Objective To discuss the clinical character,mechanism and prevention of cerebral-cardiac syn-drome(CCS) during acute stroke. Methods 189 patients with CCS caused by acute stroke were Analysed retrospec-tively. Results The incidence rate of CCS following stroke was 55.0%. 84.6% patients with CCS occur in the first 72h. The dead rate of acute stroke with CCS was 26.9%, significartly higher than that of without CCS( P<0.01 ). Conclusion CCS is associated with type and pathologic site of acute stroke. The prognosis of acute stroke with CCS was worse than that without CCS.

Objective To investigate the evolution of cognitive function and its influence factors,so as to provide evidence for guiding treatment of cognitive impairment after stroke.Methods A total of 98 cases of patients with stroke admitted in the First and Second Affiliated Hospital of Medical College of Xi'an Jiaotong University and Shaanxi Provincial People's Hospital between April and September 2009 were enrolled and recruited.Mini-mental state examination(MMSE) and Montreal cognitive function rating scale (MoCA) were adopted to assess the evolution of cognition at acute phase( within 2 weeks),6 weeks,and 12 weeks after stroke among patients within 2 weeks after onset,questionnaire score≤56,without aphasia and consiousness disturbance and at least one side of upper extremities muscle force ≥ grade 3.Results When using MMSE scale as criteria,the incidence of cognitive impairment was 24.5% at acute phase,12.1% at 6 weeks and 9.9% at 12 weeks after stroke,while the incidence was 86.8%,68.2%,and 38.0% respectively when using MoCA scale as criteria.The scales of MMSE and MoCA were increased and the incidence of cognitive impairment was decreased within 12 weeks after stroke.Logistic regression analysis indicated that,advanced age( β = -0.124 ),hypertension ( β = -3.705 ),low education level ( β = 0.560 )and depression after stroke ( β =4.613 ) were related with cognitive impairment after stroke ( all P values ＜0.05 ); low education level ( β = 0.710 ),coronary heart disease ( β = -3.649 ),elevated total cholesterol (TC) ( β = -3.361 ) and low density lipid cholesterol (LDL-C) ( β = - 5.833 ),and depression ( β =-3.612) delayed recovery of cognition after stroke.Conclusions The cognitive function improves and the incidence of cognitive impairment lowers as the time goes on within 12 weeks after stroke.The factors that may affect the improvement of cognitive function include low educational level,coronary heart disease,elevated TC and LDL-C,and post-stroke depression.

Objective To investigate the apoptosis-inducing effect of L-gossypol on human nasopharyngesl carcinoma cell line CNE2 and its possible mechanism.Methods The effect of L-gossypol on proliferation of CNE2 cells was estimated by MTT assay.Flow cytometry was used to analyz cell apoptosis induced by(-)-gossypol and the expression of Bcl-2 、Bax proteins.Caspase-3 activity was determined by caspase-3 colorimetric assay kit.Results Lgossypol was able to inhibit the proliferation of CNE2 cells in a dose-dependent and time-dependent fashion at concentrations more than 10 μmoL/L.L-gossypol regulated cell cycle and GO/G1 arrest could be observed in CNE2 cells.In the process of apoptosis,the expression of Bcl-2 was down-regulated and Bax was up-regulated,caspase-3 activity was in peak at 24h.Conclusion L-gossypol could induce apoptosis in nasopharyngeal carcinoma cell line CNE2 in vitro,which may be associated with down-regulation of Bcl-2,up-regulation of Bax genes expression and caspase-3 activation.

Hepatitis E is a globally distributed infection that varies in seroprevalence between developed and developing regions.In the less developed regions of Asia and Africa,a high seropositivity rate has been reported for hepatitis E virus(HEV)antibodies.Although acute hepatitis E is often self-limited and has a favorable prognosis,some populations experience severe manifestations,which may progress to liver failure.Moreover,some immunocompromised patients are at risk of developing chronic HEV infection and cirrhosis.Proactive screening,reducing misdiagnosis,improving patient management,timely anti-viral therapy for severe and chronic cases,and vaccination of high-risk groups are important measures to reduce the morbidity of hepatitis E.This review focused on the clinical presentation,management,and prevention of hepatitis E.

