Objective To investigate the relationship of serum levels of neurofilament light chain protein(NFL)and chemerin with cerebral ischemia after interventional therapy in elderly patients with unruptured intracranial aneurysms.Methods A total of 258 patients with unruptured in-tracranial aneurysms undergoing stent-assisted coil embolization in our hospital from January 2020 to January 2024 were enrolled.They were divided into a cerebral ischemia group(52 cases)and a non-cerebral ischemia group(206 cases).The serum NFL and chemerin levels were detected.Multivariate logistic regression analysis was conducted to analyze the risk factors for cerebral is-chemia in the patients after interventional surgery.Results The cerebral ischemia group had sig-nificantly higher ratio of implantation of 3 stents,larger diameter of aneurysms,increased levels of NFL and chemerin before operation,10 min from the start of operation and 24 h after operation,and longer operation time than the non-cerebral ischemia group(P＜0.05,P＜0.01).Larger aneu-rysm diameter,longer operation time,and higher NFL and chemerin levels were the risk factors for cerebral ischemia in patients with unruptured intracranial aneurysm after interventional sur-gery(P＜0.05,P＜0.01).The AUC value of aneurysm diameter,operation time,NFL and chemerin,and combination of these indicators in predicting cerebral ischemia in patients with un-ruptured intracranial aneurysm after interventional surgery was 0.772,0.794,0.826,0.837,and 0.920,respectively,with that of the combination higher than that of each indicator alone(P＜0.05).Conclusion For the elderly patients with unruptured intracranial aneurysms,the increases of serum NFL and chemerin levels are associated with cerebral ischemia after stent-assisted coil embolization,which can predict the risk of cerebral ischemia after interventional therapy.

Objective To investigate the relationship of serum levels of neurofilament light chain protein(NFL)and chemerin with cerebral ischemia after interventional therapy in elderly patients with unruptured intracranial aneurysms.Methods A total of 258 patients with unruptured in-tracranial aneurysms undergoing stent-assisted coil embolization in our hospital from January 2020 to January 2024 were enrolled.They were divided into a cerebral ischemia group(52 cases)and a non-cerebral ischemia group(206 cases).The serum NFL and chemerin levels were detected.Multivariate logistic regression analysis was conducted to analyze the risk factors for cerebral is-chemia in the patients after interventional surgery.Results The cerebral ischemia group had sig-nificantly higher ratio of implantation of 3 stents,larger diameter of aneurysms,increased levels of NFL and chemerin before operation,10 min from the start of operation and 24 h after operation,and longer operation time than the non-cerebral ischemia group(P＜0.05,P＜0.01).Larger aneu-rysm diameter,longer operation time,and higher NFL and chemerin levels were the risk factors for cerebral ischemia in patients with unruptured intracranial aneurysm after interventional sur-gery(P＜0.05,P＜0.01).The AUC value of aneurysm diameter,operation time,NFL and chemerin,and combination of these indicators in predicting cerebral ischemia in patients with un-ruptured intracranial aneurysm after interventional surgery was 0.772,0.794,0.826,0.837,and 0.920,respectively,with that of the combination higher than that of each indicator alone(P＜0.05).Conclusion For the elderly patients with unruptured intracranial aneurysms,the increases of serum NFL and chemerin levels are associated with cerebral ischemia after stent-assisted coil embolization,which can predict the risk of cerebral ischemia after interventional therapy.

Aging-elevated DNMT3A R882H-driven clonal hematopoiesis (CH) is a risk factor for myeloid malignancies remission and overall survival. Although some studies were conducted to investigate this phenomenon, the exact mechanism is still under debate. In this study, we observed that DNMT3A R878H bone marrow cells (human allele: DNMT3A R882H) displayed enhanced reconstitution capacity in aged bone marrow milieu and upon inflammatory insult. DNMT3A R878H protects hematopoietic stem and progenitor cells from the damage induced by chronic inflammation, especially TNFα insults. Mechanistically, we identified that RIPK1-RIPK3-MLKL-mediated necroptosis signaling was compromised in R878H cells in response to proliferation stress and TNFα insults. Briefly, we elucidated the molecular mechanism driving DNMT3A R878H-based clonal hematopoiesis, which raises clinical value for treating DNMT3A R882H-driven clonal hematopoiesis and myeloid malignancies with aging.

Objective To study the effects of low calcium dialysate on bone mineral density (BMD) in old patients with low turnover renal osteodystrophy under maintenance hemodialysis.Methods Totally 72 elderly patients aged≥ 60 years under MHD for 6 months or more with parathyroid hormone(iPTH)＜100 ng/L were selected and randomly divided into treatment group(n=36,calcium 1.25 mmol/L in dialysate)and a control group(n =36,calcium 1.5 mmol/L in dialysate),for 12 months of treatment.The changes of albumin-corrected calcium and phosphorus,calciumphosphorus product,iPTH level,bone mineral density,and other indicators as well as related adverse events were observed before and 12 months after the study.Results There was no statistically significant difference in general conditions and the correlated laboratory examinations between the two groups before and after treatment (P ＞ 0.05).After dialytic treatments with dialysate containing calcium 1.25 mmol/L for 12 months,the therapy group versus pre-therapy and control group showed statistically significant decrease in parameters of mean arterial pressure(MAP) [(88.6 ± 9.2) vs.(92.6±10.4)and(93.7±8.8)mmHg],serum calcium[(2.4±0.1)vs.(2.6±0.3)and(2.6±0.2)mmol/L,t =5.061,5.074],phosphorus[(2.0±0.2)vs.(2.1 ±0.2)and(2.1±0.3)mmol/L,t=2.276,2.271],calcium-phosphorus product[(4.7 ± 0.5) vs.(5.3 ± 0.6) and (5.4 ± 0.7) mmol2 / L2,t =4.682,4.627](all P＜0.05),and showed statistically significant increase in parameters of iPTH levels[(132.6 ±37.8) vs.(71.3 ± 11.48) and (69.7 ± 16.0) ng/L;t value 8.824 and 9.048,respectively],bone mineral density values(Lumbar:0.8±0.9 vs.-1.2±1.1 and-1.2±1.1;t value 2.170 and 2.170,respectivly.Femoral neck:-0.8± 1.0 vs.1.3±1.2 and-1.3±1.3;t value 2.258 and 2.243,respectively) (all P＜0.05).In the control group after 12 months of treatment with calcium 1.5mmol/L dialysate,there was no significant difference in related parameters (P＞ 0.05).There was no significant difference in the adverse reactions between study and control groups (P ＞ 0.05).Conclusions The low calcium dialysate(calcium 1.25 mmol/L)used in elderly patients with iPTH＜100 ng/L under MHD can effectively improve the excessive depression of parathyroid function and the decreased BMD,and better control the albumin corrected calcium,phosphorus,calcium-phosphorus product level,and has a good security.