ObjectiveTo investigate the relationship of serum interleukins(ILs), interferon γ(IFN-γ) and tumor necrosis factor α(TNF-α) with infarction area and neurological function in elderly patients with cerebral infarction(CI).MethodsOne hundred and six elderly patients with CI(CI group) in Department of Neurology of the First People's Hospital of Chuzhou were selected from January 2019 to December 2024, and they were divided into mild-to-moderate subgroup(76 cases) and severe subgroup(30 cases) according to the degree of neurological impairment. Another 50 healthy elderly people with physical examination during the same period were included in the healthy control group. The levels of serum ILs(IL-2, IL-4, IL-6, IL-10), IFN-γ and TNF-α were measured by enzyme-linked immunosorbent assay(ELISA), and the infarction area was evaluated by magnetic resonance imaging(MR). Pearson correlation analysis was performed to analyze the correlation between serum ILs, IFN-γ and TNF-α levels and infarction area and neurological function in CI patients. Receiver operating characteristic(ROC) curve was applied to assess the predictive value of serum ILs, IFN-γ and TNF-α levels on poor prognosis in elderly CI patients.ResultsThe levels of serum IL-2, IL-4, IL-6, IL-10, IFN-γ and TNF-α in the CI group were higher than those in the healthy control group(t=9.795, 9.709, 10.756, 10.660, 9.784, 9.726, P<0.001). Serum IL-2, IL-4, IL-6, IL-10, IFN-γ, TNF-α, infarction area and mRS score in the poor prognosis subgroup were higher than those in the good prognosis subgroup while the Barthel index score was lower than that in the good prognosis subgroup(t=8.121,9.004,9.468,8.552,7.665,8.220,8.404,9.874,9.343, all P<0.001). Pearson correlation analysis suggested that serum levels of IL-2, IL-4, IL-6, IL-10, IFN-γ and TNF-α were positively correlated with infarction area(r=0.523, 0.467, 0.572, 0.498, 0.534, 0.589, all P<0.001) and mRS score(r=0.475, 0.423, 0.518, 0.455, 0.491, 0.541, all P<0.001), and were negatively correlated with Barthel index(r=-0.489,-0.439,-0.534,-0.471,-0.507,-0.562, all P<0.001). The AUCs of serum IL-2, IL-4, IL-6, IL-10, IFN-γ, TNF-α and combination of six factors in predicting poor prognosis in elderly patients with CI were 0.963,0.934,0.908,0.921,0.862,0.885,0.999 respectively. The AUC of the combination of six factors was greater than that of serum IL-2, IL-4, IL-6, IL-10, IFN-γ or TNF-α alone(Z=27.481,19.355,13.150,16.461,10.289,10.674, all P<0.001).ConclusionSerum IL-2, IL-4, IL-6, IL-10, IFN-γ and TNF-α are closely related to infarction area and neurological function in elderly CI patients. The higher the levels of inflammatory factors, the larger the infarction area, and the more serious the neurological impairment.

ObjectiveTo investigate the relationship between the expression levels of Sirtuin-6(SIRT6) and Chitinase-3-like protein 1(CHI3L1) in the serum of patients with chronic hepatitis B(CHB) and the severity of liver fibrosis.MethodsA total of 124 CHB patients admitted to our hospital between March 2023 and April 2024 were included as the research subjects. According to the Scheuer system scoring results, they were assigned into a significant liver fibrosis group(Scheuer score ≥ 2) of 58 cases and a non-significant liver fibrosis group(Scheuer score<2) of 66 cases. ELISA method was used to detect the levels of serum SIRT6 and CHI3L1. Multivariate logistic regression analysis was applied to determine the risk factors for the degree of liver fibrosis in CHB patients. The diagnostic value of serum SIRT6 and CHI3L1 for the degree of liver fibrosis in CHB patients was analyzed by plotting ROC curves.ResultsCompared with the non-significant liver fibrosis group, the significant liver fibrosis group showed a significant decrease in serum SIRT6 level and a significant increase in serum CHI3L1 level in CHB patients(t/P=6.719/<0.001, 7.546/<0.001). The proportion of HBeAg positive individuals and HBV-DNA level in the significant liver fibrosis group were higher than those in the non-significant liver fibrosis group(t/P=24.125/<0.001, 10.246/<0.001). CHI3L1 was an independent risk factor for the degree of liver fibrosis in CHB patients[OR(95%CI)=2.932(1.554-5.533)], while SIRT6 was a protective factor for the degree of liver fibrosis in CHB patients [OR(95%CI)=0.586(0.435-0.789)]. The AUC of serum SIRT6, CHI3L1 and value the combined diagnosis for the degree of liver fibrosis in CHB patients was 0.897,0.856,0.963, and the AUC of the combined diagnosis was better than that of the individual diagnosis(Z=2.888, 3.676,P=0.004, 0.000).ConclusionThe serum SIRT6 level is decreased and CHI3L1 level is increased in CHB patients, they are related to the degree of liver fibrosis. The combination of the two has certain value in diagnosing the degree of liver fibrosis in CHB patients.

