Objective To analyze the levels of microRNA-29c-3p(miR-29c-3p) and mouse dimer 2(MDM2) in the serum of patients with acute cerebral infarction(ACI) and their clinical value in predicting patient prognosis.Methods Ninety ACI patients who were treated at the Affiliated Hospital of North China University of Technology from July 2021 to July 2022 were selected as the ACI group, and were divided into a subgroup of 55 patients with good prognosis(mRS score≤2 points) and a subgroup of 35 patients with poor prognosis(mRS score>2 points) based on the modified Rankin Scale(mRS) score 3 months after discharge; During the same period, 90 patients undergoing health examinations in the hospital were selected as the healthy control group. Compare the clinical data and serum miR-29c-3p and MDM2 levels of all subjects; Pearson method was used to analyze the correlation between serum miR-29c-3p and MDM2 in ACI patients; Multivariate logistic regression analysis was used to identify the factors that affect the poor prognosis of ACI patients; The value of evaluating serum miR-29c-3p and MDM2 levels in predicting poor prognosis in ACI patients using the subject's work characteristic curve. Results Compared with the healthy control group, the proportion of drinking history, total cholesterol(TC), high-sensitivity C-reactive protein(hs-CRP), and MDM2 levels in the ACI group increased, while high-density lipoprotein cholesterol(HDL-C), uric acid(UA), and miR-29c-3p levels decreased(χ2/t/P=4.472/0.034, 13.357/<0.001, 32.246/<0.001, 9.948/<0.001, 9.435/<0.001, 3.254/0.001, 9.467/<0.001); Compared with the subgroup with good prognosis, the subgroup with poor prognosis showed a decrease in serum miR-29c-3p levels and an increase in MDM2 levels(t/P=9.480/<0.001, 8.599/<0.001); There is a negative correlation between serum miR-29c-3p and MDM2 levels in ACI patients(r/P=-0.442/<0.001). The results of logistic regression analysis showed that high levels of serum hs-CRP and MDM2 were independent risk factors for poor prognosis in ACI patients [OR(95%CI)=1.563(1.181-2.069), 3.122(1.365-7.139)], and high levels of serum miR-29c-3p were protective factors [OR(95%CI)=0.735(0.569-0.950)]; The area under the curve(AUC) of serum miR-29c-3p, MDM2, and their combination in predicting poor prognosis in ACI patients were 0.825, 0.831, and 0.909, respectively. The combined predictive value of the two tests was higher than that of single tests(Z/P=2.222/0.026, 2.063/0.039). Conclusion The serum miR-29c-3p expression in ACI patients is low, while MDM2 expression is high, and the changes in levels of the two are more pronounced in ACI patients with poor prognosis. The combination of the two has high predictive value for the prognosis of ACI patients.

Objective To analyze the relationship between the expression of serum annexin A2, microRNA-9-5p(miR-9-5p) in patients with acute cerebral infarction(ACI) of intracranial atherosclerotic type and the burden of intracranial atherosclerotic plaque and the severity of the disease. Methods One hundred and seventy patients with intracranial ath-erosclerotic ACI admitted to the Department of Neurology, Bazhong Central Hospital, Sichuan Province from January 2019 to October 2022 were selected as the study group, and 173 healthy volunteers were selected as the healthy control group. The laboratory indexes were detected, and the expression of Annexin A2 and miR-9-5p in serum were detected by ELISA and fluorescent quantitative PCR, respectively. The intracranial atherosclerotic plaque load of patients with intracranial atherosclerotic ACI was measured. According to the NIHSS score, ACI patients were divided into 39 mild ACI subgroups, 56 moderate ACI subgroups, and 75 severe ACI subgroups. To analyze the expression of Annexin A2 and miR-9-5p in serum of patients with intracranial atherosclerotic ACI and their correlation with intracranial atherosclerotic plaque load and NIHSS score, the influencing factors of the occurrence of intracranial atherosclerotic ACI, and the predictive value of the expression of Annexin A2 and miR-9-5p in serum on the occurrence of severe intracranial atherosclerotic ACI. Results Compared with the healthy control group, the levels of serum triacylglycerol(TG), total cholesterol(TC), hypersensitive C-reactive protein(hs-CRP), and annexin A2 in the study group were significantly increased(t/P=11.636/<0.001, 12.198/<0.001, 45.099/<0.001, 58.651/<0.001), and the expression of miR-9-5p was significantly decreased(t/P=34.044/<0.001); The serum Annexin A2 level, intracranial atherosclerotic plaque load and NIHSS score in mild ACI subgroup, moderate ACI subgroup and severe ACI subgroup increased in turn(F/P=81.628/<0.001, 16.766/<0.001, 14.000/<0.001), and the expression of miR-9-5p decreased in turn(F/P=17.951/<0.001); The expression of serum Annexin A2 was negatively correlated with the expression of miR-9-5p in patients with intracranial atherosclerotic ACI(r/P=-0.859/<0.001), the level of serum Annexin A2 was positively correlated with the intracranial atherosclerotic plaque load and NIHSS score(r/P=0.814/<0.001, 0.649/<0.001), and the expression of serum miR-9-5p was negatively correlated with the intracranial atherosclerotic plaque load and NIHSS score(r/P=-0.737/<0.001,-0.564/<0.001); High level of Annexin A2 in serum, and high load of intracranial atherosclerotic plaque are risk factors for ACI [OR(95%CI)=1.716(1.201-2.452), 1.924(1.384-2.674)], high expression of miR-9-5p is protective factor of ACI [OR(95%CI)=0.835(0.715-0.975)]; The area under the curve(AUC) of serum Annexin A2, miR-9-5p and their combination in predicting the occurrence of severe intracranial atherosclerotic ACI were 0.833, 0.791 and 0.925, respectively, and their combined prediction was better than the single prediction(Z/P=2.530/0.011, 3.364/0.001). Conclusion The increase of serum Annexin A2 level and the decrease of miR-9-5p expression in patients with intracranial atherosclerotic ACI are related to the load of intracranial atherosclerotic plaque and the severity of the disease. The combination of the two has a high predictive value for severe ACI.

