Glioblastoma (GBM) is a typical malignant tumor, and there are no effective drugs capable of improving patient survival. Docosahexaenoic acid (DHA), a nutrient essential to animal health and neurodevelopment, exerts an anticancer effect in several types of cancer. However, the function of DHA in GBM is still unclear. Here, we showed that DHA could repress the migration and invasion of GBM U251 cells and promote their apoptosis in a dose- and time-dependent manner, indicating that DHA has an anticancer effect on GBM cells. Whole-transcriptome analysis indicated that DHA treatment mainly regulates the genes associated with receptor binding, oxidoreductase activity, organic acid transmembrane transporter activity, and carboxylic acid transmembrane transporter activity. Long non-coding RNAs (LncRNAs) involved in the regulation network of DHA were also identified, and their targets were assigned to the Gene Ontology (GO) categories. In silico analysis was conducted to predict the pathways related to the differentially expressed genes by DHA treatment. Our findings suggest that DHA acts as an antitumor agent in GBM, which may provide a suitable means of improving the efficacy of GBM treatment in the future.
Ischemic stroke is one of the most common sources of mortality in the world. Researchers have been trying to find a complementary therapy to treat ischemic stroke in order to improve its prognosis and expand the therapeutic window for reperfusion treatment. For this reason, many experimental and clinical trials studying the effects of hydrogen against ischemic stroke have been published. Hydrogen gas has been found to eliminate hydroxyl free radical and peroxynitrite anions as well as producing therapeutic effect in patients with ischemic stroke. Many studies have been published illustrating its anti -oxidative, anti-inflammatory and anti-apoptotic effects. The purpose of this article is to review the literature concerning treatment of cerebral I/R injury or ischemic stroke with hydrogen therapy. Specifically, we will examine the appropriate laboratory methods, mechanisms of hydrogen therapy, and outcomes of relevant clinical trials. We conclude this review with a discussion on future investigations of hydrogen therapy to treat ischemic stroke.
Background and objective: Adult demyelinating optic neuritis (ON) with positive myelin-oligodendrocyte glycoprotein antibody (MOG-Ab) has distinct clinical features. This study aimed to investigate the point prevalence, relationship with steroid dependency and prognosis value of MOG-Ab in adult ON. Methods: Clinical data analysis was undertaken in adults with ON admitted between December 2014 and January 2016. Patients were classified into three groups based on aquaporin-4 antibody (AQP4-Ab) and MOG-Ab status: AQP4-ON, MOG-ON and seronegative-ON. Results: A total of 158 adults with ON (190 eyes) were assessed, including 31 MOG-ON (19.6%), 67 AQP4-ON (42.4%) and 60 seronegative-ON (38.0%) cases. The female-to-male ratio was significantly lower in MOG-ON (1.8:1) than that in AQP4-ON (8.6:1) groups (p = .005). The median age, percentage of bilateral ON and visual loss at the nadir at onset was similar among the three groups. Thirty-eight eyes (76%) in the MOG-ON group showed good visual recovery (> 20/40) in the final visit, which is statistically better than that in the AQP4-ON and seronegative-ON groups (p < .001 and p = .006, resoectively). Fifteen adults with ON (9.5%) showed dependency on steroid, which was particularly prominent in the MOG-ON group (11/31, 35.5%) and rarely presented in the AQP4-ON (2, 3.0%) and seronegative-ON (2, 3.3%) groups. Results suggested less loss of pRNFL in MOG-ON than that in AQP4-ON group (p < .001), and a larger proportion of canalicular segment involved in MOG-ON adults (p = .007 and p < .001). Conclusion: MOG-ON had the smallest proportion of acute demyelinating ON in Chinese adults. One third of adults with MOG-ON predominantly showed a substantial dependency on steroids and relapse on steroid reduction or cessation, which rarely presented in AQP4-ON and seronegative-ON adults.
