Objective To study the expression of serum secreted protein acidic and rich in cysteine(SPARC), plasmin activator inhibitor 1(SERPIND1) in patients with nasopharyngeal carcinoma(NPC) and their relationship with radiosensitivity and prognosis.Methods Ninety-eight NPC patients diagnosed and treated in the hospital from January 2017 to January 2019 were collected as the NPC group, and 60 healthy individuals who underwent physical examinations during the same period were selected as the control group. Enzyme linked immunosorbent assay was used to detect serum SPARC and SERPIND1 levels. NPC patients were divided into radiation sensitive subgroup and radiation resistant subgroup based on their radiation response. The differences in serum SPARC and SERPIND1 levels among NPC patients with different clinical pathological features and radiation response were compared. Kaplan-Meier curves were drawn and the differences between curves of different SPARC and SERPIND1 expression groups were compared using Log-Rank test. COX regression analysis was used to analyze the prognostic factors of NPC. Results The serum SPARC and SERPIND1 levels in the NPC group before radiotherapy were significantly higher than the control group, the difference was statistically significant(t=37.535, 48.522, P<0.001).The serum SPARC and SERPIND1 levels of HPC patients in the radiation resistant subgroup before radiotherapy were significantly higher than those in the radiation sensitive subgroup(t/P=14.034/<0.001,7.772/<0.001). After radiotherapy, the serum SPARC and SERPIND1 levels of the two groups were significantly reduced, and the difference was statistically significant(t/P=22.974/<0.001,18.137/<0.001). The serum SPARC and SERPIND1 levels of NPC patients with TNM stage Ⅲ-Ⅳ and lymph node metastasis before radiotherapy were higher than those of NPC patients with TNM stage Ⅰ-Ⅱ and no lymph node metastasis(t/P=16.539/<0.001, 16.799/<0.001, 15.756/<0.001, 15.015/<0.001). The 3-year overall survival rates of patients with high and low serum SPARC expression were 50.00%(24/48) and 92.00%(46/50). The 3-year overall survival rates of patients with high and low serum SERPIND1 expression groups were 53.19%(25/47) and 88.24%(45/51). The 3-year cumulative survival rate of NPC patients in the high expression group of serum SPARC and SERPIND1 was significantly lower than that in the low expression group of serum SPARC and SERPIND1(Log-rank χ2=21.500, 14.790, P<0.001). Clinical stages Ⅲ-Ⅳ, lymph node metastasis, high expression of SPARC, and high expression of SERPIND1 were independent risk factors affecting the prognosis of NPC[HR(95%CI)=1.608(1.225-2.112),1.917(1.319-2.799),1.839(1.228-2.753),1.738(1.246-2.426)].Conclusion The upregulation of serum SPARC and SERPIND1 levels in NPC patients are related to adverse clinical pathological characteristics and radiation sensitivity, and are serum tumor marker for evaluating the prognosis of NPC patients.

Objective To analyze the expression and clinical significance of microribonucleic acid-143-5p(miR-143-5p) and microribonucleic acid-335-5p(miR-335-5p) in cervical cancer tissues. Methods From July 2018 to June 2020, 120 cervical cancer patients treated in our hospital were collected. Due to 5 cases of lost follow-up, a total of 115 cases were included in the statistical calculation; real-time fluorescence quantitative PCR(RT-qPCR) method was applied to detect the relative expression levels of miR-143-5p and miR-335-5p in cervical cancer tissue and its adjacent tissues; multivariate Logistic regression was applied to analyze the factors affecting the prognosis of cervical cancer patients; receiver operating characteristic(ROC) curve was applied to analyze the value of miR-143-5p combined miR-335-5p in predicting the prognosis of cervical cancer patients. Results The levels of miR-143-5p and miR-335-5p in cancer tissues were obviously