Cardiac stroke is a stroke that occurs when a heart mural thrombus falls off and embolizes in the cerebral arterial system caused by various causes of heart disease, accounting for about 30% of all ischemic strokes. At present, in order to find evidence that emboli may originate from the heart, a large number of auxiliary examinations are needed. Good blood biomarkers are essential for the rapid identification of ischemic stroke in the emergency department. However, there is no breakthrough in this area. Brain natriuretic peptide is secreted in ventricular muscle and hypothalamus. It may be an important bridge between brain and heart diseases. However, the application of brain natriuretic peptide in the diagnosis and treatment of cardiogenic stroke is still very limited. This article reviews the current research status of brain natriuretic peptide levels and cardiogenic stroke and proposes further research trends and prospects.

Objective To investigate the effects of different doses rosuvastatin on carotid vulnerable plaques and cerebral ischemic events in patients with transient ischemic attack (TIA).Methods The TIA patients with carotid vulnerable plaques were enrolled retrospectively.They were randomly divided into either a rosuvastatin conventional dose group or a high-dose group.On the basis of conventional treatment,the former was also given rosuvastatin 10 mg/d,and on the basis of conventional treatment,the latter also took rosuvastatin 20 mg/d.The patients were followed up for 6 months.Blood lipid was detected before and after treatment.The carotid intima-media thickness (IMT),atherosclerotic plaque area,and Crouse plaque score were detected with cervical vascular ultrasound.The incidences of cerebral ischemic events were compared within six months after treatment.Results A total of 71 patients were enrolled.There were 35 patients in the conventional-dose group and 36 patients in the high-dose group.Two and one patients were lost to follow up respectively in both the conventional-dose group and the high-dose group.There were no significant differences in baseline total cholesterol (TC) (5.65 ± 1.05 mmol/L vs.5.46 ±0.87 mmol/L;t =0.812,P =0.419),triacylglycerol (TG) (2.85 ± 0.74 mmol/L vs.2.95 ± 0.86 mmol/L;t =0.513,P =0.609),low-density lipoprotein cholesterol (LDL-C) (4.11 ± 0.47 mmol/L vs.4.08 ± 0.33 mmol/L;t =0.304,P =0.761),and high-density lipoprotein cholesterol (HDL-C) (1.27 ± 0.22 mmol/Lvs.1.23 ± 0.20 mmol/L;t =1.339,P =0.185) between the high-dose group and the conventional dose group.After treatment,TC (3.06±0.77 mmol/L vs.4.98 ±0.78 mmol/L;t=10.214,P＜0.001),TG (2.15±0.56 mmol/L vs.2.52 ± 0.68 mmol/L;t =2.492,P =0.015),and LDL-C (2.18 ± 0.59 mmol/L vs.3.86 ± 0.42 mmol/L;t =13.526,P＜0.001) in the high-dose group were significantly lower than those in the latter,while HDL-C (1.43 ±0.20 mmol/L vs.1.33 ± 0.21 mmol/L;t =2.010,P =0.048) was significantly higher than the conventional dose group.There were no significant differences in baseline IMT (1.59 ± 0.26 mm vs.1.58 ± 0.28 mm;t =0.152,P =0.879),plaque area (0.87 ± 0.29 mm2 vs.0.85 ± 0.34 mm2;t =0.261,P =0.749),and Crouse score (4.26 ± 0.31 mm vs.4.18 ± 0.25 mm;t =1.171,P =0.245) between the high-dose group and the conventional dose group;after treatment,IMT (1.26 ± 0.25 mm vs.1.44 ±0.27 mm;t =2.852,P=0.005),plaque area (0.50±0.25 mm2 vs.0.70±0.25 mm2;t=3.298,P=0.001),and Crouse score (2.30 ±0.26 mm vs.4.03 ±0.24 mm;t =28.509,P ＜0.001) in the high-dose group were significantly decreased compared with the conventional dose group.The incidence of cerebral ischemic events in the high-dose group was significantly lower than that in the conventional dose group (11.76％ vs.29.41％;x2 =3.202,P =0.001).Conclusions Rosuvastatin has significant lipid-lowering effect.It can eliminate or stabilize carotid vulnerable plaque and reduce ischemic stroke events.The effect of rosuvastatin 20 mg/d is superior to that of rosuvastatin 10 mg/d.

