Histon deacetylase 4 (HDAC4) modulates memory and cognitive impairment, but its association with post-stroke cognitive impairment (PSCI) is unclear. This study aimed to investigate the potential of HDAC4 for predicting PSCI risk. Sixty-nine PSCI patients and 70 control post-stroke (CPS) patients were enrolled in this case-control study. In all stroke patients, HDAC4 in peripheral blood mononuclear cells was detected by quantitative polymerase chain reaction; T-helper 17 (Th17) cells were detected by flow cytometry, and interleukin-17A was detected by enzyme-linked immunosorbent assay. HDAC4 was reduced in PSCI patients compared with CPS patients (P = 0.001). In total stroke patients, HDAC4 showed negative linkages with age (P = 0.003), history of diabetes (P = 0.012), stroke recurrence (P = 0.001), Th17 cells (P = 0.027), and interleukin-17A (P = 0.002). Additionally, multivariate logistic regression analysis revealed that HDAC4 (per unit) [odds ratio (OR) = 0.438, P = 0.024] was independently associated with a lower PSCI risk, but age (per unit) (OR = 1.061, P = 0.016) and multifocal disease (yes vs. no) (OR = 2.490, P = 0.014) were independently associated with a higher PSCI risk. By receiver operator characteristic curves, HDAC4 had an acceptable value for predicting PSCI risk [area under the curve (AUC) = 0.656, 95% confidence interval = 0.566-0.746]. The combination of HDAC4, age, and multifocal disease showed a good value for predicting PSCI risk (AUC = 0.728, 95% confidence interval = 0.644-0.811). HDAC4 may serve as a potential biomarker for predicting PSCI risk, which could facilitate the early screening and prevention of PSCI, thus promoting the management of stroke.

Retinol binding protein 4 (RBP4) is a mediator of inflammation and related to skin lesion formation, which suggests its engagement in psoriasis pathology and progression. This study intended to explore the change in RBP4 after systemic treatments, and its ability to predict treatment response in psoriasis patients. This prospective study enrolled 85 psoriasis patients and 20 healthy subjects. Plasma RBP4 was detected by enzyme-linked immunosorbent assay at baseline and 12th week (W12) after systemic treatments in psoriasis patients, as well as after enrollment in healthy subjects. Psoriasis Area and Severity Index (PASI) 75 and PASI 90 were evaluated at W12 in psoriasis patients. RBP4 at baseline was higher in psoriasis patients than in healthy subjects [median (interquartile range): 13.39 (9.71–22.92) versus 9.59 (6.57–13.72) µg/mL] (P = 0.003). In psoriasis patients, 50 (58.8

目的 分析急性前循环大血管闭塞性脑卒中(acute anterior circulation large vessel occlusive stroke,ALVOS)患者梗死核心体积(ischemia core volume,ICV)大小的影响因素及其与临床预后的关系.方法 回顾性收集2022年1月至2022年9月邯郸市中心医院神经内科收治的ALVOS患者62例,其中男性40例,女性22例,平均年龄65.6岁.根据ICV大小将患者分为小ICV(small-ICV,S-ICV)组(ICV＜50 mL,n=38)和大ICV(large-ICV,L-ICV)组(ICV≥50 mL,n=24),比较两组患者间临床特征的差异;采用多因素Logistic回归分析ALVOS患者形成L-ICV的独立影响因素;采用受试者工作特征(receiver operating characteristic,ROC)曲线评估ICV对ALVOS患者临床预后的预测效能;采用Kaplan-Meier生存分析法探讨ICV对患者生存期影响;采用Cox风险回归分析法分析ALVOS并发L-ICV患者发生死亡的危险因素.结果 与S-ICV患者比较,L-ICV患者美国国立卫生研究院卒中量表(NIHSS)评分及血红蛋白浓度较高,区域软脑膜侧支循环(regional lepto-meningeal collateral,rLMC)评分以及合并高血压史比例较低(P＜0.05);多因素Logistic回归分析显示血红蛋白浓度高(OR=1.082,95％CI:1.020～1.148;P＜0.01)是ALVOS患者发生L-ICV的独立危险因素,而rLMC评分高(OR=0.788,95％CI:0.678～0.916;P＜0.01)是发生L-ICV的保护性因素.ROC曲线分析显示预后良好和不良的ICV截断值是52.55 mL.Kaplan-Meier生存分析显示L-ICV组患者的累计生存率明显低于S-ICV组(P＜0.05).进一步对L-ICV组进行多因素Cox风险回归分析结果显示,症状性颅内出血(HR=28.855,95％CI:2.975～279.849,P＜0.05)和糖尿病(HR=13.832,95％CI:1.040～183.820,P＜0.05)是 L-ICV组患者生存的独立影响因素.结论 血红蛋白水平高是ALVOS患者形成L-ICV的独立危险因素,而rLMC评分高是其保护性因素.ICV大小对ALVOS患者的预后具有良好的预测价值.L-ICV ALVOS患者预后良好率、累计生存率低于S-ICV,其中症状性颅内出血和糖尿病是L-ICV患者生存的独立影响因素.

