Objective To explore the correlation and predictive significance of serum nuclear factor E2-related factor2(Nrf2), monocyte chemoattractant protein-induced protein 1(MCPIP1), and bromodomain-containing protein 4(BRD4) expression with postoperative recurrence in patients with atrial fibrillation(AF) undergoing radiofrequency ablation(RFA).Methods From July 2023 to July 2024, 136 patients with atrial fibrillation(AF) admitted to the Second Department of Cardiovascular Medicine, Beidahuang Group General Hospital were selected as the AF group. According to the recurrence status after radiofrequency ablation(RFA), they were further divided into a recurrence subgroup(n = 52) and a non-recurrence subgroup(n = 84). Meanwhile, 136 healthy individuals who underwent physical examinations at the same hospital during the same period were enrolled as the normal control(NC) group. ELISA method was implemented to detect serum Nrf2, MCPIP1, and BRD4 levels. Multi-factor Logical regression analysis was applied to identify factors related to post-RFA recurrence in AF patients. ROC curve analysis was used to explore the predictive value of serum Nrf2, MCPIP1 and BRD4. DCA was performed to assess the clinical utility of the combined model. Results Compared with the NC group, the AF group had a lower serum Nrf2 level and higher serum MCPIP1 and BRD4 levels(t/P = 8.026/<0.001, t/P = 12.905/<0.001, t/P = 12.889/<0.001). Compared with the non-recurrence subgroup, the recurrence subgroup showed a decreased serum Nrf2 level, as well as increased left atrial diameter(LAD), heart rate, and serum levels of MCPIP1 and BRD4(t/P = 6.596/<0.001, t/P = 6.705<0.001, t/P =4.944<0.001,t/P = 8.550<0.001,t/P = 7.507<0.001). Multivariate analysis revealed that larger LAD, faster heart rate, and higher serum levels of MCPIP1 and BRD4 were risk factors for post-RFA recurrence in AF patients, while higher serum Nrf2 level was a protective factor [odds ratio(95% confidence interval) = 1.165(1.055-1.287), 1.083(1.023-1.145), 4.746(1.765-12.763), 4.385(1.681-11.439), 0.036(0.005-0.250)]. The area under the receiver operating characteristic curve(AUC) of serum Nrf2, MCPIP1, BRD4 alone, and their combination for predicting post-RFA recurrence in AF patients was 0.813, 0.820,0.819, and 0.921, respectively. Notably, the combined AUC was significantly higher than that of each single indicator(Z/P =2.560/0.010,Z/P = 2.300/0.021,Z/P = 2.323/0.020). Within the high-risk threshold range of 0.07 ～ 0.84, the combined model of serum Nrf2, MCPIP1, and BRD4 levels had a higher net benefit rate in predicting recurrence in AF patients after post-RFA recurrence than their individual predictions. Conclusion In AF patients, serum Nrf2 level is are downregulated, while serum MCPIP1 and BRD4 levels are upregulated. They are closely related to recurrence post-RFA recurrence and can serve as biomarkers for predicting postoperative recurrence in AF patients.

Objective The correlation between the levels of serum corticotropin-releasing factor(CGN), type Ⅲ fibronectin domain protein 5(FNDC5), and platelet-activating protease-activating receptor 4(PAR4) in patients with ischemic stroke(IS) and their disease condition as well as the concurrent vascular cognitive dysfunction(VCI) was analyzed. Methods One hundred and three patients with IS admitted to the Neurology Department of Yan' an University Affiliated Hospital from July 2023 to July 2025 were selected as the IS group. They were divided into mild(n = 26), moderate(n = 35), moderately severe(n = 22), and severe(n = 20) based on the severity of the disease, and were further divided into the VCI subgroup(n =32) and the non-VCI subgroup(n = 71) according to the occurrence of VCI. 105 healthy individuals who underwent physical examinations at the same hospital during the same period were recruited as the CT group. ELISA was used to detect the levels of serum CGN, FNDC5, and PAR4; relative risk analysis was conducted to identify the factors influencing the concurrent VCI in IS patients; ROC analysis was performed to evaluate the predictive value of serum s CGN, FNDC5, and PAR4 for VCI. Results The results showed that the serum levels of CGN and PAR4 in the IS group were higher than those in the CT group,while the serum level of FNDC5 was lower than that in the CT group(t/P = 50.227/<0.001, 24.772/<0.001, 40.118/<0.001);the serum levels of CGN and PAR4 increased successively in patients with mild, moderate, moderate-severe, and severe conditions, while the serum level of FNDC5 decreased successively(F/P = 165.761/<0.001, 179.691/<0.001, 166.107/<0.001); compared with the NVCI sub-group, the serum levels of CGN, PAR4, and FNDC5 in the VCI sub-group were higher than those in the NVCI sub-group, while the serum level of FNDC5 was lower(t/P = 7.180/<0.001, 7.303/<0.001, 7.193/<0.001); patients with high serum levels of CGN, FNDC5, and PAR4 had a 1.947-fold, 0.463-fold, and 2.506-fold higher risk of developing VCI compared to those with low serum levels of CGN, FNDC5, and PAR4; the AUCs of serum CGN, FNDC5, PAR4, and their combination for predicting VCI in IS patients were 0.848, 0.850, 0.856, and 0.921, respectively, and the AUC of the combination of the three was larger(Z/P = 2.264/0.024, 2.763/0.010, 2.521/0.015). Conclusion The levels of serum CGN and PAR4 increase and the level of FNDC5 decreases in patients with IS. All are related to the severity of the disease and have certain predictive value for IS complicated with VCI.

