Objective To explore the diagnostic value of transesophageal echocardiography(TEE) combined with serum a disintegrin and metalloproteinase with thrombospondin motifs 13(ADAMTS13) and proprotein convertase subtilisin/kexin type 9(PCSK9) levels in detecting left atrial thrombus in patients with non-valvular atrial fibrillation(NVAF).Methods Ninety-six NVAF patients admitted to the Department of Cardiovascular Medicine of Panyu Central Hospital Affiliated to Guangzhou Medical University from January 2022 to December 2024 were selected as the NVAF group. Based on the presence of left atrial thrombus, patients were divided into a thrombus subgroup(n=42) and a non-thrombus subgroup(n=54). Additionally, 100 healthy individuals undergoing physical examinations during the same period were selected as the healthy control group. Serum ADAMTS13 and PCSK9 levels were measured by ELISA. Multivariate logistic regression analysis was used to identify factors influencing left atrial thrombus formation in NVAF patients. Receiver operating characteristic(ROC) curve analysis was performed to evaluate the diagnostic value of TEE parameters and serum ADAMTS13 and PCSK9 levels for left atrial thrombus.Results Compared with the healthy control group, the NVAF group showed decreased serum ADAMTS13 levels and increased PCSK9 levels(t/P=42.277/<0.001, 42.537/<0.001). The thrombus subgroup exhibited lower peak emptying velocity(PEV), 3D ejection fraction(3D-EF), and serum ADAMTS13 levels, but higher serum PCSK9 levels compared to the non-thrombus subgroup(t/P=5.112/<0.001, 5.104/<0.001, 5.117/<0.001, 5.035/<0.001). Multivariate logistic regression analysis indicated that high PCSK9 was an independent risk factor for left atrial thrombus[OR(95%CI)=2.287(1.443-3.625)], while high PEV, high 3D-EF, and high ADAMTS13 were independent protective factors[OR(95%CI)=0.714(0.600-0.850), 0.725(0.604-0.870), 0.718(0.605-0.851)]. The AUC values for TEE parameters, serum ADAMTS13, PCSK9, and their combination in diagnosing left atrial thrombus were 0.861, 0.894, 0.851, 0.863, and 0.966, respectively. Combined diagnosis demonstrated superior efficacy compared to individual parameters(Z/P=3.190/<0.001, 2.652/<0.001, 3.261/<0.001, 2.830/<0.001).Conclusion Decreased PEV, 3D-EF, and serum ADAMTS13 levels, along with increased serum PCSK9 levels, are associated with left atrial thrombus formation in NVAF patients. The combination of TEE parameters with serum ADAMTS13 and PCSK9 levels provides valuable diagnostic information for detecting left atrial thrombus in NVAF patients.

Objective To investigate the relationship between serum levels of Homer1 and milk fat globule-epidermal growth factor 8(MFG-E8) and delayed cerebral ischemia(DCI) after aneurysmal subarachnoid hemorrhage(aSAH).Methods A total of 109 patients with aSAH admitted to the Department of Neurosurgery, Linfen People's Hospital from June 2021 to June 2024 were enrolled as the aSAH group. These patients were further divided into DCI subgroup and non-DCI subgroup based on DCI occurrence. Additionally, 109 healthy individuals undergoing physical examination during the same period were selected as the healthy control group. Serum Homer1 and MFG-E8 levels were measured using enzyme-linked immunosorbent assay(ELISA). Spearman's correlation analysis was used to analyze the correlations between serum Homer1/MFG-E8 levels and modified Fisher grade and World Federation of Neurosurgical Societies(WFNS) grade in aSAH patients with DCI. Multivariate logistic regression analysis was performed to identify factors influencing DCI occurrence in aSAH patients. Receiver operating characteristic(ROC) curve analysis was used to evaluate the predictive efficacy of serum Homer1 and MFG-E8 levels for DCI.Results