Abstract:Objective To investigate the effect of miR-122-5p targeting the Toll-like receptor 4(TLR4)/myeloid differentiation factor 88(MyD88)/NF-κB pathway on H/R-induced neuronal injury.Methods Neuronal cell line HT22 was randomly divided into control group,model group,miRNA negative control group,miR-122-5p mimics group,miR-122-5p mimics+empty vector group,miR-122-5p mimics+TLR4 group,small interfering RNA(siRNA)negative control group,and TLR4 siRNA group(n=6).Except for the control group,the cells in the other groups were subjected to H/R treatment and corresponding plasmid transfection.qRT-PCR was used to detect the mRNA expression of miR-122-5p and TLR4 in HT22 cells.ELISA was utilized to measure the levels of inflammatory factors and oxidative stress factors.Results Compared with the control group,the model group showed significantly decreased levels of miR-122-5p,cell viability,and SOD activity,while obviously increased TLR4 mRNA level,apoptotic rate,lactate dehydrogenase(LDH)activity,and MDA,IL-6 and IL-18 levels(P<0.05).Treatment of miR-122-5p mimic resulted in significantly elevated levels of miR-122-5p,cell viability,and SOD activity,whereas reduced TLR4 mRNA level,apoptotic rate,LDH activity,and MDA,IL-6 and IL-18 levels when compared with the treatment of miRNA negative control(P<0.05).Compared with the miR-122-5p mimic+empty vector group,the miR-122-5p mimic+TLR4 group demonstrated significantly increased TLR4 mRNA expression,apoptotic rate,and MDA,IL-6,and IL-18 levels,while decreased cell viability and SOD activity(P<0.05).Pearson correlation analysis revealed that IL-6 level and IL-18 were negatively correlated with SOD activity(r=-0.932,P<0.01;r=-0.922,P<0.01),and positively with MDA content and LDH activity(r=0.931,r=0.819,P<0.01;r=0.935,r=0.829,P<0.01).Compared with the miR-122-5p mimic+empty vector group,the miR-122-5p mimic+TLR4 group showed significantly enhanced levels of pathway-related proteins and decreased Bcl-2 protein level(P<0.05).Compared with the siRNA negative control group,the TLR4 siRNA group exhibited significantly elevated cell viability,SOD activity,and Bcl-2 protein level,while reduced apoptotic rate,LDH activity,MDA content,inflammatory factor levels,pathway-related protein expression levels,and cleaved Caspase-3 level(P<0.05).Conclusion Expression of miR-122-5p is significantly down-regulated in H/R-induced HT22 cells.Its overexpression enhances the antioxidant capacity and viability and inhibits cell apoptosis and inflammatory response in HT22 cells by targeting the TLR4/MyD88/NF-κB pathway.

Abstract:Objective To investigate the effect of long non-coding RNA(lncRNA)metastasis-associated lung adenocarcinoma transcript 1(MALAT1)on cardiomyocyte apoptosis in acute myocardial infarction(AMI)mice by regulating the microRNA-200a-3p(miR-200a-3p)/B-cell translocation gene 2(BTG2)axis.Methods A total of 108 SPF C57BL/6J male mice were subjected,and 18 of them were randomly assigned into a control group.Then a mouse model of AMI was established in the remaining 90 mice,which were further divided into Model group,Silence control group(sh-NC group),Silencing MALAT1 group(sh-MALAT1 group),Silencing MALAT1+inhibition control group(sh-MALAT1+anti-NC group),and Silencing MALAT1+inhibited miR-200a-3p group(sh-MALAT1+anti-miR-200a-3p group),with 18 mice in each group.Mouse heart function and the expression of lncRNA MALAT1,miR-200a-3p,and BTG2 in myocardial tissues were detected,and the myocardial infarction area mice was measured.Pathological changes in myocardial tissues were observed.Cardiomyocyte apoptosis and expression of apoptosis-related proteins were detected.Results Compared with the Control group,the Model group exhibited significantly decreased left ventricle ejection fraction(LVEF),obviously increased left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)and apoptotic rate,larger myocardial infarction area,up-regulated levels of lncRNA MALAT1,BTG2,Bax and Caspase-3,and down-regulated miR-200a-3p expression(P<0.05).Silencing MALAT1 resulted in increased LVEF[(46.79±4.83)%vs(62.47±6.48)%],and reduced LVEDD(5.16±0.53 mm vs 3.28±0.37 mm),LVESD(7.28±0.74 mm vs 6.01±0.61 mm),decreased myocardial infarction area[(15.69±2.75)%vs(29.78±4.38)%],down-regulated lncRNA MALAT1(0.58±0.06 vs 1.70±0.07),BTG2(0.54±0.05 vs 1.43±0.14),Bax(0.56±0.05 vs 0.94±0.09)and Caspase-3(0.62±0.06 vs 1.03±0.11),and upregulated miR-200a-3p(1.51±0.15 vs 0.55±0.05)when compared with the sh-NC group(P<0.05).The sh-MALAT1+anti-miR-200a-3p group had significantly reduced LVEF,increased LVEDD,LVESD and apoptotic rate,enlarged myocardial infarction area,up-regulated expression of BTG2,Bax,and Caspase-3,and down-regulated expression of miR-200a-3p than the Silensing MALAT1+inhibition control group(P<0.05).Conclusion Inhibition of lncRNA MALAT1 expression suppresses cardiomyocyte apoptosis in AMI mice by targeting the miR-200a-3p/BTG2 axis.

