Objective To investigate the correlation between serum circANKRD36 and soluble receptor for advanced glycation end products(sRAGE) levels and prognosis in patients with sepsis-associated acute respiratory distress syndrome(ARDS). Methods A total of 92 sepsis patients admitted to the General Hospital of the Northern Theater Command of the Chinese People's Liberation Army from February 2024 to December 2024 were selected. According to the Sepsis-3.0 criteria and Berlin definition, patients were divided into a non-ARDS group(n=44) and an ARDS group(n=48). Based on prognosis, patients with sepsis-associated ARDS were further divided into a survival subgroup(n=28) and a death subgroup(n=20). Real-time quantitative polymerase chain reaction(qRT-PCR) was used to detect serum circANKRD36 levels, and enzyme-linked immunosorbent assay(ELISA) was used to measure sRAGE levels. The Kaplan-Meier method was used to analyze differences in 28-day survival. Multivariate Cox regression analysis was employed to identify factors influencing prognosis and death in patients with sepsis-associated ARDS.Results Serum circANKRD36 and sRAGE levels in the ARDS group were higher than those in the non-ARDS group(t/P=2.318/<0.001, 3.743/<0.001). Survival analysis showed that the mortality rate in the ARDS group was higher than that in the non-ARDS group(χ2/P=7.453/0.006). In the death subgroup, PaO2/FiO2 was lower than that in the survival subgroup, while Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ) score, Sequential Organ Failure Assessment(SOFA) score, and levels of C-reactive protein(CRP), procalcitonin(PCT), circANKRD36, and sRAGE were higher(t/P=5.670/<0.001, 5.539/<0.001, 5.201/<0.001, 9.605/<0.001, 5.360/<0.001, 10.973/<0.001, 8.834/<0.001). Multivariate Cox regression analysis indicated that high APACHE Ⅱ score, high SOFA score, high CRP, high PCT, high circANKRD36, and high sRAGE were independent risk factors for poor prognosis in sepsis-associated ARDS patients [HR(95%CI)=1.371(1.199-1.579),1.401(1.201-1.583),1.023(1.013-1.034),1.304(1.149-1.481),1.466(1.278-2.467),1.315(1.266-1.547)],while high PaO2/FiO2 was an independent protective factor [HR(95%CI)=0.975(0.963-0.987)].Conclusions Serum circANKRD36 and sRAGE levels are significantly associated with the 28-day prognosis of sepsis-associated ARDS patients. Abnormally elevated levels of serum circANKRD36 and sRAGE indicate a relatively high risk of death. These biomarkers may serve as potential indicators for evaluating prognosis in sepsis-associated ARDS, and dynamic monitoring could provide important reference for early clinical intervention and individualized treatment strategies.

Objective To investigate the relationship between the expression of secreted phosphoprotein 1(SPP1), metastasis suppressor 1(MTSS1), and solute carrier family 7 member 11(SLC7A11) in non-small cell lung cancer(NSCLC) tissues and the clinical pathological characteristics and prognosis of patients. Methods A total of 204 NSCLC patients admitted to the Department of Oncology of Huanggang Central Hospital from July 2019 to June 2021 were selected as the study objects. The expression of SPP1, MTSS1 and SLC7A11 in cancer tissues and adjacent tissues were detected by immunohistochemistry. According to the death situation within 3 years after operation, the patients were divided into death group(n=50) and survival group(n=143). Multivariate Cox regression was used to analyze the prognostic factors of NSCLC. Kaplan-Meier curve was used to analyze the relationship between the expression of SPP1, MTSS1 and SLC7A11 and the prognosis of NSCLC. Results The positive expression rates of SPP1 and SLC7A11 in cancer tissues were significantly higher than those in paracancer tissues, and the positive expression rates of MTSS1 were significantly lower than that in paracancer tissues( χ2/P=90.362/<0.001, 100.885/<0.001, 102.073/<0.001). Among the positive SPP1 expression in NSCLC patients, the percentage of patients with tumor diameter ≥5 cm, TNM staging in 35 years, lymph node metastasis and history of smoking was higher( χ2/P=5.408/0.020, 