Objective To comparatively analyze the influence of transcatheter aortic valve replacement(TAVR) and surgical aortic valve replacement(SAVR) on cardiac remodeling, including cardiac structure and cardiac electrical activity, in patients with aortic valve disease(AVD). Methods The clinical data of 107 AVD patients who were treated at Renmin Hospital of Wuhan University from January 2021 to September 2024 were retrospectively analyzed. Among them, 53 patients underwent TAVR and 54 patients underwent SAVR. Echocardiographic indicators, electrocardiogram indicators, and heart failure indicator N-terminal pro-brain natriuretic peptide(NT-pro BNP) were collected and compared. Results In terms of echocardiography, immediately after surgery and 1 month postoperatively, left atrial diameter(LAD), left ventricular diameter(LVD),right atrial diameter(RAD), and right ventricular diameter(RVD) in the SAVR group were significantly lower than those before surgery. Up to 6 months postoperatively, LVD and RVD in the SAVR group still showed significant differences compared with preoperative values(all P<0.05). In contrast, LVD and RVD in the TAVR group did not improve significantly until 1 month postoperatively(all P<0.05). However, left ventricular ejection fraction(LVEF) in the TAVR group recovered significantly at 6 months postoperatively(P<0.05), whereas LVEF did not improve significantly after SAVR. Postoperative LVD and RVD in the SAVR group were significantly lower than those in the TAVR group(P<0.05). In terms of electrocardiography,postoperative QRS and QTc intervals in the TAVR group were significantly longer than those before surgery(all P<0.05),while no obvious abnormalities were observed in the electrocardiogram indicators of the SAVR group postoperatively. After surgery, PR, QRS, and QT intervals in the TAVR group were significantly longer than those in the SAVR group(all P<0.05).In terms of laboratory tests, postoperative NT-pro BNP in the TAVR group was significantly lower than that before surgery,while postoperative NT-pro BNP in the SAVR group was significantly higher than that before surgery(all P<0.05). Conclusion The effect of TAVR on cardiac reverse remodeling is inferior to that of SAVR, but it is superior to SAVR in improving cardiac function and prognosis. In addition, TAVR can significantly reduce serum NT-pro BNP and improve myocardial injury status, but the incidence of cardiac electrical activity abnormalities is higher than that of SAVR.

Objective To investigate the relationship between serum platelet-derived growth factor BB(PDGF-BB),annexin A1(ANXA1), toll-like receptor 4(TLR4) and the condition, and the regulatory T cell(Treg)/helper T cell 17(Th17)imbalance in patients with aplastic anemia(AA), and to evaluate their prognostic predictive value. Methods A total of 85 AA patients treated in the Hematology Department of the Central Theater Command General Hospital of the Chinese People' s Liberation Army from March 2021 to August 2024 were selected as the AA group(subgrouped based on disease severity and prognosis), and 85 healthy individuals who underwent physical examinations at the hospital during the same period were selected as the normal control(NC) group. ELISA was used to detect serum levels of PDGF-BB, ANXA1, and TLR4. Flow cytometry was used to detect the proportions of Treg and Th17 cells and the Treg/Th17 ratio. Pearson correlation and point-biserial correlation were used to analyze the relationships between serum PDGF-BB, ANXA1, TLR4 levels and disease severity,Treg and Th17 cell proportions. Multivariate analysis was performed to identify factors affecting the prognosis of AA patients.ROC curves and DCA were used to evaluate the predictive value of the above serum factors for the prognosis of AA patients and the clinical value of the predictive model. Results Serum levels of PDGF-BB and ANXA1 in the AA group were significantly lower than those in the NC group, while serum TLR4 level was significantly higher(t = 11.966, 10.279, 9.092; all P<0.001). The proportion of Treg cells and the Treg/Th17 ratio in the AA group were significantly lower than those in the NC group, whereas the proportion of Th17 cells was significantly higher(t = 11. 718, 10. 365, 21. 657; all P<0. 001). Serum PDGF-BB and ANXA1 levels were negatively correlated with disease severity and Th17 cell proportion, and positively correlated with Treg cell proportion and Treg/Th17 ratio(r =-0.602,-0.501, 0.542, 0.411 for PDGF-BB;r =-0.587,-0.534, 0.481,0.398 for ANXA1; all P<0.05). Serum TLR4 level was positively correlated with disease severity and Th17 cell proportion,and negatively correlated with Treg cell proportion and Treg/Th17 ratio(r = 0.593, 0.573,-0.432,-0.452; all P<0.05). Serum levels of PDGF-BB, ANXA1, Treg cell proportion, and Treg/Th17 ratio in the severe subgroup were significantly lower than those in the non-severe subgroup, while serum TLR4 level and Th17 cell proportion were significantly higher(t = 4.872, 6.235,4.186, 8.136, 4.800, 10.146; all P<0.001). High serum TLR4 and severe disease were risk factors for poor prognosis [OR(95%CI) = 2.651(1.289-5.453), 2.756(1.236-6.144)], whereas high serum PDGF-BB and high ANXA1 were protective factors against poor prognosis in AA patients [OR(95%CI) = 0.472(0.272-0.819), 0.615(0.436-0.868)]. The AUC values of serum PDGF-BB, ANXA1, TLR4 alone and their combination in predicting poor prognosis of AA patients were 0.842, 0.901,0.881, and 0.966, respectively. The AUC of the combined panel was significantly larger than that of each single indicator(Z =3.173, 2.365, 2.001; all P<0.001). When the high-risk threshold ranged from 0.03 to 0.88, the combined prediction model using PDGF-BB, ANXA1, and TLR4 yielded a higher clinical net benefit than individual indicators. Conclusion Serum levels of PDGF-BB, ANXA1, and TLR4 in AA patients are correlated with disease severity and Treg/Th17 imbalance. Combined detection of these markers has high value for predicting the prognosis of patients.

