Objective To investigate the levels of regenerating family member 1 alpha(REG1α) and tensin homolog4(Tensin 4) in the serum of patients with colorectal cancer(CRC), and to analyze their predictive value for liver metastasis after laparoscopic radical resection of colorectal cancer. Methods A total of 124 patients with CRC who underwent laparoscopic radical resection of colorectal cancer in the Department of Gastroenterology, Wuhan Third Hospital from January 2019 to January 2022 were enrolled as the study subjects, and 60 healthy individuals undergoing physical examination were enrolled as the healthy control group. Enzyme-linked immunosorbent assay was used to detect the serum levels of REG1α and Tensin 4 in all subjects, and their correlation with the clinicopathological characteristics of patients was analyzed. Multivariate logistic regression model was used to evaluate the factors affecting postoperative liver metastasis in CRC patients. The value of serum REG1α and Tensin 4 in evaluating postoperative liver metastasis in CRC patients was assessed using receiver operating characteristic(ROC) curves. Results The serum levels of REG1α(15.41±3.16 μg/L vs. 3.02±0.54 μg/L) and Tensin 4(10.81±2.21 μg/L vs. 2.12± 0.42 μg/L) in the CRC group were significantly higher than those in the control group(t/P = 30.118/<0.001, 30.155/<0.001). Serum levels of REG1α and Tensin 4 were higher in CRC patients with TNM stage Ⅲ than in those with stage Ⅰ–Ⅱ, and higher in patients with positive lymph node metastasis than in those without(t/P = 19.452/<0.001,20.884/<0.001, 25.004/<0.001, 30.608/<0.001). The liver metastasis group had significantly higher serum REG1α and Tensin 4levels compared to the non-liver metastasis group(t/P = 16.472/<0.001, 45.063/<0.001). TNM stage Ⅲ, lymph node metastasis,elevated serum REG1α, and elevated Tensin 4 were independent risk factors for postoperative liver metastasis in CRC patients[OR(95%CI)=1.426(1.145-1.776), 1.406(1.152-1.718), 1.335(1.099-1.596), 1.297(1.096-1.535)]. The AUCs of serum REG1α, Tensin 4, and their combination for predicting postoperative liver metastasis in CRC patients were 0.841, 0.833, and0.916, respectively. The AUC of the combination was significantly larger than that of either marker alone(Z/P = 4.410/<0.001,4.462/<0.001). Conclusion Elevated serum levels of REG1α and Tensin 4 in CRC patients are closely associated with tumor malignant progression and may serve as potential serological markers for predicting liver metastasis after CRC surgery.

Objective To investigate the relationship between the expression of serum long non-coding RNA maternally expressed gene 3(lncRNA MEG3) and micro RNA-493-5p(miR-493-5p) in patients with aneurysmal subarachnoid hemorrhage(aSAH) and the degree of disease and prognosis. Methods The clinical data of 182 patients with a SAH(aSAH group) admitted to the Department of Neurosurgery, the First Hospital Affiliated to Hebei Northern University from January2023 to April 2025 were selected. The severity of a SAH patients was classified according to the World Federation of Neurosurgical Societies(WFNS) classification criteria on admission, including 112 cases in the mild subgroup(WFNS grade Ⅰ-Ⅲ)and 70 cases in the severe subgroup(WFNS grade Ⅳ-Ⅴ). In addition, 170 healthy volunteers who underwent physical examination in the hospital during the same period were set as the healthy control group. Clinical data of a SAH patients were collected, and serum levels of lnc RNA MEG3 and mi R-493-5p were detected by quantitative real-time PCR. Patients with a SAH were followed up for 6 months according to the Glasgow Outcome Scale(GOS) score, and were divided into a poor prognosis subgroup(GOS score 1-3, 61 cases) and a good prognosis subgroup(GOS score 4-5, 121 cases). Differences in serum lnc RNA MEG3 and mi R-493-5p levels and clinical data between the two subgroups were compared. Correlations of serum lnc RNA MEG3 and mi R-493-5p with disease severity and prognosis, factors affecting poor prognosis, and the predictive value of these two markers for poor prognosis were analyzed. Results Compared with the healthy control group, serum lnc RNA MEG3 level was significantly increased and mi R-493-5p level was significantly decreased in the a SAH group(t = 60.043,46.202, both P <0.001). Compared with the mild subgroup, the severe subgroup had significantly increased lnc RNA MEG3 and significantly decreased mi R-493-5p(t = 22.222, 20.157, both P <0.001). Compared with the