Objective:To explore the diagnostic value of serum solute carrier family 7 member 11 (SLC7A11), urinary retinol-binding protein (RBP) and transferrin (TRF) for acute kidney injury (AKI) in patients with sepsis.Methods:The clinical data of 204 patients with sepsis from January 2020 to December 2023 in the Second Affiliated Hospital of Xi′an Medical College were retrospectively analyzed. Among them, 102 patients complicated with AKI (AKI group), including Kidney Disease: Improving Global Outcomes (KDIGO) classification Ⅰ stage 43 cases, Ⅱ stage 36 cases, Ⅲ stage 23 cases; 102 patients did not complicate with AKI (non-AKI group). Additionally, 102 healthy individuals from the same period were selected as a healthy control group. Enzyme-linked immunosorbent assay was used to detect the serum expression level of SLC7A11, and fully automatic biochemical analyzers were used to detect urinary RBP and TRF levels. For patients in AKI group and non-AKI group, the sequential organ failure assessment (SOFA) was recorded; fully automatic analyzers were used to test hematological indicators, including creatinine, hemoglobin, platelet, albumin, uric acid, lactate, procalcitonin and C-reactive protein, and estimated glomerular filtration rate (eGFR) was calculated. Multivariate Logistic regression analysis was used to analyze the independent risk factors of AKI in patients with sepsis. Receiver operating characteristic (ROC) curve was plotted to analyze the values of serum SLC7A11 and urinary RBP, TRF in assessing the risk of AKI in patients with sepsis.Results:The serum SLC7A11 and urinary RBP, TRF in non-AKI group and AKI group were significantly higher than those in healthy control group: (28.66 ± 6.22) and (36.18 ± 7.29) ng/L vs. (14.32 ± 2.63) ng/L, (1.20 ± 0.25) and (1.47 ± 0.31) mg/L vs. (0.44 ± 0.08) mg/L, (1.82 ± 0.39) and (2.26 ± 0.45) mg/L vs. (1.08 ± 0.19) mg/L, furthermore the indexes in AKI group were significantly higher than those in non-AKI group, and there were statistical differences ( P<0.05). The serum SLC7A11 and urinary RBP, TRF in patients with KDIGO Ⅱ stage and Ⅲ stage were significantly higher than those in patients with KDIGO Ⅰ stage: (37.16 ± 7.41) and (45.20 ± 8.29) ng/L vs. (30.53 ± 6.46) ng/L, (1.50 ± 0.28) and (1.72 ± 0.35) mg/L vs. (1.31 ± 0.26) mg/L, (2.26 ± 0.46) and (2.77 ± 0.59) mg/L vs. (1.99 ± 0.40) mg/L, furthermore the indexes in patients with KDIGO Ⅲ stage were significantly higher than those in patients with KDIGO Ⅱ stage, and there were statistical differences ( P<0.05). The SOFA, creatinine and lactate in AKI group were significantly higher than those in non-AKI group: 12 (9, 15) scores vs. 7 (5, 9) scores, (133.71 ± 13.58) μmol/L vs. (108.18 ± 14.32) μmol/L and (13.61 ± 3.57) mmol/L vs. (10.95 ± 3.10) mmol/L, the albumin and eGFR were significantly lower than those in non-AKI group: (21.48 ± 2.48) g/L vs. (24.85 ± 2.83) g/L and (51.57 ± 9.64) ml/(min·1.73 m 2) vs. (59.21 ± 10.67) ml/(min·1.73 m 2), and there were statistical differences ( P<0.01); there were no statistical differences in hemoglobin, platelet, uric acid, procalcitonin and C-reactive protein between two groups ( P>0.05). Multivariate Logistic regression analysis result showed that the high SOFA, creatinine, lactate, SLC7A11, urinary RBP, urinary TRF, and low eGFR, albumin were independent risk factors for AKI in patients with sepsis ( OR = 4.864, 5.631, 2.315, 5.862, 6.852, 6.218, 0.328 and 0.226; 95% CI 1.701 to 13.907, 1.803 to 17.585, 1.350 to 3.969, 2.115 to 16.242, 2.177 to 21.566, 1.900 to 20.353, 0.151 to 0.713 and 0.092 to 0.555; P<0.01). The ROC curve analysis result showed that the area under the curve of the combined assessment of serum SLC7A11 and urinary RBP, TRF for AKI in patients with sepsis was significantly larger than serum SLC7A11 and urinary RBP, TRF alone (0.892 vs. 0.774, 0.765 and 0.755), and there was statistical difference ( Z = 2.97, 3.20 and 3.38; P<0.01). Conclusions:The elevated expression levels of serum SLC7A11 and urinary RBP and TRF in patients with sepsis have a high value for the combined detection and assessment of AKI.

