Objective To understand the epidemic status of Kala azar in Gannan of Gansu Province and to provide a scientific basis for making effective control measures.Methods The epidemic monitoring data of Gannan Kala azar from the infectious disease network direct reporting system and the Gannan County Center for Disease Prevention and Control was collected, descriptive epidemiological method was used to analyze the distribution of Kala azar.Results From 2005 to 2014, a total of 285 Kala azar cases were reported, the incidence rate was 4.21/one hundred thousand (285/6 764 645).The incidence rate in 2005 was the lowest (1.97/one hundred thousand, 13/658 961), in 2011 was the highest (6.39/one hundred thousand, 44/689 104).The cases mainly distributed in the Bailongjiang Valley in Zhouqu County (14.97/one hundred thousand, 200/1 336 150) and Diebu County (14.29/one hundred thousand, 76/531 915).Gannan had reported the cases of Kala azar all year round, and the cases were sporadically distributed.The time of the disease mainly occurred from May to August.The incidence rate in male (58.60％, 167/285), children under 5 years old (43.86％, 125/285) and farmers and herdsmen (25.26％,72/285) accounted for the major parts.In addition to Luqu County and Xiahe County, other counties had cases of imported Kala azar.Conclusion Kala azar in Gannan is happened sporadically year round.Long-term mechanism need to be established;investment funding should be ensured;the monitoring of the epidemic should be strengthened;the epidemic situation of Kala azar should be timely reported in order to effectively prevent and control the epidemic of Kala azar in Gansu.

Objective To investigate the possible roles of hemodynamics, circulating hormones, cell cation transport and cyclic nucleotides in left ventricular hypertrophy (LVH) of essential hypertension (EH) in vivo. Methods Blood pressure, total peripheral resistance (TPR) and plasma norepinephrine (NE), endothelin (ET), angiotensin Ⅱ (AngⅡ), endogenous digitalis like substances (EDLS) and atrial natriuretic peptide (ANP) were determined, along with the measurements of lymphocytic membrane ion pumps, cations and cyclic nucleotides in 45 EH patients with LVH (12 concentric hypertrophy, 33 eccentric hypertrophy), 30 normal subjects and 45 EH patients without LVH (as double concurrent controls). Multiple stepwise regression analysis was computed using left ventricular mass index (LVMI) as dependent variable and 22 parameters as independent variables. Results (1) In EH patients with LVH, increases were seen in systolic blood pressure, mean arterial pressure (MAP) and NE, ET, AngⅡ, EDLS and ANP as well as lymphocytic Na +, Ca 2+ , cAMP and cAMP/cGMP ratio, while Na + K + ATPase and Ca 2+ ATPase activities, K + and Mg 2+ decreased. (2) Five hormones were related respectively to ion pumps, Na +, Ca 2+ and cyclic nucleotides. (3) LVMI were correlated with NE, ET, AngⅡ and EDLS, Ca 2+ ATPase, Na +, cAMP and cAMP/cGMP ratio. (4) The regression equation revealed that NE, ET, Ca 2+ ATPase, Mg 2+ and cAMP were the independent factors affecting LVH. (5) TPR and AngⅡ were higher, K + was lower in concentric LVH than those in eccentric LVH. Conclusion The changes of hemodynamics, circulating hormones, cell cation transport and cyclic nucleotides, or their interaction may be involved in the pathogenesis of LVH in EH. NE, ET. Ca 2+ ATPase, Mg 2+ and cAMP seem to play more important parts in LVH . TPR , whereas AngⅡ and K + may relate to cocentric LVH.

OBJECTIVETo study the excision repair capacity of human 8-oxoguanine DNA N-glycosylase 1 (hOGG1) for 8-OH-dG and the oxidative DNA damage among workers exposed to nickel in stainless steel production environment.

METHODSA total of 231 workers exposed to nickel in a stainless steel production enterprise were recruited as nickel exposure group, and another 75 water pump workers in that enterprise were recruited as control group. The workplace occupational hazard factors were determined. Double-antigen sandwich ELISA was used to determine urinary 8-OH-dG level; RT-PCR was used to determine hOGG1 mRNA level. Pearson correlation was used to analyze the correlation between urinary 8-OH-dG level and hOGG1 mRNA level.

