Objective To investigate the therapeutic effect of joint of Shensong Yangxin Capsules and calcium dibutyryladenosine cyclophosphate on patients with heart failure with concurrent arrhythmia, and its impacts on serum matrix metalloproteinase-9(MMP-9), B-type natriuretic peptide(BNP), and aldosterone(ALD). Methods From July 2022 to July 2024, 124 patients with heart failure with concurrent arrhythmia treated in our hospital were regarded as the study subjects and included into the control group and the joint group, each with 62 patients. The control group adopted calcium dibutyryladenosine cyclophosphate, while the joint group adopted joint of Shensong Yangxin Capsules and calcium dibutyryladenosine cyclophosphate. After treatment, the clinical therapeutic effect, cardiac function indicators [left ventricular end systolic diameter(LVESD), left ventricular end diastolic diameter(LVEDD), left ventricular ejection fraction(LVEF), and stroke volume(SV)], arrhythmia indicators [24h standard deviation of normal R-R interval(SDNN), 24h continuous 5-minute standard deviation of normal R-R interval(SDANN), and root mean square of adjacent normal R-R interval differences(rMSSD)], 24h electrocardiogram parameters [PR interval, QTc interval, and 24h Q-T interval variability(24h QTV)], serum factors [matrix metalloproteinase-9(MMP-9), B-type natriuretic peptide(BNP), aldosterone(ALD), interleukin-1β(IL-1β), IL-6, and high-sensitivity C-reactive protein(hs-CRP)], and safety were evaluated. Results The joint group showed clearly better therapeutic effects than the control group(P<0.05). After treatment, the various indicators showed clear differences compared to before treatment(χ2/P=5.962/0.015), and the joint group had clearly lower LVESD(t=3.617,P<0.01), LVEDD(t=3.043,P=0.003), QTc(t=3.312,P=0.001), MMP-9(t=16.429,P<0.01), BNP(t=16.866,P<0.01), ALD(t=14.559,P<0.01), IL-1β(t=6.148,P<0.01), IL-6(t=11.977,P<0.01),and hs-CRP(t=10.736, P<0.01) than control group, and clearly higher LVEF(t=2.805,P=0.006), SV(t=6.345, P<0.001), SDNN(t=10.585,P=0.006), SDANN(t=4.982,P<0.001), rMSSD(t=10.392,P=0.003)、PR interval(t=3.592,P<0.01), 24h QTV(t=8.580,P<0.01)than control="" group.="" in="" the="" safety="" there="" was="" no="" clear="" difference="" adverse="" reactions="" between="" two="" p="">0.05). Conclusion The joint of Shensong Yangxin Capsules and calcium dibutyryladenosine cyclophosphate can clearly improve the clinical therapeutic effect of patients with heart failure with concurrent arrhythmia, promote the recovery of heart function, alleviate arrhythmia, inhibit inflammatory factors, and have high safety.

Objective To investigate the changes of serum complement C1q/tumor necrosis factor related protein 6(CTRP6) and Krüppel-like factor 10(KLF10) levels in patients with acute ischemic stroke(AIS) and their relationship with the degree of neurological deficits. Methods A total of 136 AIS patients admitted to the Department of Neurology in Mianzhu People's Hospital from January 2020 to July 2024 were selected as AIS group. According to the degree of neurological deficit [National Institutes of Health Stroke Scale(NIHSS) score], they were divided into mild subgroup( n=47), moderate subgroup( n=48) and severe subgroup( n=41). Another 68 healthy volunteers were selected as healthy control group. Serum levels of CTRP6 and KLF10 were detected by enzyme-linked immunosorbent assay. Spearman correlation analysis was used to analyze the correlation between serum CTRP6, KLF10 levels and NIHSS scores in AIS patients. Multivariate Logistic regression analysis was used to analyze the influencing factors of severe neurological deficits in AIS patients. The receiver operating characteristic(ROC) curve was used to analyze the diagnostic efficiency of serum CTRP6 and KLF10 levels for severe neurological deficits in AIS patients. Results The serum CTRP6 level in the AIS group was lower than that in the healthy control group, and the KLF10 level was higher than that in the healthy control group( t/P=14.134/<0.001,14.0374/<0.001); age, cerebral infarction volume, serum KLF10 level mild subgroup < moderate subgroup < severe subgroup, serum CTRP6 level mild subgroup >moderate subgroup > severe subgroup( F/P=31.995/<0.001,568.359/<0.001,84.772/<0.001,75.117/<0.001); Pearson correlation analysis showed that the NIHSS score of AIS patients was negatively correlated with serum CTRP6 level( rs/P=-0.759/<0.001) and positively correlated with serum KLF10 level( rs/P=0.747/<0.001); multivariate Logistic regression analysis showed that large cerebral infarction volume and high serum KLF10 level were independent risk factors for severe neurological deficits in AIS patients[OR(95%CI)=2.178(1.291-3.674),1.122(1.022-1.232)], and high serum CTRP6 level was an independent protective factor[OR(95%CI)=0.857(0.747-0.982)]; the AUC of serum CTRP6, KLF10 levels and the combination of the two in the diagnosis of severe neurological deficits in AIS patients were 0.835,0.821 and 0.915, respectively. The combination of the two was better than the single diagnosis( Z/P=2.868/0.004,3.054/0.002).Conclusion The decrease of serum CTRP6 level and the increase of KLF10 level in AIS patients are related to the aggravation of neurological deficits. The combination of serum CTRP6 and KLF10 levels has a high diagnostic efficiency for severe neurological deficits in AIS patients.

