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Wu D, Nie J, Lin H, Zhang D, Ye Z, Zhang W, Xiao J. Characteristics and predictors of low-grade renal artery stenosis in female patients with CKD. Clin Exp Hypertens 2023; 45:2175849. [PMID: 36823499 DOI: 10.1080/10641963.2023.2175849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
AIM Renal artery stenosis (RAS) is an important cause of chronic kidney disease (CKD). The main purpose of this study was to explore the clinical characteristics and predictors of low-grade RAS in female patients with CKD. METHODS One hundred and five female CKD patients from Huadong Hospital affiliated with Fudan University who underwent 3 T non-contrast renal artery magnetic resonance angiography (MRA) were analyzed. Basic statistics methods were used in the study, such as independent-sample t test,non-parametric test, binary logistic regression analysis and ROC analysis. RESULTS In this cross-sectional study, there were 50 patients with RAS and 55 without RAS (47.6% versus 52.4%). Binary logistic regression analysis demonstrated that low-level ALB and lymphocyte count, high-level SP, BUN and NLR were independent risk factors for low-grade RAS in female patients with CKD. ROC analysis indicated that eGFR, FeNa and UBCR, ALB, lymphocyte count and NLR had the best predictive value for low-grade RAS, especially eGFR with a sensitivity of 65.50% and specificity of 72.00% and FeNa with a sensitivity of 71.10% and specificity of 72.20% and BUCR with a sensitivity of 71.10% and specificity of 68.10%. CONCLUSION In female patients with CKD, FeNa, eGFR, ALB, UBCR, lymphocyte count and NLR may be good predictors of low-grade RAS, especially eGFR, FeNa and BUCR.
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Affiliation(s)
- Deping Wu
- Department of Nephrology, Huadong Hospital Affiliated to Fudan University, Shanghai, P.R. China.,Shanghai Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, P.R. China
| | - Jinli Nie
- Department of Nephrology, Huadong Hospital Affiliated to Fudan University, Shanghai, P.R. China
| | - Huagang Lin
- Department of Nephrology, Huadong Hospital Affiliated to Fudan University, Shanghai, P.R. China.,Shanghai Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, P.R. China
| | - Dexian Zhang
- Department of Nephrology, Huadong Hospital Affiliated to Fudan University, Shanghai, P.R. China
| | - Zhibin Ye
- Department of Nephrology, Huadong Hospital Affiliated to Fudan University, Shanghai, P.R. China
| | - Wan Zhang
- Department of Vascular Surgery, Huadong Hospital Affiliated to Fudan University, Shanghai, P.R. China
| | - Jing Xiao
- Department of Nephrology, Huadong Hospital Affiliated to Fudan University, Shanghai, P.R. China.,Shanghai Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, P.R. China
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Zhao J, Feng J, Ma Q, Li C, Qiu F. Prognostic value of inflammation biomarkers for 30-day mortality in critically ill patients with stroke. Front Neurol 2023; 14:1110347. [PMID: 36814998 PMCID: PMC9939760 DOI: 10.3389/fneur.2023.1110347] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/18/2023] [Indexed: 02/08/2023] Open
Abstract
Objective To explore the values of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), neutrophil to albumin ratio (NAR), prognostic nutritional index (PNI), systemic immune inflammatory index (SII) and red cell distribution width to albumin ratio (RA) for evaluating the risk of 30-day mortality of ischemic stroke or hemorrhagic stroke patients. Methods In this cohort study, the data of 1,601 patients diagnosed with stroke were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database. Among them, 908 were hemorrhagic stroke patients and 693 were ischemic stroke patients. Demographic and clinical variables of patients were collected. Univariate and multivariable Cox regression were performed to evaluate the predictive values of NLR, PLR, SII, NAR, RA, and PNI for 30-day mortality in hemorrhagic stroke or ischemic stroke patients. The receiver operator characteristic (ROC) curves were plotted to assess the predictive values of NLR, NAR, and RA for 30-day mortality of hemorrhagic stroke patients. Results At the end of follow-up, 226 hemorrhagic stroke patients and 216 ischemic stroke patients died. The elevated NLR level was associated with increased risk of 30-day mortality in hemorrhagic stroke [hazard ratio (HR) = 1.17, 95% confidence interval (CI): 1.06-1.29]. The increased NAR level was associated with elevated risk of 30-day mortality in hemorrhagic stroke (HR = 1.16, 95% CI: 1.02-1.30). The high RA level was linked with increased risk of 30-day mortality (HR = 1.44, 95% CI: 1.23-1.69). No significant correlation was observed in these inflammation biomarkers with the risk of 30-day mortality in ischemic stroke patients. The area under the curves (AUCs) of NLR, RA, and NAR for evaluating the risk of 30-day mortality of hemorrhagic stroke patients were 0.552 (95% CI: 0.503-0.601), 0.644 (95% CI: 0.590-0.699) and 0.541 (95% CI: 0.490-0.592). Conclusion NLR, NAR, and RA were potential prognostic biomarkers for predicting 30-day mortality of hemorrhagic stroke patients, which might provide clinicians an easy and cheap way to quickly identify patients with high risk of mortality.
