Sirt3-Bnip3 signaling axis alleviates myocardial ischemia/reperfusion-induced cardiac injury via regulating GSDME.

Rutin and skeletal muscle ischemia-reperfusion injury: Effects of acute treatment.

Liquiritigenin alleviates high-salt diet-induced heart damage by inhibiting TGF-β1/Smad signaling and reducing inflammation and fibrosis.

Immune deficiency and dysregulation (IDD)-associated classical Hodgkin lymphoma (cHL) is one of the common subtypes of IDD-related lymphomas. Patients with IDD-cHL are typically treated with the same chemotherapeutic regimens as those with sporadic cHL. However, the clinical differences between these groups remain poorly elucidated. To assess the impact of immune status on clinical features and treatment outcomes, 44 patients who were newly diagnosed with cHL and treated at our institution, including 12 with IDD-cHL, were retrospectively analyzed. Epstein-Barr virus-encoded small RNA positivity was significantly more common in patients with IDD-cHL than in those with sporadic cHL. Nevertheless, the baseline laboratory parameters did not significantly differ between the two groups. Patients with IDD-cHL had significantly higher rates of neutropenia than those with sporadic cHL, resulting in reduced relative dose intensity. However, the two groups were similar in terms of complete response and progression-free survival rates. Based on a prognostic analysis, serum lactate dehydrogenase (LDH) and soluble interleukin-2 receptor (sIL-2R) levels were associated with prognosis. However, their prognostic implications were contrasting in the two immune status groups. To integrate these markers, the prognostic value of the sIL-2R-to-LDH ratio (cutoff: 3.58) was evaluated. A higher ratio was significantly associated with poorer prognosis in sporadic cHL (p < 0.01). Meanwhile, in IDD-cHL, a lower ratio was associated with worse outcomes (p = 0.07). According to these findings, the overall clinical presentation of cHL and the efficacy of its treatment are significantly consistent regardless of immune status. However, the prognostic significance of specific biomarkers is distinct. The sIL-2R-to-LDH ratio may represent a broadly applicable prognostic marker, and its interpretation should be adapted according to the patient's immune background.

Serum lactate dehydrogenase (LDH) is a recognized prognostic biomarker in human lymphomas, yet its clinical significance in canine lymphoma remains insufficiently characterized. This study aimed to quantify serum LDH levels in healthy dogs and dogs with high-grade multicentric lymphoma (ML) (predominantly B-cell) and to investigate correlations between LDH levels and established clinical and laboratory prognostic indicators. Twenty-seven dogs were prospectively enrolled: healthy controls (G1, n = 7) and dogs with high-grade ML (G2, n = 20). Immunophenotyping was performed by immunohistochemistry (CD3/CD79a). LDH concentrations were measured at diagnosis (T0) and after six weeks of CHOP-based induction chemotherapy (T1). Statistical analyses included Kruskal-Wallis, Wilcoxon signed-rank, Pearson's correlation, and mixed-effects models. Dogs with high-grade ML exhibited significantly elevated LDH levels compared to controls (median 545.5 U/L, range: 288.2-2816 U/L vs. 143 U/L, range: 66-272; p < 0.001). Dogs with thrombocytopenia had higher baseline LDH (median 746 U/L, range: 612-921; p = 0.006) and greater reductions following chemotherapy (median -1011.7 U/L, range: -159 to -2064; p = 0.004). LDH levels declined significantly after treatment (overall median reduction 50.7%; post-chemotherapy range: 60.4-752 U/L; n = 15; p = 0.013), with normalization achieved in 77.8% of dogs with complete response versus 16.7% with partial or progressive disease (p = 0.02). We confirmed that serum LDH is significantly elevated in dogs with high-grade ML and declines following effective chemotherapy, supporting its utility as a dynamic biomarker of tumor burden and treatment response. Thrombocytopenic dogs may represent a biologically distinct subset warranting further investigation.

