Identification of risk factors and construction of a nomogram predictive model for post-stroke infection in patients with acute ischemic stroke

BACKGROUND Post-stroke infection is the most common complication of stroke and poses a huge threat to patients.In addition to prolonging the hospitalization time and increasing the medical burden,post-stroke infection also significantly increases the risk of disease and death.Clarifying the risk factors for post-stroke infection in patients with acute ischemic stroke(AIS)is of great significance.It can guide clinical practice to perform corresponding prevention and control work early,minimizing the risk of stroke-related infections and ensuring favorable disease outcomes.AIM To explore the risk factors for post-stroke infection in patients with AIS and to construct a nomogram predictive model.METHODS The clinical data of 206 patients with AIS admitted to our hospital between April 2020 and April 2023 were retrospectively collected.Baseline data and post-stroke infection status of all study subjects were assessed,and the risk factors for poststroke infection in patients with AIS were analyzed.RESULTS Totally,48 patients with AIS developed stroke,with an infection rate of 23.3%.Age,diabetes,disturbance of consciousness,high National Institutes of Health Stroke Scale(NIHSS)score at admission,invasive operation,and chronic obstructive pulmonary disease(COPD)were risk factors for post-stroke infection in patients with AIS(P<0.05).A nomogram prediction model was constructed with a C-index of 0.891,reflecting the good potential clinical efficacy of the nomogram prediction model.The calibration curve also showed good consistency between the actual observations and nomogram predictions.The area under the receiver operating characteristic curve was 0.891(95%confidence interval:0.839–0.942),showing predictive value for post-stroke infection.When the optimal cutoff value was selected,the sensitivity and specificity were 87.5%and 79.7%,respectively.CONCLUSION Age,diabetes,disturbance of consciousness,NIHSS score at admission,invasive surgery,and COPD are risk factors for post-stroke infection following AIS.The nomogram prediction model established based on these factors exhibits high discrimination and accuracy.

基于UPLC指纹图谱及化学识别模式的防暑清热饮质量评价

目的 建立防暑清热饮指纹图谱,结合化学识别模式评价其质量。方法以3,5-O-二咖啡酰奎宁酸为参照峰,采用《中药色谱指纹图谱相似度评价系统》(2012版)建立10批次防暑清热饮的超高效液相色谱(UPLC)指纹图谱,指认共有峰并进行相似度评价,确定每个共有峰的药材归属;运用化学模式识别法中的聚类分析(CA)、主成分分析(PCA)和正交偏最小二乘法-判别分析(OPLS-DA)确定影响制剂质量的差异性成分。结果 10批次防暑清热饮指纹图谱共有31个共有峰,相似度为0.975~0.996,指认6个共有峰,分别为9号峰(绿原酸)、19号峰(木犀草素-7-O-β-D-葡萄糖苷)、21号峰(3,5-O-二咖啡酰奎宁酸)、23号峰(橙皮苷)、29号峰(蒙花苷)和31号峰(广藿香酮);CA和PCA将10批次防暑清热饮分为3类;PCA结果显示,主成分1~6的累计方差贡献率为95.947%;OPLS-DA结果显示,共有13个峰变量重要性投影值大于1,为差异性成分。结论 该方法简便、灵敏、快速,可用于防暑清热饮的质量评价。

Uncertainty in illness and coping styles:Moderating and mediating effects of resilience in stroke patients

BACKGROUND Stroke has a great influence on the patient’s mental health,and reasonable psychological adjustment and disease perception can promote the recovery of mental health.AIM To explore the relationships among resilience,coping style,and uncertainty in illness of stroke patients.METHODS A retrospective study was used to investigate 154 stroke patients who were diagnosed and treated at eight medical institutes in Henan province,China from October to December 2019.We used the Mishel Uncertainty in Illness Scale,the Connor-Davidson Resilience Scale,and the Medical Coping Modes Questionnaire to test the uncertainty in illness,resilience,and coping style,respectively.RESULTS Resilience had a significant moderating role in the correlation between coping style and unpredictability and information deficiency for uncertainty in illness(P<0.05).Further,the tenacity and strength dimensions of resilience mediated the correlation between the confrontation coping style and complexity,respectively(P<0.05).The strength dimension of resilience mediated the correlation between an avoidance coping style and the unpredictability of uncertainty in illness(P<0.05),as well as correlated with resignation,complexity,and unpredictability(P<0.05).CONCLUSION Resilience has moderating and mediating roles in the associations between coping style and uncertainty in illness,indicating that it is vital to improve resilience and consider positive coping styles for stroke patients in the prevention and control of uncertainty in illness.

Serum microRNA-221 as a biomarker for diabetic retinopathy in patients associated with type 2 diabetes

AIM: To investigate the candidate microRNA(miRNA), miR-221 as a novel biomarker for diabetic retinopathy(DR) in patients associated with type 2 diabetes(T2D).METHODS: The subjects involved were divided into four groups: healthy control(HC), no diabetic retinopathy(NDR), non-proliferative diabetic retinopathy(NPDR) and proliferative diabetic retinopathy(PDR) group. Serum miR-221 was validated by real-time quantitative reversetranscription polymerase chain reaction(qRT-PCR). Also, serum angiotensin II(Ang II) and vascular endothelial growth factor(VEGF) were examined by enzyme-linked immunosorbent assay. In addition, receiver operating characteristic(ROC) curve was performed to explore the diagnostic accuracy of miR-221, Ang Ⅱ and VEGF for DR in patients with T2D. Spearman’s rank correlation coefficient was executed to estimate the correlations of serum miR-221 with metabolic parameters and serum markers in patients with T2D.RESULTS: Primarily, serum miR-221, Ang Ⅱ and VEGF were increased significantly in T2D patients compared to HC participant respectively, and progressive up-regulated in NDR, NPDR and PDR groups(P<0.001). Additionally, miR-221 in serum was remarkably positively correlatedwith metabolic parameters such as glycated hemoglobin(r=0.310, P=0.002) and homeostasis model assessment for insulin resistance(r=0.413, P<0.001), as well as serum markers for instance Ang Ⅱ(r=0.667, P<0.001) and VEGF(r=0.499, P<0.001). Furthermore, serum miR-221(AUC, 0.894; 95%CI, 0.833-0.955; P<0.001), Ang Ⅱ(AUC, 0.888; 95%CI, 0.828-0.949; P<0.001) and VEGF(AUC, 0.785; 95%CI, 0.695-0.875; P<0.001) had evidently diagnostic efficiency in DR, and miR-221 is the most effective among them.CONCLUSION: Serum miR-221 as a potential biomarker could be related to not only occurrence but also progression for DR in patients with T2D. However, a prospective clinical trial is warranted.

Photoinduced Merging with Copper-or Nickel-Catalyzed 1,4-Cyanoalkylarylation of 1,3-Enynes to Access Multiple Functionalizatized Allenes in Batch and Continuous Flow

A three-component reaction of 1,3-enynes and cyclobutanone oxime esters in the presence of aryl boronic acids or organozinc reagents via the photoredox/copper or photoredox/nickel catalysis has been established.This redox-neutral 1,4-cyanoalkylarylation reaction has demonstrated mild condition,high catalytic reactivity and wide functional group compatibility,allowing access to a variety of functionalized tetra-substituted allene derivatives with high chemo-and regioselectivity.Moreover,using photocatalytic continuous flow technique to promote this process would result in increased yields(70%in flow vs.61%in batch),reduced reaction times(7 min in flow vs.6 h in batch),and easy scale-up(upgrade to gram scale),showcasing its potential as a synthetic platform.