Objective To explore the diagnostic value of serum pyruvate kinase M2(PKM2) and procalcitonin(PCT) in sepsis. Methods One hundred and nineteen sepsis patients(sepsis group) admitted to the Intensive Care Unit(ICU) of Wuhan University People's Hospital from April 2022 to January 2023, and 73 non sepsis patients(non sepsis group) admitted to the ICU during the same period were selected as the study subjects. Detect and compare the serum levels of PKM2 and PCT in two groups of patients within 24 hours of admission, and use Spearman correlation test to analyze the correlation between serum PKM2 and PCT levels in sepsis patients; Using a multivariate logistic regression model to analyze the impact of various indicators on the occurrence of sepsis; Draw a receiver operating characteristic(ROC) curve to evaluate the diagnostic value of serum PKM2, PCT, and their combination in sepsis, and calculate the area under the curve(AUC). Results Compared with the non sepsis group, the serum PKM2 and PCT levels in the sepsis group were significantly increased(Z/P=9.373/<0.001, 9.013/<0.001). There is a positive correlation between serum PKM2 and PCT levels in sepsis patients(r=0.322, P<0.001). Multivariate logistic regression analysis showed that elevated levels of serum PKM2 and PCT were independent risk factors for sepsis occurrence [OR(95%CI)=1.182(1.078-1.295), 1.582(1.186-2.110)].The ROC curve shows that the AUC of serum PKM2, PCT, and their combination for diagnosing sepsis were 0.903, 0.888, and 0.941, respectively, with sensitivity of 0.863, 0.918, and 0.932, and specificity of 0.798, 0.748, and 0.857, respectively. The combined diagnostic efficacy of the two was higher than that of individual detection(Z/P=2.560/0.011, 3.423/<0.001).Conclusion The elevated serum PKM2 level in patients with sepsis is an independent risk factor for sepsis and is positively correlated with PCT. Combined detection of the two has high diagnostic value.

Objective To investigate the changes in serum Gal-1 and Gal-3 levels in patients with sepsis associated acute kidney injury(SA-AKI) of different severity levels and their relationship with in-hospital mortality. Methods Two hundred and forty-three patients with sepsis admitted to the Intensive Care Department of Linfen Central Hospital in Shanxi Province from January 2020 to January 2023 were included, including 123 SA-AKI patients as the SA-AKI group and 120 patients with simple sepsis as the simple sepsis group. Patients in the SA-AKI group were divided into stage 1 subgroup(48 cases), stage 2 subgroup(43 cases), and stage 3 subgroup(32 cases) based on acute kidney injury(AKI) staging, and were divided into death subgroup and survival subgroup according to their in-hospital outcomes. Enzyme linked immunosorbent assay was used to detect serum Gal-1 and Gal-3 levels. Analyze the influencing factors of in-hospital mortality in SA-AKI patients through multiple logistic regression analysis. The predictive value of receiver operating characteristic(ROC) curve analysis of serum Gal-1 and Gal-3 levels on the risk of in-hospital mortality in SA-AKI patients. Results Compared with the simple sepsis group, the serum Gal-1 and Gal-3 levels in the SA-AKI group increased(t/P=34.417/<0.001, 15.207/<0.001). The serum Gal-1 and Gal-3 levels in the 1st, 2nd, and 3rd subgroups increased sequentially(F/P=302.934/<0.001, 51.068/<0.001). Univariate analysis showed that age, AKI stage, use of vasoactive drugs, mechanical ventilation, acute physiological and chronic health assessment II(APACHE II) scores, blood lactate, Gal-1, and Gal-3 were the influencing factors for in-hospital mortality in SA-AKI patients(χ2/t=3.514, 43.619, 7.041, 8.483, 4.563, 4.081, 10.282, 6.335, P<0.05 or 0.01). Multivariate logistic regression analysis showed that age ≥ 60 years, AKI stage 2-3, mechanical ventilation and APACHE II score, elevated blood lactate, Gal-1, and Gal-3 levels were independent risk factors for in-hospital mortality in SA-AKI patients [OR(95% CI)=1.683(1.145-2.476), 2.710(1.107-6.633), 3.670(1.398-9.631), 1.548(1.070-2.240), 1.532(1.123-2.093), 1.438(1.042-1.984) 1.040(1.016-1.065), 1.192(1.071-1.327),P<0.05 or 0.01]. ROC curve analysis showed that the area under the curve(AUC) for predicting in-hospital mortality in SA-AKI patients was 0.720(0.454-0.960), 0.771(0.558-0.971), and 0.830(0.686-0.967) for serum Gal-1 and Gal-3 levels alone and in combination, respectively. The combined predictive value of the two indicators was greater than that of each indicator alone(Z=2.652, 2.968, P=0.008, 0.003). Conclusion The elevated levels of serum Gal-1 and Gal-3 are closely related to the worsening of the condition and in-hospital mortality in SA-AKI patients. The combined detection of serum Gal-1 and Gal-3 levels has a high predictive value for in-hospital mortality in SA-AKI patients.

