Objective:To explore the early diagnostic value and related mechanism of Lnc-IL7R/Jumonji domain-containing protein 3(Jmjd3)/keratinocyte growth factor(KGF)axis in inflammatory injury of acute respiratory distress syndrome(ARDS).Methods:① RT-qPCR and Western blot were used to detect Lnc-IL7R,Jmjd3,KGF mRNA and protein levels,as well as trimethyl-ation of histone H3 at lysine 27(H3K27)me3 protein level in serum of ARDS patients;ELISA was used to detect IL-1β,IL-6,TNF-α levels in serum.② Mitochondrial damage-associated molecular patterns(MTDs)was used to stimulate HBE cells and create traumatic ARDS cell model.HBE cells were divided into control group,model group(MTDs group),overexpression Lnc-IL7R group(Lnc-IL7R group),overexpression control group(NC group),overexpression Lnc-IL7R+overexpression Jmjd3 group(Lnc-IL7R+Jm-jd3 group).Chromatin immunoprecipitation(ChIP)was used to detect Jmjd3,IL-1β,IL-6,TNF-α histone methylation levels in pro-moter region;qRT-PCR and Western blot were used to detect Lnc-IL7R,Jmjd3,KGF,IL-1β,IL-6,TNF-α mRNA and protein levels,as well as H3K27me3 protein level.③ Injection of MTDs into tail vein of mice was used to create traumatic ARDS mice model.Eighty mice were divided into control group,MTDs group,Lnc-IL7R group,NC group and Lnc-IL7R+Jmjd3 group,with sixteen mice in each group.HE staining was used to detect pathological damage in lung tissue;ChIP and RT-qPCR were used to detect Lnc-IL7R,Jmjd3,IL-1β,IL-6,TNF-α histone methylation levels in the promoter region and mRNA levels;ELISA was used to detect IL-1β,IL-6,TNF-α protein levels in BALF;Western blot was used to detect Jmjd3,KGF,H3K27me3 protein levels in lung tissue;immunohisto-chemical staining was used to detect surfactant protein C(SPC)and surfactant protein D(SPD)protein levels in lung tissue.Results:①Compared with healthy individuals,Lnc-IL7R,Jmjd3,KGF mRNA and protein levels,IL-1β,IL-6,TNF-α protein levels in serum of ARDS patients were significant increased,while H3K27me3 protein level was significant decreased(P<0.05).②Compared with control group,Jmjd3,IL-1β,IL-6,TNF-α histone methylation levels in the promoter region,H3K27me3 protein level in HBE of MTDs group were significant decreased,while Lnc-IL7R,Jmjd3,KGF,IL-1β,IL-6,TNF-α mRNA and protein levels,Lnc-IL7R were significant increased(P<0.05);after overexpression of Lnc-IL7R,Lnc-IL7R,Jmjd3,IL-1β,IL-6,TNF-α histone methylation levels in the promoter region,KGF mRNA and protein levels,H3K27me3 protein level were significant increased,Jmjd3,IL-1β,IL-6,TNF-α mRNA and protein levels in lung tissue and BALF were significant decreased(P<0.05);overexpression of Jmjd3 could partially reverse the effects of overexpression of Lnc-IL7R on the above indicators(P<0.05).③Compared with Control group,Jmjd3,IL-1β,IL-6,TNF-α histone methylation levels in the promoter region,H3K27me3 protein level in lung tissue of MTDs group were significant decreased,while Lnc-IL7R,Jmjd3,KGF,IL-1β,IL-6,TNF-α mRNA and protein levels,H3K27me3,SPC,SPD protein levels in lung tissue and BALF were significant increased(P<0.05);after overexpression of Lnc-IL7R,Lnc-IL7R,Jmjd3,IL-1β,IL-6,TNF-α histone methylation levels in the promoter region,KGF mRNA and protein levels,H3K27me3,SPC,SPD protein levels in lung tissue were significant increased,while Jmjd3,IL-1β,IL-6,TNF-α mRNA and protein levels in lung tissue and BALF were significant decreased(P<0.05);overexpression of Jmjd3 could partially reverse the effects of overexpression of Lnc-IL7R on the above indicators(P<0.05).Conclusion:Lnc-IL7R/Jmjd3/KGF axis participates in inflammation regulation and alveolar epithelial cell injury repair in ARDS by regulating histone methylation modifications in the promoter region.Lnc-IL7R/Jmjd3/KGF can be used for early diagnosis of ARDS.

