Objective To explore the expression of microRNA-132(miR-132) and miR-34a in the serum of patients with hypertensive intracerebral hemorrhage and their relationship with prognosis. Methods One hundred and twenty patients with hypertensive intracerebral hemorrhage treated by Neurosurgery Department, Affiliated Hospital of Southwest Medical University and Sichuan Mianyang 404 Hospital from June 2020 to June 2022 were selected as the observation group. According to the severity of the patient's condition, they were divided into a mild subgroup of 32 cases, a moderate subgroup of 58 cases, and a severe subgroup of 30 cases; According to the patient's prognosis, they were divided into a subgroup of 76 cases with good prognosis and a subgroup of 44 cases with poor prognosis. Another 120 healthy individuals who underwent physical examinations at the same hospital during the same period were selected as the healthy control group. Detect the levels of serum miR-132 and miR-34a in each group; Using multivariate logistic regression to analyze the influencing factors of prognosis in patients with hypertensive intracerebral hemorrhage; The predictive value of serum miR-132 and miR-34a levels in predicting the prognosis of hypertensive intracerebral hemorrhage patients by analyzing the working characteristic curve(ROC) of subjects. Results Compared with the healthy control group, the serum levels of miR-132 and miR-34a in the observation group were significantly increased(t/P=11.907/<0.001, 12.148/<0.001); Comparison of serum miR-132 and miR-34a levels showed that the severe subgroup was more severe than the moderate subgroup and more mild subgroup(F/P=35.229/<0.001, 33.573/<0.001); Compared with the subgroup with good prognosis, the proportion of diabetes, family genetic history, systolic blood pressure, serum miR-132, miR-34a in the subgroup with poor prognosis significantly increased [χ2(t)/P=11.666/<0.001, 5.083/0.024, 3.557/0.001, 3.208/0.002, 3.592/<0.001], and the Glasgow Outcome Score(GOS score) significantly decreased,(t/P=12.458/<0.001). Logistic regression analysis showed that high miR-132, high miR-34a, high systolic blood pressure, and history of diabetes were risk factors for the prognosis of patients with hypertensive intracerebral hemorrhage [OR(95% CI)=2.077(1.352-3.190), 3.458(1.613-7.412), 1.528(1.104-2.116), 2.778(1.448-4.657)]. High GOS score was an independent protective factor [OR(95% CI)=0.682(0.501-0.928)]; The AUC of high serum miR-132, high miR-34a, and their combination in predicting the prognosis of hypertensive intracerebral hemorrhage patients were 0.719, 0.727, and 0.782, respectively. The combination of the two was superior to the single predictive value(Z/P=2.588/0.011, 2.453/0.014). Conclusion The serum levels of miR-132 and miR-34a were significantly upregulated in patients with hypertensive intracerebral hemorrhage, and the combination of the two can better predict the prognosis.

Objective To analyze the value of serum chemokine like factor 1(CKLF1) and claudin-5 in predicting hemorrhagic transformation(HT) after intravenous thrombolysis in patients with acute ischemic stroke(AIS) and their relationship with short-term prognosis. Methods Select 321 AIS patients who received intravenous thrombolysis from the Neurology Department of Wuhan Traditional Chinese Medicine Hospital from July 2019 to January 2021 as the AIS group. According to the occurrence of HT, they are divided into an HT subgroup of 63 cases and a non-HT subgroup of 258 cases. Three months after discharge, the patient was divided into a subgroup of 88 patients with poor prognosis and a subgroup of 233 patients with good prognosis based on the Modified Rankin Scale(mRS) score. Additionally, 60 healthy volunteers who underwent physical examination at the same time were selected as the healthy control group. Use enzyme-linked immunosorbent assay to detect serum CKLF1 and claudin-5 levels, and compare the levels of CKLF1 and claudin-5 in each group. Using multivariate logistic regression analysis to analyze the influencing factors of HT in AIS patients after intravenous thrombolysis; Spearman correlation analysis of the correlation between serum CKLF1, claudin-5 levels and mRS scores in AIS patients; The predictive value of serum CKLF1 and claudin-5 levels in predicting HT after intravenous thrombolysis in AIS patients using the receiver operating characteristic(ROC) curve analysis. Results