Objective　Study on the spleen volume and serum inflammatory factors in predicting the severity of acute ischemic stroke.Methods　A total of 62 patients with AIS within 24 hours of onset,admitted to our hospital from January 2021 to June 2022,were selected as the study subjects.According to the National Institutes of Health Stroke Scale(NIHSS),they were divided into mild group (NIHSS<6 points，n=30) and moderate as well as severe group (NIHSS≥6 points，n=32).The differences in serum inflammatory factors and normalized difference in spleen volume between the two groups were compared.ROC curve was used to analyze value of serum inflammatory factors and normalized difference in spleen volume in evaluating the severity of AIS.Results　There were statistically significant differences in IL-5,IL-6,IL-1β,IL-8,IL-17,IL-12P70,TNF-α and normalized difference in spleen volume between two groups (P<0.05).The area under ROC curve (AUC) of IL-6,IL-12P70 and normalized difference in spleen volume for assessing AIS severity were 0.715,0.715 and 0.826,respectively.Normalized difference in spleen volume had the largest AUC prediction,and the sensitivity and specificity were 90.0% and 74.1%.Conclusion　Normalized difference in spleen volume and serum inflammatory factors are correlated with the severity of AIS,and can be used as indicators to predict the severity of AIS.

Objective　The purpose of this study was to investigate the correlation between systemic immune inflammation index (SII) and the total imaging burden of cerebral small vessel disease (CSVD),and to evaluate its predictive value,so as to provide valuable parameters for the early diagnosis and prevention of CSVD.Methods　A total of 268 patients who were admitted to the Department of Neurology of the Affiliated Hospital of Xuzhou Medical University from September 2020 to May 2022 were continuously collected.According to the CSVD total burden score,120 patients were divided into a no and light burden group (0-1 points) and 148 patients were divided into a medium-heavy burden group(2-4 points),and calculated the ratio of SII.Spearman correlation analysis and multivariate regression analysis were used to evaluate the relationship between SII and the total burden of CSVD,and the ROC curve was used to analyze the predictive value of SII for moderate to severe burden of CSVD.Results　Compared with the no and mild burden group,patients in the moderate to severe burden group had higher levels of SII (P<0.001),and results from multivariate regression analysis showed that SII was an independent factor for moderate to severe CSVD burden (OR=1.002,95%CI 1.000-1.004,P=0.028),the ROC curve analysis results showed that the area under the SII curve=0.702 (95%CI 0.640-0.765,P<0.001),the sensitivity was 73.6%,and the specificity was 60.8%.Conclusion　SII was an independent influencing factor of the total burden of moderate-severe CSVD,and was positively correlated with the severity of CSVD.SII had a certain predictive value for the total burden of moderate-severe CSVD.

Objective　To evaluate the effects of hsa-miR-642b-3p on cerebral microvascular endothelial cells under hypoxia/reoxygenation (H/R).Methods　The H/R model of brain microvascular endothelial cells was established to analyze the expression alteration of hsa-miR-642b-3p,and the intervention was carried out accordingly.Cell death was detected by trypan blue staining,cell proliferation was detected by CCK8,cell permeability was detected by FITC-albumin,and potential GO and KEGG function enrichment of hsa-miR-642b-3p was analyzed by bioinformatics.Results　The expression of hsa-miR-642b-3p was elevated in H/R condition.After administration of hsa-miR-642b-3p inhibitor,we found the cell death was reduced,cell proliferation was increased and cell permeability was decreased under H/R condition.In addition,GO and KEGG functional enrichment analysis showed that hsa-miR-642b-3p may be involved in multiple biological functions and signal pathways such as RNA regulation,cell adhesion,TGF-β pathway and others.Conclusion　Abnormal expression of hsa-miR-642b-3p in cerebral microvascular endothelial cells under H/R may have certain value for ischemic stroke.

Objective　To study the relationship between infarct location and early neurological deterioration（END) in isolated subcortical infarctions.Methods　We collected patients who were admitted with a diagnosis of isolated subcortical infarction.According to their infarct location,patients were divided into proximal infarct group and distal infarct group.National Institutes of Health Stroke Scale (NIHSS) score was used to assess the degree of neurological impairment in both groups on the day of admission and within 3 days after admission.If the NIHSS score increased by 2 points or more within 72 hours after admission,END was considered.Baseline data and the incidence of END were compared between groups.Finally,We screened the independent risk factors for early prediction of END.Results　A total of 422 cases were collected,68 of 239 cases with proximal infarct and 13 of 183 cases with distal infarct developed END.There were statistically significant differences in age,male,LDL,history of stroke,proximal infarct and carrier artery stenosis in END,compared with non-END.Logistic regression analysis showed that age,male,history of stroke,proximal infarct and carrier artery stenosis were independent risk factors for END.Conclusion　Patients with proximal infarct are more likely to develop END in isolated subcortical infarctions,which should arouse clinical attention.

