Objective To analyze cysteinylaspartate specific proteinase-3,caspase-7,caspase-9,AMP activated protein kinase(AMPK)in the diagnosis and prognosis evaluation of sepsis.Methods Sixty patients with sepsis from the Affiliated Hospital of Xiangnan University from March 2020 to March 2023 were selected as the observation group,and another 60 healthy individuals from the physical examination center of the hospital during the same period were selected as the control group.Acute physiology and chronic health evaluationⅡ(APACHEII)score was used to evaluate the severity of the patient's condition.Serum caspase-3,caspase-7,caspase-9,AMPK and APACHEII scores were detected,and compared between the two groups.These parameters were compared with serum Caspase-3,caspase-7,caspase-9,AMPK and APACHEII scores in different disease severity groups.The patients were divided into survival group(50 cases)and death group(10 cases)according to prognosis.Serum Caspase-3,caspase-7,caspase-9,AMPK and APACHEII scores were compared between the two groups,and the correlation between serum caspase-3,caspase-7,caspase-9,AMPK and APACHEII scores were analyzed by Pearson.Receiver operating characteristic(ROC)was drawn,the area under the curve(AUC)was calculated,the predictive efficacy of serum caspase-3,caspase-7,caspase-9 and AMPK in patients death with sepsis were analyzed.Results The serum levels of caspase-3,caspase-7,caspase-9,AMPK,and APACHEII score in the observation group were higher than those in the control group,and the differences were statistically significant(t=19.501～44.219,all P<0.05).The serum caspase-3,caspase-7,caspase-9,AMPK,and APACHEII scores in the sep-tic shock group were higher than those in the severe and mild groups,and the differences were statistically significant(t=2.091～6.946,all P<0.05).The serum caspase-3,caspase-7,caspase-9,AMPK,and APACHEII scores of the death group were higher than those of the survival group,and the differences were statistically significant(t=4.576～8.835,all P<0.05).Serum caspase-3,caspase-7,caspase-9 and AMPK were positively correlated with APACHEII scores(r=0.382～0.406,all P<0.05).The AUC of combined detection of serum caspase-3,caspase-7,caspase-9,and AMPK for predicting death in sepsis patients was 0.863,with 95%confidence interval of 0.805-0.958.which was greater than that of single indicator detection,and the difference is statistical-ly significant(Z=2.912～2.294,all P<0.05).Conclusion Serum caspase-3,caspase-7,caspase-9,and AMPK in sepsis patients showed abnormally high expressions,which were closely related to disease severity and prognosis.Combined detection could improve the sensitivity and specificity of death prediction,which has certain reference value.

Objective To explore the predictive value of systemic immune-inflammation index(SII)and control of nutritional status(CONUT)score for the efficacy of immune combined chemotherapy in patients with advanced or recurrent gastric cancer.Methods A retrospective analysis was conducted on the clinical data of 143 patients with advanced or recurrent gastric cancer who underwent immune combined chemotherapy as a treatment regimen at Huangshan People's Hospital from January 2020 to December 2023.The patients were divided into a disease control group(n=105)and a disease non-control group(n=38)according to the response evaluation criteria in solid tumor(RECIST).The CONUT score and SII levels between the two groups were compared.Multivariate Logistic regression analysis was used to identify the factors influencing the efficacy of immune combined chemotherapy in patients with advanced or recurrent gastric cancer.Receiver operating characteristic(ROC)curves were employed to predict the value of pre-treatment CONUT score,SII,and their combination in predicting the efficacy of immune-combined chemotherapy for advanced or recurrent gastric cancer.Results The CONUT score(2.8±0.5)and SII level(1 073.64±141.26)in the disease control group under than those in the disease non-control group(3.3±0.7,1 183.27±186.34),and the differences were statistically significant(t=4.721,3.751,all P<0.05).Multivariate Logistic regression analysis revealed that age,degree of differentiation,maximum diameter of measurable lesions,CONUT score,and SII were all factors influencing the treatment outcome in patients with advanced or recurrent gastric cancer(Wald χ2=5.161～22.758,all P<0.05).The ROC curve results showed that the AUC(95%CI)for pre-treatment CONUT score,SII,and their combination in predicting the efficacy of immuno chemotherapy in patients with advanced or recurrent gastric cancer were 0.746(0.667～0.815),0.839(0.768～0.895)and 0.875(0.809～0.924),respectively,with sensitivities of 73.11%,76.32%and 79.68%,and specificities of 91.43%,82.86%and 84.75%,respectively.Conclusion CONUT score and SII are influencing factors for the efficacy of immuno-combined chemotherapy in patients with advanced or recurrent gastric cancer,and their combination demonstrates good predictive value for the treatment outcome.