Background: Secondary neurological deterioration in patients with spontaneous intracerebral hemorrhage (sICH) develops within the first 24 or 48 h after ICH onset and appears to portend a poor prognosis. We aimed to verify whether hypodensities within an acute ICH detected by noncontrast computed tomography (NCCT) were able to predict secondary neurological deterioration and investigate which monitoring window was of the highest predictive value. Materials/methods: This study involved sICH patients from three clinical centers of Fudan University between October 1, 2016 and March 31, 2018. Logistic regression analysis was used to assess the association between hypodensities and secondary neurological deterioration. The receiver operating characteristic curve of the subjects was performed to evaluate the critical value of the detection time window of hypodensities that best predicted the secondary neurological injury. Then, we divided the detection time window of hypodensities into 0-1.5 h, 1.5-3 h, 3-4.5 h and 4.5-6 h, and calculated the sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV) and accuracy respectively. Results: A total of 240 ICH patients met the inclusion criteria, 97 (40.42%) of whom were observed secondary neurological deterioration. Hypodensities were positive in 113 patients (47.08%), and more common in patients with secondary neurological deterioration (76.25%). The multivariate logistic regression analysis demonstrated that infratentorial hemorrhage (P < .001), the baseline hematoma volume (P = .015), and the presence of hypodensities on admission CT scan (P < .001) were independent predictors of secondary neurological deterioration. The sensitivity, specificity, PPV, and NPV of hypodensities in predicting secondary neurological deterioration were 76.3%, 72.7%, 65.5%, and 81.9%, respectively. When the time to the baseline NCCT was 114.5 min, the hypodensities were of the highest predictive value. Besides, the risk of secondary neurological deterioration predicted by hypodensities detected during 1.5-3.0 h was higher than other time periods. Conclusions: Hypodensities within hematoma detected by an NCCT scan may predict secondary neurological deterioration, independent of other clinical and imaging predictors. Hypodensities detected at 1.5-3.0 h after ICH onset have better predictive efficacy.
Aims: Atherosclerosis is more prevalent in Asian population. This distinct etiology of stroke might disadvantage Asian patients when applying. mechanical thrombectomy (MT). The purpose of this research was to evaluate the efficacy and safety of MT in a cohort of Chinese patients with acute ischemic stroke. due to large artery atherosclerosis (LAA). Methods and results: A total of 649 patients treated with MT were included. Patients were classified according to etiology of stroke as LAA and cardioembolism ones. Successful revascularization was defined as modified Thrombolysis in Cerebral Infarction (mTICI) grade >= 2b. Favorable outcome was defined as modified Rankin Scale (mRS) score <= 2 at 90 days. Logistic regression was used to identify predictors for functional outcomes. The patients with stroke of LAA etiology had significantly higher rate of favorable functional outcome (50.2% vs 36.5%, p < .001) and good collateral (grade of ASITN/SIRI: 2-3) (58.8% versus 43.2%, p < .001), and lower median baseline National Institutes of Health Stroke Scale score (NIHSS) (15.6 versus 18.2, p < .001), compared to patients with stroke of cardioembolism etiology. There was no significant difference in the rate of successful postprocedural mTICI between groups (84.5% versus 83.2%, p = .671). Rates of symptomatic intracranial hemorrhage (20.0% versus 11.7%, p = .004) and mortality (31.8% versus 18.8%, p < .001) within 3 months were notably higher in the cardioembolism group than that in the LAA group. Conclusion: Mechanical thrombectomy may be more efficacious in treating acute ischemic stroke of LAA etiology than that of cardioembolism etiology.
Acute ischemic stroke (AIS) may experience early neurological deterioration (END) and have high risks of recurrent ischemic strokes (RIS), which are often associated with a poor outcome. Post-stroke prognosis is associated with autonomic status. Recently, studies showed that heart rate variability (HRV) is an early outcome predictor in acute stroke patients. The purpose of our study was to investigate association decreased HRV by fractal dimension (FD) with early END within 72 h of admission and 1-year RIS. In this study, we assessed autonomic function of ischemic stroke patients within 24 h from symptom onset by FD. Receiver operating characteristic (ROC) curve was utilized to determine the optimal cut point of FD for END and RIS. 516 patients (mean age 66.14 +/- 10.11) with acute ischemic stroke underwent a comprehensive clinical investigation and FD test. According to the data of FD, we investigated association with END within 72 h of admission and the 1-year RIS. ROC curve analysis shown that the optimal cut point of FD for END and RIS were FD <= 1.05 and FD <= 1.15 respectively. In fully adjusted models, there was an association between FD 5 1.05 and END (adjusted odds ratio, 2.64; 95% confidence interval, 1.55-4.49; P < 0.001), there was an association between FD < 1.15 and RIS (adjusted odds ratio,5.40; 95% confidence interval, 3.02-9.64; P < .001). These findings indicate that FD <= 1.05 and FD <= 1.15 were independently associated with increased risk of END and RIS respectively, which may have predictive value in END and RIS.
