Objective To investigate the clinical effect of Fuxin Heji Decoction combined with metoprolol succinate
sustained release tablets in the treatment of coronary artery myobridge angina． Methods From February 2020 to April 2022，92 patients with angina pectoris of coronary artery muscle bridge were selected from the Department of Cardiology of the Affilia-ted Hospital of Shandong University of Traditional Chinese Medicine，Guang＇anmen Hospital of the Chinese Academy of Tradi-tional Chinese Medicine and Beijing Anzhen Hospital of the Capital Medical University． They were divided into the controlgroup and the observation group according to the random number table method，with 46 patients in each group． The controlgroup was treated with metoprolol succinate sustained-release tablets，and the observation group was treated with Fuxin Heji Chin J Diffic and Compl Cas，March 2023，Vol． 22，No． 3Decoction on the basis of the control group，The clinical effects of the two groups were observed，including the score of TCMsyndromes，the index of treadmill exercise electrocardiogram ( the time of angina pectoris during exercise，the time of ST seg-ment moving down 0． 1 mV) ，the score of the Seattle Angina Scale ( SAQ) ，the vascular endothelial function ( serum endothe-lin ( ET-1) ，nitric oxide ( NO) ，and the vascular endothelial function index ( ＲHI) before and after treatment． Ｒesults Af-ter 2 months of treatment，the total effective rate of the observation group was significantly higher than that of the control group( 89． 13% vs 76． 09% ，χ2 / P = 7． 568 /0． 023) ． After 2 months of treatment，the scores of chest tightness or chest pain，short-
ness of breath，insomnia，and anorexia in the two groups were lower than those before treatment，and the observation groupwas lower than the control group ( t / P = 3． 318 /0． 001，4． 511 / ＜ 0． 001，2． 209 /0． 030，2． 142 /0． 035) ． After 2 months oftreatment，the time of exercise angina pectoris，the time of movement ST segment downward 0． 1 mV，and the SAQ score ( thedegree of physical activity restriction，the stable state of angina pectoris，the incidence of angina pectoris，the degree of treat-ment satisfaction，and the degree of disease cognition) in the two groups were higher than those before treatment，and the ob-servation group was higher than the control group ( t / P = 4． 715 / ＜ 0． 001，6． 736 / ＜ 0． 001，2． 844 /0． 006，2． 293 /0． 024，3．
190 /0． 002，6． 084 / ＜ 0． 001，2． 229 /0． 028) ． After 2 months of treatment，the level of ET-1 in both groups was lower thanthat before treatment，and the level of NO and ＲHI index were higher than those before treatment，and the observation groupwas better than the control group ( t / P = 8． 213 / ＜ 0． 001，3． 073 /0． 003，2． 472 /0． 015) ． Conclusion Fuxin Heji Decoction combined with metoprolol succinate sustained-release tablets has a significant clinical effect on patients with coronary artery myobridge angina．

Objective To analyze the relationship between serum platelet endothelial cell adhesion molecule-1 ( PE-
CAM-1) ，growth differentiation factor 11 ( GDF11) ，fibroblast growth factor 21 ( FGF21) and cerebral artery hemodynamicsand carotid atherosclerosis in patients with lacunar cerebral infarction． Methods From January 2020 to January 2022，160patients with lacunar cerebral infarction admitted to the Department of Neurology of Shaanxi Provincial People＇s Hospital were
selected as the cerebral infarction group，and were divided into carotid atherosclerosis subgroup and normal carotid artery sub-group according to carotid artery intima-media thickness ( IMT) ． In addition，100 patients with health examination at the sametime were selected as the healthy control group，and the serum PECAM-1，GDF11，FGF21 levels and cerebral artery hemody-· Chin J Diffic and Compl Cas，March 2023，Vol． 22，No． 3namic parameters of the two groups were compared，Pearson linear correlation was used to analyze the correlation between ser-
