Objective To investigate the predictive value of changes in various indicators of routine blood tests for the severity of brain damage in patients with acute cerebral hemorrhage(ACH)in high-altitude regions.Methods A retrospective analysis was conducted using data from 249 inpatients diagnosed with ACH at a hospital in Xizang.Patient data,including demographic information and results of routine blood tests,were collected.Based on their Glasgow Coma Scale(GCS)scores,the patients were divided into 2 groups,a mild brain damage group(GCS≥13 points)and a moderate-to-severe brain damage group(GCS≤12 points).Demographic information and laboratory test results were compared between the two groups.Binary logistic regression analysis was performed to examine the relationship between indicators of routine blood tests and the severity of brain damage,and key indicators were identified.The receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive performance of key indicators in various combinations for the severity of brain injury in ACH patients.Results The moderate-to-severe group had a higher proportion of high-altitude residents,as well as elevated levels of white blood cells(WBC),neutrophils(N),neutrophil-to-lymphocyte ratio(NLR),systemic inflammatory index(SII),neutrophil-to-platelet ratio(NPR),and C-reactive protein(CRP)-to-lymphocyte ratio(CLR),compared to the mild group.On the other hand,the levels of lymphocytes(L),platelets(PLT),and platelet-to-albumin ratio(PAR)in the moderate-to-severe group were lower than those in the mild group.Binary logistic regression analysis showed that WBC(OR=1.221,95%CI:1.127-1.322),CRP(OR=1.019,95%CI:1.004-1.033),CRP-to-albumin ratio(CAR)(OR=1.845,95%CI:1.137-2.996),and CLR(OR=1.018,95%CI:1.005-1.030)were positively associated with moderate-to-severe brain damage,and that their elevated levels were associated with an increase in risk by the corresponding folds.PAR(OR=0.845,95%CI:0.721-0.990)was negatively correlated with moderate-to-severe brain damage,with an increase resulting in a reduction of risk by 0.845 times.ROC curve analysis showed that,in the mild group,the combined AUC for WBC+CRP was 0.689(optimal cutoff value 0.19,specificity 0.776,95%CI:0.624-0.755);the PAR+CAR+CLR combination(CAR was not significant,P>0.05)had an AUC of 0.675(optimal cutoff value 0.19,specificity 0.760,95%CI:0.609-0.741);the key indicator combination of WBC+PAR+CLR(CRP was not significant,P>0.05)demonstrating the strong predictive performance moderate-to-severe brain damage,yielding an AUC of 0.737(optimal cutoff value 0.08,specificity 0.624,95%CI:0.676-0.798).Conclusion The indicator combinations of WBC+CRP,PAR+CLR,and WBC+PAR+CLR exhibit significant value for predicting the severity of brain injury in ACH patients and may serve as potential predictive tools for the severity of brain damage in patients with acute cerebral hemorrhage in high-altitude regions.

