Objective To analyze the relationship between T lymphocyte subsets, interleukin-6(IL-6) levels and prognosis in AIDS patients with moderate-to-severe pneumocystis jirovecii pneumonia(PCP).Method A retrospective analysis was conducted on the clinical data of 200 AIDS patients with moderate to severe PCP admitted to Respiratory Department of Beijing Ditan Hospital, Capital Medical University from April 2020 to June 2024. The patients were divided into a poor prognosis group(n=30) and a good prognosis group(n=170) based on their survival status within 30 days of treatment. Multivariate Cox regression analysis was conducted to identify the influencing factors of prognosis in AIDS patients with moderate to severe PCP. The receiver operating characteristic(ROC) curve was used to evaluate the predictive value of T lymphocyte subsets and IL-6 levels for poor prognosis in AIDS patients with moderate to severe PCP.The dose-response relationship between T lymphocyte subsets, IL-6 and poor prognosis in AIDS patients with moderate to severe PCP was explored.Results The proportion of severe PCP, human immunodeficiency virus(HIV) viral load, lactate dehydrogenase and IL-6 levels in the poor prognosis group were higher than those in the good prognosis group, and albumin, T lymphocyte CD3+ and CD4+ counts were lower than those in the good prognosis group(χ2/t=5.267, 11.112, 5.561, 6.714, 5.159, 4.933, 5.741, all P<0.05). High HIV viral load, elevated lactate dehydrogenase, and elevated L-6 were the influencing factors of poor prognosis in AIDS patients with moderate to severe PCP [HR(95%CI)=1.383(1.212-1.578),1.012(1.003-1.021),1.495(1.049-2.132)]. Increased CD3+ and CD4+ count [HR(95%CI)=0.983(0.970-0.997),0.875(0.773-0.990)] of T lymphocytes were protective factors for good prognosis in AIDS patients with moderate to severe PCP.The area under the curve(AUC) of T lymphocyte CD3+, CD4+ count, IL-6 alone and the combination of the three in predicting the poor prognosis of AIDS patients with moderate to severe PCP were 0.766,0.802,0.768 and 0.905, respectively.The AUC of the combination of the three in predicting the poor prognosis of patients was larger(Z=2.773, 2.292, 2.686, all P<0.001). Restrictive cubic bar analysis showed that as T lymphocyte CD3+ and CD4+ counts decreased and IL-6 levels increased, the risk of poor prognosis in patients also rapidly increased.Conclusion T cell depletion and IL-6 elevation correlate with poor PCP outcomes in AIDS patients, with combined assessment providing optimal prognostic value.

Objective To investigate the relationship between systemic immune-inflammation index(SII), systemic inflammation response index(SIRI), fibrinogen-to-albumin ratio(FAR), and disease severity as well as coexisting active pulmonary tuberculosis(APTB) in patients with acute exacerbation of bronchiectasis(AEBE).Methods A retrospective analysis was conducted on 206 AEBE patients admitted to the Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University between January 2019 and May 2024. Based on bronchiectasis severity index(BSI) scores, patients were categorized into mild(n=72), moderate(n=55), and severe(n=79) AEBE groups. They were also divided into APTB group(n=62) and non-APTB group(n=144) according to APTB presence. Clinical data were collected, and SII, SIRI, and FAR were calculated. Spearman correlation analyzed associations between SII, SIRI, FAR and BSI scores. Univariate and multivariate logistic regression identified factors associated with AEBE-APTB comorbidity and constructed a nomogram prediction model. The Hosmer-Lemeshow test assessed model fit, while ROC curve, C-index, calibration curve, and decision curve analysis evaluated model performance, discrimination, calibration, and clinical utility.Results SII, SIRI, and FAR levels progressively increased with disease severity across mild, moderate, and severe AEBE groups(F/P=136.677/<0.001, 200.878/<0.001, 86.227/<0.001). Compared with non-APTB group, APTB group had older age, higher BSI scores, higher hemoptysis proportion, and elevated SII, SIRI and FAR levels(χ2/t/P=3.408/0.001, 4.545/<0.001, 7.937/0.005, 6.101/<0.001, 4.972/<0.001, 5.535/<0.001). Spearman correlation showed SII, SIRI, and FAR were positively correlated with BSI scores(rs/P=0.624/<0.001, 0.696/<0.001, 0.606/<0.001). multivariate="" logistic="" regression="" identified="" older="" high="" bsi="" siri="" and="" far="" as="" independent="" risk="" factors="" for="" aptb="" in="" aebe="" patients="" .="" a="" nomogram="" prediction="" model="" was="" constructed="" showed="" good="" hosmer-lemeshow="" p="">0.05). The AUC for predicting APTB was 0.888(95%CI: 0.837-0.928), with C-index of 0.888(95%CI: 0.869-0.895). Calibration curves showed good consistency between predicted and actual probabilities. Decision curve analysis demonstrated positive net clinical benefit when threshold probability was >0.08.Conclusion Elevated SII, SIRI, and FAR levels are associated with disease severity and APTB in AEBE patients. The nomogram model based on these indicators demonstrates high predictive value for AEBE patients with APTB.

