Objective To investigate the efficacy of alirocumab combined with neurointerventional therapy in treating elderly patients with cerebral infarction complicated by hyperlipidemia who are intolerant to statins. Methods A total of 86 elderly patients with cerebral infarction complicated by hyperlipidemia who were intolerant to statins and admitted to the Department of Neurology, General Hospital of Taiyuan Iron and Steel(Group) Co., Ltd. from January 2020 to August 2024 were retrospectively selected. They were divided into a conventional group and a combined group according to different treatment regimens, with 43 cases in each group. Both groups received basic treatment. The conventional group additionally received neurointerventional therapy, while the combined group received alirocumab combined with neurointerventional therapy.Therapeutic efficacy, adverse reactions, as well as lipid profiles, hemorheology, neurological function scores, prognosis scores,and activities of daily living scores before and after treatment were compared between the two groups. Results The total effective rate in the combined group was significantly higher than that in the conventional group(χ2= 4.914,P = 0.027). After 12 weeks of treatment, levels of TC, TG, LDL-C, Apo A1, and Apo B decreased, while HDL-C increased in both groups, with more pronounced changes in the combined group(t = 3.989, 5.946, 4.979, 6.014, 5.087, 4.977, all P <0.001). The combined group had significantly lower levels of FIB, plasma viscosity, whole blood high-shear viscosity, and whole blood low-shear viscosity than the conventional group(t = 4.851, 5.902, 4.186, 4.486, all P <0.001). NIHSS and m RS scores decreased, while MBI scores increased in both groups, with more marked improvements in the combined group(t = 5.164, 8.962, 4.387, all P <0.001). No significant difference was observed in the incidence of adverse reactions between the two groups(P >0.05). Conclusion The combination of alirocumab and neurointerventional therapy demonstrates significant efficacy in elderly patients with cerebral infarction complicated by hyperlipidemia who are intolerant to statins. It can improve lipid metabolism and hemorheology, reduce neurological impairment, enhance prognosis, and improve activities of daily living.

Objective To explore the correlations between serum levels of leucine-rich repeat kinase 2(LRRK2),Smad homolog 3(SMAD3), and prostaglandin E2(PGE2) and the severity of neurological deficits in patients with acute cerebral hemorrhage, and to evaluate the predictive value of these three biomarkers for short-term prognosis. Methods A total of124 patients with acute cerebral hemorrhage admitted to the Department of Neurosurgery of Ningde Hospital(Ningde Hospital of Shanghai First People' s Hospital) from October 2022 to October 2025 were selected as the study group, and 50 healthy individuals undergoing physical examination were selected as the healthy control group. Patients were classified into mild, moderate, and severe neurological deficit subgroups based on the National Institutes of Health Stroke Scale(NIHSS) score at admission, and into good and poor prognosis subgroups according to the modified Rankin Scale(mRS) score at 90 days after onset. Serum levels of LRRK2, SMAD3, and PGE2 were measured by enzyme-linked immunosorbent assay. Correlations between each biomarker and NIHSS score were analyzed. Logistic regression was used to identify risk factors for poor prognosis. Receiver operating characteristic(ROC) curves were constructed to evaluate the predictive value of serum LRRK2,SMAD3, and PGE2 for poor prognosis. Patients were divided into high-and low-level groups based on the optimal cut-off values derived from ROC curves, and relative risk(RR) was calculated to assess the impact of different indicator levels on prognosis. Results Serum levels of LRRK2, SMAD3, and PGE2 in the study group were significantly higher than those in the healthy control group(t = 12.741, 7.443, 18.966, all P <0.001). Serum LRRK2, SMAD3, and PGE2 levels increased progressively across the mild, moderate, and severe subgroups(F = 26.936, 32.720, 91.531, all P <0.001), and all three were significantly positively correlated with NIHSS score(r = 0.612, 0.573, 0.648, all P <0.001). Admission NIHSS score and serum levels of LRRK2, SMAD3, and PGE2 were significantly higher in the poor prognosis subgroup than in the good prognosis subgroup(t = 9.043, 6.812, 8.040, 7.141, all P <0.001). Elevated admission NIHSS score(OR =3.028, 95%CI :1.669-5.494), LRRK2(OR =2.292, 95%CI :1.348-3.898), SMAD3(OR = 2.196, 95%CI :1.327-3.634), and PGE2(OR = 2.414, 95%CI :1.257-4.637) were independent risk factors for poor prognosis. The AUCs of serum LRRK2, SMAD3, PGE2, and their combination for predicting poor prognosis were 0.828, 0.829, 0.821, and 0.930, respectively, with the combined model demonstrating superior predictive performance(Z = 2.479, 2.929, 2.757, all P <0.001). Based on the optimal cut-off values(LRRK2 ≥84.35 pg/mL,SMAD3 ≥407.86 pg/mL, PGE2 ≥ 175.73 pg/mL), the risks of poor prognosis for patients with high levels of LRRK2,SMAD3, and PGE2 were 4.667-fold(95%CI :2.551-8.837), 4.035-fold(95%CI :2.468-6.597), and 5.583-fold(95%CI :2.841-10.973) higher, respectively, compared with those with low levels. Conclusion Serum LRRK2, SMAD3, and PGE2 levels are significantly elevated in patients with acute cerebral hemorrhage and are closely associated with the severity of neurological deficits. All three are independent risk factors for poor short-term prognosis. Combined detection of these biomarkers may more effectively assess disease severity and predict adverse outcomes, potentially serving as novel auxiliary biomarkers for clinical diagnosis and treatment of acute cerebral hemorrhage.