um PECAM-1，GDF11，FGF21 and cerebral artery hemodynamic parameters in patients with lacunar infarction． Logistic multifactor regression was used to analyze the influencing factors of carotid atherosclerosis in patients with lacunar cerebral infarc-tion，and the receiver operating characteristic curve ( ＲOC) was drawn to analyze the diagnostic value of serum PECAM-1，GDF11，FGF21 levels for carotid atherosclerosis． Ｒesults Serum PECAM-1 and FGF21 in cerebral infarction group werehigher than those in healthy control group，and serum GDF11 was lower than that in healthy control group ( t = 8． 386，17．511，6． 795，P ＜ 0． 001) ． The pulsation index of middle cerebral artery and basilar artery in cerebral infarction group washigher than that in healthy control group ( t = 16． 928，7． 686，P ＜ 0． 001) ． The levels of serum PECAM-1 and FGF21 in pa-tients with lacunar infarction were positively correlated with the pulsation index of middle cerebral artery and basilar artery( PECAM-1: r = 0． 537，0． 462，P ＜ 0． 001; FGF21: r = 0． 569，0． 503，P ＜ 0． 001) ，while the levels of serum GDF11 werenegatively correlated with the pulsation index of middle cerebral artery and basilar artery ( r = － 0． 512， － 0． 498，P ＜ 0．001) ． Logistic regression analysis showed that hypertension history，high low-density lipoprotein cholesterol ( LDL-C) ，highPECAM-1，and high FGF21 were risk factors for carotid atherosclerosis in patients with lacunar cerebral infarction ［OＲ ( 95%CI) = 3． 654 ( 1． 601 － 8． 343) ，2． 481 ( 1． 508 － 4． 085) ，1． 073 ( 1． 032 － 1． 114) ，1． 024 ( 1． 011 － 1． 038) ，P ＜ 0． 01］，and high serum high-density lipoprotein cholesterol ( HDL-C) High GDF11 was the protective factor ［OＲ ( 95% CI) = 0． 781( 0． 613 － 0． 995) ，0． 992 ( 0． 987 － 0． 997) ，P ＜ 0． 05］． ＲOC curve showed that the area under the curve ( AUC) of serumPECAM-1，GDF11，FGF21 and their combined assessment of the risk of carotid atherosclerosis were 0． 798，0． 716，0． 813，0． 909，respectively，and their combined assessment efficiency was higher than that predicted by single index ( Z / P = 2． 097 /0． 036，2． 290 /0． 022，2． 005 /0． 045) ． Conclusion Serum PECAM-1，GDF11，FGF21 levels in patients with lacunar cere-bral infarction are related to cerebral artery hemodynamic parameters，which is of great significance in the evaluation of carotidatherosclerosis．

Objective To analyze the correlation between systemic inflammatory response index ( SIＲI) and short-
term prognosis in patients with Guillain-Barre syndrome ( GBS) ． Method One hundred and six patients with GBS were se-
lected from the Department of Neurology，Central South Hospital，Wuhan University from January 2014 to July 2022． Accord-
ing to the Hughes functional grading ( HFGS) ，76 patients were divided into the group with good prognosis ( HFGS score ＜ 4)
and 30 patients with poor prognosis ( HFGS score ≥ 4) ． The clinical data and inflammatory response indicators ( neutrophil
count，lymphocyte count，monocyte count，platelet count，SIＲI) of the two groups were compared． The Spearman method was
used to analyze the correlation between HFGS score and inflammatory response index of GBS patients at discharge，and the di-
agnostic value of inflammatory response index on short-term poor prognosis of GBS patients was evaluated by the subject work
characteristic curve ( ＲOC) ，and the influencing factors of short-term poor prognosis of GBS patients were analyzed by multi-
variate logistic regression． Ｒesults The proportion of dyspnea and blood glucose level in patients with poor prognosis were
higher than those in patients with good prognosis，while the serum albumin level was lower than those in patients with good
