Objective To analyze the correlation and diagnostic value of serum histone deacetylase 3(HDAC3), brain derived nerve growth factor(BDNF) levels with cognitive dysfunction(CI) in adolescents with subthreshold depression. Methods A total of 207 adolescent patients with subthreshold depression admitted to the Department of Psychiatry, Anning Hospital, Hainan Province from January 2018 to December 2021 were selected as the study subjects. The cognitive function of the patients was assessed using the Montreal Cognitive Rating Scale(MoCA), and they were divided into a non CI group of 135 patients(MoCA score ≥ 26 points) and a CI group of 72 patients(MoCA score<26 points). Serum levels of HDAC3 and BDNF were measured by enzyme linked immunosorbent assay; Pearson correlation analysis was used to examine the correlation between serum HDAC3, BDNF levels and MoCA scores in adolescent patients with subthreshold depression CI; The diagnostic value of serum HDAC3 and BDNF levels in the diagnosis of CI in adolescent patients with subthreshold depression was analyzed by drawing a subject performance characteristic curve(ROC). Results The serum HDAC3 level in CI group was higher than that in non CI group, while the BDNF level was lower than that in non CI group(t/P=11.209/<0.001, 11.554/<0.001). The scores of naming, language, visual space, and executive ability, attention, delayed recall, abstraction, orientation, and the total score of MoCA in the CI group were lower than those in the non-CI group(t/P=15.759/<0.001, 21.572/<0.001, 6.032/<0.001, 13.845/<0.001, 7.639/<0.001, 23.638/<0.001, 4.332/<0.001, 22.038/<0.001). Serum HDAC3 levels were negatively correlated with MoCA scores in patients with subthreshold depression CI in adolescents, while serum BDNF levels were positively correlated with MoCA scores(r/P=-0.534/<0.001, 0.542/<0.001). The area under the curve(AUC) of serum HDAC3 and BDNF levels in adolescents with subthreshold depression were 0.815, 0.777, and 0.866, respectively, and the AUC of combined diagnosis was greater than that of BDNF(Z=2.997,P<0.001). Conclusion The abnormal increase of serum HDAC3 expression and abnormal decrease of BDNF expression in patients with subthreshold depression and CI in adolescents have high diagnostic value for CI.

Objective To analyze the characteristics and risk factors of non-tuberculosis mycobacterium(NTM) infection in drug-resistant pulmonary tuberculosis patients, construct a predictive model, and evaluate the predictive efficacy of the model. Methods Two hundred and thirty drug-resistant pulmonary tuberculosis patients admitted to the Respiratory Department of Taihe Hospital in Shiyan City from March 2020 to May 2022 were divided into an NTM group of 39 cases and a non NTM group of 191 cases based on the presence of non-tuberculosis Mycobacterium infection. Compare the clinical data of two groups of patients; Using multivariate logistic regression equation to analyze the risk factors for NTM infection in drug-resistant pulmonary tuberculosis patients. Use R software to establish a column chart prediction model for NTM infection and conduct internal validation. Results A total of 39(16.96%) non tuberculosis mycobacterial infections occurred in 230 drug-resistant pulmonary tuberculosis patients, with no mixed infection; The top 4 NTM strains ranked were Mycobacterium intracellulatum(33.33%), Mycobacterium abscesses(23.08%), Mycobacterium Gordon(12.82%), and Mycobacterium avium(10.26%); The proportion of male patients in the NTM group, age>40 years old, farmers, primary school education or below, family income<20 000 yuan/year, comorbidities with chronic obstructive pulmonary disease(COPD), malignant tumors, and immunosuppressive therapy were higher than those in the non NTM group(χ2/P=5.487/0.019,5.529/0.018,8.129/<0.001,6.776 age="">40 years old, farmer, COPD, and concomitant malignant tumors are risk factors for NTM infection in drug-resistant pulmonary tuberculosis patients [OR(95%CI)=10.025(2.068-50.361), 36.324(8.128-162.328), 7.640(1.941-30.072), 13.832(3.938-48.588), 18.796(2.786-126.802),P<0.01]; The consistency index(C-index) of predicting NTM infection in drug-resistant pulmonary tuberculosis patients using the column chart was 0.904(95%CI 0.862-0.961). Conclusion NTM infection has a high detection rate in drug-resistant pulmonary tuberculosis patients, with the main infected population being males, farmers, and people over 40 years old; The constructed predictive model can early evaluate the NTM infection status of drug-resistant pulmonary tuberculosis patients and guide clinical early intervention.

Objective To explore the value of serum C-reactive protein/albumin ratio(CRP/Alb) in evaluating the clinical activity of Crohn's disease(CD). Methods One hundred and thirty-seven CD patients who visited the Department of Gastroenterology, People's Hospital of Wuhan University from January 2020 to May 2022 were selected to be included in the study. According to the simplified Crohn's disease activity index(CDAI), the patients were divided into 65 patients in the active phase group and 72 patients in the remission phase group. The clinical data and CRP, Alb, CRP/Alb levels of the two groups were compared. Using Spearman correlation analysis to evaluate the correlation between serum CRP, Alb, CRP/Alb levels and simplified CDAI; Using binary logistic regression analysis to identify independent risk factors affecting CD clinical activity; The value of using receiver operating characteristic curve(ROC) to analyze serum CRP, Alb, and CRP/Alb levels in evaluating clinical activity of CD. Results The CRP, CRP/Alb, erythrocyte sedimentation rate(ESR), platelet count(PLT) of CD patients in the active phase group were significantly higher than those in the remission phase group(U=6.239, 6.519, 3.566, 3.227,P<0.001), while Alb, lymphocyte count(LYM), hemoglobin(Hb), mean corpuscular volume(MCV), and hematocrit(HCT) were lower than those in the remission phase group(t/P=5.666/<0.001, 3.796/<0.001, 4.900/<0.001, 2.567/0.010, 5.410/<0.001). Spearman correlation analysis showed that CRP, CRP/Alb were positively correlated with simplified CDAI(rs=0.535, 0.559,P<0.001), while Alb was negatively correlated with simplified CDAI(rs=-0.486,P<0.001). Binary logistic regression analysis showed that high CRP/Alb was an independent risk factor for CD clinical activity [OR(95%CI)=2.959(1.190-7.363)], and high Alb was a protective factor [OR(95%CI)=0.902(0.821-0.990)];ROC curve analysis showed that the area under the curve(AUC) of serum CRP, CRP/Alb, and their combined prediction of CD clinical activity were 0.809, 0.823, and 0.837, respectively. The combined prediction efficiency of the three indicators was higher than that of single indicator prediction(Z=8.379, 9.111, 9.826,P<0.001). Conclusion The serum CRP/Alb ratio has a certain correlation with CD clinical activity, and can be used as a biomarker for evaluating CD clinical activity.