RESULTSLevel of 8-OH-dG was compared between different types of nickel-exposed workers and control workers; rolling mill workers showed no significant difference from the control group (P > 0.05), while steel making workers and steel slag disposing workers showed significant differences from the control group (P < 0.05). Level of 8-OH-dG was also compared between nickel-exposed workers with different working years and control workers; nickel-exposed workers with 0∼5 and 6∼10 working years showed no significant differences from the control group (P > 0.05), while other exposed workers showed significant differences from the control group (P < 0.05). Different types of nickel-exposed workers all showed significant differences from the control group in hOGG1 mRNA level (P < 0.05). Nickel-exposed workers with 0∼5 working years showed no significant difference from the control group in hOGG1 mRNA level (P > 0.05), while other exposed workers showed significant differences from the control group (P < 0.05). Pearson correlation analysis showed that urinary 8-OH-dG level was positively correlated with hOGG1 mRNA level (r = 0.993) in different types of nickel-exposed workers, and the correlation was significant at α = 0.01 (P < 0.05); urinary 8-OH-dG level also showed a positive correlation with hOGG1 mRNA level in nickel-exposed workers with different working years (r = 0.968), and the correlation was significant at α = 0.01 (P < 0.05).

CONCLUSIONExposure to nickel increases oxidative DNA damage among steel workers, and hOGG1 shows active excision repair capacity for 8-OH-dG.

Adult ; DNA Damage ; DNA Glycosylases ; metabolism ; DNA Repair ; Humans ; Male ; Metallurgy ; Middle Aged ; Nickel ; adverse effects ; Occupational Exposure ; adverse effects ; Stainless Steel ; Young Adult

Objective:To investigate the clinical value of nutritional indexes including body mass index (BMI), albumin (ALB), nutrition risk screening 2002 (NRS 2002) and the nutrition risk in critically ill score (NUTRIC) in 28-day prognosis of patients with sepsis related acute kidney injury (AKI).Methods:A prospective cohort study was conducted. Patients with sepsis treated in the emergency intensive care unit (EICU) of China Rehabilitation Research Center from December 1, 2018 to December 1, 2020 were observed for 7 days. Patients with sepsis related AKI were enrolled in this study. The gender, age, BMI, basic diseases, shock, number of affected organs, length of hospital stay, ALB, mechanical ventilation (MV) and vasoactive drug use, sequential organ failure score (SOFA), rapid sequential organ failure score (qSOFA) and acute physiology and chronic health evaluationⅡ(APACHEⅡ) were recorded. The NRS 2002 score and NUTRIC score were calculated. Cox regression model was used to analyze the risk factors of 28-day mortality in patients with sepsis related AKI. The receiver operator characteristic curves (ROC curves) were drawn and the areas under the ROC curves (AUC) were calculated, and the value of BMI, ALB, NRS 2002 score and NUTRIC score was analyzed to predict 28-day mortality in patients with sepsis related AKI. Kaplan Meier survival curves were used to analyze the effects of NRS 2002 score and NUTRIC score stratification on the 28 day prognosis of patients with sepsis related AKI.Results:A total of 140 patients with sepsis related AKI were enrolled, including 73 survival patients and 67 died patients within 28 days. The 28-day mortality was 47.9% (67/140). BMI in the survival group was significantly higher than that in the death group [kg/m 2: 22.0 (19.5, 25.6) vs. 20.7 (17.3, 23.9), P < 0.05], and NRS 2002 score and NUTRIC score were significantly lower than those in the death group [NRS 2002 score: 5 (4, 6) vs. 7 (6, 7), NUTRIC score: 6 (5, 7) vs. 7 (6, 9), both P < 0.05]. The ALB of the survival group was slightly higher than that of the death group, but the difference was not statistically significant. Cox regression analysis showed that NRS 2002 score and NUTRIC score were independent risk factors for 28-day death in patients with sepsis related AKI. ROC curve analysis showed that NUTRIC score had the strongest predictive ability for 28-day death [AUC = 0.785, 95% confidence interval (95% CI) was 0.708-0.850], followed by NRS 2002 score (AUC = 0.728, 95% CI was 0.647-0.800), but there was no significant difference between them. Compared with NRS 2002 score, the predictive ability of BMI and ALB was poor. Kaplan-Meier curve analysis showed that the prognosis of patients with NRS 2002 score≥5 was significantly worse than that of patients with NRS 2002 score < 5 (28-day cumulative survival rate: 42.1% vs. 75.6%, Log-Rank test: 2 = 11.884, P = 0.001), and the prognosis of patients with NUTRIC score≥6 was significantly worse than that of patients with NUTRIC score < 6 (28-day cumulative survival rate: 40.4% vs. 86.1%, Log-Rank test: 2 = 19.026, P = 0.000). Conclusions:Patients with sepsis related AKI have high nutritional risk. Both NRS 2002 score and NUTRIC score have good predictive value for the prognosis of patients with sepsis related AKI, while BMI and ALB have low predictive value. Due to the complex calculation of NUTRIC score, NRS 2002 score may be more suitable for emergency department.

