ObjectiveTo investigate the correlation between serum Neuregulin 1(NRG1), Klotho with electroencephalogram parameters and prognosis in elderly patients with Alzheimer's disease.MethodsA total of 192 elderly Alzheimer's disease patients who treated in the Department of Neurology Xi'an International Medical Center Hospital from January 2021 to December 2023 were included as the disease group, and were separated into a poor prognosis subgroup(87 cases) and a good prognosis subgroup(105 cases) according to their prognosis. In addition, 82 healthy examinees were included as the healthy control group. Electroencephalogram detection was carried out, and(δ+θ)/(α+β) value was calculated. ELISA kit was applied to detect serum NRG1 and Klotho. The Mini Mental State Examination(MMSE) was applied to evaluate the cognitive function of AD patients, and grouped into asymptomatic subgroup(47 cases), mild subgroup(66 cases), moderate subgroup(70 cases), and severe subgroup(9 cases) based on the scores. General clinical data of the disease group were collected. Spearman was applied to analyze the correlation between various indicators. Logistic regression was applied to analyze the factors influencing the prognosis of Alzheimer's disease patients. ROC was applied to analyze the prognostic value of serum NRG1 and Klotho in Alzheimer's disease patients.ResultsThe levels of NRG1 and Klotho in the disease group were lower than those in the healthy control group, and the(δ+θ)/(α+β) value was higher than that in the healthy control group(t/P=11.822/<0.001, 18.466/<0.001, 17.806/<0.001). the="" trends="" of="" and="" mmse="" levels="" showed="" asymptomatic="" subgroup="">mild subgroup > moderate subgroup > severe subgroup, and the trend of(δ+θ)/(α+β) value showed asymptomatic subgroup < mild subgroup < moderate subgroup < severe subgroup(F/P=30.523/<0.001, 58.508/<0.001, 411.618/<0.001, 69.750<0.001). NRG1 and Klotho are positively correlated with MMSE, while MMSE is negatively correlated with(δ+θ)/(α+β)(r/P=0.422/<0.001, 0.439/<0.001,-0.418/<0.001). The high-density lipoprotein cholesterol(HDL-C), NRG1, Klotho, MMSE, and proportion of daily exercise in the poor prognosis subgroup were lower than those in the good prognosis subgroup, while homocysteine(Hcy) and(δ+θ)/(α+β) value were higher than those in the good prognosis subgroup(t/χ2/P=3.979/<0.001, 7.052/<0.001, 8.769/<0.001, 4.016/<0.001, 11.305/0.001, 5.936/<0.001, 9.237/<0.001). High Hcy and(δ+θ)/(α+β) were risk factors for the prognosis of AD patients,, while high NRG1, Klotho, and MMSE were protective factors for the prognosis of AD patients[OR(95%CI)=2.266(1.493-3.440), 1.692(1.134-2.524), 0.315(0.228-0.434), 0.384(0.285-0.518), 0.401(0.269-0.598)]. The AUC of serum NRG1, Klotho, and their combination in predicting the prognosis of AD patients were 0.751, 0.783, and 0.901, respectively. The combination of the two was superior to their individual predictive efficacy(Z=4.031, 3.985, P<0.001 for all).ConclusionThe expression of serum NRG1 and Klotho is low in elderly Alzheimer's disease patients, and their expression levels are correlated with EEG parameters and prognosis.

