Objective To investigate the association between serum levels of fractalkine(FKN), follistatin-like protein 1(FSTL1), and mammalian sterile 20-like kinase 1(Mst1) and the severity of coronary artery stenosis(CAS), oxidative stress, and prognosis in patients with coronary heart disease(CHD). Methods Between January 2024 and January 2025,204 patients with CHD admitted to the Department of Cardiology at the Fourth Affiliated Hospital of Nanjing Medical University were enrolled as the case group. Based on the Gensini score, patients were divided into a mild subgroup(77 cases), a moderate subgroup(69 cases), and a severe subgroup(58 cases). Based on prognosis, patients were further divided into a favorable prognosis subgroup(152 cases) and an unfavorable prognosis subgroup(52 cases). Additionally, 105 individuals who underwent health check-ups during the same period were selected as the healthy control group. Serum levels of FKN, FSTL1,and Mst1 were measured by ELISA. Correlation analysis was performed to examine the relationships between serum FKN,FSTL1, and Mst1 levels and the severity of CAS. Multivariate LASSO-logistic regression analysis was used to identify factors associated with unfavorable prognosis in CHD patients. ROC curves were constructed to evaluate the predictive value of serum FKN, FSTL1, and Mst1 individually and in combination for unfavorable prognosis. Results Serum levels of FKN, FSTL1,and Mst1 were significantly higher in the case group than in the healthy control group(t/P = 58.392/<0.001, 43.048/<0.001,45.009/<0.001). Serum FKN, FSTL1, Mst1, and MDA levels progressively increased across the mild, moderate, and severe subgroups, while SOD and GSH-Px levels progressively decreased(F/P = 43.568/< 0.001, 31.507/< 0.001, 80.499/< 0.001,69.392/<0.001, 41.234/<0.001, 59.089/<0.001). Serum FKN, FSTL1, and Mst1 levels were positively correlated with the severity of CAS(r/P = 0.498/<0.001, 0.536/<0.001, 0.461/<0.001). Serum FKN, FSTL1, and Mst1 were positively correlated with MDA(r/P = 0. 397/< 0. 001, 0. 453/< 0. 001, 0. 409/< 0. 001) and negatively correlated with SOD and GSH-Px(FKN:r/P =-0.436/<0.001,-0.411/<0.001; FSTL1:-0.417/<0.001,-0.328/<0.001; Mst1:-0.354/<0.001,-0.442/<0.001). The unfavorable prognosis subgroup had significantly higher proportions of patients with multiple lesions, as well as higher FKN,FSTL1, Mst1, Gensini scores, CK-MB, c Tn I, and MDA levels, while SOD and GSH-Px levels were significantly lower compared with the favorable prognosis subgroup(χ2/t/P = 14.794/<0.001, 8.235/<0.001, 8.052/<0.001, 8.821/<0.001, 28.000/<0.001, 5.304/<0.001, 5.731/<0.001, 7.849/<0.001, 7.418/<0.001, 7.817/<0.001). Multiple lesions, elevated Gensini score, elevated FKN, elevated FSTL1, and elevated Mst1 were independent risk factors for poor prognosis in CHD patients [OR(95%CI) = 2.794(1.215-6.427), 3.758(2.320-6.086), 3.198(1.715-5.964), 3.015(1.545-5.882), 3.364(1.955-5.790)]. The AUCs for serum FKN, FSTL1, Mst1 alone, and their combination for predicting poor prognosis were 0.813, 0.813, 0.828, and 0.934,respectively. The combined AUC was significantly higher than that of any single marker(Z/P = 4.018/<0.001, 3.192/<0.001,3.713/<0.001). Conclusion Elevated serum levels of FKN, FSTL1, and Mst1 in CHD patients are associated with the severity of coronary artery stenosis, oxidative stress, and prognosis. The combination of these three markers may serve as a potential biomarker for predicting poor prognosis in patients with CHD.