Objective To compare the two liver volume measurements using multi-slice spiral CT (MSCT)for clinical reference.Methods Twenty-four patients with hepatic disease awaiting orthotopic liver transplantation underwent muhiphase MSCT of the upper abdomen.Liver volumes using two measurements(manual volume measurement and semi-automated volume measurement)before transplantation were compared with the actual liver volume(ALV)measured during transplantation by means of water displacement.Both measurements were timed.Correlation coefficient.one way ANOVA and Bland-Altman tests were used for statistical analysis.Results The mean liver volume estimated with the manual method and the semi-automated method were(1360±157)cm3 and(1345±152)cm3.respectively.The actual liver volume was(1307±153)cm3.There was no significant diffierence between the volumes measured using the three methods(F=0.032,P＞0.05).For all the patients,there Was significant correlation between liver volume measured by MSCT and the actual liver volume.There was a good correlation between the liver volume measured by manual method and the actual liver volume(r=0.976,P＜0.05),so did the correlation between the liver volume measured by semi-automated method and the actual liver volume (r=0.987,P＜0.05).And the semi-automated method took much shorter time[(9.2±1.8)min]compared with the manual method [(23.2±5.8)min ].Conclusion Semi-automated method provided acceptable measurements for liver volume.

Objective To investigate the CT spectral imaging features of pancreatic serous oligocystic adenoma and mucinous cystic neoplasms and to assess the value of spectral CT in differentiating between pancreatic serous oligocystic adenoma and mucinous cystic neoplasms. Methods From Feb.2010 to Dec. 2010, 27 patients with cystic neoplasms of the pancreas (group one with 15 serous oligocystic adenomas and group two with 12 mucinous cystic neoplasms) underwent dual-phase CT spectral imaging followed by surgery. Quantitative values (age, tumor size, CT value change as function of photon energy,effective-Z, iodine-water concentration, and calcium-water concentration) were compared with independent samples t test and Mann-Whitney test and non-quantitative parameters (gender, symptom, and tumor location) were compared with Chi-square test (Fisher exact). The parameters with significant differences between two groups were analyzed further and the performance of multiple parameters for joint differential diagnosis was evaluated with discriminant analysis. Results Compared to patients with mucinous cystic neoplasms, patients with serous oligocystic adenoma had younger age, lower frequency of being symptomatic and smaller tumor size. The CT values on 40 keV to 60 keV( with 10 keV increment) in late arterial phase [(36±13)HU vs. (62±23)HU, (26 ±8)HU vs. (40±15)HU, and (19±6)HU vs. (27±10)HU respectively] and 40 keV to 50 keV (with 10 keV increment) in portal venous phase [ (43 ± 14 )HU vs.(61 ±25)HU and (30 -10)HU vs. (40 ± 16)HU respectively], effective-Z (late arterial phase 7.80 ± 0. 16 vs. 8.05 ± 0. 21, and portal venous phase 7. 87 ± 0. 15 vs 8.02 ± 0. 22 ), concentration of calcium (water) [late arterial phase (5 ±3) g/L vs. (11 ±4) g/L, t= -3.836, P=0.001 and portal venous phase (7 ± 3 ) g/L vs. ( 10 ± 5 ) g/L, t = - 2.071, P = 0. 049 ] and iodine (water) [ late arterial phase (0.38 ±0.24) g/L vs. (0.78 ±0.32) g/L, t = -3.755, P=0.001 and portal venous phase (0.48 ± 0. 24) g/L vs. (0. 72 ± 0. 34 ) g/L, t = - 2. 161, P = 0. 041 ] were lower in serous oligocystic adenoma than those in mucinous cystic neoplasms. In discriminant analysis, multiple parameters [ age, symptom,tumor size, CT values on 40 keV to 50 keV, effective-Z, concentration of iodine (water) in late arterial phase and concentration of calcium (water) in portal venous phase] showed high accuracy (100%, 27/27 )of joint diagnosis between serous oligocystic adenoma (100%, 15/15 ) and mucinous cystic neoplasms (100%, 12/12). Conclusions The serous oligocystic adenoma and mucinous cystic neoplasms had distinct characteristic findings on CT spectral imaging. CT spectral imaging is highly accurate in the differential diagnosis between serous oligocystic adenoma and mucinous cystic neoplasms.