Objective:To observe and analyze the levels of vitamin D（VD） and their influencing factors in children undergoing adenoidectomy and/or tonsillectomy. Methods:A total of 147 children who received adenoidectomy and/or tonsillectomy in our hospital from November 2018 to March 2019 were selected as the experimental groups, gender and age matched 147 healthy children of the same period were selected as the control group. The differences of VD levels between the two groups were compared, the factors affecting VD levels were investigated, and patients with VD deficiency/insufficiency in the experimental groups were followed up postoperatively. Results:The VD levels of the experimental groups were（19.6±6.6） ng/mL and those of the control groups were （22.5±6.5）ng/mL, which was significantly different （P<0.01）. The experimental groups were divided into inflammation groups and Sleeping disorder breathing（SDB）groups. The VD levels of the two groups were （19.1±6.7）ng/mL and （21.9±6.4）ng/mL, which was significantly different （P<0.05）. Regression analysis showed that VD levels were negatively correlated with age, body mass index （BMI）, adenoid hypertrophy, tonsil hypertrophy and Anti-streptolysin O（ASO）levels （P<0.05）. VD values were remeasured one year postoperatively in 23 of 72 children in the VD deficiency/deficiency groups, and there was a statistically significant difference between preoperative and postoperative VD values[（14.3±3.9）ng/mL and （17.1±5.5） ng/mL, respectively, P<0.05]. There was a significant difference in postoperative VD value between the inflammation groups and the SDB groups[ （15.6±5.9） ng/mL and （20.5±2.1） ng/mL, respectively, P<0.05]. Conclusion:Children who underwent adenoidectomy and/or tonsillectomy had lower VD levels than healthy children.VD levels decreased with increasing age,BMI and ASO values,and associated with the size of adenoid and tonsil. Preoperative VD levels were lower in the inflammation groups, adenoidectomy and/or tonsillectomy improved VD deficiency/insufficiency status, and postoperative elevation of VD levels was more pronounced in the SDB groups.
Humans ; Tonsillectomy ; Adenoidectomy ; Vitamin D/blood* ; Vitamin D Deficiency ; Male ; Female ; Postoperative Period ; Child ; Case-Control Studies ; Child, Preschool

ObjectiveTo analyze the epidemiological and clinical characteristics of pertussis in Baoshan District, Shanghai from 2017 to 2024, so as to provide an evidence-based reference for optimizing prevention and control strategies. MethodsData on pertussis cases were collected from the China Disease Prevention and Control Information System, Shanghai Integrated Management and Immunization Service Information System, and follow-up epidemiological investigations. Descriptive epidemiological analyses were performed to analyze the epidemiological characteristics, clinical manifestations, and vaccine effectiveness. Joinpoint regression analyses were used to examine the temporal trends in incidence rates, and a Poisson model was constructed for spatiotemporal scan analyses. ResultsA total of 1 634 pertussis cases were reported in Baoshan District from 2017 to 2024, with a male-to-female ratio of 1.08∶1. More cases were observed in males than in females, with the age ranged from 20 days to 81 years. Among them, 59.92% were in the 6‒<11 years age group, and 63.34% were students. Low-level sporadic incidence persisted during 2017‒2023, followed by a sharp increase in 2024 (71.37/100 000). Starting in January 2024, the incidence rate showed an upward trend, peaking in May before declining. The majority of cases occurred between April and June. The trend in reported pertussis incidence rates in Baoshan District from 2017 to 2023 showed no statistically significant change (APC=10.039%, t=2.586, P=0.150). Incidence rate rose from January 2024, peaked in May (APC=133.641%, t=3.841, P=0.006), then declined significantly (APC=-47.816%, t=2.586, P<0.001). The 12 subdistricts of Baoshan District were divided into low, medium, and high population density areas, with an average annual reported incidence rate of 6.09/100 000, 8.19/100 000 and 11.96/100 000, respectively. The reported incidence rate increased with an increase in population density. Spatiotemporal scan analyses showed that cases clustered in the southwest and northeast of Baoshan District. Epidemiological follow-up investigations of 1 520 cases revealed that the main clinical symptoms were cough (97.63%) and sputum production (41.58%), and 98.13% of the cases were confirmed by positive nucleic-acid test results. Among the 1 475 cases with immunization records, 83.53% had completed the four-dose pertussis vaccine before onset. The complication incidence rates, from high to low, were in the 0-dose vaccination group, 1‒3-dose vaccination group and 4-dose vaccination group. The duration of cough, from long to short, was observed in the the 0-dose vaccination group, 1‒3-dose vaccination group and 4-dose vaccination group, correspondingly. ConclusionIt is recommended to improve the pertussis surveillance system in medical institutions and establish an active monitoring network, prioritizing deployment in school settings and areas with high population density. Enhancing diphtheria-tetanus-pertussis (DTP) vaccination coverage among 6-year-old children and further optimizing the pertussis immunization strategies are essential to prevent and reduce the risk of pertussis among school-aged children.

