Differential Analysis of Blood Routine Examination Parameters in Patients with Upper Gastrointestinal Bleeding and Lower Gastrointestinal Bleeding.

Background: This study addresses the critical need for differentiating between upper and lower gastrointestinal bleeding by focusing on blood routine parameters to enhance diagnostic precision. Objective: This study aims to identify and compare specific blood routine parameters to determine their efficacy in distinguishing between upper and lower gastrointestinal bleeding for improved clinical decision-making. Methods: This retrospective study analyzed 119 patients with gastrointestinal bleeding (GIB) admitted to our hospital between January 2017 and June 2020. Among them, 86 were diagnosed with upper GIB (UGIB) and 33 with lower GIB (LGIB). After admission, peripheral blood samples were collected for a comprehensive blood routine examination, including white blood cell count (WBC), red blood cell count (RBC), hemoglobin (Hb), platelet count (PLT), blood urea nitrogen (BUN), creatinine (Cr), and BUN to Cr ratio (BUN/Cr ratio). Differences in blood routine parameters were compared between the UGIB and LGIB groups. Receiver Operating Characteristic (ROC) curve analysis was conducted to assess the efficacy of blood routine examinations in differentiating between UGIB and LGIB. Results: The study revealed no significant differences in WBC and Cr levels between LGIB and UGIB patients (P > .05). However, UGIB patients exhibited statistically lower levels of RBC, Hb, and PLT, along with higher BUN and BUN/Cr ratio levels compared to LGIB patients (P < .05). Pearson correlation coefficient analysis indicated an inverse correlation of BUN/Cr with RBC, Hb, and PLT in GIB patients and a positive association between BUN/Cr and BUN (P < .05). ROC analysis demonstrated that RBC, Hb, PLT, BUN, and BUN/Cr ratios were effective in distinguishing UGIB from LGIB (P < .05). Conclusions: Blood routine parameters, including RBC, Hb, PLT, BUN, and BUN/Cr ratio, are valuable in differentiating between UGIB and LGIB. These parameters can serve as early evaluation indexes for GIB, facilitating timely intervention and treatment to enhance therapeutic outcomes.

An Investigation of the Correlation between miRNA-21-5p and the Classification and Short-term Prognosis of Acute Ischemic Cerebrovascular Disease.

Objective: This study aimed to investigate the potential of miRNA-21-5p as a diagnostic and prognostic marker for acute ischemic stroke (AIS), specifically examining its relevance in distinguishing between AIS and transient ischemic attack (TIA) and its predictive ability for short-term prognosis. Methods: A total of 84 AIS patients (AIS group), 39 TIA cases (TIA group), and 30 healthy volunteers (Control group) were enrolled in this study. The relative expressions of miRNA-21-5p in serum upon admission were recorded and compared. The statistical analysis involved employing Student's t-test or analysis of variance (ANOVA) to compare means. Additionally, linear correlations were evaluated to determine the associations between different variables. Results: The expression of miRNA-21-5p was significantly upregulated in the AIS group compared to the TIA and Control groups (P < .001), with no statistical difference observed between the TIA and Control groups. Furthermore, within the AIS group, the expression of miRNA-21-5p was found to be significantly increased in the poor prognosis subgroup (mRS 3-6 points) compared to the good prognosis subgroup (mRS 0-2 points) (P < .05). The area under the curve (AUC) of miRNA-21-5p for predicting AIS from TIA and 30-day poor prognosis of AIS were 0.710 and 0.641, respectively. Additionally, miRNA-21-5p showed positive correlations with the National Institutes of Health Stroke Scale (NIHSS) score and modified Rankin Scale (mRS) score of AIS patients, respectively. Conclusions: Serum miRNA-21-5p levels exhibit considerable potential as a promising biomarker. They play a crucial role in distinguishing between AIS and TIA. Additionally, these levels offer valuable predictive insights into the severity and short-term prognosis of AIS.

Diagnostic Values of Blood Count Values and Ratios in Distinguishing between Peptic Ulcer Bleeding and Esophagogastric Variceal Bleeding.