Background: Prasugrel as a second generation P2Y12 adenosine diphosphate receptor antagonist which in the cerebral aneurysms with Endovascular treatment have become more emphasized. Objective: To compare the efficacy and safety of prasugrel therapy for intracranial aneurysms with endovascular treatment. Methods: The databases of PubMed, Embase, Cochrane Library databases and China Biology Medicine disc were retrieved with computers for collecting controlled trials about the comparison in the efficacy and safety of prasugrel and clopidogrel published from inception to September 2018. At the same time, the reference materials of included literature were retrieved manually. After rigorous evaluation on literature quality, the eligible data of the trials was extracted and given a Meta-analysis by applying RevMan5.3 software. Results: Of the 96 studies identified, 7 trials were included. Results of meta-analysis showed that compared with patients receiving clopidogrel treatment, novel platelet P2Y12 receptor inhibitor prasugrel were effective in reducing the incidence of thromboembolic events (OR = 0.19, 95%CI: 0.08-0.45, P =.0001), but did not increase the risk of hemorrhagic complication (OR = 1.00, 95%CI: 0.53-1.89, P = 1.00), and the PRU (OR = 0.19, 95%CI: 0.08-0.45, P =.0001) and Percentage inhibition of platelet (MN = 37.05, 95%CI: 33.37-40.73, P <.00001) were controlled in a better range. Conclusion: In antiplatelet therapy after aneurysmal interventional therapy, the second generation of P2Y12 adenosine receptor antagonist prasugrel can significantly reduce the risk of thrombosis without increasing the risk of bleeding.
Aim: The prevalence and diagnostic values of myositis-specific autoantibodies (MSAs) and myositis-associated autoantibodies (MAAs) in dermatomyositis/polymyositis (DM/PM) were studied. Method: A commercial immunoblot assay with 16 autoantigens was used to detect MSAs and MAAs in serum samples from 130 DM/PM patients, 100 disease controls, and 50 healthy subjects. Results: The prevalence of anti-Jo-1, anti-MDA5, anti-TIF1 gamma, anti-Mi-2 beta, and anti-Mi-2 beta was significantly higher in DM/PM than in other connective-tissue diseases (CTDs). Moreover, anti-MDA5 and anti-Ro-52 were significantly higher in DM/PM with interstitial lung disease (ILD) than in DM/PM without ILD, while that of antiTIFly and anti-NXP2 were significantly lower in DM/PM with ILD than in DM/PM without ILD. For distinguishing DM/PM from other CTDs, the sensitivity, specificity, and positive predictive value (PPV) for anti-MDA5 were 28.46, 99.00, and 97.37%, respectively, with a positive likelihood ratio (LR +) of 28.46; they were 46.15, 58.00, and 58.82%, respectively, for anti-Ro-52 with an LR + of 1.10. For distinguishing DM/PM with ILD from DM/PM without ILD, the sensitivity, specificity, and PPV for anti-MDA5 were 45.57, 100.00, and 100.00%, respectively, and for anti-Ro-52 were 60.76, 73.91, and 80.00%, respectively. Conclusion: MSAs and MAAs serve as biomarkers for differentiating DM/PM from other CTDs as well as distinguishing DM/PM with ILD from DM/PM without ILD.
