Objective To investigate the diagnostic and prognostic value of serum leucine-rich alpha-2-glycoprotein 1(LRG1)and dipeptidyl peptidase 4(DPP4)levels in patients with acute cerebral watershed infarction(ACWI).Methods Selected 150 ACWI patients treated in the Baoding Second Central Hospital from January 2022 to December 2023 as the study subjects(ACWI group),and another 120 volunteers who underwent physical examinations were regarded as the control group.According to the prognosis of ACWI patients,they were separated into a good prognosis group(n=98)and a poor prognosis group(n=52).ELISA was used to detect serum LRG1,DPP4 and carcinoembryonic amtigen(CEA)levels,a biochemical analyzer was used to detect levels of albumin(ALB),adenosine deaminase(ADA),creatinine(Cre).Multivariate logistic regression was applied to analyze the influencing factors of poor prognosis in ACWI patients.Spearman correlation analysis of LRG1 and DPP4 levels with NIHSS and mRS scores in the ACWI group.The ROC curve was applied to analyze the diagnostic value of LRG1 and DPP4 levels for the occurrence of ACWI and prognosis,and Z-test was used to compare the differences in AUC.Results The serum LRG1(56.03±16.11pg/ml)and DPP4(9.90±3.25ng/L)levels in ACWI patients were higher than those in the control group(41.78±12.54pg/ml,7.34±2.32ng/L),the differences were statistically significant(t=7.951,7.272,all P＜0.001).ACWI patients with poor prognosis had higher National Institute of Health Stroke Scale NIHSS scores,mRS scores,larger infarct proportion,LRG1 and DPP4 levels than those with good prognosis(t/χ2=3.258～17.208),but had lower ALB levels than those with good prognosis(t=3.143),the differences were statistically significant(all P＜0.001).Multivariate logistic regression analysis showed that large area infarction,increased NIHSS score,mRS score,LRG1 and DPP4 levels were independent risk factors for poor prognosis in ACWI patients(Wald χ2=4.358～6.000,all P<0.05),while elevated ALB was an independent protective factor for poor prognosis in ACWI patients(Wald χ2=4.535,P<0.05).Spearman correlation analysis showed a positive correlation between serum LRG1 and DPP4 levels in ACWI patients(r=0.446,P<0.001).ROC curve analysis showed that the AUC(95%CI)for diagnosing ACWI with serum LRG1 and DPP4 were 0.788(0.734～0.835)and 0.790(0.736～0.837),respectively,while the AUC(95%CI)for combined diagnosis was 0.922(0.883～0.951),which was better than individual diagnosis(Z=5.798,5.612,all P<0.05).The AUC(95%CI)of LRG1 and DPP4 in diagnosing ACWI patients with poor prognosis was 0.796(0.722～0.857)and 0.800(0.727～0.861),respectively,and the AUC(95%CI)of combined diagnosis was 0.924(0.869～0.961),which was better than their respective individual diagnoses(Z=2.891,4.222,all P<0.05).Conclusion LRG1 and DPP4 levels are higher in the serum of ACWI patients and higher in patients with poor prognosis.The two levels are positively correlated,and the combination has a certain value in diagnosing the occurrence of ACWI and poor prognosis,which provides a theoretical basis for clinical diagnosis.