Objective To observe the efficacy of combination therapy of calcium dobesilate dispersible and monosialotetrahexosylganlioside sodium on interleukin-6 (IL-6) and monocyte chemotactic protein-1 (MCP-1) in elderly patients with painful diabetic peripheral neuropathy.Methods From January 2012 to May 2017,in the Second People's Hospital of Lianyungang 70 patients of painful diabetic peripheral neuropathy,aged ≥60 years,were analyzed in this study.They were randomly divided into observation group (35 cases) and control group (35 cases).The observation group was treated with 40mg monosialotetrahexosylganlioside sodium dissolved in 250mL physiological saline,intravenous infusion per day,and oral calcium dobesilate dispersible 0.5g twice a day for two weeks.The control group was treated with methylcobalamin injection 0.5mg per day for two weeks.The clinical treatment effects and levels of IL-6 and MCP-1 were observed and compared between the two groups.Results After two weeks of treatment,the MDNS and MNSI scores of the observation group [(13.09 ± 5.38)points,(2.53 ± 1.19)points] were significantly lower than those of the control group [(18.31 ± 6.13) points,(4.19 ± 1.05) points,t =2.036,2.365,all P ＜ 0.05] and those before treatment [(21.26 ± 4.28) points,(5.40 ± 0.89) points,t =3.251,3.698,all P ＜ 0.05].The VAS-PI scores in the observation group [(6.24 ± 1.25) points,(4.13 ± 1.69) points] were significantly lower than those in the control group[(7.26 ± 1.28) points,(6.34 ± 2.65) points] at the first and second week (t =3.265,5.395,all P ＜ 0.05).The serum levels of inflammatory cytokines IL-6 and MCP-1 in the observation group [(15.16 ±0.88) ng/L,(157.19 ± 11.22) ng,/L] were significantly lower than those in the control group[(17.87 ± 1.19) ng/L,(198.21 ± 12.07)ng/L,t =2.152,1.365,all P ＜0.05]and those before treatment[(20.26 ± 1.05) ng/L,(260.44 ± 13.63) ng,/L,t =1.235,0.965,all P ＜ 0.05].Conclusion Combination of calcium dobesilate and mono-sialotetrahexosyl ganglioside may alleviate the sensory and pain sensations in patients with painful diabetic peripheral neuropathy,possibly by reducing the level of inflammatory cytokines IL-6 and MCP-1.

Objective To observe the efficacy and safety of combination therapy of deanxit and analgecine on elderly painful diabetic peripheral neuropathy (PDPN).Methods One hundred and eighty PDPN patients,admitted to our hospital from January 2010 to May 2012,were chosen in this study; they were randomly divided into Group A (control group,n=60),Group B (analgecine treatment group,n=60) and Group C (deanxit and analgecine combined treatment group,n=60).On the basis of controlling the plasma glucose of all subjects,Group A was treated with methycobal 0.5 mg intramuscular injection once a day,three times a week for 12 weeks; Group B was treated with analgecine 3 mL intramuscular injection once a day for 2 weeks and then rested for 2 weeks,which repeated for three courses; Group C was treated with deanxit orally 1 capsule every morning and analgecine in the same way with Group B.The evaluation and analysis of the efficacy (mental state,quantitative sensory,scores of visual analog scale of pain intensity [VASPI],and nerve conduction velocity) and safety (nausea,dry mouth,diarrhea,dizziness,headache,drowsiness,fatigue,tremors,blurred vision,neutropenia,and liver dysfunction) of all patients were carried out after 12 weeks.Results (1) The anxiety and depression scale scores of Group C 12 weeks after treatment were significantly lower than those of Group A and Group B (P＜0.05).(2) After 12 weeks of treatment,cold sensation in Group B and Group C was significantly higher than that in Group A,while thermal sensation and cold pain sensation in Group B and Group C were significantly lower than those in Group A (P＜0.05).(3) VASPI scores in group C were significantly lower than those in Group A and Group B at the 1st,2nd,4th,8th and 12th weeks (P＜0.05).(4) No significant difference was observed in nerve electrophysiological examination before and 12 weeks after treatment in all 3 groups (P＞0.05).(5) One patient in Group C appeared neutropenia two weeks after treatment,but the granulocyte rose to normal after stopping the deanxit for one week; no other abnormal condition was found in the observation period.Conclusion Combination therapy of deanxit and analgecine on elderly PDPN achieves good clinical effect and it is safe using in the elderly.

