| Objective1.To study the influencing factors of post-stroke cognitive impairment in Chinese communities and the status of syndromes in Chinese medicine,analyze the influencing factors of PSCI and the distribution characteristics of TCM syndromes,and provide evidence for the early prevention and clinical syndrome research of PSCI.2.Study the serum mi RNAs expression profile phlegm-restriction type PSCI patients,to explore the pathogenesis of PSCI through the enrichment function of target genes and regulatory signal pathways;to screen out differentially expressed mi RNAs for obtaining Biomarkers with diagnostic value;To explore the correlation between mi RNAs with diagnostic value and PSCI phlegm obstructive type,provide objective evidence for molecular biology in TCM syndrome differentiation.Methods1.Investigate the residents of Hanjiadun Community Health Service Center,Highway Community Health Service Center,Baofeng Street Community Health Service Center,and Hanzheng Street Community Health Service Center Community in Qukou District of Wuhan City from April 2016 to June 2016 The subjects with different degrees of history of stroke or transient ischemic attack were selected as the study subjects.Mo CA and MMSE scales were used for cognitive function assessment and grouped into post-stroke cognitive impairment(PSCI)groups.And post-stroke cognitive normal(PSCN)group.Then,we studied the related influencing factors of post-stroke cognitive impairment in two groups of patients.Statistical analysis was used to measure the data using t-test.Count data were analyzed by chi-square test.Grade data were analyzed by single-factor logistic regression analysis and P< 0.05.The variable of entered multi-factor Logistic stepwise regression analysis to analyze the relevant influencing factors and independent influencing factors of this disease.The TCM symptom frequency distribution of the two groups of patients and the TCM symptom scores of each syndrome were compared to find out the features of the medical syndrome type.2.Through the high-throughput sequencing method,the serum mi RNA expression of PSCI patients and control group was measured,the intersection of differentially expressed mi RNA molecules in the two groups was screened,the target gene was predicted using Gene Spring12.5 software,and the known mi RNAs and new mi RNAs were detected.The predicted target genes were annotated with the KEGG biological pathway and GO gene functional enrichment to analyze the possible mechanisms of mi RNAs in the pathogenesis of PSCI.3.Select mi R-146 a and mi R-34 a from the above differential mi RNAs,increase the sample size for q RT-PCR validation,and correlate with PSCI turbid block type to determine the diagnostic value of mi R-146a and mi R-34 a in PSCI disease,and the correlation with PSCI turbid block type.Results1.The incidence of PSCI disease in this study was 39.76%.In terms of gender,the prevalence of males was 38.00%,the prevalence of females was 41.24%,and the prevalence of females was higher than that of males(P >0.05).Age,there was a significant difference between the two groups of age(P <0.05),from the perspective of the incidence of disease in each group,with an increasing trend of age,? 80 age group segment incidence decreased slightly.In terms of educational level,the PSCN group had a higher degree of junior high school education than the PSCI group,and the PSCN group had a higher overall education level(P <0.05).Among the stroke risk factors,hyperlipidemia was the influencing factor of PSCI(P <0.05).Smoking,hypertension,hyperlipidemia,diabetes,obesity,and family history of stroke were risk factors for PSCI.In the living habits,reading factors were the factors affecting the occurrence of PSCI(P <0.05),and reading and quantifying the intake of vegetables and fruits were protective factors of PSCI.A multivariate regression analysis was performed to determine the influence factors of P<0.05 in univariate analysis.It was found that age,education level,hyperlipidemia,and reading were independent influence factors of PSCI(P <0.05).Education level and reading were the protection of PSCI.factor.In the distribution of TCM syndrome frequency,the frequency of syndromes from high to low is kidney essence deficiency syndrome,phlegm obstruction syndrome,stasis syndrome,fiery internal syndrome,qi deficiency syndrome,and liver yang syndrome.Phlegm-turbidity retention card.PSCI group