BACKGROUND: To investigate the diagnostic values of blood count values and ratios in distinguishing between peptic ulcer bleeding (PUB) and esophagogastric variceal bleeding (EGVB). METHODS: Due to acute hematemesis and or melaena, 57 patients diagnosed with PUB (PUB group) and 33 cases with EGVB (EGVB group) were enrolled in this retrospective study. The levels of peripheral blood leukocyte counts (leukocyte), neutrophil counts (neutrophil), lymphocyte counts (lymphocyte), platelet counts (platelet), neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) were recorded and compared between the two groups. Student's t-test of independent samples was adopted for comparing the mean between the two groups. Model discrimination was evaluated using the area under the receiver operating characteristic curve (AUC). Comparison of AUC was performed using the Z-test. RESULTS: The levels of leukocyte, neutrophil, lymphocyte, platelet, and PLR were significantly increased in PUB group compared with EGVB group (all p < 0.05), while there was no significant statistical difference of NLR (p > 0.05); moreover, AUCs in distinguishing PUB from EGVB were 0.859, 0.811, 0.760, 0.952, and 0.687 for leukocyte, neutrophil, lymphocyte, platelet, and PLR, respectively, and significant differences were observed between platelet and any parameter of the rest (all p < 0.05); finally, the cutoff values were 8 x 109/L in distinguishing between PUB and EGVB (specificity 78.95%, sensitivity 87.88%, and Youden index 0.668) for leukocyte, 5.3 x 109/L (specificity 70.18%, sensitivity 81.82%, and Youden index 0.520) for neutrophil, 1.2 x 109/L (specificity 84.21%, sensitivity 60.61%, and Youden index 0.448) for lymphocyte, 131 x 109/L (specificity 92.98%, sensitivity 90.91%, and Youden index 0.839) for platelet, and 88 (specificity 70.18%, sensitivity 63.64%, and Youden index 0.338) for PLR. CONCLUSIONS: Leukocyte, neutrophil, lymphocyte, platelet and PLR are useful and potential biomarkers in distinguishing between PUB and EGVB; moreover, platelet can demonstrate more accurate and reliable diagnostic value.

Comparison of the Diagnostic Values of Leukocytes, Neutrophils, Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Distinguishing between Acute Appendicitis and Right Ureterolithiasis.

BACKGROUND: To compare the diagnostic values of leukocytes, neutrophils, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in distinguishing between acute appendicitis (AA) and right ureterolithiasis (RU). METHODS: In this retrospective study, 106 patients diagnosed with AA (Appendicitis group) and 33 cases with RU (Ureterolithiasis group) were enrolled due to acute right lower abdominal pain. The levels of peripheral blood leukocyte counts (leukocytes), neutrophil counts (neutrophils), lymphocyte counts (lymphocytes), platelet counts (platelets), NLR and PLR were recorded and compared between the two groups. Student's t-test for independent samples was adopted for comparing the mean between the two groups. Model discrimination was evaluated using the area under the receiver operating characteristic curve (AUC). Comparison of AUC was performed using the Z-test. RESULTS: The levels of leukocytes, neutrophils, NLR, and PLR were significantly increased in AA compared with RU (all p < 0.01), while there were no significant statistical differences of lymphocytes and platelets (all p > 0.05); moreover, AUC in distinguishing AA from RU was 0.797 (95% confidence interval (CI), 0.721 to 0.861) for leukocytes, 0.814 (95% CI, 0.740 to 0.875) for neutrophils, 0.770 (95% CI, 0.691 to 0.837) for NLR, and 0.608 (95% CI, 0.522 to 0.690) for PLR, and significant differences were observed between PLR and any of the three other parameters (all p < 0.01), while there were no significant statistical differences after pairwise comparison between leukocytes, neutrophils and NLR (all p > 0.05). Finally, the cutoff values were 13.1 × 109/L in distinguishing between AA and RU (specificity 87.88%, sensitivity 63.21%, and Youden index 0.511) for leukocytes, 7.4 x 109/L (specificity 69.70%, sensitivity 83.02%, and Youden index 0.527) for neutrophils, 5.57 (specificity 81.82%, sensitivity 68.87%, and Youden index 0.507) for NLR, and 182.5 (specificity 84.85%, sensitivity 37.74%, and Youden index 0.226) for PLR. CONCLUSIONS: Leukocytes, neutrophils, and NLR can demonstrate more accurate and reliable diagnostic values than PLR, suggesting that they are useful and potential biomarkers in distinguishing between AA and RU.

