To investigate the healing effect of Sanqi Tongshu Capsules combined with vinpocetine on acute cerebral infarction and its effects on the levels of serum high-sensitivity C-reactive protein(hs-CRP) and interleukin-10(IL-10).MethodsNinety patients with acute cerebral infarction admitted to our hospital(December 2022 to December 2023) were selected as the research subjects and randomly separated into a single group and a combination group, with 45 patients in each group. The single group was treated with vinpocetine injection, while the combination group was treated with Sanqi Tongshu Capsules on the basis of the single group. The Behavioral and cognitive functions, quality of life, vascular endothelial function related indicators, hemorheological indicators, inflammatory factor levels before treatment(T0) and 2 weeks after treatment(T1), and healing effect were observed in both groups.ResultsAfter 2 weeks of treatment, the total effective rate of the combined group(95.56%) was higher than that of the single group(77.78%)(χ2/P=6.154/0.013). After 2 weeks of treatment, the scores of daily living Scale(ADL) and simple Intelligent Mental State Examination Scale(MMSE) were increased in both single group and combined group. The combined group was significantly higher than the single group(t/P=2.384/0.019,3.774/<0.001).The scores of all items in the Comprehensive Assessment of Quality-of-Life questionnaire(GQOLI-74): material life status, physical function, psychological function, social function and overall quality of life factor were all increased. The combined group was significantly higher than the single group(t/P=2.785/0.007,2.339/0.022,2.196/0.031,3.378/0.001,8.341/<0.001);The levels of nitric oxide(NO) and IL-10 were increased, endothelin-1(ET-1) and hs-CPR were decreased, and the increases/decreases in combination group were greater than those in single group(t=4.612,4.390,3.841,10.154,all P<0.001). Whole blood high shear viscosity, whole blood low shear viscosity, plasma viscosity and fibrinogen water were significantly decreased on average(P<0.001), and the combined group was significantly lower than the single group(t=9.959,10.265,23.694,16.993,10.154,4.390, all P<0.001).ConclusionThe combination of Sanqi Tongshu Capsules and vinpocetine has prominent healing effects on acute cerebral infarction, it can improve blood circulation, reduce inflammatory reactions, and enhance cognitive behavioral function and quality of life.

Objective To investigate the predictive value of serum Netrin-1(NTN-1) combined with hemorrhage after thrombolysis(HAT) score for hemorrhagic transformation after thrombolytic therapy in acute cerebral infarction(ACI).Methods Three hundred and twelve ACI patients who received intravenous thrombolysis treatment in Neurointerventional Department of Hebei provincial people's hospital from February 2021 to June 2024 were selected. According to the hemorrhagic transformation after thrombolytic therapy, the patients were divided into hemorrhagic transformation group and non-hemorrhagic transformation group. In addition, according to the expression level of serum NTN-1, the patients were divided into high expression group and low expression group. The general data of all ACI patients were collected and the HAT score was counted. The expression level of serum NTN-1 was detected by enzyme-linked immunosorbent assay.Results There was no significant difference in gender, age, smoking history, history of transient ischemic attack, hyperlipidemia, hypertension, body mass index, time from onset to admission, and TOAST classification between hemorrhagic transformation group and non-hemorrhagic transformation group(P>0.05). The baseline NIHSS score and proportion of diabetes in hemorrhagic transformation group were higher than those in non-hemorrhagic transformation group(t/χ2=4.168, 4.837,P=<0.001, 0.028). The HAT score of the hemorrhagic transformation group was higher than that of the non-hemorrhagic transformation group, and the serum NTN-1 level was lower than that of the non-hemorrhagic transformation group(t=6.035,5.727, all P<0.001); the hemorrhagic transformation rate of the high expression group was lower than that of the low expression group(χ2/P=6.318/0.012). Logistic regression analysis showed that higher serum NTN-1 level was a protective factor for hemorrhagic transformation after thrombolytic therapy in ACI patients, while higher baseline NIHSS score, diabetes mellitus and higher HAT score were risk factors[OR(95%CI)=0.773(0.629-0.949),1.621(1.180-2.227),1.775(1.081-2.915),2.768(1.330-5.761)];The AUC of serum NTN-1, HAT score and the combination of the two in predicting hemorrhagic transformation after thrombolytic therapy in ACI patients were 0.778,0.786 and 0.884, respectively. The combination of the two was superior to their respective predictive efficacy(DeLong method was used to compare the differences)(Z=2.063, 1.984, P=0.037, 0.046). Conclusion The expression level of serum NTN-1 is closely related to the risk of hemorrhagic transformation after thrombolytic therapy in ACI patients. Serum NTN-1 combined with HAT score has a high predictive value for hemorrhagic transformation after thrombolytic therapy in ACI patients.

