Objective To analyze the related influencing factors of progressive ischemic stroke, and to investigate the value of serum markers for prediction of progressive ischemic stroke. Methods Three hundred and six patients with acute cerebral infarction were divided into progressive ischemic stroke (PIS) group (n=91) and non-progressive ischemic stroke (NPIS) group (n=215). Data of gender, age, past medical history, personal history and serum markers were collected and compared in two groups. Binary Logistic regression was used to analyze the influencing factors of PIS. The receiver operating characteristic (ROC) curves of neutrophils to lymphocytes ratio (NLR), fibrinogen and fasting blood glucose were analyzed in two groups. Results Positive rates of hypertension history, diabetes history, hypercholesterolemia history, incidence of large artery atherosclerotic (LAA) stroke were significantly higher in PIS group than those in NPIS group ( P<0.05). The levels of neutrophils, NLR, fibrinogen and fasting blood glucose were significantly higher, but the level of lymphocytes was significantly lower in patients with PIS than those in patients with NPIS (P<0.05). Logistic regression analysis confirmed that diabetes, LAA stroke, NLR, fibrinogen and fasting blood glucose were independent risk factors for the PIS ( P<0.05). The areas under ROC curve by NLR, fibrinogen and fasting blood glucose were 0.777, 0.560 and 0.574, respectively. The sensitivities of NLR, fibrinogen and fasting blood glucose were 72.5%, 59.8%and 47.3%, respectively;and the specificities were 76.7%, 51.2% and 69.8%, respectively. Conclusion The occurrence of PIS is related with blood pressure, blood lipids, inflammatory cells in peripheral bolld, fibrinogen and fasting blood glucose. The level of NLR in peripheral blood can predict the occurrence of PIS, which can be used as an important reference index for early diagnosis of PIS.

Objective To study the relationship between serum uric acid (UA) level and cerebrovascular stenosis in acute ischemic stroke (AIS) patients.Methods Five hundred and thirteen patients with AIS or old IS admitted to our hospital from April 2014 to April 2016 were divided into primary IS group (n=236),recurrent IS group (n=136),and old IS group (n=141).Venous blood samples were taken on admission for biochemical testing.The patients were further divided into serum UA≤255 μmol/L group (n=128),serum UA=256-312μmol/L group (n=129),serum UA=313-371 μmol/L group (n=129),and serum UA＞371 μmol/L group (n=127).Their cerebrovascular stenosis was assessed by CT angiography or magnetic resonance angiography after admission.Results The severity of cerebrovascular stenosis,hypertension,diabetes and hyperlipidemia was significantly different in primary IS group,recurrent IS group and old IS group (27.5％ vs 33.8％ vs 12.8％、24.2％ vs 28.7％ vs 46.8％、61.9％ vs 49.3％ vs 40.4％、71.6％ vs 61.8％ vs 46.8％,P=0.000).Logistic regression analysis showed that serum UA≤ 255 μmol/L was an independent risk factor for cerebrovascular stenosis (OR =2.787,95 ％CI:2.209-3.365,P=0.001).The risk of cerebrovascular stenosis decreased gradually with the elevated serum UA level.Conclusion Serum UA level is not directly related with recurrent IS.Low serum UA level is a risk factor for cerebrovascular stenosis in AIS.