Objective To explore the predictive value of serum Sestrin2 and stanniocalcin 1(STC1) for the prognosis of patients with hypertensive basal ganglia hemorrhage(HBGH) after minimally invasive puncture and drainage(MIPD). Methods A total of 98 patients with HBGH who were treated in the Department of Neurosurgery of Ziyang Central Hospital in Sichuan Province from June 2022 to June 2025 were selected as the HBGH group. According to the Glasgow Coma Scale score at admission, patients were divided into a mild group(27 cases), a moderate group(32 cases), and a severe group(39 cases). Based on prognosis, patients were divided into a poor prognosis group(32 cases) and a good prognosis group(66 cases). Meanwhile, 98 healthy volunteers who underwent physical examinations at our hospital were recruited as the control group. Serum levels of Sestrin2 and STC1 were measured by ELISA. Logistic regression analysis was used to identify factors influencing poor postoperative prognosis in HBGH patients. ROC curve analysis was performed to evaluate the predictive value of serum Sestrin2 and STC1 levels for poor postoperative prognosis. Internal validation was conducted using the Bootstrap method(1000 repeated samplings). The Hosmer-Lemeshow test was used to assess model fit. Decision curve analysis(DCA) was employed to evaluate the clinical net benefit. Results Compared with the control group, serum levels of Sestrin2 and STC1 were significantly higher in the HBGH group(t/P = 21.351/<0.001, 18.559/<0.001). Serum Sestrin2 and STC1 levels were significantly higher in the moderate and severe groups than in the mild group, and significantly higher in the severe group than in the moderate group(F/P = 127.258/<0.001, 84.685/<0.001). Compared with the good prognosis group, the poor prognosis group had significantly larger hematoma volume, and higher serum Sestrin2 and STC1 levels(t/P = 7.958/<0.001, 7. 816/< 0. 001, 7. 920/< 0. 001). Hematoma volume > 50 m L, elevated serum Sestrin2, and elevated STC1 were independent risk factors for poor prognosis in HBGH patients after surgery [OR(95%CI) = 2.968(1.426-6.178), 3.695(1.580-8.645), 2.134(1.300-3.504)]. The AUCs of serum Sestrin2, STC1, and their combination for predicting poor postoperative prognosis were 0.824, 0.838, and 0.927, respectively, with the combined prediction significantly superior to individual predictions(both P <0.05). The sensitivities were 81.25%, 84.37%, and 81.25%, respectively, and specificities were 69.70%,77.27%, and 89.39%, respectively. The calibration curve was closely aligned with the ideal curve. The Hosmer-Lemeshow test indicated good model fit(χ2= 1.132, df = 8, P = 0.997), confirming good consistency between predicted probabilities and actual results. Within the threshold range of 0.20 – 0.91, the combined prediction of serum Sestrin2 and STC1 for poor postoperative prognosis in HBGH patients had a higher net benefit rate than single indicator detection. Conclusion Serum Sestrin2 and STC1 levels are elevated in HBGH patients. The combination of these two indicators has higher predictive efficiency for postoperative prognosis in HBGH patients.