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Affiliation(s)
- Jun Zhao
- Senior Department of Neurology, The First Medical Center of PLA General Hospital, Beijing, China
| | - Jinli Feng
- Senior Department of Neurology, The First Medical Center of PLA General Hospital, Beijing, China
| | - Qian Ma
- Senior Department of Neurology, The First Medical Center of PLA General Hospital, Beijing, China
| | - Chunlin Li
- Department of Health Medicine, The Eighth Medical Center of PLA General Hospital, Beijing, China,Chunlin Li ✉
| | - Feng Qiu
- Senior Department of Neurology, The First Medical Center of PLA General Hospital, Beijing, China,*Correspondence: Feng Qiu ✉
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Li Y, An D, Xie X, Dong Y. The relationship between neutrophil-to-lymphocyte ratio and cerebral collateral circulation in patients with symptomatic severe intracranial artery stenosis or occlusion. J Clin Neurosci 2023; 108:13-18. [PMID: 36565522 DOI: 10.1016/j.jocn.2022.10.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 10/11/2022] [Accepted: 10/24/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND The neutrophil/lymphocyte ratio (NLR) has been considered a prognostic indicator for determining the systemic inflammatory response and atherosclerosis. We aimed to determine the relationship between NLR and the development of cerebral collateral circulation in patients with symptomatic severe stenosis or occlusion of intracranial arteries. METHODS All patients underwent digital subtraction angiography (DSA) within 14 days of admission and were divided into a group with good collateral circulation (77 patients) and a group with poor collateral circulation (86 patients) according to the DSA collateral compensation grading method. Apo B, total cholesterol, LDL, and Neutrophil count in the poor side branch group were significantly higher than in the good side branch group. Multifactorial analysis showed that high NLR levels were a valid predictor of poor collateral circulation in patients with symptomatic severe intracranial artery stenosis or occlusion. Spearman correlation analysis showed that the size of the collateral branch score was negatively correlated with NLR (r = -0.509, P < 0.001) and cholesterol content (r = -0.249, P = 0.002). NLR predicted poor collateral circulation with an AUC of 0.620 (sensitivity 66.7 %, specificity 61.3 %, 95 % CI = 0.517-0.723,P < 0.05). CONCLUSION We demonstrate a correlation between NLR levels and the development of collateral circulation in the brain in patients with symptomatic severe stenosis or occlusion of the intracranial arteries.
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Affiliation(s)
- Yao Li
- Department of Neurology, Hebei General Hospital, Shijiazhuang, China; Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, China
| | - Dongxia An
- Department of Neurointervention, Beijing Fengtai Youanmen Hospital, Beijing, China; Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, China
| | - Xiaohua Xie
- Department of Neurology, Hebei General Hospital, Shijiazhuang, China; Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, China
| | - Yanhong Dong
- Department of Neurology, Hebei General Hospital, Shijiazhuang, China; Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, China.
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Microbiota-immune-brain interactions: A lifespan perspective. Curr Opin Neurobiol 2023; 78:102652. [PMID: 36463579 DOI: 10.1016/j.conb.2022.102652] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 10/10/2022] [Accepted: 10/31/2022] [Indexed: 12/03/2022]
Abstract
There is growing appreciation of key roles of the gut microbiota in maintaining homeostasis and influencing brain and behaviour at critical windows across the lifespan. Mounting evidence suggests that communication between the gut and the brain could be the key to understanding multiple neuropsychiatric disorders, with the immune system coming to the forefront as an important mechanistic mediator. Throughout the lifespan, the immune system exchanges continuous reciprocal signals with the central nervous system. Intestinal microbial cues alter immune mediators with consequences for host neurophysiology and behaviour. Several factors challenge the gut microbiota composition, which in response release molecules with neuro- and immuno-active potential that are crucial for adequate neuro-immune interactions. In this review, multiple factors contributing to the upkeep of the fine balance between health and disease of these systems are discussed, and we elucidate the potential mechanistic implications for the gut microbiota inputs on host brain and behaviour across the lifespan.
