1.Influencing Factors of Depression in Patients with Postoperative Ovarian Cancer
Jialiang YAO ; Long ZHANG ; Jianhui TIAN ; Ze LIU ; Yun YANG ; Yiyang ZHOU ; Minghua LI ; Wang YAO ; Wenfei SHI ; Xinyi LU ; Pan YU ; Enchao CONG
Cancer Research on Prevention and Treatment 2026;53(5):349-359
Objective To explore the prevalence of depressive symptoms in postoperative patients with ovarian cancer and to analyze its influencing factors from multiple dimensions, including clinical characteristics, psychological factors, and laboratory indicators. Methods A cross-sectional study was conducted, which enrolled 235 postoperative patients with ovarian cancer. Depressive status was assessed using the patient health questionnaire, and the demographic, pathological, and medical record data of the patients were collected using the generalized anxiety disorder scale, Pittsburgh sleep quality index, European organization for research and treatment of cancer quality of life questionnaire core 30, and ECOG performance status score. Peripheral blood tumor marker (CA125), routine blood test, lymphocyte subsets, and serum cytokine levels were measured. Univariate and multivariate binary logistic regression analysis were used for statistical analysis. Results The prevalence of depression in postoperative patients with ovarian cancer was 39.15% (92/235). Univariate analysis showed that ECOG score ≥ 2 points, pain, anxiety, poor sleep quality, low quality of life, low life satisfaction, tumor recurrence, six or more cycles of chemotherapy, as well as higher levels of CA125, NLR, and NAR, and lower hemoglobin levels were significantly associated with depression (all P<0.05). Multivariate binary Logistic regression analysis showed that anxiety (OR=1.975, 95%CI: 1.231-3.170), sleep efficiency (OR=4.181, 95%CI: 1.211-14.43), sleep latency (OR=34.806, 95%CI: 4.258-284.542), ECOG performance status score, cognitive function (OR=0.918, 95%CI: 0.868-0.97), and life satisfaction were independent risk factors for depression (all P<0.05). Laboratory indicators were not independent influencing factors in the multivariate Logistic regression model. Conclusion Depression in postoperative patients with ovarian cancer is influenced by physiological, psychological, and social factors. Clinical management should focus on patients with anxiety, sleep disorders, poor physical condition, and low life satisfaction, and a comprehensive prevention and treatment strategy centered on psychological intervention and taking into account symptom management and social support should be implemented.
2.Oxidative Stress-related Signaling Pathways and Antioxidant Therapy in Alzheimer’s Disease
Li TANG ; Yun-Long SHEN ; De-Jian PENG ; Tian-Lu RAN ; Zi-Heng PAN ; Xin-Yi ZENG ; Hui LIU
Progress in Biochemistry and Biophysics 2025;52(10):2486-2498
Alzheimer’s disease (AD) is a neurodegenerative disorder characterized by progressive cognitive decline, functional impairment, and neuropsychiatric symptoms. It represents the most prevalent form of dementia among the elderly population. Accumulating evidence indicates that oxidative stress plays a pivotal role in the pathogenesis of AD. Notably, elevated levels of oxidative stress have been observed in the brains of AD patients, where excessive reactive oxygen species (ROS) can cause extensive damage to lipids, proteins, and DNA, ultimately compromising neuronal structure and function. Amyloid β‑protein (Aβ) has been shown to induce mitochondrial dysfunction and calcium overload, thereby promoting the generation of ROS. This, in turn, exacerbates Aβ aggregation and enhances tau phosphorylation, leading to the formation of two pathological features of AD: extracellular Aβ plaque deposition and intracellular neurofibrillary tangles (NFTs). These events ultimately culminate in neuronal death, forming a vicious cycle. The interplay between oxidative stress and these pathological processes constitutes a core link in the pathogenesis of AD. The signaling pathways mediating oxidative stress in AD include Nrf2, RCAN1, PP2A, CREB, Notch1, NF‑κB, ApoE, and ferroptosis. Nrf2 signaling pathway serves as a key regulator of