Objective To investigate the effects of somatostatin combined with carbazochrome sodium sulfonate and lansoprazole on oxidative stress indicators and serum vascular endothelial growth factor(VEGF) levels in elderly patients with peptic ulcer bleeding(PUB). Methods A total of 150 elderly PUB patients admitted to the Department of Digestive Medicine, Yongchuan Hospital of Chongqing Medical University from March 2021 to June 2024 were selected and divided into a control group and a treatment group using a random number table, with 75 cases in each group. The control group received carbazochrome sodium sulfonate and lansoprazole, while the treatment group received somatostatin combined with carbazochrome sodium sulfonate and lansoprazole. The therapeutic efficacy, coagulation indices [fibrinogen(Fib), thrombin time(TT), prothrombin time(PT), activated partial thromboplastin time(APTT)], oxidative stress indicators [superoxide dismutase(SOD), advanced oxidation protein products(AOPP), oxidized low-density lipoprotein(ox-LDL), malondialdehyde(MDA)],serum levels of peptide YY(PYY), VEGF, heat shock protein-70(HSP-70), hemostasis time, total hospital stay, and adverse reactions were compared between the two groups. Results The total effective rate was significantly higher in the treatment group(94.67%) than in the control group(80.00%)(χ2= 7.292,P = 0.007). After 5 days of treatment, the levels of Fib, SOD,VEGF, and HSP-70 in the treatment group were significantly higher than those in the control group, while the levels of TT,PT, APTT, AOPP, ox-LDL, MDA, and PYY were significantly lower than those in the control group(t = 5.938, 7.756, 6.661,7.528, 7.566, 9.657, 10.186, 4.882, 6.238, 8.941, 12.220, all P<0.001). The hemostasis time and total hospital stay were significantly shorter in the treatment group than in the control group(t = 5.983, 18.752, both P<0.001). There was no statistically significant difference in the incidence of adverse reactions between the treatment group(14.67%) and the control group(9.33%)(P>0.05). Conclusion The combination of somatostatin, carbazochrome sodium sulfonate, and lansoprazole demonstrates favorable efficacy in treating elderly PUB patients. It can improve coagulation indices, reduce oxidative stress response,modulate serum levels of PYY, VEGF, and HSP-70, shorten the recovery process, and exhibits good drug safety.

