Background and Purpose: Butylphtalide increases the vascular endothelial growth factor (VEGF) and decreases matrix metalloproteinase (MMP)-9 in animal models of stroke and might be of use in the management of stroke. To explore whether butylphthalide combined with conventional treatment can change the levels of MMP-9 and VEGF and the National Institutes of Health Stroke Scale (NIHSS) scores of patients with stroke.Methods: This was a prospective cohort study involving inpatients admitted to the Jiangxi Provincial People's Hospital (January–June 2019) due to acute cerebral infarction. The patients received conventional treatments with or without butylphthalide. The changes in the NIHSS scores were compared between groups. Plasma MMP-9 and VEGF were measured by enzyme-linked immunosorbent assay.Results: A total of 24 patients were included in the conventional treatment group and 46 in the butylphthalide group. The butylphthalide group showed lower MMP-9 (130 ± 59 vs. 188 ± 65, p = 0.001) and higher VEGF (441 ± 121 vs. 378 ± 70, p = 0.034) levels on day 6 compared with the conventional treatment group. The changes in MMP-9 and VEGF were significant, starting on day 3 in the butylphthalide group but on day 6 in the conventional treatment group. There were no differences between the two groups in the NIHSS scores at admission and at discharge (p > 0.05). The overall response rate was higher in the butylphthalide group compared with the conventional treatment group (63.0 vs. 37.5%, p = 0.042).Conclusion: Butylphthalide combined with conventional treatment can decrease MMP-9 levels and increase VEGF levels. The patients showed the reduced NIHSS scores, possibly suggesting some improvement in prognosis after stroke. Still, the conclusions need to be confirmed in a larger sample and in different etiological subtypes of stroke.

BackgroundLeft ventricular myocardial deformation develops dynamically when circulatory system is disturbed. What is less clear are the nature and clinical fetures of the deformation., and a consensus is yet to be reached for an ideal treatment plan. This study aims to explore the development of left ventricular myocardial deformation in septic patients by observing the serial changes in three- and two-dimensional strain parameters.Methods In this single-centered, prospective, and observational study, we eventually included 103 patients diagnosed with sepsis or septic shock at the intensive care unit (ICU) from December 2020 until December 2021. Demographic data, medicine, laboratory and ultrasound values were collected and measured on the 1st, 2nd, 3rd, 5th, 7th and 10th days after sepsis or septic shock. A total of 88 adult patients for 2D-STE and 3D-STE were divided into two groups according to their wall motion status: the non-hypokinetics group and the secondary hypokinesia group. Results Patients underwent both 3D and 2D echocardiography to evaluate left ventricular function. Comparison of four time points between the two groups showed that 2D-LVEF demonstrated a progressive, stepwise improvement each time point assessed (Ptime=0.033, Pgroup=0.041, respectively). Although 3D-LVEF slightly underestimated the LV volumes at each time point, it displayed a same changing tendency during the 10 days (Ptime=0.002, Pgroup=0.011, respectively). Then, we used both 3D and 2D STE to observe left ventricular myocardial function and validated the applicability and feasibility of 3D-STE: 2D-LVGLS Ptime=0.000, Pgroup=0.018, respectively, 2D-LVGCS Ptime=0.000, Pgroup=0.332 respectively; 3D-LVGLS Ptime=0.000, Pgroup=0.391, respectively, 3D-LVGCS Ptime=0.022, Pgroup=0.362 respectively. The level of strain first decreased and then increased in these two groups during hospitalization, but both 3D and 2D strain imaged at the 10th day assessed were lower compared to that of normal healthy people. Moreover, 3D-LVGLS had a stronger correlation with 2D- LVGLS (r=0.772, P＜0.0001).ConclusionPatients with sepsis or septic shock demonstrated improvement of LV myocardial function during hospitalization, but their myocardial function was not fully recovered to normal on the 10th day. Both 3D and 2D LVGLS could quickly detect changes of patients with covert septic myocardial dysfunction, whereas LVEF could not.