cellular redox homeostasis, exerts important antioxidant capacity and protective effects in AD. RCAN1 signaling pathway, as a calcineurin inhibitor, and modulates AD progression through multiple mechanisms. PP2A signaling pathway is involved in regulating tau phosphorylation and neuroinflammation processes. CREB signaling pathway contributes to neuroplasticity and memory formation; activation of CREB improves cognitive function and reduce oxidative stress. Notch1 signaling pathway regulates neuronal development and memory, participates in modulation of Aβ production, and interacts with Nrf2 toco-regulate antioxidant activity. NF‑κB signaling pathway governs immune and inflammatory responses; sustained activation of this pathway forms “inflammatory memory”, thereby exacerbating AD pathology. ApoE signaling pathway is associated with lipid metabolism; among its isoforms, ApoE-ε4 significantly increases the risk of AD, leading to elevated oxidative stress, abnormal lipid metabolism, and neuroinflammation. The ferroptosis signaling pathway is driven by iron-dependent lipid peroxidation, and the subsequent release of lipid peroxidation products and ROS exacerbate oxidative stress and neuronal damage. These interconnected pathways form a complex regulatory network that regulates the progression of AD through oxidative stress and related pathological cascades. In terms of therapeutic strategies targeting oxidative stress, among the drugs currently used in clinical practice for AD treatment, memantine and donepezil demonstrate significant therapeutic efficacy and can improve the level of oxidative stress in AD patients. Some compounds with antioxidant effects (such asα-lipoic acid and melatonin) have shown certain potential in AD treatment research and can be used as dietary supplements to ameliorate AD symptoms. In addition, non-drug interventions such as calorie restriction and exercise have been proven to exerted neuroprotective effects and have a positive effect on the treatment of AD. By comprehensively utilizing the therapeutic characteristics of different signaling pathways, it is expected that more comprehensive multi-target combination therapy regimens and combined nanomolecular delivery systems will be developed in the future to bypass the blood-brain barrier, providing more effective therapeutic strategies for AD.
3.Comparative efficacy of O-arm navigation-assisted and conventional posterior cervical expansive open-door laminoplasty via the intermuscular approach in the treatment of cervical spinal cord injury without fracture-dislocation
Zhe SHAO ; Wentao JIANG ; Kai SU ; Rundong GUO ; Long WANG ; Yili LI ; Xiaoteng LI ; Qiangqiang PAN ; Wei MEI ; Qingde WANG
Chinese Journal of Trauma 2025;41(3):259-266
Objective:To compare the efficacy of O-arm navigation-assisted and conventional posterior cervical expansive open-door laminoplasty (CEOL) via the intermuscular approach in the treatment of cervical spinal cord injury without fracture-dislocation (CSCIWFD).Methods:A prospective cohort study was conducted to analyze the clinical data of 60 CSCIWFD patients who were admitted to Zhengzhou Orthopedic Hospital from May 2021 to May 2023, with compression at C3-C6. Patients were randomly divided into two groups: 30 patients underwent O-arm navigation-assisted intermuscular approach CEOL (navigation-assisted group) and 30 patients underwent conventional intermuscular approach CEOL (conventional surgery group). Surgical duration, intraoperative blood loss, postoperative drainage volume, and total surgical blood loss were compared between the two groups. At 2 weeks postoperatively, CT scan was performed to evaluate the accuracy of hinge or open-door position preparation of the surgical segments. Visual analogue scale (VAS) for neck and shoulder pain and Japanese Orthopedic Association (JOA) scores were compared between the two groups preoperatively, at 2 weeks, 6 months postoperatively, and at the last follow-up. Complication rates were also evaluated.Results:A total of 60 patients with CSCIWFD were included, comprising 35 males and 25 females, aged 35-77 years [(50.9±8.6)years]. All the patients were