Objective To investigate the levels of serum sirtuin 3(SIRT3) and apolipoprotein J(Apo-J) in patients with spontaneous intracerebral hemorrhage(sICH) and their relationship with early neurological deterioration(END). Met-hods A retrospective study was conducted on 303 sICH patients(ICH group) admitted to the Neurology Department of Jiaozhou Central Hospital, Qingdao, from January 2020 to August 2024, and 155 healthy volunteers(control group) from the same hospital. Based on neurological deficit severity, sICH patients were classified into mild deficit subgroup(102 cases, NIHSS score ≤4), moderate deficit subgroup(121 cases, NIHSS score 5-20), and severe deficit subgroup(80 cases, NIHSS score >20). Patients were further divided into END subgroup(60 cases) and non-END subgroup(243 cases) based on the occurrence of END. Serum SIRT3 and Apo-J levels were measured by enzyme-linked immunosorbent assay(ELISA). Spearman correlation analysis was performed to examine the relationship between serum SIRT3 and Apo-J levels and NIHSS scores in sICH patients. Multivariate unconditional logistic regression was used to analyze the association of serum SIRT3 and Apo-J levels with END in sICH patients, and the predictive efficacy of serum SIRT3 and Apo-J levels for END was assessed using ROC curves. Results Compared to the control group, serum SIRT3 levels were decreased and Apo-J levels were elevated in the sICH group(t/P=26.232/<0.001, 30.021/<0.001). Serum SIRT3 levels progressively decreased, and Apo-J levels progressively increased across the mild, moderate, and severe deficit subgroups(F/P=805.445/<0.001, 550.374/<0.001). NIHSS scores in sICH patients were negatively correlated with serum SIRT3 levels and positively correlated with Apo-J levels(rs/P=-0.809/<0.001, 0.792/<0.001). The incidence of END among the 303 sICH patients was 19.80%(60/303). Compared to the non-END subgroup, the END subgroup showed lower serum SIRT3 levels and higher Apo-J levels(t/P=8.539/<0.001, 7.972/<0.001). Larger hematoma volume, higher baseline NIHSS scores, and elevated Apo-J were independent risk factors for END, while higher baseline GCS scores and elevated SIRT3 were independent protective factors[OR(95%CI)=1.143(1.072-1.218),1.091(1.036-1.148),1.079(1.046-1.114),0.726(0.620-0.850),0.469(0.339-0.650)].The AUC for predicting END using serum SIRT3, Apo-J, and their combination was 0.790, 0.786, and 0.891, respectively. The combined AUC was significantly higher than that of SIRT3 or Apo-J alone(Z/P=4.079/<0.001, 4.086/<0.001). Conclusion In sICH patients, serum SIRT3 levels decrease, and Apo-J levels increase, which are associated with more severe neurological deficits and the occurrence of END. The combination of serum SIRT3 and Apo-J levels demonstrates high predictive efficacy for END in sICH patients.

Objective To investigate the relationship between serum Netrin-1, nerve growth factor(NGF), electroencephalogram(EEG) abnormalities and cognitive function in epilepsy patients. Methods A total of 316 epilepsy patients diagnosed and treated in the Department of Neurology Ⅷ of Xi'an International Medical Centre Hospital from March 2022 to May 2024 were selected as a case group, and the cognitive function of epilepsy patients was assessed by Montreal Cognitive Assessment Scale(MoCA), of which 141 were classified into the subgroup of non-cognitively impaired NCDs, and 175 were classified into the subgroup of cognitively impaired CDs, and 280 cases of those who had a health check-up were selected during the same period as a control group. The enzyme-linked immunosorbent assay(ELISA) method was used to detect serum Netrin-1 and NGF levels, and an electroencephalograph was used to examine the degree of EEG abnormalities in patients with epilepsy. Spearman method was applied to analyze the correlation between serum Netrin-1, NGF levels, electroencephalogram detection, and MoCA score. The value of plotting subjects' work characteristic curve(ROC) curves to assess serum Netrin-1, NGF levels and EEG abnormalities in predicting cognitive dysfunction in patients with epilepsy. Results Compared with the control group, the serum Netrin-1 level in the case group was increased, and the serum NGF level was decreased(t=34.511, 11.727, P<0.001). There were no EEG abnormalities in the control group, and 285(90.19%) patients in the case group had EEG abnormalities. Serum Netrin-1 level increased with the severity of EEG abnormality, and serum NGF level decreased with the severity(F=113.23, 31.29,P<0.001). The serum Netrin-1 level in CDs subgroup was higher than that in NCDs subgroup, and the serum NGF level was lower than that in NCDs subgroup(t=12.594, 5.584,P<0.001). The total MoCA score of NCDs subgroup was higher than that of CDs subgroup(t=26.572,P<0.001). MoCA score was negatively correlated with serum Netrin-1 level in epileptic patients, positively correlated with serum NGF level, and negatively correlated with EEG abnormalities in epileptic patients(r=-0.452, 0.497,-0.507, P<0.001). The AUC of serum Netrin-1, NGF level, EEG abnormality and their combination in predicting cognitive dysfunction in epilepsy patients were 0.846, 0.728, 0.552 and 0.908, respectively, and the combined efficacy of the three was superior to that of each alone(Z=3.988, 6.929, 16.109, P<0.001).Conclusion Serum Netrin-1 expression is abnormally elevated and NGF expression is abnormally decreased in patients with CDs epilepsy. The MoCA score of epilepsy patients is closely related to serum Netrin-1, NGF expression, and the degree of EEG abnormalities. The combined efficacy of serum Netrin-1, NGF levels and EEG abnormalities in predicting cognitive dysfunction in patients with epilepsy is high.