The enterotoxigenic Escherichia coli (ETEC) infection is a major factor restricting the development of animal husbandry. However, the abuse of antibiotics will lead to the antibiotic residues and emergence of antibiotic-resistant bacteria. The existing vaccines face challenges in stimulating intestinal immunity, demonstrating limited prevention effects. Therefore, it is indispensable to develop a new vaccine that is safe and suitable as a feed additive to activate intestinal immunity. This study constructed yeast-cell microcapsules (YCM) carrying the DNA vaccine against ETEC by genetic engineering. Furthermore, animal experiments were carried out to explore the regulatory effects of feeding YCM on the intestinal immune system and intestinal microbiota. Saccharomyces cerevisiae was selected as the oral delivery vehicle (microcapsules) of the DNA vaccine. The codon-optimized nucleic acid sequence of K88, the main antigen of mammal-derived ETEC, was synthesized, and the yeast shuttle vector containing the corresponding DNA vaccine expression cassette was constructed by DNA recombination. The recombinant strain of YCM was prepared by transforming JMY1. Additionally, the characteristics of the YCM strain and its feasibility as an oral vaccine were comprehensively evaluated by the fluorescence reporter assay, gastrointestinal fluid tolerance assay, intestinal epithelial cell adhesion assay, intestinal retention assessment, antiserum detection, and intestinal microbiota detection. The experimental results showed that the DNA vaccine expression cassette was expressed in mammals, and the recombinant strain of YCM could tolerate up to 8 hours of gastrointestinal fluid digestion and had good adhesion to intestinal epithelial cells. The results of mouse feeding experiments indicated that the recombinant strain of YCM could stay in the intestinal tract for at least two weeks, and the DNA vaccine expression cassette carried by YCM entered the intestinal immune system and triggered an immune response to induce the production of specific antibodies. Moreover, feeding YCM recombinant bacteria also improved the abundance of gut microbiota in mice, demonstrating a positive effect in regulating intestinal flora. In summary, we prepared the recombinant strain of YCM carrying the DNA vaccine against ETEC and comprehensively evaluated its characteristics and feasibility as an oral vaccine. Feeding the recombinant YCM could induce specific immune responses and regulate intestinal microbiota. The findings provide a reference for the immunoprevention of ETEC-related animal diseases.
Animals ; Enterotoxigenic Escherichia coli/genetics* ; Saccharomyces cerevisiae/metabolism* ; Vaccines, DNA/genetics* ; Mice ; Escherichia coli Infections/immunology* ; Escherichia coli Vaccines/genetics* ; Capsules ; Mice, Inbred BALB C ; Female

Hepatocellular carcinoma(HCC)is a highly heterogeneous malignancy with poor prognosis,closely linked to oxidative stress,metabolic reprogramming,and tumor microenvironment alterations.Aldehyde dehydrogenase(ALDH)plays multifaceted roles in HCC by regulating oxidative stress,modulating glucose and lipid metabolism,sustaining cancer stem cell properties,and promoting immune evasion,making it a promising therapeutic target.This review summarizes the expression patterns and mechanistic functions of ALDH in HCC,highlights advances in ALDH-targeted therapies,including inhibitors such as disulfiram and diethylaminobenzaldehyde,and ALDH-based peptide vaccines-and discusses their potential in combination with immunotherapy and chemotherapy.Current evidence suggests that ALDH inhibition can suppress tumor growth,reverse drug resistance,and enhance antitumor immunity.Future research should aim to improve drug selectivity and safety,and to develop personalized combination strategies to optimize clinical outcomes in HCC patients.

