Objective To investigate the risk factors of ischemic stroke in Jiangsu Taixing population.Methods Case-control study was used in this investigation.Cases: all the diagnosed ischemic stroke patients in neurology department of Taixing People 's Hospital from 2011.9 to 2013.6.Controls: all the controls were selected randomly from community residents in Taixing city during the same period of time, according to the age and gender and ratio of 3:2.Univariate analysis and Logistic regression model was applied to analyze risk factors respectively.Results Seven hundred and seventy-seven stroke patients ( case group) and 518 controls ( control group) were brought into the study.It was preliminarily found in univariate analysis that compared with the control group, the rates of smoke, hypertension, diabetes, hyperlipidemia and the waist circumference, waist-to-hip ratio were significantly higher in the case group;while the total bilirubin level was significantly lower ( all P<0.001 ) .Logistic regression showed that smoking (OR=2.089, 95%CI:1.452-3.005), hypertension (OR=3.838, 95%CI:2.516-5.855) were risk factors of stroke in the elder population in Taixing, elevated total bilirubin level ( OR=0.281, 95%CI:0.155-0.508) was protective factor of stroke in the elder population ( all P<0.05 ).Conclusion No smoking, no hypertension history could make it less possible for stroke to occur, and total bilirubin level becomes protective factor of stroke.

Objective To investigate the impacts of mecobalamin on plasma inflammatory factors (plasma high-sensitivity C-reactive protein (Hs-CRP) and carotid artery plaques in patients with H type hypertension.Methods Forty-eight acute ischemic stroke patients who were diagnosed with H type hypertension in the People's Hospital of Taixing were collected,and they were randomly divided them into treatment group and control group,and 24 cases of each group.Patients in both groups were given conventional therapies,including treatment of anti platelet aggregation,plaque stability and reduced plaque treatment.While patients in the treatment group were given additional oral drug of mecobalamin,500 μg each time,three times a day,6 months in all.Each case was evaluated at the second day of hospitalization,four weeks later,eight weeks later,three months and sixth months later.The examination items involved included level of plasma homocysteine(Hcy),level of hsCRP and conditions of carotid artery plaques under ultrasonography.Results Aafter four weeks,eight weeks,three months and sixth months therapy,there were significant differences between treatment group and control group in terms of Hcy (t =4.049,3.896,6.052,6.159 ; P ＜ 0.05) and the level of hs-CRP (t =37.249,28.376,26.454,0.522P ＜ 0.01).Afrter three months and sixth months therapy,compared to the control group,the carotid artery plaques were obviously reduced,and the differences were statistically significant (t =2.309,2.434 ; P ＜ 0.05).Conclusion Mecobalamin can reduce the level of plasma homocysteine,then lead to reductions of levels of plasma inflammatory factors and volume of carotid artery plaques.

Objective To measure the expression of CD80 and CD86 in renal tissue of lupus nephritis (LN) and explore its mechanism in the development of LN.Methods Forty-nine patients with active LN and 9 patients with minor glomerular abnormalities tissues as controls were studied.The expression of CD80, and CD86 in renal tissues was detected by immunohistochemical methods.Results CD86 was expressed extensively in glomerulus, periglomerular area, tubular epithelial cells and peritubular interstitium, while CD80 was expressed only in tubular epithelial cells and peritubular interstitium.Moreover, the percentage of CD+80 and CD+86 cells in tubular epithelial cells and peritubular interstitium showed a tendency to increase with tubulointerstitial damage.The expression of CD80 and CD86 in renal tissue correlated with the systemic lupus erythematosus (SLE) disease activity index score, the degree of proteinuria, creatinine clearance and anti- dsDNA antibody.Conclusions This study shows that increased CD80 and CD86 expression with the progression of tubulointerstitial lesion might play an important role in the development of lupus nephropathy, and the tubulointerstitial expression of CD80 and CD86 could potentially serve as a surrogate marker of SLE disease activity.The co-stimulatory molecules CDg, and CD86 might play an important role in the pathogenesis of LN.

Objective:To investigate the predictive value of YKL-40 at admission on stroke-associated pneumonia (SAP) and poor outcome in patients with acute ischemic stroke (AIS).Methods:Patients with AIS admitted to Taixing People’s Hospital from February 2020 to March 2021 were enrolled prospectively. The poor outcome was defined as 3-6 points on the modified Rankin Scale at 90 d after onset. Multivariate logistic regression analysis was used to determine the independent predictors of SAP and poor outcome, and the predictive value of serum YKL-40 on SAP and poor outcome was evaluated by receiver operating characteristic (ROC) curve. Results:A total of 377 patients with AIS were enrolled. The median serum YKL-40 was 127.16 μg/L. One hundred and four patients (27.6%) had SAP, and 126 (33.4%) had poor outcomes at 90 d after onset. Multivariate logistic regression analysis showed that after adjusting for confounding factors, YKL-40 was the independent predictors of SAP (odds ratio [ OR] 1.005, 95% confidence interval [ CI] 1.003-1.008; P=0.001) and poor outcome at 90 d ( OR 1.009, 95% CI 1.006-1.011; P=0.001). The ROC curve analysis showed that the area under the curve of YKL-40 for predicting SAP was 0.769 (95% CI 0.713-0.824; P<0.001), the best cutoff value was 168.70 μg/L, and the sensitivity and specificity were 71.2% and 75.1% respectively; the area under the curve of YKL-40 for predicting poor outcome at 90 d was 0.787 (95% CI 0.735-0.840; P<0.001), the best cutoff value was 195.56 μg/L, and the sensitivity and specificity were 68.3% and 84.1% respectively. Conclusion:Higher serum YKL-40 at admission has a good predictive value for SAP and poor outcome at 90 d in patients with AIS.