Objective:To investigate the predictive value of mid-regional proadrenomedullin (MR-proADM) on poor prognosis of low-risk patients with sepsis.Methods:This was a prospective cohort study. Patients with sepsis admitted to the Emergency Intensive Care Unit of China Rehabilitation Research Center from December 2018 to December 2020 were included in this study. The patients were divided into the low-risk group (SOFA≤7) and medium-high-risk group (SOFA>7) according to the sequential organ failure assessment (SOFA) score, and the clinical characteristics of the two groups were compared. Proportional hazards regression model (COX regression model) was used to investigate the risk factors of 28-day mortality in the low-risk and medium-high-risk group. The predictive ability of MR-proADM, C-reactive protein (CRP), lactic acid (Lac), interleukin-6 (IL-6), SOFA score, and acute physiology and chronic health evaluationⅡ (APACHE Ⅱ) score for the prognosis in each group was evaluated by receiver operating characteristic (ROC) curve. The outcomes of patients with different concentration of MR-proADM in the low-risk group were compared.Results:Totally 205 patients with sepsis were included, and the 28-day mortality was 41.0% (84/205). There were significant differences in the number of organ dysfunction, acute kidney injury, use of vasoactive drugs, Lac, IL-6, SOFA score and APACHEⅡ score between the two groups ( P<0.05). Cox regression model showed that age, MR-proADM, mechanical ventilation, IL-6 and APACHEⅡ score were the risk factors of 28-day death in the low-risk group, while MR-proADM, Lac, SOFA score and APACHEⅡ score were the risk factors of 28-day mortality in the medium-high-risk group. In each group, MR-proADM had a good predictive ability for the prognosis of patients with sepsis ( P<0.001). Especially in low-risk patients with sepsis, the predictive ability of MR-proADM was better than other indicators. Kaplan-Meier survival curve suggested that the patients with MR-proADM >2.53 nmol/L had worse prognosis than those with MR-proADM ≤2.53 nmol/L, and the difference was statistically significant ( P<0.001). In the low-risk group, the mortality of patients increased from 7.8% to 58.2% if MR-proADM >2.53 nmol/L. Conclusions:MR-proADM is a risk factor for 28-day mortality in patients with sepsis, and MR-proADM can early identify the poor prognosis of low-risk patients with sepsis.

