Ischemic stroke has a high incidence,mortality and morbidity.It was demonstrated that higher white blood cell and neutrophil counts were correlated with larger infarct volume and increased stroke severity in patients with acute ischemic stroke.Recently,neutrophil/lymphocyte ratio (NLR) was shown to be correlated with risk of ischemic stroke and outcome in patients with acute ischemic stroke.This article reviews the predictive roles of NLR in ischemic stroke.

Space-occupying brain edema is a life-threatening complication in patients with cerebellar infarction, which occurs in 17-54% of the patients. The level of consciousness should be monitored closely and the changes of CT/MRI should be followed up for cerebellar infarction patients with a higher risk of deterioration. Ventriculostomy/extraventricular drainage and suboccipital decompressive craniectomy should be performed in space-occupying cerebellar infarction patients with clinical deterioration.

Objective:The characteristics of women with false elevated testosterone were analyze and the literature was reviewed to provide reference for clinical laboratory identification of false elevated testosterone.Methods:The characteristics of three patients with false elevated testosterone in Peking Union Medical College Hospital were analyzed retrospectively, and the results of different detection platforms and methods for the determination of testosterone levels were compared. International and domestic literatures related to false elevation of testosterone and detection methods of testosterone were searched for a comprehensive analysis from PUBMED and CNKI.Results:The levels of testosterone in 3 female patients were elevated by immunoassay and normal by mass spectrometry. They were excluded from the diagnosis of hyperandrogenemia. A total of 38 literatures related to testosterone detection were retrieved, of which 9 case reports of pseudohyperandrogenemia, among which 12 cases of pseudohyperandrogenemia were reported in 2 domestic literatures in 2021. All cases were confirmed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Previous studies have clearly indicated that the result of routine immunoassay in clinical laboratory for the determination of female testosterone have poor correlation with the results of LC-MS/MS, with varying degrees of deviation.Conclusions:Immunoassay tests for female testosterone is susceptible to interference and lead to elevated false results. It is suggested that clinical laboratories evaluate the detection methods used and establish a identification program, and confirm samples with suspected pseudoelevated testosterone elevation using other immune platforms or LC-MS/MS.