ObjectiveTo investigate the expression and clinical significance of serum family with sequence similarity 19 member 5(FAM19A5) and interleukin 34(IL-34) in patients with vascular cognitive impairment(VCI).MethodsOne hundred and twenty-five non-demented vascular cognitive impairment in non-dementia(VCIND) patients admitted to the Department of Neurology of Baotou Central Hospital(VCIND group) and 58 physically examined healthy people in the same time period(control group) were selected from January 2020 to December 2022, and the patients in the VCIND group were classified into the VaD subgroup(45 cases) and the non-VaD subgroup(80 cases) according to whether they progressed to vascular dementia(VaD) in the one year follow up. Serum FAM19A5 and IL-34 levels were measured by enzyme linked immunosorbent assay. The factors of VCIND progression to VaD were analyzed by multifactorial logistic regression, and the predictive energy efficiency of serum FAM19A5 and IL-34 levels on the progression of VCIND to VaD was analyzed by ROC curve.ResultsCompared with the control group, serum FAM19A5 levels were increased and IL-34 levels were decreased in the VCIND group(t=19.808, 15.706, all P<0.001). At 1 year follow up, the incidence of VaD in 125 VCIND patients was 36.00%(45/125). Serum FAM19A5 levels were increased and IL-34 levels were decreased in the VaD subgroup compared with the non-VaD subgroup(t=7.100, 5.952, all P<0.001). Increased age(OR=1.137, 95%CI:1.014 to 1.275) and elevated FAM19A5(OR=1.079, 95%CI: 1.040 to 1.119) were independent risk factors for progression of VCIND to VaD, and increased Montreal Cognitive Assessment Scale score(OR=0.603, 95%CI: 0.437 to 0.832) and elevated IL-34(OR=0.737, 95%CI: 0.624 to 0.870) were independent protective factors(P<0.05). The area under the curve for the combined prediction of VCIND progression to VaD by serum FAM19A5 and IL-34 levels was 0.880, which was greater than the 0.813 and 0.781 predicted by serum FAM19A5 and IL-34 levels individually(t=2.529 and 2.855, all P<0.05).ConclusionElevated serum FAM19A5 levels and decreased IL-34 levels were strongly associated with the progression of VCIND to VaD, and the combination of serum FAM19A5 and IL-34 levels had high predictive efficacy for the progression of VCIND to VaD.

ObjectiveTo investigate the effect of Xuebijing in treating N methyl D aspartate receptor(NMDAR) encephalitis and the changes of helper T cell 1(Th1)/Th2 immune response.MethodsOne hundred and twenty patients with anti-NMDAR encephalitis admitted to the Department of Neurology of the Second Affiliated Hospital of Hainan Medical University from January 2021 to December 2023 were selected and divided into observation group(60 cases) and control group(60 cases) by random number table method. The control group was treated with plasma exchange, and the observation group was treated with Xuebijing on the basis of the control group. The course of treatment was 10 days. The clinical efficacy, mental improvement and symptom improvement time, relevant cytokine levels, prognosis and overall incidence of adverse reactions, changes in T lymphocyte subsets(CD3+, CD4+, CD4+/CD8+), Th1[interferon-γ(IFN-γ), tumor necrosis factor-α(TNF-α)] and Th2 [interleukin-6(IL-6), interleukin-4(IL-4)] before and after treatment were compared between the two groups.ResultsThere was no significant difference in clinical efficacy between the two groups(P>0.05). The time of mental improvement and symptom improvement in the observation group was shorter than that in the control group(t/P=3.935/<0.001,3.720/<0.001). After treatment, the levels of CD3+, CD4+and CD4+/CD8+in the observation group were higher than those in the control group(t/P=3.017/0.003, 5.062/<0.001, 3.211/0.002). After treatment, the levels of IFN-γ, TNF-α and IL-6 in the observation group were lower than those in the control group, and IL-4 was higher than that in the control group(t/P=4.911/<0.001, 4.489/<0.001, 3.289/0.001, 4.191/<0.001). there="" was="" no="" statistically="" significant="" difference="" in="" prognosis="" and="" total="" incidence="" of="" adverse="" reactions="" between="" the="" two="" p="">0.05).ConclusionXuebijing can effectively improve symptoms and regulate immune function in patients with anti-NMDAR encephalitis, which may be related to the improvement of Th1/Th2 balance, and the safety is good.