Serum Homer1 and MFG-E8 levels in the aSAH group were significantly higher than those in the healthy control group(t/P=22.146/<0.001, 26.088/<0.001). compared="" with="" the="" non-dci="" dci="" subgroup="" had="" older="" higher="" proportions="" of="" aneurysm="" diameter="">15 mm, modified Fisher grade Ⅲ-Ⅳ, and WFNS grade Ⅲ-Ⅳ, as well as higher serum Homer1 and MFG-E8 levels(t/χ2/P=2.214/0.029, 4.974/0.026, 8.928/0.012, 12.118/<0.001, 6.016/0.014, 16.231/<0.001, 142.580/<0.001). In aSAH patients with DCI, serum Homer1 and MFG-E8 levels were positively correlated with modified Fisher grade and WFNS grade(Homer1:rs/P=0.306/0.002, 0.441/<0.001; MFG-E8:rs/P=0.480/<0.001, 0.386/<0.001). Multivariate logistic regression analysis showed that modified Fisher grade Ⅲ-Ⅳ, high Homer1 level, and high MFG-E8 level were independent risk factors for DCI in aSAH patients [OR(95%CI)=2.060(1.165-3.645), 1.540(1.146-2.071), 1.663(1.162-2.381)]. The areas under the curve(AUC) of serum Homer1, MFG-E8, and their combination for predicting DCI were 0.796, 0.759, and 0.906, respectively, with the combined prediction being superior to either biomarker alone(Z/P=2.265/0.024, 3.119/0.002).Conclusion Elevated serum Homer1 and MFG-E8 levels in aSAH patients are associated with higher WFNS grade, higher modified Fisher grade, and DCI occurrence. The combination of Homer1 and MFG-E8 demonstrates effective predictive value for DCI risk.

Objective To investigate the relationship between Helicobacter pylori(Hp) infection and serum nuclear factor kappa B(NF-κB), gastrin-17(G-17), and insulin-like growth factor-1(IGF-1) in elderly patients with chronic gastritis(CG).Methods A total of 120 elderly CG patients admitted to the Third Medical Center of Chinese PLA General Hospital from January to December 2024 were enrolled and divided into an Hp-infected group and an uninfected group based on Hp infection status. General patient information was collected, and serum levels of NF-κB, G-17, and IGF-1 were measured and compared between the two groups upon admission. Logistic regression analysis was used to analyze the correlation between serum NF-κB, G-17, and IGF-1 levels and Hp infection in elderly CG patients. Receiver operating characteristic(ROC) curves were plotted to evaluate the diagnostic value of serum NF-κB, G-17, and IGF-1 levels for Hp infection.Results Among the 120 elderly CG patients who underwent 13C urea breath testing, 77(64.17%) were positive(infected group) and 43(35.83%) were negative(uninfected group). Serum interleukin-6(IL-6) and C-reactive protein(CRP) levels in the infected group were higher than those in the uninfected group(t=6.944, 6.154, both P<0.05). no="" significant="" differences="" were="" observed="" in="" other="" baseline="" characteristics="" such="" as="" gender="" and="" age="" between="" the="" two="" p="">0.05). The infected group showed higher serum NF-κB levels but lower G-17 and IGF-1 levels compared to the uninfected group(t=7.967, 8.118, 5.392, all P<0.05). Logistic regression analysis indicated that high serum G-17 and IGF-1 levels were protective factors against Hp infection(OR=0.813, 0.725; P=0.002, 0.010), while high NF-κB, IL-6, and CRP levels were risk factors(OR=2.282, 2.278, 4.375; P=0.002, 0.035, 0.010). ROC analysis showed that serum NF-κB, G-17, and IGF-1 levels, both individually and in combination, had diagnostic value for Hp infection, with AUC values of 0.887, 0.794, and 0.711, respectively. Combined detection further improved diagnostic performance(AUC=0.902).Conclusion Hp infection in elderly CG patients is associated with serum NF-κB, G-17, and IGF-1 levels. Individual and combined detection of these serum markers demonstrates certain diagnostic value for Hp infection.

