Objective To compare the diagnostic value of metagenomics next-generation sequencing(mNGS) in etiological detection of diabetes mellitus complicated with community-acquired pneumonia(CAP). Methods The clinical data of134 patients with diabetes mellitus complicated with community-acquired pneumonia who treated at the Respiratory Center of the First Affiliated Hospital of Xinjiang Medical University from July 2021 to December 2024 were selected. All enrolled patients received The conventional microbiological tests(CMTs)and m NGS, and the sensitivity, specificity, positive predictive value(PPV) and negative predictive value(NPV), pathogen distribution and the consistency of detection results of the two methods were compared. The diagnostic efficiency of the two methods for diabetes mellitus complicated with community-acquired pneumonia was compared. Results Among 134 patients with DM complicated with CAP, the detection sensitivity of m NGS examination for infectious pathogens(94.3%) was higher than that of CMTs(78.3%), and the difference was statistically significant(χ 2= 9.481,P = 0.002). However, in terms of detection efficacy(0.775), specificity(60.7%), PPV(90.09%),and NPV(73.91%), there was no statistically significant difference compared with m NGS(P >0.05). In terms of pathogen detection, the bacteria most frequently detected by m NGS were mycobacterium tuberculosis(19 cases). In terms of virus detection, the most frequently detected virus was human herpes virus(66 cases). The incidence of mixed infection detected by m NGS in diabetes mellitus patients with community-acquired pneumonia was 51.49%(69/134), and the most common type of mixed infection was bacteria-virus infection. Conclusion NGS can improve the pathogen detection rate of diabetes mellitus complicated with community-acquired pneumonia, effectively increase the detection efficiency of rare and special pathogens,and provide reasonable suggestions for the formulation of anti-infection treatment.

Objective To investigate the relationship between peripheral blood CXC chemokine ligand 10(CXCL10), extracellular heat shock protein 72(eHSP72), and the condition and prognosis of patients with acute respiratory failure(ARF).Methods A total of 359 patients with ARF admitted to the Department of Emergency Medicine of Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine/Zhuhai Hospital Affiliated to Southern Medical University from February 2020 to June 2024 were selected. According to the oxygenation index(OI), they were divided into a mild group(201-300 mm Hg, 102 cases), a moderate group(101-200 mm Hg, 157 cases), and a severe group(≤100 mm Hg, 93 cases).The levels of CXCL10 and e HSP72 in peripheral blood were detected. Deaths of ARF patients within 28 days of hospitalization were recorded, and patients were categorized into a death group and a survival group. Risk factors affecting death within28 days and the predictive value of CXCL10 and e HSP72 for mortality were analyzed.Results The levels of CXCL10 and e HSP72 in peripheral blood of ARF patients were higher in the severe group than in the moderate group, and higher in the moderate group than in the mild group(F/P = 371.739/< 0.001、629.200/< 0.001). Among the 359 patients, 106 died and 253 survived. The levels of CXCL10 and e HSP72 in the death group were higher than those in the survival group(t/P = 23.237/<0.001, 22.232/<0.001). Multivariate logistic regression analysis showed that older age, severe ARF, high CXCL10 level, and high e HSP72 level were risk factors for death within 28 days of hospitalization [OR( 95%CI) = 3.762(1.668-8.486),2.640(1.249-5.583),2.201(1.218-3.979),1.864(1.149-3.026)].The AUCs of CXCL10, e HSP72, and their combination in predicting28-day mortality were 0.731, 0.733, and 0.890, respectively. The AUC of the combination was higher than that of CXCL10 or e HSP72 alone(Z = 5.404,5.032,both P <0.001).Conclusion The levels of CXCL10 and e HSP72 in peripheral blood of ARF patients are significantly increased and are associated with disease severity and poor prognosis. The combination of CXCL10 and e HSP72 improves predictive value for the prognosis of ARF patients.

Objective To explore the diagnostic value of chest CT combined with serum carbohydrate antigen 242(CA242) and cytokeratin 19 fragment(CYFRA21-1) for benign and malignant pulmonary nodules. Methods From January2023 to December 2024, 98 patients with malignant pulmonary nodules(lung cancer) admitted to the Department of Respiratory and Critical Care Medicine of the 920 th Hospital of the Joint Logistics Support Force were retrospectively selected as the lung cancer group, while 76 patients with benign pulmonary nodules admitted during the same period were selected as the benign nodule group. Enzyme-linked immunosorbent assay(ELISA) was used to detect serum CA242 and CYFRA21-1 levels.Kappa analysis was used to evaluate the consistency between chest CT alone and in combination with serum CA242 and CYFRA21-1 for diagnosing benign and malignant pulmonary nodules compared with pathological diagnosis. Receiver operating characteristic curve(ROC) analysis was used to assess the diagnostic value of chest CT and serum CA242 and CYFRA21-1 for benign and malignant pulmonary nodules. Results Serum levels of CA242 and CYFRA21-1 in the lung cancer group were higher than those in the benign nodule group(t/P = 8.194/<0.001, 8.326/<0.001). The proportion of patients with larger nodule diameter, spiculation sign, vacuolar sign, and pleural indentation sign in the lung cancer group was higher than that in the benign nodule group(t/χ 2/P = 17.422/<0.001, 14.456/<0.001, 19.531/<0.001, 18.316/<0.001). The Kappa values for chest CT alone and in combination with serum CA242 and CYFRA21-1 for diagnosing benign and malignant pulmonary nodules were 0.738 and 0.884, respectively, indicating high and excellent consistency with pathological diagnosis(P <0.01). The area under the curve(AUC) for chest CT, serum CA242, CYFRA21-1 alone, and their combination in diagnosing benign and malignant pulmonary nodules were 0.863, 0.837, 0.842, and 0.943, respectively. The AUC of the combined diagnosis of all three was higher than that of each individual method(Z/P = 2. 169/0. 030, 2. 873/0. 004, 2. 801/0. 005). Conclusion Chest CT combined with serum CA242 and CYFRA21-1 can significantly improve the diagnostic accuracy for benign and malignant pulmonary nodules, which is beneficial for early screening of lung cancer.

