Objective To investigate the therapeutic effects of endovascular repair with covered stent graft on Stanford type B aortic dissection(AD) and its impact on serum endothelin-1(ET-1) and uric acid levels using propensity score matching(PSM). Methods From July 2021 to March 2024, a total of 160 patients with Stanford type B aortic dissection(AD) admitted to the Department of Cardiovascular Surgery at the Seventh People's Hospital of Zhengzhou were enrolled in this study. These patients were randomly divided into a study group and a control group using a random number table. The control group received conventional medical conservative treatment, while the study group received endovascular repair with a covered stent graft in addition to the treatment given to the control group. The clinical data of the two groups of patients were matched at a ratio of 1:1, and ultimately, 58 pairs of patients were successfully matched. The study compared the in-hospital mortality rate, the rate of reoperation or reintervention, and the incidence of complications between the two groups. Additionally, liver and kidney function, serum ET-1 and uric acid levels were assessed before and 2 weeks after treatment. The Acute Physiology and Chronic Health Evaluation(APACHE Ⅱ) scores, SF-36 scale scores, and follow-up results were also compared between the two groups. Results There was no significant difference in in-hospital mortality rate and the rate of reoperation or reintervention between the two groups(P>0.05). However, the incidence of postoperative complications was higher in the study group than in the control group( χ 2=4.921, P=0.027). Compared with pre-treatment levels, post-treatment levels of ALT, AST, BUN, and SCr in the study group were decreased and were lower than those in the control group(t=9.296,14.561,4.473, 11.468, P<0.001). Similarly, post-treatment levels of ET-1 and serum uric acid in the study group were decreased and lower than those in the control group(t=5.182, 7.411, P<0.001). After treatment, APACHE Ⅱ scores were decreased and SF-36 scores were increased in both groups, with greater changes observed in the study group( t=5.898, 7.982, 4.525, P<0.001). Follow-up results showed that the rates of reoperation or reintervention and mortality were lower in the study group than in the control group( χ 2=8.700, 5.902, P=0.003, 0.015). Conclusion The combination of medical treatment and endovascular repair with covered stent graft for Stanford type B AD patients can improve the quality of life, enhance liver and kidney function, reduce the incidence of complications and re-treatment, and improve the prognosis. The therapeutic effect is superior to that of medical treatment alone, and this may be related to the reduction in serum ET-1 and uric acid levels.

Objective To investigate the predictive value of albumin-corrected anion gap(ACAG) in hemorrhagic transformation(HT) after intravenous thrombolysis in patients with acute ischemic stroke. Methods A total of 184 patients with acute ischemic stroke who received intravenous thrombolytic therapy in Mingji Hospital Affiliated to Nanjing Medical University from September 2021 to September 2024 were selected. They were divided into an HT group(n=39) and a non-HT group(n=145) based on whether HT occurred within 48 hours after thrombolytic therapy. Baseline data and relevant laboratory indicators on the first day of admission were collected. Multivariate logistic regression was used to analyze the influencing factors of HT occurrence in patients, and ROC curve analysis was employed to assess the predictive value of ACAG for HT occurrence in stroke patients. Results The levels of CRP, Cl -, HCO -3, and Alb in the HT group were lower than those in the non-HT group(P<0.05), while the levels of AG and ACAG in the HT group were higher than those in the non-HT group(P<0.05). Multivariate logistic regression analysis showed that ACAG[OR=14.145, 95%CI: 3.078-64.645], AG[OR=2.983, 95%CI: 1.859-4.758], CRP[OR=2.428, 95%CI: 1.101-12.082], and NIHSS score at admission [OR=3.147, 95%CI: 1.906-5.168] were all influencing factors for HT in stroke patients(P<0.05). ROC curve analysis results showed that ACAG had higher predictive efficiency than other indicators, with an AUC of 0.872(95%CI: 0.767-0.972), sensitivity of 0.725, specificity of 0.973, Youden index of 0.698, and an optimal cutoff value of 18.010 mmol/L(P<0.001). Conclusion ACAG has high efficacy in predicting HT after intravenous thrombolysis in stroke patients, outperforming other traditional indicators. A specific ACAG threshold(18.010 mmol/L) can be used clinically to effectively identify patients at high risk of hemorrhagic transformation.