Objective To investigate the effect of triglyceride-glucose(TyG)index on the prognosis of elderly patients with decompensated heart failure(HF).Methods Clinical data of 305 patients(≥75 years old)with decompensated HF admitted to our hospital from January 2020 to Decem-ber 2023 were collected and retrospectively analyzed.According to the median TyG index,they were divided into high TyG index group(≥9.11,n=155)and low TyG index group(＜9.11,n=150).The results of laboratory tests,ambulatory blood pressure monitoring(ABPM),and echo-cardiography(ECG)were obtained from the electronic medical record system of our hospital.All patients were followed up by telephone within 28 d after discharge.The clinical characteristics were compared between the two groups.Spearman correlation analysis was used to analyze the re-lationship of TyG index with cardiac function and ABPM indicators of the patients.Kaplan-Meier survival curve was plotted to analyze the influence of the TyG index on the prognosis,and ROC curve was drawn to analyze the predictive value of the TyG index for 28-day mortality in these elderly patients.Results The high TyG index group had significantly higher mortality,thicker in-terventricular septum thickness(IVST),larger proportions of diabetes and hypertension,and higher levels of fasting blood glucose,cholesterol,triacylglycerol,NT-proBNP and coefficients of variation(CV)in 24-h SBP and 24-h DBP,and lower HDL-C level when compared to the low TyG index group(P＜0.05,P＜0.01).Spearman correlation analysis revealed that the TyG index was significantly positively correlated with IVST(r=0.526,P＜0.01),24-h SBP CV(r=0.342,P＜0.01),24-h DBP CV(r=0.302,P＜0.01)and NT-proBNP level(r=0.443,P＜0.01).Further-more,Kaplan-Meier survival analysis indicated that a significantly higher 28-day cumulative sur-vival rate was observed in the low TyG index group than the high TyG index group(94.67％vs 83.23％,log rank X2=10.436,P=0.001).Additionally,ROC curve analysis showed that the AUC value of TyG index in predicting 28-day mortality in elderly patients with decompensated HF was 0.692(95％CI:0.597-0.786).When the cutoff value of TyG inde x was 9.22,the sensitivity was 76.50％,and the specificity was 63.50％.Conclusion High TyG index indicates poor prognosis in elderly patients aged over 75 years with decompensated HF,and increment of TyG index may be helpful to identify high-risk HF population.

Objective To investigate the relationship between plasma tau protein, phosphorylated tau protein (p-tau) protein and cognitive function in subjects with generalized brain atrophy. Methods A total of 100 subjects with moderate and severe brain atrophy were divided into two groups according to cognitive function: normal group (n=50 cases) and dementia group (n=50 cases). And their gender, age, educational level, etc. are recorded. The tau protein and p-tau protein content in plasma were measured by double antibody sandwich enzyme-linked immunosorbent assay (ELISA). The differences between plasm tau and p-tau protein expression and their relationship with cognitive function were analyzed. Results Plasma tau protein and p-tau protein levels were significantly higher (P<0.05) in the dementia group [(210.92±43.79)pg/mL、(81.15±16.85)pg/mL] than in the normal group[(210.92±43.79)pg/mL、(81.15±16.85)pg/mL]. Plasma tau protein and p-tau protein levels were negatively correlated with the MMSE score (P<0.05) and had no significant correlation with the degree of brain atrophy (P>0.05). Conclusion Cognitive impairment may be associated with elevated tau protein levels in patients with extensive brain atrophy.