Objective To investigate the relationship between the expression of discoidin,CUB and LCCL domain containing protein 1(DCBLD1)and cytoskeleton associated protein 2(CKAP2)in cervical cancer(CC)tissues and epithelial mesenchymal transition(EMT)and clinical prognosis.Methods 94 CC patients diagnosed and treated in Shiyan Hospital of Traditional Chinese Medicine from February 2017 to February 2019 were selected.The expression of DCBLD1 messenger ribonucleic acid(mRNA),CKAP2 mRNA,N-cadherin(N-cad)mRNA,vimentin(Vim)mRNA and TWIST mRNA in tissues was detected by real-time fluorescence quantitative PCR(qRT-PCR).The expressions of DCBLD1 and CKAP2 were detected by immunohistochemistry(IHC).Pearson correlation analysis was used to analyze the relationship between DCBLD1 mRNA,CKAP2 mRNA and EMT-related indicators.Kaplan-Meier survival curve was drawn to compare the prognosis of CC patients with different DCBLD1 mRNA and CKAP2 mRNA expression.COX regression analysis was used to analyze the prognostic factors of CC patients.Results The expression of DCBLD1 mRNA,CKAP2 mRNA,N-cad mRNA,Vim mRNA and TWIST mRNA in CC cancer tissues was higher than that in adjacent tissues,and the differences were statistically significant(t=32.763～52.824,all P<0.05).The positive rates of DCBLD1 protein(89.36%)and CKAP2 protein(87.23%)in CC cancer tissues were higher than those in adjacent normal tissues(7.45%,6.38%),and the differences were statistically significant(χ2=126.278,123.396,all P<0.001).The expression of DCBLD1 mRNA and CKAP2 mRNA in CC cancer tissues were positively correlated with the expression of N-cad mRNA,Vim mRNA and TWIST mRNA(r=0.655～0.744,all P<0.001).The expression of DCBLD1 mRNA and CKAP2 mRNA in patients with FIGO stage IB2～IIB and lymph node metastasis were higher than those in patients with stage IA～IB1 and without lymph node metastasis(t=25.644～35.674,all P<0.05).The 5-year progression free survival rates of the high expression groups of DCBLD1 mRNA and CKAP2 mRNA were 63.04%and 62.22%,respectively,which were lower than those of the low expression groups of DCBLD1 mRNA and CKAP2 mRNA(91.67%and 91.84%),respectively,and the differences were statistically significant(Log-Rank χ2=7.181,6.527,all P<0.05).FIGO stage IB2～IIB,high DCBLD1 mRNA and high CKAP2 mRNA were risk factors affecting the prognosis of CC patients(Wald χ2=8.277,15.877,10.927,all P<0.05).Conclusion The expression of DCBLD1 and CKAP2 in CC cancer tissues is significantly increased,which is related to EMT related indicators and plays a promoting role in the progression of CC tumors.They are new prognostic markers for CC.

