Objective To study the relationship between early neurological deterioration (END) and serum lipid level in acute cerebral infarction (ACI) due to large artery atherosclerosis (LAA).Methods One hundred and thirty-six LAA-induced ACI patients were divided into END group (n=57) and control group (n=79).Their baseline clinical data were recorded,and their serum levels of TC,TG,LDL-C,HDL-C,apoB,Lp (a) were measured.Results No significant difference was found in gender,incidence of DM and hypertension,history of smoking,NIHSS score,serum TG and Lp (a) level between END group and control group (P＞0.05).The serum levels of TC,LDL-C,apoB and Lp (a) were significantly higher while the age was significantly younger and the serum HDL-C level was significantly lower in END group than in control group (5.09± 1.49 mmol/L vs 4.58±0.99 mmol/L,P=0.016;3.20±1.36 mmol/L vs 2.68±0.80 mmol/L,P=0.022;1.14±0.38 g/L vs 0.95±0.24 g/L,P=0.004;277.16±243.90 mg/L vs 157.99±149.11 mg/L,P=0.020;65.95±10.94 years vs 70.08±10.98 years,P=0.032;1.13±0.30 mmol/L vs 1.32±0.44 mmol/L,P=0.007).Serum Lp (a) and HDL-C levels were related with END (P=0.006,P=0.019).Spearman correlation analysis showed that Lp (a) was not related with HDL-C (r=0.092,P=0.288).Conclusion Elevated serum HDL-C and Lp (a) levels are an independent risk factor for END in ACI patients and play a certain role in clinical assessment of END.

Objective: To investigate the diagnostic value of serum levels of aquaporin-4 (AQP4) and matrix metalloproteinase-9 (MMP-9) in predicting malignant cerebral infarction in patients with cerebral infarction. Methods: The clinical data about 66 patients with hemisphere massive cerebral infarction were collected. According to clinical symptoms and brain computed tomography (CT) findings, the patients were divided into malignant cerebral infarction group (MCI) and non-MCI group. The serum levels of AQP4 and MMP-9 were detected 1, 4, 7 days. The diagnostic value of AQP4 and MMP-9 in predicting occurrence of MCI was analysed by receiver operating characteristic (ROC) curve. Results: The serum levels of AQP4 and MMP-9 in MCI group were significantly higher than those in non-MCI group in the fourth day (P<0.05). In MCI group, AQP4 and MMP-9 in the fourth day were significant higher than other two time points (P<0.05). But in non-MCI group, AQP4 and MMP-9 in different time points have no differences (P>0.05). ROC curve analysis showed that the aera under curve for the serum levels of AQP4 was 0.654 (95% CI: 0.516-0.792). When the serum AQP4=23.49 μg/L, the sensitivity and specificity were 0.57, 0.74, respectively. Conclusions Serum AQP4 and MMP-9 levels were increased in patients with MCI. Combined detection of serum AQP4 and MMP-9 is helpful for early differential diagnosis of MCI.