As a natural flavonoid, the flavonoid luteolin is characterized by its powerful antioxidant and anti-inflammatory effects. While its precise mechanisms require further elucidation, existing evidence confirms its efficacy in ameliorating myocardial ischemia-reperfusion injury (MIRI). This research was designed to investigate the mechanism through which luteolin protects against MIRI. We established MIRI rat models through the ligation of left anterior descending coronary artery (LAD). To evaluate the cardioprotective effects of luteolin, echocardiographic analysis was performed, Hematoxylin and Eosin (HE) staining, and serum cardiac injury markers creatine kinase-MB (CK-MB) and lactate dehydrogenase (LDH). Cardiac vascular permeability was determined using Evans blue staining. To mimic ischemia-reperfusion injury, endothelial cells (ECs) were subjected to oxygen-glucose deprivation/reoxygenation (OGD/R) in vitro. Endothelial cell barrier function was evaluated through F-actin phalloidin staining and FITC-Dextran fluorescence leakage experiments. To elucidate the molecular mechanism, FOXP1 small interfering RNA (siRNA) and NLRP3 inhibitor MCC950 were administered. In MIRI rats, luteolin significantly improved cardiac function and preserved endothelial barrier integrity. These effects were associated with upregulation of FOXP1 and suppression of NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome. In OGD/R-treated endothelial cells, luteolin restored barrier function and cell viability. The protective effects of luteolin were abolished after FOXP1 silencing. Pharmacological NLRP3 inhibition (MCC950) mirrored luteolin's protection. Our study indicates that luteolin enhances endothelial barrier function and attenuates MIRI via the FOXP1-NLRP3 pathway. The current study provides a potential drug for MIRI treatment.

BackgroundImmune checkpoint inhibitors (ICIs) have emerged as a pivotal treatment for advanced esophageal squamous cell carcinoma (ESCC). However, their efficacy can significantly differ among patients, highlighting the need for reliable prognostic markers to enhance treatment outcomes. Lactate dehydrogenase (LDH) plays a key regulatory role in the complex relationship between cancer metabolism and the immune system, suggesting that monitoring LDH levels may provide valuable insights into treatment efficacy and inform personalized therapeutic strategies for advanced ESCC.ObjectiveThis study aimed to explore the prognostic significance of dynamic changes in LDH levels during ICI therapy in predicting treatment outcomes.MethodsWe retrospectively analyzed the clinical data of 126 patients with advanced ESCC who received first-line ICI therapy at the Department of Radiation Oncology, Cancer Center, Shandong Provincial Hospital, between April 2018 and November 2022. Serum LDH levels were measured after every 3 cycles of combined immunotherapy and chemotherapy. Receiver operating characteristic curve analysis determined the optimal LDH reduction threshold. Kaplan-Meier survival curves and Cox regression models assessed progression-free survival (PFS) and overall survival.ResultsAmong the 126 patients, 55 (43.6%) were classified into the LDH-increased group, while 71 (56.4%) belonged to the LDH-decreased group. Within the LDH-increased group, 78.2% (43/55) of the patients were male, compared to 90.1% (64/71) in the LDH-decreased group. The median age of patients in the LDH-increased group was 59 (range 55‐68) years, whereas the median age in the LDH-decreased group was 65 (range 58‐65) years. LDH decrease following first-line ICI therapy was associated with improved outcomes compared to LDH increases (median PFS 13.4, IQR 8.1‐24.3 mo vs median 10.8, IQR 4.8‐20.6 mo; P= .03). Patients with a posttreatment LDH decrease of more than 14.4% had a median PFS of 11.1 (IQR 7.2‐24.3) months, whereas those with an LDH decrease between 0% and 14.4% had a median PFS of 21.7 (IQR 9.4‐34.5) months. Conversely, an increase in LDH resulted in a median PFS of 10.8 (IQR 4.8‐20.6) months. Patients with tumor reduction exhibited a significantly greater decrease in LDH levels compared with those without tumor reduction (P<.001). Multivariate analysis identified LDH decrease as an independent predictor of a 41% lower mortality risk (hazard ratio 0.59, 95% CI 0.36‐0.96; P=.04).ConclusionsIn patients with advanced ESCC, a decrease in serum LDH levels ranging from 0% to 14.4% after treatment initiation was significantly associated with prolonged PFS. Notably, an early decrease in LDH levels observed after 3 cycles of immunotherapy further correlated with improved clinical outcomes. These results highlight the potential of LDH as a valuable biomarker for risk stratification and personalized treatment optimization in advanced ESCC.