Objective:To establish a clinical diagnostic scoring system for septic cardiomyopathy (SCM) and evaluate its diagnostic efficacy.Methods:A prospective cohort study was performed. Patients with sepsis and septic shock admitted to the department of emergency of China Rehabilitation Research Center were enrolled from January 2019 to December 2020. The baseline information, medical history, heart rate (HR), mean arterial pressure (MAP), body temperature and respiratory rate (RR) on admission were recorded. Laboratory indexes such as white blood cell count (WBC), hypersensitivity C-reactive protein (hs-CRP), N-terminal pro-brain natriuretic peptide (NT-proBNP), and blood lactic acid (Lac) were measured. Transthoracic echocardiography was conducted within 24 hours and on the 7th after admission. Sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluationⅡ(APACHEⅡ), and nutritional risk screening 2002 scale (NRS2002) were also assessed. The patients were divided into two groups according to whether SCM occurred or not. The risk factors of SCM were screened by univariate and multivariate Logistic regression. The cut-off value of continuous index was determined by receiver operator characteristic curve (ROC curve) and discretized concerning clinical data. The regression coefficient β was used to establish the corresponding score, and the clinical diagnostic score system of SCM was established. The diagnostic value of the model was evaluated by ROC curve.Results:In total, 147 patients were enrolled in the study and the incidence of SCM was 28.6% (42/147). Univariate Logistic regression analysis showed the risk factors of SCM included: ① continuous indicators: age, NT-proBNP, RR, MAP, Lac, NRS2002, SOFA, APACHEⅡ; ② discrete indicators: shock, use of vasoactive drugs, history of coronary heart disease, acute kidney injury (AKI). Multivariate Logistic regression analysis after discretization of above continuous index showed that age≥87 years old, NT-proBNP≥3 000 ng/L, RR≥30 times/min, Lac≥3 mmol/L and SOFA≥10 points were independent risk factors for SCM [age ≥87 years: odds ratio ( OR) = 3.491, 95% confidence interval (95% CI) was 1.371-8.893, P = 0.009; NT-proBNP≥3 000 ng/L: OR = 2.708, 95% CI was 1.093-6.711, P = 0.031; RR≥30 times/min: OR = 3.404, 95% CI was 1.356-8.541, P = 0.009; Lac≥3 mmol/L: OR = 3.572, 95% CI was 1.460-8.739, P = 0.005; SOFA≥10 points: OR = 8.693, 95% CI was 2.541-29.742, P = 0.001]. The clinical diagnostic score system of SCM was established successfully, which was composed of age≥87 years old (1 point), NT-proBNP ≥ 3 000 ng/L(1 point), RR≥30 times/min (1 point), Lac≥3.0 mmol/L (1 point), SOFA≥10 points (2 points), and the total score was 6 points. ROC curve analysis showed the cut-off value of the scoring system for diagnosing SCM was 3 points, the area under ROC curve (AUC) was 0.833, 95% CI was 0.755-0.910, P < 0.001, with the sensitivity of 71.4%, and specificity of 86.7%. Conclusion:The clinical diagnostic scoring system has good diagnostic efficacy for SCM and contributes to early identification of SCM for clinicians.

ObjectiveTo study the association of serum adiponectin and high sensitivity C-reactive protein (hs-CRP) levels to short-term outcome in patients with acute ischemic stroke (AIS). MethodsClinical data of 216 patients with AIS in Beijing Bo'ai Hospital from January, 2019 to September, 2020 were collected. The serum biochemical indicator was measured in all the patients within 24 hours after enrollment, and adiponectin was detected with enzyme-linked immunosorbent assay. Meanwhile, all patients were evaluated with National Institute of Health Stroke Scale (NIHSS). Modified Rankin Scale (mRS) was used to assess the functional outcome 90 days after onset during follow-up. ResultsThe incidence of poor outcome in patients with AIS within 90 days was 48.1%. Compared with the good outcome group, the serum adiponectin was lower (t = 5.861, P < 0.001) and the serum hs-CRP level was higher (Z = 5.525, P < 0.001) poor outcome group. Reduced serum adiponectin (OR = 0.862, 95%CI 0.751 to 0.975, P < 0.001) and increased serum hs-CRP (OR = 1.215, 95%CI 1.015 to 1.455, P < 0.001) were independent risk factors for poor outcome in patients with AIS. The areas under curve (95% CI) of serum adiponectin and hs-CRP for predicting the outcome of patients with AIS were 0.819 (0.761 to 0.877) and 0.722 (0.654 to 0.791), respectively (P < 0.001). The predictive power of serum adiponectin was higher than that of hs-CRP (Z = 2.151, P = 0.032). The optimum cut-off point of adiponectin was < 3.5 mg/L, and the Yoden index was 0.609, yielding a sensitivity of 0.704 and a specificity of 0.905. ConclusionSerum adiponectin and hs-CRP can serve as independent predictors for short functional outcome in patients with AIS.