Objective To investigate the diagnostic and prognostic value of serum leucine-rich alpha-2-glycoprotein 1(LRG1)and dipeptidyl peptidase 4(DPP4)levels in patients with acute cerebral watershed infarction(ACWI).Methods Selected 150 ACWI patients treated in the Baoding Second Central Hospital from January 2022 to December 2023 as the study subjects(ACWI group),and another 120 volunteers who underwent physical examinations were regarded as the control group.According to the prognosis of ACWI patients,they were separated into a good prognosis group(n=98)and a poor prognosis group(n=52).ELISA was used to detect serum LRG1,DPP4 and carcinoembryonic amtigen(CEA)levels,a biochemical analyzer was used to detect levels of albumin(ALB),adenosine deaminase(ADA),creatinine(Cre).Multivariate logistic regression was applied to analyze the influencing factors of poor prognosis in ACWI patients.Spearman correlation analysis of LRG1 and DPP4 levels with NIHSS and mRS scores in the ACWI group.The ROC curve was applied to analyze the diagnostic value of LRG1 and DPP4 levels for the occurrence of ACWI and prognosis,and Z-test was used to compare the differences in AUC.Results The serum LRG1(56.03±16.11pg/ml)and DPP4(9.90±3.25ng/L)levels in ACWI patients were higher than those in the control group(41.78±12.54pg/ml,7.34±2.32ng/L),the differences were statistically significant(t=7.951,7.272,all P＜0.001).ACWI patients with poor prognosis had higher National Institute of Health Stroke Scale NIHSS scores,mRS scores,larger infarct proportion,LRG1 and DPP4 levels than those with good prognosis(t/χ2=3.258～17.208),but had lower ALB levels than those with good prognosis(t=3.143),the differences were statistically significant(all P＜0.001).Multivariate logistic regression analysis showed that large area infarction,increased NIHSS score,mRS score,LRG1 and DPP4 levels were independent risk factors for poor prognosis in ACWI patients(Wald χ2=4.358～6.000,all P<0.05),while elevated ALB was an independent protective factor for poor prognosis in ACWI patients(Wald χ2=4.535,P<0.05).Spearman correlation analysis showed a positive correlation between serum LRG1 and DPP4 levels in ACWI patients(r=0.446,P<0.001).ROC curve analysis showed that the AUC(95%CI)for diagnosing ACWI with serum LRG1 and DPP4 were 0.788(0.734～0.835)and 0.790(0.736～0.837),respectively,while the AUC(95%CI)for combined diagnosis was 0.922(0.883～0.951),which was better than individual diagnosis(Z=5.798,5.612,all P<0.05).The AUC(95%CI)of LRG1 and DPP4 in diagnosing ACWI patients with poor prognosis was 0.796(0.722～0.857)and 0.800(0.727～0.861),respectively,and the AUC(95%CI)of combined diagnosis was 0.924(0.869～0.961),which was better than their respective individual diagnoses(Z=2.891,4.222,all P<0.05).Conclusion LRG1 and DPP4 levels are higher in the serum of ACWI patients and higher in patients with poor prognosis.The two levels are positively correlated,and the combination has a certain value in diagnosing the occurrence of ACWI and poor prognosis,which provides a theoretical basis for clinical diagnosis.

Objective:To investigate the serum levels of secreted frizzled-related protein-4 (SFRP-4) and heat shock protein 60 (HSP60) in pregnant women with gestational diabetes mellitus (GDM) and their predictive value for adverse pregnancy outcomes.Methods:A total of 123 pregnant women with GDM who were admitted from Jun. 2020 to Aug. 2022 were collected as the observation group, and 120 healthy pregnant women who underwent obstetric examination in our hospital were gathered as the control group. Serum SFRP-4 and HSP60 levels were detected by enzyme-linked immunosorbent assay (ELISA) , clinical data of selected persons were collected; Pearson method was used to analyze the correlation between serum SFRP-4 and HSP60 levels and glucose and lipid metabolism indexes; ROC curve was used to analyze the serum SFRP-4 and HSP60 in the diagnosis of adverse pregnancy outcomes in patients with GDM.Results:There were no obvious differences in age, pre-pregnancy BMI, gestational age, pregnancy times, and serum HDL-C or LDL-C between the control group and the GDM group ( P>0.05) . FBG, FINS, HbA1c, HOMA-IR, TG, and TC in GDM group were obviously higher than those in control group [ (6.41±0.73) vs (4.98±0.61) mmol/L, (12.35±2.33) vs (7.61±1.56) mIU/L, (9.34±1.26) vs (5.74±0.23) %, (3.42±0.55) vs (1.27±0.53) , (1.74±0.82) vs (1.21±0.23) mmol/L, (4.98±1.21) vs (4.57±1.13) mmol/L] ( P<0.05) . The levels of serum SFRP-4 and HSP60 in the GDM group were obviously higher than those in the control group [ (5.68±1.78) vs (3.26±0.95) ng/mL, (32.56±6.28) vs (18.42±3.24) ng/mL] ( P<0.05) ; Serum SFRP-4 and HSP60 in GDM patients were positively correlated with FBG, FINS, HbA1c, and HOMA-IR ( P<0.05) , but had nothing to do with TG, TC, HDL-C, and LDL-C ( P>0.05) . Compared with the good pregnancy outcome group, the serum SFRP-4 and HSP60 levels in the poor group were obviously increased [ (7.41±1.62) vs (4.75±1.55) ng/mL, (38.31±5.76) vs (29.47±5.41) ng/mL] ( P<0.05) . The AUC of serum SFRP-4 combined HSP60 to diagnose adverse pregnancy outcomes in GDM patients was 0.931, with a sensitivity of 86.05% and a specificity of 87.50%. The combined diagnostic performance was higher than that of the single test ( Z=2.070, P=0.038; Z=2.001, P=0.045) . Conclusions:The levels of serum SFRP-4 and HSP60 in GDM patients are increased, which are related to GDM pregnancy outcomes. The combination of the two has certain diagnostic value for adverse pregnancy outcomes in GDM patients.