Background: Patients with intracerebral hemorrhage (ICH) have high disability and mortality. Leukoaraiosis refers to the diffuse abnormalities of white matter on neuroimaging, which has been suggested to be with poor outcome in patients with ICH. This meta-analysis was performed to summarize the current evidence on the prognostic significance of leukoaraiosis in ICH patients. Methods: Databases were searched for published studies about leukoaraiosis and prognosis in patients with ICH. Data from eligible studies were extracted. Odds ratios (ORs) and their 95% confidence intervals (CIs) from each study were combined with DerSimonian Laird method and random effect model for quantitative analysis. Begg's funnel plot was adopted to assess the publication bias. Results: A total of nine studies with 4948 patients were finally included in this meta-analysis. Six studies reported functional outcome, two studies reported mortality, and another study reported both functional outcome and mortality. The meta-analysis showed that leukoaraiosis was significantly associated with worse functional outcome in patients with ICH (OR = 1.40, 95%CI 1.17-1.68, P < .001). In addition, leukoaraiosis was also significantly associated with higher mortality in patients with ICH (OR = 1.59, 95%Cl 1.21-2.08, P = .001). Conclusions: Leukoaraiosis is significantly associated with both worse functional outcome and higher mortality in patients with ICH. Leukoaraiosis can be a useful imaging marker for predicting outcome in patients with ICH.
Aims: There was no established consensus on the optimal blood pressure management protocol in patients with acute intracerebral hemorrhage (ICH). This study was to explore the association between blood pressure decreasing rates and survival time in patients with acute ICH. Methods: 786 acute ICH patients were enrolled in the study andhospitalized from 2004 to 2006. K-means clustering was used to classify the subjects according to the decreasing rates of blood pressure within 14 days of acute ICH patients. Cox regression was used to screen the independent influencing factors of 14-day survival in the univariate anaylsis among acute ICH patients. Results: There was significant difference in the decreasing rates of systolic blood pressure (SBP) and diastolic blood pressure (DBP) in 1-2 d and 2-3 d after admission in patients with acute ICH (P < .05) between blood pressure decreasing stability and instability groups. The independent factors of 14-day survival in patients with acute ICH included: age, 24 h the National Institutes of Health Stroke Scale (NIHSS) score, bleeding volume, blood glucose, low density lipoprotein cholesterol, serum albumin, fasting, bleeding position and lowering rates of SBP (P < .05). And the risk of death within 14 days in the SBP decreasing instability group was 1.71 (1.02 to 2.86) times than those in stability group. Conclusion: Compared with DBP decreasing rates, SBP decreasing rates had a greater impact on the survival time in patients with acute ICH. In addition, patients with instable SBP decreasing rates had inferior survival than those with stable SBP decreasing rates.
Background and purpose: The relationship between neutrophil to lymphocyte ratio (NLR) and prognosis after acute ischemic stroke (AIS) remains controversial. The aim of this cohort study and systematic review was to ascertain the association of admission NLR with major clinical poor outcomes after AIS. Methods: We analyzed data from Chengdu stroke registry and performed a systematic review for previous literature. The outcomes were hemorrhagic transformation (HT), parenchymal hematoma (PH), symptomatic intracranial hemorrhage (sICH), 3-month death or disability (modified Rankin Scale >= 3), and 3-month death. Odds ratios (ORs) and 95% confidence intervals (CIs) of NLR as a continuous and categorical variable and poor outcomes were pooled separately. We also calculated the predictive accuracy of admission NLR in different outcomes. Results: We included 808 patients from registry database and 9563 patients from previous studies. Our registry data showed that NLR 5 was associated with HT (OR 2.03, 95%CI 1.19-3.46), PH (OR 2.54, 95%CI 1.20-5.35) and 3-month death (OR 5.55, 95%CI 1.41-21.89); meta-analysis with our data and other observational studies indicated that higher NLR was associated with HT (OR 1.99, 95% CI 1.45-2.73), sICH (OR 2.22, 95% CI 1.60-3.09), 3-month death or disability (OR 1.68, 95% CI 1.18-2.38), and 3-month death (OR 2.79, 95% CI 1.57, 4.94). NLR had the highest predictive accuracy for 3-month death. Conclusions: Higher NLR is positively associated with the risk of HT and 3-month death after stroke. Considering the limited predictive ability of a single biomarker, more studies should validate the role of NLR in prognostic models.