Objective To explore the predictive value of serum hypoxia-inducible factor-1α(HIF-1α), neutrophil-to-lymphocyte ratio(NLR), and C-reactive protein-to-albumin ratio(CAR) for the prognosis of patients undergoing thoracoscopic radical resection for lung cancer.Methods Eighty lung cancer patients who underwent thoracoscopic radical resection at Tai'an Central Hospital Affiliated to Qingdao University from January 2022 to December 2023 were selected. Preoperative serum HIF-1α, NLR, and CAR levels were measured in all patients, and postoperative follow-up was conducted for one year to assess prognosis. Serum levels of HIF-1α, NLR, and CAR were compared between patients with different prognostic outcomes. Logistic regression analysis was used to investigate the relationship between these biomarkers and prognosis, and receiver operating characteristic(ROC) curves were plotted to evaluate their predictive value.Results Among the 80 patients, 19(23.75%) had poor prognosis and 61(76.25%) had good prognosis after one year of follow-up. Patients in the poor prognosis group had higher tumor staging and elevated serum levels of HIF-1α, NLR, and CAR compared to the good prognosis group(χ2/t/P=2.699/0.007、8.254/<0.001、13.383/<0.001、8.815/<0.001). logistic="" regression="" analysis="" showed="" that="" elevated="" serum="" and="" car="" levels="" were="" risk="" factors="" for="" poor="" .="" roc="" curve="" revealed="" the="" auc="" values="" of="" predicting="" prognosis="" all="" greater="" than="" indicating="" predictive="" value.="" combined="" detection="" these="" biomarkers="" further="" improved="">0.90). Optimal cutoff values were 41.175 ng/L for HIF-1α, 3.895 for NLR, and 0.525 for CAR.Conclusion Serum HIF-1α, NLR, and CAR levels are associated with prognosis in patients undergoing thoracoscopic radical resection for lung cancer and demonstrate high predictive value. These biomarkers may serve as important indicators for postoperative prognosis evaluation.

Objective To investigate the expression levels of endothelin-converting enzyme 2(ECE2) and lymphocyte antigen 9(LY9) in tissues of non-small cell lung cancer(NSCLC) patients, and to analyze their relationship with clinicopathological factors and prognosis.Methods A retrospective study was conducted on 96 NSCLC patients treated in our hospital from January 2020 to January 2022. Quantitative PCR was used to analyze the differential expression of ECE2 mRNA and LY9 mRNA in NSCLC tissues. Immunohistochemistry was performed to detect ECE2 and LY9 protein expression levels. Kaplan-Meier curves were used to analyze the impact of ECE2 and LY9 expression on NSCLC patient prognosis. Cox regression analysis was used to identify prognostic factors in NSCLC patients.Results The expression levels of ECE2 mRNA(3.01±0.54 vs. 0.76±0.20) and LY9 mRNA(2.76±0.46 vs. 0.68±0.19) in NSCLC cancer tissues were significantly higher than those in normal lung tissues(t=38.283, 40.948, both P<0.001). The positive rates of ECE2 and LY9 in NSCLC cancer tissues were 70.83%(68/96) and 66.67%(64/96), respectively, significantly higher than those in adjacent tissues(7.29%(7/96) and 6.25%(6/96), respectively)(χ2=81.417, 75.631, both P<0.001). The positivity rates of ECE2 and LY9 in NSCLC cancer tissues were significantly increased in patients with TNM stage IIIA and lymph node metastasis(χ2=13.366, 5.042, 15.247, 6.750; P=0.000, 0.025, 0.006, 0.009). The 3-year overall survival rate in the ECE2-positive group was 45.59%(31/68), significantly lower than the 85.71%(24/28) in the negative group(Log-rank χ2/P=12.900/<0.001). The 3-year overall survival rate in the LY9-positive group was 45.31%(29/64), significantly lower than the 81.25%(26/32) in the negative group(Log-rank χ2/P=12.670/<0.001). TNM stage IIIA, lymph node metastasis, positive ECE2 expression, and positive LY9 expression were identified as risk factors affecting NSCLC prognosis[OR(95%CI)=1.292(1.035-1.612), 1.289(1.047-1.587), 1.327(1.104-1.596), 1.415(1.094-1.829)].Conclusion The expression of ECE2 and LY9 is elevated in NSCLC tissues and serves as novel biomarkers for evaluating the prognosis of NSCLC patients.

Objective To explore the clinical efficacy of combination therapy with recombinant endostatin and cetuximab in advanced non-small cell lung cancer(NSCLC) and its impacts on serum Toll-like receptor 4(TLR4) and vascular endothelial growth factor(VEGF) levels.Methods A total of 120 patients with advanced NSCLC admitted to the Department of Thoracic Surgery, Hunan Second People's Hospital/Hunan Brain Hospital from October 2021 to October 2024 were enrolled. They were randomly assigned via random number table into a control group(cetuximab, n=60) and an experimental group(recombinant endostatin + cetuximab, n=60). Clinical efficacy, tumor marker levels, TLR4, VEGF, quality of life, and adverse reactions were compared between the two groups.Results The disease control rate in the experimental group was 91.67%, significantly higher than that in the control group(78.33%)(χ2/P=4.183/0.041). After three treatment cycles, levels of tissue polypeptide antigen(TPA), carcinoembryonic antigen(CEA), squamous cell carcinoma antigen(SCC), cytokeratin 19 fragment(CYFRA21-1), TLR4, and VEGF in the experimental group were significantly lower than those in the control group, while scores on the Functional Assessment of Cancer Therapy-Lung(FACT-L) scale were significantly higher(t/P=12.137/<0.001, 5.024/<0.001, 5.165/<0.001, 4.798/<0.001, 3.786/<0.001, 4.118/<0.001, 3.740/<0.001). The total incidence of adverse reactions was 11.67% in the control group and 15.00% in the experimental group, with no statistically significant difference(χ2/P=0.288/0.591).Conclusion The combination of recombinant endostatin and cetuximab demonstrates significant clinical efficacy in advanced NSCLC. It effectively reduces tumor marker levels, modulates TLR4 and VEGF expression, improves patient quality of life, and exhibits a favorable safety profile.