ObjectiveTo explore the impact of ceftriaxone and compound sulfamethoxazole on the therapeutic outcomes and levels of inflammatory markers in the cerebrospinal fluid of patients suffering from neuroborreliosis accompanied by fever.MethodsFrom August 2021 to December 2023, 88 patients diagnosed with neuroborreliosis were admitted to our hospital and divided randomly into two groups: the standard treatment group(n=44) and the combined treatment group(n=44). Both groups received a treatment regimen consisting of rifampicin and doxycycline. Additionally, ceftriaxone sodium was administered to the standard treatment group, while the combined treatment group received compound sulfamethoxazole. Treatment was carried out continuously for a duration of 6 weeks. A comparative analysis was conducted on the demographic characteristics of the patients in the two groups, changes in abnormal symptoms and signs, as well as variations in blood routine and biochemical indexes and cerebrospinal fluid inflammatory markers before and after treatment. Furthermore, the study also assessed the treatment response rates and the occurrence of adverse events in both groups.ResultsThe overall treatment efficacy in the combined therapy group reached 97.73%, surpassing significantly the efficacy observed in the standard treatment group(84.09%, χ2/P=4.950/0.026). Post-treatment, the mean values of erythrocyte sedimentation rate(ESR), serum C reactive protein(CRP), and procalcitonin(PCT) in the combined therapy group exhibited a significant decline compared to baseline levels and standard treatment group(t/P=5.342/<0.001, 5.654/<0.001, 5.543/<0.001). Furthermore, the average concentrations of interleukin-10(IL-10), tumor necrosis factor-α(TNF-α), and interferon gamma(IFN-γ) in the cerebrospinal fluid of the combined therapy group were markedly lower post-treatment than those in the pre-treatment and standard treatment groups(t/P=4.273/<0.001, .="" there="" was="" no="" discernible="" difference="" in="" the="" total="" incidence="" of="" adverse="" reactions="" between="" two="" vs.="" p="">0.05).ConclusionThe use of a combination of three drugs that include sulfamethoxazole has shown to be beneficial in alleviating the abnormal symptoms and signs in patients suffering from neuroborreliosis and fever. Furthermore, this regimen has demonstrated efficacy in reducing the levels of inflammatory factors in the cerebrospinal fluid, thereby enhancing the overall clinical outcomes. Compared to traditional treatments, the triple therapy has a lower incidence of adverse reactions, making it a safe and effective option with promising prospects for clinical applications.

ObjectiveTo investigate the features of vascular endothelial growth factor(VEGFs) and matrix metalloproteinase(MMPs) concentrations in postoperative individuals with intracranial aneurysms and their prognostic predictive value.MethodsDuring the period from December 2021 to December 2023, a total of 121 patients diagnosed with intracranial aneurysms were enrolled in our hospital and categorized into either the favorable prognosis group(n=92) or the unfavorable prognosis group(n=29). Comparative analyses were conducted to explore the distinctions in general clinical characteristics as well as the levels of serum VEGFs and MMPs expressions between these two groups. The study utilized Spearman correlation test and binary Logistic regression analysis to discover the potential risk factors linked to unfavorable postoperative results in individuals diagnosed with intracranial aneurysms. Moreover, the effectiveness of these risk factors in predicting the probability of an unfavorable postoperative outcome was evaluated through the receiver operating characteristic(ROC) curve analysis.ResultsThe average serum levels of VEGF-1, VEGF-2, MMP-1, MMP-2, and MMP-9 were also significantly elevated in the poor prognosis group compared to the good prognosis group(t/P=4.455/<0.001, 3.982/<0.001, 4.848/<0.001, 5.702/<0.001, 5.144/<0.001). Spearman correlation analysis revealed a positive correlation between