Objective To investigate the correlation between changes in the Kelch like epichlorohydrin related protein 1(Keap1) nuclear factor E2 related factor 2(Nrf2)/antioxidant response element(ARE) signaling pathway in peripheral blood of patients with acute cerebral infarction(ACI) and prognosis.Methods One hundred and ten patients with ACI diagnosed and treated in the Department of Neurology, Chaohu Hospital, Anhui Medical University, from June 2020 to March 2022 were selected as the research subjects. According to the modified Rankin Scale(mRs) scores three months after thrombolysis, they were divided into a group with good short-term prognosis and a group with poor short-term prognosis. Whether ACI recurred after one year of follow-up was divided into a group with good long-term prognosis and a group with poor long-term prognosis. Different short-term and long-term prognosis groups were compared before and 7 days after thrombolysis After 3 months of thrombolysis, the relative expression levels of Keap1, quinone oxidoreductase 1(NQO1), Nrf2, ARE proteins, and neurological impairment(NIHSS) scores in peripheral blood were analyzed. The correlation between each protein and NIHSS score was analyzed, and the predictive value of each protein on prognosis was evaluated using the subject operating characteristic curve(ROC). Results One hundred and ten ACI patients, 78 with good recent prognosis, and 32 with poor recent prognosis; Following up for 1 year, 6 cases were lost, 83 cases had good long-term prognosis, and 21 cases had poor long-term prognosis. The relative expression level of Keap1 protein and NIHSS score in the group with poor short-term and long-term prognosis after thrombolysis at 7 days and 3 months were higher than those in the group with good short-term and long-term prognosis, while the relative expression levels of NQO1, Nrf2, and ARE proteins were lower than those in the group with good short-term and long-term prognosis(P<0.001). The relative expression of Keap1 protein was positively correlated with NIHSS score 7 days and 3 months after thrombolysis(r=0.684, 0.702,P<0.001), while the relative expression of NQO1, Nrf2, and ARE protein was negatively correlated with NIHSS score(7 d: r=-0.615,-0.628,-0.609, 3 months: r=-0.631,-0.657,-0.629,P<0.001). The relative expression levels of Keap1, NQO1, Nrf2, and ARE proteins 7 days after thrombolysis, as well as the AUC of the combination of the four for predicting short-term prognosis, were 0.803, 0.717, 0.800, 0.765, and 0.907. The combination of the four was better than the individual prediction of each protein(Z/P=2.105/0.026, 2.413/0.004, 2.113/0.021, 2.205/0.016). The relative expression levels of Keap1, NQO1, Nrf2, and ARE proteins at 3 months after thrombolysis, as well as the combined prediction of AUC for poor long-term prognosis, were 0.766, 0.765, 0.812, 0.767, and 0.927. The combination of the four proteins was better than the individual prediction of each protein(Z/P=2.238/0.010, 2.241/0.008, 2.115/0.019, 2.231/0.012). There was no statistically significant difference(Z/P=0.102/0.563) between the predicted long-term prognosis of peripheral blood Keap1-Nrf2/ARE protein at 3 months after thrombolysis and the predicted short-term prognosis of peripheral blood Keap1-Nrf2/ARE protein at 7 days after thrombolysis. Conclusion The changes in the Keap1-Nrf2/ARE signaling pathway in peripheral blood of ACI patients are significantly correlated with the degree of neurological impairment and short-term and long-term prognosis, which can effectively predict the short-term and long-term prognosis from the perspective of changes in related protein content.

