Objective To investigate the expression and prognostic significance of serum adipose factor Metrnl and soluble c-kit receptor(s-kit) in patients with chronic heart failure(CHF). Methods One hundred and twenty CHF patients diagnosed and treated in the Department of Cardiology at Chongqing Fifth People's Hospital from June 2018 to February 2022 were selected as the study subjects(CHF group). They were divided into MACE subgroup(n=44) and non-MACE subgroup(n=76) based on whether major cardiovascular adverse events(MACE) occurred within one year of follow-up. A healthy control group consisted of 60 healthy individuals who underwent physical examination at the same time in the hospital. Enzyme linked immunosorbent assay was used to detect serum Metrnl and s-kit levels. Multivariate logistic regression analysis was conducted to identify the factors that affect the occurrence of MACE in CHF patients. The value of subject job characteristic curve(ROC) analysis in predicting MACE occurrence in CHF patients using serum Metrnl and s-kit.Results The serum Metrnl and s-kit levels in the CHF group were lower than those in the healthy control group(t=17.288, 21.212, P<0.001). Comparison of serum Metrnl and s-kit expression levels in NYHA grade Ⅳ<Ⅲ<Ⅱ(F/P=36.811/<0.001, 77.101/<0.001); The serum Metrnl, s-kit, and LVEF in the MACE subgroup were lower than those in the non MACE subgroup(t/P=15.708/<0.001, 8.782/<0.001, 2.933/0.004). Reduced serum Metrnl, s-kit, and left ventricular ejection fraction(LVEF) are independent risk factors for MACE in CHF patients [OR(95%CI)=1.772(1.398-2.246), 1.618(1.239-2.112), 1.511(1.140-2.004)]; The area under the ROC curve(AUC) of MACE in CHF patients evaluated by serum Metrnl, s-kit, LVEF, and three combined indicators were 0.804, 0.720, 0.758, and 0.871, respectively. The AUC of the three combined indicators was higher than their respective single indicators(Z/P=3.127/0.005, 5.320/<0.001, 4.923/<0.001). Conclusion The decrease in serum Metrnl and s-kit levels in CHF patients is related to the NYHA grading of cardiac function. The combination of serum Metrnl, s-kit, and LVEF has high predictive value for the occurrence of MACE in CHF patients.

Objective To investigate the expression levels and prognostic significance of pre protein converting enzyme Bacillus subtilisin/Kexin 6 type(PCSK6) and serine protease(Corin) in the serum of patients with acute myocardial infarction(AMI). Methods One hundred and fifty-three AMI patients admitted to Changsha Third Hospital from March 2021 to March 2022 were selected as the AMI group. According to the prognosis after 1 year of percutaneous coronary intervention treatment, they were divided into poor prognosis subgroup and good prognosis subgroup. In addition, 80 healthy volunteers who underwent physical examination during the same period were selected as the healthy control group. Using enzyme-linked immunosorbent assay to detect serum levels of PCSK6 and Corin; The relationship and predictive value of multivariate logistic regression and receiver operating characteristic(ROC) curve analysis between serum PCSK6 and Corin levels and poor prognosis in AMI patients. Results Compared with the healthy control group, the serum PCSK6 level in the AMI group increased, while the Corin level decreased(Z/P=6.705/<0.001, 5.627/<0.001). Following up for one year, the incidence of poor prognosis in 153 AMI patients was 46.41%(71/153).The serum PCSK6 levels in the poor prognosis subgroup were higher than those in the good prognosis subgroup, while the Corin levels were lower than those in the good prognosis subgroup(Z/P=6.022/<0.001, 5.846/<0.001). Multivariate logistic regression analysis showed that the independent risk of poor prognosis in AMI patients was age increase, KILLIP grade ≥Ⅲ, and PCSK6 elevation. Protective factors were left ventricular ejection fraction and Corin elevation [OR(95%)CI=1.073(1.008-1.141), 4.400(1.383-13.997), 1.105(1.058-1.154), 0.815(0.720-0.922), and 0.996(0.994-0.998)]. ROC curve analysis showed that the area under the curve for poor prognosis of AMI patients evaluated by serum PCSK6, Corin, and binomial combination was 0.783, 0.774, and 0.864, respectively. The area under the curve for poor prognosis of AMI patients evaluated by binomial combination was the largest(Z/P=2.753/0.006, 2.794/0.005). Conclusion The increase in serum PCSK6 levels and the decrease in Corin levels in AMI patients are closely related to poor prognosis and may become auxiliary prognostic indicators.