OBJECTIVE:To investigate the effect of different processing methods on 4 kinds of flavonoids contents in salt-pro-cessed Cuscuta chinensis. METHODS:Salt-processed C. chinensis piece was processed with different baking temperature (70 ℃, 100℃,130℃,160℃,190℃and 210℃),baking time(10 min,15 min,30 min,45 min,60 min and 75 min)and moisten-ing time(0.5 h,1 h,2 h,4 h and 6 h). HPLC was adopted for contents determination of hyperoside,rutin,quercetin and kaemp-ferol:the column was Synergi 4u Hydro-Rp 80A with mobile phase of methanol- 0.1% phosphoric acid (gradient elution) at a flow rate of 1.0 ml/min,the detection wavelength was 360 nm,and column temperature was 35 ℃. RESULTS:The linear range was 0.416-12.48 μg for hyperoside (r=0.999 9),0.14-4.2 μg for rutin (r=0.999 9),0.185-5.55 μg for quercetin (r=0.999 9) and 0.078-2.34 μg (r=0.999 8);RSDs of precision,stability and reproducibility tests were lower than 3%;recoveries were 95.55%-99.74%(RSD=2.12%,n=6),95.96%-101.42%(RSD=2.01%,n=6),95.76%-102.75%(RSD=2.77%,n=6), 99.42%-104.93%(RSD=2.02%,n=6). The flavonoids in salt-processed C. chinensis showed highest contents when baking tem-perature was 160℃,baking time was 60 min and moistening time was 2 h. CONCLUSIONS:Different processing methods have certain effects on flavonoids contents in salt-processed C. chinensis.

Objective:To establish the method for the determination of emodin and danshensu Pinggan oral liquid. Methods:The contents were determined by HPLC. The chromatographic conditions for emodin were as follows: an Agilent Eclipse XDB-C18 column (150 mm × 4. 6 mm, 5μm) was used and the mobile phase was methanol-water (80 ∶20). The detection wavelength was 287 nm and the flow rate was 1. 0 ml·min-1 . The column temperature was 25℃ and the injection volume was 20 μl. The chromatographic condi-tions for Danshensu were as follows:an Agilent Eclipse SB-C18 column (150 mm × 4. 6 mm, 5 μm) was used and the mobile phase was methanol-1% acetic acid solution (2 ∶98). The detection wavelength was 280 nm and the flow was 1. 0 ml·min-1. The column temperature was 30℃ and the injection volume was 20 μl. Results:Emodin had a good linear relationship within the range of 26. 75-428. 00 μg·ml-1(r=0. 999 9). The average recovery was 102. 7% and RSD was 0. 76% (n=6). Sodium Danshensu had a good linear relationship within the range of 10.17-162.77 μg·ml-1(r =0.999 9). The average recovery was 100.5% and RSD was 1. 47% (n=6). Conclusion:The method is simple, accurate and reproducible, which can be used for the quality control of the prep-aration.

Amyotrophic lateral sclerosis (ALS) is a series of upper and lower motor neuron degenerative disorders,characterized by muscle weakness and atrophy,bulbar paralysis and pyramidal signs.Recent studies showed that ALS may present with many atypical clinical manifestations,such as cognitive impairment,autonomic dysfunction,extrapyramidal disorders,paresthesia,and abnormal eye movements.This review summarized the recent understanding of atypical clinical manifestations in ALS.

OBJECTIVETo establish an HPLC method for determination of catalpol in CSF (cerebrospinal fluid) of rats.

METHODRats were intravenously injected 1.0 g x L(-1) catalpol physiological saline, and the sample of CSF from subarachnoid space of the cerebrum 40 minutes of injection. The sample of CSF from normal rats was used for blank control, the all samples were preserved in a refrigerator of - 20 degrees C, and use HPLC was employed to determine the catalpol content. The separation of catalpol was performed on Hypersil C18 reversion phase chromatographic column. The mobile phase consisted of water-acetonitrile (99.5: 0.5) with a flow rate of 1.0 mL x min(-1) and detection wavelength of 210 nm.

RESULTThe linear range of catalpol in CSF was 0.5-40 mg x L(-1) (r = 0.999 7). The absolute recoveries were (90.2 +/- 1.71)%, (89.1 +/- 1.17)% and (86.9 +/- 0.98)%; and the methodological recoveries were (99.8 +/- 1.98)%, (101.1 +/- 3.04)%, (100.1 +/- 2.30)% respectively. The within-day and between-day derivation RSD were less than 4%. Catalpol was stable in a refrigerator of -20 degrees C for 15 days.

CONCLUSIONThe method is simple and accurate for the determination of the content of catalpol in CSF.