Abstract:Objective To explore the efficacy of combined recombinant human brain natriuretic peptide(rhBNP)and dapagliflozin in the treatment of left heart failure(HF)after interventional therapy in elderly patients with acute myocardial infarction(AMI).Methods A total of 120 elderly patients with left HF after AMI interventional surgery admitted to our department from July 2023 to July 2024 were enrolled and randomly classified into an observation group(60 cases)and a control group(60 cases).Both groups were given conventional anti-HF treatment,and the control group was treated with rhBNP,whereas the observation group was given with rhBNP and dapagliflozin.The cardiac function[N-terminal pro-B-type natriutetic peptide(NT-proBNP),left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVESD)],serum indicators[myoglobin(MYO),cardiac troponin I(cTnI),aldosterone,norepinephrine(NE)]and exercise capacity[6-minute walking distance(6MWD)]were compared between groups and before treatment and after 3 months of treatment.The adverse reactions during treatment and the incidence of major adverse cardiac events(MACE)within 6 months after discharge were analyzed in both groups.Results After treatment,the NT-proBNP,LVESD,LVEDD,MYO,cTnI,aldosterone and NE were significantly reduced while the LVEF was significantly increased in the two groups compared to before treatment(P<0.05),and the NT-proBNP,LVESD,LVEDD,MYO,cTnI,aldosterone and NE were significantly lower,while the LVEF was significantly higher in the observation group after treatment than those in the control group(P<0.01).The 6MWD results after treatment were significantly higher in the observation group and the control group than those before treatment(384.62±23.37 m vs 256.48±20.42 m,354.25±24.02 m vs 258.03±21.37 m,P<0.01),and the observation group had obviously better 6MWD results after treatment than the control group(P<0.01).During treatment,no statistical differences were observed in the incidence rates of gastrointestinal reactions,hypotension,hypoglycemia and urinary tract infection between the two groups(P>0.05).The incidence rate of MACE in the observation group was notably lower in comparison with the control group(5.0%vs 18.3%,P<0.05).Conclusion rhBNP combined with dapagliflozin can improve the cardiac function and reduce the occurrence of MACE in the elderly AMI patients with left heart failure after interventional therapy,with good safety.

Abstract:Objective To investigate the correlation between vasostatin-2(VS-2)level and collateral circulation and reperfusion injury in patients with acute myocardial infarction(AMI).Methods A total of 128 patients with first-episode AMI,aged≥60 years,who received treatment in the Department of Cardiology and Department of General Practice of Dongguan Songshan Lake Tungwah Hospital from August 2022 to March 2024 were enrolled in this study.According to the Rentrop grading based on coronary angiography within 1 d after onset,they were divided into a poor-collateral circulation group(Rentrop grade 0～1,n=80)and a good-collateral circulation group(Rentrop grade 2～3,n=48).Reperfusion injury was evaluated by thrombolysis in myocardial infarction(TIMI)flow grading.Serum VS-2 level was measured before surgery.Spearman correlation analysis was used to explore the relationship between VS-2 level and Rentrop/TIMI grade,and multivariate logistic regression was performed to identify the influencing factors for collateral circulation.Results The good-collateral circulation group had significantly lower levels of creatinine(87.49±10.81 mmol/L vs 93.54±13.60 mmol/L),urea(4.67±0.84 mmol/L vs 5.46±1.29 mmol/L),troponin I(20.76±4.59 μg/L vs 24.19±5.82 μg/L)and B-type natriuretic peptide(285.61±24.87 ng/L vs 321.20±30.42 ng/L),and higher left ventricular ejection fraction[(45.79±6.78)%vs(42.35±6.53)%]than the poor-collateral circulation group(P<0.01).There were statistically differences in the results of Killip classification and TIMI classification between the two groups(P<0.05,P<0.01).The VS-2 level was obviously higher in the patients of Rentrop grades 2 and 3 than those with Rentrop grades 0 and 1(P<0.05),in those with TIMI grades 1,2 and 3 than those with TIMI grade 0(P<0.05),and in those with TIMI grades 2 and 3 than those with TIMI grade 1(P<0.05).Spearman correlation analysis revealed that the VS-2 level was positively correlated with both TIMI classification and Rentrop classification(P<0.01).Multivariate logistic regression analysis showed that TIMI classification,VS-2 level,troponin I,BNP,and Killip classification were influencing factors for good collateral circulation(P<0.01).Conclusion The more severe the reperfusion injury and the worse the collateral circulation are,the more significant the decrease in VS-2 level in AMI patients.Increasing VS-2 level can promote the formation of coronary collateral circulation and alleviate myocardial reperfusion injury.