Diagnostic Value of D-dimer in Distinguishing between Spontaneous Subarachnoid Hemorrhage and Nontraumatic Acute Headache.

BACKGROUND: Spontaneous subarachnoid hemorrhage (SSAH) and nontraumatic acute headache patients presented with symptoms similar to headache. This study was to investigate the diagnostic value of D-dimer (DD) in distinguishing patients with SSAH from those with nontraumatic acute headache. METHODS: This retrospective study was performed and data were gathered from medical records of patients with acute headache symptoms from the Emergency Department and Neurology Clinics who were admitted to the Fourth Affiliated Hospital Zhejiang University School of Medicine between January 2015 and January 2019. Of the total 114 patients with headache symptoms enrolled in this study, 46 patients were diagnosed with SSAH (SAH group) and 68 cases with nontraumatic acute headache due to other causes (non-SAH group). The plasmatic levels of PT, INR, APTT, TT, FIB, and DD were compared between the two groups. Student's t-test of independent samples was adopted for comparing the mean between the two groups. Model discrimination was evaluated using the area under the receiver operating characteristic curve (AUC). Comparison of AUC was performed using the Z-test. RESULTS: There were no significant statistical differences of the PT, INR, TT and FIB (all p > 0.05). The APTT was significantly decreased in the SSAH group compared with non-SAH group, while DD was significantly increased (all p < 0.001); moreover, AUC in distinguishing patients with SSAH from those with nontraumatic acute headache was 0.721 (95% confidence interval (CI), 0.629 to 0.801) for APTT and 0.886 (95% CI, 0.813 to 0.938) for DD. There was a significant statistical difference (p < 0.01). Finally, the cutoff values were 25.2s in distinguishing patients with SSAH from those with nontraumatic acute headache (specificity 73.53% and sensitivity 60.87%) for APTT and 0.31 mg/L (specificity 83.82% and sensitivity 84.78%) for DD. CONCLUSIONS: As an easy-to-obtain and potential biomarker, DD could demonstrate more accurate and reliable diagnostic value than APTT in distinguishing between SSAH and nontraumatic acute headache.

Peripheral Blood Platelet to Lymphocyte Ratio as Potential Diagnostic and Prognostic Markers of Acute Cerebral Infarction and its Clinical Significance.

BACKGROUND: The aim of the present study is to explore the diagnostic and prognostic value of peripheral blood platelet-to-lymphocyte ratio (PLR) in acute cerebral infarction (ACI). METHODS: We enrolled 121 patients with ACI and 35 healthy volunteers in the present study. The lymphocyte and platelet counts and the platelet-to-lymphocyte ratios of the candidates were calculated, and a receiver-operating characteristic (ROC) curve was drawn to examine whether PLR was a sensitive biomarker for distinguishing ACI patients from the healthy volunteers; moreover, the Glasgow outcome scale (GOS) results of the patients were recorded to evaluate the short-term prognosis of the patients, and the relationship between PLR and GOS were investigated. RESULTS: We observed that the platelet counts were decreased in patients with ACI compared to the healthy volunteers, but no significant differences were observed (p > 0.05). On the other hand, lymphocyte counts were significantly decreased in patients with ACI, and PLR was significantly increased in patients with ACI compared with the healthy controls (p < 0.001). Moreover, the area under the curve (AUC) of platelet counts, lymphocyte counts, and PLR were 0.5365 (95% confidence interval (CI), 0.4373 to 0.6357), 0.7526 (95% CI, 0.6630 to 0.8421), and 0.8320 (95% CI, 0.7586 to 0.9054), respectively, suggesting that PLR was a sensitive biomarker for distinguishing ACI patients from the healthy controls. Finally, the PLR of the patients were negatively correlated with the GOS score of the patients. CONCLUSIONS: We reported that PLR was significantly increased in the peripheral blood of patients with ACI, sug-gesting that PLR might be a potential early diagnostic and prognostic marker for ACI.

