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Low Triglyceride Levels are Associated with Unfavorable Outcomes in Patients with Spontaneous Intracerebral Hemorrhage.

低甘油三酯水平与自发性脑出血患者的不良结局相关。

  • 影响因子:2.83
  • DOI:10.1007/s12028-020-01023-0
  • 作者列表:"Liu Q","Zhao W","Xing Y","Hong Y","Zhou G
  • 发表时间:2020-06-18
Abstract

BACKGROUND AND AIMS:The relationship between serum lipid level and clinical outcome after spontaneous intracerebral hemorrhage (ICH) remains controversial. We sought to evaluate the association of serum lipid levels with clinical outcomes in patients with ICH. METHODS:Data on consecutive patients hospitalized with spontaneous ICH were prospectively collected from May 2005 to May 2018 and retrospectively analyzed. Following clinical and demographic data, age and gender, risk factors, serum lipid levels [total cholesterol, triglycerides (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol] and the outcomes were analyzed. RESULTS:A total of 1451 patients with ICH (mean age, 60.41 ± 12.3 years; 32.6% women) was evaluated. Although admission TG levels were associated with the outcomes at hospital discharge and 3 months in initial univariate analyses, the former association did not retain its statistical significance in multivariate logistic regression analyses adjusting for potential confounders. However, lower admission TG levels were independently associated (p = 0.045) with a higher likelihood of 12-month unfavorable outcomes (odds ratio 0.91, 95% confidence interval 0.83-0.99) in multivariate logistic regression models. CONCLUSIONS:Low TG levels at hospital admission were an independent predictor for unfavorable long-term outcomes in patients with spontaneous ICH. The exact mechanisms of the association need further investigations.

摘要

背景和目的: 自发性脑出血 (ICH) 后血脂水平与临床预后的关系仍存在争议。我们试图评估 ICH 患者血脂水平与临床结局的相关性。 方法: 前瞻性收集 2005 年 5 月至 2018 年 5 月因自发性 ICH 住院的连续患者资料并进行回顾性分析。根据临床和人口统计学资料、年龄和性别、危险因素、血脂水平 [总胆固醇、甘油三酯 (TG) 、低密度脂蛋白 (LDL) 、和高密度脂蛋白 (HDL) 胆固醇] 和结果进行了分析。 结果: 共评估了 1451 例 ICH 患者 (平均年龄 60.41 ± 12.3 岁; 32.6% 例女性)。尽管在初始单变量分析中,入院 TG 水平与出院时和 3 个月时的结局相关,但在调整潜在混杂因素的多变量 logistic 回归分析中,前者的相关性没有保留其统计学意义。然而,较低的入院 TG 水平与较高的 12 个月不良结局可能性独立相关 (p = 0.045) (比值比 0.91,95% 置信区间 0.83-0.99) 在多变量逻辑回归模型中。 结论: 入院时低 TG 水平是自发性 ICH 患者不良长期预后的独立预测因子。这种关联的确切机制需要进一步研究。

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发表时间:2020-01-29
来源期刊:Physical therapy
DOI:10.1093/ptj/pzaa022
作者列表:["Thilarajah S","Bower KJ","Hao PY","Tan D","Williams G","Larik A","Wai BC","Koh G","Clark RA"]

METHODS:BACKGROUND:People with stroke are not meeting recommended levels of physical activity. The modifiable factors associated with post-stroke physical activity levels need to be identified to develop targeted interventions. OBJECTIVE:The objective of this study was to investigate the factors at discharge from inpatient rehabilitation that are associated with physical activity levels at 3 months following discharge. DESIGN:This was a prospective cohort study. METHODS:Sixty-four people with stroke completed baseline assessments at discharge from inpatient rehabilitation and 55 completed the follow-up 3 months later. The candidate factors (i.e. gait speed, balance, strength, cognition, mood and motivation) were measured at discharge. The primary outcome measure at follow-up was walking related activity (measured by wrist-worn accelerometer). Secondary outcome measures were physical activity participation (Activity Card Sort) and intensity of physical activity (International Physical Activity Questionnaire - Short 7 days). Adjusted separate multivariable linear regression models or proportional odds regression models were used to evaluate the associations between candidate factors and physical activity. RESULTS:Gait speed and balance were associated with all aspects of physical activity. Higher level of intrinsic motivation was also associated with higher physical activity participation. Anxiety demonstrated a significant non-linear relationship with physical activity participation. LIMITATIONS:Inclusion of fatigue and individual muscle strength could have provided further insights into associations with steps per day. CONCLUSION:The results demonstrated that better physical function at discharge from inpatient rehabilitation was associated with future increased levels of physical activity. Additionally, higher levels of motivation impacted on increased physical activity participation. The influence of anxiety on physical activity participation requires further exploration. Mixed-method study designs can be utilized to further understand the factors associated with post-stroke physical activity.