Background Acetyl-coenzyme A carboxylase 1 (ACC1) regulates lipid homeostasis, T helper (Th) cell differentiation, oxidative stress, inflammation response, and neurological process, engaging in acute ischemic stroke (AIS) pathogenesis, while its clinical utility in AIS is unclear. Hence, this study intended to explore the correlation among blood ACC1, Th17, and Th1 cells, and ACC1's potency as a prognostic biomarker for AIS management. Methods ACC1 in peripheral blood mononuclear cells (PBMCs) of 160 AIS patients and 30 controls were determined using RT-qPCR; blood Th17 and Th1 cells in AIS patients were quantified by flow cytometry. Results ACC1 was increased in AIS patients compared with controls (median (interquartile range): 2.540 (1.753-3.548) vs. 0.980 (0.655-1.743), p < 0.001), which exhibited a good value to reflect AIS risk with the area under the curve of 0.872 (95% CI: 0.805-0.939). Moreover, ACC1 was positively linked with Th17 (r = 0.374, p < 0.001) and Th1 (r = 0.178, p = 0.024) cells in AIS patients. Additionally, ACC1 (r = 0.328, p < 0.001), Th17 (r = 0.272, p = 0.001), and Th1 cells (r = 0.195, p = 0.014) were positively associated with the National Institutes of Health Stroke Scale score in AIS patients. ACC1 high vs. low (p = 0.038) and Th17 high vs. low (p = 0.026) were related to shortened recurrence-free survival (RFS) in AIS patients, while Th1 cells (p = 0.179) were not correlated with RFS. Whereas ACC1 (p = 0.248), Th17 (p = 0.079), and Th1 cells (p = 0.130) were not linked with overall survival (OS) in AIS patients. Conclusion Circulating ACC1 overexpression correlates with increased Th17, Th1 cells, NIHSS score, and shortened RFS in AIS patients.

Background Long noncoding RNA growth arrest-specific 5 (lnc-GAS5) is involved in the pathophysiology of acute ischemic stroke (AIS) by regulating vascular stenosis, inflammation, and neurocyte apoptosis. This study aimed to explore the clinical value of lnc-GAS5 in patients with AIS. Methods Plasma samples were collected from 120 patients with AIS at admission and 60 controls after enrollment, and lnc-GAS5 expression in the plasma of all participants was assessed by reverse transcription quantitative polymerase chain reaction. In patients with AIS, disease severity was evaluated using National Institute of Health Stroke Scale (NIHSS) score, and plasma inflammatory cytokine levels were measured by enzyme-linked immunosorbent assay. Recurrence-free survival (RFS) was calculated during a 36-month follow-up period. Results Lnc-GAS5 expression levels were higher in patients with AIS than in the controls (p < 0.001), and it had the potential to discriminate the controls from patients with AIS (area under the curve: 0.893, 95% confidence interval: 0.849-0.938). In patients with AIS, elevated lnc-GAS5 levels were positively correlated with NIHSS score (r = 0.397, p < 0.001), diabetes mellitus (p = 0.046), and higher levels of tumor necrosis factor alpha (TNF-alpha; r = 0.374, p < 0.001), interleukin-6 (IL-6; r = 0.223, p < 0.001), and interleukin-17A (IL-17A; r = 0.222, p = 0.015). The expression levels of lnc-GAS5 were also negatively correlated with the levels of interleukin-10 (IL-10; r = -0.350, p < 0.001) and RFS (p = 0.036). Conclusion Lnc-GAS5 is correlated with higher susceptibility to AIS, inflammation, and severity, and can predict an increased risk of AIS recurrence, indicating that monitoring of lnc-GAS5 might improve the management of AIS.