Abstract:Objective To explore the predictive value of dynamic electrocardiogram(ECG)parameters combined with serum fibroblast growth factor 21(FGF21)and nerve growth factor(NGF)for ventricular arrhythmia in ST-segment elevation myocardial infarction(STEMI)patients after percutaneous coronary intervention(PCI).Methods A retrospective trial was conducted on 187 STEMI patients admitted to our hospital between June 2022 and December 2023.According to presence or absence of ventricular arrhythmia within 72 h after PCI,they were divided into arrhythmia group(65 cases)and non-arrhythmia group(122 cases).All patients underwent 24-hour dynamic electrocardiography.The ECG data[standard deviation of normal-to-normal intervals(SDNN),root mean square of successive differences(rMSSD),standard deviation of the average normal-to-normal intervals per 5-minute period(SDANN index),QT interval variability(QTV)]were collected,and serum levels of FGF21 and NGF were detected.The risk factors of ventricular arrhythmia were analyzed with logistic analysis,and predictive value of the above indicators was evaluated with receiver operating characteristic(ROC)curve analysis.Results The arrhythmia group exhibited significantly lower SDNN,rMSSD,SDANN-index and QTV,and higher serum levels of FGF21 and NGF than the non-arrhythmia group(P<0.01).Multivariate logistic regression analysis showed that SDNN,rMSSD,SDANN-index,QTV,FGF21 and NGF were independent risk factors of ventricular arrhythmia after PCI in STEMI patients(P<0.01).ROC curve analysis showed that the AUC value of combined dynamic ECG parameters(SDNN,rMSSD,SDANN-index,QTV)and serum FGF21 and NGF in predicting ventricular arrhythmia was significantly greater than that of single indicator(0.852 vs 0.736,0.752,0.718,0.763,0.692,0.740,P<0.05).Conclusion Combination of dynamic ECG parameters and serum FGF21 and NGF shows high predictive value for ventricular arrhythmia in STEMI patients after PCI,which is beneficial to early identify high-risk patients.

Abstract:Objective To investigate the correlation between serum NOD-like receptor thermal protein domain associated protein 3(NLRP3)and cysteine aspartate protease-1(Caspase-1)and disease severity of elderly diabetes mellitus(DM)patients with concomitant dementia.Methods A total of 120 elderly eligible patients admitted in our department from January 2023 to January 2025 were enrolled,and according to the results of mini-mental state examination(MMSE),they were divided into mild(43 cases),moderate(39 cases)and severe dementia group(38 cases).Another 56 patients with simple DM who received MMSE screening during the same period were enrolled as the control group.General data were collected,including hemoglibin A1c(HbA1c),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)and very low-density lipoprotein cholesterol(VLDL-C).The levels of NLRP3 and Caspase-1 were detected with enzyme-linked immunosorbent assay(ELISA).Spearman correlation analysis was used to analyze the correlation between NLRP3 and Caspase-1 levels and disease severity in the patients.Multivariate logistic regression analysis was employed to identify the influencing factors for elderly DM complicated with dementia.ROC curve was plotted to analyze the diagnostic value and calculate the area under the curve(AUC)of the two markers.Results The levels of fasting plasma glucose(FPG),HbAlc,TC,TG,LDL-C,VLDL-C,NLRP3 and Caspase-1 were significantly higher,while the HDL-C level was obviously lower in the moderate and severe dementia groups than the control group and the mild dementia group(P<0.05),and similar results were observed in the severe dementia group when compared with the moderate dementia group(P<0.05).Spearman correlation analysis suggested that the serum NLRP3 and Caspase-1 levels were positively correlated with disease severity of elderly DM patients with dementia(r=0.594,P=0.013;r=0.517,P=0.019).Multivariate logistic regression analysis identified that serum NLRP3,Caspase-1,FPG,HbAlc,TC,LDL-C and VLDL-C were risk factors of dementia in elderly patients with DM,and HDL-C was a protective factor(P<0.05,P<0.01).The AUC value of combining serum NLRP3 and Caspase-1 levels together in diagnosing elderly DM patients with dementia in was significantly higher than that of single marker(0.862 vs 0.853 and 0.771,P<0.01).Conclusion Serum NLRP3 and Caspase-1 levels are independent risk factors of elderly DM with dementia,and the indicators can be used as biomarkers for diagnosing disease severity and assisting clinical analysis of prognosis.