followed up for 12-24 months [(16.9±3.1)months]. The surgical duration and intraoperative blood loss were (121.6±17.9)minutes and (144.7±44.2)ml in the navigation-assisted group, shorter or less than (132.3±14.6)minutes and (178.7±48.7)ml in the conventional surgery group ( P<0.05). There were no statistically significant differences in postoperative drainage volume and total surgical blood loss between the two groups ( P>0.05). CT scan reviewed at 2 weeks postoperatively revealed that the accuracy rate of hinge and open-door position preparation of the surgical segments in the navigation-assisted group was 99.2% (119/120), significantly higher than 86.7% (104/120) in the conventional surgery group ( P<0.01). Before operation and at 2 weeks, 6 months postoperatively, and at the last follow-up, the VAS scores for neck and shoulder pain and JOA scores in the navigation-assisted group were 5.0(4.0, 7.0)points and (8.7±2.8)points, 3.0(2.0, 4.0)points and (10.2±2.5)points, 2.0(1.0, 2.0)points and (1 3.0±1.8)points, and 1.0(1.0, 2.0)points and (13.9±1.5)points respectively, while in the conventional surgery group, the VAS scores and JOA scores were 5.5(5.0, 6.3)points and (8.8±2.6)points, 4.0(3.0, 4.0)points and (10.4±2.5)points, 2.0(1.0, 3.0)points and (12.9±2.2)points, and 2.0(1.0, 2.0)points and (13.8±2.0)points ( P>0.05). Both groups showed improvement in neck and shoulder VAS scores and JOA scores at 2 weeks, 6 months postoperatively, and at the last follow-up, compared to preoperative scores ( P<0.05); further improvement was observed at 6 months postoperatively and at the last follow-up compared to that at 2 weeks postoperatively ( P<0.05). There were no significant differences between neck and shoulder VAS scores or JOA scores at 6 months postoperatively and at the last follow-up ( P>0.05). In the navigation-assisted group, 2 patients had axial neck-shoulder pain postoperatively, with a complication rate of 7% (2/30); while in the conventional surgery group, 7 patients had axial neck-shoulder pain and one patient developed cerebrospinal fluid leakage and low-pressure headache, with a complication rate of 27% (8/30) ( P<0.05). Conclusion:Compared to the conventional intermuscular approach, O-arm navigation-assisted intermuscular approach CEOL for CSCIWFD reduces surgical duration and intraoperative blood loss, improves the accuracy of hinge and open-door position preparation, and lowers complication rates.
4.Research progress on mechanism of curcumin in treatment of depression
Lin WANG ; Qi-fei PAN ; Wen-juan LONG ; Jia-rong DU ; Zhong-yang HU ; Xin-yao LI ; Yi-shu CHEN ; Dong-dong QIN ; Xiao-man LYU
Chinese Pharmacological Bulletin 2025;41(9):1618-1623
Depression is a prevalent mental and emotional disor-der that often results in significant emotional disturbances,cog-nitive dysfunction,and memory impairments.It is characterized by a high incidence rate,a substantial disability burden,and limited therapeutic efficacy.Currently,the long-term use of medications for the treatment of depression can result in a range of adverse reactions,highlighting the urgent need to explore no-vel approaches that can effectively alleviate depressive symptoms while minimizing side effects.Curcumin,a natural polyphenolic compound derived from the rhizome of turmeric,demonstrates considerable potential in the prevention and treatment of depres-sion,owing to its diverse array of biological activities.In recent years,numerous studies have investigated the use of curcumin for the treatment of depression.This article aims to provide a comprehensive review of the mechanisms of action underlying curcumin's efficacy in treating depression.Specifically,it focu-ses on its ability to improve neurotransmitter imbalances,restore neural plasticity,alleviate neural damage,mitigate dysfunction of the hypothalamic-pituitary-adrenal(HPA)axis,regulate in-flammatory factors and neuroinflammatory signaling pathways,and inhibit oxidative stress.This review is intended to offer in-sights and methodological references for basic research on curcu-min,as well as for the development of novel therapeutic agents for the treatment of depression.
