Objective To investigate the relationship between the levels of serum circular RNA protein tyrosine phosphatase 4A2(circ_PTP4A2),circular RNA precocious dissociation of sisters 5 homolog B(circ_PDS5B)and the volume of cerebral infarction and the degree of neurological deficits in patients with acute is-chemic stroke(AIS).Methods Ninety patients with AIS who visited the hospital from January 2021 to De-cember 2023 were selected as the AIS group,and 90 healthy individuals who underwent physical examinations during the same period were selected as the control group.The levels of serum circ_PTP4A2 and circ_PDS5B were detected by real-time fluorescence quantitative PCR,the volume of cerebral infarction was measured by magnetic resonance diffusion tensor imaging,and the degree of neurological deficit was evaluated by the Na-tional Institutes of Health Stroke Scale(NIHSS)score.According to the volume of cerebral infarction,they were divided into large-volume group(volume of cerebral infarction≥ 20 cm3,29 cases),medium-volume group(1 cm3＜volume of cerebral infarction＜20 cm3,34 cases),and small-volume group(volume of cerebral infarction≤ 1 cm3,27 cases),and according to the NIHSS scores,patients with AIS were classified into the se-vere group(NIHSS scores≥21 points,27 cases),the moderate group(NIHSS scores 5-20 points,32 cases)and the mild group(NIHSS score≤ 4 points,31 cases).Factors contributing to the increased volume of cere-bral infarction and the increased degree of neurological deficit in patients with AIS were analyzed by ordered multi-categorical Logistic regression.Results Compared with the control group,serum circ_PTP4A2 and circ_PDS5B levels were elevated in the AIS group(P＜0.05).Serum circ_PTP4A2 and circ_PDS5B levels were sequentially increased in the small-volume group,medium-volume group,and large-volume group(P＜0.05).Serum circ_PTP4A2 and circ_PDS5B levels were sequentially increased in the mild group,moderate group,and severe group(P＜0.05).Ordered multi-categorical Logistic regression showed that high NIHSS score,high circ_PTP4A2,and high circ_PDS5B were independent risk factors for increased cerebral infarction volume in AIS patients(P＜0.05),and high cerebral infarction volume,high circ_PTP4A2,and high circ_PDS5B were independent risk factors(P＜0.05).Conclusion The elevated levels of serum circ_PTP4A2 and circ_PDS5B in AIS patients are related to the increase in cerebral infarction volume and the aggravation of neurological deficits.Early detection of serum circ_PTP4A2 and circ_PDS5B levels is helpful for risk stratification in AIS patients.

Objective To investigate the clinical efficacy of low molecular weight heparin (LMWH)-assisted plasma exchange (PE) in the treatment of patients with hyperlipidemic severe acute pancreatitis (HLSAP).Methods Patients with HLSAP diagnosed and treated in Leshan People's Hospital were retrospectively selected from January 2023 to April 2024 and their clinical data were analyzed.According to the diagnosis and treatment plans,they were divided into the control group (PE) and the study group (LMWH-assisted PE).The coagulation function[fibrinogen (Fib),thrombin time (TT),activated partial thromboplastin time (APTT) and prothrombin time (PT)],plasma specific viscosity,lipid levels[total cholesterol (TC),triglyceride (TG)],inflammatory factors[white blood cell count (WBC),erythrocyte sedimentation rate (ESR),C reactive protein (CRP),amylase (AMY) and lipase (LYP)]were compared before and after treatment between the two groups.The duration of continuous renal replacement therapy (CRRT),length of hospitalization and incidence of new organ dysfunction were compared between the two groups.Results A total of 105 HLSAP patients were included in the study,with 50 in the control group and 55 in the study group.Before treatment,there was no statistically significant difference in coagulation function,lipid levels,plasma specific viscosity and inflammatory factors between the two groups (P>0.05).After treatment,Fib,TC,TG,plasma specific viscosity,WBC,ESR,CRP,AMY and LYP were significantly lower in the study group than in the control group (P<0.05),while TT,APTT and PT were significantly higher than in the control group (P<0.05).The duration of CRRT,hospitalization time and incidence of new organ dysfunction were lower in the study group than in the control group (P<0.05).In terms of adverse reactions,no transfusion adverse reactions and serious complications occurred in both groups during the treatment period.Conclusion LMWH-assisted PE has a better effect in the treatment of HLSAP,which can improve the coagulation function,blood lipid levels and inflammatory factors of HLSAP patients,shorten the hospital stay and the duration of CRRT,and reduce the incidence of new organ dysfunction.