Objective To explore the predictive value of early electroenphalography (EEG) for a malignant course in patients with large middle cerebral artery infarction (LMCAI).Methods Thirty-seven patients (20 patients with a malignant and 17 with a benign course) with stroke of >50% of the middle cerebral artery territory in early CT/MRI scan were included;Glasgow-Pittsberg Coma Scale (24 ±1 vs. 30 ±4, P =0. 003) and National Institutes of Health Stroke Scale (23 ±3 vs. 16 ±4, P =0.000) in the group with a malign course were higher than those in the group with a benign course. Early EEG was recorded within 24 h after ischemic stroke. The correlation between the change characteristics of EEG and a malignant course in patients with LMCAI was analyzed. Results The contralateral occipital background frequencies < 8 Hz (17/20 vs. 3/20, P =0.000), β frequency within the focus ≤20 Hz (19/26 vs. 7/26, P= 0-001), EEG non-reaction to stimuli (11/12 vs. 1/12, P= 0.002),slowing affecting the whole hemisphere in the lesion (17/24 vs. 7/24, P = 0. 008) and focal slowing contralateral to the lesion (16/19 vs. 3/19, P =0. 000) were significantly related with a malignant course. Whereas the contralateral occipital background frequencies ≥8 Hz (14/17 vs. 3/17, P =0. 000),β frequency >20 Hz within the focus (10/11 vs. 1/11, P =0. 001) were related with a benign course. Conclusions Early EEG has a certain predictive value for a malignant course in patients with LMCAI, and it may be used as one of the bedside monitoring approaches of LMCAI.

Objective To investigate the predictive value of the 40 Hz auditory steady state response (40-Hz ASSR) in the short-term prognosis of patients with brainstem stroke.Methods The 40-Hz ASSR and brainstem auditory evoked potentials (BAEP) examinations were recorded and graded from 36 patients with brainstem stroke admitted in the Neurological Intensive Care Unit (NICU). Tue end point of short-term prognostic evaluation was at the time of leaving the NICU. Tue patients with brainstem stroke were divided into the survival group (n =21) and the death group (including brain death,n = 15). The correlation between the grade of the 40-Hz ASSR or BAEP and the short-term prognosis was analyzed. Results The grade of the 40-Hz ASSR (r=0.571,P =0.000) or BAEP (r =0.441,P =0.001 ) was significantly correlated with the short-term prognosis in patients with brainstem stroke. The sensitivity,specificity and accuracy of the 40-Hz ASSR were 60.00％,100％ and 83.33％,respectively,and those for BAEP were 66. 67％,71.43％ and 69. 44％,respectively. Conclusions Tue 40-Hz ASSR has a certain short-term prognostic value in patients with brainstem stroke. The higher the grade of 40-Hz ASSR is,the more serious the illness,and the worse the prognosis.

Objective To observe the surface area temperature of dysmenorrhea rats with cold stagnation syndrome; To compare the different effects of Sanyinjiao (SP6) and Guanyuan (RN4).Methods Forty female SD rats were randomized into control group, model group, Sanyinjiao (SP6) group, and Guanyuan (RN4) group, 12 rats in each group. Whole body freezing method combined with estradiol benzoate injection was used to establish models. Sanyinjiao (SP6) group and Guanyuan (RN4) group received moxibustion at corresponding points for 3 times after modeling. Infrared thermal imaging was used to measure the skin temperature at the surface projection area of Sanyinjiao (SP6) and Xuehai (SP10) and Sanyinjiao-Xuehai lines before and after moxibustion.Results Compared with control group, the temperature gap between double sides of Sanyinjiao-Xuehai lines significantly increased in model group 5-30 min after moxibustion (P<0.05). 30 min after moxibustion, the temperature of right Sanyinjiao significantly decreased in other three groups (P<0.01). Compared with model group, the temperature gap between double sides of Sanyinjiao-Xuehai lines significantly decreased after 5-30 min in Sanyinjiao group (P<0.05), while Sanyinjiao-Xuehai lines significantly decreased after 10-30 min in Guanyuan group (P<0.05). Comparison between two moxibustion groups, the influence of Sanyinjiao group to temperature gap between double sides of Sanyinjiao-Xuehai lines was earlier than Guanyuan group (P<0.05).Conclusion Moxbustion can decrease the temperature gap between double sides of Sanyinjiao-Xuehai lines and ease the imbalance. And the influence of moxbustion SP6 to temperature gap between double sides of Sanyinjiao-Xuehai lines is earlier than moxibustion RN4.