Objective To explore the predictive value of serum forkhead box M1(FOXM1), Clara cell secretory protein 16(CC16), and lipoxin A4(LXA4) levels for concurrent acute lung injury(ALI) in patients with sepsis. Methods A total of 126 sepsis patients admitted to the Emergency Department of the Affiliated Hospital of Nanjing University of Chinese Medicine(Jiangsu Province Hospital of Chinese Medicine) from July 2021 to May 2024 were continuously enrolled as the observation group. Based on whether ALI occurred during hospitalization, patients were divided into an ALI subgroup(n = 41)and a non-ALI subgroup(n = 85). Additionally, 126 individuals who underwent health check-ups at the same hospital during the same period were selected as the healthy control group. Serum levels of FOXM1, CC16, and LXA4 were measured by ELISA. Multivariate logistic regression analysis was used to identify factors influencing ALI. Receiver operating characteristic(ROC) curves and decision curve analysis(DCA) were used to evaluate the predictive performance and clinical net benefit of serum FOXM1, CC16, and LXA4 levels for concurrent ALI. Results Compared with the healthy control group, the observation group showed significantly increased serum FOXM1 levels and significantly decreased CC16 and LXA4 levels(t/P =11.177/<0.001, 7.741/<0.001, 8.986/<0.001). Compared with the non-ALI subgroup, the ALI subgroup had significantly higher respiratory index, SOFA score, APACHE II score, and FOXM1 levels, while CC16 and LXA4 levels were significantly lower(t/P = 19.541/<0.001, 8.893/<0.001, 7.634/<0.001, 8.267/<0.001, 7.924/<0.001, 7.505/<0.001). High APACHE II score and high FOXM1 expression were independent risk factors for sepsis patients developing ALI [OR(95%CI) = 3.125(1.472-6.633), 2.489(1.662-4.884)]; whereas high expression of CC16 and LXA4 were independent protective factors against ALI in sepsis patients [OR(95%CI) = 0.803(0.688-0.937), 0.734(0.636-0.847)]. The AUCs for serum FOXM1, CC16, LXA4,and their combination in predicting ALI in sepsis patients were 0.824, 0.831, 0.816, and 0.951, respectively, with the combination significantly outperforming each marker alone(DeLong test, Z/P = 3.304/0.001, 3.462/0.001, 3.298/0.001). The combined model of FOXM1, CC16, and LXA4 showed a high net benefit advantage within a wide threshold probability range(0.10-0.93). Conclusion FOXM1 expression is upregulated in the serum of patients with sepsis, while CC16 and LXA4 expressions are downregulated. These three markers are independent factors associated with concurrent ALI. Combined detection of these three biomarkers demonstrates excellent predictive efficiency and clinical translational potential for ALI.