Animals ; Chromatography, High Pressure Liquid ; Glucosides ; administration & dosage ; cerebrospinal fluid ; Iridoid Glucosides ; Iridoids ; administration & dosage ; cerebrospinal fluid ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley

OBJECTIVE: To compare and analyze the risk rating for chemical hazards of aromatics complex in a petrochemical enterprise using two risk assessment methods. METHODS: Occupational hygiene investigation and chemical detection for workplaces of the construction project were made. The risk ratings were made in five workplaces including that of the aromatics extraction,disproportionation,isomerization,xylene fractionation and adsorptive fractionation. Two risk assessment methods were employed. They were the optimal indicator system of risk assessment on occupational chemical hazards( optimal indicator system) and the semi quantitative risk assessment model of Singapore. The results of risk rating generated by the two risk assessment methods were then compared and analyzed. RESULTS: Using the optimal indicator system,the risk rating of benzene was mild in the five workplaces; and the risk rating of methylbenzene and xylene was slight. However,using the semi quantitative risk assessment model of Singapore,the risk rating of benzene was extremely high in both the aromatics extraction and disproportionation workplaces; the risk rating was high in xylene fractionation,and was medium in the isomerization and adsorptive fractionation workplaces. The risk rating of methylbenzene was high in the aromatics extraction and disproportionation workplaces,and was low in the other three workplaces. The risk rating of xylene was low in the five workplaces. CONCLUSION: The optimal indicator system is more feasible,practical and objective for the assessment of chemical hazards. It is more suitable for risk assessment of occupational chemical hazards in our country.

Objective: To apply and compare two risk assessment methods for occupational lead exposure risk classification in a lead-acid battery enterprise. Methods: In April 2013, an occupational health survey was carried out in a lead-acid battery enterprise. Lead smoke and lead dust were tested in the workplace. The risk assessment index system for occupational chemical hazards that was established and optimized by the research group (referred to as "optimized index system" ) , as well as the Singapore semi-quantitative risk assessment model, was used for occupational lead exposure risk classification in the lead-acid battery enterprise. The two risk classification results were analyzed and compared. Results: In the lead smoke risk classification results, the optimized index system classified the raw material group and foundry group workshops as Class I hazardous and the assembling group workshop as Class II hazardous. The Singapore semi-quantitative risk assessment model classified the raw material group workshop as high risk and foundry group and assembling group workshops as extremely high risk. In the lead dust risk classification results, the optimized index system classified the raw material group workshop as Class I hazardous, while the plate painting group, plate cutting group, and assembling group workshops were classified as Class II hazardous. The Singapore semi-quantitative risk assessment model classified the raw material group workshop as medium risk, the plate painting group and plate cutting group workshops as high risk, and the assembling group workshop as extremely high risk. Conclusion There are some differences in risk assessment of occupational lead exposure between the two risk assessment methods. The optimized index system is comparably more reasonable and feasible, and is highly operable.