Objective To explore the predictive value of the combination of serum tumor endothelial marker 1(TEM1), heat shock protein 90(HSP90), and sirtuin 4(SIRT4) for postoperative new-onset atrial fibrillation(AF) in patients undergoing off-pump coronary artery bypass grafting(OPCABG). Methods A total of 269 patients scheduled for OPCABG were selected from the Department of Cardiovascular and Major Vascular Surgery at Yan' an Hospital, Kunming, from April 2023 to September 2025. Patients were divided into an AF group and a non-AF group based on the occurrence of new-onset AF after surgery. Serum levels of TEM1, HSP90, and SIRT4 were measured by ELISA. Multivariate logistic regression analysis was used to identify factors influencing new-onset AF after OPCABG. ROC curve analysis was performed to evaluate the predictive value of serum TEM1, HSP90, and SIRT4 for postoperative new-onset AF. The Bootstrap method was used for internal validation of the prediction model, and decision curve analysis(DCA) was employed to assess its clinical applicability.Results Compared with the non-AF group, patients in the AF group were older, had a higher proportion of right coronary artery proximal stenosis≥75%, a higher proportion of postoperative intra-aortic balloon pump(IABP) support, and shorter postoperative mechanical ventilation time(χ2/t = 5.349, 37.128, 23.804, 4.973; all P <0.001). The AF group had significantly higher serum levels of TEM1, HSP90, and SIRT4 than the non-AF group(t = 15.817, 18.456, 11.578; all P <0.001). Left ventricular ejection fraction(LVEF) was lower and left atrial volume index(LAVI) was higher in the AF group than in the nonAF group(t = 7.221, 8.976; both P <0.001). Older age, right coronary artery proximal stenosis ≥75%, postoperative IABP support, high LAVI, high TEM1, high HSP90, and high SIRT4 were independent risk factors for new-onset AF after OPCABG,while longer postoperative mechanical ventilation time and higher LVEF were independent protective factors [OR(95%CI) =2.102(1.298-3.404), 2.214(1.408-3.482), 3.018(1.484-6.136), 2.689(1.479-4.889), 2.741(1.686-4.457), 2.412(1.301-4.472), 3.104(2.081-4.630), 0.462(0.251-0.852), 0.461(0.291-0.729)]. The AUCs of serum TEM1, HSP90, SIRT4 alone,and their combination for predicting new-onset AF were 0.793, 0.789, 0.775, and 0.909, respectively. The combined model showed significantly greater predictive value than each individual marker(Z = 2.721, 2.734, 2.742; all P <0.001). Internal validation using the Bootstrap method showed a C-index of 0.869 for the prediction model, with a Hosmer-Lemeshow test result of χ2= 7.762,P = 0.729. The calibration curve demonstrated good agreement between predicted and observed outcomes. DCA showed that within a threshold range of 0.21-0.94, the combined prediction model provided a relatively high net benefit. Conclusion Serum TEM1, HSP90, and SIRT4 levels are all elevated in patients with new-onset AF after OPCABG. The combination of these three biomarkers has clinical value in predicting postoperative new-onset AF in patients undergoing OPCABG.

