Objective:To investigate the clinical characteristics and outcomes in patients with wake-up stroke.Methods:From January 2019 to December 2019, consecutive patients with acute ischemic stroke admitted to the Department of Neurology, Huizhou Municipal Central Hospital were enrolled retrospectively. The modified Rankin Scale was used to evaluate the outcome of patients at 90 d after the onset. 0 to 2 was defined as a good outcome, and >2 was defined as a poor outcome. Multivariate logistic regression analysis was used to determine the factors affecting the poor outcome of patients with wake-up stroke. Results:A total of 356 patients with acute ischemic stroke were enrolled, including 97 (27.2%) wake-up stroke, and 259 (72.8%) non-wake-up stroke. The National Institutes of Health Stroke Scale (NIHSS) score at admission and the proportion of patients with atrial fibrillation, moderate to severe stroke and cardiogenic embolism in the wake-up stroke group were significantly higher than those of the non-wake-up stroke group, and the proportion of patients with small artery occlusion was significantly lower than that in the non-wake-up stroke group (all P<0.05). Moreover, the proportion of patients with poor outcome in the wake-up stroke group was significantly higher than that in the non-wake-up stroke group (36.1% vs. 24.7%; χ2=4.546, P=0.033). In the wake-up stroke group, 62 patients (63.9%) had a good outcome, and 35 (36.1%) had a poor outcome. The NIHSS score at admission and the proportion of patients with atrial fibrillation and moderate to severe stroke in the subgroup with poor outcome were significantly higher than those in the subgroup with good outcome, and the proportion of patients receiving intravenous thrombolysis and mechanical thrombectomy was significantly lower than those in the good outcome subgroup (all P<0.05). Multivariate logistic regression analysis showed that moderate to severe stroke (odds ratio [ OR] 6.674, 95% confidence interval [ CI] 2.223-20.034; P=0.001) was independently associated with the poor outcome in patients with wake-up stroke, while intravenous thrombolysis ( OR 0.102, 95% CI 0.017-0.630; P=0.014) and endovascular mechanical thrombectomy ( OR 0.108, 95% CI 0.023-0.506; P=0.005) were independently associated with the good outcome of patients with wake-up stroke. Conclusions:In patients with wake-up stroke, the proportion of cardioembolism is higher, the clinical symptoms are more serious and the incidence of poor outcome is higher. The severity of stroke at admission is associated with poor short-term outcome, and intravenous thrombolysis and endovascular mechanical thrombectomy can improve the outcome in patients with wake-up stroke.

Objective To analyze the impact of rs3826392 polymorphism in MKK4 promoter on prognosis of colorectal cancer cases (CRC) receiving adjuvant chemotherapy. Methods The associations between rs3826392 genotype of 203 CRC cases receiving adjuvant chemotherapy and clinicopathologic factors,overall survival (OS), disease free survival (DFS) were analyzed retrospectively. Results No association was found between rs3826392 genotype and clinicopathologic factors (P > 0.05). TG+GG genotype had better OS (P = 0.018) and DFS (P =0.019) when compared with TT genotype. Cox multivariate model showed rs3826392 TG+GG genotype remained independent favorable factor for OS(HR = 0.389;95%CI = 0.177-0.855) and DFS(HR=0.491;95%CI = 0.271-0.890) respectively. Conclusion -1304G variant genotypes (i.e., TG+GG) in rs3826392 may be the biomarker of better prognosis in CRC receiving adjuvant chemotherapy.

Objective:To investigate the predictive value of STAF (score for the targeting of atrial fibrillation) score for paroxysmal atrial fibrillation (PAF) in patients with recurrent acute ischemic stroke.Methods:Consecutive patients with recurrent acute ischemic stroke hospitalized in the Department of Neurology, Huizhou Municipal Central Hospital from January 2014 to January 2020 were enrolled retrospectively. All patients were divided into a sinus rhythm (SR) group and a PAF group. PAF was defined as no PAF during the last stroke hospitalization or after discharge, and PAF was found by routine ECG, ambulatory ECG or long-term ECG monitoring after this recurrent acute ischemic stroke. Multivariate logistic regression analysis was used to evaluate the independent related factors of PAF in patients with recurrent acute ischemic stroke. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of STAF for PAF in patients with recurrent acute ischemic stroke. Results:A total of 234 patients with recurrent acute ischemic stroke were enrolled, including 174 males (74.4%), aged 67.15±10.63 years, and 199 (85.0%) in the SR group and 35 (15.0%) in the PAF group. Univariate analysis showed that the proportion of patients in age >62 years old (94.3% vs. 63.8%; χ2=12.777, P<0.001) and left atrial enlargement (54.3% vs. 11.1%; χ2=40.379, P<0.001) of the PAF group was significantly higher than those of the SR group. Multivariate logistic regression analysis showed that age (odd ratio [ OR] 1.071, 95% confidence interval [ CI] 1.028-1.114; P=0.001) or age >62 years ( OR 17.512, 95% CI 2.881-106.453; P=0.002), left atrial enlargement ( OR 17.511, 95% CI 6.298-48.687; P<0.001), absence of vascular etiology ( OR 8.562, 95% CI 2.534-28.923; P=0.001), STAF score ( OR 2.715, 95% CI 1.969-3.744; P<0.001) and STAF score ≥5 ( OR 12.714, 95% CI 5.636-28.681; P<0.001) were independently associated with PAF. ROC curve analysis showed that the area under the curve of STAF for predicting PAF in patients with recurrent acute ischemic stroke was 0.848 (95% CI 0.779-0.917), and the sensitivity and specificity of STAF ≥5 for predicting PAF were 58.1% and 89.4%, respectively; the area under the curve for predicting PAF in patients with recurrent ischemic stroke of undetermined cause was 0.809 (95% CI 0.663-0.956), and the sensitivity and specificity of STAF ≥5 for predicting PAF were 53.8% and 91.3%, respectively. Conclusions:PAF is likely to exist in patients with recurrent acute ischemic stroke and aged >62 years, left atrial enlargement and absence of vascular etiology. STAF has medium predictive value for PAF in patients with recurrent acute ischemic stroke, but the sensitivity is not high.

