Objective To explore the association between single nucleotide polymorphism(SNP)of rs556621 and recurrence of is-chemic stroke(IS)in patients with symptomatic intracranial atherosclerotic disease(sICAD).Methods This prospective,single-cen-ter cohort study consecutively enrolled patients with sICAD admitted to the Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine from March 2017 to October 2019.Genotyping analysis was performed through a TaqMan assay,clinical data related to stroke risk factors were collected,and stroke recurrence were recorded through the 2-year follow-up.The patients were divided into re-current group and non-recurrent group according to the recurrence situation,univariate analysis was used to compare the differences in stroke risk factors and distribution of rs556621 variants under dominant,recessive and allele models between participants.Multivariate COX regression analysis was applied to analyze the independent risk factors for recurrence of IS in sICAD.Results Fifty-eight sICAD patients were included in this study,and their cumulative recurrence rates of IS at 1 year and 2 years were 12.07％and 20.69％,respec-tively.Genotype analysis showed notable deviations from Hardy-Weinberg equilibrium at rs556621 locus,suggesting its potential role in ICAD susceptibility.Univariate analysis showed that the serum total cholesterol and high-density lipoprotein cholesterol in recurrent group were significantly lower than those in non-recurrent group,and the difference was statistically significant(P＜0.05).In the domi-nant genetic analysis mode,although there was no statistically significant difference in the genotype distribution of rs556621 between the two groups(P=0.096),it suggested that the dominant genetic effect of this locus may have potential effect on recurrence of IS.Multiva-riate COX regression analysis showed that patients with TT genotype at rs556621had a higher risk of 2-year recurrence of IS compared with carriers of CC or CT genotype(OR=4.659,95％CI:1.179-18.411,P=0.028).Conclusion Under dominant genetic analy-sis model,TT genotype at rs556621 is an independent risk factor for recurrence of IS in sICAD patients.

Objective To explore the association between single nucleotide polymorphism(SNP)of rs556621 and recurrence of is-chemic stroke(IS)in patients with symptomatic intracranial atherosclerotic disease(sICAD).Methods This prospective,single-cen-ter cohort study consecutively enrolled patients with sICAD admitted to the Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine from March 2017 to October 2019.Genotyping analysis was performed through a TaqMan assay,clinical data related to stroke risk factors were collected,and stroke recurrence were recorded through the 2-year follow-up.The patients were divided into re-current group and non-recurrent group according to the recurrence situation,univariate analysis was used to compare the differences in stroke risk factors and distribution of rs556621 variants under dominant,recessive and allele models between participants.Multivariate COX regression analysis was applied to analyze the independent risk factors for recurrence of IS in sICAD.Results Fifty-eight sICAD patients were included in this study,and their cumulative recurrence rates of IS at 1 year and 2 years were 12.07％and 20.69％,respec-tively.Genotype analysis showed notable deviations from Hardy-Weinberg equilibrium at rs556621 locus,suggesting its potential role in ICAD susceptibility.Univariate analysis showed that the serum total cholesterol and high-density lipoprotein cholesterol in recurrent group were significantly lower than those in non-recurrent group,and the difference was statistically significant(P＜0.05).In the domi-nant genetic analysis mode,although there was no statistically significant difference in the genotype distribution of rs556621 between the two groups(P=0.096),it suggested that the dominant genetic effect of this locus may have potential effect on recurrence of IS.Multiva-riate COX regression analysis showed that patients with TT genotype at rs556621had a higher risk of 2-year recurrence of IS compared with carriers of CC or CT genotype(OR=4.659,95％CI:1.179-18.411,P=0.028).Conclusion Under dominant genetic analy-sis model,TT genotype at rs556621 is an independent risk factor for recurrence of IS in sICAD patients.

Objective Through an analysis of three cases of ocular flutter-opsoclonus in adults and a review of the relevant literature,we summarized its characteritics to improve the clinical awareness of this sign.Methods Three cases of adult-onset ocular flutter-opsoclonus from July 2014 to July 2017 were retrospectively analyzed in terms of clinical features,cerebrospinal fluid (CSF) analysis,brain imaging,etiologies and treatment,and followed up through telephone calls.Results Case 1:A 68-year-old man presented with ocular flutter,vertigo,myoclonus,ataxia and conscious disturbance.CSF analysis demonstrated pleocytosis and mildly elevated protein level.Brain MR imaging revealed ischemia,and SPECT showed hypoperfusion involving left frontal and occipital lobes.Paraneoplastic syndrome was considered as the etiology.The symptoms subsided without any specific treatment.He died from lung cancer within one year.Case 2:A 66-year-old man presented with ocular flutter,vertigo,ataxia,conscious disturbance and fever.CSF protein level was severely elevated.Brain MR imaging revealed ischemia.Epstein-Barr virus infection was considered as the etiology.The symptoms improved with the administration of antiviral drugs and steroid.Relapse was not observed in the two-year follow-up.Case 3:A 34-year-old woman presented with opsoclonus,oscillopsia,vertigo,ataxia,conscious disturbance and fever.MR imaging showed midbrain lesions.Viral brainstem encephalitis was considered as the etiology.The symptoms improved with the administration of antiviral drugs,steroid,intravenous immunoglobulin and clonazepam.Relapse was not observed in the two-year follow-up.Conclusions Infection and tumors are common etiologies of ocular flutter-opsoclonus.Treatment includes etiological management for infection or tumors and immunosuppressive therapy.The clinical outcomes vary with the underlying etiologies.

Objective To study the influence of nitric oxide synthase (NOS) inhibitor in a rat model of Parkinson’s disease. Methods Hemi-Parkinsonism rat model was established by stereotaxic 6-hydroxydopamine (6-OHDA) lesions in striatum in which nitric oxide synthase (NOS) was inhibited by L-Nitro-Arginine (L-NNA) and apomorphin-induced rotational behavior was measured. The immunohistochemical staining method was used to observe the change of striatal nNOS-positive neurons and nigral tyrosine hydroxylase(TH)-positive neurons. Results L-NNA dramatically protected 6-OHDA-injected rats against indices of severe injury to the nigrostriatal dopaminergic pathway, including decreases in numbers of TH-positive nigral neurons and rotational behavior. The nNOS-positive neurons showed no changes in numbers. Conclusions These results indicate that NO might mediate, in part, 6-OHDA-induced neurotoxicity and nNOS-positive neurons might resist the 6-OHDA neurotoxicity. NOS inhibitor may play a role in the protection of 6-OHDA neurons.

Objective To evaluate the effect of bilateral subthalamic nuclei deep brain stimulation (STN-DBS) on anxiety and depression of patients with Parkinson's disease(PD).Methods Forty-one consecutive patients with refractory motor fluctuations and dyskinesia were assessed with Hoehn & Yahr scale, Unified Parkinson’s Disease Rating Scale Ⅲ (UPDRSⅢ), HADS, PD Questionnaire Chinese version (PDQ-39) a week before surgery and 12 months after the surgical procedure. Results The scores of UPDRSⅢ, HADS and PDQ-39 significantly increased after STN-DBS treatment (all P