Tetrahydrobiopterin (BH4) is an essential cofactor for all three nitric oxide synthase (NOS isoforms), which plays an important role in vascular diseases. GTP cyclohydrolase 1 (GCH 1) is the first-step and rate-limiting enzyme for BH4 biosynthesis in its de novo pathway. Common GCH1 gene variant C+243T in the 3'-untranslated region predicts NO excretion. The present study examined the predictive role of GCH 1 gene 3'-UTR C+243T variant in the long-term outcome of ischemic stroke. A total of 142 patients with first-onset ischemic stroke were recruited and detected for genotype of GCH1 3'-UTR C+243T by a TaqMan SNP Genotyping assay. Subsequent vascular events and death were determined over a 5-year follow-up period. The frequency of GCH1 3'-UTR +243 C/T or T/T genotype was significantly increased in patients with endpoint events as compared with those without events (74% vs 57.8%, P=0.06). Cox regression survival analysis indicated that an increased probability of death or new vascular events was found in patients with GCH1 3'-UTR +243 C/T or T/T genotype compared with those with GCH1 3'-UTR C/C genotype (40.6% vs 25.5%), GCH1 3'-UTR +243 C/T or T/T genotype relative to GCH1 3'-UTR C/C genotype was associated with the increased risk of death or vascular events even after adjustment for other risk factors (OR=2.171, 95% CI: 1.066-4.424, P=0.033). It was concluded that GCH1 3'-UTR C+243T variant was an independent predictor of worsening long-term outcomes in patients with first-onset ischemic stroke.

Objective To explore the preventive effect of twin-tube laryngeal mask airway on gastric lavage and aspiration pneumonia. Methods Between January 2015 and June 2017, 305 cases of poisoning coma patients were admitted to Emergency Department, The First Affiliated Hospital of Nanchang University. According to the inclusion criteria and exclusion criteria, 255 cases of poisoning coma patients were enrolled and randomly(random number) divided into 3 groups (n=85 in each group):group A (normal gastric lavage machine method), group B (gastric lavage endotracheal intubation), and group C (gastric lavage twin-tube laryngeal mask airway placement). Whether there was aspiration pneumonia within 12 hours after the onset was observed, and the length of hospital stay, hospitalization cost and mortality were recorded. The mean value of the two samples was compared with t test, and the four-grid data were checked by chi-square test. P<0.05 was statistically significant. Results Compared with group A, the incidence of aspiration pneumonia was significantly lower in group B and group C (group A 56.47％, group B 32.94％, group C 23.53％, P<0.01). Compared with group A, the length of hospital stay in group C was shorter [(3.39±2.12) d vs. (6.06±4.91) d,P<0.05], and the hospitalization cost was less [(25687.52±20803.44) yuan vs. (52213.91±37267.56)yuan,P<0.05]. There was no significant difference of mortality between the three groups (P>0.05).Compared with group B, the length of hospital stay in group C was shorter [(3.39±2.12) d vs.(5.51±4.37) d, P<0.05], and the hospitalization cost was less [(25687.52±20803.44)yuan vs.(50887.82±32399.76) yuan, P<0.05]. There was no significant difference of mortality between the three groups (P>0.05). Conclusions Twin-tube laryngeal mask airway for poisoning coma patients with gastric lavage, can not only ensures effective ventilation, but also reduces the probability of concurrent aspiration pneumonia, shortens hospital stay, and reduces hospitalization cost, but has no obvious effect on mortality.

Tetrahydrobiopterin (BH4) is an essential cofactor for all three nitric oxide synthase (NOS isoforms), which plays an important role in vascular diseases. GTP cyclohydrolase 1 (GCH 1) is the first-step and rate-limiting enzyme for BH4 biosynthesis in its de novo pathway. Common GCH1 gene variant C+243T in the 3'-untranslated region predicts NO excretion. The present study examined the predictive role of GCH 1 gene 3'-UTR C+243T variant in the long-term outcome of ischemic stroke. A total of 142 patients with first-onset ischemic stroke were recruited and detected for genotype of GCH1 3'-UTR C+243T by a TaqMan SNP Genotyping assay. Subsequent vascular events and death were determined over a 5-year follow-up period. The frequency of GCH1 3'-UTR +243 C/T or T/T genotype was significantly increased in patients with endpoint events as compared with those without events (74% vs 57.8%, P=0.06). Cox regression survival analysis indicated that an increased probability of death or new vascular events was found in patients with GCH1 3'-UTR +243 C/T or T/T genotype compared with those with GCH1 3'-UTR C/C genotype (40.6% vs 25.5%), GCH1 3'-UTR +243 C/T or T/T genotype relative to GCH1 3'-UTR C/C genotype was associated with the increased risk of death or vascular events even after adjustment for other risk factors (OR=2.171, 95% CI: 1.066-4.424, P=0.033). It was concluded that GCH1 3'-UTR C+243T variant was an independent predictor of worsening long-term outcomes in patients with first-onset ischemic stroke.
3' Untranslated Regions ; genetics ; Aged ; Brain Ischemia ; genetics ; Female ; GTP Cyclohydrolase ; genetics ; Humans ; Male ; Middle Aged ; Nitric Oxide ; metabolism ; Prognosis ; Risk Factors ; Stroke ; diagnosis ; genetics