ObjectiveTo investigate the levels of serum mitochondrial associated apoptosis factor 2(AIFM2) and uromodulin(UMOD) in patients with severe acute pancreatitis(SAP), and their predictive value for acute kidney injury(AKI) in SAP.MethodsOne hundred and eighty-two SAP patients(SAP group) treated at the First Affiliated Hospital of Henan University of Science and Technology from March 2020 to March 2023 were selected. Based on whether they had concurrent AKI, the SAP group was divided into a non-AKI group(132 cases) and an AKI group(50 cases), with 60 healthy individuals as the control group during the same period. Enzyme linked immunosorbent assay was used to detect serum AIFM2 and UMOD levels. The evaluation value of serum AIFM2 and UMOD for SAP complicated with AKI was assessed using logistic regression model and receiver operating characteristic curve.ResultsThe serum AIFM2 level in the SAP group was higher than that in the control group, and the serum UMOD level was lower than that in the control group(t=25.618, 48.340, P<0.001). The serum AIFM2 level, blood urea nitrogen level, blood creatinine level, and Ranson score in the AKI group were higher than those in the non-AKI group, and the serum UMOD level was lower than that in the non-AKI group(t/P=45.463/<0.001, 26.748/<0.001, 27.264/<0.001). The serum creatinine, blood urea nitrogen, cystatin C, and Ranson score of AKI group SAP patients were positively correlated with serum AIFM2(r/P=0.725/<0.001, 0.621/<0.001, 0.637/<0.001) and negatively correlated with serum UMOD(r/P=-0.710/<0.001,-0.636/<0.001,-0.671/<0.001). Blood urea nitrogen, blood creatinine, Ranson score, and serum AIFM2 were risk factors for SAP complicated with AKI[OR(95%CI)=1.589(1.258-2.006),1.594(1.252-2.028), 1.451(1.120-1.879), 1.419(1.085-1.856)], while serum UMOD was a protective factor[OR(95%CI)=0.628(0.493-0.799)]. The area under the curve(95% CI) of serum AIFM2 and UMOD combined for the evaluation of SAP complicated AKI was 0.938(0.889-0.959), which was higher than that of serum AIFM2. UMOD single detection was 0.871(0.831～0.913) and 0.862(0.821～0.896)(Z=4.344, 4.840, P=0.000, 0.000).ConclusionThe elevation of serum AIFM2 and the decrease of UMOD in SAP complicated AKI patients are related to the severity of the disease, and the combination of the two has high evaluation value for the occurrence of SAP complicated AKI.

ObjectiveTo study the expression levels of serum soluble fms-like tyrosine kinase 1(sFlt-1), retinol-binding protein(RBP), and milk fat globule-epidermal growth factor-factor 8(MFG-E8) in patients with chronic kidney disease maintenance hemodialysis, and to further analyze the correlation between the three with the residual renal function(RRF) of the patients, and their predictive value for prognosis.MethodsFrom October 2020 to April 2023, 168 chronic kidney disease maintenance hemodialysis patients admitted to our hospital were regarded as the diseased group, which were separated into the RRF group(n=28) and the no RRF group(n=140) according to the calculated value of RRF, and separated into the survival group(n=128) and the death group(n=40) according to the prognosis. ELISA was applied to detect serum sFlt-1, RBP, and MFG-E8 levels. General clinical data were collected and analyzed. Spearman's method was applied to analyze the correlation between serum sFlt-1, RBP, MFG-E8 and RRF. Logistic regression was performed to analyze the factors affecting patient prognosis. Receiver operating characteristic(ROC) curves were plotted to analyze the predictive value of serum sFlt-1, RBP, and MFG-E8 levels for prognosis.ResultsCompared with the RRF group, the proportions of patients with diabetes mellitus in the no RRF group were greatly increased(χ2/P=7.547/0.006), serum sFlt-1 and RBP levels were greatly higher(t/P=6.870/<0.001、4.449/<0.001), and MFG-E8 level was greatly lower(t/P=14.071/<0.001). Serum sFlt-1 and RBP were negatively correlated with RRF(r=-0.450,-0.562,P<0.05), and MFG-E8 was positively correlated with RRF(r=0.556,P<0.05). Compared with the survival group, serum sFlt-1 and RBP levels were greatly higher(P<0.05) and MFG-E8 level was greatly lower(P<0.05) in the death group. Diabetes, elevated serum sFlt-1 and RBP levels were risk factors affecting prognosis(P<0.05), and elevated MFG-E8 level was a protective factor affecting prognosis(P<0.05). The AUC of serum sFlt-1, RBP, MFG-E8, and the combination for predicting prognosis was 0.834, 0.836, 0.825, and 0.925, respectively, and the combined prediction of the three was greatly better than that of sFlt-1(Z=2.757, P=0.006), RBP(Z=2.804, P=0.005), and MFG-E8(Z=3.035, P=0.002) alone.ConclusionSerum Flt-1 and RBP levels are greatly increased and MFG-E8 level is greatly decreased in chronic kidney disease maintenance hemodialysis patients without RRF, which had a certain correlation with RRF and had a certain auxiliary predictive value for the prognosis.