Vertebrobasilar dolichoectasia(VBD ) can increase the risk of stroke. Significant expansion, elongation and tortuosity of the vertebrobasilar arteries are the main morphology manifestations of VBD. However, there is no consensus on the quantitative imaging assessment of VBD. Many studies showed that some quantitative parameters, such as basilar artery length and bending length, basilar angulation, vertebral tortuosity index can be used for the quantitative imaging assessment of VBD.

Objective:To investigate the risk factors for hemorrhagic transformation (HT) in patients with acute posterior circulation ischemic stroke (PCIS) and its impact on outcomes.Methods:From July 2016 to October 2019, patients admitted to the Department of Neurology, the People's Hospital of Zhengzhou and diagnosed as PCIS were enrolled retrospectively. Their demography, clinical data, laboratory and imaging findings were collected. HT was defined as no intracranial hemorrhage detected by the first head CT/MRI after onset, and intracranial hemorrhage was found during head CT/MRI reexamination within 10 d after onset. Symptomatic HT was defined as intracranial hemorrhage indicated by imaging reexamination and the National Institutes of Health Stroke Scale (NIHSS) score was higher than the baseline. The outcome was evaluated by the modified Rankin Scale at 3 months after onset, and >2 were defined as poor outcome. Multivariate logistic regression analysis was used to identify the independent risk factors for HT, symptomatic HT, and poor outcomes. Results:A total of 242 patients with PCIS were enrolled. Their age was 68.02±12.0 years, and 111 were females (45.9%). The baseline median NIHSS score was 5.9 (interquartile range: 3.1-8.8). HT occurred in 19 patients (7.9%), and 14 of them (73.7%) were symptomatic HT. Follow-up at 3 months showed that 74 patients (30.58%) had poor outcomes, of which 12 died. Multivariate logistic regression analysis showed that higher baseline systolic blood pressure (odds ratio [ OR] 1.076, 95% confidence interval [ CI] 1.021-1.135, P=0.006; OR 1.161, 95% CI 1.087-1.240, P<0.001) and larger infarct volume ( OR 31.293, 95% CI 4.542-215.592, P<0.001; OR 2.084, 95% CI 1.414-3.073, P<0.001) were the independent risk factors for HT and symptomatic HT. The higher NIHSS score ( OR 1.511, 95% CI 1.307-1.746; P<0.001), diabetes mellitus ( OR 2.041, 95% CI 1.054-3.952; P=0.034) and symptomatic HT ( OR 4.514, 95% CI 1.458-13.979; P=0.009) were the independent risk factors for poor outcomes. Conclusions:HT is rare in patients with PCIS. Higher baseline systolic blood pressure and larger infarct volume are the independent risk factors for HT in patients with PCIS. Higher baseline NIHSS scores, diabetes mellitus, and symptomatic HT are the independent risk factors for poor outcomes in patients with PCIS.

PURPOSE: In our previous studies we showed that upregulating claudin-6 (CLDN6) expression may contribute to preventing breast cancer, and that 17beta-estradiol induces a concentration- and time-related effect on CLDN6 mRNA and protein expression in MCF-7 cells. However, the mechanisms of 17beta-estradiol regulation of CLDN6 are still unclear. We determined the role of estrogen receptors in the regulation of CLDN6 expression in human breast cancer tissues and a cell line. METHODS: CLDN6, estrogen receptor alpha (ERalpha) and estrogen receptor beta (ERbeta) expression in breast cancer tissues were examined using immunohistochemistry. The human breast cancer cell line, MCF-7, which expresses ERalpha but not ERbeta was used. CLDN6 and ERalpha expression were measured by reverse transcriptase-PCR, Western blotting and immunofluorescent staining. Treatments with propyl pyrazole triol (PPT) and ICI 182, 780 (ICI) were performed. RESULTS: The results revealed that CLDN6 expression was related to ERalpha in breast cancer tissues (p=0.033). PPT, an ERalpha-selective ligand, upregulated CLDN6 expression at 10-5 mol/L after 24 hours. The effect of PPT on regulating CLDN6 expression in MCF-7 cells was blocked by ICI. CONCLUSION: These findings suggest that Eralpha reulates CLDN6 expression in breast cancer tissues and that 17beta-estradiol induces CLDN6 expression through an ERalpha pathway in MCF-7 cells.
Blotting, Western ; Breast ; Breast Neoplasms ; Cell Line ; Claudins ; Estrogen Receptor alpha ; Estrogen Receptor beta ; Estrogens ; Humans ; Immunohistochemistry ; MCF-7 Cells ; Pyrazoles ; Receptors, Estrogen ; RNA, Messenger ; Tight Junctions