OBJECTIVE To explore the clinical characteristics of the nontuberculous Mycobacteria pulmonary dis-ease(NTMPD)patients with previous pulmonary tuberculosis(PPTB)and analyze the clinical difference from the recurrence of pulmonary tuberculosis.METHODS By means of retrospective survey,the patients who were diag-nosed with NTMPD and recurrent pulmonary tuberculosis in Wuhan Pulmonary Hospital from Mar.2021 to Oct.2023 were recruited as the research subjects,a total of 395 patients with NTMPD were enrolled in the study and were divided into the PPTB-NTMPD group with 92 cases and the NPPTB-NTMPD group with 303 cases according to the history of PPTB.The baseline data,clinical symptoms,imaging findings,underlying diseases,pulmonary diseases,and species of nontuberculous Mycobacteria(NTM)were observed and compared.Totally 92 patients with recurrent pulmonary tuberculosis were randomly screened and assigned as the recurrent pulmonary tuberculo-sis group in a 1:1 ratio by matching the PPTB-NTMPD group with the gender and age.The major clinical charac-teristics were compared between the two groups.The 92 patients with PPTB-NTMPD were divided into the 1-10 years group with 40 cases,the 10-30 years group with 37 cases,and the more than 30 years group with 15 cases according to the interval between the initial diagnosis of pulmonary tuberculosis and the diagnosis of NTMPD.The major clinical characteristics were compared among the groups.RESULTS The age was(64.21±10.71)years old in the PPTB-NTMPD group,(60.26±11.83)years old in the NPPTB-NTMPD group(t=3.020,P=0.003).The proportion of patients with body mass index less than 18.5 kg/m2 was 59.78％in the PPTB-NTMPD group,41.25％in the NPPTB-NTMPD group(x2=6.155,P=0.013);the proportion of patients with cough was 77.17％in the PPTB-NTMPD group,65.68％in the NPPTB-NTMPD group(x2=4.313,P=0.038);the inci-dence of cavitary shadow was 50.00％in the PPTB-NTMPD group,35.31％in the NPPTB-NTMPD group(x2=6.414,P=0.011);the incidence of emphysema and pulmonary bullae was 29.35％in the PPTB-NTMPD group,12.87％in the NPPTB-NTMPD group(x2=13.766,P＜0.001);the incidence of chronic obstructive pulmonary disease(COPD)was 22.83％in the PPTB-NTMPD group,14.19％in the NPPTB-NTMPD group(x2=3.875,P=0.049);the incidence of damaged lung was 9.78％in the PPTB-NTMPD group,2.97％in the NPPTB-NT-MPD group(x2=7.530,P=0.014);there were significant differences.Mycobacterium intracellulare and Myco-bacterium abscessus were the predominant species of NTM in both the PPTB-NTMPD group and the NPPTB-NT-MPD group,there was no significant difference in the distribution of NTM species between the two groups of pa-tients.The incidence of patch shadow of the PPTB-NTMPD group was lower than that of the recurrent pulmonary tuberculosis group(P＜0.05),the incidence of bronchiectatic shadow of the PPTB-NTMPD group was higher than that of the recurrent pulmonary tuberculosis group(P＜0.05).There were significant differences in the age,incidence of pleural thickening and incidence of COPD among the patients with different time intervals between ini-tial diagnosis of pulmonary tuberculosis and the diagnosis of NTMPD in the PPTB-NTMPD group(P＜0.05).CONCLUSIONS The previous pulmonary tuberculosis mainly affect the body mass index less than 18.5 kg/m2 and the post-tuberculosis pulmonary diseases such as cough,pulmonary cavity,emphysema,pulmonary bullae,COPD and damaged lung of the NTMPD patients.The NTMPD patients with previous pulmonary tuberculosis are more likely to have bronchiectasia than the patients with recurrent tuberculosis.It is necessary for the clinicians to attach great importance.