Compared with the healthy control group, the serum levels of CKLF1 and claudin-5 in the AIS group increased(Z=11.953, 11.069, P<0.001). The incidence of HT after intravenous thrombolysis in 321 AIS patients was 19.63%(63/321). Cardiogenic embolism, elevated National Institutes of Health Stroke Scale(NIHSS) scores, and elevated serum CKLF1 and claudin-5 levels are independent risk factors for HT after intravenous thrombolysis in AIS patients [OR(95% CI)=1.104(1.047-1.165), 4.377(2.011-9.526), 1.195(1.106-1.292), 1.039(1.024-1.052)]. The incidence of poor prognosis after 3 months of intravenous thrombolysis in 321 AIS patients was 27.41%(88/321). Compared with the subgroup with good prognosis, the serum levels of CKLF1 and claudin-5 in the subgroup with poor prognosis increased(Z=7.145, 7.279, P<0.001). The serum levels of CKLF1 and claudin-5 in AIS patients were positively correlated with mRS scores(rs=0.517, 0.491, P<0.001). The area under the curve(AUC) of serum CKLF1 and claudin-5 levels alone and in combination predicted HT after intravenous thrombolysis in AIS patients were 0.769, 0.772, and 0.876, respectively. The AUC predicted by the combination of the two was greater than that predicted by CKLF1 and claudin-5 alone(Z=2.542,3.786, P<0.001). Conclusion Elevated levels of serum CKLF1 and claudin-5 are independent risk factors for HT after intravenous thrombolysis in AIS patients. The combination of the two has a higher value in predicting HT after intravenous thrombolysis in AIS patients. Moreover, elevated levels of serum CKLF1 and claudin-5 are associated with poor short-term prognosis in AIS patients, and are expected to become auxiliary evaluation indicators for HT and short-term prognosis after intravenous thrombolysis in AIS patients.

Objective To observe the effects of butylphthalide(NBP) combined with limb ischemic postconditioning(LIPostC) on neurological function and collateral circulation in patients with cerebral infarction. Methods From October 2020 to October 2022, 252 patients with acute cerebral infarction were diagnosed and treated in the Neurology of Bijie People's Hospital/the First People's Hospital of Bijie City. They were randomly divided into NBP+LIPostC group(combined group) with 84 cases, NBP group with 84 cases, and LIPostC group with 84 cases. The NBP group was treated with butylphthalide sodium chloride injection, the LIPostC group was treated with LIPostC intervention, and the combined group was treated with butylphthalide sodium chloride injection combined with LIPostC. All patients were treated for 14 days. The regional Pia mater collateral circulation compensation based on CTA(rLMC) was assessed before treatment, 1 day, 7 days and 14 days after treatment, the neurological function of the patients was assessed by NIHSS, and the cognitive function of the patients was assessed by MMSE, The Activities of daily living Barthel Index(BI) scoring method and the modified Rankin Scale(mRS) were used to evaluate the patients' ability of Activities of daily living. Compare the 3-month mortality rate and incidence of adverse events among three groups of patients. Results After treatment for 1, 7, and 14 days, the good rate of collateral circulation compensation, MMSE score, and BI score in each group of patients increased, while the NIHSS score and mRS score decreased. Among them, there was no statistically significant difference in the good rate of collateral circulation compensation, NIHSS, MMSE, BI, and mRS scores between the groups of patients after treatment for 1 day(P>0.05), but after treatment for 7 and 14 days, NIHSS, MMSE The differences in BI and mRS scores among the three groups were statistically significant(7 d:F/P=35.811/0.001, 86.735/0.001, 36.652/0.001, 236.965/0.001; 14 d: F/P=85.593/0.001, 154.507/0.001, 75.932/0.001, 419.197/0.001). The 3-month mortality rate of patients in the combined group is lower than that in the NBP and LIPostC groups(χ2/P=6.300/0.043), there was no statistically significant difference in the incidence of other adverse events among the three groups(P>0.05). Conclusion NBP combined with LIPostC can significantly improve collateral circulation compensation in patients with cerebral infarction, and at the same time, it is conducive to improving the neurological function, cognitive function and Activities of daily living of patients, thereby reducing mortality and improving long-term prognosis and quality of life.