Objective To screen the differentially expressed circular RNA(circRNA)in peripheral blood of patients with type 2 diabetic nephropathy(T2DN)and study the correlation between the expression of circAKT3 level and renal fibrosis.Methods A retrospectively study was conducted on 176 T2DM patients admitted to Mianyang 404 Hospital from December 2022 to December 2023 based on whether the patients developed DN,they were divided into a simple T2DM group(n=60)and DN group(n=116).At the same time,30 healthy subjects who underwent physical examination in Mianyang 404 Hospital during the same period were selected as the control group.Clinical data of all subjects were collected.DN patients were divided into microalbuminuria group(M-DN group,n=66)and macroalbuminuria group(MS-DN group,n=50)according to Mogensen classification criteria.Twenty samples were randomly selected from the control group,M-DN group,T2DM group and MS-DN group,and 2 ml peripheral venous blood was extracted for RNA extraction and circRNA microarray scanning analysis to screen the differentially expressed circRNA.The correlation between the most significant differential circRNA expression level and renal fibrosis markers and renal function indicators was statistically analyzed.Receiver operator characteristic(ROC)curve was used to analyze the diagnostic efficacy of circAKT3 for DN.Results Compared with the control group,the level of circAKT3 in MS-DN patients was down-regulated by 9.72 times,which was the most significantly down-regulated circRNA.qRT-PCR showed that compared with the control group,the relative expression of circAKT3 in the T2DM group,M-DN group and MS-DN group was 0.85±0.23,0.54±0.13 and 0.12±0.09,respectively,with the progression of DN,the relative expression level of circAKT3 in peripheral blood of patients gradually decreased,and the differences were statistically significant(t=5.100,8.568,10.960,all P＜0.001).Spearman correlation test showed that the level of circAKT3 in peripheral blood of DN patients was correlated with the duration of diabetes,serum Creatinine,BUN,cystatin C,TGF-β,CIV,PCIII and Alb were negatively,correlated(r=-0.756～-0.621,all P＜0.05).Glomerular filtration rate was positively correlated(r=0.695,P=0.010).ROC curve analysis showed that the sensitivity and specificity of circAKT3 in the diagnosis of DM were 75.3%and 71.1%,respectively,and the AUC was 0.792.The sensitivity,specificity and AUC for M-DN were 90.3%,85.7%and 0.875,respectively,and the sensitivity,specificity and the AUC for MS-DN were 88.2%,87.6%and 0.916,respectively.Conclusion The level of serum circAKT3 is significantly down-regulated in DN patients,which can be used as a potential auxiliary diagnostic marker of DN.

Objective To investigate the correlation between serum levels of microRNA(miR)-489-3p and miR-214-3p in patients with Psoriasis and the severity of disease.Methods From March 2022 to January 2024,138 Psoriasis patients who visited Zhangjiakou First Hospital were regarded as the study subjects(disease group).According to the psoriasis area and severity index(PASI)score,the 138 Psoriasis patients were separated into mild group(n=46),moderate group(n=54)and severe group(n=38).112 healthy individuals who underwent physical examinations in Zhangjiakou First Hospital during the same period were included in the control group.Real-time fluorescence quantitative PCR(RT-qPCR)method was applied to determine the serum levels of miR-489-3p and miR-214-3p in the subjects.The serum levels of miR-489-3p and miR-214-3p were compared between the disease group and the control group,and among patients with different degrees of disease.Spearman correlation analysis was applied to explore the relationship between serum miR-489-3p,miR-214-3p levels and disease severity in Psoriasis patients.Logistic regression analysis was performed to analyze the related factors affecting the severity of Psoriasis.Receiver operating characteristic(ROC)curve was applied to investigate the diagnostic value of serum miR-489-3p and miR-214-3p levels for severe Psoriasis.Results The serum levels of miR-489-3p(0.81±0.23)and miR-214-3p(0.79±0.22)in the disease group were lower than those in the control group(1.05±0.28,1.02±0.25),and the differences were statistically significant(t=7.441,7.732,all