5.Dynamic analysis of immune responses in heterotopic heart transplantation model of genetically modified pig-to-macaque
Le BAI ; Ziqiang DAI ; Zhipeng REN ; Chenghong LAI ; Xianhua LI ; Xiaoyang XIE ; Dengke PAN ; Enwu LONG ; Dianyuan LI
Organ Transplantation 2025;16(5):747-755
Objective To evaluate the efficacy of a combined immunosuppression regimen in modulating rejection in genetically modified pig-to-macaque xenogeneic heart transplantation.Methods Two xenogeneic heart transplantation models were constructed using genetically modified pigs and macaques.Dynamic monitoring of recipient peripheral blood immune parameters and observation of graft pathological changes were performed.Results Regimen 1,featuring B-cell depletion,T-cell inhibition,and C3 complement suppression,reduced lymphocyte levels but failed to control acute humoral rejection and macrophage infiltration.Regimen 2,adding C5 complement inhibition and interleukin-6 inhibition to Regimen 1,more effectively lowered lymphocyte levels,inhibited acute humoral rejection and complement activation,and decreased antibody deposition.However,a late-phase cytokine storm and residual T cells emerged.Conclusions Regimen 2 reduces the hyperacute and acute rejection risks through multi-target intervention.Yet,it requires balancing medication complexity and safety.This indicates the need to optimize cellular immune regulation and adjust the plan through dynamic multidimensional monitoring.
6.Comparative efficacy of O-arm navigation-assisted and conventional posterior cervical expansive open-door laminoplasty via the intermuscular approach in the treatment of cervical spinal cord injury without fracture-dislocation
Zhe SHAO ; Wentao JIANG ; Kai SU ; Rundong GUO ; Long WANG ; Yili LI ; Xiaoteng LI ; Qiangqiang PAN ; Wei MEI ; Qingde WANG
Chinese Journal of Trauma 2025;41(3):259-266
Objective:To compare the efficacy of O-arm navigation-assisted and conventional posterior cervical expansive open-door laminoplasty (CEOL) via the intermuscular approach in the treatment of cervical spinal cord injury without fracture-dislocation (CSCIWFD).Methods:A prospective cohort study was conducted to analyze the clinical data of 60 CSCIWFD patients who were admitted to Zhengzhou Orthopedic Hospital from May 2021 to May 2023, with compression at C3-C6. Patients were randomly divided into two groups: 30 patients underwent O-arm navigation-assisted intermuscular approach CEOL (navigation-assisted group) and 30 patients underwent conventional intermuscular approach CEOL (conventional surgery group). Surgical duration, intraoperative blood loss, postoperative drainage volume, and total surgical blood loss were compared between the two groups. At 2 weeks postoperatively, CT scan was performed to evaluate the accuracy of hinge or open-door position preparation of the surgical segments. Visual analogue scale (VAS) for neck and shoulder pain and Japanese Orthopedic Association (JOA) scores were compared between the two groups preoperatively, at 2 weeks, 6 months postoperatively, and at the last follow-up. Complication rates were also evaluated.Results:A total of 60 patients with CSCIWFD were included, comprising 35 males and 25 females, aged 35-77 years [(50.9±8.6)years]. All the patients were followed up for 12-24 months [(16.9±3.1)months]. The surgical duration and intraoperative blood loss were (121.6±17.9)minutes and (144.7±44.2)ml in the navigation-assisted group, shorter or less than (132.3±14.6)minutes and (178.7±48.7)ml in the conventional surgery group ( P<0.05). There were no statistically significant differences in postoperative drainage volume and total surgical blood loss between the two groups ( P>0.05). CT scan reviewed at 2 weeks postoperatively revealed that the accuracy rate of hinge and open-door position preparation of the surgical segments in the navigation-assisted group was 99.2% (119/120), significantly higher than 86.7% (104/120) in the conventional surgery group ( P<0.01). Before operation and at 2 weeks, 6 months postoperatively, and at the last follow-up, the VAS scores for neck and shoulder pain and JOA scores in the navigation-assisted group were 5.0(4.0, 7.0)points and (8.7±2.8)points, 3.0(2.0, 4.0)points and (10.2±2.5)points, 2.0(1.0, 2.0)points and (1 3.0±1.8)points, and 1.0(1.0, 2.0)points and (13.9±1.5)points respectively, while in the conventional surgery group, the VAS scores and JOA scores were 5.5(5.0, 6.3)points and (8.8±2.6)points, 4.0(3.0, 4.0)points and (10.4±2.5)points, 2.0(1.0, 3.0)points and (12.9±2.2)points, and 2.0(1.0, 2.0)points and (13.8±2.0)points ( P>0.05). Both groups showed improvement in neck and shoulder VAS scores and JOA scores at 2 weeks, 6 months postoperatively, and at the last follow-up, compared to preoperative scores ( P<0.05); further improvement was observed at 6 months postoperatively and at the last follow-up compared to that at 2 weeks postoperatively ( P<0.05). There were no significant differences between neck and shoulder VAS scores or JOA scores at 6 months postoperatively and at the last follow-up ( P>0.05). In the navigation-assisted group, 2 patients had axial neck-shoulder pain postoperatively, with a complication rate of 7% (2/30); while in the conventional surgery group, 7 patients had axial neck-shoulder pain and one patient developed cerebrospinal fluid leakage and low-pressure headache, with a complication rate of 27% (8/30) ( P<0.05). Conclusion:Compared to the conventional intermuscular approach, O-arm navigation-assisted intermuscular approach CEOL for CSCIWFD reduces surgical duration and intraoperative blood loss, improves the accuracy of hinge and open-door position preparation, and lowers complication rates.
7.Residual Inflammatory Risk and Intracranial Atherosclerosis Plaque Vulnerability: Insights From High-Resolution Magnetic Resonance Imaging
Ying YU ; Rongrong CUI ; Xin HE ; Xinxin SHI ; Zhikai HOU ; Yuesong PAN ; Mingyao LI ; Jiabao YANG ; Zhongrong MIAO ; Yongjun WANG ; Rong WANG ; Xin LOU ; Long YAN ; Ning MA
Journal of Stroke 2025;27(2):207-216
Background:
and Purpose This study aimed to investigate the association between residual inflammatory risk (RIR) and vulnerable plaques using high-resolution magnetic resonance imaging (HRMRI) in symptomatic intracranial atherosclerotic stenosis (ICAS).
Methods:
This retrospective study included 70%–99% symptomatic ICAS patients hospitalized from January 2016 to December 2022. Patients were classified into four groups based on high-sensitivity C-reactive protein (hs-CRP) and low-density lipoprotein cholesterol (LDL-C): residual cholesterol inflammatory risk (RCIR, hs-CRP ≥3 mg/L and LDL-C ≥2.6 mmol/L), RIR (hs-CRP ≥3 mg/L and LDL-C <2.6 mmol/L), residual cholesterol risk (RCR, hs-CRP <3 mg/L and LDL-C ≥2.6 mmol/L), and no residual risk (NRR, hs-CRP <3 mg/L and LDL-C <2.6 mmol/L). Vulnerable plaque features on HRMRI included positive remodeling, diffuse distribution, intraplaque hemorrhage, and strong enhancement.
