Objective To explore the correlation between peripheral low molecular mass peptide 2(LMP2), resolvin D1(RVD1), and cognitive impairment(CI) in acute ischemic stroke(AIS) patients. Methods From January 2021 to July 2024, 216 AIS patients and 65 healthy controls were enrolled. Followed for 6 months, AIS patients were divided into CI(n=72) and non-CI(n=144) subgroups. LMP2 and RVD1 levels were measured by ELISA. Pearson correlation analyzed their relationships with MMSE and MoCA scores. Multivariate Logistic regression identified CI risk factors, and ROC curves evaluated predictive value. Results AIS patients had higher LMP2 and lower RVD1 than controls(t/P=13.957/<0.001, 28.146/<0.001). LMP2 negatively correlated with MMSE/MoCA(r/P=-0.718/<0.001,-0.704/<0.001), while RVD1 showed positive correlations(r/P=0.707/<0.001, 0.726/<0.001). CI subgroup had higher LMP2 and lower RVD1(t/P=10.361/<0.001,-9.762/<0.001). Age, NIHSS score, infarct volume, and high LMP2 were independent risk factors for CI [OR=1.072(1.007-1.142), 1.500(1.271-1.771), 1.580(1.286-1.941), 1.006(1.003-1.008)], while high RVD1 was protective [OR=0.738(0.648-0.840)]. The AUCs for LMP2, RVD1, and their combination were 0.792, 0.804, and 0.895, with the combination being superior(Z/P=3.920/<0.001, 3.764/<0.001).Conclusion Elevated LMP2 and reduced RVD1 are linked to CI in AIS. Combined measurement enhances predictive efficacy.

Objective To evaluate rTMS plus 3D speech therapy for stroke-related swallowing/speech disorders. Methods Totally 100 stroke patients with swallowing and articulation disorders who received treatment in our hospital were regarded as research subjects. They were assigned into regular group(50 cases) and research group(50 cases) via random number table. The regular group received conventional rehabilitation training, while the research group received rTMS combined with three-dimensional visualization speech rehabilitation training on the basis of regular group. The clinical efficacy, swallowing function, articulation function, quality of life and untoward reactions were compared between the two groups before and after treatment. Results After treatment, the total effective rates of swallowing and articulation in research group were 94.00% and 96.00%, respectively, which were conspicuously higher than those in regular group(78.00% and 80.00%, χ2/P=5.316/0.021). The scores of the Modified Mann Assessment of Swallowing Ability(MMASA) and Swallowing Quality of Life Scale(SWAL-QOL) in both groups raised, with research group being conspicuously higher than regular group(t/P=7.335/<0.001, P<0.001). Frenchay Dysarthria Assessment(FDA) scores increased in both groups, and the observation group was higher than the conventional group(t/P=5.094/<0.001). the="" total="" incidence="" of="" untoward="" reactions="" in="" regular="" group="" and="" research="" was="" with="" no="" conspicuous="" p="">0.05). Conclusion rTMS-enhanced speech rehabilitation significantly improves post-stroke dysphagia/dysarthria.

Objective To compare lacosamide-topiramate combination vs topiramate monotherapy in epilepsy and its impact on serum HMGB1、FGL2 levels. Methods The clinical data of 120 epilepsy patients admitted to the Department of Neurology of Xuanwu Hospital, Capital Medical University from January 2023 to January 2025 were retrospectively selected. According to the medication situation of the patients, they were divided into 2 groups. Patients treated with topiramate alone were the monotherapy group(n=58), and patients treated with topiramate combined with lacosamide were the combination group(n=62).The clinical efficacy, epileptic seizure conditions, cognitive function, electroencephalogram, and changes in serum HMGB1 and FGL2 levels were compared between the two groups. Results The total effective rate of the combined group was 91.94%, which was higher than that of the single-drug group(77.59%)(χ2/P=4.839/0.028). After 6 months of treatment, the frequency of epileptic seizures in the combination group was less than that in the single-drug group, and the duration of seizures was shorter than that in the single-drug group(t/P=12.247/<0.001, 8.608/<0.001).The scores of the Mini-Mental State Examination(MMSE) and the Montreal Cognitive Assessment(MoCA) in the combined group were higher than those in the single-drug group(t/P=5.650/<0.001, 4.988/<0.001). The collaboration group had higher powers of α and β bands than the topiramate group, and lower powers of δ and θ bands than the topiramate group(t/P=3.366/0.001, 3.922/<0.001, 3.235/0.002, 3.152/0.002). The collaboration group had lower serum HMGB1 and FGL2 than the topiramate group(t/P=2.160/0.033, 2.945/0.004).Conclusion Lacosamide synergizes with topiramate to enhance seizure control and neuroprotection.

Objective To investigate the expression levels and clinical significance of serum proline-rich 14(PRR14) and butyrylcholinesterase(BChE) in Parkinson's disease(PD) patients.Methods A total of 120 PD patients admitted to the Department of Neurology, Xuzhou Central Hospital, from June 2022 to June 2024 were selected as the PD group. Based on the Montreal Cognitive Assessment Scale(MoCA) scores, PD patients were divided into cognitive impairment(PD-CI, n=79) and cognitively normal(PD-NC, n=41) subgroups. Additionally, 60 healthy individuals were included as controls. Serum PRR14 levels were measured using ELISA, and BChE activity was assessed by spectrophotometry. Pearson correlation analysis was used to evaluate the relationships between PRR14, BChE, Hoehn-Yahr staging, Unified Parkinson's Disease Rating Scale-Ⅲ(UPDRS-Ⅲ) scores, and MoCA scores. Multivariate logistic regression analyzed factors influencing cognitive dysfunction in PD, and ROC curves assessed the diagnostic value of PRR14 and BChE for cognitive impairment. Results The PD group had higher serum PRR14 levels and lower BChE activity compared to controls(t/P=5.148/<0.001, 5.130/<0.001). The PD-CI subgroup exhibited longer disease duration, higher Hoehn-Yahr staging, UPDRS-Ⅲ scores, and PRR14 levels, along with lower MoCA scores and BChE activity(t/P=6.069/<0.001, 4.048/0.044, 3.055/0.003, 3.540/0.001, 4.550/<0.001, 2.631/0.010). PRR14 levels positively correlated with Hoehn-Yahr staging and UPDRS-Ⅲ scores but negatively with MoCA scores(r/P=0.345/0.038, 0.452/<0.001,-0.574/<0.001). BChE activity showed the opposite trends(r/P=-0.317/0.026,-0.469/<0.001, 0.558/<0.001). High PRR14 was an independent risk factor for cognitive dysfunction [OR=1.782(1.273-2.500)], while high BChE was protective [OR=0.643(0.478-0.863)]. The AUCs for PRR14, BChE, and their combination in diagnosing cognitive dysfunction were 0.728, 0.707, and 0.842, respectively, with the combination outperforming individual markers(Z/P=2.559/0.011, 2.883/0.004). Conclusion Elevated serum PRR14 and reduced BChE activity are closely associated with cognitive dysfunction in PD. Combined detection improves diagnostic accuracy.