Objective To optimize the formula of Dahuang Xiaoshi decoction components based on its hepatoprotective activity and evaluate their efficacy.Methods The Wistar rats were randomly divided into blank group,model group,ursodeoxycholic acid group(positive group),and orthogonal groups of Dahuang Xiaoshi decoction components.The acute liver injury model induced by alpha-napthyl-i sothiocyanate(ANIT)was used to optimize the allocation ratio of Dahuang Xiaoshi decoction components by taking liver function indicators as an index and combining with multiple statistical methods.The additional Wistar rats were taken to induce liver injury and optimize the compatible dosage of Natrii Sulfas(0,1,2,4 g)in Dahuang Xiaoshi decoction components based on the biological signs and liver function biochemical indicators.On this basis,the Wistar rats were randomly divided into blank group,model group,ursodeoxycholic acid group and different dosages(low,medium and high)of the Zhibaihuang components group.The liver protective effect of Zhibaihuang components was systematically evaluated through the general biological signs,liver function biochemical indicators,lipid peroxide indicators,liver pathological examination and bile transport-related indicators.Results Dahuang Xiaoshi decoction components optimized by orthogonal and multiple statistics could improve the biological signs and ameliorate the biochemical abnormalities in rats with liver injury.Dahuang Xiaoshi decoction components combined with different dosages of Natrii Sulfas could slow down the mass loss of ANIT-induced acute liver injury rats(P＜0.01 or P＜0.05)and recall the abnormally elevated serum liver function enzyme activities(P＜0.01 or P＜0.05).Except for alkaline phosphatase(ALP),there was no statistical difference in regulating other liver function enzyme activity between different allocations of Natrii Sulfas.After comprehensive consideration,its composition was optimized to the Zhibaihuang components without Natrii Sulfas.Further pharmacodynamic evaluation results showed that the optimized Zhibaihuang components could improve their abnormal biological signs(P＜0.01 or P＜0.05),decrease the serum liver function enzyme activity(P＜0.01 or P＜0.05)and the levels of T-BiL and TG(P＜0.05),and restore the levels of hepatic lipid peroxide(P＜0.01 or P＜0.05),repair liver pathological injury,adjust the expression of bile transport proteins(P＜0.05),and thus exert good liver protective activity.Conclusion The optimized Dahuang Xiaoshi decoction components,Zhibaihuang components,was obtained through orthogonal,multiple statistics and univariate investigation.It could improve the abnormal biological signs of animals,protect the liver and reduce enzymes,resist lipid peroxidation,restore abnormal metabolic indicators,and repair liver pathological injury,which provides a reference for its further clinical application and development.

Objective:To analyze the clinical features, genetic characteristics, treatment and follow-up results of patients with hydrocephalus caused by methylmalonic acidemia combined with homocysteinuria, and to discuss the optimal strategies for assessing and treating such patients.Methods:From January 1998 to December 2020, 76 patients with hydrocephalus due to methylmalonic acidemia combined with homocysteinuria in the Department of Pediatrics in 11 hospitals including Peking University First Hospital were diagnosed by biochemical, genetic analysis and brain imaging examination. The patients were divided into operation-group and non-operation-group according to whether they underwent ventriculoperitoneal shunt. The clinical features, laboratory examinations, genotype, and follow-up data were retrospectively analyzed. Data were compared between the two groups using rank sum test, and categorical data were compared using χ 2 test. Results:Among the 76 patients (51 male, 25 female), 5 were detected by newborn screening, while 71 were diagnosed after clinical onset, 68 cases (96%) had early-onset, 3 cases (4%) had late-onset. The most common clinical manifestations of 74 cases with complete data were psychomotor retardation in 74 cases (100%), visual impairment in 74 cases (100%), epilepsy in 44 cases (59%), anemia in 31 cases (42%), hypotonia or hypertonia in 21 cases (28%), feeding difficulties in 19 cases (26%) and disturbance of consciousness in 17 cases (23%). Genetic analysis was performed in 76 cases, all of whom had MMACHC gene variations, including 30 homozygous variations of MMACHC c.609G>A. The most common variations were c.609G>A (94, 62.7%), followed by c.658_660del (18, 12.0%), c.567dupT (9, 6.0%) and c.217C>T (8, 5.3%). Therapy including cobalamin intramuscular injection, L-carnitine and betaine were initiated immediately after diagnosis. A ventriculoperitoneal shunt operation was performed in 41 cases (operation group), and 31 patients improved after metabolic intervention (non-operation group). There was no significant difference in the age of onset, the age of diagnosis, the blood total homocysteine, methionine, and urinary methylmalonic acid concentration between the two groups (all P>0.05). The symptoms of psychomotor development, epilepsy, and visual impairments improved gradually after a long-term follow-up in the operation group. Conclusions:Hydrocephalus is a severe complication of methylmalonic acidemia combined with homocysteinuria. The most common clinical manifestations are psychomotor retardation, visual impairment, and epilepsy. It usually occurs in early-onset patients. Early diagnosis and etiological treatment are very important. Hydrocephalus may improve after metabolic intervention in some patients. For patients with severe ventricular dilatation, prompt surgical intervention can improve the prognosis.