Objective:To explore the early diagnostic value and related mechanism of Lnc-IL7R/Jumonji domain-containing protein 3(Jmjd3)/keratinocyte growth factor(KGF)axis in inflammatory injury of acute respiratory distress syndrome(ARDS).Methods:① RT-qPCR and Western blot were used to detect Lnc-IL7R,Jmjd3,KGF mRNA and protein levels,as well as trimethyl-ation of histone H3 at lysine 27(H3K27)me3 protein level in serum of ARDS patients;ELISA was used to detect IL-1β,IL-6,TNF-α levels in serum.② Mitochondrial damage-associated molecular patterns(MTDs)was used to stimulate HBE cells and create traumatic ARDS cell model.HBE cells were divided into control group,model group(MTDs group),overexpression Lnc-IL7R group(Lnc-IL7R group),overexpression control group(NC group),overexpression Lnc-IL7R+overexpression Jmjd3 group(Lnc-IL7R+Jm-jd3 group).Chromatin immunoprecipitation(ChIP)was used to detect Jmjd3,IL-1β,IL-6,TNF-α histone methylation levels in pro-moter region;qRT-PCR and Western blot were used to detect Lnc-IL7R,Jmjd3,KGF,IL-1β,IL-6,TNF-α mRNA and protein levels,as well as H3K27me3 protein level.③ Injection of MTDs into tail vein of mice was used to create traumatic ARDS mice model.Eighty mice were divided into control group,MTDs group,Lnc-IL7R group,NC group and Lnc-IL7R+Jmjd3 group,with sixteen mice in each group.HE staining was used to detect pathological damage in lung tissue;ChIP and RT-qPCR were used to detect Lnc-IL7R,Jmjd3,IL-1β,IL-6,TNF-α histone methylation levels in the promoter region and mRNA levels;ELISA was used to detect IL-1β,IL-6,TNF-α protein levels in BALF;Western blot was used to detect Jmjd3,KGF,H3K27me3 protein levels in lung tissue;immunohisto-chemical staining was used to detect surfactant protein C(SPC)and surfactant protein D(SPD)protein levels in lung tissue.Results:①Compared with healthy individuals,Lnc-IL7R,Jmjd3,KGF mRNA and protein levels,IL-1β,IL-6,TNF-α protein levels in serum of ARDS patients were significant increased,while H3K27me3 protein level was significant decreased(P<0.05).②Compared with control group,Jmjd3,IL-1β,IL-6,TNF-α histone methylation levels in the promoter region,H3K27me3 protein level in HBE of MTDs group were significant decreased,while Lnc-IL7R,Jmjd3,KGF,IL-1β,IL-6,TNF-α mRNA and protein levels,Lnc-IL7R were significant increased(P<0.05);after overexpression of Lnc-IL7R,Lnc-IL7R,Jmjd3,IL-1β,IL-6,TNF-α histone methylation levels in the promoter region,KGF mRNA and protein levels,H3K27me3 protein level were significant increased,Jmjd3,IL-1β,IL-6,TNF-α mRNA and protein levels in lung tissue and BALF were significant decreased(P<0.05);overexpression of Jmjd3 could partially reverse the effects of overexpression of Lnc-IL7R on the above indicators(P<0.05).③Compared with Control group,Jmjd3,IL-1β,IL-6,TNF-α histone methylation levels in the promoter region,H3K27me3 protein level in lung tissue of MTDs group were significant decreased,while Lnc-IL7R,Jmjd3,KGF,IL-1β,IL-6,TNF-α mRNA and protein levels,H3K27me3,SPC,SPD protein levels in lung tissue and BALF were significant increased(P<0.05);after overexpression of Lnc-IL7R,Lnc-IL7R,Jmjd3,IL-1β,IL-6,TNF-α histone methylation levels in the promoter region,KGF mRNA and protein levels,H3K27me3,SPC,SPD protein levels in lung tissue were significant increased,while Jmjd3,IL-1β,IL-6,TNF-α mRNA and protein levels in lung tissue and BALF were significant decreased(P<0.05);overexpression of Jmjd3 could partially reverse the effects of overexpression of Lnc-IL7R on the above indicators(P<0.05).Conclusion:Lnc-IL7R/Jmjd3/KGF axis participates in inflammation regulation and alveolar epithelial cell injury repair in ARDS by regulating histone methylation modifications in the promoter region.Lnc-IL7R/Jmjd3/KGF can be used for early diagnosis of ARDS.