To determine whether baseline ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) radiomic markers of thoracic tumor burden and metabolic heterogeneity predict early progression and overall survival (OS) in patients with small cell lung cancer (SCLC) receiving first-line platinum-etoposide chemotherapy. We retrospectively analyzed 45 patients with SCLC who underwent baseline ¹⁸F-FDG PET/CT before chemotherapy. Radiomic features were extracted from thoracic tumor volumes, including metabolic tumor volume (MTV), total lesion glycolysis (TLG), standardized uptake value (SUV) histogram parameters, and gray-level co-occurrence matrix (GLCM) metrics. Univariable and multivariable Cox regression assessed associations with progression-free survival (PFS) and OS. Receiver operating characteristic (ROC) analysis, with area under the ROC curve (AUC), assessed discriminatory ability for early progression (PFS < 6 months) and short-term mortality (OS < 12 months). Higher log-transformed TLG (logTLG) was correlated with shorter PFS and OS in univariable analysis. In multivariable models, logTLG independently predicted PFS (hazard ratio [HR] 2.20, 95% confidence interval [CI] 1.12-4.30; p = 0.021) and OS (HR 2.54, 95% CI 1.24-5.20; p = 0.011). Age (HR 1.07 per year; 95% CI 1.02-1.12, p = 0.007) and stage IV vs. III (HR 2.46, 95% CI 1.06-5.71; p = 0.037) were additional OS predictors. GLCM texture features were not significant. ROC analysis showed MTV (AUC 0.88) and serum lactate dehydrogenase (LDH) (AUC 0.74) best predicted early progression, while age (AUC 0.79), stage (AUC 0.73), and SUV entropy (AUC 0.75) predicted short-term mortality. Kaplan-Meier curves confirmed poorer survival with high logTLG, advanced stage, and older age. Baseline thoracic PET/CT radiomics, particularly logTLG, independently predict survival in SCLC. MTV and LDH identify early progression, while age, stage, and SUV entropy predict short-term mortality, supporting integrated imaging-clinical risk stratification.

To identify pretreatment factors associated with developing primary resistance to nivolumab plus ipilimumab therapy in patients with advanced renal cell carcinoma (RCC). We retrospectively reviewed the clinical characteristics, laboratory data, and tumor-related factors in patients with advanced RCC who initiated nivolumab plus ipilimumab as first-line therapy between January 2018 and July 2021. Primary resistance was defined as radiographic or clinical progression within 3months of treatment initiation. Cases with suspected pseudoprogression were excluded. Eighty-nine patients met the inclusion criteria; 23 exhibited primary resistance. Univariate analysis identified the following significant predictive factors: body mass index (P=.006), lymph node metastasis (P=.021), sarcomatoid differentiation (P=.035), solitary metastatic organ (P=.051), liver metastasis (P=.056), and serum lactate dehydrogenase (LDH) (P=.094). Receiver operating characteristic curve analysis determined an LDH cutoff value of 174U/L, which was significantly associated with primary resistance (P=.029). Considering the number of primary resistance cases, multivariable analysis incorporated three candidate variables (lymph node metastasis, sarcomatoid differentiation, and LDH≥174U/L) and identified sarcomatoid differentiation (odds ratio, 4.264; 95% confidence interval (CI), 1.299-14.825; P=.017) and LDH≥174U/L (odds ratio, 3.634; 95% CI, 1.143-13.770; P=.028) as independent predictors of primary resistance. Sarcomatoid differentiation on pretreatment biopsy or elevated serum LDH before treatment initiation may predict primary resistance to nivolumab plus ipilimumab therapy in patients with advanced RCC. Alternative regimens should be considered in such cases, particularly for patients who are likely to experience rapid disease progression or for whom the occurrence of P-res is not clinically acceptable.

