Objective To study the incidence of low triiodothyronine (T3) syndrome in critical patients,and compare the prognosis evaluation value between low T3 syndrome and acute physiology and chronic health evaluation (APACHE) Ⅱ score.Methods A total of 160 critical patients were enrolled.APACHE Ⅱ score of patients were recorded at admission,and thyroid hormone levels were measured on the first and the third day after admission.The patients who were low T3 level were enrolled into observation group,and the patients who were normal T3 level were as control group.The patients were followed up for 28 d,then were divided into death group and survival group according to the prognosis.The prognosis evaluation value was compared between T3 and APACHE Ⅱ score by receiver operating characteristic (ROC) curve.Results The incidence rate of low T3 syndrome was 25.6％ (41/160).During the follow-up phase,the fatality rate in observation group was 41.5％(17/41),and in control group was 29.4％ (35/119),there was statistical difference (P ＜ 0.05).The ROC area under curve of T3 was 0.657 (95％ CI:0.712-0.846),APACHE Ⅱ score was 0.672 (95％ CI:0.721-0.857),and there was no statistical difference (P ＞ 0.05).Best cut-off value of T3 was 0.41 μ g/L resulting in 76.9％(40/52) sensitivity and 78.7％(85/108) specificity.Conclusion Critical patients complicated with low T3 syndrome has poor prognosis,and T3 may be a predictive marker in evaluating the prognosis of critical patients.

Objective To dynamically monitor the base excess(BE) in traumatic brain injury(TBI) patients within 3 d after admission,and to assess the impact of the early BE on prognosis.Methods Blood BE was monitored for 3 d in 56 TBI patients.Patients were classified into mild group(15 patients),moderate group (22 patients) and severe group (19 patients) according to the scores of Glasgow coma scale(GCS).Patients were classified into survival group(42 patients) and dead group(14 patients) according to prognosis.Patients were classified into high BE group (35 patients,BE≥-8 mmol/L) and low BE group (21 patients,BE ＜-8 mmol/L).The relations among BE,degree of injury and prognosis were analyzed.Results The level of BE in mild group,moderate group and severe group was increased after treatment for 1,2,3 d than that before treatment.The level of BE was consistent with the degree of injury [mild group:(-3.02 ± 0.21)mmol/L; moderate group:(-8.49 ± 1.44) mmol/L;severe group:(-9.64 ± 1.19) mmol/L].The level of BE in mild group and severe group had significant difference than that in moderate group (P＜ 0.01).The level of BE in dead group before treatment and after treatment for 1,2,3 d was significantly lower than that in survival group [(-11.97 ±2.13) mmol/L vs.(-6.29 ± 1.16) mmol/L,(-9.84 ± 1.33) mmol/L vs.(-4.89 ± 1.78)mmol/L,(-8.78 ± 2.01) mmol/L vs.(-3.61 ± 1.43) mmol/L,(-7.84 ± 1.42) mmol/L vs.(-3.10 ±0.98)mmol/L] (P ＜0.01).The scores of APACHE Ⅱ before treatment and fatality rate in low BE group were significantly higher than those in high BE group [(24.84 ± 3.68) scores vs.(16.27 ± 2.21) scores,52.4％ (11/21) vs.8.6％(3/35)] (P ＜ 0.01).The scores of GCS before treatment in low BE group was significantly higher than that in high BE group [(7.56 ± 3.09) scores vs.(10.51 ± 2.43) scores](P ＜ 0.01).Conclusion The level of early BE is a good factor on evaluating the condition and prognosis in TBI patients.

目的：通过检索挖掘多个肿瘤公共数据库中肝细胞癌（hepatocellular carcinoma，HCC）的相关数据，从转录本、蛋白质、基因突变、蛋白相互作用及相应的信号通路和功能富集等不同层面，揭示BRD（bromodomain）蛋白家族与HCC的相关性，探索BRD蛋白家族作为HCC的肿瘤进展及预后判断的潜在生物标志物价值。方法：从UALCAN数据库中获取BRD蛋白家族所有成员在HCC患者组织样本中的mRNA表达数据和患者临床信息并进行相关性分析。从TCGA数据库中获取BRD蛋白家族mRNA表达水平与HCC患者预后的数据并进行相关性分析。从The Human Protein Atlas数据库中获取BRD蛋白家族在HCC组织和正常肝组织中的免疫组化结果并进行对比分析。使用STRING数据库获取BRD蛋白家族的相互作用蛋白网络，并利用CYTOSCAPE软件对获取的相互作用蛋白进行KEGG和GO分析。结果：BRD家族7个成员均在HCC组织中高表达（P<0.01），并且与HCC患者肿瘤分级和临床分期正相关（P<0.01）,同时BRD8和BRD9的低表达提示HCC患者预后较好（P<0.05）。BRD相互作用蛋白主要参与组蛋白乙酰化修饰，并高度富集于HCC相关的信号通路。TP53基因突变HCC患者的BRD1、BRD3、BRD4、BRD7、BRD8和BRD9表达水平显著高于非突变患者（P<0.05）。结论：BRD蛋白家族分子能够作为HCC患者肿瘤分级、临床分期和预后判断的潜在靶标。

Objective:To investigate the expression of retinoic acid receptor responsive gene 2 (RARRES2), microtubule microfilament cross-linking factor 1 (MACF1), and core protein polysaccharide (DCN) in cerebrospinal fluid (CSF) of patients with neurosyphilis, and their diagnostic value for neurosyphilis.Methods:A total of 64 non neurosyphilis syphilis patients (syphilis group) and 78 neurosyphilis patients (neurosyphilis group) admitted to the Second Hospital of Nanjing between June 2020 and September 2022 were included. Among neurosyphilis patients, there were 48 early neurosyphilis patients (early group) and 30 late neurosyphilis patients (late group). Patients with neurosyphilis are treated with routine symptomatic therapy and antibiotic therapy to expel syphilis. The mRNA levels of RARRES2, MACF1, and DCN in CSF of patients with neurosyphilis before and after treatment were detected by quantitative real-time polymerase chain reaction (qRT-PCR). The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the neurological function of patients with neurosyphilis before and after treatment. The diagnostic value of various indicators for neurosyphilis was analyzed using receiver operating characteristic (ROC) curves.Results:The mRNA levels of RARRES2, MACF1, and DCN in CSF of patients with neurosyphilis were higher than those in the syphilis group (all P<0.001). The mRNA levels of RARRES2, MACF1, and DCN in the CSF of patients with advanced neurosyphilis were higher than those in the early group (all P<0.001). Compared with before treatment, the NIHSS score and RARRES2, MACF1, and DCN mRNA levels of neurosyphilis patients decreased after treatment (all P<0.001). The area under the curve (AUC), sensitivity, and specificity of the combined diagnosis of RARRES2, MACF1, and DCN mRNA in CSF for neurosyphilis were 0.995%, 100.00%, and 93.75%, respectively. The AUC and sensitivity were higher than those of individual diagnosis. Conclusions:The expression of RARRES2, MACF1, and DCN is elevated in CSF of patients with neurosyphilis, and is associated with disease severity and treatment response. These three genes may be candidate biomarkers for diagnosing neurosyphilis.