Objective To investigate the independent risk factors for early neurological deterioration(END)associated with para-median pontine infarction(PPI),to construct a scoring model based on the independent risk factors,and to evaluate its predictive value in END.Methods A total of 163 patients with PPI were retrospectively included and divided into END group(n=35)and non-END group(n=128).After screening possible clinical factors and MRI features,a scoring model was established based on the predictive value,and the predictive efficacy of the model was evaluated.Results Taking END as the endpoint event,homocysteine(Hey)level,maximum infarct size,severe leukoaraiosis(LA),mean apparent diffusion coefficient(ADC)value and inferior pontine infarction were independent risk factors for PPI related END(P＜0.05).Scores were assigned according to odds ratio(OR)value,which were 1,1,3,1,4,respectively,and a scoring model was further established.The model predicted END with an area under the curve(AUC)value of 0.910 and sensitivity of 0.743 and specificity of 0.898 when the score was ≥6 points.Conclusion The scoring model based on Hcy and MRI features has good efficacy in predicting PPI related END,and can provide a basis for prognostic evaluation.

The NOTCH signaling pathway is an evolutionarily highly conserved signaling pathway that regulates various cellular physiological processes by conducting signals between adjacent cells,and is important for cell fate,cell development,differentiation,proliferation,apoptosis,adhesion,and epithelial-to-mesenchymal transition.The NOTCH pathway involves almost all aspects of cardiac development,including primitive heart patterning,and cardiac morphogenesis,which play a crucial role in cardiac development and postnatal cardiac homeostasis.It has been found that the conduction abnormality of the NOTCH pathway and the mutation of the NOTCH signal components are closely related to a series of congenital heart defects.Furthermore,NOTCH signaling can repair myocardial injury by promoting myocardial regeneration,protecting ischemic myocardium,inducing angiogenesis,and negatively regulating cardiac fibroblast-myofibroblast transformation.This article will focus on the role of NOTCH signaling pathways in mammalian hearts and its advances in congenital heart disease.