S pontaneous intracerebral hemorrhage (ICH) accounts for 10% to 15% of all strokes and is one of the leading causes of stroke-related mortality and morbidity worldwide. Patients with ICH are generally at risk of developing stroke-associated pneumonia (SAP) during acute hospitalization. Evidence has shown that SAP not only increases the length of hospital stay (LOS) and medical cost 1,2 but also is an important risk factor of mortality and morbidity after acute stroke. 3,4 Several risk factors for SAP have been identified, such as older age, 4-12 male sex, 5,6,10,11,13 current smoking, 12 diabetes mellitus, 6 hypertension, 14 atrial fibrillation, 7,10,12 congestive heart failure, 7,12,13,15 chronic obstructive pulmonary disease, 8,[12][13][14] preexisting dependency, 8,12,13,16 stroke severity, 5,6,8,12,17,18 dysphagia, [8][9][10][11][12]14,[18][19][20] and blood glucose. 12 Meanwhile, based on these risk factors, a few risk models have been developed for SAP after acute ischemic stroke. [8][9][10][11][12] Currently, no valid scoring system is available for predicting SAP after ICH in routine clinical practice or clinical trial. We hypothesized that there might be some common grounds for the development of pneumonia after acute ischemic stroke and ICH, and those predictors for SAP after acute ischemic stroke might also be useful for predicting SAP after ICH. For clinical practice, an effective risk-stratification and prognostic model for SAP after ICH would be helpful to identify vulnerable patients, allocate relevant medical resources, and implement tailored preventive strategies. In addition, for clinical trial, it could be used in nonrandomized studies to control for case-mix variation and in controlled studies as a selection criterion.Background and Purpose-We aimed to develop a risk score (intracerebral hemorrhage-associated pneumonia score, ICH-APS) for predicting hospital-acquired stroke-associated pneumonia (SAP) after ICH. Methods-The ICH-APS was developed based on the China National Stroke Registry (CNSR), in which eligible patients were randomly divided into derivation (60%) and validation (40%) cohorts. Variables routinely collected at presentation were used for predicting SAP after ICH. For testing the added value of hematoma volume measure, we separately developed 2 models with (ICH-APS-B) and without (ICH-APS-A) hematoma volume included. Multivariable logistic regression was performed to identify independent predictors. The area under the receiver operating characteristic curve (AUROC), Hosmer-Lemeshow goodness-of-fit test, and integrated discrimination index were used to assess model discrimination, calibration, and reclassification, respectively. Results-The SAP was 16.4% and 17.7% in the overall derivation (n=2998) and validation (n=2000) cohorts, respectively.A 23-point ICH-APS-A was developed based on a set of predictors and showed good discrimination in the overall derivation (AUROC, 0.75; 95% confidence interval, 0. Ji et al Risk Score to Predict SAP After ICH 2621In the study, we aimed to ...

Mesial temporal lobe epilepsy (MTLE) is a common epileptic disorder; little is known whether it is associated with peripheral epigenetic changes. Here we compared blood whole genomic DNA methylation pattern in MTLE patients (n = 30) relative to controls (n = 30) with the Human Methylation 450 K BeadChip assay, and explored genes and pathways that were differentially methylated using bioinformatics profiling. The MTLE and control groups showed significantly different (P < 1.03e-07) DNA methylation at 216 sites, with 164 sites involved hyper- and 52 sites hypo- methylation. Two hyper- and 32 hypo-methylated sites were associated with promoters, while 87 hyper- and 43 hypo-methylated sites corresponded to coding regions. The differentially methylated genes were largely related to pathways predicted to participate in anion binding, oxidoreductant activity, growth regulation, skeletal development and drug metabolism, with the most distinct ones included SLC34A2, CLCN6, CLCA4, CYP3A43, CYP3A4 and CYP2C9. Among the MTLE patients, panels of genes also appeared to be differentially methylated relative to disease duration, resistance to anti-epileptics and MRI alterations of hippocampal sclerosis. The peripheral epigenetic changes observed in MTLE could be involved in certain disease-related modulations and warrant further translational investigations.

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BackgroundTo study the influencing factors for different healing patterns of patients with idiopathic macular holes (IMH) after vitrectomy surgery performed with the internal limiting membrane (ILM) flap technique.MethodsThis study was a retrospective, consecutive, observational case series study. We recruited 52 IMH patients who underwent vitrectomy with the ILM flap technique. The participants were divided into 2 groups: group A (25 patients), without significant glial cell proliferation in the macular area on postoperative optical coherence tomography (OCT); and group B (27 patients), with significant glial cell proliferation. The postoperative visual acuity (VA), external limiting membrane (ELM) and ellipsoid zone (EZ) recovery characteristics were compared between the two groups.ResultsThere were statistically significant differences in minimum linear diameter (MLD) of the macular hole and postoperative VA (p = 0.02, 2.81 E-4 respectively) between the two groups. Compared with patients in group A, patients in group B had poorer VA and EZ recovery in the first 12 months after surgery, and a longer ELM recovery period. The OCT results showed that patients in group B had more extensive ILM filling in the macular area after surgery than patients in group A.ConclusionThe presence of aberrant glial cell proliferation was related to a larger MLD of the IMH, and the filling approach for the ILM during the operation was related to the postoperative healing pattern and vision acuity.

These results add to the evidence of brain metabolite differences in brains of patients with UD and BD which may be of help in differentiating these two mood disorders.