Objective To explore the relationship between serum Dickkopf-3 and PDGFRβ levels and cognitive function in patients with acute ischemic stroke(AIS). Methods A total of 148 patients with AIS admitted to our hospital from March 2021 to May 2025 were selected as study subjects. The Montreal Cognitive Assessment(MoCA) was used to divide patients into a non-cognitive impairment group(n = 106) and a cognitive dysfunction group(n = 42). According to the modified Rankin Scale(mRS) score, patients were divided into a good prognosis group(n = 91) and a poor prognosis group(n = 57). General information and clinical biochemical data were collected. Serum Dickkopf-3 level was detected using electrochemiluminescence technology, and serum PDGFRβ level was detected using enzyme-linked immunosorbent assay(ELISA).Multivariate logistic regression analysis was used to identify factors associated with cognitive dysfunction and prognosis in AIS patients. ROC curve analysis was performed to evaluate the predictive value of serum Dickkopf-3 and PDGFRβ levels.Results The cognitive dysfunction group had significantly higher TC, admission NIHSS score, and PDGFRβ levels than the non-cognitive impairment group(t/P =-3.781/<0.001,-9.134/<0.001, 13.551/<0.001), while HDL-C levels, admission BI score, and Dickkopf-3 levels were significantly lower(t/P = 8.744/<0.001, 7.718/<0.001, 16.403/<0.001). The poor prognosis group had significantly longer time from onset to admission, higher admission NIHSS score, and higher PDGFRβ levels than the good prognosis group(t/P =-7.142/<0.001,-12.073/<0.001,-11.204/<0.001), while admission BI score and Dickkopf-3 levels were significantly lower(t/P = 9.002/<0.001, 13.560/<0.001). High TC, high admission NIHSS score, and high PDGFRβwere independent risk factors for cognitive dysfunction in AIS patients [OR(95%CI) = 2.123(1.216-3.704), 3.261(1.684-6.312), 2.145(1.412-3.255)], while high HDL-C, high admission BI score, and high Dickkopf-3 were independent protective factors [OR(95%CI) = 0.525(0.280-0.980), 0.564(0.377-0.842), 0.490(0.391-0.614)]. Long time from onset to admission,high admission NIHSS score, and high PDGFRβ were independent risk factors for poor prognosis [OR(95%CI) = 2.264(1.228-4.172), 3.142(1.570-6.289), 2.071(1.168-3.670)], while high admission BI score and high Dickkopf-3 were independent protective factors [OR(95%CI) = 0.552(0.388-0.784), 0.507(0.331-0.775)]. The AUCs of serum Dickkopf-3,PDGFRβ, and their combination for predicting cognitive dysfunction were 0.776, 0.767, and 0.846, respectively, with the combined prediction showing a significantly larger AUC(Z/P = 2.076/0.038, 2.159/0.027). The AUCs for predicting poor prognosis were 0.786, 0.769, and 0.866, respectively, with the combined prediction also showing a significantly larger AUC(Z/P = 2.114/0.031, 2.376/0.019). Conclusion Decreased serum Dickkopf-3 and increased PDGFRβ levels are closely associated with cognitive prognosis in patients with acute ischemic stroke. These biomarkers may serve as potential auxiliary markers for poststroke cognitive dysfunction and poor prognosis, aiding in the improvement of patient management and treatment strategies.

Keyword:Acute ischemic stroke

Objective To investigate the relationship between the expression of serum aldolase C(ALDOC), αⅡ-spectrin N-terminal fragment(SNTF), and neuron-specific enolase(NSE) and the prognosis of patients with severe cerebral contusion(CC). Methods A total of 333 patients with CC admitted to Sanmenxia Hospital of the Yellow River from February 2023 to February 2026 were selected and divided into a mild group(78 cases), a moderate group(95 cases), and a severe group(160 cases) according to disease severity. Serum levels of ALDOC, SNTF, and NSE were detected, and the correlation between serum ALDOC, SNTF, and NSE levels and the condition of patients with CC was analyzed. According to the 28-day prognosis, patients with severe CC were divided into a poor prognosis group and a good prognosis group. The influencing factors of prognosis and the predictive efficacy of serum ALDOC, SNTF, and NSE levels in patients with severe CC were analyzed. Results Serum levels of ALDOC, SNTF, and NSE increased progressively across the mild, moderate, and severe groups(F/P = 169.912/<0.001, 200.003/<0.001, 26.810/<0.001). Serum levels of ALDOC, SNTF, and NSE in patients with CC were positively correlated with disease severity(rs/P = 0.731/<0.001, 0.689/<0.001, 0.739/<0.001). The 28-day poor prognosis rate among the 160 patients with severe CC was 50.63%(81/160). Compared with the good prognosis group, patients in the poor prognosis group were older and had higher proportions of pupillary dilation, abnormal basal cisterns, and midline shift ≥5 mm, lower Glasgow Coma Scale(GCS) scores, and higher serum ALDOC, SNTF, and NSE levels(χ2/t/P = 2.779/0.006, 9.489/0.002, 7.936/0.005, 8.472/0.004, 2.496/0.014, 6.475/<0.001, 6.582/<0.001, and 3.161/0.002). Mydriasis, abnormal basal cisterns, midline shift ≥5 mm, elevated ALDOC, elevated SNTF, and elevated NSE were independent risk factors for poor prognosis in patients with severe CC [OR(95% CI) = 3.499(1.321-9.270), 2.859(1.032-7.920), 2.395(1.089-5.264),3.421(1.976-5.925), 1.144(1.078-1.214), 1.327(1.164-1.513)], and a high GCS score was an independent protective factor[OR(95% CI) = 0.288(0.126-0.657)]. The AUCs of serum ALDOC, SNTF, NSE, and their combination for predicting poor prognosis in patients with severe CC were 0.764, 0.771, 0.746, and 0.915, respectively. The combined prediction was superior to each individual marker(Z/P = 4.412/<0.001, 4.377/<0.001, 4.897/<0.001). Conclusion Elevated serum ALDOC,SNTF, and NSE levels are associated with disease aggravation in patients with CC. They are independent predictors of poor prognosis in patients with severe CC, and their combined application demonstrates higher predictive value.

