosis.Materials & methodsPatients with SSSI, as confirmed by cranial magnetic resonance imaging (MRI), who were hospitalized within 48 h after the onset of symptoms were enrolled. END was mainly defined as increment in the National Institutes of Health Stroke Scale (NIHSS) score of ≥ 2 points or any new neurological deficit. Poor functional outcome was defined as modified Rankin Scale (mRS) score of > 2 points at 3-month after the onset. The association of END with multiple indicators was assessed at the early stage of admission using multivariate logistic regression analysis, and adjusted odds ratios (aORs) were calculated.ResultsA total of 280 patients were enrolled from June 2020 to May 2021, of whom, END occurred in 44 (15.7%) patients (median age, 64 years; 70.5% male), while END occurred during sleep in 28 (63.6%) patients. History of hypertension (aOR: 4.82,p = 0.001), infarction in internal capsule (aOR: 3.35,p = 0.001), and elevated level of low-density lipoprotein cholesterol (LDL-C; aOR: 0.036,p = 0.0016) were significantly associated with the risk of END. Patients with END (aOR: 5.74,p = 0.002), history of diabetes (aOR: 2.61,p = 0.020), and higher NIHSS scores at discharge (per 1-score increase, aOR: 1.29,p = 0.026) were associated with the poor functional outcome at 3-month after the onset.ConclusionPatients with a history of hypertension, infarction in internal capsule or a higher level of LDL-C were found to be at a higher risk of END.

目的 观察高压氧联合甲钴胺对面神经炎的疗效.方法 选择面神经炎患者82例,其中男性44例,女性38例;年龄22～61岁,平均年龄41.09岁;病程1～6 d,平均病程3.54 d;病情轻度27例,中度36例,中重度13例,重度6例.随机分为观察组和对照组,各41例.两组患者入院后均接受基础治疗,对照组在基础治疗之上给予甲钴胺治疗,观察组在对照组基础上加用高压氧治疗.观察两组患者治疗后症状体征量化评分、面神经传导速度(NCV)及Portmann评分情况.结果 治疗前,两组患者症状体征(眼睑开合、额肌运动、鼻唇沟深浅、口角歪斜、总积分)评分、面神经NCV及波幅、Portmann评分比较,差异均无统计学意义(P＞0.05);治疗后,两组患者症状体征(眼睑开合、额肌运动、鼻唇沟深浅、口角歪斜、总分)评分均有所降低,且观察组显著低于对照组(P＜0.05).治疗后,两组患者面神经NCV及波幅均有所上升[观察组:(34.06±3.15)m/s vs(17.92±2.46)m/s、(3.86±0.76)mV vs(1.42±0.46)mV;对照组:(22.58±3.07)m/s vs(18.14±2.51)m/s、(2.71±0.62)mV vs(1.45±0.48)mV],且观察组显著高于对照组(P＜0.05).治疗后,两组患者Portmann评分均有所上升,且观察组显著高于对照组[(15.43±2.57)分vs(9.25±2.48)分.P＜0.05];两组治疗后均较治疗前Portmann评分升高,差异有统计学意义[观察组:(15.43±2.57)分vs(3.16±1.02)分;对照组:(9.25±2.48)分vs(3.27±1.06)分.P＜0.05].结论 高压氧联合甲钴胺可显著改善面神经炎患者症状体征,加快面神经NCV及波幅,促进其面部表情肌的自主运动功能,值得临床广泛推广并应用.

Depression is one of the early and most persistent non-motor symptoms of Parkinson's disease (PD), which remains ignored, resulting in the underdiagnosis of PD. Unfortunately, scarce studies and the non-availability of diagnostic strategies cause countless complications, highlighting the need for appropriate diagnostic biomarkers. Recently, brain-enriched miRNAs regulating vital neurological functions have been proposed as potent biomarkers for therapeutic strategies. Therefore, the present study is aimed to identify the brain-enriched miR-218-5p and miR-320-5p in the serum of the Chinese depressed PD patients (n = 51) than healthy controls (n = 51) to identify their potency as biomarkers. For this purpose, depressive PD patients were recruited based on HAMA and HAMD scores and miR-218-5p and miR-320-5p and IL-6, and S100B levels were analyzed using real-time PCR (qRT-PCR) and ELISA assay, respectively. In silico analysis was performed to identify key biological pathways and hub genes involved in the psychopathology of depression in PD. Here, we found significantly downregulated miR-218-5p and miR-320-5p following higher levels of IL-6 and S100B in depressed PD patients than in control (p < 0.05). The correlation analysis revealed that both miRNAs were negatively correlated with HAMA and HAMD, and IL-6 scores, along with a positive correlation with PD duration and LEDD medication. ROC analysis showed AUC above 75% in both miRNAs in depressed PD patients, and in silico analysis revealed that both miRNA's targets regulate key neurological pathways such as axon guidance, dopaminergic synapse, and circadian rhythm. Additional analysis revealed PIK3R1, ATRX, BM1, PCDHA10, XRCC5, PPP1CB, MLLT3, CBL, PCDHA4, PLCG1, YWHAZ, CDH2, AGO3, PCDHA3, and PCDHA11 as hub-genes in PPI network. In summary, our findings show that miR-218-5p and miR-320-5p can be utilized as future biomarkers for depression in PD patients, which may aid in the early diagnosis and treatment of Parkinson's disease.

目的 观察益气活血汤治疗缺血性脑卒中(IS)临床疗效并探讨其作用机制.方法 104例IS患者按照随机数字表法分为治疗组与对照组各52例.对照组给予规范化西医治疗,治疗组在对照组基础上予以中药益气活血汤口服,疗程均为4周.比较两组治疗前后中医证候评分、美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(mRs)评分、Barthel指数(BI)评分;比较两组血清神经生长因子(NGF)、脑源性神经营养因子(BDNF)水平;并比较两组花生四烯酸(AA)、二磷酸腺苷(ADP)诱导的血小板聚集率;比较两组治疗总有效率.结果 两组治疗后中医证候评分、NIHSS、mRs评分与治疗前比较降低(均P＜0.01),BI评分升高(P＜0.01);且治疗后治疗组中医证候评分、NIHSS、mRs评分与对照组比较降低(均P＜0.01),BI评分升高(P＜0.01).两组治疗后血清NGF、BDNF水平与治疗前比较均升高(均P＜0.01);且治疗后治疗组血清NGF、BDNF水平均高于对照组(均P＜0.01).两组治疗后AA、ADP诱导的血小板聚集率与治疗前比较均降低(均P＜0.01),且治疗后治疗组AA、ADP诱导的血小板聚集率均低于对照组(均P＜0.01).治疗组总有效率94.23％高于对照组的78.85％(P＜0.05).结论 益气活血汤可抑制血小板聚集,促进神经功能修复,减轻中医证候,改善神经功能和预后,提高日常生活活动能力,治疗IS效果显著.