Objective: To compare the clinical value of FibroScan, FIB-4, APRI and AAR diagnosing hepatic fibrosis in chronic hepatitis B virus (HBV) carriers. Methods: A total of 213 patients with chronic HBV carriers diagnosed by clinical and liver biopsy were selected. And according to HBeAg status, 149 patients were divided into HBeAg-positive group and 64 patients were divided into HBeAg-negative group. The liver stiffness measurements (LSM) was measured by FibroScan (FS), FIB-4, APRI and AAR values were calculated using FIB-4, APRI and AAR formula. And all patients underwent liver biopsy in the same period. According to the degree of hepatic fibrosis in Knodell, one decision point was set: significant hepatic fibrosis (S ≥ 2). The Spearman correlation analysis method was used to analyze the correlation of indicators and the area under receiver operator characteristic curves (AUROCs) of LSM, FIB-4, APRI and AAR were drawn according to liver biopsy pathology results as gold standard. The value of LSM, FIB-4, APRI and AAR diagnosing hepatic fibrosis in chronic HBV carriers was retrospectively analyzed. Retrospective analysis of FS, FIB-4, APRI and AAR were divided into 149 HBeAg-positive chronic HBV carriers (HBeAg-positive group) and 64 HBeAg-negative chronic HBV carriers (HBeAg) in 213 patients with chronic HBV carriers and HBeAg Negative group) in the diagnosis of liver fibrosis. Results: The LSM of 213 patients with chronic HBV carriers, 149 patients with HBeAg-positive chronic HBV carriers and 64 patients with HBeAg-negative chronic HBV carriers were significantly correlated with liver fibrosis grade≥ 2 (P < 0.001). Regardless of HBeAg status, only LSM in the three groups had moderate evaluation efficacy for evaluating significant fibrosis(S≥2), and the positive predictive value was more than 94%, but the diagnostic accuracy was not high, the minimum was 46.31% (HBeAg-positive group), the maximum value of 67.19% (HBeAg-negative group), while the remaining three kinds of serum noninvasive liver fibrosis diagnostic model indicators and diagnostic efficacy are low. The LSM in the three groups showed a significant positive correlation with liver fibrosis grade (S)≥2. Conclusion LSM is more accurate than FIB-4, APRI and AAR in diagnosing chronic HBV carriers. Dynamically monitoring changes of LSM can earlier understand the progress of liver fibrosis than the three kinds of serology noninvasive diagnostic model and is contributed to the choice of liver biopsy timing.

