Objective To explore the relationship between serum heat shock protein 27(HSP27), omentin-1, Clara cell secreted protein 16(CC16) and the severity of septic shock patients, and to predict adverse prognosis using ROC analysis.Methods From April 2022 to March 2025, 205 sepsis patients in Southern Hospital of the Sixth People' s Hospital Affiliated to Shanghai Jiao Tong University were enrolled as the observation group. They were divided into a sepsis group(n = 108) and a septic shock(SK) group(n = 97) based on disease severity. According to the 28-day survival status, SK patients were further divided into a survival subgroup(n = 56) and a death subgroup(n = 41). Meanwhile, 100 healthy individuals undergoing physical examinations at our hospital served as the healthy control group. ELISA was used to measure serum HSP27, omentin-1,and CC16 levels, and differences were compared among the groups. Relative risk(RR) analysis was applied to evaluate the impact of different levels of HSP27, omentin-1, and CC16 on the prognosis and survival of SK patients. ROC analysis was used to assess the predictive value of HSP27, omentin-1, CC16, and their combination for adverse prognosis in SK. Results The observation group showed higher serum HSP27, omentin-1, and CC16 levels than the healthy control group(t/P =46.391/<0.001, 12.406/<0.001, 27.184/<0.001). Compared with the sepsis group, the SK group had higher serum HSP27,omentin-1, and CC16 levels(t/P = 6.191/<0.001, 5.981/<0.001, 5.249/<0.001). The death subgroup exhibited higher serum HSP27, omentin-1, and CC16 levels than the survival subgroup(t/P = 47.905/<0.001, 6.214/<0.001, 18.517/<0.001). The risk of adverse prognosis in SK patients with high levels of serum HSP27, omentin-1, and CC16 was 2.264, 2.796, and 2.025 times higher than in those with low levels, respectively(χ 2/P = 9.840/0.002, 15.110/<0.001, 7.974/0.005). The AUC values of serum HSP27, omentin-1, CC16, and their combination for predicting poor prognosis in SK patients were 0.860, 0.864, 0.886, and0.965, respectively. The combined prediction of all three markers was superior to the AUC of each individual prediction(Z =2.823, 2.715, 2.386; P = 0.005, 0.007, 0.017). Conclusion Serum HSP27, omentin-1, and CC16 levels are closely related to the condition and prognosis of SK patients. ROC analysis indicates that combined detection has higher predictive value, may serve as potential biomarkers for predicting adverse prognosis in SK patients, and is beneficial for clinical evaluation of disease severity and prognosis.

Objective To construct and validate a risk prediction model for disseminated intravascular coagulation(DIC) in sepsis patients based on neutrophil-to-platelet ratio(NPR), platelet-to-lymphocyte ratio(PLR), and systemic immuneinflammation index(SII).Methods A retrospective study was conducted on 353 sepsis patients admitted to the Infectious Disease and Liver Disease Center of the First Affiliated Hospital of Xinjiang Medical University from December 2022 to December 2024. According to DIC occurrence, patients were divided into DIC group(n = 58) and non-DIC group(n = 295). Multivariate logistic regression analysis was used to identify independent risk factors for DIC in sepsis patients, and a nomogram prediction model was constructed based on NPR, PLR, SII, and other significant factors. The model' s predictive performance was evaluated using receiver operating characteristic(ROC) curve and area under the curve(AUC), while the calibration curve assessed model fit.Results Among 353 sepsis patients, 58 developed DIC, with an incidence of 16.4%. Compared with the non-DIC group, the DIC group showed significantly higher values in: mean age, proportion with diabetes history, pulmonary infections, bloodstream infections, SOFA score, APACHE Ⅱ score, shock incidence, vasoactive drug use, mechanical ventilation rate, renal replacement therapy rate, NPR, SII, prothrombin time(PT), activated partial thromboplastin time(APTT), and D-dimer(D-D). Conversely, PLR and fibrinogen(FIB) were significantly lower in the DIC group(χ 2/t/P = 2. 367/0. 018,4.173/0.041, 4.062/0.044, 4.053/0.044, 2.412/0.016, 2.757/0.006, 4.109/0.043, 4.538/0.033, 4.04/0.044, 4.304/0.038, 4.735/<0.001,-4.158/<0.001, 3.812/<0.001, 2.622/0.009, 2.662/0.008,-3.696/<0.001, 3.221/0.001). Multivariate analysis identified older age, higher SOFA score, higher APACHE Ⅱ score, elevated NPR, elevated SII, and prolonged PT as independent risk factors for DIC, while higher PLR and FIB were protective factors [OR(95%CI) = 1.091(1.013-1.175), 3.807(1.616-8.967),1.183(1.050-1.333), 4.680(2.080-6.092), 0.980(0.969-0.991), 1.001(1.000-1.003), 1.050(1.008-1.094), 0.501(0.301-0.833)]. The ROC analysis showed an AUC of 0.821(95%CI : 0.715-0.868) for DIC prediction. The calibration curve indicated good model fit(Hosmer-Lemeshow χ 2= 6.400,P = 0.603).Conclusion The age, SOFA score, APACHE Ⅱ score, NPR,PLR, SII, PT, and fibrinogen are associated with DIC in sepsis patients. The nomogram model incorporating NPR, PLR, SII,and other relevant indicators demonstrates high predictive value for DIC risk in sepsis patients.