Objective To observe the therapeutic effect of risperidone combined with Huoxue Huayu Decoction on post-stroke depression and its effect on brain Hemorheology and serum glial derived Neurotrophin(GDNF) and 5-hydroxytryptamine(5-HT).Methods Ninety-eight patients with post-stroke depression admitted to the Department of Psychiatric Intensive Care at Wuhan Wudong Hospital from August 2020 to October 2022 were selected as the study subjects. They were randomly divided into a control group of 48 cases and an observation group of 50 cases. The control group was treated with Huoxue Huayu Decoction, while the observation group was treated with risperidone combined with Huoxue Huayu Decoction. The efficacy, adverse reactions, brain Hemorheology indexes, Hamilton Depression Rating Scale(HAMD), Neurological Deficiency Rating Scale(NHISS) scores, and serum GDNF and 5-HT levels were compared between the two groups before and after treatment.Results The total effective rate of the observation group was higher than that of the control group(92.00% vs. 70.83%,χ2/P=7.318/0.007); After treatment, the Hemorheology levels(whole blood viscosity low shear, whole blood viscosity high shear, blood viscosity, fibrinogen), HAMD, NIHSS scores in both groups were lower than those before treatment, and the reduction in the observation group was greater than that in the control group(t(Z)/P=5.342/<0.001, 4.328/<0.001, 12.014/<0.001, 11.270/<0.001, 8.607/<0.001, 8.520/<0.001); After treatment, the levels of serum GDNF and 5-HT in both groups increased, and the observed group showed a greater increase than the control group(t/P=4.119/<0.001, 4.666/<0.001); There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Risperidone combined with Huoxue Huayu Decoction can effectively improve the level of Hemorheology, depressive symptoms and neurological impairment in patients with post-stroke depression.

Objective To study the expression and clinical significance of Glucagon-like peptide-1 receptor(GLP-1R) and dipeptidyl peptidase 4(DPP4) in glioma. Methods From January 2016 to January 2018, 88 cases of glioma tissues and paracancerous tissues of brain glioma patients who were treated by Neurosurgery of Wuhan First Hospital were selected, and paraffin embedded sections were made. Apply immunohistochemistry to detect the expression of GLP-1R and DPP4 proteins in tissues. Spearman rank correlation analysis of the correlation between GLP-1R and DPP4 expression in glioma tissue. Statistical analysis of the relationship between the expression of GLP-1R and DPP4 proteins and the clinical and pathological characteristics of glioma patients. Kaplan Meier survival analysis(Log rank test): The relationship between GLP-1R, DPP4 expression and patient survival prognosis. Multivariate Cox regression analysis of risk factors affecting the prognosis of glioma patients. Results The positive rates of GLP-1R and DPP4 protein expression in glioma tissues are significantly higher than those in adjacent tissues(χ2/P=34.680/<0.001, 24.908/<0.001). There is a significant positive correlation between GLP-1R and DPP4 protein expression in glioma tissue(r/P=0.604/<0.001). The positive rates of GLP-1R and DPP4 protein expression in patients with Kamofesky functional status(KPS) score<70 and WHO grade III glioma were higher than those in patients with KPS score ≥ 70 and WHO grade I-II glioma(GLP-1R:χ2/P=8.005/0.005, 7.883/0.005; DPP4:χ2/P=7.062/0.008, 6.471/0.011). The overall 5-year survival rate of glioma patients with GLP-1R and DPP4 positive expression is lower than that of GLP-1R and DPP4 negative expression, respectively(χ2/P=10.128/<0.001, 9.670/0.003). The results of multivariate Cox regression analysis showed that GLP-1R positive expression, DPP4 positive expression, WHO grade III, and KPS score<70 in glioma tissue were independent risk factors affecting patient survival and prognosis [HR(95% CI)=2.427(1.426-4.569), 1.740(1.121-2.568), 2.671(1.160-6.012), 1.628(1.017-2.592)].Conclusion The increased expression of GLP-1R and DPP4 in glioma tissue is an independent factor affecting the survival and prognosis of glioma patients.