Objective To analyze the predictive value of serum Thyroid peroxidase antibody(TPOAb), thyroid microsomal antibody(TMAb) and thyroid stimulating hormone receptor antibody(TRAb) levels on the risk of hypothyroidism(hypothyroidism) in patients with Graves' disease(GD) after 131I treatment.Methods Two hundred and nine Graves' disease patients in the Thyroid Surgery Department of the First Affiliated Hospital of Xinjiang Medical University from January 2019 to December 2020 were selected for the study. Following up for one year, 9 cases of loss of contact were divided into hypothyroidism group of 59 cases and non-hypothyroidism group of 141 cases based on the occurrence of hypothyroidism. Thyroid function indicators and radiation therapy related indicators were compared between the two groups. Multivariate logistic regression models were used to analyze the factors affecting patient prognosis, and the predictive value of patient performance characteristic curves(ROCs) was used to analyze the prognostic indicators. Results The pretreatment withdrawal time, TPOAb, TMAb levels, and 131I dose of patients in the hypothyroidism group were significantly higher than those in the non-hypothyroidism group, while TRAb was significantly lower than those in the non-hypothyroidism group(t/P=3.275/0.001, 6.013/<0.001, 7.532/<0.001, 6.662/<0.001, 4.455/<0.001); Multivariate logistic regression analysis showed that high levels of TPOAb, TMAb, and 131I dosage were independent risk factors for hypothyroidism in Graves' disease patients [OR(95%CI)=1.005(1.003-1.008), 1.205(1.101-1.320), 21.005(3.440-128.262)], while high levels of TRAb were independent protective factors for hypothyroidism in patients [OR(95%CI)=0.821(0.753-0.895)]; The area under the curve(AUC) of TPOAb, TRAb, TMAb, 131I doses, and their combination in predicting hypothyroidism in Graves' disease patients after 131I treatment were 0.770, 0.846, 0.748, 0.784, and 0.949, respectively. The diagnostic efficacy of the combination of the four in predicting patient prognosis was higher than that of their individual predictions(Z=4.639, 3.959, 5.491, 4.563,P<0.001).Conclusion The combination of TPOAb, TRAb, and TMAb can effectively predict hypothyroidism in Graves' disease patients after 131I treatment, and has high diagnostic value and efficacy.

Objective To investigate the serum levels of miR-141 and miR-181a in neonatal sepsis and their impact on the severity of the condition. Methods Fifty children with sepsis diagnosed and treated in the Neonatal Department of Hainan Modern Women's and Children's Hospital from June 2021 to August 2022 were selected as the research subjects. According to the sequential organ failure score(SOFA) of the children, they were divided into a mild group of 27 cases and a severe group of 23 cases. The levels of serum miR-141, miR-181a, C-reactive protein(CRP), Calcitonin(PCT) and acute physiology and chronic health score(APACHE-Ⅱ) were compared between the two groups. Pearson's method was used to analyze the correlation between serum miR-141, miR-181a and APACHE-Ⅱ, CRP, PCT. Multifactor logistic regression was used to analyze the factors affecting the severity of sepsis in children; ROC curve was used to analyze the value of miR-181a in predicting disease severity. Results The serum levels of miR-141 and miR-181a in the severe group were lower than those in the mild group, while CRP, PCT levels, and APACHE-Ⅱ scores were higher than those in the mild group(t=8.977, 5.972, 9.605, 7.981, 7.054, all P<0.001); Serum miR-141 and miR-181a were negatively correlated with APACHE-Ⅱ, CRP, and PCT(miR-141:r=-0.570,-0.741,-0.582, miR-181a:-0.569,-0.513,-0.576,P<0.001). High serum miR-141 and miR-181a levels are protective factors for exacerbation of sepsis in children [OR(95%CI)=0.33(0.18-0.52), 0.27(0.14-0.46)], while high APACHE II scores, CRP levels, and PCT levels are risk factors for exacerbation[OR(95%CI)=1.56(1.14-1.83), 2.18(1.52-2.71), 1.67(1.27-1.93)].The AUC of serum miR-141, miR-181a, and their combination in predicting the severity of neonatal sepsis were 0.936, 0.856, and 0.959, respectively. The combination of the two was superior to their respective independent predictive efficacy(Z=5.318, 9.652,P<0.001). Conclusion The low expression of serum miR-141 and miR-181a in neonatal sepsis is negatively correlated with APACHE-Ⅱ score, CRP, and PCT. The elevated levels of miR-141 and miR-181a are protective factors for the worsening of sepsis in children, and have good predictive value for the changes in neonatal sepsis.