Objective:To explore the expressions and significance of nucleotide binding oligomerization domain-like receptor protein 3 (NLRP3), cysteinyl aspartate specific proteinase-1 (Caspase-1) and interleukin-1β (IL-1β) in patients with hemorrhagic stroke.Methods:One hundred and three patients with hemorrhagic stroke who visited the Department of Neurosurgery of the Second Affiliated Hospital of Zhengzhou University from January 2022 to January 2024 were selected as the hemorrhage group.Another 90 healthy individuals who underwent physical examinations were selected as the control group.The differences in the levels of NLRP3, Caspase-1 and IL-1β in peripheral blood between the two groups were compared. The National Institutes of Health neurological deficiency score (NHISS) was used to evaluate the degree of neurological deficits of patients in the hemorrhage group. All patients were followed up for 3 months. The prognosis of patients was evaluated by modified Rankin scale (mRS). The statistical analysis was performed using SPSS 20.0 software. The relationship between peripheral blood indexes and blood loss, severity of neurological impairment was analyzed by Spearman correlation analysis. The predictive value of peripheral blood indexes for prognosis was evaluated by receiver operating characteristic (ROC) curves.Results:The expression levels of NLRP3 mRNA (2.67±0.42, 1.04±0.28), Caspase-1 mRNA (1.24±0.26, 0.75±0.14) and IL-1β protein ((24.92±4.97) pg/mL, (13.39±2.35) pg/mL) in the hemorrhage group were higher than those in the control group ( t=31.243, 15.967, 20.126, all P<0.05). When comparing the levels of NLRP3 mRNA, Caspase-1 mRNA and IL-1β in the peripheral blood of patients with different amounts of bleeding, those with massive bleeding were higher than those with moderate bleeding, and those with moderate bleeding were higher than those with mild bleeding (all P<0.05).The Spearman correlation analysis showed that the levels of NLRP3 mRNA, Caspase-1 mRNA and IL-1β in peripheral blood were positively correlated with the amount of bleeding in patients with hemorrhagic stroke ( r=0.646, 0.585, 0.604, all P<0.05). The levels of NLRP3 mRNA, Caspase-1 mRNA and IL-1β in patients with severe neurological deficits were higher than those in patients with moderate and mild neurological deficits, and those in patients with moderate neurological deficits were higher than those in patients with mild neurological deficits (all P<0.05). The results of Spearman correlation analysis showed that the levels of NLRP3 mRNA, Caspase-1 mRNA and IL-1β in peripheral blood were positively correlated with the degree of neurological deficits in patients with hemorrhagic stroke ( r=0.607, 0.522, 0.546, all P<0.05). The expression levels of NLRP3 mRNA, Caspase-1 mRNA and IL-1β in peripheral blood in the poor prognosis group were higher than those in the good prognosis group (all P<0.05). The prediction results indicated that bleeding into the cerebral ventricles, large amount of bleeding, and high expression of NLRP3, Caspase-1 and IL-1β in peripheral blood were independent risk factors for poor prognosis in patients with hemorrhagic stroke (all P<0.05). The area under the ROC curve for the combined assessment of poor prognosis in hemorrhagic stroke by the levels of NLRP3 mRNA, Caspase-1 mRNA and IL-1β was 0.856, which was larger than the areas under the curves of the three indicators detected separately (0.720, 0.703, 0.715, P<0.05). Conclusion:The expressions of peripheral blood NLRP3, Caspase-1 and IL-1β are up-regulated in patients with hemorrhagic stroke, and their high expressions are related to blood loss and the severity of neurological deficit, which also indicate poor prognosis of patients.

