Objective To construct and validate a nomogram-based prediction model of vascular plaque stability in patients with progressive cerebral infarction based on serum monocyte chemotactic protein-1(MCP-1),monocyte chemotactic protein-1 inducible protein 1(MCPIP1)combined with inflammatory factors.Methods A retrospective cohort study was conducted on 200 patients with progressive cerebral infarction admitted to our department from January to December 2023.All of them were assigned into a modeling group,and were divided into a stable plaque subgroup and the unstable plaque subgroup according to results of carotid multilayer spiral CT angiography.Their general data,results of laboratory tests,and other clinical indicators were collected to identify the influencing factors for vascular plaque instability with single-factor and multifactor analyses.Then a nomogram model for predicting vascular plaque stability was constructed for patients with progressive cerebral infarction.Receiver operating characteristics(ROC)curve was plotted to evaluate the predictive performance of the nomogram model.Subsequently,in a ratio of 7∶3 between the cases in the modeling group and the validation group,another 86 patients with progressive cerebral infarction admitted to our department from January to June 2024 were enrolled and served as the validation group.Their clinical data were collected for external validation of the model.Results In the modeling group,there were 68 patients(34.00％)in the stable plaque subgroup and 132 patients(66.00％)in the unstable plaque subgroup.Univariate analysis showed that there were significant differences between the 2 subgroups in terms of age(65.31±6.74 vs 67.52±7.14 years,t=2.113),comorbid diabetes mellitus[35(48.53％)vs 80(60.61％)cases,Chi-square=7.182],MCP-1(570.67±104.23 vs 693.94±128.45 pg/mL,t=6.836),MCPIP1(2.93±0.58 vs 4.08±0.75 ng/mL,t=11.051),homocysteine(Hcy,10.56±2.38 vs 16.04±3.54 μmol/L,t=11.491),C-reactive protein(CRP,6.16±2.03 vs 8.05±2.67 mg/L,t=5.122)and TNF-α(1.31±0.29 vs 1.79±0.47 ng/mL,t=7.696)(all P＜0.05).Multivariate analysis indicated that age(β=0.103,OR=1.109,95％CI=1.012～1.215),comorbid diabetes(β=2.135,OR=8.461,95％CI=1.866～38.353),Hcy(β=0.706,OR=2.026,95％CI=1.550～2.650),MCP-1(β=0.011,OR=1.011,95％CI=1.004～1.018),MCPIP1(β=1.928,OR=6.875,95％CI=2.765～17.094),CRP(β=0.327,OR=1.387,95％CI=1.022～1.883)and TNF-α(β=1.491,OR=4.443,95％CI=1.389～14.212)were independent influencing factors for vascular plaque instability in the patients with progressive cerebral infarction(all P＜0.05).The modeling formula based on these factors was Logit(P)=0.103×(age)+2.135×(combined diabetes)+0.706×(Hcy)+0.01 1×(MCP-1)+1.928×(MCPIP1)+0.327×(CRP)+1.491×(TNF-α)-34.684.ROC curve analysis revealed that the area under curve(AUC)of the model in the modeling group was 0.956(95％CI:0.931～0.981,P＜0.001),with a sensitivity of 0.841 and a specificity of 0.926,and the AUC value in validation group was 0.960(95％CI=0.925～0.996,P＜0.001).Conclusion Our nomogram prediction model has a good predictive performance for vascular plaque instability in patients with progressive stroke,and it can be used to identify high-risk patients for vascular plaque instability in clinical practice.

Objective To investigate the relationship of serum programmed cell death 4(PDCD4)and a disintegrin and metalloprotease 10(ADAM10)levels with short-term prognosis in elderly patients with large artery atherosclerosis(LAA)-related acute cerebral infarction(AIS).Methods A total of 122 elderly patients with LAA-related AIS admitted in Nanyang Second People's Hos-pital during April 2022 and April 2024 were retrospectively enrolled and served as observation group.According to their neurological function,they were categorized into mild,moderate and se-vere subgroups(29,68 and 25 cases,respectively),and based on their prognosis,they were as-signed into good and poor prognosis subgroups(72 and 50 cases,respectively).Another 125 indi-viduals taking physical examination in above hospital during the same period were included as the control group.ELISA was applied to detect serum PDCD4 and ADAM10 levels.Multivariate logis-tic regression analysis was employed to investigate the relationship of above two indicators with short-term prognosis of LAA-related AIS patients.ROC curves were plotted to analyze the predic-tive value of the indicators for short-term prognosis of the patients.Results The serum PDCD4 and ADAM10 levels were significantly higher in the observation group than the control group(P＜0.01),in the moderate and severe subgroups than the mild subgroups(P＜0.05),and in the severe than the moderate subgroups(P＜0.05).Larger proportions of severe neurologic deficit and hypertension,and higher Hcy level were observed in the poor than the good prognosis sub-groups(P＜0.01).PDCD4 and ADAM10 were correlated with poor short-term prognosis in pa-tients with LAA-related AIS(OR=2.759,95％CI:1.479-5.146,P=0.001;OR=2.818,95％CI:1.559-5.093,P=0.001).The AUC value of PDCD4 and ADAM10 alone and their combination in predicting poor short-term prognosis was 0.840,0.864,and 0.935,respectively,and the combina-tion showed better predictive performance than alone(Z=2.687,2.008,P＜0.05).Conclusion Serum PDCD4 and ADAM10 levels are higher in patients with LAA-related AIS.Their combina-tion showed good predictive efficacy for poor short-term prognosis of these patients.

Objective To investigate the relationship of serum programmed cell death 4(PDCD4)and a disintegrin and metalloprotease 10(ADAM10)levels with short-term prognosis in elderly patients with large artery atherosclerosis(LAA)-related acute cerebral infarction(AIS).Methods A total of 122 elderly patients with LAA-related AIS admitted in Nanyang Second People's Hos-pital during April 2022 and April 2024 were retrospectively enrolled and served as observation group.According to their neurological function,they were categorized into mild,moderate and se-vere subgroups(29,68 and 25 cases,respectively),and based on their prognosis,they were as-signed into good and poor prognosis subgroups(72 and 50 cases,respectively).Another 125 indi-viduals taking physical examination in above hospital during the same period were included as the control group.ELISA was applied to detect serum PDCD4 and ADAM10 levels.Multivariate logis-tic regression analysis was employed to investigate the relationship of above two indicators with short-term prognosis of LAA-related AIS patients.ROC curves were plotted to analyze the predic-tive value of the indicators for short-term prognosis of the patients.Results The serum PDCD4 and ADAM10 levels were significantly higher in the observation group than the control group(P＜0.01),in the moderate and severe subgroups than the mild subgroups(P＜0.05),and in the severe than the moderate subgroups(P＜0.05).Larger proportions of severe neurologic deficit and hypertension,and higher Hcy level were observed in the poor than the good prognosis sub-groups(P＜0.01).PDCD4 and ADAM10 were correlated with poor short-term prognosis in pa-tients with LAA-related AIS(OR=2.759,95％CI:1.479-5.146,P=0.001;OR=2.818,95％CI:1.559-5.093,P=0.001).The AUC value of PDCD4 and ADAM10 alone and their combination in predicting poor short-term prognosis was 0.840,0.864,and 0.935,respectively,and the combina-tion showed better predictive performance than alone(Z=2.687,2.008,P＜0.05).Conclusion Serum PDCD4 and ADAM10 levels are higher in patients with LAA-related AIS.Their combina-tion showed good predictive efficacy for poor short-term prognosis of these patients.