P<0.05).Serum miR-489-3p in mild,moderate and severe Psoriasis groups(0.93±0.24,0.80±0.23,0.69±0.22),miR-214-3p levels(0.91±0.24,0.77±0.22,0.66±0.21)decreased gradually,and the differences were statistically significant(F=12.423,13.168,all P<0.05).Spearman's results showed that serum levels of miR-489-3p and miR-214-3p were negatively correlated with the severity of Psoriasis in patients(r=-0.490,-0.463,all P<0.05).Serum miR-489-3p and miR-214-3p were independent protective factors for the severity of Psoriasis patients(Wald χ2=5.751,8.753,all P<0.05).ROC curve results showed that the area under the curve(AUC)of serum miR-489-3p and miR-214-3p for diagnosing severe Psoriasis alone was 0.785 and 0.792,with sensitivity of 78.9%and 73.7%,specificity of 49.9%and 54.7%,respectively.The AUC of the combined diagnosis for severe Psoriasis was 0.931,the sensitivity and specificity were 71.7%,71.1%,respectively,and the combined diagnostic efficacy of the two was better than that of miR-489-3p and miR-214-3p alone,and the differences were statistically significant(Z=3.018,2.773,all P<0.05).Conclusion The serum levels of miR-489-3p and miR-214-3p in patients with Psoriasis are both reduced,and both are negatively correlated with the severity of the disease in Psoriasis patients.The combined determination of the two has high efficacy in the diagnosis of severe Psoriasis.

Objective To investigate the value of serum long noncoding RNA small nucleolar RNA host gene 7(lncRNA SNHG7)and microRNA(miR)-34a-5p expression in the diagnosis and prognostic evaluation of bloodstream infection(BSI).Methods A total of 193 suspected BSI patients admitted to the emergency department of Guangxi Wuzhou Red Cross Hospital from March 2022 to March 2023 were collected as the study subjects.After diagnosis,BSI patients were included as the infection group(n=100),and non BSI patients were included as the non infection group(n=93).After 28 days of treatment,BSI patients were separated into a death group(n=32)and a survival group(n=68)based on their prognosis.The real time fluorgenic quantitative PCR(qRT-PCR)method was applied to detect the expression levels of serum lncRNA SNHG7 and miR-34a-5p.The Target Scan Human website was applied to predict the targeting relationship between miR-34a-5p and lncRNA SNHG7.Pearson method was applied to analyze the correlation between serum lncRNA SNHG7 level and miR-34a-5p level.Multivariate Logistic regression was applied to analyze the influencing factors of prognosis in patients with BSI.Receiver operating characteristic(ROC)curve was applied to analyze the prognostic value of serum lncRNA SNHG7 and miR-34a-5p.Results The serum lncRNA SNHG7 level(1.47±0.35)in the infection group was obviously higher than that in the non infection group(1.03±0.15),and the miR-34a-5p level(0.85±0.21)was obviously lower than that in the non infection group(1.02±0.13),and the differences were statistically significant(t=11.203,6.703,all P<0.05).Compared with survival group,the serum lncRNA SNHG(1.68±0.21 vs 1.37±0.19),C-reactive protein(CRP)(85.74±9.16mg/L vs 63.18±7.68mg/L),procalcitonin(PCT)levels(56.37±8.72ng/ml vs 34.69±5.54ng/ml),albumin(92.51±10.18g/L vs 65.27±7.24g/L),Acute Physiological and Chronic Health Evaluation(APACHE II)scores(28.15±5.12scores vs 16.35±4.31scores)of the death group were obviously higher,and serum miR-34a-5p level(0.67±0.14 vs 0.93±0.16)was obviously lower,the differences were statistically significant.(t=7.357～15.340,all P<0.05).LncRNA SNHG7 had a targeted binding site with miR-34a-5p,and lncRNA SNHG7 was negatively correlated with miR-34a-5p(r=-0.568,P<0.05).Serum lncRNA SNHG7 and miR-34a-5p were prognostic factors for BSI patients(all P<0.05).The area under the curve(AUC)of serum lncRNA SNHG7,miR-34a-5p,and their combined evaluation of prognosis in BSI patients was better than that of serum lncRNA SNHG7 and miR-34a-5p detected sepatately(Z=0.001,2.304,all P<0.05),with sensitivity and specificity of 78.12%and 97.06%,respectively.Conclusion The serum lncRNA SNHG7 level in BSI patients is obviously elevated,while the serum miR-34a-5p level is obviously reduced.The two are closely related to the prognosis of BSI patients,and the combination of the two has good evaluation value for the prognosis of BSI patients.