Objective To investigate the relationship between the expression levels of serum lncRNA taurine upregulated gene 1(lncRNA TUG1) and lncRNA metastasis-associated lung adenocarcinoma transcript 1(lncRNA MALAT1) and the severity of Parkinson 's disease(PD) and its significance for early diagnosis.Methods One hundred and twenty PD patients admitted to the Department of Neurology, Norinco General Hospital from January 2022 to January 2024 were selected as the observation group. According to Hoehn-Yahr(H-Y) classification, the patients in the observation group were divided into early subgroup(grade Ⅰ-Ⅱ) 46 cases and middle-late subgroup(grade Ⅲ-Ⅴ) 74 cases. In addition, 110 healthy volunteers who underwent physical examination during the same period were selected as the healthy control group. The expression levels of serum lncRNA TUG1 and lncRNA MALAT1 in each group were detected, and the correlation between them and the severity of PD was analyzed by Spearman; the clinical data of PD patients with different severity were compared, multivariate Logistic analysis was used to analyze the influencing factors affecting the severity of PD patients, the predictive value of serum lncRNA TUG1 and lncRNA MALAT1 in PD patients was detected by receiver operating curve(ROC).Results The levels of serum lncRNA TUG1 and lncRNA MALAT1 in the observation group were higher than those in the healthy control group(t/P=15.668/<0.001,60.822/<0.001), and the levels in the middle-late subgroup were higher than those in the early subgroup(t/P=6.670/<0.001,17.793/<0.001), the levels of the two were significantly positively correlated with the severity of the disease(r/P=0.608/<0.001,0.712<0.001); the scores of Mini-Mental State Examination(MMSE) and Unified Parkinson 's Disease Rating Scale(UPDRS) in the middle-late subgroup were higher than those in the early subgroup(t/P=5.116/<0.001,25.014/<0.001); High MMSE score, high UPDRS score, high lncRNA TUG1 and high lncRNA MALAT1 were independent risk factors affecting the severity of PD patients[OR(95%)CI=1.364(1.125-1.655),1.812(1.472-2.311),4.543(1.322-7.890),5.318(1.773-9.034)].The area under curve(AUC) of serum lncRNA TUG1, lncRNA MALAT1 alone and their combination in predicting the severity of PD patients were 0.770,0.846 and 0.894, respectively. The AUC of combined prediction was better than that of single detection(Z=2.065,3.028,P=0.037,0.026).Conclusion Serum lncRNA TUG1 and lncRNA MALAT1 levels are closely related to the pathogenesis and progression of PD. Combined detection of the two indicators is helpful to predict the early onset of PD, and combined with its changes in serum levels, it is of great significance to determine the development of PD.