Objective To investigate the evaluation value of carotid artery stenosis and serum homocysteine(Hcy) and high sensitivity C-reactive protein(hs-CRP) expression in middle-aged cerebral infarction.Methods Ninety-eight middle-aged patients with cerebral infarction admitted to the Neurology Department of West China Guang'an Hospital/Guang'an People's Hospital of Sichuan University from May 2019 to December 2022 were selected as the cerebral infarction group. According to the National Institutes of Health Stroke Scale(NIHSS) score, they were divided into mild subgroup of 30 cases, moderate subgroup of 40 cases, and severe subgroup of 28 cases; Another 80 non cerebral infarction patients in the same period were selected as the non-cerebral infarction group. All patients underwent carotid artery digital subtraction angiography(DSA) examination, and serum Hcy and hs-CRP levels were measured. The carotid artery stenosis status and serum Hcy and hs-CRP levels were compared among all subjects. Pearson's method was used to analyze the correlation between various indicators and the occurrence of cerebral infarction. The predictive value of serum Hcy and hs-CRP for middle-aged cerebral infarction was analyzed using the subject's work characteristic curve. Results 12 cases(15.00%) of carotid artery stenosis in the non-cerebral infarction group were lower than 85 cases(86.73%) in the cerebral infarction group(χ2/P=91.398/<0.001). The serum Hcy and hs-CRP levels in the cerebral infarction group were higher than those in the non-cerebral infarction group(t/P=44.901/<0.001, 44.365/<0.001). There is a statistically significant difference in the degree of arterial stenosis among patients with mild, moderate, and severe conditions(χ2/P=77.729/<0.001), with="" serum="" hcy="" and="" hs-crp="" levels="" in="" the="" severe="" subgroup="">moderate subgroup>mild subgroup(F/P=10.586/<0.001, 25.051/<0.001). The degree of arterial stenosis, serum Hcy, and hs-CRP were positively correlated with the severity of cerebral infarction(r=0.421, 0.365, 0.452, P<0.001). The area under the curve(AUC) of serum Hcy, hs-CRP, and their combination in predicting middle-aged cerebral infarction were 0.859, 0.791, and 0.863, respectively. The combined detection of AUC was higher than that of single detection(Z/P=2.251/0.005, 3.452/0.012). Conclusion DSA detection of carotid artery stenosis combined with serum Hcy and hs-CRP detection can help evaluate the risk of cerebral infarction and provide guidance for clinical prevention and treatment.

