ObjectiveTo investigate the relationship between serum levels of long non coding ribonucleic acid urothelial carcinoma antigen 1(LncRNA UCA1) and neuronal PAS domain protein 4(NPADP4) and neurological dysfunction in patients with acute cerebral infarction(ACI), and their predictive value for prognosis.MethodsA total of 163 patients with acute cerebral infarction(ACI) admitted to the Emergency Department of Nanjing University Medical School Affiliated Drum Tower Hospital from January 2021 to June 2023(ACI group)[32 cases in mild, 73 cases in moderate, and 58 cases in severe defect subgroups, respectively]and 65 healthy individuals who underwent physical examinations during the same period(control group) were selected. ACI patients were divided into poor and good prognosis subgroups based on their 90-day prognosis, with 52 cases and 111 cases in each subgroup. Real time fluorescence quantitative polymerase chain reaction and enzyme linked immunosorbent assay were used to detect the levels of serum LncRNA UCA1 and NPADP4.Spearman correlation analysis was conducted to investigate the correlation between serum LncRNA UCA1, NPADP4 levels and the National Institutes of Health Stroke Scale(NIHSS) scores of ACI patients. Multivariate logistic regression analysis was used to identify the factors contributing to poor prognosis in ACI patients, and ROC curve analysis was performed to evaluate the predictive value of serum LncRNA UCA1 and NPADP4 for poor prognosis in ACI patients.ResultsCompared with the control group, the levels of serum LncRNA UCA1 and NPADP4 increased in the ACI group(t/P=20.114/<0.001, 15.711/<0.001). The levels of serum LncRNA UCA1 and NPADP4 were higher in the severe defect subgroup than in the moderate defect subgroup than in the mild defect subgroup(F/P=187.914/<0.001, 195.031/<0.001). The levels of serum LncRNA UCA1 and NPADP4 in ACI patients were positively correlated with NIHSS scores(r/P=0.759/<0.001, 0.773/<0.001). After a 90 day follow up, the incidence of poor prognosis in 163 patients with ACI was 31.90%(52/163). Compared with the good prognosis subgroup, the levels of serum LncRNA UCA1 and NPADP4 were elevated in the poor prognosis subgroup(t/P=6.963/<0.001, 6.515/<0.001). The independent risk factors for poor prognosis in ACI patients were age, increased NIHSS score, elevated LncRNA UCA1 and NPADP4 [OR(95%CI)=1.107(1.043-1.176), 1.098(1.049-1.150), 3.479(1.941-6.235), 1.959(1.398-2.745)].The AUC predicted by serum LncRNA UCA1, NPADP4, and their combination were 0.777, 0.789, and 0.870, respectively. The AUC predicted by their combination was greater than that predicted by serum LncRNA UCA1 and NPADP4 alone(Z/P=3.312/<0.05, 2.721/<0.05).ConclusionElevated levels of serum LncRNA UCA1 and NPADP4 are closely associated with worsening neurological deficits and poor prognosis in ACI patients. The combination of serum LncRNA UCA1 and NPADP4 levels has high value in predicting poor prognosis in ACI patients.

ObjectiveTo investigate the value of serum tumor necrosis factorαstimulated gene 6(TSG-6) and ATP binding cassette subfamily A member 1(ABCA1) in predicting hemorrhagic transformation(HT) after thrombolysis and their relationship with short term prognosis in patients with acute ischemic stroke(AIS).MethodsFrom January 2021 to October 2023, 185 patients with AIS who received intravenous thrombolysis in the Department of Neurology, First Affiliated Hospital of Air Force Medical University(AIS group) and 100 healthy subjects(control group) were selected. AIS patients were divided into HT subgroup(56 cases) and non-HT subgroup(129 cases) according to whether HT occurred after thrombolysis. According to the modified Rankin scale(mRS) at 3 months after thrombolysis, AIS patients were divided into poor prognosis subgroup(47 cases) and good prognosis subgroup(138 cases). Serum TSG-6 and ABCA1 levels were detected by enzyme linked immunosorbent assay. Multivariate Logistic regression analysis was used to analyze the factors of HT after thrombolysis in AIS patients. Pearson method and ROC curve were used to analyze the correlation between serum TSG-6, ABCA1 levels and mRS score of AIS patients and their predictive value for HT after thrombolysis in AIS patients.ResultsCompared with the control group, the serum TSG-6 level in the AIS group increased and the ABCA1 level decreased(t/P=12.178/<0.001, 25.944/<0.001). The incidence of HT in 185 AIS patients after thrombolysis was 30.27%(56/185). Compared with the non-HT subgroup, the serum TSG-6 level was increased and the ABCA1 level was decreased in the HT subgroup(t/P=7.607/<0.001, 6.784/<0.001). After 3 months of follow up, the incidence of poor prognosis after thrombolysis in 185 AIS patients was 25.41 %(47/185). Compared with the good prognosis subgroup, the serum TSG-6 level was increased and the ABCA1 level was decreased in the poor prognosis subgroup(t/P=6.876/<0.001, 6.470/<0.001). The mRS score of AIS patients was positively correlated with serum TSG-6 level and negatively correlated with ABCA1 level(r/P=0.693/<0.001,-0.671/<0.001). Increased National Institutes of Health Stroke Scale score, cardiogenic embolism, and elevated TSG6 were independent risk factors for HT in AIS patients after thrombolysis, and elevated ABCA1 was a protective factor[OR(95%CI)=1.071(1.023-1.121),2.907(1.077-7.845),2.075(1.466-2.938),0.900(0.858-0.945)]. The AUC of serum TSG-6, ABCA1 levels and the combination of the two in predicting HT after thrombolysis in AIS patients were 0.802,0.786 and 0.880, respectively. The AUC of the combination of the two was greater than that of serum TSG-6 and ABCA1 levels alone(Z/P=3.161/0.002, 3.298/0.001).ConclusionThe increase of serum TSG-6 level and the decrease of ABCA1 level in AIS patients are related to the occurrence of HT and poor short term prognosis. The combination of serum TSG-6 and ABCA1 levels has a higher predictive value for HT after thrombolysis in AIS patients.