Objective To investigate the expression of serum microRNA(miR)-16a and mir-15b in patients with early-onset neonatal sepsis(EONS)and its value in clinical diagnosis and prognosis evaluation.Methods 114 children diagnosed with EONS admitted to the Department of Neonatology,Baoding Hospital of Beijing Children's Hospital Affiliated to Capital Medical University from October 2020 to October 2023 were selected as the EONS group,and 114 healthy newborns in the hospital during the same period were selected as the control group.Follow up was conducted on all EONS patients for a period of 6 months,including 34 cases in the poor prognosis group and 80 cases in the good prognosis group.The relative expression levels of miR-16a and miR-15b were measured within 6h of admission using real-time fluorescence quamtitative PCR(qRT-PCR).ROC curve was applied to analyze the diagnostic and prognostic value of serum miR-16a and miR-15b for EONS.Multivariate Logistic regression was applied to analyze the factors that affected the poor prognosis of EONS.Results Compared with the reference group,the birth weight of children in the EONS group(3.44±0.35kg/m2 vs 3.89±0.40kg/m2)was obviously reduced,and there was a obvious difference(35/114,1/114)in pathological jaundice between the two groups,and the differences were statistically significant(t=9.040,χ2=35.922,all P＜0.05).Compared with the reference group,the serum levels of miR-16a and miR-15b in the EONS group were obviously increased,and the differences was statistically significant(t=7.699,8.606,all P＜0.05).The area under the curve(AUC)of the ROC curve for the combined diagnosis of EONS by serum miR-16a and miR-15b was higher than that of miR-16a and miR-15b alone,and the differences were statistically significant(Z=2.619,2.157,all P<0.05).Compared with the good prognosis group,the poor prognosis group had a obvious decrease in body weight at birth,and a obvious increase in serum levels of miR-16a and miR-15b,and the differences were statistically significant(t=5.434,6.308,all P＜0.05).The AUC of serum miR-16a and miR-15b combined for prognostic evaluation was higher than that of miR-16a and miR-15b evaluated separately,and the differences were statistically significant(Z=2.364,2.073,all P＜0.05).Birth weight,miR-16a,miR-15b expression level was a prognostic factor of EONS(Wald χ2=33.459,16.146,49.797,all P<0.05).Conclusion MiR-16a and miR-15b are highly expressed in the serum of children with EONS,and they have certain diagnostic and prognostic value for EONS.