Objective To construct a prognostic prediction model for patients with facial nerve injury based on neuroelectrophysiological parameters, providing an objective reference for early clinical prognosis assessment and personalized treatment planning. Methods A total of 146 patients with facial nerve injury admitted to the Central Hospital Affiliated to Dalian University of Technology(Dalian Central Hospital) from January 2022 to November 2024 were enrolled. All patients received standardized treatment and eye care. Clinical characteristics were assessed before treatment. Electroneurography(ENoG), blink reflex(BR), and surface electromyography(sEMG) were performed to obtain key neuroelectrophysiological indicators, including compound muscle action potential(CMAP) amplitude and latency, R1 wave latency and amplitude, F-wave latency and occurrence rate, resting root mean square(RMS) value, and integrated electromyography(iEMG) during voluntary contraction. At six months after treatment, the House-Brackmann( HB) grading system was used to evaluate prognosis.Pearson or Spearman correlation analysis was applied to examine the correlations between neuroelectrophysiological indicators and baseline HB grade Ⅳ–Ⅵ as well as baseline Sunnybrook score. Multivariate logistic regression analysis was used to identify risk factors for poor prognosis. Based on the regression results, a nomogram prediction model was constructed. Internal validation was performed using the bootstrap method(resampling times = 1,000). The discrimination, calibration, and clinical utility of the model were assessed by calibration curve, receiver operating characteristic(ROC) curve, and decision curve analysis(DCA). Results At 6 months after onset, 116 patients(79.45%) had a good prognosis and 30(20.55%) had a poor prognosis. Compared with the good prognosis group, the poor prognosis group had significantly longer CMAP latency, R1 wave latency, and F-wave latency, higher resting RMS, and significantly lower CMAP amplitude, R1 wave amplitude, F-wave occurrence rate, and i EMG during contraction(t/P = 13.539/<0.001, 13.464/<0.001, 4.659/<0.001, 14.476/<0.001, 12.431/<0.001, 9.604/<0.001, 14.931/<0.001, 7.567/<0.001). CMAP amplitude, R1 wave amplitude, F-wave occurrence rate, and i EMG during contraction were significantly negatively correlated with baseline HB grade(rs=-0.860 to-0.675, all P <0.001) and significantly positively correlated with baseline Sunnybrook score(r = 0.643 to 0.832, all P <0.001). CMAP latency, R1 wave latency, F-wave latency, and resting RMS were significantly positively correlated with baseline HB grade(rs= 0.516 to 0.847,all P <0.001) and significantly negatively correlated with baseline Sunnybrook score(r =-0.815 to-0.478, all P <0.001). Logistic regression analysis showed that CMAP latency, R1 wave latency, and resting RMS were independent risk factors for poor prognosis in patients with facial nerve injury(all P <0.05). Conclusion The nomogram prediction model based on CMAP latency, R1 wave latency, and resting RMS demonstrates excellent predictive performance and strong clinical utility for prognostic assessment in patients with facial nerve injury. It provides a scientific basis for early identification of high-risk patients and optimization of treatment strategies.