ObjectiveTo explore the therapeutic effect of Bifid as an adjuvant therapy for mild biliary acute pancreatitis(BAP) and its impacts on inflammatory factors, intestinal function, and immune function.MethodsA total of 140 mild BAP patients treated in our hospital from February 2019 to October 2023 were collected and randomly separated into a treatment group and a reference group, with 70 cases in each group. The reference group received routine treatment, while the treatment group received adjuvant treatment with Bifid(bifid triple viable capsule) in addition to the reference group. The clinical efficacy of two groups was analyzed. The relief time of abdominal pain and relief time of bloating were compared between the two groups. The levels of C-reactive protein(CRP), interleukin-6(IL-6), white blood cell count(WBC), endotoxins, diamine oxidase(DAO), D-lactate, amylase(AMY), lipase(LIPA), and immunoglobulins(IgG, IgA, and IgM) were detected before and after treatment.ResultsThe total effective rate of the treatment group was 92.86%, which was obviously better than the reference group of 80.00%(χ2/P=4.933/0.026). After treatment, the disappearance time of abdominal pain and bloating in the treatment group were obviously shorter than those in the reference group(t/P=8.117/<0.001, 6.857/<0.001). the="" levels="" of="" serum="" and="" igm="" in="" two="" groups="" before="" treatment="" were="" not="" statistically="" p="">0.05). After treatment, the levels of CRP, IL-6, WBC, endotoxin, DAO, D-lactate, AMY, and LIPA in both groups were obviously lower than before treatment. Compared with the reference group, the difference in the treatment group was more obvious(t/P=4.087/<0.001,8.654/<0.001,12.334/<0.001,15.503/<0.001,13.900/<0.001,14.254/<0.001,26.761/<0.001,12.610/<0.001), while the levels of IgA, IgG, and IgM were obviously increased, and the treatment group were higher than the reference group(t/P=3.244/<0.001,7.351/<0.001,10.249/<0.001).ConclusionBifid adjuvant therapy can improve the efficacy of mild BAP, inhibit inflammation, regulate intestinal barrier function, and restore immune function.

ObjectiveTo investigate the changes in serum levels of serum/glucocorticoid-regulated kinase 1(SGK1) and X-box binding protein 1(XBP1) in ulcerative colitis(UC) patients with varying degrees of disease activity, and to explore their correlation with prognosis.MethodsA total of 92 active-phase UC patients and 92 remission-phase UC patients were selected from the Department of Gastroenterology, Ankang Central Hospital, from January 2021 to January 2024. The active-phase UC patients were further divided into mild, moderate, and severe subgroups based on disease activity(24, 29, and 39 patients, respectively). According to the 6-month prognosis, patients were categorized into poor prognosis(34 patients) and good prognosis(58 patients) subgroups. Serum SGK1 and XBP1 levels were measured by enzyme-linked immunosorbent assay. The correlation between serum SGK1 and XBP1 levels and prognosis in active-phase UC patients was analyzed using multivariate unconditional logistic regression and ROC curve analysis.ResultsThe serum SGK1 level in the active-phase group was higher than that in the remission-phase group, while the serum XBP1 level was lower in the active-phase group(t/P=11.051/<0.001, 14.639/<0.001). Among active phase subgroups, SGK1 levels were highest in the severe activity subgroup, followed by the moderate and mild activity subgroups, while XBP1 levels were lowest in the severe activity subgroup, followed by the moderate and mild activity subgroups(F/P=215.932/<0.001, 269.335/<0.001). The unfavorable prognosis rate among active phase UC patients was 36.96%(34/92). Compared with the favorable prognosis subgroup, the unfavorable prognosis subgroup exhibited higher disease severity and SGK1 levels, and lower XBP1 levels(χ2/t/P=4.852/<0.001, 5.689/<0.001,5.077/<0.001). Severe disease activity and elevated SGK1 were independent risk factors for unfavorable prognosis in active phase UC, while elevated XBP1 was an independent protective factor[OR(95%CI) = 4.929(1.756 to 13.833), 1.147(1.053 to 1.250), 0.783(0.677 to 0.905)]. The area under the curve(AUC) for predicting unfavorable prognosis in active phase UC was 0.795 for SGK1, 0.792 for XBP1, and 0.881 for the combined model of SGK1 and XBP1. The combined model showed significantly better predictive efficacy than SGK1 or XBP1 alone(Z/P=2.122/0.034, 2.382/0.017).ConclusionElevated serum SGK1 levels and decreased XBP1 levels in UC patients are associated with increased disease activity and poor prognosis. The combined prediction of prognosis using both SGK1 and XBP1 levels has high predictive efficacy in patients with active UC.