Objective: To investigate the correlations between the serum levels of lactate dehydrogenase (LDH), β₂‐microglobulin (β₂‐MG), and free light chains (FLCs) and the prognosis of patients with multiple myeloma (MM). Method: This retrospective study included 80 patients diagnosed with MM (MM group) at Affiliated Hospital of Hebei University between January 2020 and January 2024, and 100 healthy individuals (control group) undergoing routine physical examinations during the same period. Prognosis was assessed using the Eastern Cooperative Oncology Group (ECOG) performance status scale. Patients with a ZPS score &gt; 3 (n = 22) were classified into the poor prognosis (PP) group, while those with a ZPS score ≤ 3 (n = 58) were assigned to the favorable prognosis (FP) group. Serum levels of LDH, β₂‐MG, and FLCs were compared among the three groups, and the relationships between these biomarkers and the clinical characteristics of MM were analyzed. Results: Of 424 participants the cumulative continuation rates for year 1,2 and 3 were 91.9%, 82.7% and 75% respectively and 106 (25%) removals at the end of year 3. Doctors counselling played role in choosing implant in 177(41.7%) patients. Continuation was higher among women with prior contraceptive knowledge AOR: 3.73; 95% CI (1.20-6.21), previous contraceptive use AOR: 8.1; 95%CI (4.2-31.1), and antenatal counselling AOR: 2.24; 95% CI (1.16-3.54). The most common reasons for discontinuation were side effects in 77(45.2%) and family pressure 55(32.3%) patients. Women with no side effects were 18 times more likely to continue AOR: 18.1; 95% CI (7.5-48). Conclusion: Elevated serum levels of LDH, β₂‐MG, and FLC are risk factors for poor prognosis in patients with MM. Combined assessment of these three biomarkers may improve clinical evaluation and prognostic stratification.

This study aimed to evaluate the cardioprotective effects of total flavonoids of Dragon's blood (TFDB) on myocardial ischemia-reperfusion injury (MIRI) using advanced ultrasound imaging techniques. Twenty-four healthy New Zealand rabbits were randomly divided into observation (TFDB treatment) and control groups (n = 12 each). The observation group received TFDB (180 mg/kg) orally for 14 days prior to model establishment, while the control group received physiological saline. MIRI was induced via ligation and recanalization of the left anterior descending coronary artery. Hemodynamic parameters, including heart rate (HR) and left ventricular systolic pressure (LVSP), were recorded at baseline (t0), immediate reperfusion (t1), and subsequent intervals up to 120 min (t5). Successful MIRI modeling was confirmed in 10 rabbits per group. TFDB-treated rabbits demonstrated significantly higher HR and LVSP at t4 and t5 (p < 0.05). Serum creatine kinase-MB and lactate dehydrogenase levels were significantly lower in the TFDB group at t4 and t5 (p < 0.05). At t5, the TFDB group showed significantly higher circumferential strain and ejection fraction values (p < 0.05). Ultrasound microbubble imaging revealed significantly higher video intensity and myocardial blood flow (A × β) in the TFDB group at t5 (p < 0.05). TFDB demonstrated significant cardioprotective effects in MIRI. Ultrasound microbubble imaging combined with speckle tracking technology provides an effective approach for assessing these cardioprotective effects.