Objective:To explore the predictive value and prognosis effect of calprotectin on acute kidney injury (AKI) in patients with sepsis.Methods:A prospective observational study was conducted. From December 2018 to November 2020, patients with sepsis admitted to the Emergency Department of China Rehabilitation Research Center were enrolled. General clinical data of patients were collected continuously, and the acute physiology and chronic health evaluationⅡ (APACHEⅡ) score, sequential organ failure assessment (SOFA) score and calprotectin were evaluated in 24 h after admission. The patients were divided into the AKI group and non-AKI group according to the occurrence of AKI within 7 days after admission. Calprotectin level and other clinical data were compared between the two groups. Logistic regression was used to analyze the risk factors for AKI in patients with sepsis, and receiver operating characteristic (ROC) curve was plotted to evaluate the predictive value of calprotectin for AKI in patients with sepsis. The patients with AKI were further divided into the survival group and death group according to the 28-day outcome, and the calprotectin levels between the two groups were compared.Results:A total of 207 patients with sepsis were enrolled, and the incidence of AKI was 68.12% (141/207). The level of calprotectin in patients with AKI was higher than that in patients without AKI [4.65 (3.25, 5.61) μg/mL vs. 3.42 (2.29, 4.09) μg/mL, P < 0.001]. Multivariable Logistic regression analysis showed that APACHEⅡ score ( OR=1.090, 95% CI: 1.043-1.139), C-reactive protein ( OR=1.004, 95% CI: 1.001-1.008) and calprotectin ( OR=1.590, 95% CI: 1.269-1.991) were independent risk factors for AKI in patients with sepsis. The area under ROC curve (AUC) of calprotectin for predicting AKI was 0.716 (95% CI: 0.643-0.788). The cutoff value of prediction was 4.63 μg/mL with the Yoden index of 0.405, which yielded a sensitivity of 0.511 and a specificity of 0.894. When calprotectin was combined with APACHE II score and SOFA score respectively, the predictive ability was significantly improved with the AUC of 0.768 (95% CI: 0.701-0.834) and 0.769 (95% CI: 0.701-0.837), respectively. We further divided patients with AKI into the survival group and non-survival group according to the 28-day outcome and there was no significant difference in calprotectin between the two groups [4.80 (3.40, 5.76) μg/mL vs. 4.19 (2.89, 5.29) μg/mL, P < 0.05]. Conclusions:The level of calprotectin in the AKI group is higher than that in the non-AKI group. Calprotectin can be regarded as an effective predictor of AKI in patients with sepsis, and the combination with APACHEⅡ score or SOFA score will improve its predictive efficacy. However, there is no significant difference in the concentration of calprotectin for patients with sepsis associated AKI with different prognosis.

Objective:To establish a prediction model for major adverse cardiovascular and cerebrovascular events (MACCE) in elderly patients with emergency acute coronary syndrome (ACS) within 1 year, and to evaluate its prediction efficiency.Methods:This was a prospective cohort study. Elderly ACS patients who were admitted to the Cardiovascular Care Unit (CCU) or the Emergency Intensive Care Unit (EICU) in Beijing Bo'Ai Hospital through emergency department from January 2019 to December 2021 were successively enrolled. General data of the patients were collected within 24 h after admission, the incidence of malignant arrhythmia, complete revascularization and acute kidney injury (AKI) during hospitalization were recorded. Within 24 h, laboratory indexes such as serum creatinine (Scr), albumin (Alb), hypersensitive C-reactive protein (hs-CRP), creatine kinase isoenzyme MB (CK-MB), D-dimer, cardiac troponin I (cTnI) and N-terminal pro-brain natriuretic peptide (NT-pro-BNP) were measured. In addition, transthoracic echocardiography and the Frailty Screening Questionnaire (FSQ) were performed. Patients were followed up for the occurrence of MACCE within 1 year. The influencing factors of MACCE were screened by univariable and multivariable logistic regression analysis. The cut-off values of continuous variables were determined by receiver operating characteristic (ROC) curve and discretization was carried out with reference to clinical practice. Corresponding scores were set up according to the β regression coefficient of each variable to establish a clinical prediction score scale of MACCE. Finally, ROC curve was used to evaluate its prediction efficiency.Results:The study enrolled 322 elderly ACS patients, and the incidence of MACCE within 1 year was 24.5%. After preliminary screening of independent variables by univariable logistic regression analysis, the influencing factors of MACCE ( P<0.2) were as follows: ① Continuous indicators: age, body mass index (BMI), Alb, hs-CRP, D-dimer, NT-pro-BNP, ejection fraction (EF), Killip grade and FSQ score; ② Discrete indicators: ≥3 comorbidities, incomplete revascularization, and AKI. Multivariable logistic regression analysis after discretization of continuous indicators showed that age ≥84 years old [odds ratio ( OR)=4.351, 95% confidence interval (95% CI): 1.635-11.576, P=0.003], incomplete revascularization ( OR=6.580, 95% CI: 2.397-18.060, P < 0.001), combined with AKI ( OR=2.647, 95% CI: 1.085-6.457, P=0.032), EF ≤50% ( OR=2.742, 95% CI: 1.062-7.084, P=0.037), and FSQ≥3 points ( OR=9.345, 95% CI: 3.156-27.671, P < 0.001) were independent risk factors for MACCE. The total score of the clinical prediction system for MACCE was 8 points, including age ≥84 years old (2 points), incomplete revascularization (2 points), FSQ ≥3 points (2 points), EF ≤50% (1 point), and combined with AKI (1 point). The area under ROC curve (AUC) of the scoring system for predicting MACCE was 0.891, (95% CI: 0.844-0.938, P < 0.001). The optimal cut-off value was >3 points, and the sensitivity and specificity were 0.825 and 0.792, respectively. Conclusions:The prediction score scale of MACCE has a good diagnostic efficacy and has certain guiding value for clinicians to judge the prognosis of elderly ACS patients.