Objective To analyze the relationship between serum high mobility group protein B1(HMGB1), long chain non coding RNA H19(lncRNA H19) and the prognosis of sepsis patients.Methods One hundred and twenty-eight patients with sepsis diagnosed and treated by the Department of Critical Care Medicine of Xinjiang Uygur Autonomous Region People's Hospital from January 2020 to March 2022 were selected as the study objects. According to their 28-day clinical outcomes, they were divided into 87 survival patients and 41 death patients. Serum HMGB1 and lncRNA H19 levels were compared between the two groups. Logistic multivariate regression analysis was used to analyze the factors influencing the prognosis of sepsis patients. The ROC was drawn to analyze the prognostic value of serum HMGB1 and lncRNA H19, and the decision curve(DCA) was used to analyze the clinical benefits of serum HMGB1 and lncRNA H19 separately and jointly. Results The level of serum HMGB1 in death group was higher than that in survival group, and the level of lncRNA H19 was lower than that in survival group(t/P=5.212/<0.001, 5.487/<0.001). Logistic regression analysis showed that the increase of serum HMGB1 was an independent risk factor for the prognosis of sepsis patients [OR(95% CI)=3.710(1.965-7.004)], and the increase of serum lncRNA H19 was an independent protective factor [OR(95% CI)=0.331(0.117-0.935)]. The ROC curve results showed that the area under the curve(AUC) of serum HMGB1, lncRNA H19 and their combination in evaluating the prognosis of sepsis patients were 0.760, 0.788 and 0.867, respectively. The combined prognostic value of the two was greater than the single prediction(Z/P=3.245/<0.001, 2.641/0.008). The results of DCA curve showed that the net benefit rate of serum HMGB1 and lncRNA H19 combined evaluation model in evaluating the prognosis of sepsis patients was better than that of single detection within the threshold value of 0.23～0.73.Conclusion The increase of serum HMGB1 and the decrease of lncRNA H19 will increase the risk of death in sepsis patients at 28 days. Detection of the two levels can be used to evaluate the prognosis of patients, and the combined evaluation can improve the net benefit rate.