Objective Infrared thermal imaging can be applied to the diagnosis and auxiliary diagnosis of some diseases . The aim of this study is to explore acupuncture-induced changes in skin temperature in acupoint areas and whether skin temperature in -creases or decreases in the acupoint areas along meridians . Methods Thirty two female SD rats were randomly and equally divided into four groups:saline control,cold congealing and dysmenorrhea model , Sanyinjiao (SP6), and Guanyuan( CV4).Models were es-tablished in the latter three groups by subcutaneous injection of estradiol benzoate at 0.5 mg for 10 successive days and , 1hour after the last administration , intraperitoneal injection of oxytocin at 2 U, followed by exposure of the rats to-25℃in a freezer 4 hours a day for 5 days.Meanwhile , the control rats received normal saline only and were not exposed to low temperature .Infrared thermal imaging was used to measure the skin temperature at the acupoint areas of SP6, Xuehai (SP10), and CV4 before and at 0, 5, 10, 20, 30, 40, 50 and 60 min after needling . R esults At 0 to 5 min after nee-dling, the skin temperature of the left SP6 and right SP10 was signifi-cantly decreased in both the SP6 and CV4 groups ( [ -0. 56 ± 0.22]℃and [-0.48 ±0.11]℃, P<0.01), and so was that of the right SP10 ([ -0.64 ±0.21]℃ and [ -0.45 ±0.13]℃, P<0.05).At 5 to 10min, the skin temperature of the right SP6 and SP10 was markedly increased in the SP6 group ([-0.49 ±0.35]℃and [-0 .18 ±0.20]℃, P<0.01), and so was that of the right SP6 in the SP6 group at 20 to 30 min ([ -0.14 ±0.25]℃) as compared with the model and CV4 groups (P<0.01).At 30 to 40 min, the skin temperature of the right SP10 was remarkably elevat-ed in the SP6 group ([ -0.03 ±0.11]℃) in comparison with the model group (P<0.01).No significant differences were observed in the skin temperature of the left SP10 and CV4 at different time points among the four groups (P>0.05). Conclusion The skin temperature of SP6 and SP10 can be regulated by needling both the acupoints of SP 6 and CV4.The increase in the skin temperature of the right SP6 and SP10 in the SP6 group and no change in the CV 4 group indicated dynamic temperature changes in the acupoint area along the meridian after needling.

Objective:To investigate the risk factors for hemorrhagic transformation (HT) after intravenous thrombolysis (IVT) in patients with acute ischemic stroke (AIS), and the predictive value of Neutrophil to lymphocyte ratio (NLR).Methods:Consecutive patients with AIS received IVT in Zhengzhou People’s Hospital from January 2021 to December 2022 were retrospectively enrolled. HT was defined as no intracranial hemorrhage was found on the first imaging examination after admission, and new intracranial hemorrhage was found on the imaging examination 24 h after IVT or when symptoms worsened. sHT was defined as HT and the National Institutes of Health Stroke Scale (NIHSS) score increased by ≥4 compared to admission or required surgical treatment such as intubation and decompressive craniectomy. The baseline clinical and laboratory data of the patients were collected, and NLR, lymphocyte to monocyte ratio (LMR), and platelet to neutrophil ratio (PNR) were calculated. Multivariate logistic regression analysis was used to identify the independent predictors of HT and sHT, and receiver operating characteristic (ROC) curve was used to analyze the predictive value of NLR for HT and sHT after IVT. Results:A total of 196 patients were included (age 65.37±13.10 years, 124 males [63.3%]). The median baseline NIHSS score was 4 (interquartile range: 2-10). Twenty patients (10.2%) developed HT, and 12 (6.1%) developed sHT. Univariate analysis showed that there were statistically significant differences in age, baseline NIHSS score, creatinine, NLR, and stroke etiology type between the HT group and the non-HT group (all P<0.05); there were statistically significant differences in age, NLR, PNR, creatinine, baseline NIHSS score, and stroke etiological type between the sHT group and the non-sHT group (all P<0.05). Multivariate logistic regression analysis showed that NLR was an independent predictor of HT (odds ratio [ OR] 1.375, 95% confidence interval [ CI] 1.132-1.670; P=0.001) and sHT ( OR 1.647, 95% CI 1.177-2.304; P=0.004) after IVT. The ROC curve analysis showed that the area under the curve for predicting HT by NLR was 0.683 (95% CI 0.533-0.833; P=0.007), the optimal cutoff value was 5.78, the sensitivity and specificity were 55.0% and 84.1%, respectively. The area under the curve for predicting sHT by NLR was 0.784 (95% CI 0.720-0.839; P=0.001), the optimal cutoff value was 5.94, the sensitivity and specificity were 66.67% and 84.24%, respectively. Conclusions:A higher baseline NLR is associated with an increased risk of HT and sHT after IVT in patients with AIS, and can serve as a biomarker for predicting HT and sHT after IVT.