Comparison of the Diagnostic Values of Neutrophil, Neutrophil to Lymphocyte Ratio, and Platelet to Lymphocyte Ratio in Distinguishing Spontaneous Subarachnoid Hemorrhage from Nontraumatic Acute Headache.

BACKGROUND: To compare the diagnostic values of neutrophil, neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) in distinguishing between spontaneous subarachnoid hemorrhage (SSAH) and non-traumatic acute headache. METHODS: Of the 125 patients with headache symptoms, 54 patients were diagnosed with SSAH (SAH group) and 71 cases with nontraumatic acute headache due to other causes (non-SAH group) were enrolled in this retrospective study. The levels of peripheral blood neutrophil counts, lymphocyte counts, platelet counts, NLR and PLR were recorded and compared between two groups. Student's t-test of independent samples was adopted for comparing the mean between two groups. Model discrimination was evaluated using the area under the receiver operating characteristic curve (AUC). Comparison of AUC was performed using the Z-test. RESULTS: The levels of neutrophil counts, NLR and PLR were significantly increased in the SSAH group compared with the non-SAH group (all p < 0.01), while there were no significantly statistical differences of the lymphocyte counts and platelet counts (all p > 0.05); moreover, AUC in distinguishing between SSAH and nontraumatic acute headache was 0.918 (95% confidence interval (CI), 0.855 to 0.960) for neutrophil counts, 0.828 (95% CI, 0.751 to 0.890) for NLR and 0.616 (95% CI, 0.524 to 0.701) for PLR, and there were significant statistical differences (all p < 0.05) after pairwise comparison. Finally, the cutoff values were 4.7 x 109/L in distinguishing patients with SSAH from those with nontraumatic acute headache (specificity 88.73%, sensitivity 85.19% and Youden index 0.739) for neutrophil counts, 4 (specificity 98.59%, sensitivity 64.81% and Youden index 0.634) for NLR and 175 (specificity 92.96%, sensitivity 44.44% and Youden index 0.374) for PLR. CONCLUSIONS: Neutrophils can demonstrate more accurate and reliable diagnostic value than NLR and PLR, sug-gesting that it is a useful and potential tool in distinguishing between SSAH and nontraumatic acute headache.

Comparison of Lymphocyte Count, Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio in Predicting the Severity and the Clinical Outcomes of Acute Cerebral Infarction Patients.

BACKGROUND: To compare the prediction values of lymphocyte counts, neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) for the severity and the clinical outcomes of acute cerebral infarction (ACI). METHODS: A total of 139 patients diagnosed with ACI were enrolled in this study. Data were gathered from medical records of patients who were admitted to the Fourth Affiliated Hospital Zhejiang University School of Medicine. Stroke severity was evaluated using the National Institutes of Health Stroke Scale (NIHSS). The clinical outcomes of ACI patients were evaluated using the Glasgow Outcome Scale (GOS) at day 30. Patients were classified into two groups based on their GOS at day 30. The Student's t-test of independent samples was adopted for the com-parison of the mean between two groups. The lymphocyte counts, NLR and PLR were evaluated by comparing the areas under the receiver operating characteristic curve (AUC) in predicting the clinical outcomes of ACI. The lin-ear correlations were specifically evaluated to determine the relationship between lymphocyte counts, NLR, PLR and the NIHSS score and the clinical outcomes of ACI. Comparison of AUC was performed using the Z-test. RESULTS: The lymphocyte counts were significantly decreased in the poor outcomes group compared with the good outcomes group of ACI, while NLR and PLR were significantly increased (all p < 0.05); moreover, AUC in pre-dicting 30-day poor outcomes of ACI was 0.697 (95% confidence interval (CI), 0.614 to 0.772) for lymphocyte counts, 0.744 (95% CI, 0.663 to 0.814) for NLR, and 0.689 (95% CI, 0.605 to 0.764) for PLR, but there were no significant statistical differences (all p > 0.05). Finally, the lymphocyte counts were negatively correlated with the NIHSS score of ACI patients, while NLR and PLR were positively correlated (all p < 0.05); on the other hand, the lymphocyte counts were positively correlated with the GOS score of ACI patients, while NLR and PLR were nega-tively correlated (all p < 0.05). CONCLUSIONS: As an inflammatory and immune biomarker, lymphocyte counts demonstrate similar test perfor-mance as NLR and PLR for predicting the severity and 30-day poor outcomes of ACI.