This study examined the incidence, neuropsychological characteristics and risk factors of cognitive impairment 3 months after stroke in China. Five regions that differed in geography and economy in China were selected. Patients from the hospitals located in the five regions were prescreened at admission, and the demographic data, vascular risk factors and clinical characteristics of stroke were obtained. A battery of cognitive-specific domain tests was performed in the patients who failed to pass cognitive screening 3 months post stroke. Patients were diagnosed as having post-stroke cognitive impairment (PSCI) or no cognitive impairment (NCI) based on the results of the neuropsychological tests. Univariate analysis was performed for suspect risk factors, and significant variables were entered in multivariable logistic regression analysis. Our results showed that a total of 633 patients were recruited 3 months after stroke; complete cognitive tests were performed in 577 of the stroke patients. The incidence of PSCI in these Chinese patients was 30.7%. There were 129 (22.4%) patients with visuospatial impairment, 67 (11.6%) with executive impairment, 60 (10.4%) with memory impairment and 18 (3.1%) with attention impairment. The risk factors associated with PSCI were older age (odds ratio [OR] 1.76, 95% confidence interval [CI] 1.20-2.58), low education level (OR 2.45, 95% CI 1.65-3.64), depressive symptom (OR 1.69, 95% CI 1.09-2.61), obesity (OR 2.57, 95% CI 1.41-4.71), stroke severity 3 months post stroke (OR 1.62, 95%CI 1.10-2.37) and cortex lesion (OR 1.55, 95% CI 1.04-2.31). It was concluded that PSCI occurs commonly 3 months after first-ever stroke in Chinese patients. Visuospatial ability may be the most frequently impaired cognitive domain for the patients with stroke. The critical risk factors of PSCI are older age, low education level, depressive symptom, obesity, stroke severity 3 months post stroke and cortex lesion.

OBJECTIVETo learn the existence of natural focus of Lyme disease and its distribution.

METHODSA semi-nested polymerase chain reaction (PCR) method was developed for detection and genotyping of Borrelia burgdorferi on basis of outer surface protein A (OspA) gene. Ticks and mice collected from 6 forest areas in Beijing were detected with above methods. The positive PCR products were cloned and sequenced. The sequences were compared with published sequences for homology. IFA as used to detect IgG antibody on Borrelia burgdorferi. Lyme disease spirochete were isolated from H. longicornis were also attempted.

RESULTSB. Burgdorferi sensu lato were detected from 939 ticks and 250 mice specimens collected from above 6 study sites using primer pairs OA(1)/OA(4) and SL/OA(4). Only the specimens collected from Dongling mountain showed positive amplification. One in three adult Ixodes persulcatus with one of 57 nymph Ixodes persulcatus showed positive while 9 of 119 (7.56%) mice specimens showed positive, of which 8 were B. grinii and one B. afzelii. In this study, we attempted to isolate B. burgdorferi sensu lato strains from 160 H. longicornis ticks (20/group) but failed. Serological survey showed a 9.1% (5/55) infection rate with B. burgdorferi sensu lato in the mice of Dongling mountain forest areas.

CONCLUSIONSThe natural focus of Lyme disease including B. garinii and B. afzelii might have existed in Dongling mountain of Mentougou district, Beijing. Ixodes persulcatu and mice may serve as vectors and reservoirs, respectively.

Animals ; Antigens, Surface ; genetics ; Bacterial Outer Membrane Proteins ; genetics ; Bacterial Vaccines ; Borrelia burgdorferi ; genetics ; Borrelia burgdorferi Group ; classification ; genetics ; Humans ; Ixodes ; microbiology ; Lipoproteins ; Lyme Disease ; microbiology ; Mice ; Phylogeny ; Polymerase Chain Reaction ; methods

Background and aim:Few studies have reported hepatitis B surface antigen(HBsAg)kinetics after nucleos(t)ide analog(NA)discontinuation in patients with noncirrhotic chronic hepatitis B(CHB).The study specifically investigated long-term HBsAg kinetics after NA discontinuation. Methods:Between January 2014 to January 2024,this study prospectively enrolled 106 outpatients with noncirrhotic CHB who met the discontinuation criteria after NA consolidation treatment.Demographic,clinical,and laboratory data were collected and analyzed after NA discontinuation. Results:Ninety-six patients who finished 5 years of follow-up were included.HBsAg remained unde-tectable in 29 patients with end of treatment(EOT)HBsAg negativity.Among 67 patients with EOT HBsAg positivity,HBsAg seroclearance occurred in 12(17.9％)patients with an estimated annual inci-dence of HBsAg seroclearance of 3.6％.Patients with EOT HBsAg levels of ≤1000 IU/mL had a higher HBsAg seroclearance rate than those with EOT HBsAg levels of＞1000 IU/mL(33.3％vs.5.4％).The pro-portion of patients with HBsAg ≤1000 IU/mL increased during follow-up.Logistic regression analysis indicated that the EOT HBsAg level was an independent factor for HBsAg seroclearance and an HBsAg level decline exceeding 1 log10 IU/mL.The optimal EOT HBsAg cutoff for both HBsAg seroclearance and an HBsAg level decline exceeding 1 log10 IU/mL was 359 IU/mL. Conclusions:Patients with EOT HBsAg negativity experienced no relapse and maintained HBsAg sero-clearance during 5 years of follow-up after NA discontinuation.A higher HBsAg seroclearance rate can be obtained in patients with EOT HBsAg levels of ≤1000 IU/mL during 5 years of follow-up after NA discontinuation.Close monitoring and proper NA retreatment are recommended to guarantee the safety of NA discontinuation.