prognosis ( P ＜ 0． 05) ． The neutrophil count，monocyte count and SIＲI in the poor prognosis group were higher than those in Chin J Diffic and Compl Cas，March 2023，Vol． 22，No． 3
the good prognosis group，while the lymphocyte count was lower than those in the good prognosis group ( Z / P = 5． 552 / ＜ 0．
001，4． 493 / ＜ 0． 001，5． 982 / ＜ 0． 001，2． 441 /0． 015) ． The HFGS score of GBS patients at discharge was positively correla-
ted with neutrophil count，monocyte count and SIＲI ( r = 0． 566，0． 502，0． 708，P ＜ 0． 001) ，and negatively correlated with
lymphocyte count ( r = － 0． 397，P ＜ 0． 001) ． The area under the curve ( AUC) of neutrophil count，monocyte count，SIＲI
and their combination to predict the poor prognosis of GBS were 0． 847，0． 781，0． 874 and 0． 870，respectively． SIＲI was
more effective in predicting short － term poor prognosis of GBS than monocyte count( Z / P = 2． 408 /0． 016) ，and there was no
significant difference between it and neutrophil count or their combination( Z / P = 0． 855 /0． 392、0． 248 /0． 804) ． Logistic re-
gression analysis showed that the increase of SIＲI at admission and dyspnea during hospitalization were independent risk factors
for poor short-term prognosis of GBS patients ［OＲ ( 95% CI) = 1． 565 ( 1． 167 － 2． 098) ，6． 034 ( 1． 568 － 23． 218) ］． Con-
clusion The increase of SIＲI in GBS patients at admission and dyspnea during hospitalization suggest poor short-term progno-
sis． SIＲI can be used as a potential biomarker for short-term prognosis of GBS patients．

Objective To analyze the correlation between the levels of serum lipoprotein phospholipase A2 ( Lp-
PLA2) ，amyloid A ( SAA) and platelet endothelial cell adhesion molecule-1 ( PECAM-1) and the severity and prognosis of a-
cute cerebral infarction ( ACI) ． Methods One hundred and eighty patients with hypertension complicated with ACI admitted
to the Emergency Department of Hai＇an People＇s Hospital from July 2021 to June 2022 were selected． According to the level of
serum homocysteine ( Hcy) ，they were divided into the observation group ( 124 patients with type H hypertension) and the
control group ( 56 patients with simple hypertension) ． The observation group was further divided into non-vulnerable plaque
subgroup ( 45 cases) and vulnerable plaque subgroup ( 79 cases) according to the results of neck ultrasound examination． Ac-
cording to the changes in the score of the National Institutes of Health Stroke Scale ( NIHSS) within 72 hours after the onset of Chin J Diffic and Compl Cas，March 2023，Vol． 22，No． 3

the disease，the observation group was divided into non-early neurological deterioration subgroup ( non-END subgroup) ( 53
cases) and END subgroup ( 71 cases) ． According to the score of the modified Ｒankin Scale ( mＲS) 90 days after the onset of
the disease，the observation group was divided into a subgroup with good prognosis ( 89 cases) and a subgroup with poor prog-
nosis ( 35 cases) ． The levels of serum Lp-PLA2，SAA and PECAM-1 in each group were compared． Pearson analyzed the cor-
relation between the levels of serum Lp-PLA2，SAA，PECAM-1 and the level of Hcy，the early CT score of Alberta Stroke
Project ( ASPECTS) ，and the score of acute physiology and chronic health status scoring system II ( APACHE II) ; The effica-
cy of serum Lp-PLA2，SAA and PECAM-1 in evaluating type H hypertension complicated with ACI was analyzed by drawing
the working characteristic curve ( ＲOC) of subjects． Ｒesults Compared with the levels of serum Lp-PLA2，SAA and PE-
CAM-1，the observation group was higher than the control group ( t / P = 6． 481 /0． 005，8． 154 / ＜ 0． 001，7． 462 / ＜ 0． 001) ，
the vulnerable plaque subgroup was higher than the non-vulnerable plaque subgroup ( t / P = 7． 628 / ＜ 0． 001，8． 319 / ＜ 0．