good prognosis subgroup, the poor prognosis subgroup had a higher proportion of patients with a history of hypertension, modified Fisher scale score 3-4 at admission, Hunt-Hess scale score 3-5, WFNS grade Ⅳ-Ⅴ, aneurysm diameter ≥5 mm, cerebral vasospasm, and higher serum lnc RNA MEG3 levels, while mi R-493-5p levels were lower(χ2/t = 4.650, 99.688, 72.264, 79.006, 6.049, 39.729, 27.796,34.778;P = 0.031, <0.001, <0.001, <0.001, 0.014, <0.001, <0.001, <0.001). Serum lnc RNA MEG3 was negatively correlated with mi R-493-5p in a SAH patients(r =-0.617, P <0.001). lnc RNA MEG3 was positively correlated with WFNS grade and negatively correlated with GOS score(r = 0.723,-0.781, both P <0.001). mi R-493-5p was negatively correlated with WFNS grade and positively correlated with GOS score(r =-0.649, 0.695, both P <0.001). A history of hypertension, modified Fisher scale score 3-4 at admission, Hunt-Hess scale score 3-5, WFNS grade Ⅳ-Ⅴ, aneurysm diameter ≥5 mm, cerebral vasospasm,and high lnc RNA MEG3 level were independent risk factors for poor prognosis in a SAH patients, while high mi R-493-5p level was an independent protective factor [OR(95%CI) = 1.874(1.146-3.065), 2.863(1.541-5.319), 2.667(1.461-4.868), 4.047(1.844-8.881), 1.514(0.904-2.536), 2.442(1.397-4.270), 2.255(1.318-3.858), 0.398(0.188-0.839)]. The areas under the curve(AUC) for serum lnc RNA MEG3, mi R-493-5p, and their combination in predicting poor prognosis in a SAH patients were 0.796, 0.781, and 0.878, respectively. The AUC of the combination was significantly greater than that of either marker alone(Z = 1.968, 2.058; P = 0.043, 0.040). Conclusion In a SAH patients, serum lnc RNA MEG3 is highly expressed while mi R-493-5p is lowly expressed; these changes are more pronounced in patients with more severe conditions. The combination of lnc RNA MEG3 and mi R-493-5p has a favorable predictive effect on poor prognosis in a SAH patients.

Objective To investigate the application value of combined detection of serum cyclic guanosine monophosphate-adenosine monophosphate(cGAMP) and high-temperature requirement protein A2(HtrA2) levels in patients with severe pneumonia(SP) complicated by myocardial injury(MI). Methods A total of 102 patients with SP admitted to the Intensive Care Unit of Yulin Hospital, the First Affiliated Hospital of Xi' an Jiaotong University from January 2022 to January2025 were prospectively selected as the SP group, and 102 healthy volunteers were selected as the healthy control group at a1 ∶1 ratio. Serum c GAMP and HtrA2 levels were detected by enzyme-linked immunosorbent assay. SP patients were divided into a critical SP subgroup(48 cases) and a non-critical SP subgroup(54 cases) according to disease severity. The correlation between serum c GAMP and HtrA2 levels and disease severity was analyzed by point-biserial correlation. SP patients were further divided into an MI subgroup and a non-MI subgroup based on whether MI occurred within 28 days after admission. Factors influencing MI in SP patients and the predictive efficacy of serum c GAMP and HtrA2 levels were analyzed. Results Compared with the healthy control group, serum levels of c GAMP and HtrA2 were significantly increased in the SP group(t =14.512, 14.231, both P <0.001). Compared with the non-critical SP subgroup, serum levels of c GAMP and HtrA2 were significantly increased in the critical SP subgroup(t = 4.334, 4.363, both P <0.001). Serum c GAMP and HtrA2 levels in SP patients were positively correlated with disease severity(r = 0.498, 0.500, both P <0.001). The incidence of MI among the 102 SP patients was 50.98%(52/102). Compared with the non-MI subgroup, the MI subgroup had significantly higher levels of cardiac troponin I(cTnI), creatine kinase isoenzyme MB(CK-MB), c GAMP, and HtrA2(t = 3.444, 3.270, 5.926, 6.310; P = 0.001,0.001, <0.001, <0.001). Elevated c Tn I, elevated CK-MB, elevated c GAMP, and elevated HtrA2 were independent risk factors for MI in SP patients [OR(95%CI) = 2.326(1.270-4.260), 1.117(1.002-1.246), 2.054(1.390-3.034), 1.263(1.116-1.429)].The AUCs of serum c GAMP, HtrA2, and their combination in predicting MI in SP patients were 0.789, 0.800, and 0.912, respectively. The combined detection was superior to either marker alone(Z = 3.484, 3.132;P = 0.001, 0.002). Conclusion Elevated serum c GAMP and HtrA2 levels in SP patients are associated with increased disease severity and the occurrence of MI.Their combination demonstrates high predictive efficacy for MI.

