ObjectiveTo investigate the predictive value of serum receptor for advanced glycation end products(RAGE) and pre B cell colony enhancing factor(PBEF) levels in children with severe pneumonia(SP) secondary to acute respiratory distress syndrome(ARDS).MethodsEight hundred and seventy-five cases of SP children admitted to the Respiratory Department and Intensive Care Unit of Harbin Children's Hospital from January 2020 to February 2024 were selected and divided into 83 cases in the ARDS group and 792 cases in the non-ARDS group according to whether they were secondary to ARDS. Serum RAGE and PBEF levels were detected by enzyme linked immunosorbent assay. Pearson's correlation coefficient was used to analyze the correlation between serum RAGE and PBEF levels and the scores of the pediatric early warning score(PEWS); a multifactorial unconditional logistic regression model was established to determine the factors influencing secondary ARDS in children with SP as the dependent variable; and ROC curves were plotted to evaluate the value of serum RAGE and PBEF levels in predicting secondary ARDS in children with SP.ResultsEight hundred and seventy-five cases children with SP had secondary ARDS within 7 d of admission 83(9.49%). Compared with the non-ARDS group, serum RAGE and PBEF levels were elevated in the ARDS group(t=8.801, 9.082, all P<0.001); and there was a positive correlation between serum RAGE and PBEF levels and PEWS scores(r=0.691, 0.625, all P<0.001); Independent risk factors for secondary ARDS in children with SP were increased PEWS score, prolonged duration of mechanical ventilation, increased oxygen index, increased procalcitonin, increased RAGE, and increased PBEF[OR(95%CI)=2.308(1.535-3.469), 2.525(1.619-3.938), 3.738(2.123-6.581), 6.916(3.034-15.768), 1.085(1.061-1.109, 1.464(1.303-1.646)]; The area under the curve of RAGE, PBEF and the combination of the two for predicting secondary ARDS in children with SP was 0.791, 0.789 and 0.905, respectively, and the combination of the two was superior to their respective individual predictive efficacy(Z=4.256, 4.419, all P<0.001).ConclusionElevated serum RAGE and PBEF levels are independent risk factors for secondary ARDS in children with SP, and serum RAGE combined with PBEF levels have high value in predicting secondary ARDS in children with SP.

ObjectiveTo investigate the levels and significance of serum interleukin 19(IL-19),vasohibin-1(VASH-1), neutrophil-to-lymphocyte ratio(NLR) in type 2 diabetic nephropathy(T2DN).Methods100 patients with T2DN who were treated in our hospital from December 2020 to December 2022 were selected as the T2DN group, and 100 patients with type 2 diabetes mellitus(T2DM) alone were collected as the T2DM group. The levels of serum IL-19, VASH-1, and NLR were compared among the two groups, and the predictive value of serum IL-19, VASH-1, and NLR for DN was analyzed.ResultsThe serum levels of IL-19, VASH-1, and NLR in the T2DN group were significantly higher than those in the T2DM group(t/P=8.347/<0.001、8.277/<0.001、8.762/<0.001).According to binary Logistic regression analysis, high IL-19,VASH-1,and NLR are risk factors for T2DN [OR(95%CI)=1.120(1.037-1.210),1.006(1.001-1.012),2.586(1.165-5.740),P<0.05].Receiver operating characteristic(ROC) curve analysis showed that, The area under the curve(AUC) of serum IL-19、VASH-1、NLR and their combined prediction of T2DN were 0.807, 0.799, 0.822, 0.854, respectively. The Yoden indices were 0.520, 0.490, 0.550, 0.740.The sensitivity and specificity corresponding to the optimal critical values of IL-19 was 0.940 and 0.580, VASH-1 was 0.660 and 0.830, and NLR was 0.920 and 0.630, respectively. The combined sensitivity and specificity of the three methods was 0.860 and 0.880.ConclusionThe serum IL-19, VASH-1, and NLR of T2DN patients are increased, and the combination of serum IL-19, VASH-1, and NLR has high predictive value for T2DN.

