Cystatin C is a cysteine protease inhibitor. It is widely found in the nucleated cells and body fluids of various tissues. It is a low molecular weight basic non-glycosylated protein. Previous studies have confirmed that cystatin C is an ideal endogenous marker reflecting early renal damage. Recent studies have shown that cystatin C is involved in the pathophysiological processes of a various cardiocerebrovascular diseases.This article reviews the correlation between cystatin C and cardiocerebralvascular diseases.

Objective:To investigate the predictive value of postoperative C-reactive protein for serious complications after Da Vinci robotic surgical system radical gastrectomy of gastric cancer.Methods:The retrospective case-control study was conducted. The clinicopathological data of 298 patients with advanced gastric cancer who underwent Da Vinci robotic surgical system radical gastrectomy in the 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army from January 2017 to June 2019 were collected. There were 253 males and 45 females, aged from 24 to 86 years, with a median age of 60 years. Of the 298 patients, 275 cases underwent no serious postoperative complications and 23 cases underwent serious postoperative complications. Observation indicators: (1) serious postoperative complications; (2) analysis of risk factors for serious postoperative complications after Da Vinci robotic surgical system radical gastrectomy of gastric cancer; (3) performance evaluation of the predictive indicators. Measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers and comparison between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was conducted using the rank sum test. Univariate analysis was conducted using the chi-square test. Multivariate analysis was conducted using Logistic regression model. The receiver operating characteristic curve was drawn and the area under curve (AUC) was used to compare and estimate the efficiency of diagnostic criteria. The value of Youden index was used to determine the optimal cut-off point. Results:(1) Serious postoperative complications: of the 298 patients, 23 cases underwent complications classified ≥grade Ⅲa of Clavien-Dindo classifica-tion, including 10 cases with grade Ⅲa complications, 7 cases with grade Ⅲb complications, 4 cases with grade Ⅳa complications, 1 case with grade Ⅳb complications and 1 case with grade Ⅴ complications. (2) Analysis of risk factors for serious postoperative complications after Da Vinci robotic surgical system radical gastrectomy of gastric cancer. Results of univariate analysis showed that operation time, indicators of C-reactive protein concentration and neutrophil count at post-operative day 1, and indicators of C-reactive protein concentration, white blood cells count, neutrophil count and platelet count at postoperative day 3 and pathological stage were related factors affecting serious complications for advanced gastric cancer after Da Vinci robotic surgical system radical gastrectomy ( χ2=7.671, 4.504, 5.045, 48.293, 9.575, 15.436, 13.731, 9.537, P<0.05). Results of multivariate analysis showed that the operation time ≥250 minutes, the concentration of C-reactive protein at postoperative day 3 ≥16.65 mg/dL, the neutrophil count at postoperative day 3 ≥8.167×10 9/L, the platelet count at postoperative day 3 ≥218×10 9/L and the pathological stage of tumor as stage Ⅱ and stage Ⅲ were independent risk factors affecting serious complications for advanced gastric cancer after Da Vinci robotic surgical system radical gastrectomy ( odds ratio=3.721, 16.084, 6.056, 6.893, 12.455, 95% confidence interval: 1.032-13.421, 4.657-55.547, 1.073-34.163, 1.798-26.423, 1.338-115.930, P<0.05). (3) Performance evaluation of the predictive indicators: the C-reactive protein concentration at postoperative day 3 was a high-performance predictor with the AUC as 0.851 (95% c onfidence interval: 0.780-0.921, P<0.05) and neutrophil count and platelet count at postoperative day 3 were low-performance predictors with the AUC as 0.659 and 0.666 (95% confidence interval: 0.570-0.748 and 0.581-0.750, P<0.05). Conclusion:The C-reactive protein concentration ≥16.65 mg/dL at postoperative day 3 is a high performance predictive indicator for serious complications after Da Vinci robotic surgical system radical gastrectomy of gastric cancer.

Objective To study the correlation of wake-up stroke with progressive stroke.Methods Three hundred and twelve patients with acute ischemic stroke,admitted to our hospital from January 2014 to December 2015 were divided into progressive stroke group (n=70) and non-progressive stroke group (n=242).Demographic features,clinical characteristics,and incidence of wake-up stroke were compared between the two groups.The association between wake-up stroke and progressive stroke was analyzed.Results The incidence of wake-up stroke,homocysteine level,and fibrinogen level in progressive stroke group were significantly higher than those in the non-progressive stroke group (40.0％ vs.18.2％,P=0.000;[17.486±16.835] μmol/L vs.[14.321±7.251] μmol/L,P=0.023;[3.539±1.009] g/L vs.[3.134±0.775] g/L,P=0.000).Multivariate Logistic regression analysis showed that wake-up stoke,homocysteine and fibrinogen were the independent predictive factors of progressive stroke (OR=2.978,95％CI:1.623-5.464,P=0.000;OR=1.026,95％CI:1.002-1.052,P=0.035;OR=1.800,95％CI:1.310-2.472,P=0.000).Conclusion Wake-up stoke is a predictive factor of progressive stroke.