Inflammasomes, including NLRP3 (nucleotide-binding oligomerization domain, leucine-rich repeat, and pyrin domain-containing protein 3), participate in regulating immune activation and inflammation. Nonetheless, their specific roles in muscle contusion, one of the most common forms of sports injury, remain unknown. To address this, we investigated the role of NLRP3 in muscle contusion in Nlrp3-knockout (KO) mice, using a model of mass-drop injury (MDI)-induced contusion of the gastrocnemius muscle. Wild-type (WT) and Nlrp3-KO mice were assigned to four experimental groups: (1) WT-N: wild-type without MDI (control); (2) NLRP3-N: Nlrp3-KO without MDI; (3) WT-I: WT with MDI; and (4) NLRP3-I: Nlrp3-KO with MDI. Following MDI, tissue and serum samples were collected at 0, 48, 96, and 192 h. Muscle injury, recovery, and the extent of inflammation were evaluated by measuring body and muscle weight, serum biochemical markers, complete blood counts, and via histopathological immunohistochemical analysis. In the early phase following contusion, muscle weight was lower in the NLRP3-I group than in the WT-I group; however, in the later stages, it was significantly greater in the NLRP3-I group. Serum aspartate aminotransferase, lactate dehydrogenase, and creatine kinase were significantly lower in the NLRP3-I group than in the WT-I group, indicating reduced muscle damage following Nlrp3 knockout. The white blood cell and neutrophil counts were markedly higher in the WT-I group than in the NLRP3-I group. Based on histopathology, the NLRP3-I group exhibited less severe muscle injury, reduced tumor necrosis factor (TNF)-α, interleukin (IL)-6, CD68, CD206 and Caspase-3 expression, and reduced fibrosis, indicating a diminished contusion-induced inflammatory response and improved regeneration relative to the WT-I group. Nlrp3 knockout thus ameliorated contusion-induced muscle injury and inflammation. We hypothesize that NLRP3 regulates TNF-α and IL-6, with Nlrp3 downregulation reducing contusion-related muscle damage and fibrosis. NLRP3 thus represents a promising therapeutic target for treating sports injuries and for rehabilitation.

Effect of oral administration of Bacillus subtilis spores displaying Vibrio harveyi FlgE protein inducing protective immune responses in grouper.

Crotalaria assamica Benth alleviated acetaminophen-induced liver injury through the upregulation of Nrf2 pathway.

Background: In acute ischemic stroke, reduced oxygen supply may trigger metabolic acidosis and cellular injury. Lactate dehydrogenase (LDH), as an intracellular enzyme, helps generate energy by converting pyruvate to lactate in glycolysis. This study aimed to examine the correlation between serum LDH levels and the National Institutes of Health Stroke Scale (NIHSS) score at the onset of treatment among patients with acute ischemic stroke.Methods: This analytical observational study used cross-sectional design, involving patients with acute ischemic stroke hospitalized at Dr. Soetomo Surabaya Hospital, Indonesia, between February and May 2023. Participants were selected using consecutive sampling. Serum LDH levels and NIHSS score were measured upon admission. The correlation between LDH levels and NIHSS score was analyzed using the Spearman test, with statistical significance set at p&lt;0.05. Results: A total of 30 patients were included, of whom 16 (53.3%) were male. A significant correlation was found between LDH levels and NIHSS scores (p=0.001). The correlation coefficient (r=0.785) indicated a strong positive correlation between serum LDH levels and stroke severity.Conclusions: This study demonstrates a strong positive correlation between LDH levels and NIHSS scores at the onset of acute ischemic stroke treatment. These findings suggest that LDH may serve as a practical early biomarker for assessing stroke severity. Integrating LDH measurement into initial evaluation may facilitate faster risk stratification and support timely clinical decision-making. Further studies with larger sample sizes are needed to validate its prognostic role in routine practice.