Abstract:Objective To explore the value of a nomogram model constructed using multimodal magnetic resonance imaging(MRI)quantitative parameters combined with clinical indicators for the risk of poor prognosis in elderly patients with acute ischemic stroke(AIS)after intravenous thrombolysis.Methods A total of 105 elderly AIS patients who received intravenous thrombolysis with recombinant tissue-type plasminogen activator(rt-PA)in our hospital from January 2022 to January 2025 were recruited,and according to the score of modified Rankin Scale(mRS)at 3 months after thrombolysis,they were divided into a poor prognosis group(36 cases,mRS score≥3)and a good prognosis group(69 cases,mRS score<3).Clinical indicators including demographic data,underlying diseases,National Institutes of Health Stroke Scale(NIHSS)score at onset,rt-PA dose,and time from onset to thrombolysis,as well as multimodal MRI quantitative parameters[infarct volume,apparent diffusion coefficient(ADC)in the core region,cerebral microbleeds on susceptibility-weighted imaging,and mass effect)were collected.Univariate analysis was used to screen for differential indicators,and multivariate logistic regression analysis was applied to identify independent risk factors.A nomogram model was constructed,and internal validation was performed using Bootstrap to evaluate discriminative ability,calibration,and predictive efficacy.Results The poor prognosis group exhibited significantly higher NIHSS score at onset,larger infarct volume,more cerebral microbleeds,and larger proportion of mass effect,while obviously lower rt-PA dose and ADC in the core region when compared with the good prognosis group(P<0.05,P<0.01).Multivariate logistic regression analysis showed that NIHSS score at onset(OR=1.685,95%CI:1.237-2.235,P<0.01),infarct volume(OR=1.090,95%CI:1.024-1.158,P<0.05),cerebral microbleeds(OR=1.581,95%CI:1.322-1.840,P<0.05),mass effect(OR=3.425,95%CI:2.590-4.260,P<0.01),rt-PA dose(OR=0.156,95%CI:0.044-0.657,P<0.01),and ADC value in the core region(OR=0.997,95%CI:0.995-0.999,P<0.01)were influencing factors for poor prognosis in elderly AIS patients after thrombolysis.The C-index of the constructed nomogram model was 0.838(95%CI:0.755-0.887).The AUC value,sensitivity,and specificity of the nomogram model for predicting the risk of poor prognosis in elderly AIS patients after thrombolysis were 0.822(95%CI:0.745-0.899),81.97%,and 68.42%,respectively(P<0.05).Conclusion The nomogram model constructed using multimodal MRI quantitative parameters and clinical indicators demonstrates good predictive efficacy for poor prognosis in elderly AIS patients after thrombolysis,providing a reference for clinical individualized prognosis assessment.

Abstract:Objective To analyze the changes in IL-17A and IL-8 in H-type hypertension patients complicated with acute ischemic stroke(AIS)of different severities and their relationship with short-term prognosis.Methods A total of 150 patients with H-type hypertension combined with AIS were enrolled in our hospital from January 2023 to August 2024.According to the neurological deficit by National Institutes of Health Stroke Scale(NIHSS),the patients were into mild(score<5,45 cases),moderate(score 5～20,72 cases)and severe(score>20,33 cases)groups.The clinical data and serum IL-17A and IL-8 levels were compared in the three groups.Pearson correlation analysis was employed to analyze the correlations of serum IL-17A and IL-8 levels with NIHSS score and modified Rankin scale(mRS)score.Results The mild group had significantly younger age,smaller infarction area,shorter onset to admission time,lower mRS score and reduced levels of homocysteine(Hcy),IL-17A and IL-8,and higher platelet count than the moderate group(P<0.05).Age,Hcy,IL-17A,IL-8 and mRS score were independent risk factors for disease condition of the patients(P<0.05,P<0.01).Pearson correlation analysis indicated that serum IL-17A and IL-8 levels were positively correlated with NIHSS score and mRS score in the patients(P<0.01).The AUC value of IL-17A and IL-8 in predicting short-term prognosis was 0.752(95%CI:0.650-0.853)and 0.734(95%CI:0.627-0.840),respectively,significantly lower than that of combined detection(0.884,95%CI:0.822-0.946,P<0.05).Conclusion Serum IL-17A and IL-8 are closely associated with the condition and short-term prognosis of H-type hypertension patients complicated with AIS,and their combination has a high predictive value for the short-term prognosis of the patients.

Abstract:Objective To explore the epidemiological characteristics and influencing factors of sarcopenia in elderly patients with coronary heart disease(CHD).Methods A prospective study was conducted on 302 elderly CHD patients admitted to our hospital during January 2020 and December 2021.Based on complication with sarcopenia or not,they were divided into a sarcopenia group(n=128)and a non-sarcopenia group(n=174).The clinical data were compared between the two groups,and the risk factors for sarcopenia were analyzed.The mortality rate was also compared between them after 3 years of follow-up.Results The sarcopenia group had significantly higher age,diabetes,hypersensitive C-reactive protein(hs-CRP),chronic respiratory diseases,and mortality rate compared to the non-sarcopenia group,while BMI and left ventricular ejection fraction were significantly lower than those in the non-sarcopenia group(P＜0.05,P＜0.01).Age(OR=1.082,95％CI:1.008-1.169),chronic respiratory diseases(OR=3.493,95％CI:1.212-7.289),diabetes(OR=2.652,95％CI:1.171-5.977)and hs-CRP(OR=1.081,95％CI:1.022-1.109)were risk factors for sarcopenia in elderly CHD patients(P＜0.05),while LVEF(OR=0.941,95％CI:0.922-0.991,P＜0.05)was a protective factor.Sarcopenia was identified as an independent risk factor for 3-year mortality in elderly CHD patients(OR=2.321,95％CI:1.132～5.037,P＜0.01).Conclusion The incidence of sarcopenia is relatively high in elderly CHD patients,which can lead to poor prognosis.Early identification and treatment for population at high risk for sarcopenia should be carried out to improve the prognosis of the patients.