ObjectiveTo investigate the expression levels of serum osteopontin(OPN), interleukin 1 receptor associated kinase 4(IRAK4) and sphingosine 1 phosphate(S1P) in patients with different types of acute ischemic stroke and their relationship with modified Rankin scale score( mRS).MethodsOne hundred and fifty patients with acute ischemic stroke admitted to the Department of Neurology of Dongguan Songshan Lake Tungwah Hospital from January 2022 to December 2023 were selected as the study group(n=150). According to the classification, they were divided into large artery atherosclerosis type(n=23), small artery occlusion type(n=52), cardiogenic embolism type(n=60), other etiological type(n=11) and unknown cause type(n=4). The level of S1P was detected by enzyme linked immunosorbent assay. The neurological deficit score(NIHSS) and mRS score were recorded. The expression levels of serum OPN, IRAK4 and S1P, and the levels of serum OPN, IRAK4 and S1P in patients with different types of acute ischemic stroke and NIHSS score were compared. Pearson correlation analysis was used to analyze the relationship between serum S1P expression level and NIHSS score. The expression levels of serum OPN, IRAK4 and S1P and NIHSS scores in patients with different prognosis(mRs score) were compared. Pearson correlation analysis was used to analyze the relationship between mRs score and serum OPN, IRAK4 and S1P; the predictive value of serum OPN, IRAK4 and S1P for the prognosis of patients with acute ischemic stroke was analyzed by receiver operating curve(ROC).ResultsCompared with the healthy control group, the serum levels of OPN, IRAK4 and S1P in the study group were increased(t/P=25.882/<0.001, 14.910/<0.001, 50.674/<0.001); Except for the unexplained type, the levels of serum OPN, IRAK4 and S1P in the large artery atherosclerosis type were lower than those in the small artery occlusion type, cardiogenic embolism type and other etiological type(F/P=60.344/<0.001,17.798/<0.001,67.339/<0.001,124.678/<0.001); Compared with the subgroup with good prognosis, the expression levels of serum OPN, IRAK4 and S1P and NIHSS score in the subgroup with poor prognosis were significantly higher(t/P=5.377/<0.001, 3.829/<0.001, 3.285/<0.001, 4.805/<0.001). The expression levels of serum OPN(r/P=0.459/0.009,0.493/<0.001), IRAK4(r/P=0.423/0.017,0.479/<0.001) and S1P(r/P=0.525/<0.001,0.487/<0.001) were positively correlated with NIHSS score and mRs score. The AUC of serum OPN, IRAK4, S1P and their combination in predicting the prognosis of patients with acute ischemic stroke were 0.656,0.740,0.804 and 0.872, respectively. The AUC of the combined prediction of acute ischemic stroke was greater than that of OPN(Z=3.237,P=0.001), IRAK4(Z=5.181,P=0.001) and S1P(Z=2.018,P=0.035) alone.ConclusionThe levels of OPN, IRAK4 and S1P in patients with acute ischemic stroke are increased, and the levels of OPN, IRAK4 and S1P and NIHSS score in small artery occlusion type and cardiogenic embolism type of acute ischemic stroke are significantly higher than those in other types. The combined detection of serum OPN, IRAK4 and S1P has a high predictive value for the prognosis of patients with acute ischemic stroke.