Objective To construct a nomogram prediction model for malignant brain edema(MBE) after mechanical thrombectomy in patients with acute ischemic stroke(AACIS) based on serum NOD-like receptor hot protein domain-related protein 3(NLRP3), sE-selectin(sE-selectin) and intercellular adhesion molecule-1(ICAM-1) levels.Methods Patients with acute anterior circulation ischemic stroke(receiving mechanical thrombus removal, n=368) admitted to the Second Department of Neurology, Zhangjiakou First Hospital from January 2020 to December 2023 were selected as the study objects. According to whether MBE occurred 72 h after surgery, the patients were divided into 73 cases in the MBE group and 295 cases in the non-MBE group. Serum NLRP3, sE-selectin and ICAM-1 levels were compared between the two groups. Multivariate Logistic regression was used to analyze the risk factors of MBE after mechanical thrombectomy in AACIS patients, and the risk nomogram prediction model was constructed. Receiver operating characteristic(ROC) curve analysis of the model predicted the efficacy of MBE after mechanical thrombectomy in AACIS patients. Results Serum NLRP3, sE-selectin, ICAM-1 levels in the MBE group were significantly higher than those in the non-MBE group(t=13.570, 11.773, 8.366, all P<0.001). high="" icam-1="" levels="" and="" nihss="" score="" at="" admission="" were="" independent="" risk="" factors="" for="" mbe="" in="" aacis="" patients="" after="" mechanical="" thrombectomy="" roc="" curve="" analysis="" showed="" that="" the="" area="" under="" of="" nomogram="" prediction="" model="" based="" on="" serum="" was="" 0.980.="" consistency="" is="" which="" indicates="" has="" good="" ability.="" decision="" shows="" threshold="" probability="" this="" ranges="" from="" 0.01="" to="" its="" net="" return="" rate="">0, which is higher than the two invalid lines. Conclusion High serum NLRP3, sE-selectin, ICAM-1 levels and high NIHSS score at admission are independent risk factors for MBE after mechanical thrombectomy in AACIS patients, and the nomogram prediction model base on the above risk factors has good predictive value for MBE after mechanical thrombectomy in AACIS patients.

Objective To investigate the prognostic value of serum aquaporin 4(AQP4), high mobility group protein B1(HMGB1), and fibrinogen-like protein 2(FGL2) levels combined with intracranial pressure and partial brain oxygen pressure(PbtO2) monitoring in patients with traumatic brain injury(TBI). Methods A total of 128 TBI patients treated and treated in the South Hospital of the Sixth People's Hospital Affiliated to Shanghai Jiao Tong University/Shanghai Fengxian District Central Hospital from May 2022 to May 2024 were selected as the study objects. According to the prognosis of the patients after 3 months of follow-up, they were divided into the poor prognosis group(n=38) and the good prognosis group(n=90). ELISA method was applied to detect the expression levels of serum AQP4, HMGB1, and FGL2. Spearman method was applied to analyze the correlation between intracranial pressure, PbtO2, serum AQP4, HMGB1, FGL2 and Glasgow Coma Scale(GCS) scores in patients with different prognoses of TBI. ROC curve was applied to analyze the predictive value of intracranial pressure, PbtO2combined with serum AQP4, HMGB1, and FGL2 for the prognosis of TBI patients. Results The intracranial pressure value in the poor prognosis group was prominently higher than that in the good prognosis group, and the GCS score and PbtO2value were obviously lower than those in the good prognosis group(t/P=7.491/<0.001, 9.882/<0.001, 7.215/<0.001). The levels of serum AQP4, HMGB1, and FGL2 in the poor prognosis group were prominently higher than those in the good prognosis group(t/P=7.106/<0.001, 7.642/<0.001, 7.383/<0.001). There was a significant positive correlation between PbtO2and GCS score, while there was a significant negative correlation between intracranial pressure, serum AQP4, HMGB1, FGL2 and GCS score(r/P=0.523/<0.001,-0.515/<0.001,-0.492/<0.001,-0.617/<0.001,-0.569/<0.001). The area under the curve(AUC) of serum AQP4, HMGB1, FGL2, intracranial pressure, PbtO2and the five combined in predicting the prognosis of TBI patients were 0.882, 0.876, 0.817, 0.825, 0.756 and 0.969, respectively. The combined value of the five was superior to that of each alone in predicting the prognosis of TBI patients(Z/P=2.803/0.005, 2.769/0.006, 3.543/<0.001, 3.269/0.001, 3.956/<0.001). Conclusion The intracranial pressure, serum AQP4, HMGB1, and FGL2 levels in TBI patients are obviously elevated, while PbtO2is prominently reduced. They are closely related to prognosis, and combined detection has higher predictive value for the prognosis of TBI patients, providing certain reference for clinical application.