Objective:To explore the expressions and significance of nucleotide binding oligomerization domain-like receptor protein 3 (NLRP3), cysteinyl aspartate specific proteinase-1 (Caspase-1) and interleukin-1β (IL-1β) in patients with hemorrhagic stroke.Methods:One hundred and three patients with hemorrhagic stroke who visited the Department of Neurosurgery of the Second Affiliated Hospital of Zhengzhou University from January 2022 to January 2024 were selected as the hemorrhage group.Another 90 healthy individuals who underwent physical examinations were selected as the control group.The differences in the levels of NLRP3, Caspase-1 and IL-1β in peripheral blood between the two groups were compared. The National Institutes of Health neurological deficiency score (NHISS) was used to evaluate the degree of neurological deficits of patients in the hemorrhage group. All patients were followed up for 3 months. The prognosis of patients was evaluated by modified Rankin scale (mRS). The statistical analysis was performed using SPSS 20.0 software. The relationship between peripheral blood indexes and blood loss, severity of neurological impairment was analyzed by Spearman correlation analysis. The predictive value of peripheral blood indexes for prognosis was evaluated by receiver operating characteristic (ROC) curves.Results:The expression levels of NLRP3 mRNA (2.67±0.42, 1.04±0.28), Caspase-1 mRNA (1.24±0.26, 0.75±0.14) and IL-1β protein ((24.92±4.97) pg/mL, (13.39±2.35) pg/mL) in the hemorrhage group were higher than those in the control group ( t=31.243, 15.967, 20.126, all P<0.05). When comparing the levels of NLRP3 mRNA, Caspase-1 mRNA and IL-1β in the peripheral blood of patients with different amounts of bleeding, those with massive bleeding were higher than those with moderate bleeding, and those with moderate bleeding were higher than those with mild bleeding (all P<0.05).The Spearman correlation analysis showed that the levels of NLRP3 mRNA, Caspase-1 mRNA and IL-1β in peripheral blood were positively correlated with the amount of bleeding in patients with hemorrhagic stroke ( r=0.646, 0.585, 0.604, all P<0.05). The levels of NLRP3 mRNA, Caspase-1 mRNA and IL-1β in patients with severe neurological deficits were higher than those in patients with moderate and mild neurological deficits, and those in patients with moderate neurological deficits were higher than those in patients with mild neurological deficits (all P<0.05). The results of Spearman correlation analysis showed that the levels of NLRP3 mRNA, Caspase-1 mRNA and IL-1β in peripheral blood were positively correlated with the degree of neurological deficits in patients with hemorrhagic stroke ( r=0.607, 0.522, 0.546, all P<0.05). The expression levels of NLRP3 mRNA, Caspase-1 mRNA and IL-1β in peripheral blood in the poor prognosis group were higher than those in the good prognosis group (all P<0.05). The prediction results indicated that bleeding into the cerebral ventricles, large amount of bleeding, and high expression of NLRP3, Caspase-1 and IL-1β in peripheral blood were independent risk factors for poor prognosis in patients with hemorrhagic stroke (all P<0.05). The area under the ROC curve for the combined assessment of poor prognosis in hemorrhagic stroke by the levels of NLRP3 mRNA, Caspase-1 mRNA and IL-1β was 0.856, which was larger than the areas under the curves of the three indicators detected separately (0.720, 0.703, 0.715, P<0.05). Conclusion:The expressions of peripheral blood NLRP3, Caspase-1 and IL-1β are up-regulated in patients with hemorrhagic stroke, and their high expressions are related to blood loss and the severity of neurological deficit, which also indicate poor prognosis of patients.

Objective:To investigate the clinical characteristics of congenital esophageal atresia with gastric perforation, and to improve pediatricians′ understanding of this disease.Methods:The clinical data of five neonates with congenital esophageal atresia and gastric perforation treated in the neonatal intensive care unit of the Affiliated Hospital of Qingdao University from 2012 to 2022 were analyzed retrospectively.Results:Among the five neonates, four were boys and one was girl.The gestational age was 28 + 5 to 37 + 6 weeks, the birth weight was 1 100~2 350 g. All of them had dyspnea and feeding difficulties after birth.Gastric perforation occurred in three cases during invasive mechanical ventilation, one case during non-invasive ventilation, and one case during nasal catheter oxygen inhalation.Emergency primary gastric repair was performed, followed by secondary esophageal anastomosis.All the patients were cured and discharged from hospital. Conclusion:Gastric perforation is a rare complication of congenital esophageal atresia, which is more common in premature infants and low birth weight infants.Mechanical ventilation may promote the occurrence of gastric perforation.If gastric perforation is complicated, repair should be performed as soon as possible, and esophageal anastomosis surgery should be performed early after stability to improve the final outcome.

Objective:To explore an ideal method for establishing a mouse model of chronic atrophic gastritis (CAG).Methods:CAG mouse models were established with five different modeling methods ( N-methyl- N′-nitro- N-nitrosoguanide (MNNG), sodium salicylate, sodium deoxycholate, Helicobacter pylori infection, and combinations of them) in BALB/c and C57 mice. The effect of each modeling method was evaluated by histological observation of gastric mucosa, plasma biochemical parameters, inflammatory response score, and the expression of anti-inflammatory factors. Results:The results of histological observation of gastric mucosa showed that all of the 5 methods could successfully establish CAG mouse models. In BALB/c mice, compared with the healthy control group, significant features of CAG accompanied with intestinal metaplasia was found in the model group established by combination of MNNG-free drinking, 2% sodium salicylate and 20 mmol sodium deoxycholate. From the results of serological detection, compared with the normal control group, the mRNA expression levels of related anti-inflammatory factors interleukin-2, interleukin-10, interleukin-13 and growth differentiation factor-15 of each model group decreased, which indicated that the mice of each CAG model group had different degrees of inflammation. The results of plasma biochemical parameters indicated that plasma gastrin of each group decreased and the ratio of pepsinogen Ⅰ and pepsinogen Ⅱ significantly dropped. The above results demonstrated that in BLAB/c mice, MNNG-free drinking, 2% sodium salicylate and 20 mmol sodium deoxycholate was better than other four modeling methods. For C57 mice, it was also found that simple chemical drug mutagenesis and Helicobacter pylori replication method both could successfully establish CAG models. No matter from pathological observation, relative expression of anti-inflammatory factors and analysis of plasma biochemical parameters, the effects of combination of the two methods was better. Conclusion:The CAG mouse model established by MNNG-free drinking, 2% sodium salicylate and 20 mmol sodium deoxycholate can provide a certain reference for the establishment and application of mouse model in CAG experiments in the future for pharmacological research.