ObjectiveTo investigate the relationship between serum apurinic/apyrimidinic endonuclease 1(APE1), Y-box binding protein 1(YB-1) levels and the severity and prognosis of children with viral myocarditis(VMC).MethodsOne hundred and fifty-two children with VMC admitted to the Department of Pediatrics in Yulin Hospital, the First Affiliated Hospital of Xi 'an Jiaotong University from May 2022 to May 2023 were selected as the VMC group, according to the prognosis of the children after 1 year of follow-up, they were divided into poor prognosis subgroup(n=43) and good prognosis subgroup(n=109). A total of 113 healthy children in the same period were selected as the healthy control group. Serum levels of APE1 and YB-1 were measured by enzyme-linked immunosorbent assay. Pearson correlation analysis was used to analyze the correlation between serum APE1, YB-1 levels and differential indicators. Multivariate Logistic regression analysis was used to analyze the influencing factors of poor prognosis in children with VMC. The receiver operating characteristic(ROC) curve was used to evaluate the predictive value of serum APE1 and YB-1 levels for poor prognosis in children with VMC.ResultsThe levels of serum APE1 and YB-1 in VMC group were lower than those in healthy control group(t/P=35.472/<0.001;25.388/<0.001). After 1 year of follow-up, the incidence of poor prognosis in 152 children with VMC was 28.29%(43/152).LVEF, APE1 and YB-1 in the poor prognosis subgroup were lower than those in the good prognosis subgroup(t/P=8.878/<0.001;26.085/<0.001;14.180/<0.001), and cTnI was higher than that in the good prognosis subgroup(t/P=2.630/0.009). Pearson correlation analysis showed that APE1 and YB-1 were negatively correlated with cTnI and CK-MB, respectively, and positively correlated with LVEF(APE1:r/P=-0.575/<0.001,-0.426/0.008,0.591/<0.001;YB-1:r/P=-0.589/<0.001,-0.417/0.011,0.609/<0.001). Multivariate Logistic regression results showed that low LVEF, low APE1 and low YB-1 were independent risk factors for poor prognosis in children with VMC[OR(95%CI)=3.967(1.246-12.634)、4.778(1.728-13.214)、4.914(1.851-13.041)].The area under the curve(AUC) of serum APE1, YB-1 levels and their combination in predicting poor prognosis of children with VMC were 0.704, 0.680 and 0.897, respectively, and the AUC of their combination was greater than that of serum APE1 and YB-1 levels alone(Z/P=4.233/<0.001;4.328/<0.001).ConclusionSerum APE1 and YB-1 levels in children with VMC can reflect myocardial injury and cardiac function. The combined diagnosis of APE1 and YB-1 can significantly improve the predictive efficacy of poor prognosis in children with VMC, and provide a sufficient basis for clinical intervention.

ObjectiveTo evaluate the prognostic outcomes of pulmonary infection after congenital heart disease(CHD) in children, and to explore and analyze the related factors of poor prognosis.MethodsOne hundred and seventy-three children with postoperative lung infection after CHD admitted to the Department of Paediatric Cardiothoracic Surgery of the First Affiliated Hospital of Xinjiang Medical University from January 2022 to December 2023 were taken as the study subjects, and they were divided into 61 cases of the poor prognosis group and 112 cases of the good prognosis group according to the prognosis at 28 d of admission. Multifactorial logistic regression was used to analyse the influencing factors of poor prognosis in children with postoperative CHD lung infection; R software was used to construct a column chart prediction model of poor prognosis in children with postoperative CHD lung infection; subject work characteristics(ROC) curves were used to assess the discriminatory degree of poor prognosis predicted by the column chart model in children with postoperative CHD lung infection, and calibration curves were used to assess the model's consistency.ResultsIn the poor prognosis group, the proportion of children with immunodeficiency, mechanical ventilation time ≥48 h, New York Heart Association(NYHA) cardiac function class Ⅲ-IV, left ventricular ejection fraction(LVEF) ≤40%, WBC >12×109/L, NEU >70%, procalcitonin(PCT) >0.5 μg/L, and albumin(Alb) ≤35 g/L were all greater than those in the good prognosis group(χ2/P=7.273/<0.001, 15.949/<0.001, 9.414/0.002, 10.473/0.001, 29.572/<0.001, 21.811/<0.001, 48="" multifactorial="" logistic="" regression="" analysis="" showed="" that="" mechanical="" ventilation="" time="" nyha="" cardiac="" function="" class="" lvef="" wbc="">12×109/L, NEU >70%, Alb≤35 g/L, and PCT >0.5 μg/L were the independent risk factors for poor prognosis in children with postoperative lung infection after CHD[OR(95%CI)=7.381(2.513-21.677), 5.295(1.801-15.568), 8.928(3.030-26.300), 5.563(1.962-15.774), 3.108(1.590-6.076), 2.058(1.429-2.963), 3.415(1.211-9.626), 5.269(1.799-15.429)], and constructed a column-line graphical model; the validation results showed that the area under the ROC curve(AUC) was 0.969(95%CI 0.945-0.992), and the model predicted the risk of poor prognosis for children with postoperative lung infection after CHD in good agreement with the actual risk(χ2=7.086, P=0.681).ConclusionImmunity, duration of mechanical ventilation, NYHA cardiac function class, LVEF, WBC, NEU, ALB, PCT are the independent risk factors affecting the occurrence of poor prognosis in children with postoperative lung infection after CHD, and the column chart model constructed in this way has a good degree of differentiation and consistency, which is more intuitive for predicting the risk of its occurrence, and effective measures should be taken according to these factors, and active intervention should be carried out to reduce the risk of poor prognosis.

