Objective To investigate the relationship between serum neuron-specific enolase (NSE) level and the severity of brain injury in patients with acute ischemic stroke. Methods A total of 100 patients with acute ischemic stroke, classified as total anterior circulation infarct (TACI), partial anterior circulation infarct (PACI), posterior circalation infarct (POCI) and lacunar infarct (LACI) were included in this study. The serum levels of NSE were detected and cerebral infarc-tion volumes were measured using 32-bit OsiriX imaging software. The correlation between serum level of NSE, cerebral in-farction volume and subtypes of ischemic stroke was analyzed. Results Patients were divided into NSE≤11.46μg/L group and NSE>11.46μg/L group. The scores of NIHSS[6.0(4.0, 10.0) vs 4.0(2.0, 6.0)]were higher, the infarction volumes[4.3 (1.3, 15.9) cm3 vs 0.8(0.4,4.3) cm3]were larger in NSE>11.46μg/L group (P<0.05). The serum NSE level showed statistical-ly significant difference between TACI and other groups (P<0.01). The increased serum NSE level was correlated with in-creased infarction volume (rs=0.417,P<0.01). There was a linear regression between serum NSE level and infarction vol-ume. Its linear regression equation was =2.438+0.100 X (X:infarction volume;Y:serum NSE level). Conclusion The se-rum NSE level may be helpful for the prediction of the severity of brain injured in patients with acute ischemic stroke.

Objective To investigate the correlations of plasma brain natriuretic peptide (BNP) levels and the subtypes and the severity of acute ischemic stroke.Methods Consecutive patients with acute ischemic stroke were enrolled in the study.They were divided into large-artery atherosclerosis (LAA),smallartery occlusion (SAO) and cardioembolism (CE) according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification.Electrochemiluminescence immunoassay was used to measure plasma BNP.OsiriX software was used to calculate the cerebral infarction volume of MRI.Results A total of 159 patients with acute ischemic stroke were enrolled.Compared to the CE group,there were significant differences in the proportions of hyperlipidemia,atrial fibrillation,BNP ＞ 100 ng/L,and in the levels of lowdensity lipoprotein cholesterol (LDL-C) and BNP,as well as in the National Institutes of Health Stroke Scale (NIHSS) score and the infarct volume in the groups of LAA and SAO (all P ＜0.05).Multivariate logistic regression analysis showed that atrial fibrillation (odds ratio [OR] 148.638,95％ confidence interval [CI]17.532-1 260.182; P ＜ 0.001) and BNP ＞ 100 ng/L (OR 3.490,95％ CI 1.033-11.789; P =0.044)were the independent risk factors for CE ischemic stroke.Receiver operating characteristic curve analysis showed that the optimal cutoff value for predicting plasma BNP level of the CE ischemic stroke was 101.4 ng/L,and its sensitivity,specificity,positive predictive value,and negative predictive values were 80.56％,76.42％,50.00％,and 93.07％,respectively.The optimal cutoff value was used as a boundary,the patients were divided into a BNP ≤ 101.4 ng/L group and a ＞ 101.4 ng/L group.The proportions of males (P=0.031),hyperlipidemia (P=0.002) and smoking (P =0.026),as well as the levels of total cholesterol (P=0.020),triglyceride (P=0.024) and LDL-C (P=0.013) were significantly lower than those in the BNP ≤ 101.4 ng/L group,while the proportions of patients with ischemic heart disease (P ＜0.001) and atrial fibrillation (P＜0.001),as well as the NIHSS score and the infarct volume were significantly higher and larger than those in the BNP ≤ 101.4 ng/L group.Spearman rank correlation analysis showed that the plasma BNP levels were significantly negatively correlated with the triglycerides (r=-0.224,P=0.004) and LDL-C (r=-0.170,P=0.032) levels,and were significantly positive correlated with the NIHSS scores (P=0.167,P=0.044) and the infarct volume (P=0.281,P＜0.001).Conclusions Plasma BNP level can be used as a biological marker for early differentiating CE from non-CE ischemic stroke,as well as identifying the severity of stroke.

Objective To explore the clinical features,electroneurophysiology,neuroimaging and gene characteristics of one juvenile dentatorubral-pallidoluysian atrophy (DRPLA) pedigree with an onset of epilepsy.Methods The clinical data of the elder sister and younger brother in a family with juvenile DRPLA were collected.Furthermore,their clinical manifestations,electroneurophysiology results,neuroimaging characteristics and atrophin-1 gene CAG repeat numbers were detected and analyzed in detail.Results There were four patients in this family in total.The probands were two siblings,and they both had the onset manifestation of epilepsy.The younger brother had frequently epileptic seizure,marked cerebellar ataxia,involuntary movement and mental retardation.Compared with her younger brother,the sister had light symptoms such as mild memory deterioration without ataxia and involuntary movement,and she could undertake some simple work.The spike wave and sharp wave complex can be detected in electroencephalogram (EEG) examination,the cortical center segment lesions pathological changes were revealed in somatosensory evoked potentials (EP),and the latency period of P300 was prolonged in the both siblings.Magnetic resonance imaging (MRI) showed that the younger brother had marked atrophies in the cerebral cortex,brainstem and cerebellum.Furthermore,MRI showed that the elder sister had only mild atrophies in the cerebral cortex,brainstem and cerebellum,and that on the contrary some abnormally high signals were observed in cerebral cortex but not white matter.DRPLA gene detection revealed that the numbers of CAG repeats were 15/68 (the younger brother) and 15/64 (the elder sister),respectively.Conclusions Epilepsy,especially the myoclonus,is a common clinical manifestation for juvenile DRPLA,and many other types of epileptic seizures may arise with the development of DRPLA.DRPLA has diverse clinical heterogeneity.EEG,EP and brain MRI examination are great for DRPLA diagnosis and differential diagnosis,and the specific gene detection can be helpful for a definitive diagnosis.