Abstract:Objective To investigate the relationship between triglyceride(TG)level and the risk of death from Alzheimer's disease.Methods A total of 4 726 subjects were enrolled in this study,including 4 270 participants from the NHANES database(1999-2018)and 456 individuals from a community health check-up in a Beijing community between September 2007 and January 2009.The levels of total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),and TG were detected.The subjects were divided into four groups based on TG quartiles:Q1(0-0.80 mmol/L,823 cases),Q2(0.81-1.16 mmol/L,1 298 cases),Q3(1.17-1.72 mmol/L,1 350 cases)and Q4(1.73-6.34 mmol/L,1 255 cases).General clinical data was collected.Cox proportional hazards regression model was used to assess the association between TG and the risk of Alzheimer's disease-related death.Results Significant differences were observed among the four groups in terms of age,female,body mass index,education level,smoking,alcohol consumption,TC,TG,LDL-C and HDL-C levels,ratios of diabetes,hypertension and coronary heart disease,and proportions of antihypertensive and lipid-lowering medication use(P＜0.01).During a median follow-up time of 8.98 years,108 Alzheimer's disease-related deaths were recorded,with an incidence rate of 2.54 cases per 1000 person-years.The cumulative risk of Alzheimer's disease-related deaths was notably higher in the Q4 group than the Q1 group(P＜0.05).After adjusting for smoking,alcohol consumption,body mass index,TC and LDL-C levels,diabetes status,hypertension,heart failure,coronary heart disease,stroke,and lipid-lowering medication use,Cox proportional hazards regression model revealed that the Q3 and Q4 groups had significantly increased risks of Alzheimer's disease-related death than the Q1 group(HR=2.354,95％CI:1.041-6.113,P＜0.05;HR=2.583,95％CI:1.091-6.362,P＜0.05).Moreover,a significant increasing trend was observed across the Q2,Q3,and Q4 groups(Ptrend＜0.01).Conclusion Elevated TG level is significantly associated with an increased mortality rate from Alzheimer's disease,suggesting that hypertriglyceridemia may exacerbate the risk of death in Alzheimer's disease patients.

Abstract:Objective To explore the application efficacy of off-pump coronary artery bypass(OPCAB)grafting and on-pump coronary artery bypass(ONCAB)grafting in over 75-year-old patients with coronary heart disease(CHD).Methods A prospective cohort study was conducted on 240 consecutive patients undergoing CAB grafting in Department of Cardiac Surgery of Xuzhou Central Hospital from January 2020 to May 2025.According to different surgical methods,they were divided into OPCAB group(180 cases)and ONCAB group(60 cases).The baseline characteristics before surgery and intraoperative and postoperative indicators were compared between the two groups.Results The OPCAB group had significantly shorter operation time(210.83±43.72 min vs 274.52±41.61 min)and activated clotting time(300.12±20.31 s vs 480.22±25.34 s),and less intraoperative blood loss(300.03±100.04 mL vs 450.03±120.02 mL)and blood transfusion volume(100.02±50.02 mL vs 200.04±60.03 mL)while obviously faster bridging blood flow and higher myocardial temperature when compared with the ONCAB group(P＜0.01).The OPCAB group also exhibited significantly shorter mechanical ventilation time and length of intensive care stay,lower troponin I and creatine kinase isoenzyme levels,and lower ratios of poor chest incision healing,acute kidney injury,low cardiac output syndrome,intra-aortic balloon counterpulsation,secondary thoracotomy hemostasis,re-intubation,and renal failure when compared with the ONCAB group(P＜0.05,P＜0.01).Conclusion OPCAB has significant advantages in reducing postoperative complications,accelerating recovery,alleviating myocardial injury,and improving quality of life,especially for over 75-year-old and high-risk patients.

Abstract:Objective To analyze the structural characteristics and functional network coupling of brain spatial distance measurement in Alzheimer's disease(AD)patients based on functional magnetic resonance imaging and to explore the coupling relationship between structural connectivity with different connection distances and brain functional connectivity.Methods A total of 793 subjects were prospectively and continuously subjected from four hospitals between August 2010 and July 2022.Based on diagnosis,they were divided into AD group(284 cases),mild cognitive impairment group(MCI,254 cases),and control group(255 cases).The structural connectivity matrix was classified into long-distance,short-distance,and all-distance(original structural connectivity matrix)based on Euclidean distance between brain regions,followed by decomposition of the structural connectivity matrix into networks with equal features.The structure-function coupling coefficients were statistically analyzed using a multilinear regression model.Results Significant difference was observed in the scores of mini-mental state examination(MMSE)among the control,MCI and AD groups(P＜0.01).In the all distance-coupling distribution,the occipital visual region exhibited the highest coupling value with the dorsal attention network,while the lowest coupling value was observed in the limbic network,and a negative correlation was observed in the coupling with the functional gradient(r=-0.30,P＜0.01).In long-distance coupling,the occipital visual region and dorsal attention area had the highest coupling value,whereas the ventral attention area and limbic system region displayed the lowest coupling value,with a negative correlation between long-distance coupling and functional gradient(r=-0.23,P＜0.01).In short-distance coupling,the visual regions predominantly exhibited the highest value,while other regions were relatively low,and this coupling showed a positive correlation with the functional gradient(r=0.15,P＜0.05).Pearson correlation analysis showed the coupling scores were negatively correlated with the MMSE scores.In all-distance coupling,20 brain regions exhibited negative correlations,mainly including the superior frontal gyrus,middle frontal gyrus,precentral gyrus,paracentral lobule,superior parietal lobule,inferior parietal lobule,and lateral occipital cortex.In short-distance coupling,32 brain regions were all negatively correlated,with a distribution pattern similar to that of long-distance coupling.In long-distance coupling,13 regions showed negative correlations,primarily concentrated in the precentral gyrus,paracentral lobule,and superior parietal lobule.Conclusion Our findings indicate that structural connectivity at different spatial distances can partially affect brain activity and cognition,providing new insight for studying connectivity changes in AD based on connectivity length.