ObjectiveThe risk characteristics of epirubicin-induced cardiotoxicity in patients with malignant tumors were analyzed and an early prediction model was established.MethodsFrom may 2023 to may 2024, 320 patients with malignant tumors in the Affiliated Cancer Hospital of Xinjiang Medical University were selected for analysis. All patients were treated with epirubicin chemotherapy. They were divided into cardiac injury group and control group according to whether heart injury occurred. General data, electrocardiogram and other items were compared between the two groups. Multivariate Logistic regression was used to analyze the relationship between relevant indicators and the risk of epirubicin-induced cardiotoxicity in patients with malignant tumors, and R software was used to establish and verify the nomogram prediction model of each factor to predict the risk of epirubicin-induced cardiotoxicity in patients with malignant tumors.ResultsOf the 320 patients, 18 lost contact; Sixty-two cases(20.53%) were classified as heart injury group, among which T wave or ST segment changes were the highest, followed by EF changes. The remaining 240 patients were the control group. The age, the proportion of patients with hypertension, the accumulation of epirubicin, The Times of chemotherapy and the proportion of patients with radiotherapy in the heart injury group were higher than those in the control group(t/χ2/P=6.001/<0.001, 6.580/0.010, 7.631/<0.001, 7.117/<0.001, 6.380/0.012). Multivariate Logistic regression analysis showed that higher age, hypertension, the accumulation of epirubicin, the number of chemotherapy, and combined radiotherapy were independent risk factors for the risk of epirubicin induced cardiotoxicity in patients with malignant tumors[OR(95%CI)=1.088(1.037-1.142)、2.473(1.084-5.642)、1.676(1.373-2.046)、1.012(1.007-1.016)、2.154(1.021-4.545)]. The factors influencing the risk of epirubicin-induced cardiotoxicity in patients with malignant tumors were included in the column diagram, and the C-index of the factors predicting the risk of epirubicin-induced cardiotoxicity in patients with malignant tumors was 0.912.ConclusionThe column graph constructed by the accumulation of epirubicin and the number of chemotherapy plays a certain role in predicting the risk of epirubicin-induced cardiotoxicity in malignant tumor patients, which helps to adjust the treatment regimen early and prevent the occurrence of cardiotoxicity.