Objective To investigate the trends in levels of C-reactive protein/albumin ratio(CAR), C-reactive protein/lymphocyte ratio(CLR), and systemic inflammatory response index(SIRI) and their efficacy in assessing adverse outcomes in patients with acute severe viral hepatitis. Methods This study is a prospective observational study. A total of 115 patients with acute severe viral hepatitis diagnosed and treated in the Department of Critical Infectious Diseases, the First Affiliated Hospital of Xinjiang Medical University from June 2023 to March 2025 were selected as the study subjects. Based on their prognosis within 3 months after treatment, they were divided into a good prognosis group(n = 81) and a poor prognosis group(n = 34). Clinical data and the expression levels of neutrophil-to-lymphocyte ratio(NLR), SIRI, C-reactive protein(CRP), albumin(ALB), CAR, and CLR were measured and compared between the two groups. Spearman correlation analysis and multivariate logistic regression analysis were used to identify risk factors for short-term poor prognosis in patients with acute severe viral hepatitis, and the combined assessment efficacy of these risk factors was evaluated. Results The proportion of patients with hepatic encephalopathy, as well as the levels of ALT, CRP, CAR, CLR, and SIRI, were significantly higher in the poor prognosis group compared to the good prognosis group. In contrast, prothrombin activity(PTA) and ALB levels were significantly lower(χ2/t/P = 4.338/0.037, 6.137/<0.001, 6.093/<0.001, 6.001/<0.001, 8.193/<0.001, 5.998/<0.001, 6.990/<0.001,9.023/<0.001). Spearman correlation analysis revealed that the presence of hepatic encephalopathy, ALT, CRP, CAR, CLR, and SIRI levels were positively correlated with short-term poor prognosis, whereas PTA and ALB levels were negatively correlated(rs/P = 0.194/0.038, 0.294/0.003,-0.299/0.001, 0.492/<0.001,-0.366/<0.001, 0.439/<0.001, 0.484/<0.001, 0.440/<0.001). Elevated CAR, CLR, and SIRI were identified as significant independent risk factors for short-term poor prognosis [OR(95%CI) =2.788(1.036-5.756), 4.413(1.665-7.701), 3.185(2.757-5.790)]. The areas under the curve(AUC) for CAR, CLR, SIRI, and their combination in predicting short-term poor prognosis were 0.777, 0.806, 0.779, and 0.948, respectively. The combined predictive model demonstrated the highest efficacy(Z = 5.321, 5.013, 5.320; all P<0.001). Conclusion Higher levels of CAR,CLR, and SIRI in patients with acute severe viral hepatitis are closely associated with short-term poor prognosis. Close monitoring of these indicators can effectively assess the clinical outcomes of these patients and holds value in guiding clinical treatment.

Objective To investigate the factors influencing the prognosis of patients following radical gastrectomy for gastric cancer, and to analyze the value of the systemic immune inflammation index(SII) and nutritional risk index(NRI)in predicting the prognosis of these patients. Methods A total of 129 patients who underwent radical gastrectomy for gastric cancer at the Department of Gastroenterology of the Affiliated Hospital of Southwest Medical University/Mianyang No.404 Hospital from January 2021 to August 2022 were retrospectively enrolled. Additionally, 123 individuals who underwent health check-ups during the same period were selected as the healthy control group. Gastric cancer patients were followed up for 3 years after surgery and were divided into a recurrence and metastasis group and a non-recurrence and non-metastasis group according to their prognosis. Clinical data and differences in SII and NRI levels were collected and compared between the two groups. A Cox regression model was used to identify factors affecting the prognosis of patients after radical gastrectomy for gastric cancer, and ROC curve analysis was used to evaluate the prognostic predictive value of SII and NRI in these patients.Results Compared with the healthy control group, SII levels were significantly increased and NRI levels were significantly decreased in the gastric cancer group(t = 15.767, 16.196; both P<0.001). Eleven cases were lost to follow-up by the end of the follow-up period. Among the remaining 118 gastric cancer patients, 35 had recurrence and metastasis, while 83 did not. Compared with the non-recurrence and non-metastasis group, the recurrence and metastasis group had a lower proportion of moderately or highly differentiated tumors, a lower proportion of stage Ⅱ/Ⅲ tumors, lower albumin levels, higher SII values, and lower NRI values, with statistically significant differences(Z/P = 2.566/0.010, χ2/P = 6.039/0.014, t/P = 2.788/0.006, t/P =4.402/<0.001, t/P = 4.966/<0.001). High SII, low/moderate pathological differentiation, and pathological stage Ⅱ/Ⅲ were independent risk factors affecting the prognosis of patients after radical gastrectomy for gastric cancer, while high NRI was an independent protective factor [HR(95%CI) = 3.662(1.968-6.815), 3.625(1.853-7.092), 1.864(1.087-3.196), 5.663(2.903-11.049), 0.592(0.390-0.899)]. The AUC values of SII, NRI, and their combination in predicting the prognosis of patients after radical gastrectomy for gastric cancer were 0.739, 0.746, and 0.895, respectively. The AUC of the combination was significantly higher than that of the individual indicators(Z = 2.214, 2.382;P = 0.021, 0.019). Conclusion SII is a risk factor for recurrence and metastasis in patients after radical gastrectomy for gastric cancer, while NRI is a protective factor. The combination of the two demonstrates good predictive value for prognosis.