Objective To explore the changes and the clinical relevance of plasma p-selectin (PS) and vascular endothelial cell function in patients with carotid stenosis (CS) before and after carotid artery stenting (CAS). Methods The plasma levels of PS, yon willebrand (vWF) and endothelin-1 (ET-1) before CAS and 1hour,6 hours,24 hours,2 months after CAS in 67 patients with carotid stenosis and 54 cases of TIA with negative result from cerebral angiography were measured. The patients of the therapy group were further divided into group A and group B according to complexity of CAS. The plasma levels of PS and vWF were determined by enzyme linked immunosorbent assay,and the level of ET-1 was measured by radioimmunoassay. Results The plasma levels of PS,vWF and ET-1 all increased in the patients group after CAS. In the therapy group,the level of PS reached peak value (29.23 ± 6.98) ng/ml 1 hour after CAS, and the levels of vWF and ET-1 reached peak value (119.63 ±16.75) %, (79.71 ± 9.78) ng/L 6 hour after CAS. In therapy group, there was significant difference in the levels of PS and ET-1 between each time points after CAS and before CAS (P＜0.05,P ＜0.01 respectively). There was significant difference in the level of vWF between 1 hour, 6 hours, 24 hours after CAS and before CAS (P ＜ 0.05 orP ＜ 0.01). There was significant difference in tihe levels of PS 1 hour after CAS and ET-1 at 6 hours after CAS (P ＜0.05) ,and in the level of vWF at 1 hour,6 hours after CAS between control group and therapy group (P ＜0.01).There was significant difference in the level of vWF at every time point after CAS (P ＜ 0.05 or P ＜ 0.01), and in the level of ET-1 at 1 hour,6 hours,24 hours between A group and B group(P ＜0.05 or P ＜0.01). Conclusions PS, vWF and ET-1 were activated to some extent and related to pathological changes degree and complexity of CAS. Monitoring these biological indexes after CAS maybe of great value in predicting risk, evaluating clinical therapy and judging prognosis.

Objective To evaluate the mechanism,prevention and prognosis of complications after stent angioplasty in the treatment of carotic artery stenosis. Methods[WT5”BZ] From 1997 to 2003,312 cases of carotid artery stenosis were treated by transluminal stent-assistant angioplasty. Results Procedure-related complication developed in 23 cases including 19 cases of transient mild complications such as transient arrhythmia and hypotension in 10 cases (3.2%) during deploying stent or balloon dilation,transient cerebral ischemia symptoms in 6 cases after balloon dilation,hypotension in 3 cases after the procedure. Severe complications occurred in 4 cases after the procedure,including embolus detachment,stent migration,carotic artery occlusion and fatal cerebral hemorrhage. Conclusion Although stent-assistant angioplasty are effective for treatment of carotid artery stenosis,severe complications could develop.

Objective To explore the predictive value of serum fibrinogen(Fbg)and pentaxin-3(PTX3)levels for perioperative major adverse cardiovascular events(MACE)in elderly patients undergoing hip re-placement surgery.Methods A total of 201 patients who underwent hip replacement surgery in the Qilu Hos-pital of Shandong University,Dezhou Hospital(the hospital)from January 2022 to December 2022 were re-garded as the study group,and based on the presence or absence of MACE during the perioperative period,pa-tients were separated into the non MACE group(183 cases)and the MACE group(18 cases).Another 150 healthy examinees from the hospital were selected as the control group.Fully automated biochemical analyzer and enzyme linked immunosorbent assay(ELISA)were applied to detect serum Fbg and PTX3 levels in re-search objects.Multivariate Logistic regression was applied to analyze the influencing factors of perioperative MACE in elderly patients undergoing hip replacement surgery.Receiver operating characteristic(ROC)curve was applied to evaluate the predictive value of serum indicators for perioperative MACE in elderly patients un-dergoing hip replacement surgery.Results Compared with the control group,the serum Fbg and PTX3 levels in the study group were obviously increased,and the differences were statistically significant(P＜0.05).There were 18 cases who had MACE in elderly patients undergoing hip replacement surgery,with an incidence rate of 8.95％.Compared with the non MACE group,the serum Fbg and PTX3 levels in the MACE group were obviously increased,and the differences were statistically significant(P＜0.05).Elevated serum Fbg,PTX3,cardiac troponin I(cTnI),brain natriuretic peptide(BNP)levels,and decreased left ventricular ejection fraction were independent risk factors for perioperative MACE in elderly patients undergoing hip arthroplasty(P＜0.05).The area under the curve(AUC)of single and combined detection of serum Fbg and PTX3 levels for predicting the occurrence of perioperative MACE in elderly patients undergoing hip arthroplasty was 0.824,0.809,and 0.917,respectively.The combined prediction value of the two was higher than that of indi-vidual prediction(Z combination-Fbg=2.333,P=0.019;Z combination-PTX3=3.110,P=0.001).Conclusion The periop-erative serum Fbg and PTX3 levels in elderly patients undergoing hip replacement surgery are elevated,and the combination of the two has good predictive value for the occurrence of perioperative MACE.

Objective:To assess the association of appendicular skeletal muscle mass(ASM) to fat mass(FM) ratio in early pregnancy with the risk of gestational diabetes mellitus (GDM).Methods:A total of 468 pregnant women who visited the Nutritional Department of Peking Union Medical College Hospital or Shunyi Maternal and Child Care Service Center in 2018 and 2019 were recruited. Detailed information and clinical data were collected. The body components were measured using the bioelectrical impedance analysis (BIA) method during early pregnancy (< 14 weeks) and the ASM to FM ratio was calculated. The patients were divided into the GDM group and normal glucose tolerance (NGT) group according to the results of the oral glucose tolerance test (OGTT) performed during 24-28 weeks. Binary logistics regression was used to explore the correlation between the ASM/FM ratio and the risk of GDM. The receiver operator characteristic (ROC) curve of subjects was used to evaluate the predictive value of ASM/FM ratio for GDM and the cut-off value was reported.Results:Compared to the NGT group, the ASM and FM in early pregnancy in the GDM group were significantly higher, while the ASM/FM ratio was significantly lower. A lower ASM/FM ratio in early pregnancy was one of the risk factors of developing GDM. The cut-off value of the ASM/FM ratio was 0.809. The area under the ROC curve for predicting GDM increased from 68.1% to 72.3% when ASM/FM ratio was incorporated, with a significant difference by Delong test ( P = 0.006). Conclusion:Inadequate muscle mass would increase the risk of GDM and the ASM/FM ratio could serve as a predictor of GDM.