Objective:To investigate the method of arthroplasty for reconstructing femporomandibular joint (TMJ) after the establishment of TMJ articular defect models in the rabbits,and to clarify the replacement and repair effects of carboh fiber reinforced polyetheretherketone (CFR-PEEK) material TMJ prostheses,and to provide an experimental basis for the clinical application of CFR-PEEK artificial joints to replace TMJ.Methods:Thirteen healthy adult Japanese rabbits were randomly divided into experimental group (n=6),positive control group (n=4) and negative control group (n =3).The right TMJ articular process of the rabbits in experimental group were resected to establish the joint defect models,and then the CFR-PEEK artificial joints were impanted.The right TMJ articular process of the rabbits in positive control group were resected,and the joint defect models were established without the CFR-PEEK artificial joint implantation.The rabbits in negative control group didn't receive any treatment.The body weights of the rabbits in each group were measured in 13 weeks.The effects of fixation and replacement after artificial joint implantation were assessed by CT imaging.Results:The TMJ articular process defect model was successfully implanted with the CFR-PEEK artificial joint.The CT imaging results after threedimensional reconstruction and CT images by contrast in vitro showed that the CFR-PEEK-implanted artificial joint was fixed well,it could be instead of the normal joint function.Compared with positive control group,the weights of rabbits in experimental group were significantly increased (P＜ 0.05) at 13 weeks;compared with positive control group,the weights of rabbits in experimental group and negative control group were both significantly increased (P＞0.05) at 13 weeks,but there was no significant difference between them (P＞0.05).The weights of rabbits in experimental group and negative control group kept normal growth;the weights of rabbits in positive control group was increased slowly,and even stopped growing or was negative.Conclusion:The CFR-PEEK artificial joint can be successfully implanted into the TMJ defect model and be used to repair the defect which help to restore chewing function.The CFR-PEEK is expected to be an ideal material for reconstructing TMJ.

Objective To investigate the effect of methylation of the APC gene on expression and the correlation with clinical data in pancreatic cancer.Methods Sixty postoperative tissue samples with pancreatic cancer were collected in the First Affiliated Hospital of Zhengzhou University from August 2010 to January 2011,20 benign pancreatic disease tissues were collected as control groups.APC promoter methylation and gene expression levels were detected by Methylation Specific PCR (MSP),Real Time PCR (RT-PCR) and Western blot in 60 pancreatic carcinoma,42 metastasis and 20 benign pancreatic disease tissues,then analyze the relation between methylation of the APC gene and the clinical data.Results APC promoter methlation was observed 48.53％,46.67％ and 1.16％ in pancreatic carcinoma,metastasis and benign pancreatic disease tissue,respectively.Methylation of APC in pancreatic carcinoma and metastasis increased significantly compared with control tissues (x2 =12.903,14.402; P ＜ 0.05).There were no statistically significant differences of APC expression in these tissues (P ＞ 0.05).There was a significant correlation between methylation of APC and clinicopathological stage (x2 =6.801,P ＜ 0.05),but no correlation with gender,age,tumor size,histological grade and metastasis (x2 =0.727,1.311,0.372,0.148,0.017 ; P ＞ 0.05).Conclusion The methylation of APC gene is closely related with pancreatic carcinoma inogenesis and the clinicopathological stage,but do not effect the expression of APC in tissues.

OBJECTIVE: To analyze the characteristic of chronic paranasal sinusitis CT scans and discuss the relationship between the anatomic variations in ostiomeatal complex (OMC) and the incidence of chronic sinusitis. METHOD: One hundred and ninety-seven cases diagnosis as sinusitis were selected and analyzed,whose age ranged between 4 and 74 years old. Several common anatomical abnormalities in ostiomeatal complex were evaluated through the observation of the coronal and axial plane CT scans of the paranasal sinusitis. RESULT: The incidence of anatomic variations in OMC concentrated in the age between 11-20. The incidence of chronic sinusitis also concentrated in the age between 11-20. Deviation of nasal septum, uncinate variations, inferior-turbinate hypertrophy were observed between the chronic sinusitis group and the none chronic sinusitis group,the correlation between deviation of nasal septum, uncinate variations, inferior-turbinate hypertrophy and chronic sinusitis were significant (P<0.05). CONCLUSION The occurrence of OMC variation is common. The anatomic variations may be one of the causes of chronic paranasal sinusitis, especially deviation of nasal septum, uncinate variations and inferior-turbinate hypertrophy. If these abnormalities were altered,it will have a great significance for the preservation and treatment of chronic paranasal sinusitis.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Chronic Disease ; Female ; Humans ; Male ; Middle Aged ; Nasal Septum ; diagnostic imaging ; Paranasal Sinuses ; diagnostic imaging ; Sinusitis ; diagnostic imaging ; Tomography, Spiral Computed ; Young Adult