Objective To investigate the correlation between peripheral blood CD14+CD16+monocytes and IgG N-glycosyl levels and disease activity in patients with systemic lupus erythematosus(SLE).Methods A total of 109 SLE patients admitted to Xingtai Cental Hospital from August 2021 to November 2024 were retrospectively selected as the study objects.According to SLE disease activity index(SLE-DAI),the patients were divided into active group(n=52)and stable group(n=57).In addition,56 patients who underwent physical examination during the same period were selected as the control group.Clinical data of patients were collected,CD14+CD16+mononuclear cells were detected by flow cytometry(FCM),and IgG N-glycosyl levels were detected by hydrophilic interaction chromatography-mass spectrometry.Logistic regression analysis was performed to analyze the influencing factors of SLE-DAI,and multicollinearity test[variance inflation factor(VIF)]was performed for independent variables.The prediction model of disease activity was constructed.The effectiveness of the predictive model was evaluated by describing the recviver operator characteristic(ROC)curve and calculating the area under the curve(AUC)value.Hosmer-Lemeshow goodness-of-fit test predicted the calibration degree of the model.Results The levels of WBC,Hb,PLT,ALB,complement C3 and complement C4 in control group were higher than those in SLE group(t=8.917～22.171),and the levels of CRP were lower than those in SLE group(t=-17.359),with differences were statistical significance(all P<0.05).The CRP level and the proportion of CD14+CD16+mononuclear cells in the active group were higher than those in the stable group,and the differences were statistically significant(t=5.449,11.112,all P<0.05).The IgG glycosylation characteristics of galactosylation,sialylation and N-acetylglucosamine modification were lower than those in the stable group,and the differences were statistical significance(Z=-2.432～-0.158,all P<0.05).Spearman correlation analysis showed that the proportion of CD14+CD16+monocytes was significantly negatively correlated with IgG galactosylation,sialylation level and bisection N-acetylglucosamine modification(r=-0.656,-0.531,-0.608,all P<0.01).CD14+CD16+monocyte ratio was positively correlated with SLE-DIA(r=0.581,all P<0.01).IgG galactosylation,sialylation levels and bisection N-acetylglucosamine modification were negatively correlated with SLE-DIA(r=-0.645,-0.609,-0.503,all P<0.01).Logistic regression analysis showed that CRP>8.21mg/L,CD14+CD16+≥16.17%,sialylation<22.05%and isotropic N-acetylglucosamine modification<16.53%were independent risk factors for disease activity in SLE patients(Wald χ2=4.471～12.811,all P<0.05).The VIF values of the above independent variables were all less than 10.By establishing the Logistic regression prediction model and drawing the ROC curve,the AUC value for diagnosing SLE disease activity was 0.821(95%CI:0.733～0.905),the sensitivity,specificity and the Yodon index were 85.37%,75.67%,0.677,respectively.and the P values of Hosmer-Lemeshow goodness-of-fit test models were 0.568,respectively.Conclusion The proportion of CD14+CD16+monocytes in peripheral blood of SLE patients increase significantly,and the level of IgG glycosylation characteristics decrease,both of which are correlated with SLE-DIA.The predictive model constructed based on the two had a good ability to distinguish SLE-DIA from inactive state,with high sensitivity and moderate specificity conducive to early clinical recognition,and the model fitting effect is good.SLE-DIA can be evaluated more accurately.

Objective To explore the risk factors associated with the occurrence of dampness syndrome based on peripheral blood multiple laboratory indicators,construct predictive model and validate it.Methods A retrospective analysis was conducted on 180 patients who visited the Preventive Treatment Center of Guangdong Provincial Hospital of Chinese Medicine from May 2022 to December 2023.They were divided into two groups according to the diagnostic criteria:the damp syndrome of TCM group(n=118)and the balanced yin-yang constitution group(n=62),with the latter serving as the"non-syndrome"control group for dampness syndrome.Serum biochemical indicators were detected by electrochemiluminescence(ECL),immune cell subsets were analyzed through flow cytometer,and routine blood parameters were assessed using an automatic hematology analyzed.Logistic regression analysis was employed to screen risk factors and develop a predictive model.The Bootstrap method was used for data resampling to draw the receiver operating characteristic(ROC)curve,calibration curve,and clinical decision curve analysis(DCA)to evaluate the predictive value,consistency,and clinical efficacy of the model.Results Compared with the balanced yin-yang constitution group,the damp syndrome of TCM group showed increased levels of insulin(INS),non-high-density lipoprotein cholesterol(non HDL-C),red blood cells(RBC)and the proportion of CD4+T cells,the proportion of triglyceride(TG)>1.70 mmol/L,total cholesterol(TC)>5.20 mmol/L,low-density lipoprotein cholesterol(LDL-C)>3.37 mmol/L,and high-density lipoprotein cholesterol(HDL-C)≤1.15 mmol/L were also significantly higher,with statistical significance(U/t/χ2=-2.900～4 626,all P＜0.05).Logistic regression analysis showed that INS,TC>5.20 mmol/L,HDL-C≤1.15 mmol/L,and the proportion of CD4+T cells were independent risk factors for the occurrence of damp syndrome of TCM(all P＜0.05).Based on the screened risk factors,a forecasting model was established and a nomogram was plotted.The model had an area under the ROC curve area under curve(AUC)of 0.747(95%CI=0.672～0.822),a Brier score of 0.184 for the calibration curve,and demonstrated clinical net benefit at threshold probabilities ranging from 0.30 to 1.00.Conclusion The forecasting model constructed based on INS,TC>5.20 mmol/L,HDL-C≤1.15 mmol/L,and CD4+T cells ratio has a high predictive value for damp syndrome of TCM.