Objective To investigate the relationship between the expression of late endosomal/lysosomal adaptor,MAPK and MTOR activator 1(LAMTOR1), regulator of G-protein signaling 20(RGS20) and clinicopathological features and prognosis in advanced lung adenocarcinoma. Methods The clinical data of 144 patients with NSCLC admitted to the Department of Respiratory Medicine of the First Affiliated Hospital of Xinjiang Medical University from January 2020 to January2022 were collected. The expressions of LAMTOR1 m RNA, RGS20 m RNA and protein were detected by q PCR and immunohistochemistry. Kaplan-Meier survival analysis and Cox proportional hazard regression model were used to evaluate the effect of LAMTOR1 and RGS20 expression on patient prognosis. Results The expressions of LAMTOR1 and RGS20 m RNA in lung adenocarcinoma tissues were(2.34 ± 0.56) and(2.63 ± 0.67), which were higher than those in adjacent tissues(0.84±0.26) and(0.74 ± 0.16)(t = 29.154, 32.925, all P<0.001). The positive rate of LAMTOR1 in cancer tissues was 70.83%(102/144), which was higher than that in adjacent tissues 5.56%(8/144)(χ 2= 129.968,P<0.001); the positive rate of RGS20 in cancer tissues was 63.89%(96/144), which was higher than that in adjacent tissues 6.94%(10/144)(χ 2= 110.411, P<0.001). The positive rates of LAMTOR1 and RGS20 were higher in patients with TNM stage ⅢA than in those with TNM stage Ⅰ-Ⅱ, and higher in patients with lymph node metastasis than in those without lymph node metastasis(χ 2= 10.980,6.534,13.333,10.800;P =0.001, 0.011,<0.001, 0.001). TNM stage ⅢA, lymph node metastasis, LAMTOR1 positive and RGS20 positive were risk factors for poor prognosis in patients with lung adenocarcinoma [HR( 95%CI) = 1.344(1.099-1.645),1.305(1.074-1.584), 1.363(1.046-1.776), 1.354(1.087-1.686)].Conclusion LAMTOR1 and RGS20 are highly expressed in lung adenocarcinoma, which is associated with poor clinicopathological features and can serve as potential prognostic biomarkers.

Objective To investigate the expression of phosphoglycerate mutase 1(PGAM1) and arginine succinate synthase 1(ASS1) in hepatocellular carcinoma(HCC) tissues and explore their prognostic significance.Methods Tissue specimens and clinical data of 124 HCC patients treated in the Department of Hepatobiliary Pancreatic Hernia Surgery, Affiliated Hospital of Xuzhou Medical University from January 2020 to January 2022 were collected. The expression of PGAM1 and ASS1 proteins in HCC was detected by immunohistochemistry. The differential expression of PGAM1 and ASS1 proteins in cancer tissues of HCC patients with different clinical features was compared. Kaplan-Meier curve and Cox regression analysis were used to investigate the prognostic factors of HCC.Results The positivity rate of PGAM1 in HCC cancer tissues was higher than that in adjacent tissues(66.13% vs. 8.06%), while the positivity rate of ASS1 was lower than that in adjacent tissues(33.06% vs. 87.10%), with statistical significance(χ 2= 89.579, 75.471,P<0.001). The expression of PGAM1 and ASS1 proteins in HCC cancer tissues was negatively correlated(r s=-0.795, P<0.001). The positivity rate of PGAM1 protein in cancer tissues was higher in CNLC stages Ⅱ-Ⅲ than in stage I, and the positivity rate of ASS1 protein in cancer tissues with CNLC stages Ⅱ-Ⅲ was lower than in stage Ⅰ(χ 2/P = 22.689/< 0.001, 6.933/0.008). The overall 3-year survival rates of PGAM1 positive and negative groups were 43.90%(36/82) and 76.19%(32/42), respectively, with a statistically significant difference between the curves(Log-rankχ 2= 13.440,P<0.001). The overall 3-year survival rates of ASS1 positive and negative groups were 82.93%(34/41) and 41.98%(34/81), respectively, with statistically significant differences between the curves(Log-rank χ 2= 19.280,P<0.001). CNLC stage Ⅱ-Ⅲ and PGAM1 positivity were risk factors affecting the prognosis of HCC,while ASS1 positivity was a protective factor [HR(95%CI) = 1.602(1.175-2.183), 1.684(1.228-2.308), 0.635(0.484-0.834)].Conclusion The upregulation of PGAM1 expression and downregulation of ASS1 expression in HCC are associated with CNLC staging and are potential tumor markers for evaluating the prognosis of HCC patients.