Objective To investigate the clinical and molecular genetic changes in a Chinese family with oculopha?ryngeal muscular dystrophy(OPMD). Methods We collected the clinical data of the familial members and blood sam?ples from all available 16 familial members, including the proband. The samples were analyzed using modified poly?merase chain reaction amplification and direct sequence analysis. Results Male OPMD patients initially presented with ptosis, followed by pronunciation difficulty, dysphagia and limb weakness whereas female OPMD patients initially pre?sented with swallowing difficulty. Genetic test revealed the abnormal expansions of the GCG trinucleotide repeat from GCG6 to GCG10 in PABPN1 gene in 10 familial members. Conclusions The genetic test and prenatal diagnosis is the key for the prevention treatment of oculopharyngeal muscular dystrophy. The ptosis of eyelid may be the initial symptom for the male patients of oculopharyngeal muscular dystrophy with (GCG)10 mutation.

Objetive The present study was aimed to explore the risk factors of mid-term cognitive decline in pa?tients with indexed TIA/minor stroke (NIHSS≤3) in a Chinese hospital-based cohort. Methods We recruited all consec?utive Chinese TIA/minor stroke patients from July to December in 2012 and followed them up in stroke clinics at 3 and 18 months after indexed TIA/minor stroke. The outcome was defined as significantly cognitive decline at 18 months com?pared with that at 3 months. Results A total of 209 consecutive Chinese TIA/minor stroke cases completed their fol?low-up investigation. Among them, 24 (11.5%) exhibited significantly cognitive decline. The independent risk factors of cognitive decline post TIA/minor stroke were education years (OR=0.869,P=0.021), atrial fibrillation(OR=5.950, P=0.001) and multiple silent lacunar infarcts (OR=5.179,P=0.020). Conclusion It is necessary to evaluate the cognition among TIA/minor stroke cases and a close follow-up is required for patients with atrial fibrillation and multiple silent la?cunar infarcts frequently in order to decrease the risk of cognitive decline post TIA/minor stroke.

Objectives Brain atrophy plays a key role in post-stroke dementia. The current study aims to explore risk factors for brain atrophy in different regions in order to find the ultimate therapeutic strategy. Methods Consecutive stroke and/or transient ischemic attack (TIA) patients were recruited from July 2012 to June . The clinical features, neuro?imaging findings and risk factors were collected during hospitalization. Logistic regression analysis showed that, except for age, female gender (Odds ratio, OR=2.447, P=0.007) and the number of silent lacuna infarcts (OR=1.414, P=0.027) were independent risk factors for frontal lobe atrophy. Ischemic stroke history (OR=2.224, P=0.024) was the independent risk factor for parietal lobe atrophy. All of extra-/intracranial larger artery diseases (OR=2.584, P=0.015) and white mat?ter severity score (OR=1.112, P=0.007) as well as the number of silent lacuna infarcts (OR=1.158,P=0.042) were inde?pendent risk factors for medial temporal lobe atrophy. Moreover, diabetes (OR=2.109, P=0.001),atrial fibrillation (OR=1.934, P=0.015) and white matter severity score (OR=1.098, P=0.002) were independent risk factors for global brain atro? phy. Conclusion Risk factors for brain atrophy included diabetes,atrial fibrillation, silent lacuna infarcts and white mat?ter changes. We should pay more attention to those patients with above risk factors in order to slow down the progression of brain atrophy and also prevent them from dementia by early interventions.

The cold wave is one of the common meteorological factors which related to occurrence of disease,and growth of animals and plants.Due to seasonal restrictions and differences of the main indicators of each cold wave,it is difficult to be consistent when studying the relationship between cold wave and disease,cold wave and growth of animals and plants.In order to make the experimental results more objective and credible,it is necessary to simulate a cold spell artificially.The key technique for simulating a cold wave is to control the temperature manually,so that can achieve the standard of cold wave.Nowadays,the equipments for cold wave simulating include "artificial climate chamber" or "climate simulator",which can be used in the study of the relationship between cold wave and disease,cold wave and growth of animals and plants.The intelligent artificial climate chambers can successfully create an experimental environment that similar to the natural cold wave,thus the study of the relationship between temperature and growth or incidence of animals and plants is no longer restricted by seasonal restrictions,and maintains the consistency between different artificial cold waves,which is beneficial for analysis and judgment.However,the intelligent artificial climate chambers still needs to be further improved in terms of expanding space and manual control of air pressure and humidity.