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影响因子:2.57
发表时间:2020-01-06
DOI:10.1007/s12031-019-01474-x
作者列表:["Cheng, Xiao","Yang, Ying-Lin","Li, Wei-Han","Liu, Man","Zhang, Shan-Shan","Wang, Yue-Hua","Du, Guan-Hua"]

METHODS:Cerebral ischemia-reperfusion (I/R) is characterized by initial transient cerebral ischemia followed by reperfusion. Various pathophysiological processes are involved in brain injury and functional recovery during cerebral I/R. There are few studies on dynamic metabolic process after cerebral I/R. The present study was to observe dynamic alteration of brain injury, functional recovery, and metabolites after cerebral I/R in rats and discover potential metabolic markers. The cerebral I/R model was established by middle cerebral artery occlusion (MCAO) for 90 min, following reperfusion in rats. The results of cerebral infarction area, cerebral edema, and behavior test showed that there were dynamic changes in brain injury and functional recovery at different periods after cerebral I/R. Further analysis showed that the brain injury was severe on the first day of cerebral I/R, and there was a significant functional recovery from the 7th day of cerebral I/R, followed by an aggravation trend of brain injury from the days 7 to 28. Furthermore, Matrix-assisted laser desorption ionization mass spectrometry imaging analysis showed that the expression of ATP, glucose, and citric acid on 7th day was the highest during cerebral I/R, which indicated that energy metabolism and oxidative phosphorylation played important roles during cerebral I/R. In addition, the untargeted metabolomic results showed that the level of isocitric acid, the ratio of oxyglutaric acid/glutamic acid, and the level of pyruvic acid associated with the TCA cycle were also the highest on the 7th day during cerebral I/R, which indicated that the transient spontaneous recovery of ischemic brain on the 7th day after ischemia-reperfusion might be related to oxidative phosphorylation and energy metabolism in the brain in this period. In conclusion, the results suggest that some small molecule metabolites participate in the brain injury and functional recovery during cerebral I/R, which is of great significance to the development of therapeutic drugs and diagnostic markers.

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影响因子:2.75
发表时间:2020-01-01
DOI:10.1007/s00702-019-02124-7
作者列表:["Wang, Xiaodong","Shi, Cunxian","Pan, Hongxia","Meng, Xiaowen","Ji, Fuhai"]

METHODS:The aims of this study were to study the effects of miR-2 on cerebral ischemia–reperfusion rats and to explore its further mechanism. Rats were assigned into sham, model, miR-22 control and miR-22 groups. Observation of neurological behaviors at 24 h after operation found that neurological functions were severely damaged in the model and miR-22 control groups and these damages were improved by miR-22. RT-PCR indicated that miR-22 mRNA level in the brain tissue was significantly decreased in the model and miR-22 control groups, but increased in the miR-22 group. TTC staining showed increased percentage of cerebral infarction volume in the model and miR-22 control groups and this increase was reduced by miR-22. Immunohistochemistry showed increased densities of CD34^+ and VEGF^+ microvessels in the cortex in the model and miR-22 control groups, which were further increased in the miR-22 group. ELISA showed increased serum VEGF and Ang-1 levels in the model and miR-22 control groups, which were also further increased in the miR-22 group. Western blot analysis showed increased phosphorylation level of PI3K and Akt in brain tissue in the model and miR-22 control groups, which were further increased in the miR-22 group. Administration of LY294002, a specific PI3K pathway inhibitor, significantly reversed all the effects of miR-22 on rats in the model group. miR-22 exerts its neuroprotective and angiogenic functions via the PI3K/Akt signaling pathway, at least partly, in rats under cerebral ischemia–reperfusion.

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