Objective To explore the value of serum synaptic vesicle protein 2A(SV2A) level in the diagnosis and condition assessment of Alzheimer's disease(AD). Methods A total of 130 AD patients(60 cases of mild, 40 cases of moderate and 30 cases of severe) who visited the Department of Neurology of the 904th Hospital of the Joint Logistic Support Force of the People's Liberation Army of China from January 2021 to December 2023 and 20 healthy controls were included. The levels of serum SV2A, Aβ42, Tau protein and p-Tau181 were detected by enzyme-linked immunosorbent assay(ELISA). The correlations were analyzed in combination with cognitive function scales(MMSE, MoCA), disease severity scales(CDR, ADL, NPI) and hippocampal volume. The diagnostic efficacy of SV2A was evaluated by ROC curve. Multiple linear regression is used to screen for independent influencing factors. Results Compared with the healthy control group, the levels of serum SV2A and Aβ42 in the AD group decreased, but the levels of Tau protein and p-Tau181 increased in the AD group(t/P=12.682/<0.001,10.875/<0.001,15.923/<0.001,20.341/<0.001). In the AD group, the levels of serum SV2A and Aβ42 in patients with mild, moderate and severe AD decreased successively, but the levels of Tau protein and p-Tau181 increased successively(F/P=56.789/<0.001,32.145/<0.001,45.670/<0.001,68.912/<0.001).The serum SV2A level showed a decreasing trend with the aggravation of AD severity(150.45±15.87 ng/mL in the healthy control group vs 80.78±13.45 ng/mL in the severe AD group, P<0.001), which was significantly positively correlated with MMSE and MoCA scores(r=0.652, 0.625, both P<0.001), and negatively correlated with CDR, ADL, NPI scores and disease course(r=-0.721 to-0.552, all P<0.001), and was positively correlated with hippocampal volume(r=0.502, P<0.001). Serum SV2A level(OR=0.821, 95%CI:0.756-0.889, P<0.001), age(OR=1.123, 95%CI:1.087-1.160, P<0.001), MMSE score(OR=0.895, 95%CI: 0.856-0.934, P<0.001), ADL score(OR=1.056, 95%CI:1.023-1.089, P<0.001), and hippocampal volume(OR=0.912, 95%CI: 0.876-0.948, P<0.001) were independent risk factors for the progression of AD. The ROC curve further demonstrated that the AUC for predicting the prevalence of AD by combining serum SV2A level, age, MMSE score, ADL score and hippocampal volume increased to 0.905(95%CI: 0.856-0.954, P<0.001), which was significantly higher than that of a single indicator(P<0.001).Conclusion The level of serum SV2A is closely related to the severity of AD and cognitive function, and has high efficacy in the diagnosis of AD. It can be used as a potential biomarker for auxiliary diagnosis and disease assessment.

Objective To explore the predictive value of serum growth differentiation factor-15(GDF-15) and S100 calcium binding protein A12(S100A12) for upper gastrointestinal bleeding(UGIB) in elderly patients with peptic ulcer(PU).Methods A total of 112 patients with PU admitted to the Geriatric Department of Nanjing Tongren Hospital from March 2023 to March 2025 were selected as the PU group. Based on whether they had concomitant upper gastrointestinal bleeding(UGIB), they were divided into a concomitant subgroup and a non-concomitant subgroup. In addition, 60 healthy individuals who underwent physical examinations were selected as the healthy control group. ELISA assay for serum GDF-15 and S100A12 levels. Comparison of serum GDF-15 and S100A12 levels between groups. Multifactorial Logistic regression analysis of factors influencing the incidence of UGIB in patients with PU. Relative risk analysis of serum GDF-15 and S100A12 levels on the incidence of UGIB in patients with PU. Plotting ROC curve to analyze the predictive value of serum GDF-15 and S100A12 levels for UGIB in patients with PU. Results Serum GDF-15 and S100A12 levels were higher in the PU group than in the healthy control group(t/P=22.258/<0.001, 16.540/<0.001). Hemoglobin levels were significantly lower in the concurrent subgroup than in the non-concurrent subgroup, while serum GDF-15 and S100A12 levels were significantly higher in the concurrent subgroup than in the non-concurrent subgroup(t/P=9.274/<0.001, 6.110/<0.001, 5.473/<0.001). Elevated serum GDF-15 levels [OR(95%CI)=6.487(3.345-12.582)] and high S100A12 levels [OR(95%CI)=7.304(4.252-12.546)] are risk factors for UGIB in PU patients, while high hemoglobin levels [OR(95%CI)=0.415(0.272-0.632)] are protective factors for UGIB in PU patients. Serum GDF-15, Patients with high levels of serum GDF-15 and S100A12 who developed UGIB had a 2.734-fold(95%CI: 1.514-4.936) and 4.162-fold(95%CI: 2.102-8.241) higher risk of developing UGIB compared to patients with low levels of serum GDF-15 and S100A12 who developed UGIB(P<0.001 for both). The AUC values for predicting UGIB in PU patients using serum GDF-15, S100A12, and the combination of both were 0.816, 0.811, and 0.915, respectively. The combination of both was superior to each individually in predicting UGIB in PU patients(Z=3.220, 2.490;P=0.001, 0.013).Conclusion Serum GDF-15 and S100A12 are clearly elevated in patients with PU complicated with UGIB, and the combination of serum GDF-15 and S100A12 has high value in predicting PU complicated with UGIB.