Abstract:Objective To assess the frailty index(FI)of aged male C57BL/6J mice using the FI-31 scoring system,and to validate the effectiveness of the frailty model by integrating pathological examination and serum biomarker detection.Methods Five 6-month-old mice in the experimental animal center of our university were subjected and served as a young group.Another 10 14-month-old male C57BL/6J mice(SPF grade)were divided into a senescence group and a frailty group according to the FI-31 value,with 5 mice in each group.The FI value was compared among the three groups.The heart,liver,kidneys,spleens,and gastrocnemius muscle were collected from the three groups for pathological staining and observation,and serum senescence-associated secretory phenotype biomarkers were measured using ELISA.Results The FI-31 score was significantly higher in the senescence group and the frailty group than the young group(P＜0.05).The frailty group exhibited progressively frail in varying organs,showing segmental arterial intimal necrosis in the heart,aggravative steatosis in the liver,mesangial cell proliferation in the kidneys,macrophage deposition in the spleen,and muscle atrophy.Elevated serum levels of IL-6,IL-1β,TNF-α,MCP-1,and CXCL-10,and decreased G6PD level were observed in the frailty group when compared with the young group and the senescence group(P＜0.05).The pathological scores of the heart,liver,kidneys and spleen were 0.2-0.4 in the young group,1.4-1.8 in the senescence group and 1.6-2.2 in the frailty group.Conclusion The combination of FI-31 scoring,pathological examination,and serum biomarker detection provides a reference for assessing tissue and serum changes in frail mice.

Abstract:Objective To explore the rehabilitation effect of combination of early ankle-foot orthosis and mirror therapy on lower limb motor function in elderly patients with stroke hemiplegia.Methods A total of 148 elderly patients with stroke hemiplegia admitted in our department from December 2021 to December 2023 were enrolled and randomly categorized into a control group(early ankle-foot orthosis therapy,74 cases)and a combined group(early ankle-foot orthosis combined with mirror therapy,74 cases).The clinical therapeutic efficacy,limb function(Fugl-Meyer assessment scale,comprehensive spasticity rating scale),walking function(Holden functional ambulation classification,timed 10-meter walk test),neurological function[National Institutes of Health stroke scale(NIHSS),neurological function deficit scale(NFDS)]and quality of life[stroke-specific quality of life scale(SS-QOL)]before and after treatment were compared between the two groups.Results After treatment,the combined group exhibited a significantly higher total effective rate than the control group(95.9％vs 83.8％,P＜0.05).The motor function score,balance function score,scores of dimensions and total score of SS-QOL and Holden functional ambulation class were significantly higher,while the limb spasm scores,NIHSS score,NFDS score and 10-m walking time were significantly lower in the combined group than the control group(P＜0.01).Conclusion Early ankle-foot orthosis combined with mirror therapy has a significant efficacy on elderly patients with stroke hemiplegia,and it can significantly improve limb function and walking function,reduce the neurological deficit and enhance the quality of life in the patients.

Abstract:Objective To explore the embolization and prognosis in complex intracranial aneurysm after treatment with Lvis and Solitaire stents.Methods A total of 110 eligible patients admitted to our department between March 2020 and January 2024 were retrospectively enrolled,and according to different treatment methods,they were divided into Lvis group(49 cases)and Solitaire group(61 cases).Immediately and at 6 months after surgery,embolization was evaluated.Cerebral vascular reactivity was evaluated by transcranial Doppler flow analyzer.The incidence of complications and recurrence rate were observed within 6 months after surgery.The prognosis of patients was evaluated by modified Rankin scale.Results No significant difference was observed in embolization rate immediately after surgery between the Lvis group and Solitaire group(100.0％vs 96.7％,P＞0.05).At 6 months after surgery,the Lvis group obtained significantly higher embolization rate than the Solitaire group(95.9％vs 83.6％,P＜0.05),but no statistical difference in the incidence of complications or recurrence rate was seen between them(10.2％vs 3.3％,2.0％vs 6.6％,P＞0.05).At the time point,average arterial blood flow after breath-holding(66.12±12.35 cm/s vs 60.37±11.44 cm/s,64.25±11.67 cm/s vs 59.62±10.93 cm/s)and breath-holding index(0.61％±0.16％vs 0.45％±0.11％,0.56％±0.12％vs 0.41％±0.13％)were significantly increased in both groups(P＜0.05),and there was no obvious difference in good prognosis rate between the two group(89.8％vs 77.0％,P＞0.05).Conclusion Lvis stent and Solitaire stent have similar embolization effectiveness,incidence of complications and prognosis in the treatment of complex intracranial aneurysm.However,Lvis stent shows higher embolization rate than Solitaire stent after 6 months of follow-up.