001，8． 615 / ＜ 0． 001) ，and the END subgroup was higher than the non-END subgroup ( t / P = 7． 854 / ＜ 0． 001，8． 627 / ＜ 0．
001，9． 825 / ＜ 0． 001) ，The poor prognosis subgroup was higher than the good prognosis subgroup ( t / P = 7． 915 / ＜ 0． 001，
8． 968 / ＜ 0． 001，8． 763 / ＜ 0． 001) ． Pearson analysis showed that the serum levels of Lp-PLA2，SAA and PECAM-1 were
positively correlated with Hcy and APACHE II scores ( Hcy: r / P = 0． 691 / ＜ 0． 001，0． 725 / ＜ 0． 001，0． 674 / ＜ 0． 001; A-
PACHE II scores: r / P = 0． 591 / ＜ 0． 001，0． 640 / ＜ 0． 001，0． 683 / ＜ 0． 001) ，and negatively correlated with ASPECTS
scores ( r / P = － 0． 598 / ＜ 0． 001，－ 0． 703 / ＜ 0． 001，－ 0． 629 / ＜ 0． 001) ． The area under the curve ( AUC) of serum Lp-
PLA2，SAA，PECAM-1 and their combined detection and evaluation of type H hypertension with ACI were 0． 681，0． 709，0．
754 and 0． 924，respectively． The combined detection and evaluation efficiency of the three was higher than that of single de-
tection ( Z = 6． 863，7． 418，7． 905，P ＜ 0． 001) ． Conclusion Serum Lp-PLA2，SAA and PECAM-1 are highly expressed in
patients with type H hypertension complicated with ACI，which is closely related to the stability of carotid artery plaque，dis-
ease severity and prognosis． The combined detection of the three is of higher clinical value．

Objective To analyze the correlation between serum levels of C-type lectin-like receptor-2 ( CLEC-2) ，
S100A8 / S100A9 and major adverse cardio-cerebrovascular events ( MACCE ) in elderly patients with cardiogenic stroke
( CES) ． Methods One hundred and fiveteen elderly patients with CES admitted to the Department of Neurology，Dazhou
Central Hospital，Sichuan Province from January 2020 to January 2022 were divided into MACCE group and control group
( without MACCE) according to the occurrence of MACCE after discharge． The serum levels of CLEC-2，S100A8 and S100A9
on the day of admission were measured． Multivariate logistic regression was used to analyze the factors affecting the occurrence
of MACCE in elderly patients with CES，and the working characteristic curve ( ＲOC) of subjects was drawn to analyze the val-
ue of serum CLEC-2，S100A8，S100A9 in predicting the occurrence of MACCE in elderly patients with CES． Ｒesults One
of 115 patients lost their visit，28 of the remaining 114 patients had MACCE，and 86 had no MACCE． Among 28 MACE pa-
tients，9 were nonfatal myocardial infarction，7 were heart failure，4 were nonfatal stroke，5 were transient ischemic attack，2
were revascularized，and 1 died． The levels of serum CLEC-2，S100A8，S100A9 water in MACCE group were higher than
those in the control group ( t / P = 9． 898 / ＜ 0． 001，5． 759 / ＜ 0． 001，14． 553 / ＜ 0． 001) ． The results of multivariate logistic
regression analysis showed that atrial fibrillation，high mＲS score at discharge，high CLEC-2，high S100A8，and high S100A9
were risk factors for MACCE in elderly patients with CES ［OＲ ( 95% CI) = 2． 277 ( 1． 334 － 3． 889) ，1． 876 ( 1． 277 － 2．
·872· 疑难病杂志 2023 年 3 月第 22 卷第 3 期 Chin J Diffic and Compl Cas，March 2023，Vol． 22，No． 3

754) ，1． 702 ( 1． 237 － 2． 343) 1． 504 ( 1． 141 － 1． 983) 、1． 484 ( 1． 137 － 1． 978) ］． The area under the curve of serum
CLEC-2，S100A8，S100A9 and their combination to predict MACCE in elderly patients with CES was 0． 705，0． 672，0． 655，
0． 856． The combined prediction efficiency of the three was higher than that of single prediction ( Z / P = 2． 645 /0． 012，3．
178 / ＜ 0． 001，3． 738 / ＜ 0． 001) ． Conclusions The serum CLEC-2，S100A9，S100A8 water levels of elderly CES patients
with MACCE increased on average，which is a risk factor for MACCE，and can be used as a biological indicator for MACCE e-
valuation of elderly CES patients after discharge．