age, diabetes mellitus, and serum levels of VEGF-1, VEGF-2, MMP-1, MMP-2, and MMP-9 with poor prognosis among postoperative patients with intracranial aneurysms(r/P=0.338/<0.001, 0.361/<0.001, 0.383/<0.001, 0.386/<0.001, 0.331/<0.001). Additionally, multivariate Logistic regression analysis indicated that serum VEGF-1, VEGF-2, MMP-1, MMP-2, and MMP-9 were identified as pivotal risk factors for poor prognosis in patients with intracranial aneurysms post operation [OR(95%CI)=1.142(1.011-1.372), 1.126(1.004-1.276), 1.027(1.002-1.052), 1.029(1.006-1.052), 1.026(1.006-1.047)]. The AUC values for serum VEGF-1, VEGF-2, MMP-1, MMP-2, MMP-9 levels independently predicting poor prognosis in patients after intracranial aneurysm surgery were 0.729, 0.744, 0.759, 0.761, and 0.724 respectively, with a combined prediction AUC of 0.890. The efficacy of the combined prediction was greater than that of each individual marker(Z/P=4.344/<0.001, 4.185/<0.001, 4.013/<0.001, 4.010/<0.001, 4.350/<0.001).ConclusionThe correlation between serum VEGFs and MMPs expression levels in postoperative intracranial aneurysm patients and poor prognosis is significant. Developing a predictive model incorporating these markers holds clinical importance in early assessment and prompt intervention for this patient population, ultimately enhancing outcomes. Furthermore, such a model represents a promising biological target for future therapeutic strategies.

ObjectiveTo investigate the correlation between serum levels of CC chemokine ligand 18(CCL18) and soluble triggering receptor expressed on myeloid cell 1(sTLT-1) in patients with coronary heart disease and the severity of coronary artery disease.MethodsFrom June 2022 to June 2023, 110 patients with coronary heart disease who underwent percutaneous coronary angiography Department of cardiology, the First Affiliated Hospital of Henan University of Science and Technology were gathered as the coronary heart disease group, the SYNTAX score was applied to assess the severity of coronary artery disease, and patients were separated into mild subgroup(54 cases), moderate subgroup(37 cases), and severe subgroup(19 cases), Another 110 cases of health checkups in hospitals in the same period were selected as the healthy control group. Enzyme linked immunosorbent assay(ELASA) was applied to detect the expression levels of serum CCL18 and sTLT-1; Spearman method was applied to analyze the correlation between serum CCL18, sTLT-1 levels and the severity of coronary artery disease; Logistic regression was applied to analyze the influencing factors of the severity of coronary artery disease; receiver operating characteristic(ROC) curve was applied to evaluate the diagnostic value of serum CCL18 and sTLT-1 levels for moderate to severe coronary artery disease.ResultsThe serum levels of CCL18 and sTLT-1 in the coronary heart disease group were obviously higher than those in the control group(t/P=7.505/<0.001, 8.537/<0.001). As the degree of coronary artery disease increased, serum CCL18 and sTLT-1 levels increased sequentially in the mild, moderate, and severe subgroups of patients with coronary artery disease(F/P=24.542/<0.001, 28.067/<0.001). There was a positive correlation between serum CCL18, sTLT-1 levels and both with the severity of coronary artery lesions(r/P=0.486/<0.001, 0.391/<0.001). Multifactorial Logistic regression analysis showed that elevated CCL18 and elevated sTLT-1 were independent risk factors for the severity of coronary artery lesions [OR(95%CI)=2.376(1.169-4.830), 2.695(1.494-4.862)]; the AUCs of serum CCL18 and sTLT-1 levels and the combination of the two for the diagnosis of moderate to severe coronary artery disease were 0.748, 0.721, and 0.813, respectively, and the AUCs of the combination of the two were greater than the AUCs of serum CCL18 and sTLT-1, each of which was diagnosed alone(Z/P=2.139/0.032, 2.248/0.025).ConclusionSerum CCL18 and sTLT-1 levels were significantly elevated in patients with coronary artery disease, and both were associated with the severity of coronary artery lesions.