ObjectiveTo explore the evaluation value of geriatric nutritional risk index(GNRI), neutrophil to lymphocyte ratio(NLR) and fibrinogen to albumin ratio(FAR) for prognosis of patients with advanced gastric cancer after radical gastrectomy.MethodsA retrospective analysis was performed on the clinical data of 115 elderly patients with gastric cancer undergoing radical gastrectomy in Western Theater Command General Hospital of the PLA between January 2020 and January 2022. The general data were analyzed, including age, gender, TNM staging, tumor size, tumor differentiation, depth of tumor invasion and lymph node metastasis. The levels of preoperative GNRI, NLR and FAR were detected. After 1-3 years of follow-up, relationship between GNRI, NLR, FAR and prognosis was analyzed by univariate analysis and Kaplan-Meier survival curves, and influencing factors of prognosis were analyzed by COX proportional hazard regression analysis.ResultsThe levels of GNRI, NLR and FAR were correlated with gender, age, tumor diameter, TNM staging and lymph node metastasis(GNRI: t/P=54.308/<0.001, 31.021/<0.001, 27.002/<0.001, 17.573/<0.001, 11.376/<0.001, 37.377/<0.001; NLR: t/P=26.364/<0.001, 16.017/<0.001, 10.702/<0.001, 10.106/<0.001, 8.084/<0.001; FAR: t/P=4.154/<0.001, 5.091/<0.001, 3.776/<0.001, 5.564/<0.001). The results of Kaplan-Meier curve analysis showed that overall survival rate and progression-free survival rate in high GNRI group were higher than those in low GNRI group. The survival rate and progression-free survival rate in low NLR group and low FAR group were higher than those in high NLR group and high FAR group, respectively(P<0.05). COX proportional hazard regression analysis showed that TNM staging at stage III-IV, lymph node metastasis, high levels of NLR and FAR were risk factor affecting progression-free survival, while high level of GNRI was a protective factor[OR(95%CI)=1.933(1.227-3.046), 2.396(1.293-4.443), 2.606(1.381-4.919), 2.754(1.494-5.076), 0.297(0.098-0.894)].ConclusionIn patients with advanced gastric cancer, level of preoperative GNRI is low, while levels of NLR and FAR are high. The three indexes are related to clinicopathological characteristics and prognosis of patients.

ObjectiveTo explore type 3 β tubulin(TUBB3) and chaperone 8 containing TCP 1(CCT8) in colorectal cancer(CRC) and their correlation with epithelial mesenchymal transition(EMT) and prognostic significance.MethodsFrom January 2018 to January 2020, 112 patients with CRC were treated in the Department of Colorectal Surgery at the Affiliated Traditional Chinese Medicine Hospital of Xinjiang Medical University were selected. Real time fluorescent quantitative PCR was used to detect TUBB3, CCT8 mRNA and EMT related indicators N cadherin(E cad), E cadherin(n cad), transcription factor twist mRNA expression. The expressions of TUBB3 and CCT8 proteins were detected by immunohistochemistry. The protein expressions of TUBB3 and CCT8 in CRC with different clinicopathological features were compared. Kaplan Meier curve and Cox regression analysis were used to analyze the effect of TUBB3 and CCT8 protein on the prognosis of CRC patients.ResultsThe expressions of TUBB3 mRNA, CCT8 mRNA, N cad mRNA and TWIST mRNA in CRC tissues were higher than those in adjacent tissues, while E cad mRNA was lower than that in adjacent tissues(t/P=35.030, 38.353, 32.172, 32.405, 18.928,all P<0.001). The positive rates of TUBB3 and CCT8 proteins in CRC tissues were 91.07%(102/112), 94.64%(106/112), which were higher than those in adjacent tissues [7.14%(8/112), 6.25%(7/112)], and the difference was statistically significant(χ2=157.836, 175.032, P<0.001). There was a positive correlation between tubb3 mRNA and cct8 mRNA expression in CRC(r=0.647, P<0.001). The expression of TUBB3 mRNA and CCT8 mRNA in CRC was positively correlated with the