Objective To investigate the value of serum aquaporin 1(AQP1)level combined with extra-vascular lung water index(EVLWI)in assessing the severity and prognosis of sepsis causing acute respiratory distress syndrome(ARDS).Methods 268 patients with sepsis-induced ARDS(ARDS group)and 55 patients with sepsis alone(sepsis alone group)admitted to our hospital from January 2020 to December 2023 were selected.Patients with sepsis-induced ARDS were divided into 89 mild,109 moderate,and 70 severe groups according to the oxygenation index(OI),and 104 deaths and 164 survivors according to the 28 d prognosis.Detection of serum AQP1 levels and calculation of EVLWI.Using Spearman's method,the correlation between serum AQP1 level,EVLWI and OI in patients with sepsis-induced ARDS;the establishment of a logistic regression model to determine the factors of sepsis-induced mortality in patients with ARDS;and the plotting of ROC curves to evaluate the value of serum AQP1 level in combination with EVLWI for its assessment.Results Compared with the simple sepsis group,serum AQP1 level was reduced and EVLWI was increased in the ARDS group(P<0.05).AQP1 levels were sequentially lower and EVLWI sequentially higher in the mild,moderate,and severe groups(P<0.05).Serum AQP1 levels were positively correlated with OI in patients with sepsis-induced ARDS,and EVLWI was negatively correlated with OI in patients with sepsis-induced ARDS(P<0.05).The 28 d mortality rate in 268 patients with ARDS due to sepsis was 38.81%(104/268).The independent protective factors for death in ARDS patients with sepsis were elevated OI(OR=0.984,95%CI:0.976～0.992)and elevated AQP1(OR=0.761,95%CI:0.677～0.854),and the independent risk factors were increased SOFA score(OR=1.367,95%CI:1.142～1.636)and elevated blood lactate(OR=2.515,95%CI:1.689～3.745),and elevated EVLWI(OR=1.559,95%CI:1.290～1.885)(P<0.05).The AUC predicted by serum AQP1 level combined with EVLWI was 0.887(95%CI:0.843～0.923),which was greater than the AUC predicted by serum AQP1 level,and EVLWI alone,which was 0.792(95%CI:0.738～0.839),and 0.807(95%CI:0.754～0.852)(P<0.05).Conclusion Decreased serum AQP1 levels and elevated EVLWI were associated with increased severity and poor prognosis in patients with sepsis-induced ARDS,and serum AQP1 levels in combination with EVLWI were of high value in assessing the prognosis of patients with sepsis-induced ARDS.

Objective To investigate the risk factors of polytrauma combined with multiple organ dysfunction syndrome (MODS).Methods A retrospective case control study was performed on the clinical data of 299 polytrauma patients admitted to the Affiliated Hospital of Jiangsu University from December 2011 to June 2017.The collected information included gender,age,length of hospital stay,number of injured parts,injury severity scores (ISS),neutrophil count,leukocyte level,hemoglobin level,platelet count,activated partial thromboplastin time (APTI),and D-dimer level within 24 hours since admission.In addition,shock within 24 hours since admission,infection after 3 days since admission,damage control surgery,underlying diseases and prognostic outcomes were also recorded.All the patients were divided into MODS group (94 patients) and non-MODS group (205 patients).Univariate and multivariate logistic regression analyses were used to determine the risk factors of polytrauma combined with MODS.Receiver operating characteristic (ROC) curve was applied to further analyze those risk factors identified by the former analyses.Results In the univariate analysis,there were statistically significant differences between the two groups in the number of injured parts,ISS,hemoglobin level,platelet count,APTT,D-dimer level within 24 hours since admission,shock within 24 hours since admission,infection after 3 days since admission,damage control surgery and prognostic outcomes (P ＜ 0.05).No significant differences were found in gender,age,underlying disease,length of hospital stay,neutrophil level,the leukocyte level within 24 hours since admission between the two groups (P ＞ 0.05).The multivariate logistic regression analysis showed that ISS (OR =1.048),shock within 24 hours since admission (OR =3.913),infection after 3 days since admission (OR =27.715),and D-dimer level within 24 hours since admission (OR =1.015) were significantly associated with polytrauma combined with MODS (P ＜ 0.05).In addition,the area under ROC curve of ISS was 0.726 (95 ％ CI 0.667-0.784),and the area under ROC curve of D-dimer was 0.638 (95％ CI 0.571-0.706).Conclusions The risk factors of polytrauma patients combined with MODS include ISS,infection after 3 days since admission,D-dimer level and shock within 24 hours since admission.In the treatment of polytrauma patients,attention should be paid to assessment of injury severity and coagulation function,active resuscitation to correct shock,prevent and control infection,which can reduce and prevent the risks for polytrauma patients combined with MODS.

Objective To analyze the clinical feature and prognostic predictors of disseminated herpes zoster.Methods A retrospective study was carried out on 76 patients with disseminated herpes zoster collected from 2005 to 2012 in the Department of Dermatology,Anhui Provincial Hospital.Statistical analysis and comparisons were done.Results The incidence rate of disseminated herpes zoster was highest in the three age groups:70-79 years,30-39 years,and 60-69 years.Of these patients,59.21％ suffered from complications,and 44.74％ from postherpetic neuralgia.Logistic regression analysis showed that the occurrence of complications was significantly associated with age and impaired cellular immune function,and the incidence of postherpetic neuralgia with age,impaired cellular immune function and presence of underlying diseases.Conclusions There is a high incidence of complications in patients with disseminated herpes zoster,and impaired cellular immune function may be an important factor affecting its prognosis.