lower than those in adjacent tissues(t/P=22.710/<0.001, 22.950/<0.001); the levels of miR-143-5p and miR-335-5p in cervical cancer tissues of patients with FIGO staging of stages Ⅲ-Ⅳ, poorly differentiated tumors, and lymph node metastasis were obviously lower than those of patients with FIGO staging of stages Ⅰ-Ⅱ, highly differentiated tumors, and no lymph node metastasis(miR-143-5p: χ2/P=3.041/0.003, 3.573/0.001, 3.443/0.001;miR-335-5p: χ2/P=5.769/<0.001,2.890/0.005,2.738/0.007); the levels of miR-143-5p and miR-335-5p in cancer tissues of the poor prognosis group were obviously lower than those of the good prognosis group(t/P=3.718/<0.001, 3.150/0.002); the proportion of patients with FIGO stage Ⅰ-Ⅱ and no lymph node metastasis in the good prognosis group was higher than that in the poor prognosis group(χ2/P=18.261/<0.001, 9.635/0.002); FIGO stage Ⅲ-Ⅳ was risk factor for cervical cancer patients[OR(95%CI)=4.105(1.484-11.353)], while high levels of miR-143-5p and miR-335-5p were protetive factors[OR(95%CI)=0.196(0.084-0.458), 0.220(0.088-0.549)]; the AUC of serum miR-143-5p, miR-335-5p and their combination in predicting the prognosis of patients with cervical cancer were 0.743, 0.726 and 0.879, respectively, and the combination of the two was better than their single prediction value(Z/P=2.346/0.019, 2.601/0.009). Conclusion MiR-143-5p and miR-335-5p are downregulated in cervical cancer tissue, and the combination of the two has a high value in predicting the prognosis of cervical cancer patients.

Objective To investigate the changes and clinical significance of serum regenerated islet-derived protein 3β(Reg3β) and oncostatin M(OSM) levels in patients with acute coronary syndrome(ACS). Methods One hundred and eighty-three patients with ACS admitted to the Department of Emergency of Hainan Affiliated Hospital of Hainan Medical University/Hainan General Hospital from September 2021 to December 2022 were selected as the ACS group, and sixty-five healthy people who underwent physical examination in the hospital during the same period were selected as the healthy control group, and then the patients with ACS were divided into poor prognosis subgroup(52 cases) and good prognosis subgroup(131 cases) according to prognosis. Serum Reg3β and OSM levels were detected by enzyme-linked immunosorbent assay; Spearman correlation analysis was performed to analyze the correlation between serum Reg3β and OSM levels in patients with ACS; and factors of poor prognosis and the predictive value of serum Reg3β and OSM levels in patients with ACS were analyzed by multifactorial Logistic regression and ROC curve. Results Compared with the healthy control group, serum Reg3β and OSM levels were elevated in the ACS group(t/P=7.748/<0.001,9.450/<0.001). The incidence rate of 12-month poor prognosis in 183 ACS patients was 28.42%(52/183),and compared with the good prognosis subgroup, the poor prognosis subgroup had elevated serum Reg3β and OSM levels(t/P=7.390/<0.001,7.087/<0.001).Serum Reg3β was positively correlated with OSM levels in patients with ACS(rs/P=0.793/<0.001).The independent risk factors for poor prognosis in patients with ACS were increased age, KILLIP classification≥grade Ⅱ, increased Gensini score and elevated Reg3β, elevated OSM[OR(95%CI)=1.071(1.008-1.138),3.709(1.186-11.600), 1.045(1.022-1.067), 1.014(1.007-1.021),1.007(1.004-1.010)].Serum Reg3β, OSM levels, and the combination of the two predicted the area under the curve(AUC) of poor prognosis in ACS patients were 0.784,0.789,and 0.861,respectively, and the AUC of the combination of the two was better than that for the serum Reg3β and OSM levels alone(Z/P=2.955/0.003, 2.696/0.007).Conclusion Serum Reg3β and OSM levels are elevated in ACS patients and are closely associated with poor prognosis, and the combination of the two have high value in predicting poor prognosis in ACS patients.