目的 观察银杏内酯注射液联合多奈哌齐治疗血管性痴呆(VaD)的临床疗效及对氧化应激的影响.方法 收集2018年1月-2020年1月在邯郸市中心医院治疗的80例VaD患者,按随机数字表法分为对照组和观察组各40例.在常规治疗基础上,对照组予多奈哌齐治疗2个月,观察组予银杏内酯注射液联合多奈哌齐治疗2个月,治疗前后进行简易精神状态量表(MMSE)和日常生活能力量表(ADL)评分,检测超氧化物歧化酶(SOD)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)水平,并记录2组临床疗效及治疗过程中的不良反应.结果 治疗后观察组MMSE评分、ADL评分及SOD、GSH-Px水平均明显高于对照组(P均＜0.05),MDA明显低于对照组(P＜0.05);观察组总有效率80.0％ (32/40)明显高于对照组的57.5％(23/40),差异有统计学意义(P＜0.05);2组不良反应发生率均较低,差异无统计学意义(P＞0.05).结论 银杏内酯注射液联合多奈哌齐治疗VaD患者临床疗效显著,可有效抑制氧化应激,不良反应轻微.

目的 分析不同年龄阶段血管性痴呆(vascular dementia,VD)患者脑脊液中炎症因子水平及其临床意义,探讨其发病规律.方法 选取40例VD患者,按年龄分为老年组(≥65岁)和非老年组(<65岁),以及20例健康志愿者作为对照组.分别检测三组受试者脑脊液中炎症因子白介素-1β(interleukin-1β,IL-1β)和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α).同时对三组受试者进行细微精神状态检查(minor mental state examination,MMSE)量表测试评分以及蒙特利尔认知量表(Montreal cognitive scale,MoCA)评分.最后统计不同年龄VD患者分别与炎症因子水平、MMSE以及MoCA评分的相关性关系;炎症因子与MMSE以及MoCA评分的相关性关系.结果 与对照组相比,不同年龄组VD患者的IL-1β和TNF-α水平明显升高,且老年组升高更明显(P<0.05).不同年龄组VD患者的MMSE和MoCA评分明显低于对照组,且老年组评分降低更明显(P<0.001).相关性分析结果显示VD患者年龄与炎症水平呈正相关(P<0.05),且与MMSE、MoCA评分呈负相关(P<0.05),炎症因子与MMSE以及MoCA评分的呈负相关(P<0.05).结论 不同年龄阶段VD患者脑脊液中炎症因子呈现升高趋势,随着年龄的增加,VD炎症因子水平越高,认知功能越低.

目的 探讨血管性痴呆(VD)大鼠脑组织高水平氧化应激以及炎症反应与沉默信息调节因子1(SIRT1)的关系.方法 30只健康雄性大鼠随机分为假手术组(Sham组)、血管性痴呆模型组(VD组)和白藜芦醇组(RSV组).水迷宫实验检测大鼠学习和记忆能力,Western blot检测大鼠SIRT1的蛋白表达情况,化学比色法检测大鼠氧化应激水平,ELISA检测大鼠海马区促炎因子IL-1β和TNF-α的含量.结果 VD组大鼠海马SIRT1的蛋白表达水平较Sham组降低(P<0.01).RSV组大鼠海马SIRT1蛋白表达水平高于VD组(P<0.05).与Sham组比较,VD组大鼠逃逸潜伏期延长(P<0.01);且VD组大鼠穿过平台的次数以及在目标象限停留时间百分比低于Sham组(P<0.05).与VD组比较,RSV组大鼠逃逸潜伏期缩短(P<0.01);RSV组大鼠穿过平台的次数和在目标象限停留时间百分比均提高(P<0.05).与Sham组比较,VD组大鼠海马MDA的活性增加(P<0.001),SOD和GSH-Px活性减少(P<0.05).与VD组比较,RSV组大鼠MDA的活性降低(P<0.01),SOD和GSH-Px活性升高(P<0.05).与Sham组比较,VD组大鼠海马IL-1β和TNF-α的表达水平升高(P<0.01).与VD组比较,RSV组大鼠海马IL-1β和TNF-α的表达水平降低(P<0.01).结论 血管性痴呆脑组织高水平氧化应激和炎症反应与SIRT1密切相关,且上调SIRT1的表达能有效改善血管性痴呆,这一发现为血管性痴呆的防治提供新思路.