Objective To construct a nomogram model for the prognosis of patients with chronic obstructive pulmonary disease(COPD) complicated with pulmonary arterial hypertension based on inflammatory related indicators and coagulation markers, and to verify its predictive efficacy. Methods Clinical data of 296 patients with COPD and pulmonary arterial hypertension admitted to the Department of Respiratory and Critical Care Medicine, Shanxi Bethune Hospital from January2023 to May 2025 were retrospectively collected. Patients were divided into a training set(n = 207) and a validation set(n = 89)at a 7 ∶3 ratio. Patients in the training set were divided into a good prognosis subgroup(n = 156) and a poor prognosis subgroup(n = 51) based on their prognosis at 1 week of treatment. General information, levels of inflammatory related indicators,and coagulation markers at admission were compared between the training set and the validation set, as well as between the poor prognosis subgroup and the good prognosis subgroup. Multivariate logistic regression was used to analyze the influencing factors of patient prognosis, and a nomogram model was constructed. The predictive efficacy and clinical utility of the model were evaluated using receiver operating characteristic(ROC) curves, calibration curves, and decision curves. Results The proportions of pulmonary arterial hypertension grade Ⅲ, concomitant hypertension, and levels of NLRP3, HMGB1, and v WF in the poor prognosis subgroup were significantly higher than those in the good prognosis subgroup(χ2/t = 4.823, 4.356, 5.760,2.975, 6.867;P = 0.028, 0.037, <0.001, 0.003, <0.001). Levels of C-reactive protein, NLR, PLR, D-dimer, and fibrinogen in the poor prognosis subgroup were significantly higher than those in the good prognosis subgroup, while antithrombin Ⅲ levels were significantly lower(t = 3.431, 5.267, 5.320, 4.628, 4.527, 5.152;P = 0.001, <0.001, <0.001, <0.001, <0.001, <0.001). Elevated hypertension, PLR, NLRP3, HMGB1, D-dimer, and v WF were independent risk factors for poor prognosis in COPD patients with pulmonary arterial hypertension, while elevated antithrombin Ⅲ was an independent protective factor [OR(95%CI) =4.739(1.35-16.635), 1.037(1.010-1.065), 1.074(1.029-1.121), 1.703(1.024-2.834), 9.869(1.085-89.772), 1.054(1.025-1.084), 0.914(0.848-0.984)]. ROC curve analysis showed that the area under the curve(AUC) of the nomogram model based on inflammatory related indicators and coagulation markers was 0.937(95%CI : 0.903-0.970) in the training set and 0.938(95%CI : 0.883-0.993) in the validation set. The calibration curve showed that the predicted risk of the model was in good agreement with the actual risk in both the training and validation sets. The decision curve suggested that when the risk threshold probability ranged from 0.01 to 0.89 in the training set and 0.01 to 1.00 in the validation set, the model produced a high clinical net benefit rate, with maximum net benefit rates of 0.229 and 0.240, respectively. The AUC of the nomogram model for predicting patient prognosis was significantly greater than that of the Glasgow Prognostic Score in both the training and validation sets(Z = 3.573, 4.108; both P <0.001). Conclusion The nomogram model based on inflammatory related indicators and coagulation markers has good predictive power and practicality for the prognosis of patients with COPD and pulmonary arterial hypertension.

Objective To investigate the expression of serum thrombospondin-4(TSP-4) and podocalyxin(Podxl) in diabetic lower extremity arteriosclerosis obliterans(LEASO) and its correlation with disease severity.Methods A total of 100patients with diabetic LEASO(LEASO group) admitted to the Department of Endocrinology, Qinghai Provincial Hospital of Traditional Chinese Medicine from January 2021 to September 2024 were selected, and 100 patients with diabetes alone(nonLEASO group) were matched during the same period at a 1:1 ratio. According to the Fontaine staging system, the diabetic LEASO patients were further divided into a Fontaine stage Ⅲ–Ⅳ subgroup(n = 42) and a Fontaine stage Ⅰ–Ⅱ subgroup(n = 58). Serum TSP-4 and Podxl levels were measured by enzyme-linked immunosorbent assay. Multivariate unconditional Logistic regression analysis was used to analyze the relationship between serum TSP-4, Podxl levels and the severity of diabetic LEASO. ROC curve analysis was applied to evaluate the diagnostic value of serum TSP-4 and Podxl for diabetic LEASO and their ability to assess Fontaine stage Ⅲ–Ⅳ.Results Serum TSP-4 and Podxl levels in the LEASO group were significantly higher than those in the non-LEASO group(t/P = 9.657/< 0.001, 11.720/< 0.001). Compared with the Fontaine stage Ⅰ–Ⅱsubgroup, the Fontaine stage Ⅲ–Ⅳ subgroup showed elevated serum TSP-4 and Podxl levels(t/P = 5.346/<0.001, 6.256/<0.001). High Hb A1c, high TSP-4, and high Podxl were identified as independent risk factors for Fontaine stage Ⅲ–Ⅳ in diabetic LEASO patients, while a high ankle-brachial index was an independent protective factor [OR(95%CI) = 3.066(1.313-7.159), 3.251(1.425-7.416), 1.112(1.049-1.180), 0.451(0.282-0.722)]. The AUC values of serum TSP-4, Podxl, and their combination for predicting diabetic LEASO were 0.833, 0.841, and 0.935, respectively. The combined model was superior to either biomarker alone(Z/P = 4.372/<0.001, 3.778/<0.001). For evaluating Fontaine stage Ⅲ–Ⅳ in diabetic LEASO patients,the AUC values of serum TSP-4, Podxl, and their combination were 0.788, 0.798, and 0.877, respectively. The combined model showed a higher AUC than TSP-4 or Podxl alone(Z/P = 2.450/0.015, 1.996/0.047).Conclusion Serum TSP-4 and Podxl levels are elevated in patients with diabetic LEASO and are associated with disease severity. The combination of serum TSP-4 and Podxl has high diagnostic and evaluative value for diabetic LEASO.