This study investigates the expression features of serum lactate dehydrogenase (LDH) in patients with large cell neuroendocrine carcinoma of the lung (LCNEC) and evaluates its clinical prognostic significance. A prospective cohort study was conducted, enrolling 80 LCNEC patients admitted between January 2022 and January 2024 (case group) and 80 healthy individuals undergoing medical check-ups during the same period (control group). Serum LDH levels were quantitatively measured by enzyme-linked immunosorbent assay (ELISA). Independent risk factors for poor prognosis were analyzed using a Multifactorial Logistic Regression (MLR) model. The prognostic predictive capability of LDH was assessed with the receiver operating characteristic (ROC) curve. Serum LDH levels in the case group were notably higher than those in the control group (p < 0.05). Subgroup analysis revealed that LDH levels of patients with tumor maximum diameter ≥5 cm, low variation, stage III-IV, and lymph node metastasis were significantly higher than those of the equivalent reference groups (all p < 0.05). The poor prognosis group had higher LDH expression levels and lymph node metastasis rates compared to the good prognosis group (both p < 0.05). MLR revealed that LDH (OR = 2.130, 95% CI: 1.312-3.465) and lymph node metastasis were autonomous predictors of poor prognosis (both p < 0.05). ROC analysis indicated that LDH predicted prognosis with an AUC of 0.825 (95% CI: 0.752-0.898), an optimal critical value of 280.5 U/L, a sensitivity of 75.0%, and a specificity of 78.0%.Serum LDH levels were abnormally elevated in LCNEC patients and significantly correlated with tumor malignancy features, which can act as a valid biological marker for assessing disease prognosis.

Introduction . The exacerbation of chronic cytomegalovirus (CMV) infection in women during gestation often leads to altered liver function in their offspring. This may initiate activation of enzymes – markers of cytolysis, cholestasis and glycolysis – which affect the reflex sphere, excitation and inhibition processes in the brain. Considering the important role of liver enzymes in the regulatory mechanisms of the central nervous system, the relationship between biochemical parameters of the liver in cerebral ischemia of varying severity in offspring of mothers who suffered an exacerbation of chronic CMV infection during gestation has not been studied to date. Aim . To assess the functional state of the liver in cerebral ischemia of varying severity in newborns from mothers with exacerbation of chronic CMV infection in the second trimester of pregnancy. Materials and methods . The study involved assessing the activity of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transferase, and lactate dehydrogenase in umbilical cord serum from 42 newborns with an uncomplicated antenatal history (control group) and 68 newborns with cerebral ischemia that developed against the background of exacerbation of chronic CMV infection in their mothers in the second trimester of gestation (main group). Depending on the severity of perinatal brain injury, two subgroups were identified: the first – 36 newborns with grade I cerebral ischemia; the second – 32 newborns with grade II cerebral ischemia. Depending on the severity of perinatal brain damage, two subgroups were identified: the first – 36 newborns with cerebral ischemia of the first degree; the second – 32 newborns with cerebral ischemia of the second degree. Results . In the first subgroup of the main group, compared with the control group, lower Apgar scores at 1 minute (p &lt;0.001) and 5 minutes (p &lt;0.001), as well as lower birth weight (p &lt;0.01), were recorded. At the same time, no differences in the activity of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and gamma-glutamyl transferase were detected in the blood serum from the umbilical vein against the background of an increase in lactate dehydrogenase levels. Newborns in the second subgroup, compared with both the control group and the first subgroup, showed a decrease in Apgar scores at 1 minute (p &lt;0.001) and 5 minutes (p &lt;0.001), as well as birth weight (p &lt;0.01 and p &lt;0.001, respectively). Biochemically, newborns in the second subgroup, compared with the first subgroup, showed higher levels of aspartate aminotransferase (p &lt;0.05), alkaline phosphatase (p &lt;0.05), gamma-glutamyl transferase (p &lt;0.01), and lactate dehydrogenase (p &lt;0.05). Conclusion . Grade II cerebral ischemia in newborns of mothers with exacerbation of chronic CMV infection during the second trimester of pregnancy, compared with grade I cerebral ischemia in newborns under similar antenatal ontogenetic conditions, is characterized by more pronounced cytolysis, cholestasis, and glycolysis activation. This reflects the negative impact of intrauterine hypoxia associated with more severe cerebral pathology in newborns from mothers with exacerbation of chronic CMV infection during the second trimester of gestation.