Objective To explore the predictive value of serum glucocorticoid-regulated kinase 1(SGK1), mitogenactivated protein kinase 3(MAPK3), and C-X3-C motif chemokine receptor 1(CX3 CR1) levels for sepsis complicated with acute respiratory distress syndrome(ARDS) and their relationship with patient prognosis. Methods A total of 119 patients with sepsis admitted to the Department of Critical Care Medicine of Xi' an People' s Hospital(Xi' an Fourth Hospital) from June 2024 to November 2025 were selected as the case group. They were divided into the concurrent sub-group(n = 50) and the non-concurrent sub-group(n = 69) based on whether they developed ARDS. According to the survival outcome of sepsis patients within 28 days of hospitalization, they were further divided into the survival sub-group(n = 81) and the death subgroup(n = 38). Meanwhile, 119 healthy individuals who underwent physical examinations at the same hospital during the same period were selected as the healthy control group. The expression levels of serum SGK1, MAPK3, and CX3 CR1 were determined by enzyme-linked immunosorbent assay(ELISA). The receiver operating characteristic(ROC) curve was used to analyze the predictive value of serum SGK1, MAPK3, and CX3 CR1 for the occurrence of sepsis complicated with ARDS and poor prognosis. The calibration curve was used to verify the consistency between the predicted probability of the model and the actual clinical occurrence probability. Results Compared with the healthy control group, the levels of SGK1, MAPK3 and CX3 CR1 in the case group increased(t/P = 24.570/<0.001, 14.283/<0.001, 19.703/<0.001). The levels of serum SGK1,MAPK3 and CX3 CR1 in the concurrent subgroup were all higher than those in the non-concurrent subgroup(t/P = 4.979/<0.001, 3.146/<0.001, 4.698/<0.001). The levels of serum SGK1, MAPK3 and CX3 CR1 in the death subgroup were higher than those in the survival subgroup(t/P = 6.482/<0.001, 5.217/<0.001, 6.978/<0.001). The AUCs of serum SGK1,MAPK3, CX3 CR1 and the combination of the three for predicting sepsis complicated with ARDS were 0.864, 0.716, 0.775 and 0.936, respectively The combination of the three is superior to their individual predictive values(Z/P = 2.731/0.006, 3.927/0.001, 3.159/0.002). The AUCs of serum SGK1, MAPK3, CX3 CR1 and the combination of the three for predicting poor prognosis in patients with sepsis were 0.788, 0.691, 0.756 and 0.877, respectively The combination of the three is superior to their individual predictive values(Z/P = 2.457/0.008, 4.344/<0.001, 3.626/0.001). The calibration curve(solid line) has a high degree of conformity with the ideal curve(dashed line), and the probability predicted by the model and the actual probability of occurrence have a very small difference. The prediction accuracy and reliability of the model are relatively strong. Conclusion The levels of serum SGK1, MAPK3, and CX3 CR1 are closely related to sepsis complicated with ARDS. The combined detection of the three has a high predictive value for sepsis complicated with ARDS, and decreased SGK1 and increased MAPK3 and CX3 CR1 levels suggest a poor prognosis for patients.

Objective To investigate the effects of serum complement C1q/tumor necrosis factor-related protein 12(CTRP12) and angiopoietin-like protein 4(ANGPTL4) levels and clinical characteristics on the occurrence of postoperative instent restenosis(ISR) in patients with lower extremity arteriosclerosis obliterans(LEASO), and to evaluate their predictive value for ISR. Methods From September 2022 to September 2024, 120 patients with LEASO who underwent surgical treatment in our hospital were enrolled as the study subjects. According to whether ISR occurred one year after the operation, patients were divided into an ISR group(34 cases) and a non-ISR group(86 cases). Serum levels of CTRP12 and ANGPTL4 were measured by enzyme-linked immunosorbent assay(ELISA). Univariate and multivariate logistic regression analyses were performed to identify independent influencing factors for ISR. Pearson correlation analysis was performed to explore the correlations between serum CTRP12, ANGPTL4 and lesion length, high-sensitivity C-reactive protein(hs-CRP). The predictive efficacy of serum CTRP12 and ANGPTL4 was evaluated using receiver operating characteristic(ROC) curves. Results Compared with the non-ISR group, the ISR group had significantly higher levels of ANGPTL4 and significantly lower levels of CTRP12(t = 7.147 and 8.821; both P<0.001). The ISR group also exhibited significantly higher levels of low-density lipoprotein cholesterol(LDL-C), fasting blood glucose, glycated hemoglobin, hs-CRP, and significantly lower levels of high-density lipoprotein cholesterol(HDL-C)(t = 3.309, 3.657, 3.853, 16.724, 2.652; P = 0.001,<0.001,<0.001,<0.001, 0.009). Serum CTRP12 was negatively correlated with lesion length and hs-CRP(r =-0.652 and-0.598; both P<0.001), while ANGPTL4 was positively correlated with these parameters(r = 0.685 and 0.623; both P<0.001). Multivariate logistic regression analysis showed that longer lesion length(OR = 1.330, 95%CI : 1.157-1.529), TASC type C/D(OR = 1.900, 95%CI : 1.087-3.322), elevated LDL-C(OR = 1.583, 95%CI : 1.063-2.357), elevated hs-CRP(OR = 1.486, 95%CI :1.090-2.025), low HDL-C(OR =1.631, 95%CI : 1.037-2.565), and elevated ANGPTL4(OR = 3.366, 95%CI : 2.026-5.592) were independent risk factors for ISR, while elevated CTRP12(OR = 0.228, 95%CI : 0.119-0.436) was an independent protective factor. The area under the curve(AUC) of serum CTRP12 and ANGPTL4 alone for predicting ISR was 0.839 and 0.827, respectively. The AUC of the combined prediction increased to 0.953, which was significantly superior to either indicator alone(Z = 3.477 and 3.124; P =0.001 and 0.002). Conclusion Lesion length, serum CTRP12 and ANGPTL4 levels are independent influencing factors for postoperative ISR in patients with LEASO. Combined detection of serum CTRP12 and ANGPTL4 has good predictive value for ISR and may provide new serological evidence for the early identification of high-risk patients.