目的：分析急性脑卒中患者临床病情严重程度评分与血清炎性因子水平变化的研究。方法：选择诊断急性脑血管病患者120例，依据入院患者格拉斯哥昏迷评分分为轻度（GCS≥12）、中度（GCS ，8～11）、重度（GCS ，3～7）组，入院24h检测不同程度卒中患者血清降钙素原（PCT ，ug／L）、C反应蛋白（CRP ，mg／L）、白介素－6（IL －6，U／L）水平变化，分析IL －6、CRP、PCT 指标与格拉斯哥昏迷评分（GCS）间相关性，比较3组患者早发卒中相关性肺炎发生率。结果：轻度、中度、重度组患者血清CRP水平3组间比较水平差异有统计学意义（ P＜0．05）。入院24h血清 PCT 、CRP、IL －6水平与GCS评分二者间相关性分别为（r＝0．309；0．561；0．792，P＜0．05）。3组间早发卒中相关性肺炎发生率[（4／40，10％）比（5／40，12．50％）比（16／40，40．00％），χ2＝3．005]，差异有统计学意义（ P＜0．05）。结论：急性脑血管病患者病情严重程度评分与机体炎性反应水平关系密切，病情越重，机体炎性反应水平越高，早发卒中相关性肺炎发生率也上升。血清降钙素原水平监测对于早发卒中相关性肺炎诊断价值大。

目的:分析急性脑血管病患者临床病情严重程度评分与机体免疫功能变化的关系.方法 :选择2013年10月~2015 年10月诊断急性脑卒中患者150例,依据患者格拉斯哥昏迷评分 (GCS)分为轻度 (GCS≥12)、中度 (GCS,8~11)、重度 (GCS,3~7)3组.入院24h流式细胞仪检测外周血中T细胞亚群:CD3 +T细胞、CD4 +T细胞、CD4 +/CD8 +T细胞比例及CD4 +CD25 +调节性T淋巴细胞比例变化,评价不同程度卒中分组患者细胞免疫功能变化,分析细胞免疫功能指标与格拉斯哥昏迷评分间相关性,比较3组患者早发卒中相关性肺炎发生率.结果:轻度、中度、重度组患者CD3 +T细胞 [(22. 91 ±3. 15)%vs (21. 54 ±3. 78)%vs (20. 17 ±3. 03)%,t=0. 936]、CD4 +T细胞 [(30. 95 ±4. 28)%vs (32. 06 ±4. 89)%vs 33. 78 ±4. 91)%,t=0. 785],3组比较水平差异无统计学意义 (P>0. 05).CD4 +/CD8 +T细胞比例 [(1. 35 ±0. 06)vs (1. 12 ±0. 05)vs (0. 89 ±0. 07),F=3. 431]水平逐渐下降,CD4 +CD25 +调节性T淋巴细胞比例 [(45. 71 ±8. 05)%vs (59. 29 ±8. 17)%vs (69. 03 ±9. 95)%,t=3. 018]水平逐渐上升,3组间比较差异有统计学意义 (P<0. 05).入院24h血CD4 +CD25 +调节性T淋巴细胞比例与GCS评分二者间相关性分别为 (r=0. 584,P<0. 05).3组间早发卒中相关性肺炎发生率 [(5/50,10%)vs (6/50,12%)vs (21/50,42. 00%),χ2 =3. 091],差异有统计学意义 (P<0. 05).结论:急性脑血管病患者病情严重程度评分与免疫功能存在一定联系,随着病情程度加重,机体免疫功能处于抑制状态,早发卒中相关性肺炎发生率也明显升高.

百草枯(paraquat,PQ,1,1-二甲基-4,4-联吡啶阳离子盐),是目前世界范围内应用最广泛、非选择性的触灭型除草剂之一.近年来,随着百草枯的普及与使用,百草枯中毒也日趋增多.百草枯中毒易引发多脏器损伤甚至功能衰竭(MOF),目前在治疗上尚无特效解毒剂,常规对症处理效果极差,临床病死率高,可达60％以上,且存活者预后极差[1-2].本文选择2010-2013年入组的84例急性百草枯中毒患者,通过用大株红景天联合血液灌流及常规治疗,取得了良好的临床疗效,现将结果报告如下.