Objective To explore the correlation between plasma atherogenic index(AIP) and carotid atherosclerotic plaque(CASP) in college teachers based on propensity score matching(PSM). Methods A total of 1 965 university teachers who underwent physical examinations at the Physical Examination Center of Hebei Provincial People's Hospital from January to December 2021 were selected for analysis. Based on the diagnostic results of carotid artery ultrasound, they were divided into a CASP group of 887 cases and a CASP free group of 1 078 cases. Using PSM to match with the nearest neighbor method in a ratio of 1 to 1, the matching variables were gender, age, smoking, and alcohol consumption. Single factor and multivariate logistic regression models were used to analyze the risk factors for the occurrence of CASP after PSM; Analyze the detection rate of CASP in different groups before and after matching using AIP quartile grouping(Q1-Q4); The ROC curve further evaluates the diagnostic value of AIP in detecting CASP in university teachers. Results The propensity score matching was successful in a total of 543 pairs. After PSM matching, there were no statistically significant differences in gender, age, smoking, and alcohol consumption between the CASP group and the non CASP group(P>0.05). The results of univariate and multivariate logistic regression analysis showed that the independent risk factors for CASP formation in university teachers were BMI, SBP, FPG, SCr, LDL-C, and AIP [OR(95%CI)=1.043(1.006-1.081), 1.054(1.045-1.063), 1.192(1.083-1.311), 1.465(1.211-1.772), and 1.176(1.087-1.273)]. In subgroups Q1 to Q4, before and after PSM matching, with the increase of AIP, the detection rate of CASP in university teachers showed an upward trend(χ2/P=21.659/<0.001, 3.798/<0.001). Drawing ROC curves, AIP predicted an AUC of 0.745(95%CI 0.723-0.766) for CASP, with a cut-off value of 3.1, sensitivity of 0.583, specificity of 0.842, and Jordan index of 0.425. AIP's AUC was higher than TG, LDL-C, BMI, and FPG(Z/P=8.338/<0.001, 9.865/<0.001, 9.341/<0.001, 8.338/<0.001). Conclusion The increase of AIP level of college teachers is related to the occurrence of carotid atherosclerotic plaque, which is an independent risk factor for its occurrence, and can be used as a serum diagnostic marker of carotid plaque formation.

Objective To study the complement C1q/tumor necrosis factor related protein(CTRP), homeostasis model assessment of insulin resistance index(HOMA-IR) and homeostasis model assessment of islets in pre diabetes patients β Cell Function Index(HOMA-β) The correlation with type 2 diabetes and its predictive value. Methods From January 2020 to December 2022, 60 patients with type 2 diabetes diagnosed for the first time in the Department of Endocrinology of the People's Hospital of Xinjiang Uygur Autonomous Region were selected as the observation group, and 60 patients with pre diabetes diagnosed for the first time were selected as the control group. Detect and compare complement C1q/tumor necrosis factor related protein 1(CTRP1), CTRP3, CTRP9, and CTRP12, fasting insulin(FINS), fasting plasma glucose(FPG), HOMA-IR, and HOMA-β in two groups of patients. The independent risk factors of type 2 diabetes were screened by correlation analysis and regression analysis, and the predictive value of each independent risk factor for type 2 diabetes was evaluated by subject work curve(ROC). Results The serum levels of CTRP1 in the observation group were lower than those in the control group, and the levels of CTRP9, FINS, FPG, HOMA-IR, and HOMA-β in the serum were also lower All patients were higher than those in the control group(t/P=5.365/0.001, 4.626/0.001, 1.979/0.050, 2.330/0.021, 8.988/0.001, 5.632/0.001). Serum CTRP1 and FPG, HOMA-IR, and HOMA-β There is a negative correlation(r/P=-0.260/0.004,-0.189/0.039,-0.262/0.004) between CTRP9 and HOMA-IR and HOMA-β There is a positive correlation(r/P=0.282/0.002, 0.262/0.004). Serum CTRP9 levels, HOMA-IR, and HOMA-β Elevated serum CTRP1 level is an independent protective factor for type 2 diabetes [OR(95%CI)=5.995(1.514-23.747), 151.722(15.385-1496.220), 1.127(1.005-1.265), 0.907(0.846-0.972)]. HOMA-IR has the highest predictive value for the occurrence of type 2 diabetes(AUC=0.884, P<0.001). Conclusion Serum, CTRP9 levels, HOMA-IR, and HOMA-β All of them are independent risk factors for type 2 diabetes in patients with pre diabetes, while CTRPl level elevation is a protective factor. HOMA-IR has the highest efficacy in independently predicting disease occurrence, which has important guiding significance for clinical practice.