Objective To explore the influencing factors of sepsis associated encephalopathy(SAE) and construct a column chart model to predict the occurrence of SAE. Methods Select 213 patients with sepsis admitted to the Intensive Care Unit(ICU) of Guizhou Medical University Affiliated Hospital from March 2021 to February 2023, and divide them into SAE group and non SAE group based on the occurrence of SAE. Collect various data for single factor analysis, and conduct logistic regression analysis on the relevant factors of SAE occurrence; Use R software to construct a risk prediction model for SAE occurrence, and verify the discrimination and accuracy of the model through the area under the ROC curve(AUC) and calibration curve. Results Among 213 patients with sepsis, 84(39.44%) had SAE; SAE group APACHE II score, SOFA score, middle cerebral artery PI, arterial blood lactate(BLA), serum S100 β、 The levels of ALT, AST, IL-6, and the proportion of invasive mechanical ventilation were higher in the non SAE group than in the non SAE group(t(χ2)/P=3.974/<0.001, 3.066/0.002, 4.610/<0.001, 5.528/<0.001, 4.750/<0.001, 9.024/<0.001, 2.810/0.005, 5.063/<0.001, 7.239/0.007), local brain tissue oxygen saturation(rScO2) and albumin levels were lower than those in the non SAE group(t/P=4.935/<0.001, 3.650/<0.001); The logistic regression analysis results showed that the main risk factors for the occurrence of SAE were high APACHE II score, high SOFA score, high middle cerebral artery PI, high arterial blood lactate, and high ALT, while high rScO2 and albumin were protective factors for the occurrence of SAE [OR(95%CI)=2.347(1.316～4.184), 2.416(1.432～4.077), 2.204(1.234～3.937), 2.311(1.306～4.088), 2.326(1.376～3.933), 0.468(0.271～0.809), 0.561(0.342～0.919)]; A column chart risk model was constructed based on 7 prediction indicators to predict the occurrence of SAE. The results showed that the AUC was 0.831(95%CI 0.773～0.889), and the probability of predicting SAE occurrence was similar to the actual probability, with a goodness of fit HL test χ2=6.282, P=0.616. Conclusion The column chart risk model constructed based on seven indicators: APACHE II score, SOFA score, middle cerebral artery PI, rScO2, arterial blood lactate, ALT, and albumin has a good predictive effect on the occurrence of SAE.

Objective To investigate the effect of balloon dilatation combined with Solitaire stent on vascular patency and prognosis in patients with acute intracranial large vessel occlusion accompanied by atherosclerosis. Methods From January 2016 to May 2022, 82 patients with acute intracranial large vessel occlusion accompanied by atherosclerosis were selected from the Department of Neurology, General Hospital of Taiyuan Iron and Steel(Group) Co., Ltd. They were randomly divided into two groups: the control group and the observation group, with 41 cases in each group. The control group received Solitaire stent treatment, while the observation group received balloon dilation combined with Solitaire stent treatment. Observe 2 groups of surgical related indicators, vascular recanalization status, preoperative and postoperative 3-day cerebral blood flow perfusion [relative cerebral blood flow(rCBF), relative peak time(rTTP), relative mean transit time(rMTT), relative cerebral blood volume(rCBV)], vascular endothelial function [von Willebrand factor(vWF), endothelin-1(ET-1), nitric oxide(NO)], preoperative and discharge coma risk(GCS score) Degree of neurological impairment(NIHSS score), cognitive function(MOCA score), and complications. Results The observation group had fewer thrombus removal times than the control group, and the immediate postoperative vascular diameter was greater than the control group(t/P=5.162/<0.001, there="" was="" no="" statistically="" significant="" difference="" in="" blood="" vessel="" recanalization="" rate="" between="" the="" observation="" group="" and="" control="" p="">0.05); On the 3rd day after surgery, the rCBF level in the observation group was higher than that in the control group, while the rMTT and rTTP levels were lower than those in the control group(t/P=2.217/0.029, 4.714/<0.001, 4.919/<0.001); The serum vWF and ET-1 levels in the observation group were lower than those in the control group 3 days after surgery, while the NO levels were higher than those in the control group(t/P=6.770/<0.001, 12.292/<0.001, 8.726/<0.001); At discharge, the GCS and MOCA scores of the observation group were higher than those of the control group, while the NIHSS scores were lower than those of the control group(t/P=3.326/0.001, 6.163/<0.001, 10.584/<0.001); there="" was="" no="" statistically="" significant="" difference="" in="" the="" total="" incidence="" of="" complications="" between="" observation="" group="" and="" control="" p="">0.05).Conclusion Balloon dilatation combined with Solitaire stent in the treatment of acute intracranial large vessel occlusion with atherosclerosis can reduce the number of embolectomy, increase the diameter of blood vessels, improve the endothelial function of blood vessels, contribute to cerebral blood flow perfusion, promote disease prognosis, and have high safety.