Objective To explore the predictive value of Nerve Injury-induced Protein-1(NINJ1) for the first-pass effect in patients with acute ischemic stroke(AIS). Methods A total of 104 AIS patients who underwent mechanical thrombectomy in the Neurology Department of Liaoyang Central Hospital from January 2024 and December 2024 were enrolled in the AIS group, another 30 health check-up participants who underwent physical examination in our hospital during the same period were selected as the healthy control group. AIS patients were divided into pass subgroups(32 cases) and non-pass subgroups(72 cases) based on whether first-pass effect was achieved. Clinical and surgical data were collected, and serum NINJ1 levels were measured using ELISA. Pearson correlation analysis was performed to assess the association between serum NINJ1 levels and clinical parameters in AIS patients. Multivariate logistic regression analysis was used to identify factors influencing the first-pass effect in AIS patients. Receiver operating characteristic(ROC) curve analysis was conducted to evaluate the predictive value of clinical indicators for the first-pass effect. Results Serum NINJ1 levels were significantly higher in the AIS group compared to the healthy control group( t/P=6.999/<0.001). The pass subgroups exhibited lower age, National Institutes of Health Stroke Scale(NIHSS) scores, and serum NINJ1 levels, but higher clot burden scores(CBS) compared to the non-pass subgroups( t/P=2.865/0.005, 2.703/0.008, 5.608/<0.001, 6.194/<0.001). Pearson correlation analysis showed that serum NINJ1 levels positively correlated with NIHSS scores( r/P=0.364/0.012) and negatively with CBS( r/P=-0.452/<0.001). Multivariate Logistic regression analysis showed that low age, low NIHSS score and low serum NINJ1 level were protective factors for AIS patients' first-pass effect [OR(95%CI)=0.807(0.660-0.985),0.751(0.585-0.966),0.628(0.414-0.954)], while low CBS score was a risk factor[OR(95%CI)=2.179(1.155-4.113)]. The CBS scores and serum NINJ1 level had high predictive value for first-pass effect, with areas under the curve(AUC) of 0.772 and 0.763, respectively. Combining CBS score and serum NINJ1 level further improved the AUC to 0.899(Z=2.170,2.412,P=0.030,0.016). Conclusion NINJ1 is abnormally high expression in the serum of AIS patients, and its expression level is closely related to whether the patients can obtain the first-pass effect. Serum NINJ1 has high application value in predicting the first-pass effect.

Objective Exploring the value of serum circulating tumor cells(CTCs) in prognostic evaluation of gastric cancer surgery patients. Methods A retrospective study was conducted on 86 patients with gastric cancer admitted from January 2019 to January 2021. The expression of CTCs was detected and divided into a CTCs positive group of 78 cases and a CTCs negative group of 8 cases. The relationship between different CTCs expression and CTCs positive patients of different subtypes and clinical staging, efficacy, and prognosis of gastric cancer was analyzed. Results The positive rate of gastric cancer patients was 90.70%, and the level of CTCs was(5.12 ± 0.14)/5ml, there were significant difference(F/P=11.932/0.001). Subtype analysis showed that there were 18 cases of stromal type, with an average detection of(1.51 ± 0.06)/5ml, epithelial type(1.82 ± 0.11)/5ml, and mixed type(3.52 ± 0.21)/5ml. The detection rates of CTCs in T3-4 stage, N1-3 stage, and AJCC stage Ⅲ patients were higher than those in T1-2 stage, N0 stage, and AJCC stage Ⅰ-Ⅱ, respectively, and the differences were statistically significant( χ2/P=6.710/0.010, 8.006/0.005, 6.323/0.012), and the positive rates of CTCs in different subtypes were also statistically significant( χ2/P=4.256/0.044, 34.864/<0.001, 22.508/<0.001). The detection rate of postoperative CTCs was significantly lower than that before surgery, and the difference was statistically significant(90.70% vs. 13.96%, χ2/P=101.522/<0.001). The detection rate of CTCs in different CTCs subtypes also showed statistically significant differences( χ2/P=7.205/0.027). The survival rate of CTCs positive patients was significantly lower than that of CTCs negative patients, and the PFS and OS were significantly lower than those of CTCs negative group, with statistical significance(P<0.001). The 3-year survival rate of CTCs interstitial type patients was significantly lower than that of CTCs epithelial type and CTCs mixed type patients, and the PFS and OS were significantly lower than those of CTCs epithelial type and CTCs mixed type patients, with statistical significance(P<0.001).Conclusion Gastric cancer patients have a very high positive detection rate of CTCs, and there are multiple subtypes. The positive rate and subtypes of CTCs are closely related to the clinical stage and prognosis of patients.