The objective was to investigate the hypoglycemic action of catalpol in spontaneous diabetes db/db mice. 40 db/db mice were randomly divided into fi ve groups: model control gourp; db/db plus catalpol 40, 80, 120 mg/kg body wt. groups and db/db plus metformin 250 mg/kg group. Age-matched db/m mice were selected as normal control group. The mice were administered with corresponding drugs or solvent by gavage for 4 weeks. The oral glucose tolerance test was carried out at the end of 3rd week. After 4 weeks of treatment, the concentrations of fasting blood glucose (FBG), glycated serum protein (GSP), insulin (INS), triglyceride (TG), total cholesterol (TC) and adiponection (APN) in serum were detected. The protein expressions of phosphorylation-AMPKalpha1/2 in liver, phosphorylation-AMPKalpha1/2 and glucose transporter-4 (GLUT-4) in skeletal muscle and adipose tissues were detected by western blot. Real time RT-PCR was used to detect the mRNA expressions of acetyl-CoA carboxylase (ACC) and Hydroxymethyl glutaric acid acyl CoA reductase (HMGCR) in liver. Our results showed that catalpol could significantly improve the insulin resistance, decrease the serum concentrations of INS, GSP, TG, and TC. The concentrations of APN in serum, the protein expression of phosphorylation-AMPKalpha1/2 in liver, phosphorylation-AMPKalpha1/2 and GLUT-4 in peripheral tissue were increased. Catalpol could also down regulate the mRNA expressions of ACC and HMGCR in liver. In conclusion, catalpol ameliorates diabetes in db/db mice. It has benefi t eff ects against lipid/glucose metabolism disorder and insulin resistance. The mechanism may be related to up-regulating the expression of phosphorylation-AMPKalpha1/2.
Acetyl-CoA Carboxylase ; Acyl Coenzyme A ; AMP-Activated Protein Kinases ; Animals ; Blood Glucose ; Blotting, Western ; Cholesterol ; Fasting ; Glucose ; Glucose Tolerance Test ; Insulin ; Insulin Resistance ; Liver ; Metabolism ; Metformin ; Mice* ; Muscle, Skeletal ; Oxidoreductases ; RNA, Messenger ; Triglycerides

Objective To explore the relationship between the expression levels of serum cingulate protein(CGN)and polyligand glycan 1(SDC-1)and the disease condition and outcome of hypertensive basal ganglia hemorrhage(HBGH).Methods A total of 123 patients with HBGH admitted to the Second People's Hospi-tal of Lianyungang from February 2019 to February 2022 were selected as the study objects,and 120 healthy volunteers who underwent physical examination in the hospital during the same period were selected as the health group.Serum CGN and SDC-1 expression levels were detected in the two groups.According to the dis-ease outcome,the patients were divided into the improved group(92 cases)and the deteriorated group(31 ca-ses).Receiver operating characteristic(ROC)curve and the area under the curve(AUC)were used to analyze the predictive value of serum CGN and SDC-1 expression levels on the disease outcome of patients with HB-GH.Results Serum CGN and SDC-1 expression levels in the severe group were higher than those in the mod-erate group and the mild group,and serum CGN and SDC-1 levels in the moderate group were higher than those in the mild group,and the differences were statistically significant(P＜0.05).Serum CGN and SDC-1 expression levels in HBGH patients in three groups were higher than those in health group,and the differences were statistically significant(P＜0.05).Serum CGN and SDC-1 expression levels in the deteriorated group were higher than those in the improved group,and the differences were statistically significant(P＜0.05).The AUC of serum CGN and SDC-1 for predicting the disease outcome of HBGH patients was 0.742(95％CI:0.792-0.697)and 0.861(95％CI:0.906-0.910),respectively,and the AUC of the combination of the two was 0.917(95％CI:0.962-0.870).The amount of blood loss and ventricular rupture in the deteriorated group were higher than those in the improved group,and the Glasgow Coma Scale(GCS)score on admission was lower than that in the improved group,and the differences were statistically significant(P＜0.05).Multi-variate Logistic regression analysis showed that serum CGN≥51.63 pg/mL(OR=3.815),serum SDC-1≥450.67 μg/L(OR=4.230)and GCS score ≤8(OR=5.333)were the influencing factors for disease outcome of HBGH patients(P＜0.05).Conclusion The increased expression levels of serum CGN and SDC-1 are closely related to the disease aggravation and the deterioration of the disease outcome in patients with HBGH,and they have certain predictive value for the disease outcome in patients with HBGH.