Objective　To explore the high-sensitive solar terms and dominant meteorological factors in the onset of cerebral infarction,and to analyze the influence of daily temperature range and 24-hour temperature change on hospital admissions for cerebral infarction.Methods　Patients with cerebral infarction who were hospitalized in the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine and the Second Hospital of Tianjin Medical University from January 2019 to December 2020 were retrospectively collected.The patients were grouped according to the twenty-four solar terms to explore the high-sensitive solar terms for the admission of cerebral infarction.A generalized linear Poisson regression model was established to explore the relationship between temperature changes and cerebral infarction admissions.Results　This study finally included 17 518 patients with cerebral infarction.There were statistically significant differences in the daily temperature range among different solar terms (P<0.001).The larger stages of the daily temperature range were from “Awakening of Insects” to “Grain in Ear”,and from “Autumn Equinox” to “Beginning of Winter”.The high-sensitive solar term of cerebral infarction admission was“Cold Dew”,which was located in the period of large daily temperature range.Daily temperature range was associated with cerebral infarction admission after multivariate adjustment (RR=1.01,95%CI 1.00~1.02,P=0.017),and had a hysteresis effect.With the increase of daily temperature range,the risk of cerebral infarction admissions increased,especially in males.Conclusion　“Cold Dew” is the high-sensitive solar term for cerebral infarction admission,and daily temperature range may be the dominant meteorological factor.The admission of cerebral infarction is related to the daily temperature range.

Objective　To investigate the protective effect of complement C5a receptor 1 (C5aR1) antagonist on cerebral ischemia-reperfusion （CIR） in mice.Method　Mice were randomly divided into sham operation group,cerebral ischemia-reperfusion group (model group) and C5aR1 antagonist （PMX53）group.At 3 h before,24 h after and 48 h after cerebral reperfusion timepoint,the PMX53 group was given with PMX53,the sham group and the model group were given same volume of saline by intraperitoneall injection.At 72 h after cerebral reperfusion timepoint,neurological deficits score of mice were evaluated by the modified Longa method,the infarcted brain volume was calculated after TTC staining,the cerebral tissue water content of the ischemic hemisphere was calculated by dry and wet weight method,the mRNA expression of inflammatory factors in the ischemic hemisphere were detected by real-time PCR,and the relative expression of ZO-1 in cerebral tissue of the ischemic hemisphere was calculated by Western blot.Results　At 72 h after cerebral reperfusion,compared with the model group,neurological deficits function score,cerebral water content,cerebral infarction volume and inflammatory cytokines (IL-1β,TNF-α) were significantly decreased in the PMX53 group (all P<0.05),ZO-1 expression was significantly higher in the PMX53 group (P<0.05).Conclusion　C5aR1 antagonist can improve the neurological function score after CIR,reduce the volume of cerebral infarction,reduce the degree of cerebral edema and inflammatory response,and has a protective effect on the blood-brain barrier.

Objective　To investigate the microstructure changes of brain regions of interest in patients with Parkinson disease with dysosmia using diffusion kurtosis imaging.Methods　DKI scanning was performed in 16 patients with dysosmia and 21 patients without dysosmia.Supramarginal gyrus,postcentral gyrus,heschl gyrus and inferior temporal gyrus were selected as regions of interest.Results　The values of FA,KFA,AK and RK in the region of interest in the Parkinson disease group with dysosmia were significantly lower than those without dysosmia (P<0.05);the values of AD,MD and RD in the region of interest in the Parkinson disease group with dysosmia were significantly higher than those without dysosmia (P<0.05);There was a close correlation between the olfactory score and the right supramarginal gyrus,postcentral gyrus,inferior temporal gyrus,bilateral heschl gyrus in the Parkinson disease group with dysosmia (P<0.05).Conclusion　DKI parameters can be used as biomarkers for early diagnosis of dysosmia in Parkinson disease.