Abstract:Objective To investigate the expression of mitochondrial ATP-sensitive potassium channels(mitoKATP)and mitochondrial functional alterations in the hearts of mice with heart failure related to diabetic cardiomyopathy(DCM).Methods Eighty male mice were randomly divided into control group,DCM group,DCM related diastolic heart failure group(DHF),and DCM related systolic heart failure group(SHF),with 20 mice in each group.The mice from the DCM group,DHF group,and SHF group were separately modeled correspondingly.Western blotting was used to detect the expression levels of mitoKATP subunits,electron microscopy was employed to observe the changes in mitochondrial ultrastructure,and Seahorse XFe96 analyzer was utilized to assess mitochondrial function in each group.Results Compared to the control group,the protein level of Kir6.1 subunit(which composes mitoKATP),basal respiratory capacity,ATP production capacity,maximal respiratory capacity,and respiratory reserve capacity of mitochondrial function in cardiomyocytes were significantly declined in the DCM,DHF,and SHF groups(P＜0.05).Transmission electron microscopy revealed swollen,rounded mitochondria with reduced matrix density,shortened and sparse cristae,and partial mitochondrial fusion in the DCM,DHF,and SHF groups.The mitochondrial basal respiratory capacity,ATP production capacity,and maximal respiratory capacity in cardiomyocytes from the DHF and SHF groups were significantly lower than those in the DCM group(P＜0.05).The SHF group had obviously lower mitochondrial basal respiratory capacity[44.0±1.5 pmol/(min·μg)vs 50.0±1.9 pmol/(min·μg),P＜0.05],ATP production capacity[31.0±2.0 pmol/(min·μg)vs 37.0±3.1 pmol/(min·μg),P＜0.05],and maximal respiratory capacity[59.0±4.0 pmol/(min·μg)vs 66.0±3.0 pmol/(min·μg),P＜0.05]when compared with the DHF group.Conclusion During the progression of DCM related heart failure,the expression levels of mitoKATP in mouse heart are continuously declined,while mitochondrial dysfunction in ventricular myocytes is progressively worsen.

Abstract:Objective To explore the changes in serum soluble Fms-like tyrosine kinase 1(sFlt-1)and human cartilage glycoprotein-39(HCgp-39)levels in elderly patients with aneurysms and analyze the association of the levels with risk of cerebral vasospasm after endovascular interventional embolization.Methods A total of 103 elderly patients with intracranial aneurysms admitted in our hospital from November 2021 to January 2025 were enrolled,and all of them received endovascular interventional embolization due to aneurysm rupture hemorrhage.According to the presence or absence of cerebral vasospasm after surgery,they were classified into a vasospasm group(38 cases)and a non-vasospasm group(65 cases).Serum sFlt-1 and HCgp-39 levels were measured,and the relationship between the changes in the levels and postoperative cerebral vasospasm was analyzed.Results The vasospasm group had significantly advanced age,higher serum sFlt-1 and HCgp-39 levels,and higher modified Fisher grade than the non-vasospasm group(P＜0.05,P＜0.01).Spearman correlation analysis revealed that sFlt-1 level was positively correlated with modified Fisher grade(r=0.290,P=0.003),but HCgp-39 level was not(r=0.180,P＞0.05).Multivariate logistic regression analysis suggested that serum sFlt-1(OR=1.048,95％CI:1.022-1.075,P=0.000),HCgp-39(OR=1.037,95％CI:1.015-1.059,P=0.001)and modified Fisher grade(OR=15.267,95％CI:3.637-64.095,P=0.000)were risk factors for postoperative vasospasm.ROC curve analysis indicated that the area under the curve(AUC)values of serum sFlt-1,HCgp-39 and modified Fisher grade in evaluating postoperative vasospasm were 0.821(95％CI:0.739-0.904),0.748(95％CI:0.648-0.848)and 0.794(95％CI:0.703-0.885),respectively,and the AUC value of combined the three indicators together was 0.944(95％CI:0.902-0.986).Conclusion The abnormal increases of serum sFlt-1 and HCgp-39 levels in elderly patients with ruptured intracranial aneurysm are associated with the risk of vasospasm after endovascular interventional embolization,and the levels of the two indicators have certain evaluation value.

Abstract:Objective To investigate the value of saccadic features in the diagnosis and symptom assement of Parkinson's disease(PD).Methods A total of 76 PD patients(PD group)and 37 healthy controls(control group)admitted in the Movement Disorders Clinic of Chinese PLA General Hospital between February 2024 and July 2025 were recruited in this study.According to the results of modified Hoehn-Yahr(mH&Y)staging,the PD patients was further divided into an early PD subgroup(stage≤ 1.5,37 cases)and a moderate-stage PD subgroup(stage≥ 2,39 cases).All participants underwent prosaccade(PS),antisaccade(AS),and memory-guided saccade(MGS)tests using a video-based eye tracker.ROC curves were plotted to evaluate diagnostic efficacy,and Spearman correlation analysis was carried out to explore the relationships between saccadic features and clinical features.Results Compared with the control group,the PD group exhibited significantly increased incidences of PS,AS and MGS errors and longer AS and MGS latencies,while lower accuracy rates of PS and MGS,lower gains in PS,AS and MGS,and reduced peak velocities of AS and MGS(P＜0.05,P＜0.01).The prolonged AS latency and decreased PS accuracy rate were influencing factors for PD(P＜0.05,P＜0.01),and prolonged AS latency was an influencing factor for early PD(P＜0.01).ROC curve analysis indicated that the AUC value of combining PS accuracy rate and AS latency in differentiating PD from control individuals was 0.916,and the value of AS latency in differentiating early PD from control individuals was 0.840.Spearman correlation analysis revealed that AS latency was positively correlated with the score of the third part and the axial subscore of Movement Disorder Society-Unified Parkinson's Disease Rating Scale(ρ=0.386,95％CI:0.170-0.567,P=0.040;ρ=0.373,95％CI:0.154-0.557,P=0.047),and MGS latency was also positively correlated with the axial subscore(ρ=0.411,95％CI:0.198-0.517,P=0.024).Conclusion Prolonged AS latency may serve as a biomarker for diagnosing early-stage PD.Both AS and MGS latencies are closely associated with motor symptoms(particularly axial symptoms)of PD patient,showing their potential application value in assessing symptom and disease progression.