ObjectiveTo investigate the correlation between serum Lipocalin-2, Ficolin-2, and vascular restenosis after interventional treatment of lower extremity arteriosclerosis obliterans(LEASO).MethodsA total of 130 patients with LEASO who underwent interventional therapy in the Department of Vascular Surgery, Mingji Hospital Affiliated to Nanjing Medical University from January 2018 to June 2023 were selected as the LEASO group. According to whether vascular restenosis occurred during the 1-year follow-up, LEASO patients were divided into restenosis subgroup of 40 cases and non-restenosis subgroup of 90 cases.80 cases of healthy physical examination in the hospital during the same period were selected as healthy control group. The levels of serum Lipocalin-2 and Ficolin-2 were detected by enzyme-linked immunosorbent assay. Pearson correlation analysis was used to analyze the correlation between serum Lipocalin-2, Ficolin-2 levels and lumen diameter reduction rate in LEASO patients. Multivariate Logistic regression analysis was used to analyze the influencing factors of vascular restenosis after interventional therapy in LEASO patients. The receiver operating characteristic(ROC) curve was used to evaluate the predictive efficacy of serum Lipocalin-2 and Ficolin-2 levels on vascular restenosis after interventional therapy in LEASO patients.ResultsThe serum levels of Lipocalin-2 and Ficolin-2 in the LEASO group were higher than those in the healthy control group, and the differences were statistically significant(t/P=23.943/<0.001, 29.774/<0.001); Serum Lipocalin-2 and Ficolin-2 levels in LEASO patients were positively correlated with lumen diameter reduction rate(r/P=0.719/<0.001, 0.730/<0.001); After 1 year of interventional therapy, the incidence of vascular restenosis in 130 patients with LEASO was 30.77%(40/130). The proportion of diabetes, hypertension and serum Lipocalin-2 and Ficolin-2 levels in the restenosis subgroup were higher than those in the non-restenosis subgroup, and the differences were statistically significant(χ2/t/P=6.945/0.008,6.644/0.010,6.295/<0.001,5.657/<0.001); Diabetes, high Lipocalin-2 and high Ficolin-2 were independent risk factors for vascular restenosis after interventional therapy in patients with LEASO[OR(95%CI)=3.383(1.187-9.647),1.264(1.120-1.427),1.272(1.113-1.454)];The AUC of serum Lipocalin-2, Ficolin-2 levels and their combination in predicting vascular restenosis after interventional therapy in LEASO patients were 0.789, 0.786 and 0.875, respectively. The AUC predicted by the combination of the two was greater than that predicted by serum Lipocalin-2 and Ficolin-2 levels alone, and the difference was statistically significant(Z/P=2.502/0.012,2.339/0.019).ConclusionThe levels of serum Lipocalin-2 and Ficolin-2 in patients with LEASO are increased, which is closely related to vascular restenosis after interventional therapy. The combination of serum Lipocalin-2 and Ficolin-2 levels has a high predictive efficiency for vascular restenosis after LEASO interventional therapy.