BACKGROUND Hemorrhagic transformation (HT) is a common complication in patients with cerebral infarction. However, its pathogenesis is poorly understood. The knowledge of factors that may increase risk for HT may help in improving the safety of thrombolytic therapy. AIM To investigate the predictive value of serum calcium, albumin, globulin and matrix metalloproteinase-9 (MMP-9) levels for HT after intravenous thrombolysis (IVT) in patients with acute cerebral infarction. METHODS Five hundred patients with acute cerebral infarction who received IVT with alteplase within 4.5 h after the onset of disease between January 2018 and January 2021 at our hospital were selected as the study subjects. They were divided into groups based on computed tomography scan results of the brain made within 36 h after thrombolysis. Forty patients with HT were enrolled in an observation group and 460 patients without HT were enrolled in a control group. Serum calcium, albumin, globulin and MMP-9 levels were compared between the two groups. Regression analysis was used to discuss the relationship between these indices and HT. RESULTS The previous history of hypertension, diabetes, atrial fibrillation, cerebrovascular diseases, smoking and alcohol intake were not associated with HT after IVT in patients with acute cerebral infarction (all P > 0.05). The National Institutes of Health stroke scale (NHISS) score was associated with HT after IVT in patients with acute cerebral infarction ( P < 0.05). The serum calcium and albumin levels were lower in the observation group than in the control group (all P < 0.05). The levels of globulin and MMP-9 were significantly higher in the observation group than in the control group (all P < 0.05). Logistic regression analysis showed that NHISS score, serum calcium, albumin, globulins and MMP-9 were independent factors influencing the occurrence of HT following IVT in patients with cerebral infarction ( P < 0.05). CONCLUSION Serum calcium, albumin, globulin and MMP-9 levels are risk factors for HT after IVT in patients with acute cerebral infarction. Moreover, NHISS score can be used as a predictor of post-thrombolytic HT.

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The aim of this study was to investigate imaging features of magnetic resonance imaging (MRI), pathological features of thrombus, and expression of nucleotide-binding oligomerization domain-like receptors protein 3 (NLRP3) inflammasome in acute ischemic stroke (AIS). Their relationship with the prognosis of patients was also explored. Sixty patients with AIS admitted to the hospital were selected as the observation group, and 20 healthy objects were in the control group. The shape of the thrombus was observed by MRI, pathological features of the thrombus were observed under hematoxylin-eosin (HE) staining, and the levels of NLRP3 inflammasome and inflammatory factors in serum were detected. The MRI-T2 weighted imaging (T2WI) signal ratio and plaque enhancement rate in the observation group were higher than those in the control group significantly ( P < 0.05 ). In the observation group, the red/mixed thrombus in 6–12 h and 24 h were also much higher than that in 6 h ( P < 0.05 ). The levels of NLRP3, interleukin-1β (IL-1β), interleukin-18 (IL-18), and tumor necrosis factor-α (TNF-α) in the observation group were higher than those in the control group in 6 h, 6–12 h, and 24 h ( P < 0.05 ), and those reached the highest levels in 24 h. The ratio of fibrins/platelets in the cardiogenic thrombus reached (63.8 ± 15.6) %, which was significantly higher than that in the large-artery atherosclerotic thrombus (49.5 ± 14.2) %, P < 0.05 . The ratio of red blood cells (RBCs) in the large atherosclerotic thrombus was (30.7 ± 14.3) %, considerably lower than (42.9 ± 15.2) %, P < 0.05 . The prognosis of patients with the fibrin/platelet-rich thrombus was highly lower than that with the RBC-rich thrombus ( P < 0.05 ). The levels with poor prognosis were higher than those with good prognosis ( P < 0.05 ). MRI could be used to assist in the assessment of brain conditions in patients with AIS. NLRP3 inflammasome was involved in the inflammatory response of AIS and can be used for predicting the poor prognosis, having a certain clinical application value. In addition, different types of thrombi also laid a certain impact on prognosis.

Blockchain is a new and popular technology in the digital age. Blockchain technology is referred to as decentralised and distributed digital ledgers, which are called blocks. These blocks are linked together with the cryptographic hashes and are used to record transactions between many computers. No single block can be altered without altering the related blocks. Modification of individual block data is impossible because each block contains information from the previous block. This is the unique strength of blockchain. Timestamps and hashes are some of the important terms when blockchains are considered. Data security is guaranteed with this advanced technology. Blockchain technology finds its application in the healthcare industry with many advantages in a queue. Medical data can be transferred safely and securely for fool-proof management of the medicine supply chain, which helps in healthcare research. Blockchains are used to securely encrypt a patient’s information in the event of an outbreak of a pandemic disease. A stroke is referred to as a brain attack, also called cerebral infarction. A cerebral infarction is a sudden stoppage of blood flow in the blood vessels connected to the brain. This study focused on evaluating the application of blockchain technology in Stroke Nursing Information Management Systems. This emerging technology is already in use in the healthcare industry. The patient’s data is kept decentralized, transparent, and mainly incorruptible, thus keeping it secured and sharing of data is quick.