Diagnostic Values of Neutrophil and Neutrophil to Lymphocyte Ratio in Distinguishing between Acute Cerebral Infarction and Vertigo.

BACKGROUND: Vertigo and acute cerebral infarction (ACI) patients show similar symptoms such as dizziness and imbalance. This study was to investigate the diagnostic values of neutrophil counts and neutrophil to lymphocyte ratio (NLR) in distinguishing patients with ACI from those with vertigo. METHODS: This retrospective study was performed and data were gathered from medical records of patients with vertigo symptoms from the Department of Emergency and Neurology Clinics who were admitted to the Fourth Affiliated Hospital Zhejiang University School of Medicine between August 2017 and January 2019. Of the 173 patients with vertigo symptoms, 111 non-ACI vertigo patients (vertigo group) and 62 cases diagnosed with ACI (ACI group) were enrolled in this study. The neutrophil counts, lymphocyte counts, platelet counts, NLR, and PLT to lymphocyte ratio (PLR) within 24 hours after admission were compared between the two groups. Student's t-test of independent samples was adopted for the comparison of the mean between two groups. The neutrophil counts and NLR were evaluated by comparing the areas under the receiver operating characteristic curve (AUC) in distinguishing patients with ACI from those with vertigo. Comparison of AUC was performed using the Z-test. RESULTS: The neutrophil counts and NLR were significantly increased in the ACI group compared with the vertigo group (all p < 0.05), while there were no significant statistical differences of the lymphocyte counts, platelet counts, and PLR (all p > 0.05); moreover, AUC in distinguishing patients with ACI from those with vertigo was 0.647 (95% confidence interval (CI), 0.570 to 0.718) for neutrophil counts and 0.639 (95% CI, 0.562 to 0.710) for NLR, but there was no significant statistical difference (p > 0.05); finally, the cutoff values were 3.1 x 109/L in distinguishing patients with ACI from those with vertigo (specificity 41.44% and sensitivity 83.87%) for neutrophil counts and 2 (specificity 55.86% and sensitivity 67.74%) for NLR. CONCLUSIONS: As easy-to-obtain inflammatory biomarkers, both neutrophil counts and NLR could demonstrate diagnostic values in distinguishing between ACI and vertigo.

Circulating miR-29b and miR-424 as Prognostic Markers in Patients with Acute Cerebral Infarction.

BACKGROUND: Down-regulation of miR-29b and miR-424 have been observed in patients with acute cerebral infarction (ACI); however, the clinical significance of circulating miR-29b and miR-424 as prognostic markers still requires further investigation. METHODS: A total of 45 patients diagnosed with ACI and 45 healthy volunteers were enrolled in this study, and the clinical information of the patients were collected. The serum samples of the participants were collected and stored at -80°C. The relative expression of miR-29b and miR-424 was determined using RT-qPCR, and the serum levels of IL-6, IL-4, TNF-α, and IFN-γ were measured using an enzyme-linked immunosorbent assay (ELISA) kits. The short-term prognosis of patients was evaluated using the Glasgow Outcome scale (GOS) at day 30. RESULTS: The serum levels of miR-29b and miR-424 were significantly lower in patients with ACI compared with the healthy controls (p < 0.01) and the serum level of IL-6, IL-4, and TNF-α were significantly up-regulated in patients with ACI (p < 0.05); moreover, using the Glasgow Outcome scale (GOS) as a prognostic index, it has been proved that the serum level of both miR-29b and miR-424 were positively associated with the short-term prognosis of the patients; finally, the expression of the circulating miR-29b and miR-424 were negatively correlated with the serum level of IL-6, IL-4, and TNF-α. CONCLUSIONS: Lower levels of circulating miR-29b and miR-424 in patients with acute cerebral infarction may predict poor prognosis, and the expression of circulating miR-29b and miR-424 are negatively correlated with the serum level of some pro-inflammatory cytokines, suggesting that circulating miR-29b and miR-424 may have the potential to become prognostic markers and therapeutic targets for the management of acute cerebral infarction.