Background The diagnosis of immune thrombocytopenia (ITP) relies on clinical manifestations, as no definitive gold standard exists. Serum lactate dehydrogenase (LDH) is emerging as a potential biomarker for diagnosing severe ITP. We evaluated the diagnostic utility of LDH and its correlation with clinical severity in ITP patients. Methods This prospective observational study included 62 patients diagnosed with primary or secondary ITP. Baseline demographic and clinical data were collected, and serum LDH along with platelets were analyzed at recruitment. The diagnostic utility of serum LDH in distinguishing severe from non-severe ITP was evaluated. Results A total of 62 patients with ITP were studied, 64.5% had severe thrombocytopenia and 35.4% had non-severe thrombocytopenia. The median serum LDH level was significantly higher in severe ITP (276 [216–307]) compared to non-severe ITP (209 [184–275]), p=0.03. LDH showed a negative correlation with platelet count (ρ = -0.817, p = 0.01) and plateletcrit (p = -0.26, p = 0.03), while no correlation was observed with MPV. The cut-off value of LDH was 234U/L, with a specificity of 62.5% and sensitivity of 63.6%, respectively for diagnosing severe thrombocytopenia. Conclusion There was a significant elevation of serum LDH levels in patients with severe ITP compared to non-severe ITP.

Aim Symptomatic carotid artery stenosis (SCAS) patients face a high risk of ischemic stroke (IS) recurrence. This study evaluates the prognostic value of the serum lactate dehydrogenase (LDH)-to-albumin ratio (L/A) for predicting IS recurrence among SCAS patients. Methods In this retrospective study (January 2020-January 2023), 307 conservatively managed SCAS patients were stratified into non-recurrence (n = 238) and recurrence (n = 69) groups based on 24-month follow-up. Serum LDH and albumin were measured, and L/A was calculated. Relationships between L/A and plaque neovascularization-related parameters (peak intensity, AUCTC, CAS rate) were assessed using Pearson correlation. Independent risk factors were determined with multivariate Cox regression, while the predictive performance and risk stratification of L/A were evaluated with ROC and Kaplan-Meier curves. Results Significant differences existed in age, hypertension, hyperlipidemia, systolic blood pressure, low-density lipoprotein cholesterol, albumin, peak intensity, AUCTC, CAS rate, vulnerable plaques, and medication adherence between the two groups. Recurrent patients exhibited higher L/A (p < 0.005). L/A correlated positively to peak intensity (r = 0.323), AUCTC (r = 0.450), and CAS rate (r = 0.529; all p < 0.001). Hyperlipidemia, vulnerable plaques, peak intensity, CAS rate, and elevated L/A were independent risk factors for IS recurrence in SCAS patients. L/A could assist in predicting IS recurrence in SCAS patients (AUC: 0.801; sensitivity: 63.77%; specificity: 85.71%). High L/A significantly increased 2-year recurrence risk in SCAS patients. Conclusion Elevated L/A potentially aids in predicting IS recurrence in SCAS patients and correlates to plaque neovascularization.

On a global scale, stroke ranks as the second biggest killer and the third most prevalent cause of disability. Metabolic acidosis occurs when oxygen is not present in the blood after an ischemic stroke. The purpose of this research was to show that acute ischemic stroke patients treated at Surabaya's Dr. Soetomo General Hospital had an association between their lactate dehydrogenase (LDH) serum level and their ASPECTS score before treatment began. Sampling was conducted using consecutive admissions methods. The ASPECTS score and LDH serum examination were assessed and taken upon admission. Thirty individuals were enrolled in the trial; sixteen (53.3%) were male and fourteen (46.7%) were female. The results demonstrate a relationship or correlation between LDH and ASPECT Score according to the Spearman test. The p-value is 0.003, which is less than 0.05, indicating a meaningful relationship or correlation between LDH and ASPECTS Score based on statistical tests. The r-value of -0.279 indicates a weak inverse relationship (27.9% strength) between the ASPECT score variable and LDH, according to the results of the correlation test. The relationship between LDH and ASPECT Score is negative, where if the ASPECT score value is high, the LDH value will be low, and vice versa. In conclusion, this study demonstrates a statistically significant (p = 0.003) but weak inverse correlation (r = -0.279) between serum LDH levels and ASPECT scores in acute ischemic stroke patients.