OBJECTIVE To explore the clinical characteristics of the nontuberculous Mycobacteria pulmonary dis-ease(NTMPD)patients with previous pulmonary tuberculosis(PPTB)and analyze the clinical difference from the recurrence of pulmonary tuberculosis.METHODS By means of retrospective survey,the patients who were diag-nosed with NTMPD and recurrent pulmonary tuberculosis in Wuhan Pulmonary Hospital from Mar.2021 to Oct.2023 were recruited as the research subjects,a total of 395 patients with NTMPD were enrolled in the study and were divided into the PPTB-NTMPD group with 92 cases and the NPPTB-NTMPD group with 303 cases according to the history of PPTB.The baseline data,clinical symptoms,imaging findings,underlying diseases,pulmonary diseases,and species of nontuberculous Mycobacteria(NTM)were observed and compared.Totally 92 patients with recurrent pulmonary tuberculosis were randomly screened and assigned as the recurrent pulmonary tuberculo-sis group in a 1:1 ratio by matching the PPTB-NTMPD group with the gender and age.The major clinical charac-teristics were compared between the two groups.The 92 patients with PPTB-NTMPD were divided into the 1-10 years group with 40 cases,the 10-30 years group with 37 cases,and the more than 30 years group with 15 cases according to the interval between the initial diagnosis of pulmonary tuberculosis and the diagnosis of NTMPD.The major clinical characteristics were compared among the groups.RESULTS The age was(64.21±10.71)years old in the PPTB-NTMPD group,(60.26±11.83)years old in the NPPTB-NTMPD group(t=3.020,P=0.003).The proportion of patients with body mass index less than 18.5 kg/m2 was 59.78％in the PPTB-NTMPD group,41.25％in the NPPTB-NTMPD group(x2=6.155,P=0.013);the proportion of patients with cough was 77.17％in the PPTB-NTMPD group,65.68％in the NPPTB-NTMPD group(x2=4.313,P=0.038);the inci-dence of cavitary shadow was 50.00％in the PPTB-NTMPD group,35.31％in the NPPTB-NTMPD group(x2=6.414,P=0.011);the incidence of emphysema and pulmonary bullae was 29.35％in the PPTB-NTMPD group,12.87％in the NPPTB-NTMPD group(x2=13.766,P＜0.001);the incidence of chronic obstructive pulmonary disease(COPD)was 22.83％in the PPTB-NTMPD group,14.19％in the NPPTB-NTMPD group(x2=3.875,P=0.049);the incidence of damaged lung was 9.78％in the PPTB-NTMPD group,2.97％in the NPPTB-NT-MPD group(x2=7.530,P=0.014);there were significant differences.Mycobacterium intracellulare and Myco-bacterium abscessus were the predominant species of NTM in both the PPTB-NTMPD group and the NPPTB-NT-MPD group,there was no significant difference in the distribution of NTM species between the two groups of pa-tients.The incidence of patch shadow of the PPTB-NTMPD group was lower than that of the recurrent pulmonary tuberculosis group(P＜0.05),the incidence of bronchiectatic shadow of the PPTB-NTMPD group was higher than that of the recurrent pulmonary tuberculosis group(P＜0.05).There were significant differences in the age,incidence of pleural thickening and incidence of COPD among the patients with different time intervals between ini-tial diagnosis of pulmonary tuberculosis and the diagnosis of NTMPD in the PPTB-NTMPD group(P＜0.05).CONCLUSIONS The previous pulmonary tuberculosis mainly affect the body mass index less than 18.5 kg/m2 and the post-tuberculosis pulmonary diseases such as cough,pulmonary cavity,emphysema,pulmonary bullae,COPD and damaged lung of the NTMPD patients.The NTMPD patients with previous pulmonary tuberculosis are more likely to have bronchiectasia than the patients with recurrent tuberculosis.It is necessary for the clinicians to attach great importance.