10.636/<0.001, 6.838/<0.001, 10.352/<0.001). At the same time, the proportion of these patients in SLC7A11 positive expression was also higher( χ2=6.965, 7.638, 10.597, 16.657, P<0.001), while in MTSS1 positive expression, The proportion of patients with TNM stage Ⅰ to Ⅱ, no lymph node metastasis and no smoking history was higher( χ2=9.681, 10.611, 7.187, P<0.001). Compared with the survival group, the proportion of smoking history and occupational exposure, TNM stage Ⅲ and lymph node metastasis in the death group was significantly higher( χ2/P=7.501/<0.001,4.205/0.040,12.861/<0.001,10.907/<0.001). The survival rate of SPP1 and SLC7A11 positive patients in the death group was lower than that of the survival group, while the survival rate of MTSS1 positive patients in the survival group was higher than that of the death group( χ2/P=11.273/<0.001,11.490/<0.001,7.603/0.006). Multivariate Cox regression results showed that TNM stage Ⅲ, lymph node metastasis, positive SPP1, positive SLC7A11 and smoking history were all risk factors for poor prognosis of NSCLC. Positive MTSS1 was a protective factor for poor prognosis of NSCLC[HR(95%CI)=2.369(1.623-3.458), 1.843(1.308-2.597), 2.014(1.396-2.906), 1.986(1.420-2.777), 2.259(1.370-3.724), 0.856(0.754-0.972)]. The three-year overall survival rate of NSCLC patients with SPP1 and SLC7A11 positive expression was lower than that of SPP1 and SLC7A11 negative expression(Log Rank χ2/P=9.988/0.002, 10.608/0.001), respectively. The three-year overall survival rate of patients with positive expression of MTSS1 was higher than that with negative expression of MTSS1(Log Rank χ2/P=7.884/0.005). Conclusion SPP1 and SLC7A11 have a high positive expression rate in NSCLC tissues, while MTSS1 has a low positive expression rate in NSCLC tissues. The expression of these three proteins is closely related to the pathological features and prognosis of NSCLC.

Objective To investigate the expression of serum Claudin-5 and β-trace protein( BTP) in patients with severe acute pancreatitis( SAP) complicated with acute kidney injury( AKI) and its correlation with the severity of the disease. Methods A total of 135 SAP patients admitted to the Department of Gastroenterology, Affiliated Xidian Group Hospital of Shaanxi University of Traditional Chinese Medicine from January 2019 to August 2024 were selected. According to whether AKI was combined, they were divided into AKI group and non-AKI group. According to the degree of illness, they were divided into stage 1 SAP combined with AKI group, stage 2 SAP combined with AKI group, and stage 3 SAP combined with AKI group. The levels of serum Claudin-5 and BTP were detected by enzyme-linked immunosorbent assay. The relationship between serum Claudin-5, BTP and SAP combined with AKI was analyzed by multivariate Logistic regression analysis. ROC curve was used to analyze the predictive efficiency of serum Claudin-5 and BTP. Results The incidence of AKI in 135 patients with SAP was 44.44 %(60/135). Compared with the non-AKI group, the serum levels of Claudin-5 and BTP in the AKI group were increased(t/P=7.486/<0.001,8.502/<0.001); The levels of serum Claudin-5 and BTP in stage 1 SAP combined with AKI group, stage 2 SAP combined with AKI group and stage 3 SAP combined with AKI group increased in turn(F/P=36.526/<0.001,21.304/<0.001). High APACHE Ⅱ score, high serum creatinine, high Claudin-5 and high BTP were independent risk factors for SAP complicated with AKI[OR(95%CI)=3.375(1.123-10.147),1.025(1.010-1.041),1.001(1.000-1.001),1.320(1.130-1.542)]; The area under the curve of serum Claudin-5, BTP levels and the combination of the two in predicting SAP with AKI were 0.772,0.784 and 0.873, respectively. The combination of the two was greater than the AUC predicted by serum Claudin-5 and BTP levels alone(Z/P=2.992/0.004,3.071/0.003). Conclusion The increase of serum Claudin-5 and BTP levels is related to the occurrence and severity of SAP combined with AKI. The combination of serum Claudin-5 and BTP levels has a high predictive efficiency for SAP combined with AKI.