Objective　To investigate the correlation between serum uric acid,high sensitive C-reactive protein (hs- CRP),matrix metalloproteinase-9 (MMP-9) and the incidence and prognosis of elderly patients with acute cerebral infarction.Methods　Seventy-three elderly patients with acute cerebral infarction admitted to our hospital from June 2020 to September 2021 were selected as the observation group,and 50 healthy elderly patients examined in our hospital at the same time were selected as the control group.The levels of serum uric acid,hs-CRP and MMP-9 were compared between the two groups.The patients were divided into mild group,moderate group and severe group according to the score of stroke scale (NIHSS).The levels of serum uric acid,hs-CRP and MMP-9 were compared and the correlation was analyzed.The patients were divided into good prognosis group and poor prognosis group according to the neurological deficit score (mRS).The levels of serum uric acid,hs-CRP and MMP-9 were compared and the correlation was analyzed.Results　The levels of serum uric acid,hs-CRP and MMP-9 in the observation group were significantly higher than those in the control group (P<0.05).The levels of serum uric acid,hs-CRP,MMP-9 and NIHSS score in severe group were significantly higher than those in mild and moderate groups (P<0.05).The levels of serum uric acid,hs-CRP,MMP-9 were positively correlated with NIHSS scores (P<0.05).The levels of serum uric acid,hs- CRP,MMP-9 and mRS score in the poor prognosis group were significantly higher than those in the good prognosis group (P<0.05).The levels of serum uric acid,hs-CRP and MMP-9 were positively correlated with the mRS score (P<0.05).Conclusion　The serum uric acid,hs-CRP and MMP-9 levels in elderly patients with acute cerebral infarction were significantly increased on average,and were positively correlated with the severity of the disease,which could be used as a reference index for evaluating the condition and prognosis.

Objective　To study the clinical features of neurosyphilis patients presented as acute cerebral infarction,and to explore the value of high-resolution magnetic resonance vessel wall imaging (HR-VWI ) in the etiological diagnosis of cerebral infarction.Methods　Seven patients with neurosyphilis presented as acute ischemic stroke were included in this study from January 2018 to September 2022.The clinical characteristics,laboratory examination,and imaging data including HR-VWI were summarized and analyzed.Results　Among seven cases,six patients had multiple atherogenic risk factors,and two tested human immunodeficiency virus (HIV)-seropositive.The most common clinical manifestation was hemiplegia (71.4%),followed by dysarthria (57.1%).Diffusion-weighted magnetic resonance imaging showed high signal lesions more common in the basal ganglia and pons.HR-VWI showed vasculitis changes in infarction-related vessels in six patients,in whom the diagnosis of meningovascular syphilis was considered,while vasculitis change was only shown in one case by MR angiography.Infarct responsible vascular with evidence of atherosclerosis in one case,in whom the diagnosis of large artery atherosclerotic cerebral infarction was considered probable according to the TOAST classification.Conclusion　Clinical features of stroke after neurosyphilis can be indistinguishable from ischemic stroke.HR-VWI can reveal vasculitis of meningovascular syphilis,which is of great value in determining the mechanisms of cerebral infarction in neurosyphilis patients who with multiple atherosclerotic risk factors.

Objective　To investigate the mechanism of CirCDC14A silencing to protect astrocytes from oxygen-glucose deprivation/glyco-reoxygenation (OGD/R)-induced injury by regulating the miR-153-3p/JAK1 axis.Methods　Cerebral cortical astrocytes of neonatal rats were cultured in vitro,and the cell viability was detected by CCK-8 method;annexin V-FITC/PI staining was used to detect cell apoptosis.Western blot method was used to detect the protein expression levels of p53,Bax and Bcl-2 in each group,and the relationship between CirCDC14A and miR-153- 3p,miR-153-3p and JAK1 was analyzed by dual-luciferase reporter gene assay.Results　The cell viability increased with time; the cell viability of pcDNA3.0 CirCDC14A+si JAK1 group at 48 h and 72 h was lower than that of si-NC group,OGD/R group and OGD/R+Si+Con mimcs group (P<0.05);compared with si-NC group,the apoptosis of OGD/R group,OGD/R+Si+Con mimcs group,pcDNA3.0-CirCDC14A+si JAK1+miR-153-3p mimcs group increased significantly,and pcDNA3.0-CirCDC14A+si JAK1+miR-153-3p mimcs group had higher apoptosis than OGD/R+Si+Con mimcs group (P<0.05);Western blot results showed that:pcDNA3.0-CirCDC14A+si JAK1+miR,the protein expression levels of p53,Bax and Bcl-2 in the miR-153-3p mimcs group were lower than those in the OGD/R group,OGD/R+Si+Con mimcs group and si-NC group (P<0.05).Reduced the luciferase activity of CirCDC14A WT and JAK1-WT (P<0.05); the level of miR-153-3p in the pcDNA3.0-CirCDC14A+si JAK1+miR-153-3p mimcs group was lower than that in the other three groups (P<0.05). The JAK1 protein level was higher than the other three groups (P<0.05).Conclusion　CirCDC14A gene silencing may inhibit OGD/R-induced apoptosis of rat astrocytes by regulating the miR-153-3p/JAK1 axis,resulting in decreased cell viability and protein expression levels of p53,Bax and Bcl-2.