Acute cerebral infarction is one of the most important diseases that endanger the life and health of citizens. Inflammatory response is closely associated with the development and progression of acute cerebral infarction, and the levels of inflammatory markers can reflect the severity of inflammation. In recent years, monocyte to high-density lipoprotein cholesterol ratio (MHR) has attracted wide attention as a newly applied indicator for the degree of inflammatory response. This article reviews the association between peripheral blood MHR and acute cerebral infarction in terms of high-risk factors, risk prediction, early functional deterioration, severity assessment, hemorrhagic transformation, and prognosis.

Objective To investigate the relationship between changes in cerebral oxygen extraction fraction (cOEF) and the occurrence of cerebral hyperperfusion syndrome (CHS) after carotid artery stenting (CAS). Methods A total of 212 patients with carotid artery stenosis who underwent CAS from December 2015 to August 2019 were included. They were divided into normal group (175 cases) and high-perfusion group (37 cases) based on the occurrence of CHS after surgery. General information and preoperative and postoperative cOEF values were compared between the two groups. The influencing factors for CHS after CAS were analyzed using logistic regression models, and receiver operating characteristic (ROC) curves were drawn to calculate the area under the curve (AUC). Results There were significant differences in preoperative CAS degree, preoperative cOEF, and pos-toperative cOEF between the two groups (t=2.289-5.944, P <0.05). The logistic regression analysis showed that preoperative CAS degree, preoperative cOEF, and postoperative cOEF were influence factors for CHS (P <0.001). According to the ROC curves, the AUC values for the prediction of CHS by preoperative cOEF and postoperative cOEF were 0.734 (cut-off=0.442) and 0.775 (cut-off=0.521), respectively. Conclusion Preoperative cOEF >0.442 and postoperative cOEF >0.521 are risk factors for CHS after CAS, and cOEF monitoring during the perioperative period is of great clinical significance in CHS prevention.

The aim of this study is to investigate whether there is a correlation between serum calcium levels and clinical severity or functional outcome at discharge in Chinese patients with acute ischemic stroke. Data from 339 patients admitted to our hospital between July 2020 and July 2021 were analyzed. Baseline demographic and clinical information was collected within 24 h of admission, including serum calcium levels, stroke severity (measured by the National Institutes of Health Stroke Scale [NIHSS] score), and lesion volumes. The modified Rankin Scale [mRS] assessed functional outcomes at discharge. Our analysis showed that the median age of patients included in the study was 65 years (interquartile range [IQR], 60–70), and 60.8

钴铵素C( cblC)缺乏症在先天性细胞内钴胺素即维生素B12代谢缺陷疾病谱中最为常见,其致病基因为 MMACHC (OMIM 609831)[1].该病为常染色体隐性遗传,其主要生物学标志物就是尿甲基丙二酸( MMA )和血总同型半胱氨酸( tHcy)显著升高[2] ,故又名MMA血症伴高Hcy血症cblC型( cblC type).大多数cblC缺乏症在婴幼儿期即表现出症状,只有不到20％的患者在青春期或成人之前正常,称之为晚发型cblC缺乏症[3].现报告1 例较为罕见的以亚急性联合变性为主要表现的晚发型cblC缺乏的病例.

目的 研究芹菜素(AGN)对MPP+诱发的帕金森细胞模型中自噬、氧化应激的影响及神经保护作用.方法 CCK-8筛选AGN有效浓度,SH-SY5Y细胞分6组:①对照组;②MPP+组;③A组:AGN浓度10μmol/L;④B组:AGN浓度20μmol/L;⑤C组:AGN浓度40μmol/L;⑥D组:AGN浓度100μmol/L.确定AGN有效浓度后将细胞分为3组:对照组、MPP+组及AGN+MPP+组.检测细胞凋亡及Caspase3、Bcl-2、Bax、LC3-II、LC3-I、Beclin-1、ULK1蛋白表达,检测丙二醇、超氧化物歧化酶和谷胱甘肽过氧化物酶水平.分析每组GFP-LC3斑点.结果 AGN在40μmol/L时能显著降低MPP+诱导的细胞毒性损伤,选择40μmol/L作为最佳药物保护浓度进行后续研究.AGN+MPP+组细胞凋亡率较MPP+组下降(P<0.05).相较于MPP+组,AGN+MPP+组Caspase3表达降低,Bcl-2/Bax值升高(P值均<0.01).与MPP+组比较,AGN+MPP+组抑制MDA的表达(P<0.05),恢复GPX和SOD的活性(P<0.05).AGN+MPP+组细胞内GFP-LC3斑点较MPP+组显著减少(P<0.05).对比MPP+组,AGN+MPP+组LC3-II/LC3-I比值及Beclin-1、ULK1表达显著降低(P值均<0.05).结论 AGN能减轻MPP+诱导的SH-SY5Y细胞凋亡,增强抗氧化能力,其细胞保护作用可能与降低细胞自噬水平相关.