Objective To analyze the susceptibility of serotonin promoter single nucleotide polymorphism (SNP)rs956304 to chemotherapy-induced nausea and vomiting(CINV)in colorectal cancer.Methods Rs956304 genotypes and the clinical pathological data of 166 patients with colorectal cancer from September 2009 to April 2014 were retrospectively analyzed. Rs956304 genotype was analyzed by sequencing. The correlations between rs956304 genotype,factors of clinical pathology and CINV were analyzed by chi-square test. Unconditional logistic regression model was used to analyze the independent effect of rs956304 genotype on colorectal cancer CINV. Results Chi-square test showed that moderate to severe CINV was associated with rs956304 AG+GG genotype (P=0.011). Unconditional logistic regression model showed that the patients with AG+GG genotype had a signifi-cant higher risk of moderate to severe CINV than AA genotype(OR=3.215,95% CI:1.202 to 8.599,P=0.020). Conclusion Rs956304 AG+GG genotype is an independent risk factor for moderate to severe colorectal cancer CINV.

Objective To observe the clinical efficacy of Zhuanyaotang Granules for the treatment of degenerative lumbar spinal stenosis(DLSS).Methods Using a randomized double blind controlled design,104 DLSS patients were divided into an experimental group and a control group using a random number table method,with 52 patients in each group.The treatment group took oral Zhuanyaotang Granules,methylcobalamin tablets and celecoxib capsule simulants.The control group used Zhuanyaotang Granules simulants,methylcobalamin tablets and celecoxib capsules.The course of treatment was 3 weeks for both groups.The follow-ups were conducted at 1 month and 3 months after treatment.The intermittent claudication distance,visual analogue scale(VAS)score and JOA efficacy rating criteria for low back pain score were observed in both groups before treatment,1,2,3 weeks of treatment and 1 month after treatment and 3 months after treatment.Adverse reactions during treatment were recorded.Results There were 5 cases of detachment and 2 cases of exclusion in the experimental group,and 5 cases of detachment and 1 case of exclusion in the control group.Compared with before treatment,there were statistically significant differences in intermittent claudication distance,VAS score,and JOA score between the two groups of patients at various time points during treatment and follow-up(P<0.05);there was no statistically significant difference in intermittent claudication distance,VAS score,and JOA score between the experimental group and the control group before treatment and 1 and 2 weeks of treatment(P>0.05);compared with the two groups at 3 weeks of treatment and 1 and 3 months after treatment,the intermittent claudication distance and JOA score in the experimental group were lower than those in the control group(P<0.05);There was no significant difference in VAS score between the two groups and the control group after 3 weeks of treatment(P>0.05).There were 2 adverse reactions(4.4%)in the experimental group and 5 adverse reactions(10.8%)in the control group,without statistical significance(P>0.05).Conclusion Zhuanyaotang Granules can effectively relieve pain and improve lumbar function in patients with DLSS,which is more effective and safer than oral celecoxib capsules and methylcobalamin tablets.

OBJECTIVETo examine the association between the genotype (LL, LS and SS) of serotonin transporter promoter gene polymorphism(5-HTTLPR) and clinicopathological factors, and to investigate the effect of 5-HTTLPR on the prognosis of colorectal cancer patients.

METHODSData of peripheral blood samples of 161 colorectal cancer patients at the Second Affiliated Hospital of Guangzhou Medical University from October 2009 to January 2014 were collected retrospectively. The genotyping of 5-HTTLPR was determined by PCR and agarose gel electrophoresis. Coincidence Chi-square test was used to examine the 5-HTTLPR genotype with Hardy-Weinberg law. Chi-square test and Cox multifactor model were used to analyze the association of 5-HTTLPR genotype with clinicopathology and prognosis. All the patients were informed and agreed to participate in the study. This study was approved by the Hospital Ethics Committee (2015056).

RESULTSOf 161 colorectal cancer patients, 89 were male and 72 were female; the median age was 64 (25-85) years; 86 (53.5%) cases were colon cancer and 75 (46.5%) were rectal cancer. Genotype was LL in 12 cases, LS in 59 cases and SS in 90 cases, which complied with the law of Hardy-Weinberg genetic balance (χ²=0.288, P=0.592). Univariate analysis showed that 5-HTTLPR gene polymorphism was only associated with lymph node metastasis [lymph node metastasis rate: LL and LS genotype 21.1% (15/71);SS genotype 40.0% (36/90), χ²= 6.532, P=0.011]. The 3-year and 5-year overall survival rates of whole patients were 71% and 63% respectively. Multivariate analysis revealed that the SS genotype was an independent risk factor affecting the overall survival of colorectal cancer patients(HR=1.933, 95%CI:1.090-3.428, P=0.024).

CONCLUSIONAmong genotypes of 5-HTTLPR gene, colorectal cancer patients with SS genotype have higher risk of lymph node metastasis and poorer prognosis.

Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms ; genetics ; pathology ; Female ; Genotype ; Humans ; Male ; Middle Aged ; Polymorphism, Genetic ; Prognosis ; Retrospective Studies ; Serotonin Plasma Membrane Transport Proteins ; genetics