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Yan L, Xu D, Xiao Y, Dai M, Wang T, Zhuang X, Wu K. Genetic Polymorphism of NQO1 Gene is Associated with Susceptibility of Ischemic Stroke in Chinese Han Nationality. Neuropsychiatr Dis Treat 2022; 18:2211-2217. [PMID: 36196359 PMCID: PMC9527027 DOI: 10.2147/ndt.s379742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 09/14/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE NAD(P)H: Quinone Oxidoreductase 1 gene (NQO1) polymorphism is associated with the risk of cardiovascular disease. This study was designed to investigate the relationship between NQO1 gene polymorphism and ischemic stroke susceptibility in Chinese Han nationality. PATIENTS AND METHODS One hundred and forty-one patients diagnosed with ischemic stroke and 139 matched control groups were recruited in this study. The polymorphism distribution of rsl800566 locus and rs10517 locus of NQO1 gene was genotyped via TaqMan assay, and the concentration of Oxidized low-density lipoprotein (ox-LDL) in the blood of the subjects was detected by enzyme linked immunosorbent assay (ELISA). The relationship between the polymorphism distribution and the susceptibility to ischemic stroke was evaluated. RESULTS The frequency distribution of the three genotypes of NQO1 rs1800566 between the case group and the control group was statistically significant, and cases carrying CT and TT genotype were less likely to suffer from ischemic stroke. Compared with individuals carrying T allele, C allele carriers have higher risk of ischemic stroke. However, there was no significant difference in frequency distribution among the three genotypes of NQO1 rs10517 between controls and patients. CONCLUSION The NQO1 rs1800566 C allele may be a novel marker associated with ischemic stroke susceptibility in Chinese Han population. Polymorphism of rsl800566 locus in NQO1 gene may be protective against ischemic stroke risk.
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Affiliation(s)
- Limin Yan
- Department of Neurology, The Second Affiliated Hospital of Hainan Medical University, Haikou, People's Republic of China
| | - Dedong Xu
- Department of Neurosurgery, The Second Affiliated Hospital of Hainan Medical University, Haikou, People's Republic of China
| | - Ying Xiao
- Department of Neurology, The Second Affiliated Hospital of Hainan Medical University, Haikou, People's Republic of China
| | - Mingming Dai
- Department of Neurology, The Second Affiliated Hospital of Hainan Medical University, Haikou, People's Republic of China
| | - Ting Wang
- Department of Neurology, The Second Affiliated Hospital of Hainan Medical University, Haikou, People's Republic of China
| | - Xinhong Zhuang
- Department of Nephrology, The Second Affiliated Hospital of Hainan Medical University, Haikou, People's Republic of China
| | - Kunliang Wu
- Department of Infectious Diseases, The Second Affiliated Hospital of Hainan Medical University, Haikou, People's Republic of China
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Ying Y, Yu F, Luo Y, Feng X, Liao D, Wei M, Li X, Huang Q, Liu Z, Zhang L, Zhao T, Tu R, Xia J. Neutrophil-to-Lymphocyte Ratio as a Predictive Biomarker for Stroke Severity and Short-Term Prognosis in Acute Ischemic Stroke With Intracranial Atherosclerotic Stenosis. Front Neurol 2021; 12:705949. [PMID: 34393983 PMCID: PMC8360230 DOI: 10.3389/fneur.2021.705949] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 07/05/2021] [Indexed: 01/30/2023] Open
Abstract
Background: Neutrophil-to-lymphocyte ratio (NLR) is an indicator of poor prognosis in acute ischemic stroke (AIS), but associations between NLR with stroke severity and prognosis of intracranial atherosclerotic stenosis (ICAS)-related ischemic events have not been well-elucidated; therefore, we aimed to evaluate whether admission NLR levels correlate with the early stroke severity and short-term functional prognosis in patients with symptomatic intracranial atherosclerotic stenosis (sICAS). Methods: This retrospective study enrolled 899 consecutive patients with AIS attributed to ICAS at Xiangya Hospital stroke center between May 2016 and September 2020. The initial stroke severity was rated by the admission National Institutes of Health Stroke Scale (NIHSS) scores, and the short-term prognosis was evaluated using the 14-day modified Rankin Scale (mRS) scores after stroke onset. A severe stroke was defined as NIHSS >8; an unfavorable functional outcome was defined as mRS scores of 3-6. Admission NLR was determined based on circulating neutrophil and lymphocyte counts. Results: The median admission NLR of all patients was 2.80 [interquartile range (IQR), 2.00-4.00]. In univariate analysis, admission NLR was significantly elevated in patients with severe stroke and poor short-term prognosis. After multivariate adjustment, admission NLR levels were significantly correlated with severe stroke [odds ratio (OR), 1.132; 95% confidence interval (95% CI), 1.038-1.234; P = 0.005] and unfavorable short-term prognosis (OR, 1.102; 95% CI, 1.017-1.195; P = 0.018) in Model 1. In Model 2, the highest NLR tertile (≥3.533) remained an independent predictor of severe stroke (OR, 2.736; 95% CI, 1.590-4.708; P < 0.001) and unfavorable functional outcome (OR, 2.165; 95% CI, 1.416-3.311; P < 0.001) compared with the lowest NLR tertile (<2.231). The receiver operating characteristic (ROC) curves showed the predictability of NLR regarding the stroke severity [area under the curve (AUC), 0.659; 95% CI, 0.615-0.703; P < 0.001] and short-term prognosis (AUC, 0.613; 95% CI, 0.575-0.650; P < 0.001). The nomograms were constructed to create the predictive models of the severity and short-term outcome of sICAS. Conclusions: Elevated admission NLR levels were independently associated with the initial stroke severity and could be an early predictor of severity and poor short-term prognosis in AIS patients with ICAS, which might help us identify a target group timely for preventive therapies.