Objective To analyze the expression of microRNA-4744(miR-4744) and right open reading frame kinase 2(RIOK2) in glioma tissue and their predictive value for patient prognosis.Methods From December 2014 to November 2017, 102 patients with glioma were admitted to the Neurosurgery Department of the First Affiliated Hospital of Hebei North University. During the operation, glioma tissue and corresponding normal tissue adjacent to cancer were collected. The expression levels of miR-4744 and RIOK2 messenger RNA(mRNA) were detected by real-time fluorescent quantitative PCR, and RIOK2 protein expression was detected by immunohistochemistry. Analyze the relationship between the expression levels of miR-4744 and RIOK2 mRNA in glioma tissue and the clinical pathological characteristics of patients, the correlation between miR-4744 and RIOK2 mRNA expression levels, the relationship between miR-4744 and RIOK2 mRNA expression levels and prognosis, the influencing factors of prognosis in glioma patients, and the predictive value of miR-4744 and RIOK2 mRNA expression levels on patient mortality within 5 years after surgery.Results Compared with adjacent tissues, the expression level of miR-4744 in glioma tissue was significantly reduced, and the positive rates of RIOK2 mRNA and protein were significantly increased(t/χ2/P=44.282/<0.001, 15.538/<0.001, 101.868/<0.001). The expression levels of miR-4744 and RIOK2 mRNA in glioblastoma tissue were correlated with tumor grade, distant metastasis, and Kappa's functional state(KPS) score(miR-4744:t/P=33.443/<0.001, 45.773/<0.001, 37.920/<0.001; RIOK2: 11.453/0.001, 16.650/<0.001, 16.592/<0.001). There is a negative correlation between miR-4744 and RIOK2 mRNA expression level in glioma tissue(r/P=-0.636/<0.001). The 5-year survival rate of patients in the miR-4744 low expression group is lower than that in the miR-4744 high expression group, and the 5-year survival rate of patients in the RIOK2 mRNA high expression group is lower than that in the RIOK2 mRNA low expression group(χ2/P=20.874/<0.001, 10.437/0.001). Tumor grade III-IV, presence of distant metastasis, KPS score<80, low expression of miR-4744, and high expression of RIOK2 mRNA are independent risk factors for 5-year mortality in glioma patients [HR(95%CI)=2.224(1.297-3.813), 2.442(1.408-4.237), 2.815(1.506-5.261), 2.140(1.173-3.907), 2.114(1.129-3.958)].Compared with the survival group, the expression level of miR-4744 in glioma tissue of the death group was significantly reduced, while the expression level of RIOK2 mRNA was significantly increased(t/P=8.146/<0.001, 3.324/0.001). The area under the curve(AUC) predicted by miR-4744, RIOK2 mRNA, and their combination for 5-year mortality were 0.752, 0.711, and 0.885, respectively. The AUC predicted by the combination of miR-4744 and RIOK2 mRNA was higher than that predicted by miR-4744 and RIOK2 mRNA alone(Z/P=3.147/0.002, 3.531/0.004).Conclusion The expression of miR-4744 is low in glioma tissue, while the expression of RIOK2 mRNA is high. The two are negatively correlated and jointly regulate the progression of glioma patients, which has high value in predicting patient prognosis.

Objective To explore the clinical efficacy and possible mechanisms of butylphthalide combined with nimergoline in the treatment of non-dementia type vascular cognitive impairment(VCIND).Methods One hundred and seven VCIND patients admitted to the Neurology Department of Liaocheng Second Hospital, Shandong First Medical University from July 2018 to February 2021 were selected as the study subjects. They were randomly divided into an experimental group of 54 cases and a control group of 53 cases using a random number table method. In addition to routine treatment and cognitive function training, the control group was treated with nimergoline tablets, while the experimental group was treated with butylphthalide combined with nimergoline. After 6 months of treatment, two groups were compared in terms of cognitive function, serum inflammatory factors, oxidative stress, and nerve related growth factors.Results After 6 months of treatment, the scores on the Mini Mental State Scale(MMSE) and Montreal Cognitive Assessment Scale(MoCA) in the experimental group were higher than those in the control group(t=6.117,4.018,P<0.001). The level of serum interleukin-6(IL-6), C-reactive protein(CRP), and tumor necrosis factor-α(TNF-α)were lower than that of the control group(t=4.216, 2.863, 4.351,P<0.05). The level of malondialdehyde(MDA) was lower than that of the control group, and the levels of superoxide dismutase(SOD) and glutathione peroxidase(GSH-Px) were higher than that of the control group(t=3.857, 10.196, 5.876,P<0.001). The serum levels of brain derived nerve growth factor(BDNF), vascular endothelial growth factor(VEGF), and insulin-like growth factor-1(IGF-1) were higher in the control group than in the control group(t=5.176, 8.466, 3.831,P<0.001).Conclusion The combination of butylphthalide and nimergoline treatment can help improve cognitive function in VCIND patients, which may be related to factors such as antagonizing inflammatory reactions and regulating nerve related growth factors.