背景 颈动脉支架置入术(CAS)后微栓塞不仅发生于支架同侧颈动脉供血区,也常发生于支架对侧颈动脉供血区以及椎基底动脉供血区.目前CAS后发生支架同侧颈动脉供血区微栓塞的机制如高龄、颈动脉溃疡斑块等已相对明确,但CAS后支架对侧颈动脉供血区微栓塞的发生机制国内鲜有文献提及.目的 探讨单侧CAS后支架对侧颈动脉供血区微栓塞的发生情况,并分析其危险因素.方法 连续选取2013年12月—2018年8月在潍坊市人民医院神经内科就诊的拟行单侧CAS的颈动脉狭窄患者164例为研究对象.收集患者一般资料(性别、年龄、高血压发生情况、糖尿病发生情况、高脂血症发生情况、冠心病发生情况、心房颤动发生情况、吸烟情况、卒中史情况、术前颈动脉狭窄程度),记录术后颈动脉狭窄程度、术后支架对侧颈动脉狭窄程度、支架对侧颈动脉闭塞发生情况、左侧颈动脉病变发生情况、Ⅱ/Ⅲ型主动脉弓发生情况、CAM评分≥3分情况、闭环支架使用情况、平均增加导管和/或导丝数量、手术时间.根据CAS后3 d内的颅脑MRI平扫检查结果,剔除后循环供血区微栓塞患者,将剩余患者分为同侧组(支架同侧颈动脉供血区微栓塞)和对侧组(支架对侧颈动脉供血区微栓塞或支架两侧颈动脉供血区微栓塞).结果 164例患者中有163例完成CAS,CAS后3 d内颅脑MRI平扫检查发现72例(44.2％)新发微栓塞(其中支架同侧颈动脉供血区微栓塞39例,支架对侧颈动脉供血区微栓塞5例,支架两侧颈动脉供血区微栓塞13例,后循环供血区微栓塞15例).剔除发生后循环供血区微栓塞患者,剩余57例,将其分为同侧组(39例)和对侧组(18例).对侧组左侧颈动脉病变发生率、CAM评分≥3分发生率高于同侧组(P<0.05).多因素Logistic回归分析结果显示,左侧颈动脉病变〔OR=10.015,95％CI(2.728,42.680)〕、CAM评分≥3分〔OR=9.137,95％CI(2.564,36.271)〕是颈动脉狭窄患者CAS后发生支架对侧颈动脉供血区微栓塞的影响因素(P<0.05).结论 发生左侧颈动脉病变以及CAM评分≥3分是CAS后支架对侧颈动脉供血区微栓塞的危险因素,提示复杂的路径以及严重的主动脉弓斑块可能导致CAS后支架对侧颈动脉供血区微栓塞的发生概率增加.

目的 研究首发精神分裂症、抑郁症患者的视空间工作记忆特点.方法 选取精神分裂症患者(精神分裂症组)42例,精神分裂症Ⅰ级亲属(精神分裂症亲属组)50名,抑郁症患者(抑郁症组)35例,抑郁症Ⅰ级亲属(抑郁症亲属组)45名及健康对照者(对照组)30名.采用可重复成套神经心理状态测验(RBANS)、视空间工作记忆测试(SWM)、经典n-back工作记忆模型对视空间工作记忆能力进行评估.结果 精神分裂症组和抑郁症组RBANS总分及各因子分和矩阵工作记忆的0-back、2-back均低于对照组(P<0.01),SWM中工作记忆反应时较对照组长,正确数较对照组少(P<0.01);精神分裂症组RBANS总分及各因子分和矩阵工作记忆的0-back、2-back低于抑郁症组(P<0.05),SWM中工作记忆反应时较抑郁症组长,正确数较抑郁症组少(P<0.05).精神分裂症亲属组和抑郁症亲属组RBANS总分及各因子分、矩阵工作记忆的0-back、2-back试验评分均低于对照组,SWM中工作记忆反应时较对照组长,正确数较对照组少(P<0.05).精神分裂症亲属组矩阵工作记忆的2-back评分高于精神分裂症组(P<0.01).结论 精神分裂症、抑郁症患者确实存在视空间工作记忆的损伤,且前者更加严重.两种疾病的I级亲属同样存在不同程度的视空间工作记忆损伤,且这种损伤具有遗传特质性,可能先于疾病本身出现,不会随着疾病的缓解而好转.

Objective To explore the effect of carotid artery stenting (CAS) on cognitive function in patients with carotid artery stenosis.Methods Totally 120 patients with carotid artery stenosis were enrolled in this study,including 60 patients who underwent CAS and 60 who received drug treatment.The cognitive function of patients in two groups was measured with Wechsler Adult Intelligence Scale-Revised in China (WAIS-RC) before treatment and at 3 days and 6 months after treatment.Results In the CAS group,the scores of knowledge,arithmetic,digit span,digit symbol,and comprehension at 3 days after treatment were significantly lower than those before treatment;the scores of digit symbol and digit span at 6 months after treatment were significantly higher than those before treatment or at 3 days after treatment (F=2.66-3.86,P＜0.05).The score of block pattern in the drug treatment group at 3 days after treatment was significantly higher than that before treatment (F=3.80,P＜0.05).Conclusion Compared with drug treatment,the carotid artery stenosis patients treated by CAS experience temporary cognitive decline in the early stage,but the long-term memory and attention will be improved.

目的 探讨丁苯酞治疗帕金森病(PD)的效果及对氧化应激指标、核磁共振波谱的影响.方法 选取初次来该院住院治疗的PD患者64例,对照组32例给予常规美多芭治疗,研究组32例在对照组的基础上给予丁苯酞治疗,对两组患者行统一PD评定量表(UPDRS)评测、磁共振波谱检查,检测患者血中超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-PX)、过氧化氢酶(CAT)、丙二醛(MDA)水平.结果 两组治疗后UPDRS评分均降低,且研究组低于对照组(P<0.05);与对照组比较,研究组治疗后SOD、GSH-PX、CAT水平均升高,MDA水平降低,磁共振波谱N-乙酰天门冬氨酸(NAA)/肌酸(Cr)及胆碱复合物(Cho)/Cr升高(P<0.05).结论 在口服美多芭治疗基础上联合应用丁苯酞对PD的治疗有更好的效果,其效果可能与丁苯酞调控抗氧化酶能力有关.