Objective To explore the risk factors for secondary liver injury in children with sepsis and the predictive value of serum S100 calcium-binding protein A9(S100A9), tumor necrosis factor receptor-associated factor 6(TRAF6), and peroxiredoxin-1(PRDX1). Methods Eighty-three children with sepsis secondary to liver injury admitted to the Department of Infectious Diseases of the Affiliated Women' s and Children' s Medical Center of Guangzhou Medical University from January 2022 to January 2025 were selected as the liver injury group, and 126 children without secondary liver injury were selected as the non-liver injury group. The liver injury group was further classified into 34 cases of severe, 27 cases of moderate, and22 cases of mild according to the degree of liver injury. Serum levels of S100A9, TRAF6, and PRDX1 were detected using the ELISA method. Multifactorial logistic regression analysis was used to identify risk factors affecting secondary liver injury. Relative risk analysis was performed to assess the impact of different serum levels of S100A9, TRAF6, and PRDX1 on secondary liver injury. The predictive value of serum S100A9, TRAF6, and PRDX1 for secondary liver injury was evaluated using ROC curve analysis. Results The liver injury group had higher APACHE Ⅱ scores, SOFA scores, AST, ALT, S100A9, TRAF6,and PRDX1 levels than the non-liver injury group(t = 5.300,2.401,15.638,17.510,8.160,8.716,7.770,P<0.001). Serum levels of S100A9, TRAF6, and PRDX1 in children with different degrees of liver injury increased with the severity of injury(F =11.973,14.261,14.659,P <0.001). Higher APACHE Ⅱ scores and elevated levels of AST, ALT, S100A9, TRAF6, and PRDX1 were identified as risk factors for secondary liver injury in children with sepsis [OR( 95%CI) = 1.672(1.141-2.450),2.683(1.436-5.014),2.945(1.495-5.802),3.065(1.709-5.497),3.271(1.799-5.947),2.986(1.573-5.668)]. The AUCs of serum S100A9, TRAF6, PRDX1, and the combination of the three for predicting secondary liver injury in children with sepsis were0.844, 0.818, 0.833, and 0.936, respectively. The combination of the three markers was superior to the AUCs predicted by each of serum S100A9, TRAF6, and PRDX1 individually(Z = 3.336, 3.679, 3.213, P = 0.001, <0.001, 0.001).Conclusion Higher APACHE Ⅱ scores and elevated levels of AST, ALT, S100A9, TRAF6, and PRDX1 are risk factors for secondary liver injury in children with sepsis. The combined detection of serum S100A9, TRAF6, and PRDX1 has a high predictive value for secondary liver injury in children with sepsis.