Results:
Among 336 included patients, 21, 60, 58, and 197 were assigned to the RCIR, RIR, RCR, and NRR groups, respectively. Patients with RCIR (adjusted odds ratio [aOR], 3.606; 95% confidence interval [CI], 1.346–9.662; P=0.011) and RIR (aOR, 3.361; 95% CI, 1.774–6.368, P<0.001) had higher risks of strong enhancement than those with NRR. Additionally, patients with RCIR (aOR, 2.965; 95% CI, 1.060–8.297; P=0.038) were more likely to have intraplaque hemorrhage compared with those with NRR. In the sensitivity analysis, RCR (aOR, 2.595; 95% CI, 1.201–5.608; P=0.015) exhibited an additional correlation with an increased risk of intraplaque hemorrhage.
Conclusion
In patients with symptomatic ICAS, RIR is associated with a higher risk of intraplaque hemorrhage and strong enhancement, indicating an increased vulnerability to atherosclerotic plaques.
8.Coral calcium hydride promotes peripheral mitochondrial division and reduces AT-II cells damage in ARDS via activation of the Trx2/Myo19/Drp1 pathway.
Qian LI ; Yang ANG ; Qing-Qing ZHOU ; Min SHI ; Wei CHEN ; Yujie WANG ; Pan YU ; Bing WAN ; Wanyou YU ; Liping JIANG ; Yadan SHI ; Zhao LIN ; Shaozheng SONG ; Manlin DUAN ; Yun LONG ; Qi WANG ; Wentao LIU ; Hongguang BAO
Journal of Pharmaceutical Analysis 2025;15(3):101039-101039
Acute respiratory distress syndrome (ARDS) is a common respiratory emergency, but current clinical treatment remains at the level of symptomatic support and there is a lack of effective targeted treatment measures. Our previous study confirmed that inhalation of hydrogen gas can reduce the acute lung injury of ARDS, but the application of hydrogen has flammable and explosive safety concerns. Drinking hydrogen-rich liquid or inhaling hydrogen gas has been shown to play an important role in scavenging reactive oxygen species and maintaining mitochondrial quality control balance, thus improving ARDS in patients and animal models. Coral calcium hydrogenation (CCH) is a new solid molecular hydrogen carrier prepared from coral calcium (CC). Whether and how CCH affects acute lung injury in ARDS remains unstudied. In this study, we observed the therapeutic effect of CCH on lipopolysaccharide (LPS) induced acute lung injury in ARDS mice. The survival rate of mice treated with CCH and hydrogen inhalation was found to be comparable, demonstrating a significant improvement compared to the untreated ARDS model group. CCH treatment significantly reduced pulmonary hemorrhage and edema, and improved pulmonary function and local microcirculation in ARDS mice. CCH promoted mitochondrial peripheral division in the early course of ARDS by activating mitochondrial thioredoxin 2 (Trx2), improved lung mitochondrial dysfunction induced by LPS, and reduced oxidative stress damage. The results indicate that CCH is a highly efficient hydrogen-rich agent that can attenuate acute lung injury of ARDS by improving the mitochondrial function through Trx2 activation.
9.Polarized light microscopic mineral phase authentication and health risk assessment of raw and calcined fossil mineral Chinese medicinal material Draconis Os.