expression of N-cad mRNA and TWIST mRNA(r=0.667,0.621,0.703,0.686,P<0.001), and negatively correlated with the expression of E cad mRNA(r=-0.641,-0.587,P<0.001). The expressions of TUBB3 mRNA and CCT8 mRNA in CRC with TNM stage Ⅲ, low differentiation and lymph node metastasis were significantly higher than those in CRC with stage Ⅰ～Ⅱ, high differentiation and no lymph node metastasis(t/P=20.327, 20.455, 21.101, 15.121, 14.985, 15.759,all P<0.001). The 3 year OS of CRC patients was 43.33%(26/60) in the TUBB3 mRNA high expression group, which was lower than 70.97%(44/62) in the low expression group(Log rank χ2=8.792,P=0.003), while the 3 year OS of CCT8 mRNA high expression group was 42.86%(27/63), which was lower than 72.88%(43/59) in the low expression group(Log rank χ2=10.970, P<0.001) TUBB3 mRNA increased, CCT8 mRNA increased, TNM stage Ⅲ, poor differentiation and lymph node metastasis were independent risk factors for prognosis of CRC[HR(95%CI)=1.334(1.103-1.613), 1.322(1.108-1.577), 1.435(1.161-1.773), 1.368(1.115-1.677), 1.315(1.054-1.641)].ConclusionTUBB3 and CCT8 are up-regulated in CRC, which can promote the malignant progression of CRC by promoting EMT, and are new markers for the prognosis of CRC.

ObjectiveTo study the expression and clinical prognostic value of aortic carboxypeptidase like protein(ACLP) and collagen type XI alpha 1 chain(COL11A1) in pancreatic cancer.MethodsFrom January 2019 to January 2021,88 patients with pancreatic cancer who underwent surgical treatment in Shaanxi Cancer Hospital and Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine were selected as the study subjects. Real time fluorescence quantitative PCR and immunohistochemistry were used to detect the expression of ACLP and COL11A1 mRNA and protein in cancer tissues and adjacent tissues. Pearson correlation analysis was used to analyze the correlation between ACLP mRNA and COL11A1 mRNA. Kaplan Meier method was used to analyze the effect of ACLP and COL11A1 expression on the survival and prognosis of patients with pancreatic cancer. Cox regression analysis was used to analyze the prognostic factors of pancreatic cancer.ResultsThe relative expression levels of ACLP and COL11A1 mRNA in pancreatic cancer tissues were higher than those in adjacent tissues(t/P=31.058/<0.001, 27.642/<0.001); The positive rates of ACLP and COL11A1 in pancreatic cancer tissues were 69.32 %(61/88) and 70.45 %(62/88), respectively, which were higher than 9.09 %(8/88) and 6.82 %(6/88) in adjacent tissues(χ2=66.963, 75.155,P<0.001); The expression of ACLP mRNA was positively correlated with that of COL11A1 mRNA in pancreatic cancer tissues(r=0.642, P<0.001); The positive rates of ACLP and COL11A1 protein in pancreatic cancer tissues with TNM stage IIB ～ Ⅲ and lymph node metastasis were higher than those in pancreatic cancer tissues with TNM stage I ～ IIA and no lymph node metastasis(ACLP: χ2/P=19.704/<0.001,12.908/<0.001; COL11A1: χ2/P=22.440/<0.001, 14.569/<0.001). The 3-year overall survival rate of ACLP positive group was 22.95%(14/61), which was lower than that of negative group 44.44%(12/27)(Log rank χ2=5.433,P=0.020); The 3-year overall survival rate of COL11A1 positive group was 20.97 %(13/62), which was lower than that of negative group 50.00 %(13/26)(Log rank χ2=7.281,P=0.007). TNM stage IIB ～ Ⅲ, lymph node metastasis, ACLP positive and COL11A1 positive were independent risk factors affecting the prognosis of patients with pancreatic cancer[HR(95%CI)=1.781(1.199-2.646), 1.962(1.172-3.285),1.505(1.066-2.125),1.568(1.117-2.201)].ConclusionThe mRNA and protein expressions of ACLP and COL11A1 are significantly up-regulated in pancreatic cancer tissues. They play a promoting role in the occurrence and progression of pancreatic cancer, and are new clinical markers for evaluating the prognosis of pancreatic cancer patients.