Objective To investigate the effect of citicoline sodium combined with folic acid on neurocognitive function, stroke-related indicators, inflammation level, daily living ability and clinical safety of patients with ischemic stroke after thrombolysis. Methods Eighty-four patients with ischemic stroke after thrombolysis in Department of Neurology, the First People's Hospital of Chuzhou City from November 2021 to January 2023 were randomly divided into conventional rehabilitation group(n=42) and combined rehabilitation group(n=42): The conventional rehabilitation group was treated with routine thrombolytic therapy and rehabilitation therapy, and the combined rehabilitation group was treated with citicoline sodium and folic acid on the basis of conventional thrombolytic therapy. Neurocognitive function [NIHSS score, NCSE score, MMSE score], stroke-related indicators [D-dimer(D-D), homocysteine(Hcy), neuron-specific enolase(NSE)], inflammation level [C-reactive protein(CRP), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α)] and activities of daily living[Barthel index scale, modified Rankin scale(mRS)]were compared between the two groups before and after 3 months of treatment. The incidence of adverse events during follow-up were compared between two groups. Results The NCSE and MMSE scores of patients in the combined rehabilitation group were significantly higher than those in the control group, and NIHSS scores were significantly lower than those in the control group(t/P=2.275/0.026,4.371/<0.001,6.696/<0.001). The mean Hcy and NSE levels were significantly lower than those before treatment and in the conventional rehabilitation group(t/P=8.290/<0.001, and="" the="" mean="" d-d="" level="" was="" lower="" than="" that="" before="" but="" there="" no="" significant="" difference="" between="" two="" p="">0.05). CRP, IL-6 and TNF-α levels were significantly lower than those before treatment and in the conventional rehabilitation group(t/P=3.250/0.002, 4.804/<0.001, 6.273/<0.001). the="" average="" barthel="" index="" was="" significantly="" higher="" than="" that="" before="" treatment="" and="" conventional="" rehabilitation="" p="" mrs="" score="" lower="" but="" there="" no="" significant="" difference="" between="" two="">0.05). There was no statistical difference between the incidence of adverse events in two groups(P>0.05). Conclusion Compared with conventional rehabilitation therapy, citicoline sodium combined with folic acid can significantly improve the neurocognitive function of patients with ischemic stroke after thrombolytic therapy, reduce stroke-related indicators and body inflammation level, and improve the daily living ability of patients while ensuring clinical safety. It has important clinical significance for the rehabilitation of stroke patients after thrombolytic therapy.

Objective To analyze the relationship between blood pressure level and the causes of cerebral infarction in TOAST classification, degree of neurological impairment, prognosis in patients with acute ischemic stroke. Methods A total of 106 patients with acute ischemic stroke who were admitted to the Department of Neurology, Sinopharm Tongmei General Hospital from January 2021 to January 2023 were selected. According to the classification criteria for hypertension, the patients were divided into group A(normal hypertension, BP≤140/90 mmHg, 25 cases), group B(mild to moderate hypertension, BP of 140-180/91-110 mmHg, 67 cases) and group C(severe hypertension, BP≥180/111 mmHg, 14 cases). TOAST type of each group was determined at admission. The National Institutes of Health Stroke Scale(NIHSS) score was used to evaluate the degree of neurological impairment and the modified Barthel index(MBI) was used to evaluate the prognosis. The relationship between blood pressure level and above indicators was analyzed. Results Among the 106 patients, there were 52 patients with large artery atherosclerosis(LAA)-type stroke, 24 patients with cardiogenic embolism(CE)-type stroke and 30 patients with small artery occlusion(SAO)-type stroke. Systolic blood pressure of CE group was lower than that of LAA group and SAO group at admission(P<0.05). The NIHSS scores of group C at admission were significantly higher than those of group B and group A(P=0.005,<0.001). During 3 months of follow-up after treatment, MBI scores of group B were significantly higher than those of group A and group C(P<0.05). 74="" according="" to="" the="" mbi="" patients="" were="" divided="" into="" good="" prognosis="" with="" score="">60) and poor prognosis subgroup(32 patients with MBI score ≤ 60). There was statistically significant difference in NIHSS score at admission and decreases in systolic and diastolic blood pressure in 24h after admission between the 2 groups(P<0.05). Multivariate Logistic regression analysis found that the NIHSS score high at admission, decreases in systolic blood pressure and diastolic blood pressure in 24h after admission were prognostic factors of acute ischemic stroke [OR(95%CI)=2.428(1.053-5.595), 3.251(1.166-9.062), 3.483(1.109-10.942), P<0.05]. Conclusion Patients with CE-type acute ischemic stroke have lower systolic blood pressure than those with LAA-type and CE-type acute ischemic stroke at admission. Besides, patients with different blood pressure levels have different NIHSS scores and MBI scores. The NIHSS score at admission and decrease in blood pressure in 24h after admission are prognostic factors.