Objective To investigate the expression levels of serum tyrosine 3-monooxygenase/tryptophan 5-monooxygenase activation protein β(14-3-3β)and clara's cell secretory protein 16(CC16)in patients with chronic obstructive pulmonary disease(COPD)complicated by respiratory failure,and their relationship with prognosis.Methods A total of 232 patients with COPD complicated with respiratory failure admitted to Yantian Hospital of Southern University of Science and Technology from April 2020 to October 2023 were enrolled in the COPD complicated with respiratory failure group.According to the severity of the disease,they were divided into mild group(n=67),moderate group(n=73)and severe group(n=92).According to the 28-day prognosis,they were divided into death group(n=73)and survival group(n=159).In addition,80 patients with simple COPD(COPD group)and 80 healthy subjects(control group)were selected at the same time.Enzyme-linked immunosorbent assay(ELISA)was used to detect the expression of serum 14-3-3β and CC16.Multivariate Logistic regression analysis was used to analyze the factors of death in patients with COPD complicated with respiratory failure.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum 14-3-3β and CC16 expression on the death of patients with COPD complicated with respiratory failure.Results The expression of serum 14-3-3β in COPD complicated with respiratory failure group was higher than that in COPD group and control group(U=3.894,11.417),the expression of CC16 was lower than that in COPD group and control group(t=5.845,14.306),and the differences were statistically significant(all P<0.05),respectively.The expression of serum 14-3-3β in severe group was higher than that in moderate group and mild group(U=5.179,8.234),the expression of CC16 was lower than that of moderate group and mild group(t=4.090,9.281),and the differences were statistically significant(all P<0.05),respectively.The 28-day mortality rate of 232 COPD patients with respiratory failure was 31.47%(73/232).The expression of serum 14-3-3β in the death group was higher than that in the survival group,and the expression of CC16 was lower than that in the survival group,the differences were statistically significant(U/t=6.790,8.265,all P<0.05).The age of the death group was older than that of the survival group,the degree of airflow limitation and the number of acute exacerbations within 1 year were higher than those of the survival group,and the differences were statistically significant(t/χ2/U=3.895,7.202,3.360,all P<0.05).Age,severe airflow limitation,extremely severe airflow limitation,and the number of acute exacerbations within 1 year,elevated 14-3-3β were independent risk factors for death in patients with COPD complicated with respiratory failure(Wald χ2=3.914～22.668,all P<0.05),and elevated CC16 was an independent protective factor(Wald χ2=23.675,P<0.05).The area under the curve(AUC)of serum 14-3-3β combined and CC16 expression in predicting the death of patients with COPD complicated with respiratory failure which was greater than that of serum 14-3-3β and CC16 expression alone,the differences were statistically significant(Z=3.995,3.813,all P<0.01).Conclusion The increase of serum 14-3-3β expression and the decrease of CC16 expression in patients with COPD complicated by respiratory failure are closely related to the aggravation of the disease and poor prognosis.The combination of serum 14-3-3β and CC16 expression is of high value in predicting the death of patients with COPD complicated with respiratory failure.