ObjectiveTo investigate the relationship between the level of homocysteine (HCY) and the overall burden of cerebral small vessel disease (CSVD) in patients with ischemic stroke.MethodsA total of 322 patients with first-ever ischemic stroke admitted to the People’s Hospital of Deyang City between January 2016 and December 2017 were enrolled. The patients’ demographic information, clinical information, and serum HCY concentration were collected after admission. The presence or absence of a CSVD was assessed by MRI and the overall burden score for the CSVD was determined. Multivariate logistic regression analysis was used to assess whether serum HCY level was associated with the overall burden of CSVD.ResultsThe median level of HCY was 13.2 μmol/L (inter-quartile range: 4.3 to 22.6 μmol/L). Univariate analysis showed that the difference of HCY levels among patients with different total CSVD scores was statistically significant (F=6.874, P=0.001); Spearman correlation analyses showed that the HCY level grouped by quartiles was correlated to the number of lacunar infarctions (rs=0.267, P=0.001), Fazekas score of white matter lesions (rs=0.122, P=0.042), and enlarged perivascular space (EPV) score (rs=0.319, P=0.001), but was not correlated to cerebral microhemorrhage (rs=−0.010, P=0.869). After multivariate regression analysis to adjust the effects of other factors, compared with the patients with HCY levels in the lowest quartile group, the patients with HCY levels in the highest quartile group were more likely to develop lacunar infarction [odds ratio (OR)=1.892, 95% confidence interval (CI) (1.012, 2.987)], white matter lesions [OR=1.548, 95%CI (1.018, 1.654)], severe EPV [OR=6.347, 95%CI (3.592, 13.978)], and the increase in the CSVD score [OR=2.981, 95%CI (1.974, 5.398)].ConclusionIn patients with ischemic stroke, elevated HCY levels may be associated with the overall burden of the CSVD.
Objective To study the concentration of neurotrophins( including NGF, BDNF, NT3 and NT4) in the lung of SD rats infected by respiratory syncytial virus( RSV) , and to explore the relationship between the concentration of the neurotrophins, airway hyperresponsiveness and airway neural plasticity.Methods Twenty SD newborn rats were randomly divided into a control group and a RSV-infected group with ten rats in each group. The RSV-infected group were infected with 5 ×104 TCID50/0. 1 mL RSV each week. After 8 weeks, the bronchial responsiveness of the SD rats was assessed. The bronchial inflammation was assessed by HE staining with left lung. Synaptophysin and neurofilament expressions in the lung of SD rats were assayed by the immunohistochemistry staining. In situ hybridization was used to detect the RSV RNA in the lung. The concentration of neurotrophins in the lung of SD rats were detected by ELISA. Results The RSV-infected group showed elevated airway hyperresponsiveness and more inflammatory cells infiltrated in the lung; In situ hybridization showed positive signal of RSV RNA in lung interstitium of the RSV-infected rats. Synaptophysin and neurofilame levels in the airway were increased in the RSV-infected group. Supernatant levels of NGF and BDNF were significantly increased compared with the control group ( P lt;0. 05) . The NT3 and NT4 levels had no significant difference in all groups. The expressions of NGF and BDNF were positively related to the expressions of synaptophysin( r1 = 0. 892, r2 = 0. 995, P lt; 0. 05) and neurofilament( r1 = 0. 949, r2 =0. 936, P lt;0. 05) , also positively related to the airway hyperresponsiveness ( r1 =0. 929, r2 = 0. 910, P lt; 0. 05) . Conclusion RSV infection results in increased expressions of NGF and BDNF in the lung, which are correlated to the change of airway neural plasticity and airway hyperresponsiveness.
Objective To enhance the understanding of nonfibrotic hypersensitivity pneumonitis (nfHP) by summarizing the clinical characteristics of 32 cases of nfHP. Methods The data of 32 cases with nfHP was collected and analyzed. They were diagnosed in Beijing Friendship Hospital, Capital Medical University from Jan 1st, 2017 to Oct 31, 2021. Results The median age of the nfHP patients was 54 years, among whom 75.0% were females. The cases developed in a majority of avian exposure (22 cases, 68.8%). The main symptoms were dyspnea/shortness of breath (28 cases, 87.5%), cough (25 cases, 78.1%）and sputum production (21 cases, 65.6%). High-resolution CT (HRCT) showed diffuse ground glass opacification (25 cases, 78.1%), centrilobular ground glass nodules (20 cases, 62.5%) and air trapping (9 cases, 28.1%). Bronchoalveolar lavage fluid (BALF) featured an increase of proportion of lymphocytes (>20%, 90.6% and >40%, 50%), and a decrease of CD4+/CD8+ T cell ratio (<1.2, 65.6% and <0.8, 40.6%). Most of the cases had reduced diffusion capacity for carbon monoxide (16 cases out of 26 cases, 61.5%) and decreased total lung capacity (13 cases out of 26 cases, 50%). Few cases showed obstructive ventilatory function (6 cases out of 26 cases, 23.1%). Most cases (22 cases, 68.8%) of nfHP showed an excellent survival with short-term corticosteroid treatment. Few cases (5 cases, 15.6%) experienced spontaneous remission after antigen avoidance. Conclusions The diagnosis of nfHP includes identifying antigenic exposures, featured chest HRCT and lymocytosis in BALF. nfHP patients showed an excellent survival with short-term corticosteroid treatment as well as antigen avoidance.