Objective To investigate the expression of serum F-box protein 45(FBXO45) and solute carrier family 7 member 2(SLC7A2) in patients with breast cancer(BC) and their predictive value for postoperative recurrence and metastasis.Methods From October 2022 to October 2023, 106 BC patients who underwent surgical treatment in our hospital were selected as the study group. They were classified into a recurrence group(n = 29) and a non-recurrence group(n = 77) based on the presence or absence of recurrence or metastasis. During the same period, 106 patients with benign breast lesions served as the lesion group. ELISA was used to detect serum FBXO45 and SLC7A2 levels. Clinicopathological features and serum marker levels were compared between the recurrence and non-recurrence groups. The influencing factors for postoperative recurrence and metastasis in BC patients were explored. ROC curve analysis was used to evaluate the predictive value of serum FBXO45 and SLC7A2 for postoperative recurrence and metastasis in BC patients. Results Compared with the lesion group,the study group showed higher serum FBXO45(t/P = 9.533/<0.001, 7.431/<0.001) and higher serum SLC7A2(t/P = 7.852/<0.001, 7.145/<0.001). The recurrence group had higher proportions of clinical stage Ⅲ, lymph node metastasis, and vascular invasion than the non-recurrence group(χ 2/P = 12.626/0.002, 5.667/0.017, 8.022/0.005). Serum FBXO45, SLC7A2, clinical stage, lymph node metastasis, and vascular invasion were identified as influencing factors for postoperative recurrence and metastasis in BC patients [OR( 95%CI) = 1.954(1.052-3.630),1.721(1.125-2.633),2.128(1.080-4.193),2.576(1.133-5.856),0.585(0.387-0.885)]. The area under the curve(AUC) values of serum FBXO45, SLC7A2, and their combination in predicting postoperative recurrence and metastasis in BC patients were 0.798, 0.801, and 0.907, respectively. The combined prediction was superior to individual predictions(Z combination-FBXO45 = 2.068, Z combination-SLC7A2 = 2.127; P = 0.039, P =0.033). Conclusion Serum FBXO45 is significantly increased and serum SLC7A2 is significantly decreased in BC patients.Combined detection of both markers has higher predictive value for postoperative recurrence and metastasis in BC patients.

Objective To investigate the differences in serum receptor-interacting protein kinase(RIPK) levels among patients with steroid-induced osteonecrosis of the femoral head(SONFH) at different clinical stages, and to analyze the correlation between RIPK and the progression of SONFH. Methods A total of 267 patients with SONFH who were treated in the Department of Traumatic Surgery, the Fifth Affiliated Hospital of Xinjiang Medical University from January 2022 to January 2025 were selected as the case group, and 40 healthy subjects who underwent physical examination in the same hospital during the same period were selected as the healthy control group. Patients in the case group were classified into stages Ⅰto Ⅳ according to the Ficat staging criteria. The differences in serum levels of RIPK1, RIPK2, RIPK3, and RIPK4 were compared between the two groups and among patients with different stages. Spearman correlation analysis was used to evaluate the correlation between serum levels of each RIPK subtype and the clinical staging of SONFH. Results Among the 267 patients with SONFH, 65 cases(24.3%) were in Ficat stage Ⅰ, 78 cases(29.2%) in stage Ⅱ, 69 cases(25.8%) in stage Ⅲ, and 55 cases(20.7%) in stage Ⅳ. The serum levels of RIPK1, RIPK2, RIPK3, and RIPK4 in the case group were significantly higher than those in the healthy control group(t/P = 9.936/<0.001, 10.744/<0.001, 13.996/<0.001, 10.016/<0.001). With the progression of clinical staging(from stage Ⅰ to Ⅳ), the serum levels of RIPK1, RIPK2, RIPK3, and RIPK4 increased sequentially(F/P = 62.221/<0.001, 77.028/<0.001, 58.896/<0.001, 57.522/<0.001). Spearman correlation analysis showed that serum levels of RIPK1, RIPK2, RIPK3, and RIPK4 in patients with SONFH were significantly positively correlated with Ficat staging(r s=0.611, 0.733, 0.660, 0.704, all P<0.05). Conclusion The serum levels of RIPK1, RIPK2, RIPK3, and RIPK4 in patients with SONFH are significantly higher than those in the healthy control group, and these RIPK levels gradually increase with the progression of Ficat staging. This suggests that members of the RIPK family are closely related to the severity of SONFH and may be involved in the progression of the disease.