Objective To investigate the evaluation value of serum microRNA-19b-3p (miR-19b-3p) and microRNA-933 (miR-933) levels on cardiac function and prognosis in elderly patients with chronic heart failure. Methods A total of 108 elderly patients with chronic heart failure were selected as study group. According to the New York Heart Society (NYHA) classification, 35 patients of the study group were classified into grade Ⅱ, 40 patients were classified into grade Ⅲ, and 33 patients were classified into grade Ⅳ. A total of 90 healthy people who underwent physical examination during the same period were selected as control group. Serum miR-19b-3p and miR-933 levels were detected after admission. Cardiac function parameters [left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD)] were measured by echocardiography. The relationship between serum miR-19b-3p, miR-933 and cardiac function was analyzed by Pearson correlation method. Elderly patients with chronic heart failure were divided into occurrence group (n=34) and non-occurrence group (n=74) according to whether endpoint events occurred within one year of admission. The predictive value of serum miR-19b-3p and miR-933 in elderly patients with chronic heart failure was evaluated by receiver operating characteristic (ROC) curve. Multivariate Cox regression analysis was used to analyze the prognostic factors of elderly patients with chronic heart failure. Results Serum levels of miR-19b-3p and miR-933 in the study group were significantly lower than those in the control group (P < 0.05). The levels of serum miR-19b-3p, miR-933 and LVEF in patients with cardiac function grade Ⅳ were significantly lower than those in patients with cardiac function grade Ⅲ, grade Ⅱ and healthy population, and LVEDD was larger than that in patients with cardiac function grade Ⅲ, patients with cardiac function grade Ⅱ and healthy population (P < 0.05). Serum miR-19b-3p level was positively correlated with LVEF and negatively correlated with LVEDD in elderly patients with chronic heart failure (r =0.554, -0.368, P < 0.001). Serum miR-933 level was positively correlated with LVEF and negatively correlated with LVEDD (r=0.505, -0.410, P < 0.001). The levels of serum miR-19b-3p and miR-933 in the occurrence group were significantly lower than those in the non-occurrence group (P < 0.05). The area under the curve (AUC) of serum miR-19b-3p and miR-933 to predict the prognosis of chronic heart failure in elderly patients were 0.835 (95%CI, 0.785 to 0.885) and 0.843 (95%CI, 0.790 to 0.890), and the AUC of the combined prediction was 0.901 (95%CI, 0.851 to 0.951). Serum miR-19b-3p (HR=3.762, 95%CI, 1.854 to 7.634), miR-933 (HR=3.480, 95%CI, 1.903 to 6.364) and National Institutes of Health Stroke Scale (NIHSS) score (HR=3.047, 95%CI, 1.837 to 5.051) were the prognostic factors of chronic heart failure in the elderly (P < 0.05). Conclusion Serum miR-19b-3p and miR-933 levels are low in elderly patients with chronic heart failure. The changes of miR-19b-3p and miR-933 levels are closely related to cardiac function and prognosis, which can be used as effective indicators to predict poor prognosis in elderly patients with chronic heart failure.

Objective To establish a test of autoantibody-panel for the diagnosis of autoimmune cerebellitis (AC) and determine the prevalence of AC in patients with cerebellar ataxia of unknown etiology.Methods Autoantibody screening tests with indirect immunofluorescence were performed in serum and cerebrospinal fluid (CSF) samples of 400 previously'idiopathic'Chinese patients with cerebral ataxia (inpatients and outpatients in Peking Union Medical College Hospital or referred from hospitals of Beijing Encephalitis Group from 2016 to 2018).Immunotherapy was given to autoantibody positive patients and the effectiveness of immunotherapy was assessed.Detailed AC autoantibodies panel included anti-glutamate decarboxylase 65 (GAD65) antibody,anti-Tr (delta notch-like epidermal growth factor-related receptor (DNER)) antibody,anti-zinc finger protein 4 (ZIC4) antibody,anti-inositol 1,4,5-trisphosphate receptor 1 (ITPR1) antibody,anti-homer protein homolog 3 (Homer 3) antibody,anti-neurochondrin (NCDN) antibody,anti-carbonic anhydrase-related protein (CARP) antibody and anti-Purkinje cell antibody 2 (PCA2) antibody.Results Eight out of 400 (2％) ataxia patients were positive for this AC panel tests,of whom two were positive for anti-GAD65 antibody,two for anti-Tr antibody,one for anti-PCA2 antibody,one for anti-Homer 3 antibody and two were positive for serum anti-NCDN antibody.Autoantibodies against ZIC4,ITPR1 and CARP were not detected in this cohort.Two of the eight ataxia patients also presented with limbic encephalitis,and only one anti-GAD antibody patient was screened with underlying small cell lung carcinoma (SCLC).All the eight patients received immunotherapy and four experienced partial response.Conclusions Autoimmune cerebellitis is the cause of acquired cerebellar ataxia.Tests of autoantibodies associated with AC have diagnostic value for paraneoplastic and non-paraneoplastic cerebellar ataxia.Immunotherapy may yield partial response in patients with AC.