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Affiliation(s)
- Yuanlin Ying
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Fang Yu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Yunfang Luo
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Xianjing Feng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Di Liao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Minping Wei
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Xi Li
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Qin Huang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Zeyu Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Lin Zhang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Tingting Zhao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Ruxin Tu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Jian Xia
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.,Clinical Research Center for Cerebrovascular Disease of Hunan Province, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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Gao B, Pan W, Hu X, Huang H, Ren J, Yang C, Zhou X, Zeng T, Hu J, Li S, Gao Y, Zhang S, Chen G. Neutrophil-Related Ratios Predict the 90-Day Outcome in Acute Ischemic Stroke Patients After Intravenous Thrombolysis. Front Physiol 2021; 12:670323. [PMID: 34276399 PMCID: PMC8283126 DOI: 10.3389/fphys.2021.670323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 05/26/2021] [Indexed: 11/25/2022] Open
Abstract
Background and Purpose Mounting researches have illuminated that the neutrophil-related ratios were related to the prognosis of acute ischemic stroke (AIS). However, few have compared their predictive value and accuracy. To make such comparison and identify the best indicator on the 90-day outcome, we investigated biomarkers including neutrophil ratio (Nr), neutrophil count (Nc), lymphocyte (L), neutrophil-to-lymphocyte ratio (NLR), platelet (P or PLT), platelet-to-neutrophil ratio (PNR), NLR-to-platelet ratio (NLR/PLT), eosinophil (E), neutrophil-to-eosinophil ratio (NER), monocyte (M), and monocyte-to-neutrophil ratio (MNR). Methods This retrospective study recruited 283 AIS and 872 healthy controls (HCs) receiving intravenous thrombolysis (IVT). Blood samples were collected after 24 h of admission before IVT. Propensity Score Matching (PSM) was used to explore whether these ratios differentiated AIS and HCs. We applied univariate and multivariate analyses to evaluate the prediction effect of these ratios separately or added in the model and figured out a clinical prediction model. To estimate the discrimination and calibration of the new models, the receiver operating characteristics (ROC) curve analysis, DeLong method, and likelihood ratio test (LR test) were utilized. Results PSM showed that Nr, Nc, NLR, P, PNR, NLR/PLT, NER, and MNR facilitates the differentiation of the HCs and AIS. Among the eight biomarkers, PNR and MNR could differentiate the 90-day outcome, and it was found out that PNR performed better. Univariate regression analysis demonstrated that PNR was the only independent predictor which needs no adjustment. Besides, the multivariate regression analysis, Delong method, and LR test indicated that among the neutrophil-related ratios, NLR, PNR, NLR/PLT, NER, and MNR exerted little influence on the discrimination but could enhance the calibration of the base model, and NER proved to work best. Conclusion Low PNR was the best indicator among the neutrophil-related ratios tin predicting a poor 90-day outcome of AIS patients. Moreover, high NER performed best when predicting the 90-day outcome to improve the calibration of the base model.
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Affiliation(s)
- Beibei Gao
- Department of Internal Medicine, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Wenjing Pan
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Xueting Hu
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Honghao Huang
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Junli Ren
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Chenguang Yang
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Xinbo Zhou
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Tian Zeng
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Jingyu Hu
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Shengqi Li
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Yufan Gao
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Shunkai Zhang
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Guangyong Chen
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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