and PSCN group had statistically significant differences in the syndromes of kidney essence deficiency syndrome and phlegm obstruction syndrome(P <0.05),and PSCI group had kidney deficiency syndrome and phlegm obstruction syndrome in two groups.The incidence rate is high.There was no significant difference between the PSCI group and the PSCN group in other syndromes(P >0.05).The rate of single syndromes in the PSCI group was less,and the rate of composite syndromes was statistically significant compared with the control group(P <0.05).Comparing the mean scores of TCM symptom scores between the two groups,it was found that the difference between the kidney essence deficiency syndrome and the phlegm obstruction syndrome was significant(P <0.05),and there was no significant difference between other syndromes(P >0.05).2.The results of studies of serum mi RNA biomarkers in patients with PSCI showed that there were 40 differential mi RNAs(19 up-regulated,21 down-regulated)in patients with stroke(no cognitive impairment)compared to the control group,in patients with PSCI There were 43 differential mi RNAs(21 upregulations and 22 downregulations).The Venn diagram was used to count the difference mi RNAs shared by the two comparison groups and found that there were 20 common differential mi RNAs,mi R-132-5p,mi RNA-135 a,mi R-31,mi R-93,mi R-143,and mi R-146 a.mi R-5704,mi R-4639-3p,mi R-107,mi R-5572,mi R-204-3p,mi R-542-5p,mi R-155-5p,mi R-222,let-7g,mi R-126,mi R-197,mi R-29 a,mi R-451,mi RNA-34 a.The target gene functional analysis of these 20 mi RNAs revealed that the target genes of these mi RNAs are mainly concentrated in the MAPK signaling pathway,Axon guidance and other pathways.3.There was a significant positive correlation between mi R-146 a and mi R-34a(r=0.661,P =0.000).The area of ROC curve of mi R-146 a on the turbidity syndrome and kidney deficiency syndrome was 0.920,the standard error was 0.060,P =0.001,which was statistically significant.The cut-off value of mi R-146 a was 0.415,sensitivity was 80%,specificity was 90%,and it had good diagnostic value.It is suggested that when the patient's mi R-146 a level is 0.979 of the normal person's level,it can be used as an auxiliary index to diagnose the patient as a cloudiness card.The area of ROC curve of mi R-34 a to the cloudiness syndrome and kidney deficiency syndrome was 0.940,and the standard error was 0.061,P =0.001,which was statistically significant.mi R-34 a had a cut-off value of 0.106,a sensitivity of 90%,a specificity of 100%,and a good diagnostic value.It is suggested that when the patient's mi R-34 a level is 0.106 of the normal person's level,it can be used as a secondary index to diagnose the patient as a cloudiness card.Conclusion1.Age,education,hyperlipidemia,and reading are independent influencing factors of PSCI.Education level and reading are the protective factors of PSCI.Early detection and emphasis on the above factors will help reduce the prevalence rate.PSCI group and PSCN group had statistically significant differences in the syndromes of kidney essence deficiency syndrome and phlegm obstruction syndrome(P <0.05),and the PSCI group had kidney essence deficiency syndrome and phlegm blocking syndrome in the two groups.The incidence rate is high,suggesting that kidney essence deficiency syndrome and phlegm obstruction syndrome are the main syndromes of PSCI.2.This study used high-throughput sequencing technology to obtain the serum expression profile of PSCI patients for the first time,and found some mi RNAs that were abnormally expressed in PSCI patients.The target gene functional analysis of these mi RNAs revealed that the target genes of these mi RNAs are mainly concentrated in the MAPK signaling pathway,Axon guidance and other pathways.These pathways are closely related to the function of the nervous system.3.Both mi R-146 a and mi R-34 a have good clinical diagnostic value for PSCI.mi R-146 a is significantly up-regulated in the serum of PSCI patients compared with the control group.mi R-34 a is significantly down-regulated in the serum of PSCI patients compared with the control group,through q RT-PCR verification,mi R-146 a and mi R-34 a were considered to have high sensitivity and specificity and could be used as biomarkers for PSCI disease,and PSCI phlegm and blood stasis syndrome could play an auxiliary diagnostic role. |
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