Hepatocellular carcinoma(HCC)is a highly heterogeneous malignancy with poor prognosis,closely linked to oxidative stress,metabolic reprogramming,and tumor microenvironment alterations.Aldehyde dehydrogenase(ALDH)plays multifaceted roles in HCC by regulating oxidative stress,modulating glucose and lipid metabolism,sustaining cancer stem cell properties,and promoting immune evasion,making it a promising therapeutic target.This review summarizes the expression patterns and mechanistic functions of ALDH in HCC,highlights advances in ALDH-targeted therapies,including inhibitors such as disulfiram and diethylaminobenzaldehyde,and ALDH-based peptide vaccines-and discusses their potential in combination with immunotherapy and chemotherapy.Current evidence suggests that ALDH inhibition can suppress tumor growth,reverse drug resistance,and enhance antitumor immunity.Future research should aim to improve drug selectivity and safety,and to develop personalized combination strategies to optimize clinical outcomes in HCC patients.

Objective:To explore the diagnostic value of serum solute carrier family 7 member 11 (SLC7A11), urinary retinol-binding protein (RBP) and transferrin (TRF) for acute kidney injury (AKI) in patients with sepsis.Methods:The clinical data of 204 patients with sepsis from January 2020 to December 2023 in the Second Affiliated Hospital of Xi′an Medical College were retrospectively analyzed. Among them, 102 patients complicated with AKI (AKI group), including Kidney Disease: Improving Global Outcomes (KDIGO) classification Ⅰ stage 43 cases, Ⅱ stage 36 cases, Ⅲ stage 23 cases; 102 patients did not complicate with AKI (non-AKI group). Additionally, 102 healthy individuals from the same period were selected as a healthy control group. Enzyme-linked immunosorbent assay was used to detect the serum expression level of SLC7A11, and fully automatic biochemical analyzers were used to detect urinary RBP and TRF levels. For patients in AKI group and non-AKI group, the sequential organ failure assessment (SOFA) was recorded; fully automatic analyzers were used to test hematological indicators, including creatinine, hemoglobin, platelet, albumin, uric acid, lactate, procalcitonin and C-reactive protein, and estimated glomerular filtration rate (eGFR) was calculated. Multivariate Logistic regression analysis was used to analyze the independent risk factors of AKI in patients with sepsis. Receiver operating characteristic (ROC) curve was plotted to analyze the values of serum SLC7A11 and urinary RBP, TRF in assessing the risk of AKI in patients with sepsis.Results:The serum SLC7A11 and urinary RBP, TRF in non-AKI group and AKI group were significantly higher than those in healthy control group: (28.66 ± 6.22) and (36.18 ± 7.29) ng/L vs. (14.32 ± 2.63) ng/L, (1.20 ± 0.25) and (1.47 ± 0.31) mg/L vs. (0.44 ± 0.08) mg/L, (1.82 ± 0.39) and (2.26 ± 0.45) mg/L vs. (1.08 ± 0.19) mg/L, furthermore the indexes in AKI group were significantly higher than those in non-AKI group, and there were statistical differences ( P<0.05). The serum SLC7A11 and urinary RBP, TRF in patients with KDIGO Ⅱ stage and Ⅲ stage were significantly higher than those in patients with KDIGO Ⅰ stage: (37.16 ± 7.41) and (45.20 ± 8.29) ng/L vs. (30.53 ± 6.46) ng/L, (1.50 ± 0.28) and (1.72 ± 0.35) mg/L vs. (1.31 ± 0.26) mg/L, (2.26 ± 0.46) and (2.77 ± 0.59) mg/L vs. (1.99 ± 0.40) mg/L, furthermore the indexes in patients with KDIGO Ⅲ stage were significantly higher than those in patients with KDIGO Ⅱ stage, and there were statistical differences ( P<0.05). The SOFA, creatinine and lactate in AKI group were significantly higher than those in non-AKI group: 12 (9, 15) scores vs. 7 (5, 9) scores, (133.71 ± 13.58) μmol/L vs. (108.18 ± 14.32) μmol/L and (13.61 ± 3.57) mmol/L vs. (10.95 ± 3.10) mmol/L, the albumin and eGFR were significantly lower than those in non-AKI group: (21.48 ± 2.48) g/L vs. (24.85 ± 2.83) g/L and (51.57 ± 9.64) ml/(min·1.73 m 2) vs. (59.21 ± 10.67) ml/(min·1.73 m 2), and there were statistical differences ( P<0.01); there were no statistical differences in hemoglobin, platelet, uric acid, procalcitonin and C-reactive protein between two groups ( P>0.05). Multivariate Logistic regression