SMAD1 Regulates the Hippocampal Neuronal Death and Ferroptosis via Affecting the Transcription of PDCD4 in Cerebral Ischemia.

Results of previous studies suggested that programmed cell death 4 (PDCD4) was overexpressed in cerebral ischemia (CI), and mothers against decapentaplegic homolog 1 (SMAD1) is a transcription factor of PDCD4, and it is also elevated in CI; however, the regulatory mechanism of SMAD1/PDCD4 axis in CI remains unclear. The current work has been designed to explore the role and associated mechanisms of SMAD1/PDCD4 in CI. PDCD4 and SMAD1 expressions have been examined by real-time reverse transcription-polymerase chain reaction (RT-qPCR) method, and receiver operating characteristic (ROC) curve analysis has been performed to determine the potential diagnostic value of PDCD4 and SMAD1. An oxygen-glucose deprivation (OGD) model has been used to investigate the effects of PDCD4 and SMAD1 on CI in vitro. Cell apoptosis was evaluated using TdT-mediated dUTP nick end labeling (TUNEL) assays. The interaction between SMAD1 and PDCD4 axis has been confirmed by using dual-luciferase reporter as well as chromatin immunoprecipitation (Ch-IP) assays. Finally, the effects of SMAD1/PDCD4 axis on the ferroptosis of neuron cells have been examined. PDCD4 was overexpressed in blood samples of CI patients. ROC analysis showed the AUC for PDCD4 was 0.7478, and NIHSS and MRS scores were positively correlated with PDCD4 expression. Moreover, the cellular OGD model was established and knockdown of PDCD4 suppressed the apoptosis of neurons. Besides, knockdown of PDCD4 also inhibited ferroptosis of OGD-treated neuron cells in vitro. Additionally, SMAD1 was upregulated in blood samples of CI patients, NIHSS and MRS scores were positively correlated with SMAD1 expression, and SMAD1 is a transcriptional factor of PDCD4, and SMAD1 could transcriptionally regulate the expression of PDCD4. Finally, SMAD1 could regulate the ferroptosis of neuron cells through regulating the transcription of PDCD4. The SMAD1/PDCD4 axis regulates the growth, apoptosis, and ferroptosis of neuron cells, suggesting that targeting the SMAD1/PDCD4 axis may be a potential therapeutic method.

Diagnostic values of leukocyte, neutrophil, and neutrophil to lymphocyte ratio in distinguishing central facial paralysis from peripheral facial paralysis.

OBJECTIVE: Misdiagnosis of central facial palsy (CFP) as peripheral facial palsy (PFP) can lead to serious consequences clinically. It is unknown whether the leukocyte counts (leukocyte), neutrophil counts (neutrophil), and neutrophil to lymphocyte ratio (NLR) can be used to distinguish CFP from PFP. METHODS: Of the total 152 patients admitted for acute facial paralysis, 76 CFP patients (CFP group) caused by acute ischemic stroke (AIS) and 76 PFP cases (PFP group) without AIS were enrolled in this retrospective study. The levels of blood leukocyte, neutrophil, lymphocyte, platelet counts (platelet), NLR, and platelet to lymphocyte ratio (PLR) before or upon admission were recorded and compared between the two groups. The student t-test was adopted for comparison of the mean. Model discrimination was evaluated using the area under the receiver operating characteristic curve (AUC). Comparison of AUC was performed using the Z-test. RESULTS: Compared with PFP group, the levels of leukocyte, neutrophil, and NLR were significantly increased in CFP group (all p < 0.01), and there were still significantly statistical differences (all p < 0.01), even after adjusting for age, gender, and past medical history, while no significantly statistical differences of lymphocyte, platelet, and PLR were found between CFP and PFP (all p > 0.05); furthermore, the AUC in distinguishing CFP from PFP were 0.629, 0.671, and 0.657 for leukocyte, neutrophil, and NLR, respectively, and no significant difference of AUC was observed among leukocyte, neutrophil, and NLR (p > 0.05); finally, the cutoff values (specificity, sensitivity, and Youden index) in distinguishing CFP from PFP were 7.08 × 109/L (65.79%, 57.89%, 0.237) for leukocyte, 4.90 × 109/L (73.68%, 60.53%, 0.342) for neutrophil, and 2.88 (72.37%, 55.26%, 0.276) for NLR, respectively. CONCLUSIONS: As easy-to-obtain and inexpensive inflammatory biomarkers, leukocyte, neutrophil, and NLR could demonstrate diagnostic values in distinguishing between CFP and PFP.