Yan-Qiong PAN ; Zheng LIU ; Li-Wen ZHENG ; Ying ZHANG ; Liu ZHOU ; Xi-Long QIAN ; Fang FANG ; Xiao WU ; Sheng-Jin LIU
China Journal of Chinese Materia Medica 2025;50(15):4238-4247
This study aims to investigate the polarized microscopic mineral phase characteristics, inorganic element content, and potential health risks associated with the intake of raw and calcined fossil mineral Chinese medicinal material Draconis Os. Microscopy was employed to observe the mineralogical characteristics of Draconis Os and compare the microscopic features and phase composition of raw and calcined Draconis Os under monochromatic and orthogonal polarized light. Inductively coupled plasma mass spectrometry(ICP-MS) was employed to determine the content of 30 inorganic elements. Health risk assessment was conducted by calculating the single pollution index(P_i), average daily intake of elements for adults(ADI), target hazard quotient(THQ), non-carcinogenic assessment method-hazard quotient(HQ), and the carcinogenic risk of elements(CR). The results indicated that under monochromatic polarized light, the Draconis Os powder sections exhibited light gray-brown to gray-brown irregular fragments, some with undulating textures that were slightly curved. Under crossed polarized light, they appeared dark gray, grayish-white, and yellowish-white. Clear apatite was visible in the ground sections of Draconis Os under crossed polarized light. P_i results indicated that Draconis Os samples were free from contamination and were of good quality. According to the maximum allowable limits of heavy metals stipulated in ISO Traditional Chinese Medicine: Determination of heavy metals in herbal medicines used in Traditional Chinese Medicine, ADI, THQ, HQ, and CR were taken as assessment indicators. Only the THQ value for As(arsenic) in raw Draconis Os was greater than 1, while the THQ values for other heavy metal elements in the Draconis Os samples were all less than 1. The study demonstrates that the primary mineral phase of raw and calcined Draconis Os is apatite, with some samples co-existing with calcite, which can serve as one of the means for quality control of Draconis Os. The elemental analysis results from ICP-MS provide scientific evidence for the safety assessment of Draconis Os, indicating that Draconis Os is safe in clinical application.
Drugs, Chinese Herbal/analysis*
;
Risk Assessment
;
Minerals/chemistry*
;
Fossils
;
Humans
;
Drug Contamination
;
Mass Spectrometry
10.Residual Inflammatory Risk and Intracranial Atherosclerosis Plaque Vulnerability: Insights From High-Resolution Magnetic Resonance Imaging
Ying YU ; Rongrong CUI ; Xin HE ; Xinxin SHI ; Zhikai HOU ; Yuesong PAN ; Mingyao LI ; Jiabao YANG ; Zhongrong MIAO ; Yongjun WANG ; Rong WANG ; Xin LOU ; Long YAN ; Ning MA
Journal of Stroke 2025;27(2):207-216
Background:
and Purpose This study aimed to investigate the association between residual inflammatory risk (RIR) and vulnerable plaques using high-resolution magnetic resonance imaging (HRMRI) in symptomatic intracranial atherosclerotic stenosis (ICAS).
Methods:
This retrospective study included 70%–99% symptomatic ICAS patients hospitalized from January 2016 to December 2022. Patients were classified into four groups based on high-sensitivity C-reactive protein (hs-CRP) and low-density lipoprotein cholesterol (LDL-C): residual cholesterol inflammatory risk (RCIR, hs-CRP ≥3 mg/L and LDL-C ≥2.6 mmol/L), RIR (hs-CRP ≥3 mg/L and LDL-C <2.6 mmol/L), residual cholesterol risk (RCR, hs-CRP <3 mg/L and LDL-C ≥2.6 mmol/L), and no residual risk (NRR, hs-CRP <3 mg/L and LDL-C <2.6 mmol/L). Vulnerable plaque features on HRMRI included positive remodeling, diffuse distribution, intraplaque hemorrhage, and strong enhancement.
Results:
Among 336 included patients, 21, 60, 58, and 197 were assigned to the RCIR, RIR, RCR, and NRR groups, respectively. Patients with RCIR (adjusted odds ratio [aOR], 3.606; 95% confidence interval [CI], 1.346–9.662; P=0.011) and RIR (aOR, 3.361; 95% CI, 1.774–6.368, P<0.001) had higher risks of strong enhancement than those with NRR. Additionally, patients with RCIR (aOR, 2.965; 95% CI, 1.060–8.297; P=0.038) were more likely to have intraplaque hemorrhage compared with those with NRR. In the sensitivity analysis, RCR (aOR, 2.595; 95% CI, 1.201–5.608; P=0.015) exhibited an additional correlation with an increased risk of intraplaque hemorrhage.
Conclusion
In patients with symptomatic ICAS, RIR is associated with a higher risk of intraplaque hemorrhage and strong enhancement, indicating an increased vulnerability to atherosclerotic plaques.

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