Objective To investigate the effect of triglyceride-glucose index(TyG)on the short-term prognosis of patients with initial acute ischemic stroke.Methods A total of 391 patients with initial acute ischemic stroke who were hospitalized in Kunshan Second People's Hospital and The Affiliated Suzhou Hospital of Nanjing Medical University from Jun.2020 to Jun.2023 were retrospectively included.According to the modified Rankin scale(mRS)scores at 90 d follow-up,they were assigned to good prognosis group(286 cases)or poor prognosis group(105 cases).Logistic regression and receiver operating characteristic(ROC)curve were used to evaluate the effect of TyG on the short-term prognosis of patients with initial acute ischemic stroke.Results Compared with the good prognosis group,the patients of poor prognosis group had older age,higher proportion of atrial fibrillation,higher levels of homocysteine,triglyceride,total cholesterol,low-density lipoprotein,and TyG,and higher National Institutes of Health stroke scale(NIHSS)score(all P＜0.05).Multivariate logistic regression analysis showed that age,homocysteine,TyG and NIHSS score were independent risk factors for poor prognosis in patients with initial acute ischemic stroke(all P＜0.05).ROC curve analysis showed that TyG combined with NIHSS score had good predictive value for poor prognosis of patients with initial acute ischemic stroke,and the area under curve value was 0.795.Conclusion The combination of TyG and NIHSS score is an independent influencing factor for poor short-term prognosis in patients with initial acute ischemic stroke.

Objective:To explore the clinical application value of sound touch elastography (STE) in the evaluation of the curative effect of acupuncture and moxibustion in the treatment of stroke patients with upper limb spasm.Methods:Fifty-five patients with upper limb spasm after stroke were selected as stroke group, and thirty healthy volunteers matched with age, gender and body mass index (BMI) were selected as control group between September 2020 and March 2021. The shear wave velocity (SWV) of biceps brachii and triceps brachii were measured in both groups. In stroke group, the SWVs of biceps brachii and triceps brachii on spastic side and non-spastic side were measured before and after acupuncture treatment, and the correlations between SWV and spastic grade (X), muscle response angle (R1), passive range of motion (R2), spastic angle (R2-R1) of modified Tardieu scale (MTS) were analyzed.Results:At 0 degree, the SWV of spastic biceps brachii (3.85±0.62)m/s was significantly higher than those of the non-spastic side [(3.34±0.35)m/s] and control group [(3.15±2.66)m/s] (all P<0.001), and decreased [ (3.45±0.47)m/s] after acupuncture treatment ( P<0.001). At 90 degree, the SWV of non-spastic biceps brachii was larger than those of spastic side and control group [1.98(1.92, 2.14)m/s vs 1.98(1.92, 2.11) m/s, 1.95(1.86, 2.05)m/s, all P<0.05], and there was no significant difference between the SWV of spastic side and control group ( P>0.05). There were no significant differences in SWV of triceps brachii between the spastic side and control group at both 0 degree or 90 degree ( P>0.05). At 0 degree, SWV positively correlated with MTS (x) ( rs=0.639, P<0.001) and negatively with R1 ( rs=-0.527, P<0.001) and R2 ( rs=-0.825, P<0.001) on the spastic biceps brachii. Conclusions:STE can provide quantitative index for the objective evaluation of the curative effect of acupuncture in upper limb spasm after stroke, and it is proposed to be an effective means of clinical diagnosis and efficacy evaluation in patients with upper limb spasm after stroke.

Objective:The Chinese pediatric mesh-type reference phantoms were developed and applied in the dose assessment of X-ray radiography.Methods:The 5- and 10-year-old Chinese pediatric mesh-type reference phantoms were developed based on the CT data. Based on the phantoms, the Monte Carlo method was applied to simulate the X-ray radiography to calculate the organ dose conversion coefficient and the effective dose conversion coefficient in different radiography conditions.Results:The 5- and 10-year-old Chinese pediatric mesh-type reference phantoms were developed, and the physical parameters were consistent with the national standard. The differences of the organ mass between the established phantoms and reference data were within 2%. The database of the pediatric chest posteroanterior projection and abdominal anteroposterior projection, tube voltage 60-90 kVp, total filtration 2.5~4 mmAl were simulated, and the difference between the effective dose conversion factor and the literature result was within 3%.Conclusions:The established Chinese pediatric mesh-type reference phantoms can be applied in the studies of radiation protection and clinical medicine and their result can provide an important reference for the dose assessment of the pediatric X-ray radiography.

Objective　To investigate the correlation between red cell distribution width to platelet ratio and short-term prognosis in acute ischemic stroke.Methods　The patients with ischemic stroke admitted in the First Affiliated Hospital of Zhengzhou University during the initial 24 hours after the onset of disease between 2015-2017 were recruited prospectively.Red cell distribution width (RDW),platelet and clinical characteristics were recorded.Functional outcome at 90 days after ischemic stroke was evaluated by the modified Rankin Scale (mRS).Results　Totally 1106 patients were included.Patients with poor functional outcome were older (P＜0.001=and had more frequent histories of hypertension (P=0.015),diabetes (P=0.001),atrial fibrillation (P＜0.001=,coronary heart disease (P=0.041),stroke (P＜0.001=and higher National Institutes of Health Stroke Scale (NIHSS)(P＜0.001=,white blood cell count (P＜0.001=,RDW (P＜0.001=and RDW to platelet ratio (RPR) (P=0.034).Higher RPR levels were associated with poor functional outcome at 90 days after ischemic stroke［(odds ratio,OR) 1.09,(confidence interval,CI) 1.03~1.16，P=0.005］. Conclusion　Higher RPR levels were associated with poor short-term outcome after acute ischemic stroke.

Inflammation response is an important pathological process of neuronal cell death after stroke.Interleukin (IL)-33/ST2 system is involved in the inflammatory response process of ischemic stroke and has been proved to be a protective factor.This article reviews the role and mechanism of IL-33/ST2 system in the regulation of immune inflammation after ischemic stroke.