Objective To observe the analgesic effect of acupuncture at Guanyuan (CV4) and its effect on vasomotor substances in rats with dysmenorrhea due to coagulated cold syndrome. Method The coagulated-cold dysmenorrhea rat model was developed by Estrodiol benzoate and Oxytocin injectin plus physical freezing. The writhing response (writhing latency, writhing frequency, and writhing score) was observed, and the contents of TXB2 and 6-keto-PGF1a were detected by using enzyme-linked immunosorbent assay (ELISA). Result Compared with the saline water group, the writhing latency was significantly shortened, the writhing frequency was significantly increased, and the writhing score was more significantly increased in the model group (P<0.01);compared with the model group, the writhing latency was significantly prolonged, the writhing frequency was decreased, and the writhing score was significantly lower in the acupuncture group (P<0.05, P<0.01). Compared with saline water group, the content of plasma 6-keto-PGF1a was significantly lower (P<0.05) and the content of plasma TXB2 showed an increasing tendency (P>0.05) in the model group. Compared with the model group, the content of plasma 6-keto-PGF1a showed an increasing tendency (P>0.05) and the content of plasma TXB2 showed a decreasing tendency (P>0.05) in the acupuncture group. Conclusion The vasomotor substances are obviously disordered in the blood of cold-coagulated dysmenorrhea rat models. Acupuncture at Guanyuan can improve the writhing response and release pain, and meanwhile positively regulate the vasomotor substances such as TXB2 and 6-keto-PGF1a. The vasomotor substances are plausibly one of the major substances in the action of acupuncture in preventing and treating dysmenorrhea.

Objective To explore the effect of different acupuncture stimuli on uterine micro-circulation of dysmenorrheal rats with cold stagnation syndrome. Methods Totally 32 three-month old female SD rats in diestrus were randomly divided into saline control group, model group, A stimuli group, and B stimuli group, 8 rats in each group. Model group and treatment groups were given whole body freezing combined with estradiol benzoate injection method to establish models. A stimuli group was given deep puncture with manipulation, while B stimuli group was treated by shallow puncture without manipulation. Diameter of uterine capillary,micro-vessel, TXB2, and 6-keto-PGF1αlevels were observed in each group. Results Compared with the saline group, capillary diameter in model group was significantly reduced at 5, 10, 20, 30 min time point (P<0.01);micro-vascular diameter was significantly reduced at 5, 10, 20, 30, 40 min time point (P<0.01);plasma 6-keto-PGF1α levels decreased (P<0.01);TXB2/6-keto-PGF1αincreased significantly (P<0.01). Compared with model group, capillary diameter in A stimuli group enlarged at 5, 10, 20, 30 min time point (P<0.05), micro-vascular diameter dilated at 5, 10, 20, 30, 40 min time point (P <0.01), plasma 6-keto-PGF1α level increased (P <0.05), TXB2/6-keto-PGF1αdecreased significantly (P<0.05);micro-vascular diameter in B stimuli group dilated at 20, 30 min time point (P<0.05), plasma TXB2/6-keto-PGF1α decreased significantly (P<0.05). Compared with B stimuli group, capillary diameter in A stimuli group dilated at 5, 10, 20, 30 min time point (P<0.05) and micro-vascular diameter dilated at 5, 10, 20, 30, 40 min time point significantly (P<0.01). Conclusion Dysmenorrheal rats with cold stagnation syndrome show obvious disorder of the uterus micro-circulation and circulation related substances. Both A and B acupuncture stimuli improved uterus micro-circulation of dysmenorrheal rats with cold stagnation syndrome, and its mechanism may be related to the recovery the balance between TXB2 and 6-keto-PGF1α.