Objective To investigate the correlation and prognostic significance of cell cycle associated protein 1(CAPRIN1) and podoplanin(PDPN) expression with invasion and metastasis genes in colorectal cancer(CRC) tissues. Methods The cancer tissues and adjacent tissues of 132 patients with CRC admitted to the Department of Gastrointestinal Surgery, the Tenth Affiliated Hospital of Southern Medical University/Dongguan People 's Hospital from January 2020 to September 2021 were selected. Real-time fluorescence quantitative PCR(qPCR) was used to detect the mRNA expression of CAPRIN1, PDPN, invasion and metastasis genes[N-cadherin(N-cad), E-cadherin(E-cad), vimentin(Vim)]in adjacent tissues and cancer tissues, and the protein expression of CAPRIN1 and PDPN was detected by immunohistochemistry; R language was used to analyze the expression of CAPRIN1 and PDPN mRNA in CRC adjacent tissues and cancer tissues in the Cancer Genome Atlas(TCGA) database; Pearson correlation analysis was used to study the correlation between CAPRIN1, PDPN mRNA expression and invasion and metastasis gene mRNA expression; Kaplan-Meier curve was used to analyze the effect of CAPRIN1 and PDPN protein expression on the survival prognosis of CRC patients; Cox regression analysis was used to analyze the prognostic factors of CRC patients. Results The results of TCGA database analysis showed that the expression of CAPRIN1 and PDPN mRNA in CRC cancer tissues was higher than that in adjacent tissues( t/P=13.634/<0.001,8.866/0.003). The relative expression levels of CAPRIN1, PDPN, N-cad and Vim mRNA in cancer tissues of CRC patients were higher than those in adjacent tissues, and the relative expression level of E-cad mRNA was lower than that in adjacent tissues( t/P=45.444/<0.001,49.623/<0.001,44.997/<0.001,41.465/<0.001,26.139/<0.001). Pearson correlation analysis showed that the relative expression of CAPRIN1 and PDPN mRNA in CRC cancer tissues was positively correlated with the relative expression of N-cad and Vim mRNA, and negatively correlated with the relative expression of E-cad mRNA(CAPRIN1: r/P=0.706/<0.001,0.630/<0.001,-0.712/<0.001;PDPN: r/P=0.739/<0.001,0.662/<0.001,0.640/<0.001).The positive rates of CAPRIN1 and PDPN protein in cancer tissues of CRC patients were 71.21 %(94/132) and 74.24 %(98/132), respectively, which were higher than 8.33 %(11/132) and 10.61 %(14/132) in adjacent tissues( χ2/P=108.937/<0.001,109.421/<0.001).The positive rates of CAPRIN1 and PDPN proteins in CRC tissues with TNM stage Ⅲ and lymph node metastasis were higher than those with TNM stage Ⅰ-Ⅱ and no lymph node metastasis( χ2/P=10.407/0.001,7.955/0.005,10.160/0.001,7.659/0.006).The 3-year overall survival rate of CAPRIN1 positive group was 57.47 %(54/94), which was lower than 73.68 %(28/38) of CAPRIN1 negative group(Log-rank χ2=3.821,P=0.014). The 3-year overall survival rate of PDPN positive group was 57.14%(56/98), which was lower than 76.47 %(26/34) of PDPN negative group(Log-rank χ2=4.154,P=0.006). Multivariate Cox regression analysis showed that TNM stage Ⅲ, lymph node metastasis, CAPRIN1 positive and PDPN positive were independent risk factors affecting the prognosis of CRC patients[HR(95%CI)=1.323(1.085-1.613),1.362(1.094-1.696),1.323(1.103-1.588),1.301(1.110-1.525)].Conclusio
n The mRNA and protein expression of CAPRIN1 and PDPN are elevated in CRC cancer tissues, which are associated with the expression of invasion and metastasis genes and serve as tumor markers for prognosis evaluation of CRC.