ObjectiveTo investigate the relationship between the expression levels of serum growth differentiation factor-8(GDF-8), vascular endothelial growth factor(VEGF), and fibroblast growth factor 21(FGF21) and the occurrence of sarcopenia in patients with liver cirrhosis.MethodsFrom January 2022 to March 2024, 63 patients with liver cirrhosis complicated with sarcopenia treated in our hospital were included as the sarcopenia group, and 60 patients with liver cirrhosis were included as the control group. The serum levels of GDF-8, VEGF, and FGF21 were compared. Spearman correlation was applied to analyze the relationship between serum GDF-8, VEGF, FGF21 levels and sarcopenia staging. Logistic regression was applied to analyze the factors affecting the occurrence of sarcopenia in patients with cirrhosis. Receiver operating characteristic(ROC) curves were applied to analyze the predictive value of serum GDF-8, VEGF, and FGF21 levels for the development of sarcopenia in patients with cirrhosis.ResultsThe levels of GDF-8 and FGF21 in the serum of patients with liver cirrhosis complicated with sarcopenia were greatly higher, while the level of VEGF was greatly lower(t=7.719, 10.011,11.837, all P<0.001). The levels of GDF-8 and FGF21 in serum gradually increased with the progression of sarcopenia, while the level of VEGF gradually decreased with the progression of sarcopenia(F=16.605, 15.527,19.995,all P<0.001). The levels of serum GDF-8 and FGF21 in patients were positively correlated with the stage of sarcopenia(r=0.760, 0.525, P<0.05), while the level of VEGF was negatively correlated with the stage of sarcopenia(r=-0.546, P<0.05). There were great differences between the control group and the sarcopenia group in BMI, the proportion of diabetes history, grip strength, walking speed, RASM, and high-density lipoprotein levels(P<0.05). The history of diabetes(OR=2.496,95%CI 1.315-4.738), the increase of serum GDF-8(OR=2.115,95%CI 1.377-3.249)and FGF21(OR=2.894,95%CI 1.598-5.241)levels were risk factors for sarcopenia in patients with cirrhosis(P<0.05), and high BMI(OR=0.618,95%CI 0.461-0.828), RASM(OR=0.573,95%CI 0.370-0.887) and VEGF(OR=0.469,95%CI 0.307-0.718) levels were protective factors(P<0.05). The area under the curve(AUC) of serum GDF-8, VEGF, and FGF21 levels in predicting sarcopenia in patients with cirrhosis was 0.836, 0.912, and 0.921, respectively. The AUC of the combined detection of the three was 0.980, which was better than that of the individual detection(Z/P=3.878/<0.001、2.954/0.003、2.678/0.007).ConclusionThe levels of serum GDF-8, VEGF, and FGF21 are closely related to the occurrence of sarcopenia in patients with cirrhosis. Detecting the levels of the three in serum may have certain clinical value for predicting the occurrence of sarcopenia in patients with cirrhosis.

ObjectiveTo study the relationship between circular RNA SH3 binding protein 1(circSHKBP1), SRY-box transcription factor 3(SOX3) and chemotherapy efficacy and prognosis in patients with advanced gastric cancer.MethodsA total of 104 patients with advanced gastric cancer admitted to the Department of Oncology, Tangdu Hospital of Air Force Medical University from January 2019 to February 2021 were selected as the study group, and they were divided into chemotherapy-sensitive subgroup and chemotherapy-resistant subgroup according to the efficacy of chemotherapy; 50 healthy subjects were selected as healthy control group. Real-time fluorescence quantitative PCR was used to detect the levels of serum circSHKBP1 and SOX3 mRNA in each group; the relationship between serum circSHKBP1, SOX3 mRNA expression and clinicopathological features of patients with advanced gastric cancer was analyzed. Multivariate Logistic regression analysis was used to analyze the factors affecting the efficacy of chemotherapy. The receiver operating characteristic curve was used to analyze the value of serum circSHKBP1 and SOX3 mRNA in evaluating the efficacy of chemotherapy in patients with advanced gastric cancer.ResultsThe relative expression levels of serum circSHKBP1 and SOX3 mRNA in the study group were(3.22±0.37) and(2.72±0.35), respectively, which were higher than those in the control group(0.62±0.17),(0.71±0.19),(t=65.118,51.471,both P<0.001). The relative expression levels of serum circSHKBP1 and SOX3 mRNA in patients with TNM stage IV and poorly differentiated advanced gastric cancer were higher than those in patients with TNM stage IIIB and high and medium differentiation(t/P=37.283/<0.001,31.545/<0.001,19.169/<0.001,26.334/<0.001). The percentage of tumor stage IV in the chemotherapy-resistant subgroup and the relative expression of serum circSHKBP1 and SOX3 mRNA were higher than those in the chemotherapy-sensitive subgroup(t/P=10.037/0.002,48.609/<0.001,26.775/<0.001).Tumor stage IV, serum circSHKBP1 and SOX3 mRNA were risk factors for chemotherapy resistance in advanced gastric cancer[HR(95%CI)=1.594(1.252-2.028),1.306(1.144-1.492),1.603(1.190-2.160)]; The AUC of circSHKBP1, SOX3 mRNA and the combination of the two in predicting the efficacy of chemotherapy in patients with gastric cancer were 0.844, 0.851 and 0.922, respectively. The combination of the two was superior to their respective predictive efficacy(Z=4.745, 4.310, P<0.001).ConclusionThe serum levels of circSHKBP1 and SOX3 mRNA in advanced gastric cancer are increased, which are related to the degree of tumor differentiation, TNM stage and chemotherapy efficacy. The combination of the two has a good evaluation value for the chemotherapy efficacy of patients with advanced gastric cancer.