Objective To investigate the prevalence of hyperhomocysteincmia(HHcy)in a Tibetan population in Nagqu City and analyze the related influencing factors.Methods From May to June 2020 we recruited 758 hereditary Tibetan residents from Xinji Township,Jiaqiong Township and Seshong Township of Nagqu City as study subjects who met the inclusion criteria using the multi-stage whole cluster random sampling method.Structured questionnaires as well as clinical examinations were conducted.The prevalence of HHcy was analyzed by descriptive statistics,and the effects of different variables on the prevalence of HHcy were assessed using univariate analysis.Multifactorial Logistic regression analysis was made to explore the factors associated with the prevalence of HHcy.The expected value of each influencing factor in predicting the prevalence of HHcy was analyzed using the subject's receiver operating characteristic(ROC)curve.Results The number of HHcy among the 758 Tibetan population included amounted to 515 cases with a prevalence of 67.9％(95％CI:64.6％-71.2％).Gender,hypertension,hyperuricemia,hemoglobin abnormality,LDL-C abnormality,BMI,type of residence and duration of exercise were found to be significantly different between the two groups by univariate analysis(P＜0.05).In the multifactorial Logistic regression analysis,age,hemoglobin abnormality,diastolic blood pressure,hemoglobin volume,heart rate,HDL-C and BMI showed a positive correlation with the prevalence of HHcy,whereas gender,blood glucose abnormality,FBG,ALT,type of residence(rural)and length of exercise showed a negative correlation with the prevalence of HHcy,relative to the non-HHcy patients(P＜0.05).The area under the curve(AUC)of the ROC predictive model for HHcy prevalence was constructed as 0.785(sensitivity 0.701,specificity 0.737),and the risk of HHcy prevalence was predicted by age,sex,DBP,Hb,heart rate,FBG,HDL-C,BMI,type of residence and duration of exercise,with the critical values of age,DBP,Hb,heart rate,FBG,HDL-C being 46.5 years,77.5 mmHg,169.5 g/L,72.5 beats/min,3.65 mmol/L,and 1.66 mmol/L,respectively.For comparison with the ROC curve of the included traditional risk factor HHcy prediction model(AUC of 0.790,sensitivity 0.732,specificity 0.712),the results showed that the predictive ability of the two models was similar(P=0.075).Conclusion The Tibetan population in the three areas of Nagqu City has a high prevalence of HHcy,and a series of targeted measures should be taken to reduce the risk of related diseases.

Objective To investigate the prevalence of hyperhomocysteincmia(HHcy)in a Tibetan population in Nagqu City and analyze the related influencing factors.Methods From May to June 2020 we recruited 758 hereditary Tibetan residents from Xinji Township,Jiaqiong Township and Seshong Township of Nagqu City as study subjects who met the inclusion criteria using the multi-stage whole cluster random sampling method.Structured questionnaires as well as clinical examinations were conducted.The prevalence of HHcy was analyzed by descriptive statistics,and the effects of different variables on the prevalence of HHcy were assessed using univariate analysis.Multifactorial Logistic regression analysis was made to explore the factors associated with the prevalence of HHcy.The expected value of each influencing factor in predicting the prevalence of HHcy was analyzed using the subject's receiver operating characteristic(ROC)curve.Results The number of HHcy among the 758 Tibetan population included amounted to 515 cases with a prevalence of 67.9％(95％CI:64.6％-71.2％).Gender,hypertension,hyperuricemia,hemoglobin abnormality,LDL-C abnormality,BMI,type of residence and duration of exercise were found to be significantly different between the two groups by univariate analysis(P＜0.05).In the multifactorial Logistic regression analysis,age,hemoglobin abnormality,diastolic blood pressure,hemoglobin volume,heart rate,HDL-C and BMI showed a positive correlation with the prevalence of HHcy,whereas gender,blood glucose abnormality,FBG,ALT,type of residence(rural)and length of exercise showed a negative correlation with the prevalence of HHcy,relative to the non-HHcy patients(P＜0.05).The area under the curve(AUC)of the ROC predictive model for HHcy prevalence was constructed as 0.785(sensitivity 0.701,specificity 0.737),and the risk of HHcy prevalence was predicted by age,sex,DBP,Hb,heart rate,FBG,HDL-C,BMI,type of residence and duration of exercise,with the critical values of age,DBP,Hb,heart rate,FBG,HDL-C being 46.5 years,77.5 mmHg,169.5 g/L,72.5 beats/min,3.65 mmol/L,and 1.66 mmol/L,respectively.For comparison with the ROC curve of the included traditional risk factor HHcy prediction model(AUC of 0.790,sensitivity 0.732,specificity 0.712),the results showed that the predictive ability of the two models was similar(P=0.075).Conclusion The Tibetan population in the three areas of Nagqu City has a high prevalence of HHcy,and a series of targeted measures should be taken to reduce the risk of related diseases.