Objective To analyze the relationship between the changes in plantar pressure and nerve conduction velocity in patients with diabetic foot. Methods A total of 90 patients with diabetic foot admitted to our hospital from May 2021 to October 2023 were retrospectively selected as the research subjects. According to whether nerve conduction abnormalities occurred, the patients were divided into the non-occurrence group(n=48) and the occurrence group(n=42). The plantar pressure parameters of the two groups were compared. The Pearson correlation coefficient was used to analyze the correlation between plantar pressure and nerve conduction velocity abnormalities. Multivariate Logistic regression analysis was performed to identify the influencing factors of nerve conduction abnormalities in patients with diabetic foot. Results The plantar contact area, maximum pressure value(PP), and pressure-time integral(PTI) in the occurrence group were all higher than those in the non-occurrence group(t/P=27.046/<0.001, 32.842/<0.001, 27.560/<0.001). The conduction velocities of the median nerve, ulnar nerve, peroneal nerve, radial nerve, and tibial nerve, as well as the F-wave conduction velocities in the occurrence group were all lower than those in the non-occurrence group(t/P=9.872/<0.001, 8.921/<0.001, 8.563/<0.001, 9.125/<0.001, 10.214/<0.001, 8.347/<0.001, 7.986/<0.001, 8.023/<0.001, 9.012/<0.001, 8.765/<0.001). Pearson's test showed that the plantar contact area, PP, and PTI were all positively correlated with nerve conduction velocity abnormalities(r/P=0.789/<0.001, 0.715/0.002, 0.802/<0.001). The results of multivariate Logistic regression analysis showed that the increases in plantar contact area, PP, and PTI were all independent risk factors for nerve conduction abnormalities in patients with diabetic foot [OR(95%CI)= 2.690(1.864-2.967), 2.401(1.933-3.013), 2.474(1.847-2.842)]. Conclusion The plantar contact area, PP, and PTI are the main factors contributing to nerve conduction abnormalities in patients with diabetic foot. Clinicians should pay attention to patients with diabetic foot whose above indicators are elevated.

Objective To determine the effects of sitagliptin on renal function, endothelial function, serum neutrophil-to-lymphocyte ratio(NLR), galectin-3, and secreted frizzled-related protein 5(SFRP5) in patients with diabetic nephropathy. Methods A total of 108 patients with diabetic nephropathy treated in our hospital from October 2021 to May 2024 were selected and divided into two groups based on the random number table method, with 54 patients in each group. The control group received conventional insulin combined with benazepril treatment, and the observation group received additional sitagliptin treatment on the basis of the control group's regimen. The differences in renal function indices, endothelial function-related indices, NLR, galectin-3, and SFRP5 levels were compared between the two groups. Results After 12 weeks of treatment, the levels of SCr, BUN, and β2-MG in the observation group were lower than those in the control group(t/P=9.482/<0.001,4.287/<0.001,9.242/<0.001); the levels of NO and ET in the observation group were higher/lower than those in the control group(t/P=23.298/<0.001,35.936/<0.001);the neutrophil count, lymphocyte count, and NLR in the observation group were lower than those in the control group(t/P=16.818/<0.001,6.256/<0.001,8.132/<0.001);the serum levels of galectin-3 and SFRP5 in the observation group were lower/higher than those in the control group(t/P=3.435/0.001,5.099/<0.001).Conclusion Sitagliptin can improve renal function and vascular endothelial function in patients with diabetic nephropathy, and can also regulate the levels of serum NLR, galectin-3, and SFRP5.