Objective To investigate the levels of serum galectin-3(Gal-3), major histocompatibility complex class I-related chain A(MICA), and 25 hydroxyvitamin D [25(OH)D]in elderly patients with severe pneumonia(SP) complicated by respiratory failure(RF), and their impacts on the disease condition and prognosis. Methods Three hundred and forty-two cases of elderly SP patients admitted to the Department of Intensive Care Medicine of Beidahuang Group General Hospital from August 2022 to July 2024 were selected for the study, and the patients were categorized into 171 cases in the RF group and 171 cases in the non-RF group according to whether or not they were combined with RF. According to the Acute Physiology and Chronic Health Status ScoreⅡ(APACHEⅡ), the elderly SP patients with RF were divided into 41 cases in the low-risk subgroup, 77 cases in the medium-risk subgroup, and 53 cases in the high-risk subgroup; and according to the prognosis of the 28-d follow-up, the elderly SP patients with RF were divided into 51 cases in the death subgroup and 120 cases in the survival subgroup. Serum Gal-3 and MICA levels were measured by ELISA, and serum 25(OH)D levels were measured by high performance liquid chromatography-tandem mass spectrometry(LC-MS/MS); the correlation between serum Gal-3, MICA, and 25(OH)D levels and the degree of the disease was analyzed by the Spearman's method; the factors influencing the prognosis of death of the elderly patients with SP and RF were analyzed by multifactorial logistic analysis; the factors influencing the prognosis of death of the elderly patients with SP and RF were analyzed by multifactorial logistic analysis. The influencing factors of prognostic death in patients; the predictive value of serum Gal-3, MICA, and 25(OH)D levels on prognostic death in elderly SP combined with RF patients was evaluated by subject work characteristics(ROC) curves. Results Serum Gal-3 and MICA levels were higher in the RF group than in the non-RF group, and serum 25(OH)D levels were lower than in the non-RF group(t/P=12.674/<0.001, 20.954/<0.001, 22.872/<0.001); along with the aggravation of the disease, the levels of serum Gal-3 and MICA in the elderly patients with SP combined with RF were gradually increased, and serum 25( OH)D levels gradually decreased(F/P=41.512/<0.001, 221.162/<0.001, 165.574/<0.001); Spearman's correlation analysis showed a positive correlation between the severity of the disease in elderly SP combined with RF patients and the serum Gal-3 and MICA levels(r=0.682, 0.726, both P<0.001) and negatively correlated with serum 25(OH)D levels(r=-0.733, P<0.001); at 28 d of follow-up, the incidence of prognostic death in 171 elderly SP combined with RF patients was 29.82%(51/171). The oxygenation index(PaO2/FiO2) and serum 25(OH)D levels were lower in the death subgroup than in the survival subgroup, and the mechanical ventilation time, APACHE II score, serum Gal-3, and MICA levels were higher than those in the survival subgroup(t/P=2.392/0.018, 13.242/<0.001, 2.235/0.027, 10.805/< 0.001, 7.852/<0.001, 16.923/<0.001); and the results of multifactorial logistic regression analysis showed that prolonged mechanical ventilation, high APACHE II score, high Gal-3, and high MICA were the independent risk factors for prognostic mortality in elderly patients with SP combined with RF [OR(95%CI)=2.518(1.385-4.578),3.157(1.849-5.391),3.264(1.863-5.717),and 4.116(2.025-8.368)], and high PaO2/FiO2and high 25(OH)D were independent protective factors [OR(95%CI)=0.549(0.346-0.870),0.426(0.272-0.667)]; the area under the curve(AUC) of serum Gal-3, MICA, and 25(OH)D levels and the combination of the three for predicting prognostic death in elderly patients with SP combined with RF were 0.855, 0.850, 0.835, and 0.968, respectively, and the AUC of the combination of the three was greater than that of serum Gal-