analysis result showed that the high SOFA, creatinine, lactate, SLC7A11, urinary RBP, urinary TRF, and low eGFR, albumin were independent risk factors for AKI in patients with sepsis ( OR = 4.864, 5.631, 2.315, 5.862, 6.852, 6.218, 0.328 and 0.226; 95% CI 1.701 to 13.907, 1.803 to 17.585, 1.350 to 3.969, 2.115 to 16.242, 2.177 to 21.566, 1.900 to 20.353, 0.151 to 0.713 and 0.092 to 0.555; P<0.01). The ROC curve analysis result showed that the area under the curve of the combined assessment of serum SLC7A11 and urinary RBP, TRF for AKI in patients with sepsis was significantly larger than serum SLC7A11 and urinary RBP, TRF alone (0.892 vs. 0.774, 0.765 and 0.755), and there was statistical difference ( Z = 2.97, 3.20 and 3.38; P<0.01). Conclusions:The elevated expression levels of serum SLC7A11 and urinary RBP and TRF in patients with sepsis have a high value for the combined detection and assessment of AKI.

Objective     To explore the correlation between the imaging features of peripheral ground-glass pulmonary nodules and the invasion degree of lung adenocarcinoma, and the high risk factors for infiltrating lung adenocarcinoma under thin-slice CT, which provides some reference for clinicians to plan the surgical methods of pulmonary nodules before operation and to better communicate with patients, and assists in building a clinical predictive model for invasive adenocarcinoma. Methods    Clinical data of the patients with peripheral ground-glass pulmonary nodules (diameter≤3 cm) in thin-slice chest CT in the First Affiliated Hospital of Soochow University from January 2019 to January 2020 were continuously collected. All patients underwent thin-slice CT scan and thoracoscopic surgery in our center. According to the pathological examination results, they were divided into two groups: an adenocarcinoma lesions before infiltration group, and an invasive lung adenocarcinoma group. The thin-slice CT imaging parameters of pulmonary nodules were collected. The nodular diameter, mean CT value, consolidation tumor ratio (CTR), nodular shape, vacuolar sign, bronchial air sign, lobulation sign, burr sign, lesion boundary, pleural depression sign, vascular cluster sign and other clinical data were collected. Univariate and multivariate analyses were conducted to analyze the independent risk factors for the infiltrating lung adenocarcinoma, and to analyze the threshold value and efficacy of each factor for the identification of infiltrating lung adenocarcinoma. Results     Finally 190 patients were enrolled. There were 110 patients in the adenocarcinoma lesions before infiltration group, including 21 males and 89 females with a mean age of 53.57±10.90 years, and 80 patients in the invasive lung adenocarcinoma group, including 31 males and 49 females with a mean age of 56.45±11.30 years. There was a statistical difference in the mean CT value, nodular diameter, CTR, gender, smoking, nodular type, nodular shape, vacuolar sign, lobulation sign, burr sign, lesion boundary, pleural depression sign, vascular cluster sign between the two groups (P<0.05). However, there was no statistical difference between the two groups in age (P=0.081), lesion site (P=0.675), and bronchial air sign (P=0.051). Multiple logistic regression analysis showed that nodular diameter, mean CT value, CTR and lobulation sign were independent risk factors for differentiating preinvasive adenocarcinoma from invasive adenocarcinoma. At the same time, the threshold value was calculated by Youden index, indicating that the CTR was 0.45, the nodal diameter was 10.5 mm and the mean CT value was –452 Hu. Conclusion     In the peripheral ground-glass pulmonary nodules, according to the patient's CT imaging features, such as mixed ground-glass nodules, irregular shapes, vacuoles, short burrs, clear boundaries, pleural indentations, and vascular clusters, have a certain reference value in the discrimination of the invasion degree of ground-glass pulmonary nodules. At the same time, it is found in this research that peripheral ground-glass pulmonary nodules with diameter greater than 10.5 mm, CT value greater than –452 Hu, CTR greater than 0.45 and lobulation sign are more likely to be infiltrating lung adenocarcinoma.