ObjectiveTo investigate the changes of serum Sestrin2 and Omentin-1 levels in patients with acute cerebral hemorrhage(ACH) and their correlation with the degree of neurological deficit and prognosis.MethodsOne hundred and fifty-three ACH patients admitted to the Department of Neurosurgery of the Affiliated Hospital of Xuzhou Medical University from March 2021 to October 2023 were selected as the ACH group and 78 cases of those who had health checkups during the same period were selected as the healthy control group. ACH patients were divided into mild deficit subgroup of 52 cases, moderate deficit subgroup of 61 cases, and severe deficit subgroup of 40 cases according to the degree of neurological deficit. The ACH patients were divided into poor prognosis subgroup(41 cases) and good prognosis subgroup(112 cases) according to their prognosis at 3 month follow up. Enzyme linked immunosorbent assay was used to detect serum Sestrin2 and Omentin-1 levels; Spearman method was used to analyze the correlation between NIHSS score and serum levels of Sestrin2 and Omentin-1 in ACH patients; Logistic regression model was used to analyze the influencing factors of poor prognosis in ACH patients; and ROC curves were plotted to evaluate the serum Sestrin2, Omentin-1 levels to predict the value of poor prognosis in ACH patients.ResultsCompared with the healthy control group, the serum Sestrin2 level in the ACH group increased, while the Omentin-1 level decreased(t/P=9.721/<0.001, 11.375/<0.001). Serum Sestrin2 levels increased sequentially in the mild, moderate, and severe deficit subgroups, while Omentin-1 levels decreased sequentially(F/P=136.537/<0.001, 297.024/<0.001). Compared with the poor prognosis subgroup, the good prognosis subgroup had smaller hematoma volume, lower NIHSS score, lower serum Sestrin2 level, and higher Omentin-1 level, with statistically significant differences(t/P=5.636/<0.001, 6.440/<0.001, 6.657/<0.001, 6.104/<0.001). The NIHSS score of ACH patients was negatively correlated and positively correlated with serum levels of Sestrin2 and Omentin-1, respectively(r/P=-0.811/<0.001, 0.829/<0.001); After a 3 month follow up, the incidence of adverse prognosis in 153 ACH patients was 26.80%.The independent risk factors for poor prognosis in ACH patients were increased hematoma volume, elevated NIHSS score, and elevated Sestrin2,the independent protective factor was elevated Omentin-1 [OR(95%CI)=1.219(1.093-1.360), 1.164(1.079-1.255), 1.647(1.218-2.227), 0.976(0.963-0.989)];The serum levels of Sestrin2 and Omentin-1, as well as the area under the curve(AUC) of their combined prediction of adverse prognosis in ACH patients, were 0.795, 0.771, and 0.870, respectively. The AUC of their combined prediction of adverse prognosis in ACH patients was the highest(Z=2.493, 3.181,P=0.013, 0.002).ConclusionElevated serum Sestrin2 levels and decreased serum Omentin-1 levels in ACH patients are closely related to the severity of neurological deficits and poor prognosis. The combination of serum Sestrin2 and Omentin-1 levels has high value in predicting poor prognosis.

ObjectiveTo explore the clinical application value of serum calcium channel α2δ-1 and Resolvin D1(RvD1) levels in evaluating the condition and prognosis of patients with acute cerebral hemorrhage.MethodsA total of 126 patients with acute cerebral hemorrhage admitted to the Emergency Department of the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from January 2022 to December 2023 were selected as the study group. According to the prognosis of patients followed up for 6 months, they were divided into 52 cases of poor prognosis subgroup and 74 cases of good prognosis subgroup. In addition, 60 healthy people who underwent physical examination in the hospital during the same period were selected as healthy control group. The levels of serum α2δ-1 and RvD1 were measured by enzyme linked immunosorbent assay. Multivariate Logistic regression analysis was used to analyze the influencing factors of poor prognosis in patients with acute cerebral hemorrhage. The receiver operating characteristic(ROC) curve was used to evaluate the predictive value of serum α2δ-1 and RvD1 levels on the poor prognosis of acute cerebral hemorrhage.ResultsThe serum α2δ-1 level in the study group was higher than that in the healthy control group, and the serum RvD1 level was lower than that in the healthy control group(t=28.379, 16.412, all P<0.001). With the aggravation of the disease, the level of serum α2δ-1 in patients with acute cerebral hemorrhage gradually increased, and the level of serum RvD1 gradually decreased(F=109.100, 54.370,P<0.001). The incidence of 6-month poor prognosis in 126 patients with acute cerebral hemorrhage was 41.27%(52/126). The age, NIHSS score, hematoma volume, serum α2δ-1, and time from symptom onset to admission in the poor prognosis subgroup were higher than those in the good prognosis subgroup(t=3.331, 27.914, 21.449, 6.056, 2.301, all P<0.05), and the serum RvD1 level was lower than that in the good prognosis subgroup(t=5.824,P<0.001). Multivariate logistic regression results showed that high NIHSS score, large hematoma volume, and high α2δ-1 were independent risk factors for poor prognosis in patients with acute cerebral hemorrhage[OR(95%CI)= 2.361(1.694-3.101),2.147(1.514-2.798),1.665(1.262-2.995)], and high RvD1 was an independent protective factor[OR(95%CI)=0.389(0.255-0.662)]; the AUC of serum α2δ-1, RvD1 levels and their combined prediction of poor prognosis in patients with acute cerebral hemorrhage were 0.756,0.780 and 0.841, respectively. The area under the curve(AUC) of the combination of the two was greater than the AUC predicted by serum α2δ-1 and RvD1 levels alone(Z=2.623, 2.127,P=0.009,0.033).ConclusionSerum α2δ-1 and RvD1 levels can reflect the severity of patients with acute cerebral hemorrhage, and can be used as an auxiliary predictor of poor prognosis. The combination of the two has a high value in evaluating the prognosis of patients with acute cerebral hemorrhage.