Objective:To investigate the correlation between the level of serum 25-hydroxyvitamin D [25(OH)D] and infarction volume in patients with acute ischemic stroke (AIS) with internal carotid artery system (anterior circulation).Methods:A prospective cohort study was conducted. Patients with AIS admitted to the department of emergency of Beijing Boai Hospital from October 2017 to September 2019 were enrolled. Nutritional risk screening 2002 (NRS 2002) were assessed in all cases within 24 hours after enrollment. Fasting venous blood was collected for biochemical analysis, including albumin (ALB), homocysteine (HCY), uric acid (UA), hypersensitive C-reactive protein (hs-CRP), etc. Serum 25(OH)D level was detected by electrochemiluminescence immunoassay. Magnetic resonance imaging (MRI) was performed to calculate the volume of cerebral infarction. According to the volume of cerebral infarction, the patients were divided into small volume (≤ 1 cm 3) group, medium volume (1 cm 3 < infarct volume < 20 cm 3) group and large volume (≥20 cm 3) group. The differences of serum 25(OH)D and other indicators in each group were compared; the influencing factors of infarct volume were analyzed by Logistic regression; and the goodness of fit of regression model was tested by Hosmer-Lemeshow (HL). Results:A total of 224 patients with AIS were enrolled, 92 in small volume group, 90 in medium volume group and 42 in large volume group, and there was no significant difference in serum 25(OH)D level among small, medium and large volume groups [μg/L: 13.21 (7.47, 19.33), 11.20 (7.00, 15.07), 9.19 (6.30, 17.10), H = 4.994, P = 0.082]. There were 124 patients with AIS in anterior circulation, 45, 56 and 23 patients in the small, medium and large volume groups, respectively, with the increase of the cerebral infarction volume, the serum 25(OH)D level in small, medium and large volume groups decreased gradually, and the difference was statistically significant [μg/L: 13.22 (9.00, 19.65), 10.41 (6.72, 14.92), 8.30 (4.70, 11.30), H = 11.068, P = 0.004]. In addition, with the increase of the cerebral infarction volume, the older the patients with AIS in anterior circulation [years old: 63.0 (54.0, 75.5), 76.0 (63.0, 84.0), 82.0 (67.5, 85.0), H = 14.981, P = 0.001], the higher the nutritional risk ratio (35.6%, 53.6%, 73.9%, χ2 = 9.271, P = 0.010), the higher the serum hs-CRP level [mg/L: 1.91 (0.92, 3.40), 4.10 (1.73, 22.42), 19.74 (4.02, 68.81), H = 21.477, P < 0.001], and the lower the ALB level (g/L: 42.30±12, 38.11±5.06, 35.14±5.49, F = 19.347, P < 0.001). After adjusting for age, gender, atrial fibrillation, nutritional risk, hs-CRP and other confounding factors, serum 25(OH)D was an independent protective factor for the infarct volume of AIS in anterior circulation [odds ratio ( OR) = 0.962, P = 0.040], For every 10 μg/L decrease of 25(OH)D, the risk of one grade increase in infarction volume was increased by 47.7% respectively (goodness of fit: χ2 = 5.357, P = 0.719). Conclusion:The low serum 25(OH)D level was associated with the increase of infarct volume in the anterior circulation cerebral infarction, and early detection of serum 25(OH)D level can help risk stratification of AIS patients.