Objective To analyze the prevalence,co-prevalence of cardiovascular metabolic (CM) risk factors in women aged 15-49 years in China,and describe the influence of social economic factors on them.Methods The project data of Nutritional Status and Health Transition of Chinese Residents in 2015 were used.The changes in epidemiological characteristics of central obesity,elevated blood pressure,FPG and TG,decreased HDL-C and co-prevalence of the risk factors in women aged 15-49 years were analyzed.According to the definition of the metabolic syndrome released by the International Diabetes Federation in 2005,five cardio-metabolic risk factors appeared as central obesity,increased triglycerides,decreased HDL-C,increased blood pressure and increased plasma glucose.Co-prevalence of risk factors was defined as detecting 2 or more risk factors in a person at the same time.Multivariate logistic regression model was used to analyze the relationship between socioeconomic factors and metabolic risk factors.Results In 2015,in women aged 15-49 years in 15 provinces,the detection number (rates) of central obesity,elevated blood pressure,FPG and TG,decreased HDL-C,at least one CM risk factor and co-detection rate of CM risk factors were 944 (47.4％),464 (23.3％),123 (6.2％),327 (16.4％),1 025 (51.5％),1 501 (75.4％),and 874 (43.9％),respectively.Compared with women aged 15-19 years,the women in age group of 25-,30-,35-,40-,and 45-49 years were more likely to have central obesity (P＜0.05),the women in age group of 30-35-,40-,and 45-49 years were more likely to have elevated blood pressure (P＜0.05),the women aged 45-49 years were more likely to be affected by one or more CM risk factors (P＜0.05),but the women in age group 25-29 years group had lower risk for elevated FPG (P＜0.05).The odds of having central obesity,elevated blood pressure,FPG and TG,decreased HDL-C,at least one CM risk factor and co-prevalence of CM risk factors in women with BMI≥24.0 kg/m2 were 14.16,3.05,2.46,2.49,2.42,9.79 and 7.39 times higher than those in the women with BMI of 18.5-24.0 kg/m2,respectively.The odds of having elevated FPG and TG in women aged 15-49 years in western China and the odds of having elevated blood pressure and FPG in women aged 15-49 years in eastern China were significantly higher than those in central China.No significant correlations were found between the prevalence and co-prevalence of CM risk factors and income level or urban and rural area residences in women aged 15-49 years.Conclusions Age,BMI level and living area were the major influencing CM risk factors.The precise prevention and control measures should be taken in time for the adverse changes in CM risk factor prevalence.

OBJECTIVETo provide further pathogenic evidence of Granulocytic ehrlichia infection in China.

METHODSSpecific primers derived from 444-Epank gene were used to amplify Granulocytic ehrlichia DNA from specimens of ticks, animals and human blood. PCR products of ticks were cloned and sequenced.

RESULTS444 bp specific DNA fragments were amplified from 2 of 62 pools of Ixodes persulcatus collected from Heilongjiang province and 1 of 129 blood specimens from forest workers in Inner Mongolia. Eight animal specimens were negative. PCR products from ticks were then cloned and sequenced. It differed at 23 positions in comparison to American strain (AF047897) with 94.9% homology. The homology of deduced ammonia was 88.44%.

CONCLUSIONOur findings further confirmed that Granulocytic ehrlichia infection did exist in China.

DNA, Bacterial ; analysis ; Ehrlichia ; classification ; genetics ; isolation & purification ; Ehrlichiosis ; microbiology ; Genes, Bacterial ; Humans ; Phylogeny ; Polymerase Chain Reaction ; Sequence Analysis, DNA

Objective To investigate the efficacy of transcranial direct current stimulation(tDCS)on sleep disorder in patients with Parkinson's disease(PD).Methods From July 2021 to July 2023,patients with PD and sleep disorders in the Department of Neurosurgery of the Second People's Hospital of Guangdong Province were selected.The enrolled patients were divided into sham stimulation group(n=28)and true stimulation group(tDCS)(n=29)according to the inclusion and exclusion criteria.MDS-UPDRS,PDSS and other rating scales were used to evaluate the patients.Before and after tDCS treatment,MS-11 was used for intelligent sleep monitor-ing.The baseline and improvement of sleep disorders in the two groups before and after treatment were analyzed.Results Before tDCS treatment,there was no significant difference in general conditions and scale scores between the two groups(P＞0.05).There was no significant difference in polysomnographic monitoring results between the two groups before treatment(P＞0.05).Compared with pre-treatment,there was no significant difference in sleep monitoring results in the sham stimulation group(P＞0.05),while the sleep duration and sleep efficiency signifi-cantly increased,the nighttime awakening duration,nighttime awakening frequency,MDS-UPDRS-Ⅲ score,and LEDD dose significantly decreased in the true stimulation group,with statistical significance(P＜0.05).Conclusion Pharmacological treatment combined with tDCS treatment is effective for sleep disorders and motor function in patients with PD,which could increase the sleep duration and sleep efficiency of PD patients with sleep disorders to a certain extent,reduce the nighttime awakening duration and frequency,thereby improving the fatigue symp-toms during the daytime,and improving the efficacy of conventional pharmacological treatment for PD.