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Objectives: This study aimed to investigate the relationship between the presence of carotid arteriosclerosis (CAS) and blood pressure variability (BPV) in patients with essential hypertension. Methods:One hundred and forty four essential hypertension patients underwent ambulatory BP monitoring for 24 hours after hospitalization. Common BPV metrics were calculated. General clinical parameters, including age, gender, height, weight, history of coronary heart disease, stroke, diabetes, hypertension, smoking and drink, were recorded. Biochemical indices were obtained from a blood test. Carotid intima-media thickness (IMT) and carotid plaques were assessed to separate patients into a non-CAS group (IMT0.9 mm; n=82) and a CAS group (IMT>0.9 mm; n=62). BPV metrics and clinical parameters were analyzed and compared between the two groups.

Our study indicated that systematic inflammation and metabolites might be a pathway linking the gut microbiome with insomnia. These findings provide new insights and a better understanding of gut microbiota's role in insomnia as well as potential novel microbiome-related etiologies for insomnia.

BACKGROUND: Patent foramen ovale (PFO) and obstructive sleep apnea (OSA) are independent risk factors for young conscious stroke which may also be concomitant symptoms with it. But there is no sufficient attention on these phenomena. OBJECTIVE: To investigate the relationship between PFO, OSA and young stroke, and to look for proper treatment. METHODS: Three patients with young conscious stroke were reported, each of them was combined with PFO and OSA. All patients were diagnosed as wake-up stroke (WUS). Contrast-enhanced transcranial doppler ultrasound (c-TCD) and polysomnography (PSG) test were used for auxiliary diagnosis. RESULTS: Right-to-left shunts and moderate to severe sleep apnea were observed. Increased body mass index (BMI), hemoglobin (HGB) and hematocrit (HCT) index were also observed. After continuous positive airway pressure (CPAP) therapy, the number of microbubbles was reduced in one patient. CONCLUSIONS: These suggest that coexistence of PFO and OSA may associate with a greater risk of youth stroke. Decrease risk of stroke might occur if treating with CPAP in patients with OSA.

Objective:To investigate, in basal ganglia, the factors associated with early neurological deterioration (END) of isolated acute lacunar infarction.Methods:167 patients, in the retrospective group, with isolated acute lacunar infarction in basal ganglia, were defined by magnetic resonance imaging (MRI). The National Institutes of Health Stroke Scale (NIHSS) defined early neurological deterioration as increases of ≥ 2 within 72 hours following admission. Baseline variables predicting END were investigated with multivariate logistic regression analysis.Results:In the study, END occurred in 42 (25.15%) patients. Lesions located in posterior limb of internal capsule were independent risk factors for END (P < 0.01). Associated with END were the age of onset, history of cerebral infarction, history of diabetes, systolic blood pressure at admission and lesions of cerebral white matter. This presented significant differences (P < 0.05). With or without diabetes and different lesion location at varying layers and inter-layers, single-factor and multi-factor analysis revealed no effect on the association between positive ENT and age, history of stroke, white matter. Previous history of stroke, pathological changes of white matter, and age of onset, correlates with END which showed significant difference (P < 0.05).Conclusions:There is a close relationship between the lesion location and other related factors, such as lesions of cerebral white matter, history of cerebral infarction, history of diabetes and age, etc. and END in patients with isolated acute lacunar infarction in basal ganglia. Protective factors of END included age ≥ 65, high systolic pressure, stroke history, cerebral white matter lesions in our study.

Insomnia is a common sleep disorder of unclear etiology characterized by individuals experiencing the inability to sleep or the difficulty staying asleep. Gut-brain interaction is being explored with the intent of discerning gut microbiota and its role in many brain-related conditions including insomnia. The number and diversity of gut microbiota that colonize the digestive tract could have a significant association with insomnia, given the microbes that colonize the digestive tract integrate with and impact on the central nervous system, the immune system and multiple metabolic pathways. We aim to examine the diversity and to explore the functional impact of gut microbiota in insomniacs by examining fecal microbiome using 16S rRNA gene sequencing, serum metabolome using ultra-high-performance liquid chromatography coupled to tandem mass spectrometry (UHPLC-MS/MS), and various immune factors. Our results discover altered and distinct gut microbiota in insomniacs, with enriched Desulfovibrio, Lactobacillus and Streptococcus, and decreased abundance of Bifidobacterium, Gardnerella, Sneathia, Aerococcus and Atopobium. Non-targeted metabolomics identify 31 aberrant metabolites and implicate metabolic pathways in insomniacs. Most importantly, correlations across gut microbiome, serum metabolome and inflammatory factors are unraveled. Our study provides a better understanding of gut microbiota’s role in insomnia and new insights into potential novel etiologies for insomnia.

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