To investigate the correlation between the trigiuceride-glucose index and early neurological deterioration（END） in patients with mild ischemic stroke（MIS）. Methods This study was retrospective. Patients with acute MIS who were admitted to the Department of Neurology of the First Central Hospital of Baoding from January 2019 to December 2020 for the first time and within 72 h of onset were consecutively included. The National Institute of Health Stroke Scale（NIHSS） scores were recorded at the time of admission，and fasting venous blood was drawn in the early morning of the following day to determine routine blood，liver function，renal function，lipids and other relevant blood indices，and the trigiuceride-glucose index was calculated ln［TG（mg/dl）×FBG（mg/dl）］/2.The patients were divided into END and non-END groups according to their neurological deterioration. Multi-factor logistic regression was used to analyze the factors associated with the occurrence of END in acute MIS patients，and the subject operating characteristic curve（ROC） was used to evaluate the predictive effect of the trigiuceride-glucose index on END in acute MIS patients. Results A final total of 149 patients with acute MIS were included，39 in the END group and 110 in the non-END group. Multi-factor logistic regression analysis showed that neutrophil ratio（OR 1.054，95%CI 1.009～1.101，P=0.017）、TBIL（OR 0.718，95%CI 0.611～0.845，P<0.001）and trigiuceride-glucose index（OR 5.072，95%CI 1.645～15.640，P=0.005） were independent risk factors for the development of END in patients with acute MIS. The ROC curve analysis showed that the diagnostic cut-off value of trigiuceride-glucose index for END was 1.74 with a sensitivity of 53.8% and specificity of 81.8%. Conclusion Elevated trigiuceride-glucose index is one of the risk factors for the development of END in patients with acute MIS and has a predictive role for the development of END in patients with acute MIS.

The gatekeeper policy has been implemented for approximately ten years on a pilot population in China. It is necessary to assess the satisfaction of patients utilizing community health service (CHS) under the gatekeeper system. Our study showed that the cognition of gatekeeper policy was associated with four dimensions including doctor-patient relationships, information and support, organization of care, and accessibility (P < 0.001). One or more factors such as gender and self-perceived health scores also affected their satisfaction. General practitioners must be prepared to focus on these aspects of information and support, organization of care, and accessibility as indicators of potential opportunities for improvement. Additionally, policymakers can improve patients' satisfaction with CHS by strengthening their awareness of the gatekeeper policy.
Adolescent ; Adult ; China ; Community Health Services ; organization & administration ; Data Collection ; Female ; Humans ; Male ; Middle Aged ; Patient Satisfaction ; statistics & numerical data ; Young Adult