Abstract:Objective To evaluate the cardiac autonomic function in patients with large artery atherosclerosis(LAA)acute cerebral infarction(ACI)by deceleration capacity(DC)and acceleration capacity(AC)of heart rate,and analyze the early warning capability of the two indicators for neurological outcomes after discharge.Methods A total of 302 patients who survived from first LAA-ACI within 7 d of onset admitted in our neurological department from December 2021 to December 2023 were consecutively enrolled in this study.24-hour Holter electrocardiography was applied for DC and AC values.According to modified Rankin scale(mRS)for neurological outcomes at discharge,the patients was divided into a good outcome group(mRS score:0-2,207 cases)and a poor outcome group(mRS score:3-5,95 cases).Clinical data were compared between the two groups.Receiver operating characteristic(ROC)curve,calibration curve,and decision curve analyses were performed to evaluate the early warning capacities of DC,absolute value of AC(|AC|),and DC or|AC|combined with DC/|AC|day-night ratio.Results In the poor neurological outcome group,the levels of DC,|AC|,DC/|AC|,and the proportion of cases with elevated nighttime DC were significantly lower than those of the good outcome group[3.51(2.56,4.24)vs 5.23(4.39,6.48),4.35(3.52,5.58)vs 5.79(4.89,7.08),0.81(0.65,0.92)vs 0.94(0.87,0.97),58.07％vs 78.26％,P＜0.01],while the DC/|AC|day-night ratio was higher[1.00(0.95,1.11)vs 0.98(0.93,1.01),P＜0.01].DC,|AC|and DC/|AC|day-night ratio were risk factors for good prognosis in LAA-ACI patients at discharge(P＜0.05,P＜0.01).The AUC value of DC and DC/|AC|day-night ratio in predicting poor prognosis in LAA-ACI patients at discharge was 0.804,with a Brier index of 0.155,and a net benefit of 16.57％at the optimal cutoff value.Conclusion Prominent damage to vagal tone detected in early stage of LAA-ACI is associated with circadian rhythm decline and comparatively sympathetic hyperactivity,and is correlated with poor outcomes.Combination of declined DC and elevated DC/|AC|day-night ratio shows good early warning capacity for neurological outcomes in LAA-ACI patients at discharge.

Abstract:Objective To explore the value of diurnal variation of ventricular late potential(VLP)in dynamic electrocardiography(ECG)for assessment of the risk of fatal arrhythmias after myocardial infarction(MI).Methods A total of 206 MI patients admitted to Department of Cardiovascular Diseases of Tengzhou Central People's Hospital from May 2021 to May 2024 were recruited and served as MI group.Based on fatal arrhythmias occurred or not,these patients were divided into an arrhythmia subgroup(54 cases)and a non-arrhythmia subgroup(152 cases).Another 76 non-MI patients admitted during the same period were also subjected as the control group.ECG workstation late potential analysis system was used to collect total time required for ventricular depolarization(TQRS)and record VLP positivity.The changes in diurnal TQRS and VLP positivity were compared between the MI group and the control group,and between the arrhythmia subgroup and the non-arrhythmia subgroup.Results Both the MI group and the control group had significantly higher nighttime TQRS value than daytime value(P＜0.01),and the MI group had obviously higher daytime and nighttime TQRS values than the control group(P＜0.01).The positive rate of VLP was significantly higher in the MI group than the control group(24.8％vs 3.9％,P＜0.01).The nighttime TQRS value of both the arrhythmia subgroup and the non-arrhythmia subgroup was significantly higher than the daytime value(P＜0.01);The daytime and nighttime TQRS values were significantly higher in the arrhythmia subgroup than the non-arrhythmia subgroup(P＜0.01).The positive rate of VLP was significantly higher in the arrhythmia subgroup than the non-arrhythmia subgroup(48.1％vs 16.4％,P＜0.01).Pearson correlation analysis showed that the risk of fatal arrhythmia was positively correlated with the mean diurnal TQRS value and VLP positivity(r=0.541,r=0.676,P＜0.01).Conclusions VLP is of important value in assessing the risk of fatal arrhythmia after MI,and the risk of fatal arrhythmia is significantly correlated with diurnal TQRS and VLP positivity,which is worthy of clinical reference.