Diagnostic Values of Blood Urea Nitrogen (BUN), Creatinine (Cr), and the Ratio of BUN to Cr for Distinguishing Heart Failure from Asthma and Chronic Obstructive Pulmonary Disease.

Background: In clinical practise, it can be challenging to tell the difference between asthma and chronic obstructive pulmonary disease (COPD) and heart failure (HF), which share comparable dyspnea symptoms. We aimed to examine whether renal function indexes blood urea nitrogen (BUN), creatinine (Cr), and the ratio of BUN to Cr (BUN/Cr) can be used to distinguish HF from asthma and COPD. Methods: A total of 170 patients were admitted for dyspnea symptoms in this retrospective study. There are 69 patients with HF (HF group), 50 patients with asthma (asthma group), and 51 patients diagnosed with COPD (COPD group). The levels of BUN, Cr, and the ratio of BUN/Cr in the three groups were compared. Student's t-test or the one-way analysis of variance (ANOVA) test was used to compare means. Using the area under the receiver operating characteristic curve, model differentiation was evaluated (AUC). Z-test comparisons of AUC were carried out. Results: Compared with the asthma/COPD group (asthma group + COPD group) or the COPD group, the levels of BUN and Cr were raised in the HF group, while there was no significant difference of the BUN/Cr ratio. Compared with those in the asthma group, the levels of BUN, Cr, and BUN/Cr ratio were significantly increased in the HF group (all p < 0.05), whereas no significant differences of BUN, Cr, and BUN/Cr ratio were found between asthma and COPD. The AUC in distinguishing HF from asthma/COPD were 0.736 and 0.751 for BUN and Cr, respectively, and no significant difference was observed between BUN and Cr. The cutoff values (specificity, sensitivity, and Youden index) in distinguishing between HF and asthma/COPD were 20.45 mg/dL (79.21%, 56.52%, and 0.357) for BUN and 0.782 mg/dL (72.28%, 68.12%, and 0.404) for Cr, respectively. Conclusions: BUN and Cr showed accurate and reliable diagnostic values which could be potential biomarkers for differentiating HF from asthma and/or COPD.

Magnetic Resonance Imaging Features of Cerebral Infarction in Critical Patients Based on Convolutional Neural Network.

The clinical application of the artificial intelligence-assisted system in imaging was investigated by analyzing the magnetic resonance imaging (MRI) influence characteristics of cerebral infarction in critically ill patients based on the convolutional neural network (CNN). Fifty patients with cerebral infarction were enrolled and examined by MRI. Besides, a CNN artificial intelligence system was established for learning and training. The features were extracted from the MRI image results of the patients, and then, the data were calculated by computer technology. The gray-level cooccurrence matrix (GLCM) of T1-weighted images was 0.872 ± 0.069; the reasonable prediction (ALL) result was 0.766 ± 0.112; the gray-level run-length matrix (GLRLM) was 0.812 ± 0.101; the multigray-level area size matrix (MGLSZM) result was 0.713 ± 0.104; and the result of gray-scale area size matrix (GLSZM) was 0.598 ± 0.099. The GLCM, ALL, GLRLM, MGLSZM, and GLSZM of enhanced T1-weighted images were 0.710 ± 0.169, 0.742 ± 0.099, 0.778 ± 0.096, 0.801 ± 0.104, and 0.598 ± 0.099, respectively. The GLCM, ALL, GLRLM, MGLSZM, and GLSZM of T2-weighted images were 0.780 ± 0.096, 0.798 ± 0.087, 0.888 ± 0.086, 0.768 ± 0.112, and 0.767 ± 0.100, respectively. In short, the image diagnosis method that could reduce the subjective visual judgment error to a certain extent was found by analyzing the characteristics of MRI images of critically ill patients with cerebral infarction based on CNN.