Objective To explore the correlation between serum histone deacetylase 4(HDAC4), Rho-associated coiled-coil containing protein kinase 2(ROCK2), and growth arrest-specific gene 6(Gas6) levels with acute kidney injury(AKI) in patients with preeclampsia(PE). Methods A total of 150 patients diagnosed with PE admitted to the Obstetrics Department of Shanxi Children's Hospital(Shanxi Maternal and Child Health Hospital) between March 2022 and March 2025 were selected as the disease group. Based on the presence or absence of AKI, they were further divided into an AKI subgroup(n=71) and a non-AKI subgroup(n=79). Additionally, 94 healthy pregnant women without gestational hypertension identified during obstetric examinations at the hospital during the same period were selected as the control group. ELISA was used to detect serum levels of HDAC4, ROCK2, and Gas6. Pearson correlation analysis was performed to assess the relationship between serum HDAC4, ROCK2, and Gas6 levels and renal injury markers. Multivariate logistic regression analysis was conducted to identify factors influencing the development of AKI in patients with PE. ROC curve analysis was used to evaluate the predictive value of serum HDAC4, ROCK2, and Gas6 levels for AKI in patients with PE. Furthermore, the bootstrap method was employed for internal validation of the joint prediction model. Results The disease group had higher serum HDAC4, ROCK2, and Gas6 levels than the control group(t=22.552, 22.632, 12.355, all P<0.001). SBP, DBP, SCr, BUN, and serum HDAC4, ROCK2, and Gas6 levels were significantly higher in the AKI subgroup than in the non-AKI subgroup(t=2.412, 6.320, 16.167, 11.268, 8.602, 7.719, 8.157; P=0.017, <0.001, <0.001, <0.001, <0.001, <0.001, <0.001). Serum HDAC4, ROCK2, and Gas6 were positively correlated with SCr(r=0.493, 0.527, 0.504, all P<0.001) and BUN(r=0.482, 0.539, 0.526, all P<0.001). Elevated SBP, DBP, SCr, BUN, HDAC4, ROCK2, and Gas6 were all risk factors for AKI in PE patients[OR(95%CI) = 1.613(1.036-2.512), 1.542(1.056-2.251), 1.879(1.162-3.037), 1.924(1.223-3.026), 2.581(1.529-4.356), 2.396(1.381-4.156), 2.015(1.279-3.175)]. The risk of AKI in PE patients with high serum levels of HDAC4, ROCK2, and Gas6 was 1.604, 1.536, and 1.593 times higher, respectively, than in patients with low levels. The AUC values for predicting AKI in PE patients using serum HDAC4, ROCK2, Gas6 alone and their combination were 0.824, 0.805, 0.809, and 0.934, respectively. The combined prediction outperformed the individual predictions of serum HDAC4, ROCK2, and Gas6(Z=3.404, 3.380, 3.335; all P=0.001). Internal validation results indicated that the calibration curve between the model's predicted probabilities and actual occurrence rates closely aligned with the ideal reference line, demonstrating the model's strong calibration capability and internal consistency. Conclusion Serum HDAC4, ROCK2, and Gas6 levels are all elevated in PE patients with concurrent AKI. The combined detection of these three biomarkers can provide a reference for predicting concurrent AKI in PE patients.