Objective To investigate the relationship between serum microRNA(miRNA,miR)-9-5p,miR-21-5p and miR-206 and hemorrhagic transformation(HT)occurs and prognosis in patients with large ar-tery atherosclerotic cerebral infarction(ACI-LAA)after thrombolysis.Methods A total of 265 patients with ACI-LAA admitted to the hospital from April 2021 to November 2023 were selected as the research objects.According to whether HT occurred after intravenous thrombolysis,they were divided into non-HT group and HT group,and the expression levels of serum miR-9-5p,miR-21-5p and miR-206 were compared between the two groups.The general data of patients with ACI-LAA were collected.Univariate and multivariate Logistic regression analysis were used to analyze the influencing factors of HT occurs in patients with ACI-LAA after thrombolysis.The receiver operating characteristic(ROC)curve was used to analyze the efficacy of serum miR-9-5p,miR-21-5p and miR-206 expression levels in predicting HT occurs after thrombolysis in patients with ACI-LAA.The patients with ACI-LAA were followed up for 90 d.According to the modified Rankin scale(mRS)score,the patients were divided into a good prognosis group and a poor prognosis group,and the expression levels of serum miR-9-5p,miR-21-5p and miR-206 were compared between the two groups.Univa-riate and multivariate Logistic regression analysis were used to analyze the influencing factors of poor progno-sis in patients with ACI-LAA.ROC curve was used to analyze the efficacy of serum miR-9-5p,miR-21-5p and miR-206 expression levels in predicting poor prognosis of patients with ACI-LAA.Results HT occurred in 74(27.92％)of 265 patients with ACI-LAA after thrombolysis.Compared with the non-HT group,the National Institutes of Health Stroke Scale(NIHSS)score atadmission,the proportion of hypertension,the proportion of infarct size ≥10 cm2,and the expression levels of serum miR-21-5p and miR-206 were significantly in-creased in the HT group(P＜0.05).However,the expression level of serum miR-9-5p was decreased(P＜0.05).Hypertension,high NIHSS score at admission,the proportion of infarct size ≥10 cm2,high expression of miR-21-5p and miR-206 were risk factors for HT occurs in patients with ACI-LAA after intravenous thrombolysis,and high expression of miR-9-5p was a protective factor(P＜0.05).The ROC curve showed that the area under the curve(AUC)and 95％CI of single and combined detection of serum miR-9-5p,miR-21-5p and miR-206 for predicting HT occurs were 0.796(0.726-0.866),0.779(0.711-0.846),0.784(0.714-0.854),0.891(0.839-0.943),respectively.Among 265 patients with ACI-LAA,83 patients(31.32％)had poor prognosis at 90 d of follow-up.Compared with the good prognosis group,the age,NIHSS score at admis-sion,the proportion of HT,the proportion of infarct size ≥10 cm2,and the expression levels of serum miR-21-5p and miR-206 were increased(P＜0.05),and the expression level of serum miR-9-5p was decreased(P＜0.05)in the poor prognosis group.Advanced age,high NIHSS score at admission,HT,infarct size ≥10 cm2,high expression of miR-21-5p,and high expression of miR-206 were risk factors for poor prognosis of ACI-LAA patients,and high expression of miR-9-5p was a protective factor(P＜0.05).The ROC curve showed that The AUC(95％CI)of single and combined detection of serum miR-9-5p,miR-21-5p and miR-206 for predicting poor prognosis were 0.754(0.691-0.818),0.779(0.719-0.838),0.792(0.815-0.919),0.931(0.902-0.960),respectively.Conclusion Low expression of serum miR-9-5p,high expression of miR-21-5p and high expression of miR-206 are associated with the HT occurs and poor prognosis in patients with ACI-LAA after thrombolysis,and the combined detection of the three indicators has a high predictive value for the HT occurs and poor prognosis.

Objective To screen key genes for ferroptosis in atherosclerosis(AS)using bioinformatics methods and analyze the biological functions of key genes to gain an in-depth understanding of the pathogenesis of AS.Methods AS gene expression profile chip dataset GSE100927 was downloaded from the Gene Expression Omnibus(GEO)database.P＜0.05 and|logFC＞1|were used as the conditions to screen the differential genes of AS.These genes were intersected with ferroptosis gene dataset to screen out the genes related to AS ferroptosis.Gene ontology(GO)functional annotation and enrichment analysis of Kyoto Encyclopedia of Genes and Genomes(KEGG)were carried out.The STRING online analysis tool combined with Cytoscape visualization software was subsequently used to mine genes that play a key role in the biological process of AS,and the AS dataset GSE9874 was used as the verification set to verify the expression of key genes.Blood samples from 30 confirmed AS patients in the cardiovascular department of our hospital from January to March 2023 were collected as the experimental group,while blood samples from 20 healthy volunteers were collected as the control group.Sample RNA was extracted,and quantitative real time polymerase chain reaction(qRT-PCR)was used to verify the selected genes.Results A total of 10 differential genes related to ferroptosis were screened by bioinformatics method.GO functional enrichment analysis showed that differential genes were mainly involved in inflammation,apoptosis,oxidative stress and other biological processes,while KEGG pathway enrichment analysis showed that differential genes were mainly involved in ferroptosis,HIF-1 signaling pathway,and leukocyte migration pathway through endothelial cells.Seven key modules of gene construction were screened out through the protein interaction network,which were FTL,SLC40A1,CYBB,NCF2,HMOX1,DPP4 and ALOX5.GSE9874 was used for verification,and 5 key genes including ALOX5,DPP4,FTL,SLC40A1 and NCF2 were finally screened out.The expression detection of key genes in clinical samples by qRT-PCR showed that compared with the control group,the up-regulated genes in blood of AS group were DPP4(t=1.795,P=0.046),FTL(t=2.218,P=0.029)and SLC40A1(t=2.859,P=0.009),and the down-regulated genes were ALOX5(t=8.039,P＜0.001)and NCF2(t=11.867,P＜0.001),and the differences were significant.The experimental results were consistent with the results of bioinformatics analysis.Subgroup analysis showed that DPP4 expression in plaque group was higher than that in intima thickening group,and the difference was significant(t=2.843,P=0.036).Conclusion The key genes of ferroptosis screened by bioinformatics are AS,ALOX5,DPP4,FTL,SLC40A1 and NCF2,which may be potential targets for the diagnosis and treatment of AS,providing new ideas for the clinical diagnosis and treatment of AS.