MicroRNA-424 alleviates neurocyte injury by targeting PDCD4 in a cellular model of cerebral ischemic stroke.

Cerebral ischemic stroke is the primary cause of stroke-associated mortality and disability, and current therapeutic options are limited and ineffective. The present study aimed to investigate the potential of apoptotic therapy and the role of microRNA (miR)-424 in cerebral ischemic stroke. PC12 cells, a cloned cell line from rat adrenal pheochromocytoma, were treated with CoCl2 to construct a cellular ischemia model. mRNA and protein levels of programmed cell death protein 4 (PDCD4), Bcl-2, Bax, caspase-3, PI3K and AKT were evaluated using reverse transcription-quantitative PCR and western blot analyses, respectively. Cell Counting Kit-8 assays were performed to examine cell viability in the ischemia model. Flow cytometry was conducted to evaluate the apoptosis of ischemic cells. Furthermore, a luciferase assay was performed to verify the target gene of miR-424. It was revealed that the expression level of miR-424 was downregulated in the ischemia model, while the expression of PDCD4 was upregulated. Moreover, the expression of miR-424 was increased after treatment with miR-424 mimics. The mRNA and protein expression of PDCD4 was upregulated after transfection with pcDNA3.1-PDCD4. PDCD4 was predicted and demonstrated to be a target of miR-424. Notably, overexpression of miR-424 increased cell viability and inhibited apoptosis in the ischemia model, which was reversed by co-treatment with pcDNA3.1-PDCD4. Furthermore, overexpression of miR-424 regulated the expression of PDCD4, Bax, Bcl-2, phosphorylated-PI3K/AKT and caspase-3, which was restored after co-transfection with pcDNA3.1-PDCD4. Collectively, the results indicated that miR-424 regulated the progression of cerebral ischemic stroke in a cellular model by targeting PDCD4.

Function and mechanism of microRNA-210 in acute cerebral infarction.

Acute cerebral infarction (ACI) is a common cerebrovascular disease. Previous studies have indicated that microRNAs (miRs) are aberrantly expressed in patients with ACI. However, the functions of miRs in the pathogenesis of ACI still require further investigation. The aim of the present study was to investigate the function of miR-210 in ACI and its associated mechanism. The expression of miR-210 in the serum of 40 patients with ACI and 40 normal controls was examined using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Then, human umbilical vein endothelial cells (HUVECs) were treated with serum from patients with ACI or healthy volunteers, and a CCK-8 assay was performed to examine cell proliferation. Next, cells were stained with PI/Annexin V, and the apoptosis rate was examined using flow cytometry. Furthermore, cells were harvested and lysed, and RT-qPCR and western blotting assays were performed to compare the expression of vascular endothelial growth factor (VEGF), Notch1 and Hes1 in different groups. It was observed that the expression of miR-210 was significantly increased in the serum of patients with ACI compared with normal controls (P<0.01), and receiver operating characteristic curve analysis indicated that the area under the curve for miR-210 was 0.799 (95% confidence interval, 0.700-0.899), the optimum cut-off point was 1.397, and the sensitivity and specificity at the cut-off point were 62.5 and 87.5%, respectively. Furthermore, serum from patients with ACI induced a significant increase in proliferation (P<0.05 at 48 h, P<0.01 at 72 h) and a significant decrease in the apoptosis rate of HUVECs (P<0.01). In addition, serum from patients with ACI significantly increased the expression of VEGF, Notch1 and Hes1 at the mRNA and protein level (all P<0.01 with the exception of Notch1 mRNA expression, P>0.05). In conclusion, these results demonstrate that miR-210 is upregulated in the serum of patients with ACI, and miR-210 may be involved in the pathogenesis of ACI through regulating the proliferation and apoptosis of endothelial cells.