Objective To investigate the predictive value of Red blood cell distribution width to albumin ratio(RAR) and neutrophil-to-lymphocyte ratio(NLR) for28 d of death in patients with severe acute respiratory distress syndrome(ARDS) supported by veno-venous extracorporeal membrane pulmonary oxygenation(VV-ECMO). Methods Clinical data of VV-ECMO-supported ARDS patients admitted to the intensive care unit(ICU) of the Second Affiliated Hospital of Zhengzhou University from August 2019 to February2024 were retrospectively selected. The time of patients' initiation of VV-ECMO therapy was used as the starting point of the study, and they were divided into 49 cases in the survival group and 112 cases in the death group based on survival after 28 d of treatment. Pearson correlation coefficients were used to analyze the correlation between RAR, NLR, and PLR and APACHE Ⅱ score and SOFA score; multifactorial logistic regression was used to analyze the factors influencing the prognosis of patients with severe ARDS; and subject work characteristics(ROC) curves were used to evaluate the predictive value of RAR, NLR, and PLR on the death of 28-d mortality in those treated with VV-ECMO; Kaplan-Meier method to analyze 28 d cumulative survival of severe ARDS patients with different RAR, NLR, and PLR levels. Results RAR, NLR, and PLR were higher in the death group than in the survival group(t/P=6.802/<0.001, 4.847/<0.001, 2.936/<0.001); RAR was positively correlated with APACHE Ⅱ scores and SOFA scores in ARDS patients treated with VV-ECMO(r/P=0.175/0.027, 0.250/0.001), and PLR was negatively correlated with APACHE II score and SOFA score(r/P=-0.190/0.016,-0.397/<0.001); the results of multifactorial logistic regression analysis showed that high age, APACHE II score, SOFA score, RAR, and NLR were the main factors in the VV-ECMO-treated independent risk factors for 28-d death in ARDS patients[OR(95%CI)=1.055(1.001-1.111), 1.235(1.029-1.482), 1.284(1.022-1.614), 3.135(1.163-8.448), and 1.059(1.002-1.120)], and that ICU hospitalization prolonged duration was independent protective factor[OR(95%CI)=0.758(0.664-0.866)]; The area under the curve(AUC) of RAR, NLR, PLR, and the combination of the three for predicting 28 d death in VV-ECMO-treated patients was 0.774, 0.716, 0.584, and 0.848, respectively, and the combination of the three was superior to their respective individual predictions(Z/P=2.581/0.010, 3.947/<0.001, 5.487/<0.001); Kaplan-Meier survival analysis showed that 28 d cumulative survival was lower for those with RAR≥0.49 than for those with RAR<0.49(8.33% vs. 48.31%, χ2=30.050, P<0.001); and 28 d cumulative survival was higher for those with NLR≥24.64 was lower than those with NLR<24.64(10.61% vs. 44.21%, χ2=20.772, P<0.001); those with PLR≥401.31 had lower 28 d cumulative survival than those with PLR<401.31(12.50% vs. 36.36%, χ2=8.086, P=0.004). Conclusion RAR, NLR, and PLR all have a certain predictive value for the prognosis of patients with ARDS supported by VV-ECMO, and the combined diagnostic predictive value of the three is even higher.

Objective To investigate the expression of sex determining region Y box protein 2(SOX2), silent information regulator 1(SIRT1), and soluble interleukin-2 receptor(sIL-2R) in the serum of patients with idiopathic membranous nephropathy(IMN), and their correlation with clinical staging and prognosis. Methods A total of 316 IMN patients admitted to the Nephrology Department of the Northern Theater General Hospital of the Chinese people's Liberation Army from January 2021 to January 2023 were selected as IMN group. According to the prognosis, they were divided into poor prognosis subgroup(86 cases) and good prognosis subgroup(230 cases); Another 316 cases of healthy physical examination in the same period were selected as the healthy control group. Enzyme linked immunosorbent assay(ELISA) method was performed to detect serum SOX2, SIRT1, and sIL-2R. Receiver operating characteristic curve(ROC) method was used to analyze the predictive value of serum SOX2, SIRT1, and sIL-2R detection for the prognosis of IMN patients. Multivariate Logistic regression was used to analyze the influencing factors of poor prognosis in patients. Results Compared with the healthy control group, the SOX2 and sIL-2R in the IMN group were conspicuously higher, and SIRT1 was prominently lower(t/P=34.115/<0.001, 28.962/<0.001, 13.579/<0.001). The levels of SOX2 and sIL-2R in phase Ⅲ were higher than those in phase Ⅱ and higher than those in phase Ⅰ, and the levels of SIRT1 in phase Ⅲ were lower than those in phase Ⅱ and lower than those in phase Ⅰ(F/P=8.309/<0.001, 10.222/<0.001, 4.214/0.016). Compared with the good prognosis subgroup, the serum creatinine, proportion of glomerulosclerosis, SOX2, sIL-2R levels in the poor prognosis subgroup were significantly increased, and the SIRT1 level was significantly decreased(t/P=12.024/<0.001, 12.877/<0.001, 8.522/<0.001, 7.147/<0.001, 6.599/<0.001). The AUC of serum SOX2, SIRT1, sIL-2R and their combination in predicting the prognosis of IMN patients were 0.753, 0.733, 0.768 and 0.863, respectively, and the combined AUC of the three was better than that of their individual prediction(Z/P=3.904/<0.001, 2.652/0.008, 4.770/<0.001). High serum creatinine, glomerulosclerosis, SOX2 and sIL-2R were the influencing factors of poor prognosis in IMN patients, and high SIRT1 was an independent protective factor [OR(95%CI)=2.254(1.346-3.774), 3.474(1.877-6.429), 2.362(1.441-3.871), 1.854(1.371-2.507), 0.698(0.567-0.859)].Conclusion The serum SOX2 and sIL-2R in IMN patients are conspicuously increased, while the SIRT1 is conspicuously decreased, and all are closely related to clinical staging and prognosis.