Objective To explore the diagnostic value of serum macrophage inflammatory protein-1α(MIP-1α) and pentraxin 3(PTX3) in patients with cirrhotic ascites complicated with spontaneous bacterial peritonitis(SBP).Methods From August 2019 to December 2024, 126 patients with cirrhotic ascites diagnosed and treated in the Department of Gastroenterology, Chengdu Seventh People's Hospital were enrolled. According to the occurrence of SBP, the patients were divided into an SBP group(n=37) and a non-SBP group(n=89). Serum MIP-1α and PTX3 levels were measured by ELISA. Multivariate logistic regression analysis was used to identify influencing factors for cirrhotic ascites complicated with SBP. The diagnostic value of serum MIP-1α and PTX3 was evaluated using ROC curve analysis.Results The levels of serum MIP-1α, PTX3, and the percentage of polymorphonuclear cells in ascites in the SBP group were significantly higher than those in the non-SBP group(t/P=8.111, 8.108/<0.001). High MIP-1α, high PTX3, and a high percentage of polymorphonuclear cells in ascites were identified as independent risk factors for cirrhotic ascites complicated with SBP[OR(95%CI)=1.095(1.049-1.143), 2.265(1.530-3.352), 1.543(1.020-2.333)]. The AUC values of serum MIP-1α, PTX3, and their combination for diagnosing cirrhotic ascites complicated with SBP were 0.885, 0.884, and 0.965, respectively. The combined diagnostic value was superior to that of either biomarker alone(Z=2.804, 2.880, P=0.005, 0.004).Conclusion Serum MIP-1α and PTX3 levels are elevated in patients with cirrhotic ascites complicated with SBP. The combination of the two biomarkers demonstrates good diagnostic efficacy for this condition.

Objective To explore the changes of triglyceride-glucose(TyG) index and its clinical significance in elderly patients with type 2 diabetes mellitus(T2DM) complicated with cerebral small vessel disease(CSVD).Methods A total of 317 elderly T2DM patients admitted to Xuanwu Hospital Capital Medical University from January 2021 to October 2023 were enrolled. Patients were divided into CSVD group(n=149) and non-CSVD group(n=168) based on CSVD comorbidity. The CSVD group was further stratified into mild(n=72), moderate(n=50), and severe(n=27) subgroups according to disease severity. Spearman's correlation analysis was used to analyze the relationship between TyG index and disease severity. Multivariate logistic regression analysis was conducted to identify influencing factors for CSVD in elderly T2DM patients. Receiver operating characteristic(ROC) curve analysis was performed to evaluate the predictive value of TyG index for CSVD in elderly T2DM patients.Results The TyG index in the CSVD group was significantly higher than that in the non-CSVD group(t/P=16.531/<0.001). among="" csvd="" the="" tyg="" index="" showed="" a="" severity-dependent="" increase:="" severe="" subgroup="">moderate subgroup > mild subgroup(F/P=22.610/<0.001). Spearman's correlation analysis revealed significant positive correlations between TyG index and CSVD severity, Fazekas score, cerebral microbleeds grade, number of lacunar infarcts, and basal ganglia perivascular space grade(r/P=0.723/<0.001, 0.685/<0.001, 0.652/<0.001, 0.701/<0.001, 0.668/<0.001). Multivariate logistic regression identified long T2DM duration, high FPG, high HbA1c, high SCr, high UA, high BUN, high Cys-C, high UACR, and high TyG index as independent risk factors for CSVD [OR(95%CI)=1.526(1.298-1.795), 1.265(1.118-1.433), 1.366(1.187-1.569), 1.035(1.019-1.051), 1.108(1.010-1.027), 1.412(1.191-1.669), 2.776(2.013-3.817), 1.028(1.017-1.039), 1.722(1.375-2.156)], while high eGFR was a protective factor [OR(95%CI)=0.969(0.958-0.980)]. ROC curve analysis showed that the AUC of TyG index for predicting CSVD was 0.838, with sensitivity of 0.685, specificity of 0.929, maximum Youden index of 0.614, optimal cutoff value of 8.245, and 95%CI of 0.790-0.886.Conclusion The TyG index is closely associated with the occurrence and severity of CSVD in elderly T2DM patients and may serve as a potential predictive indicator. Long-term abnormalities in glucose, lipid, and renal function are important risk factors for CSVD.