Objective To investigate the predictive value of carotid corrected flow time(cFT) combined with radial artery resistance index(RI) for fluid resuscitation outcomes in patients with septic shock, providing a reference for precise clinical assessment and optimization of resuscitation strategies. Methods A retrospective study was conducted on 100 patients with septic shock admitted to the Department of Critical Care Medicine of Xi' an People' s Hospital(Xi' an Fourth Hospital)from January 2020 to December 2024. Patients were divided into a good prognosis group(n = 70) and a poor prognosis group(n = 30) based on 28-day outcomes. c FT and RI were measured in all patients before fluid resuscitation(T0), 6 hours after resuscitation(T6), and 24 hours after resuscitation(T24). Hemodynamic and laboratory parameters were recorded synchronously.The predictive value of each indicator for prognosis was analyzed using ROC curves. Independent risk factors for poor prognosis were identified using multivariate logistic regression. Results The corrected flow time(cFT) gradually increased with resuscitation time in both groups, and the c FT at each time point was significantly higher in the good prognosis group than in the poor prognosis group. The resistance index(RI) gradually decreased with resuscitation time in both groups, and the RI at each time point was significantly lower in the good prognosis group than in the poor prognosis group(t/P = 5.987/<0.001,9.214/<0.001, 9.563/<0.001, 4.098/<0.001, 9.567/<0.001, 11.654/<0.001;F/P = 25.368/<0.001, 148.652/<0.001, 17.854/<0.001,132.895/<0.001). Correlation analysis was performed between c FT, RI and SOFA score, APACHE Ⅱ score. The area under the curve(AUC) values of c FT, RI, and their combination for predicting poor prognosis in patients with septic shock were0.748, 0.886, and 0.957, respectively, with the combination demonstrating superior predictive value compared to either alone(DeLong method comparison: Z/P = 4.126/<0.001, 2.873/0.004). High APACHE Ⅱ score, high SOFA score, high lactate, and high RI were independent risk factors for poor prognosis in patients with septic shock, whereas high MAP, high CVP, and high c FT level were independent protective factors [OR(95%CI) = 3.892(1.725-8.776), 2.751(1.286-5.887), 5.124(2.218-11.826), 5.638(2.435-13.062), 0.438(0.234-0.821), 0.469(0.257-0.857), 0.295(0.138-0.629)]. The length of ICU stay and duration of mechanical ventilation in the good prognosis group were significantly lower than those in the poor prognosis group(t/P = 7.892/<0.001, 8.345/<0.001). Conclusion c FT combined with RI at the T24 time point can effectively predict fluid resuscitation outcomes in patients with septic shock. The combined measurement provides a reliable basis for clinical assessment of resuscitation effectiveness and adjustment of treatment strategies.

Objective To investigate the correlation of plasma signal transducing adaptor molecule binding protein(STAMBP) and transcobalamin Ⅱ(TCN2) levels with the condition and prognosis of children with status epilepticus(SE).Methods A total of 106 children with SE admitted to the Department of Neurology, Changzhou Medical Zone, No. 904 Hospital of Joint Logistics Support Force from January 2023 to January 2025 were selected as the SE group. According to disease severity, they were divided into a mild subgroup(40 cases), a moderate subgroup(36 cases), and a severe subgroup(30 cases).Based on 28-day outcomes after admission, the children with SE were divided into a poor prognosis subgroup and a good prognosis subgroup. In addition, 106 healthy children during the same period were selected as the healthy control group at a1 ∶1 ratio. Plasma levels of STAMBP and TCN2 were measured. The correlation between plasma STAMBP and TCN2 levels and disease severity was analyzed. Factors influencing poor prognosis and the predictive efficacy of plasma STAMBP and TCN2 levels were analyzed. Results Plasma STAMBP and TCN2 levels in the SE group were significantly lower than those in the healthy control group(t =-10.455,-10.982, both P <0.001). Plasma STAMBP and TCN2 levels progressively decreased across the mild, moderate, and severe subgroups(F = 138.777, 164.355, both P <0.001). Plasma STAMBP and TCN2 levels were negatively correlated with SE severity(rs=-0.778,-0.802, both P <0.001). Compared with the good prognosis subgroup,the poor prognosis subgroup had more severe disease, a higher proportion of generalized seizures and SE onset time ≥1 hour,and lower STAMBP and TCN2 levels(χ2/t/Z =-6.771, 4.096, 9.736,-6.296,-5.848;P <0.001, 0.043, 0.002, <0.001, <0.001).The 28-day poor prognosis rate among the 106 children with SE was 37.74%(40/106). Severe disease, high proportion of generalized seizures, and SE onset time ≥1 hour were independent risk factors for poor prognosis, while elevated STAMBP and TCN2 levels were independent protective factors [OR(95%CI) = 4.641(1.855-11.615), 5.847(1.334-25.632), 5.427(1.382-21.309), 0.946(0.922-0.969), 0.276(0.147-0.517)]. The AUCs for plasma STAMBP, TCN2, and their combination in predicting poor prognosis were 0.816, 0.792, and 0.925, respectively. The combined prediction showed significantly higher AUC(Z = 3.244, 3.161; P = 0.001, 0.002). Conclusion Decreased plasma STAMBP and TCN2 levels are associated with increased disease severity in children with SE and serve as independent predictors of poor prognosis. The combined application of STAMBP and TCN2 shows high predictive efficacy.