ObjectiveTo investigate the relationship between serum levels of fibroblast growth factor 23(FGF-23), growth arrest specific protein 6(Gas6) and disease activity in patients with lupus nephritis(LN).MethodsOne hundred and nineteen patients with LN admitted to the Department of Rheumatology and Immunology of Yan 'an People's Hospital from March 2021 to March 2024 were selected as LN group, and were divided into active subgroup(70 cases) and inactive subgroup(49 cases) according to SLEDAI-2000 score. Another 105 healthy subjects were selected as the control group. Serum levels of FGF-23 and Gas6 were detected by enzyme-linked immunosorbent assay. The correlations between serum FGF-23 and Gas6 levels and renal function indexes and SLEDAI-2000 scores were analyzed by Pearson correlation analysis. The influencing factors of disease activity in LN patients were analyzed by multivariate Logistic regression. Receiver operating characteristic(ROC) curve to evaluate the diagnostic value of serum FGF-23 and Gas6 levels in disease activity in LN patients.ResultsThe levels of FGF-23 and Gas6 in LN group were higher than those in healthy control group(t/P=21.040/<0.001 and 7.389/<0.001). Systolic blood pressure, diastolic blood pressure, urea nitrogen(BUN), blood creatinine(SCr), urinary protein, SLEDAI-2000 score, FGF-23 and Gas6 in active subgroup were higher than those in inactive subgroup. The levels of C3 and C4 were lower than those of inactive subgroups(t/P=2.356/0.020, 3.717/<0.001, 11.867/<0.001, 17.152/<0.001, 30.579/<0.001, 19.439/<0.001, 11.284/<0.001, 10.818/<0.001, 6.233/<0.001, 12.329/<0.001); Serum FGF-23 and Gas6 levels were positively correlated with BUN, SCr, urinary protein and SLEDAI-2000 scores, respectively(r/P=0.410/<0.001, 0.395/<0.001, 0.326/0.002, 0.563/<0.001; 0.352/<0.001, 0.384/<0.001, 0.311/0.008, 0.509/<0.001) were negatively correlated with the levels of C3 and C4(r/P=-0.408/<0.001,-0.377/<0.001;-0.376/<0.001,-0.321/<0.001); Multivariate Logistic regression analysis showed that High levels of FGF-23, Gas6 and urinary protein were independent risk factors for disease activity in LN patients[OR(95%CI)=2.136(1.224-3.727), 1.865(1.171-2.967), 2.539(1.416-4.554)]. The levels of serum FGF-23 and Gas6, as well as the area under the curve(AUC) of their combined diagnosis of disease activity in LN patients, were 0.804, 0.834, and 0.938, respectively. The AUC of their combined diagnosis was greater than that of their individual diagnosis(Z/P=3.843/<0.001, 3.270/<0.001).ConclusionSerum FGF-23 and Gas6 levels are increased in LN patients, which are related to renal function injury, decreased complement level and increased disease activity in LN patients. The combination of FGF-23 and Gas6 can effectively identify the disease activity of LN.

ObjectiveThis study aims to investigate the diagnostic value of combined detection of serum tumor necrosis factor receptor associated protein 1(TRAP1) and cysteine protease inhibitor SN(Cystatin-SN) in benign and malignant pulmonary nodules, providing reference for clinical related diagnosis.MethodsOne hundred and ninety-eight patients with pulmonary nodules who visited between July 2021 and June 2023 were selected as the study subjects. According to pathological examination results, they were divided into a benign nodule group of 42 cases and a malignant nodule group of 156 cases. Compare the serum levels of TRAP1 and Cystatin-SN between the benign nodule group and the malignant nodule group; Compare the results of single and combined serum TRAP1 and Cystatin-SN tests; Compare the diagnostic efficacy of single or combined examinations for malignant pulmonary nodules; And observe the pathological characteristics of malignant pulmonary nodules, further analyze the correlation between serum TRAP1, Cystatin-SN levels and pathological features, and the results of multiple factor Poisson regression.ResultsThe serum levels of TRAP1 and Cystatin-SN in the malignant nodule group were significantly higher than those in the benign nodule group, with statistical significance(t/P=32.273/<0.001、30.512/<0.001). In the group of malignant pulmonary nodules, there was a statistically significant difference in the levels of serum TRAP1 and Cystatin-SN in lymph node metastasis and histological differentiation(t/P=11.812/<0.001、5.547/<0.001,16.837/<0.001、8.923/<0.001); in="" the="" group="" of="" malignant="" pulmonary="" there="" was="" no="" statistically="" significant="" difference="" levels="" serum="" trap1="" and="" cystatin-sn="" terms="" clinical="" nodule="" pathological="" p="">0.05). ROC curve analysis results showed that the area under the curve(AUC) of serum TRAP1 and Cystatin-SN alone and the combination of them were 0.831,0.863,0.938, respectively, and the AUC of the combination was significantly higher than that predicted by TRAP1 and Cystatin-SN alone, with statistical significance(Z=2.127、2.038,P<0.05)ConclusionSerum TRAP1 and Cystatin-SN have good clinical value in the differential diagnosis of benign and malignant pulmonary nodules, and it has been found that serum TRAP1 and Cystatin-SN levels are highly expressed in patients with malignant pulmonary nodules, which may become potential serum biomarkers.